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Insulinoma is most commonly located in which pa of the pancreas
Viually,all insulinomas are located in the pancreas and tumors are equally distributed with the gland Bailey & Love ,26th,788.
Surgery
G.I.T
Equally distributed
Difference between acute and chronic pancreatitis is?
ANSWER: (A) Acute pancreatitis has reversible changesREF: Harrison's 18th ed chapter 313Chronic pancreatitis is a disease process characterized by irreversible damage to the pancreas as distinct from the reversible changes noted in acute pancreatitis. The condition is best defined by the presence of histologic abnormalities, including chronic inflammation, fibrosis, and progressive destruction of both exocrine and eventually endocrine tissueAlcohol is implicated in both acute and chronic pancreatitis and both can occur in young adults.
Surgery
Pathophysiology - Acute Pancreatitis
Acute pancreatitis has reversible changes
Tinea incognito is seen with -
Tinea incognito- coicosteroid modified tinea. Clinical features: topical coicosteroids will suppress the inflammation , less visible lesions. Raised margins will be diminished scaling is lost and inflammation is reduced. Concentric rings with steroid induced erythema , atrophy telengiectasia are seen . Iadvl textbook of dermatology page 271
Dental
Fungal infections, Scabies, Pediculosis
Steroid treatment
Color of the normal gingiva is
null
Dental
null
Coral pink
Guddu, a 5–year–old female was brought to the emergency with fever, headache and confusion. A provisional diagnosis of bacterial meningitis was made. The baby developed a severe allergic reaction to penicillin aroud six months back. She was admitted and intravenous antibiotics were started. Few days later her investigations revealed as: Hemoglobin – 6.0 g/L Erythrocyte count – 1.2 x 106/mm3 Platelets – 60000/mm3 Leukocyte count – 1500/mm3 Which of the following is the most likely drug responsible for the above findings ?
null
Pharmacology
null
Chloramphenicol
Which of the following will be LEAST useful in treating Obsessive Compulsive Disorder?
(D) Systematic desensitisation # SSRIs are drug of choice. Fluoxetine, fluvoxamine, paroxetine, sertraline have been approved for OCD# Antidepressants: Some patients may improve dramatically with specific serotonin reuptake inhibitors (SSRIs). Clomipramine (75-300 mg/day), a non specific serotonin reuptake inhibitor (SRI), is the first drug used effectively in the treatment of OCD. The response is better in presence of depression, but many patients with pure OCD also improve substantially. Fluoxetine (20-80 mg/day) is a good alternative to clomipramine. Fluvoxamine (50-200 mg/day) is marketed as a specific anti-obsessional drug, while paroxetine (20-40 mg/day), and sertraline (50-200 mg/day) are also effective in some patients.> Antipsychotics: These are occasionally used in low doses (e.g. haloperidol, risperidone, olanzapine, pimozide) in the treatment of severe, disabling anxiety.> Buspirone has also been used beneficially as an adjunct for augmentation in some patients.# Second line drugs include> Valproate, lithium, or carbamazepine, venlafaxine, pindolol, & MAO inhibitors esp phenelzine, buspirone, 5 -hydroxy tryptamine (5-HT), L- tryptophan, & clonazepam.MANAGEMENT OF OCDBehavior therapyPharmacotherapyIs treatment of choiceSSRIs are drug of choice. Fluoxetine, fluvoxamine, paroxetine, sertraline have been approved for OCDIncludes: Exposure and response prevention, desensitization, thought stopping, flooding implosion therapy and aversion conditioning.Clomipramine: of all the tricyclic and tetracyclic drugs, clomipramine is the most selective for serotonin reuptake exceeded in this respect only by SSRI> People with OCD who fear dirt and germs are encouraged to get their hands dirty and wait increasing amounts of time before washing them.> The therapist helps the person cope with the anxiety that waiting produces; after the exercise has been repeated a number of times, the anxiety diminishes.> Systematic desensitization techniques involve gradually exposing the client to ever-increasing anxiety-provoking stimuli.> It is important to note here, though, that such a technique should not be attempted until the client has successfully learned re- laxation skills and can demonstrate their use to the therapist.> Exposing a patient to either of these techniques without increased coping skills can result in relapse and possible harm to the client
Psychiatry
Miscellaneous
Systematic desensitisation
MC cause of intermittent stridor in a 10-day-old child sholy after bih is:
Laryngomalacia is the most common cause of inspiratory stridor in neonates. The stridor in case of laryngomalacia is not constantly present, rather it is intermittent. So laryngomalacia is also the M/C cause of intermittent stridor in neonates.
ENT
null
Laryngomalacia
The term "balanced anaesthesia" has been given by?
Ans. is 'c' i.e., Lundy Term 'balanced anaesthesia' was introduced by Lundy in 1926. Balanced anaesthesia The cardinal feature of general anaesthetics are : ? Loss of all sensations, especially pain Sleep (unconciousness) and amnesia Immobility and muscle relaxation Abolition of reflexes In modern practice of balanced anaesthesia these modalities are achieved by using combination of inhaled and iv.drugs.
Anaesthesia
null
Lundy
Focal and diffuse thickening of gall bladder wall with high amplitude reflections and 'comet tail' aifacts on USG suggest the diagnosis of:
C i.e. Adenomyomatosis - Adenomyomatosis of gall bladder is chracterized by diffuse (generalized), segmental (annular) or localized hyperplastic muscular wall thickeningQ, mucosal overgrowth and intramural diveicula/crypts/or sinus tracts (so called Rokitansky-Aschoff Sinuses). It characteristically pesents with comet tail aifacts/sign (on USG), pearl necklace sign (on oral cholecystogram or MR cholangiogr, am) and string of beads sign (on MRCP T2WI). Most thyroid carcinomas are hypoechoicQ. Whereas most thyroid adenomas are hyperechoic or isoechoic at ultrasound. Adenomyomatosis of Gall bladder *Adenomyomatosis is a special case of Gall Bladder cholesteatosis and belongs to the group of Hyperplastic Cholecystoses. *It appears as a hyperechoic tumerous thickening of the gall bladder wall (generalized or focal) originating from hyperophied Rokitanski-Aschoff Sinuses (Intramural Diveiculae).
Radiology
null
Adenomyomatosis
A 42-year-old woman is admitted to the emergency department after a fall from the balcony of her apartment. During physical examination there is an absence of heart sounds, reduced systolic pressure, reduced cardiac output, and engorged jugular veins. Which condition is most likely characterized by these signs?
Cardiac tamponade is a condition in which fluid accumulates in the pericardial cavity. It can result from pericardial effusion or from leakage of blood from the heart or proximal portions of the great vessels. The increased pressure within the pericardial sac leads to decreased cardiac filling during diastole and therefore reduced systolic blood pressure. Because of the reduced pumping capacity of the heart, there is increased pressure in the venous system, leading to the distension of the jugular venous system. Deep vein thrombosis often occurs in the lower limbs and increases the risk of pulmonary embolism. The other answers listed are conditions that affect pulmonary function rather than cardiac functions.
Anatomy
Thorax
Cardiac tamponade
CT findings of acute pancreatitis are all except:
Ans. Dilatation of pancreatic duct
Radiology
null
Dilatation of pancreatic duct
In considering the process of eruption, the pre-functional eruptive stage of a tooth begins when the:
The dental lamina serves as the primordium of ectodermal portion of deciduous teeth. The permanent molars arise directly from a distal extension of dental lamina.
Dental
null
Dental lamina begins forming
Superficial thrombophlebitis is seen in: March 2005
Ans. C: Buerger's disease Risks for superficial thrombophlebitis include: Chemical irritation of the area Disorders that involve increased blood clotting Infection Pregnancy Sitting or staying still for a prolonged period Use of bih control pills Varicose veins Superficial thrombophlebitis may be associated with: Abdominal cancers (such as pancreatic cancer) Deep vein thrombosis Factor V Leiden Prothrombin gene mutation Thromboangiitis obliterans
Surgery
null
Buerger's disease
Moschcowitz repair is done for
In Moschcowitz repair, several purse string sutures staing from below are used to obliterate the cul-de-sac of the pouch of Douglas. Care should be taken not to include the ureter in the stitch. Ref: Shaw's Textbook of Gynaecology,18th edition, p342.
Gynaecology & Obstetrics
All India exam
Enterocoele
Bull's neck is characteristically seen in:
Faucial diphtheria : commonest type of diphtheria. Characterized by fever, sore throat, pseudo membrane over fauces. Cervical adenitis with sub-mandibular edema is called bull neck.
Microbiology
Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli)
Diphtheria
Watson and Crick are associated with -
They proposed the double hellical model of DNA
Pathology
General pathology
Discovery of helical structure of DNA
All of the following statements are TRUE about second generation antihistaminic agents EXCEPT:
1st generation 2nd generation Cross BBB, cause sedation Donot cross BBB, no sedation Ach blockade, anticholinergic side effect occur No Ach blockade Useful for - Motion sickness - Drug induced parkinsonism - Muscular dystonias - Allergy Useful only for allergy Promethazine, diphenhydramine, diphenhydrinate, phenramine, Terfenadine, fexofenadine, loratidine
Pharmacology
Histamine, 5-HT and PGs
These possess high anti-motion sickness activity
Venous drainage of esophagus is into the:
Ans. b. Azygous, inferior thyroid and left gastric veins
Anatomy
null
Azygous, inferior thyroid and left gastric veins
Example of multiphasic screening is
Multiphasic screening: It is the application of two or more screening tests to a large population at one time instead of carrying out separate screening tests for single diseases.Randomised control studies suggested that multiphasic screening has not shown any benefit accruing to the population in terms of moality and morbidity reduction.
Social & Preventive Medicine
Screening
Annual health check up
Least useful for a 800-m run in a competitive event would be
800-m run would be over in about 2 min, and it would need a quick burst of activity of the muscle rather than a slow and sustained activity for prolonged periods. Option A: Oxidative phosphorylation generates ATPs in a slow and sustained manner for a low-intensity muscular activity that continues for prolonged periods (e.g., marathon). It will be the least useful of the energy systems for a sho-time event like 800-m run. Option C: LOHMANN REACTION: CREATINE PHOSPHATE - ADP - ATP - UTILIZED For such sho-duration intense muscular activity, pale fibers are more useful as they generate quick ATPs anaerobic glycolysis, using muscle glycogen as the source. Thus, options B and D are useful.
Physiology
Muscle
Oxidative phosphorylation
Role of marijuana in AIDS-related cachexia?
Ans:C- Increases appetiteMarijuana or cannabis sativa contains the active principle tetrahydrocannabinol (THC), which has an appetite stimulant effect.While marijuana derivatives do not appear to reverse cachexia, they could potentially form pa of a combination treatment for wasting.For example, cannabinoid drugs might be used to boost patients' food consumption while they undergo physical therapy or take medications designed to increase the propoion of lean tissues in their bodies.
Psychiatry
null
Increases appetite
Cytoprotectant among the following is
Amifostine:It is used as a cytoprotectant(Radioprotectant) in anticancer chemotherapy.Ref: Sharma and Sharma 3rd ed/pg 877
Pharmacology
Antibiotics
Amifostine
A 22 year old female presents with diy way papules in the seborrheic areas especially in the summer. Her father also gives a h/o similar lesions. What is the most probable diagnosis?
It is also known as Keratosis follicularis with autosomal dominant inheritance.
Skin
null
Darier's disease
Most commonly gas used in Laparoscopy is
B. i.e. (Carbon - dioxide) (560 - Dutta 4th) (217- Shaw's 14th)* Pneumoperitoneum - Most commonly used gas is carbon dioxide (1L - 4L)* For diagnostic purposes nitous oxide or room air or oxygen can be used* CO2 is safer than air and nitrous oxide which can cause air embolism and accidental explosion respectively* The flow rate of the gas is about 1 L/minutc with a pressure not exceeding 20 mm HgCONTRAINDICATIONS OF LAPAROSCOPY* Severe cardiopulmonary disease* Extensive peritoneal adhesion* Patient haemodynamically unstable* Large pelvic tumour* Generalized peritonitis* Pregnancy > 16 weeks* Significant haemoperitoneum* Previous periumbilical surgery (relative)* Intestinal obstruction* Extreme obesity
Gynaecology & Obstetrics
Miscellaneous (Gynae)
Carbondioxide
Which of the following amino acid is involved in the synthesis of ceramide?
Ceramide is synthesized in the endoplasmic reticulum from the amino acid serine. Ceramide is an impoant second messenger regulating pathways such as apoptosis, cell cycle, cell differentiation and senescence. Sphingomyelins are formed when ceramide reacts with phosphatidylcholine to form sphingomyelin plus diacylglycerol. It occurs mainly in the golgi apparatus and to lesser extend in the plasma membrane. Ref: Botham K.M., Mayes P.A. (2011). Chapter 24. Metabolism of Acylglycerols & Sphingolipids. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
Biochemistry
null
Serine
Structures passing through the lateral part of superior orbital fissure are all except:
null
Anatomy
null
Oculomotor nerve
True about Bidutamide is?
ANSWER: (D) All are trueREF: Cancer Chemotherapy and Biotherapy: Principles and Practice by bruce A. Chabner, Dan L. Longo Page 679, Goodman Gillman's 11th ed p. 1021ANDROGEN RECEPTOR ANTAGONISTS(Flutamide, Bicalutamide, and Nilutamide)* Bicalutamide is an oral non-steroidal anti-androgen used in the treatment of prostate cancer and hirsutism.It was first launched as a combination treatment (with surgical or medical castration) for advanced prostate cancer and subsequently launched as monotherapy for the treatment of earlier stages of the disease.Bicalutamide is a teratogen and must not be handled by females who are or may become pregnantAdverse reactions include reproductive system and breast disorders, breast tenderness, gynecomastia, hot flushes, gastrointestinal disorders, diarrhea, nausea, hepatic changes (elevated levels of transaminases, jaundice), asthenia and pruritus
Pharmacology
Sex-Hormone
All are true
Shoest acting skeletal muscle relaxant is ?
Ans. is 'a' i.e., Suxamethonium Suxamethonium (succinylcholine) is the shoest acting skeletal muscle relaxant. o Mivacurium is the shoest acting nondepolarizing skeletal muscle relaxant.
Pharmacology
null
Suxamethonium
Which of the following drug is not used in the management of lepra reaction?
Rifampicin is not used in the management of lepra reaction. Reversal reaction, or lepra type 1 reaction, is a delayed-type hypersensitivity reaction that arises when borderline leprosy shifts toward borderline lepromatous leprosy with treatment. The reaction is characterized by edema and erythema of existing skin lesions, formation of new skin lesions, neuritis, and additional sensory and motor loss. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs) and high-dose steroids. Erythema nodosum leprosum (ENL), also known as lepra type 2 reaction, is a complication of lepromatous leprosy. It is characterized by the development of inflamed subcutaneous nodules accompanied at times by fever, lymphadenopathy, and ahralgias. Treatment includes prednisolone, clofazimine, thalidomide, or chloroquine.
Medicine
null
Rifampicin
A-65 years alcoholic suffering from diabetes has a flexion deformity at the right little finger over the metacarpophalangeal joint of around 15 degrees. The ideal management for him would be -
The information in this question are:- Patient is alcoholic and diabetic (both are risk factors for Dupuytren's contracture). Flexion deformity at MCP joint of little finger. Patient is old (65 years). The Diagnosis is Dupuytren's contracture. The only effective treatment is by operation; however, operation is not necessary in every case; a contracture that is not progressing rapidly is often better left alone, especially in an elderly patient. Primary indication for surgery is fixed contracture of > 30° at metacarpophalangeal joint or > 15° at proximal interphalangeal joint.
Orthopaedics
null
Observation
A 36 year old male presents with a complaint of passing dark-reddish urine. He states that yesterday he played basketball for 4 hours, which was the first time he had exercised in 4 months. He awoke this morning with sore muscles and discolored urine. Physical examination is unremarkable. The urine is reddish-brown in color; dipstick test for blood is positive, the pH is 5.1, the specific gravity 1.03. Microscopic examination of the urine reveals no red blood cells. What is the most likely etiology for this presentation?
The appearance of a dark-reddish urine is suggestive of a number of conditions, including hematuria; however, there are no red blood cells present on microscopic examination. Fuhermore, the dipstick test for blood is positive, which is suggestive of myoglobinuria. Myoglobin is a pigment that, if present in the urine, will produce a positive dipstick test, even in the absence of red blood cells. Myoglobinuria can be caused when an unconditioned individual paakes in intense physical exeion. This extreme physical activity leads to muscle cell breakdown and the release of myoglobin into the blood, which is then filtered by the kidneys and excreted into the urine. If there was hemolyzed blood in the urine , a few red blood cells should have been detected on urinalysis. Ingestion of foods that contained red dye can discolor the urine; however, it would not produce a positive dipstick test. Nephrolithiasis generally results in the appearance of blood cells in the urine. Ref: Kennelly P.J., Rodwell V.W. (2011). Chapter 6. Proteins: Myoglobin & Hemoglobin. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.
Biochemistry
null
Myoglobinuria
Burkitts lymphoma shows which translocation-
Cytogenetic abnormalities in the tumor cells of Burkitt&;s lymphoma is t (8;14) ,and t (8;22) involving MYC gene on chromosome 8 witho overexpression of MYC protein having transforming activity. Reference textbook of Pathology 6th edition Author Harsha Mohan page number 378
Pathology
Haematology
t (8-14)
Patient presented with fever, coughing, headache. He developed rash on 3rd day, what is probable diagnosis ?
Ans. is 'a' i.e., Measles Measles - Rash appears 3-4 days after onset of febrile illnessMumps - There is no rashSmall pox - Already eradicatedChicken pox - Rash appears on day 1 of febrile illness.
Microbiology
null
Measles
Frieberg's disease involve -
*Frieberg's disease is osteochondritis of 2nd metatarsal head. Ref: Appley's 9th/e p.723
Anatomy
null
2nd metatarsal
The drug which is dangerous to take without medical supervision is
null
Pharmacology
null
Schedule G
Childhood-obesity prevention is an example of which of the following types of prevention? (E. REPEAT 2007)
Ref: Park's Textbook of Preventive and Social Medicine, 22nd edition, Pages 39, 40 Explanation: Preventing childhood obesity becomes primordial prevention for most of the non-communicable diseases. This is because the risk factor for other diseases is prevented, which means primordial prevention. Level of prevention Phase of disease Interventions Examples Primordial Prevention of risk factors Health education * School health education Health promotion * Lite style modification * Stop smoking * Stop alcoholism Primary Prevention of disease * Chemoprophylaxis * Condom usage * Wearing helmet * Seat belt Specific protection Secondary Prevention of spread of disease and complications Early diagnosis and prompt treatment * Screening lor any disease * Two weeks cough with sputum in ease of tuberculosis * Any fever case treated as malaria * MCR slipper in diabetes before complication Tertiary Limiting the occurred complication and rehabilitation Disability limitation * Appropriate tool cure in diabetes and leprosy Rehabilitation * Artificial limbafter road traffic accidents
Unknown
null
Primordial
A patient has 2 months POP cast for tibial fracture of left leg. Now he needs mobilisation with a single crutch. You will use this crutch on which side:
B i.e. Right side
Surgery
null
Right side
Deformity in anterior dislocation of hip is -
Ans. is 'a' i.e., Ext. rotation, abduction, flexion Anterior dislocation of hipo Anterior dislocation of the hip is much less common than posterior dislocation. Indeed, it is a very uncommon injury.o It is caused by forced abduction and lateral (external) rotation of hip, usually in a violent injury such as a motor accident on aircraft crash.o Clinically, the limb is in marked external (lateral) rotation, flexion and abduction.o There may be apparent lengthening due to abduction deformity,o Closed reduction under anaesthesia is the treatment of choice,o Complications are avascular necrosis, and secondary osteoarthritis.
Orthopaedics
Congenital Dislocation of Hip (C.D.H.)
Ext. rotation, abduction, flexion
Epithelial granuloma is caused by -
Granuloma formation is a type IV hypersensitivity reaction mediated by helper T cells. This reaction is similar to caseating granuloma formation in TB Basic Pathology, Robbins. Page no.: 56
Pathology
General pathology
Helper T cells
First line drug used for painful diabetic neuropathy is?
Ans. (b) DuloxetineRef: Harrison 18/e, chapter 384
Medicine
Endocrinology
Duloxetine
Which of the following is required in the initial stage of the synthesis of haemoglobin?
Heme is synthesized in the mitochondria. Staing substances required in the synthesis of heme are succinyl CoA and glycine. Pyridoxal phosphate is required for activation of glycine. Globin the protein pa of hemoglobin is synthesized in ribosomes.
Biochemistry
null
Glycine
S/E of OC pills is -
Ans. is 'c' i.e., Carbohydrate intolerance Adverse effects of OCPs c Nausea, vomiting, headache (migraine may be worsened). o Breakthrough bleeding or spotting, Amenorrhoea o Breast discomfo (mastalgia) o Weight gain, acne and increased body hair. o Cholasma, pruritus vulvae o Carbohydrate intolerance o Mood swing, abdominal distention (especially with minipill). o Leg vein and pulmonary thrombosis. Coronary & cerebral thrombosis --> MI, stroke u Estrogen component is responsible for venous thromboembolism. Both estrogen and progesterone are responsible for the aerial phenomena. o Mechanisms involved may be ? I. Increase in the blood clotting factors (II, VII, IX, X) Decrease antithrombin III and plasminogen activator. Increased platelet aggregation. o Rise in BP T risk of breast and cervical carcinoma (risk of endometrial and ovarian carcinoma decreases) o Benign hepatoma - may turn into malignant. Gall stones. Remember o Estrogen increases the risk of endometrial cancer. o Progesterone component decreases this risk in OC pills. o Estrogen has orable effect on lipid profile, while progesterone has opposite effect. o Progesterone component is mainly responsible for MI.
Social & Preventive Medicine
null
Carbohydrate intolerance
Following a head injury a man lost his tears from his both eyes. Absence of lacrimation is due to injury to:
The greater petrosal nerve exits the geniculate ganglion and ultimately innervates the lacrimal gland. The injury to the greater superficial petrosal nerve may cause reduction or absence of tear production. Unilateral loss of lacrimation suggests injury at or proximal to the geniculate ganglion. Ref: BDC, 4th edition, IIIrd volume, Page 23, 63.
Anatomy
null
Greater petrosal nerve
All the following are primary colours except
(D) Yellow > Blue, green and red are the primary colours but the cones with their maximal sensitivity in the yellow portion of sensitive enough in red portion to respond to red light at a lower threshold than green
Physiology
Special Senses: Vision and its Elements
Yellow
Most common nerve used conduction study in H reflex -
*The H reflex is basically an electrophysiologically recorded Achilles' tendon stretch reflex. *It is performed by stimulating the tibial nerve in popliteal fossa. *It is recorded over the soleus or gastrocnemius muscle. *It is used most commonly to evaluate S1 radiculopathy or to distinguish it from an L5 radiculopathy. REF:Ref: Text book of Neurology p.781
Anatomy
Miscellaneous
Tibial nerve
A 16-year-old girl is in your office for a preparticipation sports examination. She plans to play soccer in the fall, and needs her form filled out. Which of the following history or physical examination findings is usually considered a contraindication to playing contact sports?
The preparticipation sports physical examination is important in that it allows the physician to screen patients for potential risks associated with the sport they intend to play. That said, there are few real contraindications to sports participation. Having one eye is typically seen as a contraindication to playing contact sports like football or soccer. There are eye shields available, but in general these children are advised to avoid contact sports. Stable, repaired congenital heart disease; obesity; girls with a single ovary; and controlled diabetics are routinely allowed to participate. Other reasons to recommend against contact sports participation include hemophilia, single kidney, and unexplained syncope (until evaluated).
Pediatrics
Adolescence
Absence of a single eye
All contribute to postpaum hemorrhage, except:
Small for date
Gynaecology & Obstetrics
null
Small for date
A patient has prottitetic valve replacement and he develops endocarditis 8 months later. Organism responsible Is
Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:161 Infective Endocarditis (IE) It is the colonisation of the hea valves with microbiologic organisms, leading to the formation of friable, infected vegetations and frequently valve injury. Types 1. Acute infective endocarditis: Caused by highly virulent organisms mainly S. aureus (20-30%), seeding a previously normal valve. 2. Subacute infective endocarditis: Caused by organisms of moderate or low virulence mainly Streptococci (60-70%), seeding an abnormal or previously injured valve. 3. Endocarditis occurring in IV drug abusers: Caused predominantly by organisms found on the skin (S. aureus, Candida) and affecting the valves on the right side of the hea. 4. Prosthetic valve endocarditis: This may be early (symptoms appearing within 60 days of valve inseion), due to intraoperative infection of the valve or inseion of an infected valve or late (symptoms appearing after 60 days of valve inseion), due to late bacteraemia or earlier infection with microorganisms having a long incubation period. Prosthetic aoic valve is more prone for infective endocarditis than the mitral valve. Right sided IE has a more ourable prognosis than the left sided IE. However, when right sided IE vegetation size exceeds 2 cm, the moality increases.
Medicine
C.V.S
Staphylococcus epidermidis
Common presenting manifestations of Meniere's disease are all except:
(d) Loss of consciousness(Ref. Scott Brown, 8th ed., Vol 2, 819)The patient is fully conscious and oriented during an attack of Meniere.Meniere being a disturbance of peripheral vestibular system is therefore not characterised by any focal (such as diplopia, dysarthria, paresthesia, etc.) or generalised neurological symptoms like loss of consciousness, seizures, etc.The neurological symptoms accompany a central vestibular disturbance.However, vertigo of Meniere may be associated with vagal symptoms i.e. diaphoresis, pallor, nausea, vomiting, abdominal cramps, diarrhoea and bradycardia.
ENT
Ear
Loss of consciousness
What is the T/t of pt with carcinoid tumor of appendix of size more than 2 cm -
Carcinoid tumours * Neuroendocrine tumors - comprise a broad family of tumors, the most common of which are ; - carcinoid tumors (most commonly arising in the lungs and bronchi (so-called bronchopulmonary), small intestine, appendix, rectum, and thymus) and - pancreatic neuroendocrine tumors. - Other less common neuroendocrine tumors include those arising in the parathyroid, thyroid, adrenal, and pituitary glands) . TREATMENT OF CARCINOID SYNDROME Diuretics -- hea failure Bronehodilators -- wheezing Antidiarrhoeal agents, niacin supplementation Somatostatin analogues nwtreolide) -- 100 mg sk 8 hourly -- 3000 mg/ day Before surgery -- 150-250 nig sk 6-8 hrly 24-48 hrs prior to anaesthesia Inhibitors of serolonin synthesis are emerging as a new dam of age. to treat eareinoid syndrome. Telotristat etiprate Right hemicolectiomy Ref: Sabiston 20th Ed. ; Schwaz 11th Ed.
Surgery
All India exam
Right hemicolectomy
Which parts of cell cycle are fixed in durationa) GIb) G2c) Sd) M
The time taken for S, G2 and M phases are similar for most cell types, occupying about 6, 4 and 2 hours respectively whereas the duration of G1 shows considerable variation as short as 2 hours in rapidly dividing cells i.e., embryonic tissue or longer than 12 hours in some adult tissue.
Biochemistry
null
bcd
Infant body weight is tripled by age of –
The average birth weight of neonates is about 3 Kg. During first few days after birth, the newborn loses extracellular fluid equivalent to about 10% of the body weight. Most full term infants regain their birth weight by the age of 10 days. Subsequently, they gain weight at a rate of approximately 25 to 30 gm per day for the first 3 months of life. Thereafter they gain about 400 gm of weight every month for the remaining part of first year.
Pediatrics
null
11 months
Which type of anemia is seen in Rheumatoid ahritis?
Anemia of chronic illness traditionally encompassed any inflammatory, infectious, or malignant disease of a long-standing nature. Includes rheumatoid ahritis, severe trauma, hea disease, or diabetes mellitus. There is primarily a decreased availability of iron, relatively decreased levels of erythropoietin, and a mild decrease in the lifespan of RBCs to 70-80 days. Early onset rheumatoid ahritis with positive rheumatoid factor is more likely to have normocytic normochromic anemia.
Medicine
Rheumatoid Ahritis
Normocytic, normochromic
Which of the following is the most common urethral injury?
Rupture of the bulbar urethra There is a history of a blow to the perineum, usually due to a fall astride injury. The bulbar urethra is crushed upwards onto the pubic bone, typically with significant bruising. Extravasation of urine is common if the urine is not diveed and the extravasated urine is confined in front of the mid-perineal point by the attachment of Colles' fascia to the triangular ligament and by the attachment of Scarpa's fascia just below the inguinal ligament. The external spermatic fascia stops it getting into the inguinal canals. Extravasated urine collects in the scrotum and penis and beneath the deep layer of superficial fascia in the abdominal wall. CLINICAL FEATURES The signs of a ruptured bulbar urethra are perineal bruising and haematoma, typically with a butterfly distribution. There is usually bleeding from the urethral meatus and retention of urine is also typically present. MANAGEMENT If the diagnosis is suspected, the patient should be treated with appropriate analgesia and antibiotics should be administered. He should be discouraged from passing urine. A full bladder should be drained with a catheter placed by percutaneous suprapubic puncture using a Seldinger technique . This reduces urinary extravasation and allows investigations to establish the extent of the urethral injury. Diagnosis is made by urethrography using water-soluble contrast. If there is significant extravasation, then the perineal collection should be drained. The suprapubic catheter should remain in situ while the bruising and extravasation settle down and a stricture will typically develop at the site of the injury. The optimal treatment is delayed anastomotic urethroplasty after the swelling and bruising have settled down (typically 8-12 weeks later), with excision of the traumatised section and spatulated end-to-end reanastomosis of the urethra. Ref: Bailey and love 27th edition Pgno : 1479
Surgery
Urology
Rupture of bulbar urethra
Strawberry appearance is seen in
Rhinosporidiosis caused by rhinosporidium seeberi, mostly affects nose and nasopharynx, other sites such as lip, conjunctiva, epiglottis, larynx, trachea, bronchi, skin, vulva and vagina. In the nose, the disease is presented as leafy, polypoidal mass, pink to purple in colour and attached to the nasal septum or lateral wall. The mass is very vascular and bleeds too easily to touch. Its surface is studded with white dots representing the sporangia of fungus. hence giving it a "strawberry " appearance.
ENT
null
Rhinosporidiosis
Death of a patient due to an unintentional act by a doctor, staff or hospital is
Therapeutic misadventure is a mischance or an accident or a disaster. Therapeutic misadventure is a case in which n individual has been injured or had died due to some unintentional act by a doctor or agent of the doctor or hospital. Vicarious liability is liability for act of others i.e. an employer is responsible not only for his own negligence but also for the negligence of his employee by the principle of respondent superior (let the master answer), provided there (1) Must be employer-employee relationship, (2) While on job, (3) Employee conduct within the job of employment. Therapeutic privilege is an Exception to the rule of 'full disclosure' i.e. the doctor can use his discretion as to the facts that he discloses or of not telling the patient about the risks involved in treatment or about the diagnosis, e.g. in cases where patient is fearful, emotionally disturbed, psychotic or psycho-neurotic. The doctor should carefully note his decision in the patient's records mentioning the reasons. Ref: Krishnan vij Textbook of Forensic Medicine and Toxicology; 5th ed; Page no: 189
Forensic Medicine
Medico legal procedures
Therapeutic misadventure
Following protein is not found in organ of coi ?
Ans. is 'c' i.e., Microtubule associated protein 4 Proteins present in cochlea Actin-binding and microtubule-associated proteins regulate microfilament and microtubule number, length, organization and location in cells. In freeze-dried preparations of the guinea pig cochlea, both actin and tubulin are found in the sensory and suppoing cells of the organ of Coi. Fodrin (brain spectrin) co-localized with actin in the cuticular plates of both inner and outer hair cells and along the lateral wall of the outer hair cells. Alpha-actinin co-localized with actin in the cuticular plates of the hair cells and in the head and foot plates of the suppoing cells. It was also found in the junctional regions between hair cells and suppoing cells. o Profilin co-localized with actin in the cuticular plates of the sensory hair cells. Myosin was detected only in the cuticular plates of the outer hair cells and in the suppoing cells in the region facing endolymph. Gelsolin was found in the region of the nerve fibers. Tubulin is found in microtubules in all cells of the organ of Coi. In suppoing cells, microtubules are bundled together with actin microfilaments and tropomyosin, as well as being present as individual microtubules arranged in networks. An intensely stained network of microtubules is found in both outer and inner sensory hair cells. The microtubules in the outer hair cells appear to course throughout the entire length of the cells, and based on their staining with antibodies to the tyrosinated form of tubulin they appear to be more dynamic structures than the microtubules in the suppoing cells. The microtubule-associated protein MAP-2 is present only in outer hair cells within the organ of Coi and co-localizes with tubulin in these cells. No other MAPs (1,3,4,5) are present. Tau is found in the nerve fibers below both inner and outer hair cells and in the osseous spiral lamina.
ENT
null
Microtubule associated protein 4
Which among the following is the commonest site of fracture of mandible?
The commonest site of the mandible is condylar process followed by angle, body and symphysis of mandible (Mnemonics - CABS).
ENT
null
Condylar process
A 59-vear-old man with type 2 diabetes goes for a screening eve examination. The ophthalmologist reports that the patient has developed non-proliferative retinopathy. (List the findings.)For the above patient with a complication of diabetes, select the most likely diagnosis or findings.
Background retinopathy is present in about 90% of diabetes after 25-30 years of disease. Microaneurysms, dilated veins, dot and blot hemorrhages, cotton-wool spots, and hard exudates are common findings.
Medicine
Endocrinology
microaneurysms and hemorrhage (dot and blot)
P4 pf vagina during reproductive life is
Vaginal secretion is acidic during reproductive life which is oestrogen dependent, and inhibits growth of pathogenic organisms.
Gynaecology & Obstetrics
null
Acidic
All of the following are not true with respect to erythema multiforme except ?
Erythema multiforme Known cause MC- Viral infection, commonly Herpes simplex > Mycoplasma Drugs : antiepileptic, antibiotics,anti gout, anti retroviral etc. Other : (antimalarial >Leukemia) Unknown cause : Idiopathic C/f: Target/ iris /bulls eye lesion are seener CAUTION : ALL ARE NOT TRUE ; MEANS ALL ARE FALSE EXCEPT i.e TRUE STATEMENT IS !!!
Dental
NEET 2019
Koebner's phenomenon is seen
Commonest cause of hirsutism in a teenage girl :
Ans. is a i.e. Ovarian disease As explained earlier PCOD is the most common cause of hirsutism. PCOD most common affects teenage girls (15 - 25 years). Therefore, In teenage girls most common cause of hirsutism is PCOD.
Gynaecology & Obstetrics
null
Ovarian disease
Most common pattern of Joint involvement in psoriatic arthropathy
Asymmetrical inflammatory Oligoarthritis - Most common pattern.
Medicine
null
Asymmetrical inflammatory oligoarthritis
In transmission of malaria, mosquito bite transfers?
Ans. is 'a' i.e., Sporozoite Sporozoites are infective to man. Human infection begins when a female anopheline mosquito inoculates plasmodial sporozoites from its salivary gland during a blood meal.
Microbiology
null
Sporozoite
Osteoradionecrosis occurs at a dose of:
Life-Long threat: Hyposalivation Radiation caries Occurs 3 months after expose (PG1) Trismus Osteoradionecrosis > 70 Gy
Radiology
null
> 70 Gy
Antigen binding site in immunoglobulin is
Ans. is 'b' i.e., Hypervariable region
Microbiology
null
Hypervariable region
DOT's indicates
null
Social & Preventive Medicine
null
Short term treatment under supervision
Which is true about Sex hormone-binding globulin (SHBG):
And. A. Binds testosterone with a higher affinity than estradiolSex hormone-binding globulin binds to both testosterone and estradiol, but it binds with higher affinity to testosterone. The bioactivity of testosterone is reduced by SHBG because testosterone cannot bind to its receptor when bound by SHBG. SHBG increases the circulating half-life of testosterone by slowing the clearance and metabolism of testosterone. SHBG does not alter the secretion of inhibin or androgen-binding protein, area
Physiology
Endocrinology and Reproduction
Binds testosterone with a higher affinity than estradiol
Sq. cell tumor of urinary bladder is due to -a) Stoneb) Schistosomiasisc) Chr. cystitisd) Diabetes mellitus
Risk factors for squamous cell ca of bladder Schistosoma haematobium it's a risk factor for both TCC & sq. cell ca, but more for sq. cell ca. Chronic irritation from urinary calculi, long term indwelling catheters, chronic urinary infections Bladder diverticula
Surgery
null
abc
The important fatty acid present in breast milk which is important for growth is –
Up to 5-10% of fatty acids in human milk are polyunsaturated. Most of these are linoleic acid with smaller amounts of linolenic acid. Linoleic acid → gives rise to Arachidonic acid Linolenic acid → gives rise to Docosahexaenoic acid Docosahexaenoic acid is found in human milk and brain lipids and is required for the development of our nervous system and visual abilities during the first six months of life. Lack of sufficient Docosahexaenoic acid may be associated with impaired mental and visual functioning as well as attention deficit hyperactivity disorder.
Pediatrics
null
Docosahexaenoeic acid
Lesion is Alzheimer's disease are commonest at
Nucleus basalis of Meyne for Alzheimer's disease and Parkinson's disease dementia. The nucleus basalis of Meyne (NBM) is a large source of cholinergic innervation to widespread coical areas. There have been two repos of DBS of the NBM for either AD or PD. Ref Harrison20th edition pg 2456
Medicine
C.N.S
Nucleus of Meynes
Untrue about articular cartilage is
In synovial joints (like temporomandibular and sterno-clavicular) the articular surfaces are lined by fibro-cartilage instead of hyaline cartilage. Hyaline cartilage loses the tendency to ossify with age as it takes the role of articular cartilage Hyaline cartilage also loses the perichondrium, as it becomes articular cartilage
Unknown
null
Is of hyaline variety in all synovial joints
Smoking is not a risk factor for ?
Ans. is 'd' i.e., Alzhiemers disease Smoking is not a risk factor for the development of alzhiemers disease
Pathology
null
Alzhiemers disease
Which among the following is true about Caplan's syndrome?
Caplan's syndrome also known as rheumatoid pneumoconiosis or rheumatoid lung. It occurs in patients with both rheumatoid ahritis (usually seropositive patients) and pneumoconiosis related to mining dust (coal, asbestos, and silica) exposure and consists of multiple rounded nodules in the lung. Ref: Harrison's 17th ed chapter 314 ; Rheumatology and Immunology Therapy: A to Z Essentials edited by Larry W. Moreland, 2004, Page 186.
Medicine
null
Pneumoconiosis with rheumatoid ahritis
Which among the following is an anaerobic bacteria?
Corynebacterium diphtheriae is an aerobic and facultative anaerobic gram positive rod that appear club shaped. They are arranged in V or L shaped formations. The rods have a beaded appearance and the beads consist of granules of highly polymerized polyphosphate. These granules stain metachromatically. It is transmitted through airborne droplets. It can also infect the skin at the site of a preexisting skin lesion. It produces a toxin which inhibits protein synthesis by ADP-ribosylation of elongation factor 2 (EF-2). It can be cultured on Loeffler's medium, a tellurite plate, and a blood agar plate. The typical gray-black color of tellurium in the colony is a telltale diagnostic criterion. Methylene blue staining shows tapered, pleomorphic gram-positive rods and it can also reveal the typical metachromatic granules. Ref: Levinson W. (2012). Chapter 17. Gram-Positive Rods. In W. Levinson (Ed),Review of Medical Microbiology & Immunology, 12e.
Microbiology
null
Corynebacterium diphtheria
Commonest presentation of Hodgkin's lymphoma is -
Most patients present with palpable lymphadenopathy that is nontender; in most patients, these lymph nodes are in the neck, supraclavicular area, and axilla. More than half the patients will have mediastinal adenopathy at diagnosis, and this is sometimes the initial manifestation. Subdiaphragmatic presentation of Hodgkin's disease is unusual and more common in older males." - Harrison
Surgery
null
Painless enlargement of lymph node
Which of the following is not included in the SAFE strategy?
In order to deal with the blindness caused by trachoma, the WHO has declared the SAFE strategy which includes the following: S - Surgery A - Antibiotics F - Facial hygiene ( Face washing) E - Environmental modification Surveillance is not included in the SAFE strategy. Ref: Park's Textbook of Preventive and Social Medicine 19th edition; pages 258 - 260; Parson's Textbook of Ophthalmology 19th Edition, Page 595
Social & Preventive Medicine
null
Surveillance
A 42-year-old man with sexual interest in children (pedophilia) is given an electric shock each time he is shown a videotape of children. Later, he feels tense around children and avoids them. Which of the following management techniques does this example illustrate?
The management technique described here is aversive conditioning, in which a maladaptive but pleasurable stimulus (for this man, sexual interest in children) is paired with painful stimulus (e.g., a shock) so that the two become associated. Flooding - Type of behavioral therapy in which maximum stimulus is given in first exposure. Biofeedback - Uses principle of operant conditioning Useful in disorders which are caused by autonomic dysfunction such as tension headache Eg use of EMG to control muscle tone in disorders such as Bruxism.
Psychiatry
Miscellaneous
Aversive conditioning
Compared to conventional amalgams, spherical amalgams:
Amalgams made from lathe-cut powders or admixed powders tend to resist condensation better than amalgams made entirely from spherical powders. Since freshly triturated amalgams from spherical powders are very plastic, one cannot rely on the pressure of condensation to establish a proximal contour for a class II restoration. Spherical alloys require less mercury than typical lathe-cut alloys because spherical alloy powder has a smaller surface area per volume ratio than does the lathe-cut powder. Amalgams with low mercury content generally have better properties. Spherical alloys also require less compaction forces and have lower setting times. Reference: PHILLIPS’ SCIENCE OF DENTAL MATERIALS, 12th ed page no 343
Dental
null
None of the above
A patient has the pink papules and plaques over genital. What serotype of human papilloma virus (HPV) is the most likely cause?
C/o of Anogenital was- cause by HPV 6 HPV type Associated clinical conditions 1 (m/c) Deep plantar and palmar was 2 (m/c) Superficial plantar was 3 Plane was 4 Common was, plantar was 5 Epidermo dysplasia verruciformis 6 (m/c) Laryngeal was, Anogenital was 7 (m/c) Butcher wa Mnemonic: DSP- CELB
Dental
Viral infections
HPV 6
All of the following factors evaluate the chances of amputation in a limb, except
D i.e. Presence of infection Mangled Extremity Severity Score (MESS) can be used as predictor of eventual amputation versus limb salvageQ. Higher the score lower the chances of salvage i.e. higher score has higher chances of amputation. However recent studies have shown it to be inaccurate in predicting the functional outcome for mangled limb patient* Factors in evaluation of MESS are : Mn- " Shocked SIA"
Surgery
null
Presence of infection
All are vectors except -
Ticks are the vectors of Q fever, relapsing fever, KFD, Tularemia Mosquito are the vectors of malaria, filaria, Japanese encephalitis, dengue, chikungunya Flies are the vectors of typhoid, diarrhoea,dysentery, cholera, gastroenteritis, anthrax, yaws. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 833,834
Social & Preventive Medicine
Environment and health
Spider
'STEPS' is recommended by WHO as a method for:
From 2005, WHO introduced stepwise approach to surveillance of noncommunicable disease risk factors termed STEPS, as a pa of global surveillance strategy aiming to monitor emerging patterns and trends worldwide and contain and reduce noncommunicable diseases. Ref: Commonwealth Health Ministers Update, 2011 By Philip D Ose, Page 43; Epidemiology and Demography in Public Health By Japhet Killewo, Pages 99-100
Social & Preventive Medicine
null
Surveillance of risk factors for non communicable diseases
Twelve elderly residents living in an assisted care facility suffered from sinusitis, otitis media, and mild pneumonias during midwinter. Despite the fact that they had all received the 13-valent pneumococcal conjugate vaccine recently licensed for adults, S. pneumoniae was isolated from 10 of the patients. Which of the following is the best explanation for the pneumococcal infections?
There are more than 90 capsular immunotypes of Streptococcus pneumoniae. Immunity to S. pneumoniae is conveyed by antibodies against the specific capsular type. Vaccines have been formulated to contain the most commonly isolated capsular types. Originally, the S. pneumoniae conjugated vaccine contained seven serotypes. Unfortunately, the serotype replacement phenomenon occurred in which a nonvaccine strain began to cause disease among the vaccinated population. Over time this lead to the licensing of a 13-valent pneumococcal conjugated vaccine (PCV-13), which was recommended for children. A 23-valent nonconjugated vaccine (PV-23) was developed for children over age 2 and adults who are at risk for the disease. Recent research showed that older adults vaccinated with PCV-13 elaborated higher protective antibody titers than those immunized with PV-23. PCV-13 has now been licensed for adults 50 and older. The failure of the vaccine to protect these individuals is most likely due to the replacement phenomenon-the capsular type responsible was not present in the vaccine (c). Elderly patient do mount good immune responses to vaccines so (a) is not the likely cause. Some patients will not respond to the vaccine (b), but the effectiveness of the vaccine is higher than 17% (10/12, the number of patients who became infected). In fact, recent analyses of strains causing illness in those over 65 suggest that over 70% of the cases of invasive pneumococcal disease are covered by PCV-13. It is unlikely that the vaccine was defective (d), although this can occur.
Microbiology
General
The capsular type responsible was not present in the vaccine
Most number of false positives by a screening test is because of?
ANSWER: (D) Low prevalenceREF: Park 20ch edition page 128More prevalent disease gives less is the number of false positiveLess prevalent disease gives more is the number of false positiveHighly specific screening test gives few false positiveHighly sensitive screening test gives few false negative
Social & Preventive Medicine
Screening for Disease
Low prevalence
Residual chlorine of water should be:
Principles of chlorination:  The "chlorine demand" of the water should be estimated. The chlorine demand of the water is the difference between the amount of chlorine added to the water and the amount of residual chlorine remaining at the end of a specific period of contact at a given temperature and pH of the water. The minimum recommended concentration of free chlorine is 0.5 mg/liter for one hour. The free residual chlorine provides a margin of safety against subsequent microbial contamination which may occur during storage and distribution. Essentials of preventive and community dentistry  Soben Peter  5th edition
Dental
null
0.5 mg/ltr after 1 hr
The cardiac marker that is elevated the earliest in a case of Myocardial Infarction, among the following is -
Ans- C Myoglobin
Unknown
null
Myoglobin
luorescence is used in assessment of levels of which hormone commonly -
(A) (Thyroid) (Internet)Fluoroscopy is used in assessment of all the hormones.Fluorescence spectroscopy aka fluorometry or spectrofluorometry, is a type of electromagnetic spectroscopy which analyzes fluoescence from a sample. It involves using a beam of light, usually ultraviolet light that excites the electrons in molecules of certain compounds and causes them to emit light; typically, but not necessarily, visible light. A complementary technique isabsorption spectroscopy.Although the RIA technique is extremely sensitive and extremely specific, requiring specialized equipment, it remains among the least expensive methods to perform such measurements. It requires special precaution and licensing, since radioactive substances are used. The unique ability of RIA to measure small molecules can nowadays be achieved in many cases by non-radioactive methods such as ELISA, where the antigen-antibody reaction is measured using colorimetric, such as absorbance, fluorescence intensity or polarization. This, combined with the usual sandwich configuration of ELISA requiring two domains of an analyte to be present to generate a signal, has led to many assays being developed for ELISA instead of RIA or for RIA assays to be replaced by ELISA.
Biochemistry
Endocrinology
Thyroid
How do you manage an established freys syndrome?
MANAGEMENT OF ESTABLISHED FREY'S SYNDROMEAntiperspirants, usually containing aluminium chloride;Denervation by tympanic neurectomy;The injection of botulinum toxin into the affected skin.PreventionTechniques described to prevent Frey's syndrome following parotidectomy. These include:Sternomastoid muscle flap;Temporalis fascial flap;Inseion of aificial membranes between the skin and the parotid bed.Ref: Bailey and love, page no: 795
Surgery
Head and neck
Tympanic neurectomy
Combination of fixed dilated pupil with iris atrophy and secondary glaucoma following penetrating keratoplasty is:
Typical symptoms of Urrets zavalia, after corneal transplant in keratoconus surgery. URRETS ZAVALIA SYNDROME * Fixed dilated pupil unresponsive to pilocarpine * Iris atrophy due to iris ischemia Multiple posterior synechiae * Seen in post corneal transplantation in Keratoconus * Elevated IOP a risk factor Use of mydriatics is also considered as a risk factor
Ophthalmology
Diseases of Cornea
Urrets Zavalia Syndrome
Drug of choice for Pneumocystis Pneumonia
Cotrimoxazole is Doc for Pneumocystis Pneumonia.
Microbiology
null
Cotrimoxazole
60 year female with tense bulla in lower extremity and subepidermal bullous lesion on microscopy, diagnosis is
null
Dental
null
Bullous pemphigoid
Most common type of shock in surgical practice:-
Most common type of shock in surgical practice is hypovolemic shock. HYPOVOLEMIC SHOCK Causes of hypovolemic shock: Blood lossQ(Trauma, bleeding) Loss of plasma due to extravascular fluid sequestration in burnsQ Loss of body sodium & water (diarrhea & vomitingQ)
Surgery
Shock
Hypovolemic
Extremely pruritic excoriation & papules on buttocks with autoantibodies against epidermal transglutaminase and IgA deposition in dermis on immunohistological examination of normal perilesional skin. Diagnosis is –
Following information suggest the diagnosis of dermatitis herpetiformis. Extremely pruritic Paulo - excoriation Buttock involved Antibodies against epidermal transglutaminase IgA deposition in dermis
Dental
null
Dermatitis herpetiformis
The most definitive clinical sign of pregnancy is :
Fetal hea sounds
Gynaecology & Obstetrics
null
Fetal hea sounds
Conservative surgical treatment of PPH includes
Ans. a (Internal iliac artery ligation). (Ref. Dutta, Obstetrics 4th/ 447, Williams, Obstertrics, 21st/620, 635)Traditionally, postpartum hemorrhage (PPH) has been defined as the loss of 500 mL of blood or more after completion of the third stage of labor. This is unreasonable, because nearly half of all women who are delivered vaginally shed that amount of blood or more when measured quantitatively. After the first 24 hours it is designated late postpartum hemorrhage.Scheme for the management of true PPH:# If uterus is flabby:- Massage uterus- IV methergin (Drug of choice) - MH 2006- Oxytocin- Bladder catheterization- Examine expelled placenta# Bleeding Unresponsive to Oxytocics: Following management should be initiated immediately:- Use bimanual uterine compression- Begin blood transfusions- Explore the uterine cavity manually for retained placental fragments or lacerations.- If still flabby, hot uterine douche and intrauterine packing and- If this fails, either hysterectomy or bilateral ligation of anterior division of internal iliac arteries (in exceptional cases as an alternative to hysterectomy).
Gynaecology & Obstetrics
Miscellaneous (Gynae)
Internal iliac artery ligation
A patient is suspected to have vestibular schwannoma the investigation of choice for its diagnosis is:
Ans. B (Gadolinium enhanced MRI) Vestibular schwannoma (VS) - arise from inferior vestibular division of eight nerve as from the auditory division a. MRI with gadolinium is the current standard for screening for suspected vestibular schwannomas because of the high false negative rate associated with BSERA Treatment Under 65 years - small intracranial tumors (within the internal auditory canal) may be surgically removed through the transmastoid labyrinthine route a. Larges tumors (> 3 cm) are associated with increased incidence of hearing loss, dysequilibrium, headache facial numbness, and diplopia are removed a suboccipital craniotomy b. Huge ones can only be removed combined suboccipital and translabyrinthine approach Over age 65 with slowly growing tumors, observation is the proffered treatment.
ENT
null
Gadolinium enhanced MRI
Sudden painful diminition of vision in Anterior Uveitis is due to
Due to ciliary muscle spasm, convexity of lens increases leading to blurred vision and pain due to spasm.
Ophthalmology
null
Ciliary muscle spasm
In poal hypeension the sites of poosystemic anastomosis includes
In poal hypeension the sites of poosystemic anastomosis includes lower end of esophagus, around umbilicus, lower third of rectum and anal canal, posterior abdominal wall, bare area of liver Poosystemic anastomosis Location Poal component Systemic component Esophagus(lower end) esophageal varices Left gastric vein Azygous vein and accessory hemiazygous vein Rectum and anal canal hemorrhoids Superior rectal vein Middle and Inferior rectal vein Umbilicus caput medusae Left branch of poal vein(paraumbilical branches) Superficial (superior and Inferior) epigastric veins Posterior abdominal wall Colic and omental veins Retro peritoneal veins of abdominal wall, renal capsule, splenic and hepatic flexure Bare area of liver Hepatic venues, right branch of poal vein Phrenic and intercostal veins, Retro peritoneal veins draining into lumbar, Azygous and hemiazygous veins Liver(rarely) Patent ducts venous, Left branch of poal vein Inferior vena cava
Anatomy
G.I.T
All of the above
In case of rape victim vaginal swab is taken within?
According to the Guidelines (given by Ministry of Health and family welfare for rape victim examination): Vaginal swab should be taken within 72hrs , after this time period chances of demonstration of sperm (which might be a potential evidence) are very less.
Forensic Medicine
Trace evidences
3 days