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Tetanus is caused by
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Tetanus is caused by Clostridium tetani. It produces two toxins: tetanolysin and tetanospasmin. Tetanospasmin is responsible for tetanus. Tetanus is characterized by tonic muscular spasms usually commencing at the site of infection later become generalized, involving the whole of the somatic muscular system. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 265
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Microbiology
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Bacteriology
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Clostridium tetani
|
Which of the following is false regarding first degree burns
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First degree burns: Involves only epidermis, painful but donot blister, protective functions are intact as nd heals without scar Second degree burns: Dermal involvement and are extremely painful with weeping and blisters Third degree burns: Leathery, painless and non blanching
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Anatomy
|
General anatomy
|
Blister formation
|
A child requires how much energy per day (Kcal/ day)?
|
Ans. is 'a' i.e., 1000-1500
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Social & Preventive Medicine
| null |
1000-1500
|
Lack of beta-oxidation of fatty acid leads to?
|
Lack of beta-oxidation of fatty acids leads to the accumulation of dicarboxylic acids. Dicarboxylic aciduria is caused by a lack of mitochondrial medium-chain acylCoA dehydrogenase. It is characterized by 1. Excretion of C -C o-dicarboxylic acids in the urine. 2.Nonketotic hypoglycemia Reference: Harper's Illustrated Biochemistry 31st edition Pg 215
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Biochemistry
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Metabolism of lipid
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Dicarboxylic acid accumulation
|
Posterior styphayloma is a feature of-
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Posterior staphyloma. It refers to bulge of weak sclera lined by the choroid behind the equator. Here again the common causes are pathological myopia, posterior scleritis and perforating injuries. It is diagnosed on ophthalmoscopy. The area is excavated with retinal vessels dipping in it (just like marked cupping of optic disc in glaucoma) . Its floor is focussed with minus number lenses in ophthalmo-scope as compared to its margin.
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Ophthalmology
|
Cornea and sclera
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Pathological myopia
|
Which intravenous anaesthetic agent has analgesic effect also
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Ketamine does not elicit pain on injection, instead produces profound analgesia. Thiopentone at a concentration greater than 2.5% can produce pain on injection and venous thrombosis. Propofol is formulated as a lipid emulsion which causes pain on injection. A new aqueous prodrug, Fospropofol is associated with less pain on injection. Etomidate, although causes pain on injection, the lipid formulation of etomidate is associated with a much less frequent incidence of pain.
|
Anaesthesia
|
Intravenous Anesthetic Agents
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Ketamine
|
Which of the following statements concerning sensorineural hearing loss in children with bacterial meningitis are TRUE?
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Sensorineural hearing loss is detected by evoked-response audiometry in between 5 and 10% of children with bacterial meningitis. Up to 30% of children with meningitis caused by S. pneumoniae will have hearing deficits. Hearing loss generally is noted early in the course of bacterial meningitis and occurs despite prompt initiation of appropriate antimicrobial therapy. All children with bacterial meningitis should have hearing assessment by evoked-response audiometry before or soon after hospital discharge. Ref: Roos K.L., Brosch J.R. (2012). Chapter 199. Meningitis and Encephalitis. In G.V. Lawry, S.C. McKean, J. Matloff, J.J. Ross, D.D. Dressler, D.J. Brotman, J.S. Ginsberg (Eds), Principles and Practice of Hospital Medicine.
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Medicine
| null |
Prompt institution of antimicrobial therapy appears not to influence the incidence
|
Bacterial communication with each other in a biofilm is known as
| null |
Dental
| null |
Quorum sensing
|
Burden of disease is detected by
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Disability Adjusted Life Years (DALY) is a measure of overall disease burden expressed as a number of years lost due to ill health, disability or early death. Ref: 25th edition Park&;s Textbook of Preventive and Social Medicine, Page no. 26
|
Social & Preventive Medicine
|
Concept of health and disease
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DALY
|
Choose the wrong statement about osteomyelitis
| null |
Orthopaedics
| null |
Post surgical - Pseudomonas aeruginosa
|
In treatment of shock Dobutamine is preferred over Dopamine because?
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ANSWER: (D) All of the aboveREF: KDT 5th edp.470DopamineActs on D1 , D2 , alpha and betal receptorsLow doses: renal vasodilation (D1 action)Moderate doses: Positive ionotropism (betal action) High doses: Vasoconstriction ( alphal action)DobutamineRelatively betalspecific agonistIonotropic i.e increases force of cardiac contraction without causing vasoconstriction . increasing afterload, heart rate or BP.Therefore since dobutamine is betal specific, doesn't cause vasoconstriction, it is less arrythmogenic, and doesn't affect renal vasculature it is preferred in cardiogenic shock, however it is less suitable for shocks in which vasoconstriction is required.
|
Pharmacology
|
A.N.S.
|
All the above
|
Which of the following should be avoided in the long-term follow-up of a renal transplant recipient on ciclosporin?
|
The potential for hazardous drug interactions in patients undergoing long term immunosuppression means that paicular care is needed with prescribing. The following should be avoided in renal transplant receipients Administer live vaccines Prescribe drugs that induce or inhibit cytochrome P450 activity if patient is taking sirolimus, tacrolimus, or ciclosporin Prescribe nephrotoxic agents (such as non-steroidal anti-inflammatory drugs) Note: After a year of stable graft function, pregnancy is likely to be safe. Ref: CLINICAL REVIEW, Renal transplantation, BMJ 2011;343:d7300 ; The Renal Association. Assessment of the potential kidney transplant recipient. 2011.
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Medicine
| null |
All of the above
|
In Cleidocranial dysostosis, sometimes the roots of the permanent teeth are
| null |
Pathology
| null |
Thin and short
|
VWF factor deficiency causes:
|
Deficiency of Von willebrand factor (VWF -promote platelet adherence and activation) causes | Platelet adhesion ( |BT ) | Intrinsic pathway activity ( | aPTT) | Factor VIII in plasma C/F Mucosal bleeding - Petechiae /purpura /epistaxis / melena Tissue bleeding Rx - Desmopressin for mild form - Cryoprecipitate for severe form
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Pathology
|
Hematology
|
All of the above
|
A case of hepatocellular carcinoma involving segment IV and VI without any metastasis in a 62 year old alcoholic may be treated by all of the following except -
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Ans. is 'd' i.e., Cryotherapy o There are large number of treatment options for patients with hepatocellular carcinoma:# The only t/t modality with curative potential is- "Complete excision of hepatocellular carcinoma either by partial hepatectomy or by total hepatectomy and transplant"# Radiofrequency ablation and surgical resection have been equally effective for potentially resectable hepatocellular carcinoma in some studies so some consider radiofrequency ablation as potentially curative.T/t options for hepatocellular carcinoma :a) Surgicalc) Transarterial# Resection# Orthotopic liver transplant# Embolization# Chemoembolization# Radiotherapyb) Ablative# Percutaneous ethanol injection# Percutaneous acetic acid injection# Thermal ablation (cryotherapy, radiofrequency ablation, microwave)d) Combination transarterial/ablativee) External beam radiationf) Systemic# Chemotherapy# Hormonal therapy# Immunotherapy
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Unknown
| null |
Cryotherapy
|
Nutrition for ameloblast, immediately at the beginning of dentinogenesis occurs in
| null |
Dental
| null |
Stellate reticulum
|
Paial mole is
|
Paial mole : Karyotype is triploid either 69XXY or 69XYY One maternal and usually two paternal haploid chromosomes Ref: Dutta Obs 9e pg 186.
|
Gynaecology & Obstetrics
|
General obstetrics
|
Triploid
|
All of the following are causes microcytic hypochromic anemia except: March 2011, March 2013
|
Ans. D: Fanconi's anemiaThe red cells in aplastic anemia are usually slightly macrocytic and normochromicFanconi anemia (rare autosomal recessive disorder caused by defects in a multiprotein complex that is required for DNA repair) underlie some forms of aplastic anemia.Conditions causing microcytic, hypochromic anemia in childhood includesIron deficiency,Beta-Thalassemia trait,Lead poisoning,Chronic illness or inflammation, andSideroblastic anemiaSideroblastic anemiaIt is characterized by:-- Ineffective erythropoiesis anemia with ringed sideroblasts,- Saturation of serum iron binding capacity (usually approaching 80%),- >LDH, and- Bizarre peripheral smear with hypochromia, distoed red cells, and basophilic stippling.Causes:- Hereditary or congenital: X-linked or autosomal recessive- Acquired sideroblastic anemiaIdiopathic refractory sideroblastic anemiaSecondary to: neoplasm (Di Guglielmo's disease erythroleukemia), inflammatory, hematologic, metabolic diseases.Associated with drugs or toxins: (1) Alcohol. (2) Lead. (3) Chloramphenicol. (4) Anti TB meds: INH. (5) Anti neoplastic alkylating agents as cytophosphamide.ThalassemiaInherited anemias characterized by defects in the synthesis of one or more globin chain subunits of the adult hemoglobin tetramer (Hb A).This leads to deficient hemoglobin accumulation, resulting in hypochromic and microcytic red cells and ineffective erythropoiesis and hemolytic anemia.Signs and symptoms: Thalassemia trait has no signs or symptoms.-- Pallor, Poor growth, Inadequate food intake, Fatigue, Shoness of breath, Splenomegaly, Jaundice, Maxillary hyperplasia, Dental malocclusion, Cholelithiasis, Pathologic fracturesLaboratory: In the presence of normal iron status, Increased levels of Hb A2 (to 4 to 6%) and/or increased Hb F (to 5 to 20%) by quantitative hemoglobin analysis suppos the diagnosis.Unfounately, differentiation between iron deficiency anemia and beta- or alpha-thalassemia trait can be difficult in practice if no reciprocal increases in Hb A2 levels and/or Hb F are present.- The distinction between alpha- and beta-thalassemia depends on the measurement of the minor hemoglobins Hgb A2 and Hgb F.- If these are normal, the diagnosis of alpha-thalassemia is most likely.Hemoglobin electrophoresis:- Elevated Hb A2 levels in beta-thalassemia trait- Elevated Hb A2, elevated Hb F, reduced or absent Hb Al in beta-thalassemia major or intermedia Peripheral blood:- Pronounced microcytosis,- Anisocytosis,- Poikilocytosis,- Hypochromia,- Punctate basophilic stippling,- High percentage of target cells, nucleated RBC,- Reticulocyte count elevatedHematocrit:- 28-40% in alpha-thalassemia trait and beta-thalassemia trait- May fall to less than 10% in beta-thalassemia majorFanconi anemia (FA)It is a genetic disease with an incidence of 1 per 350,000 bihsFA is the result of a genetic defect in a cluster of proteins responsible for DNA repair.As a result, the majority of FA patients develop cancer, most often acute myelogenous leukemia, and 90% develop bone marrow failure by age 40.Clinically, hematological abnormalities are the most serious symptoms in FA.While at bih, blood count is usually normal, macrocytosis/megaloblastic anemia is the first detected abnormality, often within the first decade of life (median age of onset is 7 years).Within the next 10 years, over 50% of patients presenting haematological abnormalities will have developed pancytopenia.Most commonly, a low platelet count (thrombocytopenia) precedes a low neutrophil count (neutropenia)
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Pathology
| null |
Fanconi's anemia
|
Gonococcus resistant structure is
|
B i.e. Testis
|
Skin
| null |
Testis
|
In a patient who underwent post molar evacuation by dilatation and curettage. Which of the following test used to define successful removal of H. Mole :
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Ans-A Beta HCGMONITORING* After suction Evacuation: We send weekly serum b-HCG. Till they Become Normal.Avg. time for HCG to Came Back to Normal* After a complete Mole - 9 weeks* After a partial Mole - 7 weeks* After a Molar - 9 weeks* Once HCG is Normal* We send HCG values Monthly x6 months
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Unknown
| null |
Beta HCG
|
Injury from application of fluid above 60 or from steam is called
|
Scalds A scald is an injury from the application of fluid above 60 or from steam. Because of the cooling of the liquid due to evaporation, the lesion due to scald is not very deep. However the latent heat of the viscid fluid is high and hence, the penetration capacity of heat of such liquids is more. Thus an injury caused by hot tar, syrup, oil, etc is comparatively deeper than that caused by hot water. Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 169
|
Forensic Medicine
|
Thermal injury
|
Scalds
|
Prerequisite for applying forceps are all except:September 2007
|
Ans. C: Saggital suture should be in line with transverse diameter of pelvisConditions to be fulfilled prior to forceps operation:The fetal head must be engagedCervix must be fully dilatedMembranes must be rupturedThe position and station of the fetal head must be knownNo major CPDAdequate analgesiaBladder must be emptied.
|
Gynaecology & Obstetrics
| null |
Saggital suture should be in line with transverse diameter of pelvis
|
Which one of the following is not used as a tumor marker in testicular tumours ?
|
Carcinoembryonic antigen (CEA) describes a set of highly related glycoproteins involved in cell adhesion. CEA is normally produced in gastrointestinal tissue during fetal development, but the production stops before bih. Therefore, CEA is usually present only at very low levels in the blood of healthy adults. However, the serum levels are raised in some types of cancer, which means that it can be used as a tumor marker in clinical tests. Serum levels can also be elevated in heavy smokers. CEA are glycosyl phosphatidyl inositol (GPI) cell-surface-anchored glycoproteins whose specialized sialofucosylated glycoforms serve as functional colon carcinoma L-selectin and E-selectin ligands, which may be critical to the metastatic dissemination of colon carcinoma cells. Immunologically they are characterized as members of the CD66 cluster of differentiation. The proteins include CD66a, CD66b, CD66c, CD66d, CD66e
|
Pathology
|
General pathology
|
CEA
|
MRP2 transpoer defect leads to development of?
|
MRP2 defect: Multidrug resistance-associated protein 2 (MRP2), an ATP-dependent canalicular membrane transpoer. It is defective in Dubin Johnson syndrome. This protein is encoded by gene known as ABCC2 Gene which is mutated. Dubin Johnson syndrome- It is an autosomal recessive disorder occurs due to defect in MRP-2 protein. kernicterus is absent , with liver biopsy showing black pigmentation. Mild jaundice is seen with normal bile acids level.
|
Medicine
|
Hereditary Hyperbilirubinemia & Jaundice
|
Dubin Johnson syndrome
|
Dematome of middle finger:
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For thumb C6 For index and middle finger C7 For ring and little finger C8
|
Orthopaedics
|
Ohopaedics Q Bank
|
C7
|
Insulin resistance state causing hyperglycemia is present in -
|
Ans. is 'a' i.e., Acromegaly o Endocrinopathies associated with hvperglvcia and insulin resistance state are:# Acromegaly# Cushing syndrome# Hyperthyroidism# Pheochromocytoma# Glucagonoma
|
Pathology
|
Endocrine Pancreas
|
Acromegaly
|
After 3rd stage of labour and expulsion of placenta, patient is bleeding heavily. Ideal management would include all except: March 2005
|
Ans. C: APGAR Scoring APGAR scoring is done for the assessment of newborn and has nothing to be done with control of uterine bleed. The underlying principle in active management of the third stage is to excite powerful contractions following bih of the anterior shoulder by parenteral oxytocirV ergometrine/ uterine massage which facilitates not only early separation of the placenta but produces effective uterine contractions following its separation.
|
Gynaecology & Obstetrics
| null |
APGAR scoring
|
A 77-year-old woman presents with headaches and difficulty walking. She has an unbalanced gait and falls easily, especially when trying to walk upstairs. The tone is normal and there are no cerebellar findings. A CT scan reveals enlarged ventricles.For the above patient with neurologic symptoms, select the most likely structural pathology.
|
Adults may develop hydrocephalus as a result of occlusion of CSF pathways by tumors in the third ventricle, brain stem, or posterior fossa. In adults, the symptoms of obstructive hydrocephalus include headache, lethargy, malaise, incoordination, and weakness. Seizures do not usually occur. Dementia, altered consciousness, ocular nerve palsies, papilledema, ataxia, or corticospinal tract signs maybe present.
|
Medicine
|
C.N.S.
|
aqueductal stenosis
|
What is the most common problem following surgical treament of pterygium?
|
Recurrence of the pterygium after surgical excision is the most comon problem after pterigium excision and is seen in 30-50 % of the cases. Reference : AK Khurana 7th edition page.89
|
Ophthalmology
|
Conjunctiva
|
Recurrence
|
Ghon's focus reflects: September 2005
|
Ans. B: Primary complex Only a very small percent of Mycobacterium tuberculosis (MTB) infections result in disease, and even a smaller percentage of MTB infections progress to an advanced stage. The bacilli is engulfed by alveolar macrophages multiply and give rise to a subpleural focus of tuberculous pneumonia, commonly located in the lower lobe or the lower pa of the upper lobe.This is known as Ghon focus. The Ghon focus together with the enlarged hilar lymph node constitutes the primary complex. Small metastatic foci containing low numbers of MTB may also calcify. However, in many cases these foci will contain ble organisms. These foci are referred to Simon foci. The Simon foci are also visible upon chest X-ray and are often the site of disease reactivation.
|
Microbiology
| null |
Primary complex
|
A child suffering from asthma is to be treated with a drug that blocks the synthesis of leukotrienes. What drug would be an appropriate choice
|
zileuton mech of action:- It is a 5-LOX(lipoxygenase) inhibitor, blocks LTC4/D4 as well as LTB4 synthesis. It therefore has the potential to prevent all LT induced responses including those exeed by activation of cysLT1 receptor. Duration of action of zileuton is sho. side effects:- Hepatotoxicity
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Pharmacology
|
Respiratory system
|
Zileuton
|
Lactose fermentation is seen in -
|
Ans. is 'c' i.e., MacConkey agar o Culture on differential media that contain special dyes and carbohydrates distinguishes lactose-fermenting (colored) from non-lactose-fermenting (non-pigmented) colonies and may allow rapid presumptive identification of enteric bacteria.o Such media, used to see lactose fermentation, are :-Eosine-methylene blue (EMB)MacConkey's agarDeoxycholate agar
|
Microbiology
|
General
|
MacConkey agar
|
In burns heat loss is by/ due to -
| null |
Surgery
| null |
Exposed area by evaporation
|
Stage of contraction of family starts at -
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Ans. is 'd' i.e., Leaving home of first child Basic model of nuclear family life cyclePhases of family life cycleEvents characterizingNo. DescriptionBeginning of phaseEnd of phaseI FormationII ExtensionIII Complete extensionIV ContractionV Competed contractionVI DissolutionMarriageBirth of 1st childBirth of last child1st child leaves homeLast child has left home of parents1st spouse diesBirth of 1st childBirth of last child1st child leaves homeLast child leaves home of parents1st" spouse diesDeath of survivor (extinction)
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Social & Preventive Medicine
|
Social Science
|
Leaving home of first child
|
Crescent fracture is
| null |
Orthopaedics
| null |
Fracture of iliac crest
|
Most pathogenic species of candida is
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C. albicans is most common and most pathogenic.
|
Microbiology
| null |
C. albicans
|
The inheritance pattern of familial retinoblastomas is ?
|
Ans. is 'a' i.e., AD
|
Pathology
| null |
AD
|
The most common physical sign of cerebral metastasis-
| null |
Medicine
| null |
Focal neurological deficit
|
All of the following are true about excitation-contraction coupling in skeletal muscle except that
|
Ca2+ binds to troponin C (not Tropomyosin) to initiate muscle contraction. Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 105
|
Physiology
|
General physiology
|
Ca2+ binds to tropomyosin to initiate muscle contraction
|
Aqueous humor is produced by the
|
Aqueous humor is produced by the ciliary processes of the ciliary body. It flows from the posterior chamber, through the pupil, into the anterior chamber, and finally to the canal of Schlemm, which empties into the extraocular/episcleral veins.
|
Anatomy
|
Eye, Nose and Ear
|
Ciliary processes
|
In Human Immunodeficiency Virus (HIV) infection, diffuse lymphadenopathy in a person who is clinically well is usually a sign of which of the following?
| null |
Medicine
| null |
Persistent generalized lymphadenopathy
|
Met-tRNA would recognize:
|
Ans. AUG(Ref: Harper 31/e page 395)The first AUG sequence after the marker sequence is defined as the start codon.AUG codon binds with met tRNAI
|
Biochemistry
|
Molecular Genetics
|
AUG
|
Which of the following tests helps to differentiate between concomitant squint and paralytic squint
|
Cover tests 1) Direct cover test: It confirms the presence of manifest squint. To perform it, the patient is asked to fixate on a point light. Then, the normal looking eye is covered while observing the movement of the uncovered eye. In the presence of squint the uncovered eye will move in opposite direction to take fixation, while in apparent squint there will be no movement. 2) Alternate cover test: It reveals whether the squint is unilateral or alternate and also differentiates concomitant squint from paralytic squint (where secondary detion is greater than primary). Ref:- A K KHURANA; pg num:-327
|
Ophthalmology
|
Ocular motility and squint
|
Alternate cover test
|
Teaching children about the side effects of taking drugs comes under: March 2013 (e)
|
Ans. D i.e. Primordial prevention Primordial prevention It consists of actions and measures that inhibit the emergence of risk factors in the form of environmental, economic, social, and behavioral conditions and cultural patterns of living etc. For example, many adult health problems (e.g., obesity, hypeension) have their early origins in childhood, because this is the time when lifestyles are formed (for example, smoking, eating patterns, physical exercise). In primordial prevention, effos are directed towards discouraging children from adopting harmful lifestyles
|
Social & Preventive Medicine
| null |
Primordial prevention
|
Which sinus is present over falx cerebelli?
|
Occipital sinus is the smallest sinus, situated along the attached margin of falx cerebelli.Straight sinus runs along the line of attachment of falx cerebelli with the tentorium cerebelliInferior petrosal sinus lies in the groove between the petrous temporal bone and clivus of sphenoid.Sigmoid sinus lies between the two layers of dura of posterior cranial fossa.(Ref: Vishram Singh textbook of clinical neuroanatomy, second edition-pg189,191)
|
Anatomy
|
Brain
|
Occipital sinus
|
Most common type of injury in the oro-facial region is:
| null |
Dental
| null |
Laceration
|
Duplex steel is made up of:
|
Duplex stainless steel is a combination of both ferritic and austenitic grains of stainless steel. The basic chemical composition of duplex stainless steel is an equal mix of ferrite and austenite. This combination creates some very beneficial properties for this family of stainless steels.
|
Dental
| null |
Ferritic + austenitic grains of stainless steel
|
While dispatching blood and urine for chemical analysis, sodium fluoride is added as preservative in the following concentration -
|
10 mg/ml of Na-fluride (i.e. 100 mg/10 ml) is used with 3 mg of potassium oxalate for preserving blood.
|
Forensic Medicine
| null |
100 mg/10 ml
|
In an Rh negative mother who has delivered an Rh positive baby, prophylactic anti D is indicated:
|
If the Indirect Coomb's test (ICT) negative
|
Gynaecology & Obstetrics
| null |
If the Indirect Coomb's test (ICT) negative
|
The limit of loudness expressed as decibels that people can tolerate without substanial damage to their hearing is -
|
Sound in dB Effect 20 Whispering 40 Quiet library 60 Normal conversation 70 heavy street traffic 80 printing press 85 Recommended maximum 110 Train passing through station 120 Motor car horn 140 Threshold of pain 150-160 Mechanical damage Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 802
|
Social & Preventive Medicine
|
Environment and health
|
85
|
Highest amount iron is seen in -
|
Food rich in haem iron are liver, meat, poultry and fish. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 622
|
Social & Preventive Medicine
|
Nutrition and health
|
Meat
|
Drugs which cause both physical and psychological dependence are
|
All the above-mentioned drugs produce both physical and psychological dependence in varying degrees Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg 326
|
Psychiatry
|
Substance abuse
|
All the above
|
Which of the following is the shoest acting non-depolarizing muscle relaxant (NDMR) and causes bronchospasm?
|
Rapacuronium has a rapid onset of action, minimal cardiovascular side effects, and a sho duration of action. It was withdrawn by the manufacturer following several repos of serious bronchospasm, including a few unexplained fatalities. Histamine release may have been a factor. Ref: Morgan, Jr. G.E., Mikhail M.S., Murray M.J. (2006). Chapter 9. Neuromuscular Blocking Agents. In G.E. Morgan, Jr., M.S. Mikhail, M.J. Murray (Eds), Clinical Anesthesiology, 4e.
|
Anaesthesia
| null |
Rapacuronium
|
If stage lb cervical cancer is diagnosed in a young woman, while performing radical hysterectomy which structure would you not remove
|
Ovaries are not removed in radical hysterectomy if not diseased Types of Hysterectomy Type I : Extrafascial Hysterectomy Simple total abdominal hysterectomy with or without bilateral salpingo-oophorectomy Type II: Modified Radical Hysterectomy Removes the medial half of cardinal and uterosacral ligaments Type II differs From Type III by Uterine aery is transected at the level of ureter; Preserving the ureteral branch to the ureter Cardinal ligament is divided close to the midpoion near the ureteral dissection Anterior vesicouterine ligament is divided but posterior vesicouterine ligament is conserved Smaller margin of vagina is removed Type III Removal of most of the uterosacral, cardinal ligaments and upper one-third of the vagina Associated with Pelvic lymphadenectomy Extended Radical Hysterectomy Type IV: Additional structures removed Periureteral tissue Superior vesicle aery Three fouhs of vagina Type V: Poions of distal ureter and bladder are resected Reference: Berek and Novak's Gynecology; 15th edition; Chapter 36
|
Gynaecology & Obstetrics
|
Gynaecological oncology
|
periureteral tissues
|
Maximum margin of excision is needed for:
|
Margins of excision: Malignant melanoma: Margins to be taken depends on the tumor thickness and depth of invasion* < 1mm thickness - 1 cm margin* 1-4 mm thickness - 2cm margin* > 4mm thickness - 2-3 cm margin BCC: If tumor is non-aggressive involving trunk or extremities -Wide Local Excision If tumor is aggressive involving vital areas, cosmetic areas and recurrent - MOH'Smicrographic surgery SCC: Small or non-invasive SCC - Wide Local excision MOH'S MICROGRAPHIC Surgery- Large tumors- Aggressive tumors- Tumors involving vital areas/ cosmetic areas- Recurrent tumorsMOH'S MICROGRAPHIC SURGERY- Serial excision of tumor in small increments- Coupled with immediate microscopic analysis to ensure tumor removal- To limit resection of aesthetically valuable tissues Dermatofibrosarcoma protuberans: WLE with 2-4 cm circumferential margin + removal of underlying fascia Has unpredictable radial extensions of tumor|Permeate through large distances from primarynodule|Increased risk of recurrence after simple excision|(2-4 cm) circumferential margin is resected toprevent recurrence
|
Surgery
|
Oncology
|
Dermatofibrosarcoma protuberans
|
ALL are true regarding Anaemia of Chronic, Diseases, except -
| null |
Medicine
| null |
Decreased Ferritin
|
The best X Ray view for minimal pleural effusion
|
D i.e. Lateral decubitus
|
Radiology
| null |
Lateral decubitus
|
A30-years-old primipara in labor with transverse lie. Treatment of choice is:
|
Ans. is b, i.e. Emergency cesarean sectionRef Dutta Obs. 9/e, p 372; Williams Obs. 22/e, p 510, 23/e, p 478Patients in labor with transverse lie can be managed by external cephalic version followed by surgical rupture of the membrane.But it is important to note that the patient is a primigravida with age 30 years, i.e. elderly primi, so ECV is contraindicated.This patient requires an emergency cesarean section.
|
Gynaecology & Obstetrics
|
Malpresentation
|
Emergency cesarean section
|
Palmer sign seen in pregnancy is?
|
ANSWER: (B) Rhythmic contaction of uterusREF: Dutta 6th ed p. 65SIGNFEATURESEEN INJacqemiers sign or chadwick's signDusk)!- blue hue of vagina due to congestion8th week of pregnancy and fibroidOslanders signIncreased pulsations felt through lateral fornix8th week and PIDGoodell's signSoftening of cervix when it feels like lip6th week and pill usersHegar's signAbdominal and vaginal fingers on bimanual examination oppose , seen due to softening of cervix6-10 weeksPalmer's signRegular and rhythmic contractions of uterus4-8 weeks
|
Gynaecology & Obstetrics
|
Diagnosis of Pregnancy
|
Rhythmic contaction of uterus
|
18 months old child cellulitis of leg Sp02 88%, no prior history of hospitalization or illness most probable organism is?
|
Ans. is 'c' i.e., Streptococcal pyogenes Cellulitis is characterized by infection and inflammation of loose connective tissue, with limited involvement of the dermis and relative sparing of the epidermis. Streptococcus pyogenes and S. aureus are the most common etiologic agents. Children with relapsed nephrotic syndrome may develop cellulitis due to Escherichia coli. Cellulitis presents clinically as an area of edema, warmth, erythema, and tenderness. The lateral margins tend to be indistinct because the process is deep in the skin, primarily involving the subcutaneous tissues in addition to the dermis. Application of pressure may produce pitting. Although distinction cannot be made with ceainty in any paicular patient, cellulitis as a result of S. aureus tends to be more localized and may suppurate, whereas infections due to S. pyogenes (group A streptococcus) tend to spread more rapidly and may be associated with lymphangitis. MRSA is usually seen in hospitalised child.
|
Pediatrics
| null |
Streptococcal pyogenes
|
Provocative Test for detecting CDH?
|
Ans. b (Barlow test) (Ref Maheshwari orthopedics 4th/87).All newborn babies should be screened for hip instability by a skilled examiner using the Barlow and Ortolani tests. The baby should be relaxed and the hips flexed to 90 degree. It is possible to reduce a dislocated hip by abduction and gentle forward pressure (Ortolani) or dislocate an unstable hip by adduction and gentle backward pressure (Barlow). In both cases a soft clunk is felt as the hip reduces or dislocates repectively.DEVELOPMENTAL DISLOCATION (DYSPLASIA) OF THE HIP # Etiology:- Hereditary predisposition to jt laxity- Hormone induced jt laxity (in females)- Breech malposition# Pathology:- Femoral head dislocated upwards and laterally- Femoral neck is excessively anteverted- Acetabulum shallow- Ligamentum teres hypertrophy- Inverted limbus/fibrocartilaginous labrum of acetabulum- Stretched capsule of hip joint- Adaptive shortening of adductor muscles and hip joint,# Findings in older children:- Limitation of hip abduction- Asymmetrical thigh folds- Higher buttock fold on affected side- Galeazzi's sign (level of knees compared with hip fixed to 70deg and knees flexed)+.- Ortolani's test +.- Trendelenburg's test +.- Shortening of limb and externally rotated.- Lumbar lordosis- Telescopy +.- Trendelenburg's gait in unilateral; waddling gait in bilateral DDH.# Diagnosis:- Difficult during infancy, but USG with high frequency probe (Graff's classification) is very useful.- Clinical tests:# Barlow's test (provocative test having two parts)# Ortolani test# Radiological features:- Von Rosen's view helpful in diagnosis- Signs in older children:# Delayed appearance of ossific centre of head of femur# Retarded development of ossific centre of femoral head# Sloping acetabulum# Lateral and upward displacement of ossific centre of femoral head# Break in Shenton's line# Rx:Birth to 6 months6 months-6 yrs6 yrs-10 yrs11 yrs onwardsClosed manipulation & maintained in plaster cast or von Rosen splint.Up to 2 yrs: reduction by closed methods.After 2 yrs: Salter's osteotomyNone in bilateral.Indication is pain. Rx:THR>arthrodesis
|
Orthopaedics
|
Congenital Dislocation of Hip (C.D.H.)
|
Barlow test
|
A 25-year-old man has a negative Dick test and a positive Schick test. These results indicate that he has
|
The patient has a negative Dick test and a positive Schick test, which indicates that he has neutralizing antibodies against the group A streptococcus that causes scarlet fever. In both tests, the antigen that is injected is the toxin. If neutralizing antibodies are present, they neutralize the toxin and skin reactions do not occur. This indicates that the patient is immune to the specific strain of bacteria producing the disease. For example, the patient&;s negative Dick test means that he has neutralizing antibodies that will protect him against the strain of streptococcus that produces scarlet fever, but not against strains that may be associated with pharyngitis or other infections. Absence of the antibodies allows the toxin to host an inflammatory reaction, which indicates a lack of immunity. If the patient had a full complement of diphtheria-peussis-tetanus (OPT) immunizations, neutralizing antibodies against diphtheria should be present. The presence of a reaction for the Schick test is a not a test of cellular immunity, because it is an antigen-antibody reaction.
|
Microbiology
|
Immunology
|
Neutralizing antibodies against scarlet fever
|
Dead bone is seen on the X-ray as:
| null |
Surgery
| null |
More radiopaque
|
Commonest intrabronchial cause of haemoptysis is
|
The two most common causes for haemoptysis are bronchitis and bronchiogenic carcinoma. Bronchitis is not provided amongst the options and hence bronchiogenic carcinoma is the single best answer of choice Ref Harrison 19th edition pg 227
|
Anatomy
|
Respiratory system
|
Carcinoma lung
|
A female presented with swelling over angle of mouth. Investigation shows pleomorphic adenoma of the superficial lobe.Treatment of choice is:
|
Pleomorphic adenomas, or benign mixed tumors, are the most common neoplasms of the salivary glands. They represent approximately 60-70% of all parotid tumors and 90% of submandibular benign tumors. The mixture of epithelial, myoepithelial, and stromal elements is represented by the name, benign mixed tumor. Any of these individual components may predominate in the histology, but all three must be present to confirm the diagnosis. Both immunohistochemical stains specific for myoepithelial cells and epithelial cells can help to distinguish pleomorphic adenoma. Complete surgical excision of the tumor with uninvolved margins is the recommended treatment. For example, a superficial parotidectomy with clear margins is the treatment of a pleomorphic adenoma located in the superficial lobe of the parotid gland. Ref: Butt F.Y. (2012). Chapter 18. Benign Diseases of the Salivary Glands. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e.
|
Surgery
| null |
Superficial parotidectomy
|
A young woman complains of recurrent rhinitis, nasal discharge and bilateral nasal blockage since one year. She also had history of allergy and asthma. On examination, multiple polyps with mucosal thickening and impacted secretions are seen in nasal, cavities. Biopsy was taken and the material on culture showed many hyphae with dichotomous branching typically at 45 degree. Which of the following is most likely organism responsible?
|
Patient is suffering from allergic fungal sinusitis caused by aspergillus. Septate hyphae which show dichotonomous branching at 45 degree are characteristics of aspergillus. Allergic fungal sinusitis patients suffer from chronic sinusitis, nasal polyp, asthma and atopy. Ref: Textbook of Microbiology and Immunology By Parija, Page 640; Aspergillus Fumigatus and Aspergillosis By Jean-Paul Latge, William J. Steinbach, Page 302; Harrison's Principles of Internal Medicine, 17th Edition, Page 1259.
|
Microbiology
| null |
Aspergilus
|
Anti - mullerian Hormone is
|
AMH is a Glycoprotein, declines progressively with menopause.
|
Gynaecology & Obstetrics
| null |
Indirectly reflects primordial follicle pool.
|
Separation for the period of communicability of infected persons in such places or under such conditions as prevent transmission of infectious agent to the susceptible is known as:
|
Isolation: Separation for the period of communicability of infected persons in such places or under such conditions as prevent transmission of infectious agent to the susceptible. Quarantine: It is the limitation of movement of such well persons or animals exposed to communicable diseases for a period usually not longer than the longest incubation period of the disease to prevent effective contact with those not exposed. Segregation: It is the separation for special consideration, control of observation of some pa of a group of persons from others to facilitate control of communicable disease. Ref: Park 21st edition, page 110-111.
|
Social & Preventive Medicine
| null |
Isolation
|
Cellulose is a:
|
Option b : Cellulose is a non-starch homopolysaccharide Cellulose unbranched, non-starch homopolysaccharide It is made up of glucose molecules linked by beta (1- 4) glucosidic linkages (see fig). This linkage can't be broken down by any human enzyme due to beta anomerism at C-1. Intestinal bacteria ferments cellulose to sho-chain fatty acid (Butyrate). The most abundant organic molecule on Eah (Second most abundant is Chitin). Cellulose is present in the cell walls of plants and other organisms Starch storage polysaccharide of plants consisting of both linear and branched chain glucose molecules.
|
Biochemistry
|
Classification of carbohydrate
|
Non-starch polysaccharide
|
Infection in renal transplant patient is usually caused by -
| null |
Surgery
| null |
CMV
|
Which of the following carries the least risk of Metabolic side effects
|
Ziprasidone, Aripiprazole & Asenapine carries negligible risk of metabolic side effects like weight gain, hyperlipidemia.
|
Pharmacology
| null |
Ziprasidone
|
True regarding Crohn's disease are all except
|
The skin involvement in Crohn's disease causes erythema nodosum, scleroderma does not occur in Crohn's disease.
Other extraintestinal manifestations of Crohn's disease:
1. Migratory polyarthritis
2. Sacroiliitis
3. Ankylosing spondylitis
4. Uveitis
5.. Hepatic pericholangitis
6. Primary sclerosing cholangitis
7. Clubbing
|
Pathology
| null |
Scleroderma
|
Prolonged treatment with INH leads to a deficiency of?
|
Isoniazid can cause peripheral neuropathy due to deficiency of pyridoxine.
|
Pharmacology
| null |
Pyridoxine
|
Local anesthetics are typically injected or applied very close to their intended site of action. From which of the following routes absorption of local anaesthetic is maximum?
|
The rate of systemic absorption is propoionate to the vascularity of the site of injection: intravenous > tracheal > intercostal > caudal > paracervical > epidural > brachial plexus > sciatic > subcutaneous. Ref: Morgan, Jr. G.E., Mikhail M.S., Murray M.J. (2006). Chapter 14. Local Anesthetics. In G.E. Morgan, Jr., M.S. Mikhail, M.J. Murray (Eds), Clinical Anesthesiology, 4e.
|
Anaesthesia
| null |
Intercostal
|
True regarding Mitral valve prolapse syndrome is all,except-
|
MVP, also variously termed the systolic click-murmur syndrome, Barlow's syndrome, floppy-valve syndrome, and billowing mitral leaflet syndrome, MVP is more common in women and occurs most frequently between the ages of 15 and 30 years; Most patients are asymptomatic and remain so for their entire lives. Transient cerebral ischemic attacks secondary to emboli from the mitral valve due to endothelial disruption have been repoed. Infective endocarditis may occur in patients with MR and/or leaflet thickening. (Harrison's Principles of internal medicine, 18 th edition, page 1937 )
|
Medicine
|
C.V.S
|
Mostly symptomatic
|
Which of the following is a relatively cerebroselective anticholinesterase found to afford symptomatic improvement in Alzheimer&;s disease
|
Rivastigmine:- This lipophilic relatively cere-broselective ChE inhibitor has been introduced for Alzheimer's disease (AD). Donepezil:- Another centrally acting anti-AChE that has produced cognitive and behavioral improvement in AD. It is long-acting and suitable for once daily administration. Galantamine:- This natural alkaloid inhibitor of cerebral AChE has in addition weak agonistic action on nicotinic receptors. It is being used to afford symptomatic relief in AD. Ref:- kd tripathi; pg num:-108
|
Pharmacology
|
Autonomic nervous system
|
Donepezil
|
Amsel's criteria is used for;
|
Amsel's criteria is used for diagnosis of Bacterial vaginosis MC Vaginitis Caused by Hemophilus vaginalis aka Gardnerella vaginalis Amsel's criteria - >= 3 out of 4 required for diagnosis of Bacterial vaginosis Creamy discharge Whiff test + Fishy odor Clue cells
|
Gynaecology & Obstetrics
|
FMGE 2019
|
Gardnerella vaginosis
|
Steroids are indicated in all of the following forms of tuberculosis except.
|
Ans. (C) Ileo-caecal tuberculosis(Ref: Katzung 10/e p1263; KDT 8/e p319)*If used in intestinal tuberculosis, steroids can result in silent perforation, therefore are contra-indicated in ileo-caecal tuberculosis.
|
Pharmacology
|
Endocrinology
|
Ileo-caecal tuberculosis
|
Spontaneous CSF leak occurs in all except -
|
Ans. is 'a' i.e., Increased intracranial tensionWe are not sure of the answer.We have gone for increased intracranial tension because spontaneous C.S.F. leak is associated with intracranial hypotension.Increased intracranial tension is not associated with spontaneous C.S.F. leak.All other options mentioned in the question are associated with spontaneous C.S.F. leak.Pseudotumor CerebriPseudotumor cerebri usually presents with triad of headache, papilledema and minimal or absent focal neurological signs, but rarely the presenting feature may be a nasal C.S.F. leak.Empty sella syndromeIn empty sella syndrome, the sella turcica (the bony structure which contains pituitary enlarges). In this disease there is a defect in tissue barrier that normally keeps the cerebrospinal fluid around the brain separate from the sella turcica. As a result cerebrospinal fluid puts increased pressure on the pituitary glands and the walls of the sella turcica. The sella tunica enlarges and the pituitary shrinks.The empty sella syndrome may produce no symptoms at all and seldom produces serious symptom. About half of those affected have headaches. In rare cases there is leaking of the cerebrospinal fluid from the nose.EncephaloceleEncephalocele may present with C.S.F. leak.More on spontaneous C.S.F. leak or spontaneous intracranial hypotensionSpontaneous intracranial hypotension is a condition where patient gets postural headache due to leak of the cerebrospinal fluid in the spinal membrane.What happens is that the leak causes low C.S.F. pressure within the nervous system and thus causes a string of headache to the patient.The problem with SIH is that it is hard to diagnose and there is not a great deal of information on why it occurs.It has been associated with connective tissue diseases which may involve the dura causing tear in it.To summarize it, spontaneous C.S.F. leak is very rare and unlike other causes it does not occur due to any specific traumatic event or surgical procedure in the nervous system.Although there is not much information on the possible causes of C.S.F. leak, it is suspected that an intrinsic weakness of the spinal membrane or an abnormality of the brain structure causes the rare condition. The symptoms of SIH are so small and so common that it can often be misdiagnosed.
|
Medicine
|
C.N.S.
|
Increased intracranial tension
|
Following is associated with maximum risk of invasive cervical cancer:-
|
HSV & HIV predisposes more to pre invasive cervical cancer than invasive disease. Severity of dysplasia is directly propoional to malignancy. HPV 16 is the most common association, HPV 18 is this most malignant association with ca cervix LSIL (CIN I) , HSIL (CIN II and CIN III) and carcinoma in situ (CIS) are degrees of cervical dysplasia noted on a paps smear and confirmed on a colposcopic biopsy. Their risk of transforming into invasive cancer are CIS>HSIL>LSIL
|
Gynaecology & Obstetrics
|
Cervical Carcinoma
|
High grade squamous intraepithelial lesion (HGSIL)
|
A 40 years old man presents with a recurrent hemoptysis and purulent cough. X-ray was found to be normal. To next investigation done to aid in diagnosis is :
|
B i.e. Bronchoscopy As a rule, you can remember, for almost all cases of hemoptysis the investigation of choice is Bronchoscopy followed by HRCT; Except for hemoptysis associated with parenchymal (interstitial) lung disease where investigatim of choice is HRCT> Bronchoscopy, and in suspected bronchitis where you observe and wait for recurrence for performing Bronchoscopy.
|
Radiology
| null |
Bronchoscopy
|
Ionophores have following action except
|
Hydrophilic in character
Inophors are lipophilic (not hydrophilic).
Inophors inhibit ATP formation by inhibiting oxidative phosphorylation by abolishing proton gradient or pH gradient.
|
Biochemistry
| null |
Hydrophilic in character
|
Which of the following nerves transmits impulses originating from the vestibular apparatus?
|
The vestibular poion of cranial nerve VIII (vestibulocochlear nerve) carries impulses from the vestibular apparatus to the vestibular ganglion, which then conveys the impulses to the vestibular nuclei of the brainstem.
|
ENT
| null |
Cranial nerve VIII
|
Persistant the cultures in a root canal is mostly due to
| null |
Dental
| null |
Seepage of saliva
|
Antibodies most commonly seen in drug induced lupus are:
|
Answer is D (Antihistone Antibodies): The most commonly used marker for drug induced lupus is Antihistone Antibodies. Drug Induced Lupus is characterized serologically by the presence of Anti-Histone Antibodies and the absence of antibodies against double stranded DNA (dsDNA Antibody Negative; Anti-Histone Antibody Positive). Anti-dsDNA Serology in Drug Induced Lupus Erythematosus Almost all patients with Drug Induced Lupus will test positive for Antinuclear Antibodies (Positive ANA Test) The spectrum of Antinuclear antibodies in Drug Induced Lupus includes Positive Antihistone antibodies (most common; not specific; also seen in SLE) Positive autoantibodies against single stranded DNA (common ; not specific; also seen in SLE) Negative (absence of) autoantibodies against double stranded DNA(dsDNA) The presence of autoantibodies against dsDNA strongly suggests a diagnosis of SLE Drug Induced Lupus is typically associated with a Homogeneous ANA pattern due to the presence of Antihistone Antibodies Antibodies are seen in less than 5 percent of patients with Drug Induced Lupus The presence of Antihistone antibodies alone is not a specific test for diagnosis of Drug Induced Lupus as Antibodies to histones may also be seen in up to 50 to 80 percent of patients with idiopathic SLE. Note : Hypocomplementemia is uncommon in Drug Induced Lupus but not in SLE.
|
Medicine
| null |
Antihistone Antibodies
|
About Ectopia vesicae, following is true except -
|
Ectopia vesicae is associated with epispadias in which dorsal or upwards curvature of penis is noted.
Ventral curvature is noted in hypospadias.
|
Surgery
| null |
Ventral curvature of penis
|
Frisch bacillus affects most commonly -
|
Ans. is 'b' i.e., Noseo Frisch bacillus is Klebsiella rhinoscleromatis, which causes rhinoscleroma, a granulomatous disease of nose.Bacteria and their alternate nameso Bordetellao Clostridium tetanio Corynebacterium diphtheriaeo Corynebacterium pseudotuberculosiso Haemophilus aegypticuso Haemophilus influenzao Klebsiella pneumoniao Klebsiella ozaenaeo Klebsiella Rhinoscleromatiso Mycobacterium tuberculosiso Mycobacterium intracellulareo Mycobacterium paratuberculosiso Mycoplasmao Pseudomonas pseudomalleiBordet Gengou bacillusNicolaire s bacillusKlehs-Loeffler '.s bacillusPreisz-Nocard bacillusKoch-Weeks bacillusPfeiffer s bacillusFriedlander s bacillusAbel's bacillusFrisch's bacillusKoch's bacillusBatteys bacillusJohne's bacillusEaton agentWhitmore s bacillus
|
Microbiology
|
Bacteria
|
Nose
|
Measles shows age distribution. It is found most commonly in which age group?
|
Impoant diseases & their age distribution: Measles - 6 months to 3 years Mumps - 5-9yrs Chicken pox - 5-9yrs Rheumatic fever - 5 to 15 years Cancers, Cataract - >50 years Rota virus - younger infants Diabetes , HTN, CHD - > 40yrs
|
Social & Preventive Medicine
|
Classification, Coho Study
|
6 months to 3 years
|
All of the following substances can cause seizures except
|
Lamotrigine is antiepilepticDrugs and Other Substances That Can Cause SeizuresAlkylating agents (e.g., busulfan, chlorambucil)Antimalarials (chloroquine, mefloquine)Antimicrobials/antiviralsb-lactam and related compoundsQuinolonesAcyclovirIsoniazidGanciclovirAnesthetics and analgesicsMeperidineFentanylTramadolLocal anestheticsDietary supplementsEphedra (ma huang)GingkoImmunomodulatory drugsCyclosporineOKT3 (monoclonal antibodies to T cells)TacrolimusInterferonsPsychotropicsAntidepressants (e.g., bupropion)Antipsychotics (e.g., clozapine)LithiumRadiographic contrast agentsDrug withdrawalAlcoholBaclofenBarbiturates (sho-acting)Benzodiazepines (sho-acting)ZolpidemDrugs of abuseAmphetamineCocainePhencyclidineMethylphenidateFlumazenilRef: Harrison 19e 2547
|
Medicine
|
C.N.S
|
Lamotrigine
|
Death caused by rash and negligent of doctor is punishable under
|
Refer the byte "Legal sections".
|
Forensic Medicine
| null |
304 A IPC
|
Ductopenic cholestasis is seen in all, EXCEPT:
|
Disappearance of bile ducts, "ductopenic" cholestasis is seen with carbamazepine, chlorpromazine, tricyclic antidepressant agents. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 2560
|
Medicine
| null |
Methyldopa
|
False regarding cecal voluvus:
|
CECAL VOLVULUS -Misnomer -Involvement of ileum, cecum, transverse colon; Not only cecum. -Correct name should have been Cecocolic volvulus. -Volvulus is Mainly clockwise. -Caecum is relatively fixed. | If free or mobile | Increased chances of torsion *Predisposing factors:- -Multipara patients (due to release of relaxin) -H/O previous surgery (ligaments are divided) -Malrotation (abnormal location of cecum which is free) -Distal obstructing lesion (proximal pa of colon distention leading to torsion) *Clinical features:- Because Twisting/ is at the level of ileum -patient will present with signs and symptoms of SBO * -Colicky pain * -Bilious vomiting * -Absolute constipation *Investigations:- -IOC - Plain x-ray * KIDNEY BEAN sign -Comma shaped cecum *Treatment:- Ileocecectomy + Ileotransverse anastomosis - Most cases require operation to correct the volvulus and prevent ischemia. - If ischemia has already occurred, immediate operation is obviously required. Right colectomy with primary anastomosis is the procedure of choice In frankly gangrenous bowel, resection of the gangrenous bowel with ileostomy is a safer approach - Recurrence rates are high with cecopexy, and right colectomy remains the procedure of choice for cecal volvulus.
|
Surgery
|
Intestinal obstruction
|
Cecopexy is procedure of choice.
|
Which of the following disease is more common in patients with alfa 1 antitrypsin deficiency?
|
Alfa 1 antitrypsin is an inhibitor of proteinase 3. Antiproteinase antibodies are seen in Wegeners granulamatosis. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2343
|
Medicine
| null |
Wegeners granulamatosis
|
Low dose progestational contraceptives primarily act on
|
Progesterone in bih control pills thickens cervical mucus (primary action): hinders the travel of sperm to the uterus and making it hard for sperm to enter the tubes and feilise the egg. thins the lining of the uterus: makes implantation unlikely. Progestogen only pills are generally less effective than other forms of oral contraceptive pill with a failure rate of 2 - 6 per 100 women years. The main side effects are Irregular, low-grade, breakthrough uterine bleeding but this may settle into a regular cycle after 6 - 9 months. Skin reactions, Breast fullness Depression Increased risk of ectopic pregnancy. Benefits include: Do not carry risk of thromboembolism Do not inhibit lactation - so can use when breast feeding Suitable for diabetics - as pills containing oestrogen exacerbate risk of aerial disease in such patients Suits smokers for whom oestrogen containing formulations are contra-indicated
|
Gynaecology & Obstetrics
|
Contraceptives
|
Cervix
|
Phocomelia is due to teratogenic effect of :
| null |
Pharmacology
| null |
Thalidomide
|
Stye is an acute suppurative inflammation of
|
EXTERNAL HORDEOLUM (STYE) It is an acute suppurative inflammation of gland of the Zeis. Etiology: Causative organism commonly involved is Staphylococcus aureus. Signs : 1) Stage of cellulitis is characterised by localised, hard, red, tender swelling at the lid margin associated with marked oedema 2) Stage of abscess formation is characterised by a visible pus point on the lid margin in relation to the affected cilia. Usually there is one stye, but occasionally, these may be multiple. Ref:- A K KHURANA; pg num:-345
|
Ophthalmology
|
Diseases of orbit, Lids and lacrimal apparatus
|
Gland of Zeis
|
Features of vernal keratitis are:
|
A i.e. Papillary hyperophy
|
Ophthalmology
| null |
Papillary hyperophy
|
It is probable that physician have a higher index of suspicion for tuberculosis in children without BCG scar that those with BCG scar. If this is so and an association is found between Tuberculosis and not having BCG due to -scar, the association may be
| null |
Social & Preventive Medicine
| null |
Interviewer bias
|
Hydrocele is a type of ..... cyst -
|
Ans. is 'c' i.e., Exudation
|
Surgery
| null |
Exudation
|
Which is not true regarding the basisbof functional divisionsnof liver
|
All of the given option are true. If we have to choose one, most preferred option is 'liver is divided into 8 segments' because sometimes segment IX is described. Segment IX is a recent subdivision of segment I, and describes that pa of the segment that lies posterior to segment VIII Current understanding of the functional anatomy of the liver is based on couinand's division of the liver into eight (subsequently nine) functional segments, based upon the distribution of poal venous branches and the location of the hepatic veins in the parenchyma Segment IX is a recent subdivision of Segment I, and describes that pa of the segment that lies posterior to segment VIII Ref: Gray's anatomy Pgno :1165-1166
|
Anatomy
|
G.I.T
|
Divided into 8 segments
|
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