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36fab420-80dc-4502-b2f0-fe8a96289473
|
An example of a tumour suppressor gene is-
|
Myc
|
Fos
|
Ras
|
RB
| 3d
|
single
|
Ans. is 'd' i.e., RB Tumor suppressor geneo The replication of cell should be controlled to maintain a steady state.o Failure to inhibit cell replication is one of the fundamental alterations in the process of carcinogenesis.o Tumor suppressor genes are the genes whose products down regulate the cell cycle and thus apply brakes to cellular proliferation.o So, loss of function of tumor suppressor genes results in uncontrolled cell proliferation and carcinogenesis,o Similar to oncogene, tumor suppresor gene may be -# Cell surface receptor # Transduction molecules # Transcription factorIn additiono Cell cycle inhibitorso Regulators of cellular responses to DNA damage (DNA repair regulators)These protein products are involved in -o Cell cycle controlo Regulation of apoptosiso DNA repairTUMOUR SUPPRESSOR GENESubcellular LocationTumor su pressor GeneFunctionTumors Associated with Somatic MutationsThmors Associated with inherited MutationCell surfaceo TGF-b receptoro Growth inhibitiono Carcinomas of colono Unknown o E - cadherino Cell adhesiono Carcinoma of stomacho Familial gastric cancerInner aspect of plasma membraneNF-lInhibition of RAS signal transduction and of p21 cell - cycle inhibitorNeuroblastomasNeurofibromatosis type I and sarcomasCytoskeletonNF-2Cytoskeletal stabilitySchwannomas and meningiomasNeurofibromatosis type - 2 acoustic schwannomas and meningiomasCytosolo APC/b-catenino Inhibition of signal transdu- ctiono Carcinomas of stomach, colon, pancreas; melanomao Familial adenomatous polyposis coli/colon cancer o PTENo PI - 3 kinase signal transductiono Endometrial and prostate cancerso Unknown o SMAD 2 and SMAD4o TFG - b signal transductiona Colon, pancreas tumorso UnknownNucleuso RBo Regulation of cel l cycleo Retinoblastoma: osteosarcoma carcinoma of breast, colon, lungo Retinoblastomas, osteosarcoma o p53o Cell cycle arrest and apoptosis in response to DNAo Most human cancerso Li-Fraumeni syndrome; multiple carcinomas and sarcomas o WT - lo Nuclear transcriptiono Wilms tumoro Wilms tumor o pi6 (INK 4a)o Regulation of cel l cycle by inhibition of cyclin dependent kinaseso Pancreatic, breast, and esophageal cancerso Malignant melanoma o BRCA - l and BRCA2o DNA repairo Unknowno Carcinomas of female breast and ovary ; carcinomas of male breast o KLF 6o Transcription factoro Prostateo UnknownC-myc, fos & RAS are oncogenes (not tumor suppressor genes).
|
Pathology
|
Carcinogenesis
|
d0027fff-0202-4a70-a568-533ac4be79ee
|
Positive indicator of health -
|
IMR
|
Child mortality rate
|
MMR
|
Life expectancy
| 3d
|
single
|
Ans. is 'd' i.e., Life expectancy Mortality indicatorso These arei) Crude death rateii) Expectation of life (life expectancy)iii) Infant mortality' rateiv) Child mortality ratev) Under-5 proportional mortalitv ratevi) Maternal mortality ratevii) Disease specific mortality' rateviii) Age specific death rateix) Adult mortality ratex) Years of potential life losto Among these only life expectancy is a positive mortality indicator, i.e. increase life expectancy means improvement in health.o All other are 'negative' health indicators, i.e. increase value of these indicators implies poor health of community.
|
Social & Preventive Medicine
|
Indicators of Health
|
2739b82c-7a24-4440-b58a-35f970fb801a
|
Nephrotic syndrome is the hall mark of the following primary kidney diseases except
|
Membranous Glomerulopathy
|
IgA nephropathy
|
Minimal change disease
|
Focal segmental Glomerulosclerosis
| 1b
|
multi
|
Ans. is 'b' i.e., IgA nephropathy Most common presentation of IgA nephropathy is grass hematuria. It is the most common form of glomerulonephritis worldwide Causes of Nephrotic syndrome Minimal change disease Focal segmental glomerulosclerosis o Membranous glomerulonephritis o Diabetes nephropathy AL and AA amyloidosis Light chain deposition disease Fibrillary immunotactoid disease
|
Medicine
| null |
61936233-ae43-4ddb-a534-83dab4006b2c
|
Malate shuttle is impoant in:
|
Liver and Hea
|
Brain and Hea
|
Brain and Skeletal muscle
|
Liver and Skeletal muscle
| 0a
|
single
|
Malate shuttle is more impoant in the liver and cardiac muscles as these organs require a continuous supply of energy. Whereas Glycerol-P-shuttle is a shoer shuttle and provides a quick source of ATPs as compared to the Malate shuttle. So it is present in brain & skeletal muscles, where energy is needed quickly in case of an emergency.
|
Biochemistry
|
Link reaction
|
6e666c65-1e18-4b3c-a424-e1c783d6a66e
|
Renal involvement is usually absent in _________
|
Drug-induced systemic lupus erythematosus (SLE)
|
Adult SLE
|
Pediatric SLE
|
SLE during pregnancy
| 0a
|
multi
|
Renal involvement is usually absent in drug-induced SLE Drug involvement SLE has predominant skin involvement. Option 2: In adult, SLE kidney involvement is seen in 30-40% of patients Option 3: In pediatric SLE, Kidneys are almost always involved. Ref: Harrison&;s principles of Internal Medicine 20th edition pgno: 2525
|
Pediatrics
|
Musculoskeletal disorders
|
870bbf70-358c-4581-b23c-725da331db0b
|
MC comp. of talus is
|
Avascular necrosis
|
Non union
|
Osteoahritis of ankle joint.
|
Osteoahritis of subtalar joint.
| 0a
|
single
|
A i.e Avascular necrosis
|
Surgery
| null |
c1cbfa42-973a-4b23-88e0-3598dcdc9a21
|
Which of the following carcinoma is familial -
|
Breast
|
Prostate
|
Cervix
|
Vaginal
| 0a
|
single
|
Familial cancers
these cancers may occur at higher frequency in certain families without a clearly defined pattern of transmission.
Virtually all the common types of cancers that occur sporadically have also been reported to occur in familial forms.
examples include carcinomas of
breast
brain
colon
melanoma
ovary
lymphomas
features that characterize familial cancers include early age at onset, tumors arising in two or more close relatives of the index case, and sometimes, multiple or bilateral tumors.
|
Surgery
| null |
a2e9a0d5-8983-470a-b01d-0f24fdf723c3
|
Lallo, aged 54 years, who is a known diabetic patient develops cirrhosis. There is associated skin hyperpigmentation and restrictive cardiomyopathy which of the following is the best initial test to diagnose this case.
|
Iron binding capacity
|
Serum ferritin
|
Serum copper
|
Serum ceruloplasmin
| 0a
|
multi
|
Answer is A (Iron binding capacity): The presence of hyperpigmentation and diabetes (bronze diabetes) together with restrictive cardiomyopathy and cirrhosis.suggests a diagnosis of hereditary hematochromatosis. The best initial test to diagnose hereditary hematochromatosis are Transferrin saturation and unsaturated Iron binding capacity As transferrin saturation is not provided amongst the options, Iron binding capacity is the single best answer of choice. Note Serum ferritin levels are a good index of body iron stores and are raised early during the cause of disease. Yet serum ferritin levels should not he used as initial screening test to detect hereditary hematochromatosis. This is because serum ferritin also acts as an acute phase reactant and its levels are increased in variable infections and inflammatory conditions without iron overload. Also the serum concentration of ferritin may be increased in patients with hepatocelltdar injury as in viral hepatitis, alcoholic fatty liver disease or alcoholic liver diseases due to increased release from tissue cells.
|
Medicine
| null |
63f0ad58-7d5f-4f75-af83-509598475742
|
Insulin release is inhibited by:
|
Somatostatin
|
Glucagon
|
Acetylcholine
|
Amino acids
| 0a
|
single
|
Somatostatin, secreted by d cells of pancreas, inhibits the other two secretions of the endocrine pancreas - insulin & glucagon. The primary stimulators of the somatostatin are glucose, amino acids, and fatty acids. Parasympathetic nervous system (vagus/Ach) is a stimulator of insulin secretion. Insulin secretion is inhibited by epinephrine acting alpha-2 adrenergic receptors. Amino acids, FFAs, and glucose are the stimulators of insulin secretion.
|
Physiology
|
Endocrine System
|
b739ce7f-9a27-4390-acd3-47d0478fe42b
|
Following may be premonitary symptoms of tetanus except -
|
Sleeplessness
|
Anxious expression
|
Urinary incontinence
|
Headache
| 2c
|
multi
| null |
Surgery
| null |
cd378cee-3850-4de7-9e0e-ca4818fe091b
|
Beta blocker that can be used in renal failure is all except-
|
Propranolol
|
Pindolol
|
Sotalol
|
Oxyprenolol
| 2c
|
multi
|
Ans. is 'c' i.e., Sotalol "Sotalol is not metabolized in liver, excretion is predominantly by the kidney in the unchanged form". - Katzung 101Ve p. 229 Since it is primarly excreted in urine, it should not be used in renal failure. 0-blockers which are primarily excreted by kidney and should not be given in renal failure --> Atenolol, Sotalol, nodolol About other options Approximately 50% of pindolol is metabolized in liver, the remainder of the drug is excreted unchanged in urine - - Goodman Gillman o Propranolol and oxprenolol are mainly metabolized in liver.
|
Pharmacology
| null |
daf1abef-d863-403a-90d3-b92ae7d16eea
|
Which of the following fungus isn't a mould?
|
Aspergillus fumigatus
|
Rhizopus
|
Cryptococcus neoformans
|
Adsidia
| 2c
|
single
|
Cryptococcus in not a mould A mould or mould is a fungus that grows in the form of multicellular filaments called hyphae. Ref: Baveja 5th ed pg: 564
|
Microbiology
|
mycology
|
eb9304db-c1c4-434f-bec1-b8206e640a25
|
Which of the drug is not commonly used in PPH?
|
Mifepristone
|
Misoprostol
|
Oxytocin
|
Ergotamine
| 0a
|
single
|
Ans. is a, i.e. MifepristoneRef. Dutta Obs. 7/e, p 415, 416; Williams Obs. 23/e, p 775; COGDT 10/e, p 481; Munro Kerr's 10/e, p 426, 427Atonicity is the most common cause of PPH. Any drug which increases the tone of uterus or the force of contraction is used to control PPH and is called oxytocic or uterotonic.Commonly used oxytocics in the management of PPH are:Oxytocin/CarbetocinMetherginSyntometrine - oxytocin + methylorgonovine15 methyl PGF2a (carboprost)Misoprostol (PGE1 )
|
Gynaecology & Obstetrics
|
Complication of 3rd Stage of Labour
|
73269ec3-44f8-4c67-8974-d7d1b61b4659
|
Raynaud's phenomenon what change is seen in vessels initial stage -
|
No change (Fibrinoid, Thrombosis)
|
Thrombosis
|
Fibrinoid necrosis
|
Hyaline sclerosis
| 0a
|
single
|
Structural changes in the arterial walls are absent except late in the course, when intimal thickening can appear.
|
Pathology
| null |
3f43afeb-2df2-42d7-adbb-2487f2ce3aa8
|
Most common congenital anomaly of the upper renal tract is -
|
Duplication of renal pelvis
|
Duplication of ureter
|
Ectopic ureteric orifice
|
Congenital megaureter
| 0a
|
single
| null |
Surgery
| null |
924e8bec-d172-460a-8c33-ffef1cf61ba5
|
Exocytosis:
|
Is a calcium dependent process
|
Can be constitutive or non-constitutive
|
Requires SNARE proteins
|
All of the above
| 3d
|
multi
|
Exocytosis is a calcium dependent process. In non-constitutive exocytosis, secretory product after synthesis and processing in the RER and GA, is stored in the cytoplasm in secretory granules until an appropriate signal for secretion is received In constitutive exocytosis, prompt transpo of secretory product to the cell membrane in vesicles occurs with little or no processing or storage SNARE proteins that are involved in exocytosis
|
Physiology
|
General Physiology
|
801079d6-2426-4107-9e60-6e111b9cb5ea
|
Endodermal sinus tumor is characterised by
|
Cal Exner body
|
Psammoma bodies
|
Schiller Duval bodies
|
Homer wright body
| 2c
|
single
|
Refer Robbins page no 977Also known as endodermal sinus tumor, yolk sac tumor is of interest because it is the most common testicular tumor in infants and children up to 3 years of age. In this age group it has a very good prognosis. In adults the pure form of this tumor is rare; instead, yolk sac elements frequently occur in combination with embryonal carcinoma.
|
Pathology
|
Urinary tract
|
4931890d-f561-4bc2-bb7e-d612884bb12a
|
The following diseases are associated with Epstein-Barr virus infection, EXCEPT:
|
Infectious mononucleosis
|
Epidermodysplasia verruciformis
|
Nasopharyngeal carcinoma
|
Oral hairy leukoplakia
| 1b
|
multi
|
Ans. b. Epidermodysplasia verruciformis Epstein Barr Virus may lead to the following: Infectious mononucleosis EBV associated tumors Ref: Harrison's Principles of Internal Medicine, 16th Edition, Pages 1046, 47
|
Microbiology
| null |
467d8343-5aca-4acb-ae66-8b1f7b93e007
|
Which among the following differentiates ventricular tachycardia from WPW Patient with atrial fibrillation
|
Irregular RR interval
|
Regular RR interval
|
Broad QRS
|
Increased heart rate
| 1b
|
single
|
VT has regular RR interval.
|
Medicine
| null |
fc105a3e-97c3-43cd-b1a2-147cd83197ef
|
A patient of acute leukemia is admitted with febrile neutropenia. On day four of being treated with broad-spectrum antibiotics, his fever increases. X-ray chest shows bilateral fluffy infiltrates. Which of the following should be the most appropriate next step in the managment -
|
Add antiviral therapy
|
Add antifungal therapy
|
Add cotrimoxazole
|
Continue chemotherapy
| 2c
|
multi
| null |
Microbiology
| null |
87908bc6-c879-4860-89fc-b59222a814b9
|
Most important risk factor of recurrence of febrile seizure is -
|
Age of onset < 2 years
|
Family history
|
Seizure at time of fever peak
|
Long prolonged fever prior to seizure
| 1b
|
single
|
Ans. is 'b' i.e., Family history' Febrile convulsiono Commonest provoked seizureo Between 6 months to 5 yearo Neurologically normal childo Occurs when temp rise abruptlySimple benign febrile convulsiono Fits occur within 24 hour of onset of fever,o Duration less than 10 min.o Usually single per febrile episodeo Generalised type of convulsionAtypical febrile seizureso Presence of family history of epilepsyo Neurodevelopmental retardationo Focal neurological deficit.o Approximately 30-50% of children have recurrent seizureso Factors associated with increased recurrence risk includeAge <12 moLower temperature before seizure onsetA positive family history of febrile seizures, andComplex seizures
|
Pediatrics
|
Seizures in Childhood and Conditions that Mimic Seizures
|
874f9dcb-b3e3-4066-aa4e-b6383b627dc4
|
Vegetations on undersurface of A.V. valves are found in
|
Acute rheumatic fever
|
Libman Sach's endocarditis
|
Non thrombotic bacterial endocarditis
|
Chronic rheumatic carditis
| 1b
|
single
|
Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:163 Endocarditis associated with SLE (Libman-Sachs endocarditis): The vegetations are 3-4 mm in size, composed of degenerating valve tissue; functional disability is minimal; ventricular surface of the mitral valve is commonly involved; aoic valve involvement is rare; entire valve apparatus can be involved.
|
Medicine
|
C.V.S
|
7d8876aa-da72-4dda-8dcb-98265a57bb9d
|
This drug depolarizer cell membranes of aerobic Gram Positive Bacteria. It is effective against vancomycin resistance entercoccal infection. It may cause myopathy especially in patients taking stating .it is
|
Teicoplann
|
Daptomycin
|
Linezolid
|
Streptogramin
| 1b
|
multi
|
(Ref: KDT 6/e p741, Daptomvcin is a newer antibiotic that acts by causing depolarization.of bacterial cell membranes. It is effective in MRSA, VRSA and even streptogramin resistant SA infections as well as VRE infections. It can cause myopathy in patients taking statins.
|
Anatomy
|
Other topics and Adverse effects
|
640f1494-b535-413f-9efc-b9a6e0c2de6f
|
Both fenfluramine and phentermine
|
Produce central nervous system stimulation
|
Act to suppress appetite
|
Are effective in treating narcolepsy
|
Have been used in children with attention deficit disorders
| 1b
|
multi
|
. Both fenfluramine and phentermine have been successfully used, alone and in combination, for the treatment of obesity. They apparently reduce appetite by affecting the satiety centers in the hypothalamus. Whereas phentermine is a central nervous system (CNS) stimulant related to the amphetamines and is believed to act by releasing norepinephrine from CNS neurons, fenfluramine causes lethargy and sedation and acts by augmenting serotonin neurotransmission. For this reason, the drugs may be used together without causing excessive CNS stimulation or depression.
|
Pharmacology
|
All India exam
|
c5c36b0a-8c94-43d2-ad8b-e4536ea3919c
|
True about Hb dissociation curve is:
|
Acidosis shifts 02 dissociation curve to right
|
T CO2 shifts the curve to left
|
Hypoxia shifts curve to left
|
All
| 0a
|
multi
|
A i.e. Acidosis shifts O2 dissociation curve to right
|
Physiology
| null |
329fb8a4-1832-4837-81f0-b057bce2598c
|
A 24 year old male complained of recurrent attacks of sore throat since 2 years. The total leucocyte count was 3000/ μl. A differential count revealed severe neutropenia. The diagnosis is
|
Subleukemicleukemia
|
Agranulocytosis
|
Infectious mononucleosis
|
Leukoerythroblasticanemia
| 1b
|
single
| null |
Pathology
| null |
f0d4c498-e605-48b7-8fe1-a1723dc2ff85
|
Early morning hyperglycemia with increased blood glucose of 3.00 AM suggests:
|
Insufficient Insulin
|
Dawn Phenomenon
|
Somogyi effect
|
None of the above
| 0a
|
multi
|
Answer is A (insufficient Insulin): Early morning hyperglycemia with increased blood glucose at 3.00 Am typically suggests inadequate night time insulin dose (insufficient insulin). Dawn phenomenon also presents with early morning hyperglycemia but blood glucose is typically stable (normal) at 3.00AM. If insufficient insulin is not provided amongst the options. Dawn phenomenon may be selected as the Answer by exclusion since several textbooks do not make a distinction between Dawn phenomenon and insufficient insulin and include insufficient night time insulin as a mechanism for Dawn phenomenon. Causes of early morning hyperglycemia in diabetics using insulin: Causes Frequency Mechanism Diagnosis Treatment Insufficient Most common Inadequate night-time basal Blood glucose rises "Ist Night-time insulin insulin dose continuously throughout the night intermediate or long-acting insulin dose Dawn Common Early morning physiologic Blood glucose stable Do not eat a phenomenon surge in growth hormone and all night, then sharp carbohydrate snack coisol rise early in the morning at midnight Somogvi effect Least common Excessive night-time basal Hypoglycemia at 2-3 .1 Night-time insulin dose --> hypoglycemia in the middle of the night --> triggers release of counter- regulatory hormones am* intermediate or long-acting insulin dose *Patients with long-standing DM may not have symptoms of hypoglycemia (discomfo, tremors, sweating, etc) because of autonomic diabetic neuropathy.
|
Medicine
| null |
5e6eadec-afaf-47d1-b8c6-259852f3d548
|
Kaposi sarcoma is caused by: March 2013
|
HHV 6
|
HHV 7
|
HHV 8
|
All of the above
| 2c
|
multi
|
Ans. C i.e. HHV 8 Kaposi sarcoma (KS) It is a tumor caused by Human herpesvirus 8 (HHV8), also known as Kaposi sarcoma-associated herpesvirus (KSHV). It was originally described by Moritz Kaposi , a Hungarian dermatologist practicing at the University of Vienna in 1872. It became more widely known as one of the AIDS-defining illnesses in the 1980s. Kaposi's sarcoma (KS) is a systemic disease that can present with cutaneous lesions with or without internal involvement. Four subtypes have been described: - Classic KS, affecting middle aged men of Mediterranean descent; - African endemic KS; KS in iatrogenically immunosuppressed patients; and - AIDS-related KS. Classic KS tends to be indolent, presenting with erythematous or violaceous patches on the lower extremities. African endemic KS and AIDS-related KS tend to be more aggressive. The AIDS-related KS lesions often rapidly progress to plaques and nodules affecting the upper trunk, face, and oral mucosa. The diagnosis can be made with a tissue biopsy and, if clinically indicated, internal imaging should be done.
|
Microbiology
| null |
15da5cdd-5657-4901-8bd4-c9ef9afd9ba9
|
A fifty-year-old man, presents to his local physician complaining that he often feels as if the room is spinning when he gets up from a recumbent position or turns his head. He has not lost consciousness and has had no chest pain. He has no cardiac history and a recent treadmill test showed no abnormalities. On examination, the sensation can be produced by rapidly turning the head. It can be reproduced many times, but it eventually ceases. Nystagmus is elicited. Hearing is normal. Which of the following is the most likely mechanism for this patient's symptoms?
|
Aberrant stimulation of hair cells
|
Hair cell death in the semicircular canals
|
Insufficient cardiac output
|
Insufficient cerebral perfusion
| 0a
|
multi
|
In benign paroxysmal positional veigo, calcium carbonate crystals called otoliths, which are usually fixed in a gelatinous otolithic membrane, float freely in the endolymph. Usually, movement is sensed by the movement of this heavy membrane as it stimulates hair-like projections on sensory hair cells fixed to the membrane in the inner ear. In BPPV, the loose crystals aberrantly stimulate the hair cells with ceain head movements. Thus the sensation of veigo is produced. Hair cell death does not cause veigo. Insufficient cardiac output and cerebral blood flow lead to syncope and not veigo.
|
ENT
| null |
e850a892-8fc0-4217-b6b1-1e9addf581f7
|
Asha worker works for___ population:
|
3000
|
1000
|
5000
|
400
| 1b
|
single
|
Ans. (b) 1000Ref: K. Park 23rd ed. / 449, 21st ed. 1407* ASHA is Accredited Social Health Activist.* One ASHA works for 1000 population.* In tribal, hilly and desert areas, the norm is one ASHA per habitation.Impact Indicators of ASHA* Infant mortality rate* Child malnutrition rate* Number of TB/leprosy case detection as compared to previous year.Must knowASHA* ASHA must be the resident of the village preferably in the age group of 25-45 years.* Minimum education required for ASHA: 8th pass* ASHA is selected by village panchayat/Gram Sabha* ASHA comes under national Rural Health Mission (NRHM): 2005-2012* Act as bridge between village and ANM (Auxiliary Nurse midwife)* Training of ASHA is done by ANM and AWW for a minimum duration of 23 daysAlso know* One multi-purpose worker (MPW) is for: 5000 population* One village health guide (VHG) is for: 1000* One Anganwadi worker (AWW) is for: 400-800
|
Social & Preventive Medicine
|
Health Planning and Management
|
2a25d368-0138-4008-b0d7-ff8648dac925
|
A 10 year old boy presents with a palpable mass per abdomen. On imaging, para-aoic lymph nodes were found to be enlarged. A biopsy from the lymph node showed a starry sky appearance. What is the likely underlying abnormality -
|
Tumor suppressor gene Tp53 mutation
|
Rb tumor suppressor gene mutation
|
Translocation involving BCR-ABL genes
|
Translocation involving cMYC gene
| 3d
|
single
|
. Translocation involving cMYC gene
|
Pathology
| null |
c869790a-1a9e-4d40-b01d-5801de2455ab
|
A 45-year-old woman complains of tingling in her hands and feet, 24 hours after removal of follicular thyroid carcinoma. Her symptoms rapidly progress to severe muscle cramps, laryngeal stridor, and convulsions. Which of the following laboratory findings would be expected in this patient prior to treatment?
|
Decreased serum calcium and decreased PTH
|
Decreased serum calcium and increased PTH
|
Increased serum calcium and decreased PTH
|
Increased serum calcium and increased PTH
| 0a
|
single
|
- Given clinical features point towards hypocalcemia resulted from hypoparathyroidism. HYPOPARATHYROIDISM - Most common cause is surgical resection of parathyroids as a complication of thyroidectomy. -Parathyroid levels falls-Hypocalcemia - Hypocalcemia- | Neuromuscular excitability - From mild tingling in hands & feet to severe muscle cramps, laryngeal stridor & convulsions. - Neuropsychiatric manifestations- Depression, Paranoia & Psychoses. Increased PTH in setting of parathyroid adenoma or paraneoplastic syndrome is associated with hypercalcemia (choice D).
|
Pathology
|
Parathyroids
|
cdee75ae-93c9-41c8-bc6a-30d440b23bd6
|
Regarding Congenital Toicollis true are all except:
|
In 2/3 cases sternocleidomastoid mass is palpable
|
If untreated, may lead to Plagiocephaly
|
80% undergo Spontaneous resolution
|
Always associated with breech presentation
| 3d
|
multi
|
AlthoughLarge infants who have had difficult veex deliveries as well as those who are breech or those with hip dysplasia are at special risk for developing toicolis, it is not always associated. Congenital Muscular Toicollis Muscular toicollis is the most common variety and is presumed to result from injury to the sternocleidomastoid muscle during delivery. In toicollis the head is tilted toward and rotated away from the tight sternocleidomastoid muscle. Congenital toicollis is usually secondary to intrauterine moulding but may present with fixed sternocleidomastoid contracture or with a palpable 'tumour' within the muscle. There is a strong correlation with DDH. Most cases resolve with stretching but persistent cases develop facial asymmetry and require surgical release of the sternocleidomastoid at one or both ends. Acquired toicollis is less common and may be caused by gastro-oesophageal reflux, posterior fossa tumour/other regional abnormality, inflammation/infection, ocular problems or atlanto- axial rotatory subluxation. Treatment In patients with a suggestive history and appropriate physical findings, programs of positioning and stimulation and gentle passive stretching exercised staed within the first month of life often result in resolution. The parents should be instructed to rotate the chin gently toward the side of head tilt while simultaneously bringing the head to the upright position. As range of motion improves, the chin can be rotated past neutral and the head titled toward the opposite side. Significant correction usuall;y occurs within the first few months of life in patienys with muscular toicollis. When deformaity persists, the patient should be referred for ohopedic evaluation. Soft collars are not effective in treatment, and rigid devices producesecondary mandibular deformity. Surgical release of the sternocleidomastoid muscle is occasionally required in such patients and should be performed before the development of secondary facial asymmetry (plagiocephaly)
|
Radiology
|
Musculoskeletal Radiology
|
01d39bb8-c090-42d2-921a-66d4843a5ece
|
All are causes of Pulmonary Infiltrates with Eosinophilia with known etiology, EXCEPT:
|
Allergic bronchopulmonary mycosis
|
Eosinophilia-myalgia syndrome
|
Parasitic infestations
|
Loeffler's syndrome
| 3d
|
multi
|
This is really a good question. Need to be very thorough about it to answer. The table in harrison will give the clear answer without doubt: Allergic bronchopulmonary mycosis such as those caused by Penicillium, Candida, Curvularia, or Helminthosporium spp. A. fumigatus is the most common cause of ABPA. Loeffler's syndrome was originally repoed as a benign, acute eosinophilic pneumonia of unknown cause characterized by migrating pulmonary infiltrates and minimal clinical manifestations. Eosinophilia-myalgia syndrome is an incurable and sometimes fatal flu-like neurological condition that is believed to have been caused by ingestion of poorly produced L-tryptophan supplement. Ref: Harrisons Principles of Medicine, 18th Edition, Chapter 255, Table 255-2, Page 2119
|
Medicine
| null |
9d57bea8-7852-4b22-ac25-c69520f15628
|
Number of air changes in one hour in a drawing room should be not less than
|
3
|
2
|
4
|
5
| 1b
|
single
| null |
Social & Preventive Medicine
| null |
fd599cee-aefb-4757-9d6e-313dc05ad06d
|
A 69-year-old man is brought to the emergency department for new symptoms of confusion and sleep disturbance. He is not able to provide any history but his partner notes that he has cirrhosis due to chronic alcoholism She states that he has maintained abstinence from alcohol for the past 3 months. His medications include nadolol, furosemide, spironolactone, and lactulose.On examination, he looks jaundiced, the blood pressure is 102/78 mm Hg supine, and 86/64 mm Hg standing with an increase in heart rate from 72 to 100 beats/min. He is afebrile and the oxygen saturation is 98% on room air. The abdomen is soft; there is a palpable spleen tip and no evidence of ascites. He is not oriented to place or time and moves all four limbs on command. A digital rectal exam reveals dark black stool. Which of the following is the most likely cause?
|
spontaneous bacterial peritonitis (SBP)
|
spironolactone
|
nadolol
|
gastrointestinal (GI) bleeding
| 3d
|
multi
|
GI bleeding is the most common precipitating factor for hepatic encephalopathy. Patients with cirrhosis and portal hypertension are at risk for variceal bleeding. Diuretic therapy by causing hypokalemia, and SBP are other common causes. In this patient the postural hypotension and dark stools suggests that GI bleeding is the likely cause rather than his diuretics or SBP. Narcotics and sedatives are also frequently implicated as precipitants for hepatic encephalopathy.
|
Medicine
|
Miscellaneous
|
52897ed3-12f7-4818-8f89-accf5f40dbdf
|
Not an Aberration of Normal Development and Involution (ANDI) NOT RELATED-GYN
|
Fibroadenoma
|
Duct ectasia
|
Cyclical mastalgia
|
Intraductal papilloma
| 3d
|
single
| null |
Pharmacology
|
All India exam
|
770f7ddb-aff4-49c3-91af-7792ad2e3664
|
A 43-year-old man sustains a fracture of the tibia. There are no neurologic or muscular lesions noted on careful examination. An above-knee cast is applied. After 6 weeks, the plaster is removed. It is noted that he has a foot drop and is unable to extend his ankle because of pressure injury to which of the following?
|
Posterior tibial nerve
|
Saphenous nerve
|
Femoral nerve
|
Deep fibula (peroneal) nerve
| 3d
|
multi
|
The common fibula (peroneal) nerve divides into the superficial fibula (peroneal) nerve, which supplies the fibula (peroneal) compartment, and the deep fibula (peroneal) nerve, which supplies the extensor compartment of the leg. This injury may occur because of a fracture of the proximal fibula or because of compression of the nerve by a tightly applied plaster cast in this region.
|
Surgery
|
Orthopedics
|
cd16eb73-5c04-4ac4-ae36-e6d67f8ced13
|
Blow-out fracture of orbit is characterized by all except:
|
Diplopia
|
Tear drop" sign
|
Positive forced duction test
|
Exophthalmos
| 3d
|
multi
|
Ans. Exophthalmos
|
Ophthalmology
| null |
18156abc-94cd-406e-92ba-7dbed0bde5b6
|
Term catatonia was used by -
|
Karl kahlbaum
|
Adolf meyer
|
Leo kanner
|
Karen homey
| 0a
|
single
|
Karl kahlbaum coined the terms catatonia and cyclothymia.
|
Psychiatry
| null |
f2e2e495-3ef5-4e85-849b-2d037113e8ed
|
A 8 year old child has localized non cicatrial alopecia over scalp with itching and scales. The diagnosis is –
|
Tinea Barbae
|
Alopecia areata
|
Tinea Capitis
|
Lichen planus
| 2c
|
single
|
Information in this question are -
Non-cicatrial alopecia
Itching
Scales
Patient is child (8 years)
Amongst the given options Non-cicatricial alopecia is caused by T.Capitis and alopecia areata.
But only T.Capitis fullfils the criteria here, i.e. Non-cicatricial alopecia, Itching, Scales in a child.
Alpecia areata occurs in young adults, and there is no itching or scales.
|
Dental
| null |
aca787c7-0de1-46ec-8aeb-fd422eb8ec84
|
Profuse expectoration of two months durations and clubbing may be seen -
|
Sarcoidosis
|
Polyarteritis nodosa
|
Pulmonary artery hypertension
|
Allergic bronchopulmonary aspergillosis
| 3d
|
multi
| null |
Medicine
| null |
d06b7523-2c93-4632-a099-507c9229db56
|
True about thyroid storm -a) Bradycardiab) Hyperthermiac) Hypercalcemiad) Hypotensione) Cardiac arrhythmia
|
ab
|
bc
|
bce
|
ace
| 2c
|
multi
| null |
Medicine
| null |
933a41db-85f1-43d1-b927-401479912774
|
Rani a 24-year-old woman presents to her gynaecologist as she has chronic hypothyroidism and wants to conceive now. Her hypothyroidism is well controlled at 75 microgram of Thyroxine. She doesn&;t smoke or drink and doesn&;t have any other medical ailment. She would like to know if she should keep taking her Thyroxin. Which of the following is the best advice to give to this patient?
|
Stop taking Thyroxine and switch to methimazole as we would like to control your baby's thyroid levels
|
Thyroxine is safe during pregnancy but it is not absolutely necessary during pregnancy to continue thyroxine.
|
Thyroxine is not safe during pregnancy and it is better for your baby to be hypothyroid than hypehyroid
|
Thyroxine is safe in pregnancy and the dose of thyroxine would be increased during pregnancy to avoid hypothyroidism, which may affect the baby adversely
| 3d
|
single
|
Hypothyroidism The woman is staed on 100microgm Thyroxine if she is not already on this hormone.The dose can then be increased in 2nd TM according to values noted.Once euthyroid thyroid function should be checked in each trimester.Following an adjustment of dosage the free thyroxine is checked after 4-6weeeks.The doses are adjusted until the TSH level is between .5 - 2.5 IU/ml.If the woman is already on thyroxine prior to pregnancy the dose will usually have to be increased by 25%as pregnancy is associated with an increase in thyroxine requirement. TEXTBOOK OF OBSTETRICS, SHEILA BALAKRISHNAN,Pg no:329,2nd edition
|
Gynaecology & Obstetrics
|
Medical, surgical and gynaecological illness complicating pregnancy
|
0223b8d6-b6ea-4600-83fd-7e3c6b5f52ab
|
Acute diffuse proliferative glomerulonephritis will have all of the following features, except ?
|
Microscopic haematuria
|
Raised blood urea level
|
Raised serum creatinine level
|
Hypoalbuminaemia
| 3d
|
multi
|
Ans. is 'd' i.e., Hypo albuminaemiao Diffuse proliferative glomerulonephritis is characterized by nephritic syndrome whereas hypoalbuminemia is a feature of Nephrotic syndrome.o Clinical features of Diffuse proliferative glomerulonephritis
|
Pathology
| null |
ce99cfd7-1bba-4de0-81a5-6dcd65df8d9c
|
True about cephalic phase of gastric acid secretion-
|
Due to Gastrin
|
Accounts for 20% of output
|
Occurs when food is in stomach
|
Enterogastric reflex is invloved in secretion
| 1b
|
multi
|
Ans. is 'b' i.e., Accounts for 20% of output "During the cephalic phase of gastric acid secretion, the sight, smell, or thought of food activates cholinergic (acetylcholine- releasing) vagal fibers, which stimulate the release of HCLfrom antral parietal cells"Phases of gastric acid secretion* There are following phases of gastric acid secretion : -1) The cephalic phase (Appetite phase):# Just as salivary secretion may start before food enters the mouth, gastric secretion is also intitiated before food enters the stomach. Sight, smell or even thought of food stimulate gastric acid secretion.# It is by parsympathetic system through vagus.# This phase accounts for 20% of acid secretion.2) The gastric phase :# This phase of acid secretion comes into play when food makes contact with the gastric mucosa.# Acid secretion in this phase is brought about two factors : -i) Hormonal stimulation due to gastrin releaseii) Stretch of stomach wall due to gastric distension which activates a vago-vagal reflex as well as a local intragastric reflex.# This phase accounts for 72-80% of acid secretion.3) The intestinal phase :# Once the food enters upper portion of small intestine (i.e., duodenum) it causes small amounts of gastric juice secretion because of gastrin released from dudenal mucosa.# While the intestinal phase play only a minor role in stimulation of gastric secretion, presence of food in the intestine plays a major role in its inhibition. With the entry of food into the duodenum, gastric secretion starts slowing down.# The presence of acid, fats, and products ofprotein digestion; and increased osmolarity in the duodenum inhibit gastric secretion by: -i) Hormonal mechanism: These mentioned stimuli cause the release of several intestinal hormones like secretin, cholecystokinin (CCK), vasoactive intestinal peptide (VIP), gastric inhibitor polypeptide (GIP) and somatostatin. These local hormones inhibit the gastric secretion as well as gastric motility.ii) Neural mechanism (enterogastric reflex): The above mentioned stimuli inhibit gastric secretion and motility by intrinsic neural reflex.
|
Physiology
|
G.I.T.
|
bb3538b6-376f-40bf-9ad8-42e993db707e
|
Stain for the diagnosis of tuberculosis -
|
Auramine-rhadomine
|
India-ink
|
Geimsa stain
|
All
| 0a
|
multi
|
Ans. is 'a' i.e., Auramine-rhodamine
|
Microbiology
| null |
0cb0b37b-f13f-4d4f-951c-2df5e4275061
|
Which of the following method of protein separation is not dependent on molecular size ?
|
Gel filtration chromatography
|
Ultracentrifugation
|
Ion-exchange chromatography
|
SDS-PAGE
| 2c
|
single
|
Ans. is 'c' i.e., Ion-exchange chromatography
|
Biochemistry
| null |
beb6b37b-3275-4d77-95d2-8419cfd4d02e
|
Which of the following usually require a RNA intermediate for cloning/replication?
|
Transposons
|
Plasmids
|
Phages
|
Cosmids
| 0a
|
multi
|
A transposable element (TE or transposon) is a DNA sequence that can change its position within a genome, sometimes creating or reversing mutations and altering the cell&;s genome size. Transposition often results in duplication of the TE. Barbara McClintock&;s discovery of these jumping genes earned her a Nobel Prize in 1983. Transposable elements make up a large fraction of the genome and are responsible for much of the mass of DNA in a eukaryotic cell. It has been shown that TEs are impoant in genome function and evolution. In Oxytricha, which has a unique genetic system, these elements play a critical role in development. Transposons are also very useful to researchers as a means to alter DNA inside a living organism. There are at least two classes of TEs: Class I TEs or retrotransposons generally function reverse transcription, while Class II TEs or DNA transposons encode the protein transposase, which they require for inseion and excision, and some of these TEs also encode other proteinsRef: https://en.wikipedia.org/wiki/Transposable_element
|
Biochemistry
|
Metabolism of nucleic acids
|
501c7143-2635-45e9-a370-40d908dfd2ba
|
During cesarean section under general endotracheal anaesthesia, venous air embolism
|
Is associated with high end-tidal CO2
|
Should be treated with nitrous oxide
|
Is associated with expired nitrogen
|
Induces severe hypertension
| 2c
|
single
|
Expired Nitrogen is the most sensitive venous-air embolism detection method, as the largest component of air is nitrogen.
|
Anaesthesia
| null |
cd95b1b2-1e45-4854-8a7d-2e77825351b2
|
Night blindness is due to
|
Vitamin A
|
Vitamin B1
|
Vitamin B12
|
Vitamin B6
| 0a
|
single
| null |
Biochemistry
| null |
27f98eb9-41e4-4018-a16a-4753d5733811
|
Best drug for acute gout in a patient with renal impairment is:
|
Naproxen
|
Probenecid
|
Allopurinol
|
Sulfinpyrazone
| 0a
|
multi
|
Naproxen: The anti-inflammatory activity is stronger and it is particularly potent in inhibiting leucocyte migration - may be more valuable in acute gout: dose 750 mg stat followed by 250 mg 8 hourly till attack subsides. It is also recommended for rheumatoid arthritis and ankylosing spondylitis. Because of longer t ½ , regular use can effectively suppress platelet function. Gastric bleeding is more common than with ibuprofen. Naproxen carries lower thrombotic risk than diclofenac, etoricoxib, etc. Dose should be reduced in the elderly.
Naproxen is marketed as active single S(-) enantiomer preparation, which poses less renal burden. However, some R(+) enantiomer is formed in vivo due to inversion.
Uricosuric drugs like probenecid and sulfinpyrazone are ineffective in the presence of renal insufficiency.
Allopurinol is a drug of choice for most cases of chronic gout. Renal impairment increases the incidence of rashes and other reactions to allopurinol.
Reference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 217
|
Pharmacology
| null |
c242c478-523f-4f4c-a876-81cda9e35a3b
|
Flapping Tremors may be associated with all of the following, Except
|
Hepatic encephalopathy
|
Uremia
|
CO2 Narcosis
|
Thyrotoxicosis
| 3d
|
multi
|
Answer is D (Thyrotoxicosis) `Thyrotoxicosis (Hypehyroidism) is associated with rapid fine tremors and not flapping tremors (irregular coarse tremor) also called Asterixis. Asterexis (Flapping tremor) is most commonly seen in metabolic encephalopathies due to hepatic, renal (uremia) and respiratory failure (CO2 Nercosis). Causes of Asterixis /Flapping Tremor (Coarse irregular tremor) Typical Metabolic Encephalopathies Hepatic Encephalopathy Typically Metabolic Encephalopathies due to Uremic Encephalopathy hepatic, renal and respiratory failure are the Respiratory failure with CO2 Retention (CO2 Narcosis) most common causes. Other Metabolic Encephalopathies Hyperglycemia / Hypoglycemia Electrolyte Disturbances (Hypokalemia, Hypomagnesemia etc) Medication side Effects / Intrications Bromide intoxication Gabapentin / Pregabalin Phenytoin intoxication Valproate /Carbamazapine / Clozapine Chloral Hydrate intoxication Lithium / Levodopa Glutathemide intoxication Metrizamide / Ifbsfamide Intravenous ammonium chloride Gastrointestinal Disease Whipple's Disease Malbsorption syndrome / Idiopathic Steatorrhea Toxic Megacolon of Ulcerative Colitis Structural lesions Vascular Infarction / Haemorrhage (brainstem / intraventruculer) Subdural Empyema / hematoma Encephalitis Post-anoxic action myoclonus Brain tumors Post -surgical scars Miscellaneous Congestive Cardiac Failure Chronic Dialysis Septisemia
|
Medicine
| null |
ff78e421-87be-4809-9626-f8ab3005f923
|
Which of the following is not used in enterococcal infection?
|
Vancomycin
|
Linezolid
|
Teichoplanin
|
Cephalexin
| 3d
|
single
|
Ans: d (Cephalexin) Ref: Harrison, 16th ed, p. 830; Tripathi, 6th ed, p. 733Enterococci are resistant to all cephalosporins; therefore this class of antibiotics should not be used for treatment of enterococcal infections. Usual treatment for enterococci is combination of penicillin or ampicillin with an aminoglycoside. If patient is penicillin allergic, vancomycin can be used instead.Treatment options for anti biotic-resistant enterococcal infectionsResistance PatternBeta-Lactamase productionRecommended TherapyGentamicin plus ampicillin/sulbactam, amoxicillin/clavulanate, imipenem, or vancomycinBeta-Lactam resistance, but no beta-lactamase productionGentamicin plus vancomycinHigh-level gentamicin resistanceStreptomycin-sensitive isolate: Streptomycin plus ampicillin or vancomycinStreptomycin-resistant isolate; No proven therapy(continuous-infusion ampicillin, prolonged treatment)Vancomycin resistanceAmpicillin plus gentamicinVancomycin and beta-lactam resistanceNo uniformly bactericidal drugs; linezolid (all enterococci) or quinupristin/dalfopristin ( only)Linezolid is a member of the oxazolidinediones, a new class of synthetic antimicrobials.It is active against gram-positive organisms including staphylococci, streptococci, enterococci, gram-positive anaerobic cocci, and gram-positive rods such as corynebacteria and Listeria monocytogenes.It is primarily a bacteriostatic agent except for streptococci, for which it is bactericidal. The principal toxicity of linezolid is hematologic-reversible and generally mild.Thrombocytopenia is the most common manifestationNeutropenia may also occur, most commonly in patients with a predisposition to or underlying bone mairow suppression.Linezolid is 100% bioavailable after oral administrationLinezolid is approved for vancomycin-resistant E.faeciuminfections; nosocomial pneumonia; community- acquired pneumonia; and skin infections, complicated or uncomplicated. It should be reserved for treatment of infections caused by multidrug-resistant gram-positive bacteria.TEICOPLANINTeicoplanin is a glycopeptide antibiotic that is very similar to vancomycin in mechanism of action and antibacterial spectrum. It can be given intramuscularly as well as intravenously.Teicoplanin has a long half-life (45-70 hours), permitting once-daily dosing.It is indicated in enterococcal endocarditis, MRSA and penicillin resistant streptococcal infections, osteomyelitis, as alternative to vancomycin.
|
Pharmacology
|
Anti Microbial
|
3e656ca4-0bb0-4f83-acbd-b0100b29854d
|
A male with azoospermia found to have normal FSH & testosteron levels & normal size testes. Probable cause is
|
Vas obstruction
|
Kaltman syndrome
|
Undescended testis
|
Klinefeltor's syndrome
| 0a
|
single
| null |
Surgery
| null |
b349b664-7fcb-44bb-a1ed-53c4d3f7a3a2
|
A 5 year lod child is assessed to have developmental age of one year. His developmental patient would be
|
100
|
80
|
20
|
60
| 2c
|
single
| null |
Pediatrics
| null |
32e20ffa-c3b7-4bb1-a29f-900df86ffa87
|
In essential hypeention changes seen in the hea are-
|
Cardiac cell hyperplasia
|
Cardiac cell hyperophy
|
increse in the mitochondrial number
|
Increase in size of mitochondria
| 1b
|
single
|
Essential hypeension tends to be familial and is likely to be the consequence of an interaction between environmental and genetic factors. The prevalence of essential hypeension increases with age, and individuals with relatively high blood pressures at younger ages are at increased risk for the subsequent development of hypeension.It is likely that essential hypeension represents a spectrum of disorders with different underlying pathophysiologies. In the majority of patients with established hypeension, peripheral resistance is increased and cardiac output is normal or decreased; however, in younger patients with mild or labile hypeension, cardiac output may be increased and peripheral resistance may be normal. When plasma renin activity (PRA) is plotted against 24-h sodium excretion, ~10-15% of hypeensive patients have high PRA and25% have low PRA. High-renin patients may have a vasoconstrictor form of hypeension, whereas low-renin patients may have volumedependent hypeension. Inconsistent associations between plasma aldosterone and blood pressure have been described in patients with essential hypeension.. ref:Harrison&;s principles of internal medicine,ed 18,pg no 2048
|
Medicine
|
C.V.S
|
42f67821-567d-464b-9ea9-c0f7153fd39c
|
Enteropathy type T cell lymphoma is associated with -
|
M.A.L. Toma
|
Celiac Sprue
|
Menetrier disease
|
Crohn's disease
| 1b
|
single
|
Answer- B. Celiac SprueEnteropathy-type- T cell lymphoma is a rare complication of long-standing celiac disease.
|
Medicine
| null |
88e2f2ea-0cdb-4d67-aa2f-7498d3f10bf7
|
Best way to control house fly
|
DDT
|
Pyretheum
|
Mosquito net
|
Climination of breading places
| 3d
|
single
| null |
Social & Preventive Medicine
| null |
6b706208-b85a-4712-9f78-12e48397b14b
|
Lemon sign is seen in :
|
Spina bifida
|
Anencephaly
|
Agenesis of corpus callosum
|
Cystic hygroma
| 0a
|
multi
|
Spina bifida is a defect in the neural arch,which results in exposure of the contents of the neural canal. Most of them are seen in lumbosacral region.They may be open and closed. Banana sign: Compression or flattening of the posterior cerebellar surface. Lemon sign: Concave deformity of the frontal bones. Both above banana sign and lemon sign seen in USG in open spina bifida. Anencephaly: Absence of calvarium. Spina bifida occulta: Veebral schisis covered by normal soft tissue. Spina bifida apea: Full thickness defect of the skin and veebral arches. Cystic hygroma: Fluid filled sac that results from the obstruction of Lymphatic system. Commonly located in the neck or head area but can be present anywhere in the body. Tear drop sign: Absence of Corpus callosum. Reference: DC Duttas Textbook of Obs, 9th edition,page no.602.
|
Gynaecology & Obstetrics
|
Fetus
|
8c164874-5d36-43ea-b3b9-ad25b23025ff
|
ELISA test when compraed to western blot technique is -
|
Less sensitive, less Specific
|
More sensitive, More specific
|
Less sensitive, more specific
|
More sensitive less psecific
| 3d
|
single
|
ELISA IS more specific and sensitivity than sothern blot REF:ANANTHANARAYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.579
|
Microbiology
|
Virology
|
22d96a83-7d93-48b1-a5ad-1267b752fdb4
|
Volume of an adult eyeball ls
|
5.5mL
|
6.5mL
|
7.5ml
|
8mL
| 1b
|
multi
|
Dimensions of an adult eyeball Anteroposterior diameter 24 mm Horizontal diameter 23.5 mm Veical diameter 23 mm Circumference 75 mm Volume 6.5 ml Weight 7 gm. Image : A schematic drawing to show some critical parameters including ocular rigidity, volume distributions and aqueous and blood flow in the normal eye. Reference :- A K KHURANA; pg num:-03
|
Ophthalmology
|
Anatomy, Development and clinical examination
|
524e941b-0c62-4f39-a17c-b1eddaa68e9c
|
ANCA positive vasculitis -
|
Henoch schonlein purpura
|
Behcet's syndrome
|
Wegener's granulomatosis
|
None
| 2c
|
multi
|
Ans. (c) Wegener's granulomatosis(Ref: Robbins 9th/pg 507, Harrison 18thed p-2786-87)Option a and b are immune-mediated small-vessel systemic vasculitis. C-ANCA positive vasculitis
|
Pathology
|
Blood Vessels
|
69ccdb79-e727-44f1-965d-634dd62a0498
|
Physiological effect that is not produced by stimulation of Kappa opioid receptor is:
|
Sedation
|
Diuresis
|
Miosis
|
Constipation
| 3d
|
single
|
Ans. D. ConstipationBecause of the stimulation of u receptor constipation will occur. They can be found in the intestinal tract.This will be the cause of constipation i.e. a major side effect of u agonists, due to inhibition of peristaltic action.a. Sedationb. Analgesiac. Miosisd. Dysphoriae. DiuresisAmong the five related receptors the k-opioid receptor will bind opium-like compounds in the brain which are responsible for mediating the effects of these compounds.It effects includes altering the: -a. Moodb. Perception of painc. Consciousnessd. Motor control
|
Physiology
|
Misc.
|
f8381d37-bd3a-49b1-889c-3deac720e6ec
|
Commonest cause of convulsions in a child with Fever is ___________
|
Febrile convulsions
|
Meningitis
|
Epilepsy
|
Hypothyroidism
| 0a
|
single
|
Most commonly children with fever get convulsions and it is so called febrile convulsions. Febrile means feverish; any seizure or convulsion which is accompanied by fever is known as febrile seizure. The look of child during seizure seems life threatening (Child's whole body is shivering, shaking, twitching, eyes may roll up, there could be frothing from mouth and child may become unconscious) and it can be very frightening for parents. Reference: GHAI Essential pediatrics, 8th edition
|
Pediatrics
|
Central Nervous system
|
673c3a3c-12e7-4759-8e32-04ed9283f73c
|
Which toxin acts by ADP ribosylation-
|
Botulinum toxin
|
Shiga toxin
|
V.cholerae toxin
|
All
| 2c
|
multi
|
Ans. is 'c' i.e., V. cholerae toxin
|
Microbiology
| null |
3fe255b5-2297-44e0-8063-fbca1abb02b3
|
The most striking haematological finding in agranulocytosis is
|
Decreased absolute neutrophil count
|
Increased absolute easinophil count
|
Decreased absolute hasophil count
|
Increased absolute monocyte count
| 0a
|
single
| null |
Pathology
| null |
1b5d6555-cf5f-41e1-aa40-588b0a12ad3a
|
Which of the following is not associated with increase in the risk of seizures in future in a child with febrile seizures –
|
Developmental delay
|
Late age of onset
|
Complex partial seizures
|
Family history positive
| 1b
|
single
|
Risk factor for seizures in future (Risk factor for recurrence)
Positive family history
Atypical complex febrile convulsion
Neurodevelopment retardation (MR, CP development delay).
Early onset of febrile seizure (before 1 year)
Focal features
More than one seizures in the same day.
|
Pediatrics
| null |
dc55d836-9670-4e99-9691-0438c3278c67
|
All of the following comprise classical triad for congenital rubella syndrome, EXCEPT:
|
Sensory neural deafness
|
Cataract
|
Patent ductus aeriosus
|
Micrognathia
| 3d
|
multi
|
Congenital Rubella Syndrome - Risk of congenital defects is maximum before 11 weeks of gestation, C/F (Mnemonic: 'C D C') - Cataract - Deafness - Congenital hea disease (Most common is PDA) - IUGR - Microcephaly - Blue berry muffin lesions - Retinopathy - Most common manifestation of CRS: Sensineural deafness Late onset manifestations of CRS - Diabetes mellitus Thyroid dysfunction
|
Pediatrics
|
Paediatrics
|
840e5def-e87d-4703-8bd7-757ae8d16d8d
|
Vossius ring is seen in -
|
Diabetes Mellitus
|
Galactosemia
|
Blunt trauma
|
Retinoblastoma
| 2c
|
single
|
Ans. is 'c' i.e., Blunt trauma DiseaseCataractMyotonic DystophyChristmas tree cataractWilson's disease, chalcosisSunflower cataractDM, Down's SyndromeSnowflake cataractAtopic dermatitisBlue dot cortical cataract, posterior subcapsular cataractCongenital rubellaNuclear cataractGalactosemiaOil drop cataractComplicated cataract (Iridocyclitis, High myopia)Posterior cortical breads's crumb appearance Polychromatic lusture / Rainbow cataractBlunt traumaVossius ring on anterior surface of lens Rosette shaped cataract
|
Ophthalmology
|
Ocular Trauma
|
a042274d-9a98-49ff-8fab-95536eb08b0c
|
Which of the following is not a secretory pa of kidney?
|
Collecting tubule
|
PCT
|
DCT
|
Loop of Henle
| 0a
|
single
|
The secretory poion of kidney is contained largely within the coex and consists of a renal corpuscle and the secretory pa of the renal tubule. The excretory poion of this duct lies in the medulla. The renal corpuscle is composed of the vascular glomerulus, which projects into Bowman's capsule, which, in turn, is continuous with the epithelium of the proximal convoluted tubule. The secretory poion of the renal tubule is made up of the proximal convoluted tubule, the loop of Henle, and the distal convoluted tubule. The excretory poion of the nephron is the collecting tubule, which is continuous with the distal end of the ascending limb of the convoluted tubule. It empties its contents through the tip (papilla) of a pyramid into a minor calyx. Ref: Butterwoh IV J.F., Mackey D.C., Wasnick J.D. (2013). Chapter 29. Renal Physiology & Anesthesia. In J.F. Butterwoh IV, D.C. Mackey, J.D. Wasnick (Eds), Morgan & Mikhail's Clinical Anesthesiology, 5e.
|
Physiology
| null |
59ce796c-c210-41e6-b9b0-6d2fdfa8b8ba
|
In emergency tracheostomy the followingstructures are damaged except:
|
Isthmus of the thyroid
|
Inferior thyroid aery
|
Thyroid ima
|
Inferior thyroid vein
| 1b
|
multi
|
Inferior thyroid aery Ref: Keith L Moore 5/e p1100]Isthmus, thyroid ima aery and inferior thyroid veins are midline structures and thus can be injured during tracheostomy, more so during emergency tracheostomy. Inferior thyroid aery, a branch of the thyrocervical trunk of the subclan aery lies laterally away from midline, thus can escape injury.In emergency tracheostomy following structures can be damaged:- Isthmus- Inferior thyroid veins- Thyroid ima aery- Left brachio-cephalic vein, jugular venous arch- Pleura (especially infants)- Thymus- Esophagus (the trachea is small, mobile, and soft in infants damage the esophagus)
|
Anatomy
| null |
9151a988-2c3f-4fe7-a919-8c7036d91db9
|
A 5-year-old child with watery diarrhea for 7 days, on examination, weight = 10 kg, hanging skin folds with normal skin pinch. The composition of sodium in the ORS should be -
|
75 meq/Lit
|
60 meq/Lit
|
45 meq/Lit
|
90 meq/Lit
| 2c
|
single
|
Ans- C 45 meq/Lit Ideal Na concentration for dehydration in severe malnutrition is 45 mmol/L Ref 1 - WHO recommendations Children who are under 5 years of age with severe acute malnutrition who present with some dehydration or severe dehydration but who are not shocked should be rehydrated slowly, either orally or by nasogastric tube, with either ReSoMal, or half-strength standard WHO low-osmolarity oral rehydration solution with added potassium and glucose* at a rate of 5-10 mL/kg/h, for up to a maximum of 12 hours, unless the child has cholera or profuse watery diarrhoea. Children suspected of having cholera or have profuse watery diarrhoea should be given standard WHO low-osmolarity oral rehydration solution that is normally made, i.e. not further diluted. * standard WHO low-osmolarity oral rehydration solution (75 mmol/L sodium) should not be used ************* This is a summary of one of several WHO recommendations on the management of SAM in infants and children. The full set of recommendations can be found in 'Full set of recommendations' and in the guidelines and guidance documents under 'WHO documents' below. Full set of recommendations Ref 2- Fluid management in children with severe malnutrition and dehydration without shock 1. Children with severe acute malnutrition who present with some dehydration or severe dehydration but who are not shocked should be rehydrated slowly, either orally or by nasogastric tube, using oral rehydration solution for malnourished children** (5-10 mL/kg/h up to a maximum of 12 h). 2. Full-strength, standard WHO low-osmolarity oral rehydration solution (75 mmol/L sodium) should not be used for oral or nasogastric rehydration in children with severe acute malnutrition who present with some dehydration or severe dehydration. Either ReSoMal*** or half-strength standard WHO low-osmolarity oral rehydration solution should be given, with added potassium and glucose, unless the child has cholera or profuse watery diarrhoea. Dissolve one sachet of standard WHO low-osmolarity oral rehydration solution in 2 L water (instead of 1 L). Add 1 level scoop of commercially available combined minerals and vitamins mix1 or 40 mL of mineral mix solution (5), and add and dissolve 50 g of sugar. In some countries, sachets are available that are designed to make 500 mL of standard WHO low-osmolarity oral rehydration solution. In this situation, dilution can be revised to add 1 L. 3. ReSoMal (or locally prepared ReSoMal using standard WHO low-osmolarity oral rehydration solution) should not be given if children are suspected of having cholera or have profuse watery diarrhoea.**** Such children should be given standard WHO low-osmolarity oral rehydration solution that is normally made, i.e. not further diluted. Additionally (2-6): children with severe acute malnutrition and who have some or severe dehydration but no shock should receive 5 mL/kg ReSoMal every 30 min for the first 2 h. Then, if the child is still dehydrated, 5-10 mL/kg/h ReSoMal should be given in alternate hours with F-75, up to a maximum of 10 h; signs of improved hydration status and overhydration should be checked every half hour for the first 2 h, then hourly; ReSoMal can either be prepared from a ready-to-dilute sachet (as per supplier's instructions) or prepared with one sachet of WHO low-osmolarity oral rehydration solution plus 2 L of water with an added 50 g sugar and 40 mL mineral mix or one level scoop of combined minerals and vitamins; zinc (10-20 mg per day) should be given to all children as soon as the duration and severity of the episodes of diarrhoea start to reduce, thereby reducing the risk of dehydration. By continuing supplemental zinc for 10-14 days, this will also reduce the risk of new episodes of diarrhoea in the following 2-3 months. (Note, WHO-recommended therapeutic foods already contain adequate zinc, and children with severe acute malnutrition receiving F-75, F-100 or ready-to-use therapeutic food should not therefore receive additional zinc). Fluid management of children with severe acute malnutrition and shock 4. Children with severe acute malnutrition and signs of shock or severe dehydration and who cannot be rehydrated orally or by nasogastric tube should be treated with intravenous fluids, either: half-strength Darrow's solution with 5% dextrose, or Ringer's lactate solution with 5% dextrose. If neither is available, 0.45% saline + 5% dextrose should be used. Additionally (2-6): the general principles of resuscitation, in particular providing oxygen and improving breathing, similarly apply to children with severe acute malnutrition; the only indication for intravenous infusion in a child with severe acute malnutrition is circulatory collapse caused by severe dehydration or septic shock when the child is lethargic or unconscious (excluding cardiogenic shock); all children with severe acute malnutrition with signs of shock with lethargy or unconsciousness should be treated for septic shock. This includes especially children with signs of dehydration but no history of watery diarrhoea, children with hypothermia or hypoglycaemia, and children with both oedema and signs of dehydration; in case of shock with lethargy or unconsciousness, intravenous rehydration should begin immediately, using 15 mL/kg/h of one of the recommended fluids; it is important that the child is carefully monitored every 5-10 min for signs of overhydration and signs of congestive heart failure. If signs of overhydration and congestive heart failure develop, intravenous therapy should be stopped immediately; if a child with severe acute malnutrition presenting with shock does not improve after 1 h of intravenous therapy, a blood transfusion (10 mL/kg slowly over at least 3 h) should be given; children with severe acute malnutrition should be given blood if they present with severe anaemia, i.e. Hb <4 g or > 6g with signs of respiratory distress blood transfusions should only be given to children with severe acute malnutrition within the first 24 h of admission. * This is an extract from relevant guidelines and guidance documents as listed in 'References'. Additional guidance information can be found in these documents. ** A specific electrolyte-micronutrient product formulated according to WHO specifications for use in the management of children with severe acute malnutrition. *** ReSoMal is a powder for the preparation of an oral rehydration solution exclusively for oral or nasogastric rehydration of people suffering from severe acute malnutrition. It must be used exclusively under medical supervision in inpatient care, and must not be given for free use to the mother or caregiver. **** Three or more loose or watery stools in a day, for more than 14 days. References 1. WHO. Guideline: Updates on the management of severe acute malnutrition in infants and children. Geneva, World Health Organization; 2013 ( style="font-family: Times New Roman, Times, serif"> infantandchildren/en/). 2. WHO. Management of severe malnutrition: a manual for physicians and other senior health workers. Geneva, World Health Organization; 1999 ( 3. WHO. Training course on the management of severe malnutrition. Geneva, World Health Organization; 2002 (updated 2009)( 4. WHO. Diarrhoea treatment guidelines including new recommendations for the use of ORS and zinc supplementation for clinic-based healthcare workers. Geneva, World Health Organization; 2005 ( 5. WHO. The treatment of diarrhoea: manual for physicians and other senior health workers. Geneva, World Health Organization; 2005 ( 6. WHO. Pocket book of hospital care for children: second edition. Guidelines for the management of common illnesses with limited resources. Geneva, World Health Organization; 2013 (
|
Unknown
| null |
eef246a0-3599-4401-920e-270630bd45e9
|
Thermally dimorphic fungus is all except:
|
Coccidioidomycosis
|
Blastomycosis
|
Candida
|
Histoplasmosis
| 2c
|
multi
|
Ans. C. CandidaDimorphic fungi:Have yeast form in host & in vitro at 37degon enriched media and hyphal (mycelial) form in vitro (25degC) e.g.1. Histoplasma capsulatum2. Coccioidesimmitis3. Paracoccidioides Brasiliensis4. Blastomyces dermatitidis5. Sporothrixschenckii6. Penicillium marneffi
|
Microbiology
|
Mycology
|
01096a74-12b5-4977-b0d1-d59fd12911fc
|
Not a branch of celiac trunk
|
Left gastric artery
|
Common hepatic artery
|
Superior mesenteric artery
|
Splenic artery
| 2c
|
single
|
(C) Superior mesenteric artery # SUPERIOR MESENTERIC ARTERY (SMA) arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies the intestine from the lower part of the duodenum through two-thirds of the transverse colon, as well as the pancreas.> The coeliac trunk is the first anterior branch and arises just below the aortic hiatus at the level of T12/L1 vertebral bodies.> It divides into the left gastric, common hepatic and splenic arteries. The coeliac trunk may also give off one or both of the inferior phrenic arteries.
|
Anatomy
|
Misc.
|
dc335767-d7f6-4eff-9f5c-423d97d76392
|
1st drug to be used in absence seizures:
|
Phenytoin
|
BZD
|
Valproate
|
Carbamazepine
| 2c
|
single
|
Ans. is 'c' i.e., Valproate Choice of antiepileptic drugs (adults) Seizure typeInitial choiceSecond lineTonic-clonicPhenytoin,Carbamazepine,ValproateLamotrigine,OxcarbazepineMyoclonicPartialValproateCarbamazepine,PhenytoinLamotrigineValproate,Lamotrigine,OxcarbazepineAbsenceValproateEthosuximide,LamotrigineUnclassifiableValproateLamotriginePAEDIATRICS
|
Medicine
|
Seizures and Epilepsy
|
7eac98b8-3529-44bc-95c3-9d84bea1a878
|
What is net production rate?
|
Number of children a newborn girl has in her life time
|
Number of female children a newborn girl has in her life time
|
Number of male children a newborn girl has in her life time
|
Number of female children a newborn girl has in her life time taking into account the moality
| 3d
|
single
|
Net Reproduction Rate (NRR) Net Reproduction Rate (NRR) is defined as the number of daughters a newborn girl will bear during her lifetime assuming fixed age-specific feility and moality rates. NRR is a demographic indicator. NRR of 1 is equivalent to attaining approximately the 2-child norm. If the NRR is less than 1, then the reproductive performance of the population is said to be below replacement level. Ref: Park 25th edition Pgno : 540
|
Social & Preventive Medicine
|
Demography and family planning
|
3d399096-68bc-4d38-a439-0a3010791378
|
Most common differential diagnosis for appendicitis in children is
|
Gastroenteritis
|
Mesentric lymphadenopathy
|
Intussusception
|
Meckel's diveiculitis
| 1b
|
single
|
Differential diagnosis of acute appendicitis in children Gastroenteritis Mesenteric adenitis Meckel's diveiculitis Intussusception Henoch-Schonlein purpura Lobar pneumonia Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1209
|
Surgery
|
G.I.T
|
fa214456-a770-4005-bef8-d72c0a78d884
|
Drug distribution is inversely propoional to
|
Plasma protein binding
|
Lipid Solubility
|
fat layer in the body
|
structure of drug
| 0a
|
single
|
The extent of distribution of a drug depends on its lipid solubility, ionization at physiological pH, the extent of binding to plasma and tissue proteins, differences in regional blood flow. If PPB is high VD is low, PPB is inversly propoional to vd drugs with low vd usually have high ppb ref; KD Tripathi pharmacology 6th edition (page no;18)
|
Pharmacology
|
General pharmacology
|
5ee18f01-eb03-4ee3-ba10-4249ed48192d
|
After head injury, biconvex, lenticular shape hematoma in CT scan is characterstic of which of the following ?
|
Extradural haemorrhage
|
Subdural haemorrhage
|
Intracerebral hematoma
|
Diffuse-axonal injury
| 0a
|
single
|
Ans is 'a' ie Extradural haemorrhage CT scan (non-contrast) is the best diagnostic method to evaluate a head injury pt. (better than MRI) On CT scan ? Extradural haemorrhage appears as biconvex lentiform opacity. Subdural haemorrhage appears as concavoconvex crescentic opacity. Intracerebral blood appears on small foci, typically at grey/white matter interface, or more centrally in the white matter.
|
Surgery
| null |
369246f8-0698-4ab3-8556-01b89dacad02
|
True statements regarding octreotide are all of the following except:-
|
It is a somatostatin analogue
|
It is used for treatment of oesophageal variceal bleeding
|
It is contraindicated in acromegaly
|
It is useful in secretory diarrhea
| 2c
|
multi
|
Octreotide is a somatostatin analogue having high potency and long duration of action. It is indicated for the management of: Acromegaly Islet cell tumors Bleeding due to esophageal varices Secretory diarrhea
|
Pharmacology
|
Pituitary-Hypothalmic System and Thyroid
|
0f3bfa5a-9e64-438b-bd93-c4270ed6a49a
|
A 40 year old male, with history of daily alcohol consumption for the last 7 years, is brought to the hospital emergency room with acute onsent of seeing snakes all around him in the room, not recognizing family members, violent behavior and tremulousness for few hours. There is history of his having missed the alcohol drink since 2 days. Examination reveals increased blood pressure, tremors, increased psychomotor activity, fearful affect, hallucinatory behaviour, disorientation, impaired judgement and insight. He is most likely to be suffering from-
|
Alcoholic hallucinosis
|
Delirium tremens
|
Wernicke encephalopathy
|
Korsakoff's psychosis
| 1b
|
multi
|
This person is having symptoms of delirium after alcohol withdrawal → delirium tremens.
|
Psychiatry
| null |
ce306e2a-e5df-4052-b4c3-62b608db21aa
|
Effects of hypokalemia-
|
Acidosis
|
Arrhythmia
|
Ileus of intestine
|
Polyuria
| 0a
|
single
|
* The functional effects of hypokalemia on the kidney can include Na+-Cl- and HCO3- retention, polyuria, phosphaturia, hypocitraturia, and an activation of renal ammoniagenesis. Bicarbonate retention and other acid-base effects of hypokalemia can contribute to the generation of metabolic alkalosis * Hypokalemia is a major risk factor for both ventricular and atrial arrhythmias * Hypokalemia also results in hyperpolarization of skeletal muscle ,thus impairing the capacity to depolarize and contract; weakness and even paralysis may ensue. It also causes a skeletal myopathy and predisposes to rhabdomyolysis. Finally, the paralytic effects of hypokalemia on intestinal smooth muscle may cause intestinal ileus. (REF : harrisons principles of internal medicine, 19E, pg 308)
|
Medicine
|
Fluid and electrolytes
|
f7deac82-a2b3-4739-bc5e-7b6a86107d33
|
The sequestrated lobe of the lung is commonly supplied by-
|
Pulmonary artery
|
Intercostal artery
|
Descending aorta
|
Bronchial artery
| 2c
|
single
|
Pulmonary sequestration
Pulmonary sequestration refers to the presence of a discrete mass of lung tissue without any normal connection to the airway system.
Blood supply to the sequestered area arises not from the pulmonary arteries but from the aorta or its branches.
Sequestration may be of two types -
Extralobar sequestration → Sequestrations are external to the lung and may be found anywhere in the thorax or mediastinum. Most commonly they are associated with other congenital anomalies.
Intralobar sequestration → Found within the lung substance and are usually associated with recurrent localized infection or bronchiectasis.
|
Pathology
| null |
1fe99299-d586-46a5-93c1-ba10b7bf5556
|
What is the recommended daily energy requirement in a 15 kg child
|
1500 KCal
|
1000 KCal
|
1250 KCal
|
1400 KCal
| 2c
|
single
|
Body weight
Recommended daily energy requirement
< 10 Kg
100 KCal / kg
10 - 20 kg
1000 KCal + 50 Kcal / Kg for each kg above 10 Kg
> 20 Kg
1500 KCal + 20 KCal / Kg for each kg above 20 kg
∴ 15 kg child
= 1000 KCal + 50 X 5
= 1250 KCal.
|
Pediatrics
| null |
eda638ee-f543-43cd-b8b4-82e24b1eb7f9
|
Amongst the following, which carries the least chance of transmitting HIV infection: September 2010
|
Heterosexual Intercourse
|
Blood transfusion
|
Veical transmission
|
IV drug abusers
| 0a
|
single
|
Ans. A: Heterosexual Intercourse. Heterosexual Intercourse is the most common route but the chance of infection is less (0.30%) ,looking to the other options. Average per act risk of getting HIVby exposure route to an infected source Exposure routeChance of infection Blood transfusion 90% Childbih (to child) 25% Needle-sharing injection drug use 0.67% Percutaneous needle stick 0.30% Receptive anal intercourse* 0.04-3.0% Inseive anal intercourse* 0.03% Receptive penile-vaginal intercourse* 0.05-0.30% Inseive penile-vaginal intercourse* 0.01-0.38% Receptive oral intercourse*SS 0-0.04% Inseive oral intercourse*SS 0-0.005% * assuming no condom useSS source refers to oral intercourseperformed on a man Most commonly, people get or transmit HIV through sexual behaviors and needle or syringe use. MC mode of transmission: Hetero-sexual In hetero-sexual transmission: Male to female is commoner (as compared to female to male) Chances of transmission with accidental needle prick: 0.3%. Less commonly, HIV may be spread From mother to child during pregnancy, bih, or breastfeeding. Although the risk can be high if a mother is living with HIV and not taking medicine, recommendations to test all pregnant women for HIV and sta HIV treatment immediately have lowered the number of babies who are born with HIV. In extremely rare cases, HIV has been transmitted by Oral sex--putting the mouth on the penis (fellatio), vagina (cunnilingus), or anus (rimming). In general, there's little to no risk of getting HIV from oral sex. Receiving blood transfusions, blood products, or organ/tissue transplants that are contaminated with HIV. This was more common in the early years of HIV, but now the risk is extremely small because of rigorous testing of the blood supply and donated organs and tissues. Eating food that has been pre-chewed by an HIV-infected person. The contamination occurs when infected blood from a caregiver's mouth mixes with food while chewing. The only known cases are among infants. Being bitten by a person with HIV. Each of the very small number of documented cases has involved severe trauma with extensive tissue damage and the presence of blood. There is no risk of transmission if the skin is not broken. Contact between broken skin, wounds, or mucous membranes and HIV-infected blood or blood-contaminated body fluids. Deep, open-mouth kissing if both paners have sores or bleeding gums and blood from the HIV-positive paner gets into the bloodstream of the HIV-negative paner. HIV is not spread through saliva.
|
Social & Preventive Medicine
| null |
08879f4c-5a97-4fd0-a0fb-b185cd3ff25e
|
A 31-year-old man with AIDS complains of difficulty in swallowing. Examination of his oral cavity demonstrates whitish membranes covering much of his tongue and palate. Endoscopy also reveals several whitish, ulcerated lesions in the esophagus. These pathologic findings are fundamentally caused by loss of which of the following immune cells in this patient?
|
B lymphocytes
|
Helper T lymphocytes
|
Killer T lymphocytes
|
Monocytes/macrophages
| 1b
|
multi
|
The fundamental lesion in such case is infection of CD4+ (helper) T lymphocytes There is depletion of this cell population and impaired immune function. As a result, patients with AIDS usually die of oppounistic infections. HIV does infect the monocyte/macrophage lineage (choice D), but infected cells exhibit little if any cytotoxicity. Diagnosis: AIDS
|
Pathology
|
Immunity disorders
|
7d7c3b53-7726-4dbd-b8ef-111058a925cd
|
"Induseum Griseum" is a thin layer of grey matter in proximity to the corpus callosum. How is it related to it?
|
Lateral to the corpus callosum
|
Dorsal to the corpus callosum
|
Ventral to the corpus callosum
|
Medial to the corpus callosum
| 1b
|
multi
|
The convex superior pa of corpus callosum(dorsal) is covered by a thin layer of grey matter, the indusium griseum, embedded in which are the fibre bundles of bilateral medial and lateral longitudinal striae.Superiorly, it is also related to anterior cerebral vessels and cingulate gyrus.Ventrally, it is attached with the convex superior aspect of fornix by septum pellucidum. It is also related to lateral ventricle.(Ref: Vishram Singh textbook of clinical neuroanatomy, second edition pg 164, fig14.4)
|
Anatomy
|
Brain
|
5d1b4888-54f3-42a6-b49f-75820d818683
|
Which of the following is not a branch of Cavernous segment of Internal Carotid aery?
|
Cavernous Branch
|
Inferior Hypophyseal Branch
|
Meningeal branch
|
Ophthalmic branch
| 3d
|
single
|
The ophthalmic aery (OA) is the first branch of the internal carotid aery distal to the cavernous sinus. Branches of the OA supply all the structures in the orbit as well as some structures in the nose, face, and meninges. Occlusion of the OA or its branches can produce sight-threatening conditions.
|
Anatomy
|
Head and neck
|
888fa7cd-b0eb-4861-b83f-05ca09ed9293
|
Consider the following statementI Experimental hypertension can be produced to stimulating sinoaortic nerveII Sino-aortic nerve normally stimulates vasomotor centre Of these statements
|
I is true but II is false
|
Both I and II are true
|
I is false but II are true
|
Both I and II are false
| 0a
|
multi
|
(A) I is true but II is false Stimulation of the noradrenergic nerves to the intestine inhibits contractions in vivo.> Norepinephrine exerts both a & ft actions on the muscle> The b action, reduced muscle tension in response to excitation, is mediated via cyclic AMP and is probably due to increase: tracellular binding of Ca2+.> The a action, which is also inhibition of contraction, is associated with increased Ca2+ efflux from the muscle cells.
|
Physiology
|
Nervous System
|
f7d102c2-f044-41a1-aebf-025a4fab6a93
|
The following graph shows a relation between lung volume and intrapleural pressure changes during inspiration & expiration. What is the most likely cause
|
Due to difference in active and passive work during respiration
|
Due to difference in surfactant during inspiration and expiration
|
Due to difference in airway resistance during inspiration and expiration
|
Due to difference in intrapleural pressure
| 1b
|
single
|
"The pressure volume curve of the lung is not the same in inspiration and exhalation. This difference is called hysteresis, and it is caused by the action of surfactant" The compliance is higher during expiration than during inspiration The difference between the inflation and the deflation paths-hysteresis- exists because a greater transpulmonary pressure is required to open a previously closed airway The alveolar environment, and specifically the secreted factors that help reduce surface tension and keep alveoli from collapsing, contribute to hysteresis.
|
Physiology
|
Respiratory System
|
5c94af56-0a5e-4cb4-960f-ed2d7fda4f8d
|
In JVP y descent is absent and X wave is prominent? Thiscsuggests:
|
Restictive cardiomyopathy
|
Cardiac tamponade
|
Constrictive pericarditis
|
Right Ventricular Failure
| 1b
|
single
|
Ans. (b) Cardiac tamponadeRef.: Harrison 19th ed. /1573JVP FindingsJVP WavesFindingsConstrictive pericarditisFindingsCardiac tamponadeX waveProminentProminentY waveProminentAbsent
|
Medicine
|
C.V.S.
|
1e70ac37-84ed-40cc-bc26-bd491d3611be
|
The most reliable criteria in Guastafson method of age estimation is -
|
Attrition
|
Secondary dentin deposition
|
Transparency of root
|
Cementum apposition
| 2c
|
single
|
Transparency of root is the most reliable criterion in Gustafson's method.
|
Forensic Medicine
| null |
ad3a4e92-2202-46a8-b660-f6c6fe77b79a
|
Who described that P. intermedia is responsible for pregnancy gingivitis?
|
Loesche
|
Kornman
|
Both
|
None
| 2c
|
multi
|
Kornman and Loesche reported that the subgingival flora changes to a more anaerobic flora as pregnancy progresses; the only microorganism that increases significantly during pregnancy is P. intermedia.
|
Dental
| null |
4830ed03-acad-4267-8493-d4b9c1505636
|
Shohl's solution is -
|
Sodium citrate
|
Potassium binding resin
|
Lugol iodine
|
Radio-iodine
| 0a
|
single
|
Answer- A. Sodium citrateSodium citrate (Shohl's solution) or NaHCO: tablets (650-mg tablets contain 7.8 mEq) are equally effective alkalinizing salts.Citrate enhances the absorption of aluminum from the gastrointestinal tract and should never be ginen together with aluminum containing antacids because of the risk of aluminum intoxication.
|
Medicine
| null |
b661b66b-2ad2-40c5-ab90-65e2bcb16e03
|
A woman comes in obstructed labour and is grossly dehydrated. Investigations reveal fetal demise. What will be the MOST appropriate management in this patient?
|
Craniotomy
|
Decapitation
|
Cesarean section
|
Forceps extraction
| 2c
|
single
|
In cases of fetal demise, delivery is the best treatment due to the risk of DIC from retained IUFD. Since this patient is in obstructed labor and is grossly dehydrated, Caesarean section is the treatment of choice. Before 20 weeks of gestation the products are evacuated from the uterus by dilation and evacuation or with mifepristone and misoprostol in some cases. After 20 weeks pregnancy is usually terminated by induction of labor with prostaglandins or high dose oxytocin. Intrauterine fetal demise refers to fetal death after 20 weeks of gestation. Signs: absence of fetal hea tones at a prenatal visit beyond 20 weeks of gestation and absence of uterine growth. Lab: Declining levels of HCG may aid in diagnosis early in pregnancy. Investigation: Ultrasound shows absent fetal cardiac activity beyond 6 weeks of gestation, scalp edema, and fetal maceration. Ref: Blueprints Obstetrics and Gynecology By Tamara Callahan page 101. Manual Of Obstretics, 3/e By Daftary page 324
|
Gynaecology & Obstetrics
| null |
ef0931a2-e322-4cb0-b3ca-19ac74f090e0
|
Fascia around the nerve bundles of brachial plexus is derived from-
|
Deep cervical fascia
|
Pretracheal fascia
|
Prelaryngeal fascia
|
None
| 0a
|
multi
|
Ans. is 'a' i.e., Deep cervical fascia * The axillary sheath is a fibrous sheath that encloses the first portion of the axillary artery, together with the brachial plexus. The axillary vein lies entirely outside the sheath It is an extension of the prevertebral fascia of the deep cervical fascia.* A brachial plexus nerve block can be achieved by injecting anaesthetic into this area.
|
Anatomy
|
Upper Extremity
|
55e8cb62-17bd-4d1d-b23e-ed49342e560c
|
Which of the following is known to be severely pruritic?
|
Lichen planus
|
Psoriasis
|
Icthyosis
|
Secondary syphilis
| 0a
|
single
|
Purple polygonal papules marked by severe pruritus; lacy white markings, especially associated with mucous membrane lesions is feature of lichen planus. Psoriasis is variably pruritic. Icthyosis: characterised by severe dryness, fish like scales. There are 5 P in Lichen Planus:Plain, Purple, Polygonal, Pruritic, Papule/ Plague
|
Dental
|
Lichen planus and Other papulosquamous disorders
|
111a84e0-a7ac-4b5e-9405-66543c44f9cf
|
Cyanosis does not occur in severe anemia because:
|
Hypoxia stimulates erythropoietin production
|
Oxygen carrying capacity of available Hb is increased
|
Critica concentration of Hb required to produce cyanosis is reduced
|
Oxygen Hemoglobin curve shift to the right
| 2c
|
single
|
C i.e. Critica concentration of H required to produce cyanosis is reduced
|
Physiology
| null |
5728205d-8664-4de4-89cf-0652cf549245
|
Information obtained by lateral plate X-ray pelvimetry are all except:
|
Sacral curve
|
True conjugate
|
Bispinous diameter
|
Inclination of the pelvis
| 2c
|
multi
|
Bispinous diameter can be measured by anteroposterior view and not on lateral view of X-ray pelvimetry.
X-ray pelvimetry is of limited value in the diagnosis of pelvic contraction or cephalopelvic disproportion. Apart from pelvic capacity there are several other factors involved in successful vaginal delivery. These are the fetal size, presentation, position and the force of uterine contractions. X-ray pelvimetry cannot assess the other factors. It cannot reliably predict the likelihood of vaginal delivery neither in breech presentation nor in cases with previous cesarean section.
X-ray pelvimetry is useful in cases with fractured pelvis and for the important diameters which are inaccessible to clinical examination.
Techniques: For complete evaluation of the pelvis, three views are taken — anteroposterior, lateral and outlet. But commonly, X-ray pelvimetry is restricted to only the erect lateral view (the femoral head and acetabular margins must be superimposed) which gives most of the useful information. Anteroposterior view can give the accurate measurement of the transverse diameter of the inlet and bispinous diameter.
Hazards of X-ray pelvimetry includes radiation exposure to the mother and the fetus. With conventional X-ray pelvimetry radiation exposure to the gonads is about 885 millirad. So it is restricted to selected cases only.
|
Gynaecology & Obstetrics
| null |
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