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Recently aseptic meningitis was discovered as an adverse effect of which of the following drug?
|
Ibuprofen is a common nonsteroidal anti-inflammatory drug that is the most frequent cause of aseptic meningitis induced by drugs. The incidence of this type of aseptic meningitis is increasing, mainly among patients with underlying autoimmune connective tissue disorder Ref: G n G 13th ed.
|
Pharmacology
|
All India exam
|
Ibuprofen
|
True statement about transgenic mice is
|
In 1974 Rudolf Jaenisch created the first genetically modified animal by inseing a DNA virus into an early-stage mouse embryo and showing that the inseed genes were present in every cell.
|
Biochemistry
|
Metabolism of nucleic acids
|
Developed from DNA inseion into feilized egg
|
Borax is: NEET 13
|
Ans. Emmenagogues
|
Forensic Medicine
| null |
Emmenagogues
|
Amount of gastric juice per day is
|
A typical adult human stomach will secrete about 1.5 liters of gastric acid daily Ref: guyton and hall textbook of medical physiology 12 edition page number:406,407,408
|
Physiology
|
Renal physiology
|
2000 - 2500ml
|
"Guiding planes" relates to:
| null |
Dental
| null |
Path of insertion
|
Fat embolism commonly occurs in: UP 04
|
Ans. Fracture of long bones
|
Forensic Medicine
| null |
Fracture of long bones
|
The following anaesthetic drug causes pain on intravenous adminstration:
|
B i.e. Propofol - Incidence of pain on injection after intravenous administration of drug in small vein (eg. dorsum of wrist or hand) is 80% for etomidate, 40% for propofol, 20% for methohexital 1% and 10% for thiopental 2.5% anesthetic agents - This incidence is greatly reduced if a large vein is used, if a small dose of lidocaine (10mg) is injected sholy before. Thiopental 2.5% also causes pain on IV administration but the incidence is much higher for propofol.
|
Anaesthesia
| null |
Propofol
|
Pyruvate kinase is inhibited by -
|
Ans. is 'c' i.e., ATPPyruvate Kinaseo This enzyme catalyzes conversion of PEP to pyruvate.o Pyruvate kinase is an inducible enzyme that increases in concentration with high insulin level and decreases with glucagon.o It is activated by fructose-1,6 bisphosphate and inactivated by ATP and alanine.
|
Biochemistry
|
Glycolysis
|
ATP
|
Patient complaining of retrosternal chest pain for more than half an hour is most likely to be:
| null |
Medicine
| null |
MI
|
Copper containing enzyme is ?
|
Ans. is 'a' i.e., Cytochrome oxidase Copper containing enzymes are cytochrome oxidase, tyrosinase, lysyl oxidase, ferroxidase (ceruloplasmin), Ascorbic acid oxidase, and superoxide dismutase.
|
Biochemistry
| null |
Cytochrome oxidase
|
Infections transmitted to the baby at delivery:
|
The risk of transmission increases with the period of gestation,but the risk of teratogenecity decreases. Refer page no 294,295 of Text book of obsteics,sheila balakrishnan,2nd edition.
|
Gynaecology & Obstetrics
|
Medical, surgical and gynaecological illness complicating pregnancy
|
Toxoplasmosis
|
Edema is visible when the amount of fluid accumulated is: March 2013 (d, f)
|
Ans. D i.e. 5-6 litres
|
Medicine
| null |
5-6 litres
|
Which pa of the spine is most commonly affected in Rheumatoid ahritis:
|
Answer is A (Cervical): Rheumatoid ahritis commonly involves the joints of hands, wrist, elbow, knees, ankle, and feet in a symmetrical manner. Axial skeleton involvement is usually limited to Upper Cervical Spine.
|
Surgery
| null |
Cervical
|
Which of the following is not a significance of centric relation?
|
Face bow is to orient the maxillary cast with opening axis of articulator and mandible.
|
Dental
| null |
It helps in orienting the maxillary cast to opening axis of articulator.
|
Which one of the following is a secondary pollutant?
|
Secondary air pollutants are formed within the atmosphere itself, they arise from chemical reactions of primary pollutants, most familiar example is ozone. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 793
|
Social & Preventive Medicine
|
Environment and health
|
Ozone
|
Features of cystinuria are -
|
Ans. is 'd' i.e., All of above Cystineuriao Metabolic disorder of autosomal recessive inheritance.o Defect in transport of cystine and some other aminoacid across renal tubular ceil & interstitial cell,o Selective increase renal clearance of cystine and other basic aminoacid in urine.o High urinary cystine leads to radio - opaque hexagonal crystal,o Crystal is soluble in alkali.o Treatment - formation of stone can be reduced by alkalization of urine.
|
Pediatrics
|
Metabolism of Amino Acids
|
All of above
|
Which substance is/are not deposited in hepatocyte?
|
Bile pigment deposition at sweat pores of patients with liver disease REFERANCE. jaad .org
|
Pathology
|
G.I.T
|
Bile pigment
|
All of the following can occur in a normal neonate for heat regulation except _______
|
Neonates donot generate heat by shivering. Heat production in neonates happens by increasing the metabolic rate and oxygen consumption by releasing norepinephrine, which results in non-shivering thermogenesis through beta-oxidation of brown fat. Preterm and small-for-gestational-age (SGA) infants have scanty brown fat stores. Ref: Nelson textbook of pediatrics 21st edition pgno: 872
|
Pediatrics
|
New born infants
|
Shivering
|
Multi drug resistant tuberculosis is defined as resistance to?
|
Ans. is 'b' i.e., INH and Rifampicin o Multi-Drug Resistant Tuberculosis is defined by resistance to INH and Rifampicin.o 'Multi-Drug Resistant Tuberculosis (MDR-TB) is defined as disease caused by strain of M Tuberculosis that is resistant to both Isoniazid (ONH) and Rifampicin-the most efficacious of the first line Anti-TB drugs ' - Harrison
|
Medicine
|
Bacteriology
|
INH and Rifampicin
|
All are inhabitants of Liver except -
|
The common name for Fasciolopsis buski is the large or giant intestinal fluke.It is the largest trematode infecting humans.Pig serves as reservoir of infection for man. ( refer pgno: 127 baveja 3 rd edition)
|
Microbiology
|
parasitology
|
F. Buski
|
What is the type of Goldman tonometry?
|
Ans. is 'a' i.e., Applanation Tonometry Measurement of intraocular pressure (IOP)* Measurement of IOP is done byA) Manometry It is the only direct measure of IOP.B) TonometryIt is an indirect method of measurement of IOP. Following types of tonometers are therei) Indentation (impression) tonometerThese are the most commonly used tonometers. Example is Schiotz tonometer.ii) Applanation tonometerGoldmann applanation tonometer is the most accurate tonometer. Other types of applanation tonometers are perkins tonometer, pneumatic tonometer; air-puff tonometer, Pulse air tonometer, Tono pen.
|
Ophthalmology
|
Glaucoma
|
Applanation Tonometry
|
A lady with placenta pre delivered a baby. She had excessive bleeding and shock. After resuscitation most likely complication would be:
|
Sheehan syndrome refers to panhypopituitarism. It classically follows massive postpaum hemorrhage and associated hypotension. Abrupt, severe hypotension leads to pituitary ischemia and necrosis. In its most severe form, these patients develop shock due to pituitary apoplexy. In less severe forms, loss of gonadotrope activity in the pituitary leads to anovulation and subsequent amenorrhea. Damage to the other pituitary cell types may present as failure to lactate, loss of sexual and axillary hair, and manifestation of hypothyroidism and adrenal insufficiency symptoms. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 16. Amenorrhea. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.
|
Gynaecology & Obstetrics
| null |
Loss of menstruation
|
In Ghon's technique of autops, organs are removed
|
Refer the byte "Autopsy technique and types".
|
Forensic Medicine
| null |
As organ blocks
|
Acrodynia is associated with:
|
Ans. (b) MercuryRef: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. / 505MERCURY POISONING (HYPRAGYRISM)* Vapours of mercuric compounds are poisonous because it will be absorbed in the systemic circulation.* Mercuric compounds being soluble are more poisonous than mercurous (less soluble) compounds.Clinical Presentation of Mercury Poisoning (Remembered as MEATS)* Mercuria lentis: brownish deposition of mercury on the anterior lens.* Membranous colitis* Erethism: Characterized by shyness, irritability, tremors, loss of memory & insomnia.* Acrodynia (Pink disease): Generalized pinkish body rash starting from tips of fingers & toes# Characterized by 5 P's: Pinkish, Puffy, Painful, Paresthetic hands, and feet with Peeling of skin.* Tremors: Also known as Danbury tremors, hatters or glass-blowers shake* Salivation & gingivitis: excessive salivation associated with metallic taste, gingivitis, loosening of teeth and blue-black line on gums.Also, knowDifferent Metallic Poisoning and Their Effect on Hair And SkinPoisoningColor of Hair & SkinArsenic (As)* Yellow color of skin, hair & mucous membrane* Milk rose (Brownish pigmentation)/Rain drop pigmentation* BLACK FOOT DISEASECopper (Cu)* Jaundiced skin* Green-blue skin, hair & perspiration* Green - purple line on gumsMercury (Hg)* Blue-black line on gums with jaw necrosis and loosening of a tooth* Brown deposits on anterior lens capsule (mercurial lentils)* Acrodynia (pink disease)Lead (Pb)* Blue stippled Burtonian line on gums, especially on the upper jaw.Other Features of Mercury Poisoning*Proximal Convoluted Tubule necrosis* Prevalence of abortions are common* Minimata disease is an organic mercury poisoning due to consumption of fish poisoned by mercury.
|
Unknown
| null |
Mercury
|
Not true about hepatoblastoma
|
Ans. (b) Mature hepatocytes present(Ref: R 9th/pg 870)Histology of Hepatoblastoma can be of 2 types:Epithelial type, composed of small polygonal fetal cells or smaller embryonal cells forming acini, tubules, or papillary structuresMixed epithelial and mesenchymal type, which contains foci of mesenchymal differentiation that may consist of primitive mesenchyme, osteoid, cartilage, or striated muscle.Mature appearing hepatocytes are absent.
|
Pathology
|
Liver & Biliary Tract
|
Mature hepatocytes present
|
A patient with malabsorption who develops a deficiency of vitamin A is most likely to subsequently develop:
|
The symptoms of vitamin A deficiency result from abnormalities involving the normal functions of vitamin A. These normal functions include maintaining mucus-secreting epithelium, restoring levels of the visual pigment rhodopsin, increasing immunity to infections, and acting as an antioxidant.
|
Pathology
| null |
Night blindness
|
Fatty acids help in synthesis of all except:
| null |
Biochemistry
| null |
Glucose
|
Young male scrotal swelling since 3 yrs on examination fluctuant swelling testis not separately felt. No trauma or fever. Diagnosis -
|
Ans. is 'a' i.e., Vaginal hydorcele o Vaginal hydroceleThis is common type of hydrocele; whee acumulation of fluid occurs between the layers of tunica vaginalis in scrotum. These may! be of Pvo types : Primary and secondary?In primary vaginal hydrocele, often there is not definite cause.Secondary vaginal hydrocele accompanies disease of the testis and/or epididymis. The common causes of secondary hydrocele are epididymo-orhitis, trauma and testicular neoplasm.
|
Surgery
|
Miscellaneous (Testis & Scrotum)
|
Vaginal hydrocele
|
A 7-year-old boy presents with, patchy hair loss, boggy scalp swelling and broken and fragmented hair follicles at the surface of the scalp resembling black dots. What is the next step in establishing a diagnosis:
|
The clinical picture is suggestive of Tinea capitis. Although culture is the gold standard in its diagnosis, KOH examination of the hair is the quick method to demonstrate spored and hyphae within and around the hair. Ref: Clinical Pediatric Dermatology By Thappa, Page 57-59, Elsevier India 2009
|
Skin
| null |
KOH smear
|
Which one of the following physiological event of cardiac cycle is responsible for QRS complex?
|
The P wave represents the wave of depolarization that spreads from the SA node throughout the atria. The QRS complex represents ventricular depolarization. Ventricular rate can be calculated by determining the time interval between QRS complexes. The isoelectric period (ST segment) following the QRS is the time at which the entire ventricle is depolarized and roughly corresponds to the plateau phase of the ventricular action potential. The T wave represents ventricular repolarization and is longer in duration than depolarization. The Q-T interval represents the time for both ventricular depolarization and repolarization to occur and therefore roughly estimates the duration of an average ventricular action potential.
|
Physiology
| null |
Ventricular depolarization
|
An accustomed way of doing things is known as:
|
Habit is an accustomed way of doing things. It is the usual way of action that can be performed without thinking. Chapter: Medicine and social sciences. Ref: Park 21st edition, page: 627.
|
Social & Preventive Medicine
| null |
Habit
|
A neurosurgeon dropped his kid to the school then there he saw a child with uncontrollable laughing and precocious pubey. When he again went to the school in capital parents teachers meeting, he talked to the father of that boy and advised him to get an In1R1 done and the diagnosis was confirmed. What is the most probable diagnosis
|
Ans. a. Hypothalamic hamaoma Uncontrollable laughing and precocious pubey are suggestive of hypothalamic hamaoma. Hypothalamic Hamaoma Central precocious pubey staing before the age 3 years is often due to hypothalamic hamaomaQ . Seizures, especially laughing spells (gelastic seizures)deg are seen in children with hypothalamic hamaoma. Hypothalamic Hamaoma Central precocious pubey staing before the age 3 years is often due to hypothalamic hamaomaQ Hypothalamic hamaoma picked up by MRIQ Seizures, especially laughing spells (gelastic seizures)Qare seen in children with hypothalamic hamaoma Precocious Pubey Central precocious pubey is a.lso known as true precocious pubeyQ, peripheral precocious pubey is called pseudo-precocious pubeyQ. McCune-Albright syndrome causes pseudo-precocious pubey (Peripheral precocious pubey).
|
Pediatrics
| null |
Hypothalamic hamaoma
|
Drug of choice for Huntington's chorea is
|
Huntigton's chorea is characterized by dopaminergic overactivity and Tetrabenazine is a dopamine depleter which is the drug of choice for this condition.
|
Pharmacology
| null |
Tetrabenazine
|
Which of the following is associated with > 20% risk of chromosomal anomalies:
|
Omphalocele
|
Pathology
| null |
Omphalocele
|
What is the end product of catabolism of pyrimidine?
|
The end products of pyrimidine catabolism is CO2 and H2O.
|
Biochemistry
| null |
CO2 & H2O
|
Autoimmune destruction of platelet is seen in -
| null |
Medicine
| null |
SLE
|
Most common ovarian tumour to undergo torsion is :
|
Dermoid cyst
|
Gynaecology & Obstetrics
| null |
Dermoid cyst
|
Iron supplements given for anemia,is which level of prevention
|
Early diagnosis and treatment of disease comes under secondary level of prevention
|
Social & Preventive Medicine
| null |
Secondary
|
Enzyme defect in Classic Phenylketonuria
|
Hyperphenylalaninemias arise from defects in phenylalanine hydroxylase (type I, classic phenylketonuria (PKU), frequency 1 in 10,000 bihs), in dihydrobiopterin reductase (types II and III), or in dihydrobiopterin biosynthesis (types IV and V).Ref: Harper&;s Biochemistry; 30th edition; Chapter 29 Catabolism of the Carbon Skeletons of Amino Acids
|
Biochemistry
|
Metabolism of protein and amino acid
|
Phenylalanine hydroxylase
|
Length of Posterior vaginal wall is -
|
Ans. is 'd' i.e., More than anterior vaginal wall o The anterior wall is about 8 cm long and the posterior wall is about 10 cm long.Vaginao The vagins is a fibromuscular, canal forming the female copulatory organ,o It extends from vulva to uterus.o Mucous membrane is lined by non keratinized stratified squamous epithelium.o The anterior wall is about 8 cm long and the posterior wall is about 10 cm long,o The lumen is circular at the upper end because of the protrusion of the cervix into it.o Below the cervix, anterior and posterior walls are in contact.o The interior of the upper end of the vagina (or vaginal vault) is in the form of a circular groove that surrounds the protrudng cervix.o The groove becomes progressively deeper form before backwards and is arbitrarily divided into four parts called the v aginal fornices:y Anterior fornix lies in front of the cervix and is shallowest.Posterior fornix lies behind the cervix and is deepest.Two lateral fornices lie one on each side of the cervix. Lateral fornix is related to the transverse cervical ligament of pelvic fascia in which are embedded a network of vaginal vein and the ureter gets crossed by the uterine artery.
|
Anatomy
|
Female Genital System
|
More than anterior vaginal wall
|
Which is concerned with HUMORAL immunity
| null |
Microbiology
| null |
B cell
|
A 34-year-old man is pushing some heavy weights while doing squats. Unfounately, while maxing out, he drops the weight and immediately grabs at his upper thigh, writhing in pain. The man is admitted to the emergency depament and during physical examination is diagnosed with a femoral hernia. What reference structure would be found immediately lateral to the herniated structures
|
In a Femoral Hernia, abdominal contents are forced through the femoral ring, which is just lateral to the Lacunar Ligament (of Gimbernant) and just medial to the Femoral Vein. The Femoral Vein would be found immediately lateral to the Femoral Hernia. The adductor longus muscle as well as the pectineus muscle would be found deep and medial to the hernia.
|
Anatomy
|
Lower limb 1
|
Femoral Vein
|
You are shown PA and lateral chest radiographs from a 53-year-old woman with mild dyspnea. Which one of the following is the MOST likely diagnosis?
|
A. Incorrect. Mesothilioma appears as a rind of tissue that encircles the hemothorax. This features is not present in the provided images. B. Incorrect. Empyema demonstrates pleural effusion with air and or thickening of the pleura. These features are not present in the provided images. C. Incorrect. Bronchogenic carcinoma appears as nodule/mass within the lung parenchyma and is often spiculated. These features are not present in the provided images. D. Correct. Solitary fibrous tumor occurs in the pleural space and appears as a mass with smooth borders and incomplete sign which suggests that the finding is extraparenchymal in nature. These features are present in the provided images.
|
Radiology
|
Respiratory system
|
Solitary fibrous tumor
|
Which is most economical and best screening
|
Ref:Parks 23rd edition pg 137 High-risk or selective screening : Screening will be most productive if applied selectively to high-risk groups, the groups defined on the basis of epidemiological research. Types of screening : Mass screening. High-risk or selective screening. Multi-phasic screening.
|
Social & Preventive Medicine
|
Screening
|
High risk screening
|
In reduction genioplasty
| null |
Surgery
| null |
Symphysis part of mandible is reduced
|
In a hea patient, contraceptive of choice is ?
|
Ans. is 'a' i.e., Sterilization o Sterilization & double barrier methods are the contraception of choice in hea patients.
|
Social & Preventive Medicine
| null |
Sterilization
|
The peripheral nervous system develops primarily from:
|
The peripheral nervous system is mainly derived from the neural crest. The peripheral nervous system is primarily derived from the neural crest. Through migration and specialisation, cells of the neural crest develop into cranial, spinal, and visceral nerves and ganglia, suppo cells of the peripheral nervous system also derive from the neural crest. Neural Crest Origin: System Cell type Peripheral Nervous system (PNS) Neurons, sensory ganglia, sympathetic and parasympathetic ganglia, enteric nervous system and plexuses Sensory ganglia of CN V, CN VII, CN IX, CN X Ciliary (CN III), Pterygopalatine (CN VII), submandibular (CN VII) and otic (CN IX) parasympathetic ganglia Dorsal root ganglia Sympathetic chain ganglia Preveebral sympathetic ganglia Enteric parasympathetic ganglia of the gut (Meissner and Auerbach plexus; CN X) Abdominal/Pelvic cavity parasympathetic ganglia Neuroglial cells, olfactory ensheathing cell Schwann cells Endocrine Adrenal medulla (Chromaffin cells of adrenal medulla) Calcitonin-secreting cells Parafollicular (C) cells of thyroid Carotid body type I cells Integumentary Epidermal pigment cells Melanoblastoma (pigment cells) and Melanocytes Facial cailage and bone Facial and anterior ventral skull cailage and bones Pharyngeal arch skeletal and connective tissue components Craniofacial skeleton (frontal , parietal, squamous temporal nasal, vomer, palatine, maxillae & mandible bones) Connective tissue of head including cailage, ligaments & tendons Sensory Inner ear Corneal endothelium and stromal, choroid & Sclera of eye Neural crest contribution to Eye Endothelium of cornea & trabecular mesh work Stroma of cornea, iris, ciliary body and choroid Melanocytes of conjuctiva and Uveal tissue (Iris stroma) Ciliary muscle ganglion & nerves (Schwann cells) Orbital bones & Connective tissues Connective sheath & muscle layer of orbital blood vessels Meningeal sheath of optic nerve Sclera & pa of Vitreous (Sclera is of neural crest and mesodermal origin) Connective tissue Tooth papillae; Odontoblast (dentine of teeth) Smooth muscle, and adipose tissue of skin of head and neck Connective tissue of lacrimal, nasal, labial, palatine, oral, salivary and thyroid glands and of pharyngeal pouches i.e., thymus and parathyroid glands Connective tissue of meninges (Pia and arachnoid) Connective tissue and smooth muscle in aeries of aoic arch origin (Aoicopulmonary septum) Ref: Embryology of the Peripheral Nerves Chapter 3 in book Nerves and Nerve Injuries 2015/38
|
Anatomy
|
General anatomy
|
Neural crest
|
All are seen in treacher collin syndrome except
|
Ans. is 'd' i.e., Choanal atresia Treacher collins syndrome It is rare condition that presents several craniofacial deformities of different levels. This is a congenital malformation involving the first and second branchial arches. The disorder is characterized by abnormalities of the auricular pinna, hypoplasia of facial bones, antimongoloid slanting palpebral fissures with coloboma of the lower eyelids and cleft palate. Impoant clinical findings are :- Antimongoloid palpebral fissures Malformed malleus and incus (normal stapes) Coloboma of lower lid Conductive deafness Hypoplasia of mandible (micrognathia) and molar bones Cleft palate Malformed pinna and meatal atresia It is the most common benign neoplasm of nasopharynx. It is a highly vascular tumor and blood supply of the tumor most commonly arises from the internal maxillary aery. Juvenile nasopharyngeal angiofibroma (JNA) occurs almost exclusively in males. Female with Juvenile nasopharyngeal angiofibroma (JNA) should undergo genetic testing. Onset is most commonly in the second decades, the range is 7-19 years. The exact cause is unknown. As the tumour is predominantly seen in adolescent males in the second decade of life, it is thought to be testosterone dependent. The most common site is posterior pa of nasal cavity close to the margin of sphenopalatine foramen. The tumor stas adjacent to the sphenopalatine foramen. Large tumors are frequently bilobed or dumbbel shaped, with one poion of tumor filling the nasopharynx and the other poion extending to the pterygopalatine fossa. Clinical features Symptoms depend on spread of tumour to nasal cavity, paranasal sinuses, pterygomaxillary fossa, infratemporal fossa, cheek, orbits (through inferior orbital fissure), cranial cavity (most common site is middle cranial fossa). Nasal obstruction (80-90%) is the most common symptom, especially in the initial stages. This results in denasal speech, hyposmia, broadening of nasal bridge. pontaneous profuse & recurrent epistaxis is the second most common symptom Otalgia, conductive hearing loss, serous otitis media, due to eustachian tube obstruction. Pink or purplish mass obstructing one or both chonae in nasopharynx. Tumour in the orbit causes : proptosis; and frog-face deformity; diplopia and diminshed vision. Tumour in infratemporal fossa can cause trismus and bulge of parotid. II, III, IV, V, VI cranial nerve can be involved. Splaying of nasal bones. Swelling of cheek and fullness of face. Diagnosis and treatment Contrast CT is the investigation of choice. Biopsy should be avoided as it can cause severe bleeding. Surgical excision is the treatment of choice.
|
ENT
| null |
Choanal atresia
|
Pringle maneuvar to arrest hehemorrhage is
|
Pringle manoeuvre is used to control hemorrhage by clamping the hepatoduodenal ligament and compressing the poal triad,thereby reducing aerial and venous inflow into the liver.But it doesn't control the backflow from inferior vena cava and hepatic veins. Reference: Bailey & Love's sho practise of surgery,25 th edition,page no348.
|
Surgery
|
G.I.T
|
Clamping of hepatoduodenal ligament
|
A girl presents with hyper pigmented skin lesions, precocious puberty and some bony lesion. what is the most probable diagnosis?
|
The image represents cafe - au - lait spots. Precocious puberty, bony lesion like fibrous dysplasia are seen in Mc cune Albright syndrome,
|
Pediatrics
| null |
Mc - cune Albright syndrome
|
Function of guardian of genome p53 is whicvh of the following?
|
D- Reduced cell mutation rate. P53 is an example of a pro-apoptotic gene k/a Guardian of Genome. If DNA is damaged / mutated p53, repairs it. But if defect is beyond repair - Activation of pro-apoptotic machinery - Apoptosis Result: - Reduced cell mutation rate The p53 protein is the central monitor of stress in the cell and can be activated by anoxia, inappropriate signalling by mutated oncoproteins, or DNA damage. p53 controls the expression and activity of proteins involved in cell cycle arrest, DNA repair, cellular senescence, and apoptosis. DNA damage is sensed by complexes containing kinases of the ATM/ATR family; these kinases phosphorylate p53, liberating it from inhibitors such as MDM2. Active p53 then upregulates the expression of proteins such as the cyclin dependent kinase inhibitor p21, thereby causing cell-cycle arrest at the G1-S checkpoint. This pause allows cells to repair DNA damage. If DNA damage cannot be repaired, p53 induces additional events that lead to cellular senescence or apoptosis.
|
Pathology
|
JIPMER 2018
|
Reduce cell mutation rate
|
Which valve is present at opening of nasolacrimal duct-
|
Ans. is 'a' i.e., Hasner's valve o Nasolacrimal duct opens into inferior meatus and is closed by a mucosal flap called Hasner's valve,o Heister valve (spiral valve) is present in cyclic duct.
|
Anatomy
|
Nose
|
Hasner's valve
|
Surest proof of antemoem burn is
|
In case of burns, if death has occurred from suffocation,aspirated blackish coal paicles are seen in the nose,mouth,larynx,trachea,bronchi,oesophagus and stomach, and blood is cherry red. Presence of carbon paicles especially in the terminal bronchioles and an elevated CO saturation together are absolute proof that the victim was alive when the fire occurred. In the absence of CO in blood and soot in the airways,death may possibly result due to poisoning with carbon dioxide or deficiency of oxygen. Sometimes inhalation of smoke produces vomiting which may be inhaled and found in the smaller bronchi. Ref: K.S.Narayan Reddy's Synopsis of Forensic Medicine and Toxicology, 29th edition, Chapter 11, page-163.
|
Forensic Medicine
|
Death and postmortem changes
|
Presence of soots beyond the tracheal bifurcation
|
Most impoant step in the repair of an indirect inguinal hernia is -
|
Ans. is 'b' i.e. Narrowing of the internal ring
|
Surgery
| null |
Narrowing of the internal ring
|
Highest incidence of anemia in the tropics is due to -
|
Option 1 Chronic hookworm infection with heavy worm load: In the intestine, adult worms attach to intestinal villi with their buccal teeth and feed on blood and tissue with the aid of anticoagulants. A few hundred worms in the intestine can cause hookworm disease, which is characterized by severe anemia and iron deficiency and protein energy malnutrition resulting from blood loss. Causes: Ground itch, Serpiginous tracks, Mild pneumonitis, GIT symptoms and Iron def. anemia Option 2, 3, 4 Thread worm/Pin worm/Seat worm /Enterobius vermicularis: does not cause anemia. Ascaris lumbricoides (Roundworm): causes GIT symptoms, Malabsorption, Intussusception and Loeffler syndrome. Dracunculus medinensis (Guinea worm): Causes Guinea worm disease or dracunculiasis
|
Microbiology
|
Parasitology Pa 2 (Helminthology)
|
Hookworm
|
Dilatation of upper lobe veins is a reliable sign of:
|
Ans. Cardiac decompensation
|
Radiology
| null |
Cardiac decompensation
|
Pulmonary function abnormalities in interstitial lung diseases include all of the following except
|
A group of disorders that cause progressive scarring of lung tissue. Interstitial lung disease may be caused by long-term exposure to hazardous materials, such as asbestos or coal dust, or it can be caused by an auto-immune disease such as rheumatoid ahritis. Once lung scarring occurs, it's generally irreversible. Ref: guyton and hall textbook of medical physiology 12 edition page number:327,328,329
|
Physiology
|
Respiratory system
|
Reduced FEV1 /FVC ratio
|
A smoker is worried about the side effects of smoking. But he does not stop smoking thinking that he smokes less as compared to others and takes a good diet. This thinking is called as:
|
Ans. a. Self-exemption (Ref: style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif">; Kaplan and Sadock 11/e p590)There are many psychological barriers that need to be overcome in order to successfully quit smoking. Self-exempting belief is one of them."Self-exempting beliefs: A large majority of smokers have the belief that 'it will never happen to me'. For example, someone who runs everyday and doesn't drink alcohol may think that they have less chances of developing lung cancer than the next smoker because their lifestyle 'balances out ' the cigarettes. This is not true. Every smoker has the same risk of negative health outcomes associated with smoking as the next smoker. "Prochaska and DiClemente's Stages of Change ModelStage of ChangeCharacteristicsTechniquesPre-contemplationNot currently considering change:"Ignorance is bliss"* Validate lack of readiness Clarify: decision is theirs* Encourage re-evaluation of current behavior* Encourage self-exploration, not action* Explain and personalize the riskContemplationAmbivalent about change: "Sitting on the fence"Not considering change within the next month* Validate lack of readiness* Clarify: decision is theirs* Encourage evaluation of pros and cons of behavior change* Identify and promote new, positive outcome expectationsPreparationSome experience with change and are trying to change: "Testing the waters"Planning to act within 1 month* Identify and assist in problem solving re: obstacles* Help patient identify social support* Verify that patient has underlying skills for behavior change* Encourage small initial stepsActionPracticing new behavior for 3-6 months* Focus on restructuring cues and social support* Bolster self-efficacy for dealing with obstacles* Combat feelings of loss and reiterate long-term benefitsMaintenanceContinued commitment to sustaining new behaviorPost-6 months to 5 years* Plan for follow-up support* Reinforce internal rewards* Discuss coping with relapseRelapseResumption of old behaviors: "Fall from grace"* Evaluate trigger for relapse
|
Psychiatry
|
Tobacco-Related Disorders
|
Self-exemption
|
Number of ATP generated in one TCA cycle-
|
Ans. is 'c' i.e., 10 o In a single TCA cycle 10 molecules of ATP are produced (12 molecules according to older calculations),o One turn of the TCA cycle, starting with acetyl Co A produces 10 ATPs. When the starting molecule is pyruvate, the oxidative decarboxylation of pyruvate, the oxidative decarboxylation of pyruvate yields 2.5 ATPs and therefore, 12.5 ATPs are produced when starting compound is pyruvate. Since, two molecules of pyruvate enter the TCA cycle when glucose is metabolized (glycolysis produces 2 molecules of pyruvate), the number of ATPs is doubled. Therefore, 25 ATP molecules, per glucose molecule, are produced when pyruvate enters the TCA cycle,o Note : Previously calculations were made assuming that NADH produces 3 ATPs and FADH generates 2 ATPs. This will amount a net generation of 30 ATP molecules in TCA per molecule glucose and total 38 molecules from starting. Recent experiments show that these values are overestimates and NADH produces 2.5 ATPs and FADH produces 1.5 ATPs. Therefore, net generation during TCA is 25 ATPs and complete oxidation of glucose through glycolysis plus citric acid cycle yield a net 32 ATPs.o Energy yield (number of ATP generated) per molecule of glucose when it is completely oxidized through glycolysis plus citric acid cycle, under aerobic conditions, is as follows :- Method of ATP formationNo of ATPs gained perglucose (new calculation)No of ATPs As per old calculationPathwayStepEnzymeSourceGlycolysis1Hexokinase- Minus1Minus 1Do3Phosphofructokinase- Minus1Minus IDo5Glyceraldehyde-3-p DHNADHRespiratory chain2.5x2 =53x2=6Do61J-BPG kinaseATPSubstrate level1x2 =21x2=2Do9Pyruvate kinaseATPSubstrate level1x2 =21x2=2Pyruvate to Acetyl CoA-PyruvateDehydrogenaseNADHRespiratory chain2.5 x 2 =53x2=6 TCA cycle3Isocitrate DHNADHRespiratory chain2.5 x 2 =53x2=6Do4Alpha keto glutarate DHNADHRespiratory chain2.5 x 2 =53x2=6Do5Succinate thiokinaseGTPSubstrate level1x2 =21x2=2Do6Succicinate DHFADH2Respiratory chain1.5 x 2 =32x2=4Do8Mai ate DHNADHRespiratory chain2.5 x 2 =53 x 2= 6Net generation in glycolytic pathway 9 minus 2=710 minus 2=8Generation in pyruvate dehydrogenase reaction=5=6Generation In citric acid cycle=20=24Net generation of ATP from one glucose mole=32=38
|
Biochemistry
|
Kerbs Cycle
|
10
|
What is the X-ray diagnosis?
|
.
|
Anatomy
|
All India exam
|
Supracondylar fracture humerus
|
All of the following are mesodermal in origin except -
| null |
Anatomy
| null |
Dilators of iris
|
A 26-year-woman undeakes a prolonged fast for religious reasons. Which of the following metabolites will be most elevated in his blood plasma after 3 days?
|
As he becomes progressively more starved, his liver will synthesize ketone bodies as an additional fuel for muscle, which cannot meet all of its energy needs from fatty acid metabolism. This spares glucose for the brain and red blood cells. Higher than normal quantities of ketone bodies present in the blood or urine constitute ketonemia (hyperketonemia) or ketonuria, respectively. The overall condition is called ketosis. The basic form of ketosis occurs in starvation and involves depletion of available carbohydrate coupled with mobilization of free fatty acids . Ref: Botham K.M., Mayes P.A. (2011). Chapter 22. Oxidation of Fatty Acids: Ketogenesis. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e
|
Biochemistry
| null |
Ketone bodies
|
Which of the following processes is not a true component of swallowing?
|
The movement of the tongue against the palate is the only voluntary process among the four possible answers
|
Physiology
| null |
Movements of the tongue against the palate.
|
Glycogenin primer is glucosylated by:
|
Ans. A. UDP Glucose(Ref: Harper 31/e page 164)Glycogenin, a 37 kDa protein is glucosylated on specific tyrosine residue by UDP glucose.Glycogenenin catalyses transfer of 7 glucose residue from UDP-Glc, in l-4 linkage to form Glycogen primer.Further Glucose on glycogen primer are added by Glycogen Synthase to nonreducing end till growing chain is at least 11 glucose residue long.
|
Biochemistry
|
Carbohydrates
|
UDP Glucose
|
Treatment of choice for stab injury caecum ?
|
Ans. is 'b' i.e., ileo-transverse anastomosis These options mentioned in the question are of the year 1989; no longer seems to be valid. The management of Colonic injuries in latest edition of Schwaz is: Currently 3 methods for managing the colonic injuries are used? a. Primary repair (it includes lateral suture repair or resection of the damaged segment with reconstruction by ileocolostomy or colocolostomy) b. End colostomy c. Primary reapir with diveing ileostomy Various trials have proven that the Primary repair is safe and effective in viually all patients with penetrating wounds. Schwaz writes- "Numerous large retrospective and several prospective studies have now clearly demonstrated that primary repair is safe and effective in viually all patients with penetrating wounds. Colostomy is still appropriate in a few patients, but the current dilemma is how to select which patients should undergo the procedure. Currently, the overall physiologic status of the patient, rather than local factors, directs decision making. Patients with devastating left colon injuries requiring damage control are clearly candidates for temporary colostomy. Ileostomy with colocolostomy, however, is used for most other high-risk patients."
|
Surgery
| null |
Ileo-transverse anastomosis
|
All of the following are true about break point chlorination, except -
|
The point at which the residual chlorine appears and when all combined chlorines have been completely destroyed is the breakpoint and the corresponding dosage is the breakpoint dosage. The breakpoint chlorination achieves the same result as superchlorination in a rational manner and therefore be constructed as controlled superchlorination (refer pgno:775 park 25th edition)
|
Social & Preventive Medicine
|
Environment and health
|
1 ppm free chlorine should be present in water after break point has reached
|
Treatment of mucocele on lower lip
| null |
Surgery
| null |
Excision with adjacent glands
|
Acute Gouty ahritis is seen early in treatment following
|
Allopurinol REF: Goodman Gillman manual of pharmacology and therapeutics 2008 edition page 458 "The incidence of acute attacks of gouty ahritis mayincrease duringthe early months of allopurinol therapy as a consequence of mobilization of tissue stores of uric acid. Co-administration of colchicine helps suppress such acute attacks. After reduction of excess tissue stores of uric acid, the incidence of acute attacks decreases and colchicine can be discontinued"
|
Pharmacology
| null |
Allopurinol
|
Renal autoregulation:
|
Ans. D. Minimizes the impact of changes in arterial blood pressure on renal Na+ excretionIn the autoregulatory range, vascular resistance falls when arterial blood pressure falls. Changes in vessel caliber primarily occur in vessels upstream to the glomeruli (cortical radial arteries and afferent arterioles). Because autoregulatory range extends from an arterial blood pressure of about 80 to 180 mm Hg, renal blood flow is not maintained when blood pressure is low; in fact, the sympathetic nervous system will be activated and cause intense vasoconstriction in the kidneys. Renal autoregulation does not depend on nerves.
|
Physiology
|
Heart, Circulation, and Blood
|
Minimizes the impact of changes in arterial blood pressure on renal Na+ excretion
|
Xiphoid process fuses with sternum after: DNB 09
|
Ans. 40 years
|
Forensic Medicine
| null |
40 years
|
Secretory diarrhoea is found in-
| null |
Medicine
| null |
Shigella infection
|
Intercostal vessels and nerve runs in:
|
(Between the innermost intercostal and internal intercostal muscle) (208-BDC-l 4th) (57-Snell 7th)* Each intercostal space contains a large single posterior intercostal artery and two small anterior intercostal arteries.* The corresponding posterior intercostal vein drain backward into the azygos or hemiazygos vein and the anterior intercostal vein drain forward into the internal thoracic and musculophrenic veinsIntercostal nerves* The intercostal nerves are the anterior rami of the first 11 thoracic spinal nerves. The anterior ramus of the 12th thoracic nerve lies in the abdomen and runs forward in the abdominal wall as the subcostal nerve* In the costal groove the nerve lies below the posterior intercostal vessels. The relationship of structures in the costal groove from above downwards is vein-artery-nerve (VAN)*** Each intercostal nerve enters an intercostal space between the parietal pleura and the posterior intercostal membrane. It then runs forward inferiorly to the intercostal vessels in the subcostal groove of the corresponding rib, between the innermost intercostal and internal intercostal muscle
|
Anatomy
|
Thorax
|
Between the innermost intercostal and internal intercostal muscle
|
Most common bone involved in haemangioma?
|
Ans. is 'd' i.e., Veebrae Haemangioma This benign lesion, probably a hemaoma, is composed of vascular spaces lined by endothelial cells. They constitute 1-1.5% of all primary bone neoplasms. It has a peak incidence in the fifth decade (according to Maheshwari, young adults). About 50% of hemangiomas of bone occur in veebrae and are most commonly situated in lower thoracic and upper lumbar regions. Other common site of involvement (20%) is skull. Small bones of hands and feets may also be affected. Haemangioma of the veebra has a typical radiographic picture in the form of loss of horizontal striations and prominence of veebral striations. There is Polka dot appearance on CT. In the skull, hemangioma generally affects the calverium and is seen as an expansile lytic lesion which has a sunburst appearance with striation radiating from the centre. A hemangioma may be identified due to associated phlebolith and it may cause local gigantism of the invovled area. Hemangiomas are largely asymptomatic, and thus most are never discovered, leading some to describe these lesions as rare. Treatment is radiotherapy.
|
Surgery
| null |
Veebrae
|
All of the following are risk factors for atherosclerosis except:
| null |
Medicine
| null |
Decreased fibrinogen levels
|
Which agent is effective in killing spores?
|
Ans: D (Formaldehyde) Ref: Ammthanamyan R. Panther CKJ Textbook of Microbiology. 8th Edition. Hyderabad: Universities Press: 2009. Pg. 35-8Explanation:Formaldehyde is active against the amino group in the protein molecule.In aqueous solutions, it is markedly bactericidal and sporicidal and also has a lethal effect on viruses.It is used to preserve anatomical specimens, and for destroying anthrax spores in hair and woolDisinfectantEffective againstCharacteristicAlcoholsCompoundsActive against bacteria and fungal sporesGood general use disinfectantAldehydesActive against bacteria and virus and sporesGood activity against bacteria, virus and sporesChlorineGood disinfectant for blood and body fluid spillsActive against bacteria, virus and moderate action against spores
|
Microbiology
|
Sterilization and Disinfection
|
Formaldehyde
|
Mucocutaneous Leishmaniasis is caused by
|
L. Brasiliensis causes Espundia (Mucocutaneous Leishmaniasis).
|
Microbiology
| null |
L. Brasiliensis
|
Amongst the following extrapyramidal side effect is commonest with which drug?
|
Clozapine is an atypical antipsychotic drug and has negligible risk of extrapyramidal symptoms. Atypical antipsychotic drugs act by antagonistic actions at 5-HT2 and alpha receptors and may or may not possess D2 blocking activity. These drugs are less likely to cause extrapyramidal symptoms. However, most of these agents (except ziprasidone and aripiprazole) can result in weight gain, hyperlipidemia and new-onset diabetes mellitus.
|
Pharmacology
|
Psychiatric Illness
|
Haloperidol
|
Proteins can be separated by the following methods except:
|
Ans. C. Gas-liquid ChromatographySeparation of Plasma proteins by:a) Salting out method (using ammonium sulphate)Three proteins are separated- Albumins- Full Saturation- Globulins-Half Saturationb) Gas Liquid chromatography is used to separate volatile substances on heating. Therefore not used to separate proteins, because they get coagulated or denatured
|
Biochemistry
|
Structure & Function of Protein
|
Gas-liquid Chromatography
|
Civatte bodies are a feature of ?
|
Ans. is 'b' i.e., Lichen planus Civatte bodies (cytoid bodies/ colloid bodies/ hyaline bodies)* A characteristic histopathological feature of lichen planus* They are apoptotic basal cells present at dermo-epidermal junction and papillary dermis. Formed my macrophages engulfing the melanin.Other histopathological features of lichen planus* Hydropic degeneration of basal cells (Pathognomic feature)* Hypergranulosis (thickening of the granular layer) (focal hypergranulosis clinically creates Wickham striae)* Hyperkeratosis (thickening of stratum corneum)* Acanthosis (thickening of stratum Malpighi)* Sub-epidermal lichenoid band (deposition of lymphocytes 8c histiocytes in the upper dermis)* Pigment incontinence (dropping of melanin from damaged Keratinocytes of epidermis into dermis)* Max Joseph space /cleft (separation of the epidermis in small clefts)* Sawtooth appearance (flattened rete ridges)
|
Unknown
| null |
Lichen planus
|
PNH is associated with all of the following conditions, except :
|
Answer is D (Increased LAP scores) PNH is associated with a decreased Leukocyte Alkaline phosphase (LAP) score PNH: Paroxysmal Nuctunal haemoglobinuria: Review PNH is an Acquired Q Intracarpuscular (--) disorder, acquired at stern cell level (-) by loss characterised by undue sensitivity of red blood cell's membrane to complement (--) Common manifestations: PNH : Three common manifestation Hemolytic Anemia Venous Thrombosis Deficient Hematopoesis Probably due to defect at stem cell level Because of increased activation of Activation of complement indirectly Pancytopenia/Aplastic anemia complement and complement stimulates platelet aggregation and - Granulocytes mediated destruction hypercoagulability (thus thrombosis - Thrombocytes (thrombocytopenia) * despite thrombocytopenia) HemoglobinemiaQ Hemoglohinuriae HemosiderinuriaQ Elevated LDH Q Why is it called Paroxysmal Nocturnal haemoglobinuria? Basis : Acidification enhances activity of complement During night when one sleeps (noctunal) --> Relative Hypoxia --> Acidosis --> Enhanced complement activity Paroxysm of Haemoglobinuria identified by --> Complement mediated destruction of red blood cells passage of brown urine in morning. Red Cell Membrane is deficient in two factors which result in increased activation of complement 1. DAF Q :Decay accelerating factor that activates decay of complements 2. MIRL CD 59 : inhibits membrane attack complex
|
Medicine
| null |
Increased LAP scores
|
. Relative Risk can be obtained from -
| null |
Social & Preventive Medicine
| null |
Cohort study
|
Winging of scapula which muscle is affected
|
Winging of scapulaIn this condition, the veebral border of scapula becomes more prominent when the patient tries to push against the wallIt occurs in paralysis of the serratus anterior muscle in long thoracic nerve palsy(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 268)
|
Orthopaedics
|
All India exam
|
Serratus anterior
|
Not a Radioprotector
|
BUDR is a Non-hypoxic cell Radiosensitizer.
|
Radiology
| null |
BUDR
|
Incubation period depends on all except
| null |
Social & Preventive Medicine
| null |
Size of the infective organism
|
A 22 year old male following a spos trauma presented with pain and stiffness in the neck. On examination, the right shoulder is drooping . Which of the following muscle is likely to be paralysed?
|
Drooping of the shoulder is caused by paralysis of the trapezius. The trapezius is innnervated by spinal accessory nerve (CN XI). It causes retraction of scapula, shrugging of the shoulder and overhead abduction ( along with serratus anterior). Paralysis of trapezius causes drooping of shoulder and slight winging of scapula (the superior angle of scapula becomes more prominent) Ref: Gray&;s Anatomy for students 4th edition Pgno: 101
|
Anatomy
|
All India exam
|
Trapezius
|
Which of the following statements is true -
|
. Acute lymphoid leukemia in less than 1 year
|
Pathology
| null |
Acute lymphoid leukemia in less than 1 year
|
All are true regarding SCID except:
|
Ref: Nelson's Textbook of Pediatrics. /9th Edition, Page:Explanation:"Marked accumulations of adenosinef 22 - deoxyadenosine. and 22 -O-methyladenosine lead directly or indirectly to T-cell apoptosis, which causes the immunodeficiency " (Ref: Nelson) Severe combined ImmuntKief'iciency (SCID)Both cellular and humoral immunity affectedMC type is X-linked SCID (X-SCD) due to mutation in Common Cytokine Receptor g Chain (gC)Second most common form of SCID is absence of the enzyme adenosine deaminase (ADA)(15% patients)All patients with SCID have very small thymuses (<1 g)Thymus fail to descend from the neck, contain no thymocytes, and lack corticomeduliary distinction or Hassall corpuscles.The thymic epithelium appears histologically normal.Both the follicular and paracorticai areas of the spleen are depleted of lymphocytes.Lymph nodes, tonsils, adenoids, and Peyer patches are absent or extremely underdevelopedClinical ManifestationsAffected infants present within the 1st few months of life with Recu rrent or persistent diarrheaPneumoniaOtitis media SepsisCutaneous infectionsGrowth failurePersistent infections with opportunistic organisms including lead to deathCandida albicansPneumocystis jiroveciParainfluenza 3 virusAdenovirusRespiratory syncytial virusRotavirus vaccine virus Cytomegalovirus (CMV)Epstein-Barr virus (EBV)Varicella-zoster virusMeasles virusMMR-V vaccine virusBacillus Calmette-Guerin (BCG)Affected infants also lack the ability to reject foreign tissue and are therefore at risk for severe or fatal graft versus host disease (GVHD) from T lymphocytes in non irradiated blood products or in allogeneic stem cell transplants or less severe GVHD from maternal immunocompetent T cells that crossed the placenta while the infant was in utero.* These infants also have an absence of lymphocyte proliferative responses to mitogens, antigens, and allogeneic cells in vitro.Patients with adenosine deaminase (ADA) deficiency have the lowest absolute lymphocyte counts, usually <500/mm3.Serum immunoglobulin concentrations are low or absentNo antibodies are formed after immunizations.T cells are extremely low or absentTreatmentSCID is a true pediatric emergency.Unless immunologic reconstitution is achieved through stem cell transplantation, death usually occurs during the 1st yr of life and almost invariably before 2 yr of age.
|
Pediatrics
|
Disorders of the Respiratory Tract
|
Toxicity of leucocytes due to accumulation of cAMP
|
Elimination after 4 half lives in first order Kinetics is -
|
Ans. is 'b' i.e., 93% Half life Elimination I t1/2 50% 2 0/2 75% 3 t1/2 87.5% 41% 93.75% 5 t1/2 96.875
|
Pharmacology
| null |
93%
|
Pemphigus vulgaris is caused by:
|
Ans: (c) AutoimmuneHarrison 19th ed. / 370# PEMPHIGUS* Pemphigus is an autoimmune blistering disorder* It results from the loss of integrity of normal intercellular attachments with the epidermis.* Commonly affects indiciduals of age between 40-60.* Equal prevalence among males and females.* There are five variants of pephigus:# Pemphigus Vulgaris: most common type# Pemphigus Foliaceous: superficial pemphigus# Pemphigus Vegetans: least common type# Pemphigus Erythematous# Fogo Selvagem: an endemic form of pemphigus foliacious.* Refer to above table
|
Skin
|
General
|
Autoimmune
|
The valve of Hasner is
|
Nasolacrimal duct (NLD) opens into the Inferior meatus through the Hasner`s valve.The direction of NLD--downward, backward, and laterally from the lacrimal sac to the nose, Length- 1.8 cmSphenoid sinus and posterior ethmoids open into the sphenoethmoidal recess (Superior meatus)Frontal, Maxillary and Anterior ethmoids open into the middle meatus.Ref: Hazarika; 3rd ed; Pg 240
|
ENT
|
Nose and paranasal sinuses
|
Opening of nasolacrimal duct
|
In which of the following conditions, the medical treatment of ectopic pregnancy is contraindicated:
|
Ans. is c, i.e. Presence of fetal heart activityRef Dutta Obs. 7/e, p 186; Leon Speroff 7/e, p 1287, 1288; Novak 14/e, p 624; Williams Gynae 7/e, p 166Methotrexate: It is a folic acid analogue which inhibits dehydrofolate reductaseQ and prevents synthesis of DNA.QCandidates for methotrexate (Williams 24/e, p 384, Table 19.2): --Leon Speroff 7/e, p 1290Absolute requirementsHemodynamic stabilityQNo evidence of acute intra-abdominal bleedingQReliable commitment to comply with required follow-up careQNo contraindications to treatment viz woman should not be breast feeding/renal/hepatic dysfunction.Preferable requirementsAbsent or mild painSerum beta hCG level less than 5,000IU/L (best results seen with HCG<2000IU/L)Q It is the single best prognostic indicator of treatment success.Absent embryonic heart activityQEctopic gestational mass less than 4 cm in diameter without cardiac activity and < 3.5 cm with cardiac activityQFriends, there is no doubt on this issue that presence of cardiac activity is a relative contraindication according to books like Williams Obs 23/e, Williams Gynae 1/ed and Leon Speroff 7/ed."Fetal cardiac activity - Although this is a relative contraindication to medical therapy; the admention is based on limited evidence." --William Obs. 23/e, p 247"The presence of embryonic heart activity is not an absolute contraindication for medical management but the likelihood of failure and the risk of tubal rupture are substantially increased (therefore it is a relative contraindication)." --Leon Speroff 7/e, p 1287As far as fluid in cul-de-sac is concerned: Earlier, it was also considered a relative contraindication to medical treatment, but studies have shown that free peritoneal fluid can be seen in almost 40% of women with early unruptured ectopic pregnancy and so it's presence and absence does not accurately predict the success or failure of medical treatment.Contraindications to methotrexate treatment: (Williams 24/e, p 384, Table 19.2)Breast feedingQ Immunodeficiency statesQAlcoholism or evidence of chronic liver disease (elevated transaminases) QRenal disease (elevated serum creatinine) QHematological abnormalities (severe anemia, leukopenia or thrombocytopenia) QKnown sensitivity to methotrexateQActive pulmonary diseaseQPeptic ulcer disease. QEvidence of tubal rupture
|
Gynaecology & Obstetrics
|
Ecotopic Pregnancy
|
Presence of fetal heart activity
|
In TNM classification T3 stands for tumour size:
| null |
Pathology
| null |
>4 cm
|
To keep blood pH at 7.4, the HCO3 : H2CO3 ratio should be
| null |
Biochemistry
| null |
20:01
|
In blood transfusion, blood group most impoant is
|
. Kell
|
Pathology
| null |
Kell
|
Microangiopathic hemolytic anemia is associated with: March 2005
|
Ans. C: Hemolytic uremic syndrome Mechanism of HUS -RBCs damaged by injured vessel endothelium HUS is microangiopathic hemolytic anemia with fragmented RBC's in peripheral blood smear, thrombocytopenia and acute renal failure Infection is the triggering factor and if associated indicates a poor prognosis
|
Medicine
| null |
Hemolytic uremic syndrome
|
Which of the following is the main colonizer of sebaceous gland -
|
Propionibacterium acnes are the commonest agent causing acne in teenagers as it has affinity for sebaceous glands.
Lesions in acne develop with in the sebaceous follicle.
|
Microbiology
| null |
Propionic bacterium acnes
|
All of the following statements are true about Benedikt's syndrome except
|
. *Benedikt's syndrome involve injury to red nucleus results in ipsilateral oculomotor palsy and contralateral tremor,chorea and athetosis. Benedikt's Syndrome describes an ipsilateral III nerve palsy accompanied by contralateral 'cerebellar' tremor - a slow rhythmic tremor of the contralateral hand and foot, increased by excitement and voluntary movement, absent in sleep Ref Harrison20th edition pg 2456
|
Medicine
|
C.N.S
|
Lesion at the level of the pons
|
Bleeding ear discharge is mostly due -
|
Ans. is 'a' i.e., Glomus tumour Differential diagnosis of blood stained ear discharge :* ASOM* Acute mastoiditis* CSOM* Aural polyp* Granulations* Glomus tumor
|
ENT
|
Ear
|
Glomus tumour
|
Which one of the following is the treatment of choice for a 4cm retroperitoneal lymph node mass in a patient with non seminomatous germ cell tumor of the testis ?
|
Ans. is 'b' i.e., High orchidectomy + RPLND
|
Surgery
| null |
High Orchidectomy + RPLND
|
In ERG 'A' waves corresponds to NOT RELATED-MEDICINE
|
ERGA wave Activity of rods and conesB wave Bipolar cellC wave Retinal pigment epithelium(RPE)
|
Pharmacology
|
All India exam
|
Rods and cones
|
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