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Why a TB patient is recommend a regimen of 4 drugs on 1st visit -
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Ans. is *a' i.e., To avoid emergence of persistors 6. Two phase chemotheraphyo There are two phase of treatment of tuberculosisIntensive phaseThis is short phase in the early course of treatment and lasts for 1-3 months.Three or more drugs are given to kill as many bacilli as possible, w hich prevents emergence of persisters.The risk of re lapse is also lessened.Continuation phaseIt is aimed at sterilizing the smaller number of dormant or persisting bacilli,o Multidrug treatment in TB is given to -Prevent emergence of persistersPrevent relapsePrevent emergence of resistanceShorten the duration of treatment
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Social & Preventive Medicine
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Communicable Diseases
|
To avoid emergence of persistors
|
The agent of choice for controlling heparin induced bleeding is
| null |
Medicine
| null |
Protamine sulphate
|
Gallow's traction is used for fracture -
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Gallows traction is used for treatment of fracture shaft femur, in infants and children < 2 yrs of age.
|
Orthopaedics
| null |
Shaft femur
|
Critical period of development of fixation reflex is
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A. i.e. 2-4 months Unilateral cataract in children should be operated early in life because the critical period for development of fixation reflex is between 2" & 4th months of age.Q Age Visual Development At Bih * * * * Eye appear to move randomly & there is no central fixation Fovea is not fully developed & visual acuity is roughly 6/60. The retina is almost fully developed at bih, apa from macula which fuher develops after bih till 4-6 months of ageQ Myelination of optic nerve begins in the 7th month in utero & reaches lamina cribrosaQ(ie is completed) * Hypermetropia of +2 to +3D(2 * Orbit is more divergent (500)Q as compared to adult (450) . * A-P diameter of eyeball is 16.5 mmQ (70% of adult size which is attained by 7-8 years) * Corneal diameter is 10 mm.Q Adult size 11.7 mm is attained by 2 yrs. of age * The anterior chamber is shallower, the angle deep & the lens is more spherical as compared to the adult eye. 6 weeks (11/2 months) * Fixation reflex first becomes apparent and eye can follow bright light for a sho distance 2-4 months * Critical period for development of fixation reflexQ 4-6 months * Refixation reflex develops firmly * Macula differentiates 6-8 months * Depth perception stas developingQ 6 years * Fovea develops completely * Full visual acuity of 6/6 attained If visual developmental process is interrupted during this period by any means (eg. high anisometropia, congenital cataract) it results in amblyopia which becomes irreversible after few years. If the stimulus deprivation occurs bilaterally & severe by the age of 6 months it results in pendular nystagmus on attempted fixation. PAX6 is the master gene for eye development. Binocular Vision Psycho-optical Reflex Fusion Reflex Fixation & Refixation Reflex When a normal individual fixes * Retinal areas which coordinate visually in the Since the most accurate his visual attention on an object occipital coex so that such an object is seen vision is attained by fovea of regard, the image is formed on with both eyes as single object are k/a it is necessary that the eyes the fovea of both the eyes corresponding points. The most impoant pair be rapidly oriented so that separately, but the individual of which is foveae. Nasal half of one retina image of an object of perceives a single image. This corresponds to temporal half of other retina in interest falls upon them or state is called Binocular Single occipital coex. that of a moving object vision. It is a conditional reflex * Points on two retinae which are not retained on them. This which is not present since bih corresponding points in this sense of term are ascendancy of fovea is but is acquired during 1., 6 called disparate points and if object forms its maintained by Fixation monthsQ and is completed during retinal images on these, it will be seen double Reflex first few years. (Psycho-optical (binocular diplopia). If disparity is slight there reflex) is tendency to move the eyes so that images may be fused by means of Fusion Reflex
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Ophthalmology
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2-4 months of age
|
Over extension of complete denture for a prolonged period without adjustment may cause.
| null |
Dental
| null |
Epulis fissuratum
|
Which of the following is involved in peristalsis by causing relaxation ?
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Ans. is 'c' i.e., VIP In peristlasis :- Acetylcholine & substance P - Causing smooth muscle contraction. VIP, NO & ATP - Producing relaxation ahead of stimulus.
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Physiology
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VIP
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Function of phospholipid in cell membrance is:
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B i.e. Transduction of signals
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Physiology
| null |
Transduction of Signals
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Which of the following is an atypical antidepressant?
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Ans. is 'c' i.e., Venlafaxine Antidepressants A. Typical Tricyclic antidepressants NA + 5HT reuptake inhibitors :- Imipramine, Trimipramine, Amitriptyline, Clomipramine. Predominantly NA reuptake inhibitors :- Desipramine, Noriptyline, Amoxapine, Reboxetine. Selective serotonin reuptake inhibitors :- Fluoxetine, Paroxetine, Sealine, Citalopram, Scitalopram. B. Atypical :- Trazodone, Mianserine, Mitrazapine, Venalafaxin, Duloxetine, Tianeptine, Amineptine, Bupropion. c. MAO inhibitors :- Tranylcypramine, Meclobemide, Clorgyline.
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Psychiatry
| null |
Venlafaxine
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Surfactant deficiency causes ?
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Ans. is 'b' i.e., Respiratory distress syndromeInfant respiratory distress syndrome is due to deficiency of surfactant. Dipalmitoylphosphatidylcholine (Dipalmitoyllecithin) is the major constituent of surfactant.SurfactantSurfactant is a Soap-like substance secreted by the type-II pneumocytes of the alveolar epithelium. It is a mixture of dipalmitoyl-phosphatidycholine (dipalmitoyl-lecithin), phosphatidylglycerol, other phospholipids, neutral lipids, Surfactant proteins A, B, C and D (SP-A, SP-B, SP-C and SP-D), and carbohydrates. o Surfactant reduces the alveolar surface tension.This has three impoant physiological consequences : ?1) It reduces the collapsing tendency of lungs.2) It reduces the natural tendency of the smaller alveoli to collapse and empty into the larger ones. This is called alveolar stabilization.3) It reduces the tendency of the alveolar interstitial fluid to transudate out into the alveolar space.
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Physiology
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Respiratory distress syndrome
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Which of the following is seen in Churg-Strauss syndrome?
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Churg-Strauss syndrome is a small vessel vasculitis. The acute presentation includes skin lesions, eosinophilia and asymmetric mononeuritis multiplex. There can be a prodromal period lasting many years in which the patient can have allergic rhinitis, nasal polyposis and asthma. Treatment is by high dose steroids and cyclophosphamide. Maintenance therapy is by low dose steroids, azathioprine, methotrexate and mycophenolate mofetil. Ref: Davidson's Principles and Practice of Medicine, 22nd edition, p1118
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Medicine
|
All India exam
|
Allergic rhinitis
|
Which of the following pontic designs require surgical procedure?
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The ovate pontic is the pontic design that is most esthetically appealing. Its convex tissue surface resides in a soft tissue depression or hollow in the residual ridge, which makes it appear that a tooth is literally emerging from the gingiva.
Careful treatment planning is necessary for successful results. Socket-preservation techniques should be performed at the time of extraction to create the tissue recess from which the ovate pontic form will appear to emerge.
For a preexisting residual ridge, surgical augmentation of the soft tissue is typically required. When an adequate volume of ridge tissue is established, a socket depression is sculpted into the ridge with surgical diamonds, electrosurgery, or a dental laser.
Key Concept:
For a preexisting residual ridge, surgical augmentation of the soft tissue is typically required. When an adequate volume of ridge tissue is established, a socket depression is sculpted into the ridge with surgical diamonds, electrosurgery, or a dental laser.
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Dental
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Ovate
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Mild hoarseness with stridor is seen in:
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(b) Bilateral abductor palsy(Ref. Current Diagnosis & Treatment Otolaryngology, Lalwani, 3rd ed., 478)Laryngomalacia and tracheal stenosis do not affect the VC hence voice remain normal in these though stridor is present.
|
ENT
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Larynx
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Bilateral abductor palsy
|
Mechanism of action of bromocriptine is:
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Pharmacology
| null |
Agonism at D2 receptors
|
Bruxism occurs in _______ phase of sleep
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Bruxism can occur in any stage of sleep or at arousal from sleep. It is most common in stage N1 and N2 and least common during REM sleep Ref: guyton and hall textbook of medical physiology 12 edition page number: 721,722,723
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Physiology
|
Nervous system
|
NREM II
|
Which of the following is not a type of teukoplakia:
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Pathology
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Bullous
|
An infant presents with hypotonia and hyporeflexia. During his intrauterine period there was polyhydramnios and decreased fetal movements. Most probable diagnosis is -
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Ans. is 'a' i.e., Spinal muscular atrophy o Out of the given options only spinal muscular atrophy is able to cause hypotonia and hyporeflexia during infancy. Rest of them either present late in childhood or do not give the symptoms. o Polyhydromnios and decreased fetal movements can occur in any neuromuscular disorder which present during intrauterine life. o Lets see each option one by one. Spinal muscular atrophy (SMA) SMA is a degenerative disease of motor neurons that begin in fetal life and continue to progress in infancy and childhood. o The cardinal features are: Hypotonia Generalized weakness Absent tendon stretch refluxes Involvement of tongue face and jaw muscle but sparing of extraocular muscle and sphincters. Congenital mytonia o Congenital myotonia or myotonia congenita is a chloride channel defect of skeletal muscle. o There is weakness and generalized hyperophy of muscles. o Its ruled out as Presents in early childhood (2-3 years age) Deep tendon reflexes are preserved. Congenital myaesthenia o Its a disease of neuromuscular junction similar to myasthenia gravis except that its not autoimmune but rather due to genetic mutations. o It presents in infancy and childhood with symptom similar to myasthenia gravis. o It can be ruled out as? o It does not present in the intrauterine life (so does not cause polyhydramnios). DTRs are preserved Muscular dystrophies o Muscular dystrophy refers to a group of hereditary progressive diseases. o It includes Duchenes muscular dystrophy Limb-girdle Congenital myopathies Becker Myotonic dystrophica o All of these except congenital myopathies are easily ruled out as they present in childhood age. some may rarely present in infancy but never in the intrauterine life. o Congenital myopathies are the most difficult one to rule out. They present with hypotonia in infancy. It may also present in intrauterine life. o Only reason I'm with 'Spinal muscular atrophy' is that congenital myopathy is a very rare disease.
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Pediatrics
| null |
Spinal muscular atrophy
|
Sterilization control used in membrane filters is
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Sterilization control for membrane filters is Brevundimonas diminuta and sarratia marcescens.
|
Microbiology
| null |
Brevundimonas diminuta
|
Halo sign and handkerchief test are positive in-
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Ans. is 'a' i.e., CSF Rhinorrhoea Detection of CSF Leak in CSF Rhinorrhoea1) Biochemical testso Concentrations of Glucose are higher in CSF than in nasal discharge. Glucose value > 30-40 mg% protein value <100 mg % (max 200 mg %) support a diagnosis of CSF leako Presence of b2 transferrin is the most definitive test for detection of CSF and b2 transferrin assay is the test of choice when a confirmatory test is needed, because of high sensitivity as well as specificity.o b-trace protein (prostaglandin D synthase) is also used, however it is nonspecific as it is also present in human testes, heart and seroma.2) Basic clinical testso Tissue test (Handker chief test):- Unlike nasal mucous, CSF does not cause a tissue to stiffeno Filter paper test:- Sample of nasal discharge on a filter paper exhibits a light CSF border and a dark central area of blood, i.e., double ring sign or halo sign.o Queckensted test:- Compression of the jugular vein leas to increased CSF leak due to increase in ICPo Rhinoscopy:- Visualization of CSF leak from paranasal sinus.3) CSF tracerso Intrathecal fluorescein dye adminstration, radionuclide cisternography, CT cisternography.
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ENT
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Trauma of Nose and Face
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CSF Rhinorrhoea
|
A sea snake is -
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Forensic Medicine
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Musculotoxic
|
Rotavirus vaccine- contraindication are all of the following EXCEPT?
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ROTAVIRUS VACCINE- - Live oral vaccine - Given at 6,10 & 14 weeks (maximum age- 1 year) - Strain used- 116E strain of Indian origin - Contraindications: SCID Previous history of Intussusception / severe allergic reaction to a previous dose of the vaccine.
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Pediatrics
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Types of vaccines
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Child on top feeds
|
Which of the following prostaglandin analogues used in Glaucoma
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(Latenoprost): Ref: 88-KDT, 394-Khurana 3rd (147-KDT 6th)* Prostagland analogues used in Peptic ulcer are - Misoprostol Enprostil, Rioprostil (588-KDT)* LATANOPROST (0.0005%) It is synthetic drug which is an ester analogue of prostagland in F2a* It acts by increasing uveoscleral outflow and by causing reduction in episcleral venous pressure* Side effects - conjunctival hyperaemia, foreign body sensation and increased pigmentation of the iris.
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Pharmacology
|
Prostaglandins
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Latanoprost
|
Which can cause loose body in the joint -
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Ans. is 'c' i.e., OA o Causes of loose bodies includei) Osteoarthritisiii) Osteochondral fracture (injury) v) Synovial chondromatosisii) Osteochondritis dessicansiv) Charcot's disease o Among these, osteochondral fracture causes single loose bodies, while all other can cause multiple loose bodies, maximum by synovial chondromatosis (up to hundrades).
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Orthopaedics
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Arthritis
|
OA
|
Which of the following is an example of disability limitation?
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Resting affected limbs in neutral position Repeat from May 06 & 07 Disability limitation is the mode of intervention used if the patient presents in late pathogenic phase. The objective is to prevent the transition of the disease proecess from impairment to handicap. The sequence of events leading to disability and handicap are: Disease ---> impairment -4 disability -4 handicap Impairment - is defined as any loss or abnormality of psychological, physiological or anatomical structure or function eg. loss of foot, defective vision or mental retardation. Disability - it is inability to carry out ceain activities considered normal for human beings, because of his 'impairment'. Handicap means that the individual with 'disability' is not able to perform his duties and obligations expected of him in the society. For example: Accident is the disease (or disorder) Loss of foot is the impairment Cannot walk is the disability Unemployed is the handicap Lets see other Modes of intervention in the disease process. Modes of Intervention Modes of intervention can be defined as any attempt to interrupt the usual sequence of any disease process (right from the risk factors to handicap) There are 5 modes of intervention: Health promotion Specific protection Early diagnosis Disability limitation Rehabilitation I. Health promotion Health promotion is not directed against any paicular disease, but is intended to improve the health of people through a variety of interventions like: i) Health education ii) Environmental modifications - Like provision of safe water, installation of sanitary latrines, control of insects and rodents etc. iii) Nutritional interventions - Like food foification, child feeding programmes. iv) Lifestyle and behavioural changes 2. Specific protection is directed against specific disease through interventions such as : - Immunization - Chemoprophylaxis - Protection from carcinogens etc. 3. Early diagnosis and treatment It involves detecting and treating the disease while the biochemical morphological and functional changes are still reversible. Thus it prevents ove disease and disablement. Early diagnosis and treatment are the only effective mode of intervention in following diseases. - Tuberculosis - Leprosy - STD 4. Disability limitation - Already described 5. Rehabilitation It is the combined and coordinated use of medical, social, educational and vocational measures for enabling the handicapped persons to achieve social integration (social integration is defined as the active paicipation of disabled and handicapped people in the mainstream of community life) Option 'a' - Reducing occurence of polio by immunization is specific protection Option 'b' - Arranging for schooling of child suffering from PRPP is rehabilitation Option 'c' - Resting affected limbs in neutral position disability limitation Option 'd' - Providing calipers for walking rehabilitation
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Social & Preventive Medicine
| null |
Resting affected limbs in neutral position
|
MRI is the investigation of choice in all of the following complications of CSOM except:
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MRI gives little information in bone disease and is not useful in coalescent mastoiditis' in which CT scan would be the investigation of choice. It shows bone destruction and coalescence of mastoid air cells. In Bezold abscess, size, extent and location of abscess in soft tissues can be appreciated.Similarly, extradural abscess and cerebral abscess are better appreciated in MRI.
|
ENT
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Ear
|
Coalescent mastoiditis
|
When launching a study, many respondents are invited, some of whom fail to come, this is called
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.
|
Social & Preventive Medicine
|
Epidemiology
|
Response bias
|
A patient with salicylic acid poisoning has the following arterial blood gas analysis report: pH = 7.12; PCO2 = 18 mmHg; HCO3 = 12 mmol/L. The resulting acid-base abnormality can be best labeled as:
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Ans. is 'a' i.e. Metabolic acidosis with respiratory alkalosisRef. Harrison 17th/e p 288 & 16th/e p 2591, 266 (15th/e page 284, 286,187)Also see June 2000 Q. No. 94.In patients with salicylate poisoning, initially the acidic metabolites of salicylic acid accumulate and cause metabolic acidosis.This causes the following acid base reaction to shift to left (because of addition of H) CO2 + H20 = H2CO3 = H+ + HCO3-This causes decrease in extracellular HCO3* This in turn stimulates the medullary chemoreceptors to increase ventilation and return the ratio of / PaCO2 and thus pH towards normal* The formula given to predict the degree of compensation required for simple form of metabolic acidosis is PaCO2 = 1.5 x + 8 or you can say that the PaCO2 is expected to decrease 1.25 mm of Hg for each mmol/L decrease in The normal values of PCO2 and HCO3-Arterial PC02 - 40 +- 2 mm HgArterial - 24 +- mm HgThus a patient with metabolic acidosis and of 12 mmol/L would be expected to have a PaCO2 between 24 and 28 mm Hg. (to compensate for the acidosis)Values of PaCO2 below 24 or greater than 28 mm Hg will mean mixed disturbance.If PaCO2 is < 24 it means metabolic acidosis + respiratory alkalosis (hyperventilation has led to excess CO2 washout causing respiratory alkalosis)If PaCO2 > 28 it means - metabolic acidosis respiratory acidosisHere is a table giving predictions of compensatory response on simple acid base disturbance. Prediction of Compensatory Responses on Simple Acid-Base DisturbancesDisorderPrediction of CompensationMetabolic acidosisPaCO2 =(1.5xHCO3-) +8 OrPaCO2 will | 1.25mmHg per mmol/L | in OrPaCO22 = + 15Metabolic alkalosisPaCO2 will | 0.75 mmHg per mmol/L | in orPaCO2 will | 6 mmHg per 10-mmol/L | in OrPaCO2 = + 15Respiratory AlkalosisAcute will | 2 mmol/L per 10-mmHg | in PaCO2Chronic will | 4 mmol/L per 10-mmHg | in PaCO2Respiratory acidosisAcute will | 1 mmol/L per 10-mmHg T in PaCO2Chronic will | 4 mmol/L per 10-mmHg | in PaCO2
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Medicine
|
Fluid & Electrolyte
|
Metabolic acidosis with respiratory alkalosis
|
Which of the following drugs is best for reducing pro teinuria in a diabetic patient?
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ACE inhibitors like lisinopril, perindopril, ramipril and ARBs like losaan, telmisaan could decrease the incidence of diabetic nephropathy by decreasing protein levels in the urine especially albumin They r DOC for diabetes with HTN. Ref: KD Tripathi 8th ed.
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Pharmacology
|
Cardiovascular system
|
Perindopril
|
Drug of choice for precocious pubey:
|
Treatment of precocious pubey: Rx the underlying cause Long acting GnRH analogues (Leuprolide)
|
Pediatrics
|
Disorders of Pubey
|
GnRH agonists
|
Awareness of having a disease is
|
Ans. a (Insight). (Ref. Psychiatry by Niraj Ahuja, 5th ed., 14, 41, 57, 72, 85, 95, 171)Term DefinitionPerseverationis persistent repetition of words beyond their relevance.Verbigerationis senseless repetition of same words or phrases.Delusionsare false unshakable belief in something that is not true.Insightis awareness of being diseased or sick.Insight is preserved in OCD.Insight is rated on six point scale from one to six:# Complete denial of illness# Slight awareness of being sick and need help, but denying# Awareness of being sick, but attributed to external/physical factors.# Awareness of being sick due to something unknown in itself.# Intellectual insight.# True emotional insight.
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Psychiatry
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Miscellaneous
|
Insight
|
Carbohydrate-related to blood grouping?
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The major blood groups of this system are A, B, AB, and O.O type RBCs lack A or B antigens. These antigens are carbohydrates attached to a precursor backbone, may be found on the cellular membrane either as glycosphingolipids or glycoproteins, and are secreted into plasma and body fluids as glycoproteins. H substance is the immediate precursor on which the A and B antigens are added. This H substance is formed by the addition of fucose to the glycolipid or glycoprotein backbone. The subsequentaddition of N-acetylgalactosamine creates the A antigen, whereas the addition of galactose produces the B antigen.Reference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 138e; Transfusion Biology and Therapy
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Surgery
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General surgery
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Fucose
|
All of the following factors decrease the minimum alveolar concentration (MAC) of an inhalational anaesthetic agent except
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MINIMUM ALVEOLAR CONCENTRATION: The MAC of an inhaled anesthetic is the alveolar concentration that prevents movement in 50% of patients in response to a standardized stimulus (eg, surgical incision). MAC is a useful measure because it mirrors brain paial pressure, allows comparisons of potency between agents, and provides a standard for experimental evaluations. Ref: Miller&;s anesthesia 8th edition Ref: Morgan & Mikhail&;s clinical anesthesiology 6e
|
Anaesthesia
|
Fundamental concepts
|
Hypocalcemia
|
A 27-year-old patient with a chief complaint of mild veigo of 3-months duration is seen by a neurologist. Examination reveals a positional (horizontal and veical) nystagmus that is bidirectional. The patient repos the absence of tinnitus. Which of the following is the most likely etiology of veigo?
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Pathologic veigo is generally classified as peripheral (labyrinthine) or central (brainstem or cerebellum).The clinical presentation, in this case, is most consistent with central veigo. Positional (especially horizontal) nystagmus (to-and-fro oscillation of the eyes) is common in the veigo of central origin, but absent or uncommon in peripheral veigo. The chronicity of the veigo is characteristic of central veigo, whereas the symptoms of peripheral veigo generally have a finite duration and may be recurring.Tinnitus and/or deafness is often present in peripheral veigo, but absent in central veigo. The flocculonodular lobe, or vestibulocerebellum, is connected to the vestibular nuclei and paicipates in the control of balance and eye movements, paicularly changes in the vestibuloocular reflex (VOR), which serves to maintain visual stability during head movement.A lesion of this area of the cerebellum may result in veigo and nystagmus, whereas the spinocerebellum is involved in the coordination of limb movement.
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Microbiology
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All India exam
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Lesion of the flocculonodular lobe of the cerebellum
|
Cephalosporin that does not require dose reduction in patient with any degree of renal impairment is:
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CEPHALOSPORINS These are a group of semisynthetic antibiotics derived from &;cephalosporin-C&; obtained from a fungus Cephalosporium. They are chemically related to penicillins; the nucleus consists of a P-lactam ring fused to a dihydrothiazine ring, (7-aminocephalosporanic acid). By addition of different side chains at position 7 of [3-lactam ring (altering spectrum of activity) and at position 3 of dihydrothiazine ring (affecting pharmacokinetics), a large number of semisynthetic compounds have been produced. Cefoperazone: Like ceftazidime, it differs from other third generation compounds in having stronger activity on Pseudomonas and weaker activity on other organisms. It is good for S. typhi and B. fragilis also, but more susceptible to Beta lactamases. The indications are-severe urinary, biliary, respiratory, skin-soft tissue infections, meningitis and septicaemias. It is primarily excreted in bile; half life is 2 hr. It has hypoprothrombinaemic action but does not affect platelet function. A disulfiram-like reaction with alcohol has been repoed. Dose: 1-3 g i.m./i.v. 8-12 hourly ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:705,706
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Pharmacology
|
Chemotherapy
|
Cefoperazone
|
Germ cell tumor(s) of paediatric includes all except?
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Ans. is 'b' i.e., Leydig cell tumor Germ cell tumors o Germ cell tumors, as the name suggests, arise from Primordial germ cells (Precursor germ cells or gametocytes), o Germ cells develops early in life. In growing fetus, germ cells migrate from their point of origin to the gondal area. o Germ cells that still have to reach the gonads are called primordial germ cells. o After reaching to gonads these become mature germ cells and the end products of germ cell cycle are the egg or sperm. o Germ cell tumors arise from primordial germ cells. o Therefore germ cells tumor may be : Gonadal (In testis or ovary) ii) Extragonadal : - When primordial germ cells fail to reach the right location and divide at the site of arrest. Extra-gonadal germ cell tumors may occur at mediastinum (most common site), retroperitonium (2nd most common site), brain, pineal gland, sacrococcygeal region. o Germ cell tumor are : Seminoma/dysgerminoma Embryonal carcinoma Yolk/sac (endodermal sinus) tumor Choriocarcinoma Teratoma Non-germ cell gonadal tumors o These tumors occur in adults. These may occur very rarely in children and occur predominantly in ovary. Tumors are : - i) Surface epithelial tumors : - Serous tumor, mucinous tumor, Brenner tumor etc. ii) Sex cord stromal tumors : - Granulosa-theca cell tumor, Seoli-Leydig cell tumor.
|
Pediatrics
| null |
Leydig cell tumor
|
Regarding the action of Anti Diuretic Hormone (ADH) all are true, except:
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ADH/Vasopressin is stored in the posterior hypothalamus and is released into the blood stream when the effective osmotic pressure of plasma is increased above 285mOsm/kg. Its secretion is regulated by osmoreceptors located in the anterior hypothalamus. Vasopressin secretion is increased in: Increased effective osmotic pressure of plasma Decreased ECF volume Pain, emotion, stress, exercise Nausea and vomiting Standing Clofibrate, carbamazepine Angiotensin II Vasopressin Secretion Decreased Decreased effective osmotic pressure of plasma Increased ECF volume Alcohol Effects of vasopressin: It increases the permeability of the collecting ducts of the kidney so that water enters the hypeonic interstitium of the renal pyramids. V1A receptors mediate the vasoconstrictor effect of vasopressin and is potent stimulator of vascular smooth muscle. It cause glycogenolysis in the liver. V1B receptors in the anterior pituitary mediate increased secretion of ACTH from the coicotropes.
|
Physiology
| null |
ADH secretion occurs when plasma osmolality is low
|
The medium of choice culturing yeast form of dimorphic fungi is:
|
Ans. is 'c' i.e., SDA with antibioticsSDA with antibiotics (Chloramphenicol) is always preferred over plain SDA to avoid bacterial contamination and make it more selective.
|
Microbiology
|
Mycology
|
SDA with antibiotics
|
True statements regarding DMPA includes all the following except :
|
Risk of endometrial cancer is substantially reduced by past use of DMPA Noncontraceptive benefits of DMPA:Anemia, PID, Ectopic pregnancy, and Endometrial cancer are repoedDMPA benefits women with sickle cell diseaseRef: Novak and Bereks Gynecology; 15th Edition; Chapter 10
|
Gynaecology & Obstetrics
|
Contraception
|
Protects against ovarian cancer
|
Which of the following does not come in contact with anterolateral surface of left kidney?
|
A small medial area of the superior pole is related to the left suprarenal gland. Approximately the upper two-thirds of the lateral half of the anterior surface is related to the spleen. A central quadrilateral area lies in contact with the pancreas and the splenic vessels. Above this a small variable triangular region, between the suprarenal and splenic areas, is in contact with the stomach. Below the pancreatic and splenic areas, a narrow lateral strip which extends to the lateral border of the kidney is related to the left colic flexure and the beginning of the descending colon. Ref: Gray's anatomy 40th edition, Chapter 91.
|
Anatomy
| null |
Liver
|
Which of the following is TRUE regarding classical spontaneous bacterial peritonitis ?
|
Spontaneous bacterial peritonitis (SBP) is one of the potentially lethal complications of cirrhosis and is defined as infected ascites in the absence of any recognizable secondary cause of infection. .UGI bleeding and abdominal pain were the most common presenting symptoms of SBP SBP is an acute ascites infection an ascitic fluid polymorphonuclear (PMN) cell count of >=250 cells/mm3 both with or without a positive ascitic fluid bacterial culture. SBP can be differentiated from secondary bacterial peritonitis by the absence of a surgically treatable intra-abdominal source of infection Ref Davidson edition23rd pg 811
|
Medicine
|
G.I.T
|
Ascitic fluid neutrophil count is > 250/mm'
|
Non specific esterase is positive in all the categories of AML except
|
Non specific esterase on cytochemistry is strongly positive in M5(acute monocytic leukemia- Schilling type) and M4(acute myelomonocytic leukemia -Naegeli type) which have monocytic component.It is also positive in M3(acute promyelocytic leukemia).But non specific esterase is negative in M6(acute erythroleukemia-Di Guglielmo's syndrome),which shows positive for Periodic acid-Schiff. Reference:Textbook of pathology-Harsh Mohan,6th edition,page no:362.
|
Pediatrics
|
Childhood tumors
|
M6
|
A young patient presents with enlargement of costocondral junction and with the white line of fraenkel at the metaphysis. The diagnosis is-
|
*Enlargement of costochondral junction and white line of Frankel are seen both in scurvy and rickets. *However, best answer here is scurvy as white line frankel is seen in healing rickets, not in active rickets. And rickets refers to active disease. ref : maheswari 9th ed
|
Anatomy
|
Metabolic and endocrine disorders
|
Scurvy
|
A 54-year-old woman presents with prominent scattered erythematous papules on the right side of her forehead. She had "burning" pain and hypersensitivity in that area for the past 2 days. Her pain is localized to the right supraorbital area and the right aspect of the dorsum of her nose. She denies headaches, mental status changes, or recent infections. What is the most plausible diagnosis?
|
Woman is suffering from herpes zoster, or "shingles" - a late complication of prior infection with varicella zoster virus. The virus remains latent in the ganglia of sensory nerves after the primary infection. The characteristic shingles rash is always confined to a dermatome and does not cross the midline. Specifically, the area described by the patient is the right V1 dermatome.
|
Dental
|
Viral infections
|
Varicella zoster
|
Atropine is used in organophosphate poisoning because of its
|
Refer kDT 6/e p 106 atropine acts as antagonist in muscarinic receptors. It has no activity on nicotinic receptors and do not interfere with the release of acetylcholine
|
Anatomy
|
General anatomy
|
It is competitive antagonist of acetylcholine
|
The major functional difference between DNA and RNA is
| null |
Physiology
| null |
DNA carries the information in all living organisms
|
Most "Radiosensitive" Tissue is:
|
Bone-marrow
|
Radiology
| null |
Bone-marrow
|
Which of the following drugs is associated with the untoward side effect of renal tubular damage?
|
Cisplatin is a highly emetic and nephrotoxic agent.
Streptozocin causes the destruction of β-cells of the pancreas and may result in hyperglycemia.
Methysergide can cause retroperitoneal fibrosis on long-term use.
Cyclophosphamide can result in hemorrhagic cystitis.
|
Pharmacology
| null |
Cisplatin
|
If urine sample darkens on standing, the most likely condition is :
|
Alkaptonuria a condition d/t defective homogentisate 1, 2- dioxygenase (1/t defective tyrosine degradation) usually presents after age of 40 with characteristic triad of Homogentisic aciduria (which blacken/darkens on exposure to air /standing and is strongly Benedict's positive), Ochronosis (i.e black pigmentation of cailage & collagenous connective tissue), and Ahritis of large joints
|
Biochemistry
| null |
Alkaptonuria
|
The different semen in case of gang rape is identified by:-
|
Single photon fluorimetry has been used to differentiate between different semen in a gang rape case TESTS FOR SEMINAL STAINS Creatine phosphokinase test Acid phosphatase testQ Florence testQ (Choline iodide crystals) Barberio's test (crystals of spermin picrate)
|
Forensic Medicine
|
Trace evidences
|
Single photon flourimetry
|
Submucosal fibroid is detected by :
|
Ans. is a, b and c i.e. Hysteroscopy; Hysterosalpingography; and USG (Transabdominal) USG * Ultrasound is the main diagnostic tool in case of fibroid.deg It checks the numberdeg, locationdeg and sizedeg of fibroids and helps to reduce overlooking small fibroids during surgery (which might lead to persistence or recurrence of symptoms). USG findings in case of Fibroid Enlarged and distoed uterine contour Depending on connective tissue amount -- fibroid may have varying echogenecity (hypoechoic or hyperechoic. Vascularisation is seen at periphery. Hysteroscopy or hysterosalpingography : These methods are useful to detect submucous fibroid in unexplained infeility and repeated pregnancy wastage. The presence and site of submucous fibroid can be diagnosed by direct visualization during hysteroscopy or indirectly as a filling defect on HSG. Hysteroscopy also allows its excision under direct vision. Uterine Curettage : It can also help in diagnosis of submucous fibroid by feeling of a bump during curettage.deg Laparoscopy : is helpful if uterine size is less than 12 weeks, for detection of a subserous fibroid. It can also differentiate a pedunculated fibroid from an ovarian tumour not revealed by clinical examination and ultrasound. Investigation which can be done is MRI.deg Role of Doppler in diagnosis of Fibroid : Leiomyomas have characteristic vascular patterns which can be identified by color flow doppler. A peripheral rim of vascularity from which a few vessels arise and penetrate into the centre is seen. Doppler imaging can be used to differentiate an extrauterine leiomyoma from other pelvic masses or a submucous leiomyoma from an endometrial polyp or adenomyosis. Also know : Best investigation for submucous fibroid - Hysteroscopydeg Best investigation to detect fibroid (in general)deg -- USG (Pt choicer -- MRI (2f'd choicer
|
Gynaecology & Obstetrics
| null |
All
|
The tumor causing polycythemia due to erythropoietin production is -
|
<p>The tumors causing inappropriate rise in erythropoietin are renal cell caarcinoma,hepatocellular carcinoma ,cerebellar hemangioblastoma.</p><p>Reference :Harsh mohan textbook of pathology sixth edition pg no 359.</p>
|
Medicine
|
Haematology
|
Cerebellar hemangioma
|
A female with IUCD develops pelvic inflammatory disease. which of the following should be done:
|
Ans. is 'a' i.e., Keep the IUCD, give antibiotic, follow up for antibiotic response & then take decision regarding IUCDremoval If an IUD user receives a diagnosis of PID, the IUD does not need to be removed. However, the woman should receive treatment according to these recommendations and should have close clinical follow-up no clinical improvement occurs within 48-72 hours of initiating treatment, providers should consider removing the IUD.PID treatment regimens must provide empiric, broad spectrum antibiotic coverage of likely pathogens
|
Gynaecology & Obstetrics
| null |
Keep the IUCD, give antibiotic, follow up for antibiotic response & then take decision regarding IUCD removal
|
Which of the following culture medium is made by adding Agar:
|
Ans. (a) Solid mediumRef: Microbiology by Ananthanarayan and Paniker 8th ed. / 39-40GROWING BACTERIAL CULTURES IN LIQUIDNUTRIENT BROTH* Nutrient broth is a liquid bacterial growth medium made of powdered beef extract and short chains of amino acids that have been dissolved in water.* Liquid medium is convenient to use for growing bacteria in test tubes, and can reveal information about the oxygen requirements of bacteria growing within.* Bacteria that require oxygen will grow close to the water s surface, and bacteria that cannot tolerate the presence of oxygen will grow at the bottom of the test tube.B GROWING BACTERIAL CULTURES ON SOUP MEDIA* Broth media can be made solid by adding agar, a gel like polysaccharide extracted from red algae.* Broth with about 1.5% agar added will be liquid when heated, but solid at room temperature, making it easy to pour into a vessel, such as a Petri dish or test tube when hot.* The solution then becomes solid once cooled.
|
Microbiology
|
Culture media and method
|
Solid medium
|
Amphiphatic helices are
|
Many α helices have predominantly hydrophobic R-groups projecting from one side of the axis of the helix and predominantly hydrophilic R-groups projecting from the other side. These amphipathic helices are well adapted to the formation of interfaces between polar and nonpolar regions such as the hydrophobic interior of a protein and its aqueous environment. Clusters of amphipathic helices can create channels, or pores, through hydrophobic cell membranes that permit specific polar molecules to pass.
Note: Clusters of twisted strands of β sheet are called β barrels.
Ref: Harper’s illustrated biochemistry. 30th edition page no: 37
|
Biochemistry
| null |
α helices having predominantly hydrophobic R-groups projecting from one side and predominantly hydrophilic R-groups projecting from the other side of the axis of the helix
|
In Duke's classification of cancer rectum, B2 denotes -
| null |
Pathology
| null |
Limited to thickness of bowel wall
|
Maximum density of goblet cells is seen in
|
Goblet cells form the mucus layer of the tear film They are maximum nasally and least superiorly REF:Refer Khurana 6th edition page number 59
|
Ophthalmology
|
Conjunctiva
|
Nasal conjunctiva
|
Which is the most common cytogenetic abnormality in myelodysplastic syndrome (MDS)?
|
Monosomy 7 is most common cytogenetic abnormality in children whereas 5q - is seen frequently in adults and is very rare in children. Although 5q may be commoner than monosomy 7 in some settings, overall monosomy 7 appears more common. Myelodysplastic syndromes are a group of stem cell disorders with altered hematopoesis causing anemia. It is the most common hematologic cancer in the older adult. Course may be indolent or rapidly progress to an AML. They are characterized by the constellation of cytopenias, usually hypercellular marrow, and a number of morphologic and cytogenetic abnormalities. Ref: The Myelodysplastic Syndromes: Pathobiology and Clinical Management By John M. Bennett, Page 264 ; Wintrobe's Clinical Hematology, 10th Edition ; Neoplastic Diseases of the Blood, Issue 439, Edited By Peter H. Wiernik, 4th Edition, Page 114 ; Neoplastic Hematopathology By Daniel M. Knowles, 2nd Edition, Page 397
|
Pathology
| null |
Monosmy 7
|
Appendicitis-like syndrome is caused by
|
Yersinia enterocolitica: Type 1- Enterocolitis and gastroenteritis; Type 2- mesenteric adenitis and inflammatory terminal ileitis that may mimic appendicitisYersinia pseudotuberculosis: also mimics appendicitisRef: Ananthanarayan 9th edition, p324
|
Microbiology
|
Bacteriology
|
Y. pseudotuberculosis
|
Which of the following parameters adds predictive information regarding cardiovascular risk stratification and the measurement of serum cholesterol?
|
Recent studies have demonstrated that markers of inflammation correlate with coronary risk and that inflammation plays a role in atheromatous plaque instability. Elevations of C-reactive protein, (CRP) identify patients at increased risk of myocardial infarction (MI) and poor outcome of acute coronary syndromes. Measurement of CRP adds information regarding risk stratification to standard risk factor such as hypeension, diabetes, smoking, and lipids. Elevations in homocysteine, lipoprotein A, and plasminogen activator factor I have all been associated with an increased risk at cardiovascular events; however, at the time none have been shown to be useful in populations to improve risk stratification.
|
Medicine
| null |
C-reactive protein
|
Side effects of oxygen therapy are all except:
|
B i.e., Increased pulmonary compliance Hyperoxia (oxygen toxicity) may lead to hypoventilation, hypercapnia (but not necessarily hypoxia), absorption atelectasis, decreaed vital capacity, deterioration of pulmonary compliance & blood gasesQ, interstitial edema, pulmonary fibrosis, tonic clonic seizure & retinopathy of prematurity d/t free radicle induced damage of sulfhydryl group enzymes, endotheliumQ, epithelium and surfactant systems
|
Anaesthesia
| null |
Increased pulmonary compliance
|
Irresistible urge to do a thing repeatedly is seen in
|
An obsession is defined as an idea, impulse or image which intrudes into the conscious awareness repeatedly, patient tries to resist against it but is unable to . an obsession is usually associated with compulsion and a compulsion is defined as a form of behaviour which usually follows obsessions,the behaviour is not realistic and is either irrational or excessive compulsion may diminish the anxiety associated with obsession (Ref: a sho textbook of psychiatry, Niraj Ahuja, 7th edition, pg no 95)
|
Psychiatry
|
Anxiety disorders stress disorders and grief
|
Obsessive - compulsive disorder
|
Duret haemorrhage is/are seen in:
|
D i.e. Brain Whiplash injury results from acute hyperextension of cervical spineQ in the region of C4 - C6 veebrae. Coup & Count-re coup lesions are most commonly seen in brainQ. Lucid interval is seen in insanity & epidural haemorrhageQ Fracture - ala - signature / signature fracture is also known as depressed fracture of skull vaultQ. Depressed/ Signature fracture are caused by heavy weapon with small striking surface eg. hammerQ. Pond or Indented fracture occur in childrenQ due to elasticity of their skull bones. -Duret haemorrhages are small areas of bleeding in anterior & paramedian upper brain stem (midbrain & pons)Q produced due to progressive rise of intracranial pressure 1/t coning or downward herniation of brainstem into foramen magnum. This results in stretching & shearing of perforators of basilar aery causing duret hemorrhage , tractional damage of pituitary stalk causing diabetes insipidus; Cushing triad (bradycardia, hypeension & respiratory irregularities), mid size non reacting pupil and brainstem death.
|
Forensic Medicine
| null |
Brain
|
CD 19 positive, CD22 positive, CD103 positive monoclonal B-cells with bright kappa positivity were found to comprise 60% of the peripheral blood lymphoid cells on flow cytometric analysis in a 55 year old man with massive splenomegaly and a total leucocyte count of 3.3 x 109/L. Which one of the following is the most likely diagnosis?
|
Answer is D (Hairy cell leukemia) Presence of massive splenomegaly, and granulocytopenia, alongwith characteristic immunophenotypic features (specially CD103) suggests the diagnosis of Hairy cell leukemia. CD103 is exclusively positive in Hairy cell leukemia and thus leaves no doubt as regards the correct diagnosis.
|
Medicine
| null |
Hairy cell leukemia
|
Most specific marker for myeloid series is
|
The markers for myeloid series are CD13, CD33, CD 11b, CD15, CD117 and cMPO. c MPO is the most lineage specific marker amongst these. Regarding other options, CD 34 - Myeloid and lymphoid blasts, stem cells, CD 45 - Leukocyte common antigen (nonerythroid hematopoietic cells), CD 99 - Ewing's sarcoma/primitive neuroectodermal cells.
|
Pathology
|
Diagnostic procedures
|
CD 117
|
Which surgical procedure has the highest incidence of ureteric injury?
|
The Weheim type of radical hysterectomy for cancer of the cervix is notorious for ureteric injury for which over-dissection of the ureter or accidental injury is most often responsible. Ref: Shaw's Gynaecology, 13th Edition, Pages 180-81; Dutta Gynecology, 4th Edition, Pages 391-92; Management of Common Problems in Obstetrics and Gynecology By T. Murphy Goodwin, Main N. Montoro, Laila Muderspach, Subir Roy, 2010, Page 325; Clinical Gynecology By Bhasker Rao, 4th Edition, 1998, Page 239.
|
Gynaecology & Obstetrics
| null |
Weheim's hysterectomy
|
An 18 year old student complains of lack of interest in studies for last 6 months. He has frequent quarrels with his parents and has frequent headaches. The most appropriate clinical approach would be:
|
B i.e. Rule out depressionLet us consider the options one by one. This can be a normal behaviour but use definitely need to rule out of few disorders before reaching this conclusion. Recent studies have suggested a possible correlation b/w migraine and behavioural problems. There is nothing in the question to point out towards migraine as a cause of the headache, not there are any specific behavioural problems that can be linked to migraine.Diagnostic criteria for appositional defiantdisorder (ADD) A. A pattern of negativistic, hostile, and defiant behaviour lasting for atleast 6 months, during which four (or more) of the following are present?Often loses temperOften argues with adultsOften actively defies or refuses to comply with adults' requests or rules.Often deliberately annoys peopleOften blames others for his or her mistakes or misbehaviourIs often touchy or easily annoyed by othersIs often spiteful and resentfulIs often spiteful or vindictiveNote: Consider a criterion met only if the behaviour occurs more frequently than is typically observed in individuals of comparable age and developmental level.B. The disturbance in behaviour causes clinically significant impairment in social, academic, or occupational functioning.C. The behaviours do not occur exclusively during the course of a psychotic or mood disorder.D. Criteria are not met for conduct disorder, and if the individual is 18 years or older, criteria are not met for antisocial personality disorder.Clinical manifestations of depression in children and adolescents AnhedoniaLoss of interest andenthusiasm in play,socializing, school, andusual activities; boredom;loss of pleasureDysphoric moodTearfulness; sad, downturned expression; slumpedposture; quick temper;irritability; angerFatigabilityLethargy and tiredness; noplay after schoolMorbid ideationSelf-deprecating thoughts,statements; thoughts ofdisaster, abandonment,death, suicide, orhopelessness.Somatic symptomsChanges in sleep or appetitepatterns; difficulty inconcentrating; bodilycomplaints, paicularlyheadache and stomachache.QFrequent quarrels with parents and lack of interest in studies for last 6 months are both consistent with a diagnosis of oppositional defiant disorder. However, children with oppositional disorder typically present to the clinic by the age of 8 years. Also headache has not been mentioned as a manifestation in this disorder. The presence of frequent headaches and age of presentation (18 years) make the diagnosis of appositional delusional disorders unlikely. So symptoms of the patient here are not enough to be diagnosed as ADD.Depression can occur at any age including adolescents and young adults. Lack of interest in school is a known feature (anhedonia). Restlessness & irritability are pa of dysphoric mood & explain frequent quarrels with parents. Also somatic symptoms like headache/ heaviness of head are known associations
|
Psychiatry
| null |
Rule out depression.
|
Which of the following is FALSE regarding Kishori Shakti Yojana?
|
It is a scheme for adolescent girls and is being implemented using the ICDS infrastructure. It targets girls between 11 - 18 years of age. It addresses their needs of self development, nutrition and health state's, literacy and numerical skills, vocational skills etc. Ref: Park, Edition 21, Page - 545.
|
Social & Preventive Medicine
| null |
Targets pregnant woman
|
All of the following statements about synovial fluid are true. Except-
|
synovial fluid is plasma transudate from synovial capillaries, modified by secretory activities of type-B synovial lining cells.
|
Orthopaedics
| null |
Secreted primarily by type A synovial cells
|
A 25 year old male was hospitalized with liver cyst due to Echinococcus granulosus. He refused to undergo surgery for removal of cyst. Therefore, albendazole was used at high dose for 3 months. This patient should be monitored for the toxicity to :
| null |
Pharmacology
| null |
Liver
|
ln which of the following transmission, meiosis occurs :
|
Primary to secondary spermatocyte
|
Anatomy
| null |
Primary to secondary spermatocyte
|
Copper-T is preferably inseed postnatal, after:
|
Timings of IUD inseion During menstruation or within 10 days of begining of menstrual period: Best time for IUD inseion Cervical canal diameter greatest, lesser expulsive, least risk of pregnancy. Immediate post-paum inseion: During 1st week after delivery before woman leaves hospital. High chance of perforation High chance of expulsion Post-puerperal inseion: 6-8 weeks after delivery Can be combined with follow up visit of mother and child. Not recommended after 2nd trimester aboion. Ref: Park 25th edition Pgno: 531
|
Social & Preventive Medicine
|
Demography and family planning
|
8 weeks
|
Consider the following statements regarding thyroid hormones-
|
Thyroid Hormones physiology The thyroid secretes predominantly thyroxine (T4) and only a small amount of triiodothyronine (T3); approximately 85% of T3 in blood is produced from T4 by a family of monodeiodinase enzymes that are active in many tissues, including liver, muscle, hea and kidney. Selenium is an integral component of these monodeiodinases. T4 can be regarded as a prohormone, since it has a longer half-life in blood than T3 (approximately 1 week compared with approximately 18 hours), and binds and activates thyroid hormone receptors less effectively than T3. T4 can also be conveed to the inactive metabolite, reverse T3. T3 and T4 circulate in plasma almost entirely (> 99%) bound to transpo proteins, mainly thyroxine-binding globulin (TBG). It is the unbound or free hormones that diffuse into tissues and exe diverse metabolic actions. Some laboratories use assays that measure total T4 and T3 in plasma but it is increasingly common to measure free T4 and free T3free hormone measurements is that they are not influenced by changes in the concentration of binding proteins. For example, TBG levels are increased by oestrogen (such as in the combined oral contraceptive pill) and this will result in raised total T3 and T4, although free thyroid hormone levels are normal. Ref - davidson 20e p656
|
Medicine
|
Endocrinology
|
Majority of the circulating T3 remains in bound form
|
who gave the concept of la belle indiffernce
|
CONTRIBUTIONS OF FREUD o Father of psychoanalysis He founded a type of psychotherapy called psychoanalysis. It is nothing but analyzing the psych(MIND) o Interpretation of dreams According to Freud dreams are royal road to unconscious In dreams several conflicts that are present in the unconscious comes to the consciousness in the form of dreams Thus by analyzing ones dreams we could understand the unconscious conflicts o Psychosexual stages of life o Freud divided development into 5 stages namely psycho sexual development o It is divivded namely oral , anal , phallic, latent, genital phase. o Conversion disorders conversion disorder is conveing a psychological pain to physical symptoms present physical symptoms which has some connection with unconscious conflict is called SYMBOLIZATION present physical symptoms which has some resemblance with illness in family members, which is called MODELLING patient has illness like neurological deficit but they have apparent in concern towards their own illness which is known as LA BELLE INDIFFERENCE main defense mechanism in conversion disorder is REPRESSION o Repression defence mechanism * REPRESSION is called QUEEN of defense mechanisms o COUCH and FREE ASSOSIATION * He introduced a technique called as a couch technique where he makes the patient lie on the couch, he asks the patient to speak from 'cabbages to kings. This method is called FREE ASSOSIATION. By allowing the patient to speak whatever that comes to their mind randomly so that by analyzing their thoughts we could understand the conflict in the unconscious. o Topographical theory of mind Freud gave topographical theory mind It is divided into pre conscious, unconscious, conscious Later he disregarded topographical theory of mind and gave structural theory of mind o Structural theory of mind It is divided into id, ego, super ego Id= instinctual desires like anger, hunger, sexual instinct Ego= function of mind to work based on ego to avoid guilt from super ego Super ego= based on moral principle, obtained from family members and relatives, teachers Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition pg no. 845
|
Anatomy
|
Treatment in psychiatry
|
freud
|
Vitamin A is stored in:-
|
HSCs (Hepatic Stellate Cells) are: Pericytes which exist in the space between parenchymal cells and liver sinusoidal endothelial cells of the hepatic lobule. Also called Vitamin A-storing cells, Lipocytes, Interstitial cells, Fat-storing cells or Ito cells, Perisinusoidal cells Store 50-80% of vitamin A in the whole body as Retinyl Palmitate. Extra information: Vitamin A - The fat-soluble vitamin A, as such is present only in foods of animal origin. However, its provitamins carotenes are found in plants Retinol, retinal and retinoic acid are regarded as vitamers of vitamin A. Function of vit A - Vitamin A is necessary for a variety of functions such as vision, proper growth and differentiation, reproduction and maintenance of epithelial cells. Deficiency manifestations of the eyes - nyctalopia is one of the earliest symptoms of vitamin A deficiency.
|
Biochemistry
|
NEET 2019
|
Ito cells
|
The best bone graft which can be utilized for reconstruction is:
| null |
Dental
| null |
lilac crest graft
|
The best parameter for assessment of chronic malnutrition is -
|
parks textbook of preventive and social medicine 23rd edition * height is a stable measurement of growth as opposed to body weight .whereas the weight reflects only the present health status of the child,height indicate the events in the past also. *low height for age also knownn as nutritional stunting or drawfting.it reflects past or chronic mal nutrition.
|
Social & Preventive Medicine
|
obstetrics,pediatrics and geriatrics
|
Height for age
|
True about the basic structure of atherosclerosis plaque is ?
|
Ans. is 'c' i.e., Convex pa formed by fibrous cap
|
Pathology
| null |
Convex pa formed by fibrous cap
|
Right border of heart is formed by all except -
|
Ans. is 'b' i.e., Right ventricle o Dont get confused with above question. Most probably this question has been framed by a radiologist. Read following factsi) Right border of heart is formed by (anatomically) - Right atrium.ii) Right border of heart is formed by (on X-ray PA view) - Right atrium (majority), SVC, I VC. o Similiarly-i) Left border of heart is formed by (anatomically) - Left atrium (mainly), left auricle.ii) Left border of heart is formed by (on X-ray PA view) - Aortic knucle, Pulmonary trunk, left auricle, left atrium, left ventricle.
|
Anatomy
|
Pericardium & Heart
|
Rightventricle
|
Rao and Singh's index is?
|
RAO & SINGH'S INDEX: - It is calculated as Weight (in kg) x 100/height2 (in cm) - Normal value: 0.14 - In children with malnutrition: 0.12 - 0.14
|
Pediatrics
|
Growth
|
Age-independent index
|
Adult scabies is characterized by?
|
A i.e. Involve palm & soles
|
Skin
| null |
Involve palm & soles
|
All are elevators of the larynx except -
|
Elevators : Primary elevators act directly as they are attached to the thyroid cartilage and include stylopharyngeus, salpingopharyngeus, palatopharyngeus and thyrohyoid. Secondary elevators act indirectly as they are attached to the hyoid bone and include mylohyoid (main), digastric, stylohyoid, geniohyoid.
Depressors : They include sternohyoid, sternothyroid and omohyoid.
|
ENT
| null |
Sternohyoid
|
Leukemia associated with Disseminated Intravascular Coagulation is:
|
Major Disorders Associated With Disseminated Intravascular Coagulation (DIC)
Obstetric Complications
Abruptio placentae
Retained dead fetus
Septic Abortion
Amniotic fluid embolism
Toxemia
Infections
Sepsis (gram-negative and gram-positive)
Meningococcemia
Rocky Mountain spotted fever
Histoplasmosis
Aspergillosis
Malaria
Neoplasms
Carcinomas of pancreas, prostate, lung and stomach
Acute promyelocytic leukemia
Massive Tissue Injury
Trauma
Burns
Extensive surgery
Miscellaneous
Acute intravascular hemolysis, snakebite, giant hemangioma, shock, heatstroke, vasculitis, aortic aneurysm, liver disease.
Robbins BASIC PATHOLOGY T E N T H E D I T I O N page no.487
|
Pathology
| null |
Acute promyelocytic leukemia
|
The effect of morphine which has least tolerance is?
|
ANSWER: (C) ConstipationREF: KDT 6th edition page 457Tolerance is exhibited to all actions except meiosis and constipation
|
Pharmacology
|
Opioids
|
Constipation
|
Stability of denture can be increased by
|
V-Y plasty procedure or Z plasty procedure is used for frenectomy procedure to increase the stability of denture.
|
Surgery
| null |
Both
|
'Meralgia paresthetica' is due to the compression of which off the follwoing nerves?
|
Meralgia Paraesthetica results from compression neuropathy of the lateral cutaneous nerve of thigh. It is also called Bernhardt-Roth syndrome. This nerve can be compressed as it runs through the inguinal ligament, just medial to the Anterior superior Iliac spine. Pain, numbness, tingling and paresthesia localised to anterolateral aspect of thigh. Metabolic disorder most notably diabetes is identified as the potential cause of this condition. Ref: Apley's System of Ohopedics and Fractures 8th Edition, Page 252; Lippincott's Primary Care Ohopedics, 2008, Page 87.
|
Surgery
| null |
Lateral cutaneous nerve of thigh
|
Example of secondary active transport-
|
Ans. is 'd' i.e., Na+-amino acid transport Transport mechanismExamplesSimple diffusionMovement of fats, oxygen, CO2 through lipid portion of membraneFacilitated diffusionMovement of glucose and some amino-acidsOsmosisMovement of water into and out of the cellPrimary active transportIons K+, Na+, Ca++, H+Secondary active transportGlucose or amino-acid into the cell along Na+ (Symport or cotransport) Ca+2, H+ out of the cell against Na+ (Antiport or countertransport)
|
Physiology
|
Transport Across Cell Membrane
|
Na+-amino acid transport
|
Microscopic examination of a specimen shows 'Schiller-Duval bodies'. This most probably will have:
|
Yolk sac tumor only occurs as a pure tumor in young males (at about 3 years of age). In adults, yolk sac tumors are pa of mixed germ cell tumors. One characteristic feature of yolk sac tumor is Schiller-Duval bodies, which resemble endodermal sinuses. Schiller-Duval bodies have a capillary at the core and are surrounded by a visceral and a parietal layer (i.e., resemble primitive glomerulus). Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture.
|
Gynaecology & Obstetrics
| null |
Yolk sac tumor
|
Pre-anaesthetic medication is given to ?
|
Ans. is 'd' i.e., All of the above Preanaesthetic medication Premedication (Preanaesthetic medication) refers to the use of drugs before anaesthesia to make it more pleasant and safe. The aims are : Relief of anxiety and apprehension preoperatively and to facilitate smooth induction. Amnesia for preoperative and postoperative events. Supplement analgesic action of anaesthetics and potentiate them. Decrease secretions and vagal stimulation (undesirable reflex). Antiemetic effect extending into postoperative period. Decrease acidity and volume of gastric juice so that it is less damaging if aspirated. Drugs used in premedication 1. Sedative - antianxiety - Diazepam / Lorazepam / Midazolam. Lorazepam is used most commonly. Midazolam is used for day care surgery. 2. Opioids - Morphine / pethidine 3. Anticholinergics -. Atropine / Hyoscine / Glycopyrrolate. 4. Neuroleptics Haloperidol / chlorpromazine / triflupromazine. 5. H2 blocker or proton pump inhibitor Ranitidine / Famotidine, omeprazole / Pantoprazole. 6. Antiemitics - Metoclopramide / Domperidone / Ondansetron.
|
Anaesthesia
| null |
All of the above
|
Rate limiting step in facilitated diffusion?
|
Ans. is'b'i.e., Conformational change in transpoer(Ref: Essentials of membrane Biophysics p. 25I).The relative slowness of the rate constant for conformational change reorienting the Solute-unoccupied transpoer (Step-4) makes it the rate-limiting step in the process of facilitated diffusion.
|
Physiology
| null |
Conformational change in transpoer
|
Fixed performance device is –
|
Ventimask (venturi mask) is a fixed performance (high flow) oxygen delivery device.
Nasal cannula, non-rebreathing mask (Hudson mask) and simple mask are variable performance (low flow) devices.
|
Anaesthesia
| null |
Ventury mask
|
Hemivertebra is a defect of:
|
Ans. A. Bodya. Vertebral bodies mainly develop from ventral sclerotome (VS) and thus hemivertebra is a defect of VS.b. Hemivertebra can lead to defects in the vertebral column - scoliosis.c. Posterior vertebral arches (PVA) contribute mainly to the lamina & spines. PVA are contributed by the dorsal sclerotome.
|
Anatomy
|
Thorax
|
Body
|
Not a metabolic product of urea cycle-
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Biosynthesis of urea occurs in five steps.
1) Carbamoyl phosphate synthase-I (CPS-I), a mitochondrial enzyme, catalyzes the formation of carbamoyl phosphate by condensation of CO2 and ammonia.
Two molecules of ATP are required for the reaction. CPS-I is the rate-limiting enzyme of the urea cycle. It is an allosteric enzyme and allosterically activated by N-acetyl glutamate.
2) Ornithine transcarbamylase catalyzes the formation of citrulline from carbamoyl phosphate and ornithine.
3) Argininosuccinate synthase catalyzes the formation of argininosuccinate from citrulline and aspartate.
This reaction requires 1ATP, but 2 high energy phosphate bonds are consumed as ATP is converted to AMP + PPi.
The amino group of aspartate provides one of the two nitrogen atoms that appear in urea (The other one is provided by ammonia NH4).
4) Argininosuccinate lyase (argininosuccinase) catalyzes the cleavage of argininosuccinate into arginine and fumarate.
Fumarate enters in TCA cycle.
5) Arginase catalyzes the formation of urea from arginine by hydrolytic cleavage of arginine to yield urea and ornithine.
Ornithine is thus regenerated and can enter mitochondria to initiate another round of the urea cycle.
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Biochemistry
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Alanine
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A patient was operated for forearm fracture under general anesthesia under tourniquet. Following surgery, he was unable to move his fingers and there was sensory loss over the whole hand. Most common type of injury is:
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Ans. A. NeuropraxiaTourniquet paralysis is usually Neuropraxia. Application of tourniquet may press on all the nerves passing beneath it, resulting in mostly neuropraxia.
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Orthopaedics
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Peripheral Nerve Injuries
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Neuropraxia
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Most common source of error in a false positive finding of dental caries is:
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Although this can be caused by a variation in the morphology of the tooth, the most common source of error is the misinterpretation of cervical burnout as dental caries. Cervical burnout produces an artifact that mimics a carious lesion near the cementoenamel junction (CEJ) area of the tooth.
As the X-ray beam meets the convex proximal surface of the tooth, those X-ray photons that pass almost tangentially through the tooth surface “see” less tooth structure than those photons that pass deeper through the tooth. This area of convexity is commonly located apical to the CEJ, near the normal height of the alveolar crest.
The thinner tooth structure here absorbs fewer X-rays; consequently the area appears relatively more radiolucent on an image. Cervical burnout can also be seen in multirooted teeth, when roots that are more buccally positioned do not overlap perfectly with a lingual or palatal root in a mesiodistal direction.
The presence of a shallow furcation on either the mesial or distal surface of the tooth can make the area appear more radiolucent. However, the presence of two overlapping roots can be confirmed by identifying the periodontal ligament spaces of each root.
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Radiology
| null |
Cervical burnout
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Tophi in gout found in all regions except
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Ans. is 'b' i.e., Muscle Location of Tophi They are classically located along the helix of the ear. Can also be seen in :- Fingers Toes Prepattelar bursa Olecranon Although gout typically cuases joint inflammation, it can also cause inflammation in other synol-based structures, such as bursae and tendons. Tophi are collections of urate crystals in the soft tissues. They tend to develop after about a decade in untreated patients who develop chronic gouty ahritis. Tophi may develop earlier in older women, paicularly those receiving diuretics.
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Medicine
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Muscle
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A mother comes with her 3 year old female child with complain of that child is not eating anything. Her weight is 11 kg (50th percentile) and height is 88 cm. (75th percentile). What should be done next –
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"Allowable normal range of variation in observation, is conventionally taken between 3'd and 97th percentile curves" -Ghai
This female child has weight (50 th percentile) and height (75th percentile) in normal range of variation (3rd-97th percentile).
So, nothing should be done actively and the parent should be assured that weight and height of the child are within normal range.
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Pediatrics
| null |
Nothing should be done actively and assure the parent
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Fornication and delusion of persecution, both are together seen in -
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This question is tricky one as tactile hallucination (fornication) and delusion of persecution are seen both in cocaine as well as amphetamine abuse.
Read the question carefully, examiner has asked about the presence of fornication and delusion of persecution together.
In amphetamine abuse these two do not occur together → fornication (tactile hallucination) is seen in chronic abuse, where as paranoid ideation (delusion of persecution) occurs in acute intoxication.
On the other hand both delusion of persecution and fornication are seen together in chronic cocaine abuse. "Cocaine abuse can present with auditory hallucinations, tactile hallucination including fornication and paranoid delusion (delusion of persecution)" .
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Forensic Medicine
| null |
Cocaine psychosis
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Lingual tonsils arise:
| null |
Pathology
| null |
As developmental anomalies
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IUCD must not be used in a woman with-
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Pelvic tuberculosis is an absolute contraindication for IUD inseion. Absolute contraindications for IUD Relative contraindications for IUD Suspected Pregnancy PID Vaginal Bleeding of undiagnosed etiology Ca Cervix,Uterus or Adnexa and other pelvic tumours Previous Ectopic Pregnancy Anaemia Menorrhagia History of PID since last pregnancy purulent cervical discharge Congenital uterine malformations Unmotivated person
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Social & Preventive Medicine
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Natural Methods, Barrier Methods, IUDs, OCPs
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Pelvic tuberculosis
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All enveloped helical RNA viruses belong to one large group, which includes all of the following except:
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Ans. d. Herpes
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Microbiology
| null |
Herpes
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Which toll like receptors are involved in action of bacterial endotoxins -
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Ans. is 'b' i.e., II o Ten different mammalian Toll like receptors (TRRs) have been identified --> TLR 1 to 10. o TLRs are involved in responses to widely divergent types of molecules that are commonly expressed by microbial but not mammalian cells. TLR Microbial ligand molecules Peptidoglycan of Gram (+)ve bacteria zymosan of fungi GPI anchor of Trypanosomes Lipoarabinomannan of mycobacteria LPS (endotoxin) of Leptospira Lipoproteins of bacteria Double - stranded DNA of viruses LPS (endotoxin) of all other gram (-)ve bacteria HSF 00 of chlamydia Flagellin of bacteria CpG DNA of bacteria and protozoa Note ? o Bacterial endotoxin of all gram (-)ve organisms, bind to TLR-4, except Leptospira. o Endotoxin of leptospira binds to TLR-2.
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Pathology
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II
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