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Term used for death of full family suicide is
(D) Familicide# FAMILICIDE is a type of murder or murder-suicide in which at least one spouse and one or more children are killed, or in which a parent or parents and possibly other relatives such as siblings and grandparents are killed.> In some cases all of the family members' lives are taken. If only the parents are killed, the case may also be referred to as a parricide. Where all members of a family are killed, including when the killing takes the form of a murder-suicide, the crime may be referred to as family annihilati> Jauhar (Jowhar) is the self-immolation of women, always including queens and female royals of Hindu kingdoms, most notably the Rajput kingdoms of Rajasthan in India, when facing defeat at the hands of an enemy.> Massacre is the deliberate slaughter of members of one group by one or more members of another more powerful group. A massacre may be indiscriminate or highly methodical in application. A massacre is a single event, though it may occur during the course of an extended military campaign or war.> Mass suicide occurs when a group of people commit suicide simultaneously. Contents. Examples 1. Historical mass suicides; 2. Religiously motivated.
Forensic Medicine
Misc.
Familicide
Marble bone disease is
(Osteopetrosis): (307- Malushwari 4th edition)OSTEOPETROSIS (Marble bones, Alber's - Schonberg disease)* Characterised by dense but brittle bones* Autosomal dominant disorderCP-* Pathological fractures* Cranial nerve compression]---Due to bone encroachment on foramena* Jaw osteomyelitis (After tooth extraction)* Anemia* X-ray shows - Increased density of the all the all the bones* Cortices are widened leaving narrow medullary canal Sclerotic vertebral end plates producing a striped appearance (rugger Jersey spine)* Skull is thickened and the base densely sclerotic
Orthopaedics
Metabolic Bone Disease
Osteopetrosis
An entity of pneumothorax which leads to build up of positive pressure within the hemithorax, leading to collapse of lung, flattened diaphragm, mediastinal shift to contralateral side and eventually the venous return to the right side of hea is compromised is known as
During inspiration,air is pumped into the pleural cavity through a valvular opening in the visceral pleura and underlying injured lung,leading to build up of positive pressure within the hemithorax.Lung collapses first,and as air continuously collects in the pleural cavity,mediastinum shifts towards the oppposite side,fuher decreasing the volume of the functioning lung.Fuher increase in the pleural pressure,reduces the venous return,atrial filling,and ventricular filling and so cardiac output and cardiac function.It causes sudden death & emergency treatment is required. Reference:Bailey & Love's sho practise of surgery,25th edition,page no:1116,1117.
Surgery
Cardio thoracic surgery
Tension pneumothorax
Which of the following signs is not suggestive of a cervical spinal cord injury :
Answer is B (Increased Rectal Sphincter tone): Cervical spinal cord injury is associated with a decreased rectal sphincter tone (and not an increased rectal sphincter tone).
Medicine
null
Increased rectal sphincter tone
Milk is deficient in?
a. Iron and Vit C(Ref: Nelson's 20/e p 286-290, Ghai 8/e p 150-161)About the options:IronIron content (1mg/L) in cow & breast milk makes it difficult to maintain body iron & meet RDA of infant (8-10mg). Breastfed infants absorb iron 2-3 times more efficiently than infants fed cow's milkVit CInfants consuming pasteurized or boiled animal milk are at significant risk of developing Vitamin C deficiencyPhosphorusCow's milk is rich in phosphate; So, an infant on a diet rich in cow's milk has chances of developing hypocalcemiaVit ABreast milk as well as cow's milk contains adequate amounts of Vit A to meet the needs of infantsHence, cow's milk is deficient in Iron & Vitamin C.Note: Breast milk contains adequate amounts of all vitamins except Vit D, Vit K & Vit B12 (in strictly vegan mothers).
Pediatrics
Nutrition
Iron and Vit C
Which of the following is not true regarding schirmer test:-
The Schirmer's I test Measures combined basal and reflex tear secretion Relatively specific, but poorly sensitive Eyes closed / blink normally for 5 minutes Not useful in non co-operative adults and children Amount of wetting >10mm -normal 5-10mm -borderline < 5 mm is abnormal 5-minute Schirmer test with and without anesthesia is abnormal <5 mm with anesthesia <10 mm without anesthesia The Schirmer's II test Measures reflex tearing Addition of nasal mucosal irritation with a cotton tipped applicator Amount of wetting < 15 mm after 5 minutes - abnormal reflex secretion -moderate to severe dry eye For differentiating non-Sjogren's from Sjogren's syndrome Patient cooperation is essential for performing the test.
Ophthalmology
Nasolacrimal Disorders
Useful in non co-operative adults and children
Hay's sulpher test is used to detect w hich of the following -
Ans. is 'a' i.e., Bile salts in urineTestsUsed foro Rothera's test (nitroprusside test)o Gerhardt's test (ferric chloride test)Ketone bodies in urine acetone and acetoacetateKetone bodies in urine acetoacetate.o Benedict's testo Fchling's testReducing sugars in urine Reducing sugars in urineo Hay's sulpher testBile salts in urineo Fouchet's (borium sulphate test)o Gmelin's (nitric acid) testo Vanden Bergh testo Ehrlich's testo Schlesinger's testBile pigment: bilirubinBile pigment: bilirubinBile pigment: bilirubinBilinogens (stercobilinogen, urobilinogen)Bilinsfstercobilin. urobilin).o Ehrlich's aldehyde testPorphobilinogen and urobilinogen in urine
Biochemistry
Proteins and Amino Acids
Bile salts in urine
Serum gamma glutamyl transpeptidase maximum increased in
A. i.e. (Alcoholism) (107- U. Satyanarayan 3rd) (600- Rana -Shinde 7th)Important enzymes in the diagnosis of disease* SGPT / ALT- Liver disease (Hepatitis)* SGOT/AST- MI & Liver disease* LDH- MI, Infective hepatitis* CPK- Myocardial infarction* Aldolase- Muscular dystrophy* 5 - Nucleotidase- Hepatitis* Y- Glutamyl- transpeptidase (GGT)- Alcoholism* Y- GT is the most sensitive indicator in alcoholism* Useful test for MI in later stages* Increase serum activity seen with pancreatic disease* It is a valuable parameter in differentiating between skeletal (bone) and hepatic dysfunction associated withincreased serum ALP
Biochemistry
Enzymes
Alcoholism
The EEG rhythm having lowest frequency is-
Ans. C. DeltaThe various types of EEG waveforms are depicted below-
Physiology
Sleep Physiology
Delta
All are supplied by Ansa cervicallis except -
null
Anatomy
null
Thyrohyoid
A pregnant female presents with pain in abdomen on examination, tenderness is found in right lumbar region. TLC is 12000/cmm. and urine examination is normal.For diagnosis further test done is -->
Ans. is 'b' ultrasound abdomen [Ref Love & Bailey 24/e p. 1211 (23rd/e p. 1084)Ultrasound is a useful diagnostic method in a pregnant female presenting with right iliac fossa pain to exclude tubal or ovarian disease
Surgery
Urinary Tract
ultrasound abdomin
Best site for collection of specimen for N. meningitides ?
Ans. is 'c' i.e., Nasopharyngeal swab Best site for specimen collection for meningococci :? For cases - CSF (by lumbar puncture) For carriers - Nasopharyngeal swab As CSF is not there in options, examiner is, most probably, asking about specimen in carrier. Laboratory diagnosis of meningococcal infection Specimens CSF - Divided into three poions : One poion is centrifuged and Gram stained smears are prepared from the deposit The second poion is inoculated on blood agar or chocolate agar plates. The third poion of CSF is incubated overnight and than subcultured on chocolate agar. Blood - for culture in patients with meningococcemia and early meningitis. Nasopharyngeal swab - for carriers Petechial lesions - In cases of meningococcemia. Autopsy specimens - from meninges, lateral ventricle, surface of brain or spinal cord. Smear will show Gram negative diplococci inside the polymorphs but often extracellularly also. They are arranged in pairs, with the adjacent sides flattened. Capsulated nonmotile Transpo medium - Stua's medium Culture Blood agar, chocolate agar and Muller-Hinton starch casein hydrolysate agar are the media commonly used for culturing meningococci. Modified Thayer - Main (with vancomycin, colistin and nystatin) is a useful selective medium. Serology Antibodies to meningococcal polysaccharides can be measured by latex agglutination or hemagglutination tests or by their bactericidal activity.
Microbiology
null
Nasopharyngeal swab
Investigation to diagnose stage-I carcinoma breast –
null
Radiology
null
B/L mammogram
The effective medical therapies for variceal bleeding in the setting of cirrhosis of liver are all, EXCEPT:
MEDICAL THERAPIES FOR VARICEAL BLEEDING: Somatostatin and octreotide cause selective splanchnic vasoconstriction and lower poal pressure. Vasoactive drugs (e.g., octreotide, somatostatin, terlipressin are as effective as sclerotherapy for controlling variceal bleeding. Octreotide is the drug of choice as an adjunct to endoscopic therapy for the treatment of variceal hemorrhage. Ref:Sleisenger and Fordtran's,E-9,P-306
Medicine
null
Omeprazole
What is meant by Superfecundation?
* Superfecundation is the feilization of two or more ova from the same cycle by sperm from separate acts of sexual intercourse, which can lead to twin babies from two separate biological fathers. * The term superfecundation is derived from fecund, meaning the ability to produce offspring REF : DUTTA BOOK OF OBESTETRICS
Gynaecology & Obstetrics
All India exam
Feilization of two or more ova in different intercourses in same menstrual cycle
The effect of thiopentone on the CNS is quickly terminated because of:
Thiopentone is a ultra sho acting barbiturates ,its action is terminated because of redistribution . thiopentone is highly lipid soluble ,after i.v injection consciousness is regained in 6-10 minutes due to redistribution ,while the ultimate disposal occurs by metabolism. Greater the lipid solubility of the drug ,faster is its redistribution. Ref: KD Tripathi 8th ed
Pharmacology
Central Nervous system
Redistribution
In HCC
Clinical features of HCC Vascular bruit (25%) GI bleed (10%) Tumor rupture (2-5%) Jaundice due to biliary obstruction (10%) Paraneoplastic syndrome (<5%) Ref:Sabiston 20th edition Pgno : 1456-1463
Anatomy
G.I.T
Hemoperitoneum in 7% of cases
True about competitive inhibition with first order kinetics
Ans. (a) Km increased, Vmax sameType of InhibitionKmVmaxCompetitive inhibitionINCREASEDSAMENon-competitive inhibitionSameDECREASEDCompetitive Inhibtion: Substrate and inhibitor, both compete for same site on enzyme.Non-competitive Inhibition: Substrate and inhibitor both bind at different sites in the enzyme.
Biochemistry
Vitamins and Minerals
Km increased, Vmax same
Most common type of astigmatism in keratoconus is
Keratoconus usually have irregular astigmatism * B/L Non inflammatory ectatic condition of cornea Clinical Presentation * Young females with constantly changing power of glasses with myopia & high cylinder and irregular astigmatism SIGNS IN KERATOCONUS Munson sign Enlarged corneal nerves Oil droplet reflex( on DDO) Rizutti sign Hydrops Fleischer ring
Ophthalmology
Diseases of Cornea
Irregular astigmatism
Penicillium marneffei is seen in -
null
Microbiology
null
AIDS
Kussmaul's sign is NOT seen in: March 2011
Ans. D: Cardiac tamponade A positive Kussmaul sign is rare in cardiac tamponade Davidson's (21st ed., p-542) includes Kussmaul's sign as a clinical feature of pericardial/ cardiac tamponade Normal physiology: Ordinarily the JVP falls with inspiration due to reduced pressure in the expanding thoracic cavity. Kussmaul's sign suggests impaired filling of the right ventricle due to either fluid in the pericardial space or a poorly compliant myocardium or pericardium. This impaired filling causes the increased blood flow to back up into the venous system, causing the jugular distension. Causes of Kussmaul's sign: The differential diagnosis generally associated with Kussmaul's sign is constrictive pericarditis, along with restrictive cardiomyopathy and cardiac tamponade. With cardiac tamponade, jugular veins are distended and typically show a prominent x descent and an absent y descent as opposed to patients with constrictive pericarditis Right ventricular infarction - low ventricular compliance Right hea failure Cardiac tumours Tricuspid stenosis
Medicine
null
Cardiac tamponade
A 50 year old breast cancer patient presents with breathlessness. What does the ECG show?
HR is about 150/min with variation in electrical axis due to fluctuation in amplitude of QRS complex on beat to beat variation. Malignancies like breast cancer and lung cancer can metastasize to the hea leading to cardiac tamponade.
Medicine
ECG and Arrhythmias 1
Electrical Alternans
Average gain of Height in the first year is?
Square root of the month of the baby. Till he reaches 7 months Ref- OP. Ghai ,9th edition, Page 14
Pediatrics
Growth and development
25 cm
This type of psoriasis is commonly seen in children and may follow a streptococcal sore throat –
Guttate psoriasis occurs in children and adults. It is precipitated by URTI (e.g. streptococcal tonsilitis)
Dental
null
Guttate
In adult male person presents with drowsiness, vertigo & unconsciousness which artery is involved-
null
Medicine
null
Posterior cerebral artery
Which is the true statement regarding megaloblasitc anemia-
Ans. is 'a' i.e., Megaloblastic precursors are present in bone marrow; 'b' i.e., Mean corpuscular volume is increased; 'c' i.e., Serum LDH is increased Option a & b have been explained already. o Serum LDH is increased in megaloblastic anemia because of the following two processes that occur in megaloblastic anemia. 1. Ineffective erythropoiesis o There is replication of erythroid precursor in the bone marrow, but they die before maturation. So there is no functional release of red cells into circulation. 2. Hemolysis In megaloblastic anemia there is hemolytic destruction of red cells in periphery. The basis for hemolysis is not entirely clear. Due to destruction of RBCs by ineffective erythropoiesis and peripheral hemolysis, findings of hemolytic anemia may also occur in megaloblastic anemia, i..e, - T LDH, Reduced heptoglobin, Positive urine hemosiderin, Raised urine urobilinogen
Pathology
null
All
Acute angle closure glaucoma first line treatment?
Ans. is 'a' i.e., I.V. Mannitol Treatment of angle closure glaucoma Definitive treatment (treatment of choice) is surgery. However, intially drugs are used to decrease KW during an acute attack. Approach of treatment is as follows:- Sta i.v. mannitol or i.v. acetazolamide When IOT stas falling, sta topical pilocarpine or b-blocker (timolol). Apraclonidine/latanoprost may be added. Once IOT is reduced, surgery is done. Topical pilocarpine 2% is the preferred antiglaucomatous drug. After control of IOP, Laser (Nd : YAG) peripheral irodotomy is the definitive management of choice. If laser is not available surgical peripheral iridectomy is the procedure of choice. Other surgical procedures used are filteration surgeries (like trabeculectomy, deep sclerotomy, Viscoanulostomy). Symptomatic treatment during an attack also includes analgesics, antiemetic and topical coicosteroids to reduce inflammation. Mydriatics (e.g. atropine) are contraindicated as they precipitate glaucoma. PACG is a bilateral disease, the fellow eye is at risk of developing an acute attack in 50% cases in future. Therefore a prophylactic peripheral laser iridotomy should be performed in the fellow eye.
Ophthalmology
null
Iv mannitol
Duhamel operation is done in -
Ans. is 'd' i.e., Hirschsprung's disease
Surgery
null
Hirschsprung's disease
Gower sign is classical of one of the following condition –
null
Pediatrics
null
Duchenne muscular dystrophy
Which of the following structure is not affected in protein denaturation?
Ans. (a) Primary structureRef: Harper's Biochemistry, 30lh ed. pg. 26-29, 618-19 |PROTEIN DENATURATION* In quaternary structure denaturation, protein sub-units are dissociated and/or the spatial arrangement of protein subunits is disrupted.* Primary structure, such as the sequence of amino acids held together by covalent peptide bonds, is not disrupted by denaturation.* In secondary structure denaturation proteins adopt a random coil as they lose all regular repeating patterns such as alpha-helices and beta-pleated sheets, and configuration.* Tertiary structure denaturation involves the disruption of:1. Covalent interactions between amino acid side- chains (such as disulfide bridges between cysteine groups)2. Non-covalent dipole-dipole interactions between polar amino acid side-chains (and the surrounding solvent)3. Van der Waals (induced dipole) interactions between nonpolar amino acid side-chains.
Biochemistry
Proteins and Amino Acids
Primary structure
Most common cause of aortic aneurysm is -
Ans. is 'c' i.e., Atherosclerosis Aneurysmo Aneurysm is a localized abnormal dilatation of blood vessel or the wall of hearto When an aneurysm is bounded by true arterial wall, it is called a true aneurysm.o When wall, is ruptured and there is collection of blood outside the vessel wall {extravaseular hematoma) that is freely communicating with vessel wall - false aneurysm. Most common cause of false aneurysm is post myocardial infarction rupture.o Aneurysm due to infection that causes weakening of vessel wall - mycotic aneurysm.o The two most important causes of aortic aneurysm (not only abdominal part but in any part of aorta) are atherosclerosis and cystic medial degeneration of arterial media.Abdominal aortic aneurvsmo The most common etiology for abdominal aortic aneurysm is atherosclerosis.o Atherosclerosis causes arterial wall thining through medial destruction secondary to plaque that originates in the intima.o Besides abdominal aorta, atherosclerotic aneurysm also occur in common iliac arteries, arch and descending part of thoracic aorta.o The usual site of abdominal aortic aneurism is below the origin of renal artery and above the bifurcation of the aorta.Remembero Most common cause of aortic aneurysm (overall) = Atherosclerosis.o Most common cause of ascending aortic aneurysm = Cystic medial necrosis.o Most common cause of descending aortic aneurysm = Atherosclerosis.o Most common cause of aneurysm of aortic arch = Atherosclerosis.o Syphilitic aneurysm affect = Ascending aorta, a Aneurysm ofTakayasu arteritis affects = Aortic arch.o Most common cause of mycotic abdominal aneurysm = salmonella gastroenteritis.
Pathology
Aneurysms and Dissections
Atherosclerosis
A patient of Crohn's disease underwent resection anastomosis. Now present on 7th postoperative day with anastomotic leak from a fistula. Every day leakage volume adds up to 150-200 mL. There is no intra-abdominal collection and the patient is stable without any complaints. What will be next line of management?
Ans. (a) Conservative treatment and leave him and hope for the spontaneous resolutionRef: Sabiston 19th edition, Pages 1270-1272* As long as the patient has no signs of sepsis we can wait -- the waiting can be maximum for 4-6 weeks.* Only after 6 weeks we will plan for surgery: Excision of fistula and segmental resection of the involved bowel and reanastomosis.
Surgery
Small & Large Intestine
Conservative treatment and leave him and hope for the spontaneous resolution
A 7 year old boy presented with generalized edema. Urine examination revealed marked albuminuria. Serum biochemical examinations showed hypoalbuminemia with hyperlipidemia. Kidney biopsy was undeaken. On light microscopic examination, the kidney appeared normal. Electron microscopic examination is most likely to reveal
Minimal change disease(MCD)Also known as nil lesion or lipoid nephrosis Causes 70-90% of the Nephrotic syndrome in childhood but only 10-15% of the Nephrotic syndrome in adultsCan be associated with Hodgkin&;s disease, allergies, NSAIDs, HIVClinical and laboratory findings: Abrupt onset of edema and nephrotic syndrome accompanied by acellular urinary sedimentHypeension, microscopic hematuria, allergic symptoms and decreased renal function may be presentAcute renal failure in adults is seen mostly in patients with low serum albumin and intrarenal edema (nephrosarca) that is responsive to intravenous albumin and diureticsIn children, the abnormal urine principally contains albumin with minimal amounts of higher-molecular-weight proteins, called as selective proteinuriaLight microscopy- no obvious glomerular lesionImmunofluorescent microscopy- negative for deposits or IgM deposits in mesangium(rarely)Electron microscopy- an effacement of the foot process with the weakening of slit-pore membranesPatients with steroid resistance may have FSGS on repeat biopsyPrimary responders: patients who have complete remission (<0.2 mg/24 h of proteinuria) after a single course of prednisoneSteroid-dependent: patients who relapse as their steroid dose is taperedFrequent relapsers: those having two or more relapses in the 6 months following taperSteroid-resistant: patients failing to respond to steroid therapyRelapses: - occur in 70-75% of children after the first remissionEarly relapse predicts multiple subsequent relapsesThe frequency of relapses decreases after pubey; increased risk of relapse following the rapid tapering of steroids in all groupsRelapses are less common in adults but are more resistant to subsequent therapyPrednisone is first-line therapy; cyclophosphamide, chlorambucil, and mycophenolate mofetil are used in frequent relapsers, steroid-dependent, or steroid-resistant patients(Ref: Harrison's 18/e p2345)
Medicine
All India exam
Fusion of foot processes of the glomerular epithelial cells
Following muscles are the abductors of eye except (NOT RELATED)
Superior rectus The superior rectus muscle is one of the extraocular muscles. It is innervated by the superior division of the oculomotor nerve. In the primary posi on (looking straight ahead), the superior rectus muscle's primary func on is eleva on, although it also contributes to intorsion and adduc on. Superior oblique: The primary ac on of the superior oblique muscle is intorsion; the secondary ac on is depression (primarily in the adducted posi on); the ter ary ac on is abduc on (DOI). Both the obliques are abductors
Pharmacology
All India exam
Superior rectus
The following smooth muscle relaxants act by affecting calcium release except
Prazosin is alpha-1 blocker .
Anaesthesia
null
Prazosin
Ig seen in breast milk & secretions:
Ans: a (IgA) Ref: Ananthanarayan, 7th ed, p. 88, 89Serum IgA is the major Ig in colostrums, saliva & tears.It is concentrated in secretions and on mucus surfaces forming an antibody paste.It is important in immunity against respiratory & intestinal pathogens.Properties of Immunoglobulins:IgMIgG* Maximum intravascular concentration* Maximum molecular weight* Maximum sedimentation co efficient* Earliest Ig by the foetus* Increased in primary immune response* Activate classical pathway* Mediates hypersensitivity pneumonitis* Maximum serum concentration* Longest half life (23 days)* Only Ig to cross placenta* Ig to increase in secondary immune response* Fixes complement by classical pathway (except IgG4) IgAigE* Secreted by seromucinous glands* Ig present in milk. (Other one is IgG)* Fix complement by Alternate Pathway* Mediator of type 1 HS* Only heat labile Ig* Shortest half life (2 days), least amount in serum* Maximum carbohydrate concentration* Shows homocytotropism* Mediate Prausnitz Kustner reaction.* Ig's activating alternate pathway - IgG4, IgA, IgD* IgG in multiple myeloma, IgM in Waldenstrom's macroglobulinemia* Ig dimer is IgA. Ig pentamer is IgM
Pathology
Immunity
IgA
All are true about mammary gland, except
BREAST/MAMMARY GLAND: It is found in both sexes, but rudimentary in the male. It is a modified sweat gland. It forms an impoant accessory organ of the female reproductive system and provides nutrition to the newborn in the form of milk. SITUATION: The breast lies in the superficial fascia of the pectoralis region. It is divided into 4 quadrants, i.e. upper medial, upper lateral, lower medial, lower lateral. A small extension of the upper lateral quadrant, called the axillary tail of spence, passes through an opening in the deep fascia and lies in the axilla. The opening is called foramen of langer. EXTENT OF BASE: 1)Veically it extends from 2 to 6 th rib. 2)Horizontally it extends from the lateral border of the sternum to the mid-axillary line. DEEP RELATIONS: 1)The breast lies on the deep fascia {pectoral fascia} covering the pectoralis major. 2)Still deeper there are the pas of 3 muscles namely pectoralis major, the serratus anterior, and the external oblique muscle of the abdomen. 3)The breast is separated from the pectoralis fascia by loose areolar tissue, called retromammary space. Because of the presence of this loose tissue, the normal breast can be moved freely over the pectoralis major. BLOOD SUPPLY: It is extremely vascular. supplied by Internal thoracic aery lateral thoracic, superior thoracic and acromiothoracic branches of axillary aery lateral branches of the posterior intercostal aeries. NERVE SUPPLY: anterior and lateral cutaneous branches of the 4th to 6th intercostal nerves. The nerves convey sensory fibres to the skin and autonomic fibres to smooth muscles and to blood vessels. the nerves do not control the secretion of milk. secretion is controlled by hormone prolactin, secreted by pars anterior of the hypophysis cerebri.
Anatomy
Upper limb
Supplied by internal mammary aery
The interstitial lung disease (ILD) showing granulomas on lung biopsy is
Sarcoidosis is an inflammatory disease characterised by the presence of noncaseating granulomas.The granuloma is the pathologic hallmark of sarcoidosis. Desquamative interstitial pneumonia Is characterised by extensive accumulation of macrophages in intraalveolar spaces with minimal interstitial fibrosis.Granulomas are not formed in usual interstitial pneumonitis and diffuse alveolar damage. Reference:Harrison's Medicine-18th edition,page no:2805,2806,2167.
Medicine
Respiratory system
Sarcoidosis
Most common malignancy of liver in children is:
Hepatoblastoma is the most common malignancy of the liver in children, with most of these tumors diagnosed before 4 years of age. Hepatocellular carcinoma is the next most common, with a peak incidence between 10 and 15 years of age. Ref: Schwaz's principle of surgery 9th edition, chapter 39.
Surgery
null
Hepatoblastoma
New born male baby presented with congestive heart failure. On examination enlarged fontanelles, a loud cranial bruit and following radiological finding was noted-the most likely diagnosis:
Ref. Grainger and Allison's Diagnostic Radiology. Page. 189
Unknown
null
Vein of Galen malformation
Spironolactone should not be given with ?
Ans. is 'c' i.e., ACE inhibitors o Spironolactone is a potassium sparing diuretic, therefore, it can cause hyperkalemia decreasing the potassium diuresis. o ACE inhibitors can also cause hyperkalemia by inhibiting the production of angiotensin I, an inmmediate precursor of angiotensin II. Angiotensin causes excretion of Kt by increasing the secretion of aldosterone (Normally aldosterone enhances absoion of Na' in distal tubules in exhange of active secretion of Kt). o ACE inhibitors decrease potassium excretion by inhibiting the generation of Angiotensin. o Therefore, More pronoundced hyperkalemia can occur in patients receiving ACE inhibitors with sprironolactone.
Pharmacology
null
ACE inhibitors
Late complication of elbow dislocation
Myositis ossificans: MYOSITIS OSSIFICANS * Acquired development of non neoplastic heterotopic ossification within soft tissues * Most often in response to localized trauma * Although the process most commonly develops within skeletal muscle, the term itself is a misnomer, because nonmuscular tissue may be involved, and inflammation is rare. * Adolescents & young adults, predominantly men, are affected most frequently, although it has been repoed in infancy as well Treatment * Once diagnosis is established, usually clinically, any surgical biopsy is contraindicated in FOP. * No established medical therapy exists. * Pain medications * suppoive measures -gentle occupational and/or physical therapy. Ref maheshwari 6/e p102
Orthopaedics
Elbow injuries
Myositis ossificans
A neonate presented with fever, lethargy, abdominal distension, vomiting and constipation. Clinically he was diagnosed as volvulus neonatarum with suspected perforation. The best investigation would be –
Volvulus neonatorum The fetal alimentary canal returns from the extraembryonic coelom into the abdomen at 8-10 weeks and the bowel undergoes rotation and fixation at certain points by the attachment of its mesentery to the posterior abdominal wall. When the process is incomplete or deviates from the normal plan, the result is malfixation or malrotation. Commonly, the normal oblique attachment of the mesentery from duodenojejunal flexure of the caecum is absent, and the small bowel is attached to the posterior abdominal wall by a narrow stalk based around superior mesenteric vessels. The caecum is undescended, i.e., situated in the right hypochondrium and abnormally fixed by peritoneal bands running laterally across the second part of the duodenum. The poorly attached small bowel undergoes volvulus around the axis of the 'universal mesentery', which is twisted so that the flow of blood is cut off, producing a strangulating obstruction of the small bowel. This typically occurs in the newborn, hence the term `Volvulus neonatorum'. The terminal ileum and caecum are drawn into the volvulus and are wrapped around the stalk of the mesentery in two or three tight coils. Clinical feature A young infant, previously healthy, starts bile-stained vomiting during the first few days of the live. The abdomen is soft and non-distended; however, abdominal distension may occur which is limited to upper abdomen (epigastrium). No obstruction may occur in the first day or two after birth and meconium may be passed normally. Then, with variable suddenness, bowel actions cease with onset of obstruction. The signs vary, depending on the degree of intestinal obstruction versus ischemia. When strangulation occurs there are signs of shock, especially pallor and a vague mass of congested bowel may be palpable in the centre of the abdomen. Blood or blood-tinged mucus may be passed rectally. Ischemia may result in gangrene and perforation. Investigations   Barium contrast studies with fluoroscopy (Barium meal follow through) is the investigation of choice as X-ray is not reliable in early stages of volvulus. However, if the perforation is suspected, barium contrast should not be used because of the risk of peritonitis. Water-soluble contrast studies (iodine based) should be used. Plain X-ray of abdomen/chest is the initial investigation to demonstrate free air under the diaphragm in suspected cases of perforation.
Pediatrics
null
Plain x–ray
Which of the following statement is true -
Ans. is 'b' i.e., Cohort study involves large number of subjects* Prevalence of blindness in India: 700 per 1 lakh population (0.7%) if cut of criteria is < 3/60 (WHO criteria); or 1100 per lakh population (1.1%) if cut of criteria is < 6/60 (NPCB criteria).
Social & Preventive Medicine
Epidemiology
Cohort study involves large number of subjects
Cottel's test is used to test the patency of the nares in:
Ans: C (Deviated nasal symptom) Ref: Diseases of the Ear Nose and Throat by PL Dhingra 5th edn 2010.Page 164-165Explanation:In this test (he cheek is pulled laterally and subjective improvement in the airway is assessedIf there is relief in nasal obstruction then the test is positive and indicates an abnormality in the vestibular component of the nasal valve.
Unknown
null
Deviated nasal septum
A 38 year old woman being treated for hypeension and diabetes has the sudden onset of swelling and tenderness of the wrists and knees. On examination she is febrile and flushed. A friction rub can be heard at the left lower sterna border. Which of the following drug is most likely the cause of these findings?
Hydralazine Drug induced lupus refers to a form of lupus caused by medication, it causes some symptoms similar to those of SLE (ahritis, rash, fever, and chest pain, but no kidney involvement ) that go away when the drug is Stopped common medications that may cause drug-induced lupus include hydralazine (Apresoline), procainamide (Procan, Pronestyl), methyldopa (Aldomet), quinidine (Quinaglute), isoniazid (INH), and some anti-seizure medications such as phenytoin (Dilantin) or carbamazepine (Tegretol) compications are more common in females. It is also more common in 'slow acetylators' since the metabolism of hydralazin is reduced in these patients.
Surgery
null
Hydralazine
An elderly female presents to the emergency depament and was found to have a transmural myocardial infarction. Based on her ECG, she was staed on thrombolytie therapy with streptokinase. On fuher examination, which of the following findings would indicate that the thrombolytic therapy is risky and should be stopped
Ans. c. Significant pericardial effusion on echocardiography Fibrinolytics and anticoagulants can be continued in case of pericarditis, however, once significant pericardial effusion develops after MI, fibrinolytics should be discontinued "The risk of post MI pericardial effusion is not increased with the use of fibrinolytic agents, heparin, aspirin and other antiplatelet agents. In contrast, a pericardial effusion occurring I the setting of MI is an indication to discontinue anticoagulation and fibrinolytics. Fibrinolytic Therapy Absolute Contraindications History of cerebrovascular hemorrhage at any timeQ A non-hemorrhagic stroke or other cerebrovascular event within the past yearQ Marked hypeension (areliabl determined systolic aerial pressure >a180 mm Hg and/or a diastolic pressure>110 mm Hg) at any time during theacute presentation, suspicion of aoicdissection, and active internalbleeding (excluding menses).Q Relative Contraindications Current use of anticoagulantsQ(INR 2) A recent (<2 weeks) invasive or surgical procedure or prolonged (> cardiopulmonary resuscitation)Q Known bleeding diathesisQ PregnancyQ A hemorrhagic ophthalmic condition (e.g., hemorrhagic diabetic retinopathy) ctive peptic ulcer diseaseQ A history of severe hypeension that is currently adequatelyQ Allergic reactions to streptokinaseQ
Medicine
null
Significant pericardial effusion on echocardiography
Non-appearance of social smile even after ..... weeks, is considered as abnormal: September 2011
Ans. D: 8 weeks Child stas smiling back (social smile) when anyone talks to him or smiles at him by 6-8 weeks of age Impoant milestones: Head control: 1 month Sits with suppo: 5 months Transfer object from one hand to other: 6 months Crawls at: 8 months Says mama dada: 10 months Babies know his/ her gender: 3 years Can draw a circle: 3 years Self decisions: 7 years
Pediatrics
null
8 weeks
A child was taken for CECT Chest and contrast, was injected; child had swelling which gradually increased. There is numbness. There is pain on passive extension of fingers. He is not allowing you to touch the arm. Pulse was present. What will you do?
Ans is 'c' i.e. Immediate Fasciotomy The child is having Compartment syndrome due to extravasation of contrast. This is a medical emergency and immediate fasciotomy needs to be done to prevent tissue necrosis.Extravasation of contrast and Compartment syndromeExtravasation of contrast is a possible complication of imaging studies performed with contrasts.Most cases of subcutaneous extravasation occur due to small volumes of extravasation of contrast causing pain, minimum swelling and localized erythema that is rapidly resolved. If larger volumes are extravasated, extensive tissue and skin necrosis may occur. Compartment syndrome is a very rare complication.Acute compartment syndrome occurs when the tissue pressure within a closed muscle compartment exceeds the perfusion pressure and results in muscle and nerve ischemia. It typically occurs subsequent to a traumatic event, most commonly a fracture.If left untreated or if inadequately treated, the muscles and nerve within the compartment undergo ischemic necrosis, and a limb contracture, called a Volkmann contracture, results. Severe cases may lead to renal failure and death.The earliest of the 'classic' features are pain (or a 'bursting' sensation), altered sensibility and paresis (or, more usually, weakness in active muscle contraction). Ischaemic muscle is highly sensitive to stretch. If the limb is unduly painful, swollen or tense, the muscles (which may be tender) should be tested by stretching them. When the toes or fingers are passively hyperextended, there is increased pain in the calf or forearm.Confirmation of the diagnosis can be made by measuring the intra compartmental pressures.Treatment is emergent fasciotomy.
Radiology
Ultrasonography, CT, and MRI
Immediate Fasciotomy
The MTP act defines the following -
Ans. is 'd' i.e., All of the above Medical termination of pregnancy act (1971) o The MTP act, 1971 lays down ? 1. The conditions under which a pregnancy can be terminated. 2. The person or persons who can perform such terminations. 3. The place where such terminations can be performed.
Social & Preventive Medicine
null
All of the above
Primary cause of bleeding disorder in liver damage is due to
null
Physiology
null
decreased level of prothrombin
A 25-year-old man arrives in the emergency department in respiratory distress following a motor vehicle collision. A chest x-ray shows abdominal viscera in the left thorax. What is the most likely diagnosis?
Blunt trauma is the most common cause of diaphragmatic rupture. Associated injuries are common. In blunt trauma, the left diaphragm is ruptured more frequently than the right. The stomach, spleen, colon, and omentum may enter the left pleural cavity. Diaphragmatic injury without herniation of abdominal contents is difficult to diagnose. Patients may present with symptoms many years after the initial trauma. Early surgery is indicted.
Surgery
Stomach & Duodenum
Traumatic rupture of the diaphragm
Membranous glomerulonephritis is associated with-a) Renal venous thrombosisb) Hodgkin's diseasec) Subepithelial immune deposits d) Acute nephritis e) Hematuria
null
Medicine
null
acd
Aspirin triad is -
ASA triad (also known as Samter's Triad) is characterized by nasal polyps, asthma and aspirin intolerance . Patients with this condition develop a special rash and/or asthmatic reaction, which can be life threatening, when they take aspirin or aspirin-related drugs (ibuprofen, others). Patients with ASA triad have severe asthma and rhinosinusitis. Even after appropriate sinus surgery, the polyps can return. Optimal treatment includes sinus surgery and medical management. Most patients with ASA triad require systemic and topical coicosteroids. Good asthma treatment is critical as well. Some centers employ aspirin desensitization, a specific technique to create aspirin tolerance, which seems to improve both the asthma and the rhinosinusitis. Ref - medscape.com
Medicine
Miscellaneous
Sampter's triad
All can commonly occur in a pt. who suffered decelerating injury in which pituitary stalk was damaged. Except one ?
Ans. is 'a' ie. Diabetes Mellitus
Surgery
null
Diabetes mellitus
Radiation induced caries occurs in?
Radiation-related caries and other dental hard tissue changes can appear within the first 3 months following RT. Ref: Gupta N, Pal M, Rawat S, et al. Radiation-induced dental caries, prevention and treatment - A systematic review. Natl J Maxillofac Surg. 2015;6(2):160-166. doi:10.4103/0975-5950.183870
Radiology
null
3 months
Square root of detion is also called as ?
Ans. is 'a' i.e., Standard detion o Standard detion is square root of mean detion, so it is also known as "Root - means - square - detion". o The steps for calculating SD are ? a) First calculate mean (y) b) Then deduct this mean from each value to obtain detion from mean (x - .T) as we did in calculating mean detion (see above). c) Now square, each detion (x - )7)2 d) Add up the squared detions --> S (x - 7)2 e) Divide the result by the number of values (observations), i.e. n . f) At the end, take square root, which gives the standard detion.
Social & Preventive Medicine
null
Standard detion
Endolymph in the inner ear
Endolymph fills the membranous labyrinth and rich in K ions and is secreted by stria vascularis and the dark cells present in the utricle and near the ampullated end of semicircular ducts. Reference Dhingra 6th edition pg-24.
ENT
Ear
Is secreted by Stria vascularis
Which of the following skull fractures is called a 'Motorcyclist's fracture'?
Hinge fracture is also known as motor cyclist's fracture. Ref: The Essentials of Forensic Medicine and Toxicology By Dr K S Narayan Reddy, 28th Edition, Page 211; Guide to Forensic Medicine and Toxicology By B. Jain, 2004, Page 98; Oxford Handbook of Forensic Medicine By Jonathan P. Wyatt, Page 145; Lawyers Guide to Forensic Medicine By Bernard Knight, 2nd Edition, Page 202
Forensic Medicine
null
Hinge fracture of base of skull
Podophyllum resin is indicated in the treatment of –
Podophylin is used in anogenital wart (condyloma accuminata).
Dental
null
Condyloma acuminata
In shock, characteristic feature is -
Ans. is 'b' i.e., Poor perfusion of tissues SHOCK Shock is the clinical syndrome that results from poor tissue perfusion. In this condition tissues in the body do not receive enough oxygen and nutrients to allow the cells to function. o This ultimately leads to cellular death and may progress to organ failure and finally, to whole body failure and death. Common types of shock o Hypovalemic shock --> Due to decreased blood volume from any cause. (most common type) o Cardiogenic shock Due to inadequate pumping action of the hea. o Septic shock Caused by infection o Anaphylactic shock --> Caused by type I hypersensitivity reaction. o Neurogenic shock Caused by damage to nervous system that leads to interruption of sympathetic vasomotor input.
Pathology
null
Poor perfusion of tissues
WAGR syndrome includes all except
WAGR syndrome :  Wilms tumour. Aniridia. Genital anomalies. Mental Retardation.
Pediatrics
null
Anorectal malformation
About LET; all are false except (NOT RELATED TO PHARMACOLOGY)
LET (linear energy transfer)- it is the amount of energy deposited per unit length. Given as Kev/ micrometre. It is highest for alpha paicle (high LET), low for beta paicles and gamma emissions (Low LET). It is a propey of the radiation. OER (oxygen enhancement ratio )is the ratio of quantity of radiation required to kill tumour cells in the absence of oxygen to the quantity of radiation required to kill same amount of tumour cells in the presence of oxygen. OER is low for high LET radiations (OER= 1) and high for low LET radiations(OER= 2-3).
Pharmacology
All India exam
High LET radiations have low oxygen enhancement ratio
"Upside down" stomach on Barium meal study is seen in
"Upside down" stomach on Ba meal study is seen in Mesenteroaxial gastric volvulus. Barium swallow study showing the upside-down appearance of the stomach in the thorax with the subdiaphragmatic location of the gastroesophageal junction before surgery (a) and normal subdiaphragmatic position of the stomach one month after the surgery (b). ref - <a href=" <p>
Medicine
All India exam
Mesenteroaxial gastric volvulus
Intra-epidermal intercellular deposition of IgG is associated with -
Ans. is 'a' i.e., Pemphigus Immunofluorescence in dermatologyDiseaseIgGIgMIgAC3FibrinIF patternAntigenPemphigus vulgaris++ ++ Intercellular- between epidermal cells.Network patternDesmoglein 3IgA pemphigus ++ Do Paraneoplastic pemphigus++++ DoDesmoplakinBullous pemphigoid++ ++ Linear deposits along BMZBP230 BPI80Epidermolysis bullosa acquisita++ ++ DoCollagen 7Dermatitis herpetiformis +++ Granular papillary tip deposits along BMZEpidermal transglutaminaseSLE++++ ++ Granular deposits along BMZ Lichen planus++++++Ovoid bodies with ragged fibrin band along BMZ Bullous SLE+++ Linear BMZ depositsCollagen 7Porphyria++\ +Perivascular and BMZ deposits Amyloid+++++-H- Globular deposits in tips of apillary dermis BMZ-Basement membrane zone
Unknown
null
Pemphigus
A drug company is developing a new pregnancy-test kit for use on an outpatient basis. The company used the pregnancy test on 100 women who are known to be pregnant. Out of 100 women, 99 showed positive test. Upon using the same test on 100 non-pregnant women, 90 showed negative result. What is the sensitivity of the test -
Ans. is 'b' i.e., 99%
Social & Preventive Medicine
null
99%
For the following findings, select the most likely type of lung cancer.Has the best prognosis of all malignant lung cancers.
Because of its tendency for early exfoliation and obstruction, squamous cell cancer is often detected at an earlier stage. Even correcting for this, there is some suggestion that its prognosis is still better, perhaps because of its slow growth rate.
Medicine
Oncology
squamous cell cancer of the lung
A 7 year old boy presented with generalized edema. Urine examination revealed marked albuminuria. Serum biochemical examinations showed hypoalbuminaemia with hyperlipidaemia. Kidney biopsy was undeaken. On light microscopic examination, the kidney appeared normal. Electron microscopic examination is most likely to reveal ?
Ans. is 'a' i.e., Fusion of foot process of the glomerular epithelial cells o The child in presenting with features S/o Nephrotic syndrome most frequent cause of which amongst children is minimal change ds. o Light microscopic finding of MCD --> no abnormality o Electron microscopic finding of MCD --> fusion of foot processes of the glomerular epithelial cells o Note that loss of foot processes may also be seen in other proteinuric states (eg. Membranous glomerulonephritis, diabetes), but when the fusion is associated with normal glomeruli only then the diagnosis of MCD can be made. o MCD is also know as lipoid nephrosis as cells of the proximal tubules are often laden with lipids.
Pathology
null
Fusion of foot processes of the glomerular epithelial cells
Serum is blood plasma without:
null
Physiology
null
Fibrinogen
Postganglionic fibres to parotid gland is supplied by:
Preganglionic nerves travel in the lesser petrosal branch of the glossopharyngeal nerve and synapse in the otic ganglion. Postganglionic fibres reach the gland the auriculotemporal nerve.Ref: Gray's anatomy 40th edition, Chapter 29.
Anatomy
null
Auriculotemporal nerve
L-asparaginase is partcularly used in which type of leukemia -
null
Medicine
null
ALL
Which of the following is most resistant to antiseptics?
Resistance of organism to antiseptics in decreasing order is as follows: Prions Coccidia Spores Mycobacteria Cysts Small non-enveloped virus Trophozoites Gram-negative bacteria (non-sporulating) Fungi Large non-enveloped virus Gram-positive bacteria Lipid enveloped / medium sized virus (HIV, HBV)
Microbiology
null
Prion
True regarding SA-14-14-2 Japanese Encephalitis vaccine -
Ans. is 'a' i.e., Cell culture derived live attenuated
Social & Preventive Medicine
null
Cell culture derived live attenuated
Histological features of chronic hepatitis -a) Fibrosis of porta hepatisb) Architectural changesc) Bridging necrosisd) Ballooning degenerations
In chronic hepatitis : Liver architecture is usually well preserved. Portal zones infiltrated with lymphocytes and plasma cells and there is fibrosis of porta hepatis. Bridging necrosis seen by linking of fibrous septa between the lobules. Ballooning degeneration is seen in Acute hepatitis.
Pathology
null
ac
Protein present in brown adipose tissue:
Ref: Guyton & Hall. Body Temperature Regulation, and Fever. In: Textbook of Medical Physiology. 12th ed. Philadelphia: Saunders Elsevier; 2012. P873. Canong's Review of Medical Physiology, 21st edition.Explanation:'"Brown fat is richly supplied with sympathetic nerves that release norepinephrine, which stimulates tissue expression of mitochondrial uncoupling protein f also called thermogenin). It increases thermogenesis "The lipids in cells are of three main types:Structural lipids - Inherent part of the membranes and other parts of cells; andNeutral fat - Stored in the adipose cells of the fat depots.Brown fatBrown FatMakes up a small percentage of total body fat.More abundant in infants but is present in adults as wellIt is located in:Between the scapulasAt the nape of the neckAlong the great vessels in the thorax and abdomenOther scattered locations in the body* The fat cells as well as the blood vessels have an extensive sympathetic innervation. (Remember. In white fat depots, the principal sympathetic innervation is solely on blood vessels and not on fat cells)Ordinary lipocytes have only a single large droplet of white fat, whereas brown fat cells contain several small droplets of fat.Brown fat contain relatively abundant mitochondria.In these mitochondria, there is the usual inward proton conductance that generates ATP (oxidative phosphorylation) but there is in addition a second proton conductance that does not generate ATP.This "short-circuit" conductance depends on a 32-kDa uncoupling protein (UCP l)It causes uncoupling of metabolism and generation of ATP, so that more heat is producedSympathetic stimulation - Releases norepinephrine - b3-adrcnergic receptors - | lipolysis. - increased fatty acid oxidation in mitochondria - | heat production.Nerve discharge to brown fat is also increased after eating, so that heat production is increased.Hormones secreted by Adipose TissueAdiponectin - Modulates glucose and fat metabolism in liver and skeletal muscleLeptin - Regulated energy homeostasisNorepinephrine (symphathetic stimulation) - Mobilization of free fatty acidsPerilipin - Involed in the formation of lipid droplets in adipocytes.
Physiology
Heart, Circulation, and Blood
Thermogenin
Treponema pallidum was discovered by -
Ans. is 'c' i.e., Schaudinn and Hoffman BacteriaDiscovered byLepra bacillus (M. Leprae)Hansen (1874)GonococcusNeisser(1879)StaphylococcusOgston(1881)Diphtheria bacillus (C. Diphtheria)Loeffler(1884)Tetanus bacillus (C. Tetani)Nicolaier(1884)PneumococcusFraenkel (1886)Causative organism for Malta fever (Brucella)Bruce(1887)Spirochete of syphilis (T pallidum)Schaudinn and Hoffmann (1905)
Microbiology
Spirochetes
Schaudinn and Hoffman
Which of the following true about Libman sac’s endocarditis--
In SLE, mitral and tricuspid valvulitis with small, sterile vegetations, called LibmanSacks endocarditis is occasionally encountered. The lesions are small single or multiple, sterile, granular pink vegetations ranging from 1 to 4 mm in diameter. The lesions may be located on the undersurfaces of the atrioventricular valves, on the valvular endocardium, on the cords, or on the mural endocardium of atria or ventricles. An intense valvulitis may be present, characterized by fibrinoid necrosis of the valve substance that is often contiguous with the vegetation. Subsequent fibrosis and serious deformity can result that resembles chronic RHD and require surgery'.
Medicine
null
On either side of valve
Following FISH technique depicts?
Ans. C. TranslocationGiven technique is FISH (Fluorescent in situ hybridization).Above image is of translocation as a combination of two colours is seen in one chromosome.(A). Duplication(B). Deletion
Biochemistry
Molecular Genetics
Translocation
A 55-year-old man complains of pain in his back, fatigue and occasional confusion. He admits to polyuria and polydipsia. An X-ray examination reveals numerous lytic lesions in the lumbar veebral bodies. Laboratory studies disclose hypoalbuminemia, mild anemia, and thrombocytopenia. A monoclonal IgG peak is demonstrated by serum electrophoresis. Urinalysis shows 4+ proteinuria. A bone marrow biopsy discloses foci of plasma cells, which account for 18% of all hematopoietic cells. What is the appropriate diagnosis?
Plasma cell myeloma (multiple myeloma) is characterized by a multifocal infiltration of malignant plasma cells in the bone marrow. Major diagnostic criteria for plasma cell myeloma include marrow plasmacytosis (>30%), plasmacytoma on biopsy, and immunoglobulin paraprotein (M-component). In this patient, the neoplastic clone secretes excess kappa light chains. Waldenstrom macroglobulinemia is a neoplastic disorder of small lymphocytes that secrete IgM.Diagnosis: Multiple myeloma
Pathology
Hematology
Multiple myeloma
The following is true of vancomycin EXCEPT:
(Ref: KDT 6/e p732) Vancomycin is a glycopeptide that acts by inhibiting bacterial cell wall synthesis. It is a bactericidal drug (like other cell was synthesis inhibitors). It is the drug of choice for MRSA and enterococci resistant to penicillins Nephrotoxicity, ototoxicity and red man syndrome are prominent adverse effects of vancomycin.
Pharmacology
Other topics and Adverse effects
It acts by inhibiting bacterial protein synthesis
Thiamine deficiency causes -
null
Medicine
null
All
Features associated with DNS include all of the following except:
(b) Atrophy of turbinate(Ref. Cummings, 6th ed., 474)There is no pressure atrophy of the turbinates on the side of deviation of septum. In DNS there occurs hypertrophy of turbinate of opposite site.
ENT
Disease of External Nose & Nasal Septum
Atrophy of turbinate
Cranial nerve involved in sarcoidosis is
.
Anatomy
All India exam
7th
Most important dose-limiting toxicity of cancer chemotherapy is :
Depression of bone marrow is usually the most significant dose-limiting toxicity with cancer chemotherapy.
Pharmacology
null
Bone marrow suppression
A most common cause of bony ankylosis-
Ankylosis Ankylosis is the fusion of bones in a joint leading to stiffness of the joint. Ankylosis may be : - 1) Fibrous ankylosis: - Two articular surfaces are fused by fibrous tissue. The feature are : - Some movement of joint is possible (though just a jog of movement). Movements may be painless or painful. Most common cause is tubercular arthritis. 2) Bony ankylosis: - There is a bony union between two articular surfaces. The features are : - No movements possible. a Joint is painless A most common cause is acute suppurative arthritis (septic arthritis). Sometimes, stiffness may also occur due to extra-articular etiology such as in Bum contracture, myositis ossificans etc. It is called False ankylosis.
Orthopaedics
null
Pyogenic arthritis
Botulism is most commonly due to
Food-borne botulism is caused by the ingestion of the preformed toxin. The source of botulism is usually preserved food - meat and meat products. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 269
Microbiology
Bacteriology
Meat
Neuroblastoma Originates from the following. Choose the true/false statements. 1. Adrenals 2. Peripheral Nerve 3. Paraveebral retroperitoneum 4. Posterior Mediastinum 5. Lymph node
Neuroblastoma originate from adrenals, peripheral nerves and posterior mediastinum. Ref: O.P.Ghai 7th Ed Page 590-591,6th Ed page 573,Robbins 8th Ed page 476.
Pediatrics
null
1, 2, 4 - True & 3, 5 - False
The inferior oblique muscle is supplied by:
Ans: a (Oculomotor nerve) Ref: Chaurasia, 4 ed, p. 112,113A simple one! All external muscles of the eye are supplied by oculomotor nerve except the lateral rectus (abducent nerve) and the superior oblique (by trochlear).Remember 3The inferior oblique is fleshy throughout.In the primary position of the eye, its function is:elevation,abduction andextortion.Actions of extraocular musclesMuscleprimarysecondarytertiaryMRadduction LRabduction SRelevationintorsionadductionIRdepressionextorsionadductionSOintorsiondepressionabductionIOextorsionelevationabductionSome useful mnemonics:All superiors are intorters. So inferiors are extortersAll recti are adductors. So obliques are abductors Also remember: The first muscle to be affected in thyroid ophthalmopathyThe last muscle to be affected in retrobulbar block- inferior rectus-superior oblique
Anatomy
Orbit
Oculomotor nerve
Which of the following hormones is elevated in small cell carcinoma of lung
Hormones produced by small - cell cancer lung are : ACTH. AVP. Calcitonin. Gastrin releasing peptide.
Medicine
null
ANF
A 2 year old boy presents with fever for 3 days which responded to administration of paracetamol. Three days later he developed acute renal failure, marked acidosis and encephalopathy? His urine showed plenty of oxalate crystals. The blood anion gap and osmolal gap were increased. Which of the following is the most likely diagnosis -
Ans. is 'b' i.e., Diethyl glycol poisoning It is case of Ethylene glycol poisoning.The key to the diagnosis of Ethylene glycol poisoning is recognition of-Anion gap acidosisIncreased osmolar gapIncreased oxalate crystals in urine Ethylene glycol poisoningEthylene glycol is readily available as a constituent of antifreezes for car radiatorsYoung children are sometimes attracted by the sweet taste of ethylene glycol and it has sometimes been used criminally to give 'body' and sweetness to white table wines.Ethylene glycol, itself, can only cause direct depression of central nervous system, however their oxidized products i.e., aldehyde and oxalates can cause severe metabolic acidosis and renal failure.Ethylene glycol poisoning can be divided into three stages.Management of Ethylene glycol poisoningSodium bicarbonate to correct acidemiaThiamine, folinic acid, magnesium and high dose pyridoxine to facilitate metabolism.Ethanol or Fomepizole is given to competitively inhibit the metabolism of Ethylene glycol. (Ethanol or Fomepizole occupies the enzyme alcohol dehydrogenase, and are metabolized instead of Ethylene glycol).Hemodialysis to eliminate ethylene glycol.
Medicine
Toxicology
Diethyl glycol poisoning
Which of the following statements is true regarding menorrhagia?
Menorrhagia is defined as heavy but regular menstrual bleeding. Menorrhagia denotes regularly timed episodes of bleeding that are excessive in amount (>80mL) and/or duration of flow (>7 days) According to the recent update, the term heavy menstrual bleeding has replaced menorrhagia. Hemoglobin concentration below 12 g/dL increase the chance of identifying women with heavy menstrual bleeding. A normal level, however, doesnot exclude heavy menstrual bleeding, as many women with clinically significant bleeding have normal values. All patients should undergo a pelvic examination and, if the menstrual pattern has changed substantially or if anemia is present, a vaginal sonography should be carried out as the most impoant supplemental examination. Vaginal sonography combined with an endometrial biopsy is a reliable method for diagnosing endometrial hyperplasia or carcinoma, but it is insufficient for diagnosing endometrial polyps and fibroids; these can be diagnosed more reliably by sonohysterography or hysteroscopy. Appropriate treatment considerably improves the quality of life of the patients. Non-steroidal anti-inflammatory drugs and tranexamic acid reduce menstrual blood loss by 20-60% Drug treatment should be used and evaluated before surgical interventions are considered. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 122
Gynaecology & Obstetrics
Disorders of menstruation
Heavy and regularly timed episodes of bleeding
Epimers of glucose -
Ans. is 'a' i.e., Mannose Isomerism of sugarso Sugars Exhibit Various Forms of Isomerismo Glucose, with four asymmetric carbon atoms, can form 16 isomers.(Formula given as 2n,where n is number of asymmetric carbon atoms).o The more important types of isomerism found with glucose are:D and L isomerism :The designation of a sugar isomer as the D form or of its mirror image as the L form is determined by its spatial relationship to the parent compound of the carbohydrates, the three-carbon sugar glycerose (glyceraldehyde).The L and D forms of this sugar, and of glucose, are shown in Figure.The presence of asymmetric carbon atoms also confers optical activity on the compound.When a beam of plane-polarized light is passed through a solution of an optical isomer, it rotates either to the right, dextrarotatoiy (+), or to the left, levorotatory (-).The direction of rotation of polarized light is independent of the stereochemistry of the sugar, so it may be designated D(-), D(+), L(-), or L(+).Pyranose and furanose ring structures:The ring structures of monosaccharides are similar to the ring structures of either pyran (a six-membered ring) or furan (a five-membered ring). For glucose in solution, more than 99% is in the pyranose form.Alpha and beta anomers:The ring structure of an aldose is a hemiacetal, since it is formed by combination of an aldehyde and an alcohol group.Similarly, the ring structure of a ketose is a hemiketal.Crystalline glucose is a-D-glucopyranose.Epimers:Isomers differing as a result of variations in configuration of the -OH and -H on carbon atoms 2, 3, and 4 of glucose are known as epimers. Biologically, the most important epimers of glucose are mannose and galactose, formed by epimerization at carbons 2 and 4, respectively.Aldose-ketose isomerism:# Fructose has the same molecular formula as glucose but differs in its structural formula, since there is a potential keto group in position 2, the anomeric carbon of fructose , whereas there is a potential aldehyde group in position 1, the anomeric carbon of glucose.
Biochemistry
Chemistry of Carbohydrates, Amino sugars, and Mucopolysaccharides
Mannose
Retraction of tympanic membrane touching the promontory. It is called ?
Ans. is 'c' i.e., Atelectasis Tympanic membrane retraction The retracted segment of eardrum is often known as a retraction pocket. The terms "atelectasis" or sometimes "adhesive otitis media" can be used to describe retraction of a large area of the pars tensa.
ENT
null
Atelectasis
Butressing bone formation is the tissue response to increase occlusal forces seen in
null
Dental
null
Stage II repair
In CLL basically which cell predominates ?
Ans. is 'b' i.e., B cell [
Pathology
null
B cell
Fascial layer separating the rectum from the coccyx is?
Lower third of the rectum is separated anteriorly from the prostate/vagina by- Denonvilliers' fascia Posteriorly from the coccyx and lower two sacral veebrae by- Waldeyer's fascia These fascial layers act as barriers to malignant invasion
Surgery
Rectum and anal canal
Waldeyer's fascia
Enterovirus 72 is:
Hepatitis A virus was originally classified as Enterovirus type 72 but is now assigned to a separate genus Hepatovirus in the family Picornaviridae. Picornaviruses are Icosahedral, 28-30 nm (small size), nonenveloped single stranded RNA viruses; Linear positive sense RNA genome. Hepatitis B : belongs to Hepadnaviridae , DNA virus. Hepatitis C : belongs to Flaviviridae, RNA virus. Hepatitis E: belongs to Hepeviridae , RNA virus.
Microbiology
Virology (RNA Virus Pa-1,2 & Miscellaneous Viruses)
Hepatitis A
Presence of infectious agent on clothes or dressings is termed
Contamination - the presence of an infectious agent on a body surface.; also on or in clothes; beddings; toys; surgical instruments or dressing or anther inanimate aicles or substance including water, milk, and food. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 101
Social & Preventive Medicine
Epidemiology
Contamination
Which of the following pubertal events in girls is not estrogen dependant:
In girls the sequence of development of puberty is (Mnemonic: GTPH in males). G = Growth spurt T = Breast development (Thelarche) P = Pubic hair development (Pubarche) H = Height increases; peak growth velocity attained in males = Menstruation starts (Menarche) (Axillary hair develop after menstruation starts) ►The main hormone responsible for secondary sexual characteristics in females is estrogen ►Estrogen leads to • Breast development • Growth spurt, i.e. height attained • Production of cervical mucus • Cornification of vaginal cells • Menstruation (menstruation occurs due to withdrawal of progesterone in an oestrogen primed uterus) ►Estrogen leads to ►As far as hair growth is concerned – in females also the hormone responsible is Androgens(produced by adrenals and ovary)
Gynaecology & Obstetrics
null
Hair growth
In a 10 year old child presented with anaphylactic shock, drug of choice is:
A i.e. IV adrenaline Intravenous adrenaline is the drug of choice in anaphylactic shock.
Anaesthesia
null
I/V adrenaline