diff --git "a/train.csv" "b/train.csv"
--- "a/train.csv"
+++ "b/train.csv"
@@ -70,3 +70,827 @@ d9f648af-a752-4368-999d-05e13c345ce0,False about obstructive jaundice,Unconjugat
 1d4ccb9d-1924-4aa6-b07c-0ed46fe31c20,Which of the following is the best procedure done for intrapaum fetal monitoring:,Fetal echocardiography,Fetal scalp pH,Continuous electrical fetal hea monitoring,Physical examination,2,single,"Electrical Fetal hea monitoring is useful as: (1) Provides accurate information, (2) Helpful in diagnosing fetal distress, (3) Directs about intervention to prevent fetal death or morbidity, (4) It is superior to intermittent monitoring methods.",Gynaecology & Obstetrics,"Intra Uterine Growth Restriction, Intrapaum and Antepaum Fetal Surviellance"
 236d1eb1-f2e1-43b0-90f3-f88deff358cb,"Which of the following is measured by the device, Bellow's spirometer?",TLC,RV,Closing volume,ERV,3,single,"The spirometer is a simple device for measuring gas volumes. The frequently used water spirometer, rolling seal spirometer and bellows spirometer. The last two are not water-filled and are more poable. The VT, IRV, ERV, IC, and VC can all be measured with a spirometer (as can the forced expiratory volume in 1 second , forced vital capacity , and forced expiratory flow ). The RV, the FRC, and the TLC, however, cannot be determined with a spirometer because the subject cannot exhale all the gas in the lungs. The lung volumes not measurable with spirometry can be determined by the nitrogen-washout technique, by the helium-dilution technique, and by body plethysmography. The FRC is usually determined, and RV (which is equal to FRC minus ERV) and the TLC (which is equal to VC plus RV) are then calculated from volumes obtained by spirometry. Ref: Levitzky M.G. (2007). Chapter 3. Alveolar Ventilation. In M.G. Levitzky (Ed), Pulmonary Physiology, 7e.",Physiology,
 a2630da3-17a1-4149-b424-4b04b2c42f1c,Which of the following is a newly emerging food poisoning organism,Salmonella typhimurium,Enterococcus,Diphtheria,Pseudomonas,0,single,"Ans: a (Salmonella typhimurium) Ref: Ananathanarayan,7th ed, p. 303Of the above given, S. typhimurium causes food poisoningSalmonella gastroenteritisS. typhimurium is the most common cause of food poisoning due to salmonella species.Incubation period--6-24 hrsFood poisoning is never caused by S. typhi. Source of transmission: poultry, meat, milk and milk products.C/F-nausea, vomiting, diarrhoea, abdominal cramps, fever.Blood culture is usually negativeNoteS. aureus is the most common cause of food poisoning in the westIP and clinical features of various bacteria causing food poisoiningIncubation period Organism responsible 1- hrs S. aureus-nausea, vomiting, diarrheaB. cereus-nausea, vomiting 8-16 hrs C. perfringes-abdominal cramps, diarrhoea (vomiting rare)B. cereus-abdominal cramps, diarrhoea, vomiting > 16 hrs Vibrio cholera-watery diarrhoeaETEC-watery diarrhoeaEHEC-bloody diarrhoeaSalmonella species-inflammatory diarrhoeaCamphylobacter jej uni-inflammatory diarrhoeaShigella species- dysentryV. parahaemolyticus-dysentry",Microbiology,Enterobecteriaceae
+f94f9f8f-fb28-44f0-9381-3dca473e305d,Atherosclerosis initiation by fibroblast plaque is mediated by injury to ?,Smooth muscle,Media,Adventitia,Endothelium,3,single,"Ans. is 'd' i.e., Endothelium The most acceptable hypothesis for the pathogenesis of atherosclerosis is ""the response to injury hypothesis"". According to this hypothesis, atherosclerosis is a chronic inflammatory response of the aerial wall initiated by injury to endothelium. Pathogenesis of atherosclerosis Following stages occurs in the pathogenesis of Atherosclerosis: Endothelial injury Earliest stages of the development of atherosclerosis are mediated by the inflammatory cascade. Inflammation mediated injury to endothelium is the cornestone in the development of atherosclerosis. After injury, endothelium is activated and there is increased expression of adhesion molecule-VCAM-1 and there is increased permeability to endothelium. TNF is the major cytokine to induce this expression. Migration of leukocytes When VCAM-1 is expressed on endothelium, leukocytes adhere to the endothelium. Leukocytes than cross the endothelial barrier and begin to accumulate in subendothelial intimal space. Macrophages engulf LDL cholesterol and form foam cells - formation of earliest lesion, i.e. fatty streak. Macrophages also form oxygen free radicals that cause oxidation of LDL to yield oxidized LDL (modified LDL). Smooth muscle cell migration and proliferation Inflammatory cells in subendothelial intimal space secrete cytokines, mainly PDGF, TGF-ct and FGF which cause migration of smooth muscle cells from media to subendothelial intimal space as well as their proliferation. Maturation of plaque Smooth muscle cells synthesize extracellular matrix (especially collegen) and conve a fatty streak into a mature fibrofatty atheroma, and contribute to the progressive growth of atherosclerotic lesions.",Pathology,
+bdf94942-49c0-4d9a-b990-a7bfb7099857,The WBC that is considered “second line of defence” is:,Neutrophil,Eosinophil,Basophil,Monocyte,3,single,"Monocyte is considered as the second line of defence.
+ 
+Phagocytosis by Macrophages.
+Macrophages are the end-stage product of monocytes that enter the tissues from the blood. When activated by the immune system, they are much more powerful phagocytes than neutrophils, often capable of phagocytizing as many as 100 bacteria. They also have the ability to engulf much larger particles, even whole RBCs or, occasionally, malarial parasites, whereas neutrophils are not capable of phagocytizing particles much larger than bacteria. Also, after digesting particles, macrophages can extrude the residual products and often survive and function for many more months.
+Reference: GUYTON AND HALL TEXTBOOK OF MEDICAL PHYSIOLOGY, THIRTEENTH EDITION(INTERNATIONAL EDITION ) page no 458",Physiology,
+cbc8a1b1-532c-490e-a17d-9168083fabae,Mark the true statement regarding use of Lithium in maniac-depressive psychosis?,Monotherapy for acute episodes,Monitoring of serum concentration is not useful for guiding dose adjustment,Can result in leucocytosis,Can result in hypehyroidism on long term use,2,multi,"Lithium Use : Prophylaxis of mania alone, with sedatives in acute mania. Monitoring of S. concentration is significant to know the toxicity of drug S/E of Lithium Lithium use for a long time causes benign and reversible T-wave flattening Seizures Polyuria and compensatory polydipsia Dermatitis, folliculitis, vasculitis Weight gain",Pharmacology,Psychiatric Illness
+2b7ff41e-66e4-467a-97ec-9ea4e5e98cbc,Determination of Pulp vitality by pulse oximeter based on:,Beer's law.,Pascal's law.,Doppler law.,Poisslues law.,0,single,"Pulse oxymetry-
+
+Based on Beer Lambert law
+Utilization of a probe that transmits red (640 mm) and infrared light
+Photo detector as a receptor site
+Different absorption ability of light by oxygenated and deoxygenated haemoglobin leads to changes in the amount of light differently absorbed by the vascular bed before reaching the photo detector.",Dental,
+c5165fb3-3a59-49ed-9de0-4dbbced2cf08,An Isograft indicates transfer of tissues between -,Unrelated donors,Related donors,Monozygotic twins,From the same individual,2,single,,Surgery,
+e197f947-1bdd-4efd-887a-b72faa9441c5,All of the following are causes of congenital blindness Except,Toxoplasmosis,Congenital rubella,Vitamin A deficiency,Cataract,2,multi,"Causes of congenital blindness:ToxoplasmosisCongenital cataractsGenetic diseaseCongenital rubellaCongenital glaucomaUsher syndrome(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 318 - 319)",Pediatrics,All India exam
+b15c5039-0f3c-4195-8331-35b9632899c7,Hypersecretory glaucoma is seen in –,Epidemic dropsy,Marfan's syndrome,Hypertension,Diabetes,0,single,"""In epidemic dropsy, glaucoma is wide angle glaucoma, with normal chamber and angle. Outflow is within normal limits. The queous shows raised level of histamin, prostaglandin and protein suggesting that glaucoma is hypersecretory"". _ Mukherjee",Ophthalmology,
+01b9f068-4db2-45e5-94b8-19d4f7d290f7,"A 14-year-old girl presents with quadriparesis, facial palsy, winging of scapula and ptosis. There is h/o similar illness in father and brother but less severe. Her CPK level is also raised (500IU/L). She is probably suffering from?",Emery-Dreifuss muscular dystrophy,Becker muscular dystrophy,Limb-girdle dystrophy,Scapulofaciohumeral dystrophy,3,single,"Facial muscle involvement is not seen with Becker and Limb-girdle muscular dystrophy Emery Dreifuss and Becker are XLR disease so can't be present in a girl child. Hence by exclusion the diagnosis is Dx: Scapulo-Faciohumeraldystrophy. Facio-Scapulo-humeral dystrophy Autosomal dominant inheritance and has an onset in childhood or young adulthood. Facial weakness is the initial manifestation-->inability to smile, whistle or fully close the eyes. Weakness of the shoulder girdles-->makes arm elevation difficult. Scapular winging becomes apparent with attempts at abduction and forward movement of the arms. The serum CK level may be normal or mildly elevated. No specific treatment is available, ankle-foot ohoses are helpful for foot-drop.",Medicine,Myasthenia Gravis and Muscular dystrophy
+44e3f7ec-ad90-49bc-9f91-54f959bae81b,Which of the following is true statement regarding human eye,Cornea cut off wavelength upto 400 nm,Normal eye medium will permit wavelength of 400- 700 nm,Even after cataract surgery UV rays are not penetrated,Lens will not reflect light,1,multi,"Ans. b (normal rye medium will permit wavelength of 400- 700 ntn) Ref: yanoff 3rd ed p 383, internet sitesCornea and lens act as special filters absorbing the more energetic wavelength of the electromagnetic spectrum that can damage the retina. Cornea absorbs wavelength below 295nm where as lens absorbs strongly in the long U V B (300 - 315) and most of the UV A (315 - 400) wave-lengths. Eye light transmittance is relatively high in the 400nm-700nm range.",Ophthalmology,Anatomy
+6a19df3c-6af0-4673-8e2b-02d86ddc7523,Which of the following muscle is not a hybrid muscle,Pectoralis major,Extensor digitorum,Flexor digitorum profundus,Brachialis,1,single,"Extensor digitorum Hybrid muscles are the muscles having more than one nerve supply Pctoralis major: lateral & medial pectoral nerves Brachialis: additional proprioceptive fibres from radial nerve, in addition to its muscular nerve, musculocutaneous nerve. Extensor digitorum is supplied by the posterior interosseous nerve only.",Surgery,
+161fc4a5-e9fb-44c6-9a4b-2d734cf01ebc,Delayed union of fracture of a bone follo-wing a surgical treatment may be due to,Infection,Inadequate circulation,Inadequate mobilization,All of the above,3,multi,D i.e. All,Surgery,
+f18b19db-efc0-40d3-accd-5d2dcb3b1879,What is the pressure of inspiration?,Intrapleuarl,Transpulmonary,Trans chest wall,Alveolar pressure,0,multi,"Ans: a (Intrapleural) Ref: Ganong,22nd ed,p. 6651The main pressure in lung related to inspiration is intrapleural pressure.Intrapleural pressure.The pressure in the intrapleural space between the lungs and chest wall is intrapleural pressure.Intrapleural pressure changes from -2.5 to -6 mmHg during inspiration. During strong inspiratory effort it may reach up to -30 mmHg.Transpulmonary pressureIt is the difference between alveolar pressure and intrapleural pressure. It is the measure of elastic forces in the lungs.Alveolar pressure or intrapulmonary pressureIt is the pressure inside the lung alveoli. When no air flows the alveolar pressure is considered to be equal to the atmospheric pressure, i.e., 0 cm of water.During inspiration it decreases to -1 cm of water.During expiration it increases to+1 cm of water.",Physiology,Respiratory System
+cdfbd205-6f98-4cdc-9d76-29c0e9887cef,One standard detion in normal standard curev includes value-,50%,68%,95%,100%,1,single,Ref:Parks 23rd edition pg 849. 1SD : confidence limit = 68% 2SD : confidence limit = 95% 3SD : confidence limit = 99.7%,Social & Preventive Medicine,Biostatistics
+d000623f-eba6-4e64-8cc0-3ed932403fce,Foam cells are seen in infection with which virus ?,Measles,EBV,Molluscum contagiosum,RSV,1,single,"Ans. is 'b' i.e., EBV EBV encephalomyelitis shows :Abnormal white matter with perivascular infiltrates of inflammatory cells and foam cells.Some myelin is replaced by lipid-filled macrophages and hyperplastic astrocytes.",Microbiology,
+fc374693-12de-4ca4-8854-34bd1a9c686b,"During extraction of the upper first molar, the mesio buccal root is missing and is suspected to have been pushed into the maxillary sinus.
+The best position for the patient immediately after the incident is",To position the patient upright,To position the patients in a semi inclined posture to visualize the perforation,Trendelenberg position,Reverse trendelenberg position,0,single,,Surgery,
+ffa5b47b-7d02-489f-9bcf-f6753b2be449,Rescue P.C.I is done for which of the following?,Persistent chest pain with ST elevation > 60 min after thrombolysis,Persistent chest pain with ST elevation > 30 min after thrombolysis,Persistent Chest pain with ST elevation >90 min after thrombolysis,Pain with ST elevation for >120minutes after thrombolysis,2,single,Option C = Rescue P.C.I. After thrombolysis ST Elevation begin to reduce If ST Elevation persisting in spite of thrombolysis. So it's failure of thrombolysis | within 90 minutes Rescue PCI Types of PCI Primary PCI done for STEMI (Door to device time < 90 minutes). Delayed PCI done for Unstable Angina NSTEMI Rescue PCI Failure of thrombolysis (within 90 minutes).,Medicine,Acute coronary syndrome
+fefb2a6d-129a-4ebd-9100-fcdb862c98a2,Fever associated with infection,Accelerates bacterial and viral replication,Left shifts the oxygen dissociation curve,Is due to interleukin-1 released from CD4 T-helper cells,Increase oxygen release to tissue,3,single,"Fever right shifts the oxygen dissociation curve, which allows for a greater release of oxygen to the tissue, making oxygen easily available to neutrophils and monocytes for use in the oxygen-dependent myeloperoxidase system of bactericidal killing. Having more oxygen available to tissue also enhances wound healing. In addition, fever interferes with bacterial and viral replication by providing a hostile environment for incubation. Fever is produced by the release of interleukin-I from macrophages. Interleukin-I, in turn, stimulates the hypothalamus to synthesize prostaglandins, which interact with the thermoregulatory center to produce fever.",Physiology,General physiology
+8cf45c14-9de1-4f72-a51c-e0ab03cd4518,Last organ to putrefy in females is?,Liver,Uterus,Brain,Breast,1,single,"Ans. is 'b' i.e., Uterus Order of putrefactiono Order of appearance of putrefaction from earliest to last is : larynx, trachea > stomach, intestine > spleen, liver > brain, lungs > heart > kidney, bladder > uterus/prostate > bone.o Amongst the soft tissues uterus in female and prostate in malesm are last to undergo putrefaction, as uterus and prostate resist putrefaction. Otherwise bones are last to undergo putrefaction, overall.",Forensic Medicine,Injuries
+567e1d6a-5444-4e1a-b07a-98417b051c28,Hamartomatous lung tissue is?,Hypoplasia of lung,Congenital cyst,Lobar sequestration,Congenital cystic adenomatoid malformation,3,single,"Ans. (d) Congenital cystic adenomatoid malformation(Ref: Robbins 9th/pg 670; 8th/pg 679)Congenital cystic adenomatoid malformation (CCAM): Hamartomatous Q or dysplastic lung tissue, usually confined to one lobe.",Pathology,Respiration
+c50f51df-27d7-43e6-9be6-4b89df294edb,Test for diagnosis of pyogenic meningitis is?,Widal,CSF PCR,CSF examination,PET scan,2,single,ANSWER: (C) CSF examinationREF: Harrison 17th ed chapter 376The diagnosis of bacterial meningitis is made by examination of the CSF. The need to obtain neuroimaging studies (CT or MRI) prior to LP requires clinical judgment.A broad-range PCR can detect small numbers of viable and nonviable organisms in CSF and is expected to be useful for making a diagnosis of bacterial meningitis in patients who have been pretreated with oral or parenteral antibiotics and in whom Gram's stain and CSF culture are negative,Microbiology,Bacteria
+22c45247-65d6-4168-aa89-428eb6ccf1c3,Causes of thickened gallbladder wall on ultrasound examination are all except:,Postprandial state,Cholecystitis,Congestive cardiac failure,Kawasaki disease,3,multi,"Ans: D (Kawasaki disease) Ref: Manual of Emergency Critical Care Ultrasound Vicke E Noble. 2nd ed. Pg 156Explanation:Kawasaki disease is associated with hydrops of gallbladder.Gallbladder Wall Thickening A gallbladder wall that is thickened is a sign of inflammation. This is a non-specific finding, and many other pathologic processes, as well as a postprandial gallbladder, can give you falsely elevated measurements.It is important to measure the wall of the anterior gallbladder surface because of the acoustic enhancement artifact mentioned.Because sound waves travel through a fluid-filled structure, no attenuation occurs. Thus, when those sound weaves hit the back of the gallbladder, they will be so strong that they will obscure an accurate picture of the wall thickness.For gallbladder wall thickness, greater than 3 mm is abnormal.Differential for Thickened Gallbladder WallPostprandialRenal failureAscitesHepatitisHypoalbuminemiaHIV/AIDSAdenomyomatosisMultiple myelomaCholecystitisCongestive heart failure",Radiology,Abdominal Radiography
+0210576a-e7fd-40c4-b51e-acd13de82132,"In caloric test, cold water stimulation causes movement of eye -",Some side,Opposite side,Up,Do\vn,1,single,"Ans. is 'b' i.e., Opposite side [Ref: Dhingra 5th/e p. 48}o Each ear is irrigated twice : once with cold water (70C below the body temperature, i. e. 300C) and then with warm water (70C above the body temperature, i.e. 440C).o Cold water provokes nystagmus towards the opposite ear, while warm water provokes nystagmus towardssame ear (COWS Cold - oppsite, Warm - same).",ENT,Assessment of Vestibular Function
+b9c3c5cc-127b-46a2-bfdc-d23bd2412409,Which of the following is not false about annual risk of TB,ARI of 1% = 75 new cases,Current ARI in India is 1.7%,It is represents new cases of TB,It is assessed by tuberculin conversion in previously non-vaccinated children,3,multi,"Incidence of TB infection (Annual infection rate, Annual risk of Infection ARI) : Percentage of population under study who will be newly infected (not diseased or cases) with TB among Non-infected in 1 year. Expresses attacking force of TB in community In developing countries 1% ARI corresponds to: 50 SS +ve cases per 100,000 general population Tuberculin conversion index is the ""best indicator for evaluation of TB problem and its trend"" in the community. Current ARI in India : 1.5% Ref: Park 25th edition Pgno : 190-191",Social & Preventive Medicine,Communicable diseases
+f6c9fd05-bcda-4397-bcaa-a17d65107ad3,"A 12-year-old girl presents to the casualty with symptoms of fever, shoness of breath, and cough. A chest X-ray reveals complete consolidation of the lower lobe of the left lung. Cultures of the lower lobe of the left lung would most likely reveal which organism?",Streptococcus pneumoniae,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginosa,0,single,"The history and findings are consistent with a lobar pneumonia. The most common etiologic agent of lobar pneumonia is Streptococcus pneumoniae. ESSENTIALS OF DIAGNOSIS Productive cough, fever, rigors, dyspnea, early pleuritic chest pain Consolidating lobar pneumonia on chest radiograph Lancet-shaped gram-positive diplococci on Gram stain of sputum Ref: Papadakis MA, McPhee SJ, ""Pneumonia, Pneumococcal."" Quick Medical Diagnosis & Treatment",Microbiology,
+19de7ff4-cb68-4c51-afe3-07a425f20c91,IgA deposits on skin biopsy,Henoch Schouleiln puspura,Giant cell aeritis,Microscopic polyangitis,Wegener's granulomatosis,0,single,A.i.e. Henosch Schonlein purpura,Skin,
+8705fb60-c237-4804-a9cf-8adbb631bcd3,A Dentin 'Primer'?,Etches the dentin,It increases the surface energy & wets the dentin surface,Removes the smear layer,Conditions the dentin,1,single,,Dental,
+d0b35238-78a6-454d-9bc9-65180db85bbb,Which of the following hormonal activity is expected immediately prior to Ovulation?,LH surge,FSH surge,Progestrone surge,Estrogen surge,0,single,"Ovulation occurs due to the effect of increased concentration of LH. In the pre-ovulatory phase of the menstrual cycle, the ovarian follicle will undergo a series of transformations called cumulus expansion, which is stimulated by FSH. This is followed by LH surge.",Physiology,
+e2e8a056-13c0-457f-945f-da4fdb9afbd6,Following are fibrous joints :,Pubic symphysis,Fronto parietal suture,Manubrio sternal joint,Inf. radio ulnar joint,1,single,"B. i.e. Frontoparietal sutureSkull sutures (except sphen-occipital), vomer- sphenoid rostrum schindylesisQ, inferior tibiofibular syndesmosis and dentoalveolar gomphosis (tooth socket) joints are fibrous joints. A Schindylesis is a specialized suture where a rigid bone fits into a groove on a neighbouring element eg a cleft between the alae of vomer, which receives the rostrum of the sphenoid. (i.e. vomer - sphenoidal rostrum junction)Q- Epiphyseo-diaphyseal growth plateQ, costochondral, 1st chondrosternal and sphenoocipital joints are synchondrosis/ syncendrosis or primary cailaginous joints; whereas, symphysis pubis, symphysis menti, sacrococcygeal, interveebral and manubriosternal jointsQ are symphyses or secondary cailaginous joints.Aicular cailage of most (not all) synol joints are lined by hyaline cailage Q. In some synol joints the cavity is paially or completely subdivided into two by an aicular disc, made up of fibrocailage eg. Temporomadibular jt, sternoclavicular jt, menisci of knee joint. More mobile the joint the more commonly it discloates eg shoulder jtQ. MCP Jt. is a condylar - synol joint",Anatomy,
+df59eac7-87b1-4805-9c47-0caf96a3450d,For exhumation the order should be passed by -,Chief judicial magistrate,Executive magistrate,Police officer,Session judge,1,single,"The body is exhumed only when, there is written order from the executive magistrate.",Forensic Medicine,
+aeb420c2-ede8-48bc-9400-a5ae531f15ee,The radiograph of a 32 year old patient is shown below. The patient is asymptomatic and the lesion revealed in the radiograph is an accidental finding. The most likely diagnosis is:,Stafne’s bone cavity,Radicular Cyst,Dentigerous cyst,Lateral periodontal cyst,0,single,"Radiological signs:
+The lesion presents as a chance radiographic finding. It is a round or an ovoid (<3 cm) uniform radiolucency with a well-defined, usually corticated, margin. Stafne’s bone cavity is non-expansile and is found below the mandibular canal just anterior to the angle of the mandible. The location of Stafne’s bone cavity distinguishes it from odontogenic lesions, whose origin is within the alveolar bone.",Radiology,
+1a609bd8-639f-4895-a5f5-80bbb896e2f6,Magistrate inquest not needed in: JIPMER 14,Homicide,Exhumation,Police custody death,Dowry death,0,single,Ans. Homicide,Forensic Medicine,
+2d3da5b6-6af9-49c5-9439-17fbc983657d,"Which of the following disease with bird, ahropod and human chain",Malaria,Japanese encephalitis,Paragonimus,Plague,1,single,"Agent factors :- * Caused by group B arbovirus (flavivirus) * The main reservoirs are Ardeid birds and pigs * Pigs are amplifiers of the virus and they do not manifest ove symptoms but circulates the virus Host factors :- * Most common in the age group of <15 years of age * Man - incidental dead end host * Affects other animals also and horse is the only animal which does not shows symptoms of encephalitis Vector:- * Transmitted by culex tritaeniorrhynchus - most impoant vector, others are C.Vishnuii and c. Gelidus * Incubation period is 5-15 days * Case fatality rate - 20-40% Ref:- K Park, 24th ed; pg num:- 302-303",Social & Preventive Medicine,Communicable diseases
+91cfdd64-e451-462f-b6a2-c5b338415892,Potter syndrome is not assoiated with,Bilateral renal agenesis,Bilateral multicystic kidney disease,oligohydromnios,Polyhydromnios,0,single,"Since there is b/l kidney agenesis or cystic disease there is no urine production
+leading to oligohydromnios",Surgery,
+f1f94f1c-3d9d-4b68-9c3d-b6757a8a4fcd,Increase in pauwel's angle indicate,Good prognosis,Impaction,More chances of displacement,Trabecular alignment displacement,2,single,"Pauwel's classification - depending on angle (Pauwel's angle) formed by the line with the horizontal. More the Pauwell's angle, more unstable is the fracture with poorer prognosis Type I : <30deg Type II : 30-50deg Type III: >50deg(worst prognosis)",Orthopaedics,Lower Limb Traumatology
+e08402ae-00b1-4649-872f-dfa4df0f6eb2,"A 28 year old female teacher is found to have a prolonged bleeding time and normal platelet count. She had a bleeding of ""easy bleeding"" with frequent bleeding of the gums, epistaxis, cutaneous bleeding and menorrhagia, further testing revealed a deficiency of Von willebrand factor. Which of the following thrombogenic processes involving platelets is most directly impaired?",Adhesion,Aggregation,Formation of fibrinogen bridges,Conformational change with activation of phospholipid surface,0,single,"Disruption of the endothelium exposes subendothelial Von willebrand factor (VWF) and collagen, which promotes platelet adherence and activation.
+Deficiency of Von willebrand factor (VWF) causes
+
+
+↓ Platelet adhesion (↑ BT)
+
+
+↓ Intrinsic pathway activity (↑ aPTT)",Pathology,
+0d4f79ee-cc91-4c9a-902d-020973012371,"Ifa Panchayat is dissolved, elections are to be held within?",1 month,3 months,6 months,1 year,2,single,"Ans. is 'c' i.e., 6 months",Social & Preventive Medicine,
+7a9a95de-c499-4203-bee7-fc1f9bf3abd1,Stomach is derived from ?,Foregut,Midgut,Hindgut,Allantois,0,multi,Foregut,Anatomy,
+053c4aff-1541-4fbd-8f3c-32fa0921e82a,Which of the following is the main enzyme responsible for activation of xenobiotics?,Cytochrome P-450,Glucuronyl transferase,Glutathione S-transferase,NADPH cytochrome P-450-reductase,0,single,"Xenobiotics are compounds which may be accidently ingested or taken as drugs or compounds produced in the body by bacterial metabolism. The cytochrome P-450 enzyme family is involved in the biotransformation reaction of xenobiotics. They are heme containing membrane proteins localized in the smooth endoplasmic reticulum of liver. They are so named because they absorb light at wavelength of 450nm, when exposed to carbon monoxide. Ref: Vasudevan Biochemistry, 3rd Edition, Pages 310-2",Biochemistry,
+fabc62e9-fb0e-472f-b241-0c4bcf67fb58,In Familial hypercholesterolemia there is deficiency of,LDL receptor,Apoprotein A,Apo protein C,Lipoprotein lipase,0,single,"LDL receptors 
+
+Familial hypercholesterolemia (type IIa) is due to deficiency of functional LDL receptors as a result of different types of mutations.",Biochemistry,
+9e679825-10cc-4de3-8119-2c4bf95f52f0,"Botulinum affects all of the following, EXCEPT:",Neuromuscular junction,Preganglionic junction,Post ganglionic nerves,CNS,3,multi,"Diplopia, dysphagia, dysahria, dry mouth, vomiting, thirst, constipation are the clinical features associated with botulinum toxin. Patients experience minimal or no CNS effects and usually there's no significant alteration in their mental status. Ingested, inhaled or formed botulinum toxin travels through the vascular system and affects neuromuscular junction, pre ganglionic junction and post ganglionic nerves. Ref: Textbook of Microbiology, Ananthanarayan and Paniker, 7th Edition, Chapter 28, Page 263 & 264 ; Harrisons Principles of Internal Medicine, 16th Edition, Page 843.",Microbiology,
+0ba825fe-e43e-4ae9-80a9-9072015050a5,Which of the following is a poor prognostic factor for childhood ALL.,"Total Leukocyte count 4000-100,000",Age < 2 years,Testicular involvement,Blasts in peripheral smear,2,multi,"Answer is C (Testicular involvement) Testicular involvement / enlargement is a typical poor prognostic factor for childhood ALL Age < 2 years versus Testicular Involvement Typically Age < 1 year is considered a poor prognostic factor Although Age < 2 year has been mentioned as a poor prognostic factor in ceain textbooks including Hoffman's Hematology (4th/1158) most textbooks use the criteria of Age < 1 year to define a poor prognostic factor Since testicular involvement provided amongst the option is an established poor prognostic factor, this is selected as the single best answer of choice.",Medicine,
+1fb6c54f-550d-4cbc-8589-2d74176aa032,Relining of complete denture is not indicated when,Denture contains broken teeth,There is excessive resorption of the ridge,Vertical dimension is excessively reduced and has to be changed,Centric relation does not coincide with centric occlusion,2,single,,Dental,
+eeb3a5e2-a7c2-47da-9432-d862656581e7,Which of the following condition is necessary prerequisite for this change?,Rupture of membranes,Scanty liquor amnii,Adequate liquor amnii,Air inside the uterine cavity,2,single,"Ans. (C). Adequate liquor amniiThe photograph shows maceration, a sign of intrauterine death.Conditions favoring maceration: Intact membranes; adequate liquor amnii & NO air.",Forensic Medicine,Sexual Offenses
+db812c4b-e8f1-46dc-9427-762cf351a82e,Savita is 32 weeks pregnant presents in causality and diagnosed as a case of APH. Vitals are unstable with BP 80/60 which of the following is next step in M/n,Careful observation,Blood transfusion,Medical induction of labour,Immediate cesarean section,1,multi,Ans. is b i.e. Blood transfusion,Gynaecology & Obstetrics,
+02822b49-7e2e-4242-be13-00ea86d52dac,"All are true about Cancer breast, except:",Affected sibling is a risk factor,Paget's disease of nipple is intraductal type of CA,Common in aged nulliparous,Increased incidence with prolonged breast feeding,3,multi,Ans. (d) Increased incidence with prolonged breast feeding* Paget's Disease is a superficial manifest of an underlying Intra ductal carcinoma breast,Surgery,Breast
+d1fd564a-489c-4075-9f2d-fe1fcf5a93b3,"Which of the following vitamin reduces the risk of insulin resistance, obesity, and the metabolic syndrome?",Vitamin A,Vitamin C,Vitamin D,Vitamin B12,2,single,"Higher Intakes of Vitamin D May Be Beneficial There is evidence that Vitamin D intake considerably higher than that required to maintain calcium homeostasis reduce the risk of insulin resistance, obesity, and the metabolic syndrome, as well as various cancers. There is growing evidence that higher vitamin D status is protective against various cancers, including prostate and colorectal cancer, and also against prediabetes and the metabolic syndrome. Desirable levels of intake may be considerably higher than current reference intakes, and ceainly could not be met from unfoified foods. While increased sunlight exposure would meet the need, it carries the risk of developing skin cancer. Reference: Harper; 30th edition; Page no: 552, 553",Biochemistry,vitamins
+0e24270a-7b1e-4f2c-b71c-0de8a0f931c8,The following drugs have significant drug interactions with digoxin except:,Cholestyramine,Thiazide diuretics,Quinidine,Amlodipine,3,multi,Ref:KDT 6/e p499 Cholestyramine inhibits itestinal absorption of digoxin. Thiazides result in hypokalemia and thus make precipitate digitalis toxicity by pharmacodynamic interaction. Quinidine and verampil reduces the exceion of digoxin and does make precipitate toxicity (pharmacokinetic interaction),Pharmacology,Cardiovascular system
+e718f928-325c-4060-9148-a827bc5e985b,Antiboiotic Prophylaxis for infective endocarditis is indicated in:,Isolated secundum ASD,Mitral valve prolapse without regurgitation,Prior coronary aery bypass graft,Coarctation of aoa,3,single,Answer is D (Coarctation of Aoa) Coarctation of Aoa is a high risk cardiac lesion fior the development of infective endocarditis and an indication fir antibiotic prophyloxis.,Medicine,
+baae18da-a29b-47f6-b733-828463dcb084,"Adder Head"" appearance is found in:",X-ray,USG,IVP,CT,2,single,VP,Radiology,
+0745edd3-4f4f-4971-97c5-89e0880be160,Ortolani's test is done for,Congenial dislocation of the knee joints,Congenital dislocation of the hip joints,Congenital dislocation of the shoulder joints,Congenital dislocation of the elbow joints,1,single,B. i.e. (Congenital dislocation of hip joints) (410 - Apley 8th)Important Tests**Ortolani's and Barlow's test Galeazzi test (604 CDT 4th)Congenital dislocation of hip joints** Apprehension testRecurrent dislocation of shoulder joints* Bryant's Call ways Hamilton ruler testHamilton ruler testAnterior dislocation of shoulder joints* **Pivot-shift testAnterior cruciate ligament* Lachman testAnterior cruciate ligament* Drawer testCruciate ligament (Ant & Post)* **Mc-Murray's testMeniscus injury* Appley's grinding testMeniscus injury* **Thomas testHip flexion deformity* ** Ankle joint has LEAST chances for recurrent dislocations,Orthopaedics,Congenital Dislocation of Hip (C.D.H.)
+6e0a9179-1648-4b92-ae0a-fd8970b75146,A 50 year old female patient complains of difficulty in swallowing. Patient gives h/o multiple diagnostic CT-scans of the head and neck region. This patient may be predominantly susceptible to which of the following?,Medullary thyroid carcinoma,Follicular thyroid carcinoma,Anaplastic thyroid carcinoma,Papillary thyroid carcinoma,3,multi,"The incidence of thyroid carcinomas, predominantly papillary thyroid carcinomas, increases in humans after radiation exposure. There is strong dependence on age at exposure—susceptibility to radiation-induced thyroid cancer is higher in children than adults. There is little evidence for a dose response for individuals exposed during adulthood. Females are 2 to 3 times more susceptible than males to radiogenic and spontaneous thyroid cancers.
+
+Reference: White and Pharoah, Oral radiology, ed 8th, pg-92",Radiology,
+b72ab647-ae5f-45cf-99fa-a2cf138ae036,Secondary retention for a removable partial denture is provided by,The indirect retainer,The direct retainer,Intimate contact between the denture bases and the underlying tissues,Direct and indirect retainers,2,single,,Dental,
+3dcd635a-5f00-4e07-962c-4feafc753682,Which of the following may be seen in second degree Hea block (select three options):,Change in QRS complex morphology,Atrial rate more than ventricular rate,Prolonged conduction time,All of the above,3,multi,"Answer is A, B, and C Second degree AV block (Type I and /or Type II) may be associated with prolonged conduction time (prolonged PR interval), Atrial rate more than ventricular rate and change in QRS complex morphology (Tipe II). Name Rhythm Rate (beats/minute) P waves (lead II) PR Interval QRS complex First-degree atrio- ventricular (AV) block Regular That of underlying sinus rhythm; both atrial and ventricular rates will be the same Sinus origin: one P wave to each QRS complex Prolonged (more than 0.20 second); remains constant Normal (0.10 second or less) Second-degree AV Atrial: regular Atrial: that of Sinus origin Varies; progressively Normal (0.10 block, Mobitz I Ventricular: irregular underlying sinus rhythm lengthens until a P wave isn't conducted second or less) Ventricular: depends on number of impulses conducted through AV node: will he less than atrial rate (P wave occurs without the QRS cmplex); a pause follows the dropped QRS complex Second-degree AV Atrial: regular Atrial: that of Sinus origin: two or Normal or Normal if block at block, Mobitz II ventricular: usually underlying sinus three P waves prolonged; remains level of bundle of regular, but may be rhythm (sometimes more) constant His; irregular if Ventricular: depends before each QRS conductions ratios vary on number of Impulses conducted through AV node; will be less than atrial rate complex bundle branches Third-degree AV block Atrial: regular Atrial: that of Sinus P waves with Varies greatly Normal if block at Ventricular: regular underlying sinus rhythm Ventricular:40 to 60 if paced by AV junction; 30 to 40 (sometimes less) if paced by ventricles; will be less than atrial rate no constant relationship to the QRS complex; P waves found hidden in QRS complexes and T waves level of AV node or bundle of His; wide if block in bundle branches No constant Relationship between P wave and QRS complex is a feature of Third degree or complete hea block. One P wave to each QRS complex is a feature of First degree block",Medicine,
+31868f6c-233a-40ee-880e-9c668509a8b1,"An ill 16 days old baby girl is brought to the emergency. On examination pallor and dyspnoea present with a respiratory rate of 85 per minute. Her HR is 200 bpm, hea sounds are distant and a gallop is heard. X-ray showed cardiomegaly. An echocardiogram shows dilated ventricles and dilation of the left atrium. An ECG shows ventricular depolarization complexes that have low voltage. Which of the following is the most likely diagnosis?",CHF,Glycogen storage disease,Pericarditis,Aberrant left coronary aery arising from pulmonary aery,0,multi,"In CHF pallor, dyspnoea, tachypnoea, tachycardia and cardiomegaly are common regardless of the cause.The most common causes of CHF in children include myocarditis caused by adenovirus and coxsackievirus B.The echocardiogram shows ventricular and left atrial dilatation as well as poor ventricular function. With glycogen storage disease of the hea muscle thickening would be expected. With pericarditis- pericardial effusion is seen. On ECG, the voltages of the ventricular complexes seen with aberrant origin of the left coronary aery are not diminished, and a pattern of myocardial infarction can be seen. *",Pediatrics,Impoant Viral Diseases in Children
+8265f7d0-1476-40a3-bdf9-b42bc2f25dc2,Egg shell calcification is seen in all except –,Sarcoidosis,Silicosis,Post irradiation lymphoma,Bronchogenic CA,3,multi,,Radiology,
+4e296c2e-150a-4123-bc01-b56e4e0d89af,"In inversion of the foot, the sole will face:",Upwards,Downwards,Laterally,Medially,3,multi,"Ans: d (Medially) Ref: BDC, Vol. II, 4th ed, p. 155; Kieth L. Moore, 4th ed, p. 638Inversion is the movement in which the medial border of the foot is elevated, so that the sole faces medially.Eversion is the movement in which the lateral border of the foot is elevated. So that the sole faces laterally.Joints of the foot and the Movements taking place there:JOINTTYPE OF JOINTMOVEMENTSAnkle jointHinge jointPlantar flexion, dorsiflexionSubtalar joint (talocalcaneal)Plane synovialInversion, eversionT alocalcaneonavicularBall and socketGliding and rotator movementsCalcaneocuboidPlane synovialInversion, EversionTarsometatarsalPlane synovialGliding or slidingIntermetatarsalPlane synovialLittle movement possibleMetatarsophalangealCondylarFlexion, extension, adduction, abduction and circumductionInterphalangealHinge varietyFlexion, Extension",Anatomy,Foot
+7b859b05-5bd6-4dc0-828f-d5ff4da65f24,"Where does the ""knot"" is put in the neck during judicial hanging?",The back of the neck,Under angle of jaw,Below the chin,Choice of hangman,1,single,"In judicial hanging, a rope to allow a drop of five to seven metres according to the weight, build and age of the person, is looped round the neck, with the knot under the angle of the jaw. This causes fracture-dislocation usually at the level of the second and third, or third and fouh cervical veebrae. Ref: The essentials of forensic medicine and toxicology by Dr K S Narayan Reddy, 27th edition, Page 306.",Forensic Medicine,
+7025db05-412a-4479-89f3-fecc9ec7b174,Seal finger and whale finger are associated with -,Listeria,Erysipelothrix,Corynebacterium,Treponema,1,single,"Ans. is 'b' i.e., Erysipelothrix",Microbiology,
+22e6e599-7193-4569-be03-a7a0a006faec,Which of the following muscle acts as unlocker of knee?,Gracilis,Popliteus,Saorius,Biceps femoris,1,single,"Popliteus rotates the tibia medially on the femur or, when the tibia is fixed, rotates the femur laterally on the tibia. At the beginning of flexion of the fully extended knee, lateral femoral rotation by popliteus muscle unlocks the joint.Must know:Locking of knee joint is due to the the action of quadriceps femoris, that brings about medial rotation of femur on tibia in later stages of extension. Ref: Snells, Clinical anatomy, 7th Edition, Page 650.",Anatomy,
+7a9e4db6-6173-4fc2-8d5f-daf8061734a3,A 60 yr old chronic smoker presents with painless gross hematuria of 1 day duration. Which is the investigation of choice to know the cause of hematuria?,USG,X-ray KUB,Urine routine,Urine microscopy for malignant cytology cells,3,single,"A chronic smoker with painless gross hematuria should be suspected as having bladder cancer. The most common form of bladder cancer is transitional cell carcinoma (TCC). Tobacco use, followed by occupational exposure to various carcinogenic materials such as automobile exhaust or industrial solvents are the most frequent risk factors. Hematuria is the presenting symptom in 85-90% of patients with bladder cancer. It may be gross or microscopic, intermittent rather than constant. Exfoliated cells from both normal and neoplastic urothelium can be readily identified in voided urine. Ref: Scher H.I., Motzer R.J. (2012). Chapter 94. Bladder and Renal Cell Carcinomas. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.",Surgery,
+a3e2c40f-e525-4ee7-9740-5198788b345f,The most sensitive method for detecting cervical Chlamydia trachomatis infection is:,Direct fluorescent antibody test,Enzyme immunoassay,Polymerase chain reaction,Culture on irradiated McConkey cells,2,single,"Ans. is 'c' i.e., Polymerase chain reactionRef: Harrison, 17th/e, p. 1074,19th/e, p. 1165 and Ananthanarayan, 9th/e, p. 415Amplification assays such as ligase chain reaction and polymerase chain reaction are the most sensitive chlamydial diagnostic method.Other methods are:(a) Cell culture: Sensitivity (60-80%).(b) Direct immunofluorescent antibody test: Sensitivity 70-80% and quite specific.(c) ELISA: 60-80%.",Microbiology,Bacteria
+5256f96e-c7f4-4440-a781-fc2bd24471cd,"A labourer involved with repair-work of sewers was admitted with fever, jaundice and renal failure. The most appropriate test to diagnose the infection in this patient is -",Weil Felix test,Paul Bunnell test,Microscopic agglutination test,Microimmunofluorescence test,2,single,,Microbiology,
+6e42770a-97fb-4a08-8c0d-1dd4126cfb63,Congestive hea failure in an infant is characterized by all except,Pedal edema,Tachypnea,Sweating,Poor weight gain,0,multi,"Congestive Cardiac Failure in InfantsSymptomsSignsuFeeding difficultyuTakes less volume per feeduDiaphoretic while suckinguForehead sweating.uSuck-rest-suck cycle.uPoor weight gainuPeriorbital edema uClothes no longer fituIncreasing cloth sizeuRapid breathing/nasal flaring/cyanosis/chest retractions.uTachycardia.uHepatomegaly.uOccasionally Splenomegaly.uPeriorbital edemauEdema in flanks. uDependent edema (Refer: Nelson's Textbook of Paediatrics, 19thedition, pg no:1530)",Anatomy,All India exam
+fa2a40f5-7d07-473b-9175-f891e8923e19,Congenital hydrocele is best treated by,Eversion of sac,Excision of sac,Lord's procedure,Herniotomy,3,single,"Congenital hydrocele is best treated with herniotomy if they do not resolve spontaneously. Established acquired hydrocele often have thick walls. They are treated by subtotal excision of the sac. If the sac is small, thin walled and contains clear fluid, Lord's operation is done. Jaboulay's operation where the sac is eveed with placement of testis in a pouch created by dissection in the fascial planes of the scrotum, is an alternative. Reference : page 1328 Bailey and Love's sho practice of surgery 25th edition and page 1072 SRB's manual of surgery 5th edition",Surgery,Urology
+90d792a9-7a4b-460c-b069-b9aa6a2d7823,Rate limiting step in cholesterol synthesis is catalysed by which of the following enzyme?,HMG CoA synthetase,HMG CoA reductase,Thiokinase,Mevalonate kinase,1,multi,"Conversion of HMG CoA to mevalonate by HMG CoA reductase is the rate limiting step in the synthesis of cholesterol. Cholesterol is an allosteric inhibitor of HMG CoA reductase Statin drugs acts as competitive inhibitors with mevalonate for binding to HMG CoA reductase. Insulin ors the active form of HMG CoA reductase and increases cholesterol synthesis. Glucagon ours the inactive form and decreases cholesterol synthesis. Ref: Biochemistry By John W. Pelley, page 89.",Biochemistry,
+63de4ee4-9b7b-4312-aad2-45f5aa3cac7b,Vaccine administered by following route is,Typhoral live,H1n1 killed,H1n1 live,Yellow fever live,2,single,Hlnl live (Intranasal route),Social & Preventive Medicine,Influenza
+1ce23a0f-15cf-429f-a350-a4050d1d43f6,A 40-year old diabetic patient presents with proptosis of one eye and black eschar over palate. The likely organism is :,Pseudomonas,Candida,E. coli,Mucor,3,single,,Medicine,
+53ae491c-15c1-4c77-8dcb-fba7d3f5dd29,Coloured urine is not seen in :,Quinine,Rifampcin,Nitrofurantoin,Pyridium,0,single,Answer is A (Quinine) Quinine is not associated with discoloured urine.,Medicine,
+eccfcb56-f984-4dc4-bcd2-db1dfa7a96cc,Investigations in a clinically suspected case of tuberculosis -,Mantoux (in children),Sputum AFB,Bactec,All of the above,3,multi,,Medicine,
+fec423fb-be98-40a8-a9f3-477f6e7555f4,Schizophrenia is treated by,Anti depressants,Anti psychotics,Anti epileptics,Mood stabilizers,1,single,"Ans. is 'b' i.e., Anti psychotics",Pharmacology,
+bdf6c4e6-9034-4e26-9b63-674a147b16c3,Fries test is used in the diagnosis of:,Gonorrhoea,Herpes,Chanchroid,Granuloma venereum,3,single,Granuloma venereum,Microbiology,
+e151e45d-2260-4b55-a9b1-564232e2982e,"A 45-year-old woman complains of severe headaches and difficulty in swallowing. Over the past 6 months, she has noticed small, red lesions around her mouth as well as thickening of her skin. The patient has ""stone facies"" on physical examination. Which of the following antigens is the most common and most specific target of autoantibody in patients with this disease?",C-ANCA (anti-proteinase-3),Double-stranded DNA,P-ANCA (anti-myeloperoxidase),Scl-70 (anti-topoisomerase I),3,multi,"Scleroderma (refer to the image below) Autoimmune disease of connective tissue. Antinuclear antibodies are common but are usually present in a lower titer than in patients with SLE. Antibodies viually specific for scleroderma include:- Nucleolar autoantibodies (primarily against RNA polymerase) Antibodies to Scl-70, a non-histone nuclear protein topoisomerase; Anticentromere antibodies (associated with the ""CREST"" variant of the disease). The Scl-70 autoantibody is most common and specific for the diffuse form of scleroderma and is seen in 70% of patients. -Autoantibodies to double-stranded DNA (choice B) are seen in patients with SLE. -Autoantibodies to SS-A/SS-B are seen in patients with Sjogren syndrome. (Fig: A fibroblastic focus is present at the arrows.) Diagnosis: Scleroderma",Pathology,Immunity disorders
+23b2d44a-f5e5-47b8-9004-ddd6e0c183d8,Grave's ophthalmopathy mostly presents as September 2010,Proptosis,Ptosis,Reduced intraocular tension,Increased power of convergence,0,single,"Ans. A: Proptosis Graves' ophthalmopathy (also known as thyroid eye disease (TED), dysthyroid/thyroid-associated orbitopathy (TAO), Graves' orbitopathy) is an autoimmune inflammatory disorder affecting the orbit around the eye, characterized by upper eyelid retraction, swelling (edema), redness (erythema), conjunctivitis, reduce dpower convergence and bulging eyes (proptosis).",Ophthalmology,
+6a48770d-2b73-46ee-a45f-151619ca08ad,Earliest lesion seen in atherosclerosis is:,Fatty streaks,Intimal thickening,Fibrinoid necrosis,Plaque,0,single,"Ans: A (Fatty streaks) Ref: Robbins Pathologic Basis of Disease, 8th edition.Explanation:Fatty streaks are the earliest lesions in atherosclerosis "" Ref: RobbinsMorphology of AtherosclerosisFatty StreaksThese are the earliest lesions in atherosclerosis.They are composed of lipid-filled foamy macrophages.Beginning as multiple minute flat yellow spots, they eventually coalesce into elongated streaks 1 cm or more in length.These lesions are not significantly raised and do not cause any flow disturbanceAortas of infants less than 1 year old can exhibit fatty streaks, and such lesions are seen in virtually all children older than 10 years, regardless of geography, race, sex, or environment.The relationship of fatty streaks to atherosclerotic plaques is uncertainThey may evolve into precursors of plaques, not all fatty streaks are destined to become advanced lesions.Atherosclerotic PlaqueThe key processes in atherosclerosis are intimal thickening and lipid accumulationAtheromatous plaques impinge on the lumen of the artery and grossly appear white to yellow: superimposed thrombus over ulcerated plaques is red-brown.Plaques vary from 0.3 to 1.5 cm in diameter but can coalesce to form larger massesAtherosclerotic lesions are patchy, on cross- section, the lesions appear ""eccentric""Local flow disturbances (e.g., turbulence at branch points) leads to increased susceptibility to plaque formation.In descending order, the most extensively involved vessels are theLower abdominal aorta (MC)The coronary arteries (Second MC)The popliteal arteriesThe internal carotid arteriesVessels of the circle of WillisVessels of the upper extremities are usually spared, as are the mesenteric and renal arteries, except at their ostia.Atherosclerotic plaques have three principal components:Cells, including smooth muscle cells, macrophages, and T cellsECM, including collagen, elastic fibers, and proteoglycansIntracellular and extracellular lipidSuperficial fibrous cap composed of smooth muscle cells and dense collagen.Beneath and to the side of the cap (the ""shoulder"") is a more cellular area containing macrophages, T cells, and smooth muscle cells.Deep to the fibrous cap is a necrotic core, containing lipid (primarily cholesterol and cholesterol esters), debris from dead cells, foam cells (lipid-laden macrophages and smooth muscle cells), fibrin, variably organized thrombus, and other plasma proteins and cholesterolThe periphery of the lesions show neovascularization (proliferating small blood vessels;Plaques generally continue to change and progressively enlarge due to cell death and degeneration, synthesis and degradation (remodeling) of ECM, and organization of thrombus.Atheromas often undergo calcificationAtherosclerotic plaques are susceptible to the following clinically important changes* Rupture, ulceration, or erosion of the intimal surface of atheromatous plaques exposes the blood to highly thrombogenic substances and induces thrombosis.* Such thrombosis can partially or completely occlude the lumen and lead to downstream ischemia.* If the patient survives the initial thrombotic occlusion, the clot may become organized and incorporated into the growing plaque.* Hemorrhage into a plaque. Rupture of the overlying fibrous cap, or of the thin-walled vessels in the areas of neovascularization, can cause intra-plaque hemorrhage; a contained hematoma may expand the plaque or induce plaque rupture.* Atheroembolism. Plaque rupture can discharge atherosclerotic debris into the bloodstream, producing microemboli* Alienism formation. Atherosclerosis-induced pressure or ischemic atrophy of the underlying media, with loss of elastic tissue, causes weakness resulting in aneurysmal dilation and potential rupture.",Pathology,Atherosclerosis and Arteriosclerosis
+fce5a305-66f4-4bcf-9ef7-30f40f13724d,Flipped LDH indicating Myocardial Infarction is represented by:,LDH-1> LDH-2,LDH-2 > LDH-1,LDH-4 > LDH-5,LDH-5 > LDH-4,0,single,"When LDH-1 is greater than LDH-2, it is referred to as flipped LDH and is indicative of MI. LDH-1 isoenzyme is found primarily in hea muscle and is lesser in concentration than the LDH-2 Isoenzyme which is primarily found in RBC. When the concentration of LDH-1 is observed to be greater than LDH2. It is referred to as flipped LDH and is indicative of Myocardial infarction. LDH has five isoenzymes: LDH-1 LDH-1 is found primarily in hea muscle 17% to 27% LDH-2 LDH-2 is primarily found in Red blood cells 27% to 37% LDH-3 LDH-3 is highest in the lung 18% to 25% LDH-4 LDH-4 is highest in the kidney, placenta, and pancreas 3% to 8% LDH-5 LDH-5 is highest in the liver and skeletal muscle 0% to 5% The LDH test helps determine the location of tissue damage. Thus in Normal ratios LDH-1 is less than LDH-2 and LDH-5 is less than LDH-4. When LDH-1 is greater than LDH-2: It is referred to as flipped LDH. It is indicative of MI. When your LDH-5 is greater than your LDH-4: It could mean damage to the liver or liver disease. This includes cirrhosis and hepatitis. Ref: Harrisons 19th edition",Medicine,C.V.S
+97ae6d3d-e7f8-4c18-9093-50932f99240b,Dimension stability of hydrocollids may be achieved by,optimizing w:p,using cold water,prolonged manipulation,using humidor,3,single,,Dental,
+ffc37c4f-6c0f-4cb2-8cf2-abd2349316d0,Blood supply of stomach is/are:,Left gastric aery,Sho gastric aery,Lt gastroepiploic aery,All,3,multi,A. i.e. Left gastric aery; B. i.e. Sho gastric aery; C. i.e. Left gastroepiploic aery,Anatomy,
+39115fee-b58b-4020-ae8f-9a2653811340,Which of the following ultrasound finding has the highest association with aneuploidy?,Choroid plexus cyst,Nuchal translucency,Cystic hygroma,Single umbilical aery,2,single,All the above mentioned are ultrasound findings associated with increased risk of aneuploidy although the highest association is seen with cystic hygroma Nuchal translucency and cystic hygroma are both measured in the first trimesterTrisomy 21 is the most common aneuploidy associated with increased NT and cystic hygroma While monosomy X presents as second-trimester hygroma.,Microbiology,All India exam
+a90571f1-9a01-4477-ab8a-5613d6dd48f9,Which of the following is not a component of transpo system?,Receptor activation,Selective gate,Non-selective channel,Energy coupling system,0,single,"Functions: Transpo Systems An essential role of biomembranes is to allow movement of all compounds necessary for the normal function of a cell across the membrane barrier. These compounds include a vast array of substances like sugars, amino acids, fatty acids, steroids, cations and anions to mention a few. These compounds must enter or leave the cells in an orderly manner for normal functioning of the cell. A. 1. Ion Channels Ion channels are transmembrane channels, pore-like structures composed of proteins. Specific channels for Na+, K+, Ca++, and Cl- have been identified. Cation conductive channels are negatively charged within the channel and have an average diameter of about 5 to 8 nm. All ion channels are basically made up of transmembrane subunits that come together to form a central pore through which ions pass selectively. All channels have gates and are controlled by opening and closing. Types of Gates Two types of gated channels. They are a. Ligand-gated channels: In this, a specific molecule binds to a receptor and opens the channel. Example: Acetylcholine receptor is present in the postsynaptic membrane. It is a complex of five subunits, having a binding site for acetylcholine. Acetylcholine released from the presynaptic region binds with the binding site of the postsynaptic region, which triggers the opening of the channel and influx of Na+. b. Voltage-gated channels: These channels open or close in response to changes in membrane potential. Some propeies of ion channels * Composed of transmembrane protein subunits. * Highly selective. * Well regulated by the presence of ""gates"". * Two main types of gates: Ligand-gated and voltage-gated. * Activities are affected by ceain drugs. * Mutations of genes encoding transmembrane proteins can cause specific diseases. 2. Ionophores Ceain microorganisms can synthesize small organic molecules, called ionophores, which function as shuttles for the movement of ions across the membrane. Structure: These ionophores contain hydrophilic centres that bind specific ions and are surrounded by peripheral hydrophobic regions. Types: Two types: (a) Mobile ion carriers: Like valinomycin (Refer uncouplers of oxidative phosphorylation). (b) Channel formers: Like gramicidin. 3. Water Channels (Aquaporins) In ceain cells, e.g. in red blood cells, and cells of the collecting ductules of the kidney, the movement of water by simple diffusion is enhanced by movements of water through water channels, composed of tetrameric transmembrane proteins called aquaporins. About five distinct types of aquaporins have been recognised. CLINICAL ASPECT Recently mutations in the gene encoding AP-2 (Aquaporin 2) protein, have been shown to be the cause of one type of nephrogenic diabetes insipidus. 4. Gap Junction Ceain cells develop specialized regions on their membranes for intercellular communications which are in close proximity. Function: They mediate and regulate the passage of ions and small molecules upto 1000 to 2000 mol wt, through a narrow hydrophilic core connecting the cytosol of adjacent cells. Structure: They are primarily composed of protein, called connexon which contains four membrane-spanning a-helices. the mitochondrial membrane also has paicularly energy coupling mechanism.Ref: MN Chatterjea Textbook of Medical Biochemistry, 8th edition",Biochemistry,Respiratory chain
+963aee66-8c6e-46da-ae29-8b9d67cdad80,Burst supression pattern on EEG is typically seen in:,Anoxic encephalopathy,Absence seizures,SSPE,Herpes simplex encephalitis,0,multi,"Ref: Ref: Harrisons 18/e p e-45 chapter
+ As the depth of coma increases, the EEG becomes nonreactive and may show a burst-suppression pattern, with bursts of mixed-frequency activity separated by intervals of relative cerebral inactivity. In other instances there is a reduction in amplitude of the EEG until eventually activity cannot be detected. Such electrocerebral silence does not necessarily reflect irreversible brain damage, because it may occur in hypothermic patients or with drug overdose.
+The prognosis of electrocerebral silence, when recorded using an adequate technique, depends upon the clinical context in which it is found. In patients with severe cerebral anoxia, for example, electrocerebral silence in a technically satisfactory record implies that useful cognitive recovery will not occur.",Unknown,
+9f2fbb1d-f367-43da-9dd8-8571d1fafb84,To feel comfoable and cool in a factory the conrrected effective temperature ( in degree Farenheit) should be -,Less tha 69,Between 69 and 76,Between 77 and 80,Between 81 and 82,1,single,"Comfo zones: In deg C of corrected effective temperature Pleasant and cool 20 Comfoable and cool 20-25 (69-76F) Comfoable 25- 27 (77-80F) Hot and uncomfoable 27-28 Extremely hot 28+ Intolerably hot 30+. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 792",Social & Preventive Medicine,Environment and health
+fb2e4621-c209-4746-9c52-e8679882f93b,Test used for factor VIII deficiency identification is-,PT,APTT,D dimer,FDP,1,single,"Ans. is 'b' i.e., APTT o Factor VIII is a part of the intrinsic pathway of coagulation. The test used to identity1 the defects in the intrinsic and common pathways of coagulation is PTT. Thus prolonged PTT is a feature of patient with factor VIII deficiency.o Patients with hemophilia have deficiency of factor VIII that results in prolonged PTT.o Tests used to evaluate different aspects of hemostasis.Bleeding timeo It is not a test for coagulation rathers it tests the ability of the vessels to vasoconstrict and the platelets to form a hemostatic plug.o It is the time taken for a standardized skin puncture to stop bleeding,o Normal reference value is between 2-9 minutes.o Prolongation generally indicates the defect in platelet number or function.Prothrombin time (PT)o This assay tests the extrinsic and common coagulation pathway.o So, a Prolonged PT can result from deficiency of factor V, VII. X, prothrombin or fibrinogen.Partial thromboplastin time (PTT)o This assay tests the intrinsic and common coagulation pathways.o So, a prolonged PTT. can results from the deficiency of factor V, VHI, IX, X, XI, XII, prothrombin or fibrinogen.Thrombin timeo It is the time taken for clotting to occur when thrombin is added to the plasma,o It tests the conversion of fibrinogen to fibrin and depends on adequate fibrinogen level,o Prolonged thrombin time results from decreased level of fibrinogen.Defective coagulation pathwayPTAPTTExtrinsicIntrinsicCommonIncreasedNormalIncreasedNormalIncreasedIncreased",Pathology,Bleeding Disorders
+090f4f67-eab2-4ffc-a9d0-d03da739bf9f,"A 19 year old female presents with pain in the neck for 5 days. She is not able to wear tie for her job because of neck pain. H/O fatigue and lethargy for 10 days. She had flu like symptoms 20 days ago which resolved spontaneously. BP 110/80 mmHg, Pulse 48/min. Extremities are cold and dry. Neck is very tender. ECG normal. TSH is elevated. ESR 30 mm/hr. Next appropriate step",Atropine injection,Levothyroxine administration,Aspirin,Increase iodine intake in food,2,multi,"Answer: c) Aspirin (SCHWARTZ 19TH ED, P-1525; SABISTON 19TH ED, P-895)Granulomatous or Subacute or De Quervain's thyroiditisMost commonly occurs in 30- 40 year-old womenStrong association with the HLA-B35Fever with Sudden or gradual onset of neck painH/o preceding URI; Viral etiologyGland - enlarged, tender, firmClassically progresses through four stages: Hyperthyroid-Euthyroid-Hypothyroid-EuthyroidA few patients develop recurrent diseaseEarly stages: | ESR, Tg, T4, and T3 levels are elevated, TSH decreasedDuring Hypothyroid stage: elevated TSHLow radio-iodine uptakeFNAC - multinucleated giant cells of an epithelioid foreign body type and aggregates of lymphocytes activated macrophages, and plasma cellsSelf-limiting diseaseAspirin and NSAIDs are used for pain reliefPrednisolone for severe casesShort-term thyroid replacement may be needed and may shorten the duration of symptoms",Surgery,Thyroid Gland
+b37eb019-4f8c-4131-8ff9-c2413a5b227e,"Headache, apathy and deteriorating level of consciousness occurring weeks after head injury suggests;",Chronic subdral haematoma.,Pontine hemorrhage,Continuing cerebral.,Depressed skull fracture.,0,single,Chronic subdral haematoma,Surgery,
+ee83bd7f-cd04-446e-b0a5-da98e920bc7c,A 27-year female wearing high heels stumbled and sustained inversion injury at ankle. Which ligament is most likely to be injured in the given case?,A,B,C,D,0,single,"Ans. A. (A)A. Anterior Talofibular ligamentAnkle sprains: Usually caused by the falls from height or twists of ankle. When the plantar-flexed foot is excessively inverted, the anterior and posterior talofibular and calcaneofibular ligaments are stretched and torn. The anterior talofibular ligament is most commonly torn.",Anatomy,Lower Extremity
+be77f10a-1e08-4ccb-9d32-23f49a68712d,Asymmetric tonic neck reflex (ATNR) disappears at ______,6 months,5 months,9 months,8 months,0,single,"Asymmetric tonic reflex (ATNR) diappears by 6-7 months postnatally The tonic neck reflex is produced by manually rotating the infant&;s head to 1 side and observing for the characteristic fencing posture (extension of the arm on the side to which the face is rotated and flexion of the conralateral arm) An obligatory tonic neck response, in which the infant becomes ""stuck"" in the fencing posture, is always abnormal and implies a CNS disorder Ref: Nelson 21st edition pgno: 3059",Pediatrics,New born infants
+b1bc5067-e456-4968-b690-6d49ec25e155,Ligament teres is a remnant of ?,Ductus aeriosus,Umbilical aery,Umbilical vein,Ductus venosus,2,single,Umbilical vein,Anatomy,
+0f810d3c-d7f0-4783-b806-e554b894b843,Sho structured primi gravida has height less then,140 cm,145 cm,150 cm,135 cm,0,single,140 cm,Gynaecology & Obstetrics,
+1081d0b1-9e05-4d2a-8c52-1668deea11ac,Which of the following is the most specific and sensitive screening test for renovascular hypeension?,HRCT,CT Angiography,Captopril enhanced radionucleotide scan,Doppler ultrasound of renal aeries,1,single,"Hypeension due to an occlusive lesion of a renal aery is renovascular hypeensionIn the initial stages, the mechanism of hypeension generally is related to activation of the renin-angiotensin system. Obstruction of the renal aery leads to decreased renal perfusion pressure, thereby stimulating renin secretion. Over time, possibly as a consequence of secondary renal damage, this form of hypeension may become less renin-dependent.As a screening test, renal blood flow may be evaluated with a radionuclide -ohoiodohippurate (OIH) scan, or glomerular filtration rate may be evaluated with a - diethylenetriamine pentaacetic acid (DTPA) scan before and after a single dose of captopril (or another ACE inhibitor).Contrast aeriography remains the ""gold standard"" for evaluation and identification of renal aery lesions.Harrison 19e pg: 1618",Medicine,All India exam
+00ff4465-6c03-4e07-8986-8f169563b6fc,Role of egg lecithin in propofol formulation is?,Acts as emulsifying agent,Acts as preservative,Acts as carrier vehicle,Acts as antibacterial,0,single,Propofol is an insoluble drug that requires a lipid vehicle for emulsification. Current formulations of propofol use a soybean oil as the oil phase and egg lecithin as the emulsifying agent.,Anaesthesia,Intravenous Anesthetic Agents
+97680640-ea40-4384-bdfb-b6ae47417707,"A 63 year old man presents with a triad of angina, syncope and congestive hea failure. Which of the following valvular hea lesion can be suspected-",antral stenosis,Tricuspid regurgitation,Aoic stenosis,Aoic regurgitation,2,single,"Even severe AS may exist for many years without producing any symptoms because of the ability of the hyperophied LV to generate the elevated intraventricular pressures required to maintain a normal stroke volume. Most patients with pure or predominant AS have gradually increasing obstruction over years, but do not become symptomatic until the sixth to eighth decades. Exeional dyspnea, angina pectoris, and syncope are the three cardinal symptoms. Dyspnea results primarily from elevation of the pulmonary capillary pressure caused by elevations of LV diastolic pressures secondary to reduced left ventricular compliance and impaired relaxation. Angina pectoris usually develops somewhat later and reflects an imbalance between the augmented myocardial oxygen requirements and reduced oxygen availability. Exeional syncope may result from a decline in aerial pressure caused by vasodilation in the exercising muscles and inadequate vasoconstriction in nonexercising muscles in the face of a fixed CO, or from a sudden fall in CO produced by an arrhythmia. ( Harrison&;s principle of internal medicine,18th edition,pg no.1939 )",Medicine,C.V.S
+0ba7be74-d02c-464a-beab-eb016eab8ec3,Generalised thickening of cortical and cancellous bones is seen in,Osteopetrosis,Pagets disease,Osteogenesis imperfecta,Infantile hyperostosis,3,single,,Pathology,
+e4d314d7-fe07-4bd3-ab11-21901e00f699,An athelete presented with red coloured urine after 2 days of history of severe exeion. The most probable cause is?,Hemoglobinuria,Hemosiderinuria,Hematuria,Myoglobinuria,3,single,"Myoglobinuria REF: Harrison's Internal Medicine 17th edition chapter 382, Physiology and pathology of the urine by john dixon p. 49 Red color urine may be due to hemoglobin or myoglobin. In the question clue is given that patient is an athlete who competed in an event which lead to sternous exercise and hence increased myoglobin in the urine. ""The states of energy deficiency cause activity-related muscle breakdown accompanied by myoglobinuria, appearing as light-brown- to dark-brown-colored urine""",Surgery,
+b358361d-b258-43e3-8919-436d1a86eefc,High false positive cases in a community signify that disease has -,High prevalence & Low incidence,High incidence & Low prevalence,Low prevalence & Low incidence,High incidence & High prevalence,1,multi,,Social & Preventive Medicine,
+a0f71cba-c03d-4edd-859b-c5c33ada55af,Which of the following is released from hypothalamus?,Orexin,Cortisol releasing hormone,Neuropeptide,Ghrelin,1,single,"There are 6 established hypothalamic releasing and inhibiting hormones : 
+
+Corticotropin-releasing hormone (CRH),
+Thyrotropin releasing hormone (TRH),
+Growth hormone releasing hormone (GRH),
+Growth  hormone inhibiting hormone (GIH),
+Luteinizing hormone releasing hormone (LHRH) and
+Prolactin inhibiting hormone(PIH).",Physiology,
+b9596ff7-85da-4b76-992a-3d853eb04bfd,Vestibulo-Ocular Reflex Mediated by:,Flocculonodular Lobe,Vermal portion of Spinocerebel 1 um,Neocerebellum,Paravermal region of Spinocerebellum,0,single,Ans:A (Flocculonodular Lobe) Ref: Pal GK. Cerbellurn. In: Textbook of Medical Physiology. Ahuja Publishing House. 2007: 116: 871.Explanation:Functional Division of CerebellumVestibulo cerebellum/Arch-cerebellum (Flocculonodular lobe)Connections with vestibular apparatusConcerned with equilibrium and learning induced changes in vesiihulo-occular reflexSpino cerebellumVermis - controls muscle movements of axial bodyIntermediate zone - controls muscle movements of limbsCerbrocerbellum (Ponto cerebellum/Neo cerbellurn) Overall planning programming of motor activities,Physiology,Cerebellum and Brainstem
+c05388eb-3222-4392-9709-dbb418dd27f8,Which statement best describes the cranial fossa?,The middle cranial fossa contains the cribriform plate.,The anterior cranial fossa contains the pituitary gland.,The middle cranial fossa is floored by the sphenoid and temporal bones.,The internal acoustic meatus lies in the middle cranial fossa.,2,multi,The floor of the middle cranial fossa is made up of the body and greater wing of the sphenoid as well as the squamous temporal bone. The cribriform plate forms pa of the floor of the anterior cranial fossa The middle cranial fossa contains the pituitary gland. The internal acoustic meatus lies in the posterior cranial fossa.,Anatomy,Cranial cavity
+5709cea6-ffc2-4d49-b423-28d815cec8da,Which of the following vitamin enhances intestinal absorption of calcium?,Vitamin D,Vitamin K,Vitamin B1,Vitamin B2,0,single,Vitamin Functions Deficiency Disease D Maintenance of calcium balance Enhances intestinal absorption of Ca2+ and mobilizes bone mineral Regulation of gene expression and cell differentiation Rickets = poor mineralization of bone Osteomalacia = bone demineralization Reference: Harper; 30th edition; Page no: 550,Biochemistry,vitamins
+168e4c3a-95f4-42fe-9a7b-6e3bff6fd7b2,Which of these is the most impoant indication for Strassmans Metroplasty done for a bicornuate uterus?,Infeility,Menorrhagia,Repeated early pregnancy losses,Associated vaginal atresia,2,single,Habitual aboion is the most impoant indication for surgical treatment of women who have a double uterus. The aboion rate in women who have a double uterus is to three times greater than that of the general population. Best diagnosis of the condition is made by laparohysteroscopy. Strassmans Metroplasty,Gynaecology & Obstetrics,Mullerian Abnormalities
+ad1aeb26-1595-4830-b4bf-1253674644df,"A 2-year-old child had burns on buttocks, both legs, face, neck and singeing of hair. Total surface area burnt: JIPMER 14",27%,37%,45%,55%,1,multi,Ans. 37%,Forensic Medicine,
+81d4b17e-e48f-43dc-82ee-034548e32fd2,Which test helps to differentiate between concomitant squint and paralytic squint,Cover - uncover test,Alternate covertest,Direct cover test,None of the above,1,multi,This procedure causes breakdown of binocular fusion mechanism thus helpful to differentiate.,Ophthalmology,
+bf4e6c71-9fa8-4d6b-b5ed-20bb873383f1,Best disinfectant of cholera stool is-,Bleaching powder,Cresol,Phenol,Lime,1,single,"Cresol is an excellent coal-tar disinfectant. It is 3 to 10 times as powerful as phenol, yet no more toxic. Cresol is best used in 5 to 20 percent strength for disinfection of farces and urine. Cresol is an all-purpose general disinfectant. (refer pgno :128 park 23 rd edition)",Social & Preventive Medicine,Epidemiology
+fee1883d-f49b-43d6-99bc-07aabf7f2f9b,Black eye is a type of -,Patterend abrasion,Ectopic abrasion,Ectopic bruise,Friction abrasion,2,single,The synopsis of forensic medicine & toxicology ; Dr k.s.narayan reddy ; 28th edition ; Pg .no . 107 Black eye is the most common example for ectopic bruising or percolated contusion .,Forensic Medicine,Mechanical injuries
+edf8a6fd-63af-4c0e-8013-e3ba366dcec7,In a patient with a type of familial dyslipidemias he presented with palmar Xanthomas and he ias at increased risk of atherosclerosis and CAD.In Lipid profile there was elevation of triacylglycerols and cholesterol.And the IDL and chylomicrons were elevated.What is the pathophysiology of the condition?,LDL deficiency,VLDL overproduction,Apo C-2 deficiency,Apo E deficiency,3,single,Reference: Harpers illustrated biochemistry 30th edition page 275,Biochemistry,Metabolism of lipid
+1ab02ba4-f579-4542-b16f-a0df6a4f05c9,Endolymphatic duct drains into :,Subdural space,External space,Subarachnoid space,Succulus,0,single,Ans:A.)Subdural Perilymph drains into subarachnoid space through the aqueduct of cochlea... Endolymph is absorbed in subdural space.,Anatomy,
+ecbe331f-316c-4739-b032-121e412c8e02,Usually associated with parvovirus B19 infection in those with hereditary spherocytosis-,Mild to moderate splenomegaly,Aplastic crisis,Gallstones,Hemolytic crisis,1,multi,"Ans. is 'b' i.e., Aplastic crisis o Parvovirus B19 selectively infects erythroidprecursors and is the most common aetiological agent that induces aplastic crisis in patients with hereditary spherocytosis (and other Hemolytic disorders).Transient aplastic crisiso Persons with decreased erythrocytes caused by conditions such as iron deficiency anemia, human immunodeficiency virus sickle cell disease, spherocytosis or thalassemia are at risk of transient aplastic crisis if infected with parvovirus B19.o The virus causes a cessation of erythrocyte production,o Parvovirus infection may be the first manifestation in HS.o It begins with reticulocytosis and thrombocytosis.",Medicine,Immunology and Rheumatology
+eb7ac4a5-646e-48cd-ab30-430f8643bb30,Carcinoma of the prostate arise from -,Central zone,Peripheral zone,Transitional zone,Periurethral zone,1,single,,Surgery,
+62f6d5bb-6085-4328-97a0-3e3776f9ae78,A patient with cushinoid features presents with hemoptysis; he shows no response to dexamethasone suppression test; most likely diagnosis here is:,Adrenal hyperplasia,Adrenal adenoma,Ca lung with ectopic ACTH production,Pituitary microadenoma,2,single,Answer is C (Ca lung with ectopic ACTH production); Lack of suppression to dexamethasone challenge (ACTH producing tumor) and presence of hemoptysis (Carcinoma lung) in a patient with Cushinoid features suggests a diagnosis of Carcinoma lung with ectopic ACTH secretion. As a method of diagnostic workup of any patient with suspected Cushings we screen the patient with plasma coisol levels at 8:00 a.m. in the morning. Those with increased coisol levels are subjected to a dexamethasone supression test. In the given question there is lack of suppression to dexamethasone challenge so option (d) is out. Out of the choices remaining the presence of hemoptysis points towards the diagnosis of carcinoma lung with ectopic ACTH.,Medicine,
+b72c9d20-5b2a-4353-ab60-fa1a899fde6b,Symptomatic treatment is not required in withdrawal of:,Cannabis,Morphine,Alcohol,Cocaine,0,single,"Since cannabis causes very mild withdrawal symptoms hence, no symptomatic treatment is required. LSD and other hallucinations also do not cause any withdrawal symptoms .",Psychiatry,Substance Related and Addictive Disorders
+e7127a67-7144-4e6f-9cdc-28dd805000dd,"Following death of a person, what happens to potassium level in the vitreous.",Potassium level falls,Potassium level increases,Remains unchanged,It depends on cause of death,1,multi,Potassium concentration raises at the rate of 0.17-0.25 mmol per hour following death. It helps in determination of time since death.,Forensic Medicine,
+3ec267ef-dc91-4a47-81de-070ce0bf7213,"Under transplantation of humans organs act, the punishment for the doctor involved is",< 1 year,< 2 years,2-5 years,> 5 years,2,single,"The Transplantation of Human Organs Act 1994, amended in 2011, and 2012 Chapter VI and VII deals with the trial and punishment of offences under this act. Under this act, doctors involved will be punished for a period of 2-5yrs. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr. PC IGNATIUS PAGE NO: 389",Forensic Medicine,Medical Jurisprudence
+37de6d96-2eee-4132-8db9-89e72edab01b,Staphylococcus aureus does not cause which of the following skin infection:,Ecthyma gangrenosum,Bullous impetigo,Botryomycosis,Cellulitis,0,single,Ans. is. a. Ecthyma gangrenosum,Microbiology,
+2aa8f835-c0c4-4f2e-895f-4630adf47221,"A young lady with symptoms of hypehyroidism with elevated T4 and TSH levels. On examination, patient was not experiencing Tachycardia or excessive sweating.Fuher examination reveals bitemporal hemianopia. Next step of management",Sta beta blockers immediately,Conservative management sufficient,Sta antithyroid drugs and wait for symptoms to resolve.,Sta antithyroid drugs and do urgent MRI,3,multi,"Hypehyroidism with elevated levels of T4 and TSH levels and bitemporal hemianopia is highly suggestive of TSH secreting adenoma. Urgent MRI should be done to confirm the diagnosis of TSH secreting pituitary adenoma along with antithyroid drugs. Thyrotropin-secreting pituitary tumors (TSH-omas) are a rare cause of hypehyroidism and account for less than 1% of all pituitary adenomas. - Origin - anterior pituitary- MC cause of hyper pituitarism - Pituitary adenoma C/F Functional (Secreting) Non-Functional (Non-Secreting)Early Presentation due to physiologic Delayed presentation (Big enough toeffect cause neurological deficit) | Bitemporal Hemianopia Seen on 3rd / 4th Decade- M = F- MC type of pituitary adenoma is Prolactinoma IOC for diagnosis - MRIOther work-up done Full Endocrinologic ProfileFormal visual field testing TreatmentBromocriptine (Dopamine agonist) -Prolactinoma- Shrink prolactinoma in 6 to 8 weeks- Growth hormone security tumors - shrinkage occur < 20% Pts | Agent Octreotide | GH level in 70% Pts , | Tumor volume in 30% Indications of Sx in pituitary adenoma- GH Secreting tumors- Primarily Cushing Disease- Adenoma causing acute visual deterioration- Non-Prolactin secreting macroadenoma causing symptoms by mass effect Surgical ApproachIntranasal Trans-Sphenoidal , Sub labial Indications of Radiosurgery in pituitary adenoma- Used as primary therapy- Adjuvant therapy after subtotal resection- Recurrent disease",Surgery,Thyroid
+688c3768-9fb8-4541-b844-f89b7c2c6af5,Statuary rape is -,Less than 15 years,Less than 16 years,Less than 18 years,Less than 20 years,2,single,"Ref:Textbook of Forensic medicine and toxicology (V.V.Pillay) 17th edition, page no.388 Minimum age at which female can give consent for sex by what age is 18 years. As per Sec.375IPC unlawful sexual intercourse by man with a woman with or without her consent when she is under 18 years of age. The criminal law (Amendment) Act,2013 has increased the previous recomended age of consent from 16 to 18 years, which means any sexual activity irespective of presence of consent with a woman below the age of 18 will constitute statutory rape.",Forensic Medicine,Sexual offences and infanticide
+2a1c313d-df98-47f8-9d5c-bf439f33f228,A patient on amiodarone is diagnosed to have cornea verticillata. What should be management –,Stop the drug,Penetrating keratoplasty,Lamellar keratoplasty,Observation,0,single,"Cornea Verticillata
+
+This is a whorl-like opacity in the corneal epithelium seen in patients on long-term treatment with medication such as amiodarone, chloroquine, phenothiazines and indomethacin.
+It is also seen in patients with Fabry disease and its carrier state. The condition is generally asymptomatic, harmless and reversible on stopping the drug.
+The whorl-like pattern shows the direction of migration of corneal epithelial cells. Occasionally the condition had been known to cause glare and surface discomfort which response to topical lubricants.",Ophthalmology,
+a46b9738-93ca-472e-bea5-de525420db24,Most aggressive lung CA:,Squamous cell CA,Adenocarcinoma,Small cell lung CA,Large cell CA,2,multi,"Ans. (c) Small cell lung CARef: Robbings 9th ed./ 717* Small cell carcinoma is a highly malignant tumor with a strong relationship to cigarette smoking.* Around 1% occurs in nonsmokers.* They are the most aggressive of lung tumors, metastasizing widely and are always fatal.",Pathology,Characteristics and Epidemiology of Neoplasia
+356ed30d-cba2-4520-97e7-23c04c4067e4,Chemoprophylaxis is indicated for all except-,Typhoid,Meningococcal meningitis,Cholera,Plague,0,multi,"Chemoprophylaxis There is no role of Chemoprophylaxis in Typhoid. For chemoprophylaxis in meningococcal meningitis, Rifampicin, Ciprofloxacin & Ceftriaxone is used. Tetracycline is used in Cholera and Plague.",Social & Preventive Medicine,"Intestinal Infections, Worm Infestations"
+becc6670-95ca-4530-a5ee-afcd3b4ca1b6,"In pontaic fever, which antigen is seen in urine?",Lipopolysaccharide-1,Lipopolysaccharide-2,Lipopolysaccharide-4,Lipopolysaccharide-6,0,single,"Ans. is 'a' i.e., Lipopolysaccharide-1 Legionella are classified into serogroup on the basis ofgroup specific lipopolysaccharide (somatic antigen or 'O' antigen). Legionella pneumophila sero-group-1 (LP-1) is the most common infecting organism. Urine test detect LP-1.",Microbiology,
+7903a702-b0c9-42b8-aca5-1642a098ff81,Mediastinal lymph node calcification is seen in which one of the following-,Metastatic neoplasm,Lymphoma,Sarcoidosis,Bronchiectasis,2,single,"Ref:Robbins Basic Pathology (9th Edition),page no.478,479 Sarcoidosis Although sarcoidosis is considered here as an example of a restrictive lung disease, it is impoant to note that sarcoidosis is a multisystem disease of unknown etiology characterized by noncaseating granulomas in many tissues and organs. MORPHOLOGY The diagnostic histopathologic feature of sarcoidosis is the noncaseating epithelioid granuloma, irrespective of the organ involved. This is a discrete, compact collection of epithelioid cells rimmed by an outer zone of largely CD4+ T cells. The epithelioid cells are derived from macrophages and are characterized by abundant eosinophilic cytoplasm and vesicular nuclei. It is not uncommon to see intermixed multinucleate giant cells formed by fusion of macrophages. A thin layer of laminated fibroblasts is present peripheral to the granuloma; over time, these proliferate and lay down collagen that replaces the entire granuloma with a hyalinized scar. Two other microscopic features are sometimes seen in the granulomas: (1) Schaumann bodies, laminated concretions composed of calcium and proteins; and (2) asteroid bodies, stellate inclusions enclosed within giant cells. Their presence is not required for diagnosis of sarcoidosis--they also may occur in granulomas of other origins. Rarely, foci of central necrosis may be present in sarcoid granulomas, suggesting an infectious process. Caseation necrosis typical of tuberculosis is absent The lungs are involved at some stage of the disease in 90% of patients. The granulomas predominantly involve the interstitium rather than air spaces, with some tendency to localize in the connective tissue around bronchioles and pulmonary venules and in the pleura (""lymphangitic"" distribution). The bronchoalveolar lavage fluid contains abundant CD4+ T cells. In 5% to 15% of patients, the granulomas eventually are replaced by diffuse interstitial fibrosis, resulting in a so-called honeycomb lung. Intrathoracic hilar and paratracheal lymph nodes are enlarged and calcification in 75% to 90% of patients, while a third present with peripheral lymphadenopathy. The nodes are characteristically painless and have a firm, rubbery texture. Unlike in tuberculosis, lymph nodes in sarcoidosis are ""nonmatted"" (nonadherent) and do not ulcerate.",Pathology,Respiratory system
+44634f4a-e203-402e-9a56-aec9702a1423,"""Candle-wax spots"" in the retina are present in",Sarcoidosis,Toxoplasmosis,Syphilis,Tuberculosis,0,single,"(A) Sarcoidosis # OCULAR MANIFESTATIONS OF SARCOIDOSIS:> Anterior segment: Conjunctival involvement has been reported in patients with ocular sarcoidosis.> Sarcoidosis granulomas are solitary, yellow ""millet-seed"" nodules.> Anterior uveitis occurs in 22%- 70% of patients with ocular sarcoidosis, and is usually granulomatous & chronic.> Iris nodules have been reported in up to 12.5% of patients with sarcoidosis associated uveitis.> Exacerbations of granulomatous uveitis are often associated with an appearance of fresh iris or fundus nodules.> Posterior synechiae, cataract and glaucoma are common complications.> Corneal band keratopathy develops in a few patients and is usually associated with hypercalcemia.> Posterior segment: The most common manifestations at the posterior segment are vitritis, intermediate uveitis, panuveitis, posterior uveitis, retinal vasculitis & optic nerve involvement. Other manifestations include choroidal nodules & exudative retinal detachment.> Overall, patients with chronic posterior uveitis and panuveitis have significantly more complications than do patients with anterior uveitis.> ""Candle wax drippings"" and ""punched-out"" lesions can be seen in patients with uveitis secondary to sarcoidosis.",Ophthalmology,Miscellaneous
+2fa36968-f396-4677-a256-c353757b82b8,The number of doses recommended for oral Ty21a typhoid vaccine is:,14,5,3,1,2,single,"The Ty21a vaccine is licensed for use in individuals > 5 years. A three dose regimen is recommended. Vaccine is administered on alternate days: 0n days 1, 3 and 5. Ref: Park 21st edition, page 215.",Social & Preventive Medicine,
+9587b40f-5950-423e-aaa2-7a05f813f832,The drug used in petit mal seizures and has a narrow spectrum of antiepileptic activity is,Lamotrigine,Ethosuximide,Phenytoin,Primidone,1,single,Ethosuximide and valproate are the drugs of choice for absence seizures and are more effective than lamotrigineReference: Katzung Pharmacology; 12th edition; Page no: 418,Pharmacology,Central Nervous system
+037720db-3d5f-4488-be9b-b12a0cc81c2d,Which test is not useful in a patient with history of Syncopal attack?,Electrophysiological testing,Tilt Table testing,PET Scan,Holter monitoring,2,single,"Answer is C (PET Scan) : PET scan has- not been mentioned as a test to investigate syncope in Harrisons text. It is the single best answer of exclusion. Electrophysiological tests and 24 hour ECG Holter monitoring are indicated in patients where history suggests a cardiac disease. Upright tilt table testing is indicated for suspected neurogenic / vasodepressor syncope in patients with normal history / examination. Invasive Cardiac Electrophysiologic testing : provides diagnostic and prognostic information regarding Sinus Node function, AV conduction and Supraventricular and Ventricular arrhythmia. Holter monitor : provides 24 - 48 hours monitoring of ECG rhythm on an outpatient basis and is indicated for detection of conduction abnormalities. Upright tilt table testing : Is a test for vasodepressor / neurogenic syncope in patients with normal history / examination. In susceptible patients upright tilt at an angle between 60deg to 80deg for 30 to 60 minutes induces a vasovagal episode. Indications for Table Tilt test include : Recurrent syncope - Single syncope episode that caused injury - Single syncope event in high risk setting (pilot, commercial vehicle driver) Syncope The choice of diagnostic test should be guided by the history and physical examination For All patients Serum electrolytes Glucose Haematocrit",Medicine,
+897b2724-c93d-4e41-965a-d58fbd6c8cde,Magic syndrome is seen in:,Behcet disease,Aphthous major,Herpetiform,Bloom syndrome,0,single,“MAGIC syndrome” (Mouth and Genital ulcers with Inflamed Cartilage) has been proposed to describe patients with clinical features of both relapsing polychondritis and Behcet disease.,Pathology,
+3eb8e753-2c11-4d5a-aee4-da83f114752e,Acute hemorrhagic conjunctivitis is caused by ?,Enterovirus 70,Adenovirus,Poliovirus,Hepadnavirus,0,single,"Ans. is 'a' i.e., Enterovirus 70 Acute hemorrhagic conjunctivitis (AHC) may be caused by adenoviruses, but two enteroviruses, enterovirus 70 and coxsackie A24 variant, are the major causes.",Microbiology,
+f5168131-b12b-4477-8c70-9199583db3ae,In a 24 year old man weight of the upper limb is transmitted to the axial skeleton by:,Coracoacromial ligament,Coracoclavicular ligament,Costoclavicular ligament,Coracohumeral ligament,1,single,"The axial skeleton shapes the longitudinal axis of the human body. Coracoclavicular ligament suspends the scapula from the lower one third of the clavicle and forms a strong bond between them. The weight of the upper limb is transmitted to the axial skeleton through this ligament. A fracture of the clavicle, medial to the attachment of this ligament leads to drooping of upper limb. Ref: TB of Anatomy and Physiology PR Ashalatha, 1st Ed, Page 110",Anatomy,
+edcaea9c-f584-43db-a696-4422c66034d4,Primary health care was proposed in 1978 at:,Alma ata,New York,Geneva,Delhi,0,single,"Answer: A. Alma ata. (Ref Park's Textbook of PSM 22nd/Pg.832)The new approach to health care came into existence in 1978 following an international conference at Alma Ata (USSR).The Alma-Ata conference defines the primary health care as follows: Primary health care is essential health care made universally accessible to individuals and acceptable to them, through their full participation and at a cost the community and the country can afford.Millennium Development Summit was held in New York in 2000 where MDG are formulated.World Health Assembly is held in Geneva, which is a head quarter of WHO.Note: The term ""comprehensive health care"" (womb to tomb) was first used by Bhore committee in 1946.",Social & Preventive Medicine,Healthcare of the Community & International Health
+f5469d2e-345d-44db-89b9-e3f00f74341d,Schizophrenia is treated by:,Anti depressants,Anti psychotics,Anti epileptics,Mood stabilizers,1,single,,Pharmacology,
+c55a313a-5fd4-479d-9513-944926fede44,Gene involved in Cowden syndrome is,P53,PTEN,RB,Ras,1,single,"(B) PTENo""Phosphatase and Tensin'' homolog (PTEN) - protein in humans encoded by the PTEN gene. Gene mutations promotes development of cancers.[?]Cowden's disease/Multiple Hamartoma Syndrome:-Part of PTEN hamartoma tumor syndrome-An autosomal dominant syndrome-Trichilemmomas - Numerous tumors of hair follicles in face-Multiple hamartomatous polyps in GI tract, Lipomas, Granulomas-Very high risk of breast, Follicular endometrail carcinoma & thyroid carcinomaoTreatment: Bilateral mastectomies recommended-Contraindicated are mammography & other radiation exposure of breast tissue.-Mean age at presentation <10 years-Very high risk of breast, follicular carcinoma of thyroid & Endometrial carcinomaoPTEN (phosphatase and tensin homologue) is a membrane-associated phosphatase encoded by a gene on chromosome 10q23 that is mutated in Cowden syndrome, an autosomal dominant disorder marked by frequent benign growths, such as skin appendage tumors, and an increased incidence of epithelial cancers, particularly of the breast, endometrium, and thyroid.oPTEN acts as a tumor suppressor by serving as a brake on the PI3K/AKT arm of the receptor tyrosine kinase pathway.oPTEN gene function is lost in many cancers through deletion, deleterious point mutations, or epigenetic silencing.SELECTED TUMOR SUPPRESSOR GENES & ASSOCIATED FAMILIAL SYNDROMES & CANCERS, SORTED BY CANCER HALLMARKS*Gene (Protein)Familial SyndromesAssociated CancersInhibitors of Mitogenic Signaling PathwaysAPC (Adenomatous polyposis coli protein)Familial colonic polyps and carcinomasCarcinomas of stomach, colon, pancreas; melanoma*. NF1 (Neurofibromin-1)Neurofibromatosis type 1 (neurofibromas and malignant peripheral nerve sheath tumors)Neuroblastoma, juvenile myeloid leukemia*. NF2 (Merlin)Neurofibromatosis type 2 (acoustic schwannoma and meningioma)Schwannoma, meningioma*. PTCH (Patched)Gorlin syndrome (basal cell carcinoma, medulloblastoma, several benign tumors)Basal cell carcinoma, medulloblastoma*. PTEN (Phosphatase and tension homologue)Cowden syndrome (variety of benign skin, GI, and CNS growths; breast, endometrial, and thyroid carcinoma)Diverse cancers, particularly carcinomas and lymphoid tumors*. SMAD2, SMAD4 (SMAD2, SMAD4)Juvenile polyposisFrequently mutated (along with other components of TGFb signaling pathway) in colonic & pancreatic CaInhibitors of Ceil Cycle Progression*. RB Retinoblastoma (RB) proteinFamilial retinoblastoma syndrome (retinoblastoma, osteosarcoma, other sarcomas)Retinoblastoma; osteosarcoma carcinomas of breast, colon, lung*. CDKN2A p16/INK4a & pU/ARFFamilial melanomaPancreatic, breast, and esophageal carcinoma, melanoma, certain leukemiasInhibitors of ""Pro-growth"" Programs of Metabolism and Angiogenesis*. VHL (Von Hippel Lindau (VHL) protein)Von Hippel Lindau syndrome (cerebellar hemangioblastoma, retinal angioma, renal cell carcinoma)Renal cell carcinoma*. STK11 (Liver kinase B1 (LKB1) or STK11)Peutz-Jeghers syndrome (GI polyps, GI cancers, pancreatic carcinoma and other carcinomas)Diverse carcinomas (5%-20% of cases, depending on type)*. SDHB, SDHD (Succinate dehydrogenase complex subunits B & D)Familial paraganglioma, familial pheochromocytomaParaganglioma",Pathology,Neoplasia
+78353090-0d67-40f9-9067-b6ddcfa932cc,Supraventricular crest lies between-,Pulmonary orifice and atrioventricular orifice,Atrioventricular orifice and fossa ovalis,SVC and right atrium,Right an dleft coronary artery,0,single,"Ans. is 'a' i.e., Pulmonary orifice and atrioventricular orifice Interior of right ventricle* It is anteroinferior chamber and projects to the left of right atrium. It is in contact with the sternum.* It is divided into -i) Rough inflowing part (ventricle proper)# It is developed from right half of primitive ventricle.# Its interior is rough due to the presence of muscular ridges known as trabeculae carneae, which are more prominent in apical region.# Trabeculae carneae are of 3 types: -1. Ridges - Linear elevations.Supraventricular crest - a ridge present between the pulmonary and atrioventricular orifices, extends downwards in the posterior wall of the infundibulum.2. Bridges -'Muscular elevations with fixed ends on ventricular walls, the center being free.Septomarginal trabecula: It is a specialized bridge which extends from the right of ventricularseptum to the base of anterior papillary muscle. It contains the right branch of atrioventricular bundle.3. Papillary muscles are conical projections of muscle fiber bundles. Their base is attached to the ventricular wall and the apex is attached to the chordae tendinae, which are further attached to the cusps of atrioventricular (AV) valves. There are three papillary muscles in the right and two in the left ventricle. They regulate closure of atrioventricular valves.ii) Smooth outflowing part (infundibulum or conus arteriosus)# Smooth outflowing part develops from mid portion of bulbus cordis and surrounds pulmonary valveSupraventricular crest (crista supraventriculars) or infundibuloventricular crest separates tricuspid (AV) orifice and pulmonary orifice, i.e. inlet and outlet parts.",Anatomy,Thorax
+47a7e08c-e3a3-46bf-8927-d9e194a385c1,Which of the following is freely filtered by kidney across glomerular capillariesa)  Albumin (across glomerular capillaries)b) Globulinc) Creatinined) HCO3 e)  Glucose,cde,acd,bde,ade,0,single,"Freely filterable substances by glomerulus
+-        Water
+-        Na+
+-        Cl-
+-        HCO3-
+-        Inulin
+-        Glucose
+-        Creatinine
+ 
+-        Free Calcium or phosphate",Physiology,
+de848149-c145-4341-95fd-5e7fb647e705,Antibodies associated with GTCS in SLE :,Anti neuronal ab,Anti-Ro ab,Anti-Sm ab,None,0,multi,"Ans.A Anti neuronal ab (Ref: Harrison's Internal medicine 18th/Table 319-1; 17th edition, P. 2076). Autoantibodies in Systemic Lupus Erythematosus (SLE) Antibody Prevalence, % Antigen Recognized Clinical Utility Antinuclear antibodies 98 Multiple nuclear Best screening test; repeated negative tests make SLE unlikely Anti-dsDNA 70 DNA (double-stranded) High titers are SLE-specific and in some patients correlate with disease activity, Anti-Sm 25 Protein complexed to 6 species of nuclear U1 RNA Specific for SLE; no definite clinical correlations; most patients also have anti Anti-RNP 40 Protein complexed to U1 RNA Not specific for SLE; high titers associated with syndromes that have overlap blacks than whites Anti-Ro (SS-A) 30 Protein complexed to hY RNA, primarily 60 kDa and 52 kDa Not specific for SLE; associated with sicca syndrome, predisposes to subacute cutaneous with decreased risk for nephritis Anti-La (SS-B) 10 47-kDa protein complexed to hY RNA Usually associated with anti-Ro; associated with decreased risk for nephritis Antihistone 70 Histones associated with DNA (in the nucleosome, chromatin) More frequent in drug-induced lupus than in SLE Antiphospholipid 50 Phospholipids, 2 glycoproteins 1 cofactor, prothrombin Three tests available ELISAs for cardiolipin and 2G1, sensitive prothrombin Antierythrocyte 60 Erythrocyte membrane Measured as direct Coombs' test; a small proportion develops overt hemolysis Antiplatelet 30 Surface and altered cytoplasmic antigens on platelets Associated with thrombocytopenia but sensitivity and specificity are not good; Antineuronal (includes anti-glutamate receptor) 60 Neuronal and lymphocyte surface antigens In some series a positive test in CSF correlates with active CNS lupus. Antiribosomal P 20 Protein in ribosomes In some series a positive test in serum correlates with depression or psychosis Also remember: Antibody Best screening test for Antibody ANA SLE Anti-Histone Drug-induced lupus Antinuclear antibodies SLE, nonspecific Anti-dsDNA; Anti-Sm Specific for SLE Anti-sm (Nelson's Paediatric Textbook) Marker of CNS lupus Anti-DNA Level of which correlates with disease activity Anti-Ro (SS-A) SACL, neonatal lupus Anti-Ro and Anti-La ie risk of nephritis (protective against nephritis) Antiphospholipid Hematological and Fetal Loss Antiribosomal protein Depression and Psychosis Anti-basement membrane Goodpasture syndrome Anticardiolipin, lupus anticoagulant SLE, antiphospholipid syndrome Anticentromere Limited scleroderma (CREST syndrome) Anti--Scl--70 (anti--DNA topoisomerase 1) Scleroderma (diffuse) Anti--SSA, anti--SSB (anti-Ro, anti--La) Sjogren syndrome Anti--Jo--1, anti--SRP, anti--Mi--2 Polymyositis, dermatomyositis Anti--TSH receptor Graves disease Anti--U1RNP (ribonucleoprotein) Mixed connective tissue disease c-ANCA (PR3-ANCA) Granulomatosis with polyangiitis (Wegener) IgA antiendomysial, IgA anti--tissue transglutaminase Celiac disease p-ANCA (MPO--ANCA) Microscopic polyangiitis, Churg--*JStrauss syndrome Anti--ACh receptor Myasthenia gravis Rheumatoid factor (antibody, most commonly IgM, specific to IgG Fc region), anti--CCP Rheumatoid arthritis Anti--glutamate decarboxylase Type 1 diabetes mellitus Anti--desmoglein Pemphigus vulgaris Anti--hemidesmosome Bullous pemphigoid Antimicrosomal, antithyroglobulin Hashimoto thyroiditis Antimitochondria! 1*< biliary cirrhosis Anti--smooth muscle Autoimmune hepatitis ALSO KNOW: LE cells Neutrophils with LE bodies seen in SLE, RA Penicillamine drug induced Hematoxilin bodies SLE endocarditis (Libmann-Sack) 'Wire-loop' lesions SLE type IV nephritis",Unknown,
+b90b1e07-21e0-4760-a2dc-8edd5fddac7d,Tonsillar fossa is bounded anteriorly by,Pharyngobasilar fascia,Palatopharyngeal fold,Buccopharyngeal fascia,Palatoglossal fold,3,single,"Tonsilar fossa is bounded by Anterior - Palatoglossal fold containing palatoglossal muscle Posterior - Palatopharyngeal fold containing palato pharyngeal muscle Apex - Soft palate, where both arches meet Base - Dorsal surface of posterior one-third of tongue. (Ref: Anatomy of head, neck and brain. Vishram Singh. P 227 )",ENT,Pharynx
+8ae09b49-665e-45e3-ac3d-869ff1a96a44,"""Castration anxiety"" is seen in which phase of Sigmond Freud's psychosexual stages of development",Oral,Anal,Phallic,Genital,2,multi,"Phallic phase (3-5years): Male child develops Oedipus complex (sexual feeling towards mother) and will be afraid that father may castrate him for this termed as ""Castration anxiety"".",Psychiatry,
+04c2701f-e97b-451d-a824-49d4c35c4ffb,Shock causes:,Stagnant hypoxia,Anemic hypoxia,Hypoxic hypoxia,Histotoxic hypoxia,0,single,"Ans: A (Stagnant hypoxia)Ref: Pat GK, Hypoxia and Oxygen Therapy, In: Textbook of Medical Physiology, 2nd ed, Abuja Publishing House 2011: 94: 754-55Explanation:Refer the explanation of previous question",Physiology,Circulation: Circulatory Shock and Its Treatment
+a8b60e51-39fd-45f3-bc37-6b0ab6126430,"Two or more parallel vertical surfaces of abutment teeth shaped to direct the prosthesis during placement and removal, are known as:",Orientation plane,Parallel block out,Survey lines,Guiding planes,3,multi,,Dental,
+2b84d3c8-a571-4f34-aaea-b58afabb9ee5,Calcium silicate based material is:,MTA,Geristore,Dieket,Retroplast,0,single,"Mineral trioxide aggregate was developed by Dr Torabinejad in 1993. 
+It contains tricalcium silicate, dicalcium silicate, tricalcium aluminate, bismuth oxide, calcium sulfate and tetracalcium aluminoferrite.
+pH of MTA is 12.5.
+
+Textbook of Endodontics Nisha Garg 3rd Ed",Dental,
+d364fa9c-b9f9-4328-bf4c-070339d50af1,Which of the following statements about Total Infra–Venous Anaesthesia (TIVA) is true –,Causes More Renal Toxicity,Reduces Cerebral Metabolic Rate,Risk of Malignant Hyperthermia is high,Inhibits Hypoxic Pulmonary Vasconstriction,1,multi,"Total intravenous anaesthesia refers to a technique in general anaesthesia using a compination of agents given solely by IV route and in the absence of all inhalation agents.
+TIVA (Total intravenous anaesthesia) is produced by IV propoful. Propofol decreases the cerebral metabolic rate.
+Propofol does not impair renal function, does not trigger malignant hyperthermia and does not inhibit hypoxic pulmonary vasoconstriction.",Anaesthesia,
+4eafd9d8-b2ea-4f44-ac7f-a12103f61945,"In Profound MR, IQ is",50-69,35-49,20-34,< 20,3,single,IQ range for categoriesICD-10DSM-IVMild50-6950-55 to 70Moderate35-4935-40 to 50-55Severe20-3420-25 to 35-40ProfoundBelow 20Below 20-25Reference: Oxford Textbook of Psychiatry; 3rd edition; Chapter 18; Learning Disability,Psychiatry,Child psychiatry
+f0a88604-cf9c-4181-87f8-e3daccd3d389,Which of the following iodinated compound is present in a maximum concentration in the thyroid?,Monoiodotyrosine (MIT),Diiodotyrosine (DIT),T3,Reverse T3,1,single,"THYROID HORMONE SYNTHESIS AND SECRETIONThyroid hormones are synthesized in the colloid, near the apical cell membrane of the follicular cells. Catalyzed by the enzyme thyroidal peroxidase, iodide in the thyroid cell is oxidized to iodine.The iodine enters the colloid and is rapidly bound at the 3 position to tyrosine molecules attached to thyroglobulin, forming monoiodotyrosine (MIT).MIT is next iodinated at the 5 position, forming diiodotyrosine (DIT).Two DIT molecules then condense in an oxidative process (""coupling reaction"") to form one thyroxine (T4) molecule.Some T3 is probably formed within the thyroid gland by condensation of MIT with DIT. A small amount of reverse T3 (rT3) is also formed.In the normal thyroid, the average distribution of iodinated compounds is 23% MIT, 33% DIT, 35% T4, 7% T3, and 2% reverse T3.",Microbiology,All India exam
+7a6581e6-e0e5-4135-a642-cb80351a063c,Silicosis caused by ?,Gold,Coal,CO,Silica,3,single,"Ans. is 'd' i.e., Silica",Social & Preventive Medicine,
+e3b9ae95-2b0e-42af-a27a-f6c0b51af476,Human development index includes -,Crude death rate,Life expectancy at one year,Life expectancy at bih,All,2,multi,"Ans. is 'c' i.e., Life expectancy at bih According to 22nd/e of Park, options 'd & e' are not the components of HDI. o Expected years of schooling (not adult literacy rate) and GNI per capita (not GDP) are the components of HDI.",Social & Preventive Medicine,
+4d8ea9c6-e243-4402-8393-ac53373773ce,One of the constituents of the commonly used metered dose inhalers in bronchial asthma which is an air pollutant & dangerous to earth's stratosphere is -,Flurocarbons,Salbutamol,Ozone,Oxygen,0,single,,Medicine,
+8f5f61e2-a8ea-4d15-ba76-823918e49d3b,"H. capsulatum, a dimorphic fungus, is found in soil heavily contaminated with bird droppings. Which of the following statements best describes the presence of the organism in tissue biopsies?",Yeasts with broad-based bud,Single-cell yeasts with pseudohyphae,Arthrospores,Oval budding yeasts inside macrophages,3,multi,"Histoplasma capsulatum is a dimorphic fungus that forms two types of spores: tuberculate macroconidia and microconidia. Inhalation of the microconidia transmits infection. Inhaled spores (microconidia) are engulfed by macrophages and develop into yeast forms. Most infections remain asymptomatic; small granulomatous foci heal by calcification. However, pneumonia can occur. The heterophile antibody test is useful for early diagnosis of infectious mononucleosis. The figure below illustrates the oval budding yeasts.",Microbiology,Mycology
+940903a9-03dd-4900-bf86-2a421380958b,Budding reproduction in tissue is seen in,"Cryptococcus, candida","Candida, rhizopus","Rhizopus, mucor","Histoplasma, candida",0,single,"Cryptococcus is a yeast, candida is a yeast-like fungus. Both are reproduced by budding Histoplasma is a dimorphic fungus Mucor and Rhizopus are produced by asexual means sporangiospores Reference: Textbook of Microbiology; Baveja; 4th edition",Microbiology,mycology
+e6b8da32-0a36-4ef8-8d82-e1eb2a517c9b,True about polio:,Paralytic polio is most common,Spastic paralysis seen,IM injections and increased muscular activity lead to increased paralysis,Polio drops in pulse polio immunisation given only in <3 years old children,2,multi,"False 90-95% of polio infections are asymptomatic False Acute flaccid paralysis is seen in Polio & not spastic paralysis True Risk of paralytic polio is increased by tonsillectomy, strenous physical exercise, tooth extraction,Injection (intramuscular) False OPV drops are given to all children less than 5 yr age in pulse polio immunisation",Pediatrics,Impoant Viral Diseases in Children
+c853613f-ef01-4ea6-afc6-2a467d44aecc,The retention of dowel in a pin retained crown is increased by,"Increased length, smooth surface and increased taper.","Increased length, serrated surface and increased taper.","Increased length, smooth surface and parallel sides.","Increased length, serrated surface and parallel sides.",3,multi,"Post should be at least 2/3 the root length, parallel sided and serrated for increased retention in the canal",Dental,
+08531c7b-c9f3-49f2-a8f2-e64ac23974e7,Which of the following drugs can be administered by subcutaneous route?,Albuterol,Metaproterenol,Terbutaline,Pirbuterol,2,single,terbutaline can be given as s.c (0.25mg) in asthma.,Pharmacology,
+f00410d1-d829-45fa-8643-4dcc815bb0e6,Mycosis fungoides which is not true:,It is the most common form of cutaneous lymphoma.,Pautriers microabscess.,Indolent course and easily amenable to treatment.,Erythroderma seen and spreads to peripheral.,2,multi,"Mycosis Fungoides:
+Mycosis fungoides is synonymous with Cutaneous T cell lymphoma.",Medicine,
+ccb6817f-6a6b-49c6-879b-0bd13daf314d,Bacterial pyogenic parotitis affecting the parotid gland is most common after: March 2008,Uveo-parotid fever,Mumps,Debilitation after major surgery,After administration of iodine,2,single,"Ans. C: Debilitation after major surgery Acute bacterial parotitis is now infrequent, but its historical impoance. Mumps and bacterial parotitis were differentiated by 1800, but neither was effectively treated. The moality rate for bacterial parotitis was 80%. Before antibiotics and intravenous administration of fluids were available, bacterial parotitis occurred in postoperative patients or other severely ill patients who became dehydrated and contributed to their demise as an incurable sepsis.",Surgery,
+f2bed904-d182-4df2-97d4-3e5d9186bc39,Patient diagnosed as squamous cell intraepithelial lesion which of the following has the highest risk for progression to carcinoma;,Low grade squamous intraepithelial neoplasia,High grade squamous intraepithelial neoplasia,Squamous intraepithelial associated with HPV 16,Squamous intraepithelial neoplasia associated with HIV,1,single,"High grade squamous intraepithelial lesion have a propensity to progress and become invasive, therefore need investigations and treatment Ref: Shaw Gynecology 17 e pg 410.",Gynaecology & Obstetrics,Gynaecological oncology
+a2cc3df8-77f3-4290-a580-d66398b9439d,Autosomal recessive polycystic kidney disease features include:,Can be diagnosed intrauterine,Proceeds to renal failure till children reaches school going age,Can be palpated abdominally,Hypertension doesn't develop until late stages of the disease,0,multi,"Ans. A. Can be diagnosed intrauterineExplanationClinical features of ARPKD (Autosomal recessive polycystic kidney disease) are:Classic ARPKD is generally diagnosed in utero or within the neonatal period and characterized by greatly enlarged echogenic kidneys in diseased fetuses. (Option a)Reduced fetal urine production may contribute to oligohydramnios and pulmonary hypoplasia.About 30% of affected neonates die shortly after birth due to respiratory insufficiency. Close to 60% of mortality occurs within the first month of life.In the classic group, most patients are bom with renal insufficiency and ESRD (End stage renal disease). (Option b)However, infants often have a transient improvement in their GFR; death from renal insufficiency at this stage is rare.Some patients are diagnosed after the neonatal stage and form the older group. Morbidity and mortality in this group often involve systemic hypertension, progressive renal insufficiency, and liver manifestations.The hallmarks of ARPKD liver disease are biliary dysgenesis due to a primary ductal plate malformation with associated periportal fibrosis, namely congenital hepatic fibrosis (CHF) and dilatation of intrahepatic bile ducts (Caroli's disease). CHF and Caroli's disease can then lead to portal hypertension exhibiting hepatosplenomegaly, variceal bleeding, and cholangitis.Some patients with the diagnosis of ARPKD at 1 year of age with nephromegaly exhibit slowly declining renal function over 20 years with only minimally enlarged kidneys at ESRD (Option c and e) and markedly atrophic kidneys following renal transplantation.The slow progression of renal disease is likely due to increasing fibrosis rather than the development of cysts.Systemic hypertension is common in all ARPKD patients, even those with normal renal function. (option d)",Pathology,Kidney
+78c840a3-5ead-4b96-97b6-6b99a2b98f9b,You are the medical officer in charge of the immunisation programme at a sub-centre and you are informed by the local ASHA worker that one of the children who was immunised has has been dizzy. On fuher investigation it was confirmed that the symptoms were due to anxiety of pain of the injection and not as a result of the vaccine. You would consider the incidence as:,Vaccine reaction,Injection reaction,Programme error,Coincidental,1,single,"The following are the adverse effect following immunisation: Vaccine reaction - Here the event is caused by the inherent propeies of the vaccine when given correctly. Programme error - In this case the event is as a result of error in preparation, handling or administration of the vaccine. Coincidental - The event after immunisation is not caused by the vaccine but by a chance association. Injection reaction - The anxiety of the pain an injection itself may cause hyperventilation, dizziness etc. This is not a result of the vaccine and is called injection reaction. Ref: Park, 21st Edition, Page 103, 107.",Social & Preventive Medicine,
+dc05e667-659f-4f8f-a534-b329a1b356cc,Bicipital aponeurosis lies over which structure in cubital fossa:-,Median cubital vein,Radial nerve,Brachial aery,Anterior interosseous aery,2,single,Bicipital aponeurosis lies superficial to the brachial aery and median nerve. -lies deep to superficial veins. -provides protection for the deeper structures during venepuncture at cubital fossa. -routinely released to decompress the median nerve,Anatomy,Muscles of arm and forearm region & Cubital fossa
+77e67056-21d4-4dad-ba62-f785e6ce4e38,Postponing paying attention of conscious impulse or conflict is a mature defence mechanism known as -,Sublimation,Suppression,Humor,Anticipation,1,single,Suppression is pushing of unwanted feelings into unconscious which has reached conscious awareness.,Psychiatry,
+3779c7ae-2be8-498b-adc9-45465595bf19,The commonest site of perforation during colonoscopy is -,Caecum,Hepatic flexure,Splenic flexure,Sigmoid colon,3,single,"• Risks of colonoscopy: Perforation and hemorrhage
+• MC site of bleeding after colonoscopy: Stalk after polypectomy.
+• MC site of perforation during colonoscopy: Sigmoid colon
+• Perforation can be caused by excessive air pressure, tearing of the antimesenteric border of the colon from excessive pressure on colonic loops, and at the sites of electrosurgical applications",Surgery,
+cbd91783-e901-4672-9ec1-7f58bce041da,"A 74-year-old woman develops occipital headache, vomiting, and dizziness. She looks unwell, her blood pressure is 180/100 mm Hg, pulse is 70/min, and respirations are 30/min. She is unable to sit or walk because of unsteadiness. Over the next few hours, she develops a decline in her level of consciousness.For the above patient with altered level of consciousness, select the most likely diagnosis.",basal ganglia hemorrhage,cerebellar hemorrhage,pontine hemorrhage,lobar intracerebral hemorrhage,1,multi,"Cerebellar hemorrhage, when mild, may present with only headache, vomiting, and ataxia of gait. Patients may complain of dizziness or vertigo. The eyes may be deviated to the side opposite the hemorrhage. Nystagmus is not common, but an ipsilateral sixth nerve palsy can occur. This is the only type of intracerebral hemorrhage that commonly benefits from surgical intervention.",Medicine,C.N.S.
+6c5c0933-9307-485a-a14b-305f77c287ef,Which is an uricosuric drug-,Allopurinol,Probenecid,Indomethacin,Aspirin,1,multi,"Ans. is 'b' i.e., Probenecid Uricosuric drugs are probenacid, sulfinpyrazone and benzbromarone.",Pharmacology,
+8556ec34-5fc9-46de-8be9-bce2fbd3ea06,"After an incised wound ,new collagen fibrils are seen along with a thick layer of growing epithelium.The approximate age of the wound is",4-5days,About 1week,12-24hrs,24-48 hrs,0,single,"Ref Robbins 9/e p106 Incised wound for the formation of collagen and new tissue, thick layer of epithelial ,and granulation tissue formation along with new blood vessels requires atleast 4_5 days",Anatomy,General anatomy
+7a277163-0216-4d34-838f-3f4ca53d763c,"After delivery, a 28 year old pre ecclamptic primigra has a soft uterus with moderate-to-heavy bleeding. There is no laceration and there is PPH diagnosed due to uterine atony. Which of the following is the best management option?",0.2-mg intramuscular (IM) ergonovine (Methergine),20 units of IV oxytocin,10 units of oral oxytocin,250 mg prostaglandin F2-alpha orally,1,multi,Ergot derivatives should not be given in patients with hypeension since this is classically known to increase blood pressure. A high BP may provoke a post paum ecclampsia Oxytocin is not orally effective . Prostaglandin F2-alpha is given IM.,Gynaecology & Obstetrics,Pregnancy induced Hypeension
+784827e3-b944-4c14-98d5-ed648eb38bc8,Trendlenburg's test done for varicose veins is for detection of:,Perforator in competency,Deep veins patency,Saphenofemoral incompetency,Site of perforators,2,single,"Ans: C (Saphenofemoral incompetency) Ref : 74 A Manual on Clinical Surgery S. DasExplanation:Clinical Examination of Varicose VeinsBrodie-Trendelenherg TestDone to determine the incompetency of Saphenofemoral valve.Patient is placed in recumbent position.Limbs are raised to empty the veins. Veins are milked proximally for further emptying.Saphenofemoral junction is compressed either with the thumb of the examiner/toumiquet and the patient is asked to stand up quickly.There are two variants of this test.The first method is to assess saphenofemoral incompetency. The pressure is released and if the column of blood fills up quickly from above downwards it indicates saphenofemoral incompetency.The second method is to assess the perforators. Here, the pressure is maintained for one minute. Gradual filling of the veins during this period indicates incompetent perforators allowing reflux of blood from deep veins to superficial veins.Positive Brodie--Trendelenberg test i~ an indication for surgery.Tests to Assess Saphenofemoral IncompetencyBrodie -Trendelenberg testMorrisey's cough impulse testTests to Assess Deep VeinsPerthe's testModified Perthe's testTests to Assess PerforatorsMultiple tourniquet testPratt's testFegan's testBrodie-Trendelenberg testTest to Assess V alves in Superficial VeinSchwartz testNote:Even though Brodie-Trendelenberg test is used to assess both saphenofemoral incompetency and incompetent perforators its primary purpose is to assess saphenofemoral incompetency.",Surgery,Varicose Veins
+1a161e71-2d41-43e3-a3ed-4317413c6d86,"Arrange the following 4 enzymes of gluconeogenesis in sequence: A. Pyruvate carboxylase B. Glucose - 6 - phosphatase C. Phosphoenol pyruvate carboxy kinase D. Fructose 1,6 Bisphosphatase",D-C-A-B,A-C-D-B,B-A-D-C,C-D-B-A,1,single,,Biochemistry,Gluconeogenesis
+463091e2-e514-46e3-aedb-931a3af6545e,Specific poison for succinate dehydrogenase is ?,Cyanide,Malonate,Arsenite,Fluoride,1,single,B i.e. Malonate,Biochemistry,
+3a63a6c3-1c1d-4578-a6b2-08e42456d546,Most common widespread zoonotic disease in the world is -,Rabies,Leptospirosis,Brucella,Anthrax,1,single,"<p> Leptospirosis is the most wide zoonotic disease in the world. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:291. <\p>",Social & Preventive Medicine,Communicable diseases
+e68f5568-fcaa-4ff5-b664-5065ebba2d96,Post operative muscle ache is caused by,d-TC,Suxamethonium,Gallamine,Pancuronium,1,multi,,Anaesthesia,Muscle relaxants
+aa9ef9b2-7854-491c-baf4-6df499428906,Blood stained sputum may be the only symptom in?,Bronchiectasis,Carcinoma bronchus,Adenoma bronchus,Pulmonary T.B.,2,single,"Ans. is 'c' i.e., Adenoma bronchus",Surgery,
+1e61071d-fa24-4df4-b39d-ad51308c63e2,Inherited hyperammonemia is a result of deficiency of which enzyme of Krebs-Henseleit urea cycle?,Malate dehydrogenase,Isocitrate dehydrogenase,N-acetyl glutamate synthetase,Succinate dehydrogenase,2,single,"Inherited hyperammonemias are a group of six diseases caused by inborn deficiencies of the enzymes of the Krebs-Henseleit urea cycle. The enzymes involved are: 1. N-acetyl glutamate synthetase 2. Arbamyl phosphate synthetase (CPS) 3. Ornithine transcarbamylase (OTC) 4. Argininosuccinic acid synthetase (citrullinemia) 5. Argininosuccinase deficiency 6. Arginase deficiency Most Severe Cases: In the most severe forms of the hyperammonemic disorders, the infants are asymptomatic at bih and during the first day or two of life, after which they refuse their feedings, vomit, and rapidly become inactive and lethargic, soon lapsing into an irreversible coma. Profuse sweating, focal or generalized seizures, rigidity with opisthotonos, hypothermia, and hyperventilation have been observed in the course of the illness. These symptoms constitute a medical emergency, but even with measures to reduce serum ammonia, the disease is usually fatal. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 37. Inherited Metabolic Diseases of the Nervous System. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e.",Biochemistry,
+598d5484-6c3d-4983-aa72-cafaf6a4719a,Punishment for infanticide comes under -,IPC102,IPC324,IPC302,IPC300,2,single,"Ref:Textbook of forensic medicine and toxicology (V.V.Pillay) 17th edition, page no.377 Infanticide refers to the deliberate killings of chlid below the age of one year.In England, Germany, UK, there is a clear-cut distinction between homicide and infanticides. In India, no such distinction exists, and accuse is punished under sec.302IPC,the same manner as in murder.",Forensic Medicine,Sexual offences and infanticide
+ed76ceeb-7206-424c-b2b0-222a1d226703,Carotid artery stenosis screening invivo choice is -,USG,CT,MRI,Doppler,3,single,"Ans. is 'd' i.e., Doppler o Color doppler ultrasonography is the screening method of choice (not simple USG : option a is incorrect),o Carotid angiography is the investigation of choice for diagnosis,o MRI is the investigation of choice for demyelinating disorder, e.g. multiple sclerosis.Investigations in nervous systemo Investigation of choice for white matter disease - MRI (CT is second choice),o Investigation of choice of acoustic neuroma - GD enhanced MRIo Best investigation for all brain tumors - Contrast enhanced MRIo Investigation of choice for meningeal carcinomatosis - Contrast (gadolinium) enhanced MRI.o Investigation of choice for posterior fossa tumor - MRIo Investigation of choice for para meningeal rhabdomyosarcoma - MRIo Investigation of choice for nasopharyngeal angiofibroma - Contrast enhanced CT.o Investigation of choice for hydrocephalus in older patients and for low pressure hydrocephalus - MRI.o Investigation of choice for acute (<48hrs) subarachnoid hemorrhage (SAH) - Non-Contrast CT scan,o Investivation of choice to know the etiology of SAH - Four vessels digital substruction angiography.o Hallmark of SAH - Blood in CSF on lumbar puncture,o Investigation of choice for chronic SAH - MRI.o Primary procedure of choice for evaluating intracranial complications of acute head injury - CT scan,o Best modality for assessing fractures of the skull base, calvarium and facial bone - CT scan,o Investigation of choice for demyelinating disorders MRI.o Investigation of choice for AV malformation and aneurysm - Angiography (MRI angiography or CT angiography),o Investigation of choice for Craniospinal infection - MRIo Investigation of choice for all intrinsic spinal cord lesions; all causes of cord compression - MRI.o Procedure of choice for emergent evaluation of acute intracerebral hemorrhage - CT scan,o Investigation of choice for myelopathy - MRI.o Shape of epidural hematomas on imaging - Biconvex, hyperdense or mixed density.o Shape of acute subdural hematoma on imaging - Crescent-shaped, hyperdense or mixed density ,o Chronic subdural hematoma on imaging - Hypodense.o Most sensitive test for ischaemic stroke - Diffusion weighted (DW) MRI.",Radiology,Head and Neck Imaging
+9696296f-f81e-42b8-90e5-398da9c83945,Proposed guideline value for Radioactivity in drinking water is:,Gross a activity 0.1 Bq/L and Gross b activity 1.0 Bq/L,Gross a activity 1.0 Bq/L adn Gross b activity 0.1 Bq/L,Gross a activity 1.0 Bq/L and Gross b activity 10.0 Bq/L,Gross a activity 10 Bq/L and Gross b activity 1.0 Bq/L,0,single,Key guidelines aspects of WHO recommended drinking water quality: Colour <15 true colour units (TCU) Turbidity <1 nephlometric turbidity units (NTU) pH: 6.5-8.5 Total dissolved solids (TDS) <500 mg/Litre Zero pathogenic microorganisms Zero infectious viruses Absence of pathogenic protozoa and infective stages of helminthes Fluoride <1.0 ppm (0.5-0.8 ppm: Optimum level) Nitrates <45 mg/Litre Nitrites <3 mg/Litre Gross alpha radiological activity <0.5 Bq/Litre (new guidelines -WHO) Gross Beta radiological activity <1.0 Bq/Litre (new guidelines-WHO) Ref: Park 25th edition Pgno: 762,Social & Preventive Medicine,Environment and health
+ec9dbeb5-1b72-43fd-869c-896778e840e3,Lens develops from?,Endoderm,Mesoderm,Surface ectoderm,Neuroectoderm,2,single,"Ans. c (Surface ectoderm). (Ref. Human Embryology by IB Singh, 6th/352)LENS# LENS develops from surface ectoderm.# Compared to the cornea, it has a much lower converging power of 17 diopters because of the relatively similar refractive indices of aqueous humor, lens, and vitreous body (cornea 42 D).# However, the lens is the only part of the refractive apparatus that is adjustable.# Adjustment to near vision (accommodation) therefore involves only the lens.# In addition, the lens functions as a UV filter for wavelengths between 300 and 400 nm and thus has a protective function for the macula.# Notching of the lens = ""pseudocoloboma"".# Wilson's disease can induce a yellow-green lens discoloration (chalcosis/ sunflower cataract).# Granular gold deposits located under the lens (chrysiasis lends) can occasionally occur after prolonged treatment with gold preparations (e. g. in primary chronic polyarthritis ).# Other medications, e.g., amiodarone or chlorpromazine, are sometimes deposited in the lens.# In patients with cataract, glittering cholesterol crystals are not infrequently found in the lens (so-called Christmas tree/ decoration cataract).",Ophthalmology,Lens
+36d1d9e0-62d6-4065-832c-1fedd97d046c,Features of neurogenic shock are,↑Peripheral resistance ↓ cardiac output,↑ Venous return ↑ cardiac output,↓Peripheral resistence↓cardiac output,Venoconstriction ↓cardiac output,2,single,,Medicine,
+eee99c0a-bd81-4fc8-9fa2-3e168d8be995,Palm of one hand is placed horizontally across the mouth and nostrils in,Manual strangulation,Palmar strangulation,Garrotting,Mugging,1,multi,"palmar strangulation Here the palm of one hand is placed horizontally across the mouth and nostrils, it's pressure being reinforced by placing the other palm on the top of it at right angles, the heel of the palm above pressing upon the front of the neck. Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 134",Forensic Medicine,Asphyxia
+90172650-01d2-4312-8c6d-5f71bbe8695c,In RDS all of the following statements are true except,Usually occurs in infants born before 34 weeks of gestation,Is more common in babies born to diabetic mothers,Leads to cyanosis,Is treated by administering 100% oxygen,3,multi,"Administration of 100% oxygen may increase the O2 load on fetal lung tissue. Hence, it is not given . Reference: GHAI Essential pediatrics, 8th edition",Pediatrics,New born infants
+b9799e1c-a706-43df-8a51-7f1fa165d79c,"National program for prevention and control of Cancer, Diabetes, Cardiovascular disease and stroke (NPCDCS), true is -","Separate centre for stroke, DM, cancer",Implementation in some 5 states over 10 districts,District hospital has specialised facilities,Subcentre has facility for diagnosis and treatment,2,multi,"Ans. is 'c' i.e., District hospital has specialised facilities Sational program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS1 Introduction Single centre fi- cancer, diabetes, cardiovascular disease, stroke. 100 districts in 21 states being covered in 1 1 th live year plan. 20,000 subcentres and 700 community health centres (CHCs) covered. o Activities as sub-centres Health promotion for behaviour and lifestyle change. Oppounistic screening of BP. blood glucose (strip method) in age > 30 years. Referral to CHC of cases of DM, HT. o Activities at CHCs : Diagnosis and management at NCD clinic. Home visits by nurse for bedridden cases. Referral to district hospital for complicated cases. o Activities as District hospital : Health promotion Screening of population > 30 years. Diagnosis and management of cardiovascular disease. Home-based palliative care for chronic, debilitating progressive patients. Specialized facilities. Urban health check-up shceme JOr diabetes and high BP : Screen urban slum population. Screen population > 30 years and pregnant females. Cancer control in NPCDCS : Regional cancer control scheme : Regional cancer centres to act as referral centres for complicated cases. Oncology wing development scheme. Decentralized NGO scheme : IEC activities and early cancer detection. lEC at central level. Research and mining.",Social & Preventive Medicine,
+5a242165-f06e-49de-9b9c-0cc4e1303f75,All of the following are ACTH independent Cushing syndrome except :,Pituitary adenoma,Adrenal hyperplasia,Adrenocoical carcinoma,McCune Albright Syndrome,0,multi,ACTH dependent Cushing syndrome is caused by : ACTH producing pituitary adenoma Ectopic ACTH Bronchial or pancreatic carcinoid Small cell cancer of lung Medullary carcinoma of thyroids Pheochromocytoma ACTH Independent Cushing syndrome is caused by : Adrenocoical adenoma/ carcinoma Primary pigmented nodular adrenal disease Adrenal hyperplasia McCune Albright Syndrome Petrosal/Peripheral ACTH ratio > 2 indicates the presence of a pituitary adenoma-secreting ACTH. NOTE: Overall the most common cause of Cushing's syndrome is Iatrogenic steroids but if asked regarding ACTH dependent cause then answer should be given as Pituitary adenoma.,Medicine,Cushing Syndrome
+396db5cd-55ab-434e-b14e-5c2742dd08d9,Hereditary spherocytosis is characterized by: March 2004,Anemia,Splenomegaly,Jaundice,All of the above,3,multi,Ans. D i.e. All of the above,Pathology,
+653fbea7-3a1f-41e2-87fc-e541eb92292b,Ketamine can be given by all of following routes except-,IV,IM,SC,Nasally,2,multi,"Ketamine has been administered intravenously, orally , rectally, intramuscularly and epidural route and very rare intranasal but not subcutaneous",Anaesthesia,Intravenous Anesthetic Agents
+f8d93899-b196-427e-9c0e-0f2a4e909a21,"All of the following are features of Devic's syndrome (neuromyelitis optica), except?",Separate attacks of acute optic neuritis and myelitis,Optic neuritis is either unilateral or bilateral,Brain MRI is typically normal,It has a fulminant demyelinating process and progress to death in 1-2 year,3,multi,Devic's disease is a variant of multiple sclerosis. Fulminant demyelinating process is seen with another variant called Marburg's variant.,Medicine,
+23a3d4a0-103f-4d6c-bcb9-dc8bab68b013,Which of the following is true about calcification of teeth?,Calcification of primary teeth is almost complete at time of birth,Calcification of all primary teeth and few permanent teeth complete at birth,Calcification of all permanent teeth complete at birt,Calcification of primary teeth starts around birth,0,multi,,Dental,
+2cb2be45-b5db-4716-b3a6-84875ab3ee77,"A 7 years old boy presented with painful boggy swelling of scalp, multiple sinuses with purulent discharge, easily pluckable hairs and lymph nodes enlarged in occipital region. Which one of the following would be most helpful for diagnostic evaluation?",Bacterial culture,Biopsy,KOH mount,Patch test,2,single,Ans. c. KOH mount,Skin,
+2bd24bb6-bc8e-44cd-b4da-e5b6808aaa6d,All the following are seen in Hyperparathyroidism except,Subperiosteal erosion of bone,Loss of lamina dura,Calvarial thickening,Pepper - pot skull,2,multi,Calvarial thickening is a feature of Hypoparathyroidism.,Radiology,
+edf16f12-4d4c-48c3-bb35-478666e34498,Spore forming anaerobic gram positive bacilli ?,Bacillus Anthracis,Clostridia,Corynebacterium,Peptostreptococcus,1,single,"Ans. is 'b' i.e., Clostridia There are two medically impoant spore forming bacteria. Both of them are 'gram positive' `bacilli' :-Aerobic : BacillusAnaerobic (obligate anaerobes) : Clostridia.",Microbiology,
+daf88486-94e5-4799-960e-a3fc5137e1ab,Drug of choice for Falciparum Malaria is:-,Chloroquine,Mefloquine,ACT,Proguanil,2,single,DOC for Falciparum Malaria - ACT.( Aemisinin based Combination therapy ) In Noh Eastern states:- ACT-AL co-formulated tablet of Aemether-20 mg / Lumefantrine - 120 mg. Primaquine 0.75 mg/ kg Body weight on day 2. 2. In Other States:- ACT-SP -Aesunate 50 mg tablet for 3 days and Sulphadoxine (500mg) - Pyremethamine (25mg) tablets for 1 Day. Primaquine tablets should be given on Day 2.,Social & Preventive Medicine,"VBDs, Arboviral & Viral Infections, Surface Infections"
+b44f4bc6-30c3-4cd1-81b2-f172a886dea9,All are causes of white-dot syndrome except:,Fuch's heterochromic uveitis,VKH syndrome,HIV retinopathy,Sympathetic ophthalmitis,3,multi,Ans. Sympathetic ophthalmitis,Ophthalmology,
+12af2d6a-1cf7-4dda-ab1d-0044c5ad8243,Maximum flow of Type1 inlay wax at 45degree,2%,3%,10%,70%,3,single,,Dental,
+a7bcda01-d462-4e60-bd9c-394439c1f79f,Platypnea is seen with?,Hepato-pulmonary syndrome,Hepato-renal syndrome,Renal aery stenosis,Kyphoscoliosis,0,single,Platypnea: Increase dyspnea on sitting position Seen in 1. Atrial myxoma 2. Hepatopulmonary syndrome,Medicine,Acute Kidney Injury
+013a96ca-7ed9-437b-bdf4-e7482a816fa3,Neuro lathyrism results due to,Aflatoxin,Pyruvic acid,BOAA,Sanguinarine,2,single,,Social & Preventive Medicine,
+9dda09e1-8bdc-4fae-be9e-ef95d04e3f71,Factor V Leiden is caused due to a mutation that results in a substitution at position 506 glutamine to which of the following:,Alanine,Arginine,Glycine,Glutamine,1,single,"Mutation in factor V (called the Leiden mutation, after the city in the Netherlands where it was discovered) causes recurrent DVTs. The mutation results in a glutamine to arginine substitution at position 506 that renders factor V resistant to cleavage by protein C. As a result, an impoant antithrombotic counter-regulatory pathway is lost Ref: Robbins 8th edition Chapter 4.",Pathology,
+0729894e-e71d-4e69-8f53-5ae6a8ee75c2,Kunkel's test is done to demonstrate presence of ................. in blood.,Lead,CuSO4,CO,Dhatura,2,single,Carbon monoxide (CO),Forensic Medicine,
+7af5d515-19b4-4b9c-b795-224e68a0176b,In which case cystometric study is indicated -,Neurogenic bladder,Stress incontinence,Fistula,Urge incontinence,0,single,"Cystometric studies are urodynamic studies in which the pressure changes in the bladder is simultaneously measured with bladder filling and during micturition.
+It helps in accurate assessment of detrusor and sphincter activity especially if a neurogenic abnormality is suspected.
+Though it is also used in stress incontinence but the aim here is to rule out any neurogenic cause.",Surgery,
+a18b8864-370a-4ef2-a61f-1265eba77975,Fish tank granuloma is seen in -,Mfortuitum,Mkansasi,Mmarinum,M leprosy,2,single,"Ans. is 'c' i.e., M. Marinum o Fish tank granulomaalso called ' swimming pool granuiomaf is caused by M. marinum.Principal types of opportunist mycobacterial disease in man and the usual causative agents.DiseasesUsual causative agentLymphadenopathyM. avium complexM. scrofulaceumSkin lesionPost-trauma abscessSwimming pool granulomaBuruli ulcerM. chelonaeM.fortuitumM. terraeM.marinumM. ulceransPulmonary' diseaseM. avium complexM. kansasiiM.xenopiM.malmoenseDisseminated diseaseAIDS-relatedM, avium complexM.genevenseM.avium complexM. chelonae",Microbiology,Bacteria
+f30e750a-793d-4431-9be7-df8681f20a4f,TYNDALLISATION is a type of,intermittent sterilization,pasteurisation,boiling,autoclaving,0,multi,,Microbiology,
+6928a986-b002-4115-9c81-631f67d6c07a,"A 49-year-old female taking ibuprofen for increasing joint pain in her hands presents with increasing pain in her midsternal area. Gastroscopy reveals multiple, scattered, punctate hemorrhagic areas in her gastric mucosa. Biopsies from one of these hemorrhagic lesions reveal mucosal erosions with edema and hemorrhage. No mucosal ulceration is seen.",Active chronic gastritis,Acute gastritis,Autoimmune gastritis,Chronic gastritis,1,single,"Gastritis is a nonspecific term that describes any inflammation of the gastric mucosa. Acute gastritis refers to the clinical situation of gastric mucosal erosions (not mucosal ulcers). Acute gastritis is also known as hemorrhagic gastritis or acute erosive gastritis. Acute gastritis is associated with the use of nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and coicosteroids, and also with alcohol, chemotherapy, ischemia, shock, and even severe stress. Two types of stress ulcers are Curling's ulcers, seen in patients with severe burns, and Cushing's ulcers, seen in patients with intracranial lesions. Grossly acute gastritis appears as multiple, scattered, punctate (less than 1 cm) hemorrhagic areas in the gastric mucosa. This is helpful in differentiating acute gastritis from peptic ulcers, which tend to be solitary and larger. Microscopically the gastric mucosa from a patient with acute gastritis is likely to reveal mucosal erosions, scattered neutrophils, edema, and possibly hemorrhage. Acute gastritis. Erosion and complete effacement of the epithelium is observed. The residual glands, on the left, display regenerative changes with basophilic epithelium. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition",Pathology,miscellaneous
+3ce61463-a3ad-4e05-8e97-b404f9f04e0e,Sedimentation coefficient of Ig E is:,7S,8S,11S,20 S,1,single,Ans : b 8S Ref: Ananthanarayanan 8th editionSvedberg unit - a sedimentation constant of 1 x 1013sec. Sedimentation unit is studied by ultracentrifugation - for diversity of antibody moleculeIgG -7IgA -7IgM -19Ig D -7IgE -8,Microbiology,Immunology
+5f8a32c1-31db-477e-99cd-467e1f443720,DNA dependent RNA synthesis is inhibited by:,Rifampicin,Ethambutol,Colchicine,Chloromycetin,0,single,Rifampicin,Pharmacology,
+9e9842eb-7ec0-4d06-9a22-bbcb97151aec,Iliac crest involvement is common in which condition: March 2007,Ankylosing spondylitis,Rheumatoid ahritis,Reiter's syndrome,Osteoahritis,0,single,"Ans. A: Ankylosing Spondylitis The basic pathologic lesion of ankylosing spondylitis occurs at the entheses, which are sites of attachment to bone of ligaments, tendons, and joint capsules. Enthesopathy results from inflammation, with subsequent calcification and ossification at and around the entheses. Inflammation with cellular infiltration by lymphocytes, plasma cells, and polymorphonuclear leukocytes is associated with erosion and eburnation of the subligamentous bone. The process usually stas at the sacroiliac joints. Other enthesopathic sites include the iliac crest, ischial tuberosity, greater trochanter, patella, and calcaneum. Ankylosing spondylitis/ AS/ Bechterew's disease/ Bechterew syndrome/ Marie Strumpell disease/Spondyloahritis is a chronic, painful, degenerative inflammatory ahritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine. AS is a systemic rheumatic disease and one of the seronegative spondyloahropathies. About 90% of the patients express the HLA-B27 genotype. Men are affected more than women by a ratio in excess of 10:1. Typical signs of progressed AS are the visible formation of syndesmophytes on X-rays and abnormal bone outgrowths similar to osteophytes affecting the spine. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine. In 40% of cases, ankylosing spondylitis is associated with iridocyclitis causing eye pain and photophobia. 4.1 AS is also associated with ulcerative colitis, Crohn's disease, psoriasis, and Reiter's disease Other complications are aoic regurgitation, Achilles tendinitis, AV node block and amyloidosis & restrictive lung disease. A clinical examination and X-ray studies of the spine, which show characteristic spinal changes and sacroiliitis, are the major diagnostic tools. The Schober's test is a useful clinical measure of flexion of the lumbar spine performed during examination.",Surgery,
+17a37bf5-e78b-48f2-be15-16c1049d1427,"A 40-year-old man presents with a 2-week history of recur- rent oral ulcers, genital ulcers, intermittent arthritic pain of the knees, and abdominal pain. Physical examination reveals shallow ulcerations of the mucosa of the glans penis, as well as oral aphthous ulcers and conjunctivitis. Which of the following is the most likely diagnosis?",Behyet disease,Genital herpes,Gonorrhea,Polyarteritis nodosa,0,multi,"Behget disease is a systemic vasculitis characterized by oral aphthous ulcers, genital ulceration, and ocular inflammation, with occasional involvement of the nervous, gastrointestinal, and cardiovascular systems. The mucocutaneous lesions show a non-specific vasculitis of arterioles, capillaries, and venules. The cause of the necrotizing inflammation of small blood vessels is not known, but an association with specific HLA subtypes suggests an immune basis. Herpes (choice B) does not present with arthritis.Diagnosis: Behqet disease",Pathology,Blood Vessels
+c6e0048e-68f8-493d-8bdf-bcd1afea8f1e,About biotransformation not true ?,Active metabolite generation,Polar to less polar,Less polar to more polar,Generate active drug from prodrug,1,multi,"Ans. is 'b' i.e., Polar to less polar",Pharmacology,
+be876641-0cee-4b0d-973f-af68790776da,"In which phase of cell cycle, proof reading occurs?",G1,S,G2,M,1,single,EVENTS PHASE of cell cycle Proofreading S phase Most repairs G1 phase Mismatch repair G2 phase,Biochemistry,Molecular Biology
+2435c2fd-0ab9-4097-9969-6ce371e46532,The number of ATPs generated in krebs cycleare ?,12,24,15,30,1,single,"Ans. is 'b' > b' i.e., 24 One turn of the TCA cycle, staing with acetyl CoA produces 10 ATPs. When the staing molecule is pyruvate, the oxidative decarboxylation of pyruvate, the oxidative decarboxylation of pyruvate yields 2.5 ATPs and therefore, 12.5 ATPs are produced when staing compound is pyruvate. Since, two molecules of pyruvate enter the TCA cycle when glucose is metabolized (glycolysis produces 2 molecules of pyruvate), the number of ATPs is doubled. Therefore, 25 ATP molecules, per glucose molecule, are produced when pyruvate enters the TCA cycle.Note : Previously calculations were made assuming that NADH produces 3 ATPs and FADH generates 2 ATPs. This will amount a net generation of 30 ATP molecules in TCA per molecule glucose and total 38 molecules from staing. Recent experiments show that these values are overestimates and NADH produces 2.5 ATPs and FADH produces 1.5 ATPs. Therefore, net generation during TCA is 25 ATPs and complete oxidation of glucose through glycolysis plus citric acid cycle yield a net 32 ATPs.Energy yield (number of ATP generated) per molecule of glucose when it is completely oxidized through glycolysis plus citric acid cycle, under aerobic conditions, is as follows :- Method ofNo of ATPsNo of ATPsPathwayStepEnzymeSource ATP formationgained perglucose(new calculation)As per oldcalculationGlycolysis1Hexokinase MinusMinus 1Do3Phosphofructokinase MinusMinus 1Do5Glyceraldehyde-3-p DHNADH Respiratory chain2.5 x 2 = 53 x 2 = 6Do61,3-BPGkinase ATPSubstrate level1 x 2 -- 21 x 2 = 2Do9Pyruvate kinaseATP Substrate level1 x 2 = 21 x 2 = 2Pyruvate to?PyruvateNADH Respiratory chain2.5x2= 53x2= 6Acetyl CoA Dehydrogenase TCA cycle3Isocitrate DHNADH Respiratory chain2.5x2= 53 x 2= 6Do4Alpha keto glutarate DHNADH Respiratory chain2.5x2= 53x2= 6Do5Succinate thiokinaseGTP Substrate level1 x 2 = 21 x 2 = 2Do6Succicinate DHFADH2Respiratory chain1.5x2= 32 x 2= 4Do8Malate DHNADH Respiratory chain2.5x2= 53 x 2= 6Net generation in glycolytic pathway 9 minus 2= 7 10 minus 2= 8Generation in pyruvate dehydrogenase reaction 5 * 6Generation in citric acid cycle 20 * 24Net generation of ATP from one glucose mole 32 * 38",Biochemistry,
+10fa25e5-2afd-4660-bd47-8759e3004d33,"Child with mild squint. Intrauterine, bih history, developmental history till date all normal. Corneal reflex normal. All other eye parameters normal except exaggerated epicanthal fold. Diagnosis ?",Pseudostrabismus,Accomodative squint,Exophoria,Esophoria,0,multi,"Ans. is 'a' i.e., Pseudostrabismus Epicantnic fold causes Pseudoesotropia (Pseudostrabismus).",Ophthalmology,
+9c66c905-3a4a-440e-973f-270b04fe9a86,Pain-sensitive intracranial structure is:,Piamater,Pial vassels,Duramater,Brain matter,2,single,C i.e.Duramater,Physiology,
+afa909b3-f7e2-4c1c-9747-9638994735ce,Not used for iron poison in: FMGE 09; NEET 13,Magnesium hydroxide,Desferrioxamine,Gastric lavage,Penicillamine,3,single,Ans. Penicillamine,Forensic Medicine,
+23294025-db77-485a-a342-16e13930f3b2,"Posterior relations of the head of the pancreas include all of the following, except:",First pa of the duodenum,Common bile duct,Inferior vena cava,Aoa,0,multi,"The posterior relations of the head of the pancreas include the common bile duct, inferior vena cava and the right and left renal veins terminating into it. The first pa of the duodenum is an anterior relation of the head of the pancreas.Ref: Clinical Anatomy, By Richard S. Snell, 6th edition, Page 230; Clinical Anatomy (A Problem Solving Approach), By Neeta V Kulkarni, 2nd edition, Page 689.",Anatomy,
+daea259a-2232-46db-8d5a-e04d5a1d4c5c,Which of the following events is involved in cleavage of the zygote during week 1 of development?,A series of meiotic divisions forming blastomeres,Production of highly differentiated blastomeres,An increased cytoplasmic content of blastomeres,A decrease in size of blastomeres,3,single,"Cleavage is a series of mitotic divisions by which the large amount of zygote cytoplasm is successively paitioned among the newly formed blastomeres. Although the number of blastomeres increases during cleavage, the size of individual blastomeres decreases until they resemble adult cells in size.",Anatomy,"Development period- week 1,2,3,4"
+2490c0e2-5e57-46de-a276-0163f4b35337,"A female child with virilization, hypertension with low plasma renin diagnosis is :",21α hydroxylase deficiency,11 β hydroxylase deficiency,3β hydroxylase deficiency,Conn’s syndrome,1,single,"9] Congenital adrenal hyperplasia represents a group of autosomal recessive inherited, metabolic errors,
+each characterized by decency or total lack of a particular enzyme involved in the biosynthesis of cortical steroids,
+Steroidogenesis is then channelled into other pathways leading to increased production of androgens,
+which accounts for virilization.
+Simultaneously, the decency of cortisol results in increased secretion of ACTH resulting in adrenal hyperplasia.
+Following enzymes are implicated in the congenital adrenal hyperplasia 21 α hydroxylase decency (partial or complete) 17 α hydroxylase deficiency 11β hydroxylase
+deficiency 21 α hydroxylase deficiency
+• Two forms of this deficiency include -
+A. Salt-wasting adrenogenital ism
+B. Simple Virilizing adrenogenital ism
+A) Salt-wasting syndrome (complete lack) The salt wasting syndrome results from complete lack of 21 hydroxylases.
+There is no synthesis of mineralocorticoids and glucocorticoids in the adrenal cortex.
+Decreased mineralocorticoids causes marked sodium loss in the urine, resulting in hyponatremia, hyperkalemia, acidosis and hypotension.
+Because of the enzyme block, there is increased formation of 17 - hydroxyprogesterone, which is then shunted into the production of testosterone.
+This may cause virilism (pseudo-hermaphroditism) in female infants.
+That is (XX) Female with 21 hydroxylase deficiency develops ovaries,
+female ductal structures and external male genitalia. But in the male child, the effect of increased testosterone will not be manifested at the time of birth.
+The complete21 hydroxylase deficiency or salt wasting syndrome usually comes to light only after the birth because in utero the electrolytes and uids
+can be maintained by maternal kidneys. Males with this disorder comes to clinical attention 5 to 15 days later because of salt losing crisis while
+females come to attention soon after the birth because of the virilization.
+B) Simple Virilizing adrenogenital syndrome (Partial deficiency) Occurs in individuals
+with partial deficiency of 21 hydroxylases Less severe deficiency of mineralocorticoid, is sufficient for salt reabsorption, but the lowered glucocorticoid fails to cause
+feedback inhibition of ACTH secretion.
+Thus level of aldosterone is mildly reduced, testosterone is increased and ACTH elevated with resultant adrenal hyperplasia.
+11B hydroxylase deficiency-. Rare Leads to decreased cortisol and increased ACTH.
+This, in turn, leads to the accumulation of DOC (deoxycorticosterone) and 11 deoxycortisol
+both of which are strong mineralocorticoids. This results in increased sodium retention by the kidneys and hypertension, hypokalemia.
+Patients also develop virilization due to androgen excess. 17 α hydroxylase deficiency - Patients with deficiency of 17 hydroxylases also have impaired cortisol production,
+increased ACTH and secondary increased DOC.
+These patients, however, cannot synthesize normal amount of androgens and estrogens.
+This is because the gene that codes for 17 α hydroxylase is the same for the enzyme in the adrenal cortex and the gonads and the decency is same in both organs.
+Because of decreased sex hormones, genotypic females develop primary amenorrhoea and fail to develop secondary sex characteristics while genotypic
+males will present as pseudohermaphrodite.
+3 β hydroxylase deficiency 3-β hydroxylase deficiency is a rare genetic disorder of steroid biosynthesis that results
+in decreased production of all three groups of adrenal steroids which include mineralocorticoid, glucocorticoid and sex steroids.
+Decreased mineralocorticoid secretion
+results in varying degrees of salt wasting in both males and females.
+Decent androgen production results in ambiguous genitalia in males
+The usual presentation is a male child with ambiguous genitalia and severe salt wasting. Sometimes it may also occur in females",Medicine,
+0b9a50a8-7210-4ff5-81f6-b49dee01c09b,'Patterned' abrasion is variety of:,Linear abrasion,Pressure abrasion,Sliding abrasion,Superficial bruise,1,single,"Ans. is 'b' ie pressure abrasion (Ref: Parikh; 6/e, p4.3).An abrasion is a superficial injury involving only the superficial layers of the skin (epidermis only), caused by friction and / or pressure between the skin and some rough object or surface. It bleeds very slightly, heals rapidly in a few days and leaves no scar.They can be classified into 3 types, depending on the manner they are created.ScratchIs a linear injury produced by a sharp object, such as pin, thorn or finger nail.Graze (Sliding, scraping or grinding abrasion).Is produced when a broad surface of skin slides against a rough surface.It is also known as brush or friction burn because it is caused by the frictional force and resembles a burn after dryingIt is commonly found in road traffic accidents.Imprint, Pressure or contact abrasion.Is produced as a result of direct impact or pressure of or contact with some object at right angles to the skin surface.The cuticle is crushed, and the object marks a reproduction of its shape and pattern on the to the skin, therefore it is known as patterned abrasion.Example are ligature marks in hanging and strangulation, nail and thumbs marks in throttling, teeth marks in biting, radiator, grill or tyre mask in vehicular accidents.",Forensic Medicine,Sexual Offenses
+1d267206-3dd2-462b-9b44-8a3a48c31c12,Pimozide belongs to class of:,Thiothixanthene,Phenothiazine,Butyrophenone,Diphenyl butyl piperidine,3,multi,"Thioxanthenes are flupenthioxol. Butyrophenones are haloperidol, trifluperidol , penfluridol. Phenothiazines are Chlorpromazine, triflupromazine , thioridazine, flufenazine. Promazine belongs to the group of other of other hetero cyclics that is diphenyl butyl piperidine. Ref: KD Tripathi 8th ed.",Pharmacology,Central Nervous system
+7b33754c-beaa-43e5-81f5-f4c3f8bf2245,Which of the following drugs is antipseudomonal penicillin?,Cephalexin,Dicloxacillin,Piperacillin,Cloxacillin,2,single,,Pharmacology,
+b3dcc864-5d6f-4d14-b6bf-143f4d777784,Following poisoning retards putrefaction: NEET 13,Aluminium phosphide,Lead,Arsenic,Copper,2,single,Ans. Arsenic,Forensic Medicine,
+3bad3d0c-b14c-4ec4-a203-a124976139a0,True statements about parotid gland,Duct opens oppsite to upper 2nd molar tooth,Duct pierces Masseter,Develops from ectoderm,Secretomotor fibres come from facial nerve,0,multi,"The duct runs forwards for a sho distance between the buccinator and the oral mucosa. Finally, the duct turns medically and opens into the vestibule of the mouth(gingivobuccal vestibule)opposite the crown of the upper second molar tooth. Notes: Parotid abscess may be caused by spread of infection from the opening of parotid duct in the mouth cavity. <img src="" /> REF.BDC VOL.3,Sixth edition pg 110",Anatomy,Head and neck
+17b8471f-d82c-4236-a843-66e19ce561b0,Which of the following statement is false about hydrocele?,Arises due to patent processus vaginalis,Wait for 5 years for spontaneous closure of congenital hydrocele,Lord's plication of sac for small hydrocele,Jaboulay's eversion of sac for medium hydrocele,1,multi,Treatment of Hydrocele Congenital Hydrocele: Usually spontaneous obliteration by 2 years age. If persists then Herniotomy. Treatment of Vaginal Hydrocele 1. Small hydrocele: Lord's procedure (Plication of sac)Q 2. Medium hydrocele: Jaboulay's procedure (Eversion of sac)Q 3. Large hydrocele: Excision of sacQ,Surgery,Testis and scrotum
+0efb3876-ad2b-44d1-99c9-73c50708d75b,The main difference between dental stone and dental plaster is:,Chemical composition,Self life,Shape and size of particles,Solubility in water,2,single,,Dental,
+fa6f9581-fb3b-49be-b366-c97793f765ff,A normally developing 10 months old child should be able to do all of the following except –,Stand alone,Play peak to boo,Pick up a pellet with thumb and index finger,Build a tower of 3–4 cubes,3,multi,"A child starts trying to build a tower of cubes (2 cubes) by the age of 1 year.
+
+About other options
+
+Child can stand with support by 9 months.
+Child can play peak-a-boo game by 10 months.
+Child can pick up a pellet with thumb and index finger (pincer grasp) by 9 months.",Pediatrics,
+2d7752b3-6526-4bba-90a1-b7862767573b,Lines of Blaschko&;s are along,Lymphatics,Nervs,Developmental,Blood vessels,2,single,"Blaschko&;s lines, are lines of normal cell development in the skin. These lines are invisible under normal conditions.",Anatomy,General anatomy
+864d863c-3c3f-4f72-b1dc-bf0ec9e8d0c3,All the teeth in patient’s mouth are similarly affected as shown in the radiograph. What is the most likely anomaly?,Type 1 dentinal dysplasia,Type 2 dentinal dysplasia,Taurodontism,Amelogenesis imperfecta,1,multi,"Dentinal dysplasia
+Dentinal dysplasia is an inherited condition affecting both dentitions. It is divided into two types: Type I (radicular dentinal dysplasia) and Type II (coronal dentinal dysplasia). It occurs less frequently than dentinogenesis imperfecta.
+Clinical features
+Type I is the more frequent type. Teeth erupt normally with no obvious abnormality but rapidly develop mobility resulting from limited root support. In type II, the deciduous teeth are similar to those in dentinogenesis imperfecta, whereas the permanent teeth appear normal.
+Radiological signs
+In Type I, all the teeth, except the canines, have extremely short roots. The roots are conical or blunted. There is pulpal obliteration and the inferior aspects of the crown exhibit linear crescent-shaped radiolucent lines. Periapical radiolucencies are commonly seen associated with non-carious teeth in Type I dentinal dysplasia. In Type II dentinal dysplasia, obliteration of the pulp occurs post eruption in the deciduous dentition. In the permanent dentition, there is alteration in the configuration of the pulp resulting in enlarged pulp chambers extending well down into the root. The pulp contains multiple calcifications.
+Ref: Interpreting Dental Radiographs by Keith Horner, Jon Rout and Vivian E Rushton",Radiology,
+4ad3b836-706a-47a9-9ccc-68d9feb2f5e7,Middle aged female with mass in sella turcica hormone increased is -,Prolactin,Thyroxine,Extrogen,ADH,0,single,"The sella turcica is a saddle shaped depression of the sphenoid bone.
+It forms the caudal border of the pituitary gland. Sella turcica is an anatomically complex area with a number of different potential pathologies especially neoplastic process.
+Pathologies of sella turcica can lead to important clinical presentations such as hormonal imbalances from pathologies affecting the pituitary gland and neurological symptoms from the mass effect.
+Sella turcica is critically located as several structures pass close to it due to compression of the adjacent structures.
+
+Important anatomical structures related to sella
+
+Optic chiasm
+Pituiatry gland
+Internal carotids​
+Gavernous sinus and cranial nerves
+Sphenoid sinuses",Medicine,
+3d26c59a-23b7-4f94-bd3a-46c52e94717f,Hyoid bone fracture most common occurs in ?,Manual strangulation,Hanging,Smothering,Traumatic asphyxia,0,single,"Ans. is 'a' i.e., Manual strangulation As manual strangulation (throttling) is among the most violent form of asphyxia, hyoid fracture and other injury to neck structures is more common.",Forensic Medicine,
+e8e89c2e-3ded-4f79-8b72-c4c15b0e0022,"""Acute Meningoencephalitis"" is caused by:",E. histolytica,Nageleria,Giardia,E.coli,1,single,Nageleria,Microbiology,
+d700bd56-0b0c-44cc-9099-5986224e73ba,The process of destroying all microbes including spores is called :,Disinfection,Antisepsis,Asepsis,Sterilization,3,multi,,Microbiology,
+6ff91b9c-ef2d-4e23-8bbe-91abe79cf929,All are major symptoms of sinusitis except,Nasal blockage,Facial congestion,Nasal congestion,Halitosis,3,multi,"According to Rhinosinusitis task force definition of sinusitis,Major criteria-Facial pain, pressure, congestion, nasal obstruction, nasal/postnasal discharge, hyposmia and feverMinor criteria- Headache, halitosis, and dental painRef: Hazarika; 3rd ed; Pg 328",ENT,Nose and paranasal sinuses
+fd69db25-3857-40ab-acb4-d7aedc45b959,Most sensitive nerve fiber to hypoxia,A,B,C,All are equally sensitive,1,multi,Question repeated,Physiology,Nervous system
+344ff8fd-3b80-4311-9f67-a5f54e3e0fff,Nasal septum is formed except by,Perpendicular plate of ethmoid,Vomer,Nasal bone,Lateral cailage,3,multi,"The bony pa is formed by: 1.Vomer 2.Perpendicular plate of ethmoid 3.Nasal spine of frontal bone 4.Rostrum of sphenoid 5.Nasal crest of nasal, palatine and maxillary bones. NOTES: The cailaginous pa is formed by; 1.Septal cailage 2.Septal process of inferior nasal cailages The cuticular pa is formed by; 1.Fibrofatty tissue Ref.BDC volume3,Sixth edition pg 240",Anatomy,Head and neck
+041f5188-7539-4b9a-8784-b7ebf0f10021,Metoprolol is preferred over Propranolol as it: September 2010,Is more potent in blocking beta-1 receptors,Is more potent in blocking beta-2 receptors,Is more effective in suppressing essential tremors,Impairs exercise capacity,0,single,"Ans. A: Is more potent in blocking beta-1 receptors Metoprolol is cardioselective beta blocker, more potent in blocking beta-1 than beta-2 adrenergic receptors.",Pharmacology,
+6acbf6b1-7c5c-42a8-a0f9-cae7485b9eb3,"All will predispose to atherosclerosis, except",Homocystinemia,Fibrinogen,Calcium,Lipoprotein A,2,multi,"Elevated plasma levels of  homocysteine are associated with increased risk of atherosclerosis, thrombosis and hypertension.
+Lipoprotein A inhibits fibrinolysis, therefore predisposes to atherosclerosis.
+Atherosclerosis (Greek  athere-mush)  is a complex disease characterized by thickening or hardening of arteries due to the accumulation of lipids (particularly cholesterol, free, and esterified), collagen, fibrous tissue, proteoglycans, calcium deposits, etc. in the inner arterial wall. 
+Satyanarayana, Ed 3, Pg No 152",Biochemistry,
+c4dbe11c-2ef0-4043-adcb-5a068e9afe0e,"Most serious complication seen in other eye after traumatic injury to one eye: March 2005, September 2008",Subconjunctival hemorrhage,Corneal edema,Sympathetic ophthalmia,Sudden loss of vision,2,single,"Ans. C: Sympathetic ophthalmia Sympathetic ophthalmia (SO) is a condition in which serious inflammation attacks the sound eye after injury (including intraocular surgeries) to the other. It is the most dreaded complication of unilateral severe eye injury, as it can leave the patient completely blind. Symptoms may develop from days to several years after a penetrating eye injury. Sympathetic ophthalmia is thought to be an autoimmune inflammatory response toward ocular antigens, specifically a delayed hypersensitivity to melanin-containing structures from the outer segments of the photoreceptor layer of the retina. It is thought that Louis Braille, who injured his left eye as a child, lost vision in his right eye due to SO Floating spots and loss of accommodation are among the earliest symptoms. The disease may progress to severe iridocyclitis with pain and photophobia. Commonly the eye remains relatively painless while the inflammatory disease spreads through the uvea. The retina, however, usually remains uninvolved. Papilledema, secondary glaucoma, vitiligo and poliosis of the eyelashes may accompany SO. Diagnosis is clinical, seeking a history of eye injury. An impoant differential diagnosis is Vogt-Koyanagi-Harada syndrome (VKH), which is thought to have the same pathogenesis, without a history of surgery or penetrating eye injury. Definitive prevention of SO requires prompt (within the first 7 to 10 days following injury) enucleation of the injured eye. Evisceration--the removal of the contents of the globe while leaving the sclera and extraocular muscles intact--is easier to perform, offers long-term orbital stability, and is more aesthetically pleasing. But evisceration may lead to a higher incidence of SO compared to enucleation. Immunosuppressive therapy is the mainstay of treatment for SO. When initiated promptly following injury, it is effective in controlling the inflammation and improving the prognosis.",Ophthalmology,
+efdbc8fc-57c6-4154-b35f-0907d23ad414,Least commonly seen in conduct disorder seen in girls:-,Run away from home,High risk sexual behavior,Physical aggression,Emotional bullying,2,single,"Conduct disorder - Persistent pattern of antisocial behavior in which the individual repeatedly breaks social rules and carries out aggressive acts.in conduct disorder they do it deliberately usually characterized by aggression and violation of the rights of others boys with conduct disorder show physical & relationship aggression but In girls relationship aggression is more predominant than physical aggression children with conduct disorder usually have behaviors characterized by aggression to persons or animals, destruction of propey, deceitfulness or theft, and multiple violations of rules, such as truancy from school.",Psychiatry,JIPMER 2018
+4a4c2a4f-37d5-469b-a65e-107ee1b863da,Which of the following aminoglycosides has the highest nephrotoxicity?,Paromomycin,Streptomycin,Amikacin,Neomycin,3,single,,Pharmacology,
+3d486b16-b896-442c-8c67-2e9530e89fce,Least conduction velocity is seen in:,AV node,Purkinje fibers,Bundle of His,Ventricular myocardial fibres,0,single,,Physiology,
+70b9add1-240f-481d-828b-c58c8fe422cf,Familial adenomatous polyposis is characterized by all except,Autosomal recessive transmission,More than 100 polyps in colorectal area,Polyps seen in duodenum,Extra-intestinal manifestations are present,0,multi,"Familial adenomatous polyposis (FAP) Is a rare, inherited condition caused by a defect in the adenomatous polyposis coli (APC) gene - located in 5q 21 chromosome. FAP is autosomal dominant- >50% chance of inheritance in family members Has > 100 adenomatous polyps 100% RISK of malignancy Polyp formation - by 15 yrs. 100% develop malignancy - by 40 yrs. TOC: Total proctocolectomy + ileal pouch-anal anastomosis (TPC + IPAA) M/C/C of death after TPC = Peri-ampullary Ca (polyps in duodenum - periampullary region) Two variants of FAP Gardner's syndrome Osteoma (mandible) Congenital hyperophy of the retinal pigmented epithelium (CHRPE) lesions Sebaceous cysts Benign lymphoid polyposis of ileum Desmoid tumors Supernumerary teeth Turcot's syndrome: Brain tumors Medulloblastoma - m/c associated with FAP Glioblastoma multiforme - m/c associated with HNPCC",Surgery,JIPMER 2017
+40ae648a-18eb-4a2e-9f36-61f10e1caa20,"In Steiner's analysis, SNA demonstrates:",Position of mandible in relation to cranial base,Position of maxilla in relation to cranial base,Maxillo-mandibular relationship,None of the above,1,multi,"Relating the Maxilla to the Skull: The angle SNA is formed by joining the lines S-N and N-A . The mean reading for this angle is 82°.
+Steiners analysis demonstrates the position of maxilla and mandible in relation to the cranial base. 
+If the angular reading is more than 82°, it would indicate a relative forward positioning or protrusion of the maxilla. Conversely, should the reading be less than 82°, it would indicate a relative backward or recessive location of the maxilla.",Dental,
+7e269e71-d868-4733-a3d5-26ab218f1880,. Sulphasalazine is NOT used for the treatment of-,Crohn's disease,Rheumatoid ahritis,Sarcoidosis,Ulcerative colitis,2,single,"Sulhasalazine is not used for treatment of sarcoidosis As a treatment for sarcoidosis, these drugs are most likely to be effective in people who have skin symptoms or a high level of calcium in their blood. Hydroxychloroquine (Plaquenil) and chloroquine (Aralen) are antimalarial drugs that are used to treat sarcoidosis Ref Davidson 23rd edtion pg 981",Medicine,Miscellaneous
+fa1ba371-3b43-4adc-8c74-f121d9323965,Post traumatic stress disorder is differentiated from other anxiety disorders by which of the following symptoms?,Nightmares,Re-living of past adverse event,Hypervigilance,Avoidance,1,single,"This question is not about the diagnostic features of PTSD. This is about the differential diagnosis. PTSD is an anxiety disorder and it shares symptoms with other disorders. Impoant features in distinguishing the condition are given below. Differential diagnosis: Point 1: Etiologically significant trauma should be present for a diagnosis of PTSD. E.g. A traumatic event in the past. Point 2: 'Intentionality' or 'aboutness' is an impoant factor for PTSD. Nightmares, flashbacks or reliving experiences should be related to the past event. PTSD concerns memory - Intrusion of past stressors into the present. Point 3: Avoid a 'stimulus' or 'activity' that provokes the memory of the past event. In the above question, only reliving experience is mentioned as connected to the past experiences. Hence, that is the answer for this question. All other symptoms can be see in other anxiety disorders. Ref: Kaplan & Sadock's, Comprehensive Textbook of Psychiatry, 9th Edition, Page 2659",Psychiatry,
+88396977-bf8d-4ece-a0fc-575f404283d8,Which muscle is responsible for unlocking of knee?,Popliteus,Quadriceps femoris,Semitendinosus,Semimembranosus,0,single,"Ans. A PopliteusRef: BDC, vol II pg. 155* Quadriceps femoris is the main and only extensor of knee.* It produces locking action as a result of medial rotation of the femur during the last stage of extension.* To reverse this lock popliteus muscle comes into action and does so by the lateral rotation of femurRemember: Lock is: Quadriceps femoris muscle and, Key is popliteus muscle.Muscles producing movements at the knee jointMovementPrincipal musclesA. Flexion * Biceps femoris* Semitendinosus* SemimembranosusB. ExtensionQuadriceps femorisC. Medial rotation of flexed leg* Popliteus* Semimembranosus* SemitendinosusD. Lateral rotation of flexed leg * Biceps femorisExtra Mile* Quadriceps femoris incudes: Rectus femoris, Vastus Lateralis, Vastis Medialis, Vastus Intermedius.* Rectus femoris is also known as ""kicking muscle""",Anatomy,Lower Extremity
+1815507f-a0d9-4c6a-a954-8e44adbac33e,Polymorphic ventricular tachycardia can occur when terfenadine(antihistaminic):,Is coadministrator with azithromycin,Is coadministrator with fluconazole,Is given in higher doses,Reduces QT interval,2,single,"Torsades de pointes (polymorphic ventricular tachycardia) occurs when terfenadine is taken in higher doses or when hepatic metabolism is impaired by disease or by drugs which inhibit the cytochrome P450 responsible for metabolism of terfenadine. Drugs include erythromycin, clarithromycin, ketoconazole and itraconazole. Azithromycin and fluconazole that are excreted unchanged in the urine have not been associated with impaired metabolism of terfenadine. Terfenadine blocks the delayed rectifier potassium channels and prolongs cardiac repolarization and the QT interval.",Pharmacology,
+186ba321-f9f4-4bd3-9680-24c873078dda,Which component transfers four protons:,NADH-Q Oxidoreductase,Cytochrome -C oxidase,Cytochrome C - Q oxidoredictase,Isocitrate Dehydrogenase,0,single,A i.e. NADH-Q Oxidoreductase; C i.e. Cytochrome C-Q oxidoreductase,Biochemistry,
+d59ca3dc-2b96-40aa-8223-e981776414be,"All of the following are true about Asthma, Except:",Charcol Leydin crystals may be seen in sputum,Reversible Airflow obstruction is a characteristic feature,Large airways are involved,Small airways are not involved,3,multi,"Answer is D (Small airways are not involved): Asthma involves both large and small airways but alveoli are not involved Charcot Leyden crystals may be seen in sputum: Pathology by woolf lsr (1998)/434 Sputum from Asthmatics show ceain characteristic features, including charcot leydencrystas The microscopically identifiable features described in sputum are three 'C's Charcot Leyden crystals - Derived from granules of eosnophils andfbund only in Asthma Curshmann spirals - Curiously twisted casts of airways : Whorls of shed epethelium Creola bodies - Clumps of cells or isolated metaplastic cells Reversible Airflow obstruction is a charachteristic feature (Davidsons 18th/55, 326) Reversible Bronchoconstriction is the hallmark of Asthma The charachteristic feature of Asthma is Intermittent and Reversible airflow obstruction. Narrowing of airways is usually reversible, but in some patients with chronic asthma there may be an element of irreversible airflow obstruction Asthma involves both large and small airways Asthma involves Large and small airways hut not alveoli - 'Allergic Diseases: Diagnosis Treatment' 3rd/ 120 The large and small airways are both involved in Asthma -'Childhood Asthma: Diagnosis, Treatment & Management' r/15 Intermittent Asthma responds better to bronchodilator therapy than persistant Asthma Bronchodilators are effective drugs for the treatment of acute exacerbations or intermittent episodes of Asthma but they are not sufficient to control asthma in patients with persistant symptoms (persistant asthma) Bronchodilators are not sufficient to control Asthma in patients with persistant symptoms'",Medicine,
+f266abec-35bb-4c01-87b8-021c6642f20d,"In emergency, which aery can be safely ligated ?",Internal iliac,Popliteal,Renal aeryInternal carotid,All,0,multi,Ans. is 'a' i.e. Internal iliac,Surgery,
+09fbf2ac-da41-49f6-bb49-78f2ed4855de,Late metabolic acidosis is seen in-,Term infant given formula feed,Preterm baby getting cow milk,Long term breast feeding,None of the above,1,multi,"Ans. is 'b' i.e., Preterm baby getting cow milk Late metabolic acidosis (LMA) o Late metabolic acidosis is a special type of acidosis in apparently healthy premature infant. o This hyperchloremic acidosis appeares during second and third week of life, and resolves spontaneously within a couple of weeks. Definition ""An acidosis occuring after second day of life, in which base excess values are lower than -5meq/L on two consecutive estimations done at least 24 hours apa"". Etiology o Prematurity is the most impoant single predisposing factor in the development of LMA. o The incidence varies considerably depending upon the gestational maturity and protein content of feeding formula. o In preterm neonates fed on a modified cow's milk the risk of developing LMA is very high.",Pediatrics,
+5eede647-0b0b-4e9e-b1de-221700c58f1a,Chemotherapeutic drugs can cause?,Only necrosis,Only apoptosis,Both necrosis and apoptosis,Anoikis,2,multi,"Ans. is 'c' i.e., Both necrosis and apoptosis o Injurious stimuli, e.g., radiation, cytotoxic anticancer durgs, heat and hypoxia, can induce apoptosis if the insult is mild, but large doses of same stimuli result in necrotic cell death.",Pathology,
+f2531634-72e7-48a7-81f6-177d58425bfd,Which of the following nerve is involved in Frey's syndrome?,Trigeminal,Mandibular,Ariculo temporal,Lingual,2,single,"Syndrome (Gustatory Sweating) aka auriculotemporal syndrome: Frey's syndrome arises as a complication of parotid surgery usually manifesting several months after the operation. lt is characterised by sweating and flushing of the preauricular skin during mastication causing nuisance to the person or social embarrassment. It is the result of damage to auriculotemporal nerve and aberrant innervation of sweat glands by parasympathetic secretomotor fibres which were destined for the parotid. Now instead of causing salivary secretion from the parotid, they cause secretion from the sweat glands. The condition can be treated by tympanic neurectomy which intercepts these parasympathetic fibres at the level of middle ear. Some people like to place a sheet of fascia lata between the skin and the underlying fat to prevent secretomotor fibres reaching the sweat glands. Generally, no treatment other than reassurance is required in most of these patients. Also known as Crocodile tears (gustatory lacrimation): There is unilateral lacrimation with mastication. This is due to faulty regeneration of parasympathetic fibres which now supply lacrimal gland instead of the salivary glands. It can be treated by section of greater superficial petrosal nerve or tympanic neurectomy.",Surgery,
+485df1f3-140b-460d-89e2-d35cda7239d8,Opening of mouth is caused by:,Lateral pterygoid,Medial pterygoid,Temporalis,Masseter,0,single,"Ans. A Lateral pterygoidRef: Grays, 41st ed. pg. 507-508* The primary function of the lateral pterygoid muscle is to pull the head of the condyle out of the mandibular fossa along the articular eminence to protrude the mandible.* The effort of the lateral pterygoid muscles acts in helping lower the mandible and open the jaw whereas unilteral action of a lateral pterygoid produces contralateral excursion (a form of mastication), usually performed in concert with the medial pterygoids.* Unlike the other three muscles of mastication, the lateral pterygoid is the only muscle of mastication that assists in depressing the mandible i.e. opening the jaw. At the beginning of this action it is assisted by the digastric, mylohyoid and geniohyoid muscles.",Anatomy,Neuroanatomy
+0c2e0b04-3761-4870-9e00-142c5ca752e8,All are true about streptococcus Except,M-protein is responsible for production of mucoid colonies,M-protein is responsible for virulence,Mucoid colonies are virulent,Classified based on their haemolytic propeies.,0,multi,"Mucoid colonies are due to the production of the capsule of hyaluronic acid not due to M-protein. Growth characteristic of Strep. pyogenes: On blood agar, virulent stains form matt or mucoid colonies while avirulent from glossy colonies. M, T, R are proteins found on the outer pa of the cell wall and forms the basis of Griffith classification. M protein - acts as virulence factor and antibody against it is protective. T and R protein - No relation to virulence Ref : 208",Microbiology,All India exam
+d0a95794-ea5e-4b1c-a30f-1b6e4c58a9c4,What is monitored in a patient of Pre eclamsia ?,Uric acid,Platlet count,LFT,All of the above,3,multi,"Ans. is 'd' i.e. All of the abov Investigations in a case of Pre eclampsia* URINE for proteins/albumin. 24 hours urine protein* CBC: There is hemoconcentration so HB values are false elevated. Low platlets indicate HELLP syndrome* Sr uric acid: It is a biochemical marker of preeclampsia. Raised levels (>4.5 mg/dl) indicate renal involvement and also correlate with severity of preeclampsia, volume contraction and fetal jeopardy.* LFT: SGOT, SGPT, Bilirubin* RFT: Sr creatinine* Coagulation profile may be required in severe cases:i) BTii) CTiii) PT, APTTiv) Fibrinogen levelsv) FDP",Gynaecology & Obstetrics,Miscellaneous (Gynae)
+b83ec510-9c3f-4f3c-ae71-6cad16b917ea,In a young female of reproductive age an absolute contraindication for prescribing oral contraceptive pills is:,Diabetes,Hypertension,Obesity,Impaired liver function,3,single,"Ans-D i.e., Impaired liver function Repeat Q No 173 (Nov. 2004)Absolute contraindications include:A personal h/O thromboembolic venous, arterial or cardiac disease or severe or multiple risk factor for these. Transient cerebral ischaemic attacks without a headache.Infective hepatitis, until 3 months after liver function tests has become normal, and another liver disease including disturbances of hepatic excretion e.g. cholestatic jaundice, Dubin Johnson and Rotor syndromes.A migraine, if there is a typical aura, focal features or if it is severe and lasts > 72 hours despite t/t or is treated with an ergot derivative.Carcinoma of the breast or the genital tractOther conditions including SLE, porphyria, following the evacuation of a hydatidiform mole (until urine and plasma gonadotropin concentrations are normal), undiagnosed vaginal bleeding.Relative contraindications of OCP'sThe family history of venous thromboembolism, arterial disease or a known prethrombotic condition e.g. Factor V Leiden (pretreatment coagulation investigation is advised).Diabetes mellitus which may be precipitated or become more difficult to control (avoid if there are diabetic complications).Hypertension (avoid if B.P. exceeds 160/100)Smoking > 40 Cigarettes per day (15 Cigarettes/day enhances the risk of circulatory disease and constitutes an absolute contraindication for women over 35 years.Long-term immobility (e.g. due to Leg plaster, confinement to bed.Breastfeeding (until weaning or for 6 months after birth).Obesity",Unknown,
+5602f3e5-6f42-4102-ab85-4e8426f8a377,"A tracheostomised patient, with poex tracheostomy tube, in the ward, developed sudden complete blockage of the tube. Which of the following is best next step in the management?",Immediate removal of the tracheostomy tube,Suction of tube with sodium bicarbonate,Suction of tube with saline,Jet ventilation,0,multi,"Immediate removal of the tracheostomy tube is best next step in the management in the above case -Suction of tube with sodium bicarbonate is done to avoid the blockage. -Suction of the tube with saline can't be used when there's a complete obstruction. - Jet ventilation is done below the level of larynx, when we're operating on the larynx.",ENT,Ca Larynx
+a48aea6e-3421-42b8-8a92-767a3436d2f1,"All of the following are well recognised predisposing factors for adult respiratory distress syndrome, except:",Multiple blood transfusions,Septicemia,Status asthmaticus,Toxic gas inhalation,2,multi,Status asthmaticus is an example of type 2 respiratory failure while ARDS is type 1 respiratory failure. All other choices lead to cytokines release and damage the alveoli leading to ARDS.,Medicine,Respiratory Failure
+be63f66a-3eaa-44fb-99a7-5d95ecbecf3f,Gottron papules is seen in ?,Dermatomyositis,Scleroderma,Sarcoidosis,Behcets syndrome,0,single,"Ans. is 'a' i.e., Dermatomyositis",Skin,
+0fcd762f-fc59-486b-b27d-3295dbaf0e2c,Which among the following is the BEST irrigating fluid during ECCE?,Ringer lactate,Normal saline,Balanced salt solution,Balanced salt solution + glutathione,3,single,"BSS plus a balanced salt solution enhanced with bicarbonate, dextrose and glutathione. It is specially used for surgeries requiring prolonged irrigation such as phacoemulsification, pars plana vitrectomy and automated extracapsular cataract extraction. Balanced sterile solution is a sterile physiologically balanced irrigating fluid. It is the most frequently used solution during ophthalmic surgery to keep the cornea from drying out. BSS plus solution causes less corneal edema and endothelial cell damage following vitrectomy. The glutathione protects against depletion of endothelial ATP levels and maintains the integrity of the cell membrane by counteracting endogenous and exogenous oxidative agents. Ref: Surgical Technology for the Surgical Technologist: A Positive Care Approach By Association of Surgical Technologists page 223. Ocular Toxicity of Intraoperatively Used Drugs and Solutions By Rudolph Marie Matheus Antonius Nuijts page 16. Clinical Ophthalmology: Contemporary Perspectives, 9/e By Gupta page 43.",Ophthalmology,
+7842833c-724b-42e9-988f-9a546ef012bc,Acute Gouty ahritis is seen early in treatment following -,Probenecid,Allopurinol,Rasburicase,All of the above,3,multi,"All of the above Rapid lowering of urate level in chronic gout, by any means, may precipitate an attack of acute gout, probably by causing the dissolution of tophi. o It is therefore usual to give prophylactic suppressive treatment with indomethacine, colchicine or steroid cover during first 2 months of allopurinol or uricosurics. o Amongs the given options, allopurinol, probenecid and Rasburicase are the drugs that lower serum urate level. So, all three can precipitate acute gout. However, among these three, allopurinol is used most commonly therefore is the best answer here.",Pharmacology,
+a5f415f4-c085-46c1-936b-4550065920f9,Chandler's index is associated with: September 2006,Round worm,Hook worm,Pin worm,Tape worm,1,single,"Ans. B: Hook worm Morbidity and moality from hookworm infection depend much on the worm load. Chandler worked out an index on the basis of an average number of hookworm eggs per gram of feces for the entire community, Chandler's index is still used in epidemiological studies of hookworm disease. By this index, worm loads in different population groups can be compared and also the degree of reduction of egg output after mass treatment.",Social & Preventive Medicine,
+94ba87f0-bd34-460a-b611-f816dfefea3b,Heparin is the commonly used anticoagulant in cardiac surgery. All of the following are true about heparin except-,Weakest acid found in living things,Most commercial preparations of heparin now utilize pig intestinal slimes,Act via Antithrombin activation,Produce thrombocytopenia,0,multi,Ans. is 'a' Weakest acid found in living organism Heparin is a direct acting anticoagulant Chemical nature and preparationHeparin is a sulfated mucopolysaccharide which occurs in the secretory granules of mast cells.It is the strongest organic acid in the body and in the solution it carries an electronegative charge.It is prepared commercially from a variety of animal tissues (generally porcine intestinal mucosa or bovine lung).Mechanism of Action of HeparinHeparin acts by activating antithrombin which is a naturally occuring inhibitor of activated coagulation factors of intrinsic and common pathway. 'Adverse effects of HeparinBleedingHeparin induced thrombocytopeniaOccurs more commonly in heparin derived from bovine lung.Heparin induced thrombocytopenia should be suspected in whom the platelet count falls by 50% or more after starting heparin and usually occurs 5 or more days after starting therapy.In patients with heparin induced thrombocytopenia following drugs should be substituted.Danaparoid sodiumHirudinArgatrobanOsteoporosis - (most frequently seen in pregnancy)Hypersensitivity reactions & skin necrosis,Pharmacology,Anticoagulants and Coagulants
+bafc8c3c-4119-4aa0-a7e5-0f48ed28ccd4,One of the following is the first enzyme to be released at the site of wound?,Aminopeptidase,ATPase,Acid phosphatase,Alkaline phosphatase,1,single,Ref - Krishan Vij textbook of forensic medicine and toxicology 5e pg - 202,Forensic Medicine,Mechanical injuries
+ab838e4c-721e-490c-b721-f2eec9403c66,Sign of diabetic ketoacidosis is-,Loss of sweating,Depression,Dehydration,Absent deep tendon reflexes,2,single,"Physical findings of diabetic ketoacidosis are tachycardia, dehydration/hypotension, hypothermia, tachypnea/Kussmaul respirations/ respiratory distress, abdominal tenderness (may resemble acute pancreatitis or surgical abdomen), lethargy/obtundation/cerebral edema/possibly coma. Reference : page 2418 Harrison's Principles of Internal Medicine 19th edition",Medicine,Endocrinology
+7d6f7593-99bd-4fa2-9722-2e813270f187,Which of the following drug is used in scabies as single oral dose agent: March 2011,Permethrin,Retinoids,Ivermectin,Co-trimoxazole,2,single,"Ans. C: Ivermectin Ivermectin is used as single oral dose of 200 microgram/ kg body weight It can be repeated after 2 weeks It is indicated in epidemics of scabies in orphanages and Norwegian scabies Scabies: Incubation period: 4 weeks Pathognomic lesion: Burrow, which lies in stratum corneum MC site in infants: Scalp, face Most severe form: Norwegian scabies Drug used orally: Ivermectin",Skin,
+15285e5f-a482-4072-a123-0ebf1995c01b,Most common complication after ERCP is,Acute Pancreatitis,Acute cholangitis,Acute cholecystitis,Duodenal perforation,0,single,"Complication perforation(1.3%)/hemorrhage (1.4%),pancreatitis (4.3%) and sepsis (3-30%). Bailey & Love 26th, 208",Surgery,G.I.T
+8ce680ed-3297-4dda-bb9b-ec514e2f3279,Progesterone production in the ovary is primarily by:,Stroma,Corpora albicans,Corpora lutea,Mature follicles,2,single,,Physiology,
+68ce51d2-1478-4b0f-a475-66709c49f908,"Which of the following clinical situations is associated with an increase in predominantly conjugated (""direct"") bilirubin?",Physiologic jaundice of the neonate,Kernicterus Following Rhesus Incompatibility,Gilbe's Syndrome,Pancreatic head tumor,3,single,"Of the conditions listed, only pancreatic head tumors are associated with an increase in conjugated (""direct"") bilirubin (obstructive jaundice). Increased levels of unconjugated (""direct"") bilirubin result from hemolysis over liver defects that impair uptake or conjugation mechanism in liver cells (Gilbe's syndrome, Crigler- Najjar syndrome) positive. Unconjugated bilirubin may cross the immature blood brain Barrier of the newborn and cause Kernicterus. The physiologic jaundice of the newborn observed during the first week of bih is usually mild and due to relatively immature liver conjugation. Ref: Cothren C., Biffl W.L., Moore E.E. (2010). Chapter 7. Trauma. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.",Surgery,
+2db2d6a0-d45d-4cb4-93d3-02fb80d7c6f0,"The use of kinematic face bow is contraindicated in the
+edentulous patients because",It has to be used on the mandibular ridge,Recording base may be unstable on the edentulous mandible,Movement of bases may lead to inaccuracy in recording hinge axis,All of the above,3,multi,,Dental,
+3c33c260-cb6b-4e51-80cc-39885fca466e,Regarding carcinoma Gallbladder true statement,Squamous cell carcinoma is the most common,Present with jaundice,Good prognosis,65% survival after surgery,1,multi,"Clinical features Most commonly presents with right upper quadrant pain often mimicking cholecystitis and cholelithiasis Weight loss, jaundice and abdominal pain are less common presenting symptoms Chronic cholecystitis with a recent change in quality or frequency of the painful episodes in 40% patients Malignant biliary obstruction with jaundice, weight loss and RUQ pain Ref: Sabiston 20th edition Pgno : 1512-1514",Anatomy,G.I.T
+a544e2fd-3cd4-4d3d-9b0a-ec6848b70e9d,Which anaesthetic agent increases intracranial tension among the following,Thiopentone,Propofol,Lignocaine,Sevoflurane,3,single,All inhalational anaesthetics directly act on cerebral blood vessels→vasodilatation→increase cerebral blood flow→ increase intracranial tension,Anaesthesia,
+a3ceeb36-5207-4a64-b433-d608219c0967,Granules of Eleidin are present in which of the following layer?,Stratum corneum,Stratum lucidum,Stratum spinosum,Stratum basale,1,single,Stratum Lucidum - Also called clear cell layer. Present only in skin of palms and soles. Translucent due to presence of refractile Eleidin granules,Dental,"Layers of epidermis, dermis"
+15012daa-62ab-439c-be19-d228ae5bcb4e,Which of the following drug is a long acting beta–2 agonist ?,Albuterol,Salmeterol,Pirbuterol,Orciprenaline,1,single,,Pharmacology,
+ccd164d1-984c-4b6f-a02e-fac406b5a4be,Antidepressant drug used in nocturnal enuresis is:,Imipramine,Fluoxetine,Trazodone,Seraline,0,single,Sleep related enuresis- Treatment Bed alarms (behavioral therapy)- TOC Desmopressin (DOC) Imipramine (TCA Antidepressant),Psychiatry,Sleep Disorders
+b5ec622b-1dc1-432e-8325-4cf29c72af46,"Five days after an uneventful cholecystectomy, an asymptomatic middle-aged woman is found to have a serum sodium level of 125 mEq/L. Which of the following is the most appropriate management strategy for this patient?",Administration of hypeonic saline solution,Restriction of free water,Plasma ultrafiltration,Hemodialysis,1,single,"The initial, and often definitive, management of hyponatremia is free-water restriction. Symptomatic hyponatremia, which occurs at serum sodium levels less than or equal to 120 mEq/L, can result in headache, seizures, coma, and signs of increased intracranial pressure and may require infusion of hypeonic saline. Rapid correction should be avoided so as not to cause central pontine myelinolysis, manifested by neurologic symptoms ranging from seizures to brain damage and death. Additionally, a search for the underlying etiology of the hyponatremia should be undeaken. Acute severe hyponatremia sometimes occurs following elective surgical procedures due to a combination of appropriate stimulation of antidiuretic hormone and injudicious administration of excess free water in the first few postoperative days. Other potential etiologies include hyperosmolarity with free-water shifts from the intra- to the extracellular compament (eg, hyperglycemia), sodium depletion (eg, gastrointestinal or renal losses, insufficient intake), dilution (eg, drug-induced), and the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).",Anaesthesia,Preoperative assessment and monitoring in anaesthesia
+b04ed4e3-15a4-452d-b6fb-7d0849520507,Reversible cause of dementia is -,Alzheimer's disease,Parkinsonism,Hypothyroidism,Vascular dementia,2,single,"Ans. is 'c' i.e., Hypothyroidism Causes of dementiaReversible causesSurgically treatableMedically treatableo Normal pressure hydrocephaluso Brain tumors (frontal lobe tumor)o Meningiomao Subdural hematoma (Head injury)o Hydrocephaluso Hypothyroidismo Depressiono HIV infectiono Alcohol abuseo Vitamin B12, Folate, Niacin deficiencyo Any metabolic or endocrine disturbanceo Neurosyphiliso Hashimoto's encephalopathy o Wilson's diseaseo Celiac disease or Whipple's diseaseo Chronic meningoencephalitiso Drugs and toxin (toxic dementia)Irreversible causeso Alzheimer's diseaseo Huntington's choreao Lewy body dementiao Vascular (Multi-infarct) dementiao Parkinson's diseaseo Creutzfeld Jakob diseaseo Pick's diseaseo Overall Alzheimer's disease is the most common cause. Vascular dementia is the 2nd most common cause.",Psychiatry,Dementia Due to Metabolic Causes
+29447292-3080-4f86-a058-16c7cd4c807e,A obese female having hirsutism on laboratory investigation has high level of LH and androgens. Likely cause is-,PCOS,Exogenous steroid ingestion,Turner syndrome,Kleinfelter syndrome,0,single,"Ans. is 'a' i.e., PCOS o The clinical and laboratory features of the patient described in the question match with those of PCOS as depicted in the table. So the most appropriate answer is PCOS.Clinical features of polycystic ovarian diseaseClinical featureHannonalSequelaeo Young womano | E2. levelo Diabaetes (15%)o Central obesityo | FSH | LH > 10 IU/mlo CVS disorder# SMI > 30kg/cm2o | FSK/LH ratioo Lipidaemia# Waist line > 35o | Androgenso Hypertensiono Gligomenorrhoea, amenorrhoeao Testosterone,epiandrostenedione. |dehydropepiandrosterone |o Endometrial cancero Infertility (20%)o Breast cancero Hirsutismo Premature ovariano Acanthosis nigra due to insulin resistance, Thick pigmented skin over the nape of neck, inner thigh and axillao 17-alpha-hvdroxy progesterone> 800 ng.'dLfailure following surgeryo Testosterone > 2 ng/mlo Most androgens from ovaryo | fasting insulin > l0mlu/Lo Protactin |o Sex hormone binding globulin (SHBG)o | E2/oestrone (E1) ratioo F glucose,'insulin ratio <4-5 (normal 2-4-4-5)",Gynaecology & Obstetrics,Disorders of Ovulation - Anovulation 
+ecd37a96-1618-42f3-8e8e-317805ff7250,"Which of the following is a feature of papillon lefevre
+syndrome?",destructive periodontitis,palmar-plantar keratosis,calcification of dura,all the above,3,multi,,Dental,
+ade72f9a-6b13-4e9f-bfa1-b1cd94ea5207,All are used in the management of head injury patient except?,Neuromuscular paralysis,Nor-epinephrine,Sedation,Glucocoicoids,3,multi,"Glucocoicoids are useful for management of vasogenic edema from tumor or brain abscess. In contrast glucocoicoids are avoided in case of head trauma, ischemic and hemorrhagic stroke. Norepinephrine or pressor therapy is used to maintain a MAP to maintain CPP> 60 mm Hg. Sedation is done with propofol or midazolam. Neuromuscular paralysis will be necessary and the patient will need ventilator suppo. This will ensure securing the airway and keeping pCO2 between 30-35mmHg.",Medicine,Raised ICP and Brain death
+ee5d7bf0-621a-4dd9-a662-dc6f7299773e,Not a premalignant condition: March 2005,Retinitis pigmentosa,Crohn's disease,Ulcerative colitis,Leukoplakia,0,single,"Ans. A: Retinitis pigmentosaGIT premalignant conditionsOf the four major primary small-bowel tumors (adenocarcinomas, lymphomas, carcinoid, and leiomyosarcomas), adenocarcinomas and lymphomas are associated with diseases that seem to increase the risk of developing these malignancies.Immunoproliferative small intestinal disease and celiac disease, are thought to predispose patients to the development of primary lymphoma.Increased risk is also associated with conditions, such as immunodeficiency syndromes, nodular lymphoid hyperplasia, Crohn's disease, the gastrointestinal polyposis syndromes, hereditary nonpolyposis colon cancer, neurofibromatosis, long-standing ileostomy, and urinary diversion procedures.Patient with long standing ulcerative colitis are at risk of developing colonic epithelial dysplaia and carcinoma.Oral cavity premalignant conditionsMany oral SCCs develop from premalignant conditions of the oral cavity.A wide array of conditions have been implicated in the development of oral cancer, including leukoplakia, erythroplakia, palatal lesion of reverse cigar smoking, oral lichen planus, oral submucous fibrosis, discoid lupus erythematosus, and hereditary disorders such as dyskeratosis congenital and epidermolysis bullosaOther pre-malignant conditions include actinic keratosis, Barrett's esophagus and cervical dysplasia.",Medicine,
+af19e4b3-3f46-46d2-81c9-2847f361cff6,Which of the following is false about Takotsubo Cardiomyopathy,Due to major catecholamine discharge,Lv Contractile dysfunction,Presents with acute chest pain,Echo never reverts back to normal,3,multi,Echo comes back to normal in two weeks.,Medicine,
+8eba895c-2d5b-4bb2-8406-2b25a0e86fdd,"In rheumatic heart disease, infective endocarditis is detected by echocardiogram and the largest vegetations seen are due to-",Streptococcus viridans,Staphylococcus aureus,Candida albicans,Salmonella typhi,2,single,,Medicine,
+d2ac768b-802c-42b6-9bad-b543d3bf5845,Hereditary non-polyposis colorectal cancer (HNPCC) has an increased risk of all the following except,Endometrium,Ovary,Stomach,Pancreas,3,multi,"Hereditary non-polyposis colorectal cancer (Lynch syndrome)Hereditary non-polyposis colorectal cancer (HNPCC) is characterised by an increased risk of colorectal cancer and also cancers of the endometrium, ovary, stomach and small intestine.It is an autosomal dominant condition caused by a mutation in one of the DNA mismatch repair genes. The most commonly affected genes are MLH1 and MSH2. The lifetime risk of developing colorectal cancer is 80%, and the mean age of diagnosis is 45 years. Most cancers develop in the proximal colon. Females have a 30-50% lifetime risk of developing endometrial cancerRef: Bailey and Love, 27e, page: 1260",Surgery,G.I.T
+5ecaa0ed-8d29-40b5-b01f-df7e1339e66e,Iodine RDA is -,300 microgram,500 microgram,150 microgram,50microgram,2,single,"Ans. is 'c' i.e., 150 microgram o The RDA of iodine for adults is 150 microgram.GroupRecommended daily intakePreschool children (0-59 months)School children (6 - 12 years)Adults (>12 years)Pregnancy and lactation90 meg120 meg150 meg250 meg",Social & Preventive Medicine,Nutrition and Health
+e44640d5-48ed-4062-87c2-fc924592d230,Spanish windlass was practices in Spain as a method of execution. It is a type of:,Bansdola,Mugging,Garrotting,Hanging,2,single,Garrotting Garrotting: One of the methods of hemicidal strangulation The victim is attacked from behind without warning and strangled by grasping throat or by throwing a ligature over the neck and tightening it quickly. In this way a single assailant can kill a healthy robust adult. Garrotting was practices as a mode of execution in Spain. Pougal and Turkey. In Spain it was known as `spanish windlass' in which an iron collar around the neck was tightened by a screw for strangling Other common methods of homicidal strangulation are: Throttling - by hand Bansdola - In this type of strangulation the neck is compressed between two sticks of bamboos one in front and other behind the neck. Both the ends are tied with a rope squeezing the victim to the death. Sometimes a single stick is placed across the .front of the neck with a foot on each end of the stick. Mugging - Strangulation is caused by holding the neck of the victim in the bend of the elbow.,Forensic Medicine,
+bf20b057-cff7-4fe2-b8f2-8f60d8f02394,Dispropoionately increased blood urea levels compared to serum creatinine (urea creatinine ratio 20:1) can be seen in the following except -,Prerenal failure,CCF,Intrinsic renal failure,Hypovolemia,2,multi,"Intrinsic or intrarenal acute renal failure (ARF) occurs when direct damage to the kidneys causes a sudden loss in kidney function. The most common causes of intrinsic acute renal failure are acute tubular necrosis (ATN), acute glomerulonephritis (AGN), and acute interstitial nephritis (AIN) . Ref Harrison20th edition pg 236",Medicine,Kidney
+3dc0dd82-3432-4b61-ad9f-a773a732b840,"For RNA, which blotting technique is used -",Western blot,Northern blot,Southernblod,None,1,multi,"Ans. is 'b' i.e., Northern blot TechniqueSample analyzedGel usedProbeSouthern blotDNAQYesRadioactive DNAAllele specific oligonucleotide (ASO)DNANoAllele specific oligonucleotideMicroarravm-RNA or c-DNANoDNA probeNorthern blotRNAQYesDNA probeWestern (immuno) blotProtein QYesLabeled antibody QSouth Western blotProtein DNANoDNA probeELISAProtein or antibodiesNoAntibody Q (Specific for protein to be measured)ProteomicsProtein QYes-",Biochemistry,Molecular Biology Techniques
+488aeeec-1039-4582-8348-f2c04094b206,Which bacteria acts by inhibiting protein synthesis?,Pseudomonas,Staphylococcus,Streptococcus,Klebsiella,0,single,"Ans. is 'a' i.e., Pseudomonas",Microbiology,
+1cc342d1-07ab-444f-87fe-500db0036571,Panthothenic acid is coenzyme of which of the following reaction (s):,Dehydrogenation,Oxidation,Decarboxylation,Acetylation,3,single,"D i.e. Acetylation Pantothenic acid is necessary for synthesis of coenzyme A (CoA)Q, which functions as a coenzyme for acetylation reactionsQ",Biochemistry,
+19643593-8cbc-490a-b617-6d7c0c212d20,Delusion that someone from high socio economic status is loving you is in -,Othello syndrome,Capgras syndrome,De clerambault syndrome,Franklin syndrome,2,single,,Psychiatry,
+9d1f476f-83c0-4020-9a21-eca236b4b831,Oesophageal motility disorder are best diagnosed by?,Barium studies,Endoscopy,24 hour pH monitoring,Manometry,1,single,"Answer is B (Endoscopy): Dysphagia for solids alone suggests a probable mechanical cause for dysphagia such as carcinoma, stricture or esophageal web. The investigation of choice for such cases is Endoscopy.",Medicine,
+7a834eac-011c-46e0-8580-ea4dde20b332,"Quinine given to a patient of falciparum malaria caused sweating and palpitation, the likely cause is?",Cinchonism,Hyperglycemia,Hypoglycemia,Hypokalemia,2,single,"Ans. is 'c' i.e., Hypoglycemia o Sweating and palpitations suggest hypoglycemia; which can occur due to quinine. Cinchonism is characterized by ringing in ears, nausea, vomiting, veigo, headache, mental confusion, difficulty in hearing and vision. Hypotension and cardiac arrhythmias develop on rapid i.v. injection.",Pharmacology,
+19dbac31-b1e5-4fb4-8c2d-bb1220dad8a5,"Good pasture's syndrome is characterized by all of the following, except:",Glomerulonephritis,Leucocytoclastic Vasculitis,Diffuse alveolar haemorrhage,Presence of antibodies to Basement Membrane,1,multi,Answer is B (Leucocytoclastic Vasculitis) Leucocytoclastic vasculitis is not a typical feature of Good pasture's syndrome Triad of Goodpasture's syndrome (Ferri 's Color Atlas & Text of Clinical Medicine) Glomerulonephritisdeg (RPGN; crescents) Pulmonary HaemorrhageQ (Diffuse Alveolar Haemorrhage) Antibodies to basement membrane antigensQ (Anti-GBM antibodies),Medicine,
+bed1db02-0efc-436d-912c-12b439b7bd88,Main source of energy derived from,Fat,Glycogen,Lactate,Ketone,1,single,"Glycogen is the reserve carbohydrate in animals. It is stored in liver and muscles.The phosphorylated enzyme is less sensitive to allosteric inhibitors. Thus even if cellular ATP and glucose-6-phosphate are high, Phosphorylase will be active. The glucose-1-phosphate produced from glycogen in the liver may be conveed to free glucose for release to the blood.",Biochemistry,Metabolism of carbohydrate
+5782c8ae-0a5b-4b61-9c36-9f7cd6db1019,Reverse Coarctation is seen in,Giant cell arteritis,Takayasu arteritis,Polyarteritis nodosa,Microscopic polyangitis,1,single,Reverse Coarctation ;weak or absent pulse in upper limb + pulse present in lower limb.,Medicine,
+744ac7f5-db9c-4287-8b7e-bac76d27f977,Measures involved in sentinel surveillance includes all of the following except.,Identifying missing cases in notification of diseases,Identifying new cases of infection,Identifying old and new cases,Identifying cases free of disability,3,multi,"Ans. (d) Identifying cases free of disability* Surveillance: Is the ongoing systematic collection and analysis of data and the provision of information which leads to action being taken to prevent and control a disease, usually one of an infectious nature* Surveillance is of many types:- Passive Surveillance: Data is itself reported to the health system; For e.g., A patient with fever coming on his own to the PHC, CHC, Dispensary, Private Practitioner, Hospital- Active Surveillance: Health system seeks out 'actively' the collection of data, i.e., goes out to community to collect data; For e.g., Stool sample collection from home in Polio Program.- Sentinel Surveillance: Monitoring of rate of occurrence of specific conditions to assess the stability or change in health levels of a population, It is also the study of disease rates in a specific cohort, geographic area, population subgroup, etc. to estimate trends in larger population; For e.g., Use of health practitioners to monitor trends of a health event in a population- 1. Sentinel Surveillance helps in 'identifying missing cases' and 'supplementing notified cases'ALSO REMEMBER* Most of the national health programs in India rely on Passive Surveillance for morbidity and mortality data collection.* Active Surveillance: Is seen in NVBDCP (Health worker goes house to house every fortnight to detect fever cases, collect blood slides and provide presumptive treatment under malaria component) and National Leprosy Elimination Program (Modified Leprosy Elimination Campaigns)* Sentinel Surveillance is done in National AIDS Control Program wherein STD Clinics, ANC Clinics have been identified as sentinel sites to monitor trends of HIV/AIDS in the country",Social & Preventive Medicine,Concept of Control
+c8025448-c143-4985-bc62-6f4497321667,Which of the following drug crosses placenta,Heparin,Warfarin,Dicumarol,Nicoumalone,1,single,"(Warfarin) (601-KDT6th)* WARFARIN - It crosses placenta and is secreted in milk however quantity of active form is generally insufficient to affect the suckling infants* HEPARIN - does not cross BBB or placenta**- It is the anticoagulant of choice during pregnancy*** Bleeding due to overdose is the most serious complication of heparin therapy** other side effects are thrombocytopenia, * alopecia, * osteoporosis*, hypersensitivity reactions.",Pharmacology,Hematology
+9c2b91bb-26f4-4111-aeb0-b5a39cb3ee6b,Vocal cord palsy is not associated with -,Vertebral secondaries,Left atrial enlargement,Bronchogenic carcinoma,secondaries in mediastinum,0,single,,ENT,
+20538003-bd04-47e0-bf66-be95c6645f2c,Thymic hypoplsia is seen in which of the following,Wiskott Aldrich syndrome,Digeorge syndrome,IgA deficiency,Agammaglobulinamia,3,single,"Ref Robbins 9/e p224 Thymic Hypoplasia: DiGeorge Syndrome DiGeorge syndrome results from a congenital defect in thymic development with deficient T cell maturation. T cells are absent in the lymph nodes, spleen, and peripheral blood, and infants with this defect are extremely vulnera- ble to viral, fungal, and protozoal infections. Patients are also susceptible to infection with intracellular bacteria, because of defective T cell-mediated immunity. B cells and serum immunoglobulins are generally unaffected. The disorder is a consequence of a developmental mal- formation affecting the third and fouh pharyngeal pouches, structures that give rise to the thymus, parathy- roid glands, and poions of the face and aoic arch. Thus, in addition to the thymic and T cell defects, there may be parathyroid gland hypoplasia, resulting in hypocalce- mic tetany, as well as additional midline developmental abnormalities. In 90% of cases of DiGeorge syndrome there is a deletion affecting chromosomal region 22q11, as discussed in Chapter 6. Transplantation of thymic tissue has successfully treated some affected infants. In patients with paial defects, immunity may improve spontane- ously with age.",Anatomy,General anatomy
+8b0cca19-6794-4dda-8555-999825700403,Rett's syndrome occurs due to deficiency of ?,Niacin,Biotin,Carotene,Vit D,1,single,"Ans. is 'b' i.e., Biotin",Pediatrics,
+6a559d18-5fc8-4293-909f-6dcbf1fdb8c2,The Triat in which the parents are clinically normal and only siblings are affected but males and females are affected in equal propoions is:,AD,AR,XLD,XLR,1,multi,AR,Pathology,
+33b1f0a4-58b5-4b1e-9ed0-0ce1aced7e51,Vitamin K is ivolved in the posttranslational modification?,Glutamate,Aspartate,Leucine,Lysine,0,single,,Biochemistry,
+3991ab18-1f83-4290-8b8a-40f4ad1697df,True about primary peritonitis,Mostly monobacterial,It is chemical peritonitis proceeds secondary peritonitis,Needs peritoneal lavage,Occurs with Cirrhosis of liver,3,multi,"(D) Occurs with Cirrhosis of liver # # PRIMARY (SPONTANEOUS) BACTERIAL PERITONITIS> Peritonitis is either primary (without an apparent source of contamination) or secondary.> The types of organisms found and the clinical presentations of these two processes are different. In adults, primary bacterial peritonitis (PBP) occurs most commonly in conjunction with cirrhosis of the liver (frequently the result of alcoholism).> However, the disease has been reported in adults with metastatic malignant disease, postnecrotic cirrhosis, chronic active hepatitis, acute viral hepatitis, congestive heart failure, systemic lupus erythematosus, and lymphedema as well as in patients with no underlying disease. PBP virtually always develops in patients with ascites.> While enteric gram-negative bacilli such as Escherichia coli are most commonly encountered, gram-positive organisms such as streptococci, enterococci, or even pneumococci are sometimes found.> In PBP, a single organism is typically isolated; anaerobes are found less frequently in PBP than in secondary peritonitis, in which a mixed flora including anaerobes is the rule. In fact, if PBP is suspected and multiple organisms including anaerobes are recovered from the peritoneal fluid, the diagnosis must be reconsidered and a source of secondary peritonitis sought.",Surgery,Miscellaneous
+0397f010-664b-4e76-90fc-8256260db0fe,Osgood Schlatter disease is associated with osteochondritis of,Patella,Femur medial condyle,Tibial tubercle,Femur lateral condyle,2,single,Types of Osteochondritis and Nomenclature Traction apophysitis (chronic strain injuries) Tibial Tuberosity Osgood-Schlatter Calcaneum Sever The lower pole of patella Sinding-Larsen&;s,Microbiology,All India exam
+0c4491bc-9574-43c6-96b0-788752754133,Datura seeds resemble -,Ricinus communis,Capsicum,Opium,None,1,multi,"↵The seeds of datura closely resemble those of the capsicum universally used over India as a condiment, and the difficulty of their detection is enhanced by the fact that, apart from the bitterness, the poison-seeds have little taste and as impure salt is generally used in India.",Forensic Medicine,
+6c6493f2-f979-4fa9-ac9e-05a0421dafcb,Measles is infective for:,One day before and 4 days after rash,Four days before and five days after rash,Entire incubation period,Only during scabs falling,1,multi,"Measles/English Measles is spread through respiration (contact with fluids from an infected person&;s nose and mouth, either directly or through aerosol transmission), and is highly contagious -- 90% of people without immunity sharing a house with an infected person will catch it. The infection has an average incubation period of 14 days (range 6-19 days) and Period of communicability in measles is approximately 4 days before and 5 days after the appearance of the rash. Measles is an infection of the respiratory system caused by a virus, specifically a paramyxovirus. REF : ananthanarayana 10th ed",Microbiology,All India exam
+b226189d-af7e-4612-93f2-8cd73557f8d7,True about Caspases is?,Involved in apoptosis,Cause necrosis,Involved in pain pathway,Are cytokines inhibitor,0,multi,"ANSWER: (A) Involved in apoptosisREF: Robbins pathology 7th edition page 27-29Caspases are essential in cells for apoptosis, or programmed cell death, in development and most other stages of adult life, and have been termed ""executioner"" proteins for their roles in the cell Some Caspases are also required in the immune system for the maturation of lymphocytes",Pathology,Apoptosis
+5b09f4db-7ef6-4ad7-b356-273a8d91bc37,Metachromatic granules are stained by?,Ponder's stain,Negative stain,Gram's stain,Leishman stain,0,single,"Ans. is 'a' i.e., Ponder's stain",Microbiology,
+e8879409-6038-41f0-85ed-c7aab99ad82b,Finger print bureau was first established in the following country:,India,England,USA,France,0,single,"Dactylography or fingerprint system or dermatoglyphics or Galton system was first used in India in 1858, by Sir William Herschel in Bengal. Sir Francis Galton systematised this in 1892. Finger print bureau was first established in Kolkata.Fingerprints are impressions of patterns formed by the papillary or epidermal ridges of the fingeips. Ref: The essentials of forensic medicine and toxicology by Dr K S Narayan Reddy, 27th edition, Page 76.",Forensic Medicine,
+ccedc14b-e67c-4001-ac2f-ba3d1c05fdf2,Which of the following drug acts against Pseudomonas -,Piperacillin,Methicillin,Nafcillin,Cloxacillin,0,single,"Ans. is 'a' i.e., Piperacillin Drugs acting against Pseudomonas. o Penicillins- Piperacillin, Carbenicillin, Ticarcillin, Mezlocillin. o Cephalosporins - Ceftazidime, Cefoperazone, Cefepime. o Carbapenems- Imipenem, meropenem o Monobactams - Aztreonam. o Aminoglycosides - Tobramycin, Gentamycin, Amikacin. o Fluroquinolones - Ciprofloxacin, Levofloxacin, Norfloxacin.. o Other - Polymixin B, Colistin.",Pharmacology,
+a9a7b299-3332-4bd7-8de4-4837c7b31f2b,Cicatrial Alopecia is seen in:,Tenia Capitis,Psoriasis,DLE,Alopecia Aereta,2,single,C. i.e. DLE,Skin,
+14ad749d-17b1-4bea-9f35-41d5fb11c816,"According to Spetzler-Main criteria, how much score is given for a 5 cm nidus with AV malformation?",3,4,2,5,2,single,"Spetzler-Main AVM grading scale. Graded Feature Points Assigned Size of AVM < 3 cm 3-6 cm >6 cm 1 2 3 Eloquence1 of adjacent brain Noneloquent Eloquent 0 1 Venous drainage Superficial Deep 0 1 'Eloquent areas include: visual, language, and sensorimotor coex; the thalamus and hypothalamus; the internal capsule; the brainstem; the cerebellar peduncles; and the deep cerebellar nuclei.",Surgery,JIPMER 2018
+44c444b1-70f2-4e52-94f0-78544786ed41,Which of these following statements is wrong about Tacrolimus?,It is one of the macrolide antibiotic,It can be safely administered with any nephrotoxic drug,Glucose intolerance is a well known side effect,It is used as prophylaxis for transplant rejection,1,multi,"The side effects of Tacrolimus includes, nephro and hepato toxicity. It can also cause hypeension, tremors, seizure, diabetes mellitus and blurred vision. It should be better avoided with other hepato and renal toxicity drugs. Ref: Manzoor M. Khan (2008), Chapter 4 ""Immunesupressive Agents"", In the book, ""Immunopharmacology"", Springer Publications, USA, Page 91 ; Katzung, 9th Edition, Pages 941, 942",Pharmacology,
+e828463d-f844-4e66-acb8-7b75e9733df4,Macrosomia is a,Large size baby,Big mouth,Large head,Large tongue,0,single,"Macrosomia:- A condition where a baby is large before bihFactors causing macrosomia:Mother having diabetesMother having gestational diabetesObese mother(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 777, 897 - 899)",Pediatrics,All India exam
+0cf7ee02-2b75-4f5a-a94c-dc293653698e,Which one of the following device conves radioactive emissions to light for detection?,Geiger counter,Photographic film,Scintillation counter,Radiotracer,2,single,"Scintillation counter: It measures ionizing radiation. The sensor, called a scintillator, consists of a transparent crystal, usually phosphor, plastic, or organic liquid that fluoresces when struck by ionizing radiation. A sensitive photomultiplier tube (PMT) measures the light from the crystal. The PMT is attached to an electronic amplifier and other electronic equipment to count and possibly quantify the amplitude of the signals produced by the photomultiplier. Geiger counter: Is a type of paicle detector that measures ionizing radiation. They detect the emission of nuclear radiation: alpha paicles, beta paicles or gamma rays. It detects radiation by ionization produced in a low pressure gas in a Geiger Muller tube.",Radiology,Nuclear medicine
+f0f4d63e-5f4d-4994-bca1-ae5af65f0433,Enterobius commonly inhabit the: September 2011,Duodenum,Jejunum,Ileum,Caecum,3,single,"Ans. D: Caecum Adult Enterobius vermicularis worms inhabit the caecum, appendix and adjacent poions of the ascending colon, lying closely applied to the mucosal surface. Pinworm (genus En terobius)/Threadworm/Seatworm, It is a nematode (roundworm) and a common human intestinal parasite, especially in children. It inhabits the caecum, appendix and adjacent poion of the ascending colon, lying closely applied to the mucosal surface It causes enterobiasis, or less precisely as oxyuriasis in reference to the family Oxyuridae. The pinworm appears as a white, small and delicate nematode. The adult female has a sharply pointed posterior end, is 8 to 13 millimeters long, and 0.5 millimeter thick. The adult male is considerably smaller, measuring 2 to 5 millimeters long and 0.2 millimeter thick, and has a curved posterior end. The eggs are translucent and have a surface that adheres to environmental objects. The eggs measure 50 to 60 micrometers by 20 to 30 micrometers, and have a thick shell that is flattened on one side. The small size and colorlessness of the eggs make them invisible to the naked eye, except in barely visible clumps of thousands of eggs. Eggs may contain a developing embryo or a fully developed pinworm larva.Inside the host, the larvae grow to 140-150 micrometers in length Pinworms spread through human-to-human transmission, by ingesting (i.e., swallowing) infectious pinworm eggs and/or by anal sex. The eggs are hardy and can remain ble (i.e., infectious) in a moist environment for up to three weeks.They do not tolerate heat well, but can survive in low temperatures: two-thirds of the eggs are still ble after 18 hours at -8 degrees Celsius (18 degF). After the eggs have been initially deposited near the anus, they are readily transmitted to other surfaces through contamination. The surface of the eggs is sticky when laid, and the eggs are readily transmitted from their initial deposit near the anus to fingernails, hands, night-clothing and bed linen.From here, eggs are fuher transmitted to food, water, furniture, toys, bathroom fixtures and other objects.Household pets often carry the eggs in their fur, while not actually being infected. Dust containing eggs can become airborne and widely dispersed when dislodged from surfaces, for instance when shaking out bed clothes and linen.Consequently the eggs can enter the mouth and nose through inhalation, and be swallowed later. Although pinworms do not strictly multiply inside the body of their human host, some of the pinworm larvae may hatch on the anal mucosa, and migrate up the bowel and back into the gastrointestinal tract of the original host. This process is called retroinfection. Despite the limited, 13 week lifespan of individual pinworms, autoinfection (i.e., infection from the original host to itself), either through the anus-to-mouth route or through retroinfection, causes the pinworms to inhabit the same host indefinitely",Microbiology,
+bd88d061-0cde-4bad-aaaf-1147a1018f51,Which of the following results in increase in secretion of ADH?,Hypervolemia,Hypeension,Hypovolemia,Decrease osmolarity,2,single,"Ans: C HypovolemiaRef: Guyton 12th/e p. 9051Hypovolemia (Decreased ECF) stimulates the release of ADH.Vasopressin secretion is increased by: - i) Increased osmolarity (osmotic pressure) of plasma; ii) Decreased ECF volume; iii) Pain, emotion, stress, exercise; iv) Nausea and vomiting; v) Standing; vi) Clofibrate, Carbamazapine; vii) Angiotensin II.",Physiology,
+c51ac107-3607-4bb8-8ed2-f6b8984f2cd1,Urine osmolality in Diabetes insipidus is,<150 mmol/L,<300 mmol/L,<600 mmol/L,<900 mmol/L,0,single,"Diabetes insipidus is condition characterised by excessive thirst excretion of large amounts of severely diluted urine Those with diabetes insipidus continue to uinate large amount of urine in spite of water deprivation.Ref: DM Vasudevan, 7th edition, page no: 373",Biochemistry,Endocrinology
+88613448-175a-4979-835b-9fc73ab95aad,1-a hydroxylation in Vitamin-D metabolism takes place in,Skin,Liver,Kidney,Blood,2,single,"Vitamin D is a fat-soluble vitamin molecule found in fish liver oils, and also produced in the skin when subjected to ultraviolet rays from sunlight. The main function of the vitamin is to increase the utilization of calcium and phosphorus in bones and teeth. A mixture of several forms of vitamin D: Vitamin D3 is synthesized in the skin upon exposure to ultraviolet light; in contrast, vitamin D2 is obtained only from the diet. Both vitamins D2 and D3 are metabolized to 25-hydroxyvitamin D in the liver, and then to the active 1,25 dihydroxy form in the kidney. Vitamin D has a major role in the intestinal absorption of calcium, bone calcium balance and renal excretion of calcium.Ref: Ganong&;s review of medical physiology;24th edition; page no-379",Physiology,Endocrinology
+7450511e-382a-4dcf-8432-99316daafe96,Magaldrate is conveed by gastric acid to ?,Magnesium hydroxide,Magnesium hydroxide and calcium carbonate,Magnesium hydroxide and Aluminium hydroxide,Calcium carbonate and aluminium hydroxide,2,single,"Ans. is `c' i.e., Magnesium hydroxide and Aluminium hydroxide Magaldrate: Magaldrateis a common antaciddrug that is used for the treatment of duodenal and gastric ulcers, esophagitis from gastroesophageal reflux. Magaldrate is a hydroxymagnesium aluminate complex that is conveed rapidly in gastric acid to Mg(OH), and Al(OH)3, which are absorbed poorly and thus provide a sustained antacid effect.",Pharmacology,
+52208617-c3a7-4e5d-97f5-e0e47cd31a5d,Which of the following nerves are affected after spinal anaesthetic block –,Motor and sensory only,Sensory and autonomic nerve only,Sensory nerves only,"Sensory, autonomic and motor nerves",3,single,"Local anesthetics block generation and conduction of nerve impulse at all part of neuron where they come in contact, without causing structural damage. Thus not only sensory but motor impulses and autonomic control is also interrupted.",Anaesthesia,
+59d4556e-ea0b-4b7c-8dd5-d7f02333ae84,Drug of choice for Treponema Pallidum is?,Penicillin G,Tetracycline,Azithromycin,Doxycycline,0,multi,"ANSWER: (A) Penicillin GREF: Microbiology, Volume 2; Volume 9, Part 2 edited by E. Edward Bittar, Neville Bittar p; 241See APPENDIX-65 for ""SEXUALLY TRANSMITTED DISEASES""""Parenteral penicillin G remains the treatment of choice for syphilis (Treponema pallidu and resistance to penicillin has not been reported""",Pharmacology,D.O.C
+d5d4145c-7f09-4ff7-9be7-6676ee265b21,"If hemoglobin status of a population with mean value is 10.3 gm % with SD 2 gm%, then 5% population will be below what value of Hb?",6.67,7.35,9,8.6,1,single,.,Social & Preventive Medicine,Biostatistics
+1620d0bd-b4a2-4146-9563-195b87dddb5a,Inclusion body conjunctivitis true is all except:,Self limiting,Present only in infants,Occurs while passage from bih canal,Caused by chlamydia,1,multi,Ans. Present only in infants,Ophthalmology,
+ead90362-60ec-48c7-b1b8-e59518ce1958,"A 55 year old man, a chronic smoker is brought to emergency with history of polyuria, polydipsia, nausea and altered sensorium for last two days. He had been diagnosed as having squamous cell carcinoma of lung two months prior to this. On examination, he was lethargic and confused. An ECG was normal except for a narrowed QT interval. Which one of the following is the most likely metabolic abnormality ?",Hypematremia,Hypercalcemia,Hypokalemia,Hyponatremia,1,multi,,Medicine,
+9d09a6ed-526a-486d-a5df-7645e78fe5a1,EBV causes all EXCEPT:,Nasopharyngeal carcinoma,Burkitt s lymphoma,Verrucous lymphoma,Hodgkin's lymphoma,2,multi,"ANSWER: (C) Verrucous lymphomaREF: Jawett's 24th edition Section IV. Virology > Chapter 33. Herpesviruses Cancer by EBV:EBV is recognized as a cause of Burkitt's lymphoma, nasopharyngeal carcinoma, Hodgkins disease, and some other lymphomas. Sera from patients with Burkitt's lymphoma or nasopharyngeal carcinoma contain elevated levels of antibody to virus-specific antigens, and the tumor tissues contain EBV DNA and express a limited number of viral genes. EBV-associated B cell lymphomas are a complication for immunodeficient patients",Microbiology,Virology
+99f60ba1-f322-4be1-a2a2-c32f47dbd23e,"All of the following are required more during lactation as compared to pregnancy, except ?",Iron,Vitamin A,Niacin,Energy,0,multi,"Ans. is 'a' i.e., Iron Required more during lactation as compared to pregnancy : Energy, Vitamin A, thiamin, riboflavin, Vitamin C, niacin, and Vitamin B12. Required more during pregnancy : Iron, protein, and folate. Same requirment in pregnancy and lactation : Fat, calcium, zinc, magnesium, and vitamin B6.",Social & Preventive Medicine,
+e7088208-653d-469d-a4d7-21a43ce758d7,Not a B cell marker -,CD 19,CD 20,CD 134,CD 10,2,single,. CD 134,Pathology,
+ab34fb12-0b7e-433c-95a3-ac7b63fbaebf,Actinomycosis is commonly seen in -,Tibia,Mandible,Scapula,Femur,1,single,,Medicine,
+1254a5a8-b91d-488a-be86-31996f0fa084,"In sebaceous glands, accumulation of sebum leads to:",Milia,Acne,Epidermoid cyst,Miliaria,1,single,Ans. b. Acne4 steps in pathogenesis of Acne are:Sebum productionHyperkeratosis of pilosebaceous unitPropionibacterium acnes colonization of pilosebaceous unit Inflammation,Skin,General
+4aaa1979-d835-4536-9c75-19b54a255241,"A young girl presents with abdominal pain and a recent change in bowel habit, with passage of mucus in stool. There is no associated blood in stool and symptoms are increased with stress. The most likely diagnosis is-",Irritable bowel syndrome,Ulcerative colitis,Crohn's disease,Amebiasis,0,single,"Childhood Chronic ill health in childhood or adolescent IBD may result in growth failure, metabolic bone disease and delayed pubey. Loss of schooling and social contact, as well as frequent hospitalisation, can have impoant psychosocial consequences.Treatment is similar to that described for adults and may require glucocoicoids, immunosuppressive drugs, biological agents and surgery. Monitoring of height, weight and sexual development is crucial. Children with IBD should be managed by specialised paediatric gastroenterologists and transitioned to adult care in dedicated clinics . Pregnancy A women's ability to become pregnant is adversely affected by active IBD. Pre-conceptual counselling should focus on optimising disease control. During pregnancy, the rule of thirds applies: roughly one-third of women improve, one-third get worse and one-third remain stable with active disease. In the post-paum period, these changes sometimes reverse spontaneously. Drug therapy, including aminosalicylates, glucocoicoids Delayed growth and pubeal development: chronic active inflammation, malabsorption, malnutrition and long-term glucocoicoids contribute to sho stature and delayed development, with physical and psychological consequences. * Metabolic bone disease: more common with chronic disease beginning in childhood, resulting from chronic inflammation, dietary deficiency and malabsorption of calcium and vitamin D. * Drug side-effects and adherence issues: young people are more likely to require azathioprine or biological therapy than adults. Poor adherence to therapy is more common than with adults, as younger patients may feel well, lack self-motivation to adhere and believe that drugs are ineffective or cause side-effects. * Loss of time from education: physical illness, surgery, fatigue in chronic inflammatory bowel disease, privacy and dignity issues, and social isolation may all contribute. * Emotional difficulties: may result from challenges in coping with illness, problems with forming interpersonal relationships, and issues relating to body image or sexual function. Ref Davidson edition23rd pg823",Medicine,G.I.T
+4f2b500c-9ed9-4f6f-9eeb-c8091d9ab862,Length of umbilical cord is?,40-50 cms,60- 120 cms,30-100 cms,25-40 cms,2,single,ANSWER: (C) 30-100 cmsREF: Dutta 6th ed p. 40The normal length of umblical cord is around 50cms with usual variation between 30-100 cms,Gynaecology & Obstetrics,The Amnion and Umbilical Cord
+8542fa2b-0d2b-47ff-add1-f43fabe3d782,Vinyl chloride has been implicated in -,Angiosarcoma of liver,Angiofibroma of nose,Hepatomas,Bladder cancer,0,single,,Pathology,
+da0009e4-46b1-421f-aa47-86d95139e8da,Vitamin B12 intrinsic factor absorption occurs in,Duodenum,Ileum,Jejunum,Colon,1,single,"Most of the vitamins are absorbed in the upper small intestine, but vitamin B12 is absorbed in the ileum.Vitamin B12 binds to intrinsic factor and the complex is absorbed across the ileal mucosa.Vitamin B12 and folate absorption are Na+ independent.Other vitamins are absorbed by carriers that are Na+ cotranspoers.(Ref: Ganong&;s Review of medical physiology, 23 rd edition, page 458)",Physiology,G.I.T
+43e26e31-67d1-41b7-9def-5abfe2104297,Splenunculi are commonly seen in,Hilum of spleen,Tail of spleen,Mesocolon,Splenic ligaments,0,single,"A. (Hilum of spleen) (1103-B & L 25th)ACCESSORY SPLEEN (Splenunculi) - probably results from a failure of infusion of splenic embryonic tissues* They are located near the hilum of the spleen in 50% of cases and related to the splenic vessels or behind the tail of pancreas in 30%. The remainder are located in the mesocolon or the splenic ligaments* These are functionally similar to the spleen and while performing splenectomy for blood dyscrasias removal of these accessory spleens are obligatory, otherwise there always remains a chance of recurrence* Axis of spleen enlargement projects into- Greater sac**",Surgery,Spleen
+38c64ae0-eb3d-42f1-8b9f-622c9ceac602,Causative agent of Favus is:,Tinea schoenleinii,Tinea rubrum,Malassezia furfur,Epidermophyton floccosum,0,single,"Ans. A. Tinea schoenleiniiFavous usually affect scalp, but occurring occasionally on any part of the skin and even at times on mucous membrane, caused by Tinea schoenleinii.",Skin,Fungal Infection
+0ca63e38-ee16-487e-9b4b-4258089454f9,Zona Pellucida disappears by:-,Before ferilisation,During feilization,5th day after feilization,7th day after feilization,2,single,"Zona pellucida is thick membranous covering made up of glycoprotein, the microvilli of oocyte and follicular cells project into zona pellucida for nutrition. it prevent polyspermy and implantation. Blastocyst forms at 4th day and by the end of 5th day, zona pellucida disappears and implantation takes place at 6th -7th day after feilization.",Anatomy,"Development period- week 1,2,3,4"
+5ee5ca07-d119-469b-9b41-d65bb8875368,Storage form of thyroid hormone-,Tri-iodo tyrosine,Tri - iodo thyronine,Thyroglobulin,Di-iodo tyrosine,2,single,"The synthesis and storage of thyroid hormones occurs between the follicular cells and the colloid. The storage form of thyroid hormone is thyroglobulin. Thyroglobulin is a large glycoprotein synthesized in the follicular cells and has a molecular weight of around 650 000 with about 140 tyrosine residues, depending on the form of thyroglobulin. Approximately one quaer of these residues is iodinated at the apical-colloid interface. Once iodinated, thyroglobulin is taken up into the colloid of the follicle where, still incorporated in the protein, a coupling reaction between pairs of iodinated tyrosine molecules occurs. The coupling of two tyrosine residues each iodinated at two positions (di-iodotyrosine, DIT) produces tetra-iodothyronine or thyroxine (T4 ) whilst the combination of DIT with mono-iodotyrosine (MIT) produces tri-iodothyronine (T3 ). Such coupling can occur within a single molecule of thyroglobulin or between dimerized molecules of the protein. This coupling is catalyzed by TPO. Thyroid hormones are stored in this state and are only released when the thyroglobulin molecule is taken back up into the follicular cells. Stimulated by TSH, thyroglobulin droplets are captured by the follicular cells by a process of pinocytosis. Fusion of the droplets with lysosomes results in hydrolysis of the thyroglobulin molecules and release of T3 and T4. Reference : page 2285 Harrison's Principles of Internal Medicine 19th edition",Medicine,Endocrinology
+1cc9b83f-ecc5-4ef8-9b40-ff4ee326ba97,Congenital hepatic fibrosis is a characteristic feature of,Multicystic renal dysplasia,ARPKD,Familial juvenile nephronophthisis,Medullary sponge kidney,1,single,Infantile and Iuvenile forms are associated with congenital Hepatic fibrosis.,Pathology,
+a7fe280b-34b8-4a85-9a19-dde598ba89a2,MHC restriction is a pa of all except aEUR',Antiviral cytotoxic T cell,Antibacterial helper T cell/cytotoxic cells,Allograft rejection,Autoimmune disorder,3,multi,"Autoimmune disorder Major histocompatibility complex : Major histocompatibility complex, also called the human leucocyte antigen (HLA) complex is a 4 megahase region on chromosome 6. This region is densely packed with genes. These genes encodes two major proteins or antigens i.e., MHC I & MHC II. These proteins play an impoant role in the differentiation of foreign cells from host cell. Presence of these proteins is necessary for identification of host cells. Identification of the cells is impoant for immune responses. If the cell is recognised as self, the immune system will not mount an immune response against it. How does MHC helps in this ??? Cells continuously display small pieces of their own internal protein, carrying them, outsie the cell membrane where the immune system can see them. These peptides are just pieces of the normal proteins found inside the cell. These peptides are held together at the cell surface by major histocompatibility complex, which holds these peptides together for the immune system to examine them. Each persons immune system is customized early in life to ignore these peptides, so healthy cells are not able to trigger the immune system and they are left alone. But if any virus or other microorganism is multiplying inside the cell, the peptides synthesized by it also is displayed on the surface. The MHC displays these unusual (foreign) protein on the surface of the cell. The immune system is triggered because of these peptides, staing, a series of event that will eventually lead to killing of the cell containing foreign peptide. MHC is also the cause of tissue rejection during skin grafts and organ grafts. This is how the MHC protein got its name; the term histocompatibility refers to the difficulty of finding compatible grafts between a donor and a patient. Each person has their own collection of MHC molecules. If you graft a piece of skin that has a different collection of MHC types they will trigger the immune system to destroy the cell. So a compatible donor is needed such as a relative who has a similar collection of MHC molecules. MHC is also active against cancer Cancer cells, like normal cells, display pieces of their own protein on their surface. So if any of these proteins carries recognizable cancer mutations, this provides a signal to the immune system that something is wrong and the cell is killed. MHC plays role in activation of T helper cells (Th) MHC class II molecules are present on the membranes of dendritic cells, macrophages. These cell function as antigen presenting cell during immune response. They capture the antigen and present it to T helper cells. In response, the T helper cells secrete cytokines that stimulate B cell proliferation and antibody production. The impoant point about T helper cells is that they respond to only those antigens which have been presented to them by cells that have host matching MHC complex on the presenting cell. In general the antigen presenting cell .first phagocytoses the protein antigen and cleaves it to peptides in the lysosomes. These peptides are then extruded and attached to the presenting cell's surface MHC complex. T helper cells first, make sure, that these MHC class II molecules are host's own MHC and then responds appropriately. So, we can say that receptor on the T helper cell is thus responsive to the combination of antigen and host matching MHC complex on the presenting cell. Helper / inducer T cells (CD4)---) MHC class II restriction - Suppressor T cells (CD8) MHC class I restriction Cytolytic cytotoxic T cells (CD8) MHC class I restriction (Kills viral infected cells, tumor cells, facilitates graft rejection)",Pathology,
+6025c13b-9771-4204-a4b0-6b192e535d66,During cardiac imaging the phase of minimum motion of hea is:,Late systole,Mid systole,Late diastole,Mid diastole,3,single,"D i.e. Mid diastole- During cardiac imaging (such as MRI, CT, electron beam tomography), mid diastolic phase (or diastasis) of cardiac cycle is usually (but not always) associated with lowest (minimum) mean motion of hea.Q- Optimum phase (i.e. with minimum cardiac motion) for cardiac and coronary vessel imaging is mid-diastole (diastasis) at low or intermediate hea rates; but is variable and may occur in late systole at high hea rates.Cardiac Motion and Imaging- Radiological imaging by CT and MRI can detect coronary aery disease in early stage. However, the use of these tools to cardiac imaging is severely limited because of motion aifacts produced by constantly in motion hea completing an entire cycle of contraction and relaxation in about 1 second.- So radiological cardiac imaging requires a 'window' of minimum cardiac motion to reduce motion aifacts and achieve meaningful images. The phase of minimum cardiac motion is although variable and depends on several factors especially hea rate and the chamber (i.e. right /left - atrium or ventricle) to be specifically imaged. However, the phase of minimum cardiac motion (= optimum phase for cardiac & coronary vessel imaging).",Physiology,
+8f18a81d-6806-400d-9cf4-ec61e03f6322,Mandibular nerve does not supply:?,Buccinator,Masseter,Tensor tympani,Temporalis,0,single,A. i.e. Buccinator,Anatomy,
+d5d03cd8-055b-49bf-9b2d-4b8dc3fd6b4d,"A 68-year-old man is admitted to the coronary care unit with an acute myocardial infarction. His postinfarction course is marked by congestive hea failure and intermittent hypotension. On the fouh day in hospital, he develops severe midabdominal pain. On physical examination, blood pressure is 90/60 mm Hg and pulse is 110 beats per minute and regular; the abdomen is soft with mild generalized tenderness and distention. Bowel sounds are hypoactive; stool Hematest is positive. Which of the following is the most appropriate next step in this patient's management?",Barium enema,Upper gastrointestinal series,Angiography,Ultrasonography,2,multi,"In the absence of peritoneal signs, angiography is the diagnostic test of choice for acute mesenteric ischemia. Patients with peritoneal signs should undergo emergent laparotomy. Acute mesenteric ischemia may be difficult to diagnose. The condition should be suspected in patients with either systemic manifestations of aeriosclerotic vascular disease or low cardiac-output states associated with a sudden development of abdominal pain that is out of propoion to the physical findings. Because of the risk of progression to small-bowel infarction, acute mesenteric ischemia is an emergency and timely diagnosis is essential. Although patients may have lactic acidosis or leukocytosis, these are late findings. Abdominal films are generally unhelpful and may show a nonspecific ileus pattern. Since the pathology involves the small bowel, a barium enema is not indicated. Upper gastrointestinal series and ultrasonography are also of limited value. CT scanning is a good initial test, but should still be followed by angiography in a patient with clinically suspected acute mesenteric ischemia, even in the absence of findings on the CT scan. In addition to establishing the diagnosis in this stable patient, angiography may also assist with operative planning and elucidation of the etiology of the acute mesenteric ischemia. The cause may be embolic occlusion or thrombosis of the superior mesenteric aery, primary mesenteric venous occlusion, or nonocclusive mesenteric ischemia secondary to low-cardiac output states. A moality of 50% to 75% is repoed. The majority of affected patients are at high operative risk, but early diagnosis followed by revascularization or resectional surgery or both are the only hope for survival. Celiotomy must be performed once the diagnosis of aerial occlusion or bowel infarction has been made. Initial treatment of nonocclusive mesenteric ischemia includes measures to increase cardiac output and blood pressure. Laparotomy should be performed if peritoneal signs develop",Anaesthesia,Preoperative assessment and monitoring in anaesthesia
+3c5f5bd3-3837-4d04-a563-59fc07cbd6c6,Drugs undergoing acetylation include all except:,Dapsone,Metoclopramide,Procainamide,INH,1,multi,"Ans. B. MetoclopramideAcetylation by N-acetyl transferases (NAT)e.g, S - SulfonamidesH - HydralazineI - IsoniazidP - Procainamide, PASD - DapsoneC - Clonazepam, Caffeine",Pharmacology,General Pharmacology
+bda5a250-7d66-4377-9fd1-952db0a9f251,A group of expes discussing a topic in front of the audience without any specific order. This mode of communication is known as: September 2008,Panel discussion,Group discussion,Team presentation,Symposium,0,single,"Ans. A: Panel discussion In panel discussion there is a chairman/moderator and 4-8 speakers. Each speaker prepares separately, the other speakers hear one another for the time at the session itself. Panel discussions, however, differ from team presentations. Their purpose is different. In a team presentation, the group presents agreed-upon views; in a panel discussion, the purpose is to present different views. Also in a team presentations, usually speakers stand as they speak; in panel discussions, usually speakers sit the whole time. Technically, a panel discussion consists of questions and answers only, and a symposium consists of a series of prepared speeches, followed by questions and answers. The chairman/ moderator must monitor time and manage questions. If each paicipant is making a speech for a set period of time, he should signal the speakers at the one minute to go mark and at the stop mark. If a speakers goes more than one or two minute he can stop them to gave the equal rights to each speakers. The chairman/ moderator must be a biased person; he is neither in our nor against the topic. At the end the compare should summarize the discussion and thank the panel members.",Social & Preventive Medicine,
+7ae4d04b-7e5e-4455-abcb-068b61031179,Starvation and diabetes mellitus can lead on to ketoacidosis which of the following features is in our of ketoacidosis due to diabetes mellitus.,"Increase in glucagon/insulin ratio, increased CAMP and increased blood glucose","Decreased insulin, increased free fatty acid which is equivalent to blood glucose","Decreased insulin, increased free fatty acid which is not equivalent to blood glucose","Elevated insulin and free fatty acid, equivalent to blood glucose",0,single,"A i.e. Increase in glucagons/ insulin ratio, increased C- AMP & increased blood sugar.In diabetes little glucose is oxidized as fuel, except by the brain. The rest of tissues burn a large amount of fat, paicularly the liver where the amount of acetyl COA formed from fatty acids exceeds the capacity of the tricarboxylic acid cycle to oxidize it. The excess acetyl COA is conveed to ketone bodies l/t ketonemia, ketonuria & ketoacidosisDiabetics not only have a defect in the tissue utilization of glucose but also appears to be metabolically poised to produce maximum amount of glucose from amino acids (gluconeogenesis) and to prevent glucose from being utilized to to form fat. (fat synthesis)Insulin is decreased & glucagons is increased 1/t Dglucagon/ insulin ratioQ. Glucagon acts elevation in C- AMPQ",Biochemistry,
+2773c7ba-b414-43d6-809b-51fb6e2c106e,ARDS true?,Type 2 respiratory failure,Lung compliance decreased,Increase in diffusion capacity,none,1,multi,"ARDS is a clinical syndrome of severe dyspnoea of rapid onset, hypoxaemia and diffuse pulmonary infiltrates leading to respiratory failure.ARDS is characterised by Po2/Fio2(inspiratory O2 fraction)<200 mmHg.There will be no hypercapnia, so the patient will have type 1 respiratory failure. 
+There will be a stiff-lung syndrome with collapse and decreased compliance of the lungs due to loss of surfactant.",Medicine,
+f31e136f-03b2-4c6c-ac9a-1b44363e8c93,Hypeension is seen with all except-,Erythropoitin,Cyclosporine,NSAID,Levodopa,3,multi,"Ans. is d i.e., Levodopa Drug causing hypeension Cocaine MAO inhibitors Oral contraceptives Clonidine withdrawl Tricyclic antidepressants Cyclosporine Glucocoicoids Rofecoxib (NSAID) Erythropoietin Valdecoxib (NSAID) Sympathomimetics",Pharmacology,
+602956cf-ddb9-4e59-b5d1-c0ac6568d3da,Beta 2 agonist used in rescue therapy in acute respiratory conditions are all except?,Formoterol,Salbutamol,Bambuterol,Ketotifen,3,multi,"Ans. is 'd' i.e., Ketotifen Formoterol, Salbutomol and bambuterol are p 2 agonists. o Ketotifen is a mast cell stabilizer.",Pharmacology,
+596a9bae-2d55-449d-9c81-2f0e7154a1eb,The post mortem report in case of death in police custody should be recorded as,Tape recording,Video recording,Photographic recording,All,1,multi,"Ans. b (Video recording). (Ref. Parikh, FMT, 5th ed., 130)Installation of video camera in jail and recording of postmortem in case of death in police custody is according to human rights.",Forensic Medicine,"Law & Medicine, Identification, Autopsy & Burn"
+23a18676-636e-4059-a12b-c8b65f9ee614,Reversible loss of polarity with abnormality in size and shape of cells is known as?,Metaplasia,Anaplasia,Dysplasia,Hyperplasia,2,single,"Dysplasia is reversible
+Anaplasia is irreversible",Pathology,
+78001841-a752-480d-b11c-941bc1a1fac3,During autopsy for virology study which agent is used for storing tissue: NEET 14,Sodium chloride,Alcohol,Rectified spirit,50% glycerine,3,single,Ans. 50% glycerine,Forensic Medicine,
+4a9525b2-901b-4f48-a4e9-e720ee523694,The protective bacterium in the normal vagina is:,Peptostreptococcus,Lactobacillus,Gardenella vaginalis,E. coli,1,single,"Vagina has inhabitant bacteria called as Doderleins bacteria which is a lactobaccilli, and converts the glycogen present in vaginal epithelium into lactic acid.
+Thus, pH of the vagina is acidic
+The pH of the vagina in an adult woman is 4 -5.5 with an average of 4.5.
+The pH of vagina varies with age — for further details see preceding text.",Gynaecology & Obstetrics,
+31b43938-594a-4d44-a3a6-6a28058171fb,Bence jones proteinuria is derived from?,Alpha globulins,Light chain globulins,Gamma globulins,Delta globulins,1,single,Ans. (b) Light chain globulins(Ref: R 9th/pg 598-602)Excretion of light chains in the urine has been referred to as Bence Jones proteinuria.Light chains includes k and l (kappa and lambda),Pathology,Misc. (W.B.C)
+8b1e7f01-b79f-4f24-a759-3f3fed9c1978,Which of the following drugs used to treat type II diabetes mellitus causes weight loss:,Metformin,Glimepiride,Repaglinide,Gliclazide,0,single,,Pharmacology,
+27eb5249-ce63-4440-92ac-25f6e3eb6356,Pradhan mantra swasthya suraksha yojana was launched in:,2003,2006,2007,2008,1,single,"Pradhan mantra swasthya suraksha yojana was approved in 2006 with the objective of correcting imbalances in availability of affordable teiary level healthcare in the country. Ref: National Health Programmes in India, J.Kishore, 10th edition pg: 84",Social & Preventive Medicine,
+0f896d5f-c39d-4a50-a1aa-9ed2a58fab4e,Which of the following measures sensitivity: September 2011,True negatives,True positives,False positives,False negatives,1,multi,Ans. B: True positives Sensitivity denotes true positives,Social & Preventive Medicine,
+a5907673-ff1e-457a-9a0e-51229dcc8d8a,Caput succedaneum in a newborn is: Karnataka 07,Collection of blood under the pericranium,Collection of sero-sanguineous fluid in the scalp,Edema of the scalp due to grip of the forceps,Varicose veins in the scalp,1,single,Ans. Collection of sero-sanguineous fluid in the scalp,Forensic Medicine,
+cf39481b-9bf0-494c-bce7-e8c914f1b05e,Zero order kinetics is seen in all except,High dose salicylates,Phenytoin,Ethanol,Methotrexate,3,multi,"Zero order kinetics is seen in high dose of salicylates,ethanol and phenytoin. Ref-KDT 6/e p31",Anatomy,General anatomy
+2d7a877b-f78b-42b3-8c67-8ea86bb2105a,In a normal healthy person the arterial oxygen is considered satisfactory if SPO2 is more than,80,85,90,Any of the above,2,multi,"Ans. c (90) (Ref H-17th/l590-91; pg. A-15)In a normal healthy person the arterial oxygen is considered satisfactory if SP02 is more than 90.Arterial O2 tensionPaO212.7 +- 0.7 kPa (95 +- 5 mm Hg)Arterial CO2 tensionPaCO25.3 +- 0.3 kPa (40 +- 2 mm Hg)Arterial O2 saturationSaO20.97 +- 0.02 (97 +- 2%)Arterial blood pHpH7.40 +- 0.02Arterial bicarbonateHCO3-24 + 2 mEq/LBase excessBE0 +- 2 mEq/LDiffusing capacity for carbon monoxide (single breath)DLCO0.42 mL CO/s/mm Hg (25 mL CO/min/mm Hg)Dead space volumeVD2 mL/kg body wtPhysio dead space; dead space-tidal vol ratioVD/VTKnow at rest & exercise(a) Rest < 35% VT(b) Exercise < 20% VTAlveolar-arterial difference for O2P(A -a) O2< 2.7 kPa (20 mm Hg)Educational Point# Alveolar hypoventilation exists by definition when arterial PC02 (PaC02) increases above the normal range of 37-43 mm Hg, but in clinically important hypoventilation syndromes PaC02 is generally in the range of 50-80 mm Hg.# A decrease in the Anion Gap can be due to:- an increase in unmeasured cations;- the addition to the blood of abnormal cations, such as lithium (lithium intoxication) or cationic immunoglobulins (plasma cell dyscrasias);- a reduction in the major plasma anion albumin concentration (nephrotic syndrome); (A fall in serum albumin by 1 g/dL from the normal value decreases the anion gap by 2.5 mEq/L).- a decrease in the effective anionic charge on albumin by acidosis; or- hyperviscosity and severe hyperlipidemia.",Medicine,Respiratory
+4e1715fe-0bc3-494e-b6eb-2d4617245aef,"A 40-year-old man presents with 5 days of productive cough and fever. Pseudomonas aeruginosa is isolated from a pulmonary abscess. CBC shows an acute effect characterized by marked leukocytosis (50,000/mL) and the differential count reveals shift to left in granulocytes. Which of the following terms best describes these hematologic findings?",Leukemoid reaction,Leukopenia,Myeloid metaplasia,Neutrophilia,0,single,"Circulating levels of leukocytes and their precursors may occasionally reach very high levels (>50,000 WBC/mL). These extreme elevations are sometimes called leukemoid reactions because they are similar to the white cell counts observed in leukemia, from which they must be distinguished. The leukocytosis occurs initially because of accelerated release of granulocytes from the bone marrow (caused by cytokines, including TNF and IL-1) There is a rise in the number of both mature and immature neutrophils in the blood, referred to as a shift to the left. In contrast to bacterial infections, viral infections (including infectious mononucleosis) are characterized by lymphocytosis Parasitic infestations and ceain allergic reactions cause eosinophilia, an increase in the number of circulating eosinophils. Leukopenia is defined as an absolute decrease in the circulating WBC count.",Pathology,Basic Concepts and Vascular changes of Acute Inflammation
+614f4210-d584-4e21-b2e3-6472f398f00a,A patient present with dysphagia of 4 weeks duration. Now he is able to swallow liquid food only. Which of the following is the one investigation to be done:,Barium studies are the best to be done,Upper GI endoscopy is to be done,CT scan is needed,Esophageal manometry,1,multi,"Answer is B (Upper GI endoscopy is to be done) The patient is presenting with new onset dysphagia for solids alone (able to swallow liquids). This suggests dysphagia due to mechanical obstruction (carcinoma, stricture, web) which is best diagnosed by endoscopy. Note: Barium swallow is the recommended initial investigation Endoscopy is the investigation of choice.",Medicine,
+b4f990b1-cddf-4802-b986-10c61383fcb1,"Inhalation of fungal spores can cause primary lung infections. Of the following organisms, which one is most likely to be associated with this mode of transmission?",C. immitis,S. schenckii,C. albicans,T. tonsurans,0,single,"C. albicans and Candida tropicalis are opportunistic fungi, and as part of the normal flora are not transmitted by inhalation. C. immitis is a dimorphic fungus and inhalation of the spores transmits the infection. Sprothrix is also a dimorphic fungus but its portal of entry is cutaneous. Trychophyton is a dermatophyte and one of the causes of athlete's foot.",Microbiology,Mycology
+eac1c406-7e99-4957-9684-2dff2b6d9f07,Fleeting skin lesions are often present in patients with:,Viral hepatitis B,Acute cholangitis,Viral hepatitis A,Carcinoma head of pancreas,0,single,"Fleeting skin lesions are often presents in patients with hepatitis B. Ref: Schiff's diseases of liver, Edition -11, Page - 3.",Medicine,
+95016012-c708-472e-bc82-ca45706c8de4,"In which of the following locations, Carcinoid tumor is most common",Esophagus,Stomach,Small bowel,Appendix,3,multi,"carcinoid tumour commonly occurs in appendix(45%),ileum(25%),rectum(15%).other sites are(15%)other pas of GIT ,bronchus, and testis SRB,5th,877.",Surgery,Head and neck
+e77a5910-d85b-445f-98bf-906ab456b458,S100 is a marker used in the diagnosis of all Except,Melanoma,Schwannoma,Histiocytoma,Basal cell cancer,3,multi,"Acidic protein, 100% Soluble in ammonium sulfate at neutral pH (derivation of name) S100 protein family is multigenic group of nonubiquitous cytoplasmic EF-hand Ca2+-binding proteins, sharing significant structural similarities at both genomic and protein levels; S100 protein family has 24 known human members each coded by a separate gene; at least 19 on chromosome 1q21 Helps regulate cell contraction, motility, growth, differentiation, cell cycle progression, transcription and secretion Structurally similar to calmodulin",Pathology,General pathology
+bdae4721-695e-4983-bc69-4012c1a87907,A Patient who is on antihypertensive drug develops a dry cough. Which of the following drug might be responsible for the condition:,Diuretics,ACE inhibitors,Calcium channel blockers,Beta blockers,1,single,"The angiotensin-converting enzyme normally helps in conversion of angiotensin I to angiotensin II, which acts as a vasoconstrictor in case of hypovolemia.
+In addition to that, ACE also helps in the breakdown of bradykinin.
+When ACE inhibitors (captopril) are given, it inhibits ACE and in addition inhibits the breakdown of bradykinin also, which leads to accumulation of bradykinin level in the body.
+This increased level of bradykinin presents with a Dry cough, rashes, urticaria and angioedema.",Pharmacology,
+95952308-e34f-4e57-b1fc-b7227ca74170,Mad Cow disease (Spongiform disease) occurs due to,C J virus,Arena Virus,Kuru Virus,Parvo Virus,0,single,"Mad cow disease or bovine spongiform encephalopathy i.e. Caused by “prions”
+“PRIONS” are unconventional transmissible agents, proteinaceous in nature.”
+Diseases caused by prions are
+Kuru
+Creutzfeldt Jakob Disease.
+Gerstmann Straussler Scheinker Syndrome
+Fatal Familial Insomnia.
+Scrapie Of Sheep
+Transmissible Encephalopathy of Mink.
+Bovine Spongiform Encephalopathy (Mad Cow Disease)",Microbiology,
+401f06f5-0cc0-49c8-ab84-8b432053a073,Schwann cells are derived from:,Neural crest cells,Endoderm,Mesoderm,Ectoderm,0,single,,Surgery,
+591db8ae-5677-413e-af48-48e4111b7dbc,A patient on lithium therapy was found to be hypeensive also. Which of the following antihypeensive drugs is contraindicated in a patient on lithium therapy in order to prevent toxicity?,Clonidine,Beta blockers,Calcium channel blockers,Diuretics,3,single,"Diuretics (thiazide, furosemide) by causing Na+ loss promote proximal tubular reabsorption of Na+ as well as Li+ --plasma levels of lithium rise. ref : KD Tripati 8th ed.",Pharmacology,Central Nervous system
+72f39ade-71df-4733-9ef5-cce8ff78a9f1,"In marasmus, which of the following is not seen?",Edema,Voracious appetite,Hepatomegaly not seen,Child is active,0,single,"Edema is a feature of Kwashiorkor, not seen in marasmus. Kwashiorkor Marasmus Edema Present absent appetite poor Voracious appetite CNS involvement apathy Active child Hepatomegaly seen Not seen Skin and hair changes More common Less common",Pediatrics,FMGE 2019
+bcaf945c-3adc-4287-ac79-628fdabe0155,"A 23-year-old woman presents with a rubbery, freely movable 2-cm mass in the upper outer quadrant of the left breast. A biopsy of this lesion would most likely histologically reveal",Large numbers of neutrophils,A mixture of fibrous tissue and ducts,Large numbers of plasma cells,Necrotic fat surrounded by lipid-laden macrophages,1,multi,"The most common benign neoplasm of the breast is fibroadenoma, which typically occurs in the upper outer quadrant of the breast in women between the ages of 20 and 35. These lesions originate from the terminal duct lobular unit and histologically reveal a mixture of fibrous connective tissue and ducts. Clinically, fibroadenomas are rubbery, freely movable, oval nodules that usually measure 2 to 4 cm in diameter. Numerous neutrophils are seen in acute bacterial infection of the breast (acute mastitis), which is usually seen in the postpaum lactating or involuting breast. Dilation of the breast ducts (ectasia) with inspissation of breast secretions is characteristic of mammary duct ectasia, which is common in elderly women. If large numbers of plasma cells are also present, the lesion is called plasma cell mastitis. Fat necrosis of the breast, associated with traumatic injury, is characterized by necrotic fat surrounded by lipid-laden macrophages and a neutrophilic infiltration. Fibroadenoma Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition",Pathology,miscellaneous
+924c74cd-b716-4189-a874-37e201803f6d,Most common pa of larynx involved in TB ?,Anterior,Posterior,Middle,Anywhere,1,single,"Ans. is 'b' i.e., Posterior Essential otolaryngology 2""d/e p. 1139] Disease affects the posterior third of larynx more commonly than anterior pa. The pas affected in descending order of frequency are :- i) Interarytenoid fold, ii) Ventricular band, iii) Vocal cords, iv) Epiglottis.",ENT,
+95117632-48a6-406d-a182-13181792e521,Pyogenic granuloma is associated with,Gastric adenocarcinoma,Pseudomonas infection,Ulcerative colitis,Intestinal tuberculosis,2,single,"Pyogenic granuloma is a misnomer as there is no granuloma. It is a benign vascular lesion that bleeds easily on trauma.
+It is associated with Inflammatory Bowel disease (Ulcerative colitis > Crohn's disease).",Dental,
+562a26c1-857f-41c3-9f46-95d0f18e7cba,Epithelial rests of Malassez are found in,Pulp,Gingiva,Periodontal Ligament,Alveolar mucosa,2,single,,Dental,
+5a099680-e853-4b92-9d5c-de8c86f55891,Muscle relaxant used in renal failure -,Ketamine,Atracurium,Pancuronium,Fentanyl,1,single,"As Atracurium and Cis-atracurium are inactivated by Hoffman's elimination, they are the muscle relaxants of choice for both liver and renal failure.",Anaesthesia,Muscle relaxants
+07cb00a8-27aa-4917-a9b9-369c38b87aac,"Ramachandran is on the surgical ward with non-seminomatous tumor of testis and more than 4 retroperitoneal lymph nodes involved. You are the resident who is making a decision about fuher management. The treatment include all of the following, except:",Retroperitoneal Lymph Node Dissection (RPLND),Inguinal orchiectomy,Chemotherapy,Radiotherapy,3,multi,"Inguinal orchiectomy with high ligation of the cord at the internal ring is the initial management of testicular tumour. Multi Agent chemotherapy and followed by surgical resection is one modality of treatment. Ref: Bailey & Love, 25th Edition, Page 1269.",Surgery,
+0f52a203-4d3d-4fee-b3c2-ee98ee03fe10,"A 34-year-old female has a history of intermittent episodes of severe abdominal pain. She has had multiple abdominal surgeries and exploratory procedures with no abnormal findings. Her urine appears dark during an attack and gets even darker if exposed to sunlight. The attacks seem to peak after she takes erythromycin, because of her penicillin allergy. This patient most likely has difficulty in synthesizing which one of the following?",Heme,Creatine phosphate,Cysteine,Thymine,0,multi,"The patient has acute intermittent porphyria, which is a defect in one of the early steps leading to heme synthesis. The buildup of the intermediate that cannot continue along the pathway leads to the dark urine, and it turns darker when ultraviolet (UV) light interacts with the conjugated double bonds in the molecule. Erythromycin is metabolized through an induced P450 system, which requires increased heme synthesis. This leads to metabolite buildup to the level where the abdominal pain appears. The defect in heme synthesis does not affect creatine phosphate, cysteine, thymine, or methionine levels.",Biochemistry,Proteins and Amino Acids
+77dbd24c-97be-40ee-9fee-cdd9f1db9137,Most common type of hypospadias is: September 2011,Glandular,Penile,Coronal,Perineal,0,single,"Ans. A: Glandular Glandular hypospadias is common and does not usually require treatment Hypospadias: The external meatus opens on the underside of the penis or the perineum, and the inferior aspect of the prepuce is poorly developed (hooded prepuce) Meatal stenosis occurs Bifid scrotum 6 - 10 months of age is the best time for surgery",Surgery,
+88583589-3126-49ce-b502-07c7fd8f5c63,"In a subclan aery block at outer border of 1st rib, all of the following aeries help in maintaining the circulation to upper limb, EXCEPT?",Subscapular aery,Superior thoracic aery,Thyrocervical trunk,Suprascapular aery,1,multi,"A rich anastomosis exists around the scapula between branches of subclan aery (first pa) and the axillary aery (third pa). This anastomosis provides a collateral circulation through which blood can flow to the limb when the distal pa of subclan aery or the proximal pa of axillary aery is blocked. Scapular anastomoses occur between the following branches of proximal subclan and distal axillary aery: Branches of Subclan aery: Thyrocervical trunk, Suprascapular and Deep branch of transverse cervical.Branches of Axillary aery: Subscapular, Posterior circumflex humeral and Thoracoacromial aeires.",Anatomy,
+819417b2-a1f3-4434-a377-9f1f50574b12,Lymphatics of suprarenal gland drain into lymph nodes -,Internal iliac,Para-aortic,Superficial inguinal,Coeliac,1,single,Suprarenal glands drain into para-aortic nodes.,Anatomy,
+f6d11bc7-a1c9-4b8d-b8aa-416d1a2b0a18,"All of the following can be involved in an injury to the head of the fibula, EXCEPT:",Anterior tibial nerve,Common peroneal nerve,Superficial peroneal nerve,Tibial nerve,3,multi,"The common peroneal nerve is extremely vulnerable to injury as it winds around the neck of the fibula. At this site, it is exposed to direct trauma or is involved in fractures of the upper pa of the fibula. While passing behind the head of the fibula, it winds laterally around the neck of the bone, pierces peroneus longus muscle, and divides into two terminal branches: the superficial peroneal nerve and deep peroneal nerve (anterior tibial nerve). Injury to common peroneal nerve causes foot drop.Ref: Clinical Anatomy By Regions By Richard S. Snell, 9th edition, Page 485.",Anatomy,
+819f97b4-d137-4e7e-a425-3503a6e0c4ab,Pain felt between great toe and 2nd toe is due to involvement of which nerve root -,L5,S2,S1,S3,0,single,First web space of foot is supplied by deep peroneal nerve (L5),Anatomy,
+b6b26951-01dc-442f-ae96-db59e03a0aa9,Which of the following is non-competitive inhibitor of intestinal alkaline phosphatase?,L-Alanine,L-Tyrosine,L-Tryptophan,L-Phenylalanine,3,single,"Ans. d (L-Phenylalanine) (Ref. Biochemistry by Vasudevan, 4th ed., 57; 5th ed., 55-56)ALKALINE PHOSPHATASE# The pH optimum for the enzyme reaction is between 9 and 10.# It is activated by magnesium and manganese.# Zinc is a constituent ion of ALR# It is produced by osteoblasts of bone, and is associated with the calcification process.# It is localised in cell membranes (ecto-enzyme), and is associated with transport mechanisms in liver, kidney and intestinal mucosa.# For estimation, sodium phenyl phosphate is used as the substrate, pH is adjusted to 9.9, serum sample is added as the source of ALP and incubated.# Normal serum value of ALP is 40-125 U/L.# Raised Levels:Mild increasepregnancy.Moderate (2-3 times) increaseIn infective hepatitis, alcoholic hepatitis or hepatocellular carcinoma, Hodgkin's lymphoma, congestive cardiac failure or ulcerative colitis.Very high levels of ALP (10-12 times)In extrahepatic obstruction (obstructive jaundice) or cholestasis.Drastically high levels of ALP (10-25 times)Bone diseases where osteoblastic activity is enhanced such as Paget's disease, rickets, osteomalacia, osteoblastoma, metastatic carcinoma of bone, and hyperparathyroidism.Iso-enzymes of Alkaline Phosphatase# Alpha-1 ALP moves in alpha-1 position, it is synthesized by epithelial cells of biliary canaliculi. It is about 10% of total activity and is increased in obstructive jaundice and to some extent in metastatic carcinoma of liver.# Alpha-2 heat labile ALP is stable at 56degC; but loses its activity when kept at 65degC for 30 minutes. It is produced by hepatic cells. Therefore, exaggerated alpha-2 band suggests hepatitis. This liver iso-enzyme forms about 25% of total ALP.# Alpha-2 heat stable ALP will not be destroyed at 65degC, but is inhibited by phenylalanine. It is of placental origin, which is found in blood in normal pregnancy. An iso-enzyme closely resembling the placental form is characteristically seen in circulation in about 15% cases of carcinoma of lung, liver and gut and named as Regan iso-enzyme (after the first patient in whom it was detected) or carcinoplacental iso-enzyme. Chronic heavy smoking also increases Regan iso-enzyme level in blood. Normal level is only 1% of the total ALP.# Pre-beta ALP is of bone origin and elevated levels are seen in bone diseases. This is most heat labile (destroyed at 56degC, 10 min). Wheat germ lectin will precipitate bone isoenzyme. This constitutes about 50% of normal ALP activity.# Gamma-ALP is inhibited by phenylalanine and originates from intestinal cells. It is increased in ulcerative colitis. About 10% of plasma ALP are of intestinal variety.# Leucocyte alkaline phosphatase (LAP) is significantly decreased in chronic myeloid leukemia. It is increased in lymphomas and leukemoid reactions.ALANINE AMINO TRANSFERASE (ALT)# It is also called as serum glutamate pyruvate transaminase (SGPT).# The enzyme needs pyridoxal phosphate as co-enzyme.# Normal serum level of AL T for male is 13^4-0 U/L and for female is 10-28 U/L.# Very high values (100 to 1000 U/L) are seen in acute hepatitis, either toxic or viral in origin.# Both ALT and AST levels are increased in liver disease, but ALT > AST.# Moderate increase (25 to 100 U/L) may be seen in chronic liver diseases such as cirrhosis, Hepatoma.# A sudden fall in ALT level in cases of hepatitis is very bad prognostic sign.NUCLEOTIDE PHOSPHATASE# It is also known as 5' nucleotidase.# It is a marker enzyme for plasma membranes and is seen as an ecto-enzyme (enzyme present on the cell membrane).# Serum samples contain both ALP and NTP.# These are distinguished by Nickel ions which inhibit NTP but not ALP.- Normal NTP level in serum is 2-10 IU/L. It is moderately increased in hepatitis and highly elevated in biliary obstruction.# Unlike ALP, the level is unrelated with osteoblastic activity and therefore unaffected by bone disease.GAMMA GLUTAMYL TRANSFERASE (GGT)# The old name was gamma glutamyl transpeptidase.# It can transfer gamma glutamyl residues to substrate.# In the body it is used in the synthesis of glutathione.# It is seen in liver, kidney, pancreas, intestinal cells and prostate gland.",Biochemistry,Enzymes
+bb5bb631-ba53-4cec-9ff0-64ed67ce022e,Mondors disease is:,Migratory thrombophlebitis seen in pancreatic Ca,Thromboangitis obliterans,Thrombosis of deep veins of the leg,Thrombophlebitis of superficial veins of breast,3,single,"Ans: D (Thrombophlebitis of superficial veins of breast) Ref: Bailey dt Love's Short Practice of Surgery, 25th Edition,833-4Explanation:Mondor's diseaseThrombophlebitis of the superficial veins of the breast and anterior chest wallCan also involve armCauseIdiopathicClinical featuresThrombosed subcutaneous vessel , usually attached to the skin - pathognomonic feature.When the skin over the breast is stretched by raising the arm. a narrow, shallow subcutaneous groove alongside the cord becomes apparent.Differential DiagnosesLymphatic permeation from occult carcinomaManagementConservativeRestriction of arm movements is advised.Resolv es within few months without any complicationAssociation with breast carcinoma is Coincidental",Surgery,Miscellaneous (Breast)
+c2831b92-d8ad-4873-a0ea-17f2078f9d75,Treatment of Choice in Sleep Apnea Syndrome:,Continuous positive pressure ventilation.,Sedatives.,Antidepressants.,Antiepileptics,0,single,"(A) Continuous positive pressure ventilation# Sleep apnea: Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep.> The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal (a 3-second or greater shift in EEG frequency, measured at C3, C4, O1, or O2), a blood oxygen desaturation of 3-4deg/: or greater, or both arousal and desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a ""Sleep Study"".> Treatment: The most common treatment and arguably the most consistently effective treatment for sleep apnea is the use of a continuous positive airway pressure (CPAP) device, which 'splints' the patient's airway open during sleep by means of a flow of pressurized air into the throat. However the CPAP machine only assists inhaling whereas a BiPAP machine assists with both inhaling and exhaling, and is used in more severe cases. Medications like Acetazolamide lower blood pH and encourage respiration. Low doses of oxygen are also used as a treatment for hypoxia but are discouraged due to side effects.",Psychiatry,Miscellaneous
+e60b7a7c-e773-4fef-a983-247ce49a9fb7,Rectal polyp most commonly presents as,Obstruction,Bleeding,Infection,Changes into malignancy,1,single,".LOWER GI BLEED- * Bleeding in the GIT below the level of the ligament of Treitz. * Normal faecal blood loss is 1.2 ml/day. A loss more than 10 ml/day is significant.* Angiodysplasia. * Diveicular disease - commonest cause in Western countries. * Tumours of colon or small bowel. * Anorectal diseases--Haemorrhoids, fissure in ano. * Ulcerative colitis * Crohn's disease. * Colorectal polyps; rectal carcinomas. * Intussusception ref:SRB&;s manual of surgery,ed 3,pg no 925.",Surgery,G.I.T
+58742f0f-2e9e-4d60-a741-11f0591727ff,Ulipristal acetate is a/an:,GnRH agonist,Androgen antagonist,Selective estrogen receptor modulator,Selective progesterone receptor modulator,3,single,"Ans. is d, i.e. Selective progesterone receptor modulatorRef: Harrison's Principles of Internal medicine 19th/ed, p2391Ulipristal acetate (trade name Ella One in the European Union, Ella in the US for contraception, and Esmya for uterine fibroid) is a selective progesterone receptor modulator (SPRM).PharmacodynamicsAs an SPRM, ulipristal acetate has partial agonistic as well as antagonistic effects on the progesterone receptor. It also binds to the glucocorticoid receptor, but is only a weak anti-glucocorticoid relative to mifepristone, and has no relevant affinity to the estrogen, androgen and mineralocorticoid receptors. Phase II clinical trials suggest that the mechanism might consist of blocking or delaying ovulation and of delaying the maturation of the endometrium.Medical Uses* Emergency contraception: For emergency contraception, a 30mg tablet is used within 120 hours (5 days) after an unprotected intercourse or contraceptive failure. It has been shown to prevent about 60% of expected, pregnancies, and prevents more pregnancies than emergency contraception with levonorgestrel.* Treatment of uterine fibroids: Ulipristal acetate is used for preoperative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age in a daily dose of a 5mg tablet. Treatment of uterine fibroids with ulipristal acetate for 13 weeks effectively controlled excessive bleeding due to uterine fibroids and reduced the size of the fibroids.InteractionsUlipristal acetate is metabolized by CYP3A4 in vitro. Ulipristal acetate is likely to interact with substrates of CYP3A4, like rifampicin, phenytoin, St John's wort, carbamazepine or ritonavir. Therefore, concomitant use with these agents is not recommended. It might also interact with hormonal contraceptives and progestogens such as levonorgestrel and other substrates of the progesterone receptor, as well as with glucocorticoids.Adverse EffectsCommon side effects include abdominal pain and temporary menstrual irregularity or disruption. Headache and nausea were observed under long-term administration (12 weeks), but not after a single dose.ContraindicationsUlipristal acetate should not be taken by women with severe liver diseases because of its CYP-mediated metabolism. It has not been studied in women under the age of 18.Pregnancy: Unlike levonorgestrel, and like mifepristone, ulipristal acetate is embryotoxic in animal studies. Before taking the drug, a pregnancy must be excluded.",Gynaecology & Obstetrics,Physiology & Histology
+007d5aaa-28aa-46a0-b9a1-b410630d4bb5,A patient presented with ahritis and purpura. Laboratory examination showed monoclonal and polyclonal cryoglobulins. Histopathology showed deposits of cryoglobulins around the vessels. The patient should be tested for which of the following ?,HBV,HCV,EBV,Parvovious,1,single,"Hepatitis C This is caused by an RNA flavivirus. Acute symptomatic infection with hepatitis C is rare. Most individuals are unaware of when they became infected and are identified only when they develop chronic liver disease. Eighty per cent of individuals exposed to the virus become chronically infected and late spontaneous viral clearance is rare. There is no active or passive protection against hepatitis C virus (HCV). Hepatitis C infection is usually identified in asymptomatic individuals screened because they have risk factors for infection, such as previous injecting drug use , or have incidentally been found to have abnormal liver blood tests. Although most people remain asymptomatic until progression to cirrhosis occurs, fatigue can complicate chronic infection and is unrelated to the degree of liver damage. Hepatitis C is the most common cause of what used to be known as 'non-A, non-B hepatitis'. If hepatitis C infection is left untreated, progression from chronic hepatitis to cirrhosis occurs over 20-40 years. Risk factors for progression include male gender, immunosuppression (such as co-infection with HIV), prothrombotic states and heavy alcohol misuse. Not everyone with hepatitis C infection will necessarily develop cirrhosis but approximately 20% do so within 20 years. Once cirrhosis has developed, the 5- and 10-year survival rates are 95% and 81%, respectively. One-quaer of people with cirrhosis will develop complications within 10 years and, once complications such as ascites develop, the 5-year survival is around 50%. Once cirrhosis is present, 2-5% per year will develop primary hepatocellular carcinoma. Ref Davidson edition23rd pg877",Medicine,G.I.T
+1dfe0a51-259c-4aad-8ae2-f94640af28c7,"All of the following structures passes through the Alcock canal, EXCEPT:",Internal pudendal vein,Internal pudendal nerve,Internal pudendal aery,Obturator internus muscle,3,multi,"Alcock canal or pudendal canal stas from the lesser sciatic notch and runs forward on the medial surface of the ischial tuberosity up to the pubic arch where it is continuous with the deep perineal pouch. Contents of the pudendal canal are:Pudendal nervePudendal aery and veinWithin the canal pudendal nerve give rise to following branches:Perineal nerveDorsal nerve of penis or clitorisRef: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy.",Anatomy,
+7a26e088-4af9-4d66-925f-e4e91d76f6ca,"Marfans Syndrome affecting eyes, skeletal system, and the cardiovascular system is caued by the mutation in the gene",Fibrillin 1,Fibrillin 2,Fibulin,Elastin,0,single,"Marfan Syndrome Is Caused by Mutations in the Gene for Fibrillin-1. It is inherited as an autosomal dominant trait. It affects the eyes (eg, causing dislocation of the lens, known as ectopia lentis), the skeletal system (most patients are tall and exhibit long digits and hyperextensibility of the joints), and the cardiovascular system (eg, causing weakness of the aoic media, leading to dilation of the ascending aoa). Abraham Lincoln may have had this condition. Most cases are caused by mutations in the gene (on chromosome 15) for fibrillin-1.Mutations in the fibrillin-1 gene have also been identified as the cause of acromicric dysplasia and geleophysic dysplasia, which are characterized by sho stature, skin thickening, and stiff joints. Congenital contractural arachnodactyly is associated with a mutation in the gene for fibrillin-2.Ref: Harper&;s Biochemistry; 30th edition; Chapter 50; The Extracellular Matrix",Biochemistry,miscellaneous
+62ef7333-9fb0-4988-a7e7-9dccd56f784c,RNA primer is synthesized by -,Topoisomerase,Helicase,DNA primase,DNA ligase,2,single,"Ans. is 'c' i.e., DNA primase ProteinFunctionDNA polymerasesDeoxynucleotide polymerizationHelicasesProcessive unwinding of DNATopoisomerasesRelieve torsional strain that results from helicase-induced unwindingDNA primaseInitiates synthesis of RNA primersSingle-strand binding proteinsPrevent premature reannealling of dsDNADNA ligaseSeals the single strand nick between the nascent chain and Okazaki fragments on lagging strand",Biochemistry,Transcription
+611d453b-6d05-4abc-a471-5760f6d99806,Biochemical analytes measured in the triple test are all the following Except,hCG,AFP,Unconjugated estriol,Inhibin A,3,multi,"Second-Trimester ScreeningPregnancies with fetal Down syndrome are characterized by lower maternal serum AFP levels--approximately 0.7 MoM, higher hCG levels--approximately 2.0 MoM, and lower unconjugated estriol levels--approximately 0.8 MoM. This triple test can detect 61 to 70 percent of Down syndrome.Levels of all three markers are decreased in the setting of trisomy 18.Ref: William&;s Obstetrics; 24th edition; Chapter 14",Gynaecology & Obstetrics,Diagnosis in obstetrics
+f40a69ac-3908-4578-9738-88b2db21a8e7,"A preterm baby is born with synchronised upper chest movement, minimal nasal flare, expiratory grunting heard by the stethoscope, but has no chest or xiphoid retractions. The Silverman score is:",1,2,3,4,1,single,"The Silverman Anderson retraction score of respiratory distress syndrome (RDS): Upper chest Lower chest Xiphoid retraction Nares dilatation Expiratory grunt Grade 0 Synchronised No retraction None None None Grade 1 Lag on inspiration Just visible Just visible Minimal By stethoscope Grade 2 See-saw Marked Marked Marked Without stethoscope Mild RDS: Score 1-3 Moderate RDS: 4-7 Severe RDS: 7-10 Ref: Advances in Pediatrics by Dutta By Jaypee Brothers, Medical Publishers, 2007, Page 89.",Pediatrics,
+5b431bce-c54d-41fa-9bfa-8f24dcfc0115,Bacteriostatic antitubercular drug among the following is :,Isoniazid,Rifampicin,Streptomycin,Ethambutol,3,single,,Pharmacology,
+62409778-b511-41d6-b92f-516152bca1a1,Yoke muscle pair is,Rt LR and Rt MR,Rt so and Lt Io,Rt LR and Lt MR,All the above,2,multi,"Right lateral rectus and left medial rectus.
+Yolk muscles are pair of muscles one from eye which contracts simultaneously during version movement.",Ophthalmology,
+f2db47da-2a9b-4244-ab72-7fb372b1fa70,Causes of restrictive cardiomyopathy are -,Amyloid,Sarcoidosis,Storage disease,All of the above,3,multi,"Restrictive cardiomyopathy is characterised by a primary decrease in ventricular compliance , resulting in impaired ventricular filling during diastole. Restrictive cardiomyopathy can be idiopathic or associated with systemic disease that also happen to affect the myocardium for example radiation fibrosis, amyloidosis, sarcoidosis, or products of inborn errors of metabolism Robbins 9 th edition page no. 401",Pathology,Cardiovascular system
+4aed3cb7-f6b2-4bda-b2c0-1230c3e61e34,"3-year-old child comes in ER with Hv'o vomiting, loose watery motion for 3 days, on examination, the child was drowsy, sunken eye. Hypothermia and skin pinch take time to revert back, diagnosis",No dehydration,Mild dehydration,Some dehydration,Severe dehydration,3,single,"on  A child with severe dehydration will have at least two of the following four signs: sensorium is abnormally sleepy or lethargic, sunken eyes, drinking poorly or not at all, and a very slow skin pinch.
+A child with some signs of dehydraon will have two of the following: restlessness or irritability, sunken eyes, drinking eagerly or slow skin pinch.
+A child with either one or none of these signs is classified as having no signs of death",Pediatrics,
+f68d215d-20f5-4c82-a386-02445dc44ebc,"A 50 years old lady presented with lump in the left breast, which has developed suddenly in weeks. Perimenstrual symptoms are present. No associated family history. On examination, the lump is well circumscribed, fluctuant, 1.5 cm oval in shape. Most likely diagnosis:",Breast cyst,Galactocele,Fibroadenoma,Breast cancer,0,single,"Fibroadenoma - it occurs in 2nd to 3rd decade of life Galactocele - it occurs in 3rd to 4th decade of life. Breast cancer - there is no associated family history and lump has developed suddenly hence breast cancer is ruled out. Breast cyst - it occurs in 5th to 6th decade of life. Examination revealed fluctuant lesion which point towards breast cyst. - Often multiple, may be bilateral & can mimic malignancy. Typically present suddenly - Diagnosis can be confirmed by aspiration and / or ultrasound.",Surgery,Breast
+33bfa0d9-46a8-40c3-a99d-9b701eed3773,HIV can -,Cross blood brain barrier,RNA virus,Inhibited by 0.3% H2O2,Thermostable,0,single,it can cross blood brain barrier and cause cns infection REF:ANANTHANARAYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.576,Microbiology,Virology
+e7ad538e-9273-4e0b-87b2-bab411a372ca,Heamorrhagic external otitis media is caused by,Influenza,Proteus,Streptococcus,Staphylococcus,0,single,"Otitis externa haemorrhagica It is characterized by for mation of haemorrhagic bullae on the tympanic membrane and deep meatus. It is probably viral in origin and may be seen in influenza epidemics. The condition causes severe pain in the ear and blood-stained discharge when the bullae rupture. Treatment: with analgesics is directed to give relief from pain. Antibiotics are given for secondary infection of the ear canal, or middle ear if the bulla has ruptured into the middle ear. Ref:- Dhingra; pg num:-52",ENT,Ear
+bf962e59-dbe7-43f8-a366-6db035e81c1f,A 7 year old male patient presents to the clinic for routine dental examination and has history of frequent snacking and sugary beverages. Intraoral examination shows multiple pit and fissure caries and subsurface enamel porosity manifesting as milky white opacity. Tactile probing should not be used in this case because of all of the following EXCEPT?,"Insertion  of  the  explorer  into  the  suspected lesion inevitably disrupts the surface layer covering very early lesions, thereby eliminating the possibility for remineralization of the decalcified area",Probing of lesions and suspected lesions results in the transport of  cariogenic  bacteria  from  one area  to another,Frank lesions requiring restoration are generally apparent visually  without  the  need  for  probing.,It may induce spontaneous bleeding,3,multi,"Traditionally, dentists have relied upon a visual-tactile radiographic  procedure  for  the detection  of  dental caries. This procedure involves the visual identification of demineralized  areas  (typically  white  spots)  or  suspicious pits or fissures and the use of the dental explorer to determine the  presence of a  loss of continuity  or breaks in the enamel and to assess the softness or resilience of the enamel. Caries lesions located on interproximal tooth surfaces  have  generally  been  detected  with  the  use  of  bitewing radiographs. These procedures have been used routinely in virtually every dental office in the United States for the past 50 years. Tactile probing with an explorer is no longer used for caries detection in most European countries, and this protocol has now been adopted by many U.S. dental schools. The primary concerns that led to the discontinuation of the probing procedure were as follows:
+1. The  insertion  of  the  explorer  into  the  suspected lesion inevitably disrupts the surface layer covering very early lesions, thereby eliminating the possibility for remineralization of the decalcified area; 
+2. The probing of lesions and suspected lesions results in the transport of  cariogenic  bacteria  from  one area  to another;  and  
+3. Frank lesions requiring restoration are generally apparent visually  without  the  need  for  probing.",Dental,
+418561b6-f3f8-426e-8516-cb4104e280fb,Most dangerous paicles causing pneumoconiosis are of size,A. 1-5 micron,B. <1 micron,C. 5-15 micron,D. 10-20 micron,0,single,"In pneumoconiosis, the most dangerous paicles range from 1-5 micron in diameter, because they may reach the terminal small airway and settle in there lining notes The solubility and cytotoxicity of paicles ,modify the nature of pulmonary response",Anatomy,Respiratory system
+af2763f0-33d6-4d62-b91a-a1808160df66,"Calculate the deficit for a 60 kg person,with Hb - 5 g/dl add 1000 mg for iron stores.",1500,2500,3500,4000,1,single,"Iron deficit = Bodyweight(kg) x 2.3 x (15 - Hb) + 1000
+      = 60 x 2.3 x (15 - 5) + 1000
+      = 2380 (close to 2500)",Medicine,
+0fe4c348-ea07-4893-836e-83b4fccf6b45,Which of the following is not a cause of glomerular proteinuria?,Diabetes Mellitus,Amyloidosis,Multiple myeloma,Nil Lesion,2,single,"Multiple myeloma is characterized by tubular proteinuria. The Bence Jones proteins induce tubular damage Increased beta-2-microglobulin levels in urine is an prognostic indicator of Multiple myeloma Diabetes Mellitus and amyloidosis lead to damage to basement membrane of the kidney leading to glomerular proteinuria in form of albuminuria Nil Lesion is also called as minimal change disease and presents as glomerular cause of proteinuria leading to nephrotic presentation . Multiple Myeloma: SPEP will demonstrate a sharp peak (""church spire"" orM band) in the gamma globulin region as shown below:",Medicine,Nephrology
+2be6a760-0e08-45a1-a92d-01673c4f4619,Which of the following does not cause Insulin release-,Rosiglitazone,Nateglinide,Glimipiride,Tobutamide,0,single,"Ans. is 'a' i.e., Rosiglitazone o Oral hypoglycemic drugs may be divided into two groups. 1. Group 1 These drugs reduce plasma glucose by stimulating insulin production, therefore called insulin secretogogues. Hypoglycemia is a well known side effect. Examples are: i) Sulfonylureas: first generation (chlorpropamide, tobutamide); second generation (Glimipiride, glyburide, glipizide, gliclazide). ii) Megalitinnide/D-phenylalanine analogues: Nateglinide, Rapaglinide. 2. Group 2 These drugs reduce blood glucose without stimulating insulin production, therefore are insulin nonsecretogogues. These durgs do not cuase hypoglycemia when used alone and can cause hypoglycemia, only when used with other oral hypoglycemics. Examples are: i) Biguanides: Metformin, Phenformin ii) Thiazolidinediones: Rosiglitazone, Pioglitazone, Troglitazone. iii) alpha-glucosidase inhibitors: Acarbose, miglital.",Pharmacology,
+1e743463-1cfa-471e-b6ce-7afc105df17d,Which of the following endocrine tumors is most commonly seen in MEN I ?,Insulinoma,Gastrinoma,Glucagonoma,Somatotrophinoma,1,single,In MEN 1 : * Gastrinoma (>50%) * Insulinoma (10-30%) * Glucagonoma (<3%) * Somatotrophinoma (25%) Reference : page 2336 Harrison's Principles of Internal Medicine 19th edition,Medicine,Endocrinology
+a6a80e21-ef83-4e66-8e5b-2c6f53af99ef,The following is the least useful investigation in multiple myeloma :,ESR,X-Ray,Bone scan,Bone marrow biopsy,2,single,"Answer is C (Bone scan) Bone scans are least useful for diagnosis of Multiple Myeloma. Cytokines secreted by myeloma cells suppress osteoblastic activity therefore typically no increased uptake is observed. In multiple myeloma the osteohlastic response to bone destruction is negligible. The bone scan therefore is often normal or may show areas of decreased uptake (photopenia).It has been found to be less useful in diagnosis than plain radiography. Ig protein /24 hour is a major ciriteria for diagnosis "" align=""left"" height=""133"" width=""100""> Note : Serum M component is most commonly IgG Q (IgG (53%), IgA (25%), IgD (I%) Bence Jones proteins are light chain protein only Q.",Medicine,
+c9e6d495-1190-492f-b867-98f0ca24ed06,Most common organism causing ventilator associated pneumonia -,Legionella,Pneumococcus,Pseudomonas,Coagulase negative staphylococcus,2,single,,Microbiology,
+226c17a9-13fe-4496-bc2e-5aabce4fef1c,"A 2-week-old baby is irritable and feeding poorly. On physical examination, the infant is irritable, diaphoretic, tachypneic and tachycardic. There is circumoral cyanosis, which is not alleted by nasal oxygen. A systolic thrill and holosystolic murmur are heard along the left sternal border. An echocardiogram reveals a hea defect in which the aoa and pulmonary aery form a single vessel that overrides a ventricular septal defect. What is the appropriate diagnosis?",Atrial septal defect,"Coarctation of aoa, preductal",Patent ductus aeriosus,Truncus aeriosus,3,multi,"Truncus aeriosus refers to a common trunk for the origin of the aoa, pulmonary aeries and coronary aeries. It results from absent or incomplete paitioning of the truncus aeriosus by the spiral septum during development. Most infants with persistent truncus aeriosus have torrential pulmonary blood flow, which leads to hea failure. None of the other choices are distinguished by a single vessel that carries blood from the hea.",Pathology,Cardiac disorders
+a7d937b5-0a4b-4c68-8e93-e4b0d74ab5f5,prophylaxis for Pneumocystis carinii is indicated in HIV positive patents When CD4 count is-,<300 cells/mm3,< 200 cells / mm3,< 100 cells/mm3,< 50 cells / mm3,1,single,"Low CD4 count correlated with risk of PCP (p < 0.0001); 79% had CD4 counts less than 100/microl and 95% had CD4 counts less than 200/microl. Bacterial pneumonia has been linked to several HIV-related factors, including CD4 counts, having an uncontrolled viral load, and not being on antiretroviral therapy. HIV-positive people with a weak immune system, paicularly a CD4 count below 200 cells/mm3, are at greatest risk. Ref Harrison20th edition pg 1107",Medicine,Infection
+93f4a1b7-d3d6-431e-b837-46e6d4b55c01,index finger infection spreads to -,Thenar space,Mid palmar space,Hypothenar space,Flexion space,0,single,"Ans. is 'a' i.e., Thenar space o Thenar space communicates w'ith the index finger while the mid palmar space communicates with the middle, ring and little fingers.o Thus infection of index finger leads to thenar space infection while the infection of middle, ring or little finger leads to mid palmar space infection.FeaturesMidpalmar spaceThenar space1. ShapeTriangular.Triangular2. SituationUnder the inner half of the hollow of the palm.Under the outer half of the hollow of the3. ExtentProximalDistalDistal margin of the flexor retinaculum.Distal palmar crease.Distal margin of the flexor retinaculum.Proximal transverse palmar crease.4, CommunicationsProximalDistalForearm space.Fascial sheaths of the 3rd and 4th lumbricals; occasionally 2nd.Fascial sheath of th first lumbrical, occasionally 2nd.5. BoundariesAnteriorPosteriori) Flexor tendons of 3rd, 4th. and 5th fingersii) 2nd, 3rd and 4th lumbricalsiii) Palmar aponeurosisFascia covering interossei and metacarpals.Intermediate palmar septumi) Short muscles of thumb.ii) Flexor tendons of the index finger.iii) First Lumbricalsiv) Palmar aponeurosis.Transverse head of adductor pollicis.Laterali) Tendon of flexor pollicis longus with radial bursa.ii) Lateral palmar septum.Intermediate palmar septum.MedialMedial palmar septum6. DrainageIncision in either the 3rd or 4th web space.Incision in the first web. posteriorly.",Orthopaedics,Management In Orthopedics
+b28caa9b-0ae8-4ea2-addf-76fc73e080ab,Acute appendicitis is best diagnosed by -,History,Physical examination,X-ray abdomen,Ba meal,1,single,,Medicine,
+d0165435-9190-451d-999f-8e8e0596b44b,All are clinical features of chalcosis except,Kayser - Fleischer ring,Sun - flower cataract,Deposition of golden plaques at the posterior pole,Dalen- fuch's nodules.,3,multi,Dalen - fuch's nodules are formed due to proliferation of the pigment epithelium ----- sympathetic ophthalmitis.,Ophthalmology,
+e78e2365-89f3-427d-a951-82876bf39f99,Bidextrous grip is seen at what age?,4 months,5 months,6 months,7 months,0,single,"Ans. A. 4 monthsFINE MOTOR MILESTONES: AgeMilestone4 monthsBidextrous reach6 monthsUnidextrous reach9 monthsImmature pincer grasp12monthsMature pincer grasp15monthsImitates scribbling, tower of 2 blocks18monthsScribbles, tower of 3 blocks2 yearsTower of 6 blocks, veical & circular stroke3 yearsTower of 9 blocks, copies circle4 yearsCopies cross, bridge with blocks5 yearsCopies triangle",Pediatrics,
+8dc0e2f2-b982-457b-a5eb-512c51653fb5,A victim of Tsunami has difficulty in overcoming the experience. She still recollects the happening in dreams and thoughts. The most likely diagnosis is,Post traumatic stress disorder,Conversion disorder,Panic disorder,Phobia,0,single,"PTSD is characterised by recurrent and intrusive recollections of the stressful event, either in flashbacks (images, thoughts, or perceptions) and/or in dreams. There is an associated sense of re-experiencing of the stressful event. There is marked avoidance of the events or situations that arouse recollections of the stressful event, along with marked symptoms of anxiety and increased arousal. The other impoant clinical features of PTSD include paial amnesia for some aspects of the stressful event, feeling of numbness, and anhedonia (inability to experience pleasure). Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 112",Psychiatry,Anxiety disorders stress disorders and grief
+82f52bd9-9d86-4880-bd37-5e126fc39c3f,"A tumor has the following characteristic retrobulbar location within the muscle cone, well defined capsule, presents with slowly progressive proptosis, easily resectable, occurs most commonly in the 2nd to 4th decade. Most likely diagnosis is -",Capillary hemangioma,Cavernous hemangioma,Lymhangioma,Hemangiopericytome,1,single,"Ref: Clinical ophthalmology 5th/e p.670 *Cavernous hemangioma is the most common benign, intraconal tumor in adults. *Hemangiopericytoma is also retrobulbar intraconal lesion found in adults but is a rare tumor. Moreover owing to its tendency to invade the adjacent tissues, its margins are less distinct than cavernous hemangioma. *Rest 2 options i.e. Dermoid and Capillary hemangioma are primarily extraconal lesions.",Ophthalmology,"Diseases of orbit, Lids and lacrimal apparatus"
+eca703b2-c8ec-4ddf-9185-3408795e9219,"For Status epilepticus, treatment of choice is: September 2012",Ethosuximide,Sodium valproate,Lamotrigine,Lorazepam,3,single,Ans. D i.e. Lorazepam,Medicine,
+5e886651-1eb4-4a2b-9708-86ad0d2df14c,All are subjective tests for audiometry except:,Tone decay,Impedance audiometry,Speech audiometry,Pure tone audiometry,1,multi,"(b) Impedance audiometry(Ref. Scott Brown, 6th ed., Vol 2; 2/12/1)Impedance audiometry is an objective test. It does not require the cooperation of patient.Other objective audiometry tests are; OAEs, Electrocochleography and BERA",ENT,Hearing Loss
+564f1c25-6740-4039-b44e-67676960268f,The mesial surface of the crown is almost parallel to long axis and the root of a:,Maxillary 1st premolar,Mandibular 2nd Premolar,Maxillary canine,Mandibular canine,3,multi,,Dental,
+2e4474c3-a6a1-4ac7-b7f1-29d595a093b1,Tonic neck relfex is lost in lesion of -,Cerebral coex,Midbrain,Medulla,Spinal cord,2,single,"Ans. is 'c' i.e., Medulla",Physiology,
+b54af3d2-b60d-4f99-9ea6-bffc15fe5cc0,More than 90% patients of CREST syndrome with the limited cutaneous form of this disorder make which of the following autoantibodies?,Anti-centromere,Anti-DNA topoisomerase l,Anti-double-stranded DNA,Anti-Golgi,0,single,"All forms of scleroderma are thought to have a strong autoimmune component, and glucocoicoids and azathioprine are used to suppress the inflammatory complications of scleroderma. (Other drugs that can be used in therapy include penicillamine, which inhibits collagen cross-linking, NSAIDS for pain, and ACE inhibitors to protect the kidney if hypeension or renal damage occurs). The anti-centromere antibody is quite specific for CREST syndrome (96% of cases), and is only seen in a minority of patients with diffuse scleroderma (mainly those with Raynaud's phenomenon) and rarely in systemic lupus erythematosus and mixed connective tissue disease.Also know:Anti-DNA topoisomerase I , also called anti-Scl-70 occurs commonly (64-75%) in diffuse scleroderma, but only rarely in CREST syndrome.Anti-double-stranded DNA is fairly specific for systemic lupus erythematosus, although it only occurs in 50-60% of lupus cases.Anti-Golgi antibodies are seen most often in systemic lupus erythematosus and Sjogren syndrome. Ref: Hellmann D.B., Imboden Jr. J.B. (2013). Chapter 20. Musculoskeletal & Immunologic Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds),CURRENT Medical Diagnosis & Treatment 2013.",Pathology,
+d3ce95e3-cc52-483b-9ef1-7004bd2bc26e,Name of mumps vaccine is,Jeryl Lynn,Edmonshon Zagreb,Schwatz,Moraten,0,single,"Widely used live attenuated mumps vaccine include the jeryl Lynn, RIT 4385, Leningrad-3, L-Zagreb and Urable strains. The current mumps strain (jeryl Lynn) has the lowest associated incidence of post-vaccine aseptic meningitis.",Social & Preventive Medicine,Epidemiology
+d5d04e58-c79f-4cd8-a16a-86957e7e0352,Sacro-Iliac joint involvement is common in which condition?,Ankylosing spondylitis,Rheumatoid arthritis,Reiter's syndrome,Osteoarthritis,0,single,"(A) Ankylosing spondylitis # ANKYLOSING SPONDYLITIS (AS, from Greek ankylos, crooked; spondylos, vertebrae; -itis, inflammation), previously known as Bekhterev's disease, Bekhterev syndrome, and Marie-Strumpell disease, is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures. AS is a form of spondyloarthritis, a chronic, inflammatory arthritis where immune mechanisms are thought to have a key role. It mainly affects joints in the spine and the sacroiliac joint in the pelvis, and can cause eventual fusion of the spine.> The typical patient is a young male, aged 20-40; however, the condition also presents in females.> The condition is known to be hereditary. Symptoms of the disease first appear, on average, at age 23 years. These first symptoms are typically chronic pain and stiffness in the middle part of the spine or sometimes the entire spine, often with pain referred to one or other buttock or the back of thigh from the sacroiliac joint.",Orthopaedics,Miscellaneous
+df6a272b-7829-430a-8a33-e4699311c2f7,Infertility issues with leiomyoma can be addressed by,Combined oral contraceptive pills,DMPA,GnRH agonist,Ulipristal,2,single,GnRH agonist treatment is approved for treating infertility associated with fibroid uterus.,Gynaecology & Obstetrics,
+55c0de7e-7d82-443c-94a9-f92be029d521,An adult male sustained accidental burns and died 1 hour later. Which of the following enzymes will be increased in the burn area?,ATPase,Aminopeptidase,Acid phosphatase,Alkaline phosphatase,0,single,"Answer: a) ATPase (KS NARAYAN REDDY 33rd ED P-327)In antemortem burns, skin adjacent to the burnt area will show increase in the following enzymes after certain time intervalEnzymeAge of wounds (hour)ATPases1Esterases1Aminopeptidases2Acid phosphatase4Alkaline phosphatase8",Forensic Medicine,Injuries
+71486f22-c9b4-4b95-aafb-bdc9ac5e5ac6,Recommended daily dietary requirment of folate (folic acid) in children ?,80-120 mg,200 mg,400 mg,600 mg,0,single,"Ans. is 'a' i.e., 80-120 mg Recommended daily allowances of folic acid are:- Healthy adults - 200 micro gm.(mcg) Pregnancy - 500 mcg Lactation - 300 mcg Children - 80-120 mcg",Social & Preventive Medicine,
+80dc11de-9ef9-4971-b7d2-a32de25dd7b0,Alcohol dependence is seen which of the following phase,Oral,Phallic,Anal,Latency,0,multi,Ans. is 'a' i.e. Oral PhasePsychiatric disorders resulting from fixation of regression to this phase* Oral phase (Birth 1 Vx year)* Alcohol dependence or drug dependence* Severe mood disorder* Dependent personality traits and disorders* Schizophrenia* Ana! phase* Obsessive compulsive traits* Obsessive compulsive disorder* Phallic (oedipal) Phase (3-5 years)* Oedipus complex is the primary cause of hysteria and other neurotic symptoms* Latency phase (5-12 years)* Neurotic disorders* Genital phase (12 years onward)* Neurotic disorders,Psychiatry,Substance Abuse
+85ee024c-012e-4424-90f1-e37da3395ab2,CAMP acts through:,Activation of protein kinase,Activation of adenylate cyclase,Ca2+ release.,All,0,multi,"A i.e., Activation of protein kinase",Physiology,
+9dd73ab3-16bc-4abf-aa0c-a2092461ec54,A four-fold increase in the titre obtained in Weil- Felix reaction is diagnostic of -,Rickettsial infection,Fungal infection,Spirochetal infection,Viral infection,0,single,"In weil-felix test, host antibodies to various rickettsial species cause agglutination of Proteus bacteria because they cross-react with bacterial cell surface antigens. Reference: Harrison20th edition pg 1011",Medicine,Infection
+2907ab39-83ce-40d9-8be0-fbea58bfffe0,The diameter of Tricuspid orifice is,2cm,2.5cm,3cm,4cm,3,single,ValveDiameter of OrificePulmonary2.5cmAoic2.5cmMitral3cmTricuspid4cmRef: BD Chaurasia; Volume 1; 6th edition; Table 18.1,Anatomy,Thorax
+656853e5-84ee-4e79-bdb7-9eab31cda926,Most common cause of hirsutism in a teenage girl:,Ovarian disease,Pheochromocytoma,Obesity,Adrenogenital syndrome,0,single,"As explained earlier PCOD is the most common cause of hirsutism.
+PCOD most common affects teenage girls (15–25 years). Therefore, In teenage girls most common cause of hirsutism is PCOD.",Gynaecology & Obstetrics,
+71c1c672-d240-46ee-a51f-1012f7a35ec1,CSF is stored at:Kerala 11,4degC,-20degC,Room temperature,-70degC,0,single,Ans. 4degC,Forensic Medicine,
+0ceaea9e-c661-46de-b56e-36a9773829d4,Gastrosplenic ligament is derived from?,Splenic artery,Splenic vein,Dorsal mesogastrium,Ventral mesogastrium,2,single,ANSWER: (C) Dorsal mesogastriumREF: Langman's Medical Embryology 9th edition 293The gastrosplenic ligament (ligamentum gastrosplenicum or gastrolienal ligament) is part of the greater omentum. Embryonically the gastrosplenic ligament is derived from the dorsal mesogastrium. The gastrosplenic ligament is made of peritoneum that connects the greater curvature of stomach with the hilum of the spleen. Contains: Short gastric vessels and left Gastro-Epiploic vessels,Anatomy,Abdomen & Pelvis
+88524b08-bbae-42ef-9cc8-35ea7d85a948,"A 59-year-old male is found to have a 3.5-cm mass in the right upper lobe of his lung. A biopsy of this mass is diagnosed as a moderately differentiated squamous cell carcinoma. Workup reveals that no bone metastases are present, but laboratory examination reveals that the man's serum calcium levels are 11.5 mg/dL. This patient's paraneoplastic syndrome is most likely the result of ectopic production of",Parathyroid hormone,Calcitonin,Parathyroid hormone-related peptide,Calcitonin-related peptide,2,single,"Symptoms not caused by either local or metastatic effects of tumors are called paraneoplastic syndromes. Bronchogenic carcinomas are associated with the development of many different types of paraneoplastic syndromes. These syndromes are usually associated with the secretion of ceain substances by the tumor cells. For example, ectopic secretion of ACTH may produce Cushing's syndrome, while ectopic secretion of antidiuretic hormone (syndrome of inappropriate ADH secretion) may produce hyponatremia. Hypocalcemia may result from the production of calcitonin, while hypercalcemia may result from the production of parathyroid hormone-related peptide (PTHrP), which is a normal substance produced locally by many different types of tissue. PTHrP is distinct from parathyroid hormone (PTH) patients with this type of paraneoplastic syndrome have increased calcium levels and decreased PTH levels. As a result of decreased PTH production, all of the parathyroid glands in these patients are atrophic. Other tumors associated with the production of PTHrP include clear cell carcinomas of the kidney, endometrial adenocarcinomas, and transitional carcinomas of the urinary bladder. Lung cancers are also associated with multiple, migratory venous thromboses. This migratory thrombophlebitis is called Trousseau's sign and is more classically associated with carcinoma of the pancreas. Hyperophic osteoahropathy is a syndrome consisting of periosteal new bone formation with or without digital clubbing and joint effusion. It is most commonly found in association with lung carcinoma, but it also occurs with other types of pulmonary disease. Erythrocytosis is associated with increased erythropoietin levels and some tumors, paicularly renal cell carcinomas, hepatocellular carcinomas, and cerebellar hemangioblastomas. It is not paicularly associated with bronchogenic carcinomas. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.",Pathology,miscellaneous
+a2593ea3-4ab0-4355-b501-29349059e474,"Crossing over, true is;",Occurs during diplotene stage,Between non sister chromatids of homologous chromosomes,Between sister chromatids of homologous chromosomes,Between non homologous chromosomes sister chromatids,1,multi,"Crossing over is the exchange of genetic material between non sister chromatids of homologous chromosomes occuring during pachytene stage of prophase I of meiosis.Recombination of genes in the same chromosome is brought about by crossing over. Ref: PRINCIPLES OF GENETICS, By Eldon John Gardner, Michael J. Simmons, D. Peter Snustad, 8th Edition, Page 163",Biochemistry,
+da799290-f6ea-4520-a731-f3b40e6de7e6,Bloom Richardson grading -,Carcinoma breast,Carcinoma lung,Carcinoma prostate,Cercinoma ovary,0,single,"Ans. is 'a' i.e., Carcinoma breasto Bloom Richardson Grading and its variants are used to grade breast cancers.",Pathology,Breast
+a1c3aa81-681e-4a77-b2e4-0ac271869746,Which among the following is FALSE about congenital toxoplasmosis?,IgA is better than IgM in detection,Diagnosed by detection of IgM in cord blood,IgG is diagnostic,Not recalled,2,multi,"Negative IgM with positive IgG indicates past infection. The presence of IgM antibody (which does not cross placenta) in the infant's circulation will diagnose congenital toxoplasmosis. The double sandwich IgA-ELISA is more sensitive than the IgM-ELISA for detecting congenital infection in the fetus and newborn. The methods used to detect IgM are 1)Double sandwich IgM ELISA 2)IgM immunosorbent assay. Ref: Kim K., Kasper L.H. (2012). Chapter 214. Toxoplasma Infections. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.",Microbiology,
+2f982a95-4801-4c7b-b40b-3e6e6bdfa0b6,Superior suprarenal aery originates from:,Abdominal aoa,Renal aery,Inferior phrenic aery,Splenic aery,2,single,Inferior phrenic aery,Anatomy,
+67ceb846-ab6f-411b-8c28-d9e47f0fe14d,Most common cause of Papillary necrosis is,Diabetes Mellitus,Sickle cell anaemia,Analgesics,Pyelonephritis,2,single,Major causes of Papillary Necrosis1. Analgesic nephropathy2. Sickle cell nephropathy3. Diabetes with UTI4. Prolonged NSAID use Reference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 340; Tubulointerstitial Diseases of the Kidney,Medicine,Kidney
+fd8ef88d-5c1d-408a-8821-22c2ad3a590f,Alzheimer's disease is associated with: September 2012,Delerium,Delusion,Dementia,All of the above,2,multi,"Ans. C i.e. Dementia Alzheimer's dementia Coical (NOT subcoical) dementia, Progressive, Associated with Apo E gene, Neurofibrillary tangles are seen and Donepezil is used in management",Psychiatry,
+ebe354ca-9e17-4c7c-8d77-c2443abc2949,Essential amino acids are all except:,Leucine,Lysine,Methionine,Proline,3,multi,10 amino acid are essential - T - Threonine V -VALINE P- Phenylalanine A- Arginine T- Tryptophan M- Methionine I -Isoleucine L -Leucine L - Lysine 2 amino acid are semi essential -Arginine and histidine can be synthesized by adults and not by growing children,Biochemistry,DNB 2018
+314a1cb9-da06-4362-a1fe-4b5a61a14392,What is tuberculoma?,Granuloma present in the lungs,Tuberculous periapical granuloma,Tuberculous lesion of the lymph nodes,None of the above,1,multi,"Tuberculosis may also involve the bone of the maxilla or mandible. One common mode of entry for the microorganisms is into an area of periapical inflammation by way of the blood stream; an anachoretic effect.
+It is conceivable also that these microorganisms may enter the periapical tissues by direct immigration through the pulp chamber and root canal of a tooth with an open cavity. The lesion produced is essentially a tuberculous periapical granuloma or tuberculoma. These lesions were usually painful and sometimes involve a considerable amount of bone by relatively rapid extension.
+Ref: Shafer's textbook of oral pathology 7th edition page 321-322",Pathology,
+8bcfe52e-721e-419b-b49e-3dc053045196,Clinical features of rheumatic fever are all except-,Cardiomegaly,Joint pains,ST segment elevation,Increased PR interval,0,multi,"Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:146-147 Rheumatic Fever Acute, recurrent, inflammatory disease, mainly of children (aged 5-15 years), typically occurring 1-5 weeks after group A streptococcal infection. Pathophysiology 1. Cross reactivity of host antistreptococcal antibodies to cardiac antigens 2. Microbe initiated autoimmune reactivity. Jones Criteria for Diagnosis of Rheumatic Fever Major Criteria Carditis Pancarditis, seen in 50-60% of patients, develops within the first 2 weeks of rheumatic fever. Pericarditis is evidenced by presence of a pericardial rub, myocarditis by tachycardia, soft S1, presence of S3 and CCF and endocarditis by the presence of Carey-Coombs' murmur (mitral diastolic murmur). Ahritis (60-75%) Flitting and fleeting type of polyahritis involving large joints with no residual deformity is seen in 60-75% of patients and occurs early in rheumatic fever. Jaccod's ahritis: Ulnar detion of 4th and 5th finger with flexion at metacarpophalangeal joints is the only residual deformity seen in rheumatic polyahritis. Subcutaneous Nodules Non-tender nodules are seen over bony prominences like elbows, shin, occiput, spine in 3-5% of patients and occur 3-6 weeks after onset of rheumatic fever. Patients who have subcutaneous nodules almost always have carditis. Erythema Marginatum (< 5% and evanescent) Macular lesions with an erythematous rim and central clearing in a bathing suit distribution are seen in < 5% of patients and occur early in rheumatic fever. Chorea (Sydenham's Chorea) (2-30%) A neurological disorder with rapid, involuntary and purposeless non-repetitive movements with a self limiting course of 2-6 weeks is more common in females and is a late manifestation of rheumatic fever. Minor Criteria Clinical 1. Fever 2. Ahralgia 3. Previous history of rheumatic fever or rheumatic hea disease. Laboratory 1. Acute phase reactants (leucocytosis, raised ESR, C-reactive protein) 2. Prolonged PR interval in ECG (> 0.2 sec). WHO Criteria Jones major and pa of the minor criteria except prior history of rheumatic fever/rheumatic hea disease and C-reactive protein. Essential Criteria Evidence for recent streptococcal infection as evidenced by: 1. Increase in ASO titre a. > 333 Todd units (in children) b. > 250 Todd units (in adults). 2. Positive throat culture for streptococcal infection. 3. Recent history of scarlet fever. Two major (or) one major and two minor criteria, in the presence of essential criteria, is required to diagnose Acute Rheumatic Fever. A Positive Rheumatic Fever history is usually elicited in only 50% of patient with Rheumatic Hea Disease. Valve Involvement in Rheumatic Hea Disease Mitral valve alone 50% Aoic valve alone 15-20% Mitral and Aoic valves together 35-40% Mitral, Aoic and Tricuspid valves 2-3% Pulmonary valve is viually never involved. In RHD, mitral valve is most commonly involved followed by involvement of the aoic valve as the pressure gradient across the mitral valve is the greatest, followed by that across the aoic valve. So, the mitral valve is more susceptible to develop pathological changes than the aoic valve.",Medicine,C.V.S
+95443365-5133-4755-885b-b06fbe019af5,A dense persistent nephrogram may be seen in all of the following except:,Acute ureteral obstruction,Systemic hypeension,Severe hydronephrosis,Dehydration,1,multi,B i.e. Systemic hypeension,Radiology,
+dd2a0d9a-28f5-4679-9d0b-9d9c8f4d0e29,Most common type of mesentric cyst is,Entergenous cyst,Chelolymphalic cyst,O mental cyst,Urogenital cyst,1,single,"Chelolymphalic cyst :
+
+It is commonest type of mesentric cyst.
+It has congenital misplaced lymphatic tissue.",Surgery,
+33adc3f0-e555-474f-841d-c61beb8963ed,"According to WHO, membranous glomerulonephritis seen in SLE, is -",Class II,Class III,Class IV,Class V,3,single,"Ans. is 'd' i.e., Class V",Pathology,
+b6154c1e-79ee-461a-8c9e-1f7063c25db5,All the following can be used to grow human viruses except?,Continuous cell lines,Suckling mice,Embryonated egg,Enriched media,3,multi,The virus needs cellular components for there growth,Microbiology,Virology
+3211af99-26bf-4fa3-a702-924410320c6c,"When a child is not able to perform the following motor functions such as skipping, walking on heels, hopping in place or going forwards in tandem gati, his motor development is considered to be below ?",3 years,4 years,6 years,8 years,1,single,"Ans. is 'b' i.e., 4 years o A child hops on one foot by 4 years and skips by 5 years. o As this child can not hop, the age of this child is less than 4 years.",Pediatrics,
+8cb58471-ef9b-485d-89cb-89b15929bab3,"The alveoli are filled with exudate. The air is displaced, converting the lung into a solid organ. This description suggests-",Chronic bronchitis,Bronchial asthma,Bronchiectasis,Lobar pneumonia,3,single,"• ‘Bacterial invasion of the lung parenchyma causes the alveoli to be filled with an inflammatory exudate, thus causing consolidation (“solidification”) of the pulmonary tissue’…..Robbins definition of pneumonia",Pathology,
+8898babd-1c9e-4fbf-8cc6-2ac2d9364eeb,Antoni A & Antoni B Pattern's are seen in,Schwannoma,Neurofibroma,Meningioma,Teratoma,0,single,"Schwannoma *Distinctive histologic patterns seen within the peripheral nerve sheath tumor Schwan noma include the Antoni A and Antoni B regions oThese are the classic microscopic appearances of a schwannoma, which is benign. oNote the more cellular ""Antoni A"" pattern on the left with palisading nuclei surrounding pink areas (Verocay bodies). On the right is the ""Antoni B"" pattern with a looser stroma, fewer cells, and myxoid change. oNotice the whirly swirly pattern and how the cell nuclei are closely bunched together ... almost as if they're forming a fence (Verocay bodies). oSchwannomas are benign spindle cell tumors that occur along the edges of peripheral nerves.They can usually be removed without damaging the nerve itself.",Surgery,
+73a922a7-4e62-497c-8246-1fdb550e29c2,Incised wound which is not a feature ?,Length is the greatest dimention,Width is more than the thickness of the blade,Margins are inveed,Hesitation cuts are seen in suicidal attempt,2,single,"Ans. is 'c' i.e., Margins are inveed Margins are eveed, clear, and clean cut.",Forensic Medicine,
+ede0c847-d6e8-47f4-9442-6912bb0e2124,Which among the following NOT a pharmacological action of opioids,Cough suppression,Anti-emesis,Miosis,Truncal rigidity,1,single,,Pharmacology,
+466854b8-df37-4c54-b353-c104058b0846,Which one of the following is a malignant bone tumour?,Osteoid osteoma,Chondroma,Chondrosarcoma,Osteochondroma,2,single,"(C) Chondrosarcoma # MALIGNANT PRIMARY BONE TUMORS include osteosarcoma, chondrosarcoma, Ewing's sarcoma, malignant fibrous histiocytoma, fibrosarcoma, and other sarcoma types. Multiple myeloma is a hematologic cancer which also frequently presents as one or more bone tumors.# CLASSIFICATION of BONE TUMOURS:> Cartilage tumors Osteochondroma: Chondromas Enchondroma Periosteal chondroma Chondroblastoma Chondromyxoid fibroma Chondrosarcoma Dedifferentiated Mesenchymal Clear cell Periosteal> Osteogenic tumors: Osteoid osteoma (B), Osteoblastoma> Fibrogenic tumors: Desmoplastic fibroma of bone, Fibrosarcoma of bone> Fibrohistiocytic tumors: Histiocytoma of bone> Ewing sarcoma/Primitive neuroectodermal tumor> Giant cell tumors: Giant cell tumor> Notochordal tumors: Chordoma> Vascular tumors: Haemangioma and related lesions, Angiosarcoma> Myogenic, lipogenic, neural and epithelial tumors: Leiomyosarcoma of bone, Lipoma of bone, Adamantinoma and osteofibrous dysplasia> Tumors of undefined neoplastic nature: Aneurysmal bone cyst Simple bone cyst; Fibrous dysplasia (B); Langerhans cell histiocytosis (LCH)",Orthopaedics,Miscellaneous
+2a8fd512-a3c3-495d-abb9-414f08273de8,"New born term baby born by vaginal delivers' had respiratory' distress, grunt, with scaphoid abdomen -Most probable diagnosis is -",HMD,Diphragmatic hernia,Pneumothorax,Meconium aspiration syndrome,1,single,"Ans. is 'b' i.e., Diaphragmatic hernia o Diaphragmatic Hernia is defined as a communication between abdominal & thoracic cavities with or without abdominalContents in thorax.MC Bochdalek type.More common on left (85%)30% of CDH have associated anomalesCardiac anomalis is MC anomalis.In cardiac (Hypoplastic left heart syndrome most common).o X ray showing multiple gas locales within the lower left chest, the majority of the rest of the left lung opacified. The left hemidiaphragm can not be seen. The mediastinum and the heart are deviated to the contralateral right side.",Pediatrics,Disorders of the Respiratory Tract
+06c22c8b-b4d1-47e5-941a-807cdb23bd24,Confirmatory test for syphilis is-rpt qun,FTA-ABS,VDRL,PCR,Culture and sensitivity,0,single,rpt qun,Microbiology,Bacteriology
+4b5598b2-e166-4a6b-bd05-9debb46d2d87,The placenta secretes a hormone that is utilized in the early detection of pregnancy. This hormone is:,Endothelial growth factor (EGF),Human chorionic gonadotropin (hCG),Human chorionic somatotropin (HCS),Relaxin,1,single,"The synthesis and secretion of hCG begins about day 6 of pregnancy, presumably from the trophoblast cells. Pregnancy tests utilize the measurement of hCG for detection of the embryo. Endothelial growth factor (EGF) is synthesized by the cytotrophoblast cells in the early placenta, then is synthesized by the syncytiotrophoblast cells later (6-8 week old placenta). EGF maintains the trophoblast. Relaxin is synthesized by decidual cells at the time of paurition and acts to ""soften"" the cervix and pelvic ligaments. IGF act similarly to EGF by stimulating differentiation of the cytotrophoblast cells. HCS is synthesized by syncytiotrophoblast cells and will promote general growth. It is essential in the stimulation of mammary duct proliferation in development of the breast during pregnancy. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 22. Reproductive Development & Function of the Female Reproductive System. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.",Physiology,
+2e50b900-3b19-43e9-bfb9-351ce8907426,Ulceration of the vulva is commonly seen in all except,Bacterial vaginosis,Syphilis,Chancroid,Behcet's disease,0,multi,"Ans. is a, i.e. Bacterial vaginosisRef: Dutta Gynae 6th/ed, p262Vulval ulcersVulval ulcers are predominantly due to sexually transmitted diseases. Rarely, it may be due to non-specific causes.Malignant ulcer is also rare. The various etiological factors related to vulval ulcers are given in the below Table.Ulcers of the VulvaSTD relatedIdiopathicTuberculosisMalignancySystemic disease related or dermatoses* Syphilis* Herpes genitalis* Chancroid* Granuloma inguinale* Lymphogran-uloma venereumBehget's diseaseAphthous ulcersLipschutz ulcersTubercularPrimay* Squamous cell carcinoma* Malignant melanoma* Basal cell carcinomaSecondary* Leukemia* Choriocarcinoma* Lupus erythematosus* Crohn's disease* Lichen planus* Lichen sclerosus* Sjogren's syndromeNote: Lipschutz ulcer: The lesion affects mainly the labia minora and introitus. In acute state, there may be constitutional upset with lymphadenopathy. The causative agent may be Epstein-Barr virus. Treatment is with antiseptic lotions and ointment.",Gynaecology & Obstetrics,Sexually Transmitted Disease in the Female
+7d3a48c9-9cfe-4a48-b402-cb45913c8a2d,Thalidomide can be used in all of the followingconditions except?,Behcet syndrome,HIV associated peripheral neuropathy,HIV associated mouth ulcers,Erythema nodosum leprosum,1,multi,HIV associated peripheral neuropathy,Pharmacology,
+63f37b72-1533-4ca9-985c-1fc78ad9caaa,In children with classical galactosemia all are true except:,E. coli neonatal sepsis is common,Elimination of galactose in diet will not reverse cataract,Galactose conves to galactitol which is toxic to brain,Children with Duae variant of galactosemia are asymptomatic,1,multi,"E. coli sepsis is common and the onset often precedes the diagnosis of galactosemia Elimination of galactose reverse growth failure, cataract, renal and hepatic dysfunction Galactokinase deficiency -> accumulation of galactose and galactitol Duae variant- a single amino acid substitution, has 50% of normal enzyme activity- asymptomatic",Pediatrics,Disorders of Carbohydrate Metabolism
+1871cc41-1e63-4584-a2fe-8b62b4e136b3,"When a person changes position from standing to lying down, following change is seen:",Hea rate increases,Venous return to hea increases immediately,Cerebral blood flow increases,Blood flow at apices of lung decreases,1,single,"B i.e. Venous return to hea increases immediately In standing posture, 300- 500m1 of blood pools in venous capacitance vessels of lower extremities, which is immediately returned towards heaQ on assuming lying down posture. Cardiovascular system Onlying On standing - Stroke volume - Cardiac output - Venous return - Central blood pool Increase Decrease - Central venous pressure - Aerial BP - Abdominal & limb flow - Hea rate - Peripheral venous pooling - Total peripheral resistance Decrease Increase - Abdominal & limb resistance - Small vein pressure",Physiology,
+58cb2f04-f0c1-4ff8-b693-ad8734746d6b,Metrorrhagia is,Heavy menstrual bleeding,Intermenstrual bleeding,Break through bleeding,Post coital bleeding,1,single,The term intermenstrual bleeding is updated nomenclature for metrorrhagia.,Gynaecology & Obstetrics,
+4600d02f-5965-4b62-8549-0626a3952919,Effective red cell diameter,Different in males and females,Diameter of 500 microns,Thalassemia minor anemia may present with normal RBC diameter,Mixed iron and folic deficiency anemia produce microcytic,2,single,"Answer: (C) Thalassemia minor anemia may present with normal RBC diameter (265-68-Hrshmohon 7th) (630= Rabbins- basis disease)Red blood cell distribution width (RDW or RCDW) is a measure of the variation of red blood cell (RBC) volume that is reported as part of a standard complete blood count. Usually red blood cells are a standard size of about 6-8 pm in diameter. Certain disorders, however, cause a significant variation in cell size. Higher RDW values indicate greater variation in size. Normal reference range in human red blood cells is 11.5-14.5%. If anemia is observed, RDW test results are often used together with mean corpuscular volume (MCV) results to determine the possible causes of the anemia. It is mainly used to differentiate an anemia of mixed causes from an anemia of a single cause. Deficiencies of Vitamin Bl2 orfolate produce a macrocytic anemia (large cell anemia) in which the RDW is elevated in roughly two- thirds of all cases; however, a varied size distribution of red blood cells is a hallmark of iron deficiency anemia, and as such shows an increased RDW in virtually all cases. In the case of a mixed iron and B!2 deficiency, there will normally be a mix of both large cells and small cells, causing the RDW to be elevated. An elevated RDW (red blood cells of unequal sizes) is known as anisocytosis. An elevation in the RDW is not characteristic of all anemias; anemia of chronic disease,hereditary spherocytosis, acute blood loss, aplastic anemia (anemia resulting from an inability of the bone marrow to produce red blood cells), and certain hereditary hemoglobinopathies (including some cases of thalassemia minor) all may present with a normal RDW* The human erythrocyte is a biconcave disc, 7-2 pm in diameter, and has a thickness of 2-4 pm at the periphery and 1 mm in the centre* More than 90% of the weight of erythrocytes consists of haemoglobin. The life span of red cell is 120 +- 30 day.* Range of normal red cell count in health in 5.5 +- 1.0 x1012/L in men and 4.8 +- l.0x 1012/l in women* Packed cell volume (PCV) or haematocrit- 0.47 + 0.07L/L (40-54%) in men- 0.42 +- 0.05 L/L (37-47%) in women* Reticulocyte count (%)0.5-l .5* Red cell distribution width-11.5-14.51. Mean corpuscular volume (MCV) =PCV in L/LRBC Count/L Normal value is 85 +- 8fl (77-93 fl)2. Mean corpuscular haemoglobin (MCH) =Hb/LRBC Count/L Normal range is 29.5 +2.5pg (27-32 Pg)3. Mean corpuscular haemoglobin concentration (MCHC) =Hb /dlPCV in L/LNormal value is 32.5 +2.5 g/dl (30-35 g/dl)* The size of the RBC is measured by MCV. MCHC is independent of red cell count and size *** Monocyte is the largest mature leucocyte in peripheral blood* Flow cytometry is done on - Lymphocytes* The anticoagulant used in Wintrobe ESR- Double oxalate1. Alkaline phosphatase is specific to Neutrophils cells2. Acid phasphatase is found in all hematopoitic cells but the highest levels are found in macrophages and osteoclasts (Monocytes)* Anticoagalant of choice for coagulation test is 3.2% sodium citrate *** Potassium oxalate + sodium fluoride is anticoagulant used in collection of blood sugar.Increases Leucocyte Alkaline phosphateDecreased Leucocyte Alkaline phosphate* Infections* Leukamoid reactions* Polycythemia- vera* Paroxysmal nocturnal hemoglobinuria (PNH)* CMLBlood group A is associated with1. Carcinoma stomach, cervix salivary gland pancreas2. Pernicious anemia3. Thrombosis in OCP users",Pathology,Blood
+0373c995-1375-4b64-b4fc-757f2ee9055c,The most impoant indication for surgical repair of a Bicornuate Uterus is -,Infeility,Dysmenorrhoea,Menorrhagia,Recurrent aboions,3,single,The most impoant indication for surgical repair of a Bicornuate Uterus is Recurrent aboions Recurrent aboions occur due to - Decreased space for embryo to grow and Relatively less blood supply,Gynaecology & Obstetrics,"Aboions, Spontaneous & Induced Emergency Contraception (Hey,whats the hurry !)"
+e8a22fc1-13a5-4097-a643-4c67ec2b090b,Uses of  α2 agonists are all EXCEPT:,To produce sedation,Glaucoma,Benign hyperplasia of prostate,Hypertension,2,multi,,Pharmacology,
+f52691c3-72ef-4683-808b-fb8ce8418f83,Treatment of solitary rectal ulcer are A/E:a) Laxativesb) Rectopexyc) Bandingd) Sclerosant injectione) Enema,cd,bc,bd,ac,0,single,,Surgery,
+4a2d3570-642b-4afb-812a-761a67380ef9,Craniotabes is seen in following except –,Rickets,Syphilis,Osteogenesis imperfecta,Thalassemia,3,multi,,Pediatrics,
+686cd2ab-481a-4ae2-9939-5de79056ae75,Maternal moality rate is -,Maternal deaths / 100000 live bihs,Maternal death /100 live bihs,Maternal death /1000 bihs,Maternal death /1000 live bihs,0,single,"Park&;s textbook of preventive and social medicine 23rd edition. * Maternal moality rate is the no of maternal deaths in a given period per 100,000 women of reproductive age during the same time period.",Social & Preventive Medicine,"obstetrics,pediatrics and geriatrics"
+7010f58c-0284-4199-bf04-72b8821ca5a2,Colour of crystals in positive Florence test is -,Yellow,White,Purple,Dark Brown,3,single,"Ref:The essential of forensic medicine and toxicology Dr.K.S NARAYAN REDDY 32nd edition pg no 415 the stain is estracted by 10% HCL and a drop is placed on a glass slide and allow to dry a cover slip is place dover this , and a drop of florence solution(KI,iodide and water) this allowed to run under the cover slip .if the semen is present, dark brown crystals of choline iodide appeared immediately , they are rhombic or needle shaped crystals resembling haemin but are larger, arranged in clusters,rossettes, crosses etc... Choline orginate from the seminal vessicles,the test is not a proof of seminal fluid but only of presence of some vegetables or animal substances . a negative reaction is proof that the stain is not seminal",Forensic Medicine,Special topics
+039f5c62-0aad-41af-af51-6f98b51cd97e,Factor Xa is necessary for conversion of prothrombin to thrombin,Only in the extrinsic pathway,Only in the intrinsic pathway,As part of both extrinsic and intrinsic pathways,Only if the normal blood clotting cascade is inhibited,2,multi,"Ans. (c) As part of both extrinsic and intrinsic pathways(Ref: Robbins 9th/pg 118-119; 8th/pg 119)Activated factor IX along with factor VIIIa (Intrinsic pathway) & factor VIIa (extrinsic pathway), converge to activate Factor X to Xa is necessary for conversion of prothrombin to thrombin (common pathway)",Pathology,Bleeding Disorders
+abec181b-7779-41cf-87de-124ae93f5e69,True about Rotameter –,Rotameter reading may not get affected by dirt inside the tube,Rotameter reading may not get affected by static electricity,The height to which bobbin rises indicates the flow rate,A rotameter is a variable pressure flowmeter,2,multi,"As the gas flows through the rotameter, bobbin rises and the upper end of bobbin determines the flow rate.
+Rotameter works on variable area (variable orifice) and constant pressure principle (not variable pressure).
+Causes of inaccurate reading in rotameter are :- Static electricity, Dirt inside the tube, Non-vertical tube, back pressure by ventilator, Defect in top sealing washer.",Anaesthesia,
+7c5f7238-1b8d-4c64-a1cc-1ed6965d42f0,"Neurocysticercosis is treated by all the following drugs, EXCEPT -",Albendazole,Niclosamide,Flubendazole,Praziquantel,1,multi,,Medicine,
+78647e01-58cb-4288-98b9-1044314042fb,What is an ideal method to prevent aspiration pneumonia?,Cuffed endotracheal tube,Inhalational anaesthesia,Increased intra abdominal pressure,Full stomach,0,single,"Ans: A (Cuffed endotracheal tube) Ref: Bailey, 24th ed, p. 46; Ajay Yadav, p. 101A cuffed endotracheal tube is used to:1. Facilitate artificial airway ventilation or surgery around face or airway.2. Protection of lung if there is a risk of pulmonary aspiration.Predisposing factors for aspiration:1. Full stomach-- single, most important factor.2. | Level of consciousness.3. Conditions which reduce the tone of LES:Pregnancy (acid aspiration in late pregnancy- Mendelson syndrome)Abdominal tumorsObesity, hiatus herniaPresence of nasogastric tubeDrugs-Atropine, glycopyrrolate, opioids, thiopentone.4. Conditions delaying gastric emptyingDiabetes, hypothyroidism, pain, anxiety, anticholinergics, opium.Management:Prevention:Management - full stomach patients:1. Empty stomach2. H2blockers- to reduce acid production.3. Metoclopramide4. Neutralisation of gastric contents by antacids1. Regional anesthesia is preferred2. Awake intubation3. Rapid sequence intubation- Sellick maneuver",Unknown,
+9d401433-8335-487e-8723-fcfc3b43c520,A mutation that results in a value replacement for glutamic acid at position 6 of the B chain of hemoglobin 5 hinders normal hemoglobin function and results in sickle-cell anemia when the patient is homozygous for this mutation. This is an example of which of the following types of mutation?,Deletion,Frameshift,Inseion,Missense,3,single,"Missense mutations are those in which a single base change (point mutation) results in a codon that encodes for a different amino acid residue. The effects of these types of mutations can range from very minor or even undetectable to major, depending on the impoance of the altered residue to protein folding and function. Nonsense mutations are also point mutations in which the affected codon is altered to a stop (nonsense) codon, resulting hi a truncated protein. Frame shift mutations are due to one or two base ""pair inseions or deletions such that the reading frame is altered. These mutations generally lead to truncated proteins as well, since in most protein coding regions the unused reading frames contain numerous stop codons.",Biochemistry,
+1c6b51f6-061b-4337-be54-7a3afdb0121a,Which of the following vessel does not cross the midline of the body:,Left gonadal vein,Left renal vein,Left brachiocephalic vein,Hemiazygous vein,0,single,"The left gonadal vein drains into the left renal vein which crosses the midline to join inferior vena cava. All the other options (Left renal vein, left brachiocephalic vein and hemiazygous vein) cross the midline.Ref: Human Anatomy, B D Chaurasia, 4th Edition, Volume 2, Chapter 24, Page 297, 307, 316; Clinical Anatomy by Systems, Richard S. Snell, 2007 Edition, Page 166, 167, 840.",Anatomy,
+88f65fcf-7f12-4cd9-a59d-7e1933832055,Daily maintenance fluid for a child weighing 24 kg is:,1000 mL/day,800 mL/day,1540 mL/day,1580 mL/day,3,single,Fluid requirement in a child in this child weighing 24 kg is:1540 mL. For first 10 kg: 100ml/kg For next 10 kg : 50ml/kg For each kg. above 20 : 20 ml/kg (1-10 kg) 100 x 10 = 1000 mL (11-20 kg) 50 x 10 = 500 mL; For next 4 kg (21-24 kg) 20 x 4= 80 mL,Pediatrics,"Fluid, Electrolyte"
+21ccfd25-2de4-4c76-a545-4e8e20990135,OCP protects against all EXCEPT: September2012,Hepatic adenoma,Fibroadenoma breast,Carcinoma ovary,Uterine malignancy,0,multi,"Ans. A i.e. Hepatic adenoma OCP's administration may result in hepatic adenoma. Oral contraceptive pills Protects against: - Uterine Ca, - Ovarian Ca, - RA, - Endometriosis etc.",Gynaecology & Obstetrics,
+9d9ab080-4904-4d16-8c55-91d9f246d59e,"In a chronic alcoholic, all the following may be seen in the liver except -",Fatty degeneration,Chronic hepatitis,Granuloma formation,Cholestatic hepatitis,2,multi,"Alcoholic liver disease
+There are three distinct forms of liver disease -
+1. Hepatic steatosis (fatty liver)
+2. Alcoholic hepatitis
+(a) Acute alcoholic hepatitis
+     Focal necrosis
+     Cholestasis
+     Mallory hyaline bodies
+(b) Chronic hepatitis
+3. Alcoholic cirrhosis",Pathology,
+d72f1d0f-b091-48f0-8986-c1920d587db4,"Ring sideroblasts, with iron laden occurs in",Endoplasmic reticulum,Nucleus,Mitochondria,Nuclear membrane,2,single,"i.e. (Mitochondria) : (301-Harsh Mohan 6th ) (625-Robbins & Cotran-Pathologic basis of disease 8th)Ringed sideroblasts is characteristic of sideroblastic anemia /Myelodysplastic SyndromeRinged sideroblast in which haem synthesis is disturbed as occurs in sideroblastic anaemiasRinged sideroblasts containing numerous large granules, often forming a complete or partial ring around the nucleus. These ringed arrangement of these granules is due to presence of iron laden mitochondria around the nucleus",Pathology,Blood
+20bea810-4e48-472f-9763-77c1bc4abfc6,Signal from Baroreceptors goes to -,Caudal ventrolateral medulla,Rostral dorsolateral medulla,Nucleus of tractus solitarius,None of the above,2,multi,"Ans. is C Nucleus of tractus solitarius o Baroreceptors are mechanoreceptors that are located in the adventia of carotid artery and aorta, at specialized locations called sinuses. Carotid sinus is a little bulge at the root of internal carotid artery, located just above the bifurcation of the common carotid artery. It is innerv ated by the sinus nerve, a branch of glossopharyngeal (IX cranial) nerve. Aortic arch (aortic sinus) also contains mechenoreceptors (stretch receptors) which are similar to carotid sinus receptors. However, their afferent nerve fibers travel in the aortic nerve, a branch of Vagus (X cranial) nerve. o The sinus nerve (from carotid sinus) and aortic nerve/vagal fibers (from aortic sinus) are together called 'Sino- aortic nerves'. They, together, are also refered to as 'Buffer nerves' because they are the afferents of cardiovascular reflexes that buffer abrupt changes in blood pressure. o Baroreceptors are highly sensitive to any change in mean blood pressure. Sinoaortic nerves (buffer nerves) normally discharge rhythmically, synchronous with the pressure fluctuation during systole and diastole. They respond to BP changes between 70 mm Hg and 150 mm Hg. When BP rises, baroreceptors are stimulated and their afferents (through sinoaortic nerves) stimulate nucleus of tractus solitarus (NTS) which inturn inhibits the pressor area of VMC, i.e., Rostral ventrolateral medula (RVLM). This results in decreased sympathetic outflow and therefore decreases in vasomotor tone and vasodilation. Vasodilation brings down the BP. Thereby helping hemostasis. Activated NTS also stimulates nucleus ambiguous (cardioinhibitory center) of medulla, which increases parasympathetic (vagal) output, through vagus, that decreases heart rate. Reduction in heart rate reduces the cardiac output, which also reduces BP. Baroreceptor stimulation also weekly inhibits respiration, o When BP falls, for instance while changing the posture from lying down to standing, reverse change takes place. When a person stands up, his blood is pooled in the veins of lowrer limbs by the effect of gravity. Central venous pressure and venous return decrease, which causes a fall in stroke volume. Hence the systolic BP falls. As a result, the discharge rate of baroreceptors decreases leading to a decrease in the inhibitory' influence on the pressor area of VMC. Hence vasomotor tone increases, leading to vasoconstriction, and consequently an increase in BP. Simultaneously, the nucleus ambiguous of the vagus is also inhibited, increasing the heart rate and consequently stroke volume and eventually BP. Thus fall in BP due to change of posture is very brief (Transient).",Unknown,
+6a25c0d5-4d53-429a-ac5c-0bf0145cba6d,Intrinsic factor of castle is secreted by which of the following cells in gastric glands,Chief cells,Parietal cells,Enterochromaffin cells,B cells,1,single,"The stomach also adds a significant volume of digestive juices to the meal. Like salivary secretion, the stomach actually readies itself to receive the meal before it is actually taken in, during the so-called cephalic phase that can be influenced by food preferences. The gastric secretions arise from glands in the wall of the stomach that drain into its lumen, and also from the surface cells that secrete primarily mucus and bicarbonate to protect the stomach from digesting itself, as well as substances known as trefoil peptides that stabilize the mucus-bicarbonate layer. The glandular secretions of the stomach differ in different regions of the organ. The most characteristic secretions derive from the glands in the fundus or body of the stomach. These contain two distinctive cell types from which the gastric secretions arise: the parietal cells, which secrete hydrochloric acid and intrinsic factor; and the chief cells, which produce pepsinogens and gastric lipase. The acid secreted by parietal cells serves to sterilize the meal and also to begin the hydrolysis of dietary macromolecules. Intrinsic factor is impoant for the later absorption ofvitamin B12 or cobalamin. Pepsinogen is the precursor of pepsin, which initiates protein digestion. Lipase similarly begins the digestion of dietary fats.REF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, KIM BARRETT, HEDDWEN BROOKS, SCOTT BOITANO, SUSAN BARMANTWENTY THIRD EDITIONPAGE NO:432",Physiology,G.I.T
+424f3042-0451-4000-b7b0-98263483b83b,Which is not echogenic while doing ultrasonography-,Bile,Gas,Bone,Gall stones,0,multi,"Bile and urine are least echogenic.
+Bone, gas, and organ boundaries are most echogenic.",Radiology,
+90c70586-ea3f-41f4-8ac1-708dc4adf6a8,Features of mycotic aneurysm are all except,Bacterial endocarditis is common etiology,Commonly it is fusiform aneurysm,Aorta and visceral vessels affected commonly,Multilobed aneurysm with narrow neck,1,multi,Mycotic aneursm is commonly saccular.,Surgery,
+69eaa494-e859-4153-8835-b552dddc2d21,Microvesicular fatty liver is caused by -,DM,Valproate,Starvation,IBD,1,single,"Ans. is 'b' i.e., Valproate Steatosiso Accumulation of triglyceride fat droplets within the heaptocytes is known as steatosis or fatty liver. It may be of two types -1. Microvesicular steatosis - Multiple tiny droplets accumulate that do not displace the nucleus.2. Macrovasicular steatosis - A single large droplet accumulates that displaces the nucleus.Causes of steatosisMicrovesicularMacrovesicularo Reye's syndromeo Acute fatty liver of pregnancyo Jamaican vomiting sicknesso Drugs - valproic acid, tetracycline, nucleoside analogueo Wolman's diseaseo Lysosomal acid lipase deficiencyo Congenital defects of urea cycle enzymeso Early stage of alcoholic cirrhosiso Chronic viral hepatitiso Alcoholic liver diseaseo DM - insulin resistanceo Lipodystrophyo PEM, starvationo Dysbetalipoproteinemiao TPN, Jejunoileal bypasso Inflammatory bowel diseaseo Syndrome x (obesity, DM, hypertriglyceridemia)o Drugs - CCBs, synthetic estrogens, nucleoside analogues",Pathology,Liver
+4319f41c-953a-4903-82a9-96c4b32c6849,Child protection scheme is under which ministry -,Ministry of health and family welfare,Ministry' of Social welfare,Ministry' of women and child development,Ministry of education,2,single,"Ans. is 'c' i.e., Ministry of women and child developmento In 2006 the Ministry' of Women and Child Development (MWCD) proposed adoption of Integrated Child Protection Scheme (ICPS).o In 2009 the central government take the scheme its approval and has begun the extensive task of providing children with a protective and safe environment to develop and florish.o The purpose of the scheme is to provide for children in difficult circumstances, as well as to reduce the risks and vulnerabilities children have in various situations and actions that lead to abuse, neglect, exploitation, abandonment and separation of children.",Social & Preventive Medicine,Health Programmes in India
+7084cbc3-05da-4499-bfb4-df024e39ebe5,Indication for surgery in a case of adrenal incidentaloma,Size>5 cm,Bilateral adrenal metastasis,Functional tumor,All of the above,3,multi,"Ref: Bailey&;s 26thE pg: 780. Treatment of Incidentaloma: Any non-functioning adrenal tumour greater than 4 cm in diameter and smaller tumours that increase in size over time should undergo surgical resection. Non-functioning tumours smaller than 4 cm should be followed-up after 6, 12 and 24 months by MRI and hormonal evaluation.",Surgery,Endocrinology and breast
+06d06437-d265-4554-ab42-19b43d7aa768,In case control study of buccal carcinoma-,CA is commoner in zarda pan users than non users,Zarda pan is a cause of buccal CA,Zarda pan is associated with buccal CA,"If use of zarda pan is stopped, number of cases will reduce",2,single,Case control studies often retrospective studies are a common first approach to test causal hypothesis. In recent years case control study has emerged as a permanent method of epidemiological investigation. Both exposure and outcome has occurred before the study. Study proceeds backwards from effect to cause. It uses a control or comparison group to suppo or refute an inference (refer pgno:71 park 23 rd edition),Social & Preventive Medicine,Epidemiology
+55ba5eb4-7157-40c5-988f-26f06ff082f9,Nephrotic syndrome is characterised by,Proteinuria,Hyperlipidemia,Oedema,All,3,multi,"Ans. is 'a' i.e., Proteinuria; 'b' i.e., Hyperlpidemia; 'c' i.e., Oedema Pathophvsiologv of nephrotic syndrome Proteinuria o The most impoant feature of nephrotic syndrome is massive proteinuria (>3.5 gm/day) o Proteinuria results from altered permeability of glomerular filtration barrier for protein. o The largest propoion of protein lost in the urine is albumin but globulins are also excreted in some diseases. The ratio of low to high molecular weight proteins in urine in various cases of syndrome is a manifestation of the selectivity of proteinuria. A highly selective proteinuria consists mostly of low molecular weight proteins, i.e. albumin & transferrin, where as apoorly selective proteinuria consists of higher molecular weight globulin in addition to albumin. Edema o Proteinuria leads to hypoalbuminemia that results in decreased colloid osmotic pressure edema. Hyperlipidemia o Increased synthesis of lipoproteins by liver. o Decreased catabolism of lipids. o There is increased cholesterol, triglycerides VLDL, and LDL. Lipiduria o Hyperlipidemia results in lipiduria due to excessive leakiness of glomerular filtration barrier.",Pathology,
+821f6586-f2f3-4fee-9c2f-eb7e53aa5a03,All the following are the risk factors for cervical cancer except,Young age at first intercourse,Multiple sexual paners,Low parity,Low socioeconomic status,2,multi,"There are numerous risk factors for cervical cancer: Young age at first intercourse (younger than 16 years), Multiple sexual paners, Cigarette smoking, race, High parity, Low socioeconomic status, and Chronic immune suppression. Reference: Novak's gynaecology; 14th edition; Chapter 35; Uterine cancer",Gynaecology & Obstetrics,Gynaecological oncology
+addd9f5a-ff2d-4161-a9f7-8409749ff195,Characteristic feature of korsakoff psychosis is,Disorientation,Delirium,Coarse tremor,Amnesia,3,single,,Medicine,
+e64863b6-ded9-4aa5-b987-b06de7b394d3,Person preoccupied by worries about ill health is :,Hypochondriac,Maniac,Depressed,Delirium,0,single,A i.e. Hypochondriasis,Psychiatry,
+07e8f3a1-63b5-4eae-a132-0286b9ef48d3,"Terminal branches of facial nerve are all, EXCEPT:",Mandibular nerve,Marginal branch,Temporal,Cervical,0,multi,"The facial nerve crosses lateral to the styloid process and penetrates the parotid gland. In the parotid gland, the nerve divides at the pes anserinus into 2 major divisions; ie, the superiorly directed temporal-facial and the inferiorly directed cervicofacial branches. After the main point of division, 5 major branches of the facial nerve exist, as follows:Temporal (ie, frontal)ZygomaticBuccalMarginalCervical",Anatomy,
+d53153f0-8be3-4794-9307-aafc24da8c85,Which of the following is orexigenic?,Serotonin,Ghrelin,OCX,GA,1,single,"Ghrelin: Anorexigenic and somatotrophic signal from the stomach Akio Inui1 About the author top of page Abstract Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor, is synthesized principally in the stomach and is released in response to fasting. Ghrelin is structurally related to motilin and, together, they represent a novel family of gut-brain regulatory peptides. In addition to having a powerful effect on the secretion of growth hormone, ghrelin stimulates energy production and signals directly to the hypothalamic regulatory nuclei that control energy homeostasis. The study of ghrelin has extended our understanding of how growth is controlled and has shown that the stomach is an impoant component of this system.",Physiology,General physiology
+455bf6be-62c3-4ec0-ba1e-eafa0b49459b,Metformin is NOT effective in lowering of blood sugar level in which of the following patients?,Non diabetics,Obese diabetics,Type 2 diabetics,Diabetics not responding to sulfonylureas,0,single,"(Ref:KDT 6/e p269) Metformin is the drug of choice for the treatment of obese diabetic patients, as it causes weight loss. It does not cause release of insulin, therefore less chances of hypoglycemia.",Anatomy,Other topics and Adverse effects
+9f553c15-928f-41f8-8e94-021521702b9b,"You are conducting a survey in your village and the person you are interviewing is a 32 year old post graduate working as a clerk. His total family income is 20,000 Rs per month. According to Kuppuswamy's socio economic status scale, he belongs to:",Upper socioeconomic class,Upper socioeconomic class,Lower middle socioeconomic class,Upper lower socioeconomic class,1,single,"Kuppuswamy's socio economic status scale takes into account education, occupation and monthly family income. Since he is a post graduate he gets 6 points for education. His job as a clerk gives him 5 points and a monthly family income of 20000 Rs gives him 12 points which gives him a total of 23 points and so he belongs to upper middle socioeconomic class. Socio economic status Total score Upper socio economic status 26 - 29 Upper middle socioeconomic status 16 - 25 Lower middle socioeconomic status 11 - 15 Upper lower socioeconomic status 5 - 10 Lower socioeconomic status <5 Ref: Park, Edition 21, Page 639",Social & Preventive Medicine,
+3bad04f5-219b-4bb5-ae68-388ffbc6415f,True regarding the development of ear:,Eustachian tube opens at the level of interior turbinate,Pinna develops from the cleft of Ist arch,Growth of the inner- ear completed by 4th month,All,3,multi,"A i.e. Eustachian tube opens at the level of inferior turbinate; B i.e. Pinna develops from the cleft of arch; C i.e. Growth of inner ear completed by 4th monthEustachian tube connects tympanic cavity with nasopharynx. It is about 36cm long in adults and runs downwards, forwards & medially at an angle of 45deg with horizontal from bony tympanic end to slit like pharyngeal end. Tympanic end is in the anterior wall of middle ear, just above the level of floor. While nasopharyngeal end is situated in the lateral wall about 1 -1.25 cm behind the posterior end of inferiro turbinateQ",Anatomy,
+6c222a4a-e7b4-49f9-a9ee-e09f8545f7df,Gastric irritation is least with following NSA1D: (PGI June 2008),Diclofenac,Acetaminophen,Ibuprofen,Naproxen,1,single,"Ans. B (Acetaminophen) ""Gastric mucosal damageQ: Gastric pain, mucosal erosion/ ulceration and blood loss are produced by all MSAIDs to varying extents: relative gastric toxicity is a major consideration in the choice of MSAIDs. Paracetamol"", a very weak inhibitor of COX is practically free of gastric toxicity and selective (misoprosto) administered concurrently with NSAIDsanatgonise their gastric toxicity""- KDT 6th/186Aspirin is acetylsalicylic acid KDT 6th/187",Pharmacology,Prostaglandins
+bbfbb8af-7798-4233-8908-54a4b8611430,The concetration of potassium in microgram in ORS is-,30 meq,20 meq,90 meq,60 meq,1,single,"Ans. is 'b' i.e., 20 meq",Pediatrics,
+64f80edc-9494-4b09-b361-0d50d21ff9cb,Abnormal mousy/mushy odour of urine is associated with,Phenylketonuria,Tyrosinemia,Maple syrup urine disease,Hawkinsuria,0,single,"Ans. a (Phenylketonuria) (Ref. Harrison's Internal Medicine 17th/Ch. 358)Inborn errors of amino acid metabolism associated with abnormal odourInborn error of metabolismUrine odorGlutaric acidemia (type II)Sweaty feet, acridHawkinsinuriaSwimming poolIsovaleric acidemiaSweaty feet, acridMaple syrup urine diseaseMaple syrup/Burnt sugarHypermethioninemiaBoiled cabbageMultiple carboxylase deficiencyTomcat urineOasthouse urine diseaseHops-likePhenylketonuriaMousy or mustyTrimethylaminuriaRotting fishTyrosinemiaBoiled cabbage, rancid butterTHE HYPERPHENYLALANINEMIAS# result from impaired conversion of phenylalanine to tyrosine.# The most common and clinically important is phenylketonuria (frequency 1:10,000), which is an autosomal recessive disorder characterized by an | concentration of phenylalanine and its by-products in body fluids and by severe mental retardation if untreated in infancy.# It results from | activity of phenylalanine hydroxylase (phenylketonuria type I).# The accumulation of phenylalanine inhibits the transport of other amino acids required for protein or neurotransmitter synthesis, reduces synthesis and increases degradation of myelin, and leads to inadequate formation of norepinephrine and serotonin.# Phenylalanine is a competitive inhibitor of tyrosinase, a key enzyme in the pathway of melanin synthesis, and ac- counts for the hypopigmentation of hair and skin.# Untreated children with classic phenylketonuria are normal at birth but fail to attain early developmental milestones, develop microcephaly, and demonstrate progressive impairment of cerebral function.# Hyperactivity, seizures, and severe mental retardation are major clinical problems later in life.# EEG abnormalities; ""mousy"" odor of skin, hair, and urine (due to phenylacetate accumulation); and a tendency to hypopigmentation and eczema are devastating clinical picture.# In contrast, affected children who are detected and treated at birth show none of these abnormalities.Treatment# To prevent mental retardation, diagnosis and initiation of dietary treatment of classic phenylketonuria must occur before the child is 3 weeks of age.# Dietary phenylalanine restriction is usually instituted if blood phenylalanine levels are >250 pmol/L (4 mg/dL).# Treatment consists of a special diet low in phenylalanine and supplemented with tyrosine, since tyrosine becomes an essential amino acid in phenylalanine hydroxylase deficiency.# With therapy, plasma phenylalanine cone should be maintained between 120 and 360 pmol/L (2 and 6 mg/dL).# Dietary restriction should be continued and monitored indefinitely..# Pregnancy risks can be minimized by continuing lifelong phenylalanine-restricted diets and assuring strict phenylalanine restriction 2 months prior to conception and throughout gestation.ConditionEnzyme DefectClinical FindingsInheritance1. Phenylketonuria type IPhenylalanine hydroxylaseMental retardation, microcephaly, hypopig- mented skin and hairs, eczema, ""mousy"" odorAR2. Phenylketonuria type IIDihydropteridine reductaseMental retardation, hypotonia, spasticity, myoclonusAR3. Phenylketonuria type III6-Pyruvoyl- tetrahydropterin synthaseDystonia, neurologic deterioration, seizures, mental retardationAR4. GTP cyclohydrolase I deficiencyGTP cyclohydrolase IMental retardation, seizures, dystonia, temperature instabilityAR5. Carbinolamine dehydratase deficiencyPterin-4-carbinolamine dehydrataseTransient hyperphenylalaninemia (benign)AR",Pediatrics,Inborn Errors of Metabolism
+38ccb378-9091-4565-a595-bfd77b13ea9a,Clinical features of infectious mononucleosis,Glandular involvement,Febrile,Palatine petechiae,All of the above,3,multi,,Pathology,
+cae8e457-d314-4013-b5a3-15fc16015f33,Small cuff size will lead to?,Falsely increased BP,Falsely low BP,No effect on BP,Fluctuating BP,0,multi,"a. Falsely increased BP(Ref: Nelson's 20/e p 2164)In older children, a mercury sphygmomanometer with a cuff that covers approximately two-thirds of the upper part of the arm or leg may be used for blood pressure measurement. A cuff that is too small results in falsely high readings, whereas a cuff that is too large records slightly decreased pressure.",Pediatrics,Miscellaneous
+8ea4240e-bfb6-448a-9a91-288b8198fd93,Ulcer with undermined edges is seen in,Malignant ulcer,Tubercular ulcer,Venous ulcer,Diabetic ulcer,1,single,"Tubercular ulcers typically have undermined edges. Reference: Bailey & Love&;s Sho Practices of Surgery 27th Edition, Page no. 78",Surgery,General surgery
+f52cfc68-7b88-4f84-9a79-117dbce9da60,Which of the following is NOT associated with elevation of prostatic specific antigen?,Acute prostatitis,BPH,Prostatic intraepithelial neoplasm,Prostatic needle biopsy,2,single,"Prostatic Intraepithelial Neoplasia ( PIN) is a precancerous condition; not detected by rectal examination, TRUS , or MRI; does not cause rise in PSA level . It is usually identified after TURP for BPH with final histology or by prostatic biopsy.Reference: page1048 SRB&;s manual of surgery 5th edition",Surgery,Urology
+fa1276ec-3538-4c56-a23c-85732a5eb5b1,Muscle relaxant used in renal failure :,Ketamine,Atracurium,Pancuronium,Fentanyl,1,single,B i.e. Atracurium,Anaesthesia,
+17073b03-4f15-462e-86f2-79428819b591,Redistribution phenomenon is seen in:,Halothane,Ether,Thiopentone,All,2,multi,,Pharmacology,
+b634a7e2-4f0b-4d25-ba86-3da9ccf4726a,"A 20 years female has hepatosplenomegaly, fever, pallor and generalized lymphadenopathy. Lab test useful for diagnosis is/are -a) ESRb) Electrophoresisc) Parasite detection in aspirated) ELISAe) Routine haemogram",acd,ace,cde,ade,1,multi,,Microbiology,
+3a963c53-2aa9-4e2c-96e4-4570516f18fb,Gastrinoma a/w,Diarrhoea,Constipation,Achlorhydria,Multiple superficial gastric ulcers,0,single,"Diarrhoea is due to hypergastrinaemia.It is associated with severe ulcers,not superficial SRB's manual of surgery,5th edition,710.",Surgery,G.I.T
+d9fd0e3c-af5e-4108-abd5-6e5c40f71bab,CAGE questionnaire is used in:AP 07; MP 09; NEET 13,Alcohol dependence,Opiate poisoning,Dhatura poisoning,Barbiturate poisoning,0,single,Ans. Alcohol dependence,Forensic Medicine,
+966accb6-3050-4ff9-9e8f-9b9d46f44bea,Which of the following is used in exocytosis?,Ca,Mg,Na,K,0,single,Ans. (a) CaExocytosis is a calcium dependent process where in the cellular contents are moved out of the cell in the form of vesicles (Cell Vomiting),Physiology,General
+4d208459-fcab-41dc-a5b7-d984359ac2b9,Therapeutic blood range of theophylline in microgram per L is:,0-5,10-May,15-May,20-May,3,single,Theophylline is having a narrow margin of safety so therapeutic drug monitoring is essential If levels increase more than 20mg/L- side effects occurs ESSENTIAL OF MEDICAL PHARMACOLOGY SEVENTH EDITION KD TRIPATHI PGNO.226,Pharmacology,Respiratory system
+00f2c259-7b5b-407e-81f1-172da8846455,Lift off test is used for which of the following muscles?,Supraspinatus,Subscapularis,Infraspinatus,Biceps Breachii,1,single,"Ans. is 'b' i.e., Subscapularis TestMuscle TestedLift off testSubscapularisJobe testSupraspinatusSpeed testBicepsYergason testBicepsBelly press testSubscapularis",Orthopaedics,Injuries Around Shoulder
+26b146ff-0f13-4e9d-b4fe-d3aac7fd1f7d,Which of the following is not a structural element of TMJ?,Sigmoid notch,Articular disc,Capsular ligament,Joint cavities,0,single,Sigmoid notch (or) mandibular notch forms the sharp upper border of the ramus the condyle and coronoid process.,Dental,
+10ff3d1e-3020-4a37-956e-a1bc43b06fc8,Prognostic stage groups in carcinoma breast include all except,Tumour size,Grade,HER-2 status,Age,3,multi,"Prognostic stage groups include TNM plus grading, and status of biomarkers HER-2, ER, and PR Ref: AJCC 8th edition",Surgery,Endocrinology and breast
+e11268cf-9f08-491b-8937-3875cbd26f46,"Arrange the following subtypes of schizophrenia, in order of prognosis, with the best prognosis first and the worst prognosis last, 1. Paranoid schizophrenia2. Catatonic schizophrenia3. Simple schizophrenia4. Disorganised schizophrenia",4-2-1-3,2-1-3-4,2-1-4-3,1-2-4-3,2,single,"The correct sequence is Catatonic schizophrenia followed by Paranoid schizophrenia followed by Disorganised schizophrenia followed by Simple Schizophrenia Please remember in both DSM-5 and ICD-11, these subtypes have been removed",Psychiatry,Schizophrenia Spectrum and Other Psychotic Disorders
+92659a1c-5537-4957-ba76-a9c6551a8730,Mammalian Mitochondria are involved in all of the following Except,Fatty acid synthesis,DNA synthesis,Fatty acid oxidation (b-oxidation),Protein synthesis,3,multi,Protein synthesis is a cytoplasmic process.Fatty acid synthesis stas with the production of Acetyl Co-A within the mitochondria. b-oxidation of fatty acid oxidation also occurs in mitochondria. Mitochondrial DNA synthesis occurs within the mitochondria.,Microbiology,All India exam
+46385fe7-8048-4d88-86e2-fea7ab1cef01,Cross examination of the prosecution witness is done by-,Public prosecutor,Defence counsel,Judge,None,1,multi,"In government prosecutions, cross examination is done by defense lawyer.",Forensic Medicine,
+802fc468-07e6-4fe2-af8b-5843c890a6b2,Pseudo pocket is seen in the,Base of the pocket lies on cementum,Gingivitis,Periodontitis,Base of the pocket and lies on alveolar bone,1,single,,Dental,
+da060f81-4590-4c94-a8e7-76d29351bb61,Thickness of oxygen inhibition layer in composite curing is:,1-50 micrometer,15-150 micrometer,50-500 micrometer,1000-2000 micrometer,2,single,"When composite is light cured, oxygen in the air causes an interference in the polymerization resulting in the formation of an oxygen inhibition layer on the surface of the composite.The oxygen-inhibited layer is the sticky, resin-rich uncured layer that is left on the surface.Thickness is about 50-500 micrometer.
+Reference- Sturdevant 6th ed P:237",Dental,
+61b825a9-0c74-4550-925c-ccd161969c2a,Hassall&;s corpuscles are present in,Thymus,Lymphnode,Spleen,Liver,0,multi,Inderbir Singh's Human Histology Sixth edition Pg 140 The medulla of thymus contains pink staining rounded masses called the corpuscles of Hassal,Anatomy,General anatomy
+84911b71-e906-4984-8346-6418c0aed663,Triamterene causes,Better glucose tolerance,Muscle cramps,Decrease in urea level,Hypokalemia,1,single,"Inhibitors of renal epithelial Na+ channel Include Triamterene and amiloride. Triamterene:- It is incompletely absorbed orally, paly bound to plasma proteins, largely metabolized in liver to an active metabolite and excreted in urine. Plasma t 1/2 is 4 hours, effect of a single dose lasts 6-8 hours. Side effects:- consist of nausea, dizziness, muscle cramps and rise in blood urea. Impaired glucose tolerance and photosensitivity are repoed, but urate level is not increased. Ref:- kd tripathi; pg num:-590",Pharmacology,Kidney
+f885e11a-4a80-464f-aa2a-9bdaa6baff55,Persistent vomiting in G.O.O. causes -a) Hyponatremic hyperchloremia occurb) Hypernatremia without ↓ed Cl- alkalosisc) Hypokalemic metabolic alkalosisd) Paradoxical aciduria,cd,bc,bd,ac,0,single,"Repetitive vomiting leads to hypochloremic, hypokalemic metabolic alkalosis. The urine is alkaline initially but eventually it becomes acidic (paradoxical aciduria)
+
+
+
+Cause of paradoxical aciduria 
+
+Initially the kidney compensate for metabolic alkalosis by reabsorbing hydrogen and chloride ions in exchange for sodium, potassium and bicarbonate. But gradually as the body stores of sodium and especially potassium become depleted, kidney starts retaining these ions in exchange of hydrogen ions, thus the urine becomes acidic and metabolic alkaline state is further aggravated.",Surgery,
+cdf04af4-0d45-4d27-8595-36b6c320df52,All are immediate causes of death in burns except,Injury,Suffocation,Toxemia,Shock,2,multi,Immediate causes of death in burns Shock Suffocation Injury Delayed causes of death Toxemia Inflammatory complications Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 163,Forensic Medicine,Thermal injury
+b2f91d4c-fb35-4117-a5a0-673197e79b72,Mucositis is caused by:,5-Fluorouracil,Methotrexate,Paclitaxel,Cisplatin,0,single,"Flurouracil is used mainly for solid malignancies,i.e colon, rectum, pancreas, liver, urinary bladder, head, and neck. Genetic deficiency of dihydropyridine dehydrogenase(DPD) leads to Fluorouracil toxicity. Major toxicity is myelosuppression, mucositis, diarrhea, nausea, vomiting, peripheral neuropathy (hand-foot syndrome)also occurs. Other given drugs are anti-cancerous drugs without mucositis. ESSENTIALS OF MEDICAL PHARMACOLOGY-SEVENTH EDITION-K.D TRIPATHI Page; 864",Pharmacology,Other topics and Adverse effects
+b39016d6-d5f1-4498-bef3-37d4eec914d7,Complications of therapy with radioactive iodine includes -,Thyroid malignancy,Hypothyroidism,Leukemia,All,1,multi,Ans. is 'b' i.e. Hypothyroidism,Surgery,
+f8bbd265-100a-4cda-9ec7-c1e9f4dafc0a,Uterine souffle :,Is a soft blowing murmur synchronous with foetal hea sounds,Is due to increase in blood flow through the dilated uterine vessels,Is due to the active foetal movements,Indicates the underlying foetal distress,1,single,"Ans. is b i.e. Is due to increase in blood flow through the dilated uterine vessels Uterine souffle is a soft blowing systolic murmur The sound is synchronous with maternal pulse It is due to increase in blood flow through the dilated uterine vessels Heard low down at the sides of the uterus, best on the left side It can also be heard in big uterine fibroid. Note Soft blowing murmur synchronous with the fetal hea sound is called Fetal / Funic souffle.",Gynaecology & Obstetrics,
+d84bbbff-2835-4d0a-bd1f-2b8ee74e126c,Investigation of choice in bronchiectasis is,Bronchoscopy,MRI thorax,HRCT lung,Chest X-ray,2,single,"HRCT chest is more specific for bronchiectasis and is the imaging modality of choice for confirming the diagnosis.CT findings include airway dilation(detected as parallel ""tram tracks"" or as the ""signet-ring sign""-a cross sectional area of the airway with a diameter at least 1.5 times that of the adjacent vessel),lack of bronchial tapering(including the presence of tubular structures within 1 cm from the pleural surface.),bronchial wall thickening in dilated airways,inspissated secretions (eg.,the "" tree-in-bud"" pattern ),or cysts emanating from the bronchial wall(especially pronounced in cystic bronchiectasis.) Reference:Harrison's medicine-18th edition,page no:2143.",Medicine,Respiratory system
+cdc0bbbc-6b84-4ff4-927d-4641d2b07d58,Nyctalopia is due to deficiency of,Vitamin A,Vitamin B,Vitamin C,Vitamin E,0,single,,Biochemistry,
+5287cf4d-ca07-40e0-b32a-81ebe7c460b8,False about hepatic adenoma-,Benign lesion,OCP use,Older females,Cold on isotopescan,2,multi,"Ans. is 'c' i.e., Older females o Hepatic adenomas are benign solid neoplasms of liver.MC seen in younger females (20-40 years of age)Usually solitaryRisk factor - Prior/current use of estrogens (OCP)o Clinical FeaturesPatients usually present with upper abdominal pain.Physical examinated is usually unrevealing,o Microscopic FeaturesCords of congested or Fat laden hepatocvtes-absent biliary ductules or normal liver architecture,o DiagnosisCT Scan - Well circumscribed heterogenous mass showing early enhancement during arterial phase.MRI Scan - Hyperintense on T, weighted image and enhance early after gadolinium injection,o Isotope Scan - Hepatoma appears cold.o ComplicationsRupture with intraperitoneal bleeding.Malignant transformation (rare) - to HCCo TreatmentHepatic artery embolisation.Resection.",Surgery,"Hepatic Tumors, Cysts, and Abscesses"
+f9305a4e-40ad-41fa-8be2-3fe7dc212bfa,Renal threshold for serum glucose level-,100 mg/dl,200 mg/dl,300 mg/dl,400 mg/dl,1,single,"Ans. is 'b' i.e., 200 mg/dl * The transport maximum for glucose is 375 mg/min whereas the filtered load of glucose is only 125 mg/min.* Therefore, in normal conditions 100% of glucose is reabsorbed in proximal tubules.* When plasma glucose concentration is 100 mg/dl the filtered load is at its normal level, 125 mg/min, there is no loss of glucose in the urine.* However, when the plasma concentration of glucose rises above about 200 mg/dl, increasing the filtered load about 250 mg/min, a small amount of glucose begins to appear in the urine.* This point is termed as threshold for glucose.* Note that this appearance of glucose in the urine occurs before the transport maximum is reached.* The reason for the difference between threshold and transport maximum is that not all nephron have same transport maimum for glucose, and some of the nephron therefore begin to excrete glucose before others have reached their transport maximum.* The overall transport maximum for the kidneys, which is normally about 375 mg/min, is reached when all nephrons have reached their maximal capacity to reabsorb glucose.* That means, above filtered load of 250 mg/min of glucose, some glucose will appear in the urine (threshold level), whereas above filtered load of 375 mg/min, all the glucose will be excreted because all the nephrons have reached to their transport maximum.* Thus, Renal threshold for glucosei) At plasma levels - 200 mg/dlii) At filtered load - 250 mg/min",Physiology,Kidneys and Body Fluids
+65f2ce5a-dd89-45fc-a2cd-5f369acffe77,"A 9-year-old boy diagnosed as uncomplicated pulmonary tuberculosis. He is put on isoniazid, rifampin, and ethambutol at home after initial treatment given at hospital. Which is accurate statement for this scenario?",His 3-year-old sibling should receive INH prophylaxis,A baseline test of auditory function test is essential before drug treatment is initiated,Polyahralgia is a potential adverse effect of the drugs the boy is taking,"His mother, who takes care of him, does not need INH prophylaxis",0,multi,Prophylaxis with INH is always advisable for family members and close contacts in active cases. None of the drugs prescribed is associated with nephrotoxicity. Polyahralgia is a side effect of pyrazinamide that's not given in this case. Routine LFTs should be done in younger patients if INH plus rifampin given in higher doses. Ocular Function test should be done before staing ethambutol.,Pharmacology,"Mycobacterial Diseases (TB, Leprosy and MAC)"
+47d1dbea-e18b-4ece-8462-61a575298168,How much luting agent is required for cementation of crown?,3/4th filled slightly upto the margin,1/4th filled,1/2 filled,Full to prevent bubble,2,single,,Dental,
+7e4ff08e-29c7-47d1-9239-f79e6e0595d0,Functional unit of muscle:,Sarcomere,Actin,Myosin,Troponin,0,single,"Functional unit of muscle is : sarcomere It is the pa of myofibril present between two succsive z lines. Ref: Guyton and Hall textbook of medical physiology 12th edition, page number:86,87",Physiology,Cardiovascular system
+86281c8e-6384-4402-aa3a-80420e029ef0,Cause of exudative retinal detachment are:,Scleritis,Toxaemia of pregnancy,Central serous retinopathy,All,3,multi,Ans. All,Ophthalmology,
+4d147d09-ab73-40ed-814e-379b8d4df231,"A 47-year-old man suddenly develops high fever and hypotension. He has a generalized erythematous macular rash, and over the next day, develops gangrene of his left leg. Which of the following is the most likely organism?",Corynebacterium diphtheriae,Streptococcus group C,Neisseria gonorrhoeae,Streptococcus group A,3,single,"Streptococcus group A can cause a toxic shock-like syndrome, and has been increasing in frequency in North America. Streptococcal toxic shock-like syndrome was so named because of its similarity to staphylococcal toxic shock syndrome. The illness includes fever, hypotension, renal impairment, and the respiratory distress syndrome. It is usually caused by strains that produce exotoxin. It may be associated with localized infection as well; the most common associated infection is a soft tissue infection such as necrotizing fasciitis. The mortality is high (up to 30%), usually secondary to shock and respiratory failure. The rapid progression of the disease and its high mortality demand early recognition and aggressive treatment. Management includes fluid resuscitation, pressor agents, mechanical ventilation, antibodies, and, if necrotizing fasciitis is present, surgical debridement.",Medicine,Infection
+197f4476-5229-44a6-b9fb-813967c23cfc,"In amyloidosis of the tongue, the amyloid is deposited primarily in the:",Stromal connective tissue,Cells of the surface epithelium,Nuclei of the striated muscle cells,Cytoplasm of the striated muscle cells,0,single,,Pathology,
+37585fbd-5eda-48c4-8b39-761335c90b6e,Which of the following is the most common cause of emergency depament visit related to LSD and its related substances?,Bad trip,Flashbacks,Synaesthesia,Papillary dilatation,0,single,"The most frequent acute medical emergency associated with LSD use is a panic episode (the ""bad trip""), which may persist up to 24 h.A trip is a period of intoxication from a hallucinogenic drug, such as lysergic acid (LSD) or magic mushrooms (psilocybin). It is called a trip because perceptions of the world change so dramatically, it can feel as if a trip to a strange, new land is taken. Unpleasant experience of hallucinogen intoxication is known as a bad trip.Harrison 19e pg: Cocaine and Other Commonly Abused Drugs",Microbiology,All India exam
+9f5413a7-dacf-4629-94f5-0e1ecc12dfbf,Bilateral destruction of auditory cortex in man causes,Almost total deafness,Hearing defect for higher frequency sounds,Deficiency in interpretation of sounds,Inability for the orientation of sounds,2,single,(C) Deficiency in interpretation of sounds # Lesion of auditory cortex leads to loss of recognition of total patterns with loss of analysis of properties of sound and sound localisation.> Thus lesion of auditory cortex leads to defect in interpretation of sounds.,Physiology,Special Senses: Hearing and Equilibrium
+db51ede8-e2b6-4637-9ff2-bc6efb98d662,The following infection resembles malignancy -,Echinococcus granulosus,E. multilocularis,E.vogeli,E. oligarthus,1,single,"Ans. is 4b' i.e., E. multilocularis o The chief character of E. multilocularis cyst is its tendency to proliferate, thereby resembling a neoplasm.Hydatid disease of liver is caused byo Echinococcus granulosuso Echinococcus multiloculariso Echinococcus vogeli- Unilocular cystic lesions- Multi locular alveolar hydatid cyst- Polycystic hydatid disease.",Microbiology,Parasitology
+fc4ad074-28fe-4b8f-bde1-79c50dadad98,A 1 year old child is brought to you with delayed milestones. On examination you note that the child is very fair with hypopigmented hair and blue eye. He has also got eczemas. The child was also very irritable. What is your diagnosis?,Albinism,Phenylketonuria,Alkaptonuria,Cystinosis,1,single,"This child is suffering from Phenylketonuria. Here there is inability to conve phenylalanine to tyrosine due to phenylalanine hydroxylase deficiency. The decreased pigmentation in this condition is due to reduced melanin formation. The treatment is a diet low in phenylalanine with tyrosine supplementation. Delay in initiation of treatment will lead to mental retardation. Ref: Essential revision notes for MRCP by Philip A Kalra, Edition 3, Page - 322 ; Harrison, Edition 17, Page - 2470",Pediatrics,
+7554130a-14b4-467f-a3be-c7e1805c35bf,Incomplete closure of palpebral apeure is called: March 2004,Lagophthalmos,Chalazion,Entropion,Ectropion,0,multi,Ans. A i.e. Lagophthalmos,Ophthalmology,
+538f53ba-899f-474e-b89f-d544dde0f46b,Galactokinesis means :,Sustaining lactation,Secretion of milk,Ejection of milk,Synthesis of milk,2,single,Ejection of milk,Gynaecology & Obstetrics,
+a989c88e-9b3e-4862-a67c-d39025976502,"The tendon of Sartorius, gracilis, and semi-tendinosus muscles forms a Pes Anserinus at the neck of tibia. Similar kind of structure is also seen in?",Parotid,Submandibular,Cheek,TMJ,0,single,,Anatomy,
+95e37320-0495-470b-ab41-fe26b8d4ec5c,"Serological testing of patient shows HBsAg, IgM Anti-HBc and HBeAg positive . The patient has-",Chronic hepatitis B with low infectivity,Acute hepatitis B with high infectivity,Chronic hepatitis with high in fectivity,Acute on chronic hepatitis,1,single,HBs Ag is the first marker appear in the blood after infection. Anti HBc is the earliest antibody seen in blood. HBeAg indicates infectivity REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.546&547,Microbiology,Virology
+f6b9c641-ad72-4d28-a62d-612a9ee6e031,All of the following are seen in GH deficiency except?,Hyperglycemia,Stunting,Delayed bone age,High pitched voice,0,multi,"From late in the first year until mid-teens, poor growth and/ or shoness is the hallmark of childhood GH deficiency. It tends to be accompanied by delayed physical maturation so that bone maturation and pubey may be delayed by several years. Severe GH deficiency in early childhood also results in slower muscular development, so that gross motor milestones may be delayed. Some severely GH-deficient children have recognizable, cherubic facial features characterized by maxillary hypoplasia and forehead prominence. These children have a high pitched voice and are stunted. GH deficiency is associated with hypoglycemia. In contrast gigantism or acromegaly is associated with impaired glucose tolerance.",Medicine,Diseases of Thyroid
+3e9a4b1f-974d-4a3c-ad63-02cf27319af9,"Hydatidiform - mole, characterized histologically by",Hyaline membrane degeneration,Hydropic degeneration of the villous stroma,Non proliferation of cytotrophoblasts,Non proliferation of syncytiotrophoblasts,1,multi,"(Hydropic degeneration of the villous storma): Ref: 193-97, 201-DHYDATIDIFORM MOLE (Vesicular mole) - It is an abnormal condition of placenta where there are partly degenerative and partly proliferative changes in the young chorionic villi.* It is best regarded as a benign neoplasm of the chorion with malignant potential* Vaginal bleeding is the commonest presentation (90%) ""white currant in red currant juice""* Expulsion of grape like vesicles (rich in HCG) per vaginum is diagnostic of vesicular mole* Histology shows - hydropic degeneration of the villous stroma with absence of blood vessels and trophoblastic proliferationRISK FACTORS FOR MALIGNANT CHANGE* Patient above the age of 40 irrespective of parity* Patients having previous 3 or more births irrespective of age. Age is more important than the parity* Initial serum hCG > 100,000 mIU/ml* Uterine size >20 weeks* Previous history of molar pregnancy* Large (> 6 cm) thecaleutin cystsImportant features of complete and Partial molesFEATURESCOMPLETE (CLASSIC) MOLEINCOMPLETE* Embryo/fetusAbsentPresent* Hydropic degeneration of villiPronounced and diffusedVariable and focal* Trophoblast hyperplasia * Uterine sizeDiffuseFocal* Theca leutin cystsMore than the date (30 - 60%)Less than the date* KaryotypeCommon (25 - 50%)Uncommon* phCG46 XX (85%) Paternal in originTriploid (90%) diploid (10%)* Classic clinical symptomsHigh (> 50, 000)CommonSlight elevation (< 50,000)Rare* Risk of persistent gestational trophoblastic neoplasia (GTN)20%<5%",Gynaecology & Obstetrics,Miscellaneous (Gynae)
+54076d21-a9fb-409d-b5bd-03c2cf3a6fc9,The nerve impulse which leads to initiation of smooth muscle contraction,Cause opening of the calcium channel which leads to increase in Ca+2 contraction,Cause both plasma membrane and T - tubules to undergo depolarisation,Inhibits Na+ entry in sarcomere,Is initiated by binding of acetylcholine to receptors in sarcoplasmic reticulum,0,multi,"Ans. (a) Cause opening of the calcium channel which leads to increase in Ca2+ contraction(Ref: Ganong, 25th ed/p.116)The never impulse which leads to initiation of smooth muscle contraction Cause opening of the calcium channel which leads to increase in Ca2+ contraction",Physiology,Muscle Physiology
+c33b030b-ec27-4d02-9508-ad96fb9d6559,"In a family, the father has widely spaced eyes, increased facial hair and deafness. One of the three children has deafness with similar facial features. The mother is normal. Which one of the following is most likely pattern of inheritance in this case?",Autosomal dominant,Autosomal recessive,X-linked dominant,X-linked recessive,0,single,"A i.e. Autosomal dominant (most likely) Waardenburg's Syndrome (WS) is a rare autosomal dominant syndrome characterized by pigmentary disturbances (skin, hair, iris), sensorineural hearing loss, and other developmental anomalies such as dystopia canthorum (widely spaced eyes) and blepharophimosis. The syndrome that closest matches the features provided in the question is Waardeburg syndrome type-I. This is inherited as an autosomal dominant fashion and hence is the answer of exclusion. As the question does not provide us with details as to the sex of the three children, a sex linked inheritance pattern cannot be worked out. Also the combined presentation of an affected father, unaffected mother and one affected child among three children is possible with both an autosomal dominant and an autosomal recessive inheritance pattern. In absence of any more details, the answer to this question cannot be deduced through the exploration of various permutations and combinations. How both autosomal dominant and autosomal recessive inheritance can be responsible for the above combination: Autosomal Dominant Autosomal recessive (A-affected allele and a normal allele) If the disease is transmitted in an Autosomal Dominant then :Father (affected) will be either 'AA' or 'Aa' Mother (unaffected) will be 'aa' If father is AA and mother aa, the offsprings will be 1. aA - 100% affected If father is Aa and mother aa, the offsprings will Aa - 50% affected aa - 50% not affected The scenario in the above question therefore is possible autosomal dominant inheritance if father is Aa and mother is aa (A'-affected allele and 'a' normal allele) If the disease is transmitted in an Autosomal recessive form :Father (affected) will be 'AA' Mother (unaffected) may be 'aa' or 'Aa' If father is AA and mother aa, the offsprings will be 1. aA - 100% not affected, (but carriers) If father is AA and mother Aa, the offsprings will be Aa - 50% not affected, carrier AA - 50% affected The scenario in the above question therefore is possible with autosomal recessive inheritance if father is aa and mother is Aa",Medicine,
+60c47f03-e07f-45b1-afbc-be51daf0e7e4,"All of the following statements about Heparin are true, except:",Causes Alopecia,Non Teratogenic,Releases Lipoprotein Lipase,Causes Hypokalemia,3,multi,"Heparin inhibits the production of aldosterone. It thus lead to severe Hyperkalemia and not hypokalemia as mentioned in the choice above. Ref: Harrison's Textbook of Internal Medicine, 16th edition, Page 1261; K D Tripathi Textbook of Pharmacology, 5th Edition, Pages 561-63",Pharmacology,
+b06d4abd-e44c-4b39-9a59-c135ac716144,Tigroid white matter on MRI is seen in?,Pantothenate kinase deficiency,Pelizaeus-merzbacher disease,Neuroferritinopathy,Aceruloplasminemia,1,single,"The tigroid pattern/ leopard skin sign occurs on MRI head is seen in Pelizaeus-merzbacher disease, due to creation of islands of perivascular myelin due patchy myelin deficiency. It is a rare hypomyelination syndrome caused by mutation in proteolipid protein, PLP 1 gene at chromosome Xq22. Child will show slow psychomotor development with nystagmus(pendular eye movements), hypotonia, extrapyramidal symptoms and spasticity. Tigroid pattern is also seen in metachromatic leucodystrophy.",Radiology,Neuroradiology
+76a59ebb-dea4-4071-8d19-11f0d3a6579b,Which of the following is the Nysten's law,Cadaveric rigidity does not appear in hot humid conditions,Cadaveric rigidity appears faster in older and the young than in middle age,Cadaveric rigidity occurs in men earlier than in woman,"Cadaveric rigidity affects successively the masticatory muscles, those of the face and the neck, those of the trunk and arms and finally those of lower limbs rruk",3,multi,"In rigor mois, all muscles of body, both voluntary and involuntary are involved. Externally it first appears in the eye lids, then lower jaw, muscles of the face, neck upper limbs and lastly lower limbs. This descending pattern or proximodistal progression is called Nysten's law. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 26",Forensic Medicine,Death and postmortem changes
+07757400-13ed-48a3-819b-fb50789beddc,If a drug is active against the pre-erythrocytic stage of the malarial parasite it will be useful as a:,Suppressive prophylactic,Causal prophylactic,Clinical curative,Radical curative,1,single,If a drug is active against the pre-erythrocytic stage of the malarial parasite it will be useful as a Causal prophylactic. Stage killed Clinical Use Pre-erythrocytic Causal Prophylaxis Erythrocytic Clinical cure Suppressive Prophylaxis Exo-erythrocytic Radical cure Gametocytic Prevention of transmission,Pharmacology,Anti-Malaria Drugs
+175a2dbb-2556-484b-bbc7-e0f04d220dcc,All are true statement about tracheostomy and larynx in children except:,Omega shaped epiglottis,Laryngeal cailages are soft and collapsable,Larynx is high in children,Trachea can be easily palpated,3,multi,"Infant's larynx differs from adult in:It is situated high up (C2 - C4).Q (in adults = C3 - C6)Of equal size in both sixes (in adults it is larger in males)Larynx is funnel shapedThe narrowest pa of the infantile larynx is the junction of subglottic larynx with trachea and this is because cricoid cailage is very smallEpiglottis is omega shaped, soft, large and patulous.Laryngeal cailages are soft and collapse easilySho trachea and sho neck.Vocal cords are angled and lie at level of C4Trachea bifurcates at level of T2Thyroid cailage is flat. The cricothyroid and thyrohyoid spaces are narrow.Tracheostomy in Infants and Children Trachea of infants and children is soft and compressible and its identification may become difficult and the surgeon may easily displace it and go deep or lateral to it injuring recurrent laryngeal nerve or even the carotid.During positioning, do not extend too much as this pulls structures from chest into the neck and thus injury may occur to pleura, innominate vessels and thymus or the tracheostomy opening may be made twoo low near suprasternal notchTracheostomy in Infants and Children The incision is a sho transverse one, midway between lower border of thyroid cailage and the suprasternal notch. The neck must be well extended.A incision is made through two tracheal rings, preferably the third or fouh.",ENT,
+ce5c0538-d1f0-4709-b043-eb99bad92073,Drug NOT used in pulmonary hypeension is?,Calcium channel blocker,Endothelin receptor antagonist,Alpha blocker,Prostacyclin,2,single,"alpha blockers Pulmonary hypeension General management Diuretic therapy may be useful as it relieves pulmonary edema. Anticoagulant therapy is advocated for all patients. Specific management Calcium channel blockers Patients who have substantial reductions in pulmonary aerial pressure in response to sho acting vasodilators at the time of cardiac catheterization should he initially treated with calcium channel blockers. Endothelin receptor antagonist Bostenan is a non-selective endothelium receptor antagonist, is an approved t/t ,for patients who are NYHA .functional classes III and IV. Phosphodiesterase-5 inhibitors Slidenafil is used for patients who are NYHA functional classes II and Prostacyclins Iloprost is a prostacyclin analogue used in PAH patients who are NYHA functional classes III and IV. Pulmonary circulation is unique in that it accommodates a blood flow that is almost equal to that of all the other organs of body but still maintains low pressure. The factors responsible for low pressure in pulmonary circulation (even with large volume of blood) are:- - Larger diameter of pulmonary vessels due to thin wall of pulmonary aery and aerioles.",Medicine,All India exam
+ec856a59-d95e-42d7-a37e-ea862345ece9,Which of the following is a good prognostic factor in ALL:,High WBC count,Male sex,Age < 2 years,Hyperdiploidy,3,multi,"Answer is D (Hyperdiploidy): Hyperdiploidy is associated with a good prognosis Hyperdiploidy is associated with a good prognosis Patients with hyperdiploidy (>50 chromosomes) or DNA index > 0.16 have a ourable prognosis - Age < 2 years has a poor prognosis Patients who are very young (< 2 years) and older patients (> 10 years) tend to have a worse prognosis- lthough most textbooks use the criteria of Age < 1 year to define a poor prognostic factor, Age < 2 year has been mentioned as a poor prognostic factor in ceain textbooks including Hoffman's Hematology (4th/1158) Since Hyperdiploidy provided amongst the option is an established good prognostic factor, this is selected as the single best answer of choice. High WBC count is associated with a poor prognosis Initial leukocyte count at diagnosis has proved to be an impoant prognostic factor in viually every ALL study. Different studies (textbooks) quote different values for the initial WBC count that is associated with a poor prognosis but uniformly a high WBC count carries a poor prognosis. Different text books Favourable WBC count Unourable WBC count Wintrobe's Hematology < 10,000 > 20,000 Hoffman Hematology < 50,000 > 50,000 Manual of Clinical oncology <30,000 >30,000 Inference Low WBC count High WBC count Male sex is associated with a poor prognosis 'Female patients have a rare ourable prognosis'",Medicine,
+6022af1f-be7a-4b78-8cda-43e0bac536e5,"A 28 year old labourer, 3 yrs back presented with penile ulcer which was not treated. Later he presented with neurological symptoms for which he got treated. Which is the test to monitor response to treatment?",VDRL,FTA ABS,TPI,RPR,0,single,"This is a case of neurosyphilis. A positive nontreponemal CSF serologic test result (CSF VDRL) establishes the diagnosis of neurosyphilis (and an increased cell count in response to the spirochete documents the presence of active disease). In VDRL test, the inactivated serum is mixed with cardiolipin antigen on a special slide & rotated for 4 minutes. Cardiolipin remains as uniform crystals in normal serum but it forms visible clumps on combining with regain antibody. The reaction is read under low power microscope. By testing serial dilutions, the antibody titre can be estimated. The results are repoed as reactive, weak by reactive / not reactive. The VDRL test can be used for testing CSF also, but not plasma. A number of modification of VDRL test have been developed, of which the Rapid Plasma Reagin (RPR) is the most popular. In RPR test. VDRL antigen containing carbon paicles which make the result more clear cut & evident to the naked eye The RPR test is done with unheated serum / plasma but is not suitable for testing CSF. Ref: Ananthanarayanan & Paniker's textbook of microbiology Ed 8 Pg - 375; Klausner J.D., Hook III E.W. (2007). Chapter 20. Neurosyphilis. In J.D. Klausner, E.W. Hook III (Eds), CURRENT Diagnosis & Treatment of Sexually Transmitted Diseases.",Microbiology,
+d206f3ae-78c2-4aa1-ba04-e81ab373e4eb,70 year old man has abdominal pain with mass inabdomen. Angiography reveals aneurysm of aoa. Mostlikely cause is:,Trauma,Atherosclerosis,Syphilis,Congenital,1,single,. Atherosclerosis,Pathology,
+47ac8f04-a1ca-46e4-9960-2ded9c8f8cc0,Which of the following is false regarding neonatal resuscitation?,T - tube delivers free flow oxygen,Self - inflating bag should not be used without reservoir,Self - inflating bag can deliver free flow oxygen,Flow inflating bag delivers free flow oxygen,1,multi,1. T - tube delivers free flow oxygen - TRUE 2. Self - inflating bag should not be used without reservoir - FALSE - can be used but FiO2 will be less. 3. Self - inflating bag can deliver free flow oxygen - TRUE 4. Flow inflating bag delivers free flow oxygen - TRUE,Pediatrics,JIPMER 2017
+1ea18537-26ca-425e-a211-fe1cc09cb12b,The most impoant prognostic factor of Wilms tumor-,Histopathology,Ploidy of cells,Age < 1 y,Mutation of c 1p gene,0,single,"Robbins basic pathology 10th edition page no 290. Wilms tumor or nephroblastoma is the most common primary tumor of the kidney in children. On microscopic examination, Wilms tumors are characterized by recognizable attempts to recapitulate different stages of nephrogenesis. The pattern of anaplastic cells within the primary tumor has impoant implications for prognosis.",Pathology,"Pediatrics, environment and nutrition"
+839dd9af-05f9-4176-9a4c-b4f823e1d998,The relationship of mean height of two group of children is best studied by-,Student's test,Linear regression,Chi-square test,Test of propoions,0,single,.,Social & Preventive Medicine,Biostatistics
+74b423a0-e7da-4261-9c3d-ce779fe3b13d,Advantage of brachytherapy – a) Non-invasiveb) Less radiation hazard to normal tissuec) Max.radiation to diseased tissued) Can be given in all malignanciese) Doesn't require trained personnel,a,c,ac,bc,3,multi,"As the radiotherapy source is placed directly in contact with tumor, maximum radiation exposure occurs to tumor tissue with relative sparing of adjacent normal tissue.
+Brachytherapy is invasive and requires trained personnel.
+Brachytherapy can be used in most (not all) of the malignancies where radiotherapy is the component of treatment.",Radiology,
+be4163d5-5131-4c2c-9f8a-06c1c6847912,Acyl carnitine functions in:,Transport of long chain fatty acid,Transport of short chain fatty acid,Transport of NADH,Transport of FADH,0,single,"Ans: a (Transport of long....) Ref: Vasudevan, 4th ed, p. 129The long chain fatty acyl CoA cannot pass through the inner mitochondrial membrane. There fore a transporter, carnitine is involved in transfer of fatty acids.Beta oxidation:Beta oxidation is absent in brain and erythrocytes (because erythrocytes lack mitochondria and fatty acids do not cross BBB).Carnitine acyl transferase -1 is inhibited by Malonyl CoA.Clinical correlate:Carnitine acyl transferase(CAT) deficiency (myopathic form)Although all tissues contain CAT most common form of genetic deficiency is myopathic form and due to a defect in muscle specific CAT gene.Features:Muscle aches, red urineRhabdomyolysis, myoglobinuriaProvoked by exerciseIncreased by high fat; low carbohydrate dietMuscle biopsy: increased muscle triglyceride in cytoplasmTreatment: Cease muscle activity, give glucose.",Biochemistry,Lipids
+728bd3c2-ba04-4c37-a92c-c5509d48d426,Fatal period in sulphuric acid poisoning is :,2-4 hours,6-10 hoursd,12-16 hours,8-14 hours,2,single,C i.e. 12 -16 hours,Forensic Medicine,
+8080b3aa-ce1f-40d7-a1d4-4518f86a8206,Most common method of anterior capsulotomy in phacoemulsification,Can-opener capsulotomy,Intercapsular capsulotomy,Capsulorhexis,Envelop capsulotomy,2,single,Answer- C. CapsulorhexisThe most commonly used technique for anterior capsulotomy during phacoemulsification is continuous curvilinear capsulorhexis (CCC).,Ophthalmology,
+d1d0e411-17aa-4d27-abaa-1861e322a1b8,A 26 year old female patients presents to emegency with history of consuming hair dye paraphenylenediamine . What shall be the expected outcome in such patient ?,Blindness,Nerve pathology,Dermatitis,Rhabdomyolysis,3,multi,"Hair dye poisoning(Paraphenylenediamine ): Cost-effective alternative to Organophosphate poisoning Readily available to masses. Clinical manifestations are Angioedema leading to dysphasia and respiratory distress, Rhabdomyolysis, Intravascular hemolysis, Acute renal failure and hepatic necrosis. Myocarditis or fatal arrhythmia may also occur in PPD poisoning. Mainstay of management is early recognition and suppoive measures as there is no specific antidote",Medicine,JIPMER 2017
+052b9f9b-c1bc-4bda-9e26-9c5ef73fc2c3,"Generally, radiotherapy should not be used for treating benign conditions. The only possible exception being:",Chondromyxoid fibroma,Extensive pigmented villonodular synovitis,Benign fibrous histiocytoma,Desmoplastic fibroma so extensive that it cannot be surgically excise,1,multi,"Ans. B. Extensive pigmented villonodular synovitisPVNS is commonly seen around knee. Synovial inflammation occurs due to cholesterol and pigment deposition. Radiotherapy may alleviate this disease. Else one has to go with synovectomy. Malignant transformation is reported but very rare.SYNOVIAL SARCOMA is a soft tissue tumor that does not have synovial origin despite its name. It is a rare but aggressive tumor that arises from tendon sheaths or joint capsules where there are multipotent stem cell rests that differentiate into mesenchymal as well as epithelial structures, hence a BIPHASIC TUMOR. It is characterized by Ctrl (X;18). Excision is the treatment of choice.",Orthopaedics,Bone Tumour
+7792a094-090b-4e50-b6b9-eaa3f8187a7e,Blockade of nerve conduction by a local anaesthetic is characterized by -,Greater potential to block a resting nerve as compared to a stimulated nerve,Need to cross the cell membrane to produce the block,Large myelinated fibers are blocked before small myelinated fibers,Cause consistant change of resting membrane potential,1,multi,"Ans. is 'b' i.e., Need to cross the cell membrane to produce the block Penetration of axonal membrane by L.A. o Local anaesthetics are weak bases and are used in the form of acid salts (usually HCL). o They penetrate the axoplasmic membrane in unionized form (unionize molecules are lipid soluble and diffusible). o Inside axon they becomes ionized and act from inside of Na+ channel. Sodium bicarbonate speeds the onset of action of LAs by increasing the unionized form (weak bases are unionized at alkaline pH). About other option Stimulated fibers are blocked rapidly (not resting fibers) Smaller fibers are more sensitive than larger o LA does not effect resting membrane potential as it does not block the Na+ channel in resting state (see above explanantion). LA inhibits depolarization as it prolonges the inactive state and prolongs the refractory period.",Pharmacology,
+505c7f14-3a1a-4336-a5bd-ffbd362e593e,Presence of spiral grooves in the barrel of weapon is referred to as:,Rifling,Incendiary,Cocking,None of the above,0,multi,"Ans. (A). RiflingShotgunRifled gunCHOKING:* The terminal few cms (7-10) is constricted in shot guns.* Reduces the pelletsdispersionQ* Increases the explosive forces of the pellets.* Increases the velocity of the pellets.RIFLING:* Interior of bore has spiral grooves which run parallel to each other, but twisted spirally from breech to muzzle end.* These grooves are called 'rifling'* Imparts Spinning motion to the bulletQ* Greater power of penetration.* Straight trajectory* Increases accuracy & rangeFully choked shotgun - Least dispersion of pelletsUnchoked shotgun - Maximum dispersionQ of pellets. Paradox gun: A smooth bore gun with small terminal part rifled.Bullets that impart great tissue destruction:Soft nosed bullet that flatten on impactDum Dum bulletBullets that fragment (frangible bullet)Bullets that mushroom on impact",Forensic Medicine,"Law & Medicine, Identification, Autopsy & Burn"
+d1155e80-aa21-442e-bea1-3982ad2f31f4,Duhamel procedure is done for -,Hirschsprung's disease,HPSS,Meckels diverticulum,Volvulus,0,single,"Ans. is 'a' i.e., Hirschsprung's disease * Surgery in Hirschsprung's disease aims to remove the aganglionic segment and 'pull-through' ganglionic bowel to the anus (e.g. Swenson, Duhamel, Soave and transanal procedures) and can be done in a single stage or in several stages after first establishing a proximal stoma in normally innervated bowel.",Surgery,Small & Large Intestine
+6cfa1ab3-bd18-4fd5-9e40-42280bc13424,Post coital test showing non motile sperms in the cervical smear and Motile sperms from the posterior fornix suggests :,Faulty coital practice,Immunological defect,Hypospadias,Azoospermia,0,single,"Ans. is a i.e. Immunological defect Post coital test is a test for evaluation of the potential role of cervical factor in infeility. The couple is advised intercourse close to ovulation time, in the early hours of morning (preferably) The woman presents herself at the clinic within 2 hours after the intercourse. The mucus is aspirated from the cervical canal and posterior fornix (acts as control) and spread over a glass slide. Result : 10-50 motile Sperms with progressive movement/ HPF in cervical mucus seen Cervical factor ruled out Less than 10 sperms / HPF Need for proper semen analysis to see oligospermia Sperms immotile in mucus aspirated from cervical canal and motile in specimen from posterior fornix or Rotatory/ shaky movement seen in sperms aspirated from cervical canal Immunological defect",Gynaecology & Obstetrics,
+69c15d01-7378-40e1-9fda-f7221aba32e4,The current Global strategy for malaria control is called –,Modified plan of operation,Malaria Eradication Programme,Malaria Control Programme,Roll back Malaria,3,multi,,Social & Preventive Medicine,
+b5fdabc9-3c15-4ccd-be8b-89f16e01fb2b,Which of the following is a first-generation Cephalosporin used for surgical prophylaxis?,Ceftriaxone,Cefoxitin,Cefazolin,Cefepime,2,single,"First-Generation Cephalosporins: include - Cefazolin, Cephalexin, Cephradine, Cefadroxil, Cephalothin and Cephapirin Cefazolin is good for skin preparation as it is active against skin infections from S.pyogenes and MRSA. It is administered Intramuscular or Intravenous (i.e Parenteral drug).It is a drug of choice for surgical prophylaxis.Cefazolin does not penetrate the CNS and cannot be used to treat meningitis. Cefazolin is better tolerated than Antistaphylococcal Penicillins, and it has been shown to be effective for serious Staphylococcal infections e.g Bacteremia. Oral First generation drugs may be used for the treatment of urinary tract infections and Staphylococcal or Streptococcal infections, including cellulitis or soft tissue abscess.",Pharmacology,Cell Wall Synthesis Inhibitors
+4e093915-8d90-4a28-9acb-ad4080e82b56,"""Birbeck granules"" are seen in",Melanosomes,Lamellar bodies,Keratohyalin granules,Langerhan cells,3,single,"""Tennis racket"" shaped Birbeck granules are seen in Langerhan cells, which are antigen presenting cells present in epidermis.",Dental,
+71723e91-54e3-4c7c-81d8-270e0a9b0522,"For each extra-articular manifestation of RA, select the most likely diagnosis.Associated with increased frequency of infections.",Felty syndrome,rheumatoid vasculitis,episcleritis,Sjogren syndrome,0,single,"Felty syndrome consists of chronic RA, splenomegaly, and neutropenia. The increased frequency of infections is due to both decreased number and function of neutrophils.",Medicine,Immunology and Rheumatology
+d37c8381-7042-41f1-aa7a-3322147d9acc,Bakers cyst is a type of:,Pulsion diveiculum of knee joint,Retention cyst,Bursitis,Benign tumor,0,single,Baker's cyst:- It is a pulsion diveiculum of knee joint.- It usually found in the posterior aspect of the knee joint.- It is associated with medial meniscal injury.,Orthopaedics,Osteochondritis and Avascular Necrosis
+05be107d-ad86-436a-89d5-f01907d21e37,Most common cranial nerve involved in ophthalmoplegic migraine is:,II nerve,III nerve,V nerve,VI nerve,1,single,Ans. III nerve,Ophthalmology,
+098f380b-b8d4-4cf7-bc50-97402f92e8e0,Position of wrist in cast of colle's fracture is:,Palmar detion & pronation,Palmar detion & supination,Dorsal detion & pronation,Dorsal detion & supination,0,single,A . i.e. Palmar detion & pronation,Surgery,
+f7a51603-5d03-4538-a682-d1a9992ea83f,. Gall stones -,Are about twice as common in men as in women,There is an increased incidence of stones in diabetics,About 80-90% of gall stones are radio-opaque,Are usually more than 50 mm in diameter,1,multi,,Surgery,
+6afce37d-3655-49cd-bc4f-a317e1eef7b2,Dental procedures for which antibiotic of choice for the prophylaxis of endocarditis in adults is (Note: Patient is allergic to penicillin and he is not able to take oral medicine):,Clarithromycin 500mg 1 hr. before dental procedures,Cephalexin 2g 1 hour before dental procedures,Cefadroxil 2g 1 hour before dental procedures,Clindamycin 600 mg. 30 min. before dental procedures,3,multi,,Medicine,
+65284fff-7bd7-4719-bb10-715b75b4b39e,Neonate triangular cord sign on USG is seen in -,Galactosemia,Biliary atresia,Hepatitis,None,1,multi,"Ans. is 'b' i.e., Biliary atresiao Triangular cord sign is seen in biliary ateria due to fibrosis.",Radiology,Abdominal Radiography
+2f5963a7-7bfc-4803-8289-811a3f1ae150,Surgery for elective hemicolectomy for carcinoma colon is described as -,Clean,Clean contaminated,Dirty,Contaminated,1,single,"Ans. is 'b' i.e., Clean contaminated",Surgery,General Management of Wounds
+1e15b4c7-03d7-4ff0-95fe-53c7621cdc4a,Concentration of adrenaline used with lidocaine is?,0.180555556,1.430555556,1:20000,1:200000,3,single,"(334) 1 in 200000 REF: Miller 6th ed p. 589 USES AND DOSES OF ADRENALINE: USE DOSE Anaphylaxis SC or IM injection is 0.3-0.5 mg 1:1,000 Croup Racemic adrenaline is a 1:1 mixture of the dextrototary (d) and levorotatory (1) isomers of adrenaline Local anesthetics 1 in 200000",Anaesthesia,
+f706d5a0-833c-4e31-becf-6727a173e6a7,Patient on treatment on carbidopa + levodopa for 10 yrs now has weaning off effect. What should be added to restore action -,Tolcapone,Amantadine,Rasagiline,Benzhexol,0,single,"Ans. is 'a' i.e., Tolcapone o Both entacapone and tolcapone enhance and prolong the therapeutic effect of levodopa-carbidopa in advanced and fluctuating parkinsons disease. They may be used to smoothen off the 'wearing off', increase 'on' time and decrease loff' time, improve activities of daily living and allow levodopa dose to be reduced,o Treatment of on - off phenomenon in parkinsonism:Add one or two additional doses of levodopa.Continuous delivery of levodopa in duodenum.Avoid proteins in diet.Controlled release oral levodopa.'' peripheral decarboxylase inhibitor.Use of subcutaneous apomorphine.",Pharmacology,Anti-Parkinsonism
+24b6f004-882c-4f5b-a92a-134f6a2a06da,A 33-year-old man has never been vaccinated for hepatitis B. Serologic tests reveal negative hepatitis B surface antigen (HBsAg) and positive antibody to surface antigen. Which of the following conditions does this serologic pattern best fit with?,previous hepatitis B infection,chronic active hepatitis,acute hepatitis B infection,poor prognosis,0,single,"The antibody can be demonstrated in 80-90% of patients, usually late in convalescence, and indicates relative or absolute immunity. In contrast, HBsAg occurs very early and disappears in < 6 months. Persistence of HBsAg indicates chronic infection. The pattern in this patient is also seen postvaccination, and perhaps as a consequence of remote infection.",Medicine,G.I.T.
+59943834-1b81-422a-8fa4-a4097df69354,Which of the following is seen in cystic fibrosis?,Low sweat chloride levels,Elevated sweat chloride levels,Low sweat sodium levels,Elevated sweat potassium levels,1,single,"b. Elevated sweat chloride levels(Ref: Nelson's 20/e p 2100)Because the function of sweat gland duct cells is to absorb rather than secrete chloride, salt is not retrieved from the isotonic primary sweat as it is transported to the skin surface; chloride and sodium levels are consequently elevated. So sweat chloride is usually 60mEq/L in cystic fibrosis.",Pediatrics,Respiratory System
+d01029b5-2e28-45ac-93d7-c1a524cd59e9,All of the following are true for retinopathy of prematurity except:,Occurs in premature infants due to late crying,Due to hypoxia there occurs neovascularization followed by fibroproliferation,End result is bilateral blindness,Blindness can be prevented by early diagnosis and ablation of vascular premature retina with cryotherapy or photocoagulation,0,multi,Ans. Occurs in premature infants due to late crying,Ophthalmology,
+0255b23e-45f6-4f9a-a407-cc8bcbc85cd3,The diagnosis of diabetes mellitus is ceain in which of the following situations?,Abnormal oral glucose tolerance in a 24-yrs-old woman who has been dieting,"Successive fasting plasma glucose concentrations of 8, 9, and 8.5 mmol/L in an asymptomatic, otherwise healthy businesswoman",A serum glucose level >7.8 mmol/L in a woman in her twenty-fifth week of gestation after a 50-g oral glucose load,Persistent asymptomatic glycosuria in a 30-yrs-old woman,1,single,"The occurrence of hyperglycemic ketoacidosis or hyperglycemic hyperosmolar coma is diagnostic of diabetes mellitus. Similarly, persistent fasting hyperglycemia , even if it is asymptomatic, has been recommended by the National Diabetes Data Group as a criterion for the diagnosis of diabetes. However, abnormal glucose tolerance-whether after eating or after a standard ""glucose tolerance test"" -can be caused by many factors (e.g., anxiety, infection or other illness, lack of exercise, or inadequate diet). Similarly, glycosuria may have renal as well as endocrinologic causes. Therefore, these two conditions cannot be considered diagnostic of diabetes. Gestational diabetes is diagnosed in women between the twenty-fouh and twenty-eighth weeks of gestation, first using a 50-g oral glucose load if the I-h glucose level >7.8 mmol/L (140 mg/dL); a 100-g oral glucose test is performed after an overnight fast. Gestational diabetes is initially treated with dietary measures; if the postprandial glucose level remains elevated, insulin therapy is often staed. About 30% of women with gestational diabetes will eventually develop true diabetes mellitus.",Medicine,Endocrinology
+3800f6d3-c5d1-4290-9a23-0b9e0ef1d297,Features of alcohol withdrawl are all EXCEPT: March 2013,Epileptic seizure,Restlessness,Hallucination,Hypersomnolence,3,multi,"Ans. D i.e. Hypersomnolence Alcohol and psychiatry Wernicke's encephalopathy involves: Mammilary bodies Korsakoff's syndrome presents as: - Profound and persistent anterograde amnesia and Confabulation Feature of alcoholic paranoia: Hallucination Questionarrie used: CAGE Alcohol withdrawl: - Visual and tactile hallucination (hangover), - Delirium tremens - MC symptom of alcohol withdrawl; Disorientation, Anxiety, Perceptual defect; Chlordiazepoxide is used for management",Psychiatry,
+36236915-15b5-41b5-88b7-01034c6cb19d,The number of line angles in a permanent maxillary central incisor is,Two,Four,Six,Eight,2,single,,Dental,
+7852f2d4-e399-4a5e-b2e2-ec313fe8a6b0,The opercular poion of the cerebral coex that contains Broca's area is which of the following?,Superior frontal gyrus,Inferior frontal gyrus,Cingulate sulcus,Insula,1,single,"Motor speech area of Broca (Brodmann's area 44, 45) occupies the opercular and triangular poions of the inferior frontal gyrus of the dominant hemisphere. Broca's area is formed of two minor gyri, called pars opercularis and pars triangularis, that lie in the posterior end of the inferior frontal gyrus. This area subserves expressive language function.",Anatomy,
+cb1895a4-53ee-46a4-844c-7acf8cb1a609,Autopsy is known by all names except ?,Obduction,Necropsy,Biopsy,Postmoem examination,2,multi,"Ans. is 'c' i.e., Biopsy An autopsy (also known as a post-moem examination, obduction, necropsy, or autopsia cadaverum) is a highly specialized surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause and manner of death and to evaluate any disease or injury that may be present.",Forensic Medicine,
+00e6c446-8079-46ca-920a-dcd09b7eb9b6,Which of  the following has strongest association with osteosarcoma?,Wilms tumor,Retinoblastoma,Rhabdomyosarcoma,Ewings tumor,1,single,Retinoblastoma and osteosarcoma both can occur due to mutation in common gene i.e RB gene. Hence both have strongest association.,Pathology,
+9447607c-a9e6-47ef-9de6-508baf5481e3,Most useful for sex determination is: Kerala 08,Skull,Femur,Pelvis,Tibia,2,single,Ans. Pelvis,Forensic Medicine,
+596565b9-1e3c-4555-83d6-1fac5f979d26,Features of shock,Decreased GFR,Increased renin,Decreased rennin,Decreased Coisol,0,single,"In early clinical septic shock, renal function was lower, which was accompanied by renal vasoconstriction, a lower renal oxygen delivery, impaired renal oxygenation, and tubular sodium reabsorption at a high oxygen cost compared with controls decrease or decline in the GFR implies progression of underlying kidney disease or the occurrence of a superimposed insult to the kidneys. This is most commonly due to problems such as dehydration and volume loss. An improvement in the GFR may indicate that the kidneys are recovering some of their function Ref Davidson 23rd edition pg 460",Medicine,C.V.S
+6ffb5460-546d-493b-b123-737e6c763586,DOC for listeria meningitis:,Ampicillin,Cefotaxime,Cefotriaxone,Ciprofloxacin,0,single,"Ans. is 'a' i.e., Ampicillin Treatment of listeria infectiono The antibiotic of choice for listeria infection is ampicillin or penicillin G.Antibiotic regimens for listeria infection||||First line regimensPenicillin allergic patientsAlternative drugso Ampicillin or Penicillin is the drug of choiceo Trimethoprim sulphame- thoxazoleo Imipenem and meropenemo Other antibiotic that are less effective# Vancomycin# Erythromycin# Chloramphenicol",Medicine,Bacteriology
+6f281615-4859-4a7a-84a8-07e79c55d4d1,"All of the following statements about neuromuscular blockage produced by succinylcholine are true, except:",No fade on Train of four stimulation,Fade on tetanic stimulation,No post tetanic facilitation,Train of four ratio > 0.4,1,multi,Succinylcholine is a depolarizing neuromuscular blocker. With succinylcholine no fading is observed after train of four or tetanic stimulation. All four stimulatory responses after TOF stimulation are suppressed to the same extent. REF : Smith and atkenhead 10th ed,Anaesthesia,All India exam
+7812f895-581e-4c47-a3c7-23734b04491b,A man is stuck with lathi on the lateral aspect of the head of the fibula. Which of the following can occur as a result of nerve injury,Loss of sensation of lateral foot,Loss of sensation of adjacent sides of 1st & 2nd toe,Inversion inability,Loss of dorsiflexion,3,single,"The common peroneal nerve is extremely vulnerable to injury as it winds around the neck of the fibula if that happens, clinical features are:Motor loss-a)The foot drop is due to paralysis of muscles of anterior compament of the leg (dorsiflexors of the foot) {dorsiflexion not possible}.b)Loss of extension of toes due to the paralysis of extensor digitorum longus & extensor hallucis longus.c)Loss of eversion of the foot due to paralysis of peroneus longus & brevis.Sensory loss- Sensory loss on the anterior aspect of the leg & whole of the dorsum of foot except the cleft between the great & second toes, which is supplied by the branch from the deep peroneal nerve.",Anatomy,Abdomen and pelvis
+cafbb28c-3a0d-436d-85c0-1eded8e44f55,Contraception with increased risk of actinomycosis -,OCPs,Condom,IUCD,Vaginal,2,single,"Ans. is 'c' i.e., IUCD o Actinomycosis may occur by use of IUCD.Side effects and complications of lUDs1. Bleeding - Most common2. Pain - Second major side effect3. Pelvic infection - PID4. Uterine perforation5. Pregnancy6. Ectopic pregnancy7. Expulsion8. Mortality' - extremely rare",Social & Preventive Medicine,Family Planning
+012fcc39-b037-46f3-8a0e-1dfe556a6165,A six year old male baby presents to a hospital with recurrent gross hematuria for 2 years. There is no h/o burning micturition or pyuria. Urine routine examination demonstrated no pus cells and urine culture was sterile. Serum C3 levels were normal. What is the most probable diagnosis-,Wilm's tumour,IgA nephropathy,Post-streptococcal glomerulonephritis,Urinaiy tract infection,0,single,"Wilms tumor is a rare kidney cancer that is highly treatable. Most kids with Wilms tumor survive and go on to live normal, healthy lives. Also known as nephroblastoma, Wilms tumor can affect both kidneys, but usually develops in just one Wilms' Tumor; Nephroblastoma) Wilms tumor is an embryonal cancer of the kidney composed of blastemal, stromal, and epithelial elements. Genetic abnormalities have been implicated in the pathogenesis, but familial inheritance accounts for only 1 to 2% of cases. Diagnosis is by ultrasonography, abdominal CT, or MRI The AMER1 gene is located on the X chromosome (one of the two sex chromosomes), so when Wilms tumor is caused by mutations in this gene, the condition follows an X-linked dominant pattern Ref Harrison20th edition pg 233",Medicine,Kidney
+6d893f23-4404-4711-97df-e266c407ecdc,Diagnosis of carcinoid tumors is done by:,5HIAA,DHEA,DHEA,Metanephrines,0,single,Answer is A (5HIAA): The diagnosis of typical carcinoid tumors is done by measurement of 5HIAA levels. Diagnosis of Carcinoid Tumors (Harrison) The diagnosis of carcinoid syndrome relies on measurement of urinary or plasma serotonin or its metabolites in the urine. Typical carcinoid syndrome (high level of serotonin) is characterized by high levels of 5HIAA. The measurement of 5HIAA is most frequently used for typical carcinoid syndrome. Most physicians' only use urinary 5HIAA levels / excretion rates however plasma and platelets serotonin levels if available provide additional information. Platelet serotonin levels (5-HT) are more sensitive than urinary 5HIAA levels but are not generally available. Atypical carcinoid syndromes (low levels of serotonin) may have normal or minimally elevated 5HIAA levels. In such patient's urinary levels of other tryptophan metabolites such as 5HTP should be measured. Elevated levels of urinary 5 HTP is suggestive of an atypical carcinoid syndrome.,Medicine,
+413efacc-9e54-44e4-b93f-f089da1be4f7,A 6 years child has foreign body in trachea .Best initial management is,Heimlich's maneuver,Cardiac massage,Intubation,Oxygen mask with IPPV,0,single,"Ans. is 'a' i.e.Heimlich's maneuver The best option here is Heimlich's maneuver.""Heimlich man oeuvre: stand behind the person and place your arms around his lower chest and give four abdominal thrusts. The residual air in the lungs may dislodge the foreign body providing some airway. ""Heimlich's maneuveris actually performed for laryngeal foreign bodies and not for tracheal or bronchial foreign bodies.Heimlich's is performed for completed obstruction and should not be tried in partial obstructions (for fear of causing total obstruction )If Hemlocks m fails then cricothyrotomy or emergency tracheostomy is done.Once the emergency is over, foreign body can be removed by direct laryngoscopy or by laryngofissure (if body is impacted )Tracheal & Bronchial foreign bodiesEmergency removal is not indicated in these ( unless there is airway obstruction or they are of vegetable matter eg seeds likely to swell up)Removed by bronchoscopy with full preparation and under GA.Rigid bronchoscope is used.",Unknown,
+8dcc696c-7f89-4cd2-851f-042d34b20d67,Stapes develops from:,1st arch,2nd arch,3rd arch,4th arch,1,single,"Malleus and incus are derived from mesoderm of 1"" arch. Stapes develops from second arch except its footplate and annular ligament which are derived from the otic capsule.",ENT,
+ca6e10af-26f9-4d9e-9da2-1a71873cfa12,Buerger waves (alpha waves) of EEG have the rhythm per sec of -,0-4,7-Apr,13-Aug,13-30,2,single,C i.e. 8-13,Physiology,
+a9f146a8-0c75-4d12-9a71-8851bc43fb95,Type of cataract in chalcosis is,Sunflower cataract,Blue dot Cataract,Snowflake cataract,Polychromatic lustre,0,single,Answer- A. Sunflower cataract,Ophthalmology,
+608c0483-82b4-4cd6-b8bc-d8335d7f4d4a,"Following are more common in multipara women than primipara woman, EXCEPT:",Anemia,Placenta pre,PIH,None of the above,2,multi,"The incidence of preeclampsia in multiparas is variable but is less than that for primiparas. Risk factors associated with pre-eclampsia: Primigravida (young and elderly) Family history (Hypeension, pre-eclampsia, eclampsia) Placental abnormalities Poor placentation Hyperplacentosis Placental ischemia Molar pregnancy Genetic disorder Immunologic phenomenon New paternity Pre-existing vascular or renal disease Thrombophilias Ref: Textbook of Obstetrics by DC Dutta, 6th edition, Page 222.",Gynaecology & Obstetrics,
+33073045-5925-4618-8c87-44951c55fd12,Which category of ICD is associated with schizophrenia,F0,F1,F2,F3,2,single,"ICD ICD mentions International classification of mental and behavioural disorders this was given by WHO( World health Organisation) ICD is used all over the world except America latest edition of ICD is ICD11 ICD 11 was released in 2018 DSM DSM mentions Diagnostic and Statistical manual of mental disorders this was given by APA( American Psychiatric Assosiation) DSM is used in America latest edition of DSM is DSM 5 ICD 11 was released in 2018 categorisation ofmental disorders in ICD 10 is mentioned below F00-F09 Organic, including symptomatic, mental disorders F10-F19 Mental and behavioural disorders due to psychoactive substance use F20-F29 Schizophrenia, schizotypal and delusional disorders F30-F39 Mood disorders ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992",Psychiatry,Symptoms and signs in psychiatry and classification
+a6cc2e3a-7c24-4ec8-bc91-ab000d9c6082,Terminal axillary draining lymph nodes -,Anterior,Posterior,Scapular,Apical,3,single,"Ans. is 'd' i.e., Apical o The apical group of axillary lymph node receives lymph from anterior (pectoral), posterior (subscapular), central and lateral (humeral) group of axillary lymph nodes. Hence apical group of lymph node is the terminal group of axillary lymph node.Axillary lymph nodeRelated vesselsAnterior (pectoral)Along lateral thoracic vesselsPosterior (scapular)Along subscapular vesselsLateralMedial to axillary veinApical (terminal or infraclavicular)Along axillary vessels",Anatomy,"Pectoral Region, Axilla & Brachial Plexus"
+0a3d17ed-547e-4dd0-adc7-deb090827afd,True about gastric acid secretion:,"Secretion ,l,ses with secretin",H2 blockers prevent release,Total acid output indicates parietal cell mass activity,All,3,multi,"A i.e. Secretion decreases with secretin B i.e., H2 blocker prevents relapse C i.e., Total acid output indicates parietal cell mass activity",Physiology,
+4df1c663-2bd4-4f2d-b90c-9d2cb9adaa9f,All of the swelling moves with deglutition except: March 2012,Thyroglossal cyst,Thyroid swelling,Branchial cyst,Tuberculous lymph nodes,2,multi,"Ans: C i.e. Branchial cyst Swellings which are adherent to the larynx and trachea moves on swallowing, e.g. thyroid swelling, thyroglossal cyst & subhyoid bursitis. Tuberculous & malignant lymph nodes when they become fixed to the larynx or trachea will also move on deglutition",Surgery,
+e0a36d91-11cf-4b05-a8e1-33eea89d1412,Shakir's tape is an example of:,Community paicipation,Intersectoral coordination,Equitable distribution,Appropriate technology,3,single,Norms under Appropriate technology: Technology that is scientifically sound. adaptable to local needs. acceptable to those who apply it and those for whom it is used. can be maintained using the locally available resources. - Shakir's tape used to measure mid-arm circumference of child accept all the above norms.,Social & Preventive Medicine,"PH Care, Elements & Principles"
+29ff1468-bf9c-442f-81b9-ab7524e294be,In pyogenic liver abscess commonest route of spread,Hematogenous through poal vein.,Ascending infection through biliary tract,Hepatic aery,Local spread,1,single,"""Along with cryptogenic infections, infections from the biliary tree are presently the most common identifiable cause of the hepatic abscess. Biliary obstruction results in bile stasis, with the potential for subsequent bacterial colonization, infection and ascension into the liver. This process is k/a ascending suppurative cholangitis. The nature of biliary obstruction is mostly related to stone disease or malignancy. In Asia, intrahepatic stones and cholangitis (recurrent pyogenic cholangitis) is a common cause, whereas, in the Western world, malignant obstruction is becoming a more predominant factor"" Ref : Sabiston 18/e p1485",Anatomy,G.I.T
+64168483-ee9b-4e9f-9426-398295d8f02b,Most common cause for acute infantile gastroenteritis is?,Adenovirus,E coli,Norwalk virus,Rota virus,3,single,"ANSWER: (D) Rota virusREF: www.ncbi.nlm.nih.gov, J Clin Microbiol v. 26(12); Dec 1988Though none of the text books specifically mention most common causes of acute infantile gastroenteritis, most of the literature search in pubmed , cochrane and medscape and major text books of pediatrics point to: Viruses are more common causes of gastroenteritits in children. Of the viruses most common is rotavirus.Other viruses implicated are calciviruses, Norwalk, adenovirus.Also E.coli is a major cause of diarrhea in children.Other bacteria are: campylobacterium, yersinia enterocolitica, A. hydrophillia .",Pediatrics,Stomach and Intestines
+b0eb0a2d-7462-46a1-8057-05372c86bc19,Hypotension in acute spinal injury is due to:,Loss of sympathetic tone,Loss of parasympathetic tone,Orthostatic hypotension,Vasovagal attack,0,single,"• High spinal cord injuries can also result in systemic hypotension because of loss of sympathetic tone.
+• The patient will usually have hypotension and relative bradycardia and will show evidence of good peripheral perfusion on physical examination.
+• The term neurogenic shock is used but is somewhat of a misnomer because these patients are typically hyperdynamic, with high cardiac output secondary to loss of sympathetic vascular tone.
+Treatment
+• Hypotension associated with high spinal injury can be treated by alpha-agonist phenylephrine.",Surgery,
+f9a9287d-ef70-41db-8124-854060ffd6f8,What overlies the lateral wall of the mastoid antrum?,Tegmen tympani,Mastoid process,Tympanic plate,Suprameatal triangle,3,multi,"BOUNDARIES: SUPERIORLY-Tegmen tympani and beyond it the temporal lobe of the cerebrum INFERIORLY-Mastoid process containing the mastoid air cells ANTERIORLY-It communicates with the epitympanic recess through the aditus. The aditus is related medially to the ampullae of the superior and lateral semicircular canals. and posterosuperiorly to the facial canal POSTERIORLY-It is separated by a thin plate of bone from the sigmoid sinus. Beyond the sinus, there is the cerebellum MEDIALLY-Petrous temporal bone LATERALLY-It is bounded by pa of the squamous temporal bone. This pa corresponds to the suprameatal triangle seen on the surface of the bone. Ref:BDC VOLUME 3,sixth edition pg 281",Anatomy,Head and neck
+c83df0f3-7835-4cf2-b569-fc5f257872fb,Ferruginous bodies are seen in?,Silicosis,Bysinosis,Asbestosis,Baggassosis,2,single,"Ans. is 'c' i.e., Asbestosis ""Ferruginous bodies are most commonly seen in asbestosis"". ------------Chandrasoma Taylor* Ferruginous bodies represent foreign inorganic or organic fibers coated by complexes of iron and glycoproteins.* While ferruginous bodies are most commonly seen in asbestosis they are not diagnostic because it may be seen in other type of pneunoconiosis.* When asbestos fiber is coated by iron and glycoprotein, this ferruginous body is called asbestos body-characteristic of asbestosis.* Ferruginous bodies are best seen in section that have stained for iron with prussion blue.* Microscopically ferruginous bodies give a Sheikh Kebab appearance.",Pathology,Respiration
+d0da1479-4d71-4bd4-bf7c-04b028f862a0,"65-year-old man presents with anaemia and posterior column dysfunction, the likely cause is -",B1-deficit,B12-deficit,SSPE,Multiple selerosis,1,single,,Medicine,
+f48f441c-aa4e-4633-85ec-23701bb7217f,Which type of cattle poisoning occurs due to ingestion of LINSEED plant?,Aconite,Atropine,Pilocarpine,Hydrocyanic acid,3,single,"Hydrocyanic acid is also used as cattle poison. Cattle poisoning has been known to occur from eating linseed plant because of the natural development of a cyanogenic glycoside which may liberate hydrocyanic acid. Ref: Essentials of Forensic Medicine and Toxicology By Dr K S Narayan Reddy, 27th Edition, Pages 559-60",Forensic Medicine,
+29a74e03-0163-431c-a2e5-084902f25342,"A 40 year old female patient complains of excessive bleeding and drowsiness. Patient gives a history of road traffic accident 5 hours ago and had a lacerated wound on lower back region. General physical examination reveals-
+Blood pressure-80/60mmHg.
+Juglar venous pressure- low.
+Pulsus paradoxus- present.
+Cardiac output- Increased.
+The patient is in which type of shock?",Neurogenic,Obstructive,Distributive,Hypovolemic,2,single,"Includes anaphylactic shock, septic shock and spinal cord injury (neurogenic shock).
+Inadequate organ perfusion is associated with vascular dilatation and hypotension, low systemic vascular resistance, inadequate afterload and a resulting abnormally high cardiac output.
+In anaphylaxis, vasodilatation is due to excess histamine release.
+Neurogenic shock is caused by traumatic or pharmacological blockage of the sympathetic nervous system, producing dilatation of resistance arterioles and capacitance veins, leading to relative hypovolemia and hypotension.
+
+In neurogenic shock, because of loss of vascular tone, JVP will fall.",Pathology,
+4f35d97f-70e7-40c9-befe-f9c759900efd,Which of the following induction agent produce cardiac stability-,Ketamine,Etomidate,Propofol,Midazolam,1,single,"Ans. is 'b' i.e., Etomidate Effects of Etomidate on cardiovascular systemEtomidate has minimal effects on the cardiovascular system.It causes mild reduction in peripheral vascular resistance which may cause a slight decline in arterial blood pressure.Myocardial contractility and cardiac output are usually unchanged. Etomidate does not release histamine. Cardiovascular effect of Propofol:The major cardiovascular effect of propofol is a decrease in arterial blood pressure due to a drop in systemic vascular resistance (inhibition of sympathetic vasoconstrictor activity, cardiac contractility and preload).Propofol markedly impairs the normal arterial baroreflex response to hypotension. Sometimes there may be a marked drop in preload.Cardiovascular effect of barbiturates (Thiopental)The cardiovascular effect of barbiturates vary markedly depending on the volume status, bas line autonomic tone and preexisting cardiovascular disease.Normally, intravenously administered barbiturates cause a fall in blood pressure.Cardiac output is maintained due to increase in heart rate and increased myocardial contractility from compensatory baroreceptor reflexes.However, in the absence of adequate baroreceptor response (e.g., hypovolemia, congestive heart failure, b adrenergic blockade) cardiac output and arterial blood pressure may fall dramatically due to uncompensated pooling and unmasked direct myocardial depression.Effect of ketamine on cardiovascular systemKetamine causes central stimulation of sympathetic system which causes increased arterial blood pressure, heart rate and cardiac output. There is also increase in pulmonary artery pressure and myocardial work.Because of these effects, ketamine should be avoided in patients with coronary artery disease, uncontrolled hypertension, congestive heart failure and arterial aneurysms.",Anaesthesia,Anesthesia for Cardiovascular Disease and Surgery
+0c380894-e01c-4c6a-87f3-2b0068db25d0,Which of the following statement regarding Septic tank is true ?,The minimum capacity of a septic tank should be at least 100 gallons,A capacity of 20-30 gallons or 2 & half to 5 c.ft. per person is recommended for household septic tanks,The length of septic tank is usually equal to its breadth.,There should be a minimum air space of 3 cm between level of liquid in the tank & under-surface of the cover,1,multi,"SEPTIC TANK It is water-tight masonry tank into which household sewage is admitted for treatment. It is satisfactory means of disposing excreta & liquid wastes from individual dwellings, small groups of houses & institutions which have adequate water supplies but do not have access to a public sewerage system. Main design features of septic tank are: - Capacity : Depends on number of users. A capacity of 20-30 gallons or 2 and half to 5 c.ft. / person is recommended for household septic tanks. Minimum capacity of a septic tank= at least 500 gallons. - Length is usually twice the breadth. - Depth = 1.5 to 2 m (5-7 ft.). - Recommended liquid depth = 1.2 m (4 ft.). - There should be a minimum air space of 30 cm (12 in.) b/w level of liquid in tank & undersurface of cover. - There are submerged inlet & outlet pipes. - In some septic tanks, bottom is sloping towards inlet end, facilitating retention of solids as sludge. - Septic tank is covered by a concrete slab of suitable thickness & provided with manhole. - These are designed in this country to allow a retention period of 24 hours. Too long retention period will result in undue septicity of effluent. Too sho period gives insufficient treatment. - Sewage is purified by anaerobic digestion in tank f/b aerobic oxidation outside the tank. - De-sludging should be done atleast once/ year.",Social & Preventive Medicine,Water
+b4857be7-6e12-4aee-8c53-2500b5ba6eed,Following are adverse effects of Clofazimine except,Skin staining,Icthyosis,Diarrhoea,Gastritis,3,multi,"Clofazimine is a brick red, fat-soluble crystalline dye. It has weakly bactericidal action against M. leprae It has an anti-inflammatory effect, which is useful in the management of ENL reactions. High drug concentrations are found in the intestinal mucosa, mesenteric lymph nodes and body fat. The most noticeable side effect is skin discoloration, ranging from red to purple-black The degree of discoloration depending on the dose and amount of leprous infiltration. Urine, sputum and sweat may become pink. Clofazimine also produces a characteristic ichthyosis on the shins and forearms. Gastrointestinal side effects, ranging from mild cramps to diarrhoea and weight loss, may occur as a result of clofazimine crystal deposition in the wall of the small bowel.",Dental,Mycobacterial Infections
+6b4cc7c6-c1bc-4dba-b49c-34a9f1648bca,Osteoblastic secondaries arises from: March 2003,Renal carcinoma,Thyroid carcinoma,GIT carcinoma,Prostate carcinoma,3,single,Ans. D i.e. Prostate carcinoma Metastases to bones are usually osteolytic. Osteoblastic lesions are uncommon.,Surgery,
+c8985d5b-5424-40f6-b3bb-d20b9ac4800d,"A 52 year old male presents to his physician with a chief complaint of a substantial increase in the size of his breasts over the past few months. Three months ago he was diagnosed with hypeension, and placed on antihypeensive medication. Which of the following medications was most likely prescribed?",Captopril,Furosemide,Hydrochlorothiazide,Spironolactone,3,single,"All of the medications listed as answer choices can be effectively used in the treatment of hypeension. Spironolactone is a ""potassium-sparing"" diuretic that exes its action primarily as a competitive inhibitor of aldosterone receptors in the distal nephron. One of the repoed side effects of spironolactone is gynecomastia. None of the other choices have gynecomastia as a side effect. Captopril is an angiotensin-conveing enzyme (ACE) inhibitor that causes a decrease in plasma angiotensin II concentration, resulting in decreased aldosterone secretion. Furosemide is a ""loop diuretic"" that acts by inhibiting the reabsorption of sodium and chloride ions in the loop of Henle as well as in the proximal and distal renal tubules. Hydrochlorothiazide is a ""thiazide diuretic"" that inhibits the reabsorption of sodium and chloride ions in the distal renal tubules. Ref: Snyder P.J. (2011). Chapter 41. Androgens. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.",Pharmacology,
+232a864b-b3d1-4ccb-881b-76a473e59e59,True about treatment of nocturnal enuresis,lmipramine,CPZ,Alprazolam,Haloperidol,0,multi,A i.e. Imipramine,Psychiatry,
+e7748524-13f1-45f7-8fa8-c2ad528570ba,50 year old male with positive family history of prostate cancer has come to you for a screening test. The screening test done to pickup prostate cancer is,DRE,PSA,DRE + PSA,Endorectal coil MRI with T1 and T2 W images,2,single,"Prostate-specific antigen (PSA) and Digital rectal examination (DRE) Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years. Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65). Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).",Surgery,Urology
+d2562808-8c78-4dce-bfeb-7094dc1eaa0d,Refsum's syndrome is associated with ?,Retinitis pigmentosa,Xerophthalmia,Chalcosis,Diabetes retinopathy,0,single,"Ans. is 'a' i.e., Retinitis pigmentosa Associations of retinitis pigmentosa Ocular associations : These include myopia, primary open angle glaucoma, microphthalmos, conical cornea and posterior subcapsular cataract. Systemic associations : These are in the form of following syndromes :- i) Laurence-Moon-Biedl syndrome : It is characterised by retinitis pigmentosa, obesity, hypogenitalism, polydactyly and mental deficiency. ii) Cockayne's syndrome : It comprises retinitis pigmentosa, progressive infantile deafness, dwarfism, mental retardation, nystagmus and ataxia. iii) Refsum's syndrome : It is characterized by retinitis pigmentosa, peripheral neuropathy and cerebellar ataxia. iv) Usher's syndrome : It includes retinitis pigmentosa and labyrinthine deafness. v) Hallgren's syndrome : It comprises retinitis pigmentosa, vestibulo-cerebellar ataxia, congenital deafness and mental deficiency.",Ophthalmology,
+3578797e-4ca6-4e94-ad12-7fba922a06a9,"All are synonyms for PM staining seen in dependant pas of the body during postmoem, except: PGI 13",Cadaveric lividity,Suggilation,Livor mois,Algor mois,3,multi,Ans. Algor mois,Forensic Medicine,
+83241744-1250-4281-a6d8-672591871108,All viruses can be cultured in,Chemically defined media as that used for bacteria,Living systems only,Agar culture,Non living systems also,1,multi,Viruses can be cultivated in living systems only.,Microbiology,
+3e897822-0a45-46b6-87d4-d643aac4b1f0,Bone marrow finding in myelofibrosis-,Dry tap (hypocellular),Megaloblastic cells,Microcytic cells,Thrombocytosis,0,single,"Dry tap is usually defined as a ""failure to obtain bone marrow on attempted marrow aspiration"". The diagnosis and management of many haematological diseases depends on examination of the bone marrow, which involves two separate specimens i.e. a cytologic and a histologic preparation.Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called a trephine biopsy) and bone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, lymphoma, anemia, and pancytopenia. The bone marrow produces the cellular elements of the blood, including platelets, red blood cells and white blood cells. While much information can be gleaned by testing the blood itself (drawn from a vein by phlebotomy), it is sometimes necessary to examine the source of the blood cells in the bone marrow to obtain more information on hematopoiesis; this is the role of bone marrow aspiration and biopsy.",Pathology,General pathology
+06980865-1717-4a36-a03e-eb20a056d899,"40 yr old female presented with breast lump of size 4 cm with involvement of skin and mobile palpable axillary LN, FNAC of lesion showed intrductal carcinoma. What is the initial management of for this pt?",Radiotherapy,Neo-adjuvant chemotherapy,Modified radical mastectomy,Simple mastectomy,1,single,".Locally Advanced Carcinoma of Breast (LABC) * It means locally advanced tumour with muscle/chest wall involvement, extensive skin involvement or fixed axillary nodes. It will be T3, T4a, T4b, T4c or T4d or N2 or N3. * It is investigated by FNAC of tumor, mammography of opposite breast, chest CT, CT abdomen or whole body bone scan. Biopsy is needed to assess receptor status. * Treatment of LACB is always palliative by simple mastectomy, toilet mastectomy, chemotherapy and therapy using tamoxifen. * Initial neoadjuvant chemotherapy; surgery; radiotherapy; adjuvant chemotherapy are other therapeutic plan. ref:SRB&;s manual of surgery,ed 3,pg no 491",Surgery,Endocrinology and breast
+316aa068-c56a-479e-97f8-12700093e966,Pott's spine is commonest at which spine:,Thoracolumbar,Sacral,Cervical,Lumbosacral,0,single,"ANSWER: (A) ThoracolumbarREF: Apley 387-389, S M Tuli 3rd edition page 192Most common site of skeletal tuberculosis is spine followed by hip and knee SPINE (50%) > HIP > KNEECommonest spine involved in spine TB is Thoracolumbar/Dorsolumbar T12-L1 (Lower thoracic to be precise)LOWER THORACIC > LUMBAR > UPPER THORACICParaplegia due to pott s spine most commonly involves upper thoracic vertebrae as in upper thoracic vertebrae there is more acute kyphosis, spinal canal is narrow and spinal cord is relatively large.First symptom of TB spine is ""Pain on movement""Commonest symptom of TB spine is ""Back pain""",Orthopaedics,TB of the Spine
+9d193952-cd22-4aab-a77e-c28dbfa697ea,A patient present with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers inthe sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment -,Intravenous ceftriaxone,Intravenous metronidazole,Intravenous steroids and sulphasalazine,Hydrocoisone enemas,1,single,"This may be caused by haemorrhage from the colon, anal canal or small bowel. It is useful to distinguish those patients who present with profuse, acute bleeding from those who present with chronic or subacute bleeding of lesser severity .Severe acute lower gastrointestinal bleeding .This presents with profuse red or maroon diarrhoea and with shock. Diveicular disease is the most common cause and is often due to erosion of an aery within the mouth of a diveiculum. Bleeding almost always stops spontaneously, but if it does not, the diseased segment of colon should be resected after confirmation of the site by angiography or colonoscopy. Angiodysplasia is a disease of the elderly, in which vascular malformations develop in the proximal colon. Bleeding can be acute and profuse; it usually stops spontaneously but commonly recurs. Diagnosis is often difficult. Colonoscopy may reveal characteristic vascular spots and, in the acute phase, visceral angiography can show bleeding into the intestinal lumen and an abnormal large, draining vein. In some patients, diagnosis is achieved only by laparotomy with on-table colonoscopy. The treatment of choice is endoscopic thermal ablation but resection of the affected bowel may be required if bleeding continues. Bowel ischaemia due to occlusion of the inferior mesenteric aery can present with abdominal colic and rectal bleeding. It should be considered in patients (paicularly the elderly) who have evidence of generalised atherosclerosis. The diagnosis is made at colonoscopy. Resection is required only in the presence of peritonitis. Meckel's diveiculum with ectopic gastric epithelium may ulcerate and erode into a major aery. The diagnosis should be considered in children or adolescents who present with profuse or recurrent lower gastrointestinal bleeding. A Meckel's 99mTc-peechnetate scan is sometimes positive but the diagnosis is commonly made only by laparotomy, at which time the diveiculum is excised Primary prevention of variceal bleeding If non-bleeding varices are identified at endoscopy, b-adrenoceptor antagonist (b-blocker) therapy with propranolol (80-160 mg/day) or nadolol (40-240 mg/day) is effective in reducing poal venous pressure. Administration of these drugs at doses that reduce the hea rate by 25% has been shown to be effective in the primary prevention of variceal bleeding. In patients with cirrhosis, treatment with propranolol reduces variceal bleeding by 47% (number needed to treat for benefit (NNTB) 10), death from bleeding by 45% (NNTB 25) and overall moality by 22% (NNTB 16). The efficacy of b-blockers in primary prevention is similar to that of prophylactic banding, which may also be considered, paicularly in patients who are unable to tolerate or adhere to b-blocker therapy. Carvedilol, a non-cardioselective vasodilating b-blocker, is also effective and may be better tolerated at doses of 6.25-12.5 mg/day). For these, dose should be titrated, as tolerated, to achieve a hea rate of 50-55 beats/min, if possible.metrandazole can be given sigmoidal ulcer Ref Davidson edition23rd pg 869",Medicine,G.I.T
+400e6742-bacc-4a9c-a429-59663de48fe7,"Lalita, a female pt. presents with pigmentation of the lips and oral mucosa and intestinal polyps. Her sister also gives the same history. Most probable diagnosis is -",Carcinoid tumor,Melanoma,Villous adenoma,Peutz-Jegher syndrome,3,single,"Ans. is 'd' ie. Peutz-jeghers syndrome Peutz-Jeghers syndorme consists of: hamaomatous polyps throughout the intestine with maximum density in the jejunum* melanosis of the oral mucous membrane and the lips. The melanosis takes the form of melanin spots sometimes presents on the digits and the perianal skin, but the pigmentation of the lips is the sine quanon.",Surgery,
+4a6c9724-dec1-4fd3-a976-36de2d9f0dd4,Tripod fracture is the name given for -,Zygomatic fracture,Maxillary fracture,Mandibularfracture,Temporal fracture,0,single,"Ans. is 'a1 i.e., Zygomatic fracture o Zygoma fracture is also known as tripoid fracture.Clinical features of zygoma fractureo Considerable swelling over zygomatic arch is common and makes clinical diagnosis more difficult.o Flattening of malar prominence.o Step-deformit of infraorbital margin.o Anaesthesia in the distribution of infraorbital nerve.o Trimus, due to depression of zygoma on the underlying coronoid process.o Oblique palpebral fissure, due to the displacement of lateral palpebral ligament.o Restricted ocular movement, due to entrapment of inferior rectus muscle. It may cause diplopia.o Periorbital emphysema, due to escape of air from the maxillary sinus on nose-blowing.o The mucosa of the maxillary sinus may be lacerated and cause epistaxis on that side.o Fracture of the zygoma may or may not be painful to palpation and running a finger along the zygomatic arch may give a feel of a depressedfracture or a small dimple. The cheek may appear flattened; compared symmetry with the opposite side. This may be obvious immediately following trauma or several days later once swelling has subsided.",ENT,Nose and PNS
+54652668-3927-473e-956b-4150ffae04ed,"A 12-year-old boy reported with a class II and div 1 malocclusion with proclined upper incisor and deep bite. Intraoral examination revealed a bilaterally symmetrical face, convex profile, potentially competent Lips with normal incisor display during rest and smile. Cephalometric finding showed that the patient had a horizontal growth direction with CVMI stage III, increased overjet and normal lower incisor inclination
+
+What would be the appliance of choice for this patient",Twin block,Activator,Bioator,Supermarionator,0,multi,,Dental,
+5e6d06ee-9b1f-4f5d-bebf-5d12e5ffa4d3,"For diagnosis of carcinoma cervix, PAP smear screening is done to",100% Informative,Detects to change into sarcoma,Prevents progress of the disease,Every six months cervical smear in all sexually active women.,2,multi,"C. i.e. (Prevents progress of the disease) (721- Basic pathology 8th)* PAP smear is highly effective screening tool in the detection of cervical dysplasia and carcinoma and has reduced the incidence of cervical carcinoma* Flow cytometry is used routinely in the classification of leukemias and lymphomas* Pap smear is 90- 95% accurate in detecting early lesions such as CIN but is less sensitive in detecting cancer when frankly invasive cancer or fungating masses are present. Inflammation, necrosis and hemorrhage may produce false- positive smears (608 - Harrisons 17th)* Annual cervical smear in all sexually active women (above the age of 18 years) having any risk factors",Pathology,Female Genital Tract
+727a3efd-7dd0-4355-8073-514f975edb01,SLE like reaction is caused by,Hydralazine,Rifampicin,Paracetamol,Furosemide,0,single,SLE like syndrome is caused due to S-SULPHONAMIDES H-HYDRALAZINE I-ISONIAZIDE P-PROCAINAMIDE Ref-KDT 7/e p66,Anatomy,General anatomy
+b505916d-fe21-43b6-b055-a1858a24b218,Platelet transfusion is not indicated in -,Dilutional Thrombocytopenia,Immunogenic Thrombocytopenia,Aplastic Anemia,DIC,1,single,,Medicine,
+e1cf7219-d88d-46d2-b1bb-5b1ee155fa99,The drug of choice in digitalis induced ventricular arrhythmias is:,I.V. Lignocaine,Phenytoin,Quinidine,Procainamide,0,single,(IV Lignocaine): Ref: 463-KDT (514-KDT 6th)Treatment of digitalis induced ventricular arrhythmias* Lignocaine IV repeated as required is the drug of choice. It suppresses the excessive automaticity but does not accentuate A V block* Phenytoin is also useful but not preffered now (sudden death occurs)* Quinidine and procainamide are contraindicated.,Pharmacology,C.V.S
+f564a8d3-b368-483a-b152-5282c616089e,Deformity in transient synovitis of Hip ?,Abduction,Flexion,External rotation,All of the above,3,multi,"Ans. is 'd' i.e., All of the above Transient synovitis of Hip Transient synovitis of hip is also known as observation hip, toxic synovitis or irritable hip. Its a self-limiting, inflammatory condition of the synovium, that lasts only a sho time (therefore known as transient) It is the most common cause of hip pain and limp in children under 10 yrs of age. Cause is not known but association has been seen with a recent history of an upper respiratory tract infection. Presentation is with hip pain or limp. The limb is in attitude of slight flexion, abduction and external rotation. The child may have low grade fever. The ESR, C-Reactive protein & WBCs count are normal (This differentiates Transient synovitis from Septic ahiritis a serious condition, in which patient has high grade fever and elevated ESR, C-Reactive protein and WBC count). Radiograph or ultrasound may show widening of the joint space However, most of the time x-ray is normal. Usually the treatment of a clinically suspected case of transient synovitis of hip is Bed rest, NSAIDS and observation. USG guided aspiration is indicated for :- Temperature > 99.5deg F ESR > 20 (Raised ESR) Severe hip pain with ROM",Surgery,