Goodnight7/full_MedC-K · Datasets at Hugging Face

question stringlengths 1 1.57k	exp stringlengths 1 22.5k ⌀	subject_name stringclasses 21 values	topic_name stringlengths 3 135 ⌀	answer stringlengths 1 287 ⌀
Which of the following play most impoant role in memory:	Ans: a. Synaptic Net.Synaptic network s single best answer "Long-term memory involves changes in the structure of neurons including growth of new processes and synapses.So, to the extent that you remember anything about this material on memory tomorrow, or next week, or next year, it will be because structural changes in synapses are beginning in your brains.	Physiology	null	Synaptic network
Which of the following is false regarding transfusion associated anaphylactic reactions?	Ref: Aled scape/ Transfusion reactionsExplanation:Allergic transfusion reactions occur on a continuum of severity ranging from mild (urticarial) to moderate (anaphylactoid) to severe (anaphylactic). Anaphylactic transfusion reactions are severe allergic reactions characterized by profound hypotension and shock.Causes of anaphylaxis include:Recipient IgE or IgG antibodies to IgA in patients who have complete or partial (i.e., lack an isotopic or allotypic) IgA determinantRecipient IgE or IgG antibodies to polymorphic forms of other serum proteins (IgG. haptoglobin. C4, etc.) in transfused donor bloodRecipient sensitization to various compounds, including drugs in donor blood, chemicals used to produce or sterilize IV tubing and plastic bags, and foodstuffsCoincidental reaction to drugs or food taken prior to transfusionIg A deficiencyIn patients with IgA deficiency --Anti-IgA antibodies may develop after exposure to IgA in transfusions: anaphylactic reactions to IV immune globulin (IVIG) and other blood products that contain IgA may occur.Washed blood product can reduce the incidence of Anaphylaxis	Medicine	Transfusion	Seen in IgG deficient individuals
Hepatitis E usually affects ?	Ans. is `b' i.e., Adults	Microbiology	null	Adults
Subdural empyema is most commonly caused by:	Answer is C (Streptococcus pneumoniae): Aerobic and Anaerobic streptococci are the most common aetiological agents for subdural ernphyema. influenzae is the most common causative organism in Children, and not in Adults. Subdural Empyema is a collection of pus in the space between he dura and arachnoid. In most cases a single organism is responsible, but many cultures are sterile because patients are often receiving antimicrobial therapy. The major pathogens include Aerobic and anaerobic Streptococci (about 50%) Staph (about 12-16%) Aerobic gram -ye bacilli (3-10%) Other anaerobes (5%)	Medicine	null	Streptococcus pneumoniae
What is Cock's Peculiar tumour -	Ans. is 'a' i.e., Ulceration of sebaceous cyst on the scalp o Cocks peculiar tumour is actually a complication of sebaceous cyst -# When the sebaceous cyst of the scalp ulcerates excessive granulation tissue forms resembling fungating epithelioma. This is called cock's peculiar tumour.Also know these terms -o Cylindroma -# A malignant epithelial tumour also k/a Turban tumor# Known as cylindroma because of histological appearanceo Pilomatrixoma (Calcifying epithelioma of Malherbe)# It is a benign hair follicle derived tumouro Pott's puffy tumour# It is osteomyelitis of the skull associated with subperiosteal swelling and edema.	Surgery	Plastic & Reconstructive Surgery	Ulceration of sebaceous cyst on the scalp
Which of the following is not found in commercially available tooth paste?	null	Dental	null	astringent
A bactericidal drug would be preferred over a bacteriostatic drug in a patient with	Bactericidal drugs kill the bacteria whereas bacteriostatic drugs only inhibits bacterial growth. Bacteriostatic activity is adequate for the treatment of most infections ,bactericidal activity nay be necessary for cure in patients with altered immune system like neutropenia ,HIV and other immunosuppressive conditions Refer KDT 6/e p686	Pharmacology	Chemotherapy	Neutropenia
Mechanism which is responsible for gentamicin ototoxicity is:	Ototoxicity involves progressive and irreversible damage to, and eventually destruction of, the sensory cells in the cochlea and vestibular organ of the ear.	Pharmacology	null	Direct hair cell toxicity.
Non-dominant hemisphere does all of the following function, except	(A) Parallel thinking # Hemispheres Versus "Cerebral Dominance":> Hemisphere is concerned with categorization and symbolization and has often been called the dominant hemisphere.> However, it is dear that the other hemisphere is not simply less developed or "non dominant"; instead, it is specialized in the area of spatiotemporal relations.> It is this hemisphere that is concerned, for example, with the identification of objects by their form and the recognition of musical themes. It also plays a primary role in the recognition of faces.> Consequently, the concept of "cerebral dominance" and a dominant and non-dominant hemisphere has been replaced by a concept of complementary specialization of the hemispheres, one for sequential-analytic process (Categorical hemisphere) and one for visuospatial relations (the representational hemisphere).> Categorical hemisphere is concerned with language functions, but hemispheric specialization is also present in monkeys, so it antedates the evolution of languages	Physiology	Nervous System	Parallel thinking
What about durham pin is true ?	Ans. is 'd' i.e., All the above Denham pin It is a type of pin used to give skeletal traction. Threaded poion of the pin engages the bony coices and reduces the chances of pin sliding. This type of pin is used commonly to give skeletal traction through the cancellous bone i.e. calcaneum. It can also be used to give traction through osteoporotic bones.	Surgery	null	All the above
Nerve roots involved in klumpke's paralysis is:	Klumpke's Paralysis is due to injury of the lower trunk of branchial plexus. It involves mainly the T1 nerve root and paly C8 nerve root. All the small muscles of the hand are paralysed. Claw hand, horner syndrome and loss of sensation on the medial aspect of the arm are the common disabilities. Ref: B D Chaurasia's Human Anatomy: Volume 1, Page 52.	Anatomy	null	C8, T1
A 2-year-old child develops acute respiratory distress. 0/E breath sounds are decreased with wheeze on right side. Chest X-ray shows diffuse opacity on right side--Most probable diagnosis:	Foreign body aspiration is a very common problem in pediatric age group (< 4 years). In the question, child is presenting with sudden onset respiratory distress and there is U/L decreased breath sounds + U/L wheezing and on chest X-ray a diffuse opacity is seen on right side i.e. there is clinical and radiological evidence of bronchospasm and collapse suggestive of a foreign body in bronchus	ENT	null	Foreign body aspiration
Minimal reabsorption in kidney occurs for	Minimal reabsorption for ureaRef: Ganong&;s review of medical physiology; 24th edition; page no; 682, 681	Physiology	Renal physiology	Urea
Pathology in Marfan syndrome ?	Ans. is 'a' i.e., Fibrillin I o Marfan syndrome is an autosomal dominant disorder due to mutation in fibrillin-1 gene on chromosomal 15.Fibrillin-1 is a part of elastic fibres, thus defect in fibrillin-1 affects following systems:-1) Skeletal abnormalities: Tall with thin built; arachnodactyly (long and slender fingers and hand, spider like); decrease in upper segment: Lower segment body ratio (i.e. lower limbs are proportionately more lengthened); scoliosis and kyphosis; pectus excavatum and pectus craniatum; Hypermobility (laxity) of joint with hyperextensibly; high arched palate and dolicocephalic skull.2) CVS abnormalities : Mitral valve prolapse causing mitral regurgitation; aortic aneurysm begning at base of aorta and involving ascending aorta; cystic medial necrosis causing dissection of aorta (most common cause of death).3) Ocular abnormalities: Ectopia lends (with bilateral superolateral lens dislocation), elongated eyeball.4) Others: Spontaneous pneumothorax ; inguinal and incisional hernias.	Pathology	Cytogenetic Disorders	Fibrillin I
Atropine causes:	Ans: b (Tachycardia) Ref: KDT, 6th ed, p. 107The most prominent action of atropine on heart is tachycardia due to the blockade of M receptors on the S A node through which vagal tone decreases heart rate.Other effects of atropine are:CNS: Overall stimulant action,rise in body temperature due to action on hypothalamusCVS: Tachycardia, no marked effect on BPGIT: Decreases intestinal motility by GI smooth muscle relaxationRESP: Bronchodilatation and reduced airway resistanceURINARY: Relaxes bladder and causes urinary retentionEYE: Local anesthetic action on cornea. Mydriasis, Cycloplegia, Abolition of light refelexGLANDS: Decreases lacrimation, Sweating, Salivation by M blockade	Pharmacology	A.N.S.	Tachycardia
A biopsy of the antrum of the stomach of an adult who presents with epigastric pain reveals numerous lymphocytes and plasma cells within the lamina propria, which is of normal thickness. There are also scattered neutrophils within the glandular epithelial cells. A Steiner silver stain from this specimen is positive for a small, curved organism, which is consistent with	Chronic gastritis is histologically characterized by the presence of lymphocytes and plasma cells. It is impoant to realize that the presence of neutrophils within the glandular epithelium indicates active inflammation and may be the main type of inflammation present (acute gastritis), or may be combined with more numerous chronic inflammations (active chronic gastritis). Chronic gastritis is divided into subgroups based either on etiology (immunologic or infectious), location (antrum or body), histopathology, or clinical features. H. pylori gastritis is associated with infection by H. pylori, a small, curved, gram-negative rod that is found in approximately 20% of the general population. The organisms are found in the mucus overlying the surface/foveolar epithelium. These changes tend to affect primarily the antral or antral-body-fundic mucosa. This is the type of gastritis normally associated with active chronic gastritis. The therapy for Helicobacter is either triple therapy (metronidazole, bismuth salicylate, and either amoxicillin or tetracycline) or double therapy (omeprazole and clarithromycin). In contrast, autoimmune gastritis, also known as diffuse corporal atrophic gastritis or type A atrophic gastritis, is characterized by the presence of autoimmune antibodies including parietal cell antibodies and intrinsic factor antibodies. This type of gastritis is associated with pernicious anemia and achlorhydria. Pernicious anemia is the result of decreased intrinsic factor, which in turn produces a vitamin B12 deficiency. This vitamin deficiency causes megaloblastic anemia and subacute combined disease of the spinal cord. Histologically there is diffuse atrophy (reduced mucosal thickness), gland loss, widespread intestinal metaplasia, and variable chronic and acute inflammation. These changes are found predominately in the body-fundus mucosa (usually absent in the antrum). There is an increased risk for gastric cancer, but these patients do not develop peptic ulcers. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition	Pathology	miscellaneous	Helicobacter pylori
During moderately intense isotonic exercise all of the following increase except:	In mild-to-moderate exercise: There is increase in sympathetic drive. This results in an increase in stroke volume and hea rate, resulting in an increase in cardiac output; increased respiratory drive; dilation of vessels in the active muscles. This is due to a "muscle chemoreflex" because of metabolites from muscles e.g. K+, adenosine, NO. Diastolic BP (indicator of total peripheral resistance) either remains unchanged or decreases to some extent. The mean aerial pressure increases. Increase in ventilatory ratethat matches the increase in O2consumption and CO2production by the body. The stimulus for increased ventilation rate is due toactivation of joint proprioceptors at the beginning of the exercise.	Physiology	Circulation	Total Peripheral resistance
A 62-year-old woman eats a high carbohydrate meal. Her plasma glucose concentration rises, and this results in increased insulin secretion from the pancreatic islet cells. The insulin response is an example of	Negative feedback mechanisms ensure a proper level of hormone activity at the target tissue. After a stimulus (plasma glucose) causes a release of the hormone (insulin), conditions or products resulting from the action of the hormone (decrease sugar) tend to suppress its fuher release. In other words, the hormone (or one of its products) has a negative feedback effect to prevent oversecretion of the hormone or overactivity at thetarget tissueThe increase in plasma insulin lowers the plasma glucose concentration which in turn results in decreased insulin secretion	Physiology	General physiology	Negative feedback
Killing of a 6 months old child by parents is known as ?	Ans. is 'b' i.e., Infanticide Infanticide refers to killing a child after delivery, to till 1 year after bih. Infanticide in India is considered equivalent tomurder and is tried under section 302 IPC. Law considers every child as born dead and therefore in a case of infanticide,it has to be proved that the child was born alive and was then killed. Thus the first question in the investigation of a case of infanticide is, whether the child was still born or dead born or whether it was born live.	Forensic Medicine	null	Infanticide
Painful arc syndrome which movement is painful:-	* Painful arc syndrome is subacute tendinitis of the rotator cuff tendons due to vascular congestion.* Treatment is usually rest +physiotherapy + NSAIDS. If not treated, local steroids and surgery can be done.* Pain is aggravated as arm transverses an arc between 60 and 120 degrees.	Orthopaedics	NEET 2019	Mid abduction
Most common cause of stridor in children is:	(Laryngomalacia) (272-D)Laryngomalacia - (congenital laryngeal stridor)* It is the most common condition causing an inspiratory stridor at or shortly after birth.* It may persist throughout infancy & disappears by 2 years of age* Stridor increased on crying but subsides on placing the child in prone position, cry is normal.* Foreign bodies in the larynx are uncommon because they are either coughed out or causes fatal obstruction within a few minutes. If helps is not to hand.	ENT	Larynx	Laryngomalacia
Retinoblastoma can occur bilaterally in how many percentage of the cases?	25-30% bilateral involvement . Seen in childrens between 1-2 yrs of age. Ref : ak khurana 6th edition	Ophthalmology	Tumors	25-30%
Education criteria for mental retardation is ?	Ans. is 'a' i.e., Mild	Social & Preventive Medicine	null	Mild
Which of the following is naturally occurring tertiary amine and lipid-soluble reversible anticholinesterases:	All other reversible anticholinesterases are synthetic quaternary compounds and are lipid insoluble.	Pharmacology	null	Physostigmine.
Funicular hernia is type of:	Types of Indirect Inguinal Hernia - 1. Bubonocele - Hernia is limited to the inguinal canal 2. Funicular - Processus vaginalis is closed just above epididymis. Contents of the sac can be felt separately from testis, which lies below the hernia. 3. Complete or scrotal - Testis appears to lie within the lower pa of hernia.	Surgery	Hernia and abdominal wall	Indirect inguinal hernia
Not true about amoebic liver abscess	Larval forms of E.histolytica are not seen in the abscess	Anatomy	G.I.T	Larvae are seen
Translocation seen in Follicular lymphoma	MalignancyTranslocationAcute myeloid leukemia (AML)(8;21)(q22;q22)(15;17)(q22;q21)Chronic myelogenous leukemia (CML)(9;22)(q34;q11)Burkitt lymphoma(8;14)(q24;q32)Mantle cell lymphoma(11;14)(q13;q32)Follicular lymphoma(14;18)(q32;q21)Ewing sarcoma(11;22)(q24;q12)Prostatic adenocarcinoma(7:21)(p22;q22)(17:21)(p21;q22)Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 7; Neoplasia; Page no:317; Table: 7-8	Pathology	General pathology	14;18
Most common cause of Bronchiolitis is ?	<a href=" syncytial virus (RSV)</a> is the most common cause of bronchiolitis. Sometimes, the common also can cause it. Bronchiolitis is one of the common serious acute lower respiratory tract infection in infants. Affected infants are between ages of 1 and 6 months but the disease can affect children upto 2 years old.Disease usually occur in winter and spring .Respiratory syncytial virus is implicated in most cases.other causative agents include parainfluenza virus,influenza virus,adeno virus,Mycoplasma. protection against RSV is mediated by antibodies of IgG3 subclass. Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:356,7th edition	Pediatrics	Respiratory system	RSV
Cholinomimetics are useful in all of the following conditions EXCEPT	cholinomimetics use- 1.as miotic- in glaucoma/to reverse the effect of mydriatics after refraction testing/to prevent adhesions between lens and iris or cornea 2.in myasthenia gravis 3.in postoperative paralytic ileus 4.post operative decurarization 5.in cobra bite 6.in belladonna poisoning 8.in Alzheimer's disease REF: ESSENTIALS OF MEDICAL PHARMACOLOGY: KD TRIPATHI:7TH EDITION; PAGE NO 109	Pharmacology	Autacoids	Paial hea block
Gene mutations in Cystic fibrosis occurs at -	In cystic fibrosis, CFTR gene mutation occurs on the long arm of chromosome 7 Reference: Ghai essential pediatrics, 9 th edition, page 392	Medicine	Genetics	Long arm of chromosome 7
Paget's disease of the breast, true is	Pagets disease of nipple is a superficial manifestation of intraductal carcinoma.It mimics eczema of nipple and areola. There is a hard lump just beneath the areola which later ulcerates and cause destruction of nipple.. Its unilateral condition ,seen in menopausal women not associated with itching.	Surgery	null	Intraductal carcinoma
Ketamine is useful as an anesthetic agent in-	(Refer: Morgan and Mikhail’s Clinical Anaesthesiology, 5th edition, pg no. 182 – 184) Ketamine is a potent bronchodilator and relieves bronchospasm →Intravenous anaesthetic agent of choice in asthmatic Ketamine increases ICT, IOP and cardiac oxygen demand, therefore contraindicated in other three conditions Note-Inhalation anaesthetic agent of choice in asthmatics is halothane.	Unknown	null	Intracranial hemorrhage
What is true about Meniere&;s disease	Electrocochleography shows changes diagnostic of Meniere's disease. Normally the ratio of summating potential to action potential is 30%. In Meniere's disease, this ratio is greater than 30%. Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 7th Edition; page no.113	ENT	Ear	Electrocochleography is the gold standard for diagnosis
Which of the following is antitubercular drugs bus assoasiated with hypothyroidism	Refer KDT 7th/771 Ethionamide PAS They are two antitubercular drugs assoasiated with hypothyroidism and goitre	Pharmacology	Chemotherapy	Ethionamide
Commonest presentation of primary biliary cirrhosis?	Ans is 'a' i.e., Pruritus Harrison writes "Most patients with Primary biliary cirrhosis are asymptomatic, and the disease is initially detected on the basis of elevated serum alkaline phosphatase levels during routine screening. Often the earliest symptom is pruritus, which may be either generalized or limited initially to the palms and soles. In addition fatigue is commonly a prominent early symptom. After several months or years, jaundice and gradual darkening of the exposed areas of the skin (melanosis) may ensue."	Surgery	null	Pruritis
What is the recommended isolation period of Hepatitis A from the initial onset of symptoms?	Isolation period of Hepatitis A is first 14 days of illness and for at least 7 days after jaundice show up. Incubation period of Hepatitis A is 10-50 days, commonly about 30-35 days.	Social & Preventive Medicine	null	2 weeks
Which of the following contraceptives provides complete protection against sexually transmitted disease: March 2013 (b, g)	Ans. B i.e. Barrier method Barrier methods They block sperm from entering the uterus. The following are barrier methods of contraception: - Condom - Female condom - Cervical cap (including Lea's Shield) - Diaphragm The male (and female) condom provides excellent protection against sexually transmitted infections.	Social & Preventive Medicine	null	Barrier method
True about conn&;s syndrome-	Ans is option 2 and 3 Decrease K+ and proximal myopathy In Conn&;s disease Proximal myopathy occurs due to hypokalemia. Hypokalemia causes alteration of electrical excitability of nerve and muscle fibre membranes, which prevents transmission of normal action potential, leading to severe muscle weakness. Ref Harrison 17/e p 2260,2261,2253	Medicine	Endocrinology	Decreased K+
Culture mediam for corynebacterium diphtheria?	Ans. is 'a' i.e., Loefflers serum slope	Microbiology	null	Loefflers serum slope
Fetal growth restriction is defined as estimated fetal weight is below the ------ for their Gestational age	IUGR is replaced by fetal growth restriction, which was designed to identify fetuses with estimated weight below the 10th percentile for their gestational ages.Reference: Practical guide to High-risk pregnancy and delivery; Chapter 4; Fetal growth restriction	Gynaecology & Obstetrics	General obstetrics	10th percentile
Sporulation is seen in which phase of bacterial growth phase?	Ref: Ananthanarayan, 8thed. pg. 24Features of Stationary Phase1. Viable count of cells remain stationary as an equilibrium exists between dying cells and newly formed cells2. Cells are viable and show irregular staining due to intracellular storage granules3. Sporulation occurs at this stage4. Production of antibiotics and exotoxins is also seen at this stage.	Microbiology	General	Stationary phase
One of the following is the most specific cardiac anomaly of a newborn to a diabetic mother:	Congenital malformation in fetus of a diabetic mother : * M/C system involved in congenital malformation CVS > CNS * Most specific structural anomaly seen - caudal regression syndrome ( sacral agenesis ) * Most specific cardiac anomaly seen in babes of diabetic mother - TGV	Gynaecology & Obstetrics	Gestational Diabetes Mellitus	Transposition of great vessels
Neuronal degeneration is seen in all of the following except	Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery. This condition is typically caused by a blunt neural injury due to external blows or shock-like injuries to muscle fibers and skeletal nerve fibers, which leads to repeated or prolonged pressure buildup on the nerve. Ref: guyton and hall textbook of medical physiology 12 edition page number:74,75	Physiology	Nervous system	Neuropraxia
Which among the following is the best diagnostic method for finding out ovulation?	The finding of secretory endometrium confirms ovulation. The use of an endometrial biopsy (EMB) near the end of the luteal phase can provide reassurance of an adequate maturational effect on the endometrial lining. Within 48 hours of ovulation, the cervical mucus changes under the influence of progesterone to become thick, tacky, and cellular, with loss of the crystalline fernlike pattern on drying. Ref: Ghadir S., Ambasumyan G., DeCherney A.H. (2013). Chapter 53. Infeility. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.	Gynaecology & Obstetrics	null	Endometrial biopsy
1st urge at micturition comes at -	Ans. is 'c' i.e., 150 ml "First urge to void is felt at a bladder volume of about 150 ml, and a marked seme offullness at about 400 ml".- Ganong	Physiology	Bladder and Micturition Physiology	150 ml
During physical examination of a patient with history of TIA, it is found that the ankle jerk reflex is absent. Which of the following nerves is responsible for the reflex arc?,	The ankle jerk reflex, elicited by tapping the tendo Achilles with the reflex hammer, is mediated by Tibial nerve. The superficial fibular (peroneal) nerve supplies the foot eveor muscles of the lateral compament of the leg and provides sensory supply for the dorsum of the foot. The deep fibular (peroneal) nerve innervates the foot extensor and inveor muscles in the anterior compament of the leg and supplies skin between the first and second toes. The common fibular (peroneal) nerve combines the functions of the superficial and deep branches.	Anatomy	Nerve supply of Lower Limb	Tibial
Which of the following is the predominant immunoglobulin isotype secreted in the human MALT?	Ans. (d)The vast majority of the antibody generated in the human MALT (Mucosal Associated Lymphoid Tissues) is of the IgA isotype. IgE, IgG and IgM are present, but at far lower levels, and IgD is essentially absent.	Microbiology	Immunology	IgE
Abdominal Aorta Bifurcates at the level of	Abdominal Aorta Bifurcates at the Lower border of L4	Anatomy	null	Lower border of L4
For post-exposure prophylaxis, dose of human rabies immunoglobulin is:	Human rabies immune globulin (HRIG): 20 IU/kg, maximum injected locally, rest IM in gluteal region. It is indicated in only in category III bites. Equine rabies immunoglobulin (ERIG)- It is given at dose of 40 IU/kg . Being heterologous in origin (horse), it is associated with serum sickness; hence not in use.	Microbiology	Virology Pa-2 (RNA Virus Pa-1,2 & Miscellaneous Viruses)	20 IU/kg
PARULIS is an inflammatory enlargement seen in	null	Pathology	null	End of sinus tract
Prader willi syndrome and Angel man syndrome are examples of	Genomic imprinting is a proces of epigenetic modification of nucleotides in which only one allele of specific gene is functioning, while the other allele is silenced based on the parent of origin.	Biochemistry	null	Genomic Imprinting
Which pa of the ear has origin from all the three layers of germ layer:	The eardrum forms from the joining of the expanding first pharyngeal pouch and groove.Around day 30 of gestation, the endoderm-lined first expands to form the tympanic cavity, which subsequently envelops the inner ear ossicles.Simultaneously, the first pharyngeal groove, which is lined with ectoderm, expands to form the developing external auditory meatus.Separated by a thin layer of splanchnic mesoderm, the tympanic cavity and external auditory meatus join to form the tympanic membrane.As a result, the tympanic membrane is derived from all three germ layers.	Anatomy	null	Tympanic membrane
Consider the following 1* Malnutrition deficiency 2. Lithostatin (pancreatic stone protein 3. Cassava tuber Oxidant stress (heightened cytochrome P-450 activity) Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ?	Calcification, which is another sign of chronic inflammation, can develop throughout the pancreas. These calcifications are like stones that are within the tissue itself, or within the pancreatic duct Ref Davidson 23rd edition pg 765	Medicine	Miscellaneous	1, 2 and 3 only
A diagnosed case of psoriasis, taking MTX since last 15 yrs presents with jaundice and abnormal LFT. So, what will be the course of management:	Methotrexate is hepatotoxic drug- Therefore, abnormal liver function test & jaundice (in history)- Next step- stop Mtx- Therefore, B is ruled out 3 systemic drugs used in psoriasis1. Mtx (Teratogenic, hepatotoxic)2. Cyclosporine (nephrotoxic)-3H( HTN, Hyperiglyceridemia , Hyperichosis)3. Acitretin- teratogenic, dyslipidemia. In psoriasis systemic steroids are C/I Dapsone have no role.	Dental	Psoriasis	Stop Mtx, sta cyclosporine
In human dioploid cells rabies vaccine the schedule of immunisation is -	null	Social & Preventive Medicine	null	0,3,7,14,30,90
A 35 year old is given excessive intravenous Benzodiazepine.She suddenly becomes agitated, combative, and exhibits involuntary movements. The anesthesiologist determines that she is having a reaction to the drug which has been given in excess. Next step would be adminstration of:	Flumazenil	Pharmacology	null	Flumazenil
Malignant pustule is seen in -	Ans. is 'a' i.e., Cutaneous anthrax [Ref: Anantnarayan 8/ep 245\Anthrax is primarily a disease of the domestic animals.Humans are usually accidental hosts when brought into contact with infected animalsThe most common form of anthrax is cutaneous anthrax which is usually occurred via injured skin or musous membraneCutaneous anthraxCutaneous anthrax usually begins 2-5 days after inoculation of spores into an exposed part of the body typically the forearm or the hand.The initial lesion is an erythematous papule which may be mistaken for insect bite. This papule usually progresses through vesicular and ulcerative stages in 7-10 days to form a black eschar surrounded by edema The lesion is known as "malignant pustule" although it is neither malignant nor pustule. Associated symptoms are usually mild and the lesion typically heals very slowly after the eschar separates.Cutaneous anthrax generally resolves spontaneously but 10-20% of untreated patients may develop septicemia.Cutaneous anthrax generally resolves spontaneously but 10-20% of untreated patients may develop fatal septicemia or meningitis.	Microbiology	Bacteria	Cutaneous anthrax
A 35 year old captain in the army has been plagued by a painful, erosive lesion near his ear lobe since his return from operation dese storm several years ago. Punch biopsy of the leading edge of the erosion reveals macrophages distended with oval amastigotes. How was this infection acquired?	This is the history of cutaneous leishmaniasis caused by the L. tropica or L. major. The vector is sandfly (Phlebotomus sergenti or P.papatasii). This disease is also called as Delhi boil, Baghdad boil and oriental sore. Most cases of cutaneous leishmaniasis are seen in Afghanistan, Brazil, Iran, Iraq, Peru, and Saudi Arabia.	Microbiology	Parasitology Pa 1 (Protozoology)	Bite of sandfly
Polysaccharide capsular resistance to phagocytosis is seen in	The virulence of Streptococcus pneumoniae depends on the capsular polysaccharide. The capsular polysaccharide because of its acidic and hydrophilic propeies, protects the cocci from phagocytosis. Capsulated streptococcus pneumoniae are not phagocytosed efficiently in fluid media or exudates, however, they are susceptible to surface phagocytosis, being engulfed against a firm surface, such as a fibrin clot or epithelium. The enhanced virulence of type 3 Streptococcus pneumoniae is due to an abundance of its capsular material. Non-capsulated strains are avirulent. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 226	Microbiology	Bacteriology	Streptococcus pneumoniae
All of the following causes death in coarctation of Aorta except –	The causes of mortality in co-arctation of aorta are : Hypertension o Aortic dissection o Premature atherosclerosis Rupture of aorta o Left ventricular failure o Infective endocarditis Cerebral haemorrhage (due to aneurysm rupture)	Pediatrics	null	Anterior MI
Tensors of vocal cord are	Intrinsic muscles acting on vocal cords: Abductors: Posterior cricoarytenoid Adductors: Lateral cricoarytenoid, lnterarytenoid (transverse arytenoid) Thyroarytenoid (external pa) Tensors: Cricothyroid, Vocalis (internal pa of thyroarytenoid) Intrinsic muscles acting on laryngeal inlet: Openers of laryngeal inlet: Thyroepiglottic (pa of thyroarytenoid) Closers of laryingeal inlet: Interarytenoid (oblique pa), Aryepiglottic (posterior oblique pa of interarytenoids)	ENT	null	Cricothyroid and internal thyroarytenoid
All of the following are useful in the intravenous therapy for hypertensive emergencies except	Ans. (D) Nifedipine(Ref: Katzung 10/e p145, 179: KDT 8th/e p618, 619)Nifedipine can be used rarely for the rapid control of blood pressure but the route of administration is sublingual. Fenoldopam is a D1 agonist used i.v. for hypertensive emergencies whereas urapidil is an a blocker. Enalaprilat (not enalparil) can also be used for the same indication.	Pharmacology	C.V.S	Nifedipine
An elderly multiparous woman with intrauterine foetal death was admitted with strong labour pains. The patient suddenly goes in shock with cyanosis respiratory disturbances and pulmonary oedema. The most likely clinical diagnosis is :	Amniotic fluid embolism	Gynaecology & Obstetrics	null	Amniotic fluid embolism
Technique used for Aspiration of sperm directly from Testes for In-vitro feilization is:	Testicular sperm aspiration (TESA) is a procedure sample of sperm cells are removed from the testicle through a small needle attached to a syringe. Other methods used are PESA: Percutaneous Epididymal Sperm Aspiration both TESA and PESA can be done under LA. MESA: Microsurgical Epididymal Sperm Aspiration TESE: Testicular Sperm Extraction MESA is the best technique for getting useable sperms since the epididymal sperms are the 'Ready'sperms which are ejaculated with the sexual act MESA allows for diagnosis and possible reconstruction of ductal pathology and because it usually yields very large numbers of sperm, sperm cryopreservation and avoidance of repeat surgery may be possible ICSI: Intracytoplasmic sperm injection GIFT: Gamete intra fallopian tube transfer IVF: In vitro feilisation	Gynaecology & Obstetrics	Infeility (Eggs'plantation!)	TESA
A 25 year old female patient history of 6 months, altered sensorium, involuntary rnovements,memory deficit, headache convulsions, abnormal movements, forgetfulness, 4 attack during day, 2 attack at night. CT normal :	Epilepsy It is a case of epilepsyTwo features our the diagnosis of epilepsy:-Presence of altered sensoriumOccurrence of epilep.sy during sleepDissociation disorders may resemble epilepsy, especially complex paial seizure.Dissociative disorders are a group of psychiatric syndromes characterized by disruptions of aspect of consciousness, identity, memory, motor behaviour or environmental awareness.They may resemble epilepsy in presentation but an impoant feature of these disorders is that the patient is always ale and oriented.Two impoant ways to rule out organic epilepsy from psychogenic epilepsy are:-i) Abnormality in E.E.G.- Generalized tonic clonic seizures always produce marked E.E.G. abnormalities during and after the seizure.ii) Increase in prolactin secretion- Measurement of serum prolactin levels may also help to distinguish between organic and psychogenic seizures, since most generalized seizures and many complex seizures are accompanied by rise in serum prolactin.Amnesia can occur in ceain epilepsies (complex paial seizures)Complex paial seizures are characterized by foal seizure activity accompanied by a transient impairment of the patient's ability to maintain normal contact with the environment (altered sensorium)The patient is unable to respond appropriately to visual or verbal commands during the seizure and has impaired recollection or awareness of the ictal phase.Examination immediately following the seizure may show an anterograde amnesia (memory deficits) or in cases involving the dominant hemisphere, a postictal aphasia.Other two options can be easily rule outSomatization disorderIn these cases patient will compain of number of symptoms involving multiple organ .system of the body.Hypochondriasis In lzypochondriasis patient complains that he has some serious ailment and he consults many dotors.	Psychiatry	null	Epilepsy
Common posterior cranial fossa tumours include all of following except -	Ans. is 'b' i.e., Oligodendroglioma o Oligodendrogliomas are uncommon tumours of childhood, occur predominently in the cerebral coex and originate in white matter (Supratentorial). Common childhood infratentorial post fossa tumors 1) Cerebellar astrocytoma (cystic astrocytoma) 3) Brainstem glioma 2) Medulloblastoma (Primitive neuroectodermal tumor) 4) Ependymoma	Pediatrics	null	Oligodendroglioma
Which of the following is not a complication of Total Parenteral Nutrition	.catheter related complication infections hydrothorax,pneumothorax,hemothorax cardiac tamponade injuriesto aeries and veins thrombotic complication air embolism metabolic complication azotemia essential fatty acid def fluid overload metabolic bone disease liver dysfunction glucose imbalance electrolyte imbalance trace elements and vitamin def	Surgery	General surgery	Congestive cardiac failure
H1 antihistaminics afford benefit in a number of conditions. All of the following conditions are benefited by antagonism of histamine :	In common cold , excessive secretions (like rhinorrhoea) are due to cholinergic overactivity. First generation antihistaminics possess anticholinergic propey and therefore are effective for common cold. On the other hand, all other conditions are allergic and reare benefited by antagonism of H1 receptors.	Pharmacology	Histamine, 5-HT and PGs	Common cold
Cardiac output during pregnancy is maximal at :	32nd week	Gynaecology & Obstetrics	null	32nd week
A 58-year-old woman had a mitral valve replacement, and was placed on anticoagulants and prophylactic antibiotics following her surgery. Five days after her surgery, she developed a sharply demarcated, erythematous rash on her left thigh. Two days after the rash appeared, large hemorrhagic bullae began to form in the area of the rash. Which of the following medications most likely caused the patient's rash?	Warfarin is a coumarin anticoagulant used for the prophylaxis and treatment of thromboembolic complications associated with cardiac valve replacement and atrial fibrillation, as well as the prophylaxis and treatment of venous thrombosis and pulmonary embolism. Warfarin may cause necrosis of the skin (typically on the breasts, thighs, and buttocks) generally between the third and tenth days of therapy. The lesions are initially sharply demarcated, erythematous, and purpuric. They may resolve or progress to large, irregular, hemorrhagic bullae that can eventually lead to necrosis. The mechanism for this reaction is related to warfarin's ability to deplete protein C, which can lead to a state of hypercoagulability and thrombosis in the cutaneous microvasculature. Aspirin is commonly used for its antiplatelet effect; however, it would not be indicated for anticoagulation of a patient with a recent cardiac valve replacement. Fuhermore, aspirin is not associated with the development of this type of skin necrosis. Cefazolin is a first-generation cephalosporin antibiotic commonly used as a perioperative prophylactic agent. If the patient was allergic to this antibiotic, an erythematous rash might have appeared. However, the rash would not lead to the appearance of large, hemorrhagic bullae. Heparin is an intravenous anticoagulant indicated for the prophylaxis and treatment of thromboembolic complications associated with cardiac valve replacement and atrial fibrillation. It is also indicated for the prophylaxis and treatment of venous thrombosis, pulmonary embolism, and for treatment of some coagulopathies. Although heparin is associated with the development of thrombocytopenia, it is not associated with skin necrosis.	Pharmacology	null	Warfarin
Bias can be eliminated by all except:	Ans. d. Multivariate analysis (Ref: Park 23/e p73, 83, 21/e p68-70, 78-79, 84; en.wikipedia.org/wiki/Bias_(statistics); style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">Multivariate analysis refers to the analysis of two or more dependent variables at a time. It is done after the study has been conducted, to analyze the study. While matching, binding and randomization all are done when the study is being conducted. (AIIMS November 2010 Repeat)."Confounding factors are an important source of bias. This can be removed by matching in case-control studies.""The selection bias can be eliminated by randomization.""Interviewer's bias can be eliminated by double-blinding."Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental maneuver is performed is known as selection bias. In the given question, researcher is concerned that the smokers might differ from non-smokers in their diet, exercise, etc. This concern is known as selection bias.Some important Types of Biases in Epidemiological StudiesInterviewer bias* Interviewer devotes more time of interview with cases as compared to controlsQMemory/ Recall bias* Cases are more likely to remember exposure more correctly than controlsQSelection bias (Susceptibility bias)* Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental manoeuvre is performedQInformation bias (Observer or misclassification bias)* Connective type of bias in which proportion of subjects are misclassified on exposure or diseases* Occurs due to people's curiosity and confusion of goals when trying to choose a course of action* It includes reporting, recall, interviewer & attention biasQBiasBias is any 'systematic error' in an epidemiological study, occurring during data collection, compilation, analysis and interpretation0Predominantly Biases are of 3 TypesSubject biasInvestigator biasAnalyzer bias* Error introduced by study subjects.* Examples:- Hawthorne effect- Recall biasQ* Error introduced by investigator* Selection biasQ* Error introduced by analyzer Some Important Types of Biases in Epidemiological StudiesApprehension bias* Certain levels (pulse, blood pressure) may alter systematically from their usual levels when the subject is apprehensiveAttention bias (Hawthorne effect)* Study subjects may systematically alter their behaviour when they know they are being observedQBerkesonian bias (Admission rate bias)* Bias due to hospital cases and controls being systematically different from each otherQInterviewer bias* Interviewer devotes more time of interview with cases as compared to controlsQLead time bias (Zero time shift bias)* Bias of over-estimation of survival time, due to backward shift in starting point, as by screening proceduresQMemory/ Recall bias* Cases are more likely to remember exposure more correctly than controlsQNeymann Bias (Prevalence-incidence bias)* Bias due to missing of fatal cases, mild/ silent cases and cases of short duration of episodes from the studyQSelection bias (Susceptibility bias)* Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental manoeuvre is performedQ Minimization of Biases in Epidemiological Studies by BlindingTypeMethodMinimizesSingle blindingStudy subjects are not aware of the treatment they are receivingSubject biasDouble blindingStudy subjects as well as investigator are not aware of thetreatment study subjects are receivingSubject bias + Investigator biasTriple blindingStudy subjects, investigator as well as analyzer are not awareof the treatment study subjects are receivingSubject bias + Investigator bias + Analyser bias	Social & Preventive Medicine	Principles of Epidemiology	Multivariate analysis
Which of the following is not a cause of oropharyngeal carcinoma?	Ans. is 'a' i.e., Occupational exposure to hydrochloric acid Etiology of oropharyngeal carcinoma Tobacco in any form - cigarette smoking or chewing Heavy alcohol abuse Beetle nut chewing Plummer vinson syndrome, cirrhosis Syphilis Trauma Dental irritation Poor oral hygiene Occupational exposure to isopropyl alcohol, sulphuric acid and nickel HPV infection	ENT	null	Occupational exposue to hydrochloric acid
Larva of which of the following is seen in feces	Filariform larva is the infective form of strongyloides stercoralis The rhabditiform larva migrates into the lumen of the intestine and passes down the gut to be released in faeces Ref : panikers textbook of Medical parasitology 8th edition page 182	Microbiology	parasitology	Strongyloides stercoralis
Antibiotic potentiating the effect of NM blocker?	Ans. is 'b' i.e., Aminoglycoside Impoant interactions of skeletal muscle relaxants General anaesthetics potentiate competitive blockers in the following order : Isoflurane (most), sevoflurane, desflurane, enflurane, Holothane and nitrous oxide (least). . Anticholinesterase (neostigmine, pyridostigmine & edrophonium) reverse the action of competitive blockers, they can enhance depolarizing neuromuscular blockers. Calcium channel blockers (verapamil) potentiate both competitive and depolarizing neuromuscular blockers. Diuretics produce hypokalemia which enhances competitive block. Diazepam, propranolol and quinidine intensify competitive block. Aminoglycosides, tetracycline, polypeptide antibiotics, clindamycin and lincomycin can potentiate competitive block. High doses of glucocoicoids reduce the effect of competitive blockers	Anaesthesia	null	Amino glycos ide
Dent disease is due to defect of?	Dent's disease (or Dent disease) is a rare X-linked recessive inherited condition that affects the proximal renal tubules of the kidney. It is one cause of Fanconi syndrome and is characterized by tubular proteinuria, excess calcium in the urine, the formation of calcium kidney stones, nephrocalcinosis, and chronic kidney failure. About 60% of patients have mutations in the CLCN5 gene (Dent 1), which encodes a kidney-specific chloride/proton antipoer, and 15% of patients have mutations in the OCRL1 gene (Dent 2). Dent's disease often produces the following signs and symptoms: Rickets Extreme thirst combined with dehydration Nephrolithiasis (kidney stones) Hypercalciuria (high urine calcium - >300 mg/d or >4 mg/kg per d) with normal levels blood/serum calcium) Aminoaciduria (amino acids in urine) Phosphaturia (phosphate in urine) Diagnosis is based on a genetic study of CNCL5 gene Ref: wikipedia	Pathology	Nervous system	Chloride channel
A patient presents with low serum calcium, high phosphorus and etevated PTH. Which of the following investigations is least contributory to establish a diagnosis -	Ans is option 1.. Vit D levels Vit d deficiency is associated with hypophosphatemia and not hyperphosphatemia Renal failure, pseudohypoparathyroidism and increased urinary myoglobin may all be associated with combination of hypocalcemia, hyperphosphatemia and elevated PTH levels Ref Harrison 19/e p2482	Medicine	Endocrinology	Vitamin D levels
Earliest phenotypic manifestation of Idiopathic hereditary hemochromatosis is-	Answer is D (Increased Transferrin Saturation) The Most Common Manifestation of Hemochromatosis is Hepatomegaly. Liver Enzymes may be normal or elevated depending on the extent of hepatocyte damage. A transferrin saturation of more than 45% is the earliest phenotypic abnormality in hereditary hematochromatosis' Transferrin saturation and measurement of unbound iron bindeng capacity are recommended fir initial scrceening of individuals Tests Recommended for screening for Hereditary Hematochromatosis Transferrin Saturation The transfrrin saturation f wore than 45% is the earliest phenotypic abnormality in hereditary hematochromatosis Transferrin saturation is considered the best initial screening test for hereditary hematochromotosis Transferrin saturation has a high sensitivity of >90% in diagnosing hereditary hematochromatosis Transferrin saturation is the ratio of serum iron to total iron binding capacity (SUTIBC) Iron binding capacity (Unbound /Unsaturated) Unbound Iron binding capacity is an alternative screening test. Unbound Iron binding capacity UIBC=TIBC-Serum Iron Unbound iron binding capacity is decreased in hematochromatosis	Medicine	null	Increased transferrin saturation
Live vaccine is -	Ans. is 'c' i.e., Sabin polioLive attenuatedInactivated or killedImmunoglobulins Bacterial BOG Typhoid oral VTral Oral Polio (Sabin) Yellow fever Measles Rubella Mumps Chicken pox Influenza Rickettsial Epidemic TyphusBacterial Typhoid Cholera Pertussis Meningitis Plague Viral Rabies Injectable polio (Salk) Influenza Hepatitis AJE KFDHuman normal Hepatitis A,B Measles Rabies Tetanus Mumps Human Specific Varicella Diptheria Non-Human (antisera) Diphtheria Tetanus Gas Gangrene Botulism RabiesSubunit Vaccines Hepatitis B Typhoid Vi antigenToxoids Diphtheria TetanusBoth active & passive immunization can be given together Diphtheria Hepatitis B Tetanus Rabies	Microbiology	Immunity	Sabin polio
Prolonged use of one of the following anticonvulsant can produce weight loss -	Ans. is 'c' i.e., Topiramate o Use of topiramate is limited by its unwanted side effects paicularly weight loss, sedation and naming difficulties. Note - Other drug causing weight loss is Felbamate.	Pharmacology	null	Topiramate
Which of the following anti TB drugs acts on extracellular organisms and is bactericidal drug?	Streptomycin is the only anti-TB drug which acts on extracellular organisms and is bactericidal. All first line antitubercular drugs are bactericidal except ethambutol which is bacteriostatic. Impoant points about first line ATT: Drug Action Hepatotoxic Bacteria Inhibited Isoniazid CIDAL Yes Both Rifampicin CIDAL Yes Both Pyrazinamide CIDAL Yes Intracellular Ethambutol STATIC No Both Streptomycin CIDAL No Extracellular	Pharmacology	Mycobacterial Diseases (TB, Leprosy and MAC)	Streptomycin
The exact pa of the antigen that reacts with the immune system is called as ?	Ans. is 'b' i.e., Epitope Epitope . Also known as "antigenic determinant". . It is antibody binding site of antigen. . It is the smallest unit of antigenicity. . Antigenic determinants is composed of structures on the surface of molecules and can be constructed in two ways: 1. Within a single segment of primary sequence 4. Sequential epitopes 2. Assembled from residues far apa in the primary 3. Conformational epitopes sequence but brought together on the surface by the folding of the molecule into its native conformation . The majority of antigenic structures recognized by antibodies depend on the teiary configuration of the antigen (conformational), while T cell epitopes are defined by the primary structure (sequential). Paratope . The pa of the antibody or T cell receptor that interact with the epitope. "The idiotype is defined as the specific region of the fab poion of the 1g molecules to which antigen binds".	Microbiology	null	Epitope
Best treatment for remission of acute ulcerative colitis is ?	GLUCOCOICOIDS Effective for inducing remission in both UC & CD. No role in maintenance in either UC or CD. Once clinical remission is achieved , they should be tapered.	Surgery	Inflammatory bowel disease	Prednisolone
Which of the following is not a feature of MEN type	Ans: d (Adrenocortical adenoma)Ref: Harrison, 17 ed pg. 2359MEN I (Wermer's syndrome) is characterized by pituitary, parathyroid & pancreatic affection. Pheochromocytoma is seen in all three even though less common in MEN I MEN' I (wermer's)MEN IIA (sipple)MEN II BPi tut aryAdenomaHyperplasia ParathyroidHyperplasiaAdenomaCarcinomaHyperplasia PancreasIslet cell hyperplasia,AdenomaCarcinoma Adrenal Pheochromocy- tomaPheochrom- ocytomaThyroid Ccell hyperplasiaC-cell hyperplasia MedullarycarcinomaMedullary carcinomaMucocutan- eous ganglioneu- romaMarta noidHabitus Less commonPheochromo- cytomaForgut carcinoidSubcutaneous/ visceral lipomaDermal angiofibroma Mutant gene RETRET MEN Hirschsprung - loss of function in RET protooncogene MEN 2A - gain of function in RET protooncogene.Please don't confuse Wermer's syndrome (MEN 1) with Werner's syndrome which is adult progeria. It is a rare condition and predisposes to papillary cancer thyroid.	Medicine	Endocrinology	Adrenocortical adenoma
Samters triad is seen in patients with -	Ans. is 'a' i.e.. Asthma [Ref: Dhingra 5th/ep. /55jSamter's triado Samter's triad is a medical condition consisting of asthma, aspirin sensitivity, and nasal/ethmoidal polyposis. It occurs in middle age (twenties and thirties are the most common onset times) and may not include any allergies.o Most commonly, the first symptom is rhinitis.o The disorder typically progeses to asthma, then polyposis, writh aspirin sensitivity coming last,o The aspirin reaction can be severe, including an asthma attack, anaphylaxis, and urticaria in some cases. Patients typically react to other NSA1DS such as ibuprofen, although paracetamol is generally considered safe,o Anosmia (lack of smell) is also typical, as the inflammation reaches the olfactory receptors in the nose.	ENT	Nose and PNS	Asthma
Besides zidovudine and lamivudine, which following drug is a reverse transcriptase inh v used in the treatment of HIV infection?	Anti-Retroviral drugs (a) Nucleoside reverse transcriptase inhibitors (Nis) : Zidovudine (AZT), Didanosine, Zalcitabine, Stavudine, Lamivudine, Abacavir (b) Nonnucleoside reverse transcriptase inhibitors (NNis) : Nevirapine, Eirenz, Delavirdine (c) Protease inhibitors : Ritonavir, Indinavir, Nelfinavir, Saquinavir, Amprenavir*, Lopinavir Ref Harrison 20th edition pg 789	Medicine	Infection	Abacavir
Chloride responsive alkalosis, causes are-	Repeat	Medicine	Fluid and electrolytes	Severe vomiting
The bone matrix has the following crystals ?	Ans. is 'a' i.e., Calcium hydroxyapatite Structure of bone Bone is a specialized connective tissue. o Bone components are :? Inorganic elements (65%) Organic matrix (35%) 1. Inorganic elements It is the mineral phase, principally composed of calcium and phosphate, mostly in the form of hydroxyapatite.	Surgery	null	Calcium hydroxyapatite
Cabot&;s ring is seen in-	In the peripheral blood smear of megaloblastic anaemia . Cabot rings are thin, threadlike, red to violet rings or "figure 8" shaped inclusions in red blood cells. Cabot rings are remnants of the mitotic spindle, and can be seen in megaloblastic anemia, medication effect, myelodysplasia and other forms of dyserythropoiesis. reference :textbook of Pathology, 7th edition ,Author Harsha Mohan ,page number 283, figure 10.20	Pathology	Haematology	Megaloblastic anemia
Not a surgical landmark for parotid surgery	surgical landmark of parotid surgery are : Tragal pointer Digastric posterior belly Styloid process tympansmastoid suture ref : hazarika 4th ed	ENT	All India exam	Inferior belly of omohyoid
Comparison of efficacy of a new drug B with an existing drug A is done in which phase of clinical trials?	"The purpose of phase III trials is to obtain adequate data about the efficacy and safety of drugs in a larger number of patients of either sex in multiple centres usually in comparison with the standard drug." Phase I: Human Pharmacology (Non-therapeutic trials): Done in healthy persons Phase II: Therapeutic exploratory trials: conducted in patients to determine therapeutic effects, effective dose range and fuher evaluation of safety and pharmacokinetics in patients Phase III: Therapeutic confirmatory trials: Conducted to obtain adequate data about the efficacy and safety of drugs in a larger number of patients of either sex in multiple centres usually in comparison with the standard drug. Phase IV: Post marketing studies	Pharmacology	CLINICAL TRIALS, DRUG LABEL	Phase III
Vogt Koyanagi–Harada (VKH) syndrome is –	VKH syndrome is a multisystem disorder characterized by chronic granulomatous uveitis with exudative retinal detachment that is often associated with neurological and cutaneous manifestations.	Ophthalmology	null	Chronic granulomatous uveitis
Features of hereditary spherocytosis include all of the following except :	Answer is C (MCV Ted) Mean corpuscular volume of RBC is decreased in patients with hereditary spherocytosis. Hereditary spherocytosis is characterised by defect in one of the proteins in the cytoskeleton of Red cell membrane, leading to loss of membrane, and hence decreased ratio of surface area to volume and consequently spherocytosis. Characteristic Laboratory abnormalities The mean corpuscular volume (MCV) : is decreasedQ The mean corpuscular Hb. concentration (MCHC) : is increasedQ Osmotic fragility is : increasedQ Remember the following also : * Most common membrane defect is that of Ankyrin Q * One characteristic clinical presentation is Striking splenomegaly Q * Treatment of choice is (anemia, splenomegaly, jaundice) Splenectomy Q	Medicine	null	\|mcv
Which one of the following is NOT a component of the filtration slit diaphragm at the glomerulus?	The filtration barrier in the glomerulus is composed of the endothelial cells of glomerular capillaries, basement membrane that covers the endothelial cells, and foot processes of the epithelial cells surrounding the basement membrane Podocytes are separated by apparent gaps called filtration slits. Each filtration slit is bridged by a thin diaphragm. The filtration slit diaphragm is composed of several proteins, such as nephrin, podocin, a-actinin. Batin gene (also known as BSND) codes for the protein batin; this protein recruits the Cl- channel CLCNKB to the basolateral membrane in the TAL of loop of Henle.	Physiology	Excretory System (Kidney, Bladder) Acid-Base Balance	Batin
By what age does a child achieve the following developmental milestone?	Age Milestones 4 months 6 months 9 months 10-12 months 12 months Bidextrous grasp Unidextrous / palmar grasp(Ulnar grasp) Immature Pincer grasp Palmar grasp (Radial grasp) Mature Pincer grasp	Pediatrics	null	6 months
Uses of PUVA – a) Pigmented purpuric lesionb) Herpes zosterc) Mycosis fungoidesd) Lupus panniculitise) Lichenoid dermatitis of Gougerot & Blum	Indications for PUVA and UVB Established major indications :- Psoriasis, atopic dermatitis, vitiligo, mycosis fungoides, Polymorphic light eruption, pompholyx. Less frequently treated (less evidence of effectiveness) :- Pityriasis rosea, morphea, chronic urticaria, Pityriasis lichenoid chronica, Alopecia totalis & Universalis, Lichen plaints, Pityriasis rubra pilaris, Granuloma annulare, Generalized pruritis, Nacrobiosis lipoidics. "Pignzented pruritic lichenoid dermatosis of Gougerot & Blum can be treated by PUVA".	Dental	null	ace
Drug of choice for Bupivacaine induced cardiac arrythmia	Bretylium is a class III Antiarrythmic used to treat Bupivacaine induced ventricular tachycardia.	Pharmacology	null	Bretylium
Quod Hanc is-	Ans. is 'd' i.e., Psychologic impotence	Forensic Medicine	null	Psychologic impontence
Area of skin supplied by single nerve supply	A dermatome is an area of skin that is mainly supplied by a single spinal nerve. There are eight cervical nerves (C1 being an exception with no dermatome), twelve thoracic nerves, five lumbar nerves and five sacral nerves. Each of these nerves relays sensation (including pain) from a particular region of skin to the brain. Spinal nerves not only play an important role in differentiation and motor innervation of the limb musculature, but also provide sensory innervations for the dermatomes.	Pathology	null	Dermatome
Inactivated microorganisms are used in the manufacture of which of the following:	null	Microbiology	null	Salk vaccine
False statement about MODY is -	Maturity-onset diabetes of the young (MODY) is characterized by autosomal dominant inheritance, early onset of hyperglycemia (usually <25 years; sometimes in neonatal period), and impaired insulin secretion. It is non insulin requiring diabetes and can be managed by diet and sulfonylurea (paicularly HNF-1a and HNF-4a forms). Reference : page 806-7 Davidson's Principles and practice of Medicine 22nd edition	Medicine	Endocrinology	Insulin dependent

Which of the following play most impoant role in memory:

Ans: a. Synaptic Net.Synaptic network s single best answer "Long-term memory involves changes in the structure of neurons including growth of new processes and synapses.So, to the extent that you remember anything about this material on memory tomorrow, or next week, or next year, it will be because structural changes in synapses are beginning in your brains.

Physiology

null

Synaptic network

Which of the following is false regarding transfusion associated anaphylactic reactions?

Ref: Aled scape/ Transfusion reactionsExplanation:Allergic transfusion reactions occur on a continuum of severity ranging from mild (urticarial) to moderate (anaphylactoid) to severe (anaphylactic). Anaphylactic transfusion reactions are severe allergic reactions characterized by profound hypotension and shock.Causes of anaphylaxis include:Recipient IgE or IgG antibodies to IgA in patients who have complete or partial (i.e., lack an isotopic or allotypic) IgA determinantRecipient IgE or IgG antibodies to polymorphic forms of other serum proteins (IgG. haptoglobin. C4, etc.) in transfused donor bloodRecipient sensitization to various compounds, including drugs in donor blood, chemicals used to produce or sterilize IV tubing and plastic bags, and foodstuffsCoincidental reaction to drugs or food taken prior to transfusionIg A deficiencyIn patients with IgA deficiency --Anti-IgA antibodies may develop after exposure to IgA in transfusions: anaphylactic reactions to IV immune globulin (IVIG) and other blood products that contain IgA may occur.Washed blood product can reduce the incidence of Anaphylaxis

Medicine

Transfusion

Seen in IgG deficient individuals

Hepatitis E usually affects ?

Ans. is `b' i.e., Adults

Microbiology

null

Adults

Subdural empyema is most commonly caused by:

Answer is C (Streptococcus pneumoniae): Aerobic and Anaerobic streptococci are the most common aetiological agents for subdural ernphyema. influenzae is the most common causative organism in Children, and not in Adults. Subdural Empyema is a collection of pus in the space between he dura and arachnoid. In most cases a single organism is responsible, but many cultures are sterile because patients are often receiving antimicrobial therapy. The major pathogens include Aerobic and anaerobic Streptococci (about 50%) Staph (about 12-16%) Aerobic gram -ye bacilli (3-10%) Other anaerobes (5%)

Medicine

null

Streptococcus pneumoniae

What is Cock's Peculiar tumour -

Ans. is 'a' i.e., Ulceration of sebaceous cyst on the scalp o Cocks peculiar tumour is actually a complication of sebaceous cyst -# When the sebaceous cyst of the scalp ulcerates excessive granulation tissue forms resembling fungating epithelioma. This is called cock's peculiar tumour.Also know these terms -o Cylindroma -# A malignant epithelial tumour also k/a Turban tumor# Known as cylindroma because of histological appearanceo Pilomatrixoma (Calcifying epithelioma of Malherbe)# It is a benign hair follicle derived tumouro Pott's puffy tumour# It is osteomyelitis of the skull associated with subperiosteal swelling and edema.

Surgery

Plastic & Reconstructive Surgery

Ulceration of sebaceous cyst on the scalp

Which of the following is not found in commercially available tooth paste?

null

Dental

null

astringent

A bactericidal drug would be preferred over a bacteriostatic drug in a patient with

Bactericidal drugs kill the bacteria whereas bacteriostatic drugs only inhibits bacterial growth. Bacteriostatic activity is adequate for the treatment of most infections ,bactericidal activity nay be necessary for cure in patients with altered immune system like neutropenia ,HIV and other immunosuppressive conditions Refer KDT 6/e p686

Pharmacology

Chemotherapy

Neutropenia

Mechanism which is responsible for gentamicin ototoxicity is:

Ototoxicity involves progressive and irreversible damage to, and eventually destruction of, the sensory cells in the cochlea and vestibular organ of the ear.

Pharmacology

null

Direct hair cell toxicity.

Non-dominant hemisphere does all of the following function, except

(A) Parallel thinking # Hemispheres Versus "Cerebral Dominance":> Hemisphere is concerned with categorization and symbolization and has often been called the dominant hemisphere.> However, it is dear that the other hemisphere is not simply less developed or "non dominant"; instead, it is specialized in the area of spatiotemporal relations.> It is this hemisphere that is concerned, for example, with the identification of objects by their form and the recognition of musical themes. It also plays a primary role in the recognition of faces.> Consequently, the concept of "cerebral dominance" and a dominant and non-dominant hemisphere has been replaced by a concept of complementary specialization of the hemispheres, one for sequential-analytic process (Categorical hemisphere) and one for visuospatial relations (the representational hemisphere).> Categorical hemisphere is concerned with language functions, but hemispheric specialization is also present in monkeys, so it antedates the evolution of languages

Physiology

Nervous System

Parallel thinking

What about durham pin is true ?

Ans. is 'd' i.e., All the above Denham pin It is a type of pin used to give skeletal traction. Threaded poion of the pin engages the bony coices and reduces the chances of pin sliding. This type of pin is used commonly to give skeletal traction through the cancellous bone i.e. calcaneum. It can also be used to give traction through osteoporotic bones.

Surgery

null

All the above

Nerve roots involved in klumpke's paralysis is:

Klumpke's Paralysis is due to injury of the lower trunk of branchial plexus. It involves mainly the T1 nerve root and paly C8 nerve root. All the small muscles of the hand are paralysed. Claw hand, horner syndrome and loss of sensation on the medial aspect of the arm are the common disabilities. Ref: B D Chaurasia's Human Anatomy: Volume 1, Page 52.

Anatomy

null

C8, T1

A 2-year-old child develops acute respiratory distress. 0/E breath sounds are decreased with wheeze on right side. Chest X-ray shows diffuse opacity on right side--Most probable diagnosis:

Foreign body aspiration is a very common problem in pediatric age group (< 4 years). In the question, child is presenting with sudden onset respiratory distress and there is U/L decreased breath sounds + U/L wheezing and on chest X-ray a diffuse opacity is seen on right side i.e. there is clinical and radiological evidence of bronchospasm and collapse suggestive of a foreign body in bronchus

ENT

null

Foreign body aspiration

Minimal reabsorption in kidney occurs for

Minimal reabsorption for ureaRef: Ganong&;s review of medical physiology; 24th edition; page no; 682, 681

Physiology

Renal physiology

Urea

Pathology in Marfan syndrome ?

Ans. is 'a' i.e., Fibrillin I o Marfan syndrome is an autosomal dominant disorder due to mutation in fibrillin-1 gene on chromosomal 15.Fibrillin-1 is a part of elastic fibres, thus defect in fibrillin-1 affects following systems:-1) Skeletal abnormalities: Tall with thin built; arachnodactyly (long and slender fingers and hand, spider like); decrease in upper segment: Lower segment body ratio (i.e. lower limbs are proportionately more lengthened); scoliosis and kyphosis; pectus excavatum and pectus craniatum; Hypermobility (laxity) of joint with hyperextensibly; high arched palate and dolicocephalic skull.2) CVS abnormalities : Mitral valve prolapse causing mitral regurgitation; aortic aneurysm begning at base of aorta and involving ascending aorta; cystic medial necrosis causing dissection of aorta (most common cause of death).3) Ocular abnormalities: Ectopia lends (with bilateral superolateral lens dislocation), elongated eyeball.4) Others: Spontaneous pneumothorax ; inguinal and incisional hernias.

Pathology

Cytogenetic Disorders

Fibrillin I

Atropine causes:

Ans: b (Tachycardia) Ref: KDT, 6th ed, p. 107The most prominent action of atropine on heart is tachycardia due to the blockade of M receptors on the S A node through which vagal tone decreases heart rate.Other effects of atropine are:CNS: Overall stimulant action,rise in body temperature due to action on hypothalamusCVS: Tachycardia, no marked effect on BPGIT: Decreases intestinal motility by GI smooth muscle relaxationRESP: Bronchodilatation and reduced airway resistanceURINARY: Relaxes bladder and causes urinary retentionEYE: Local anesthetic action on cornea. Mydriasis, Cycloplegia, Abolition of light refelexGLANDS: Decreases lacrimation, Sweating, Salivation by M blockade

Pharmacology

A.N.S.

Tachycardia

A biopsy of the antrum of the stomach of an adult who presents with epigastric pain reveals numerous lymphocytes and plasma cells within the lamina propria, which is of normal thickness. There are also scattered neutrophils within the glandular epithelial cells. A Steiner silver stain from this specimen is positive for a small, curved organism, which is consistent with

Chronic gastritis is histologically characterized by the presence of lymphocytes and plasma cells. It is impoant to realize that the presence of neutrophils within the glandular epithelium indicates active inflammation and may be the main type of inflammation present (acute gastritis), or may be combined with more numerous chronic inflammations (active chronic gastritis). Chronic gastritis is divided into subgroups based either on etiology (immunologic or infectious), location (antrum or body), histopathology, or clinical features. H. pylori gastritis is associated with infection by H. pylori, a small, curved, gram-negative rod that is found in approximately 20% of the general population. The organisms are found in the mucus overlying the surface/foveolar epithelium. These changes tend to affect primarily the antral or antral-body-fundic mucosa. This is the type of gastritis normally associated with active chronic gastritis. The therapy for Helicobacter is either triple therapy (metronidazole, bismuth salicylate, and either amoxicillin or tetracycline) or double therapy (omeprazole and clarithromycin). In contrast, autoimmune gastritis, also known as diffuse corporal atrophic gastritis or type A atrophic gastritis, is characterized by the presence of autoimmune antibodies including parietal cell antibodies and intrinsic factor antibodies. This type of gastritis is associated with pernicious anemia and achlorhydria. Pernicious anemia is the result of decreased intrinsic factor, which in turn produces a vitamin B12 deficiency. This vitamin deficiency causes megaloblastic anemia and subacute combined disease of the spinal cord. Histologically there is diffuse atrophy (reduced mucosal thickness), gland loss, widespread intestinal metaplasia, and variable chronic and acute inflammation. These changes are found predominately in the body-fundus mucosa (usually absent in the antrum). There is an increased risk for gastric cancer, but these patients do not develop peptic ulcers. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition

Pathology

miscellaneous

Helicobacter pylori

During moderately intense isotonic exercise all of the following increase except:

In mild-to-moderate exercise: There is increase in sympathetic drive. This results in an increase in stroke volume and hea rate, resulting in an increase in cardiac output; increased respiratory drive; dilation of vessels in the active muscles. This is due to a "muscle chemoreflex" because of metabolites from muscles e.g. K+, adenosine, NO. Diastolic BP (indicator of total peripheral resistance) either remains unchanged or decreases to some extent. The mean aerial pressure increases. Increase in ventilatory ratethat matches the increase in O2consumption and CO2production by the body. The stimulus for increased ventilation rate is due toactivation of joint proprioceptors at the beginning of the exercise.

Physiology

Circulation

Total Peripheral resistance

A 62-year-old woman eats a high carbohydrate meal. Her plasma glucose concentration rises, and this results in increased insulin secretion from the pancreatic islet cells. The insulin response is an example of

Negative feedback mechanisms ensure a proper level of hormone activity at the target tissue. After a stimulus (plasma glucose) causes a release of the hormone (insulin), conditions or products resulting from the action of the hormone (decrease sugar) tend to suppress its fuher release. In other words, the hormone (or one of its products) has a negative feedback effect to prevent oversecretion of the hormone or overactivity at thetarget tissueThe increase in plasma insulin lowers the plasma glucose concentration which in turn results in decreased insulin secretion

Physiology

General physiology

Negative feedback

Killing of a 6 months old child by parents is known as ?

Ans. is 'b' i.e., Infanticide Infanticide refers to killing a child after delivery, to till 1 year after bih. Infanticide in India is considered equivalent tomurder and is tried under section 302 IPC. Law considers every child as born dead and therefore in a case of infanticide,it has to be proved that the child was born alive and was then killed. Thus the first question in the investigation of a case of infanticide is, whether the child was still born or dead born or whether it was born live.

Forensic Medicine

null

Infanticide

Painful arc syndrome which movement is painful:-

* Painful arc syndrome is subacute tendinitis of the rotator cuff tendons due to vascular congestion.* Treatment is usually rest +physiotherapy + NSAIDS. If not treated, local steroids and surgery can be done.* Pain is aggravated as arm transverses an arc between 60 and 120 degrees.

Orthopaedics

NEET 2019

Mid abduction

Most common cause of stridor in children is:

(Laryngomalacia) (272-D)Laryngomalacia - (congenital laryngeal stridor)* It is the most common condition causing an inspiratory stridor at or shortly after birth.* It may persist throughout infancy & disappears by 2 years of age* Stridor increased on crying but subsides on placing the child in prone position, cry is normal.* Foreign bodies in the larynx are uncommon because they are either coughed out or causes fatal obstruction within a few minutes. If helps is not to hand.

ENT

Larynx

Laryngomalacia

Retinoblastoma can occur bilaterally in how many percentage of the cases?

25-30% bilateral involvement . Seen in childrens between 1-2 yrs of age. Ref : ak khurana 6th edition

Ophthalmology

Tumors

25-30%

Education criteria for mental retardation is ?

Ans. is 'a' i.e., Mild

Social & Preventive Medicine

null

Mild

Which of the following is naturally occurring tertiary amine and lipid-soluble reversible anticholinesterases:

All other reversible anticholinesterases are synthetic quaternary compounds and are lipid insoluble.

Pharmacology

null

Physostigmine.

Funicular hernia is type of:

Types of Indirect Inguinal Hernia - 1. Bubonocele - Hernia is limited to the inguinal canal 2. Funicular - Processus vaginalis is closed just above epididymis. Contents of the sac can be felt separately from testis, which lies below the hernia. 3. Complete or scrotal - Testis appears to lie within the lower pa of hernia.

Surgery

Hernia and abdominal wall

Indirect inguinal hernia

Not true about amoebic liver abscess

Larval forms of E.histolytica are not seen in the abscess

Anatomy

G.I.T

Larvae are seen

Translocation seen in Follicular lymphoma

MalignancyTranslocationAcute myeloid leukemia (AML)(8;21)(q22;q22)(15;17)(q22;q21)Chronic myelogenous leukemia (CML)(9;22)(q34;q11)Burkitt lymphoma(8;14)(q24;q32)Mantle cell lymphoma(11;14)(q13;q32)Follicular lymphoma(14;18)(q32;q21)Ewing sarcoma(11;22)(q24;q12)Prostatic adenocarcinoma(7:21)(p22;q22)(17:21)(p21;q22)Ref: Robbins and Cotran Pathologic Basis of Disease; 9th edition; Chapter 7; Neoplasia; Page no:317; Table: 7-8

Pathology

General pathology

14;18

Most common cause of Bronchiolitis is ?

<a href=" syncytial virus (RSV)</a> is the most common cause of bronchiolitis. Sometimes, the common also can cause it. Bronchiolitis is one of the common serious acute lower respiratory tract infection in infants. Affected infants are between ages of 1 and 6 months but the disease can affect children upto 2 years old.Disease usually occur in winter and spring .Respiratory syncytial virus is implicated in most cases.other causative agents include parainfluenza virus,influenza virus,adeno virus,Mycoplasma. protection against RSV is mediated by antibodies of IgG3 subclass. Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:356,7th edition

Pediatrics

Respiratory system

RSV

Cholinomimetics are useful in all of the following conditions EXCEPT

cholinomimetics use- 1.as miotic- in glaucoma/to reverse the effect of mydriatics after refraction testing/to prevent adhesions between lens and iris or cornea 2.in myasthenia gravis 3.in postoperative paralytic ileus 4.post operative decurarization 5.in cobra bite 6.in belladonna poisoning 8.in Alzheimer's disease REF: ESSENTIALS OF MEDICAL PHARMACOLOGY: KD TRIPATHI:7TH EDITION; PAGE NO 109

Pharmacology

Autacoids

Paial hea block

Gene mutations in Cystic fibrosis occurs at -

In cystic fibrosis, CFTR gene mutation occurs on the long arm of chromosome 7 Reference: Ghai essential pediatrics, 9 th edition, page 392

Medicine

Genetics

Long arm of chromosome 7

Paget's disease of the breast, true is

Pagets disease of nipple is a superficial manifestation of intraductal carcinoma.It mimics eczema of nipple and areola. There is a hard lump just beneath the areola which later ulcerates and cause destruction of nipple.. Its unilateral condition ,seen in menopausal women not associated with itching.

Surgery

null

Intraductal carcinoma

Ketamine is useful as an anesthetic agent in-

(Refer: Morgan and Mikhail’s Clinical Anaesthesiology, 5th edition, pg no. 182 – 184) Ketamine is a potent bronchodilator and relieves bronchospasm →Intravenous anaesthetic agent of choice in asthmatic Ketamine increases ICT, IOP and cardiac oxygen demand, therefore contraindicated in other three conditions Note-Inhalation anaesthetic agent of choice in asthmatics is halothane.

Unknown

null

Intracranial hemorrhage

What is true about Meniere&;s disease

Electrocochleography shows changes diagnostic of Meniere's disease. Normally the ratio of summating potential to action potential is 30%. In Meniere's disease, this ratio is greater than 30%. Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 7th Edition; page no.113

ENT

Ear

Electrocochleography is the gold standard for diagnosis

Which of the following is antitubercular drugs bus assoasiated with hypothyroidism

Refer KDT 7th/771 Ethionamide PAS They are two antitubercular drugs assoasiated with hypothyroidism and goitre

Pharmacology

Chemotherapy

Ethionamide

Commonest presentation of primary biliary cirrhosis?

Ans is 'a' i.e., Pruritus Harrison writes "Most patients with Primary biliary cirrhosis are asymptomatic, and the disease is initially detected on the basis of elevated serum alkaline phosphatase levels during routine screening. Often the earliest symptom is pruritus, which may be either generalized or limited initially to the palms and soles. In addition fatigue is commonly a prominent early symptom. After several months or years, jaundice and gradual darkening of the exposed areas of the skin (melanosis) may ensue."

Surgery

null

Pruritis

What is the recommended isolation period of Hepatitis A from the initial onset of symptoms?

Isolation period of Hepatitis A is first 14 days of illness and for at least 7 days after jaundice show up. Incubation period of Hepatitis A is 10-50 days, commonly about 30-35 days.

Social & Preventive Medicine

null

2 weeks

Which of the following contraceptives provides complete protection against sexually transmitted disease: March 2013 (b, g)

Ans. B i.e. Barrier method Barrier methods They block sperm from entering the uterus. The following are barrier methods of contraception: - Condom - Female condom - Cervical cap (including Lea's Shield) - Diaphragm The male (and female) condom provides excellent protection against sexually transmitted infections.

Social & Preventive Medicine

null

Barrier method

True about conn&;s syndrome-

Ans is option 2 and 3 Decrease K+ and proximal myopathy In Conn&;s disease Proximal myopathy occurs due to hypokalemia. Hypokalemia causes alteration of electrical excitability of nerve and muscle fibre membranes, which prevents transmission of normal action potential, leading to severe muscle weakness. Ref Harrison 17/e p 2260,2261,2253

Medicine

Endocrinology

Decreased K+

Culture mediam for corynebacterium diphtheria?

Ans. is 'a' i.e., Loefflers serum slope

Microbiology

null

Loefflers serum slope

Fetal growth restriction is defined as estimated fetal weight is below the ------ for their Gestational age

IUGR is replaced by fetal growth restriction, which was designed to identify fetuses with estimated weight below the 10th percentile for their gestational ages.Reference: Practical guide to High-risk pregnancy and delivery; Chapter 4; Fetal growth restriction

Gynaecology & Obstetrics

General obstetrics

10th percentile

Sporulation is seen in which phase of bacterial growth phase?

Ref: Ananthanarayan, 8thed. pg. 24Features of Stationary Phase1. Viable count of cells remain stationary as an equilibrium exists between dying cells and newly formed cells2. Cells are viable and show irregular staining due to intracellular storage granules3. Sporulation occurs at this stage4. Production of antibiotics and exotoxins is also seen at this stage.

Microbiology

General

Stationary phase

One of the following is the most specific cardiac anomaly of a newborn to a diabetic mother:

Congenital malformation in fetus of a diabetic mother : * M/C system involved in congenital malformation CVS > CNS * Most specific structural anomaly seen - caudal regression syndrome ( sacral agenesis ) * Most specific cardiac anomaly seen in babes of diabetic mother - TGV

Gynaecology & Obstetrics

Gestational Diabetes Mellitus

Transposition of great vessels

Neuronal degeneration is seen in all of the following except

Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery. This condition is typically caused by a blunt neural injury due to external blows or shock-like injuries to muscle fibers and skeletal nerve fibers, which leads to repeated or prolonged pressure buildup on the nerve. Ref: guyton and hall textbook of medical physiology 12 edition page number:74,75

Physiology

Nervous system

Neuropraxia

Which among the following is the best diagnostic method for finding out ovulation?

The finding of secretory endometrium confirms ovulation. The use of an endometrial biopsy (EMB) near the end of the luteal phase can provide reassurance of an adequate maturational effect on the endometrial lining. Within 48 hours of ovulation, the cervical mucus changes under the influence of progesterone to become thick, tacky, and cellular, with loss of the crystalline fernlike pattern on drying. Ref: Ghadir S., Ambasumyan G., DeCherney A.H. (2013). Chapter 53. Infeility. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.

Gynaecology & Obstetrics

null

Endometrial biopsy

1st urge at micturition comes at -

Ans. is 'c' i.e., 150 ml "First urge to void is felt at a bladder volume of about 150 ml, and a marked seme offullness at about 400 ml".- Ganong

Physiology

Bladder and Micturition Physiology

150 ml

During physical examination of a patient with history of TIA, it is found that the ankle jerk reflex is absent. Which of the following nerves is responsible for the reflex arc?,

The ankle jerk reflex, elicited by tapping the tendo Achilles with the reflex hammer, is mediated by Tibial nerve. The superficial fibular (peroneal) nerve supplies the foot eveor muscles of the lateral compament of the leg and provides sensory supply for the dorsum of the foot. The deep fibular (peroneal) nerve innervates the foot extensor and inveor muscles in the anterior compament of the leg and supplies skin between the first and second toes. The common fibular (peroneal) nerve combines the functions of the superficial and deep branches.

Anatomy

Nerve supply of Lower Limb

Tibial

Which of the following is the predominant immunoglobulin isotype secreted in the human MALT?

Ans. (d)The vast majority of the antibody generated in the human MALT (Mucosal Associated Lymphoid Tissues) is of the IgA isotype. IgE, IgG and IgM are present, but at far lower levels, and IgD is essentially absent.

Microbiology

Immunology

IgE

Abdominal Aorta Bifurcates at the level of

Abdominal Aorta Bifurcates at the Lower border of L4

Anatomy

null

Lower border of L4

For post-exposure prophylaxis, dose of human rabies immunoglobulin is:

Human rabies immune globulin (HRIG): 20 IU/kg, maximum injected locally, rest IM in gluteal region. It is indicated in only in category III bites. Equine rabies immunoglobulin (ERIG)- It is given at dose of 40 IU/kg . Being heterologous in origin (horse), it is associated with serum sickness; hence not in use.

Microbiology

Virology Pa-2 (RNA Virus Pa-1,2 & Miscellaneous Viruses)

20 IU/kg

PARULIS is an inflammatory enlargement seen in

null

Pathology

null

End of sinus tract

Prader willi syndrome and Angel man syndrome are examples of

Genomic imprinting is a proces of epigenetic modification of nucleotides in which only one allele of specific gene is functioning, while the other allele is silenced based on the parent of origin.

Biochemistry

null

Genomic Imprinting

Which pa of the ear has origin from all the three layers of germ layer:

The eardrum forms from the joining of the expanding first pharyngeal pouch and groove.Around day 30 of gestation, the endoderm-lined first expands to form the tympanic cavity, which subsequently envelops the inner ear ossicles.Simultaneously, the first pharyngeal groove, which is lined with ectoderm, expands to form the developing external auditory meatus.Separated by a thin layer of splanchnic mesoderm, the tympanic cavity and external auditory meatus join to form the tympanic membrane.As a result, the tympanic membrane is derived from all three germ layers.

Anatomy

null

Tympanic membrane

Consider the following 1* Malnutrition deficiency 2. Lithostatin (pancreatic stone protein 3. Cassava tuber Oxidant stress (heightened cytochrome P-450 activity) Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ?

Calcification, which is another sign of chronic inflammation, can develop throughout the pancreas. These calcifications are like stones that are within the tissue itself, or within the pancreatic duct Ref Davidson 23rd edition pg 765

Medicine

Miscellaneous

1, 2 and 3 only

A diagnosed case of psoriasis, taking MTX since last 15 yrs presents with jaundice and abnormal LFT. So, what will be the course of management:

Methotrexate is hepatotoxic drug- Therefore, abnormal liver function test & jaundice (in history)- Next step- stop Mtx- Therefore, B is ruled out 3 systemic drugs used in psoriasis1. Mtx (Teratogenic, hepatotoxic)2. Cyclosporine (nephrotoxic)-3H( HTN, Hyperiglyceridemia , Hyperichosis)3. Acitretin- teratogenic, dyslipidemia. In psoriasis systemic steroids are C/I Dapsone have no role.

Dental

Psoriasis

Stop Mtx, sta cyclosporine

In human dioploid cells rabies vaccine the schedule of immunisation is -

null

Social & Preventive Medicine

null

0,3,7,14,30,90

A 35 year old is given excessive intravenous Benzodiazepine.She suddenly becomes agitated, combative, and exhibits involuntary movements. The anesthesiologist determines that she is having a reaction to the drug which has been given in excess. Next step would be adminstration of:

Flumazenil

Pharmacology

null

Flumazenil

Malignant pustule is seen in -

Ans. is 'a' i.e., Cutaneous anthrax [Ref: Anantnarayan 8/ep 245\Anthrax is primarily a disease of the domestic animals.Humans are usually accidental hosts when brought into contact with infected animalsThe most common form of anthrax is cutaneous anthrax which is usually occurred via injured skin or musous membraneCutaneous anthraxCutaneous anthrax usually begins 2-5 days after inoculation of spores into an exposed part of the body typically the forearm or the hand.The initial lesion is an erythematous papule which may be mistaken for insect bite. This papule usually progresses through vesicular and ulcerative stages in 7-10 days to form a black eschar surrounded by edema The lesion is known as "malignant pustule" although it is neither malignant nor pustule. Associated symptoms are usually mild and the lesion typically heals very slowly after the eschar separates.Cutaneous anthrax generally resolves spontaneously but 10-20% of untreated patients may develop septicemia.Cutaneous anthrax generally resolves spontaneously but 10-20% of untreated patients may develop fatal septicemia or meningitis.

Microbiology

Bacteria

Cutaneous anthrax

A 35 year old captain in the army has been plagued by a painful, erosive lesion near his ear lobe since his return from operation dese storm several years ago. Punch biopsy of the leading edge of the erosion reveals macrophages distended with oval amastigotes. How was this infection acquired?

This is the history of cutaneous leishmaniasis caused by the L. tropica or L. major. The vector is sandfly (Phlebotomus sergenti or P.papatasii). This disease is also called as Delhi boil, Baghdad boil and oriental sore. Most cases of cutaneous leishmaniasis are seen in Afghanistan, Brazil, Iran, Iraq, Peru, and Saudi Arabia.

Microbiology

Parasitology Pa 1 (Protozoology)

Bite of sandfly

Polysaccharide capsular resistance to phagocytosis is seen in

The virulence of Streptococcus pneumoniae depends on the capsular polysaccharide. The capsular polysaccharide because of its acidic and hydrophilic propeies, protects the cocci from phagocytosis. Capsulated streptococcus pneumoniae are not phagocytosed efficiently in fluid media or exudates, however, they are susceptible to surface phagocytosis, being engulfed against a firm surface, such as a fibrin clot or epithelium. The enhanced virulence of type 3 Streptococcus pneumoniae is due to an abundance of its capsular material. Non-capsulated strains are avirulent. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 226

Microbiology

Bacteriology

Streptococcus pneumoniae

All of the following causes death in coarctation of Aorta except –

The causes of mortality in co-arctation of aorta are : Hypertension o Aortic dissection o Premature atherosclerosis Rupture of aorta o Left ventricular failure o Infective endocarditis Cerebral haemorrhage (due to aneurysm rupture)

Pediatrics

null

Anterior MI

Tensors of vocal cord are

Intrinsic muscles acting on vocal cords: Abductors: Posterior cricoarytenoid Adductors: Lateral cricoarytenoid, lnterarytenoid (transverse arytenoid) Thyroarytenoid (external pa) Tensors: Cricothyroid, Vocalis (internal pa of thyroarytenoid) Intrinsic muscles acting on laryngeal inlet: Openers of laryngeal inlet: Thyroepiglottic (pa of thyroarytenoid) Closers of laryingeal inlet: Interarytenoid (oblique pa), Aryepiglottic (posterior oblique pa of interarytenoids)

ENT

null

Cricothyroid and internal thyroarytenoid

All of the following are useful in the intravenous therapy for hypertensive emergencies except

Ans. (D) Nifedipine(Ref: Katzung 10/e p145, 179: KDT 8th/e p618, 619)Nifedipine can be used rarely for the rapid control of blood pressure but the route of administration is sublingual. Fenoldopam is a D1 agonist used i.v. for hypertensive emergencies whereas urapidil is an a blocker. Enalaprilat (not enalparil) can also be used for the same indication.

Pharmacology

C.V.S

Nifedipine

An elderly multiparous woman with intrauterine foetal death was admitted with strong labour pains. The patient suddenly goes in shock with cyanosis respiratory disturbances and pulmonary oedema. The most likely clinical diagnosis is :

Amniotic fluid embolism

Gynaecology & Obstetrics

null

Amniotic fluid embolism

Technique used for Aspiration of sperm directly from Testes for In-vitro feilization is:

Testicular sperm aspiration (TESA) is a procedure sample of sperm cells are removed from the testicle through a small needle attached to a syringe. Other methods used are PESA: Percutaneous Epididymal Sperm Aspiration both TESA and PESA can be done under LA. MESA: Microsurgical Epididymal Sperm Aspiration TESE: Testicular Sperm Extraction MESA is the best technique for getting useable sperms since the epididymal sperms are the 'Ready'sperms which are ejaculated with the sexual act MESA allows for diagnosis and possible reconstruction of ductal pathology and because it usually yields very large numbers of sperm, sperm cryopreservation and avoidance of repeat surgery may be possible ICSI: Intracytoplasmic sperm injection GIFT: Gamete intra fallopian tube transfer IVF: In vitro feilisation

Gynaecology & Obstetrics

Infeility (Eggs'plantation!)

TESA

A 25 year old female patient history of 6 months, altered sensorium, involuntary rnovements,memory deficit, headache convulsions, abnormal movements, forgetfulness, 4 attack during day, 2 attack at night. CT normal :

Epilepsy It is a case of epilepsyTwo features our the diagnosis of epilepsy:-Presence of altered sensoriumOccurrence of epilep.sy during sleepDissociation disorders may resemble epilepsy, especially complex paial seizure.Dissociative disorders are a group of psychiatric syndromes characterized by disruptions of aspect of consciousness, identity, memory, motor behaviour or environmental awareness.They may resemble epilepsy in presentation but an impoant feature of these disorders is that the patient is always ale and oriented.Two impoant ways to rule out organic epilepsy from psychogenic epilepsy are:-i) Abnormality in E.E.G.- Generalized tonic clonic seizures always produce marked E.E.G. abnormalities during and after the seizure.ii) Increase in prolactin secretion- Measurement of serum prolactin levels may also help to distinguish between organic and psychogenic seizures, since most generalized seizures and many complex seizures are accompanied by rise in serum prolactin.Amnesia can occur in ceain epilepsies (complex paial seizures)Complex paial seizures are characterized by foal seizure activity accompanied by a transient impairment of the patient's ability to maintain normal contact with the environment (altered sensorium)The patient is unable to respond appropriately to visual or verbal commands during the seizure and has impaired recollection or awareness of the ictal phase.Examination immediately following the seizure may show an anterograde amnesia (memory deficits) or in cases involving the dominant hemisphere, a postictal aphasia.Other two options can be easily rule outSomatization disorderIn these cases patient will compain of number of symptoms involving multiple organ .system of the body.Hypochondriasis In lzypochondriasis patient complains that he has some serious ailment and he consults many dotors.

Psychiatry

null

Epilepsy

Common posterior cranial fossa tumours include all of following except -

Ans. is 'b' i.e., Oligodendroglioma o Oligodendrogliomas are uncommon tumours of childhood, occur predominently in the cerebral coex and originate in white matter (Supratentorial). Common childhood infratentorial post fossa tumors 1) Cerebellar astrocytoma (cystic astrocytoma) 3) Brainstem glioma 2) Medulloblastoma (Primitive neuroectodermal tumor) 4) Ependymoma

Pediatrics

null

Oligodendroglioma

Which of the following is not a complication of Total Parenteral Nutrition

.catheter related complication infections hydrothorax,pneumothorax,hemothorax cardiac tamponade injuriesto aeries and veins thrombotic complication air embolism metabolic complication azotemia essential fatty acid def fluid overload metabolic bone disease liver dysfunction glucose imbalance electrolyte imbalance trace elements and vitamin def

Surgery

General surgery

Congestive cardiac failure

H1 antihistaminics afford benefit in a number of conditions. All of the following conditions are benefited by antagonism of histamine :

In common cold , excessive secretions (like rhinorrhoea) are due to cholinergic overactivity. First generation antihistaminics possess anticholinergic propey and therefore are effective for common cold. On the other hand, all other conditions are allergic and reare benefited by antagonism of H1 receptors.

Pharmacology

Histamine, 5-HT and PGs

Common cold

Cardiac output during pregnancy is maximal at :

32nd week

Gynaecology & Obstetrics

null

32nd week

A 58-year-old woman had a mitral valve replacement, and was placed on anticoagulants and prophylactic antibiotics following her surgery. Five days after her surgery, she developed a sharply demarcated, erythematous rash on her left thigh. Two days after the rash appeared, large hemorrhagic bullae began to form in the area of the rash. Which of the following medications most likely caused the patient's rash?

Warfarin is a coumarin anticoagulant used for the prophylaxis and treatment of thromboembolic complications associated with cardiac valve replacement and atrial fibrillation, as well as the prophylaxis and treatment of venous thrombosis and pulmonary embolism. Warfarin may cause necrosis of the skin (typically on the breasts, thighs, and buttocks) generally between the third and tenth days of therapy. The lesions are initially sharply demarcated, erythematous, and purpuric. They may resolve or progress to large, irregular, hemorrhagic bullae that can eventually lead to necrosis. The mechanism for this reaction is related to warfarin's ability to deplete protein C, which can lead to a state of hypercoagulability and thrombosis in the cutaneous microvasculature. Aspirin is commonly used for its antiplatelet effect; however, it would not be indicated for anticoagulation of a patient with a recent cardiac valve replacement. Fuhermore, aspirin is not associated with the development of this type of skin necrosis. Cefazolin is a first-generation cephalosporin antibiotic commonly used as a perioperative prophylactic agent. If the patient was allergic to this antibiotic, an erythematous rash might have appeared. However, the rash would not lead to the appearance of large, hemorrhagic bullae. Heparin is an intravenous anticoagulant indicated for the prophylaxis and treatment of thromboembolic complications associated with cardiac valve replacement and atrial fibrillation. It is also indicated for the prophylaxis and treatment of venous thrombosis, pulmonary embolism, and for treatment of some coagulopathies. Although heparin is associated with the development of thrombocytopenia, it is not associated with skin necrosis.

Pharmacology

null

Warfarin

Bias can be eliminated by all except:

Ans. d. Multivariate analysis (Ref: Park 23/e p73, 83, 21/e p68-70, 78-79, 84; en.wikipedia.org/wiki/Bias_(statistics); style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">Multivariate analysis refers to the analysis of two or more dependent variables at a time. It is done after the study has been conducted, to analyze the study. While matching, binding and randomization all are done when the study is being conducted. (AIIMS November 2010 Repeat)."Confounding factors are an important source of bias. This can be removed by matching in case-control studies.""The selection bias can be eliminated by randomization.""Interviewer's bias can be eliminated by double-blinding."Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental maneuver is performed is known as selection bias. In the given question, researcher is concerned that the smokers might differ from non-smokers in their diet, exercise, etc. This concern is known as selection bias.Some important Types of Biases in Epidemiological StudiesInterviewer bias* Interviewer devotes more time of interview with cases as compared to controlsQMemory/ Recall bias* Cases are more likely to remember exposure more correctly than controlsQSelection bias (Susceptibility bias)* Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental manoeuvre is performedQInformation bias (Observer or misclassification bias)* Connective type of bias in which proportion of subjects are misclassified on exposure or diseases* Occurs due to people's curiosity and confusion of goals when trying to choose a course of action* It includes reporting, recall, interviewer & attention biasQBiasBias is any 'systematic error' in an epidemiological study, occurring during data collection, compilation, analysis and interpretation0Predominantly Biases are of 3 TypesSubject biasInvestigator biasAnalyzer bias* Error introduced by study subjects.* Examples:- Hawthorne effect- Recall biasQ* Error introduced by investigator* Selection biasQ* Error introduced by analyzer Some Important Types of Biases in Epidemiological StudiesApprehension bias* Certain levels (pulse, blood pressure) may alter systematically from their usual levels when the subject is apprehensiveAttention bias (Hawthorne effect)* Study subjects may systematically alter their behaviour when they know they are being observedQBerkesonian bias (Admission rate bias)* Bias due to hospital cases and controls being systematically different from each otherQInterviewer bias* Interviewer devotes more time of interview with cases as compared to controlsQLead time bias (Zero time shift bias)* Bias of over-estimation of survival time, due to backward shift in starting point, as by screening proceduresQMemory/ Recall bias* Cases are more likely to remember exposure more correctly than controlsQNeymann Bias (Prevalence-incidence bias)* Bias due to missing of fatal cases, mild/ silent cases and cases of short duration of episodes from the studyQSelection bias (Susceptibility bias)* Groups to be compared are differentially susceptible to the outcome of interest, even before the experimental manoeuvre is performedQ Minimization of Biases in Epidemiological Studies by BlindingTypeMethodMinimizesSingle blindingStudy subjects are not aware of the treatment they are receivingSubject biasDouble blindingStudy subjects as well as investigator are not aware of thetreatment study subjects are receivingSubject bias + Investigator biasTriple blindingStudy subjects, investigator as well as analyzer are not awareof the treatment study subjects are receivingSubject bias + Investigator bias + Analyser bias

Social & Preventive Medicine

Principles of Epidemiology

Multivariate analysis

Which of the following is not a cause of oropharyngeal carcinoma?

Ans. is 'a' i.e., Occupational exposure to hydrochloric acid Etiology of oropharyngeal carcinoma Tobacco in any form - cigarette smoking or chewing Heavy alcohol abuse Beetle nut chewing Plummer vinson syndrome, cirrhosis Syphilis Trauma Dental irritation Poor oral hygiene Occupational exposure to isopropyl alcohol, sulphuric acid and nickel HPV infection

ENT

null

Occupational exposue to hydrochloric acid

Larva of which of the following is seen in feces

Filariform larva is the infective form of strongyloides stercoralis The rhabditiform larva migrates into the lumen of the intestine and passes down the gut to be released in faeces Ref : panikers textbook of Medical parasitology 8th edition page 182

Microbiology

parasitology

Strongyloides stercoralis

Antibiotic potentiating the effect of NM blocker?

Ans. is 'b' i.e., Aminoglycoside Impoant interactions of skeletal muscle relaxants General anaesthetics potentiate competitive blockers in the following order : Isoflurane (most), sevoflurane, desflurane, enflurane, Holothane and nitrous oxide (least). . Anticholinesterase (neostigmine, pyridostigmine & edrophonium) reverse the action of competitive blockers, they can enhance depolarizing neuromuscular blockers. Calcium channel blockers (verapamil) potentiate both competitive and depolarizing neuromuscular blockers. Diuretics produce hypokalemia which enhances competitive block. Diazepam, propranolol and quinidine intensify competitive block. Aminoglycosides, tetracycline, polypeptide antibiotics, clindamycin and lincomycin can potentiate competitive block. High doses of glucocoicoids reduce the effect of competitive blockers

Anaesthesia

null

Amino glycos ide

Dent disease is due to defect of?

Dent's disease (or Dent disease) is a rare X-linked recessive inherited condition that affects the proximal renal tubules of the kidney. It is one cause of Fanconi syndrome and is characterized by tubular proteinuria, excess calcium in the urine, the formation of calcium kidney stones, nephrocalcinosis, and chronic kidney failure. About 60% of patients have mutations in the CLCN5 gene (Dent 1), which encodes a kidney-specific chloride/proton antipoer, and 15% of patients have mutations in the OCRL1 gene (Dent 2). Dent's disease often produces the following signs and symptoms: Rickets Extreme thirst combined with dehydration Nephrolithiasis (kidney stones) Hypercalciuria (high urine calcium - >300 mg/d or >4 mg/kg per d) with normal levels blood/serum calcium) Aminoaciduria (amino acids in urine) Phosphaturia (phosphate in urine) Diagnosis is based on a genetic study of CNCL5 gene Ref: wikipedia

Pathology

Nervous system

Chloride channel

A patient presents with low serum calcium, high phosphorus and etevated PTH. Which of the following investigations is least contributory to establish a diagnosis -

Ans is option 1.. Vit D levels Vit d deficiency is associated with hypophosphatemia and not hyperphosphatemia Renal failure, pseudohypoparathyroidism and increased urinary myoglobin may all be associated with combination of hypocalcemia, hyperphosphatemia and elevated PTH levels Ref Harrison 19/e p2482

Medicine

Endocrinology

Vitamin D levels

Earliest phenotypic manifestation of Idiopathic hereditary hemochromatosis is-

Answer is D (Increased Transferrin Saturation) The Most Common Manifestation of Hemochromatosis is Hepatomegaly. Liver Enzymes may be normal or elevated depending on the extent of hepatocyte damage. A transferrin saturation of more than 45% is the earliest phenotypic abnormality in hereditary hematochromatosis' Transferrin saturation and measurement of unbound iron bindeng capacity are recommended fir initial scrceening of individuals Tests Recommended for screening for Hereditary Hematochromatosis Transferrin Saturation The transfrrin saturation f wore than 45% is the earliest phenotypic abnormality in hereditary hematochromatosis Transferrin saturation is considered the best initial screening test for hereditary hematochromotosis Transferrin saturation has a high sensitivity of >90% in diagnosing hereditary hematochromatosis Transferrin saturation is the ratio of serum iron to total iron binding capacity (SUTIBC) Iron binding capacity (Unbound /Unsaturated) Unbound Iron binding capacity is an alternative screening test. Unbound Iron binding capacity UIBC=TIBC-Serum Iron Unbound iron binding capacity is decreased in hematochromatosis

Medicine

null

Increased transferrin saturation

Live vaccine is -

Ans. is 'c' i.e., Sabin polioLive attenuatedInactivated or killedImmunoglobulins Bacterial BOG Typhoid oral VTral Oral Polio (Sabin) Yellow fever Measles Rubella Mumps Chicken pox Influenza Rickettsial Epidemic TyphusBacterial Typhoid Cholera Pertussis Meningitis Plague Viral Rabies Injectable polio (Salk) Influenza Hepatitis AJE KFDHuman normal Hepatitis A,B Measles Rabies Tetanus Mumps Human Specific Varicella Diptheria Non-Human (antisera) Diphtheria Tetanus Gas Gangrene Botulism RabiesSubunit Vaccines Hepatitis B Typhoid Vi antigenToxoids Diphtheria TetanusBoth active & passive immunization can be given together Diphtheria Hepatitis B Tetanus Rabies

Microbiology

Immunity

Sabin polio

Prolonged use of one of the following anticonvulsant can produce weight loss -

Ans. is 'c' i.e., Topiramate o Use of topiramate is limited by its unwanted side effects paicularly weight loss, sedation and naming difficulties. Note - Other drug causing weight loss is Felbamate.

Pharmacology

null

Topiramate

Which of the following anti TB drugs acts on extracellular organisms and is bactericidal drug?

Streptomycin is the only anti-TB drug which acts on extracellular organisms and is bactericidal. All first line antitubercular drugs are bactericidal except ethambutol which is bacteriostatic. Impoant points about first line ATT: Drug Action Hepatotoxic Bacteria Inhibited Isoniazid CIDAL Yes Both Rifampicin CIDAL Yes Both Pyrazinamide CIDAL Yes Intracellular Ethambutol STATIC No Both Streptomycin CIDAL No Extracellular

Pharmacology

Mycobacterial Diseases (TB, Leprosy and MAC)

Streptomycin

The exact pa of the antigen that reacts with the immune system is called as ?

Ans. is 'b' i.e., Epitope Epitope . Also known as "antigenic determinant". . It is antibody binding site of antigen. . It is the smallest unit of antigenicity. . Antigenic determinants is composed of structures on the surface of molecules and can be constructed in two ways: 1. Within a single segment of primary sequence 4. Sequential epitopes 2. Assembled from residues far apa in the primary 3. Conformational epitopes sequence but brought together on the surface by the folding of the molecule into its native conformation . The majority of antigenic structures recognized by antibodies depend on the teiary configuration of the antigen (conformational), while T cell epitopes are defined by the primary structure (sequential). Paratope . The pa of the antibody or T cell receptor that interact with the epitope. "The idiotype is defined as the specific region of the fab poion of the 1g molecules to which antigen binds".

Microbiology

null

Epitope

Best treatment for remission of acute ulcerative colitis is ?

GLUCOCOICOIDS Effective for inducing remission in both UC & CD. No role in maintenance in either UC or CD. Once clinical remission is achieved , they should be tapered.

Surgery

Inflammatory bowel disease

Prednisolone

Which of the following is not a feature of MEN type

Ans: d (Adrenocortical adenoma)Ref: Harrison, 17 ed pg. 2359MEN I (Wermer's syndrome) is characterized by pituitary, parathyroid & pancreatic affection. Pheochromocytoma is seen in all three even though less common in MEN I MEN' I (wermer's)MEN IIA (sipple)MEN II BPi tut aryAdenomaHyperplasia ParathyroidHyperplasiaAdenomaCarcinomaHyperplasia PancreasIslet cell hyperplasia,AdenomaCarcinoma Adrenal Pheochromocy- tomaPheochrom- ocytomaThyroid Ccell hyperplasiaC-cell hyperplasia MedullarycarcinomaMedullary carcinomaMucocutan- eous ganglioneu- romaMarta noidHabitus Less commonPheochromo- cytomaForgut carcinoidSubcutaneous/ visceral lipomaDermal angiofibroma Mutant gene RETRET MEN Hirschsprung - loss of function in RET protooncogene MEN 2A - gain of function in RET protooncogene.Please don't confuse Wermer's syndrome (MEN 1) with Werner's syndrome which is adult progeria. It is a rare condition and predisposes to papillary cancer thyroid.

Medicine

Endocrinology

Adrenocortical adenoma

Samters triad is seen in patients with -

Ans. is 'a' i.e.. Asthma [Ref: Dhingra 5th/ep. /55jSamter's triado Samter's triad is a medical condition consisting of asthma, aspirin sensitivity, and nasal/ethmoidal polyposis. It occurs in middle age (twenties and thirties are the most common onset times) and may not include any allergies.o Most commonly, the first symptom is rhinitis.o The disorder typically progeses to asthma, then polyposis, writh aspirin sensitivity coming last,o The aspirin reaction can be severe, including an asthma attack, anaphylaxis, and urticaria in some cases. Patients typically react to other NSA1DS such as ibuprofen, although paracetamol is generally considered safe,o Anosmia (lack of smell) is also typical, as the inflammation reaches the olfactory receptors in the nose.

ENT

Nose and PNS

Asthma

Besides zidovudine and lamivudine, which following drug is a reverse transcriptase inh v used in the treatment of HIV infection?

Anti-Retroviral drugs (a) Nucleoside reverse transcriptase inhibitors (Nis) : Zidovudine (AZT), Didanosine, Zalcitabine*, Stavudine, Lamivudine, Abacavir (b) Nonnucleoside reverse transcriptase inhibitors (NNis) : Nevirapine, Eirenz, Delavirdine* (c) Protease inhibitors : Ritonavir, Indinavir, Nelfinavir, Saquinavir, Amprenavir*, Lopinavir Ref Harrison 20th edition pg 789

Medicine

Infection

Abacavir

Chloride responsive alkalosis, causes are-

Repeat

Medicine

Fluid and electrolytes

Severe vomiting

The bone matrix has the following crystals ?

Ans. is 'a' i.e., Calcium hydroxyapatite Structure of bone Bone is a specialized connective tissue. o Bone components are :? Inorganic elements (65%) Organic matrix (35%) 1. Inorganic elements It is the mineral phase, principally composed of calcium and phosphate, mostly in the form of hydroxyapatite.

Surgery

null

Calcium hydroxyapatite

Cabot&;s ring is seen in-

In the peripheral blood smear of megaloblastic anaemia . Cabot rings are thin, threadlike, red to violet rings or "figure 8" shaped inclusions in red blood cells. Cabot rings are remnants of the mitotic spindle, and can be seen in megaloblastic anemia, medication effect, myelodysplasia and other forms of dyserythropoiesis. reference :textbook of Pathology, 7th edition ,Author Harsha Mohan ,page number 283, figure 10.20

Pathology

Haematology

Megaloblastic anemia

Not a surgical landmark for parotid surgery

surgical landmark of parotid surgery are : Tragal pointer Digastric posterior belly Styloid process tympansmastoid suture ref : hazarika 4th ed

ENT

All India exam

Inferior belly of omohyoid

Comparison of efficacy of a new drug B with an existing drug A is done in which phase of clinical trials?

"The purpose of phase III trials is to obtain adequate data about the efficacy and safety of drugs in a larger number of patients of either sex in multiple centres usually in comparison with the standard drug." Phase I: Human Pharmacology (Non-therapeutic trials): Done in healthy persons Phase II: Therapeutic exploratory trials: conducted in patients to determine therapeutic effects, effective dose range and fuher evaluation of safety and pharmacokinetics in patients Phase III: Therapeutic confirmatory trials: Conducted to obtain adequate data about the efficacy and safety of drugs in a larger number of patients of either sex in multiple centres usually in comparison with the standard drug. Phase IV: Post marketing studies

Pharmacology

CLINICAL TRIALS, DRUG LABEL

Phase III

Vogt Koyanagi–Harada (VKH) syndrome is –

VKH syndrome is a multisystem disorder characterized by chronic granulomatous uveitis with exudative retinal detachment that is often associated with neurological and cutaneous manifestations.

Ophthalmology

null

Chronic granulomatous uveitis

Features of hereditary spherocytosis include all of the following except :

Answer is C (MCV Ted) Mean corpuscular volume of RBC is decreased in patients with hereditary spherocytosis. Hereditary spherocytosis is characterised by defect in one of the proteins in the cytoskeleton of Red cell membrane, leading to loss of membrane, and hence decreased ratio of surface area to volume and consequently spherocytosis. Characteristic Laboratory abnormalities The mean corpuscular volume (MCV) : is decreasedQ The mean corpuscular Hb. concentration (MCHC) : is increasedQ Osmotic fragility is : increasedQ Remember the following also : * Most common membrane defect is that of Ankyrin Q * One characteristic clinical presentation is Striking splenomegaly Q * Treatment of choice is (anemia, splenomegaly, jaundice) Splenectomy Q

Medicine

null

|mcv

Which one of the following is NOT a component of the filtration slit diaphragm at the glomerulus?

The filtration barrier in the glomerulus is composed of the endothelial cells of glomerular capillaries, basement membrane that covers the endothelial cells, and foot processes of the epithelial cells surrounding the basement membrane Podocytes are separated by apparent gaps called filtration slits. Each filtration slit is bridged by a thin diaphragm. The filtration slit diaphragm is composed of several proteins, such as nephrin, podocin, a-actinin. Batin gene (also known as BSND) codes for the protein batin; this protein recruits the Cl- channel CLCNKB to the basolateral membrane in the TAL of loop of Henle.

Physiology

Excretory System (Kidney, Bladder) Acid-Base Balance

Batin

By what age does a child achieve the following developmental milestone?

Age Milestones 4 months 6 months 9 months 10-12 months 12 months Bidextrous grasp Unidextrous / palmar grasp(Ulnar grasp) Immature Pincer grasp Palmar grasp (Radial grasp) Mature Pincer grasp

Pediatrics

null

6 months

Uses of PUVA – a) Pigmented purpuric lesionb) Herpes zosterc) Mycosis fungoidesd) Lupus panniculitise) Lichenoid dermatitis of Gougerot & Blum

Indications for PUVA and UVB Established major indications :- Psoriasis, atopic dermatitis, vitiligo, mycosis fungoides, Polymorphic light eruption, pompholyx. Less frequently treated (less evidence of effectiveness) :- Pityriasis rosea, morphea, chronic urticaria, Pityriasis lichenoid chronica, Alopecia totalis & Universalis, Lichen plaints, Pityriasis rubra pilaris, Granuloma annulare, Generalized pruritis, Nacrobiosis lipoidics. "Pignzented pruritic lichenoid dermatosis of Gougerot & Blum can be treated by PUVA".

Dental

null

ace

Drug of choice for Bupivacaine induced cardiac arrythmia

Bretylium is a class III Antiarrythmic used to treat Bupivacaine induced ventricular tachycardia.

Pharmacology

null

Bretylium

Quod Hanc is-

Ans. is 'd' i.e., Psychologic impotence

Forensic Medicine

null

Psychologic impontence

Area of skin supplied by single nerve supply

A dermatome is an area of skin that is mainly supplied by a single spinal nerve. There are eight cervical nerves (C1 being an exception with no dermatome), twelve thoracic nerves, five lumbar nerves and five sacral nerves. Each of these nerves relays sensation (including pain) from a particular region of skin to the brain. Spinal nerves not only play an important role in differentiation and motor innervation of the limb musculature, but also provide sensory innervations for the dermatomes.

Pathology

null

Dermatome

Inactivated microorganisms are used in the manufacture of which of the following:

null

Microbiology

null

Salk vaccine

False statement about MODY is -

Maturity-onset diabetes of the young (MODY) is characterized by autosomal dominant inheritance, early onset of hyperglycemia (usually <25 years; sometimes in neonatal period), and impaired insulin secretion. It is non insulin requiring diabetes and can be managed by diet and sulfonylurea (paicularly HNF-1a and HNF-4a forms). Reference : page 806-7 Davidson's Principles and practice of Medicine 22nd edition

Medicine

Endocrinology

Insulin dependent