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Which of the following toxin acts by inhibiting protein synthesis?
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Shiga toxin also known as verotoxin, was first identified in a major cause of dysentry called Shigella dysentriae. Shiga toxin contains an enzymatic domain and 5 binding domains which bind to globotriaosylceramide (Gb3), a glycosphingolipid on the surface of cells and the complex is internalized. The internalized shiga toxin hydrolyse the ribosomes, preventing fuher protein synthesis. Shiga toxin is composed of two distinct peptide subunits: The first located on the larger A subnit is an N-glycosidase that hydrolyzes adenine from specific sites of ribosomal RNA of the mammalian 60s ribosomal subunit, irreversibly inhibiting protein synthesis. The second is a binding site on the B subunit that recognizes glycolipids of target cell membranes (glycolipid Gb 3). Ref: Toxins and Hemostasis: From Bench to Bedside By R.Manjunatha Kiri, Page 642-643 ; Textbook of Pathology By V. Krishna, Page 178 ; Interaction of Pathogenic Bacteria with Host Cells By Virginia L. Clark, Volume 236, Page 67 ; Microorganisms in foods 5: Microbiological Specifications of Food Pathogens By International Commission on Microbiological Specifications for Food, Page127
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Microbiology
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Shiga toxin
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The phenomenon of cancer cells switching to glycolysis even in the presence of adequate oxygen for oxidative phosphorylation is known as:
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Even in the presence of ample oxygen, cancer cells shift their glucose metabolism away from the oxygen hungry, but efficient, mitochondria to glycolysis. This phenomenon, called the Warburg effect and also known as aerobic glycolysis, has been recognized for many years (indeed, Otto Warburg received the Nobel Prize for discovery of the effect that bears his name in 1931), but was largely neglected until recently. This metabolic alteration is so common to tumors that some would call it the eighth hallmark of cancer. Ref: Robbins 8th edition Chapter 2.
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Biochemistry
| null |
Warburg effect
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All of the following structures are present deep to Pterion except
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Structures present deep to Pterion areMiddle meningeal vein and aeryStem of lateral sulcus of brain Reference: Chourasia; 6th edition; 12th page
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Anatomy
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Head and neck
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Temporal branch of Facial nerve
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The appropriate size of LMA for an average adult patient weighing 50 kg is:
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Ans. c. 4.0
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Anaesthesia
| null |
4
|
Incidence of scar rupture in a pregnant lady with previous LSCS is :
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0.20%
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Gynaecology & Obstetrics
| null |
0.20%
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Capsicum seed can be confused with: NEET 14
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Ans. Dhatura
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Forensic Medicine
| null |
Dhatura
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"Groundglass hepatocytes" are seen in which of the following viral hepatitis?
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Ans. b (Hepatitis B) (Ref Robbins 7th/899; TABLE 18-7)Robbins 7th/B99HBV HISTOLOGY# HBV infected hepatocytes may exhibit a cytoplasm packed with spheres and tubules of HBsAg, producing a finely granular eosinophilic cytoplasm (GROUNDGLASS HEPATOCYTES).Key Morphologic Features of Viral HepatitisAcute Hepatitis (Enlarged. reddened liver: greenish if cholestatic)Parenchymal changes:Regenerative changes:Hepatocyte injury: swelling (ballooning degeneration)- hepatocyte proliferationCholestasis: canalicular bile plugs- Sinusoidal cell reactive changesHCV: mild focal fatty change of hepatocytes- Accum of phagocytosed debris in Kupffer cellsHepatocyte necrosis: isolated cells or clusters- Influx of mononuclear cells into sinusoidsCytolysis (rupture) or apoptosis (shrinkage)- Portal tracts: Inflammation: pred mononuclearIf severe: bridging necrosis (portal-portal, central-central, portal-central)- Inflammatory spillover into adj parenchymaLobular disarray: loss of normal architecture- hepatocyte necrosisChronic Hepatitis- Changes shared with acute hepatitis: Hepatocyte injury, necrosis, and regeneration- Sinusoidal cell reactive changes; Portal tracts:- Inflammation: Confined to portal tracts, or Spillover into adjacent parenchyma, with necrosis of hepatocytes (interface hepatitis); Bridging inflammation and necrosis- Fibrosis: Portal deposition, or Portal and periportal deposition, or Formation of bridging fibrous septa- HBV: "ground-glass" hepatocytes ; "sanded" nuclei- HCV: bile duct epithelial cell proliferation, lymphoid aggregate formation; Cirrhosis: The end-stage outcome
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Pathology
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Liver & Biliary Tract
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Hepatitis B
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Tumour arising from Rathke's pouch is
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Rathke's pouch develop at the roof of oral cavity from surface ectoderm to form most of pituitary . Posterior pituitary develops from diencephalon. Craniopharyngioma is a tumor that develop in the sella turcica.
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Anatomy
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FMGE 2017
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Craniopharyngioma
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All are presentation of retinoblastoma except:
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C i.e. Cataract
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Ophthalmology
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Cataract
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During Hysterectomy, Ureter is liable for injury at?
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Where it crosses uterine aery REF: Novak's Gynecology chapter 5, chapter 22 "About 75% of all iatrogenic injuries to the ureter result from gynecologic procedures, most commonly abdominal hysterectomy" "Significant aerial bleeding during hysterectomy usually arises from the uterine aeries or the ovarian vessels near the inseion of the infundibulopelvic ligaments. Blind clamping of these vessels presents a risk for ureteral injury; therefore, the ureters should be identified in the retroperitoneal space and traced to the area of bleeding to avoid inadveent ligation" At about the level of the ischial spine, the ureter crosses under the uterine aery in its course through the cardinal ligament; the ureter divides this area into the supraureteric parametrium surrounding the uterine vessels and the infraureteric paracervix molded around the vaginal vessels and extending posteriorly into the uterosacral ligament. In this location, the ureter lies 2 to 3 cm lateral to the cervix and in proximity to the inseion of the uterosacral ligament at the cervix. This proximity warrants caution when using the uterosacral ligament for vaginal vault suspension
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Gynaecology & Obstetrics
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Where it crosses uterine aery.
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Intravenous resuscitation is required in a patient with 30% burns. Which of the following will be the best choice of fluid in the first 24 hours?
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Most commonly used fluid for resuscitation in burns is ringer lactate. Some centres use human albumin solution or fresh-frozen plasma, and some centres use hypeonic saline. Intravenous resuscitation is indicated for children with a burn greater than 10% TBSA and adults with 15% TBSA. Parkland formula is the most widely used formula for calculating fluid replacement in the first 24 hours. The formula is Volume in ml = Total percentage body surface area x weight in kilograms x 4. Half of this volume is given in first 8 hours, and the second half is given in the subsequent 16 hours. In children, maintanence fluid is also given which is primarily dextrose saline. Ref: Bailey and Love's Sho Practice of Surgery, 24th edn, Page 271-2
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Surgery
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Ringer lactate
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Which of the following criteria can be used to determine if a pheochromocytoma lesion is benign or malignant
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Ref Robbins 8/e p1159-1161;9/e p1135 Pheochromocytoma and their related counterpas in extra adrenal sites called paraganglioma, are notorious Because the only reliable indicator of metastasis potential is the presence of distant metastasis . Very malignant appearing tumors may not metastasize and benign appearing tumors may produces metastases . These tumors should all be considered " potentially malignant" .
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Anatomy
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General anatomy
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Cannot be determined by microscopic examination
|
Non cicatrical alopecia is present in-
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C. i.e. Psoriasis
|
Skin
| null |
Psoriasis
|
Time dependent Killing is exhibited by all the following drugs except:
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* Time dependent killing(TDK) : Here, the killing activity depends upon the length of time, plasma concentration is above MIC. It is shown by:* Beta Lactams.* Vancomycin Concentration dependent killing(CDK) : Here, killing activity depends upon the ratio of plasma concentration to MIC.It is shown by:* Aminoglycosides.* Flouroquinolone* MetronidazoleSo, Gentamicin is the answer.
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Pharmacology
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Protein Synthesis Inhibitors
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Gentamicin
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Prozone phenomenon is due to-
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Ans. is 'b' i.e., Excess antibody
|
Microbiology
| null |
Excess antibody
|
Cart wheel appearance of Tympanic membrane is seen in which stage of Asom
| null |
ENT
| null |
Stage of Pre-suppuration
|
Rocky mountain spotted fever Cause and vector are:-
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RICKETTSIAL DISEASE CAUSE VECTOR RESERVOIR EPIDEMIC TYPHUS R. prowazekii Louse Man ENDEMIC TYPHUS R. typhi Flea Rodents SCRUB TYPHUS R. tsutsugamushi Trombiculid mite Rodents INDIAN TICK TYPHUS R. conori Tick Rodents RMSF R. ricketisii Tick Rodents R.POX R. akari Mite Rodents Q FEVER Coxiella - Cattle TRENCH FEVER Baonella Louse Man
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Social & Preventive Medicine
|
VBDs, Arboviral & Viral Infections, Surface Infections
|
R. Rickettsii and tick
|
Fluid content of the blood is:
| null |
Physiology
| null |
Plasma
|
Emergency contraceptives are effective if administered within following period after unprotected intercourse:
|
Ans. is d, i.e. 120 hoursRef: Shaw 15th/ed, p237; Current Concepts in Contraception and Women Death, pl05, Leon Speroff8th/ed, p1042The standard recommendation is to start emergency contraceptive not later than 72 hours. The greatest protection is offered, if it is taken within 12 hours, as postponing the dose by 12 hours raises the chances of pregnancy by almost 50%.For this reason, the treatment should be initiated as soon as possible after sexual exposure.Note: But here the question says - till how long are ECs effective or till how long can they be administered. - Ref: Shaw 14th/ed, p213 says"The tables can be offered up to 120 hours, but its efficacy decreases with the longer coital - drug interval.""Treatment should be initiated as soon after exposure as possible, and the standard recommendation is that it be no later than 120 h." - Ref: Leon Speroff 8th/ed, p1042 According to current concepts in contraception's and women health alsoEmergency contraception can be given up to 5 days.This is because"Emergency contraception is not an abortifacient i.e. it will not act after implantation has occured. This is also the basis for the window period of 5 days for use effectiveness of EC, as the whole process from deposition of sperms to implantation takes about 5 days." - Ref: Current Concepts in Contraception and Women Health p108
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Gynaecology & Obstetrics
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Contraceptives
|
120 hours
|
All of the following are true regarding Temporal arteritis except
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(B) Unilateral headache # Giant cell arteritis or Cranial arteritis or Temporal arteritis> Occurs almost exclusively in individuals > 50 years> The disease is characterized by the complex of fever, anemia, high ESR, and headaches in a patient over the age of 50 years.> A well recognized & dreaded complication of giant cell arteritis, particularly in untreated patients, is ischemic optic neuropathy, which may lead to serious visual symptoms, even sudden blindness in some patients.
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Medicine
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Miscellaneous
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Unilateral headache
|
Adequate Total per capita water for Urban domestic purposes?
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Ans. is 'c' i.e., 150-200 litresThe basic physiological requirements for drinking water have been estimated at about 2 litres per head per day.A daily supply of 150-200 litres per capita is considered as an adequate supply to meet the needs for all urban domestic purposes.
|
Social & Preventive Medicine
| null |
150-200 Liters
|
An autoimmune disease is – a) Pemphigus vulgarisb) Psoriasisc) Lichen planusd) Acne vulgaris
|
Autoimmune skin disorders
Autoimmune bullous skin disorders
Pemphigus
Bullous pemphigoid
Dermatitis herpetiformis
Lichen planus
Lichen planus is believed to be an autoimmune disorder as it often occurs concurrently with other autoimmune disorders like primary biliary cirrhosis, diabetes, chronic active hepatitis.
Psoriasis
The theory that psoriasis is an autoimmune disorder is based on the fact that scientist have found an abnormally large number of T cells in the patch of psoriasis.
Autoimmune connective tissue disorders
Lupus erythematosus
Dermatomyositis
Scleroderma
Mixed connective tissue disease
Bechet's disease
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Dental
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abc
|
Aerial blood supply to Little's area is from all the following except
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Aeries supplying Little's area are: a. Sphenopalatine aery. b. Superior labial aery. c. Anterior ethmoidal aery. d. Septal branches of greater palatine aery.
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Pathology
|
All India exam
|
Posterior ethmoidal aery
|
Ligamentum teres is the remnant of
|
(A) Umbilical vein SOME FREQUENTLY ASKED REMNANTS* Ductus arteriosusLigamentum arteriosum* Ductus venosusLigamentum venosum* Left umbilical veinLigamentum teres of liver* Right umbilical veinDisappears* Vitello-intestinal ductMeckel's diverticulum* Wolffian ductGartner duct> After obliteration, the umbilical vein forms the ligamentum teres and the ductus venosus becomes ligamentum venosum.
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Anatomy
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Misc.
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Umbilical vein
|
Classification of aoic dissection depends upon
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Aoic dissection occurs when blood splays apa the laminarplanes of the media to form a blood-filled channel within theaoic wall.The clinical manifestations of dissection depend primarily on the poion of the aoa affected; the most serious complicationsoccur with dissections involving the proximalaoa and arch.Thus, aoic dissections generally are classified into two types-Proximal lesions: type A dissections, Distal lesions,type B dissectionsRobbins Basic pathology,9th edition,pg no.347
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Pathology
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Cardiovascular system
|
Level of aoa affected
|
True about helicobacter pylori are all except -
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Microbiology
| null |
It provides life long immunity
|
All are indications for penile angiography except:
|
Priapism is of two types. A low-flow (ischemic), painful priapism and the other high-flow (non-ischemic), painless priapism.
Penile angiography is not indicated in the painful, low-flow priapism. It is indicated for the high-flow, non-ischemic priapism which is painless.
Priapism
Priapism is defined as prolonged erection in the absence of a sexual stimulus.
It can be classified into 2 types:
A. Low-flow (ischaemic) priapism.
features little or absent intracorporal blood flow
due to veno-occlusion
it represents a true compartment syndrome involving the penis
manifests as painful, rigid erection
cavernous blood gas values are consistent with hypoxia, hypercapnia, and acidosis
ischaemic priapism beyond 4th hour requires emergency intervention (decompression of the corpora cavernosa is recommended for counteracting the ischemic effects)
B. High-flow (non-ischemic) priapism
due to unregulated arterial blood flow
presents with semi-rigid, painless erection
Penile or perineal trauma is frequently associated
cavernous blood gas values do not reveal hypoxia or acidosis
Penile angiography is indicated in high-flow priapism and not in low-flow, painful priapism.
Campbell Urology 8/e p845 writes-
"Penile arteriography has use as an adjunctive study to identify the presence and site of a cavernous artery fistula in the patient with nonischemic priapism. At this time, arteriography is not routinely used for diagnosis and is otherwise usually performed as part of an embolization procedure."
About other options
Peyronie's disease
It is also k/a penile fibromatosis
It is due to fibrous plaques in one or both corpus cavernosum. They may later calcify or ossify.
It affects middle-aged and older men.
Patients present with complaints of painful erection, curvature of the penis, and poor erection distal to the involved area. The penile deformity may be so severe that it prevents satisfactory vaginal penetration.
Examination of the penile shaft reveals a palpable dense, fibrous plaque of varying size involving the tunica albuginea.
Spontaneous remission occurs in about 50% of cases. Initially, observation and emotional support are advised. If remission does not occur, p-aminobenzoic acid powder or tablets or vitamin E tablets may be tried for several months. However these medications have limited success. Surgery is done in refractory cases-Excision of the plaque with replacement with a dermal or vein graft or tunica vaginalis graft. Penile prosthesis can be inserted after plaque incision.
We are not quite sure about use of penile angiography in Peyronie' s disease.
Campbell's Urology 8/e p826 writes about Peyronie's disease -
"Currently, the use of vascular testing is variable. Some centers perform duplex Doppler testing on all patients with Peyronie's disease; other centers do not perform vascular testing at all, despite that patients are routinely operated on for Peyronie's disease and, in some cases, receive prostheses as the primary treatment option. At our center, vascular testing is done on all patients who are prospective surgical candidates. Initially, these patients are examined with color Doppler ultrasonography. If the peak systolic velocity, end-diastolic velocity, and resistive index are normal, the patients are not further tested. If the end-diastolic velocity and the resistive indices are not normal, our patients are tested with DICC"
What is DICC?
DICC or Dynamic Infusion Cavernosometry and Cavernosography are widely accepted as the reference diagnostic techniques for evaluation of veno-occlusive dysfunction.
Cavernosometry refers to a method of determining cavernosal pressure response to standardized rates and volumes of fluid infusion in order to define the presence and degree of venous leak.
Cavernosography refers to a radiographic demonstration of the corpora cavernosa and their venous effluents after intracavernosal injection of dilute contrast agent.
Cavernosometry and cavernosography as angiographic techniques which along with arteriography constitute the gold standard for diagnosis of vasculogenic impotence.
But Campbell's urology mentions DICC separate from selective penile angiography.
Thus we are not very sure about Peyronie's disease. But we are dead sure, painful priapism is not an indication for penile angiography
Erectile dysfunction
"Penile arteriography is another invasive test mainly used prior to penile surgical revascularization in young men with posttraumatic surgical revascularization in young men with posttraumatic or congenital arteriogenic erectile dysfunction with on vascular risk factors, or in studying cases of high flow priapism."- Handbook of Sexual and Gender Identity Disorders By David L Rowland, Luca Incrocci p55
A-V malformation
Well, penile A-V malformation is quite rare. I could not find any documented evidence for use of penile angiography in A-V malformation, but its use is quite self-evident.
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Surgery
| null |
Painful priapism
|
Most impoant enzyme in DNA replication for chain elongation
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Ans. is 'c' i.e.,DNA polymerase III Impoant DNA PolymerasesIn ProkaryotesDNA polymerase I :- Helps in gap filling and synthesis between okazaki fragments of lagging strand, and replaces ribonucleotides of RNA primer by deoxyribonucleotides. It has (i) 3' 5' exonuclease activity, (ii) 5' 3' exonuclease activity and (iii) polymerase (5' -> 3' polymerase) activityDNA polymerase II:- Helps in (i) proof reading (3' 5' exonuclease activity), and (ii) DNA repair.DNA polymerase III :- It is the main enzyme that synthesizes prokaryote DNA, i.e., synthesis of leading and lagging strand. It has (i) 5' -> 3' polymerase (or simply polymerase) activity for DNA synthesis, and (ii) 3'->5' exonuclease activity for proof reading.In EukaryotesDNA polymerase a :- It has primase activity (i.e. synthesizes RNA primer), and initiates DNA synthesis.DNA polymerase p :- It is a DNA repair enzymeDNA polymerase y :- Replicates mitochondrial DNADNA polymerase ?:- Helps DNA synthesis on lagging strand, i.e. elongation of okazaki fragments on lagging strand. It also has 5'->3' exonuclease activity for proof reading.DNA polymerase c :- Helps in DNA synthesis on leading strand. It also has 5'43 'exonuclease activity for proof reading.
|
Biochemistry
| null |
DNA polymerase III
|
Which of the following is the least common site of pain in a case of rheumatoid ahritis? NOT RELATED- OHO
|
.
|
Pharmacology
|
All India exam
|
Low back
|
Superficial perineal muscles include-
|
Muscles in superficial perineal space.
- Ischiocavernosus
- Bulbospongiosus
- Superficial transverse perinei
|
Anatomy
| null |
Bulbospongiosus
|
Which anaesthetic modality is to be avoided in sickle cell disease –
| null |
Anaesthesia
| null |
I.V. Regional Anaesthesia
|
Commonest cause of ureteric injury during surgical operation is
|
Surgical trauma during pelvic surgery is the most common cause of ureteric trauma This occurs most often during vaginal or abdominal hysterectomy when the ureter is mistakenly divided, ligated, crushed or excised. Pre-emptive ureteric catheterisation makes it easier to identify the ureters. ( ref : Bailey 27th ed , chap 76 , pg no 1415 )
|
Surgery
|
Urology
|
Hysterectomy
|
Misoprostol is an analogue of
|
Misoprostal: PGE-1 Given transvaginally and orally Dose of 25 micrograms every 4 hrs is found to be more effective than PGE -2 for cervical ripening and labor induction. Oral use of misoprostal is less effective than vaginal administration . Ref: Dutta Obs 9e pg 485.
|
Gynaecology & Obstetrics
|
Abnormal labor
|
PGE1
|
The thickness of thin rubber dam is:
| null |
Dental
| null |
0.006 inch
|
Which of the following is true about seminoma?a) It is radiosensitiveb) It arises only from cryptorchid testisc) AFP is increasedd) It is chemosensitive
|
Seminomas are both radiosensitive & chemosensitive tumors.
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Surgery
| null |
ad
|
Radical dissection of neck includes all except -
| null |
Surgery
| null |
Phrenic nerves
|
Not a feature of traumatic optic neuropathy:
|
Macular edema is not a characteristic feature of traumatic optic neurpathy. Traumatic Optic Neuropathy Loss of vision. Dilatation of pupil. Impaired Pupillary light reflex. Contrast sensitivity is decreased. Central or centrocecal scotoma (though less common, it can be seen in traumatic optic neuropathy) MRI is the investigation of choice for visualization of optic nerve. Treatment -Steroids/ Surgical decompression.
|
Ophthalmology
|
Retina
|
Macular edema
|
Codex alimentarius is related to -
|
Food standards are done by CODE ALIMENTARIUS, PFA STANDARDS, THE AGMARK STANDARDS, BUREAU OF INDIA STANDARDS. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 610)
|
Social & Preventive Medicine
|
Nutrition and health
|
Food stardardization
|
Sinus not present at birth is -
|
Development and grwoth of paransal sinuses
|
ENT
| null |
Frontal
|
Tillaux fracture involves:
|
Tillaux fracture Lower tibial epiphysis injury (anterolateral pa)
|
Orthopaedics
|
Lower Limb Traumatology
|
Lower end tibia
|
EEG rhythm in full awake and ale state?
|
Ans. is 'b' i.e., BetaBeta wave is seen when the person is fully awake and ale and is thinking with maximum concentration.Therefore it is also called arousal or ale response.
|
Physiology
| null |
Beta
|
Atractiloside act as ?
|
Ans. is 'b' i.e., Inhibitor of oxidative phosphorylationInhibitors of electron transpo chain?Inhibitors of respiratory chain may be divided into three groups : ?1. Inhibitors of electron transpo chain properThese inhibitors inhibit the flow of electrons through the respiratory chain. This occurs at following sites.Complex I (NADH to CoQ) is inhibited by : - Barbiturates (amobarbital), Piericidin A (an antibiotic), rotenone (an insectiside), chlorpromazine (a tranquilizer), and guanethidine (an ntihypeensive). These inhibitors block the transfer of reducing equivalents from FeS protein to CoQ.Complex II is inhibited by : - Carboxin and TTFA inhibit transfer of electon from FADH2 to CoQ, whereas malanate competitively inhibit from succinate to complex II. Complex III (Cytochrome b to cytochrome CI) is inhibited by : - Dimercaprol, antimycin A, BAL(British antilewisite), Naphthyloquinone. These inhibitors block the transfer of electrons from cytochrome b to cytochromeComplex IV (cytochrome C oxidase) is inhibited by : - Carbon monoxide, CN-, H2S and azide (N3-). These inhibitors block the transfer of electrons from cytochrome aa3 to molecular oxygen and therefore can totally arrest cellular respiration.2. Inhibitors of oxidative phosphorylationThese compounds directly inhibit phosphorylation of ADP to ATP. Oligomycin inhibits Fo component of F0F, ATPase. Atractiloside inhibits translocase, a transpo protein that transpos ADP into mitochondria for phosphorylation into ATP.3. UncouplesAs the name suggests, these componds block the coupeling of oxidation with phosphorylation. These compounds allow the transfer of reducing equivalents in respiratory chain but prevent the phosphorylation of ADP to ATP by uncoupling the linkage between ETC and phosphorylation. Thus the energy instead of being trapped by phosphorylation is dissipated as heat. Uncouplers may be :-Natural :- Thermogenin, thyroxineSynthetic :- 2, 4-dinitrophenol (2, 4-DNP), 2, 4-dinitrocresol (2, 4-DNC), and CCCP (chlorocarbonylcyanidephenyl hydrazone).
|
Biochemistry
| null |
Inhibitor of oxidative phosphorylation
|
Champagne glass pelvis is seen in
|
(Achandroplasia): (306- Maheshwari 4th edition)Champagne - glass' pelvic cavity found in ACHONDROPLASIA(275-Aids to radiological differential diagnosis chapman)ACHONDROPLASIA(Primary defect of enchondral bone formation, Autosomal dominant (but 80% are spontaneous mutations)SkullPelvis1. Large skull, small base, small sella, steep clivus small funnel shaped foramen magnum2. Hydrocephalus - of variable severity (+ obstruction)1. Square iliac wings2. "Champagne-glass" pelvic cavity3. Short narrow sacrosciatic notch4. Horizontal sacrum articulating low on the iliamThoraxAppendicular Skeleton1. Thick, stubby sternum2. Short ribs with deep concavities to the anterior ends1. Rhizometic micromelia with bowing of long bones2. Widened metaphyses3. Ball and socket epiphyseal/metaphyseal junctions4. Broad and short proximal and short proximal and middle phalanges5. Trident shaped hands**Axial Skeleton1. Decreasing interpedicular distance caudally in the lumber spine2. Short pedicles with a narrow sagittal diameter of the lumber spinal canal3. Disc heigh/ body weight ratio is 1.0 (Normal 0.3)4. Posterior scalloping5. Anterior vertebral body beak at T12/L1/L2
|
Orthopaedics
|
Miscellaneous
|
Achandro plasia
|
Type A (augmented) adverse drug reactions are characterized by all EXCEPT:
|
Predictable (Type A or Augmented) reactions - quantitatively responses- includes side effects, toxic effects and consequences of drug withdrawal. They are more common, dose-dependent and mostly preventable and reversible. Ref ; KD Tripathi pharmacology 7 th edition (page no; 82)
|
Pharmacology
|
General pharmacology
|
Qualitatively abnormal responses to the drug
|
A specimen from a lung biopsy reveals occasional plexiform lesions within pulmonary aerioles. This abnormality is most characteristic of
|
) Pulmonary vascular sclerosis refers to the vascular changes associated with pulmonary hypeension. Elevation of the mean pulmonary aerial pressure is the result of endothelial dysfunction and vascular changes. The vascular changes vary with the size of the vessel. The main aeries have atheromas that are similar to systemic atherosclerosis, but are not as severe. Medium-sized aeries show intimal thickening and neomuscularization. Smaller aeries and aerioles show intimal thickening, medial hyperophy, and reduplication of the internal and external elastic membranes. A distinctive aeriolar change, a plexiform lesion, consists of intraluminal angiomatous tufts that form webs. This pattern is thought to be diagnostic of primary hypeension The changes of pulmonary vascular sclerosis may be primary or secondary. Primary pulmonary vascular sclerosis almost always occurs in young women, who develop fatigue, syncope (with exercise), dyspnea on exeion (DOE), and chest pain. Secondary sclerosis may occur at any age, and symptoms depend on the underlying cause. Possible causes include ceain types of hea disease, such as mitral valve disease, left ventricular failure, and congenital valvular disease with left-to-right shunt, as well as ceain types of pulmonary disease, such as chronic obstructive or interstitial lung disease and recurrent pulmonary emboli. Pulmonary hypeension is also associated with diet pills (Redux and Fen-Phen), while "exotic" causes include Crotalaria spectabilis ("bush tea") and adulterated olive oil Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.
|
Pathology
|
miscellaneous
|
Pulmonary hypeension
|
Incised looking laceration is seen in all, except AFMC 11; NEET 13
|
Ans. Chest
|
Forensic Medicine
| null |
Chest
|
Large placenta is seen in
|
Ans. a Twins. (Ref. Dutta, Obstetrics, 4th/pg.221)D/d of Large placenta/hyperplacentosis:# Twin pregnancy# Hydrops fetalis# Diabetes in pregnancy# IUGRHUMAN PLACENTA# It is Discoid, Deciduate and Haemchorial.# It develops from--- foetal (4/5th)--chorionic frondosum and- maternal (l/5th)--decidua basalis.# Its development begins at 6th week of gestation and is completed by 12th week.Q# Its weight is 500 gms and weight of blood in it is 500 ml.# Fetal blood flow through placenta = 400 ml/min# Decidua basalis retains its characteristic appearance till term and becomes the maternal portion of placenta.# Line of separation of placenta after birth of the baby is through decidua spongiosum.# Fetal surface has attachment of umbilical cord with ramification of umbilical vessels and aminon.# Only decidua basalis and blood in the inter villou space are of maternal origin.# Maternal surface has shaggy looks with cotyledons.# Placentome = fetal cotyledon.# Villi are the functional units of placenta. Umbilical arteryUmbilical veinO2 saturation50-60%70-80%pO2 (mm Hg)20-2530-40# Placental calcification is a feature of postmaturity.# Signs of Placental aging:- Appearance of syncytial knots.- Decreased stromal tissue including Hofbauer cells.- Partial deficiency of Langhan's cells.- Thinning of basement membrane layer of foetal endothelium.# Most common tumour of placenta is choriohaemangioma.QDiscriptionDiscriptionType of placentaPlacenta with umbilical cord attached to its marginPlacenta with chorionic plate smaller than basal platePlacenta associated with increased rate of prematurityPlacenta with accessory lobes in the membranes away from main body of placenta, connected by large vessels to main body which if it goes to cervix causes formation of "Vasa previa"--a vital cause of bleeding of fetal originBattledore placentaCircumvallate placenta.Circumvallate placenta.Succenturiate placenta.Placenta with functioning villi covering all foetal membranesPlacenta with central portion missingMembranous placenta.Fenestrated placenta.
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Gynaecology & Obstetrics
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Miscellaneous (Gynae)
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Twins
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Socially acquired behavior is known as: March 2005, September 2010
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Ans. A: Culture Culture is defined as "learned behaviour which has been socially acquired". It is the central concept around which cultural anthropology has grown. Socialization refers to the process of inheriting norms, customs and ideologies. It may provide the individual with the skills and habits necessary for paicipating within their own society; a society itself is formed through a plurality of shared norms, customs, values, traditions, social roles, symbols and languages. Socialization is thus 'the means by which social and cultural continuity are attained' Acculturation means culture contact.
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Social & Preventive Medicine
| null |
Culture
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Glucose diffusion in RBC by ?
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Ans. is 'a' i.e., GLUT 1
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Physiology
| null |
GLUT I
|
A 58 year old woman has been diagnosed with locally advanced breast cancer and has been recommended for chemotherapy. She has five years history of myocardial infarction and congestive heart failure. Which antineoplastic drug should be best avoided?
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Ans. is 'a' i.e. AnthracyclineRef: Katzung 8th/e 937-938, Harrison 16th/e p 475 (15th/e p 434)Anthracyclines are anticancer antibiotics and they include Doxorubicin (Adriamycin) and Daunorubicin.The major toxicity of anthracyclines is potentially irreversible cumulative dose related toxicity.They may causes arrhythmias and cardiomyopathy. Because of their cardiotoxicity these drugs should be avoided in the patient mentioned in the questionUses of DoxorubicinCa Breast Ca Endometrium Ca ovary Ca testicleCa thyroid Ca lungHodgkin's disease Non Hodgkin disease SarcomasUses of DaunorubicinIt has far narrower spectrum of activity than Doxorubicin It is mainly used in acute leukemia
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Pharmacology
|
Anti-Neoplastic Agents
|
Anthracycline
|
A 9-year-old girl child developed a 10 mm area of induration on the left forearm 72 hours after intradermal injection of 0.1 ml of purified protein derivative (PPD). Which of the following is most likely to be seen on the X-ray of this patient?
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Most Mycobacterium tuberculosis infections are asymptomatic and subclinical infections. In most healthy people primary tuberculosis is asymptomatic, although it may cause fever and pleural effusion. Generally, the only evidence of infection, if any remains, is a tiny, fibrocalcific pulmonary nodule at the site of the infection. Viable organisms may remain dormant in such lesions for decades. If immune defenses are lowered, the infection may be reactivated, producing communicable and potentially life-threatening disease. Testing for latent tuberculosis is done by detecting T-cells specific for or delayed hypersensitivity to M. tuberculosis antigens. This can be detected by either IFN-g release assays (IGRAs) or the tuberculin (purified protein derivative , or Mantoux) skin test.
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Pathology
|
Pulmonary Tuberculosis and Lung Abscess
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No abnormal findings
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All are seen in hypersplenism except:
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Ans. (d) Hypocellular bone marrowRef: Sabiston 19/e p 1553-1554Hypersplenism:* Spleen Enlargement+Decrease in Cell count in more than one cell line (Anemia, thrombocytopenia, leucopenia) is known as hyper splenism* Important feature on Bone marrow study is there will be Hyper plasia and immediate improvement of blood counts after splenectomy
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Surgery
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Spleen
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Hypocellular bone marrow
|
False regarding invlovement in Crohn's disease
|
Ans. is 'b' i.e., Rectum
|
Surgery
| null |
Rectum
|
Latanoprost (PGF2 alfa) is used in -
|
Ans. is 'd' i.e., Glaucoma PG F2 alpha (Latanoprost) is used in glaucoma.
|
Pharmacology
| null |
Glaucoma
|
The standard sutureless cataract surgery is done with phacoemulsification and foldable IOL has an incision of –
|
In phacoemulsification, the nucleus is emulsified using high frequency sound waves and then sucked out of the eye through a small (3.2 mm) incision.
|
Ophthalmology
| null |
3mm–3.5mm
|
Following sign is diagnostic of which condition?
|
Ans. C. Carcinoma stomacha. Ulcerating carcinoma of the stomach with mass is the most frequent type encountered in North America and Western Europe.b. These carcinomas have been described as irregular, saucer-shaped lesions with ulcerated centers.c. Such a configuration may produce the meniscus or Carman sign, which indicates a large irregular ulcer with a mass.d. This is a long-present lesion. The size of the tumor is not in itself an indication of benignity or malignancy.e. The most important criteria for malignancy are irregularity of the ulcer, failure to project from the lumen of the stomach, and nodularity of the surrounding mass.f. Occasionally a benign ulcer surrounded by a large ulcer mound may simulate an ulcerating carcinoma.Carman Meniscus SignLarge gastric ulcer seen on UGI convex in towards the lumen of the stomach, rolled edges suggestive of malignancy
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Radiology
|
G.I.T.
|
Carcinoma stomach
|
Glaukomflecken is –
|
Epithelial cell necrosis leads to focal opacification of the lens epithelium as glaucomflecken in acute angle-closure glaucoma.
|
Ophthalmology
| null |
Lens opacity due to glaucoma
|
Elimination after 4 half lives in first order Kinetics is
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Ans. is 'b' i.e., 93% Half life Elimination 1t%2 50% 2t'/2 75% 3 0/2 87.5% 41 93.75% 5 t'/ 96.875
|
Pharmacology
| null |
93%
|
Hyperventilation in high altitude is due to
|
Hyperventilation in high altitude is due to respiratory alkalosis Ref: guyton and hall textbook of medical physiology 12 edition page number:375,376,377
|
Physiology
|
Respiratory system
|
Respiratory alkalosis
|
The following regarding colostomy are true except :
|
• Bailey says “Double-barrelled colostomy was designed so that it could be closed by crushing the intervening ‘spur’ using an enterotome or a stapling device. It is rarely used now, but occasionally the colon is divided so that both ends can be brought to the surface separately, ensuring that the distal segment is completely defunctioned".
• May be colostomy or ileostomy.
• May be temporary or permanent.
• Temporary or defunctioning stomas are usually fashioned as loop stomas.
• An ileostomy is spouted; a colostomy is flush.
• Ileostomy effluent is usually liquid whereas colostomy effluent is usually solid.
• Ileostomy patients are more likely to develop fluid and electrolyte problems.
• An ileostomy is usually sited in the right iliac fossa.
• A temporary colostomy may be transverse and sited in the right upper quadrant.
• End-colostomy is usually sited in the left iliac fossa.
• All patients should be counseled by a stoma care nurse before operation.
|
Surgery
| null |
Double barreled colostomy is commonly done nowadays
|
The first step in public health procedure is-
|
* The steps in public health procedure are as follows- 1) Survey. 2) Situation analysis. 3) Programme planning. 4) Programme operation. 5) Financing. 6) Programme appraisal.
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Surgery
| null |
Situation analysis
|
A young patient is diagnosed to have choriocarcinoma the treatment of choice is :
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Chemotherapy
|
Gynaecology & Obstetrics
| null |
Chemotherapy
|
In a family, the father has widely spaced eyes, increased facial hair and deafness. One of the three children has deafness with similar facial features. The mother is normal. Which one of the following is least likely pattern of inheritance in this case-
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Ans. is 'a' i.e., Autosomal dominant (most likely) o It is typical presentation of waardeburg syndrome type - 1. --> Widely spaced eyes, Hearing loss, Increased facial hair o It is an autosomal dominant disorder. o In autosomal disorder, if one parent is affected and the other is normal, 25% of children (1 out of 4) will manifest disease.
|
Pediatrics
| null |
Autosomal dominant
|
Chvostek sign is?
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1. Chvostek sign - seen in hypocalcemia - Twitching of Circumoral Muscle on tapping of Facial Nerve 2. Inability to open eye on tapping of facial nerve - L.P.S 3rd nerve
|
Medicine
|
Electrolyte Imbalance
|
Twitching of circumoral muscles on tapping of facial nerve
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Coho study is a type of -
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Ans. is 'b' i.e., Analytic study Coho study o Coho study is a type of analytic observational study (like case control study). o Coho study proceeds forward from cause to effect, i.e., disease has not occured in subjects (In contrast to case-control study which proceeds backward from effect to cause).
|
Social & Preventive Medicine
| null |
Analytic study
|
Lambda - Panda sign is typically seen in-
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Ans. is 'a' i.e., Sarcoidosis o Lambda sign and Panda sign on Gallium scan are typically described for sarcoidosis.o Active pulmonary and/or mediastinal sarcoidosis is gallium avid and a positive gallium scan can support the diagnosis of sarcoidosis. Typical patterns of uptake have been described as 'panda' and 'lambda'signs.y Lambda sign - Formed from increased uptake in bilateral hilar and right paratracheal nodes y Panda sign - Formed from increased uptake in the parotids and lacrimal glandso A Lambda sign in combination with a so-called Panda sign (Lambda-Panda Sign) is a highly specific pattern for sarcoidosis.# The degree of uptake typically depends on the activity of disease and gallium scan is positive only in the setting of active parenchymal disease and negative in remission
|
Medicine
|
Interstitial Lung Disease
|
Sarcoidosis
|
COWS is related to ?
|
Ans. is'b'i.e., Caloric testln bithermal caloric< test rCold water provokes nystagmus towards the opposite ear, while wann wotet grovolecs nystagmus towards sarne ear (COWS:- Cold - opposite, Warm - same).
|
ENT
| null |
Caloric test
|
Pulmonary fibrosis is seen with :
|
Bleomycin is a marrow sparing drug but it causes pulmonary fibrosis and skin toxicity as adverse effects. Another anticancer drug causing pulmonary fibrosis is busulfan.
|
Pharmacology
| null |
Bleomycin
|
Phocomelia is-
|
Ans. is 'a' i.e., Absent long bones 'Phacomelia' o Is a term applied to a marked reduction in the size of limbs The distal pa of the limbs are placed very near the trunk (absent long bones). o Seen in foetuses of mothers who recieved thalidomide during pregnancy.
|
Pediatrics
| null |
Absence of long bones
|
Cutaneous vasoconstriction is mediated by
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Sympathetic noradrenergic division constricts the blood vessels of the skin(which limits bleeding from wounds). Ref: Ganong&;s review of medical physiology; 23rd edition; pg: 268.
|
Physiology
|
Nervous system
|
Sympathetic adrenergic nerves
|
Which is an indicator of severe Ulcerative colitis?
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(A) Blood in lumen on sigmoidoscopy # Severe Ulcerative collitis: Bowel movements >6 per day, Severe Blood in stool, Severe Fever 37.5C mean.Tachycardia >90 mean pulse, Anemia <75%, Sedimentation rate >30 mm, Endoscopic appearance Spontaneous bleeding, ulcerations.> Sigmoidoscopy is used to assess disease activity and is usually performed before treatment. If the patient is not having an acute flare, colonoscopy is used to assess disease extent and activity.> Endoscopically mild disease is characterized by erythema, decreased vascular pattern, and mild friability.> Moderate disease is characterized by marked erythema, absent vascular pattern, friability and erosions, and severe disease by spontaneous bleeding and ulcerations.
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Medicine
|
Miscellaneous
|
Blood in lumen on sigmoidoscopy
|
Dilator pupillae is supplied by -
|
Dilator pupillae muscle is suppliedby the postganglionic fibers arising from the cervical sympathetic chain. ... Oculomotor nerve supplies the skeletal as well as the smooth muscles of the eyeball. It carries the pre-ganglionic fibers from the Edinger-Westphal to supply two smooth muscles in the eyeball Ref AK khurana 6/e
|
Ophthalmology
|
Ocular motility and squint
|
Post-ganglionic sympathetic fibers from cervical sympathetic chain
|
Non-depolarizing blockade is potentiated by:
|
Neuromuscular-blocking drugs block neuromuscular transmission at the neuromuscular junction, causing paralysis of the affected skeletal muscles. This is accomplished either by acting presynaptically the inhibition of acetylcholine (ACh) synthesis or release or by acting postsynaptically at the acetylcholine receptors of the motor nerve end-plate. While some drugs act presynaptically (such as botulinum toxinand tetanus toxin), those of current clinical impoance work postsynaptically.
|
Pharmacology
|
Anesthesia
|
Quininidine
|
Refrigerated blood stored up to 48 hours before transfusion can destroy which of the following
|
Treponema pallidum is killed in 1 to 3 days at 0-4degrees centigrade, so transfusion syphilis can be prevented by storing blood in the refrigerator before transfusion Stored frozen at -70deg C in 10% glycerol, or in liquid nitrogen (-130 deg C), it remains ble for 10-15 years. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th edition; Pg:379
|
Microbiology
|
Bacteriology
|
Treponema pallidum
|
A 30-yebar old patient presented with features of acute meningoencephalitis in the casualty. His CSF on wet mount microscopy revealed motile unicellular microorganisms. The most likely organism is -
|
Naegleria fowleri, the only pathogenic species of naegleria Human infection comes from water containing the amoebae and usually follows swimming or diving in ponds. Patients are mostly previously healthy young adults or children. The amoebae invade the nasal mucosa, pass through the olfactory nerve branches in the cribriform plate into the meninges and brain to initiate an acute purulent meningitis and encephalitis (primary amoebic meningoencephalitis). The incubation period is 2 days to 2 weeks. The disease almost always ends fatally within a week Diagnosis can be made by CSF examination. The fluid is cloudy to purulent, with prominent neutrophil leucocytosis, elevated proteins and low glucose, resembling pyogenic meningitis. Failure to find bacteria in such specimens should raise the possibility of PAM. Wet film examination of CSF may show the trophozoites. Cysts are never seen CSF or brain. At autopsy, trophozoites can be demonstrated in brain histologically.Culture can be obtained in agar seeded with Escherichia coli or in the usual cell cultures used for virus isolation. Both trophozoites and cysts occur in culture. Amphotericin B has been used in treatment with limited success TEXTBOOK OF MEDICAL PARASITOLOGY,CKJ PANIKER,6TH EDITION,PAGE NO 33
|
Microbiology
|
parasitology
|
Naegleria fowleri
|
All of the following methods are used for the diagnosis of HIV infection in a 2 months old child, except:
|
HIV ELISA is required for detection of antibodies against the virus. The antibodies may be present in the infant because of maternal infection also because IgG antibodies can cross the placental barrier. So, this test is not reliable for diagnosis of HIV in a 2 month old child. HIV culture method is called as 'peripheral blood mononuclear cells' (PBMC) using the virus microculture in macrophages concept. PBMC are drawn in high concentration from centrifugation of freshly drawn anticoagulated venous blood. HIV-1 PCR and p24 antigen assay are standard techniques used for viral detection in infants and children. HIV-1 PCR detects both RNA and proviral DNA with sensitivity and specificity of more than 98%.
|
Pathology
|
Immunodeficiency Disorders
|
HIV ELISA
|
Artery of hindgut is
| null |
Anatomy
| null |
Inferior mesenteric
|
Usual sign of opioid withdrawal: PGI 13
|
Ans. Yawning
|
Forensic Medicine
| null |
Yawning
|
Congenital toxoplasmosis, all are true, except
|
Congenital toxoplasmosis is a disease that occurs in fetuses infected with Toxoplasma gondii, a protozoan parasite, which is transmitted from mother to fetus.
It can cause miscarriage or stillbirth.
It can also cause serious and progressive visual, hearing, motor, cognitive, and other problems in a child.
Most infected infants appear healthy at birth.
They often do not develop symptoms until months, years, or even decades later in life.
Infants with severe congenital toxoplasmosis usually have symptoms at birth or develop symptoms within the first six months of life.
Symptoms may include:
Premature birth — as many as half of infants with congenital toxoplasmosis are born prematurely, abnormally low birth weight, eye damage, jaundice, yellowing of the skin and whites of the eyes, diarrhea, vomiting, anemia, difficulty feeding, swollen lymph nodes, enlarged liver and spleen, macrocephaly, an abnormally large head, microcephaly, an abnormally small head, skin rash, vision problems, hearing loss, motor and developmental delays, hydrocephalus, a buildup of fluid in the skull, intracranial calcifications, evidence of areas of damage to the brain caused by the parasites, seizures, mild to severe mental retardation.
Ref : https://www.healthline.com/health/congenital-toxoplasmosis#risks
|
Microbiology
| null |
None of the above
|
The reagent used in Apt test is
|
Alkali denaturation test (Apt-Downey test / apt test)Used to detect differentiate Fetal or neonatal blood from maternal blood (Qualitative).PrincipleMethodFetal hemoglobin (alpha 2 gamma 2 subunits) is resistant to alkali (basic) denaturation, whereas adult hemoglobin (alpha2 beta 2 subunits) is susceptible to such denaturation.Exposing the blood specimen to sodium hydroxide (NaOH) will denature the adult but NOT the fetal hemoglobin.The fetal hemoglobin will appear as a pinkish color under the microscope while the adult hemoglobin will appear as a yellow-brownish colorThe blood is mixed with sterile water to cause hemolysis of the RBCs, yielding free hemoglobin,The 5 ml pink hemoglobin-containing supernatant is then mixed with 1 mL of 1% NaOH.Fetal hemoglobin will stay pink and adult hemoglobin will turn yellow-brown.Adult hemoglobin changes color because it is less stable and will conve to hematin.Clinical UsesVaginal bleeding in late pregnancy is tested to rule vasa pre.Neonatal bloody vomitus or bloody stool to rule out swallowed maternal blood.To detect the presence of fetal blood in the maternal circulation in cases of suspected fetal-maternal hemorrhage.Positive test indicates that blood is of fetal origin.Negative test indicates that the blood is of maternal origin.
|
Pathology
|
All India exam
|
Sodium hydroxide
|
Hanging drop method is used for-
| null |
Microbiology
| null |
Trichomonas
|
Predict the effect of aldosterone hypersecretion on body fluid pH and electrolytes ?
|
Aldosterone increases the rate of sodium absorption and potassium secretion by the kidneys, but in high concentrations aldosterone also stimulates hydrogen ion secretion. Therefore elevated aldosterone levels such as occur in patients with Cushing's syndrome can elevate body fluid pH above normal (alkalosis). The major factor that influences the rate of hydrogen ion secretion, however, is pH of the body fluids. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 20. The Adrenal Medulla & Adrenal Coex. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.
|
Physiology
| null |
pH increased, K+ decreased, Na+ increased
|
Isovolumetric relaxation preceeds:
|
Ventricular ejection
|
Physiology
| null |
Ventricular ejection
|
Saw tooth appearance in abdominal barium enema X ray is seen in
|
Diveicula These are abnormal outpouchings or sacs of colon wall that occur due to interactions of high intraluminal pressures, disordered motility and low diet in fiber Formed on mesenteric side of antimesenteric taenia coli Results in protrusion of mucosa and submucosa through layers of muscle It is Pseudodiveiculum or False diveiculum Radiological evidence in prediveicular disease Saw tooth appearance of colon Shoening of bowel Crowding of haustra Picket fencing of folds Ischemic colitis- Ba. Enema - Thumb print sign Ulcerative colitis
|
Surgery
|
GIT
|
Diveiculosis
|
Receptor responsible for malignant hyperthermia is?
|
ANSWER: (B) Ryanodine receptorREF: Morgan 3ra e p. 869This condition is known by a number of names, including malignant hyperthermia (MH), malignant hyperthermia syndrome (MHS), and malignant hyperpyrexia.Signs and symptoms:The typical symptoms of malignant hyperthermia are due to a hyper catabolic state, which presents as a very high temperature, an increased heart rate and breathing rate, increased carbon dioxide production, increased oxygen consumption, acidosis, rigid muscles, and rhabdomyolysis.The symptoms usually develop within one hour after exposure to trigger substances, but may even occur several hours later in rare instances.Causes:Volatile anesthetic gases Local anesthetics Depolarizing muscle 1 relaxantshalothane, sevoflurane, desfluranelidocaine, bupivicaine, mepivacainesuccinylcholineOtherOpiates (morphine, fentanyl), ketamine, barbiturates, nitrous oxide, propofol, etomidate, benzodiazepinesGenetics:Malignant hyperthermias inheritance is autosomal dominant. The defect is typically located on the long arm of the nineteenth chromosome (19ql3.1) involving the ryanodine receptor.
|
Anaesthesia
|
Depolarising Neuromuscular Blocking Agents
|
Ryanodine receptor
|
Hinge axis face bow records:
|
Kinematic facebow or Hinge axis facebow
A facebow with adjustable caliper ends used to locate the transverse horizontal axis of the mandible (GPT8)
It locates the true (exact) centre of condylar rotation or transverse horizontal axis.
It is preferred in full mouth reconstructions.
Hinge axis face-bow records—relationship of teeth to the axis of rotation of the jaw.
It usually requires a fully adjustable articulator.
When we consider the rotation of any circular object, only the central point rotates, any other point within the circle will show translatory movement. Similarly in the condyle, the centre alone will display pure rotation. This principle used to determine the true centre of rotation using kinematic facebow. • The condylar rods are first positioned arbitrarily similar to facia type of facebow at a point 13 mm anterior to the auditory meatus on the canthotragal line.
The patient is instructed to make opening and closing movements in CR. The opening should not be greater than 12 mm as then the condyle will then begin to translate instead of rotating.
The position of the condylar rod is shifted around the arbitrary mark until it shows pure rotation. This is the centre of condylar rotation. This point is marked, the condylar rods are locked, the facebow assembly is removed and mounted on an appropriate articulator.
Key Concept:
Hinge axis face-bow records—relationship of teeth to the axis of rotation of the jaw.
Face-bow measures relationship of maxilla to Opening and closing axis.
Ref: Textbook of prosthodontics V Rangarajan Ed. 2nd
|
Dental
| null |
Relationship of teeth to the axis of the relation of the jaw
|
During a routine checkup, a 50-year-old man is found to have blood in his urine. He is otherwise in excellent health. An abdominal CT scan reveals a 2-cm right renal mass. You inform the patient that staging of this tumor is key to selecting treatment and evaluating prognosis. Which of the following is the most important staging factor for this patient?
|
The choice of surgical approach or treatment modalities is influenced more by the stage of a cancer than by its cytologic grade. The significant criteria used for staging vary with different organs. Commonly used criteria include (1) tumor size, (2) extent of local growth, (3) presence of lymph node metastases, and (4) presence of distant metastases. The other choices reflect grade of the tumor.Diagnosis: Renal cell carcinoma
|
Pathology
|
Neoplasia
|
Metastases to regional lymph nodes
|
Part of colon with no mesentery-
|
Ans. C. Ascending colona. The large intestine develops as a fully mesenteric organ. However, after the rotation of the gut tube in utero, large portions of it come to lie adherent to the retroperitoneum, which means that some parts of the colon are fixed within the retroperitoneum, and other parts are suspended by a mesentery within the peritoneal cavity. Those portions of the colon within the retroperitoneum are separated from other retroperitoneal structures by a thin layer of connective tissue which forms an avascular field during surgical dissection, but which offers little or no barrier to the spread of disease within the retroperitoneum.b. The caecum may be within the retroperitoneum, but more frequently is suspended by a short mesentery. The ascending colon is usually a retroperitoneal structure although the hepatic flexure may be suspended by a mesentery. The transverse colon emerges from the retroperitoneum on a rapidly elongating mesentery and lies, often freely mobile, in the upper abdomen.c. The transverse mesocolon shortens to the left of the upper abdomen and may become retroperitoneal at the splenic flexure. Occasionally the splenic flexure is suspended by a short mesentery. The descending colon is retroperitoneal usually to the level of the left iliac crest.d. As the colon enters the pelvis it becomes increasingly more mesenteric again at the origin of the sigmoid colon, although the overall length of the sigmoid mesentery is highly variable. The distal sigmoid colon lies on a rapidly shortening mesentery as it approaches the pelvis; by the level of the rectosigmoid junction the mesentery has all but disappeared, so that the rectum enters the pelvis as a retroperitoneal structure. The caecum and proximal ascending colon are often more mobile on a longer mesentery in the neonate and infant than they are in the adult.e. The mesorectum is enclosed by meso rectal fascia, a distinct covering derived from the visceral peritoneum that is also called the visceral fascia of the mesorectum, fascia propria of the rectum or the presacral wing of the hypogastric sheath. The fascia bounds the mesorectum posteriorly and thus lies anterior to the retro rectal space and the pre-sacral fascia. The meso rectal fascia is surrounded by a very thin layer of loose areolar tissue which separates it from the posterior and lateral walls of the true pelvis. Superiorly, the meso rectal fascia blends with the connective tissue bounding the sigmoid mesentery. Laterally, it extends around the rectum and mesorectum and becomes continuous with a denser condensation of fascia anteriorly. In males this anterior fascia is known as the rectovesical fascia of Denon Villiers, and in females it forms the fascia of the rectovaginal septum.
|
Anatomy
|
Large Intestine, Rectum, and Anal canal
|
Ascending colon
|
Among patients with polymyositis, which one of the following auto-antibodies is associated with an increased risk of interstitial lung disease?
|
Myositis Specific Antibodies Anti Jo-1 and anti synthetase antibodies Polymyositis and dermatomyositis with Interstitial lung disease, ahritis, mechanic's hands Anti-Mi-2 Dermatomyositis with rash Anti MDAS Dermatomyositis with rapidly progressive lung disease Anti-10 Juvenile dermatomyositis Anti-Signal recognition paicle Severe acute necrotizing myopathy
|
Medicine
|
Systemic Lupus Erythematous
|
Anti-Jo-1 antibody
|
One gm of Hb liberates _______ mg of billurubin .
|
Approximately 35mg of bilirubin is formed from 1g of Hb. About 6g of Hb is broken down per day. A total of 300mg of bilirubin is formed everyday; of which 80% is from destruction of old RBCs, 10% from ineffective erythropoiesis and the rest 10% from degradation of myoglobin and other heme containing proteins. Reference : page 249 Textbook of Biochemistry D M Vasudevan 6th edition
|
Pediatrics
|
New born infants
|
34
|
A 60-year-old man with no significant past medical history is scheduled for elective cholecystectomy. He has been taking aspirin daily. Preoperative recommendations should include which of the following?
|
Discontinuation of aspirin at least 1 week before surgery. Aspirin inactivates platelet cyclo-oxygenase and thus inhibits platelet aggregation. The effect of aspirin is irreversible and lasts for the entire life span of the platelets. Therefore, aspirin should be discontinued for at least 1 week before surgery.
|
Surgery
|
Miscellaneous
|
Discontinuation of aspirin at least 1 week before surgery
|
Missing cases are detected by?
|
ANSWER: (C) Sentinel surveillanceREF: Park 20th edition page 38The word surveillance is the French word for "watching over"Sentinel surveillance is useful for answering specific epidemiologic questions because sentinel sites may not represent the general population or the general incidence of disease, they may have limited usefulness in analyzing national disease patterns and trends. (REF: http://www.usaid. gov/our_work/global_health/id/surveillance/sentinel.html)SURVEILLANCE:Continuous scrutiny of factors that determine the occurrence and distribution of diseases and other conditions of ill healthTypes:1. Active Surveillance:* One way to overcome the limitations of passive surveillance and get a better picture of disease burden in the community is for health workers to visit health facilities and communities to seek out cases. This is known as active surveillance.Eradication and elimination programmes may require a very active surveillance programme aimed at detecting every case.During outbreak situations surveillance must be intensified with the introduction of active case findingPassive Surveillance:Passive surveillance yields only limited data because many sick people do not visit a health facility and because those cases that do show up may not be correctly classified, recorded, or reportedSentinel Surveillance:A method of identifying the missing cases and thereby supplementing the notified casesFor example, in HIV/AIDS surveillance the proportion of the population positive for HIV7 must be monitored as well as the number of new cases of AIDS. This requires special HIV seropre vale nee surveillance usually done in a few representative sites ('sentinel surveillance").
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Social & Preventive Medicine
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Concept of Control
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Sentinel surveillance
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Malignant transformation is commonly seen in:
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Ans. (b) Gastric ulcer* Malignant transformation is very rarely seen in gastric ulcer (<1%) - Not so common.* Giant gastric ulcer (>2cm) is associated with cancer in 6-15% cases* Of the above choices we can opt for choice B' only - but it is not so common.
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Surgery
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Stomach & Duodenum
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Gastric ulcer
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Eye lens dislocation seen in –a) Marfan\'s syndromeb) Homocystinuriac) Down\'s syndromed) Klinefelter syndrome
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Marfan syndrome and homocystinuria can cause dislocation of lens.
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Ophthalmology
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ab
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'First order 'symptoms of schizophrenias' schizopremia include all except:
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There are 11 first rank symptoms first three are related to thoughts - thought inseion , withdrawal & broadcasting next three are related to hallucinations -1St person ,2ND person & 3RD person next three are made phenomena remember MADE VOLITION, MADE IMPULSE, MADE AFFECT (mood) Last two are Somatic passivity & Delusional perception
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Surgery
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Depersonilization
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Micro nodular cirrhosis is commonly seen in all except,
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Ans. is 'a' i.e., Chronic hepatitis B Cirrhosis of the liver is a pathological entity which clinically represents the end stage of chronic liver disease.It is characterized by three features.Bridging fibrous septa Q in the form of delicate bands or broad scars linking portal tracts with one another and portal tracts with terminal hepatic veins.Parenchymal nodules Q containing proliferating hepatocytes encircled by fibrosis with diameters varying from very small to large. iii) Disruption of architecture of the entire liver.Cirrhosis is defined as micronodular or macronodular depending upon the size of parenchymal nodules Micronodular cirrhosis Q - Parenchymal nodules < 3 mm in size * Macronodular cirrhosis - Parenchymal nodules > 3 mm in size Viral hepatitis commonly causes macronodular cirrhosis Q.In viral hepatitis the cirrhosis is characterized by irregularly large sized nodules separated by variable but mostly broad scars.This pattern of cirrhosis is historically called postnecrotic cirrhosis Q.Postnecrotic cirrhosis is not only applied to viral hepatitis but to all forms of cirrhosis in which the liver shows large irregular sized macronodules with broad scars regardless of the etiology.Also remember theseAlcholic cirrhosis is typically micronodular Q, but can become macronodular in later stages.Viral cirrhosis is typically macronodular. Cirrhosis associated with virus is called postnecrotic cirrhosis. Postnecrotic cirrhosis is also called posthepatitis cirrhosis macronodular cirrhosis and coarsely nodular cirrhosis.Cirrhosis in hemochromatosis is typically micronodular (can be macronodular sometimes).Wilson's disease causes macronodular cirrhosis.Biliary cirrhosis whether primary or secondary is micronodular.
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Medicine
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Cirrhosis and Alcoholic Liver Disease
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Chronic hepatitis B
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Most common cause of hypercalcemic crisis is :
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A hypercalcaemiccrisisis an emergency situation with a severehypercalcaemia, generally above approximately 14 mg/dL (or 3.5 mmol/l)The most common cause is hypercalcemia of malignancy, although granulomatous diseases, previously undetected primary hyperparathyroidism, medication-induced hypercalcemia, and a few rarer causes may result in this endocrine emergency as well. Stepwise approach for management of Hypercalcemic crisis Step 1: Confirm the diagnosis. Step 2: Restore normal hydration - Through IV fluids(200-500 ml/hr of NS )should be administered to maintain a urine output of >100 ml/hr. Step 3: Use of loop diuretics to be limited to hypercalcemic crisis associated with hea failure or renal failure. Calcitonin or bisphosphonates-Preferred drugs for hypercalcemic management after restoring normal hydration with IV fluids.
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Surgery
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Parathyroid and adrenal glands
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Malignancy
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Scarring loss of hair is seen in
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Conditions causing scarring alopecia Causes of non-cicatricial alopecia (non-scarring) Traumatic causes of scarring alopecia may be due to: Injury Surgery Radiation Traction (tight curls) Central centrifugal cicatricial alopecia Infections causing scarring alopecia include: Bacterial infection: boils and abscesses (Staphylococcus aureus) Fungal infection: kerion (inflammatory tinea capitis) Viral infection: shingles (herpes zoster) Inflammatory skin diseases causing scarring alopecia include: Folliculitis decalvans Dissecting cellulitis Lichen planopilaris Frontal fibrosing alopecia Alopecia mucinosa Discoid lupus erythematosus Localised scleroderma Anagen effluvium Androgenetic alopecia Dermatopathia pigmentosa reticularis Telogen effluvium Trichotillomania (Trichotillosis) Conditions resulting in reversible patchy hair thinning, poor hair quality and bald patches include: Localised alopecia areata Localised infection, such as tinea capitis Severe local skin disease, such as psoriasis, seborrhoeic dermatitis, atopic dermatitis, pityriasis rubra pilaris, cutaneous lupus erythematosus, cutaneous T-cell lymphoma Generalised skin disease (erythroderma) Systemic diseases resulting in reversible patchy hair thinning, poor hair quality and bald patches include: Iron deficiency Thyroid hormone deficiency Systemic lupus erythematosus Syphilis Severe acute or chronic illness (Ref: Harrison 20th edition pg 1234
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Dental
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Autoimmune skin disorders
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Discoid lupus erythematosus
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60 year old asymptomatic female shows following change in tunica media of blood vessels. Diagnosis?
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Ans. (a) Medial calcificationMedial artery calcification (MAC) is also known as Monckeberg's arteriosclerosis, is a nonobstructive condition leading to reduced arterial compliance that is commonly considered as a nonsignificant finding.With the H&E stain, calcium appear deep blue-purple.
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Pathology
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Cellular Pathology
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Medial calcification
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The results of the pulmonary functions tests shown below, the best diagnosis is -ParametersActualPredictedFE VI (L)1[?]23[?]5-4[?]3FVC(L)4[?]14[?]6-5[?]4FEVL'FVC (%)2972-80PEF (L/min)80440-540DLCO120%100%
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Ans. is 'a' i.e. Asthma o .All expiratory parameters are reduced in the data given with timed vital capacity of 29%.o FEV1/FVC is reduced in obstructive airway disease with lowering of peak expiratory flow rates. Due to air trapping in asthma the DLco may be normal or increased.
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Medicine
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Asthma
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Asthma
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