question
stringlengths
1
1.57k
exp
stringlengths
1
22.5k
subject_name
stringclasses
21 values
topic_name
stringlengths
3
135
answer
stringlengths
1
287
Type IIIB Endometrial cancer (FIGO) is
null
Gynaecology & Obstetrics
null
Endometrial cancer with vaginal involvment
Secondary Polycythemia may be seen in:
Answer is A (Cor pulmonale): Secondary polycythemia due to decreased tissue oxygenation may be seen in chronic corpulmonale. Polycythemia may also be seen in association with cyanotic congenital hea diseases. Physiologically Appropriate Polycythemia Physiologically inappropriate polycythemia (Secondary to decreased tissue oxygenation or hypoxic (Secondary to appropriate erythropoietin production erythrocytosis) or response) High-altitude erythrocytosis (Monge disease) * Tumors, cysts, hemangiomas, and so foh Pulmonary disease * Androgen abuse - Chronic cor pulmonale * Erythropoietin abuse - Ayerza syndrome * Familial polycythemia Cyanotic congenital hea disease Hypoventilation syndromes - Primary alveolar hypoventilation - Pickwickian syndrome, Ondine curse - Positional desaturation - Sleep apnea Abnormal hemoglobins - Inherited - Acquired: Drugs and chemicals, carboxyhemoglobin - Familial polycythemia
Medicine
null
Cor pulmonale
Most definitive diagnosis of sinusitis is
Sinuscopy or Diagnostic nasal endoscopy is the most appropriate investigation.The classical feature is the presence of mucopus in the middle meatus or above the middle meatusA more appropriate investigation would be CT scan of the nose and PNS.Ref: Hazarika; 3rd ed; Pg 331
ENT
Nose and paranasal sinuses
Sinuscopy
Intravenous regional anaesthesia is contraindicated in
As tourniquet application can precipitate sickling and hypoxia, IVRA is contraindicated in sickle cell anemia.
Anaesthesia
null
Sickle cell disease
Coverings of spermatic cord are all except ?
Ans. is 'd' i.e., Daos muscleThe spermatic cord consists of a tubular sheath extending from the deep inguinal ring to the upper pa of posterior border of testis. Constituents of spermatic cord are ?Ductus deferens (Vas deferens)Aeries :- Testicular aery, cremestric aery, aery to ductus deferens.Veins :- Pampiniform plexus.Nerves :- Genital branch of genitofemoral nerve and sympathetic plexus around aeries.Others :- Lymphatics, remains of the processes vaginalis.Covering of spermatic cord, from within outwards, are :- (i) internal spermatic fascia, (ii) cremasteric fascia and (iii) external spermatic fascia.
Anatomy
null
Daos muscle
BCG vaccine in HIV (+) newborn is:
Ans (a)BCG vaccine should not be given to infants and children with active HIV disease. Babies born to mother with AFB positive spectum should not be given BCG at birth, but only after a course of preventive chemotherapy.
Microbiology
Bacteria
Contraindicated
A person is diagnoses with pulmonary embolism invasive modality for diagnosis is -
Ans. is 'b' i.e., Pulmonary angiography o The definitive diagnostic for pulmonary thromboembolism is pulmonary angiography.o It is the most specific investigation for pulmonary> thromboembolism but it is expensive time consuming and invasive,o Therefore chest CT with contrast has virtually replaced angiography as the diagnostic test.o Best investigation when there is clinical suspicion of pulmonary embolism - Contrast enhanced CT.
Medicine
Pulmonary Embolism
Pulmonary angiography
Wof is an immunosuppressant that acts by inhibiting mTOR and is non nephrotoxic
mTOR INHIBITORS Sirolimus This new and potent immunosup-pressant is a macrolide antibiotic (like tacrolimus), which was earlier named Rapamycin. Mech of action:- It binds to immunophillin FKBP and the sirolimus-FKBP complex inhibits kinase called 'mammalian target of rapamycin' (mTOR). uses:- 1)For prophylaxis and therapy of graft rejection reaction, sirolimus can be used alone, but is generally combined with lower dose of cyclosporine/tacrolimus and/or coicosteroids and mycophenolate mofetil. It is paicularly suitable for patients developing renal toxicity with cyclosporine.( Sirolimus is non nephrotoxic). 2)sirolimus coated stents are being used to reduce the incidence of coronary aery restenosis, by inhibiting endothelial proliferation at the site. Adverse effects:- Significantly, sirolimus is not nephrotoxic, but it can suppress bone marrow, mainly causing thrombocytopenia. Rise in serum lipids is common. Other adverse effects are diarrhoea, liver damage and pneumonitis. Ref:- kd tripathi; pg num:-882
Pharmacology
Immunomodulators
Sirolimus
Which of the following Osteotomy is carried out for mandibular deformity
null
Surgery
null
All of the above
Paramesonephric duct develops into:
Ans. D. Uterus MaleFemaleMesonephric ductDuct of epididymisDuct of epoophoron(Wolffian duct)Ductus deferensPart of bladder and urethra Ejaculatory duct Part of bladder and prostatic urethra (Paramesonephric or Mullerian duct)Appendix of testisUterine tube Prostatic utricleUterus Vagina
Gynaecology & Obstetrics
Obstetrical Anatomy
Uterus
True about immunoglobulins-
null
Microbiology
null
IgG has maximum serum concentration
Toxin involved in the streptococcal toxic shock syndrome is:
Streptococcal TSS is caused by pyrogenic exotoxin. Ref: Text Book of Microbilogy By Ananthanarayan, 8th Edition, Page 208-209 ; Harrison's Principles of Internal Medicine, 14th Edition, Page 889, 15th Edition, Page 903
Microbiology
null
Pyrogenic toxin
Radiopharmaceutical used for the liver scan is
Tc-99m sulphur colloid is used in liver scan.Tc-99m DTPA measurement of GFR.Tc99m-sestamibi is taken up by cells with a high concentration of mitochondria i.e. highly cellular/metabolically active tissues such as the hea but also abnormal tissues such as oxyphil cell parathyroid adenomas, myeloma and breast cancer.
Radiology
GIT and hepatobiliary system
Tc-99m sulphur colloid
From which of the following routes absorption of local anaesthetic is maximum?
Ans. is 'a' i.e., Intercostal According to miller "The greater the blood supply to the area injected, the greater is the systemic absorptionSites of absorption from greatest to least include:-Intrapleural > intercostal > pudendal > caudal > epidural > brachial plexus > infiltration.
Anaesthesia
Miscellaneous (Local and Regional Anesthesia)
Intercostal
Atypical pneumonia is caused by all except
Haemophilus influenza causes lobar pneumonia .it is one of the frequent cause of fatal pneumonia in the pandemic of influenza in 1918 _1919 where as atypical pneumonia is not as serious as typical pneumonia Ref:anantnarayan and paniker's microbiology 10th edition
Microbiology
Bacteriology
Hemophilus
A 28 year female patient presented with history of bilateral hearing loss and tinnitus. She can hear better in noisy environment. Examination showed intract ear drums bilaterally and Rinne test is negative bilaterally. Pure tone audiometry given below. What is the most probable diagnosis?
Ans. (c) Stapedial otosclerosisRef: Logan Turners ENT 11th Ed; Page No-464Otosclerosis* Most commonly seen in third decade, i.e. 20-30 years of age.* Most commonly seen in females, with a ratio of 2:1.* It is most commonly seen in white peoples.* The most common site origin of otosclerosis is fissula ante fenestrum.* It is aggravated by any hormonal change, be it pregnancy or menopause.* It is an autosomal dominant disorder and positive family history.* Clinical features:# Patients presents with bilateral progressive conductive hearing loss (70-85%).# Otosclerosis is the most common cause of bilateral progressive conductive hearing loss in adults.# This patient gives the typical history of haring better in noisy surroundings, which is known as Paracusis willisii phenomenon. This is because the speaker raises his voice in noisy surroundings which now cross the hearings threshold of the patient.# Less commonly tinnitus can also occur in otosclerosis, particular in cochlear otosclerosis and active otosclerosis.# Sometimes otosclerosis is associated with Osteogenesis imperfecta and blue sclera, when it constitutes van dar Hoeve syndrome.* Investigation:# Tympanic membrane appears pearly white (normal) in 90% patients; it is called as mature otosclerosis.# 10% cases of otosclerosis are active. In these the active division is taking place on the medial wall of middle ear leading to increase vascularity. This appears pinkish through the intact tympanic membrane leading to flamingo pink appears of TM also known as Schwartz sign.# Audiometric test:Tuning fork testFindingsRinne'sNegativeWeber'sLateralized to the worst earABCSame as examinerSchwabachLengthenedGelle'sNegative (i.e. change in the pressure of EAC does not produce ant y change in hearings as ossicular chain is already fixed.* Pure tone Audiometry:# The audiogram of the patients shows anA-B gap > 15dB (Suggestive of conductive hearing loss). Complete fixation of foot plate leads to the maximum conductive hearing loss of 60dB.# There is typical dip at 2000Hz in the bone conduction curve. This dip is because of fixation of footplate of stapes, the natural frequency of which 2000Hz. Hence its fixation fails to transit this frequency sound.# This dip is known as "Carhart's notch". This dip disappears after the mobilization of footplate and stapes during the management of otosclerosis.TreatmentActive casesMature cases* Sodium fluoride (NaF):# Inactive cases i.e. when Scwartze sign is present, medial medical management with sodium fluoride is done.# NaF accelerates the maturation of the focus by increasing osteoblastic and decreasing osteolytic activity.# It also inhibits the proteolytic enzymes that release cytotoxic chemicals to Cochlea.* Surgery: In mature otosclerosis when the foot plate is fixed and active division has stopped the treatment consists of mobilization of foot plate of stapes. The surgical procedure s are:-* Stapedectomy:# Here the whole of the stapes is removed and the oval window is then covered with a fascia graft and prosthesis is placed over the graft with other end of prosthesis attached to the long process of incus.# The change of perilymph fistula, SN hearing loss and vertigo is higher in stapedectomy as compared to stapedotomy. Hence it is not preferred nowadays.# It is contraindicated in chronic nephritis, RA, pregnancy and lactation.* Bisphosphonates have also been used as they inhibit bone resorption.* Stapedotomy:# This is a more conservative and better procedure where the incudostapedial joint is separated; the Stapedial tendon is cut and the suprastructure of stapes (head, neck, anterior and posterior crura) is removed leaving the foot plate behind.# The most common prosthesis is used here Teflon piston.* Postoperative Complication:# Conductive hair loss.# Perilymph fistula# Facial nerve palsyHow to rule out other options?Meniere's disease# It is also known as endolymphatic hydrops. It is frequently a unilateral condition and seen in more commonly in young females (20-40 years).# It is largely idiopathic.Clinical features* Vertigo: It is the first symptoms of Meniere's disease and it lasts for at least 20 minutes till a maximum of up to 24 hours. This sudden onset of vertigo of Meniere's disease associated with vagal symptoms, i.e. nausea, vomiting, abdominal cramping, diarrhoea and bradycardia.* SN hearing loss and tinnitus can be seen.Investigations* Rinne Test: Positive* Weber test: Towards the normal ear* ABC: Shortened* Schwabach: Shortened* Recruitment: Positive* SISIS:70-100% (because of recruitment)Management* Salt and water restrictions* Labyrinthine sedatives* Vasodilators* Meniett deviceVestibular neuronitis* This condition is characterized by acute onset vertigo, nystagmus and tinnitus with nausea and vomiting lasting for days to weeks.* This is most likely because of viral infection involving the vestibular nave.* The cochlear part is not involved, so the hearing remains normal.* The caloric test shows diminished response.* It is managed by labyrinthine sedatives.
ENT
Ear
Stapedial otosclerosis
Select the false statement about P. jiroveci?
Ans. is 'b' i.e., Frequently associated with CMV Lets see each option one by one. Robbin's Option 'a' - See following statements of Topley's mycology; "Pneumocystis are found in low number in the lungs of mammalian hosts with intact immune system and in more abundance in homeotherms with compromised immune status". "A decrease in cell mediated immunity is the single most impoant risk factor for the development of pneumocystis pneumonia". So, P. jiroveci may be seen both in immunocompromised individuals and individuals with intact immune system, but it causes pneumonia only in immunocompromised individuals. Option 'b' - P.jirovecii may be associated with CMV infection but it is not usually associated with CMV infection. Option 'c' - P.jirovecii may be associated with penumatocele formation but pneumatoceles are not associated in all cases of P.jirovecii pneumonia. Option 'd' - Option 'c' is paially correct. - Usually the diagnosis of pneumocystis pneumonia is confirmed by histopathologic staining of BAL fluid collected by bronchoscopy, but it can also be diagnosed by microscopic examination of induced sputum. Diagnosis
Microbiology
null
Frequently associated with CMV
Capacitance of sperms takes place in
Sperm is the male reproductive cell in the sexual reproduction. Capacitation is the penultimate step in the maturation of mammalian spermatozoa and is required to render them competent to feilize an oocyte. This step is a biochemical event; the sperm moves normally and looks mature prior to capacitation. In vivo, this step typically occurs after ejaculation, in the female reproductive tract. Ref: Ganong&;s review of medical physiology; 24th edition; page no:-422
Physiology
Endocrinology
Uterus
Complication which commonly accompanies acute prostatitis -
• Acute inflammation of prostate associated with UTI • Caused by ascending urethral infection or reflux of infected urine into prostatic ducts • MC organism: E. coli • Patients present with sudden onset high grade fever with chills and rigors, severe irritative symptoms and enlarged, tender and boggy prostate • Catheterization and prostatic massage is contraindicated • MC used antibiotics are: TMP-SMX and Ciprofloxacin (Both are having better concentration in prostatic tissue)  • Around 4-6 weeks of antibiotic therapy is used to avert chronic bacterial prostatitis. Chronic Bacterial Prostatitis • Due to persistent bacterial infection of prostate • Insidious in onset, characterized by relapsing or recurrent UTI caused by persistence of pathogen in prostatic fluid despite of antibiotic therapy • Diagnosis is made by microscopic examination and culture of prostatic expressate and culture of urine obtained before and after prostatic massage. • Treated by chronic antibiotic suppression (3–4 months) Prostatic Abscess • Most cases result from complications of acute bacterial prostatitis • Fluctuation is a very late sign • Predisposing factors: Diabetes, renal insufficiency, immunosuppression, urethral instrumentation, chronic indwelling catheter • Diagnosis: TRUS or pelvic CT scan is crucial for diagnosis and treatment • Treated by transurethral drainage and antibiotics
Surgery
null
Seminal vesiculitis
An 18-year-old female passenger injured in a rollover car crash was rushed to the emergency department. After the patient is stabilized she undergoes physical examination. She demonstrates considerable weakness in her ability to flex her neck, associated with injury to CN XI. Which of the following muscles is most probably affected by nerve trauma?
The iliocostalis thoracis muscle is found in the deep back and functions to maintain posture. It is not associated with neck flexion. The sternocleidomastoid muscle is innervated by CNXI and functions in contralateral rotation and bilateral flexion of the neck. Rhomboid major and minor are both innervated by the dorsal scapular nerve and serve to adduct the scapulae. Teres major is innervated by the lower subscapular nerve and serves to medially rotate and adduct the humerus.
Anatomy
Upper Extremity
Sternocleidomastoid
Which of the following statements about Cushing's disease is true?
Cushing's syndrome is due to increased adrenal coisol production, regardless of aetiology.Cushing's disease usually is caused by a pituitary microadenoma producing high adrenocoicotropin (ACTH) levels.In most patients, coisol levels would be suppressed as a result of the high-dose dexamethasone suppression test.Transsphenoidal microsurgical removal of the microadenoma is the treatment of choice in most centres.
Microbiology
All India exam
Pituitary microadenoma usually is present
Intractable secondary glaucoma is seen in:
Ans. (a) Diffuse iris melanomaRef: Surgical Pathology of Head & Neck p. 1935Intractable secondary glaucoma may also occur in cases of blunt trauma due to anteriorly dislocated lens setting caught in the pupil.Iris melanoma(malignant neo plasms that arise from neuroectodermal melanocytes with in the Iris)Circumscribed/nodular iris melanoma* Present as pigmented spot on the iris* These tumors are usually localized, well circumscribed and nodular* These tumors usually tend to involve only a limited segment of the angle circumference and hence glaucoma is less common and usually treatableDiffuse iris melanoma* Present as a unilateral dark iris (hyperchromic heterochromia) Q* These tumors show a flat and diffuse infiltration pattern of growth* The infiltration invades the intertrabecular spaces and plugs the drainage mechanism, resulting in an intractable secondary glaucoma
Ophthalmology
Uveal Tract
Diffuse iris melanoma
A normally developing 10 months old child should be able to do all of the following except _________
the child is able to make tower of 2 blocks by 15 months and tower of 3 blocks by 18 months. Ref: OP GHAI - ESSENTIAL PEDIATRICS - 8 TH edition page no 50
Pediatrics
Growth and development
Build a tower of 3-4 cubes
Trench mouth is caused by
null
ENT
null
Borrelia vincenti
A child with pyoderma becomes toxic and presents with respiratory distress. His CXR shows patchy areas of consolidation and multiple bilateral thin walled air containing cysts. The most likely etiological agent in this case is:
b. Staph aureus(Ref: Nelson's 20/e p 2088-2093, Ghai 8/e p 379-381)The given chest X-ray finding is suggestive of pneumonia with pneumatoceles, seen in infection due to Staph aureus.
Pediatrics
Respiratory System
Staph aureus
For most molar anchor teeth, retainer used is:
null
Dental
null
W56
Locard’s principle is concerned:
Ref. Textbook of forensic medicine. Krishnan Vij. Page. 302   Locard Principle: When any two objects come into contact, there is always a transfer of material from each object on the other. Some examples are fingerprints, footprints,hair, tool marks etc.
Unknown
null
Theory of exchagnge
Most common ovarian tumor
Ans. (a) Serous cystadenoma(Ref: Robbins 9th/pg 1023)*Most ovarian tumors are surface epithelial (65-70%)*Serous cystadenoma is the most common surface epithelial tumor
Pathology
Female Genital Tract
Serous cystadenoma
Best diagnostic aid in blunt trauma abdomen is -
Ans. is 'd' i.e., Ultrasound
Surgery
null
Ultrasound
Which of the following lipids is found exclusively in mitochondria?
Cardiolipin Is a Major Lipid of Mitochondrial Membranes Phosphatidic acid is a precursor of phosphatidylglycerol, which in turn gives rise to cardiolipin. This phospholipid is found only in mitochondria and is essential for the mitochondrial function. Decreased  cardiolipin levels or alterations in its structure or metabolism cause mitochondrial dysfunction in aging and in pathological conditions including heart failure, hypothyroidism, and Barth syndrome (cardioskeletal myopathy). HARPERS ILLUSTRATED BIOCHEMISTRY30th ed, Page No:343
Biochemistry
null
Cardiolipin
Lateral repositioning flap is done for
null
Dental
null
gingival recession
A 20 yr old girl presents with 9 month history of neck swelling with thyrotoxicosis symptoms. On investigation increased T4 and decreased TSH with palpable 2 cm nodule was found. Next investigation will be
In clinical cases of thyroid nodule, Thyroid profile (T3 T4 TSH) is done. If TSH is low, thyroid scan is done to see if nodule is hot or cold. If TSH is low or normal, ultrasound followed by FNAC is done Source :Sabiston 20 th edition Pg 890
Surgery
Endocrinology and breast
Thyroid scan
Investigation of choice for Hydrocephalus in infants ?
Brain imaging Imaging tests can help diagnose hydrocephalus and identify underlying causes of the symptoms. These tests may include: Ultrasound. Ultrasound imaging, which uses high-frequency sound waves to produce images, is often used for an initial assessment for infants because it&;s a relatively simple, low-risk procedure. The ultrasound device is placed over the soft spot (fontanel) on the top of a baby&;s head. Ultrasound may also detect hydrocephalus prior to bih when the procedure is used during routine prenatal examinations. Magnetic resonance imaging (MRI) uses radio waves and a magnetic field to produce detailed 3D or cross-sectional images of the brain. This test is painless, but it is noisy and requires lying still. MRI scans can show enlarged ventricles caused by excess cerebrospinal fluid. They may also be used to identify underlying causes of hydrocephalus or other conditions contributing to the symptoms. Children may need mild sedation for some MRI scans. However, some hospitals use a very fast version of MRIthat generally doesn&;t require sedation. Computerized tomography (CT) scan is a specialized X-ray technology that can produce cross-sectional views of the brain. Scanning is painless and quick. But this test also requires lying still, so a child usually receives a mild sedative. Drawbacks to CT scanning include less detailed images than an MRI, and exposure to a small amount of radiation. CT scans for hydrocephalus are usually used only for emergency exams. Reference: GHAI Essential pediatrics, 8th edition
Pediatrics
Central Nervous system
Cranial USG
A pt. presented with renal cell carcinoma invadving IVC and the renal vein. False statement is ?
Ans. is 'b' ie. IVC involvement indicates inoperability A renal cell carcinoma that has spread to renal vein, IVC or even upto the thorax (hea) is operable. A preop biopsy is not necessary as a RCC is the most common malignant neoplasm of kidney (90 - 95%) and any solid renal mass is considered to be RCC until unless proved otherwise. A chest x-ray should be done to rule out pulmonary metastasis as it will make the Ca of stage IV with worst prognosis and also decide the tit plan. Radiotherapy, Chemotherapy or Hormonal therapy have little role in RCC t/t. More about Renal cell carcinoma Its the MC malignant neoplasm of kidney (90 - 95%) MC site of origin is prox. convoluted tubules RCC originates in the coex and tends to grow out into perinephric tissue. Usually situated at poles (commonly at upper pole) Male female ratio is 2 : 1 Age - 5th to 6th decade Risk factors: i) Cigarette smoking ii) Obesity iii) Polycystic kidney ds iv) Tuberous sclerosis v) Von-Hippel lindau syndorme (Cerebellar hemangioblastoma, retinal angiomatosis and b/1 renal cell Ca) Histologically RCC is an adenocarcinoma. It has been reclassified into subtypes of which Clear Cell Ca is the MC type. Classical triad of RCC consists of Hematuria Flank pain Palpable flank mass Earliest and MC presenting feature is hematuria. Paraneoplastic syndormes i) Fever of unknown origin ii) Anemia iii) Erythrocytosis (d/t secretion of erythropoietin by RCC) (but anemia is a more common finding) iv) Hypeension v) Abnormal liver function (Stauffers syndrome ie non metastatic hepatic dysfunction) vi) Hypercalcemia vii) Neuromyopathy viii) Amyloidosis ix) Increased ESR (MC paraneoplastic syndrome) x) Dysfibrogenemia xi) Cushing's syndrome xii) Galactorrhoea xiii) Feminization and masculanization MC route of metastasis is hematogenous MC site of distant metastasis is lung (canon ball secondaries, secondaries may be pulsatile) Inv. of choice --> CT scan.
Surgery
null
IVC involvement indicates inoperability
Commonest neurological tumour associated with NF-2:-
NF is a type of genetic condition Gene Chromosome Protein Features NF 1 17 Neurofibromin - Cafe-au-lait-macules (CALM) NF 2 22 Merlin -Vestibular Schwannoma (Acoustic neuroma): commonest neurological tumour. -Giant Neurofibromas, Meningioma - Axillary Freckling
Dental
FMGE 2018
Acoustic neuroma
Tumor seen exclusively in parotid:
Wahin Tumor: Viually restricted to the parotid gland More common in Male; Smoking is most impoant risk factor EXTRA EDGE: Most common salivary gland tumor - Pleomorphic Adenoma. Most common Benign salivary gland tumor - Pleomorphic Adenoma MC Primary malignant salivary gland tumor - Mucoepidermoid carcinoma. Adenoid cystic carcinoma - Most aggressive salivary tumor, can cause perineural invasion. Larger the size of salivary gland more likely it's benign. Smaller the size of salivary gland more likely it's malignant. MC salivary gland involved - parotid gland > submandibular gland.
Pathology
DNB 2018
Wahin tumor
Unna boot is used in treatment of
null
Orthopaedics
null
Varicose ulcer
Hypochloremia, hypokalemia and alkalosis are seen in?
Ans is 'a' i.e. Congenital hyperophic pyloric stenosis Biochemical abnormality in congenital hyperophic pyloric stenosis is a regular feature of AIIMS and AI examinations it has been repeated several times. The biochemical abnormalities seen are: ( I ) Hypokalemia (3) Alkalosis and (2) Hypochloremia (4) Paradoxical aciduria
Surgery
null
Congenital hyperophic pyloric stenosis
Axillary abscess is safely drained by which approach
Axillary abcess should be incised through the floor of axilla, midway between the anterior and posterior axillary folds,and nearer to the medial wall in order to avoid injury to the main vessels running along the anterior,posterior and lateral walls.
Anatomy
null
Floor
Anti HIV drug used for prevention of vertical transmission -
Ans. is 'a' i.e., Nevirapine Treatment during pregnancyo HIV infected mother can transmit the virus to fetus/infant during pregnancy, during delivery or by breast feeding,o Early diagnosis and antiretroviral therapy to mother and infant significantly decrease the rate of intrapartum and perinatal transmission (vertical transmission) of HIV infection,o Zidovudine treatment of HIV infected pregnant women from the beginning of second trimester through delivery and of infant for 6 weeks following birth decreases the rate of transmission from 22.6% to < 5%.o Single dose of nevirapine given to the mother at the onset of labor followed by a single dose to the newborn within 72 hours of birth decreased transmission by 50%. This is the prefered regimen now in developing countries.
Pharmacology
Anti-Viral
Nevirapine
Thump print sign in the abdominal radiograph indicates which of the following conditions?
The thump print sign is seen in Inflamatory bowel disease (Ulcerative colitis, Crohns), infectious colitis (amoebic, pseudomembranous), ischaemic bowel disease and diveiculitis. The sign is a result of haustral mucosal thickening in most of the cases.
Surgery
null
All the above
Alcohol dependence is associated with all of the following except
Amotivational syndrome is seen with chronic cannabis abuse.
Psychiatry
null
Alcohol amotivational syndrome
A patient presented in casualty with a history of sudden paplitation, sensation of impending doom and constriction in his chest. This lasted for about 10-15 minutes after which he became all right. The diagnosis is likely to be:
D i.e. Panic attack Feeling of impending doom with sympathetic symptoms (chest discomfo/pain/constriction, anxiety apprehension, breathlessness, sweating, palpitations, tremors etc.) of sudden onset and lasting for few minutes are diagnostic of Panic attackQ. - In generalized anxiety disorder, there must be a period of atleast 6 monthsQ with prominent tension, worry & feeling of apprehension about every day events & problems. The onset is also insidious (not abrupt as in panic attack). Symptoms of anxiety are seen both in panic attack & generalized anxiety disorder; but panic attack is differentiated by sudden onset of symptoms of severe anxiety (like feeling of impending doom) lasting for few minutesQ. Panic Attack Episode (discrete period) of acute anxiety (i.e. intense fear or discomfo) of sudden (abrupt) onset like out of the blue, reaching a peak within 10 minutes and usually lasting for < 1-hour (most commonly diminished with in 30 minutes). The clinical picture is that of acute severe anxiety that builds up quckly and include various features of sympathetic stimulation because hyper ventilation caused by anxiety lit Paco2. >4 of the following symptoms developing abruptly and reaching a peak within 10 minutes are required. Sensation of shoness of breath or smothering (paradoxical feeling of breathlessness)Q Chocking sensation Chest pain or discomfo PalpitationQ, pounding hea, tachycardia (accelerated hea rate) Feeling dizzy, unsteady, light-headed or faint Paresthesias (numbness or tingling) Trembling or shaking or tremor Chills or hot-flushes SweatingQ Fear of dying (impending doom)Q Fear of losing control or going crazy (apprehension)Q Derealization (feeling of unreality) or depersonalization (being detached from oneself) Nausea or abdominal distress Recurrent, unexpected panic attack and at least one of the attack has been followed by >1 month of 1 of the following a) Persistent concern about having additional (fuher) attacks b)Worry about the implications of the attack or its consequences (eg because of physical symptoms patients are likely to fear that they are experiencing a hea attack, stroke or the like; or occasionally patients think they are going crazy or are out of control) c) A significant change in behavior related to attacks (because they think that attacks indicate a serious undiagnosed physical illness). Panic attacks should not be d/t medical disorder, social /specific phobia, OCD, PTSD, or seperation anxiety; but it may or maynot be associated with agoraphobia. Agoraphobia Anxiety about being in places or situations from which escape might be difficult(2 (or embarrassing) or in which help may not be available in the event of having an unexxpected or situationally predisposed panic attack or panic like symptoms. Agoraphobic fears typically involves characteristic clusters of situations that include
Psychiatry
null
Pannic attack
The cough response caused while cleaning the ear canal is mediated by stimulation of:
Auricular branch of vagus nerve provide innervation of the external auditory canal. So mechanical stimulation of ear canal while cleansing it cause stimulation of this nerve branch of vagus nerve and may induce cough. The auricular branch of vagus nerve passes through the mastoid canaliculus and through a space between the mastoid process and the tympanic pa of the temporal bone to the external ear and external auditory canal. The ear canal receives sensory fibers from the glossopharyngeal nerve through its communicating branch with the vagus nerve.
ENT
null
The X cranial nerve
All of the following can cause methemoglobinemia except-
Methemoglobinemia is a rare but potentially life - threatening complication that may follow theadministration of ceain drugs that causes oxidation of hemoglobin to Methemoglobin. Drugs whichcause this - prilocaine benzocaine, rarely Lignocaine, nitroglycerine, Phenytoin sulphonamide.
Anaesthesia
Regional Anesthesia
Bupivacaine
Amine hormone is ?
Ans. is 'd' i.e., Thyroxine
Physiology
null
Thyroxine
Darkening of urine on standing is associated with
Alkaptonuria is caused by defect of the enzyme homogentisate 1,2-dioxygenase(homogentisic acid oxidase).The disorder comes to attention due to change in colour of urine to brownish black/ staining of diapers.The urine becomes dark on standing,especially if the pH of urine is alkaline,due to the presence of homogentisic acid.Excessive urine homogentisate results in positive reducing substances. Reference:Essential pediatrics-Ghai,8th edition,page no:653.
Pediatrics
Metabolic disorders
Alkaptonuria
Extravascular hemolysis causes -
null
Pathology
null
Jaundice
Which of the following is most strongly associated with coronary hea disease?
Apolipoprotien B (major LDL protien) is better predictors of CHD. Ref-Park&;s textbook of Preventive and Social Medicine 24th edition.
Social & Preventive Medicine
Non communicable diseases
Apolipoproteins
A 19 year old boy fell from the motorbike on his shoulder. The doctor diagnosed him as a case of Erb's paralysis. All of the following signs and symptoms will be observed in this boy, EXCEPT?
Due to Erb's paralysis there is damage of biceps brachii and supinator due to which there is loss of pronation of forearm. It is associated with loss of abduction at shoulder joint, loss of lateral rotation and loss of flexion at elbow joint and is not associated with loss of pronation at radioulnar joint.Erb's paralysis occur from damage at the Erb's point which is the meeting point of 6 nerves such as ventral rami of C5 and C6, suprascapular and nerve to subclavius of upper trunk and two divisions of upper trunk. Muscles paralysed are supraspinatus, deltoid, teres minor, infraspinatus, biceps brachii, brachialis, brachioradialis and supinator. PositionParalysis ofOveraction of Adduction of armSupraspinatus and deltoidAdductors of the shoulderMedial rotation of the armTeres minor and infraspinatusMedial rotators of the shoulderExtension of forearmBiceps brachii, brachialis and brachioradialisExtensors of elbowPronation of forearmBiceps brachii and supinatorPronators of forearm
Anatomy
null
Loss of pronation at radioulnar joint
Svere myopathy commonly is a side effect of
ESSENTIALS of medical PHARMOCOLOGY SEVENTH EDITION KD TRIPATHI Page :636,637 Impoant statins are :lovastatin Simvastain, pravastatin, rosuvastatin etc Rosuvastatin This is the latest and the most potent statin (10 mg rosuvastatin :::::. 20 mg atorvastatin), with a plasma tlh. of 18-24 hours. Greater LDL-CH reduction can be obtained in severe hypercholesterolaemia; paly due to its longer persistence in the plasma. In patients with raised TG levels, rosuvastatin raises HDL-CH by 15--20% (greater rise than other statins). Dose: Sta with 5 mg OD, increase if needed upto 20 mg/ day, (max 40 mg/ day) ROSUV AS, ROSYN 5, 10, 20 mg tabs. Adverse effects All statins are remarkably well tolerated; overall incidence of side effects not differing from placebo. Notable side effects are: * Headache, nausea, bowel upset, rashes. * Sleep disturbances (probably more with lipophilic drugs). * Rise in serum transaminase can occur, but liver damage is rare. * Muscle tenderness and rise in CPK levels occurs infrequently. Myopathy is the only serious reaction, but is rare ( < 1 per 1000). Few fatalities due to rhabdomyolysis are on record. Myopathy is more common when nicotinic acid/ gemfibrozil or CYP3A4 inhibitor- ketoconazole I erythromycin/ cyclosporine I HIV protease inhibitor is given concurrently. Gemfibrozil inhibits the hepatic uptake of statins by the organic anion traspoer OATP2.it must not be given to pregnant ladies. Uesd in primary hyperlipipidemias.
Pharmacology
Other topics and Adverse effects
Rosuvastatin
In a young female of reproductive age with regular menstrual cycles of 28 days ovulation occurs around 14th day of periods. When is the first polar body extruded
A i.e. 24 hours prior to ovulationEvent In OogenesisTime periodMaximum number of germ cell (Oogonia & few oocyte) - 7 million are found by5th month (prenatal)All oogonia become atretic and only primary oocyte surrounded by follicular cell (k/a primordialfollicle) remain by7", month (prenatal)All primary oocyte have staed prophase of meiosis I, but instead of proceeding into metaphase,they enter diplotene stageNear the time of bihPrimary oocyte remain in prophase of meiosis I untilPubeyPrimordial follicle (with primary oocyte) grow to form primary/ preantral- follicle, which grows intosecondary / vesicular / Graffian- follicle. The 2deg follicle enters preovulatory stage - 36 hours beforeovulation (when LH surge occurs) resulting in completion of meiosis I and formation ofsecondary oocyte and 1st polar bodyQ- 36 hours before ovulation2deg oocyte enters meiosis 11 but arrests in metaphase- 3 hours before ovulationMeiosis II is completed with formation of ovulin and 2" polar body only ifFeilization occursWithout feilization 2deg oocyte degenerates with in- 24 hours after ovulation
Anatomy
null
24 hrs prior to ovulation
Basophilic stippling is seen with
i.e. (Thalassaemia) : (292-Harsh mohan 6th) (658-H17th/6th)Punctate basophilia or basophilic stippling is diffuse and uniform basophilic granularity in the cell which does not stain positively with Perl's reaction (in contrast to pappenhamer bodies which stain positively)Examples -* Aplastic anaemia* Thalassaemia* Myelodysplasia* Infections* Lead poisoning* Howell -Jolly bodies - present in Megaloblastic anemia and after splenectomy* Basophilic leucocytosis indicative of CML**PYRIMIDINE 5' - NUCLEOTIDASE (PSN) DEFICIENCY - Highly distinctive feature of this condition is a morphological abnormality of the red cells known as basophilic stippling. This condition is rare but it probably ranks third in frequency among red cell enzyme defects (after G6PD deficiency and pyruvate Kinase deficiency) (658-H17th)
Pathology
Blood
Thalassaemia
Which is the WRONG way to apply dam using a wingless clamp?
null
Dental
null
Attach the dam over the clamp and frame outside the mouth, then put the assembly over the tooth using clamp holders OVER the dam.
Thumb print sign is seen in: March 2011
Ans. C: Ischemic colitis Earlier features of intestinal ischemia seen on abdominal radiographs include bowel wall edema, known as "thumb printing". Radiological signs in GIT: Thumb printing sign: Ischemic colitis Bird of prey sign: Sigmoid volvulus Double bubble sign (X-ray abdomen): - Annular pancreas - Duodenal atresia String sign: - Crohn's disease - Pyloric stenosis Single bubble sign: Pyloric stenosis Chain of lake appearance: Chronic pancreatitis Fox sign: Acute pancreatitis Widening of duodenal C loop: Carcinoma of head pf pancreas
Radiology
null
Ischemic colitis
Endothelium activation refers to -
Ans. is 'd' i.e., Increased expression of adhesion molecules for leukocyte recruitment o Vascular endothelium in its normal, unactivated state does not bind circulating cells or impede their passage,o In acute inflammation, the endothelium is activated and can bind leukocytes as a prelude to their exit from the bloodvessels.o Inflammatory mediators like thrombin, IL - 1, Platelet Activating Factor, Histamine And TNFactivate endothelial cells by increasing expression of adhesion molecules which can bind leukocytes for leukocyte recruitment.
Pathology
Miscellaneous (Blood Vessels)
Increased expression of adhesion molecules for leukocyte recruitment
An amoebic liver abscess can be diagnosed by demonstrating-
Exploratory puncture is one of the most practical methods for confirming the diagnosis of amboebic liver abscess. The aspirated pus may be examined for the demonstration of trophic forms (trophozoites) of E. histolytica. Aspirations from the center of amoebic liver abscess do not show trophozoites, while aspirates from the margins show trophozoites About other options Option 'a' "Cysts are never seen in extraintestinal lesions" Option 'c & d' In extraintestinal amoebiasis, often stool examination is negative
Microbiology
null
Trophozoites in the pus
Carboxylases requires -
Ans. is 'd' i.e., Biotin o Biotin is a coenzyme for carbon dioxide fixation reactions.o It serves as prosthetic group of ATP-dependent carboxylase, i.e., in carboxylation reactionQ,o It acts as coenzyme tor acetyl-CoA carboxylaseQ, propionyl-CoA carboxylaseQ, pyruvate carboxylaseQ and metbylcartonyl-CoA carboxylase.
Biochemistry
Mechanisms of Enzyme Action
Biotin
Mechanism of action of sulfonamide is?
Ans. is 'c' i.e., Inhibits folate synthesis Sulfonamides are bacteriostatic and act by inhibiting folic acid synthesis by inhibiting enzyme folate synthatase.
Pharmacology
null
Inhibits folate synthesis
Osteoradionecrosis results from:
null
Radiology
null
Radiation, trauma, infection
All are true about Net protein utilization (NPU) except
• 1 gram of proteins is equivalent to: 6.25 grams Nitrogen • NPU of India diets: 50-80
Social & Preventive Medicine
null
1 gram protein is equivalent to 1 gram Nitrogen
Following vasectomy for family planning, a patient should be advised to use some other method of contraception, till :
null
Gynaecology & Obstetrics
null
null
The structures passing posterior to diaphragm are all except:
D i.e. Greater splanchnic nerve
Anatomy
null
Greater splanchnic nerve
True about acid phosphatase is ?
Acid phosphataseAcid phosphatase (ACP) hydrolyzes phosphoric acid esters at pH 5-6.It is found in different isoforms in prostate, spleen, liver, erythrocytes, platelets and bones. Prostatic and erythrocyte isoform can be differentiated by ?i) Prostatic isoform is inhibited by taarate (taarate sensitive), whereas erythrocyte isoform is not.ii) Erythrocyte isoform is inhibited by formaldehyde and cupric ions, whereas prostatic isoform is not.Acid phosphatase, paicularly prostatic enzyme, is unstable at room temperature above 37degC and at pH above 7.0 and more than 50% of the acid phosphatase activity may be lost in 1 hour at room temperature.
Biochemistry
null
Erythrocyte isoform is inhibited by cupric ions
Which is not a dietary fiber ?
Ans. is 'b' i.e., LactuloseDietary fibres (Review) Dietary fibre consists of unabsorbable cell wall and other consititutents of vegetable food like celluloseQ, lignin, hemicellulosee, gums, pectinsdeg, aliginates and other polysaccharides.In herbivorous animals, intestinal microoganism breakdown these polysaccharides into acetate, propionate and butyrate.These polysaccharides contain 13-glycosidic linkages.Therefore, they cannot be digested by a-amylase present in human saliva and pancreatic juice because a-amylase breaks a-glycosidic bond (especially 1-4 a linkage).So, dietary fibers are not digested or hydrolyzed but are fermented by colonic bacteria except for lignin, which is neither digested nor fermented by intestinal microorganismsdeg.Dietary fibre absorbes water in the intestine, swells, increase bulk of stool by increasing water content of faeces and soften it, decreases transit time by facilitating colonic tansit."The presence of fibre shoens the transit timese and increases the stool bulk".Dietary fibre is of two types : -Soluble fibree : - These are pectin, aliginates, and gums. These absorb upto 15 times its weight in water as it moves through GIT, producing softer stools. Its good sources are oat, flaxseeds, peas, beans, apple, citrus fruits, carrots, bareley and psyllium.Insoluble fibredeg : - These are cellulose, hemicellulose and lignin. These promote movement of material through digestive system and increases stool bulk. Its good sources are wheat flour, wheat bran, nuts and vegetables.
Biochemistry
null
Lactulose
RNA polymerase does not require :
D i.e. Primer
Biochemistry
null
Primer
The protein in the GBM responsible for charge dependent filtration is
Glomerular basement membrane contains: a. Collagen type IV b. Laminin c. Polyanionic proteoglycans (responsible of charge-dependent filtration) d. Entactin e. Fibronectin f. Sialoglycoprotein coating on endothelial and visceral epithelial cells. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 551
Pathology
Urinary tract
Proteoglycan
Which is the most impoant prognostic marker in ALL?
Response to treatment is the most impoant prognostic marker in ALL. Leucocyte count> 50000/ul Poor prognosis Hyperploidy Favorable prognostic factor Response to treatment Remission status at 14 days of chemotherapy is best guide to prognosis. Organomegaly Poor prognosis. Lymph node, liver, spleen and testis enlargement indicate spread of cancer Unorable prognostic factors for ALL: Extreme age group: <1 year or >10 years Black males TLC>1 lac/cu.mm Organomegaly CNS Leukemia L2 ALL, pre B cell and mature B cell ALL Hypoploidy t(9:22) and t(4:11) Remission> 14 days
Medicine
AML & ALL
Response to treatment
A patient complains of knee pain. Routine investigations are unremarkable and still, the patient is unsatisfied. Urine turns black on standing, what is the enzyme involved?
Alkaptonuria - Due to deficiency of Homogentisate dioxygenase/ oxidase (requires Iron) Fresh urine is normal in colour On standing or on exposure to air - turns Black - Homogentisic acid accumulated - get oxidised - gives rise to Black urine - Homogentisic acid gets polymerized in body forming ALKAPTON BODIES, which gets accumulated in: Cailages - Nose, ear pinna, interveebral disc Connective tissue has bluish black colour. Patient develops ahralgia & ahritis. - This condition is known as Ochronosis. Ahritis is also known as ochronotic ahritis - Benedict 's test is positive due to homogentisic Acid, which is a Reducing substance - Treatment drug is NITISINONE
Pediatrics
NEET Jan 2020
Homogentisate oxidase
Minimum pneumothorax is best seen in which of the following view (chest x-ray)?
A pneumothorax is, when looked for, usually easily appreciated. Typically they demonstrate: visible visceral pleural edge is seen as a very thin, sharp white line. no lung markings are seen peripheral to this line.
Physiology
All India exam
Chest x-ray in complete expiration
Calculate GCS of 25 old head injury patient with following parameters confused,opening eyes in response to pain ,localising pain response to pain
Glasgow coma scale: Eye opening Best verbal response Best motor response Response Score Response Score Response Score Spontaneously 4 Oriented and Converses 5 Obeys commands 6 To verbal stimuli 3 Disoriented and converses 4 Localises pain 5 To pain 2 Inappropriate words 3 Flexion- withdrawal to pain 4 Never 1 Incomprehensible words 2 Abnormal flexion (decoicate rigidity) 3 No response I Abnormal extensive obsturing 2 No response 1 Maximum score is : 15 Minimum score is :03 RE: BAILEY AND LOVE 27TH ED
Surgery
All India exam
11
The nerve supply to pronator muscle of distal radioulnar joint is :
Pronator of proximal radioulnar joint - Pronator teres (median nerve). Pronator of distal radioulnar joint - Pronator quadratus (anterior interosseous nerve).
Anatomy
null
Anterior interosseous nerve
Acquire IgA deficiency may occur in ?
Severe Congenital toxoplasmosis Block in B cell differentiation due to defective interaction between T and B cells. Naive B cells are not able to differentiate into IgA - producing cells.
Microbiology
null
Severe Congenital toxoplasmosis
Which category of ICD is associated with mood disorders?
Ans. is 'd' i.e., F3 International classification of disease-10 (ICD-10)o ICD -10 is WHO classification for all diseases and health problems (and not only psychiatric disorders). ICD-10 uses alpha numeric code made of an alphabet (in contrast DSM-IV uses numerical coding) - 'F' is for mental disorders. There are 10 main categories denoted by digits 0 to 9.CodeCategoryF0Organic, including symptomatic mental disorders.FIMental and behaviuor disorders due to psychoactive substance useF2Schizophrenia, schizotypal and delusional disordersF3Mood (affective) disordersF4Neurotic, stress-related and somatoform disorders.F5Behavioral syndromes associated with physiological disturbances and physical factorsF6Disorders of adult personality and behaviourF7Mental retardationF8Disorders of psychological developmentF9Behavioural and emotional disorders with onset usually occuring in childhood or adolescence.
Social & Preventive Medicine
Miscellaneous
F3
True about intertrochanteric fracture
null
Orthopaedics
null
> 1 inch shortening
Influenza is caused by which virus -
Ans. is 'b' i.e., Orthomyxovirus DNA virusesPoxviridaeVariola, vaccinia, cowpox, monkeypox, tanapox, molluscum contagiosumHerpesviridaeHSV-1, HSV-2, varicella-zoster, EBV, CMV, HTLV-1, RK-virusAdenovirideAdenovirusParvoviridaeParvovirus, Adenosatellovirus, DensovirusPapovaviridaePapilloma \4rus (HPV), PolyomavirusHepadnaviridaeHepatitis-B virus RNA VirusesPicornaviridaePoliovirus, Coxsackievirus, Echovirus, Enterovirus, Rhinovirus, Hepatitis A virusCaliciviridaeNorwalk virus, Hepatitis E virusTogaviridaeRubella virus, Eastern equine encephalitis virus, Western equine encephalitis virusFlaviviridaeYellow fever virus, Dengue virus, St. Louis encephalitis virus, West nile virus, Hepatitis C virus, Hepatitis G virusCoronaviridaeCoronavirusesRhabdoviridaeRabies virus, Vesicular stomatitis virusFiloviridaeMarburg virus, Ebola virusParamyxoviridaeParainfluenza virus, Respiratory syncytial virus, Newcastle disease virus, Mumps virus, Rubeola (measles) virusOrthomyxoviridaeInfluenza virus
Microbiology
Virology
Orthomyxovirus
'Whip-lash' Injury is caused due to-
* Whiplash Injury is caused by sudden unexpected hyperextension of cervical spine followed immediately by flexion. <img alt="" src=" /> Ref: Apley's 9th/e p.820
Anatomy
Spinal injuries
Acute hyperextension of the spine
Increase in height in first year is by –
At birth, the average height of a child is 50 cm.             During first year height increases about 50% of birth height (25 cm).
Pediatrics
null
50%
The pre-malignant condition with the highest probability of progression to malignancy is
Incidence of malignant change in erythroplakia is 17- fold higher than in leukoplakia.
Surgery
null
Erythroplakia
Hemoglobin unlike myoglobin showsa) Sigmoid curve of oxygen dissociationb) Positive cooperativityc) Hills coefficient of oned) None of above
Hb-O2 dissociation curve- Sigmoid shape Co-operativity- Hb is a tetramer. If one molecule of O2 binds to the tetramer more easily if other O2 is already bound.   Hills coefficient of Hb- 2.8
Physiology
null
ab
Not an Ideal Candidate for inseion of IUCD
The Ideal IUCD candidateThe planned parenthood federation of America has described the ideal IUCD candidate as a woman:who has born at least one childhas no history of pelvic diseaseis willing to check the IUCD tailhas access to follow up and treatment of potential problems, andis in a monogamous relationshipRef: Park pg no: 497
Social & Preventive Medicine
Demography and family planning
Cancer Cervix
A 32 year old male with painless lymph node in cervical region. Lymph node biopsy shown normal thyroid gland features. The thyroid is normal on palpation clinically. The diagnosis is
Thyroid tissue present in cervical lymph nodes in the face of a clinically normal thyroid gland is a metastasis from an occult primary thyroid carcinoma Occasionally, a metastatic papillary thyroid cancer manifests as a painless lateral neck mass that is clinically detected before detecting the primary thyroid lesion. Comment: Normal thyroid tissue is a trap by examiner, remeber in young people papillary thyroid cancer mostly is well differentiated. Well differentiated cells look like normal cells and tend to grow .and spread more slowly than poorly differentiated cells (anaplastic carcinoma). Sabiston 20th edition pg 926
Surgery
Endocrinology and breast
Papillary carcinoma thyroid
Tourette is a disorder of
Tourette's disorder(Gilles de la Tourette) - combined vocal and multiple motor tic disorder. presence of both multiple motor and one or more vocal tics (>1 year) Onset <18 years involuntary, spasmodic, stereotyped movement of small groups of muscles; seen most predominantly in moments of stress or anxiety Ex: Nose twitching, Shoulder shrugging, Sustained eye closure, Tensing of abdominal or limb muscles Etiology- Neurotransmitter dysregulation in basal ganglia, striatum, and frontal lobes. Rx- Haloperidol , pimozide(first line) , Risperidone , olanzapine comorbidity- ADHD, OCD AUTO IMMUNE-PANDAS( Peadiatric Auto immune NeuroPsychiatric disorders assosiated with Streptococcus) Akathisia* Motor restlessness (unpleasant need to move), usually in the lower extremities Ballismus* Intermittent, coarse, large-amplitude, jerking, shaking, flinging movements Chorea* Irregular, spasmodic movements, usually affecting the limbs or face Tic* Non-rhythmic, Stereotyped, rapid, recurring movement, involuntary or semivoluntary, and sudden in onset. TYPES: (motor tic) or vocalization (phonic or vocal tic) Tremor* Unintentional, somewhat rhythmic, muscle movement involving oscillations of one or more pas of the body Stereotypy* Repetitive, usually meaningless, gestures, habits, or automatisms Reference: P 3617: chap 46.Tic Disorders(Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th Edition)P 81 DSM-5
Psychiatry
All India exam
Tics
All of the following radiologic features are seen in patients with chronic cor pulmonale, except
Diagnosis of Chronic cor pulmonale:Chest X-rayECGECHORight ventricular hyperophyRight atrial dilatationProminent pulmonary aeryPeripheral lung fields show reduced vascular markingsFeatures of hyperinflation: Widened intercostal space, increased translucency of lung and flattened diaphragm. Right ventricular hyperophy Right axis detionProminent R wave in lead V1 & inveed T waves in right precordial leadsLarge S in Lead I, II and IIILarge Q in lead IIITall Peaked P waves (P pulmonale) in lead II, III and aVF.Right ventricular dilatation and tricuspid regurgitation(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 1913-1915)
Medicine
All India exam
Kerley's B lines
Osgood schlatter disease is osteochondritis of ?
Ans. is 'a' i.e., Tibial tuberosity
Surgery
null
Tibial tuberosisty
A male neonate is born with an omphalocele (shown in Figure below). This entity can be distinguished from gastroschisis, because in an omphalocele, the protrusion is:Giant omphalocele in a newborn male.
In omphalocele (see figure below), the swelling is covered by a membrane formed by the peritoneum, Wharton's jelly, and amnion. The membrane is transparent, and underlying intestine can be seen. The other features listed are characteristic of gastroschisis. In gastroschisis, the protrusion is not covered by a membrane and the other features listed apply.Radiograph shows large swelling due to gastroschisis. (Multiple loops of bowel lying on the right side and outside of the abdomen)Radiograph shows large swelling due to gastroschisis. (Bowel loops wrapped in synthetic bag to reduce bowel sequentially.)
Surgery
Hernia
Associated with partial or complete malrotation of the bowel
Xeroderma pigmentosum is caused due to defect in: (Repeat)
Ref: Chapter 7. Neoplasia; page: 275; Robbins and Cot ran Pathologic Basis of Disease: 8t>? editionExplanation:* Defective DNA - repair syndromes are set of syndrome due to defect in DNA repair genes and resultant DNA instability.* These are autosomal recessive in inheritance and include:Xeroderma pigmentosumBloom syndromeAtaxia telangiectasia.* Whereas, HNPCC is associated with inactivation of DNA mismatch repair gene, resulting in increased susceptibility to colon cancer, and cancers of Endometrium, ovary etc.,* Example for Base pair defect is Sickle cell anemia; example for Translocation defect is Philadelphia chromosome in CML - t (9:22).
Pathology
Cytogenetic Disorders
Nucleotide excision repair
A 23-year-old individual who believes in megavitamins therapy develops a severe headache, fundoscopy reveals papilloedema. The likely cause for this problem is
null
Medicine
null
Vitamin A intoxication
Which of the following transmits the Internal Carotid aery?
ForamensStructuresCribriform plate of ethmoidOlfactory nervesOptic foramenOptic nerve, ophthalmic aery, meningesSuperior orbital fissureOculomotor, trochlear, and abducens nerves; ophthalmic division of trigeminal nerve; superior ophthalmic veinForamen rotundumMaxillary division of trigeminal nerve, small aery and veinForamen ovaleMandibular division of trigeminal nerve, veinForamen lacerumInternal carotid aery, sympathetic plexusForamen spinosumMiddle meningeal aery and veinInternal acoustic meatusFacial and vestibulocochlear nerves, internal auditory aeryJugular foramenGlossopharyngeal, vagus, and spinal accessory nerves; sigmoid sinusHypoglossal canalHypoglossal nerveForamen magnumMedulla and meninges, spinal accessory nerve, veebral aeries, anterior and posterior spinal aeries
Anatomy
All India exam
Foramen lacerum
Which of the following compounds acts as a benzodiaz epine antagonist?
A specific BZD antagonist flumazenil is used for BZD poisoning ,it is a BZD analogue which has little intrinsic activity (no effect on normal subject), but competes with BZD agonist as well as inverse agonist for BZD receptor &reverse its effect . Ref: KD tripathi 8th ed.
Pharmacology
Central Nervous system
Flumazenil
Structures Passing Through The Foramen Marked in the Diagram are all EXCEPT?
The Structure Marked is Foramen Magnum Lower pa of medulla oblongata (not the spinal cord) passes through posterior pa of foramen magnum, and veebralaeries are transmitted through the subarachnoid space in foramen magnum Ref : BD chaurasia
Anatomy
All India exam
Spinal cord
70 year old man with cervical lymphadenopathy.What can be the cause -
Ans. is 'a' i.e., Nasopharyngeal carcinoma o Among the given options only nasopharyngeal carcinoma is a common cause of cervical nodes in 70 years male,o Information in this question :i) Cervical adenopathy (Neck node) Most common presentation of nasopharyngeal carcinoma.ii) Type B tympanogram Indicates serous otitis media, which may be a complication of nasopharyngeal carcinoma due to eustachian tube blockade.o Thus, among the given options, nasopharyngeal carcinoma is the answer of choice.Clinical features of nasophary ngeal carcinomao Symptomatology of nasopharyngeal carcinoma is divided into five main groupsNasal symptomsNasal obstruction, nasal discharge, denasal speech (rhinolalia clausa), episiaxis.Otologic symptomsOtologic symptoms are due to obstruction of eustachian tube.This results in serous or suppurative otitis media. Which causes conductive deafness.Presence of unilateral serous otitis media in adult should raise the suspicion of nasopharyngeal carcinoma.Tinnitus and dizziness may occur.OphthalomoneuroLogical symptomsThese symptoms occur due to spread of tumor to the surrounding regions.Squint and diplopia due to involvement of VP cranial nerve.Ophthalmoplagia due to involvement of IIIrd. IVth &. VIth cranial nerve.Facial pain & reduced corneal sensations due to Vth nerve involvementExophthalmos and blindness due to direct extension into the orbit.Jugular foramen syndrome (IXth, Xth, XIth cranial nerve involvementj due to pressure by enlarged lateral retropharyngeal lymph nodes.Cranial nerve XIth involvement due to extension of growth to hypoglossal canal.Horner's syndrome due involvement of cervical sympathetic chain.Neckmass:-Itisthemnstcommonpresentation(60-90%)Due to cervical lymphadenopathy.Distant metastasisInvolve bone, lung, liver and other sites.
ENT
Pharynx
Nasopharyngeal carcinoma
Vi antigen is present in all except-
Vi antigen is present in all except S.paratyphi A. Vi Antigen: It is the surface polysaccharide envelope or capsular antigen covering the O antigen. Expressed in :- S.typhi, S. paratyphi C, S. dublin and some strains of Citrobacter freundii. When Vi antigen is present, it renders the bacilli inagglutinable with the O antiserum. Poorly immunogenic and antibody titres are low, not helpful in diagnosis , hence not employed in the Widal test. Complete absence of the Vi antibody in a proven case of typhoid fever- Poor prognosis. Note: Vi Antibodies are not seen in normal population.
Microbiology
Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli)
S.paratyphi A
Child having long history of hemoglobin 5 gm% next step?
Ans. is 'b' i.e., CBC,reti count with peripheral smear In above question, if child is stable, then no need to give blood transfusion. Before staing Iron, we have to rule out types of anemia as Iron is indicated only in nutritioral anemia. Hb ele ctrophoresis is indicated if there is featuer of hemolytic anemia (thalassemia) so over all our next step is complete hemogram with manual peripheral smear examination. (obtion b).
Pediatrics
null
CBC,reti count with periphesal smear.
Serum alkaline phosphatase levels increases in:
Ans. C. HyperparathyroidismSerum alkaline phosphatase is increased in hyperparathyroidism, rickets, obstructive jaundice and Paget's disease.
Biochemistry
Enzymes
Hyperparathyroidism
Which of the following is true regarding the trophozoite of E. histolytica?
Ans. (d) Shows erythrophagocytosis Differntial features of intestinal entamoede Features E. histolytica E. hamanni E. coli Trophozoite Size (pm) 12-60 4-12 20-50 Motility Motility Active Sluggish Pseudopodia Finger shaped, rapidly extruded Finger shaped, rapidly extruded Sho, blunt, slowly extruded Cytoplasm Clearly defined into endoplasm and ectoplasm Clearly defined into ectoplasm and endoplasm Not defined Inclusions Red blood cells present, no bacteria Bacteria and other paicles, no red blood cells Bacteria and other paicles, no red blood cell Nucleus Not clearly visible in unstained films; It is eccentric Not clearly visible in unstained films Visible in unstained films Karyosome Small, central Small, eccentric Large, eccentric Differntial features of intestinal entamoede Features E. histolytica E. hamanni E. coli Nuclear membrane Delicate, with fine chromatin dots Coarse chromatin granules Thick, with coarse chromatin Cyst Size (pm) 10-15 5-10 10-30 Nuclei in mature cyst 4, central karyosome 4 8, eccentric karyosome Glycogen mass Seen in uninucleate, but not in quadrinucleate stage Seen in uninucleate, but not in quadrinucleate stage Seen upto quadrinucleate stage Chromatidial bars 1-4, with rounded ends Often numerous, shape irregular Splinter like with angular ends
Microbiology
null
Shows erythrophagocytosis
You have diagnosed intrinsic asthma in a patient and is explaining to him regarding his illness. He has no family history of asthma. All the following are true regarding intrinsic asthma, EXCEPT:
Intrinsic asthma is a non atopic condition and so no allergen is detected. The onset in during adulthood and family history may be absent. No preceding allergic illness may be evident and unlike extrinsic asthma it has no association with chronic bronchitis or nasal polyp. Ref: Harsh Mohan Pathology Quick Review, 4th Edition, Page 652
Pathology
null
Dander is the commonest allergen
A 40 year old presenting with dizziness on standing with systolic reduction of BP of 50mm Hg;appropriate treatment -a) Graded compression stockingsb) Salbutamolc) Fludrocortisoned) β-blockers
null
Medicine
null
ac
Root Value of Pudendal Nerve is:
Ans. B. S2 S3 S4 The pudendal nerve (Root Value S2 S3 S4 ) is the main nerve of the perineum. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter. If damaged, most commonly by childbirth, lesions may cause sensory loss or fecal incontinence.
Anatomy
Lower Extremity
S2S3S4
Budd chiari syndrome can be caused by -
Ans. is 'd' i.e., AllBudd-chiari syndrome o Budd-chiari syndrome is the clinical picture caused by occlusion of the hepatic vein or inferior vena cava.o It presents with classical triad of abdominal pain, ascites and hepatomegaly.Causes of Budd-chiari syndromeHepatic vein thrombosisMyeloproliferative disorders (Polycythemia)Inherited disorder of coagulation --> deficiency of antithrombin, protin 'C' & 'S'.o Antiphospholipid syndromeo Paroxysmal nocturnal hemoglobinuriao Intraabdominal cancers, paicularly hepatocellular carcinoma.Pregnancyo Oral contraceptives (estrogen + Progesteron) 2. Membranous web in inferior vena cova. I am not sure about option 'c'
Pathology
null
All