id
stringlengths
36
36
question
stringlengths
1
1.57k
opa
stringlengths
1
287
opb
stringlengths
1
287
opc
stringlengths
1
286
opd
stringlengths
1
301
cop
class label
4 classes
choice_type
stringclasses
2 values
exp
stringlengths
1
22.5k
subject_name
stringclasses
21 values
topic_name
stringlengths
3
135
9388fdcc-b63f-4323-84f7-5bd2482980dc
In case of non-hemorrhagic infarct in cerebral coex, reactive astrocytes can be seen as early as ________ after the insult.
1 hr
1 day
1 week
1 month
2c
single
Reactive astrocytes Can be seen as early as 1 week after the insult. As the process of liquefaction and phagocytosis proceeds, astrocytes at the edges of the lesion progressively enlarge, divide, and develop a prominent network of cytoplasmic extensions.
Pathology
Miscellaneous
5d71731b-f2b3-4fb8-b573-a97780bcbc68
Eednaton agent is:
Corynebacterium
Pseudomonas
Mycoplasma
Gonococcus
2c
single
Mycoplasma
Microbiology
null
44f748c7-5f7b-4557-8ec8-481a36f6830e
A 30-year-old male patient came to emergency depament with chief complaint of painful skin rash. Antivirals and analgesics were prescribed but there was no improvement in the symptoms of the patient. Viral strains, therefore isolated and were found to lack viral phosphorylating enzymes. Which of the following drug is most likely to be effective in treatment of this condition?
Acyclovir
Ganciclovir
Famiciclovir
Foscarnet
3d
single
The image shows dermatomal distribution of vesicular lesions which are suggestive of shingles/ herpes zoster. Acyclovir, Famiciclovir, valaciclovir and ganciclovir are nucleoside analogues which must be phosphorylated to nucleotide analogues in order to function. However, if viral strains are lacking in viral phosphorylating enzymes, this step is not possible. This renders these viral strains resistant to these drugs. However, Foscarnet is a pyrophosphate analogue which directly inhibits viral DNA polymerase and therefore, does not require viral phosphorylating enzymes. Another impoant drug is cidofovir, which is a nucleotide analogue and therefore, it also does not require viral phosphorylating enzymes and hence, useful in such cases.
Unknown
Integrated QBank
a77f4667-0736-4e62-b645-079d4d879dde
The calorie content (per 100 ml) of term human milk is:
67
77
87
97
0a
single
Ans. A. 67The calorie intake of term human milk is 67calorie/100ml. Other components of term human milk are:Protein: 1.1g/100mlFat: 4.5gm/100ml
Pediatrics
Nutrition
a0baf13b-8839-48b6-a89d-b182cc31929c
True about coding strand of DNA:
Template strand
Minus strand
Runs at 5- - 3' direction
Runs at 3' - 5' direction
2c
multi
C i.e. Runs at 5'- 3' direction
Biochemistry
null
18914079-1186-42c6-9ce1-57a87b7e593b
As a result of straddle injury, a patient had rupture of bulbar urethra. He presented with urethral bleeding and swelling in the perineum. All of the following are true regarding his management EXCEPT: March 2013
Suprapubic cyststomy
Immediate catheterization
Urethrography
Symptomatic & suppoive
1b
multi
Ans. B i.e. Immediate catheterization Urethra MC cause of urethral stricture: Trauma Pa of urethra injured in pelvic fracture: Membranous urethra Mechanism of urethral injury: Fall astride a projecting object (History of blow to perineum) Triad of ruptured bulbar urethra (Avoid catheterization): - Retention of urine, - Perineal hematoma & - Bleeding from external urinary meatus
Surgery
null
c20ce6ec-cc27-4176-a692-a3b64d9cb5a1
Spleen is derived from -
Ventral mesogastrium
Dorsal mesogastrium
Septum transversorium
Allantois
1b
multi
Ans. is 'b' i.e., Dorsal mesogastrium o Spleen develops as a collection of mesenchymal cells in the dorsal mesogastrium.o Initially the splenic tissue is arranges as a number of lobules which later join together to form a single spleen. The notches in the superior border of adult spleen are representatives of growth that separated the lobules during fetal period.
Anatomy
Spleen
86bfe429-d362-495e-9fb5-e4f0967bce08
Which of the following causes hea failure with reduced ejection fraction?
Restrictive cardiomyopathy
Hemochromatosis
Amyloidosis
Dilated Cardiomyopathy
3d
single
null
Medicine
Hea failure
03053d27-a199-42dc-a54b-c569ef9d90b8
All of the following are true regarding chronic myeloid leukemia, except?
Philadelphia chromosome
Tyrosine kinase inhibitors (TKIs) are the drug of choice
Most cases present in blast phase
Sea-blue histiocytes are seen in the bone marrow
2c
multi
Chronic myeloid leukemia Most common myeloproliferative neoplasm Caused by reciprocal translocation between between long arms of chr 9 & 22 giving rise to shoened chromosome 22 which is referred to as Philadelphia chromosome (Ph chromosome). Most cases present in chronic phase Patient present with hyperleucocytosis, massive splenomegaly Bone marrow is hypercellular with granulocytic hyperplasia. Sea-blue histiocytes can be seen. After a variable period, some patients may transform to accelerated phase or blast crisis. Tyrosine kinase inhibitors are the drug of choice, eg. Imatinib, Dasatinib, etc.
Pathology
Chronic Myelogenous Leukemia
a414234a-d852-4c1c-9cb8-eace94e6522b
The prothrombin time is high in a patient with liver disease. However, the prothrombin time is normalized after the injection of vitamin K. This is a feature in
Severe hepatocellular disease
Chronic alcoholic liver disease
Deficiency of hepatic g-carboxylase
Cholestatic liver disease
3d
single
null
Medicine
null
551e6c0d-6ae5-4fde-99c4-982886ee91ce
Which of the following not causes lens dislocation:
Ehlers-Danlos syndrome
Marfan's syndrome
Sulphite oxidase deficiency
Diabetes mellitus
3d
single
D. Diabetes mellitusEctopia Lentis with Systemic Anomalies Khurana 6th/2l5-l61. Marfan's syndrome: In this condition lens is displaced upwards and temporally (bilaterally symmetrical)2. Homocystinuria: In it the lens is usually subluxated downwards and nasally.3. Weil-Marchesani syndrome: forward subluxation of lens which may cause pupil block glaucoma.4. Ehlers-Danlos syndrome. In it the ocular features are subluxation of lens and blue sclera.5. Hyperlysinaemia: It is an extremely rare condition occasionally associated with ectopialentis.6. Stickler syndrome. Ectopialentis is occasionally associated in this condition7. Sulphite oxidase deficiency: Ectopialentis is a universal ocular feature.(Parson 22nd/275): Causes of Ectopia lentisA. FamilialAutosomal dominant formAutosomal recessive form (associated with iris coloboma, aniridia, microspherophakia, ectopiapupillae)B. Other systemic diseasesMarfan, Ehlers-Danlos, Weil-Marchesani, Homocystinuria, Sulphite oxidase deficiency, HyperlysinaemiaC. Secondary to eye diseasesUveitis, hypermature cataract, pseudoexfoliation syndrome, ciliary body tumourD. Secondary to trauma(May or may not be associated with underlying defective zonules due to syphilis)
Ophthalmology
Lens
f81691b3-4a7c-41ed-906e-6b6b05825b65
Subpubic angle in female is
70 degrees
90 degrees
120 degrees
180 degrees
1b
single
Ans. is 'b' i.e., 90 degrees PELVISTraitMaleFemale1) Bony frameworkMassive, rougher, marked muscle sites. Stands higher and more erect.Less massive, slender, smoother.Less muscle marking.2) GeneralDeep funnel.Flat bowl.3) IliumLess vertical; curve of iliac crest reaches higher level and is more prominent.More vertical; distance between iliac crests is less; iliac fossae shallow; curves of crest well marked.4) Preauricular sulcus (attachment of anterior sacroiliac ligament)Not frequent; narrow, shallow.More frequent, broad and deep5) AcetabulumLarge, 52 mm. in diameter; directed laterallySmall, 46 mm. in diameter; directed anterolaterally.6) Obturator foramenLarge, often oval with base upwardsSmall, triangular with apex forwards.7) Greater sciatic notchSmaller, narrower, deeper.Larger, wider, shallower.8) Illeo-pectineal lineWell marked and rough.Rounded and smooth.9) Ischial tuberosityInvertedEverted; more widely separated10) Body of pubisNarrow, tirangular, thick; short is chial ramus.Broad, square; ischial ramus is lengthened and narrowed; pits on posterior surface if borne children.11) Ramus of pubisIt is like continuation of body of pubis.Has a constricted or narrowed appearance and is short and thick.12) Ischiopubic ramiMore everted, thicker and rougher.Less everted, thinner and smoother.13) SymphysisHigher, bigger and narrow in width.Margins of pubic arch everted.Lower, wider and rounded, margins of pubic arch not everted; distance between two pubic tubercles greater. The dorsal border is irregular and shows depressions or pits (scars of parturition).14) Subpubic angleV-shaped, sharp angle 70deg to 75deg.U-shaped, rounded, broader angle 90deg to 100deg15) Pelvic brim or inletHeart-shapedCircular or elliptical; more spacious; diameters longer.16) Pelvic cavityConical and funnel-shapedBroad and round17) Pelvic outletSmallerLarger18) Sacroiliac articulationLarge, extends to 2 1/2 to 3 vertebrae.Small, oblique, extends to 2 to 2 1/2 vertebrae.19) Sacroliliac joint surfaceLarge and less sharply angulated.L-shaped and elevated anteriorly.20) SacrumLonger, nanrower, with more evenly distributed curvature; promontory well marked. Body of first sacral vertebra larger.Shorter, wider; upper half almost straight, curve forward in lower half; promontory less marked.Body of first sacral vertebra small.21) CoccyxLess movableMore movable22) Ischiopubic index73 to 9491 to 115 Public length in mm.------------------Ischial length in mm.x 100 23) Sciatic notch index4 to 55 to 6 Width of notch index------------------Depth of sciatic notchx 100 24) Pubic ramus ratio1:12 : 1 or greater
Forensic Medicine
Law & Medicine, Identification, Autopsy & Burn
15a89bc0-1e2e-4664-9557-a897d2cee4a6
An important difference between leuprolide and ganirelix is that ganirelix:
Can be given orally
Immediately reduces gonadotropin secretion
Must be given in a Pulsatile fashion
Initially stimulates release of LH and FSH
1b
multi
GnRH agonists like leuprolide, goserelin and nafarelin etc. are used by parenteral route. Continuous administration of these agents decreases gonadotropin secretion whereas pulsatile administration increases the secretion. When used continuously even then first few doses cause increased secretion of gonadotropins (LH and FSH) leading to flare up reaction in prostatic carcinoma. GnRH antagonists like cetrorelix and ganirelix are also used by parenteral route but these drugs immediately reduce gonadotropin secretion.
Pharmacology
null
ebe8161c-c6e8-4137-8cd1-af4f9e5ea810
Goose skin or cutis anserina seen in :
Drowning
Lightening
Strangulation
Fire arm injury
0a
single
A i.e. Downing Cutis anserina or Goose skin is seen in drowningQ; but has no value as a diagnostic sign of death from drowning
Forensic Medicine
null
6c333536-267b-4caa-a01a-e032ed3069b1
Thiazide diuretics can be used for the treatment of all of these conditions except:
Idiopathic hypercalciurea with nephrocalcinosis
Hyperlipidemia
Congestive Heart Failure
Hypertension
1b
multi
Ans. (B) Hyperlipidemia(Ref: KK Sharma 2/e p230-231)Thiazides cause hyperlipidemia as adverse effect and thus cannot be used to treat this condition.Indications of thiazides:Diuretic UsesNon-diuretic UsesHypertension (First line drugs)Diabetes insipidusCongestive heart failureIdiopathic hypercalciurea with Nephrocalcinosis
Pharmacology
Diuretics and Antidiuretics
389452f0-5f7b-4f38-ab3c-c6d78c028202
Medial border of Hesselbach's triangle is formed by:
Linea alba
Linea semilunaris
Inferior epigastric artery
Conjoint tendon
1b
single
Ans. (b) Linea semilunarisRef: Gray's 41st edn/1080-81; Keith L Moore clinical anatomy 4thed/ 193-4# HESSELBACH'S TRIANGLE* Medial border: Lateral margin the rectus sheath, also called linea semilunaris* Superolateral border: Inferior epigastric vessels* Inferior border: Inguinal ligament, sometimes referred to as Pouparts ligament.
Anatomy
Abdominal Wall
a727370f-3970-4aa5-802d-4a3abf62522d
A Middle aged man brought to casualty with unilateral headache, right eye congested and painful, with sudden vision loss. The diagnosis is
Angle Closure Glaucoma
Corneal edema
CRVO
CRAO
0a
single
(A) Angle Closure Glaucoma# Angle-closure glaucoma, also known as narrow-angle glaucoma, is caused by blocked drainage canals in the eye, resulting in a sudden rise in intraocular pressure.> This is a much more rare form of glaucoma, which develops very quickly and demands immediate medical attention. Symptoms of angle-closure glaucoma may include:> Hazy or blurred vision: The appearance of rainbow-colored circles around bright lights Severe eye and head pain Nausea or vomiting (accompanying severe eye pain) Sudden sight loss
Ophthalmology
Miscellaneous
52ab218a-e65e-4f1d-b6a7-e8b41ecfe628
Malonyl acetyltransferase has an activity of how many enzymes-
1
2
3
4
1b
single
Ans. is 'b' i.e., 2 o Malonyl acetyl transferase (MAT) is a part of multienzyme complex : Fatty acid synthase.It has two activities:-Acetyl transferase or acetyl transacylase (El)Malonyl transferase or malonyl transacylase (E2)Fattv acid svnthaseo Fatty acid synthase is a multienzyme complex containing seven enzyme activities and an acyl carrier protein (ACP).o The seven enzyme activities are -Acetyl transacylase (El)Molonyl transacylase (E2)Ketoacyl synthase (E3)Ketoacyl reductase (E4)Hydratase (E5)Enoyl reductase (.E6)Thioesterase (E7)o Fatty acid synthase complex in a dimer composed of two identical monomer units.
Unknown
null
4bf60488-1574-4a3e-af43-5966598a85f6
All can cause recurrent pulmonary infection except:
VSD
Recurrent LVF
TOF
ASD
2c
multi
Answer is C (TOF) ASD, L VF and VSD are all associated with pulmonary congestion and hence predispose to pulmonary infections. TOF is associated with reduced pulmonary blood flow (oligenic lung fields) due to right ventricular outflow obstruction and hence does not predispose to recurrent pulmonary infections.
Medicine
null
08d4e20f-db99-4e39-a03d-70af23634dd6
Selective V2 receptor agonist useful for the treatment of central diabetes insipidus is :
Arginine vasopressin
Desmopressin
Lypressin
Terlipressin
1b
single
null
Pharmacology
null
86aa497f-98c5-4ada-a7a8-7c8f18895bf4
A young permanent incisor with an open apex has a pinpoint exposure due to a traumatic injury that occurred 24 hours previously. The best treatment is
Place calcium hydroxide on the pinpoint exposure
Open the pulp chamber to find healthy pulp tissue and perform a pulpotomy
Initiate a calcium hydroxide pulpectomy
Initiate conventional root canal treatment with gutta-percha
1b
single
Because the exposure site is likely significantly contaminated from the injury that occurred 24 hours previously, direct pulp capping with calcium hydroxide is contraindicated. A calcium hydroxide pulpectomy should not be the automatic procedure accomplished because continued root elongation and closure of the pulp canal will likely not occur. A calcium hydroxide pulpotomy is preferable for a traumatized tooth with an open apex with either a large exposure or a small exposure of several hours or days postinjury. Clinically, the tooth should be anesthetized and, under sterile conditions, and the clinician should open the pulp chamber in search of healthy pulp tissue. It is likely that vital tissue will be present within 24 hours of the injury.
Dental
null
2caa467b-8e29-437c-8f1f-d8ec622a827a
Cerebellar toxicity is seen with :
Cisplatin
Cytarabine
Bleomycin
Actinomycin D
1b
single
Cytarabine causes cerebellar ataxia.
Pharmacology
null
136dc8a9-c48e-4268-a51d-b680e96b8ecc
Embgryological development of the human vertebra is from -
Somite
Endoderm
Ectoderm
None
0a
multi
null
Anatomy
null
89ad1c15-d1df-4b13-ba60-60312adf1535
Left Kidney is preferred for transplantation because
Longer renal Vein
Higher location
Ease of surgery due to anatomical relations
To prevent damage to liver
0a
single
The left kidney is preferred because of implantation advantages associated with a longer renal vein making anastomosis easier Also know, procurement of kidney, In a brainstem dead donor, the organ to be procured should be preserved to maintain its functional integrity. For this purpose the organ should be perfused with organ preservative solution twice before it is transplanted to the recipient. The first perfusion is done just after the abdomen is opened at laporotomy and the second perfusion is done just after the organ has been removed from the donor. Commonly used preservative solutions include UW solution (University of Wisconsin) and Eurocollins solution. After removal from the donor, the organ is placed in two sterile bags and stored at 0-4degC by immersion in ice while they are transpoed to the recipient centre Ref srb's manual of surgery 5e p993 , Internet
Anatomy
Urology
b7c09536-4a95-4984-b21e-c1d327af9706
Orientia Tsutsugamushi causes:
Epidemic typhus
Endemic typhus
Scrub typhus
Q fever
2c
single
Disease Causative organism Vector Epidemic typhus R. prowazekii Louse Endemic typhus R.typhi Flea Scrub typhus Orientia Tsutsugamushi Mite Q fever Coxiella No ahropod transmission
Microbiology
Systemic Bacteriology (Haemophilus, Yersinia, Spirochaetes, Ricketssia, Chlamydia, Mycoplasma and Miscellaneous Bacteria)
25d670fc-4958-4e5c-9906-99ff737f4a08
Local lymph nodules are enlarged near the infected wound. Increased amount of macrophages, lymphocytes, lymphatic follicles in the coical layer and large amount of plasma cells were revealed on histological examination. What process in the lymphatic nodules represent these histological changes?
Antigen stimulation
Acquired insufficiency of the lymphoid tissue
Tumour transformation
Innate insufficiency of the lymphoid tissue
0a
single
In the given question there is enlargement of local lymph nodes near the infected wound. Histologically:- Presence of Macrophages, Lymphocytes, Lymphatic follicles in the coical layer and large amount of Plasma cells. It is because the antigens from the wound are going to be drained to the lymph node. These antigens will cause B cell activation, once the B cell are going to be activated, they are going to get conveed into the Plasma cell and that is responsible for causing enlargement of the lymph node. Therefore, after any kind of infection or any kind of inflammation the reactive lymph node enlargement will occur and this is explained on the basis of Antigen stimulation.
Pathology
Basic Concepts
3b761e90-a516-4e9e-a275-ceb2e705d271
Which of the following is not a feature of Syndenham's chorea?
Hypotonia
Unintelligible speech
Emotional lability
Seizures
3d
single
Sydenham chorea (SC) is a neurological disorder of childhood resulting from infection Group A beta-hemolytic streptococcus (GABHS), the bacterium that causes rheumatic fever. SC is characterized by rapid, irregular, and aimless involuntary movements of the arms and legs, trunk, and facial muscles. Sydenham's chorea is characterized by the abrupt onset (sometimes within a few hours) of neurologic symptoms, classically chorea, usually affecting all four limbs. Other neurologic symptoms include behavior change, dysahria, gait disturbance, loss of fine and gross motor control with resultant deterioration of handwriting, headache, slowed cognition, facial grimacing, fidgetiness and hypotonia. Also, there may be tongue fasciculations ("bag of worms") and a "milk sign", which is a relapsing grip demonstrated by alternate increases and decreases in tension, as if hand milking. Non-neurologic manifestations of acute rheumatic fever are carditis, ahritis, erythema marginatum, and subcutaneous nodules. The PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) syndrome is similar, but is not characterized by Sydenham's motor dysfunction. PANDAS presents with tics and/or a psychological component (e.g., OCD) and occurs much earlier, days to weeks after GABHS infection rather than 6-9 months later. It may be confused with other conditions such as lupus and Tourette syndrome. Movements cease during sleep, and the disease usually resolves after several months. Unlike in Huntington's disease, which is generally of adult onset and associated with an unremitting autosomal dominant movement disorder and dementia, neuroimaging in Sydenham's chorea is normal and other family members are unaffected. Other disorders that may be accompanied by chorea include abetalipoproteinemia, ataxia-telangiectasia, biotin-thiamine-responsive basal ganglia disease, Fahr disease, familial dyskinesia-facial myokymia (Bird-Raskind syndrome) due to an ADCY5 gene mutation, glutaric aciduria, Lesch-Nyhan syndrome, mitochondrial disorders, Wilson disease, hypehyroidism, lupus erythematosus, pregnancy (chorea gravidarum), and side effects of ceain anticonvulsants or psychotropic agent Ref Davidson 23rd edition pg 1025
Medicine
Miscellaneous
3cfcb9f6-855d-4b35-a3bf-3d65ddc8a154
The most common lysosomal storage disorder is
Gaucher's disease
Taysach's disease
Wolman disease
Niemann pick's disease
0a
single
Ans. (a) Gaucher's diseaseRef: Harper's Biochemistry, 30th ed. pg. 251LYSOSOMAL STORAGE DISEASE* Lyzosomal storage disorders are a group of approximately 50 rare inherited metabolic disorders that result from defects in lysosomal function.* Lysosomal storage disorders are caused by lysosomal dysfunction usually as a consequence of deficiency of a single enzyme required for the metabolism of lipids, glycoproteins (sugar containing proteins) or so-called mucopolysaccharides.* Gaucher's disease is the most common of the lysosomal storage diseases. It is a form of sphingolipidosis (a subgroup of lysosomal storage diseases), as it involves dysfunctional metabolism of sphingolipids.* The disorder is characterized by bruising fatigue, anemia, low blood platelets, and enlargement of the liver and spleen.
Biochemistry
Lipids
be80457c-8f9a-4987-b63d-1da5193ea4ea
Blister formation in burn case is in –
Intraepidennal
Subepidermal
Subdermal
Subfascial
1b
single
null
Dental
null
f295cb33-ca3c-4b1d-9118-97a4ccc3686d
Soap bubble appearance at lower end of radius, the treatment of choice is:
Local excision
Excision and bone grafting
Amputation
Radiotherapy
1b
single
Treatment for GCT at commoner sites is as given in Table Site Treatment of choice Lower end of femur Excision with Turn-o-Plasty Upper end of tibia Excision with Turn-o-Plasty Lower end of radius Excision with fibular grafting Lower end of ulna Excision Upper end of fibula Excision
Surgery
null
b5c2a3df-cf94-4cb9-82f1-4c1a3618702d
Retraction of tympanic membrane touching the promontory. It is called -
Mild retraction
Severe retraction
Atelectasis
Adhesive otitis
2c
multi
Ans. is 'c' i.e., Atelectasis Sade's grading of Pars tensa retractionGradeTitleDescription1Retracted earSlight retraction of ear drum2Severe retractionRetracted drum touching the incus or stapes3AtelectasisTympanic membrane touching promontory4Adhesive otitisTympanic membrane adherent to promontory5 Spontaneous perforation of atelectatic ear drum with otorrhea & polyp formation
ENT
Disorders of Middle Ear (Otitis Media)
0b86d9d2-31e1-41ae-93c9-c17e91d2ad0b
KFD is caused by?
Flavivirus
Myxovirus
Alphavirus
Phlebovirus
0a
single
Ans. (a) FlavivirusRef: Jawetz 24thed ch-38
Social & Preventive Medicine
KFP
38744f55-59f5-45af-b8ff-70be9b79ecfa
Which of the following is not a prerequisite for transvaginal sonography (TVS)?
Consent
Full bladder
Empty bladder
Lithotomy position
1b
single
Ans-BREF: Danforth s Obstetrics and Gynaecology 10th edition page 541-542Transabdominal sonography (TAS)Transvaginal sonography (TVS)TAS uses lower frequency sound waves (3.5 to 5.0 MHz) to allow for the deeper penetration required to visualize intra-abdominal structures.TVUS uses higher frequency sound waves (5 to 8 MHz), which allow higher image resolution but with less tissue penetration.Image clarity is comparatively lower.TAS is most useful in fully assessing large masses that extend out of the pelvis.Image clarity with TVUS usually is superior when evaluating ovarian abnormalities as compared with TAS.Helpful to distinguish between ovarian and uterine masses.In addition, TVUS with Doppler sonography affords assessment of the flow of blood within vessels adjacent to and within the uterus and ovaries.Where TVS cannot be performed, such as in pediatric or adolescent patients. Best performed with a fully distended urinary bladder, enabling a better acoustic window without interfaces to reflect echoes to visualize the uterus and adnexa.Best performed in patients placed in the lithotomy position with an empty bladder.Consent required.Consent required.
Unknown
null
06b7b438-c67c-4808-bcd7-f2367cd155c7
80 kg male with bilateral upper limb, right lower limb with perineum burns 3rd degree, amount of fluid required in first 8 hours is
3920 ml
4920 ml
5920 ml
6560 ml
3d
single
Answer- D. 6560 mlThe amount of fluid required fot the above patient = 4ml x 80 x 41 = 13120 ml.Half of the calculated fluid is gtum in first 8 hrs and half in next 76 hrs.So the amount of fluid to be given in the first hrs = total fluid required/ 2 = 1312O/ 2 = 6560ml
Surgery
null
79018154-facf-41d9-bec1-91202cf17564
Which of the following is seen in megaloblastic anemia
Howell Jolly bodies
Cabot ring
Basoptilic stippling
All of the above
3d
multi
All the 3 features can be seen in Megaloblastic anemia.
Pathology
null
f595d190-ba27-44d1-b3c1-ab5461e23142
The classical lobule of the liver is centred around
Postal vein
Bile duct
Central vein
Hepatic aery
2c
single
The "classic" liver lobule is the sixsided polyhedral prism with poal triads (hepatic aery, poal vein, and bile duct) at each of the corners. The vessels of the poal triads send distributing branches along the sides of the lobule, and these branches open into the sinusoids. The long axis of the lobule is transversed by the central vein, and this vessel receives blood from the sinusoids. Interconnecting sheets of hepatocytes are disposed in a radial pattern from the central vein to the perimeter of the lobule. Ref - pubmed.com
Anatomy
General anatomy
9d816ca7-2ae8-4fc3-992e-8afae1b6a2bb
Which of the following germ cell tumor is malignant
Leyidg cell tumor
Seoli cell tumor
Seminoma
Dermoid cyst
2c
single
In postpubeal males, 95% of testicular tumors arise from germ cells, and all are malignant. Seminomas are soft, well-demarcated, gray-white tumors that bulge from the cut surface of the affected testis. Large tumors may contain foci of coagulation necrosis, usually without hemorrhage. Microscopically, seminomas are composed of large, uniform cells with distinct cell borders, clear, glycogen-rich cytoplasm, and round nuclei with conspicuous nucleoli Robbins Basic Pathology. Ninth edition. Page no 659,660 points to note Genetic alterations in seminoma: Isochromosome p12 Mutations of KIT (oncogene) KIT amplification. Seminoma: Positive for: KIT PLAP AFP is NEVER elevated in seminoma. Seminomas almost never occur in infants. Spermatocytic seminoma: Tumor cells have a nucleus with spireme chromatin.
Pathology
Urinary tract
ebb6005a-8b56-42d4-90f3-20ea5019aa6a
Oxygen Hb dissociation curve: Inulin clearance closely resembles:
GFR
Renal plasma flow
Creatinine clearance
PAH clearance
0a
single
GFR
Physiology
null
a68ba389-6898-489c-9639-90848c5cb1fa
Which of the following abolishes the therapeutic effect of levodopa:
Thiamine
Carbidopa
Pyridoxine
Benserazide
2c
single
Pyridoxine abolishes therapeutic effect of levodopa by enhancing peripheral decarboxylation of levodopa, less is available to cross to the brain. Ref KD Tripathi 8th ed.
Pharmacology
Central Nervous system
f5d32952-a279-4050-9554-caeccb204bcf
Sjogren's syndrome refers to disease of ?
Parotid glands
Thyroid disease
Parathyroid glands
Multiple endocrine neoplasia
0a
single
Ans. is 'a' i.e., Parotid glands
Surgery
null
bef82857-e765-4c72-af2c-a4763a8c94a3
Transducin is a protein found in:
Glomerulus
Retina
Skeletal muscle
Adrenal medulla
1b
single
Retina REF: Ganong 22nd edition, chapter 8, http://en.wikipedia.org/wiki/Transducin Transducin (also called Gt) is a heterotrimeric G protein that is naturally expressed in veebrate retina rods and cones. Mechanism of action: Heterotrimeric Transducin (alpha-beta-gamma subunits) is activated by a conformational change in rhodopsin due to the absorption of a photon by rhodopsin's active group retinal. Activation causes the GDP bound to the alpha subunit to be exchanged with GTP from solution and results in activated alpha dissociating from beta-gamma. Active Transducin-alpha then causes cyclic GMP Phosphodiesterase to increase its activity, thereby lowering the concentration of cGMP, an intracellular second-messenger molecule. Decrease in cGMP concentration leads to the closure of cGMP-regulated Na+ and Ca2+ ion channels and a hyperpolarized membrane potential. This chain of signaling events is also called "the veebrate photo transduction cascade"
Ophthalmology
null
cfac1ec5-13ee-458e-b344-6ab6053079ff
A 10 month child weighing 5 kg and 65 cm presents with cough and cold. He was found to have a respiratory rate of 48 per minute with no retractions, grunting, cyanosis. There is no history of convulsions. Which is true ?
No pneumonia, only cough and cold
Child has pneumonia
Severe pneumonia
Very severe disease
0a
multi
SIGNS AND SYMPTOMS CLASSIFICATION THERAPY WHERE TO TREAT cough or cold no fast breathing no chest indrawing No pneumonia home remedies home respiratory rate/min .>60 in<2 months age >50 in2-12 months >40 in1-5 years chest indrawing pneumonia cotrimoxazole home chest indrawing cyanosis severe pneumonia IV/IM Penicillin hospital Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:356,7th edition
Pediatrics
Respiratory system
6e51982d-aaa8-4801-958f-36e5a3f3132e
In a patient with hypertrophied adenoids, the voice abnormality that is seen is -
Rhinolalia clausa
Rhinolalia aperta
Hot potato voice
Scatacto voice
0a
single
Rhinolalia clausa is lack of nasal resonance (hyponasality). It is seen in conditions which block the nose or nasopharynx. So will be see in case of allergic rhinitis, adenoids and nasal polpys. Palatal paralysis will lead to hypernasality and not hyponasality
ENT
null
a5f0414b-8148-4b52-b5e6-8d1656bcd31e
Which route of drug administration avoids first pass hepatic metabolism and is used with drug preparation that slowly releases drugs for periods as long as seven days ?
Topical
Transdermal
Sublingual
Oral
1b
single
null
Pharmacology
null
22b6cb0c-b0bd-420e-a246-e3dd8ce98def
Ectocervix is lined by:
Non-ciliated columnar epithelium
Stratified squamous epithelium
Ciliated columnar epithelium
Cuboidal epithelium
1b
single
Epithelium of cervixThe epithelium of the cervix is varied.The ectocervix (more distal, by the vagina) is composed of nonkeratinized stratified squamous epithelium.The endocervix (more proximal, within the uterus) is composed of simple columnar epithelium.
Anatomy
null
53349460-5ad4-4718-a18d-bf77552ef2f4
Bronchial secretion secretes -
IgA
IgE
IgM
IgG
0a
single
In its secretory form, IgA is the main immunoglobulin found in mucous secretions, including tears, saliva, sweat, colostrum, and secretions from the genitourinary tract, gastrointestinal tract, prostate, and respiratory epithelium. It is also found in small amounts in the blood Ref: Ananthanarayan & Parker's textbook of microbiology 9th edition pg:97
Microbiology
Immunology
4717beb0-7985-45e5-b8a7-08d48f51af1b
Age of adolescence:
10-14 years
14-20 years
6-10 years
1-3 years
1b
single
Infants (0 to 1 year old) Toddlers (1 to 3 years old) Preschoolers (3 to 6 years old) School-aged children (6 to 12 years old) Adolescents (12 to 19 years old).
Dental
null
0fe3f919-414c-475b-a89d-ecd9c7459185
True about hepatitis with HCV is:
Present with fulminant liver failure
Chronicity is not seen
Genotyping helps in treatment duration
Feco/oral transmission
2c
multi
Genotyping is helpful for predicting the likelihood of response and duration of treatment. Patients with genotypes 1 and 4 are generally treated for 12 months, whereas 6 months of treatment is sufficient for other genotypes. Genotyping can be performed by direct sequence analysis, reverse hybridization to genotype-specific oligonucleotide probes, or restriction fragment length polymorphisms(RFLPs).
Medicine
Hepatitis
08f001a2-5384-4899-8c2a-39193449ad3c
Omeprazol is used in the treatment of
Peptic Ulcer
Amoebiasis
Malaria
Cholera
0a
single
null
Pharmacology
null
199e23cf-838f-4e61-a722-c73c8694e022
Closing of midline diastema by using a removable appliance
Reciprocal single simple anchorage
Reciprocal simple compound anchorage
Reciprocal stationary single anchorage
Reciprocal stationary compound anchorage
0a
single
null
Dental
null
546c8720-82c5-40e0-8191-f8c4bab4a6d6
A 3 year old boy with normal developmental milestones with delayed speech and difficulty in communication and concentration. He is not making friends. Most probable diagnosis is ?
Autism
ADHD
Mental retardation
Specific learning disability
0a
single
Ans. is 'A' i.e., Autism Delayed speech, difficulty in communication and concentration in a 3 year old child suggests the diagnosis of autism. Autism is characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organize It is one of three recognized disorders in the autism spectrum, the other two being Asperger syndrome, which lacks delays in cognitive development and language, and pervasive developmental Disorder-not otherwise specified (commonly abbreted as PDD-NOS)
Pediatrics
null
eb5bb5a9-deb4-4cea-927b-7259da3b0583
A patient with chronic renal failure and bone pains will have deficiency of which vitamin:
Vitamin A
Vitamin B
Vitamin C
Vitamin D
3d
single
null
Biochemistry
null
a28a7eac-9186-4748-923a-6bc729b52fb7
Fascia around nerve bundle of brachial plexus is derived from
Preveebral fascia
Pretracheal fascia
Investing layer
Superficial cervical fascia
0a
single
The muscular floor of the posterior triangle is covered by preveebral layer of deep cervical fascia which forms the fascial carpet of the floor of posterior triangle.The axillary sheath around subclan aery and brachial plexustravelling from root of neck to the upper limb.pus collected in the posterior triangle deep to its fascial carpet from tubercular cervical veebrae may track downwards and laterally along the axillary sheath to first appear in the axilla or even in the arm subsequently.Reference: Textbook of anatomy, Upper limb, and thorax, Vishram Singh, 2nd edition, page no.80
Anatomy
Upper limb
0896a4c7-a828-4cb7-937c-1d3bbc5ac858
X-ray view for fracture patella
Skyline view
Judet view
Water's view
Oblique view
0a
single
null
Orthopaedics
null
d5c40b25-eea6-4a03-baf4-dedd6921a02f
In psychiatry, personal history does not include:
Food preference
Academic history
Occupational history
Marital history
0a
single
Ans: A. Food preferenceThough food preference is an impoant pa of personal history elsewhere, it is not as impoant as the other options in diagnosing psychiatric conditions or planning their management.Components of Personal and Social History: Perinatal history; Childhood history; Educational history; Pubey history; Menstrual and obstetric history; Occupational history; Sexual and Marital history
Psychiatry
null
6a8c929e-07a4-4882-b631-4b85a5b4ab22
Which of the following is the classical triad of Budd-Chiari syndrome?
Fever, jaundice, abdominal pain
Fever, ascites, jaundice
Hepatomegaly, abdominal pain, ascites
Abdominal pain, jaundice, hepatomegaly
2c
single
Classical triad of Budd - Chiari syndrome is Ascites Hepatomegaly (Mnemonic - AsHA) Abdominal pain Etiology of Budd - Chiari syndrome: Hepato-venous outflow obstruction caused by Hepatic venous Thrombosis /IVC obstruction Acutely obstruction results in tender hepatomegaly. Chronically liver is atrophied but caudate lobe will be hyperophied IOC for diagnosis - venography TOC in hepatic failure - liver transplantation TOC in Hepatic vein thrombosis - shunt - preferred shunt is side to side poocaval shunt
Surgery
Poal Hypeension
52a57bad-2d61-47b6-838b-72707d51fd14
Phenylketonuria is -
AD
AR
X linked dominant
X linked recessive
1b
single
Ans. is 'b' i.e., ARAutosomal recessive disordersMetabolicHematologicalEndocrineSkeletalNarvouso Cystic fibrosiso Phenylketonuriao Galactosemiao Homocystinuriao Lysosomal storage diso a1-antitrypsin deficiencyo Wilson diseaseo Hemochromatosiso Glycogen storage disorderso Sickle cell anemiao Thalassemiaso Congenital adrenal hyperplasiao Albinismo EDS (some variants)o Alkaptonuriao Friedreich ataxiao Spinal muscular atrophyo Neurogenic muscular atrophies
Pathology
Mendelian Disorders: Single-Gene Defects
d2af718b-b2fe-4fff-9d4c-6f631fdd7765
Which of the following parasite does not enter into the body by skin penetration :
Dracunculus
Necatar Americana
Ancylostoma duodenale
Stronglyoides
0a
single
Ans. is 'a' i.e. Dracunculus Dracunculus enters the body through ingestion of Cyclops along with water.Mode of entry of intestinal nematodes:* Ingestion of eggs-Ascaris & Trichuris trichiura* Skin penetration by 3rd stage larva-Ancylostoma duodenale* Ingestion of uncooked meat-Necator Americana Strongyloides stercoralis Trichinella spiraliscarrying the larva * Mode of entry of tissue nematodes:* Dracunculus-Drinking water containing cyclops* W. bancrofti-Mosquito bite* B. Malayi-Mosquito bite* Loa - Loa-Deerflies* Onchocerca volvulus-Blackfly
Unknown
null
7d389cb6-e142-47c5-a617-af8263daa124
To eradicate measles the percentage of population to be vaccinated is at least............%
70
80
85
95
3d
single
95
Social & Preventive Medicine
null
35caef87-fd44-49b2-808d-0c391ca1c525
Which of the following is a duty of multipurpose worker male: March 2010
He will visit schools at regular interval in the PHC
Organizes staff meetings
Regularly visit to every house in his area
Attends patients in the OPD
2c
single
Ans. C: Regularly visit to every house in his area It has been said to the credit of a competent MPHW that he knows his wards as a shepherd knows his sheep.
Social & Preventive Medicine
null
12b14a4f-d023-41ef-aee3-36204c0f3844
All of the following are the electrocardiographic features of Hyperkalemia, except-
Prolonged PR interval
Prolonged QT interval
Sine wave patterns
Loss of P waves
1b
multi
Early ECG changes of hyperkalemia, typically seen at a serum potassium level of 5.5-6.5 mEq/L, include the following: Tall, peaked T waves with a narrow base, best seen in precordial leads. Shoened QT interval. ST-segment depression . Ref Harrison 20th edition pg 1411
Medicine
C.V.S
166fb457-11f7-4675-939f-207cca8605dc
Denominator for calculating perinatal moality rate is: September 2009
1000 bihs
1000 live bihs
1000 still bihs
1000 population
1b
single
Ans. B: 1000 live bihs 164. Perinatal moality, defined as number of stillbihs (28 weeks of gestation and more) and deaths in the first week of life (early neonatal deaths) per 1,000 live bihs, is a useful additional indicator, and work is ongoing to improve estimates of stillbih rates, a major component of perinatal moality.
Social & Preventive Medicine
null
22f17ff2-59d1-4d47-9135-241f3bee0ddf
Tear drop sign is seen in:
Fracture of floor of orbit
Fracture of lateral wall of nose
Le Fo's fracture
Fracture on zygomatic arch
0a
multi
"Tear Drop" sign is a radiological sign seen in blow out fracture of orbit. It signifies entrapment and herniation of orbital content through a defect in floor of orbit into maxillary antrum.
ENT
null
a3b924a6-878a-4685-b18b-184a5db04d95
Thymus gland abscess seen in congenital syphilis is called as
Fouchier’s abscess
Politzeri abscess
Douglas abscess
Dubois' abscess
3d
multi
Abscesses of the thymus gland were first described by Dubois in 1850 as a product of congenital syphilis. Chiari believed that the Dubois abscess was a cyst formed by the thymus tissue invading Hassall's corpuscles, the result of pronounced syphilitic changes. Key Concept: An abscess of the thymus (also known as "Dubois' abscess") is a condition that is one of many possible causes of cysts in the mediastinum. It can present with chest pain behind the sternum. It can be associated with congenital syphilis.
Surgery
null
024fc4a3-69ed-4f16-9e59-738c7165443b
Fever increases the basal metabolic rate about ---for each 1 Degree raise in bodv temperature
3%
7%
10%
20%
1b
single
(B) 7%# During sleep, the rate falls about 10% below that of waking levels.> Fever increases the metabolic rate about 7% for each degree rise in body temperature.
Pharmacology
Miscellaneous (Pharmacology)
7528d025-cc61-441f-b65e-f41b1dcb5275
False about Criggler najar syndrome?
Absence of UDPG enzyme
Normal liver biopsy
Conjugated hyperbilirubinemia
Type 1 is more severe
2c
multi
Ans. is 'c' i.e., Conjugated hyperbilirubinemia Criggler-Najjar Syndrome* CN syndrome is a congenital unconjugated hyperbilirubinemia. Basic defect is either reduced or absent UDPG transferase.* There are two types of CN syndrome:-1) Type I# It is an autosomal recessive disorder in which UDPG transferase is absent. Thus phenobarbitone has no effect (as enzyme is absent).# It is more severe hyperbilirubinemia than type II. There may be kernicterus. LFTs and liver histology are normal.2) Type II# It is an autosomal dominant disorder in which UDPG transferase is reduced. Phenobarbitone can reduce unconjugated Bilirubin by inducing UDPG transferase.# LFTs and liver histology are normal and there is no kernicterus
Pathology
Liver & Biliary Tract
b8e74581-3ae3-456d-86cf-507b68dcce77
CAMBRA stands for:
Caries measurement by routine assessment
Caries modification by reassessment
Caries management by risk assessment
Caries monitoring by regular assessment
2c
single
Caries Management By Risk Assessment (CAMBRA): It is a popular caries management technique, whereby the risk factors are assessed to prevent further caries and manage the condition. Reference- Sturdevant 6th ed pg-65
Dental
null
81257eb9-7bbb-4aa7-a142-1de0ab8fc7bf
Shine-Dalgarno sequence in bacterial mRNA is near:
AUG codon
UAA codon
UAG codon
UGA codon
0a
single
Ans. A. AUG codon(Ref: Harper 31/e page 395)Shine Dalgarno sequence is the marker sequence. The first AUG codon after Shine Dalgarno sequence is the start codon in bacteria. Similarly in eukaryotes there is Kozak sequence.
Biochemistry
Molecular Genetics
d4acad4d-13e2-42fb-b65b-7f23eb1a90d1
Anesthesia of choice for induction in day care surgery is?
Propofol
Ketamine
Halothane
Pancuronium
0a
single
ANSWER: (A) PropofolREF: Morgan's anesthesia 3rd ed, p. 173, 884Day care/OPD anesthesiaInduction agent of choice: PropofolMuscle relaxant: Mivacurium, succhinylcholineInhalation agents: sevoflurane, desfluraneTIVA (total Intravenous anesthesia): Propofol, remi/al/sufentanilSwitch technique:Induction by propofol, maintainence with sevo/iso flurane, Rapid emergence with Propofol
Anaesthesia
Miscellaneous General Anesthesia
11c4dd07-1c91-47b8-8b9f-f9182ac9e5b1
Anakinra is a -
IL - 1 antagonist
IL - 2 antagonist
IL - 6 antagonist
IL - 10 antagonist
0a
single
Ans. is 'a' i.e., IL-1 antagonisto Anakinra is an IL-1 antagonist.o It is used for some rare syndromes dependent on IL-1 production :Neonatal - onset inflammatory diseaseMuckle - Wells syndromeFamilial cold urticariaSystemic juvenile - onset inflammatory arthritisRA
Pharmacology
Immunomodulator
37f8bd18-e890-4d45-99a7-385e33300cf1
Midazolam dose in children is (through Im)
0.5 mg/kg
0.25 mg/kg
0.1 mg/kg
2.5 mg/kg
2c
single
null
Dental
null
cf3403e5-6e20-4472-96cf-5f7a03e182d5
Pathologic features of brain in AIDS are all, except
Perivascular giant cell invasion
Microglial nodules
Vasculitis
Temporal lobe infarction
2c
multi
Unlike most other viral encephalitides, HIV does not seem to infect neurons and perivasculitis is conspicuously absent" - Anderson pathology 10th/e p. 2728 "Characteristic multinuclear Giant cells of macrophage origin are seen in deep white matter of frontal and temporal lobes particularly in perivascular location" - Anderson p. 10th /e . These lines from Anderson have clarified any doubts regarding this question. The answer is fairly obvious. Other characteristic pathologic feature of CNS in AIDS are : Diffitse and focal spongiform changes Vascular myelopathy of post column of spinal cord Major cells affected are macrophages and monocytes Most characteristic finding is chronic inflammatory reaction with widely distributed infiltrates of microglial nodules.
Medicine
null
0b2d2d79-7b27-4cba-b0e8-15599b744c61
All are true regarding bleaching powder, except –
Contains about 33% of available chlorine
It is a stable compound
White amorphous compound
Strong bleaching agent
1b
multi
Bleaching powder : - Bleaching powder is also known as chlorinated lime. It is a disinfectant mainly used for disinfecting Water Faeces Urine It kills most of the organism when used in strength of 1 to 3% The chief drawback of bleaching powder is that it is an unstable compound and loses its chlorine content on storage. Its action is rapid and brief A good sample of bleaching powder contains 33% of "available chlorine". It is a white amorphous powder with a pungen smell of chlorine. When mixed with excess of lime it retains its strength, this is called stabilized bleach. Bleaching powder should be stored in a cool dry place.
Social & Preventive Medicine
null
fda312a2-8335-4512-baa0-9af2d71d7501
The glabella may show the remains of the
Anterior fontanel
Posterior fontanel
Metopic suture
Lambdoid suture
2c
single
Metopic suture is occasionally present in about 3-8% individuals. It lies in the median plane and separates the two halves of the frontal bone. Normally it fuses at 6 years of age. Ref BDC volume 3,sixth edition pg 5
Anatomy
Head and neck
0d30d72e-7552-43fc-8684-e133d7dee8b3
All the following drugs are hallucinogens except
Mescaline
Phencyclidine
Ketamine
Pentostatin
3d
multi
Pentostatin is an anticancer drug Hallucinogens-LSD,Phencyclidine,ketamine,mescaline etc Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg. 326
Psychiatry
Substance abuse
405ee39a-7055-45d8-9184-7b0248bf23f6
SAFE strategy does not include which of the following?
Surgery of lids
Antibiotics
Follicular stage prevention
Environmental hygeine
2c
single
SAFE strategy includes Surgery of lids Antibiotics Facial cleanliness Environmental hygiene
Ophthalmology
null
f55d8147-93ab-4a09-95f4-f8fc5fcaf63f
Earliest and often the only presentation of TB kidney is:
Increased frequency
Pain
Hematuria
Renal calculi
0a
single
Clinical Features Earliest symptom is urinary frequency. Tuberculosis of genital tract should be considered in the presence of following situations Chronic cystitis that refuses to respond to adequate treatment Sterile pyuria, gross or microscopic hematuria. Non- tender enlarged epididymis with beaded or thickened vas. Chronic draining scrotal sinus. Induration or nodulation of prostate and thickening of one or both seminal vesicle.
Surgery
Kidney and ureter
1e3ff7df-8a89-4549-8f0e-5279fd38e300
About iliolumbar ligament, which of the following statements is false (2018)
A) It is attached to transverse process of L5
B) Attached to the iliac crest
C) Lower pa has attachment to Sacrospinous Ligament
D) Upper pa has attachment to Quadratus Lumborum
2c
multi
iliolumbar ligament is a strong, triangular ligament, extending from the thick transverse process of the fifth lumbar veebra to the posterior pa of the inner lip of the iliac crest. It is continuous with the middle and anterior layers of the thoracolumbar fascia and gives paial origin to the quadratus lumborum. It is covered anteriorly by the psoas, and posteriorly by the erector spinae. It prevents anteroinferior slipping of the fifth lumbar veebra under the influence of body weight, and also prevents forwards movement at the sacroiliac joint. sacrospinous ligament bind the sacrum to the ischium. Ref:- BD chaurasia volume 2, pg num:-396,397
Anatomy
Abdomen and pelvis
cca642a9-e79e-4391-bc0a-173a55f0c299
Inhibin inhibits:
LH releasing hormone
LH
Estrogen and progesterone
FSH
3d
single
FSH
Pathology
null
886f4410-5d93-42c8-9e05-582d52c1ece3
Which of the following is not given in ophthalmia neonatorum –
Erythromycin locally
Tetracycline 1%
Penicillin locally
Silver nitrate
3d
multi
Prophylactic use of 1% silver nitrate (Crede's method) is obsolete now. Erythromycin and tetracycline ointment are frequently used for prophylaxis. Penicillin is used for treatment of sensitive strains of gonococci.
Ophthalmology
null
be2b6130-cf5c-492a-b6d0-04b8274d1d22
Double density sign in Mitral stenosis is a sign of enlargement of-
Right Atrium
Left Atrium
Left Auricle
Right Auricle
1b
single
Ans. is 'b' i.e., Left Atrium o Double Density sien in Mitral Stenosis is a sign of enfargementof Left Atrium.Double density sign is seen on frontal chest radiograph in the presence of left atrial enlargement and occurs when the right side of the left atrium pushes behind the right cardiac shadows indenting the lung and forming its own district sihhouette.If large enough it can actually reach beyond the border of the right atrium.
Medicine
Valvular Heart Disease
511f34c3-66df-4ee4-a669-a30639db2ca8
Sentinel lymph node biopsy is used for
Breast carcinoma
Penile cacinoma
Retroperitoneal sarcoma
Hepatic carcinoma
0a
single
Sentinel Lymph Node Mapping and Biopsy For breast cancer, sentinel lymph node is the largest lymph node in the axilla and is the first to receive the lymph and potential metastases drained from the breast. Intraoperative lymphatic mapping and biopsy of the sentinel lymph node initially introduced for the staging of melanoma has been similarly used for the detection of axillary metastases in breast cancer, where it has also become the accepted standard of care. In both the cases the method provides for minimally invasive surgery, and its success is now stimulating attempts to introduce it in the staging of the thyroid, gastric, colonic, lung and endometrial cancers. In breast cancer surgery this technique avoids significant morbidity of axillary dissection and inexperienced hands has proven to provide acceptable rates of metastatic identification
Surgery
null
9f2ec86d-ef58-48fd-a7a1-6c81e6efa6a6
The resting membrane potential of a cell:
Is dependent on the permeability of the cell membrane to K+ being greater to Na+
Falls to zero if Na+/K+ ATPase in membrane is inhibited
Is equal to the equilibrium potential for K+
Is equal to the equilibrium potential of Na+
0a
multi
Is dependent on the permeability of the cell membrane to K+ being greater to Na+ REF: Ganong, 22nd edition, BRS physiology, 4th edition page 11 Ionic Basis of nerve Resting Membrane Potential: Resting membrane potential is potential difference across the cell membrane in millivolts. Which is by convention -70 Mv Resting membrane potential is established by diffusion potential that results from concentration differences of permeable ions. And each permeable ion attempts to derive the membrane potential towards its equilibrium potential. Resting membrane potential (-70 mV) is close to equilibrium potential of K+ and C1-- (both -85 mV) and far away from the equilibrium potential of Na+ ( +65 mV). That means at rest the nerve membrane is more permeable to K+ than Na+ Na+ is actively transpoed out of neurons and other cells and K+ is actively transpoed into cells, but because of K+ permeability at rest is greater than Na+ permeability. Therefore, K+ channels maintain the resting membrane potential. Ionic Basis of nerve Action Potential: Depolarization causes rapid opening of the activation gates of Na+ channels and thus Na+ conductance promptly increases. Thus the membrane potential is driven towards the equilibrium potential of Na+ ion (+65 mV) Thus the rapid depolarization during upstroke is due to inward Na+ current Depolarization slowly opens K+ channels and increases K+ conductance to even higher levels than at rest. The combined effect of closing Na+ channels and greater opening of K+ channels make the K+ conductance higher than the Na+ conductance and membrane potential is repolarized. Thus repolarization is caused by outward K+ current. The K+ conductance remains higher than at rest for some time after closure of Na+ channel and the membrane potential is driven more closer to K+ equilibrium potential than at rest. This is called as undershoot.
Physiology
null
0ff43eb0-cb29-4fea-964c-0b686f39aaf3
A 7-year-old boy with h/o trauma 2 months back now presents with fever and acute pain over thigh. On X-ray femoral shaft shows lesions with multiple laminated periosteal reaction next line of management:
CRP measurement
Core biopsy
Tc99 MDP scan
MRI
3d
single
(d) MRI- Information in this question are: 1st Decade, diaphyseal lesion with onion peel reaction goes towards Ewing's sarcoma. Next best investigation is MRI for soft tissue involvement, marrow involvement and micrometastasis. Overall the best investigation is Biopsy to confirm the diagnosis but MRI is done before the biopsy, to localize the best site for biopsy.
Orthopaedics
Miscellaneous
e2159481-bd42-4534-9338-b12c9305cbf1
A 21-year-old unmarried woman has premenstrual fullness of breast and pain, the likely diagnosis is:
Galactocele
Fibroadenosis
Fibroadenoma
Mastitis
1b
single
It is usually seen in women of 4th and 5th decade of life (also not rare in young females) with complain of an intermittent mammary discomfort or an area of lumpiness or nodularity in the breast. The changes are generally bilateral. Pain is cyclical with a premenstrual exacerbation. Most likely the girl in question is suffering from fibroadenosis though her age is not consistent with the fibroadenosis.
Gynaecology & Obstetrics
null
ac7ee540-29a8-4d67-8228-6db506c09c83
Which papillae are completely keratinized
Fungiform
Filiform
Circumvallate
Foliate
1b
multi
null
Dental
null
9e6176a1-83f2-47d0-a32f-ca17c5f745b9
ECT is advocated in following except -
Chronic schizophrenia
Catatonic schizophrenia
Severe depression
Severe psychoses
0a
multi
Simple chronic schizophrenia is not an indication for ECT.
Psychiatry
null
3672e82b-7ec2-40d4-886c-616bc38672dc
A child presents in casuality in stable condition after a blunt abdominal trauma associated with splenic trauma. T/t of choice is -
Observation
Splenectomy
Arterial embolisation
Splenorrhaphy
0a
single
null
Surgery
null
66501023-82b2-4aba-9753-f24bdfd5bb84
CSF rhinorrhoea is due to the fracture of which of the following March 2008
Nasal bones
Cribriform plate
Temporal bone
Maxillary bone
1b
single
Ans. B: Cribriform Plate CSF rhinorrhoea can follow a head injury. CSF from anterior cranial fossa reaches the nose by way of cribriform plate, ethmoid air cells or frontal sinus. CSF from middle cranial fossa reaches the nose sphenoid sinuses. Sometimes, injuries of the temporal bone result in leakage of CSF into the middle ear and thence the Eustachian tube into the nose (otorhinorrhoea). The meninges are torn and cerebrospinal fluid leaks down the nose. Ascending infection may cause meningitis
ENT
null
1528541b-47df-41f5-ad9c-dec2ff65c20d
What is the function of chordae tendineae?
Opens A-V valve
Prevents regurgitation
Helps contraction of papillary muscles
Passes action potential to papillary muscles
1b
single
ANSWER: (B) Prevents regurgitationREF: BRS Anatomy 7th ed page 152, Gray's anatomy 40tn ed chapter 56CHORDAE TENDINEAE (TENDINOUS CORDS)They are fibrous collagenous structures supporting the cusps of the atrioventricular valvesFalse chordae connect papillary muscles to each other or to the ventricular wallincluding the septum, or pass directly between points on the wall (or septum, or both).The true chordae usually arise from small projections on the tips or margins of the apical one-thirds of papillary muscles, but sometimes arise from the bases of papillary muscles or directly from the ventricular walls and the septum. They are attached to various parts of the ventricular aspects or the free margins of the cusps. They have been classified into first-, second-and third-order chordae according to the distance of the attachment from the margins of the cusps.Fan-shaped chordae have a short stem from which branches radiate to attach to the margins (or the ventricular aspect) of the zones of apposition between cusps and to the ends of adjacent cusps. Rough zone chordae arise from a single stem which usually splits into three components that attach to the free margin.True chordae of the mitral valve may be divided into intercusp (or commissural) chordae, rough zone chordae, including the special strut chordae, so-called 'cleft' chordae and basal chordae. Most true chordae divide into branches from a single stem soon after their origin from the apical one-third of a papillary muscle, or proceed as single chordae that divide into several branches near their attachment. Basal chordae, in contrast, are solitary structures passing from the ventricular wall to the mural cusp.Function: Papillary muscles contracts to tightens the chordae tendineae preventing the cusps of the valves from being everted into the atrium by pressure developed by pumping action of the heart. This prevents regurgitation of the ventricular blood into the atrium.
Anatomy
Pericardium & Heart
3534eee7-b400-432e-8184-4e203e4a7a9e
Denominator of dependency ratio includes population of age
>15 years + > 65 years
15 - 65 years of age
< 65 years
> 65 years
1b
single
null
Social & Preventive Medicine
null
df6ab767-cb80-4a87-91a2-1ebcc8f3a7c5
All of the following may occur in Down's syndrome except-
Hypothyroidism
Undescended testis
Ventricular septa! defect
Brushfield's spots
1b
multi
Ans. is 'b i.e., Undescended testis Undescended testis has not been described as an association with Down's syndrome.
Pediatrics
null
5940ed65-4234-465f-9d68-86a77c555d00
The most frequent curvature of maxillary first molar root is
Mesial
Distal
Buccal
Lingual
2c
single
null
Dental
null
54384581-7d62-408c-9730-d87c55509823
Which of the following propeies make pyridostigmine different from neostigmine
It is more potent
It is longer acting
It produces less muscarinic side effects
It does not have any direct action on NM receptor
1b
single
Ref-KDT 7/e p108 Pyridostigmine acts for 3 to 6 hours as compared to 0.5 to 2 hourshours dur of action of neostigmine. It is less impoant than neostigmine Rest of the propeies are similar to neostigmine
Anatomy
Other topics and Adverse effects
528f4ad8-92f0-44cd-beb8-c7c6007d6a50
Which of the following is an Antimetabolite
Methotrexate
Cyclosporine
Etoposide
Vinbalstine
0a
single
Refer KDT 6/e p 823 Methotrexate is an Antimetabolite that acts By inhibiting DHFRase
Pharmacology
Chemotherapy
5a73439f-7a99-4687-90e2-468b566e98da
Which of the following extraocular muscle is not supplied by occulomotor nerve?
Inferior oblique
Inferior rectus
Medial rectus
Lateral rectus
3d
single
ANSWER: (D) Lateral rectusREF: Khurana 4th ed page 313Nerve supply of extraocular muscle:The extraocular muscles are supplied by third, fourth and sixth cranial nerves. The third cranial nerve (oculomotor) supplies the superior, medial and inferior recti and inferior oblique muscles. The fourth cranial nerve (trochlear) supplies the superior oblique and the sixth nerve (abducent) supplies the lateral rectus muscle.Note:Remember this Mnemonic for intraocular muscles nerve supply[?] SO4 -LR6- Rest all by 3rd (Oculomotor nerve)
Ophthalmology
Anatomy
88fb1dc7-e91b-462f-b38e-888c4b833555
Fever persisting even after treatment of pneumonia. The likely diagnosis is
Empyema
Fungal lesion
Hydrothorax
All of the above
0a
multi
null
Medicine
null
9f158355-55ea-480e-bf6b-f83074b1ee38
Chandler's index is -
No. of eggs of hookworm in per gram stool
No. of eggs of hookworm in per gram soil
No. of eggs of hook work in 100 gram soil
Percentage of stool specimens positive for hookworms
0a
single
null
Social & Preventive Medicine
null
167d630f-0b54-46da-a67c-e0fa9f8b69ff
Which of the following channelopathies is associated with calcium channel disorder of muscles?
Hypokalemic periodic paralysis
Episodic ataxia type 1
Hyperkalemic periodic paralysis
Paralysis Spinocerebellar ataxia 1.
0a
single
Ans. a (Hypokalemic periodic paralysis). (Ref. Harrison medicine 15th ed., -2295, 16th ed., 2339, 2363, 2536)1.Spinocerebellar ataxia 1Trinucleotide repeat (CAC) expansion in gene.2.Episodic ataxia type 1K channel gene mutations.3.Hypokalemic periodic paralysisL- type Ca++ channelopathy.4.Hyperkalemic periodic paralysisPoint mutation sodium channel.5.Malignant hyperthermiaMutation in Ryanodine receptor gene.6.MyotoniaMutation in Cl channel gene.Educational points:Clinical Features of Periodic Paralysis and Nondystrophic Myotonias Calcium ChannelSodium Channel Potassium ChannelFeatureHypokalemic PPHyperkalemic PPParamyotoniaCongenitaAnderson's SyndromeMode of InheritanceADADADADAge of onsetAdolescenceEarly childhoodEarly childhoodEarly childhoodMyotoniaNoYesYesNoEpisodic weaknessYesYesYesYesFrequency of attacks of weaknessDaily to yearlyMay be 2-3/dWith cold, usually rareDaily to yearlyDuration of attacks of weakness2-12 hFrom 1-2 h to >1 day2-24 h2-24 hSerum K+ level during attacks of weaknessDecreasedIncreased or normalUsually normalVariableEffect of K+ loadingNo changeIncreased myotonia, then weaknessIncreased myotoniaNo changeEffect of muscle coolingNo changeIncreased myotoniaIncreased myotonia, then weaknessNo changeFixed weaknessYesYesYesYes
Medicine
Miscellaneous
6ca862a1-7063-4ec9-846d-1c8d52a2079d
Which pigment accumulates in brown atrophy of hea?
Melanin
Lipofuscin
Hemosiderin
Hemozoin
1b
single
Lipofuscin, or "wear-and-tear pigment," is an insoluble brownish-yellow granular intracellular material that accumulates in a variety of tissues (paicularly the hea, liver, and brain) as a function of age or atrophy.Lipofuscin represents complexes of lipid and protein that derive from the free radical-catalyzed peroxidation of polyunsaturated lipids of subcellular membranes. It is not injurious to the cell but is a marker of past free radical injury. The brown pigment, when present in large amounts, impas an appearance to the tissue that is called brown atrophy. Melanin is an endogenous, brown-black pigment that is synthesized by melanocytes and acts as a screen against harmful ultraviolet radiation.Hemosiderin is a hemoglobin-derived granular pigment that is golden yellow to brown and accumulates in tissues when there is a local or systemic excess of iron.( Robbins Basic Pathology, 9th edition, page 24 )
Pathology
General pathology