Goodnight7/full_MedC-K · Datasets at Hugging Face

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True about Gaucher disease	This is an inborn error of metabolism due to failure of degradation of glucocerebrosides. The enzyme beta-glucosidase is deficient in this condition.Ref: DM Vasudevan, 7th edition, page no: 192	Biochemistry	Metabolism of carbohydrate	Due to deficiency of enzyme b-Gluco-cerebroisidase
Stages of pneumonia are all except:-	The stages of pneumonia/consolidation are:- i. Stage of Exudation ii. Stage of Red hepatisation iii. Stage of Grey hepatisation iv. Stage of Resolution	Medicine	null	Stage of Cavitation
Most common Complication of TIPSS procedure	Since systemic blood is shunted toxins ( NH3) travel to brain causing encephalopathy. Hence TIPSS is contra indicated in encephalopathy patients.	Surgery	null	Hepatic Encephalopathy
Schirmer's test detects abnormality of which nerve?	(Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 389)Schirmer's test is used for the production of tear by lacrimal glandsPreganglion secretory fibers for lacrimal gland arise from the lacrimatory nucleus and pass through the facial nerve, then to its greater petrosal branch. Greater petrosal nerve forms nerve to the pterygoid canal to reach pterygopalatine ganglion. Postganglionic fibers supply lacrimal gland*Thus, lesion in any structure of this pathway will have positive Schirmer's test	Ophthalmology	Diseases of orbit, Lids and lacrimal apparatus	Facial
All except one is required for the diagnosis of obesity hypoventilation syndrome	Repeated	Medicine	Respiratory system	Hypeension
OCP are associated with which of the following complication (Repeat 2009)	Ans b (Optic neuritis)Ophthalmic complication of OCP central retinal artery occlusion prethrombosis of central retinal vein perivasculitis, inflammation of anterior segment of the eye ' macular hemorrage Papillitis & lesions of optic nerve causing variable degree of visual loss	Surgery	Miscellaneous	optic neuritis
Hydrogen sulphide acts on which complex of cytochrome oxidase	Complex IV inhibitors i. Carbon monoxide, inhibits cellular respiration ii. Cyanide (CN-) iii. Azide (N3-) iv. Hydrogen sulphide (H2S)Ref: DM Vasudevan Textbook of Medical Biochemistry, 6th edition, page no: 234	Biochemistry	Respiratory chain	Comlex IV
Which structure lies midway between the ASIS & pubic symphysis :	A. i.e. Femoral aery Femoral aery traverses the femoral triangle from its base (which is formed by inguinal ligament - attached between ASIS and Pubic tubercle) at midinguinal pointQDeep inguinal ring lies 1/2 inch above midinguinal pointQ; Superficial inguinal ring lies I/2 inch bellow midinguinal point; and Saphenous opening lies 4 cm below & lateral to the pubic tubercle.	Anatomy	null	Femoral aery
First antibody to appear in hepatitis -	Anti-HBV appears in serum a week or two after the appearance of HBsAg. It is therfore the earliest antibody marker to be seen in blood? long before anti-HBe or anti-HBs. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-546	Microbiology	Virology	IgM-anti-HBc
In which of the following vasculitis lung involvement does not occur:	Answer- B. Polyaeritis nodosa (PAN)Microscopic polyangiitis (microscopic polyaeritis, hypersensitivity, or leukocytoclastic vasculitis): This type of necrotizing vasculitis generally affects aerioles, capillaries, and venule.Wegener granulomatosis (Granulomatosis with polyangitis)- is a necrotizing vasculitis characterized by th e triad ofacute necrotizing granulomasnecrotizing or granulomatous vasculitisrenal disease in the form of focal necrotizing often crescentic, glomerulitis"Churg- Strauss syndrome(allergic granulumatosis and angiitis) is a multisystem diseases with cutaneous involvement gastrointestinal tract bleeding, and renal disease.	Medicine	null	Polyaeritis nodosa (PAN)
Which of the following drug is commonly used in narcoanalysis?	Ans. (B) Scopolamine hydrochloride(Ref: J Psychiatry and Law 1993:3:447-471)Controlled administration of intravenous hypnotics to obtain information from subjects who are unable or unwilling to provide it otherwise, is known as Narcoanalysis or Narcosynthesis.Drugs used for narcoanalysis are:[?]Ethanol[?]Scopolamine[?]Temazepam[?]Barbiturates like Thiopentone and AmobarbitalThese drugs are also known as truth drug or truth serum.Phenobarbitone is not used, rather amobarbital is used for narcoanalysis.	Pharmacology	A.N.S.	Scopolamine hydrochloride
The function common to neutrophils, monocytes, and macrophages is:	Phagocytic cells are: neutrophils monocytes macrophages	Pathology	Oxygen dependent bacterial killing	Phagocytosis
Which of the following enzyme is involved in rejoining sho fragments of DNA on the lagging strand?	The okasaki fragments that are sho segments of DNA formed on the lagging strand of DNA in the 5'-3' direction are joined by DNA ligase. Ref: Textbook of Biochemistry By D M Vasudevan, 3rd Edition, Pages 347-8	Biochemistry	null	DNA Ligases
Ototoxicity caused by:	Ans. (b) StreptomycinRef : KDT 6th ed. / 743-44* Streptomycin has been assigned to pregnancy category D by the FDA.* Streptomycin crosses the placenta; reported cord concentrations have been equal to or less than the mothers serum concentration.* There are reports of fetal eighth cranial nerve damage with subsequent bilateral deafness. Most authorities, including the Centers for Disease Control and the American Thoracic Society, discourage the use of streptomycin during pregnancy due to the risk of fetal ototoxicity.	Pharmacology	Adverse Drug Effect	Streptomycin
The instrument below is used for	This is used for monitoring temperature, core temperature monitoring.	Anaesthesia	null	Oesophageal temperature probe
Alkalinization of urine is required to treat toxicity of all except:	Changes in urinary pH affect tubular reabsorption of drugs that are paially ionized - * Weak bases are ionize more and are less reabsorbed in acidic urine.* Weak acids ionize more and are less reabsorbed in alkaline urine. Urine is alkalinized in barbiturate, methotrexate and salicylate poisoning.	Pharmacology	Sympathetic System	Amphetamine
Which of the following is the feature of vegetations in Libmann Sacks endocarditis?	Mitral and tricuspid valvulitis with small, sterile vegetations, called Libman-Sacks endocarditis, is occasionally encountered in systemic lupus erythematosus. The lesions are small (1 to 4 mm in diameter), single or multiple, sterile, pink vegetations with a way (verrucous) appearance. They may be located on the undersurfaces of the atrioventricular valves, on the valvular endocardium, on the chords, or on the mural endocardium of atria or ventricles.	Pathology	Endocarditis	Small or medium sized on either or both sides of valve
Permanent impairment of fingerprints occurs in all except	Permanent impairment of fingerprints occurs in: Leprosy Electrical injuries Radiation injuries Ridge alteration occur in: Acanthosis nigricans Scleroderma	Forensic Medicine	Human identification	Acanthosis nigricans
True about ascent to high altitude:	Respiratory alkalosis occurs Polycythemia is due to increased erythropoietin Acute mountain sickness develops 8-24 hr after arrival at altitude and lasts 4-8 days. Acute altitude illness: 3 forms Acute mountain sickness (AMS) The pathophysiology of AMS is not well understood. The essential factor responsible for this condition is hypoxemia High altitude cerebral edema (HACE) High altitude pulmonary edema (HAPE)	Physiology	Respiratory System Pa 3	Acetazolamide may be given prophylactically
Phenol test or Reidel Walker test is done to determine:	Ans. d. Efficacy of a disinfectants	Microbiology	null	Efficacy of a disinfectants
The instrument shown here is useful for:	null	Dental	null	Removal of crown
Goodpasture syndrome has antibodies against:	(Refer: Robbins Pathologic Basis of Disease, 8thedition, pg no: 709)	Unknown	null	Collagen 4
Zygote is dependent on which of the following for its nutrition -	Ans. is 'd' i.e., All the above While zygote is passing down the fallopian tube and after a brief period as it enters the uterus, it depends for its nutrition on the yolk sac granules (deutoplasm) embedded in its cytoplasm and on the fluid medium surrounding it which is secreted by the walls of the uterine tube and uterus.It also derives its energy from the stored carbohydrate in sperm, whichfeilized the ovum,	Gynaecology & Obstetrics	null	All the above
Urine is collected for examination in a pregnant female by :	Early morning sample	Gynaecology & Obstetrics	null	Early morning sample
Okazaki fragments are found during	DNA synthesis is always into 5&; to 3&; direction in both strands The strand which is discontinuously synthesized is referred to as the &;lagging strand &; otherwise called the retrograde strand The small DNA molecules attached to its own primer RNA are called Okazaki fragments The synthesis along the lagging strand is in 5&; to 3&; directionRef: DM Vasudevan, 7th edition, page no: 580, 581	Biochemistry	Metabolism of nucleic acids	Replication
Which type of pelvis is associated with increased incidence of 'face to pubis' delivery:	As discussed in the text in Table 1.1 face-to-pubis delivery is common in anthropoid pelvis.	Gynaecology & Obstetrics	null	Anthropoid pelvis
HIV primarily replications in which cells -	Ans. is 'a' i.e., CD4 T-cells * The receptor for the virus is the CD4 antigen on surface. The cells affected are :# CD4 T Cells (major target)# B lymphocytes# Monocytes and macrophages# Langerhans cells in dermis# Glial cells and microglia in the CNS# Follicular dendritic cells from tonsils can be infected by HIV without the involvement of CD4	Microbiology	Virology	CD4T-cells
According to The Workmen's Compensation Act, 1923, which of the following is considered an occupational disease?	Ans. b. Anthrax (Ref: style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">According to The Workmen's Compensation Act, 1923, Anthrax is considered an occupational disease.List of Occupational Diseases as per Employee Compensation Act 1923 (Workmen Compensation Act, 1923)Part APart BPart C* Infectious and parasitic diseases contracted in an occupation where there is a particular risk of contamination (Anthrax)* Diseases caused by work in compressed air* Diseases caused by lead or its toxic compounds* Poisoning by nitrous fumes* Poisoning by organophosphorus compounds.* Diseases caused by phosphorus or its toxic compounds.* Diseases caused by mercury or its toxic compounds* Diseases caused by benzene or its toxic homologues.* Diseases caused by nitro and amido toxic derivatives of benzene or its homologues.* Diseases caused by chromium, or its toxic compounds* Diseases caused by arsenic or its toxic compounds.* Diseases caused by radioactive substances or radiations.* Primary epitheliomatous cancer of the skin, caused by tar, pitch, bitumen, mineral oil, anthracence, or the compounds, products or residues of these substances.* Disease caused by the toxic halogen derivatives of hydrocarbons (of the aliphatic and aromatic series).* Diseases caused by carbon disulphide.* Occupational cataract due to infrared radiations.* Diseases caused by manganese or its toxic compounds.* Skin diseases caused by physical, chemical or biological agents not included in other items.* Hearing impairment caused by noise.* Poisoning by dinitrophenol or a homologue or by substituted or by the salts of such substances.* Diseases caused by beryllium or its toxic compounds.* Diseases caused by cadmium or its toxic compounds.* Occupational asthma caused by recognized sensitizing agents inherent to the work process.* Diseases caused by fluorine or its toxic compounds.* Diseases caused by nitroglycerine or other nitro acid esters.* Diseases caused by alcohols and ketones.* Diseases caused by asphyxiant carbon monoxide, and its toxic derivatives, hydrogen sulphide.* Lung cancer and mesotheliomas caused by asbestos.* Primary neoplasm of the epithelial lining of the urinary bladder or the kidney or the ureter.* Snow blindness in snow bound areas.* Disease due to effect of cold in extreme cold climate.* Pneumoconiosis caused by sclerogenic mineral dust silicosis, anthracosilicosis, asbestosis) and silicotubercuiosis provided that silicosis is an essential factor in causing the resultant incapacity or death.* Bagassosis* Bronchopulmonary diseases caused by cotton, flax hemp and sisal dust (Byssinosis).* Extrinsic allergic alveolitis caused by the inhalation of organic dusts.* Bronchopulmonary disease caused by hard metals.* Acute pulmonary edema of high altitude.	Social & Preventive Medicine	Occupational Health	Anthrax
Radiological factors indicating an unstable pelvis are all except:	Radiographic factors indicating unstable pelvis are: Posterior sacroiliac complex displacement >1cm Avulsion fracture of sacral or ischial end of the sacrospinous ligament. Avulsion fractures of the L5 transverse process Disruption of pubic symphysis with pubic diastasis of 2 cm with posterior pelvic injury or injury to anterior/ posterior sacroiliac ligament or sacrospinous ligaments. Presence of gap rather than impaction in the posterior pelvic ring.	Orthopaedics	Pelvis and Hip Injury	Isolated disruption of pubic symphysis with pubic diastasis of 2 cm
Angioid streak is seen in -	null	Medicine	null	Pseudoxanthoma elasticum
Xiphoid process fuses with body of sternum by:	40 years	Forensic Medicine	null	40 years
Uveitis is caused by –a) TBb) Staphylococcusc) Streptococcusd) Klebsiellae) E.Coli	TB causes chronic granulomatous uveitis. Staphylococcus and streptococcus cause acute non-granulomatous pyogenic uveitis.	Ophthalmology	null	abc
A young female presented to you with primary amenorrhea. Examination reveals normal breast development and absent axillary hairs. Pelvic examination shows a normally developed vagina with clitoromegaly. On ultrasound, gonads are visible in the inguinal region. What is the most likely diagnosis?	Ans. is b, i.e. Partial androgen insentivity syndromeIn the question patient has 1deg amenorrhea:* Breast development is normal and absent axillary hair. (This means it cannot be Mayer Rokitansky kiister hauser syndrome --where Breast and pubic as well as axillary hair are well developed and it cannot be Gonadal dysgenesis as none of the secondary sexual characteristics are developed in it).We are left with 2 options:Option a --Complete androgen insensitivityOption b --Partial androgen insensitivityIn both these conditions --Breast development will be normal and pubic hair and axillary hair will be absent but clitoromegaly will be seen in partial androgen insensitivity only.	Gynaecology & Obstetrics	Disorders in Menstruation	Partial androgen insensitivity syndrome
A patient presents with thrombocytopenia, eczema and recurrent infections. What is the most probable diagnosis?	Wiskott-Aldrich syndrome (WAS) is an X-linked platelet/immunologic disorder caused by mutations in the WASP gene. The triad of eczema, recurrent infections, and microthrombocytopenia that characterizes WAS only occurs in 27% of the cases. The immunologic defects include low serum concentrations of IgM, while IgA and IgG are normal and IgE is frequently increased. Ref: The Elements of Immunology By Fahim Halim Khan, 2009, Page 413 ; Harrison's 17th ed chapter 310	Medicine	null	Wiskott Aldrich syndrome
A baby presents with refusal to feed, skin lesions, seizures, ketosis organic acids in urine with normal ammonia; likely diagnosis is:	Baby in the above mentioned case scenario is showing signs and symptoms of multiple carboxylase deficiency such as dermatitis severe metabolic acidosis, organic acid excretion. Ref: Essentials of Pediatrics By Nelson, 16th Edition, Pages 356 ; The Embryo: Scientific Discovery and Medical Ethics By Shraga Blazer, Page 246 ; NORD Guide to Rare Disorders: National Organization for Rare Disorders, Page 483	Biochemistry	null	Multiple carboxylase deficiency
Carbamoyl phosphate intermediates the synthesis of	(B) Urea & Pyrimidine # Biosynthesis of urea begins with the condensation of CC>2, NHs and ATP to form carbamoyl phosphate, a reaction catalyzed by carbamoyl phosphate synthase I which is a mitochondrial enzyme, and rate limiting or pacemaker enzyme and the enzyme is active only in the presence of its allosteric activator N-acetylglutamate, which enhances the affinity of synthase for ATP.	Biochemistry	Miscellaneous (Bio-Chemistry)	Urea & Pyrimidine
Which of the following is not true about Diplococcus pneumoniae	Streptococcus pneumoniae is optochin sensitive. Optochin sensitivity: the sensitivity of Streptococcus pneumoniae to optochin is useful in differentiating it from other streptococci. When a disc impregnated with optochin is applied on a plate of blood agar inoculated with Streptococcus pneumoniae, a wide zone of inhibition appears on incubation. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 225	Microbiology	Bacteriology	Optochin resistance
A patient on Bilonatumomab for refractory B cell All is now resistance to the drug. Which drug to be used:-	Drug Mechanism Use Vorinostat HDAC inhibitor Cutaneous T cell lymphoma Brentuximab Man against CD30 Hodgkin lymphoma Pembrolizumab PD-1 Melanoma Lung Cancer Head and neck cancer Tisagenlecleucel Ca therapy ALL Blinatumomab Bispecific t-cell engages ( targets CD19 and CD3) ALL	Pharmacology	JIPMER 2019	Pembrolizumab
Horizontal semicircular canal responds to	The three canals lie at right angles to each other but the one which lies at right angles to the axis of rotation is stimulated the most.Thus horizontal canal will respond maximum to the rotation on the veical axis. (Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 6th edition; page no.17)	ENT	Ear	Rotational acceleration
Roof of the Anatomical snuff box is formed by the	Anatomical snuff box boundaries: Lateral wall Abductor pollicis longus Extensor pollicis brevis Medial wall Extensor pollicis longus Roof Cephalic vein Sup branch of radial nerve Floor Radial styloid, scaphoid, trapezium,1st meta carpal Content Radial Aery Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 893.	Anatomy	Upper limb	Sup branch of radial nerve
Which of these differentiates between ante moem and post moem burns?	SPECIFIC FINDINGS IN ANTEMOEM BURNS 1.SOOT PAICLES UPTO THE LEVEL OF TERMINAL BRONCHIOLE. 2. PRESENCE OF CARBOXYHEMOGLOBIN IN BLOOD. 3. Cyanide IN BLOOD 4. CURLING ULCER IN FIRST PA OF DUODENUM. NON SPECIFIC FINDINGS IN BURNS( ANTEMOEM + POSTMOEM BURNS) 1. PUGILISTIC ATTITUDE OR HEAT STIFFENING. 2. HEAT RUPTURE 3. HEAT HEMATOMA 4. HEAT FRACTURE.	Forensic Medicine	Thermal injuries	Soot paicles up to terminal bronchioles
Arrange the following in sequential order of their involvement in estrogen synthesis: A. Progesterone B. Androgen in granulosa cell C. Androgen in theca cell D. Aromatase	Interaction of follicular theca and granulosa cells for production of estrogens. The theca cells, under the control of luteinizing hormone (LH), produce androgens that diffuse into the granulosa cells. In mature follicles, follicle-stimulating hormone (FSH) acts on granulosa cells to stimulate aromatase activity, which conves the androgens to estrogens. AC - Adenylate cyclase; ATP - Adenosine triphosphate; cAMP - Cyclic adenosine monophosphate; LDL - Low density lipoproteins.	Physiology	Female Reproductive System	A-C-B-D
Left bundle branch block (LBBB) on ECG can suddenly develop in all of the following except:	Ans. b. Ashman phenomenon (Ref: Harrison 18/e p1835) style="font-size: 1.04761904761905em; font-weight: bold; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">Ashman phenomenon:Ashman phenomenon is an intraventricular conduction abnormality caused by a change in the heart rate.Wide QRS complex) on the surface ECGA RBBB pattern is more common because of the longer refractory period of the right bundle branch, although association with LBBB has been documentedCauses of Left Bundle Branch Block (LBBB)* Aortic stenosis* Dilated cardiomyopathy* Acute myocardial infarction* Extensive coronary artery disease* Primary disease of the cardiac electrical conduction system* Long standing hypertension leading to aortic root dilatation and AR* Hypokalemia* Hyperkalemia	Medicine	Electrocardiography	Ashman phenomenon
C-3 convertase in alternate complement pathway -	null	Microbiology	null	C3bBb
Treatment of latent TB infection in Tuberculin positive, HIV positive patients:	Ans. is 'a' i.e., 1NH biweekly for 9 month Dosing regimens for treatment of latent tuberculosis* AdultsChildren <12IsoniazidStandard regimen:o 300 mg PO daily for nine months Alternate regimens:o 300 mg PO daily for six months900 mg PO twice weeklyD for nine months900 mg PO twice weeklyD for six monthsStandard regimen:o 10 to 15 mg/kg PO daily for nine months; not to exceed 300 mg/dayAlternate regimen:o 20 to 30 mg/kg PO twice weekly for nine months; not to exceed 900 mg/dayIsoniazid and rifapentineIsoniazid (orally once weekly for 12 doses, given by direct observation):o 15 mg/kg, rounded up to the nearest 50 or 100 mg; 900 mg maximumRifapentine (orally once weekly for three months, given by direct observation):o 10 to 14 kg: 300 mgo 14.1 to 25 kg: 450 mgo 25.1 to 32 kg: 600 mgo 32.1 to 49.9 kg: 750 mg o >50 kg: 900 mg maximumSee noteYIsoniazid (orally once weekly for 12 doses, given by direct observation):o 15 mg/kg, rounded up to the nearest 50 or 100 mg; 900 mg maximumRifapentine (orally once weekly for three months, given by direct observation):o 10 to 14 kg: 300 mgo 14.1 to 25 kg: 450 mgo 25.1 to 32 kg: 600 mgo 32.1 to 49.9 kg: 750 mgo >50 kg: 900 mg maximumRifampin600 mg PO daily for four months10 to 20 mg/kg PO daily for four months; not to exceed 600 mg/dayIsoniazid and rifampinIsoniazid 300 mg PO daily for three monthsIsoniazid 10 to 15 mg/kg PO daily for three months; not to exceed 300 mg/day Rifampin 600 mg PO daily for three monthsRifampin 10 to 20 mg/kg PO daily for three months; not to exceed 600 mg/day	Medicine	Bacteriology	INH biweekly for 9 month
In MI, which enzyme is raised in 4 to 6 hrs. & decreases in 3 to 4 days :	Answer is C (Creatinine phosphokinase) Creatinine phosphokinase is seen at 4 to 8 hours (May be seen at 2-4 hours), peaks at 24 hours and return to normal by 72 hours. Creatinine phosphokinase MB (CPKMB) Very sensitive (CPK MB isoenzyme increases the specificity) 'Absence in change in levels of CPK and CPKMB during the 1st 2 days essentially excludes the diagnosis of MI' -Chandrasoma CK elevation used to be test of choice in First 24 hours. ('Cardiac troponins are now preferred'). CKMB is still the test of choice for detecting recurrent ischaemic event.	Medicine	null	CPK
The most impoant factor in fracture healing is:	D i.e. Immobilization	Surgery	null	Immobilisation
Rubella causes all except	Rubella: Rubella/ german measles is caused by RNA virus of togavirus family. Rubella inhibits cell division and this is the reason for congenital malformations. Congenital Rubella syndrome refers to infants born with defects secondary to intrauterine infections sometime after bih. It consists of triad of symptoms of deafness, cardiac malformation and cataract . Other defects include glaucoma , retinopathy, microcephalus, cerebral palsy , intrauterine growth retardation, hepatosplenomegaly, mental and motor retardation. Reference: GHAI Essential pediatrics, 9 th edition	Pediatrics	Infectious disease	AS
Optical urethroplasty is done in:(Internet)	(Congenital stricture of urethra) (1388-89-Baily & Love 24th) (Internet) (1362-Baily & Love 25th)Hypospadias - surgical plastic repair of hypospadias is currently accomplished by a variety of highly successful one stage operations and is routinely performed between 6 and 19 months of age (1008-CSDT 12(tm))Epispadias - Treatment consist of correction of penile curvature reconstriction of the bladder neck in incontinent patients.Congenital urethral stricture - commonly these strictures are thin diaphragms that may respond to simple dilation onto direct vision internal urethrotomy.A single treatment by optical urethrotomy or dilatation is usually effective (1388-Bailey & Love 24th)* A one stage dorsal free graft urethroplasty for bulbar urethral structure to reduce the incidence of urethrocele.	Surgery	Urethra & Penis	Congenital stricture of urethra
A 78-year-old man with advanced renal disease has the ECG(lead II). What is the diagnosis?	(a) Source: (Fuster, p. 313)No atrial activity is detected. The ventricular rate is slightly irregular. Beat number 4 is a ventricular premature contraction. The T waves are tall and markedly peaked. This type of T wave is characteristic of hyperkalemia, as is absence of visible atrial activity. The potassium level was 8.2 mmol/L.	Medicine	C.V.S.	hyperkalemia
Acute changes in brain due to wernicke's encephalopathy in chronic alcoholics is most frequently seen in:	Acute changes are most frequently seen in the 1. Mamillary bodies And also seen in 2. Around the third and fouh ventricles and 3. Aqueduct of the midbrain. Ref: Thorarinsson BL, S C I E N T I F I C P A P E R O V E R V I E W	Medicine	null	Mamillary bodies
Secondary oocyte consists of	Ans. d (23 X)Secondary oocyte consist of 23 X chromosomes.The chromosomal complement of a primary oocyte is 46 XX and that of secondary oocyte is 23 X.Sequence of maturation of ovarian primordial follicle after primary follicle stage:Primordial follicle(Single layered ovarian follicle)Spermatogonium (diploid, 2N) \|\|Primary Spermatocyte (diploid, 2N)Primordial follicle \|\|Secondary Spermatocyte (haploid, N)Secondary follicle (Antral follicle) \|\|Spermatid (haploid, N)(Spermatogenesis begins with Spermatogonia.Full development takes 2 months.It occurs in seminiferous tubules)Graffian follicle\|Corpus luteum\| Corpus albicans # While majority of oogonia divide, some enter into prophase of first meiotic division and are primary oocytes. These are surrounded by flat cells, which are called primordial follicles, and are present in cortex of the ovary.# At birth, there is no more mitotic division and all the oogonia are replaced by primary oocytes, which have finished prophase of first meiotic division and remain in resting phase between prophase and metaphase.# The first stage of maturation occurs with full maturation of ovarian follicle just prior to ovulation but the final maturation occurs only after fertilization.# The primary oocyte undergoes first meiotic division giving rise to secondary oocyte and one polar body.# Secondary oocyte has haploid number of chromosomes.# Ovulation occurs soon after formation of secondary oocyte.# The secondary oocyte completes the second meiotic division only after fertilization by the sperm in the fallopian tube.	Gynaecology & Obstetrics	The Ovarian Cycle	23 X
True about mucosa associated lymphoma	Gastric lymphoma This is a rare tumour, accounting for less than 5% of all gastric malignancies. The stomach is, however, the most common site for extranodal non-Hodgkin lymphoma and 60% of all primary gastrointestinal lymphomas occur at this site. Lymphoid tissue is not found in the normal stomach but lymphoid aggregates develop in the presence of H. pylori infection. Indeed, H. pylori infection is closely associated with the development of a low-grade lymphoma (classified as extranodal marginal-zone lymphomas of MALT type). EUS plays an impoant role in staging these lesions by accurately defining the depth of invasion into the gastric wall. The clinical presentation is similar to that of gastric cancer and endoscopically the tumour appears as a polypoid or ulcerating mass. While initial treatment of low-grade lesions confined to the superficial layers of the gastric wall consists of H. pylori eradication and close observation, 25% contain t(11:18) chromosomal translocations. In these cases, additional radiotherapy or chemotherapy is usually necessary. High-grade B-cell lymphomas should be treated by a combination of rituximab, chemotherapy , surgery and radiotherapy. The choice depends on the site and extent of tumour, the presence of comorbid illnesses, and other factors, such as symptoms of bleeding and gastric outflow obstruction. The prognosis depends on the stage at diagnosis. Features predicting a ourable prognosis are stage I or II disease, small resectable tumours, tumours with low-grade histology, and age below 60 years. Ref Davidson edition23rd pg805	Medicine	G.I.T	H. Pylori predisposes
Which is not Glucogenic?	The glucogenic amino acids are: Alanine Arginine Asparagine Aspaic Cysteine Glutamic Glutamine Glycine Histidine Methionine Proline Serine ValineRef: DM Vasudevan, 7th edition	Biochemistry	Metabolism of carbohydrate	Lysine
The gene for folic acid transpoer is located on which chromosome:	C i.e. 21Folic acid transpoer gene (SLC 19 AI solute carrier family 19) is located on long arm of chromosome 21 (21q) Q at band 22.3. Transpo of folate occurs by potocytosis which functionally couples folate receptor, folate transpoer and V- type h+ pump.	Biochemistry	null	21
The best treatment for class V lesion on a tooth along with extensive class II caries is:	With class V lesion and extensive class II cavity in the same tooth the remaining enamel surface with the supported healthy dentin will be much less hence in such situation full crown restoration will be long lasting.	Dental	null	A full crown restoration
Which has maximum nicotinic effect-	Ans. is 'b' i.e., Carbachol o Amongst the given options carbachol has maximum nicotinic actions. It has nicotinic as well as muscarinic action.	Pharmacology	null	Carbachol
Indications for cesarean hysterectomy are all except:	Cesarean hysterectomy refers to an operation where cesarean section is followed by removal of the uterus. Peripartum hysterectomy is the surgical removal of the uterus either at the time of cesarean delivery or in the immediate postpartum period (even following vaginal delivery). Some indications for peripartum hysterectomy Uterine atony Abnormal placentation – Bleeding – Accrete syndromes Uterine extension Uterine rupture Cervical laceration Postpartum uterine infection Leiomyoma Invasive cervical cancer Ovarian neoplasia M/C cause of cesarean/peripartum hysterectomy is PPH.	Gynaecology & Obstetrics	null	Couvelaire uterus
The parasympathetic secretomotor nerve supply to the nose is	The nerve of the pterygoid canal passes through the pterygoid canal to reach the pterygopalatine ganglion. The parasympathetic fibres relay in this ganglion. Postganglion are parasympathetic fibres arising in the ganglion ultimately supply the lacrimal gland and the mucosal glands of the nose, palate, and pharynx. The gustatory or taste fibres do not relay in the ganglion and are distributed to the palate. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.	Anatomy	Head and neck	Vidian nerve
Foot process effacement is seen on EM in ?	Ans. is All 'a' i.e., Minimal change disease, 'b' i.e., Focal segmental GN, 'c' i.e., IgA nephropathyo Foot process effacement is noted in patients with nephrotic syndrome.o A variety of injurious stimuli may cause the podocyte to react with flatteninng or simplification of the foot process architecture.While most commonly noted in lipoid nephrosis (minimal change disease), foot process effacement can also be seen in focal segmental glomerulosclerosis, membranous glomerulonephropathy and in other glomerulonephritis.So, keep in mind that foot process efffacement is seen most commonly in minimal change disease, but can also occur in other glomerulonephropathies causing nephrotic syndrome (FSGS, IgA nephropathy, MPGN) o For option IgA nephropathy is a type of mesangioproliferative GN.	Pathology	null	All
Most common organism associated with reactive arthritis is?	null	Medicine	null	Chlamydia
Which of the following drug is category B (adequate studies in pregnant woman have failed to demonstrate a fetal risk)?	Category B drugus are the one that have shown no risks in animal studies, but human studies do not exist or also if adverse effect have been seen in animal studies with no such effect im well controlled human trials. eg.ranitidine,paracetamol. TEXT BOOK OF OBSTETRICS,Sheila Balakrishnan,2nd edition,page no.564	Gynaecology & Obstetrics	Medical, surgical and gynaecological illness complicating pregnancy	Ranitidine
Which of the following is true regarding Hybridoma Technique	All the following statements are corret.	Biochemistry	null	All of the above
Hu is defined under section: NEET 14	Ans. 319 IPC	Forensic Medicine	null	319 IPC
Pale infarcts are seen at all of the following sites except-	Ans is 'd' i.e., Lung INFARCTION o An infarct is an area of ischemic necrosis by occlusion of either the aerial supply or venous drainage in a paicular tissue. Pathogenesis o Mostly it is caused by interrupted blood supply. o "Nearly 99% of all infarcts results from thrombotic or embolic events and almost all result. from aerial occlusion". o Other causes of interrupted aerial supply are local vasospasm, extrinsic compression of a vessel by tumor, twisting of vessel e.g., in testicular torsion, expansion of atheroma due to hemorrhage within the plaque. o Venous obstruction usually cause congesion, edema, infarction does not occur because bypass channels rapidly open after the thrombus, providing some outflow from the area, which inturn improves aerial inflow. Infarct cause by venous thrombosis is more likely in organs with a single venous outflow channel, such as in testis and ovary. Types of infarct o Infarcts are classified on the basis of their color. o Infarcts are classified into either Red (Haemorrhagic) or White or Pale (anaemic) infarcts, reflecting the amount of haemorrhage. Red infarcts (Haemorrhagic) : occur with : Venous occlusions (eg ovarian torsion); In loose tissues (such as lungs); In tissues with dual circulation (e.g. Lung & S. intestine) In tissues that were previously congested because of sluggish venous out flow. When flow is reestablilshed to a site of previous aerial occulusion and necrosis. White or Pale infarcts : occur with : Aerial occlusions, or In solid organs e.g. Hea, spleen, Liver, kidney and brain where the solidity of tissue limits the amount of haemorrhage that can seep into the area of ischaemic necrosis.	Pathology	null	Lung
All are split - thickness skin graft except	Wolfe graft is full thickness skin graft.	Surgery	null	Wolfe graft
Enteropathy type T cell lymphoma is associated with -	Answer- B. Celiac SprueEnteropathy-type- T cell lymphoma is a rare complication of long-standing celiac disease.	Medicine	null	Celiac Sprue
Fine touch is transmitted via:	Ans. A. The dorsal lemniscal systema. Lateral spinothalamic tract carries pain and temperature;b. Anterior spinothalamic tract carries crude touch;c. All other sensations are carried by dorsal lemniscal.	Physiology	Nervous System	The dorsal lemniscal system
A young 25 year old man following A presented with proptosis (pulsatile in nature) ,chemosis and pain in right eye after 4 days. On Examination there was bruit on forehead and right eye. The probable diagnosis is	B i.e. Carotico cavernos Fistula	Ophthalmology	null	Carotico cavernous Fistula
BERA can be most accurate from which gestation?	Ref: Clohertys Manual of Neonatal Care, 6th edition. Page 646 and ENT DhingraExplanation:"ABR is reliable after 34 weeks postnatal age. "Ref: ClohertyBRAINSTEM EVOKED RESPONSE AUDIOMETRY (BERA)Other nameso Auditory brainstem responses (ABR)o Brainstem auditory evoked response (BAER)o Brainstem auditory evoked potential (BAEP).Measures the electroencephalographic waves generated hy the auditory system in response to clicks through three electrodes placed on the infant's scalp.The characteristic waveform recorded from the electrodes becomes better defined with increasing postnatal age.ABR is reliable after 34 weeks postnatal age.At present, because of the increased risk of injury to the auditory pathway beyond the cochlea (auditory nerve) including auditory dyssynchrony, ABR is the preferred screening method to evaluate hearing loss in the NICE graduate.Non-invasive technique to find integrity of central auditory pathways through the 8th cranial nerve, pons and midhrain.Electrical potentials are generated in response to several click stimuli or tone-bursts and picked up from the vertex by surface electrodes.It measures hearing sensitivity in the range of 1000 - 4000 Hz.In normal person. 7 waves are produced in the first 10 milliseconds.The 1st, 3rd and 5th waves are most stable and are used in measurements.Parameters studied in waveforms:o Latencyo Inter-wave latencyo Amplitude.The exact anatomic site of neural generators are:o Wave 1 - Distal part of CN 8.o Wave 2 - Proximal part of CN 8 near the brainstem.o Wave 3 - Cochlear nucleuso Wave 4 - Superior olivary complexo Wave 5 - Lateral lemniscuso Wave 6 & 7 - Inferior colliculus.UsesScreening for hearing in infants.To determine the threshold of hearing in:o Infants.o Children.o Uncooperative adultso Malingerers.To diagnose retroeochlear pathology (e.g.: Acoustic neuroma).To diagnose brainstem pathology (e.g.: Multiple sclerosis or Pontine tumors)To monitor CN 8 intraoperatively in surgery of acoustic neuromas to preserve the function of cochlear nerve.	ENT	Hearing Loss	34 weeks
Parapharygeal space is also known as	Parapharyngeal space is situated on the side of the pharynx. It is pyramidal in shape with the base at the base of the skull and apex at the hyoid bone. It contains carotid vessels, jugular vein, last 4 cranial nerves and cervical sympathetic chain. Ref: Diseases of ENT, PL Dhingra, 7th edition, pg no. 301	ENT	Pharynx	Lateral pharyngeal space
A patient undergoing chest x-ray following an automobile accident is found to have an enlarged mediastinum with bilateral hilar and right paratracheal adenopathy. The patient has been asymptomatic, but careful examination demonstrates an enlarged cervical lymph node. This node is biopsied and demonstrates involvement by small, non-caseating granulomas. Occasional giant cells with stellate inclusions are seen within the granulomas. These are most likely which of the following?	The cells described are asteroid bodies, and are classically associated with sarcoidosis, although they are not completely specific for this disease. Anitschkow cells are a form of activated histiocyte with an unusual wavy chromatin. They are found within inflammatory lesions called Aschoff bodies in the heas of patients with acute rheumatic hea disease. Paget's cells are individual adenocarcinoma cells found within the squamous epithelium of the skin.	Pathology	null	Asteroid bodies
Which of the following is not true about Mumps: March 2007	Ans. B: Incubation period is less than 14 Incubation period of mumps is 14-18 days The more common symptoms of mumps are: Parotid inflammation/ parotitis in 60-70% of infections. Fever Headache Orchitis, referring to painful inflammation of the testicle.Males past pubey who develop mumps have a 30 percent risk of orchitis. There is no specific treatment for mumps. Mumps viral infections in adult males carries a 25% risk that the testes may become infected which in rare cases leads to sterility. After the illness, life-long immunity to mumps generally occurs. Complications Infection of other organ systems Sterility in men (this is quite rare, and mostly occurs in older men) Mild forms of meningitis (rare, 40% of cases occur without parotid swelling) Encephalitis (very rare, rarely fatal) Profound (91 dB or more) but rare sensorineural hearing loss, uni- or bilateral Pancreatitis manifesting as pain abdomen and vomiting Oophoritis (inflammation of ovaries) but feility is rarely affected.	Medicine	null	Incubation period is less than 14 days
All are true regarding Scheuermann's osteochondritis except?	Scheuermann's osteochondritis has autosomal dominant inheritance. It commonly affects adolescent boys. It is characterised by irregular ossification of veebral endplates and dorsal kyphosis. Most patients are asymptomatic. It can present with backache which is aggravated by exercise. Management is by protective postural exercises with avoidance of excessive activity. Ref: Davidson's Principles and Practice of Medicine, 22nd edition, p1130	Medicine	All India exam	Autosomal recessive inheritance
Which among the following electrolyte disturbance following diarrhoea can cause convulsions?	Hyponatremia can result from diarrhea, vomiting, burns, diuretic administration, and administration of sodium-poor parenteral solutions. Seizures and coma usually are associated with severe hyponatremia and may be life-threatening. Acute hypernatremia usually is caused by severe water depletion with diarrhea especially in children. Ref: Harrison's 17th edition, chapter 46	Medicine	null	Hyponatremia
All are true about liver adenoma except	Clinical features Symptomatic ( upper abdominal pain) in 50-75%, related to hemorrhage or local compressive symptoms Two major risks - Rupture and malignant transformation Pathology Composed of cords of benign hepatocytes containing increased glycogen and fat, without bile ductules, fibrous septa, poal tracts or central vein Normal architecture of the liver is not seen in these lesions Central large plates of hepatocytes separated by dilated sinusoids which are perfused solely by peripheral aerial feeding vessels(lack poal venous supply), under aerial pressure Hemorrhage and necrosis are commonly seen	Anatomy	G.I.T	Normal liver architecture
First retinal abnormality in diabetic retinopathy: (PGI Dec 2007)	Ans. A (Microaneurysm) [Ref Khurana 4th/260-62; Parson 20th/294-98}"The earliest detectable lesion is microaneurysms in the macular area" -Khurana 4th/260Diabetic Retinopathy: Classification- 4 types Khurana 4th/260-62Non-proliferative Diabetic RetinopathyMicro aneurysmQ in macular area (the earliest detectable lesionQ)Retinal haemorrhage both deep (dot & blot haemorrhage) & superficial haemorrhages (flame shaped)Hard exudateQRetinal oedemaCotton-wool spotQProliferative Diabetic RetinopathyPDR develops in >50% of cases after about 25 years of the onset of diseaseThe hallmark Q of PDR is the occurence of neovasculari- ation'i over the changes of very severe NPDRVitreous detachment & vitreous haemorrhage may occurDiabetic MaculopathyMacular edemaQ is termed as clinically significant macular edemaChanges in macula affect visionD.Maculopathy-4 subtypeFocal exudative maculopathyDiffuse exudative maculopathyIschaemic maculopathyMixed maculopathyAdvanced Diabetic Eye DiseasePersistent vitreous haemorrhageTractiona! retinal detach m entQNeovascularglaucoma Q	Ophthalmology	Vascular Disorders	Microaneurysm
Phase I trial is done to test:	Ans. D. PharmacokineticsPhase I trial is also called First in human trial. In this phase, 10-100 healthy people are enrolled to calculate pharmacokinetic data. Phase 0 trials are also done sometimes prior to phase I studies to calculate early pharmacokinetic data. Phase II and III trials usually enrol patients. Phase II trials enrol 50-100 and usually determine drug efficacy and dose ranging. Phase III trials confirm the efficacy in larger population (100-1000). Phase IV trials are also known as postmarketing studies which determine safety (adverse drug reactions, adverse events, and drug-drug interactions). Even safety of long-term drug treatment can be determined in Phase IV trials which can be missed in clinical trials due to limited duration of clinical trials.	Pharmacology	General Pharmacology	Pharmacokinetics
New infectious agents are -	A new genus Henipavirus has been recently identified with the Nipah and Henda viruses causing zoonotic outbreaks. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:515	Microbiology	Virology	Nipah virus
All of the following are tumor markers, except	Beta-2 microglobulin and not beta macroglobulin may be used as a tumor marker (as in multiple myeloma).	Pathology	null	Beta-2 macroglobulin
Felty syndrome is characterised by A/E	Ans. is 'd' i.e., Thrombocytopenia Felty's syndrome is characterized by the combination of rheumatoid ahritis, splenomegaly and neutropenia. The condition is more common in those aged 50-70 years, and is more prevalent in females than males	Pediatrics	null	Thrombocytopenia
Inversion of foot is at	C. i.e. Talocalcaneal joint	Anatomy	null	Talocalcaneal joint
The motility of cell is due to protein-	Functions of Microtubules include determination of cell shape and various cell movements.	Physiology	null	Tubulin
After the first postoperative year of cardiac transplantation, the most common cause of death is	Chronic graft rejection is manifested in cardiac allografts as chronic vascular rejection of main and intramuscular coronary arteries. Myointimal proliferation and medial scarring result in diffuse and eccentric arterial narrowing referred to as accelerated graft atherosclerosis. Infection remains the primary cause of death within the first year of cardiac transplant, but accelerated graft arteriosclerosis is the most common cause of mortality thereafter. Percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, and re-transplantation are the current options for combating this problem.	Surgery	Transplantation	Accelerated graft arteriosclerosis
Shape memory is seen in:	null	Dental	null	NITINOL wire
Thyroid carcinoma associated with hypocalcemia is	Answer is B (Medullary Carcinoma) Medullary carcinoma of thyroid secretes calcitonin and this causes reduction in calcium levels.	Medicine	null	Medullary carcinoma
Fetal abdominal circumference is measured at the level of :	Abdominal Circumference (AC) is measured in the transverse section of the fetal abdomen at the level of the fetal stomach and the umbilical poion of the poal vein.This is usually affected in IUGR and is less useful in dating as it is the parameter most affected by fetal growth. Refer page no 479 of Text book of obstetrics,sheila balakrishnan 2 nd edition.	Gynaecology & Obstetrics	Diagnosis in obstetrics	Stomach and umbilical vein, perpendicular to spine
A 16 year old boy presented with asymptomatic, multiple erythamatous annular lesions with a collarette of scales at periph-ery of the lesions present on the trunk. The most likely diagnosis is:	C i.e. Pityriasis rosea Pityriasis rosea is a self limiting disorderQ of unknown etiology, with a suspected association with Herpes virus 7 and 6Q. It presents with development of usually asymptomatic (i.e. no prodromal or constitutional system), sharply (well) demarcated, larger (2-6 cm), annular (oval-round), erythematousQ (red to brown) lesion k/a primary/herald/mother patch mostly located on trunk in children and young adults (10-35 yrs)( 2. Similar but smaller secondary eruptions appear in crops at interval of usually 2 weeks distributed along lines of cleavage in christmas (fir) tree appearanceQ. Lesions demonstrate fine (cigarette paper) collarette of scaleQ just inside the peripheray of plaque.	Skin	null	Pityriasis rosacea
Which of the following is a stain for fat cells?	ANSWER: (C) Sudan IVREF: See APPENDIX-24 for "HISTOLOGY/PATHOLOGY/ MICROBIOLOGY STAINS" APPENDIX - 24Histology/Pathology/Microbiology StainsT issue/substanoeStainCommentAmyloidGross stainingLugol's iodine Light microscopyH & E, Congo redPolarised lightCongo redMetachromatic stainMethyl violet, crystal violetFluorescent stainThioflavin TNon specific stainPAS, Toludine blue. Aldan blueCaldum/calcificationVon kossa Alizarin Red SFor small quantitiesCalcein Tetracycline labellingBest for bone mineralizationConnective tissueVan Gieson stain (Picric Add + Acid Fuchsin)Simplest method of differential staining of Collagen and other Connective TissueTrichome stain (Gomori trichrome stain, Lillie's trichome & Masson trichome)Red = keratin/muscleBlue/green = bone /'collagenPink = cytoplasmCarcohydrate (Glycogen, cellulose etc)Periodic acid-Schiff stainNon specific for glycogenDiastaseSpecific for glycogenBest's carmine LipidSudan stains{Sudan III, IV, Sudan Back-B, Oil Red 0)Oil Red O largely replaced Sudan III and Sudan IVOil Red O is also used in a technique for staining latent fingerprintsOsmium tetra oxideAs a lipid stain, it is useful in scanning electron microscopy (SEM)LipofuscinSudan Black B MucinMuscarmineMost specific but less usefulPASMost sensitive, For neutral mucopolysaccharidesAlcian blue Bismark brownCan be used with live cellsColloidal iron Micro organismsFungiH & EBluePASRedGomori methamine silverMost sensitiveMycobacteriumZ N stain/methodCarbol fuchsinAuramine Rhodamine stainMost sensitive, mixture of Auramine O and Rhodamine B, used in fluorescence microscopySpirochetesWarthin starry silver stain H PyloriWarthin starry silver stainGiemsa stainH&E Pneumocystis/ Cryptococcus/ cocci diomycetesGomori methamine silver	Pathology	Histo Pathology	Sudan IV
In a person with HIV-1 infection, which of the following is the most predictive of the patient's prognosis	Amplification assays (-PCR, DNA PCR, and b DNA tests) are routinely used to detect viral RNA in clinical specimens. The tests can be quantitative when reference standards are used, and appropriate positive and negative controls must be included in each test. Because these molecular based tests are very sensitive, they form the basis for plasma viral load determinations. It is generally agreed that the amount of HIV in the blood (viral load) is of significant prognostic value. There are continual rounds of viral replication and cell killing in each patient, and the steady-state level of virus in the blood varies with individuals. A single measurement of plasma viral load approximately 6 months after infection can predict the risk of development of AIDS in men several years later. In women, viral load appears to be less predictive. The plasma viral load appears to be the best predictor of long-term clinical outcome, whereas CD4 lymphocyte counts are the best predictor of sho-term risk of developing an oppounistic disease. Plasma viral load measurements are a critical element in assessing the effectiveness of antiretroviral drug therapy. Ref:- Baveja textbook of Microbiology	Microbiology	Virology	Level of HIV-1 RNA in plasma
All of the following are biochemical markers included for triple test except	Triple test It is a combined biochemical test which includes MSAFP,hCG,UE3(unconjugated oestriol).Maternal age in relation to confirmed gestational age is also taken into account.It is used for the detection of Down&;s syndrome.In an affected pregnancy,level of MSAFP and UE3 tend to be low while that of hCG is high.It is performed in 15-18 weeks. D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,pg no:106,7th edition	Gynaecology & Obstetrics	Diagnosis in obstetrics	Human placental lactogen (HPL
Maximum collagen in wound healing is seen at which stage of healing	ref Robbins 9/ep106-108 When the levels of collagen production and degradation equalize, the maturation phase of tissue repair is said to have begun. During maturation, type III collagen, which is prevalent during proliferation, is replaced by type I collagen.Originally disorganized collagen fibers are rearranged, cross-linked, and aligned along tension lines. The onset of the maturation phase may vary extensively, depending on the size of the wound and whether it was initially closed or left open, ranging from approximately 3 days to 3 weeks. The maturation phase can last for a year or longer, similarly depending on wound type.	Anatomy	General anatomy	End of third week
Elective endodontic treatment is contraindicated in	null	Dental	null	Recent MI
Which of the following is not a High Risk Characteristic in proliferative diabetic retinopathy	Proliferative Diabetic Retinopathy Early PDR- Presence of new vessels High risk PDR NVD >= 1/3 - 1/2 disc area or NVD and Vitreous or Preretinal haemorrhage or NVE >= 1/2 disc area and Preretinal or Vitreous haemorrhage	Ophthalmology	Retina	NVD + Clinically signifacnt macular edema
Normal aqueous production rate -	Aqueous humour is derived from plasma within the capillary network of ciliary processes.The normal aqueous production rate is 2.3ml/min. Ref:ophthalmology -AK khurana -6th edition chapt:10 page no:221	Ophthalmology	Glaucoma	2ml/min
Ex-Press giaueoma implant is oiaily up of:	Ans. d. Stainless steel	Ophthalmology	null	Stainless steel
A 45 year - male presents with abrupt onset pain, weakness, loss of contour of shoulder and muscle wasting on 5deg day of tetanus toxoid immunization. Likely cause is:	Brachial plexus neuritis Ref: Basic neurology [By John Gilroy 3/e p594; "Brachial plexus neuritis is characterized by a sudden paralysis of muscles supplied through the brachial plexus and is often associated with painful dysesthesia of the arm. The condition occurs in known viral infections (herpes zoster, Epstein-Barr virus), following injections of tetanus toxoid, in putative viral infections; and as an autobnmune disorder following a surgical procedure."- Basic neurology By John Gilroy 3/e p594 Brachial plexus neuritis usually is characterized by the acute onset of excruciating unilateral shoulder pain, followed by flaccid paralysis of shoulder and parascapular muscles several days later. The syndrome can vary greatly in presentation and nerve involvement. Brachial neuritis (BN) exists in an inherited and an idiopathic form. In the idiopathic version, the pathophysiology is unknown, but the condition is generally thought to be an immune system - mediated inflammatory reaction against nerve fibers of the brachial plexus. The onset of pain in brachial neuritis (BN) is often abrupt and may follow recent illness, surgery, immunization, or even trauma (see Causes, below). Up to two thirds of cases begin during the nighttime. Sensory abnormalities are of usually of less intensity than the pain and muscle weakness. Causes: The exact cause of brachial neuritis is unknown, but the condition has been linked to many antecedent events or illnesses, as follows: Viral infection (paicularly of the upper respiratory tract) Bacterial infection (eg, pneumonia, diphtheria, typhoid) Parasitic infestation S urgery 2 Trauma (not related to shoulder) Vaccinations (eg, influenza, tetanus, diphtheria, tetanus toxoids, peussis [DPT J. smallpox, swine flu) Childbih Miscellaneous medical investigative procedures (eg, lumbar puncture, administration of radiologic dye) Systemic illness (eg, polyaeritis nodosa, lymphoma, systemic lupus erythematosus, temporal aeritis, EhlersDanlos syndrome) A rarer, hereditary form of BN has been localized to the SEPT9 gene on chromosome arm 17q and should be considered a distinct disorder. This entity presents in a younger age group, and is characterized by recurrent, often bilateral attacks. Dysmorphic facial features (eg, hypotelorism, long nasal bridge, facial asymmetry) can also be present. Diagnosis: Other causes of severe pain, such as an acute herniated cervical disc, should be excluded. In brachial plexus neuritis, electromyography and nerve conduction studies reveal abnormalities in more than one nerve; in contrast, cervical radiculopathy may show osteophytes and interspace narrowing on cervical spine x-rays and neuroforaminal disc impingement of MRI. Treatment: of brachial plexus neuritis is suppoive, with analgesics for pain, physical therapy to maintain shoulder strength/mobility, and reassurance that the condition generally will improve, albeit slowly.	Anaesthesia	null	Brachial plexus neuritis
MOST common acute complication of hemodialysis is:	Hypotension is the most common acute complication of hemodialysis. It is paicularly common among patients with diabetes mellitus. The factors that appear to increase the risk of hypotension, are excessive ultrafiltration with inadequate compensatory vascular filling, impaired vasoactive or autonomic responses, osmolar shifts, overzealous use of antihypeensive agents, and reduced cardiac reserve. Ref: Harrisons principles of internal medicine, 18th edition, Page: 2324.	Medicine	null	Hypotension
Which of the following decreases effectiveness of insulin -	Ans. is 'a' i.e., Thiazide o Thiazide, furosamide, coicosteroids, oral contraceptives, salbutamol, nifedipine tend to raise blood sugar and reduce effectiveness of insulin.	Pharmacology	null	Thiazide
Causes of exudative retinal detachment are all except -	Occurs due to the retina being pushed away by a neoplasm or accumulation of fluid beneath the retina following inflammatory or vascular lesions. Etiology: Systemic diseases- toxaemia of pregnancy, retinal HTN, blood dyscrasias. Ocular diseases- scleritis, central serous retinopathy, orbital cellulitis, retinoblastoma, malignant melanoma of choroid. Ref: Khurana 5th edition , page no 298	Ophthalmology	Vitreous and retina	High myopia

True about Gaucher disease

This is an inborn error of metabolism due to failure of degradation of glucocerebrosides. The enzyme beta-glucosidase is deficient in this condition.Ref: DM Vasudevan, 7th edition, page no: 192

Biochemistry

Metabolism of carbohydrate

Due to deficiency of enzyme b-Gluco-cerebroisidase

Stages of pneumonia are all except:-

The stages of pneumonia/consolidation are:- i. Stage of Exudation ii. Stage of Red hepatisation iii. Stage of Grey hepatisation iv. Stage of Resolution

Medicine

null

Stage of Cavitation

Most common Complication of TIPSS procedure

Since systemic blood is shunted toxins ( NH3) travel to brain causing encephalopathy. Hence TIPSS is contra indicated in encephalopathy patients.

Surgery

null

Hepatic Encephalopathy

Schirmer's test detects abnormality of which nerve?

(Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 389)*Schirmer's test is used for the production of tear by lacrimal glands*Preganglion secretory fibers for lacrimal gland arise from the lacrimatory nucleus and pass through the facial nerve, then to its greater petrosal branch. Greater petrosal nerve forms nerve to the pterygoid canal to reach pterygopalatine ganglion. Postganglionic fibers supply lacrimal gland*Thus, lesion in any structure of this pathway will have positive Schirmer's test

Ophthalmology

Diseases of orbit, Lids and lacrimal apparatus

Facial

All except one is required for the diagnosis of obesity hypoventilation syndrome

Repeated

Medicine

Respiratory system

Hypeension

OCP are associated with which of the following complication (Repeat 2009)

Ans b (Optic neuritis)Ophthalmic complication of OCP central retinal artery occlusion prethrombosis of central retinal vein perivasculitis, inflammation of anterior segment of the eye ' macular hemorrage Papillitis & lesions of optic nerve causing variable degree of visual loss

Surgery

Miscellaneous

optic neuritis

Hydrogen sulphide acts on which complex of cytochrome oxidase

Complex IV inhibitors i. Carbon monoxide, inhibits cellular respiration ii. Cyanide (CN-) iii. Azide (N3-) iv. Hydrogen sulphide (H2S)Ref: DM Vasudevan Textbook of Medical Biochemistry, 6th edition, page no: 234

Biochemistry

Respiratory chain

Comlex IV

Which structure lies midway between the ASIS & pubic symphysis :

A. i.e. Femoral aery Femoral aery traverses the femoral triangle from its base (which is formed by inguinal ligament - attached between ASIS and Pubic tubercle) at midinguinal pointQDeep inguinal ring lies 1/2 inch above midinguinal pointQ; Superficial inguinal ring lies I/2 inch bellow midinguinal point; and Saphenous opening lies 4 cm below & lateral to the pubic tubercle.

Anatomy

null

Femoral aery

First antibody to appear in hepatitis -

Anti-HBV appears in serum a week or two after the appearance of HBsAg. It is therfore the earliest antibody marker to be seen in blood? long before anti-HBe or anti-HBs. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-546

Microbiology

Virology

IgM-anti-HBc

In which of the following vasculitis lung involvement does not occur:

Answer- B. Polyaeritis nodosa (PAN)Microscopic polyangiitis (microscopic polyaeritis, hypersensitivity, or leukocytoclastic vasculitis): This type of necrotizing vasculitis generally affects aerioles, capillaries, and venule.Wegener granulomatosis (Granulomatosis with polyangitis)- is a necrotizing vasculitis characterized by th e triad ofacute necrotizing granulomasnecrotizing or granulomatous vasculitisrenal disease in the form of focal necrotizing often crescentic, glomerulitis"Churg- Strauss syndrome(allergic granulumatosis and angiitis) is a multisystem diseases with cutaneous involvement gastrointestinal tract bleeding, and renal disease.

Medicine

null

Polyaeritis nodosa (PAN)

Which of the following drug is commonly used in narcoanalysis?

Ans. (B) Scopolamine hydrochloride(Ref: J Psychiatry and Law 1993:3:447-471)Controlled administration of intravenous hypnotics to obtain information from subjects who are unable or unwilling to provide it otherwise, is known as Narcoanalysis or Narcosynthesis.Drugs used for narcoanalysis are:[?]Ethanol[?]Scopolamine[?]Temazepam[?]Barbiturates like Thiopentone and AmobarbitalThese drugs are also known as truth drug or truth serum.Phenobarbitone is not used, rather amobarbital is used for narcoanalysis.

Pharmacology

A.N.S.

Scopolamine hydrochloride

The function common to neutrophils, monocytes, and macrophages is:

Phagocytic cells are: neutrophils monocytes macrophages

Pathology

Oxygen dependent bacterial killing

Phagocytosis

Which of the following enzyme is involved in rejoining sho fragments of DNA on the lagging strand?

The okasaki fragments that are sho segments of DNA formed on the lagging strand of DNA in the 5'-3' direction are joined by DNA ligase. Ref: Textbook of Biochemistry By D M Vasudevan, 3rd Edition, Pages 347-8

Biochemistry

null

DNA Ligases

Ototoxicity caused by:

Ans. (b) StreptomycinRef : KDT 6th ed. / 743-44* Streptomycin has been assigned to pregnancy category D by the FDA.* Streptomycin crosses the placenta; reported cord concentrations have been equal to or less than the mothers serum concentration.* There are reports of fetal eighth cranial nerve damage with subsequent bilateral deafness. Most authorities, including the Centers for Disease Control and the American Thoracic Society, discourage the use of streptomycin during pregnancy due to the risk of fetal ototoxicity.

Pharmacology

Adverse Drug Effect

Streptomycin

The instrument below is used for

This is used for monitoring temperature, core temperature monitoring.

Anaesthesia

null

Oesophageal temperature probe

Alkalinization of urine is required to treat toxicity of all except:

Changes in urinary pH affect tubular reabsorption of drugs that are paially ionized - * Weak bases are ionize more and are less reabsorbed in acidic urine.* Weak acids ionize more and are less reabsorbed in alkaline urine. Urine is alkalinized in barbiturate, methotrexate and salicylate poisoning.

Pharmacology

Sympathetic System

Amphetamine

Which of the following is the feature of vegetations in Libmann Sacks endocarditis?

Mitral and tricuspid valvulitis with small, sterile vegetations, called Libman-Sacks endocarditis, is occasionally encountered in systemic lupus erythematosus. The lesions are small (1 to 4 mm in diameter), single or multiple, sterile, pink vegetations with a way (verrucous) appearance. They may be located on the undersurfaces of the atrioventricular valves, on the valvular endocardium, on the chords, or on the mural endocardium of atria or ventricles.

Pathology

Endocarditis

Small or medium sized on either or both sides of valve

Permanent impairment of fingerprints occurs in all except

Permanent impairment of fingerprints occurs in: Leprosy Electrical injuries Radiation injuries Ridge alteration occur in: Acanthosis nigricans Scleroderma

Forensic Medicine

Human identification

Acanthosis nigricans

True about ascent to high altitude:

Respiratory alkalosis occurs Polycythemia is due to increased erythropoietin Acute mountain sickness develops 8-24 hr after arrival at altitude and lasts 4-8 days. Acute altitude illness: 3 forms Acute mountain sickness (AMS) The pathophysiology of AMS is not well understood. The essential factor responsible for this condition is hypoxemia High altitude cerebral edema (HACE) High altitude pulmonary edema (HAPE)

Physiology

Respiratory System Pa 3

Acetazolamide may be given prophylactically

Phenol test or Reidel Walker test is done to determine:

Ans. d. Efficacy of a disinfectants

Microbiology

null

Efficacy of a disinfectants

The instrument shown here is useful for:

null

Dental

null

Removal of crown

Goodpasture syndrome has antibodies against:

(Refer: Robbins Pathologic Basis of Disease, 8thedition, pg no: 709)

Unknown

null

Collagen 4

Zygote is dependent on which of the following for its nutrition -

Ans. is 'd' i.e., All the above While zygote is passing down the fallopian tube and after a brief period as it enters the uterus, it depends for its nutrition on the yolk sac granules (deutoplasm) embedded in its cytoplasm and on the fluid medium surrounding it which is secreted by the walls of the uterine tube and uterus.It also derives its energy from the stored carbohydrate in sperm, whichfeilized the ovum,

Gynaecology & Obstetrics

null

All the above

Urine is collected for examination in a pregnant female by :

Early morning sample

Gynaecology & Obstetrics

null

Early morning sample

Okazaki fragments are found during

DNA synthesis is always into 5&; to 3&; direction in both strands The strand which is discontinuously synthesized is referred to as the &;lagging strand &; otherwise called the retrograde strand The small DNA molecules attached to its own primer RNA are called Okazaki fragments The synthesis along the lagging strand is in 5&; to 3&; directionRef: DM Vasudevan, 7th edition, page no: 580, 581

Biochemistry

Metabolism of nucleic acids

Replication

Which type of pelvis is associated with increased incidence of 'face to pubis' delivery:

As discussed in the text in Table 1.1 face-to-pubis delivery is common in anthropoid pelvis.

Gynaecology & Obstetrics

null

Anthropoid pelvis

HIV primarily replications in which cells -

Ans. is 'a' i.e., CD4 T-cells * The receptor for the virus is the CD4 antigen on surface. The cells affected are :# CD4 T Cells (major target)# B lymphocytes# Monocytes and macrophages# Langerhans cells in dermis# Glial cells and microglia in the CNS# Follicular dendritic cells from tonsils can be infected by HIV without the involvement of CD4

Microbiology

Virology

CD4T-cells

According to The Workmen's Compensation Act, 1923, which of the following is considered an occupational disease?

Ans. b. Anthrax (Ref: style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">According to The Workmen's Compensation Act, 1923, Anthrax is considered an occupational disease.List of Occupational Diseases as per Employee Compensation Act 1923 (Workmen Compensation Act, 1923)Part APart BPart C* Infectious and parasitic diseases contracted in an occupation where there is a particular risk of contamination (Anthrax)* Diseases caused by work in compressed air* Diseases caused by lead or its toxic compounds* Poisoning by nitrous fumes* Poisoning by organophosphorus compounds.* Diseases caused by phosphorus or its toxic compounds.* Diseases caused by mercury or its toxic compounds* Diseases caused by benzene or its toxic homologues.* Diseases caused by nitro and amido toxic derivatives of benzene or its homologues.* Diseases caused by chromium, or its toxic compounds* Diseases caused by arsenic or its toxic compounds.* Diseases caused by radioactive substances or radiations.* Primary epitheliomatous cancer of the skin, caused by tar, pitch, bitumen, mineral oil, anthracence, or the compounds, products or residues of these substances.* Disease caused by the toxic halogen derivatives of hydrocarbons (of the aliphatic and aromatic series).* Diseases caused by carbon disulphide.* Occupational cataract due to infrared radiations.* Diseases caused by manganese or its toxic compounds.* Skin diseases caused by physical, chemical or biological agents not included in other items.* Hearing impairment caused by noise.* Poisoning by dinitrophenol or a homologue or by substituted or by the salts of such substances.* Diseases caused by beryllium or its toxic compounds.* Diseases caused by cadmium or its toxic compounds.* Occupational asthma caused by recognized sensitizing agents inherent to the work process.* Diseases caused by fluorine or its toxic compounds.* Diseases caused by nitroglycerine or other nitro acid esters.* Diseases caused by alcohols and ketones.* Diseases caused by asphyxiant carbon monoxide, and its toxic derivatives, hydrogen sulphide.* Lung cancer and mesotheliomas caused by asbestos.* Primary neoplasm of the epithelial lining of the urinary bladder or the kidney or the ureter.* Snow blindness in snow bound areas.* Disease due to effect of cold in extreme cold climate.* Pneumoconiosis caused by sclerogenic mineral dust silicosis, anthracosilicosis, asbestosis) and silicotubercuiosis provided that silicosis is an essential factor in causing the resultant incapacity or death.* Bagassosis* Bronchopulmonary diseases caused by cotton, flax hemp and sisal dust (Byssinosis).* Extrinsic allergic alveolitis caused by the inhalation of organic dusts.* Bronchopulmonary disease caused by hard metals.* Acute pulmonary edema of high altitude.

Social & Preventive Medicine

Occupational Health

Anthrax

Radiological factors indicating an unstable pelvis are all except:

Radiographic factors indicating unstable pelvis are: Posterior sacroiliac complex displacement >1cm Avulsion fracture of sacral or ischial end of the sacrospinous ligament. Avulsion fractures of the L5 transverse process Disruption of pubic symphysis with pubic diastasis of 2 cm with posterior pelvic injury or injury to anterior/ posterior sacroiliac ligament or sacrospinous ligaments. Presence of gap rather than impaction in the posterior pelvic ring.

Orthopaedics

Pelvis and Hip Injury

Isolated disruption of pubic symphysis with pubic diastasis of 2 cm

Angioid streak is seen in -

null

Medicine

null

Pseudoxanthoma elasticum

Xiphoid process fuses with body of sternum by:

40 years

Forensic Medicine

null

40 years

Uveitis is caused by –a) TBb) Staphylococcusc) Streptococcusd) Klebsiellae) E.Coli

TB causes chronic granulomatous uveitis. Staphylococcus and streptococcus cause acute non-granulomatous pyogenic uveitis.

Ophthalmology

null

abc

A young female presented to you with primary amenorrhea. Examination reveals normal breast development and absent axillary hairs. Pelvic examination shows a normally developed vagina with clitoromegaly. On ultrasound, gonads are visible in the inguinal region. What is the most likely diagnosis?

Ans. is b, i.e. Partial androgen insentivity syndromeIn the question patient has 1deg amenorrhea:* Breast development is normal and absent axillary hair. (This means it cannot be Mayer Rokitansky kiister hauser syndrome --where Breast and pubic as well as axillary hair are well developed and it cannot be Gonadal dysgenesis as none of the secondary sexual characteristics are developed in it).We are left with 2 options:Option a --Complete androgen insensitivityOption b --Partial androgen insensitivityIn both these conditions --Breast development will be normal and pubic hair and axillary hair will be absent but clitoromegaly will be seen in partial androgen insensitivity only.

Gynaecology & Obstetrics

Disorders in Menstruation

Partial androgen insensitivity syndrome

A patient presents with thrombocytopenia, eczema and recurrent infections. What is the most probable diagnosis?

Wiskott-Aldrich syndrome (WAS) is an X-linked platelet/immunologic disorder caused by mutations in the WASP gene. The triad of eczema, recurrent infections, and microthrombocytopenia that characterizes WAS only occurs in 27% of the cases. The immunologic defects include low serum concentrations of IgM, while IgA and IgG are normal and IgE is frequently increased. Ref: The Elements of Immunology By Fahim Halim Khan, 2009, Page 413 ; Harrison's 17th ed chapter 310

Medicine

null

Wiskott Aldrich syndrome

A baby presents with refusal to feed, skin lesions, seizures, ketosis organic acids in urine with normal ammonia; likely diagnosis is:

Baby in the above mentioned case scenario is showing signs and symptoms of multiple carboxylase deficiency such as dermatitis severe metabolic acidosis, organic acid excretion. Ref: Essentials of Pediatrics By Nelson, 16th Edition, Pages 356 ; The Embryo: Scientific Discovery and Medical Ethics By Shraga Blazer, Page 246 ; NORD Guide to Rare Disorders: National Organization for Rare Disorders, Page 483

Biochemistry

null

Multiple carboxylase deficiency

Carbamoyl phosphate intermediates the synthesis of

(B) Urea & Pyrimidine # Biosynthesis of urea begins with the condensation of CC>2, NHs and ATP to form carbamoyl phosphate, a reaction catalyzed by carbamoyl phosphate synthase I which is a mitochondrial enzyme, and rate limiting or pacemaker enzyme and the enzyme is active only in the presence of its allosteric activator N-acetylglutamate, which enhances the affinity of synthase for ATP.

Biochemistry

Miscellaneous (Bio-Chemistry)

Urea & Pyrimidine

Which of the following is not true about Diplococcus pneumoniae

Streptococcus pneumoniae is optochin sensitive. Optochin sensitivity: the sensitivity of Streptococcus pneumoniae to optochin is useful in differentiating it from other streptococci. When a disc impregnated with optochin is applied on a plate of blood agar inoculated with Streptococcus pneumoniae, a wide zone of inhibition appears on incubation. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 225

Microbiology

Bacteriology

Optochin resistance

A patient on Bilonatumomab for refractory B cell All is now resistance to the drug. Which drug to be used:-

Drug Mechanism Use Vorinostat HDAC inhibitor Cutaneous T cell lymphoma Brentuximab Man against CD30 Hodgkin lymphoma Pembrolizumab PD-1 Melanoma Lung Cancer Head and neck cancer Tisagenlecleucel Ca therapy ALL Blinatumomab Bispecific t-cell engages ( targets CD19 and CD3) ALL

Pharmacology

JIPMER 2019

Pembrolizumab

Horizontal semicircular canal responds to

The three canals lie at right angles to each other but the one which lies at right angles to the axis of rotation is stimulated the most.Thus horizontal canal will respond maximum to the rotation on the veical axis. (Ref: Diseases of EAR, NOSE and THROAT by PL Dhingra; 6th edition; page no.17)

ENT

Ear

Rotational acceleration

Roof of the Anatomical snuff box is formed by the

Anatomical snuff box boundaries: Lateral wall Abductor pollicis longus Extensor pollicis brevis Medial wall Extensor pollicis longus Roof Cephalic vein Sup branch of radial nerve Floor Radial styloid, scaphoid, trapezium,1st meta carpal Content Radial Aery Ref: Gray's Anatomy The Anatomical Basics of Clinical Practice 41 e pg 893.

Anatomy

Upper limb

Sup branch of radial nerve

Which of these differentiates between ante moem and post moem burns?

SPECIFIC FINDINGS IN ANTEMOEM BURNS 1.SOOT PAICLES UPTO THE LEVEL OF TERMINAL BRONCHIOLE. 2. PRESENCE OF CARBOXYHEMOGLOBIN IN BLOOD. 3. Cyanide IN BLOOD 4. CURLING ULCER IN FIRST PA OF DUODENUM. NON SPECIFIC FINDINGS IN BURNS( ANTEMOEM + POSTMOEM BURNS) 1. PUGILISTIC ATTITUDE OR HEAT STIFFENING. 2. HEAT RUPTURE 3. HEAT HEMATOMA 4. HEAT FRACTURE.

Forensic Medicine

Thermal injuries

Soot paicles up to terminal bronchioles

Arrange the following in sequential order of their involvement in estrogen synthesis: A. Progesterone B. Androgen in granulosa cell C. Androgen in theca cell D. Aromatase

Interaction of follicular theca and granulosa cells for production of estrogens. The theca cells, under the control of luteinizing hormone (LH), produce androgens that diffuse into the granulosa cells. In mature follicles, follicle-stimulating hormone (FSH) acts on granulosa cells to stimulate aromatase activity, which conves the androgens to estrogens. AC - Adenylate cyclase; ATP - Adenosine triphosphate; cAMP - Cyclic adenosine monophosphate; LDL - Low density lipoproteins.

Physiology

Female Reproductive System

A-C-B-D

Left bundle branch block (LBBB) on ECG can suddenly develop in all of the following except:

Ans. b. Ashman phenomenon (Ref: Harrison 18/e p1835) style="font-size: 1.04761904761905em; font-weight: bold; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">Ashman phenomenon:Ashman phenomenon is an intraventricular conduction abnormality caused by a change in the heart rate.Wide QRS complex) on the surface ECGA RBBB pattern is more common because of the longer refractory period of the right bundle branch, although association with LBBB has been documentedCauses of Left Bundle Branch Block (LBBB)* Aortic stenosis* Dilated cardiomyopathy* Acute myocardial infarction* Extensive coronary artery disease* Primary disease of the cardiac electrical conduction system* Long standing hypertension leading to aortic root dilatation and AR* Hypokalemia* Hyperkalemia

Medicine

Electrocardiography

Ashman phenomenon

C-3 convertase in alternate complement pathway -

null

Microbiology

null

C3bBb

Treatment of latent TB infection in Tuberculin positive, HIV positive patients:

Ans. is 'a' i.e., 1NH biweekly for 9 month Dosing regimens for treatment of latent tuberculosis* AdultsChildren <12IsoniazidStandard regimen:o 300 mg PO daily for nine months Alternate regimens:o 300 mg PO daily for six months900 mg PO twice weeklyD for nine months900 mg PO twice weeklyD for six monthsStandard regimen:o 10 to 15 mg/kg PO daily for nine months; not to exceed 300 mg/dayAlternate regimen:o 20 to 30 mg/kg PO twice weekly for nine months; not to exceed 900 mg/dayIsoniazid and rifapentineIsoniazid (orally once weekly for 12 doses, given by direct observation):o 15 mg/kg, rounded up to the nearest 50 or 100 mg; 900 mg maximumRifapentine (orally once weekly for three months, given by direct observation):o 10 to 14 kg: 300 mgo 14.1 to 25 kg: 450 mgo 25.1 to 32 kg: 600 mgo 32.1 to 49.9 kg: 750 mg o >50 kg: 900 mg maximumSee noteYIsoniazid (orally once weekly for 12 doses, given by direct observation):o 15 mg/kg, rounded up to the nearest 50 or 100 mg; 900 mg maximumRifapentine (orally once weekly for three months, given by direct observation):o 10 to 14 kg: 300 mgo 14.1 to 25 kg: 450 mgo 25.1 to 32 kg: 600 mgo 32.1 to 49.9 kg: 750 mgo >50 kg: 900 mg maximumRifampin600 mg PO daily for four months10 to 20 mg/kg PO daily for four months; not to exceed 600 mg/dayIsoniazid and rifampinIsoniazid 300 mg PO daily for three monthsIsoniazid 10 to 15 mg/kg PO daily for three months; not to exceed 300 mg/day Rifampin 600 mg PO daily for three monthsRifampin 10 to 20 mg/kg PO daily for three months; not to exceed 600 mg/day

Medicine

Bacteriology

INH biweekly for 9 month

In MI, which enzyme is raised in 4 to 6 hrs. & decreases in 3 to 4 days :

Answer is C (Creatinine phosphokinase) Creatinine phosphokinase is seen at 4 to 8 hours (May be seen at 2-4 hours), peaks at 24 hours and return to normal by 72 hours. Creatinine phosphokinase MB (CPKMB) Very sensitive (CPK MB isoenzyme increases the specificity) 'Absence in change in levels of CPK and CPKMB during the 1st 2 days essentially excludes the diagnosis of MI' -Chandrasoma CK elevation used to be test of choice in First 24 hours. ('Cardiac troponins are now preferred'). CKMB is still the test of choice for detecting recurrent ischaemic event.

Medicine

null

CPK

The most impoant factor in fracture healing is:

D i.e. Immobilization

Surgery

null

Immobilisation

Rubella causes all except

Rubella: Rubella/ german measles is caused by RNA virus of togavirus family. Rubella inhibits cell division and this is the reason for congenital malformations. Congenital Rubella syndrome refers to infants born with defects secondary to intrauterine infections sometime after bih. It consists of triad of symptoms of deafness, cardiac malformation and cataract . Other defects include glaucoma , retinopathy, microcephalus, cerebral palsy , intrauterine growth retardation, hepatosplenomegaly, mental and motor retardation. Reference: GHAI Essential pediatrics, 9 th edition

Pediatrics

Infectious disease

AS

Optical urethroplasty is done in:(Internet)

(Congenital stricture of urethra) (1388-89-Baily & Love 24th) (Internet) (1362-Baily & Love 25th)Hypospadias - surgical plastic repair of hypospadias is currently accomplished by a variety of highly successful one stage operations and is routinely performed between 6 and 19 months of age (1008-CSDT 12(tm))Epispadias - Treatment consist of correction of penile curvature reconstriction of the bladder neck in incontinent patients.Congenital urethral stricture - commonly these strictures are thin diaphragms that may respond to simple dilation onto direct vision internal urethrotomy.A single treatment by optical urethrotomy or dilatation is usually effective (1388-Bailey & Love 24th)* A one stage dorsal free graft urethroplasty for bulbar urethral structure to reduce the incidence of urethrocele.

Surgery

Urethra & Penis

Congenital stricture of urethra

A 78-year-old man with advanced renal disease has the ECG(lead II). What is the diagnosis?

(a) Source: (Fuster, p. 313)No atrial activity is detected. The ventricular rate is slightly irregular. Beat number 4 is a ventricular premature contraction. The T waves are tall and markedly peaked. This type of T wave is characteristic of hyperkalemia, as is absence of visible atrial activity. The potassium level was 8.2 mmol/L.

Medicine

C.V.S.

hyperkalemia

Acute changes in brain due to wernicke's encephalopathy in chronic alcoholics is most frequently seen in:

Acute changes are most frequently seen in the 1. Mamillary bodies And also seen in 2. Around the third and fouh ventricles and 3. Aqueduct of the midbrain. Ref: Thorarinsson BL, S C I E N T I F I C P A P E R O V E R V I E W

Medicine

null

Mamillary bodies

Secondary oocyte consists of

Ans. d (23 X)Secondary oocyte consist of 23 X chromosomes.The chromosomal complement of a primary oocyte is 46 XX and that of secondary oocyte is 23 X.Sequence of maturation of ovarian primordial follicle after primary follicle stage:Primordial follicle(Single layered ovarian follicle)Spermatogonium (diploid, 2N) ||Primary Spermatocyte (diploid, 2N)Primordial follicle ||Secondary Spermatocyte (haploid, N)Secondary follicle (Antral follicle) ||Spermatid (haploid, N)(Spermatogenesis begins with Spermatogonia.Full development takes 2 months.It occurs in seminiferous tubules)Graffian follicle|Corpus luteum| Corpus albicans # While majority of oogonia divide, some enter into prophase of first meiotic division and are primary oocytes. These are surrounded by flat cells, which are called primordial follicles, and are present in cortex of the ovary.# At birth, there is no more mitotic division and all the oogonia are replaced by primary oocytes, which have finished prophase of first meiotic division and remain in resting phase between prophase and metaphase.# The first stage of maturation occurs with full maturation of ovarian follicle just prior to ovulation but the final maturation occurs only after fertilization.# The primary oocyte undergoes first meiotic division giving rise to secondary oocyte and one polar body.# Secondary oocyte has haploid number of chromosomes.# Ovulation occurs soon after formation of secondary oocyte.# The secondary oocyte completes the second meiotic division only after fertilization by the sperm in the fallopian tube.

Gynaecology & Obstetrics

The Ovarian Cycle

23 X

True about mucosa associated lymphoma

Gastric lymphoma This is a rare tumour, accounting for less than 5% of all gastric malignancies. The stomach is, however, the most common site for extranodal non-Hodgkin lymphoma and 60% of all primary gastrointestinal lymphomas occur at this site. Lymphoid tissue is not found in the normal stomach but lymphoid aggregates develop in the presence of H. pylori infection. Indeed, H. pylori infection is closely associated with the development of a low-grade lymphoma (classified as extranodal marginal-zone lymphomas of MALT type). EUS plays an impoant role in staging these lesions by accurately defining the depth of invasion into the gastric wall. The clinical presentation is similar to that of gastric cancer and endoscopically the tumour appears as a polypoid or ulcerating mass. While initial treatment of low-grade lesions confined to the superficial layers of the gastric wall consists of H. pylori eradication and close observation, 25% contain t(11:18) chromosomal translocations. In these cases, additional radiotherapy or chemotherapy is usually necessary. High-grade B-cell lymphomas should be treated by a combination of rituximab, chemotherapy , surgery and radiotherapy. The choice depends on the site and extent of tumour, the presence of comorbid illnesses, and other factors, such as symptoms of bleeding and gastric outflow obstruction. The prognosis depends on the stage at diagnosis. Features predicting a ourable prognosis are stage I or II disease, small resectable tumours, tumours with low-grade histology, and age below 60 years. Ref Davidson edition23rd pg805

Medicine

G.I.T

H. Pylori predisposes

Which is not Glucogenic?

The glucogenic amino acids are: Alanine Arginine Asparagine Aspaic Cysteine Glutamic Glutamine Glycine Histidine Methionine Proline Serine ValineRef: DM Vasudevan, 7th edition

Biochemistry

Metabolism of carbohydrate

Lysine

The gene for folic acid transpoer is located on which chromosome:

C i.e. 21Folic acid transpoer gene (SLC 19 AI solute carrier family 19) is located on long arm of chromosome 21 (21q) Q at band 22.3. Transpo of folate occurs by potocytosis which functionally couples folate receptor, folate transpoer and V- type h+ pump.

Biochemistry

null

21

The best treatment for class V lesion on a tooth along with extensive class II caries is:

With class V lesion and extensive class II cavity in the same tooth the remaining enamel surface with the supported healthy dentin will be much less hence in such situation full crown restoration will be long lasting.

Dental

null

A full crown restoration

Which has maximum nicotinic effect-

Ans. is 'b' i.e., Carbachol o Amongst the given options carbachol has maximum nicotinic actions. It has nicotinic as well as muscarinic action.

Pharmacology

null

Carbachol

Indications for cesarean hysterectomy are all except:

Cesarean hysterectomy refers to an operation where cesarean section is followed by removal of the uterus. Peripartum hysterectomy is the surgical removal of the uterus either at the time of cesarean delivery or in the immediate postpartum period (even following vaginal delivery). Some indications for peripartum hysterectomy Uterine atony Abnormal placentation – Bleeding – Accrete syndromes Uterine extension Uterine rupture Cervical laceration Postpartum uterine infection Leiomyoma Invasive cervical cancer Ovarian neoplasia M/C cause of cesarean/peripartum hysterectomy is PPH.

Gynaecology & Obstetrics

null

Couvelaire uterus

The parasympathetic secretomotor nerve supply to the nose is

The nerve of the pterygoid canal passes through the pterygoid canal to reach the pterygopalatine ganglion. The parasympathetic fibres relay in this ganglion. Postganglion are parasympathetic fibres arising in the ganglion ultimately supply the lacrimal gland and the mucosal glands of the nose, palate, and pharynx. The gustatory or taste fibres do not relay in the ganglion and are distributed to the palate. Ref: BD Chaurasia's HUMAN ANATOMY, Volume 3, 4th edition.

Anatomy

Head and neck

Vidian nerve

Foot process effacement is seen on EM in ?

Ans. is All 'a' i.e., Minimal change disease, 'b' i.e., Focal segmental GN, 'c' i.e., IgA nephropathyo Foot process effacement is noted in patients with nephrotic syndrome.o A variety of injurious stimuli may cause the podocyte to react with flatteninng or simplification of the foot process architecture.While most commonly noted in lipoid nephrosis (minimal change disease), foot process effacement can also be seen in focal segmental glomerulosclerosis, membranous glomerulonephropathy and in other glomerulonephritis.So, keep in mind that foot process efffacement is seen most commonly in minimal change disease, but can also occur in other glomerulonephropathies causing nephrotic syndrome (FSGS, IgA nephropathy, MPGN) o For option IgA nephropathy is a type of mesangioproliferative GN.

Pathology

null

All

Most common organism associated with reactive arthritis is?

null

Medicine

null

Chlamydia

Which of the following drug is category B (adequate studies in pregnant woman have failed to demonstrate a fetal risk)?

Category B drugus are the one that have shown no risks in animal studies, but human studies do not exist or also if adverse effect have been seen in animal studies with no such effect im well controlled human trials. eg.ranitidine,paracetamol. TEXT BOOK OF OBSTETRICS,Sheila Balakrishnan,2nd edition,page no.564

Gynaecology & Obstetrics

Medical, surgical and gynaecological illness complicating pregnancy

Ranitidine

Which of the following is true regarding Hybridoma Technique

All the following statements are corret.

Biochemistry

null

All of the above

Hu is defined under section: NEET 14

Ans. 319 IPC

Forensic Medicine

null

319 IPC

Pale infarcts are seen at all of the following sites except-

Ans is 'd' i.e., Lung INFARCTION o An infarct is an area of ischemic necrosis by occlusion of either the aerial supply or venous drainage in a paicular tissue. Pathogenesis o Mostly it is caused by interrupted blood supply. o "Nearly 99% of all infarcts results from thrombotic or embolic events and almost all result. from aerial occlusion". o Other causes of interrupted aerial supply are local vasospasm, extrinsic compression of a vessel by tumor, twisting of vessel e.g., in testicular torsion, expansion of atheroma due to hemorrhage within the plaque. o Venous obstruction usually cause congesion, edema, infarction does not occur because bypass channels rapidly open after the thrombus, providing some outflow from the area, which inturn improves aerial inflow. Infarct cause by venous thrombosis is more likely in organs with a single venous outflow channel, such as in testis and ovary. Types of infarct o Infarcts are classified on the basis of their color. o Infarcts are classified into either Red (Haemorrhagic) or White or Pale (anaemic) infarcts, reflecting the amount of haemorrhage. Red infarcts (Haemorrhagic) : occur with : Venous occlusions (eg ovarian torsion); In loose tissues (such as lungs); In tissues with dual circulation (e.g. Lung & S. intestine) In tissues that were previously congested because of sluggish venous out flow. When flow is reestablilshed to a site of previous aerial occulusion and necrosis. White or Pale infarcts : occur with : Aerial occlusions, or In solid organs e.g. Hea, spleen, Liver, kidney and brain where the solidity of tissue limits the amount of haemorrhage that can seep into the area of ischaemic necrosis.

Pathology

null

Lung

All are split - thickness skin graft except

Wolfe graft is full thickness skin graft.

Surgery

null

Wolfe graft

Enteropathy type T cell lymphoma is associated with -

Answer- B. Celiac SprueEnteropathy-type- T cell lymphoma is a rare complication of long-standing celiac disease.

Medicine

null

Celiac Sprue

Fine touch is transmitted via:

Ans. A. The dorsal lemniscal systema. Lateral spinothalamic tract carries pain and temperature;b. Anterior spinothalamic tract carries crude touch;c. All other sensations are carried by dorsal lemniscal.

Physiology

Nervous System

The dorsal lemniscal system

A young 25 year old man following A presented with proptosis (pulsatile in nature) ,chemosis and pain in right eye after 4 days. On Examination there was bruit on forehead and right eye. The probable diagnosis is

B i.e. Carotico cavernos Fistula

Ophthalmology

null

Carotico cavernous Fistula

BERA can be most accurate from which gestation?

Ref: Clohertys Manual of Neonatal Care, 6th edition. Page 646 and ENT DhingraExplanation:"ABR is reliable after 34 weeks postnatal age. "Ref: ClohertyBRAINSTEM EVOKED RESPONSE AUDIOMETRY (BERA)Other nameso Auditory brainstem responses (ABR)o Brainstem auditory evoked response (BAER)o Brainstem auditory evoked potential (BAEP).Measures the electroencephalographic waves generated hy the auditory system in response to clicks through three electrodes placed on the infant's scalp.The characteristic waveform recorded from the electrodes becomes better defined with increasing postnatal age.ABR is reliable after 34 weeks postnatal age.At present, because of the increased risk of injury to the auditory pathway beyond the cochlea (auditory nerve) including auditory dyssynchrony, ABR is the preferred screening method to evaluate hearing loss in the NICE graduate.Non-invasive technique to find integrity of central auditory pathways through the 8th cranial nerve, pons and midhrain.Electrical potentials are generated in response to several click stimuli or tone-bursts and picked up from the vertex by surface electrodes.It measures hearing sensitivity in the range of 1000 - 4000 Hz.In normal person. 7 waves are produced in the first 10 milliseconds.The 1st, 3rd and 5th waves are most stable and are used in measurements.Parameters studied in waveforms:o Latencyo Inter-wave latencyo Amplitude.The exact anatomic site of neural generators are:o Wave 1 - Distal part of CN 8.o Wave 2 - Proximal part of CN 8 near the brainstem.o Wave 3 - Cochlear nucleuso Wave 4 - Superior olivary complexo Wave 5 - Lateral lemniscuso Wave 6 & 7 - Inferior colliculus.UsesScreening for hearing in infants.To determine the threshold of hearing in:o Infants.o Children.o Uncooperative adultso Malingerers.To diagnose retroeochlear pathology (e.g.: Acoustic neuroma).To diagnose brainstem pathology (e.g.: Multiple sclerosis or Pontine tumors)To monitor CN 8 intraoperatively in surgery of acoustic neuromas to preserve the function of cochlear nerve.

ENT

Hearing Loss

34 weeks

Parapharygeal space is also known as

Parapharyngeal space is situated on the side of the pharynx. It is pyramidal in shape with the base at the base of the skull and apex at the hyoid bone. It contains carotid vessels, jugular vein, last 4 cranial nerves and cervical sympathetic chain. Ref: Diseases of ENT, PL Dhingra, 7th edition, pg no. 301

ENT

Pharynx

Lateral pharyngeal space

A patient undergoing chest x-ray following an automobile accident is found to have an enlarged mediastinum with bilateral hilar and right paratracheal adenopathy. The patient has been asymptomatic, but careful examination demonstrates an enlarged cervical lymph node. This node is biopsied and demonstrates involvement by small, non-caseating granulomas. Occasional giant cells with stellate inclusions are seen within the granulomas. These are most likely which of the following?

The cells described are asteroid bodies, and are classically associated with sarcoidosis, although they are not completely specific for this disease. Anitschkow cells are a form of activated histiocyte with an unusual wavy chromatin. They are found within inflammatory lesions called Aschoff bodies in the heas of patients with acute rheumatic hea disease. Paget's cells are individual adenocarcinoma cells found within the squamous epithelium of the skin.

Pathology

null

Asteroid bodies

Which of the following is not true about Mumps: March 2007

Ans. B: Incubation period is less than 14 Incubation period of mumps is 14-18 days The more common symptoms of mumps are: Parotid inflammation/ parotitis in 60-70% of infections. Fever Headache Orchitis, referring to painful inflammation of the testicle.Males past pubey who develop mumps have a 30 percent risk of orchitis. There is no specific treatment for mumps. Mumps viral infections in adult males carries a 25% risk that the testes may become infected which in rare cases leads to sterility. After the illness, life-long immunity to mumps generally occurs. Complications Infection of other organ systems Sterility in men (this is quite rare, and mostly occurs in older men) Mild forms of meningitis (rare, 40% of cases occur without parotid swelling) Encephalitis (very rare, rarely fatal) Profound (91 dB or more) but rare sensorineural hearing loss, uni- or bilateral Pancreatitis manifesting as pain abdomen and vomiting Oophoritis (inflammation of ovaries) but feility is rarely affected.

Medicine

null

Incubation period is less than 14 days

All are true regarding Scheuermann's osteochondritis except?

Scheuermann's osteochondritis has autosomal dominant inheritance. It commonly affects adolescent boys. It is characterised by irregular ossification of veebral endplates and dorsal kyphosis. Most patients are asymptomatic. It can present with backache which is aggravated by exercise. Management is by protective postural exercises with avoidance of excessive activity. Ref: Davidson's Principles and Practice of Medicine, 22nd edition, p1130

Medicine

All India exam

Autosomal recessive inheritance

Which among the following electrolyte disturbance following diarrhoea can cause convulsions?

Hyponatremia can result from diarrhea, vomiting, burns, diuretic administration, and administration of sodium-poor parenteral solutions. Seizures and coma usually are associated with severe hyponatremia and may be life-threatening. Acute hypernatremia usually is caused by severe water depletion with diarrhea especially in children. Ref: Harrison's 17th edition, chapter 46

Medicine

null

Hyponatremia

All are true about liver adenoma except

Clinical features Symptomatic ( upper abdominal pain) in 50-75%, related to hemorrhage or local compressive symptoms Two major risks - Rupture and malignant transformation Pathology Composed of cords of benign hepatocytes containing increased glycogen and fat, without bile ductules, fibrous septa, poal tracts or central vein Normal architecture of the liver is not seen in these lesions Central large plates of hepatocytes separated by dilated sinusoids which are perfused solely by peripheral aerial feeding vessels(lack poal venous supply), under aerial pressure Hemorrhage and necrosis are commonly seen

Anatomy

G.I.T

Normal liver architecture

First retinal abnormality in diabetic retinopathy: (PGI Dec 2007)

Ans. A (Microaneurysm) [Ref Khurana 4th/260-62; Parson 20th/294-98}"The earliest detectable lesion is microaneurysms in the macular area" -Khurana 4th/260Diabetic Retinopathy: Classification- 4 types Khurana 4th/260-62Non-proliferative Diabetic RetinopathyMicro aneurysmQ in macular area (the earliest detectable lesionQ)Retinal haemorrhage both deep (dot & blot haemorrhage) & superficial haemorrhages (flame shaped)Hard exudateQRetinal oedemaCotton-wool spotQProliferative Diabetic RetinopathyPDR develops in >50% of cases after about 25 years of the onset of diseaseThe hallmark Q of PDR is the occurence of neovasculari- ation'i over the changes of very severe NPDRVitreous detachment & vitreous haemorrhage may occurDiabetic MaculopathyMacular edemaQ is termed as clinically significant macular edemaChanges in macula affect visionD.Maculopathy-4 subtypeFocal exudative maculopathyDiffuse exudative maculopathyIschaemic maculopathyMixed maculopathyAdvanced Diabetic Eye DiseasePersistent vitreous haemorrhageTractiona! retinal detach m entQNeovascularglaucoma Q

Ophthalmology

Vascular Disorders

Microaneurysm

Phase I trial is done to test:

Ans. D. PharmacokineticsPhase I trial is also called First in human trial. In this phase, 10-100 healthy people are enrolled to calculate pharmacokinetic data. Phase 0 trials are also done sometimes prior to phase I studies to calculate early pharmacokinetic data. Phase II and III trials usually enrol patients. Phase II trials enrol 50-100 and usually determine drug efficacy and dose ranging. Phase III trials confirm the efficacy in larger population (100-1000). Phase IV trials are also known as postmarketing studies which determine safety (adverse drug reactions, adverse events, and drug-drug interactions). Even safety of long-term drug treatment can be determined in Phase IV trials which can be missed in clinical trials due to limited duration of clinical trials.

Pharmacology

General Pharmacology

Pharmacokinetics

New infectious agents are -

A new genus Henipavirus has been recently identified with the Nipah and Henda viruses causing zoonotic outbreaks. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:515

Microbiology

Virology

Nipah virus

All of the following are tumor markers, except

Beta-2 microglobulin and not beta macroglobulin may be used as a tumor marker (as in multiple myeloma).

Pathology

null

Beta-2 macroglobulin

Felty syndrome is characterised by A/E

Ans. is 'd' i.e., Thrombocytopenia Felty's syndrome is characterized by the combination of rheumatoid ahritis, splenomegaly and neutropenia. The condition is more common in those aged 50-70 years, and is more prevalent in females than males

Pediatrics

null

Thrombocytopenia

Inversion of foot is at

C. i.e. Talocalcaneal joint

Anatomy

null

Talocalcaneal joint

The motility of cell is due to protein-

Functions of Microtubules include determination of cell shape and various cell movements.

Physiology

null

Tubulin

After the first postoperative year of cardiac transplantation, the most common cause of death is

Chronic graft rejection is manifested in cardiac allografts as chronic vascular rejection of main and intramuscular coronary arteries. Myointimal proliferation and medial scarring result in diffuse and eccentric arterial narrowing referred to as accelerated graft atherosclerosis. Infection remains the primary cause of death within the first year of cardiac transplant, but accelerated graft arteriosclerosis is the most common cause of mortality thereafter. Percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, and re-transplantation are the current options for combating this problem.

Surgery

Transplantation

Accelerated graft arteriosclerosis

Shape memory is seen in:

null

Dental

null

NITINOL wire

Thyroid carcinoma associated with hypocalcemia is

Answer is B (Medullary Carcinoma) Medullary carcinoma of thyroid secretes calcitonin and this causes reduction in calcium levels.

Medicine

null

Medullary carcinoma

Fetal abdominal circumference is measured at the level of :

Abdominal Circumference (AC) is measured in the transverse section of the fetal abdomen at the level of the fetal stomach and the umbilical poion of the poal vein.This is usually affected in IUGR and is less useful in dating as it is the parameter most affected by fetal growth. Refer page no 479 of Text book of obstetrics,sheila balakrishnan 2 nd edition.

Gynaecology & Obstetrics

Diagnosis in obstetrics

Stomach and umbilical vein, perpendicular to spine

A 16 year old boy presented with asymptomatic, multiple erythamatous annular lesions with a collarette of scales at periph-ery of the lesions present on the trunk. The most likely diagnosis is:

C i.e. Pityriasis rosea Pityriasis rosea is a self limiting disorderQ of unknown etiology, with a suspected association with Herpes virus 7 and 6Q. It presents with development of usually asymptomatic (i.e. no prodromal or constitutional system), sharply (well) demarcated, larger (2-6 cm), annular (oval-round), erythematousQ (red to brown) lesion k/a primary/herald/mother patch mostly located on trunk in children and young adults (10-35 yrs)( 2. Similar but smaller secondary eruptions appear in crops at interval of usually 2 weeks distributed along lines of cleavage in christmas (fir) tree appearanceQ. Lesions demonstrate fine (cigarette paper) collarette of scaleQ just inside the peripheray of plaque.

Skin

null

Pityriasis rosacea

Which of the following is a stain for fat cells?

ANSWER: (C) Sudan IVREF: See APPENDIX-24 for "HISTOLOGY/PATHOLOGY/ MICROBIOLOGY STAINS" APPENDIX - 24Histology/Pathology/Microbiology StainsT issue/substanoeStainCommentAmyloidGross stainingLugol's iodine Light microscopyH & E, Congo redPolarised lightCongo redMetachromatic stainMethyl violet, crystal violetFluorescent stainThioflavin TNon specific stainPAS, Toludine blue. Aldan blueCaldum/calcificationVon kossa Alizarin Red SFor small quantitiesCalcein Tetracycline labellingBest for bone mineralizationConnective tissueVan Gieson stain (Picric Add + Acid Fuchsin)Simplest method of differential staining of Collagen and other Connective TissueTrichome stain (Gomori trichrome stain, Lillie's trichome & Masson trichome)Red = keratin/muscleBlue/green = bone /'collagenPink = cytoplasmCarcohydrate (Glycogen, cellulose etc)Periodic acid-Schiff stainNon specific for glycogenDiastaseSpecific for glycogenBest's carmine LipidSudan stains{Sudan III, IV, Sudan Back-B, Oil Red 0)Oil Red O largely replaced Sudan III and Sudan IVOil Red O is also used in a technique for staining latent fingerprintsOsmium tetra oxideAs a lipid stain, it is useful in scanning electron microscopy (SEM)LipofuscinSudan Black B MucinMuscarmineMost specific but less usefulPASMost sensitive, For neutral mucopolysaccharidesAlcian blue Bismark brownCan be used with live cellsColloidal iron Micro organismsFungiH & EBluePASRedGomori methamine silverMost sensitiveMycobacteriumZ N stain/methodCarbol fuchsinAuramine Rhodamine stainMost sensitive, mixture of Auramine O and Rhodamine B, used in fluorescence microscopySpirochetesWarthin starry silver stain H PyloriWarthin starry silver stainGiemsa stainH&E Pneumocystis/ Cryptococcus/ cocci diomycetesGomori methamine silver

Pathology

Histo Pathology

Sudan IV

In a person with HIV-1 infection, which of the following is the most predictive of the patient's prognosis

Amplification assays (-PCR, DNA PCR, and b DNA tests) are routinely used to detect viral RNA in clinical specimens. The tests can be quantitative when reference standards are used, and appropriate positive and negative controls must be included in each test. Because these molecular based tests are very sensitive, they form the basis for plasma viral load determinations. It is generally agreed that the amount of HIV in the blood (viral load) is of significant prognostic value. There are continual rounds of viral replication and cell killing in each patient, and the steady-state level of virus in the blood varies with individuals. A single measurement of plasma viral load approximately 6 months after infection can predict the risk of development of AIDS in men several years later. In women, viral load appears to be less predictive. The plasma viral load appears to be the best predictor of long-term clinical outcome, whereas CD4 lymphocyte counts are the best predictor of sho-term risk of developing an oppounistic disease. Plasma viral load measurements are a critical element in assessing the effectiveness of antiretroviral drug therapy. Ref:- Baveja textbook of Microbiology

Microbiology

Virology

Level of HIV-1 RNA in plasma

All of the following are biochemical markers included for triple test except

Triple test It is a combined biochemical test which includes MSAFP,hCG,UE3(unconjugated oestriol).Maternal age in relation to confirmed gestational age is also taken into account.It is used for the detection of Down&;s syndrome.In an affected pregnancy,level of MSAFP and UE3 tend to be low while that of hCG is high.It is performed in 15-18 weeks. D.C.DUTTA&;S TEXTBOOK OF OBSTETRICS,pg no:106,7th edition

Gynaecology & Obstetrics

Diagnosis in obstetrics

Human placental lactogen (HPL

Maximum collagen in wound healing is seen at which stage of healing

ref Robbins 9/ep106-108 When the levels of collagen production and degradation equalize, the maturation phase of tissue repair is said to have begun. During maturation, type III collagen, which is prevalent during proliferation, is replaced by type I collagen.Originally disorganized collagen fibers are rearranged, cross-linked, and aligned along tension lines. The onset of the maturation phase may vary extensively, depending on the size of the wound and whether it was initially closed or left open, ranging from approximately 3 days to 3 weeks. The maturation phase can last for a year or longer, similarly depending on wound type.

Anatomy

General anatomy

End of third week

Elective endodontic treatment is contraindicated in

null

Dental

null

Recent MI

Which of the following is not a High Risk Characteristic in proliferative diabetic retinopathy

Proliferative Diabetic Retinopathy Early PDR- Presence of new vessels High risk PDR NVD >= 1/3 - 1/2 disc area or NVD and Vitreous or Preretinal haemorrhage or NVE >= 1/2 disc area and Preretinal or Vitreous haemorrhage

Ophthalmology

Retina

NVD + Clinically signifacnt macular edema

Normal aqueous production rate -

Aqueous humour is derived from plasma within the capillary network of ciliary processes.The normal aqueous production rate is 2.3ml/min. Ref:ophthalmology -AK khurana -6th edition chapt:10 page no:221

Ophthalmology

Glaucoma

2ml/min

Ex-Press giaueoma implant is oiaily up of:

Ans. d. Stainless steel

Ophthalmology

null

Stainless steel

A 45 year - male presents with abrupt onset pain, weakness, loss of contour of shoulder and muscle wasting on 5deg day of tetanus toxoid immunization. Likely cause is:

Brachial plexus neuritis Ref: Basic neurology [By John Gilroy 3/e p594; "Brachial plexus neuritis is characterized by a sudden paralysis of muscles supplied through the brachial plexus and is often associated with painful dysesthesia of the arm. The condition occurs in known viral infections (herpes zoster, Epstein-Barr virus), following injections of tetanus toxoid, in putative viral infections; and as an autobnmune disorder following a surgical procedure."- Basic neurology By John Gilroy 3/e p594 Brachial plexus neuritis usually is characterized by the acute onset of excruciating unilateral shoulder pain, followed by flaccid paralysis of shoulder and parascapular muscles several days later. The syndrome can vary greatly in presentation and nerve involvement. Brachial neuritis (BN) exists in an inherited and an idiopathic form. In the idiopathic version, the pathophysiology is unknown, but the condition is generally thought to be an immune system - mediated inflammatory reaction against nerve fibers of the brachial plexus. The onset of pain in brachial neuritis (BN) is often abrupt and may follow recent illness, surgery, immunization, or even trauma (see Causes, below). Up to two thirds of cases begin during the nighttime. Sensory abnormalities are of usually of less intensity than the pain and muscle weakness. Causes: The exact cause of brachial neuritis is unknown, but the condition has been linked to many antecedent events or illnesses, as follows: Viral infection (paicularly of the upper respiratory tract) Bacterial infection (eg, pneumonia, diphtheria, typhoid) Parasitic infestation S urgery 2 Trauma (not related to shoulder) Vaccinations (eg, influenza, tetanus, diphtheria, tetanus toxoids, peussis [DPT J. smallpox, swine flu) Childbih Miscellaneous medical investigative procedures (eg, lumbar puncture, administration of radiologic dye) Systemic illness (eg, polyaeritis nodosa, lymphoma, systemic lupus erythematosus, temporal aeritis, EhlersDanlos syndrome) A rarer, hereditary form of BN has been localized to the SEPT9 gene on chromosome arm 17q and should be considered a distinct disorder. This entity presents in a younger age group, and is characterized by recurrent, often bilateral attacks. Dysmorphic facial features (eg, hypotelorism, long nasal bridge, facial asymmetry) can also be present. Diagnosis: Other causes of severe pain, such as an acute herniated cervical disc, should be excluded. In brachial plexus neuritis, electromyography and nerve conduction studies reveal abnormalities in more than one nerve; in contrast, cervical radiculopathy may show osteophytes and interspace narrowing on cervical spine x-rays and neuroforaminal disc impingement of MRI. Treatment: of brachial plexus neuritis is suppoive, with analgesics for pain, physical therapy to maintain shoulder strength/mobility, and reassurance that the condition generally will improve, albeit slowly.

Anaesthesia

null

Brachial plexus neuritis

MOST common acute complication of hemodialysis is:

Hypotension is the most common acute complication of hemodialysis. It is paicularly common among patients with diabetes mellitus. The factors that appear to increase the risk of hypotension, are excessive ultrafiltration with inadequate compensatory vascular filling, impaired vasoactive or autonomic responses, osmolar shifts, overzealous use of antihypeensive agents, and reduced cardiac reserve. Ref: Harrisons principles of internal medicine, 18th edition, Page: 2324.

Medicine

null

Hypotension

Which of the following decreases effectiveness of insulin -

Ans. is 'a' i.e., Thiazide o Thiazide, furosamide, coicosteroids, oral contraceptives, salbutamol, nifedipine tend to raise blood sugar and reduce effectiveness of insulin.

Pharmacology

null

Thiazide

Causes of exudative retinal detachment are all except -

Occurs due to the retina being pushed away by a neoplasm or accumulation of fluid beneath the retina following inflammatory or vascular lesions. Etiology: Systemic diseases- toxaemia of pregnancy, retinal HTN, blood dyscrasias. Ocular diseases- scleritis, central serous retinopathy, orbital cellulitis, retinoblastoma, malignant melanoma of choroid. Ref: Khurana 5th edition , page no 298

Ophthalmology

Vitreous and retina

High myopia