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Which of the following is not an indication for endotracheal intubation?
|
Pneumothorax requires urgent needle thoracocentesis and/or Intercostal drainage. Pneumothorax is a known complication of endotracheal intubation and mechanical ventilation and is certainly not an indication for the same.
|
Anaesthesia
| null |
Pneumothorax
|
Teratogenicity results when drugs are given during
| null |
Pharmacology
| null |
First trimester
|
Balloon valvotomy is successful in all of the following cases except –
|
It is indicated in MS without calcification.
|
Pediatrics
| null |
Calcified mitral stenosis
|
Hep Burn Osteometric board is used to measure-
|
Ans. 'a' i.e., Length of long bones o Hep Bum Osteometric board is used to accurately measure length of long bones.Hepburn Osteometric Boardo It is ait instrument used to measure length oflong bones.o It has a rectangular base with ruler fixed along one of its long sides,o An upright is fixed at one end of the board and a second one slides along the board.o Bone is placed with one of its ends along the fixed upright and the movable upright is brought upto the other end of the bone. The distance between the uprights is the length of the long bone,o Stature can be calculated from the length of long bones and used for identification. Femur and tibia give more accurate values compared to humerus and radius.
|
Forensic Medicine
|
Identification - Medicolegal aspects
|
Length of long bones
|
Which of the following drugs should be given in a patient with acute angle closure glaucoma .except
|
Three drugs in the option i.e clozapine,fluph fluphen,paroxentine have anti-cholinergic propeies and should be avoided in angle closure glaucoma. Ref-KDT 6/e p426
|
Pharmacology
|
Autonomic nervous system
|
Pilocarpine
|
Which among the following drug is contra-indicated in renal failure?
|
Renal failure patients given repeated doses of pethidine are prone to experience similar effects. All the other drugs are safe in renal failure. Ref: KD Tripathi 8th ed
|
Pharmacology
|
Central Nervous system
|
Pethidine
|
Male-female differentiation of fetus occurs at
|
Genotype of embryo is established at feilization. But male and female embryos are phenotypically distinguishbletill week 6. Ref: Gray's 39e/p-1289
|
Anatomy
|
General anatomy
|
10-12 weeks
|
Synthesis of protein occurs on:
| null |
Biochemistry
| null |
Poly ribosomes
|
Traditionally scrotal carcinoma is associated with which of the following occupations?
|
Ans. is 'a' i.e., Chimney sweeps & 'b' i.e., Mule spinners * Carcinoma of the scrotum.* It is traditionally recognized as an occupational hazard for chimney sweeps and mule spinners.* It was described by Potts.* Unlike carcinoma of the penis, carcinoma of the scrotum is almost unknown in India and Asiatic countries.* The growth starts as a wart or ulcer and as it grows it may involve the testis.* The growth is excised with a margin of healthy skin. If associated enlargement of the inguinal nodes does not subside with anti- biotics, a bilateral block dissection should be carried out up to the external nodes.
|
Surgery
|
Testis & Scrotum
|
Chimney sweeps
|
Which of the following organism causes a life-threatening gastroenteritis as a result of use of a broad spectrum antimicrobial agents
|
The use of broad spectrum antibiotics such as ampicillin and clindamycin has been associated with pseudomembranous colitis. Antibiotic administration results in the proliferation of drug resistant C. difficile that produces Toxin A (a potent enterotoxin with cytotoxic activity) and Toxin B (a potent cytotoxin). This disease is best treated by discontinuing the use of the offending antibiotic and administering oral doses of metronidazole or vancomycin. Administration of antibiotics may also lead to a milder form of diarrhea, called antibiotic associated diarrhea. This form is associated with C. difficile in about 25 percent of the time.
|
Microbiology
|
Bacteriology
|
Clostridium difficile
|
Hep-2 cells are a type of-
|
Ans. is 'c', i.e. Continous cell lines
|
Microbiology
| null |
Continuous cell lines
|
Botulinum toxin acts by
|
Ref: HL Sharma 3rd ed pg no:133 botulinum toxin and beta-bungaro toxin inhibits the release of Ach into the synapse
|
Pharmacology
|
Autonomic nervous system
|
Inhibits Ach release
|
The commonest pancreatic tumor is:
|
M/C type - Adenocarcinoma Non-specific Tumour Marker - CEA Specific Tumour Marker - CA 19.9 Chemotherapy Regimen - Gemcitabine MC site of metastasis - Liver M/C site for CA pancreas - Head > Body > Tail Neuroendocrine Tumors (NET) of Pancreas- M/C NET of Pancreases - Non-Functional (PPOMA)- M/C functional NET of Pancreas - Insulinoma- M/C functional & Malignant NET of Pancreas - Gastrinoma
|
Surgery
|
Pancreas
|
Ductal adenocarcinoma
|
Bite cells are characteristic of -
|
Exposure of G6PD deficient red cells to high levels of oxidants causes cross linking of reactive sulfhydril groups on globin chains which become denatured and form membrane bound precipitates known as Heinz bodies. As inclusion bearing red cells pass through the splenic cords, macrophages pluck out the Heinz bodies. As a result of membrane damage some of these paially devoured cells retain an abnormal shape appearing to have a bite taken out of it.This is called as bite cells. Reference; Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.page no. 634
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Pathology
|
Haematology
|
G6PD deficiency
|
A four year old boy Tinu has normal developmental milestones except delayed speech. He is interested to watch spinning objects like fan and the washing machine. His parents struggle to get him interested in other children at home. People often comment that he is disinterested and self centred. What will be your thought regarding his diagnosis?
|
Tinu's presentation is that of poor 'theory of mind' or lack of perspective taking, poor communication and social skills and obsessive interests in spinning objects, which is common in ASD (autism spectrum disorder). Autism is characterized by triad of impaired social development, disturbed communication and language and presence of stereotypes. Ref: The Biology of the Autistic Syndromes By Christopher Gillberg, Mary Coleman, 2000, Page 25
|
Psychiatry
| null |
Autism Spectrum Disorder
|
True about Arboviruses is -
|
- chikungunya is a disease caused by group A virus, the chikungunya virus and transmitted by Aedes aegypti. - KFD was first recognized inas Shimoga district of Karnataka in India. - India is a yellow fever receptive area, that is an area in which yellow fever does not exist, but where conditions would permit it's development if introduced. - Dengue is caused by dengue virus. - there are four virus serotypes which we designated as DENV1, DENV2, DENV3 and DENV4. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:283,247,288,289 <\p>
|
Social & Preventive Medicine
|
Communicable diseases
|
Chikungunya is transmitted by Aedes aegypti
|
NADPH oxidase deficiency causes impaired immunity which of the follwoing process?
|
Chronic granulomatous disease is a rare, X-linked deficiency of NADPH oxidase activity which drastically impairs the ability of macrophages and neutrophils to destroy pathogens. Patients are especially vulnerable to mycobacteria, E coli, and staphylococcus since these organisms produces catalase to defend themselves against hydrogen peroxide attack by phagocytes.
|
Biochemistry
| null |
Chronic granulomatous disease
|
A patient presented with numbness of little and ring finger, atrophy of hypothenar muscles. The nerve damaged will be?
|
This is a case of cubital tunnel syndrome, which is caused by compression or irritation of the ulnar nerve as it passes under the medial epicondyle before it branches to deep and superficial branches. Symptoms are usually tingling and numbness in the cutaneous distribution of the ulnar nerve. In severe cases, muscle weakness may be apparent, with atrophy of the hypothenar eminence.Also know: Deep branch of ulnar nerve supplies:Hypothenar compamentAdductor pollicisDorsal interosseiPalmar interosseiMedial lumbricalsSuperficial branch of ulnar nerve supplies:Palmaris brevis Surrounding skin of the digit 5 and the medial side of digit 4
|
Anatomy
| null |
Ulnar nerve before division into superficial and deep branches
|
An elderly male accompanied by his son.The son tells his father has fever, cough, shoness of breath since 2 weeks. The patient is a known case of chronic bronchitis and diabetes. Travel history to Wuhan City, China is present. What is the symmetry of the causative virus?
|
The patient is suffering from coronavirus disease 2019. The symmetry of the causative virus is enveloped helical symmetry. Coronaviridae is a family of which have the following propeies: Unsegmented genome of positive-sense, single-stranded RNA viruses. They are enveloped viruses. They exhibit helical symmetry. Coronavirus is the causative agent of severe acute respiratory syndrome (SARS-CoV). Viruses with Helical Symmetry: Mnemonic: ABC FOR PARAmedics Arenavirus Bunyavirus Coronavirus Filovirus Ohomyxovirus Rhabdovirus Paramyxovirus Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition
|
Microbiology
|
Virology
|
Enveloped helical symmetry
|
Multipleround to oval erythematous patches with fine central scale distributed along the skin tension lines on the trunk is highly suggestive of?
|
.
|
Pathology
|
All India exam
|
Pityriasis rosea
|
Leutic glossitis is an intra-oral manifestation caused by
| null |
Pathology
| null |
Trepenoma pallidium
|
About Langerhans cell histiocytosis, true are all except:
|
d. Gonadal involvement occurs(Ref: Nelson's 20/e p 2484-2489; Ghai 8/e p 620-623)a. Peak incidence less than 3 years of age: True; More common and more severe in younger childrenb. Radiosensitive: True, as Bone lesions and Pituitary lesions, causing DI, respond well to radiotherapyc. Diffuse form is known as Letterer-Siwe disease: Trued. Gonadal involvement occurs: FALSE; Gonadal involvement is usually not seen in LCH.
|
Pediatrics
|
C.V.S.
|
Gonadal involvement occurs
|
Which fruit juice helps in preventing UTI:
|
Ans. is 'c' i.e. Cranberry Cranberry juice has been traditionally used for the treatment and prophylaxis of urinary tract infection.Recent randomized controlled trials have demonstrated its utility in prophylaxis of UTIs but not for treatment.
|
Surgery
|
Miscellaneous (Kidney & Uterus)
|
Cranberry
|
Essential drug is?
|
ANSWER: (B) Those drugs that satisfy the health care needs of the majority of the populationREF: KDT 6th edition page 5Essential drugs (medicines), as defined by the World Health Organization (WHO) are "those drugs that satisfy the health care needs of the majority of the population; they should therefore be available at all times in adequate amounts and in appropriate dosage forms, at a price the community can afford.
|
Pharmacology
|
Pharmacokinetics
|
Those drugs that satisfy the health care needs of the majority of the population
|
The Burrows in scabies is in the –
|
Mite burrows into stratum corneum. These burrow is visible clinically as an irregular gray - brown line.
|
Dental
| null |
Stratum corneum
|
Immediate stiffnes postmoem occurs in :
|
B i.e. Cadaveric spasm
|
Forensic Medicine
| null |
Cadaveric spasm
|
One week after an extended hysterectomy, the patient leaks urine per vaginum. In spite of the leakage, she has to pass urine from time to time. The most likely cause is :
|
Ureterovaginal fistula
|
Gynaecology & Obstetrics
| null |
Ureterovaginal fistula
|
Which of the following does not cause Polyuria?
|
Rhabdomyolysis leads to myoglobinuria which leads to blockage of tubules and thereby reduction of urine output. Interstitial nephritis is characterized by tubular damage leading to polyuria. Hypokalemic nephropathy in choice B and ADH insufficiency (diabetes insipidus) in choice C leads to Polyuria.
|
Medicine
|
Nephrotic and Nephritic syndrome
|
Rhabdomyolysis
|
CCA can be palpated at
| null |
Anatomy
| null |
Thyroid cartilage.
|
A patient who has suffered severe chest trauma in an automobile accident is found to have fluid in the right pleural space. A thoracentesis reveals the presence of chylous fluid in the pleural space, suggesting a rupture of the thoracic duct. In which regions of the thorax is the thoracic duct found.
|
Posterior and superior mediastinum o Thoracic duct is the main lymphatic channel of the body that drains to the venous system from the body except the: -Right thorax -Right arm -Right head and neck o It begins as a continuation of the cisterna chyli at the level of the T 12 veebras. It passes to the right of the aoa through the aoic hiatus. It then ascends to the right of the oesophagus with the azygous vein on its left. Posteriorly are the right posterior intercostal aeries. o At the level of the fifth thoracic veebra the duct passes superiorly and to the left, posterior to the oesophagus (posterior mediastinum). It then ascends on the left side of the oesophagus into the superior mediastinum. At this point, the aoa lies anteriorly and posteriorly is the anterior longitudinal ligament of the veebral bodies. o Superiorly, within the neck the thoracic duct passes laterally to arch over the dome of the right pleura. It passes laterally and posterior to the carotid sheath and anterior to the veebral aeries. During this final section: o It can divide into 2-3 branches o It is joined by lymphatic trunks from: o The left side of the head - the jugular trunk o The left arm - the left subclan trunk o All the branches merge with the subclan vein, the internal jugular vein or the left brachiocephalic vein near the intersection of all three o On route, the thoracic duct receives lymphatic efferents from: -Intercostal nodes -Anterolateral and -posterior mediastinal nodes -Tracheobronchial nodes
|
Surgery
| null |
Posterior and superior mediastinum
|
All of the following are manifestations of congenital syphilis except:-
|
Gumma- seen in teiary syphilis Late signs of Congenital syphilis Symptom/sign Descriptions Olympian brow Bony prominence of the forehead caused by persistent or recurrent periostitis Higoumenaki's sign Unilateral or bilateral thickening of the sternoclavicular third of the clavicle Saber shins Anterior bowing of the midpoion of tibia Hutchinson teeth Peg-shaped upper central incisors with a notch along the biting surface Mulberry molars Abnormal 1st lower molars with excessive number of cusps Saddle nose Depression of the nasal root Rhagades Linear scars in a spoke-like pattern from mucocutaneous fissures of mouth, genitalia Hutchinson triad Hutchinson teeth, interstitial keratitis, and 8th nerve deafness Clutton joint Unilateral or bilateral painless joint swelling Manifestations of early congenital syphilis include Syphilitic rhinitis Maculopapular rash Condyloma lata
|
Pediatrics
|
FMGE 2018
|
Gumma
|
What is the position of the leg in fracture neck of femur: September 2007
|
Ans. B: External rotation deformity of less than 45 degree Capsule of the hip joint prevents full external rotation in intra-capsular/ fracture neck of femur. So external rotation will be there but not significant, whereas in case of extra-capsular/inter-trochanteric femoral fractures, leg will be externally rotated to such an extent that lateral surface of foot touches the bed as there is no check by the capsule of hip joint.
|
Surgery
| null |
External rotation deformity of less than 45 degree
|
Which one of the following is not a feature of renal aery stenosis?
|
In renal aery stenosis - Hypeension is difficult to control with drugs. Patients often respond to Revascularization procedures like percutaneous renala aery angioplasty . There may be decline in GFR during therapy with ACE -inhibitors or ARB'S. Renal aery stenosis can be unilateral or bilateral, so kidneys may be asymmetrical . Atherosclerosis is the common cause of renal aery stenosis in elderly. Ref:Harrison 20 th edition pg no 1906
|
Medicine
|
Kidney
|
Hypeension responds well to drugs
|
CSF glucose level is
|
Answer is B (2/3 of plasma glucose):
|
Medicine
| null |
2/3 plasma glucose
|
All are true about communicability of Malaria, except-
|
Ans. is 'a' i.e. The number of gametocytes in blood increases with time o A malarial parasite (Plasmodium) has got 2 hosts Man is the intermediate host Mosquito is the definitive host o Plasmodium undergoes 2 cycles of development - The asexual or human cycle The sexual or mosquito cycle o The mosquito cycle begins when a mosquito feeds on an infected mass and ingests gametocytes o Malaria is communicable as long as mature, ble gametocytes exist in the human circulating blood in sufficient density to infect vector mosquitoes. o In P. vivax infections, gametocytes appear in blood 4-5 days after the appearance of the asexual parasites. o In P. falciparum infections gametocytes appear 10-12 days after the first appearance of asexual parasites. o Gametocytes are the most numerous during the early stage of infection when their density may exceed 1000 per cubic mm of blood. o They also tend to occur in waves in blood.
|
Social & Preventive Medicine
| null |
The number of gametocytes in blood increases with time
|
Xray aifact is
|
Aifacts can present in a variety of ways including abnormal shadow noted on a radiograph or degraded image quality and have been produced by aificial means from hardware failure, operator error, and software (post-processing) aifacts. Common CausesImproper handling of the filmsErrors while processing the filmsPatient movement while taking the shootingCommon aifactsmotion aifact - due patient movement resulting in the distoed imageimage compositing (or twin/double exposure) - superimposition of two structures from different locations due to double exposure of same film/plateradio-opaque objects on or external to the patient (e.g. necklaces, piercings, buttons, hair)(Ref: Radiographic Imaging and Exposure, 4e. Mosby chapter 9)
|
Radiology
|
All India exam
|
All of the above
|
On the basis of BMI obesity is labeled at
|
Body mass index (BMI) or Quetelet index:Defined as the body mass divided by the square of the body height, and is expressed in units of kg/m2BMIWeight status< 18.5 Underweight18.5-24.9 Healthy25.0-29.9Overweight>= 30.0Obese30.00-34.99 Obese class I35.00-39.99 Obese class II>= 40 Obese class IIIRef: Harrison's 18/e p608, 622, 630
|
Medicine
|
All India exam
|
30
|
The following are predisposing factors for Esophageal carcinoma except
|
Answer is D (Benzene therapy) Benzene therapy has not been mentioned in the best of predisposing factors for carcinoma esophagus, and is the single best answer of exclusion. Predisposing factors for carcinoma esophagus : 1. Alcohol consumptionQ 2. Smoking cigarettes Q 3. Ingested Carcinogens Nitrates Q Smoked opiates Fungal toxins in pickled vegetables 4. Mucosal damage Chronic AchalasiaQ Lye ingestion / Hot tea Radiation induced strictures Q 5. Host Susceptibility 1. Patterson Kelley syndrome Q or Plummer Vinson syndrome Q 2. Esophageal web v + GlossitisQ + Iron deficiency 2. Tylosis palmaris et plantaris Q..Congenital hyperkeratosis Q and pitting ofpalms and soles Q 6. Chronic Gastric Reflux, ie. Barrett's esophagus for Adenocarcinoma Q
|
Medicine
| null |
Benzene therapy
|
Osteoporosis is seen in :
|
Answer is D (All of the above) : Estrogen deficiency (Hypogonadal state) is known to cause osteoporosis. The most frequent estrogen deficient state is the cessation of ovarian function at the time of menopause. Thyrotoxicosis and Cushing's syndrome are known endocrine causes of osteoporosis.
|
Medicine
| null |
All of the above
|
Thaliomide is used in all except ?
|
Ans. is 'b' i.e., HIV neuropathy
|
Pharmacology
| null |
HIV neuropathy
|
Abruptio placentae occurs in all except:
|
Abruptio placenta is premature separation of normally situated placentaQ resulting in hemorrhage.
Risk factors:
Increased maternal age - Increased parity
Pre eclampsia - Chronic hypertension
Preterm ruptured membranes pregnancy - Sudden uterine decompression as in hydramnios and twin
Cigarette smoking - Thrombophilia
Cocaine abuse - Previous abruption
External trauma - Folic acid deficiency
Uterine leiomyoma
My – My- I pity all of you out there as you have to memorise so many lists (not only in gynae, obs but in other subjects as well). Even I have gone through the same phase. Friends I had devised a simple method to learn these lists. For some lists, I used to draw diagrams and then at the time of exam that diagram was reproduced in my mind. Try it out for yourself. e.g.
|
Gynaecology & Obstetrics
| null |
Alcoholics
|
Monogenic transmission of diabetes mellitus occurs in:
|
d. Maturity Onset Diabetes of the Young (MODY)(Ref: Nelson's 20/e p 2760-2780, Ghai 8/e p 541-548)MODY refers to forms of diabetes are associated with monogenic defects in pancreatic b-cell function.
|
Pediatrics
|
Endocrinology
|
Maturity Onset Diabetes of the Young (MODY)
|
Bone Density is best studied by –
|
DEXA scan is the gold standard test for screening of bone density (to rule out asteoporosis).
|
Radiology
| null |
DEXA scan
|
Investigation of choice for lumbar prolapsed disc
|
Investigation of choice for PID at any level is MRI.
|
Orthopaedics
| null |
MRI
|
An athletic male with itchy lesion at groin as shown below, causative agent can be all EXCEPT:
|
Ans. d. AspergillusThe itchy lesion in picture is a typical dermatophyte infection, and its known Jock's itch or Tineacruris. It is also known as Dhobi's itch. Since it is a dermatophyte infection, it cannot be caused by Aspergillus.
|
Skin
|
Fungal Infection
|
Aspergillus
|
True statement about treatment of intussusceptions
|
In the infant with ileocolic intussusception, after resuscitation with intravenous fluids, broad-spectrum antibiotics and nasogastric drainage, non-operative reduction can be attempted using an air or barium enema (see Chapter 6, Fig. 6.14). Successful reduction can only be accepted if there is free reflux of air or barium into the small bowel, together with resolution of symptoms and signs in the patient. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1198
|
Surgery
|
G.I.T
|
Air enema
|
In comparison to breast milk, colostrum has higher content of:
|
Ans. is c, i.e. SodiumRef. Dutta Obs 7/e, p 148Colostrum is a deep yellow serous fluid secreted from breasts starting from pregnancy and for 2-3 days after delivery.CompositionIt has higher specific gravity and higher protein, Vitamin A, D, E, K, immunoglobulin, sodium and chloride content than mature breast milk.It has lower carbohydrate, fat and potassium than mature milk.AdvantagesAntibodies (IgA, IgG, IgM) and humoral factor (lactoferrin) provide immunological defence to the new born.Laxative action due to fat globules.It is an ideal natural starter food.Extra Edge ProteinFatCarbohydrateWaterColostrum8.62.33.286Breast milk1.23.27.587
|
Gynaecology & Obstetrics
|
Abnormality of Puerperium
|
Sodium
|
All of the following infections are sexually transmitted, except:
|
Candida albicans, molluscum contagiosum virus and group B streptococcus are sexually transmitted diseases. Echinococcus granulosus is spread through feco-oral route. Sexually transmitted pathogens include : Bacteria such as Neisseria Gonorrhea, Chlamydia trachomatis, Mycoplasma hominis, Treponema pallidum, Hemophilus ducreyi, Gardenella vaginalis, Group B streptococci. Fungi such as Candida albicans, Viruses such as HSV, Hepatitis B, CMV, HPV, Molluscum Contagiosum, Protozoa such as Trichomonas vaginalis and Entamoeba histolytica. Ref: Harrison's Principle of Internal Medicine, 16th Edition, Page 1095, 1762, Chapter 220; Blaustein's Pathology of the Female Genital Tract By Ancel Blaustein, 5th Edition, Page 161
|
Medicine
| null |
Echinococcus
|
Lorenzo oil used in treatment of:
|
Adrenoleukodystrophy- Bone marrow transplant & Lorenzo oil Enzyme replacement therapy for- Gaucher disease- Human recombinant acid b-glucosidase (Imiglucerase) Velaglucerase alfa Taliglucerase alfa Fabry's disease- Agalsidase beta Hurler disease- Aldurazyme
|
Pediatrics
|
Lysosomal Storage Diseases
|
Adrenoleukodystrophy
|
Surgery of choice for chronic duodenal ulcer is -
|
Highly selective vagotomy Procedure of choice for chronic or intractable duodenal ulcers Nerves of Latarjet supplying the antrum are preserved (and hence gastric motility) Drainage procedure is not required Lowest Moality rate and side effects. Minimal chances of dumping Syndrome and gastric atony Relatively high recurrence. Ref: Maingot's 11/e chapter 11 & 12; Schwaz 9/e p913
|
Anatomy
|
G.I.T
|
Highly selective vagotomy
|
Right hepatic duct drain all, Except
|
Right hepatic duct drains into segment V, VI, VII, VIII and left hepatic duct drains into segment I, II, III, IV, the segment I have an independent supply of poal and hepatic veins. Reference SRB edition :5 page:593
|
Surgery
|
G.I.T
|
Segment III
|
Disclosing solution stains
| null |
Dental
| null |
Glycoprotein
|
Most common cause of ectopic ACTH production
| null |
Medicine
| null |
Small cell carcinoma lung
|
All of the following are true about pachydermia laryngitis except
|
PACHYDERMIA LARYNGIS It is a form of chronic hyperophic laryngitis affecting posterior pa of larynx in the region of interarytenoid and posterior pa of the vocal cords. Clinically, patient presents with hoarseness or husky voice and irritation in the throat. Indirect laryngoscopy reveals heaping up of red or grey granulation tissue in the interarytenoid region and posterior thirds of vocal cords; the latter sometimes showing ulceration due to constant hammering of vocal processes as in talking, forming what is called "contact ulcer." The condition is bilateral and symmetrical. It does not undergo malignant change. However, biopsy of the lesion is essential to differentiate the lesionfrom carcinoma and tuberculosis. Aetiology is unceain. It is mostly seen in men who indulge in excessive alcohol and smoking. Other factors are excessive forceful talking and gastro-oesophageal reflux disease where posterior pa of larynx is being constantly bathed with acid juices from the stomach. Treatment is removal of granulation tissue under operating microscope which may require repetition, control of acid reflux and speech therapy. Ref:- Dhingra; pg num:-292,293
|
ENT
|
Larynx
|
Premalignant condition
|
The most common sequelae of tuberculous spondylitis in an adolescent is:
|
(b)- The usual outcome of healed tuberculosis in spine is the bony ankylosis and in peripheral joints like Hip and Knee Fibrous ankylosis is seen.
|
Orthopaedics
|
TB of the Spine
|
Bony-ankylosis
|
Biguanides acts by following except -
|
Ans. is 'a' i.e., | insulin release from pancreash Biguanides acts by : o Suppress hepatic gluconeogenesis and glucose output from liver major action. o Enhance insulin mediated glucose disposal in muscle and fat (Increased peripheral utilization of glucose) by enhancing GLUT-I transpo from intracellular site to plasma membrane. o Retad intestinal absorption of glucose. o Promote peripheral glucose utilization by enhancing anaerobic glycolysis.
|
Pharmacology
| null |
|Insulin release from pancreas
|
A patient presented with renal cell carcinoma invading IVC and renal vein. False statement is:
|
Patients with renal vein or IVC involvement by tumour but without evidence of metastatic disease remain surgical candidates. Occasionally, nephrectomy and removal of IVC tumour thrombus need to be done. Bench surgery and autotransplantation is performed for larger tumours in a solitary kidney. Chest X-ray should be done to rule out pulmonary metastasis .
|
Surgery
|
Kidney and ureter
|
IVC involvement indicates inoperability
|
Preventable cuses of mental retardation are -
|
Ans. is `c' i.e., Cretinism Cretinism is due to deficiency of Iodine, which can be preventable.
|
Pediatrics
| null |
Cretinism
|
A population of 100000 is under surveillance during an year. 100 cases were positive for malarial thick smear. What is the annual parasite index -
|
Ans. is 'a' i.e., 1 per 1000 * Annual Parasite Incidence = (confirmed cases during one year/population under surveillancee) x 1000* Population under surveillance = 100000* Confirmed cases =100API =100------100,000x 1000 = 1* So, API is 1 per 1000 population.
|
Social & Preventive Medicine
|
Communicable Diseases
|
1 per 1000
|
Diatoms are -
|
Diatoms are unicellular algae.
|
Forensic Medicine
| null |
Algae
|
Hydramnios is complicated by all except: March 2005
|
Ans. C: Post Dated Pregnancy Complications during pregnancy: Pre-eclampsia (25%) Malpresentations Premature rupture of membranes Preterm labour Accidental hemorrhage Complications during labour: Early rupture of membranes Cord prolapsed Uterine ineia Retained placenta, postpaum hemorrhage
|
Gynaecology & Obstetrics
| null |
Post dated pregnancy
|
Earliest site of bone involvement in hematogenous osteomyelitis is ?
|
Ans. is 'a' i.e., Metaphysis Pathophysiology of acute osteomyelitis Organism reach the bone through blood stream from a septic focus elsewhere in the body. Metaphysis of long bone is the earliest and most common site involved because : - i) Metaphysis is highly vascular ii) Commonest site is metaphysis. This is because of the peculiar arrangement of the blood vessels in that area, which leads to relative vascular stasis, ouring bacterial colonization. . iii) Metaphysis has relatively few phagocytic cells than physis or diaphysis. iv) Metaphysis has thin coex.
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Surgery
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Metaphysis
|
A gastric biopsy is taken from a 42 year old man. As the pathologist inspects the specimen, he observes numerous, normal cuboidal-to-columnar cells with apical membrane-bound secretion granules in the gastric glands. From which area of the stomach was the biopsy most likely taken?
|
The pathologist saw normal chief cells, which are abundant in the body and fundus of the stomach. Chief cells secrete pepsinogen, which is stored in apical membrane- bound granules. The body and fundus of the stomach contain high concentrations of four other types of cells in the epithelium. The parietal (oxyntic) cells are large, pyramidal, and acidophilic with central nuclei (look like a "fried egg"). They make and secrete HCl. The mucous neck cells secrete mucus and appear clear. The enteroendocrine cells have affinity for silver stains and exhibit a positive chromaffin reaction; these cells synthesize amines, polypeptides, or proteins.The cardiac region is a narrow, circular band at the transition between the esophagus and stomach, consisting of shallow gastric pits and mucous glands. It does not normally contain an abundance of chief cells.The columns of Morgagni are found in the rectum, not in the stomach. These are mucous membrane infoldings in the submucosa of the proximal anal canal. They would not contain chief cells.The greater omentum is a four-layered fold of peritoneum that hangs from the greater curvature of the stomach and attaches to the transverse colon. It would not contain chief cells.
|
Anatomy
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Fundic region
|
All are true about pleomorphic adenoma except:-
|
Risk of malignant transformation is low (3-5%) in pleomorphic adenoma. Malignant mixed tumors include cancers originating from pleomorphic adenomas, termed carcinoma ex pleomorphic adenoma, and de novo malignant mixed tumors. The risk for malignant transformation of benign pleomorphic adenomas is 1.5% within the first 5 years, but risk increases to 9.5% when the benign tumor has been present for more than 15 years.
|
Surgery
|
Salivary Glands
|
Malignant transformation risk is high
|
Which nerve is near to mandibular third molar (medial aspect) and is likely to be damaged while removing 3rd molar?
| null |
Surgery
| null |
Lingual nerve
|
Laryngeal mask is contraindicated in all except-
|
Ans. is 'b' i.e., Ocular surgeries Indications of LMA1. As an alternative to intubation wrhere difficult intubation is anticipated (difficult airway).2 To facilitate endo-tracheal intubation in a patient with difficult airw ays.Situations involving a difficult mask fit.Securing airw ay (as cardiopulmonary resuscitation) in emergency where intubation and mask ventilation is not possible.For minor surgeries (short surgeries), where anaesthetist wants to avoid intubation.As a conduit for bronchoscopes, small size tubes, gum elastic bougies.For extra and intra-ocular surgeries including retinopathy surgery in premature infants LMA is particularly useful in ophthalmic surgery as problems created by other two airways are eliminated : -Face mask creates problem in surgical field access due to its size (LMA provides a better access).Endotracheal intubation may cause raised IOT (LMA has no effect).Contraindications of LMA1. Conditions with high risk of aspiration i.e., full stomach patients, hiatus hernia, pregnancy.2. Oropharyngeal abscess or mass (tumor).3. Massive thoracic injury4. Massive maxillofacial trauma
|
Anaesthesia
|
Breathing Systems
|
Ocular surgeries
|
All of the following muscles are supplied by accessory nerve except
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Anatomy
| null |
Stylopharyngeus
|
A 40 year old woman has severe, disabling rheumatoid ahritis. Rheumatoid factor is positive. What would a biopsy of the synovium of her knee most likely reveal?
|
Severe rheumatoid ahritis causes a proliferative synovitis with extensive damage to the synovium of the joint. The synol membrane becomes markedly thickened (pannus formation), with edematous villous projections that extend into the joint space. The intense inflammatory infiltrate that is present is typically composed of plasma cells, lymphocytes, and macrophages. Ref: Bednar M.S., Light T.R. (2006). Chapter 10. Hand Surgery. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Ohopedics, 4e.
|
Surgery
| null |
A proliferative synovitis with many lymphocytes, macrophages, and plasma cells
|
Wernicke's aphasia is seen due to lesion in?
|
ANSWER: (C) Superior temporal gyrusREF: Gray's anatomy 39th edition, page 415See previous question
|
Medicine
|
Aphasia
|
Superior temporal gyrus
|
Most common disease caused by CMV in a postrenal transplant patients:
|
Ans. (c) PneumoniaRef: Bailey 26th edition, Page 1416* Most common viral infection following kidney transplant is CMV- which presents with Interstitial pneumonia
|
Surgery
|
Transplantation
|
Pneumonia
|
The best test to detect iron deficiency anaemia in a community with Iwo prevalence of iron deficiency is -
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Medicine
| null |
Serum ferritin
|
Scrum pox is seen among ………………… players -
| null |
Surgery
| null |
Rugby
|
In myocardial infarction the infarct acquires hyperemic rim with an yellow centre at
|
3 – 7 days Findings
Gross examination at border
Softening yellow-tan center Histopathology
(light microscopy)
Beginning of disintegration of dead muscle fibers
Necrosis of neutrophils
Beginning of macrophageremoval of dead cells at border
|
Unknown
| null |
3-7 days
|
The predominant immunoglobulin in sulcular fluid is:
| null |
Dental
| null |
Ig G
|
Middle lobe of prostrate is present in between:
|
A i.e. Prostratic urethra & Ejaculation duct Board Review series AnatomyMedian lobe which lies between urethra and the ejaculatory duct is prone to benign hyperophy. QPosterior lobe, which lies behind the urethra and below the ejaculatory duct contains glandular tissue and is prone to carcinomatous transformation.Q
|
Anatomy
| null |
Prostratic urethra & Ejaculation duct
|
Iritis roseata is seen in:
|
Ans. Syphilis
|
Ophthalmology
| null |
Syphilis
|
Most common cause of intracranial haemorrhage is -
| null |
Medicine
| null |
Intracerebral haemorrhage
|
Which of the following is NOT a component of Saint's triad?
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Saint's triad is a medical condition of the concurrence of hiatus hernia,gallstones& diveiculosis of colon. Reference:SRB's manual of surgery,5th edition,page no:641.
|
Surgery
|
G.I.T
|
Esophageal diveicula
|
After overnight fasting, levels of glucose transporters reduced in:
|
Ans. C. Adipocytes(Ref: Harper 29/e page 158, Harper 30/e page 192)GLUT-4 and InsulinGlucose uptake into muscle and adipose tissue is controlled by insulin, which is secreted by the islet cells of the pancreas in response to an increased concentration of glucose in the portal blood.In the fasting state, the glucose transporter of muscle and adipose tissue (GLUT-4) is in intracellular vesicles.An early response to insulin is the migration of these vesicles to the cell surface, where they fuse with the plasma membrane, exposing active glucose transporters.These insulin sensitive tissues only take up glucose from the bloodstream to any significant extent in the presence of the hormone.As insulin secretion falls in the fasting state, so the receptors are internalized again, reducing glucose uptake.
|
Biochemistry
|
Carbohydrates
|
Adipocyte
|
Which of the following is the most severe form of Diptheria
|
Ref: Harrisons, 19th ed. pg. 978* Diptheria is a nasopharyngeal and skin infection caused by Corynebacterium diphtheriae. Toxigenic strains of C. diphtheria produce a protein toxin that causes systemic toxicity, myocarditis, and polyneuropathy.* The toxigenic strains cause pharyngeal diphtheria, while the non-toxigenic strains commonly cause cutaneous disease.* Harrisons states: "Respiratory/pharyngeal form of diphtheria is from notiable diseases, while cutaneous diphtheria is NOT"* Most severe form of diphtheria: Laryngeal
|
Microbiology
|
Bacteria
|
Laryngopharynx
|
A 5-year-old child presents with a history of fever off–and–on for past 2 weeks and petechial spots all over the body and increasing pallor for past 1 month. Examination reveals splenomegaly of 2 ems below the costal margin. The most likely diagnosis is –
|
Pallor (anemia), petechial spot (thrombocytopenia), fever (infection due to neutropenia) with splenomegaly suggest the diagnosis of acute leukemia.
Further, the presence of splenomegaly eliminates aplastic anaemia and ITP as the possibilities
"Splenomegaly and lymphadenopathy are extremely uncommon in ITP and their presence should lead one to consider other possible diagnosis". - Robbin's
"Splenomegaly is characteristically absent in aplastic anemia and if present the diagnosis of a plastic anemia should be seriously questioned".
Hypersplenism is a condition characterised by splenomegaly and cytopenias with a normal hyperplastic marrow and response to splenectomy.
Although cytopenias resulting from hypersplenism may give rise to most manifestations mentioned in the question these are more likely with massively enlarged spleens and not with minimally enlarged spleen as in the question above (2cm below costal margin in a 2 year old child).
|
Pediatrics
| null |
Acute leukemia
|
A 23-year-old male patient presented with a history of back pain, which is more in the morning and relieved by bathing in warm water. What is the likely additional finding present in this patient?
|
Ans. d. Decreased chest wall expansion (Ref: Harrison 19/e p2170, 18/e p2775)History of back pain, which is more in the morning and relieved by bathing in warm water is characteristic of spondylo arthropathy, like ankylosing spondylitis. Ankylosing spondylitis leads to extra-parenchymal restrictive lung disease, associated with decreased chest wall expansion."Ankylosing Spondylitis: The initial symptom is usually dull pain, insidious in onset, felt deep in the lower lumbar or gluteal region, accompanied by low-back morning stiffness of up to a few hours 'duration that improves with activity and returns following inactivity. "- Harrison 19/e p2170"Ankylosing Spondylitis: Initially; physical findings mirror the inflammatory process. The most specific findings involve loss of spinal mobility, with limitation of anterior and lateral flexion and extension of the lumbar spine and of chest expansion. Limitation of motion is usually out of proportion to the degree of bony ankylosis, reflecting muscle spasm secondary to pain and inflammation. Pain in the sacroiliac joints may be elicited either with direct pressure or with stress on the joints. In addition, there is commonly tenderness upon palpation at the sites of symptomatic bony tenderness and paraspinous muscle spasm. ''-- Harrison 19/e p2170A. Obstructive lung diseaseB. Restrictive lung disease* Asthma* Bronchiectasis* Bronchiolitis* Cystic fibrosis* COPD (Chronic bronchitis, Emphysema)Mnemonic- "ABCDE"ParenchymalExtra Parenchymal* Sarcoidosis* Pneumoconiosis* Idiopathic pulmonary fibrosis* Drug/Radiation induced interstitial lung disease* Neuromuscular diseases:- Diaphragmatic palsy- Guillain-Barre syndrome- Muscular dystrophy- Cervical spine injury* Chest wall diseases:- Kyphoscoliosis- Obesity- Ankylosing spondylitisAnkylosing Spondylitis/Marie-Strumpell or Bchtrew's diseaseEtiology & Pathogenesis:More than 90% patients of AS are HLA B27 positiveQ.The enthesis. the site of ligament attachment to bone is primary site of pathology in ASQ.Sacroilitis is the earliest manifestation with features of both enthesitis & synovitisQ.Clinical Presentation:Males are affected more frequently than females.Age of onset is 15-25 years (late adolescence & early adulthood )Q.The initial symptom is usually dull pain, insidious in onset, accompanied by low back morning stiffness of up to few hours duration that improves with activity and returns following period of inactivityQ.Arthritis in hips & shoulders (root joints) occur in 25-35%Q.Peripheral joints (usually shoulder, hips & knees) are involved in one third of patientsQ.Most serious complication of spinal disease is spinal fracture with even minor trauma.MC extra-articular manifestation is acute anterior uveitis (iridocyclitis)Q.Diagnosis:Radiological Examination(The following changes may be seen on an X-ray of the pelvis)* Haziness of sacro-iliac jointsQ* Irregular subchondral erosions in SI jointsQ* Sclerosis of the articulating surfaces of SI jointsQ* Widening of sacro-iliac joint spaceQ* Bony ankylosis of the sacro-iliac jointsQ* Calcification of the sacro-iliac ligaments and sacro- tuberous ligaments* Evidence of enthesopathy: Calcification at the attachment of the muscles, tendons and ligaments, particularly around the pelvis & heelQ.X-ray of Lumbar spine in Ankylosing Spondylitis* Squaring of vertebraQ: The normal anterior concavity of the vertebral body is lost because of calcification of the anterior tongitudinai ligament* Loss of lumbar lordosisQ* Bridging osteophytes (syndesmophytes)Q* Bamboo spine appearanceQ due to syndesmophytes & paravertebral ossificationTreatment:Phenylbutazone is the most effective drugQ (causes aplastic anemia).Indomethacin is most commonly used NSAIDQ.
|
Medicine
|
Disorder of Metabolism & Connective Tissue
|
Decreased chest wall expansion
|
Drug given for antibiotic associated pseudomembranous enterocolitis and is part of anti H. Pylori treatment:
|
Ans. C. MetronidazoleTriple drug regimen given for H. Pylori include- clarithromycin, amoxicillin, tetracycline, metronidazole. Out of all these drugs metronidazole is drug of choice for pseudomembranous colitis.
|
Pharmacology
|
Anti Microbial
|
Metronidazole
|
True about pseudocyst of pancreas -
|
Answer is 'd' i.e. can present from mediastinum of pubis
|
Surgery
| null |
Can present from mediastinum to pubis
|
Postponing paying attention of conscious impulse or conflict is mature defence mechanism known as
|
Sublimation: Gratification of an impulse whose goal is retained but whose aim or object is changed from a socially objectionable one to a socially valued one. Suppression: Conscious or semiconscious decision to postpone attention to a conscious impulse or conflict. Humour:ove expression of feelings without personal discomfo and without unpleasant effo on others. Anticipation: Realistic anticipation of or planning for future inner discomfo. Ref: Synopsis of Psychiatry, 11e, pg 161.
|
Psychiatry
|
Cognitive development and defence mechanism
|
Suppression
|
Saccular diverticulum of extrahepatic bile duct in choledochal cyst is classified as -
| null |
Surgery
| null |
Type II
|
Embryologically hard palate develop from:
| null |
Anatomy
| null |
All of the above
|
Bone marrow biopsy is useful in the diagnosis of -
| null |
Pathology
| null |
Aleukemic leukemia
|
Laminin is present in:(1998)
|
Ans: b (Basement membrane)Ref: Robbin's, 7th ed, p. 105 & 6thed, p. 100
|
Pathology
|
Cellular Pathology
|
Basement membrane
|
Which radiological procedure is used for studying vesico-ureteric reflux?
|
The diagnosis of vesico ureteric reflux is made using micturition cystourethrogram. Other techniques used in diagnosing vesico ureteric reflux are simple or delayed cystography or voiding cinefluoroscopy. In a case of vesico ureteral reflux, cystogram may show one of the following findings: Persistently dilated lower ureter, areas of dilatation in the ureter, ureter visualized throughout its entire length shows, presence of hydroureteronephrosis with a narrow juxtavesical ureteral segment or changes of healed pyelonephritis. Ref: Smith's General Urology, 17e, Chapter 12
|
Radiology
| null |
Micturition cystourethrogram
|
A 43-year-old man with chronic hepatitis and liver cirrhosis is admitted with upper GI bleeding. He has marked ascites and shows multiple telangiectasias, liver palmar erythema, and clubbing. A diagnosis of bleeding esophageal varices secondary to portal hypertension is made. Portal pressure is considered elevated when it is above which of the following?
|
Portal hypertension is suspected clinically if esophageal varices are detected, hypersplenism occurs, or ascites develop. Normal portal venous pressure is 5-10 mm Hg. Pressure may be measured indirectly by using hepatic venous wedge pressure (occlusive hepatic wedge pressure). About two-thirds of patients with portal hypertension will develop varices of which one-third will bleed.
|
Surgery
|
Pancreas
|
12 mm Hg
|
In a patient with AIDS, chorioretinitis is typically caused by –
|
The most common cause of chorioretinitis in AIDS is CMV.
|
Ophthalmology
| null |
Cytomegalovirus
|
All are true about persistent caliber aery except?
|
Persistent caliber aery is called Dieulafoy's lesion. It is a large calibre aeriole that runs beneath the gut mucosa and bleeds pinpoint mucosal erosion. For management of bleeding in Dieulafoy's lesion, endoscopic therapy like thermal coagulation or band ligation is effective. In case of failure to control bleeding with above methods, angiographic embolization is used. Deep enteroscopy is used in patients with diffuse small bowel pathology like vascular ectasia.
|
Medicine
|
Bleeding from the GUT and diseases of esophagus
|
Deep enteroscopy
|
Dermal Nitrate test is done for the detection of-
| null |
Forensic Medicine
| null |
Gunpowder residue
|
Dark ground microscopy is used to see?
|
Darkfield / Dark ground microscope in which reflected light is used instead of transmitted light used in the ordinary microscope. Flagella are less than 0.02 um in thickness and hence beyond the limit of resolution of the light microscopes. They may in some instances be seen under dark field / Dark ground illumination. They can be visualized by special staining techniques in which their thickness is increased by mordanting or by electron microscopy. Ref: Textbook of Microbiology; Ananthanarayan and Paniker; 9th edition; Pg no: 11
|
Microbiology
|
general microbiology
|
Flagella
|
Infant with hepatomegaly, hypoglycemia. hyperlipidemia and acidosis , diagnosis?
|
In type 1 Glycogen storage disorder the usual clinical features are : hepatomegaly failure to thrive hypoglycemia, becomes worse after overnight fasting, an inability of the liver to release glucose into the blood. ketosis acidosis hyperlipidemia, since free fatty acids are mobilised excessively to provide for energy needs of the body Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:636,7 th edition
|
Pediatrics
|
Gastrointestinal tract
|
Von Gierke's
|
Hairy cell leukemia&; is a Neoplastic proliferation of :
|
Hairy cell leukemia review : Presentation is with a triad of : Splenomegaly :often massive. However hepatomegaly is less common while lymphadenopathy is rare. Pancytopenia and thereby, resulting infections. Vasculitis like syndrome :Erythema nodosum and cutaneous nodules due to perivasculitis and PAN. Course : Hairy cell leukemia follows an indolent course. REF: ROBBINS pathology 10th edition
|
Pathology
|
All India exam
|
B. cells
|
Bioavailability is:
| null |
Pharmacology
| null |
Amount of drug that reach the systemic circulation
|
Beaded margin of eyelid is seen in?
|
Lipoid proteinosis REF: org/121/ case pre sentations/lipoid2/robati.html, http: //en .wikipedia. org/wiki/Urba chdeg70E2%80%93Wiethe_diseas e "Urbach--Wiethe disease (also known as lipoid proteinosis and hyalinosis cutis et mucosae) is a rare autosomal-recessive disorderwith fewer than 300 repoed cases since its discovery, that presents in early childhood with hoarseness, skin infiltration, and thickening, with beaded papules on eyelid margins, and facial acneiform or pock-like scars"
|
Ophthalmology
| null |
Lipoid proteinosis
|
A 40-year-old man presents with 5 days of productive cough and fever. Pseudomonas aeruginosa is isolated from a pulmonary abscess. The CBC shows an acute effect characterized by marked leukocytosis (50,000 WBC/mL), and the differential count reveals numerous immature cells (band forms). Which of the following terms best describes these hematologic findings?
|
Leukemoid reaction. Circulating levels of leukocytes and their precursors may occasionally reach very high levels (>50,000WBC/mL). Such a situation, referred to as a leukemoid reaction, is sometimes difficult to differentiate from leukemia. In contrast to bacterial infections, viral infections (including infectious mononucleosis) are characterized by lymphocytosis, an absolute increase in the number of circulating lymphocytes. Parasitic infestations and certain allergic reactions cause eosinophilia, an increase in the number of circulating eosinophils. Leukopenia is defined as an absolute decrease in the circulating WBC count. Myloid metaplasia (choice C) and myeloproliferative disease (choice D) are chronic disorders of the hematopoietic system. Although technically correct, neutrophilia (choice E) by itself does not demonstrate immature cells (band forms) and usually refers to lower levels of increased neutrophils.Diagnosis: Pulmonary abscess
|
Pathology
|
Inflammation & Repair
|
Leukemoid reaction
|
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