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True about the statement is: When null hypothesis is rejected when it is true?
null
Dental
null
Type I alpha error
Thin filament consists of all except:
Myosin is thick filament. All others  in the options are thin filaments.
Physiology
null
Myosin
A 1-year-old boy presents with a delay in motor development. Progressive muscle weakness and blindness ensue, and the patient dies within a year. The brain at autopsy shows swollen neurons that contain numerous lysosomes filled with lipid. Which of the following is the most likely diagnosis?
Tay-Sachs disease is a lethal, autosomal recessive disorder caused by an inborn deficiency of hexosaminidase A, which permits the accumulation of ganglioside GM1 in CNS neurons. The disease is fatal in infancy and early childhood. Retinal involvement increases macular transparency and is responsible for a cherry-red spot in the macula. On histologic examination, lipid droplets are seen in the cytoplasm of distended nerve cells of the CNS and peripheral nervous system. Electron microscopy reveals the lipid within lysosomes in the form of whorled "myelin figures." Swollen neurons that exhibit marked vacuolization of the perikaryon and contain lysosomes filled with lipid can also occur in other lipid-storage diseases (e.g., Gaucher disease, Niemann-Pick disease). The other diseases do not produce such neuronal changes.Diagnosis: Tay-Sachs disease
Pathology
Central Nervous System
Tay-Sachs disease
Most common cause of neonatal meningitis-
Ans. is 'b' i.e., E. coli o E. coli & streptococcus agalactie (group B streptococci) are the two most common cause of neonatal sepsis and meningitis.
Pediatrics
null
E. coli
Primary complex in which of the following sites suggest congenital tuberculosis -
null
Medicine
null
Liver
R-factor in bacteria is transferred by
Conjugation Bacterial conjugation is the transfer of genetic material between bacteria through direct cell to cell contact or through a bridge- like the connection between two cells. Conjugation is a process whereby a donor (male) bacterium makes physical contact with a recipient (female) bacterium. Donor status is determined by the presence of plasmid. This plasmid codes for specialized fimbria (sex pilus) and for self-transfer. Sex pilus (conjugation tube) helps in transfer of genetic material from male bacterium to female bacterium. The plasmid is known as transfer factor (sex factor or fertility factor). The plasmid may be R factory which codes for transferrable multiple drug resistance. The DNA of the plasmid replicates during transfer so that each bacterium receives a copy → Recipient becomes a donor and the donor retains its donor status.
Microbiology
null
Conjugation
CO2 is primarily transpoed in the aerial blood as
D i.e. Bicarbonate Transpo of CO2 in the form of bicarbonate ions accounts for approximately 70% of transpoed carbon dioxide from the tissues to lungs Q. So CO2 is transpoed as plasma HCO3 - > RBC > HCO3- > Carbamino compound > dissolved CO2 Q &Transpo of Carbon Dioxide Carbon dioxide is transpoed in the blood as: HCO3- (70%) > carbamino compounds (23%) > dissolved CO2 (7%) Chloride Shift/ Hamburger Phenomenon When the negatively charged (HCO3-) bicarbonate ions move out of red blood cell into the plasma, to maintain the electrolytic equilibrium the negatively charged chloride ions move into the Red blood Cells from plasma (In plasma plenty of sodium chloride is present). This process is mediated by band 3 membrane protein Chloride shift occurs in: 1 secondQ Hematocrit of venous blood is: greater (by 3%)than that of aerial bloodQ PH of venous blood (7.36) is lower than that of aerial blood (7.40)Q * For each CO2 molecule added to RBC there is increase in one osmotically active paicle in cell either HCO3- or CI-. So RBC take up water & swell. For this reason plus a fact that some aerial fluid returns lymphatics rather than the veins, the hematocrit of venous blood is 3% greater than aerial bloodQ. Amount of 02 enters the body/min = 250 inVininQ Amount of CO2 excreted by lung/ min = 200 inVininQ (288 L/day)Q * CO2 is 20 times more soluble than 02
Physiology
null
Bicarbonate
What is the sequence of development of pubey in girls ?
The sequence of SPECIFIC events of Pubeal events in girls is thelarche, pubarche, linear growth spu, menarche. Please note: This is not to confuse with accelarated general physical growth which is the first event in pubey Pubey Specific events in girls Events in boys 1st Thelarche Testicular enlargement 2nd Pubarche Penile enlargement & pubic hairs 3rd Linear Growth,Height, spu Linear Growth spu 4th Menarche Axillary hair and facial hairs In girls, pubeal development typically takes place over 4.5 years. The first sign of pubey is accelerated growth, and breast budding is usually the first recognized pubeal change, followed by the appearance of pubic hair, peakgrowth velocity, and menarche.... Novaks Gyne
Gynaecology & Obstetrics
DNB 2018
Thelarche, Pubarche, linear growth spu, Menarche,
A 70 - year- old man was administered penicilline intravenously. Within 5 minutes, he developed genralised urticaria, swelling of lips, hypotension and bronchospasm. The first choice of treatment is to administer:
Ans. is 'b' i.e. epinephrine injection Urticaria, swelling of lips, hypotension and bronchospasm within 5 minutes of i.v penicillin suggests anaphylactic reaction. It's a major problem with the use of penicillin.The t/t of choice for anaphylaxis is i.v epinephrine.
Pharmacology
Penicillin & Cephalosporin
Epinephrine inj.
Daily water requirement in child weighing 30 kgs, height 123 m and BSA of 1 m2 is-
Ans. is 'b' i.e., 1700 ml Fluid requirment in a child o It depends on the weight of a child :- Weight Water requirments < 10 kg o 100 ml/kg/day 10-20 kg o 100 ml / kg / day for first 10 kg (i.e. 1000 ml) + 50 ml / kg / d for every kg above 10 kg. >20 kg o 100 ml/kg/day for first 10 kg (i.e. 1000 ml) + 50 ml / kg / d for next 10 kg (i.e. 500 ml) + 20 ml / kg / d for every kg above 20 kg. o The child in question has weight of 30 kg. o So, fluid requirment will be :- i) 1000 ml for first 10 kg Plus ii) 500 ml for 10-20 kg Plus iii) 200 ml (20 x 10) for 20-30 kg o Total requirment will be 1700 ml.
Pediatrics
null
1700 ml
Drug of choice for ADHD is
.
Anatomy
General anatomy
Methylphenidate
Double bubble sign is seen in -
Ans. is 'd' i.e., All of the above o Double bubble sign is seen in duodenal atresia, duodenal web, deudenal stenosis, Ladd's band, Annular pancreas, Malrotation of gut, preduodenal vein.Single Bubble signCongenita] hypertrophic pyloric stenosisDouble Bubble signDuodenal atresiaDuodenal webDuodena] stenosisLadd's bandAnnular pancreasMalrotation of gutPreduodenal veinTriple Bubble signJejunal or proximal ileum atresiaMultiple Bubble signIleal atresia
Radiology
Abdominal Radiography
All of the above
A 16 year old boy does not attend school because of the fear of being harmed by school mates. He thinks that his classmates laugh at him and talk about him. He is even scared of going out of the market. He is most likely suffering from:
The history is suggestive of delusion of persecution (fear that schoolmates may "harm" him) and delusion of reference (belief that classmates laugh at him and talk about him). Had they not used the term "harm" and "scared" a diagnosis of social anxiety disorder could have been enteained.
Psychiatry
Schizophrenia Spectrum and Other Psychotic Disorders
Schizophrenia
Bad trip is seen with which of the following drugs?
LSD is a type of hallicinogen LSD means lysergic acid diethylamide LSD was introduced and first used by ALBE HOFFMANNBad trip is seen with LSD and cannabis but common with LSD Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg 330-336
Psychiatry
Substance abuse
LSD
Chromosome involved in Wilm's tumor is
WTl is the best characterized Wilms tumor gene. It is located at chromosome llp13 and encodes for a transcription factor that is critical for normal development of kidneys and gonads. WT2 is localized to a cluster of genes at llpl5. Reference: Essential paediatrics; O.P.Ghai; Childhood Malignancies; Page no: 617
Pediatrics
Childhood tumors
11
Groove sign is seen in-
Ans. is 'c' i.e., LGV * 'Groove sign of Greenblatt' is pathognomonic of LGV (secondary stage) - when inguinal lymph nodes are enlarged, they are separated by Poupart's ligment, producing a groove.Lymphogranuloma venerum (lymphogranuloma inguinale)* LGV is caused by chlamydia trachomatis, serotypes LI, L2, L3. Serotype L2 is the most common cause. The clinical course of LGV consist of following three stages : -i) First stage (Primary LGV): - Self limited, Single, asymptomatic, painless, non bleeding genital ulcer.ii) Secondary stage: - Painful inguinal lymphadenopathy (Remember - Ulcer is painless but lymphadenopathy is tender & painful). Swollen lymph nodes coalesce to form bubos, i.e., matted lymph nodes. Buboes may rupture to form discharging sinus.# Groove's sign - Enlarge lymph nodes both above and below inguinal ligament.iii) Tertiary LGV (genitorectal syndrome): - Characterized by proctocolitis.Complications of LGV* Esthiomene - Enlargement, thickening and fibrosis of labia.* Elephantiasis of the genitals* Rectal stricture* Systemic - Arthritis, pneumonitis, Perihepatitis
Skin
S.T.D.
LGV
Hyperchloremic acidosis is seen in-
The combination of hyperkalemia and hyperchloremic metabolic acidosis is often present, even at earlier stages of CKD (stages 1-3).In patients with diabetic nephropathy or in those with predominant tubulointerstitial disease or obstructive uropathy; this is a non-anion-gap metabolic acidosis.
Medicine
Fluid and electrolytes
A
A patient with cervix cancer is missed by a screening test and later diagnosed with advanced disease. This time interval is called ?
Ans. is 'a' i.e. Lead time
Social & Preventive Medicine
null
Lead time
The internal pudendal aery arises from which of the following aeries?
The internal iliac aery divides into an anterior and a posterior trunk near the greater sciatic foramen.Branches of ANTERIOR TRUNKUmbilical aeryObturator aeryUterine aeryInferior vesical and vaginal aery (females)Middle rectal aeryInternal pudendal aeryInferior gluteal aeryBranches of POSTERIOR TRUNKIliolumbar aeryLateral sacral aerySuperior gluteal aery
Anatomy
null
Internal iliac aery
Increased Ig A levels are seen in
Serum IgA increased in - Alcoholic cirrhosis Serum IgM increased in -Primary biliary cirrhosis (Ref: Clin Exp Immunol.2009 Oct; 158(1): 115-124, Liver.1984 Jun;4(3): 214-8)
Pathology
G.I.T
Alcoholic cirrhosis
Rituximab is a monoclonal antibody used for treatment of:-
Rituximab is a monoclonal antibody against CD20. It is used for treatment of: Non-Hodgkin lymphoma Chronic lymphoid leukemia Rheumatoid ahritis SLE Auto-immune hemolytic anemia Idiopathic thrombocytopenic purpura
Pharmacology
Targeted Anticancer Drugs and Immunosuppressants
Non-Hodgkin's lymphoma
The least common type of intussusceptions is:
Types of Intussusceptions (in decreasing order) Ileocolic (77%) Ileo-ileo-colic (12%) Ilioileal (5%) Colocolic (2%): MC in adults Multiple (1%) Retrograde (0.2%)
Surgery
Intestinal obstruction
Multiple
Most definitive diagnosis of sinusitis is by
Sinuscopy is a method of Endoscopic sinus observation or surgery using Nose telescope. It involves the evaluation of nasal and sinus passages using the endoscope called Sinuscope. The Sinuscope has a narrow tube with a built-in camera so that the physician can see the internal details of the sinuses. By observing the sinus, it is possible to diagnose the problems and treat properly.
ENT
Nose and paranasal sinuses
Sinuscopy
An 18 year old male patient presented to the clinic with pain and swelling in the lower jaw. Intraoral examination revealed localized gingival bleeding in the right posterior region. On palpation, pulsations can be appreciated. Lesions are also appreciated on the frontal bone on a radiograph. Which condition is present in this patient?
Vascular malformation (VM) in bone occurs more frequently than the central hemangioma (CH) of bone. Some 35% of VMs occur in bone, whereas CHs of bone are rare. The CH of bone is a benign tumor that rarely occurs in the jaws; it occurs more frequently in the skull and vertebrae. It may be congenital or traumatic in origin and may be difficult to differentiate from VM. The usual complaint of a patient with a VM or CH is of a slow-growing asymmetry of the jaw or localized gingival bleeding. Numbness and tenderness or pain may also be described. This solitary tumor is found approximately twice as often in female patients, and about 65% occur in the mandible. Some tumors demonstrate pulsation and bruits. Paresthesia is occasionally a feature.
Radiology
null
Vascular malformation
Most common anterior mediastinal tumor?
Ref: Bailey and Love, 26th edition, P 868Most common anterior mediastinum tumor is thymoma. Choice B is seen in posterior mediastinum. Choice C and D are found in middle mediastinum.
Pathology
Misc.
Thymoma
Functional unit of Liver is
Anatomical unit of liver - Hepatic Lobule Functional unit of liver- Liver Acinus
Anatomy
Systemic histology
Liver Acinus
Grievous hurt is defined under:
Ans: a (320 IPC) Ref: Reddy, 21st ed, p. 244Grievous hurt is defined under IPC 320Some important IPC'sIPC 375 - definition of rapeIPC 376 - punishment of rapeIPC 320 - definition of grievous heartIPC 84 - deals with the criminal responsibility of insaneIPC304A - deals with criminal negligenceIPC 304B - dowry deathIPC 300 - defines murderIPC 299 - defines culpable homicideIPC 302 - punishment of murderIPC 304 - punishment of culpable homicide
Forensic Medicine
Introduction to Forensic Medicine and Medical Jurisprudence
320IPC
Glaucoma is caused by -
Ans. is 'a' i.e., Raised intraocular pressure The most common risk factor known is increased intraocular pressure (lOP)o Glaucoma is a group of eye diseases causing optic nerve damage i.e., glaucoma is a chronic, progressive optic neuropathy caused by a group of ocular conditions which lead to damage of optic nerveo Optic neuropathy in glaucoma results in a characteristic appearance of optic disc and a specific pattern of irreversible visual field defects, called glaucomatous changes. It is worth noting that raised IOP without optic neuropathy is not referred to as glaucoma, it is simply called ocular hypertension.So, glaucoma is a type of optic neuropathy, which is usually caused by increased IOP.
Ophthalmology
General Considerations - Definition, Classification, Pathogenesis
Raised intraocular pressure
Best indicator for nutritional status for a child is -
Rate of increase of height and weight is the best measure for nutritional status of a child. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. 500,501
Social & Preventive Medicine
obstetrics,pediatrics and geriatrics
Rate of increase of height and weight
Aerosolized ribavirin is used in the treatment of bronchiolitis with –
null
Pediatrics
null
RSV
Amplification of DNA uses the polymerase chain reaction (PCR) technique. Cation used in PCR is:
PCR is an in vitro method for the polymerase-directed amplification of specific DNA sequences using two oligonucleotide primers that hybridize to opposite strands and flank the region of interest in the target DNA. The specificity and yield in amplifying a paicular DNA fragment by PCR reaction is affected by the proper setting of the reaction parameters (e.g., enzyme, primer, and Mg2+ concentration, as well as the temperature cycling profile). Ref: Feng X., Lin X., Brunicardi F.C. (2010). Chapter 15. Molecular and Genomic Surgery. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.
Biochemistry
null
Magnesium
Which of the following statements about mycosis fungoides is not true?
C i.e. It has indolent course and good prognosis
Skin
null
It has a indolent course and good prognosis
Babesiosis is transmitted by -
Ans. is 'a' i.e., Tick Babesiao Babesiosis is a protozoan disease caused by two species of Babesia : Babesia microti and Babesia divergens.o It is transmitted by loxdid tick.o Babesia infects the RBCs and resides inside the RBCs ( intraerythrocytic). Intraery throcytic infection of Babesiosis is characterised by maltese cross. Maltese cross is a characteristic arrangement of parasites within the erythrocytes - Parasites within erythrocytes are arranged such that pointed ends of four parasites come in contact thereby giving a tetrad configuration resembling a maltese cross. Tetrad forms or 'Maltese cross' appearance is considered pathognomic of Babesiosis.o Clinically Babesiosis presents with chills, fever, mild hepatosplenomegaly, and mild hemolytic anemia,o Treatment includes Atovaquone plus azithromycin or quinine plus clindamycin.o Babesiosis can easily be confused with P. falciparum malaria.Following two features distinguish Babesiosis from malariaPresence of maltese cross in Babesiosis (absent in malaria)Absence of pigment Hemozoin in Babesiosis (present in malaria)Note - Maltese cross is also seen in cryptococcus and aspergillus.
Microbiology
Parasitology
Tick
Manifestation of Acute Dissection include all of the following, Except:
Answer is C (MR) Mitral Regurgitation is not a feature of Aoic dissection Aoic Regurgitation and Pericardial Tamponade may be seen in proximal dissection Hemopericardium and cardiac tamponade may complicate a dissection involving the ascending aoa (type A lesion with retrograde dissection): Acute Aoic Regurgitation (AR) is an impoant and common complication of proximal dissection - Acute Myocardial Ischemia may be associated with Aoic dissection 'Bowel Ischemia, hematuria and myocardial Ischemia have all benn observed with Aoic dissection'
Medicine
null
MR
Pancytopenia is most common after:
Hepatitis is the most common preceding infection, and post hepatitis marrow failure accounts for about 5% of etiologies in most series. Patients are usually young men who have recovered from a bout of liver inflammation 1 to 2 months earlier; the subsequent pancytopenia is very severe. The hepatitis is seronegative (non-A, non-B, non-C, non-G) and possibly due to a novel, as yet undiscovered, virus. Ref: Harrison's principle of internal medicine 17th edition, chapter 102.
Medicine
null
Hepatitis
Which is NOT a third generation Cephalosporin
Ans. is 'd' i.e., Cefuroxime Third generation cephalosporins include Parenteral OralCefotaxime - CefiximeCeftizoxime - Cefpodoxime proxetilCeftriaxone - CefdinirCeftazidime - Ceftibuten Cefoperazone Also knowFourth generation cephalosporinsCefepimeCefaparole
Pharmacology
Anti Microbial
Cefuroxime
Rigor moritis devolops ..... after death :
B i.e. 1 - 2 hours
Forensic Medicine
null
1-2 hrs
All of the following murmurs may be heard in patients with aoic regurgitation except:
Answer is D (Pansystolic murmur)
Medicine
null
Pansystolic murmur
Best investigation to see calcification is:
Ans: A (CT ?) Ref: Harrison !v Principles of internal medicine.18th edition.Explanation:CT is the best technique to detect pericardial calcification; however, overpenetrated films, conventional tomography, fluoroscopy, and MRI may be helpful.Plain radiographs have poor sensitivity for detection of coronary calcification and have a reported accuracy as low as 42%High-quality mammography is the best diagnostic tool for the identification of breast calcifications.
Radiology
Ultrasonography, CT, and MRI
CT
Maximum FiO2 which can be given through a nasal oxygen catheter:-
A nasal cannula is generally used wherever small amounts of supplemental oxygen are required, without rigid control of respiration, such as in oxygen therapy. Most cannulae can only provide oxygen at low flow rates--up to 5 litres per minute (L/min)--delivering an oxygen concentration of 28-44%. Rates above 5 L/min can result in discomfo to the patient, drying of the nasal passages, and possibly nose bleeds (epistaxis). Also with flow rates above 6 L/min, the laminar flow becomes turbulent and the oxygen therapy being delivered is only as effective as delivering 5-6 L/min. The nasal cannula is often used in elderly patients or patients who can benefit from oxygen therapy but do not require it to self respirate. These patients do not need oxygen to the degree of wearing a non-rebreather mask. It is especially useful in those patients where vasoconstriction could negatively impact their condition, such as those suffering from strokes.
Anaesthesia
Anesthesia Circuit
0.44
Osteogenesis imperfecta
null
Pathology
null
manifests with blue sclera which are pathognomonic of this disease
True about neuropraxia
Neuropraxia is due to compression of the nerve,the nerve conduction velocity is increased. It has good prognosis Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:74,75,76
Anatomy
General anatomy
Both
Agonistic action at which of the following adrenergic receptor result in the reduction of excess secretion
Ref-KDT 6/e p146 Stimulation of Alpha 2 receptors located on ciliary epithelium reduces secretion of aqueous humor.
Anatomy
Other topics and Adverse effects
Alpha 2 receptor
All of the following features are seen in the viral pneumonia except:
Typical Pneumonia Atypical pneumonia -Bacterial etiology -Alveolar exudate + neutrophilic infilitration -C/F - High grade fever productive Cough Pleuritis Signs of consolidation -Non - bacterial etiology (e.g. Virus) -Interstitial tissue inflammation -C/F- Low grade fever Dry cough Malaise no signs of consolidation
Pathology
Infectious Lung Disease: Pneumonia
Predominance of alveolar exudate
Which of the following causes BOTH superior and inferior rib-notching in a chest radiograph?
Superior rib notching -Polio -Restrictive lung disease -Neurofibromatosis -Connective tissue disease -Osteogenesis imperfecta Inferior rib notching -Thrombosis of aoa -Coarctation of aoa -Blalock Taussig shunt -Occlusion of subclan aery -Pulmonary AV malformation Both Superior and inferior rib notching -NF-1 -Hyperparathyroidism
Radiology
Radiology Q Bank
NF-1
The most accurate diagnostic test for Zollinger-Ellison syndrome (ZES) is
-All patients with gastrinoma have an elevated gastrin level, and hypergastrinemia in the presence of elevated basal acid output (BAO) strongly suggests gastrinoma. -Patients with gastrinoma usually have a BAO >15 mEq/h or >5 mEq/h if they have had a previous procedure for peptic ulcer. -Acid secretory medications should be held for several days before gastrin measurement, because acid suppression may falsely elevate gastrin levels. 1). The diagnosis of Zollinger-Ellison syndrome (ZES) is confirmed by the secretin stimulation test. An intravenous (IV) bolus of secretin (2 U/kg) is given and gastrin levels are checked before and after injection. - An increase in serum gastrin of 200 pg/mL or greater suggests the presence of gastrinoma. Patients with gastrinoma should have serum calcium and parathyroid hormone levels determined to rule out multiple endocrine neoplasia type 1 (MEN1) and, if present, parathyroidectomy should be considered before resection of gastrinoma.
Surgery
Stomach & Duodenum
Secretin stimulation test
What is the average number of fleas of each species per rodent called -
<p> It is the average number of each species per rat/rodent. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:294. <\p>
Social & Preventive Medicine
Communicable diseases
Specific Flea index
Periosteal reaction in a case of acute osteomyelitis can be seen earliest at: March 2012
Ans: B i.e. 10 days The earliest sign to appear on the X-ray is a periosteal new bone deposition (periosteal reaction) at the metaphysis. It takes about 7-10 days to appear Osteomyelitis Earliest site of involvement: Metaphysis Diagnosis of acute OM: Blood culture (positive in 65% cases) Periosteal reaction seen in acute OM appears after: 10 days MC organism in acute OM: Staph. aureus Brodies abscess: - Equilibrium between host & organism; - Abscess cavity remains without fuher enlargement
Surgery
null
10 days
Which of the following is not associated with zinc deficiency: March 2005
Ans. C: Pigmentation Acrodermatitis enteropathica is a rare inherited form of zinc deficiency, characterized by periorificial and acral dermatitis, alopecia, and diarrhea. Symptoms of Zinc Deficiency Poor Immune system Weight loss Intercurrent infections Hypogonadism in males Lack of sexual development in females Growth retardation Dwarfism Delayed pubey in adolescents Rough skin Poor appetite Mental lethargy Delayed wound healing Sho stature Diarrhea One easily recognized sign which may be caused by zinc deficiency is white spots, bands, or lines on fingernails (leukonychia). Some women may have multiple parallel white bands or lines on the fingernails marking menstrual cycles when marginal zinc deficiency was present.
Medicine
null
Pigmentation
Preimplantataion genetic diagnosis is used for
Pre implantation genetic diagnosis is used for daignosis of single gene disorders such as cystic fibrosis, β - thalassemia and hemophilia.
Gynaecology & Obstetrics
null
Single gene mutation analysis
Which of the following about phenytoin is true ?
Ans. is 'a' i.e., It follows zero order kinetics Phenytoin is metabolized in liver by hydroxylation and glucuranide conjugation (option 'c' is incorrect) o This drug follows saturation kinetics (kinetics changes from first order to zero order within therapeutic concentrations) Phenytoin is an enzyme inducer and induces the metabolism of many drugs. Phenytoin is a known teratogenic and produces fetal hydantoin syndrome.
Pharmacology
null
It follows zero order kinetics
False about stagardt's disease
Stagardt's disease is autosomal recessive.
Ophthalmology
null
Autosomal dominant
All of the following are killed vaccines, EXCEPT:
17-D vaccine is a live attenuated vaccine used to control yellow fever. Killed vaccines are used to control typhoid, cholera, peusis, plague, rabies, salk (polio), influenza, hepatitis A, B, japanese encephaltis and KFD. Ref: Park's Textbook Of Preventive and Social Medicine 20th edition page 98.
Social & Preventive Medicine
null
17-D Vaccine
Kerley B line are seen at
Ans. is 'd' i.e., Pleural surface Kerley's line Kerley's line is a linear opacity which, depending on its locaton, extent and orientation, may be be fuher classified as :? Kerley's A lines o These are thin, non-branching lines radiating from hilum. These lines are 2-6 cm in length. These lines are found in the mid and upper zones of the lung fields pleural. These lines are due to the thick interlobar septa. Kerley's B lines (septal lines) These are transverse (Horizontal) lines at the lung base pleural. These are 1-2 cm in length and are perpendicular to pleura. Kerley's B line is due to the thickening of interlobar septa due to edema caused by pulmonary venous hypeension (congestion), as occurs in left ventricular failure or mitral stenosis
Medicine
null
Pleural surface
All of the following are true about BCG vaccine except.
Site of injection should be cleaned with soap but not with disinfectant or spirit.
Microbiology
null
Site of injection should be cleaned with spirit
Commonest etiology of erythema multiforme is -
A. i.e. Viral
Skin
null
Viral
Apex national institute of ophthalmology is
Dr RP Centre for Ophthalmic Sciences, New Delhi has been designated as the apex national institute of ophthalmology.
Ophthalmology
Community Ophthalmology
Dr. R P Centre for Ophthalmic Sciences , Delhi
Which laser is used in the management of after cataracts:
Ans. Nd-YAG
Ophthalmology
null
Nd-YAG
Which of the following statements about Kaposi sarcoma is not true?
Ans. A. The most common site is scalpKaposi sarcoma is mostly seen in extremities: most commonly on feet and occasionally on hands, ears, and nose.* Lesions are usually dark blue or purple and they may blanchewhen tumid (swollen).* Locally aggressive lesions can ulcerate, fungate or leave pigmented scars.* Lesions are usually multifocal which eventually fuse to form plaques and tumors of several centimeters in size.* Lymph nodes, mucosae and viscera may be involved as the disease progresses, although this can occur without skin involvement.Characteristic purple-colored plaques on the alar and tip of the nose in an HIV-positive female patient.
Skin
Miscellaneous
The most common site is scalp
All of the following veins lack valves except
Veins which do not have valves are:IVCSVCHepatic, ovarian, uterine, renal, emissary, cerebral, pulmonary, and umbilical veinsPoal venous system is a valveless system
Anatomy
null
Femoral vein
The best laboratory test to use in the diagnosis of Lupus vulgaris in the oral cavity is:
null
Pathology
null
Biopsy
Risk factor for melanoma are all of the following EXCEPT: March 2013
Ans. B i.e. Black people Melanoma is commoner in fair complexion Malignant melanoma/ MM Mode of spread of MM: Lymphatic channels or hematogenous Cutaneous melanoma arises from: Epidermal melanocytes MC site involved in lentigo maligna (least common): Face MC type of MM: Superficial spreading Most malignant type of MM: Noduar melanoma
Surgery
null
Black people
Preferred fluoroquinolone against m. leprae is -
Ans. is 'a' i.e., Ofloxacin Drugs acting on M. leprae* Established agents used to treat leprosy include dapsone (50-100 mg/d), clofazimine (50-100 mg/d, 100 mg three times weekly, or 300 mg monthly), and rifampin (600 mg daily or monthly. Of these drugs, only rifampin is bactericidal.* The sulfones (folate antagonists), the foremost of which is dapsone, were the first antimicrobial agents found to be effective for the treatment of leprosy and are still the mainstay of therapy.* Other antimicrobial agents active against M. leprae in animal models and at the usual daily doses used in clinical trials include ethionamide/prothionamide; the aminoglycosides streptomycin, kanamycin, and amikacin (but not gentamicin or tobramycin); minocycline; clarithromycin; and several fluoroquinolones, particularly preferred is ofloxacin.* Next to rifampin, minocycline, clarithromycin, and ofloxacin appear to be most bactericidal for M. leprae, but these drugs have not been used extensively in leprosy control programs. Most recently, rifapentine and moxifloxacin have been found to be especially potent against M. leprae in mice. In a clinical trial in lepromatous leprosy, moxifloxacin was profoundly bactericidal, matched in potency only by rifampin.
Pharmacology
Anti Microbial
Ofloxacin
When the patient fails to understand normal speech but can understand shouted or amplified speech the hearing loss is termed as
DEGREES OF HEARING LOSS 0-25dB-Not significant impairment- no significant difficulty with faint speech 26-40dB-Mild impairment-Difficult with faint speech 41-55dB-Moderate impairment -Frequently difficult with normal speech 56-70dB-Moderately severe impairment-Frequently difficult with loud sound 71-91dB-Severe impairment-Can understand only shouted or amplified sound Above 91-Profound impairment-Usually cannot understand even amplified sound Ref: Diseases of EAR, NOSE AND THROAT by PL DHINGRA - 6th Edition. Page no. 39
ENT
Ear
Severe hearing loss
Local anaesthetics :
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Pharmacology
null
Block the influx of sodium into the cell
Gingival sulcus is V shaped and it barely permits the entrance of a
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Dental
null
Periodontal probe
A child with three days history of upper respiratory tract infection presents with stridor, which decreases on lying down postion. What is the most probable diagnosis -
Ans. is 'b' i.e., Laryngotracheobronchitis This child has : - i) 3 days history of upper respiratory tract infection. ii) Followed by stridor These features suggest the diagnosis of croup. Clinical manifestations of Croup Most patients have an upper respiratory tract infection with some combination of - Rhinorrhea Pharyngitis Mild cough Low grade fever o After 1-3 days signs and symptoms of upper respiratory tract obstruction become apparent - Barking cough Hoarseness Inspiratory stridor
Pediatrics
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Laryngotracheobronchitis
Predominant bacteria found in two days old plaque
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Dental
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Streptococci
Most common movemnet force involved in fractures of the spine is which of the following?
Flexion injury is the commonest spinal injury. Ref: Essential ohopedics by Maheshwari 3rd Edition, Page 144,259,260.
Surgery
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Flexion
Which arm of tRNA binds it to vibosomal surface
Pseudoridine arm of tRNA is involved in binding of aminoacyl tRNA to ribosomal surface.
Biochemistry
null
Pseudouridine arm
Benefits of LNG lUCD are all except :
Mirena now used as first line of treatment of menorrhagia, in addition to the contraceptive effect. Another use is in providing progestogens component of hormone replacement therapy after menopause. THE TEXTBOOK OF GYNAECOLOGY SHEILA BALAKRISHNAN SECOND EDITION PAGE NO 379
Gynaecology & Obstetrics
Contraception
stage 2 endometrial cancer
Most common drug induced Extra Pyramidal Syndrome includes
(A) Dystonia # Drug Induced & Tardive Movement Disorders> Movement disorders secondary to pharmacological agents represent a large number of extrapyramidal disorders seen by neurologists and psychiatrists in the outpatient setting.> Involuntary movements, including tremor, chorea, athetosis, dyskinesias, dystonia, myoclonus, tics, ballismus and akathisia, may be symptoms of primary neurologic disease or occur secondary to pharmacotherapy CHARACTERISTICS* TremorRhythmic. Oscillatory movement categorized according to its relationship to activity or posture* ChoreaIrregular, unpredictable brief jerky movements* AthetosisSlow, writhing movements of distal parts of limbs* DyskinesiasRecessive abnormal involuntary movements* DystoniaSlow sustained, posturing or contractions of a muscle or group of muscles* MyoclonusRapid, brief shock like muscle jerks* TicRepetitive, irregular stereotype movements or vocalizations* BallismusWild flinging or throwing movements* AkathisiaSubjective sensation of restlessness often associated with inability to keep still. Easily confused with psychiatric symptoms such as agitation, hyperactivity and anxiety> Central stimulants that act as indirect dopamine agonists such as amphetamine> Levodopa, a precursor of dopamine> Direct dopamine agonists such as bromocriptine> Presynaptic dopamine antagonists (dopamine depleting agents) such as reserpine> Neuroleptics such as haloperidol (Haldol) or chlorpromazine (Thorazine), and other medications such as metoclopramide (Reglan) which antagonize or block central dopamine receptors> By far, the most common cause of drug-induced and tardive syndromes are those that block or antagonize dopamine receptors, usually the neuroleptics.
Medicine
Miscellaneous
Dystonia
The earliest manifestation of increased intracranial pressure following head injury is:
Early signs of elevated iCP include drowsiness and a diminished level of consciousness (altered mental status). Coma and unilateral papillary changes are late signs and require immediate intervention. Ref: Harrison's Internal Medicine, 16th Edition, Page 1633; Clinical Hepatology: Principles and Practice of Hepatobiliary Diseases By Henryk Dancygier, Scott L. (FRW) Friedman, H. D. (CON) Allescher, U. (CON) Beuers, Volume 2, 2010, Page 938
Surgery
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Altered mental status
Function of external oblique muscle:
External oblique: Most superficial muscle which originates from the outer pa of the 5th to 12th ribs on each side of the rib cage. This muscle then runs diagonally down each side and connects to the iliac crest, linea alba, and the pubis. Function: External oblique contributes to the maintenance of abdominal tone, increasing intra-abdominal pressure (as in active expiration), and lateral flexion of the trunk against resistance. Bilateral contraction flexes the trunk forward and aid in movement of spine and back. Contraction of external oblique muscle approximates the two crura (medial and lateral) of superficial inguinal ring like a slit valve to maintain the integrity of inguinal canal.
Anatomy
Abdominal wall ,Inguinal and Femoral region
All of the above
P wave is absent in-
Absence of the P wave with a flat baseline may indicate: Fine atrial fibrillation Sinoatrial arrest (with a secondary escape rhythm ) in ventricular fibrilation ,ventriculat tachycardia and atrial asystole,a waves are present Ref Harrison 20th edition pg 1423
Medicine
C.V.S
Atrial fibrillation
A Poly A base sequence would be most likely found at the
The addition of a poly A tail to the 3' end is one of the post-transcriptional modifications that occurs in the processing of eukaryotic messenger RNA (mRNA). A cap consisting of a guanosine derivative is attached to the 5' end. Intervening sequences (introns) are removed by splicing. All of these processing events occur in the nucleus of eukaryotes. Prokaryotic mRNA undergoes none of these modifications.
Surgery
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3' end of a eukaryotic mRNA
Type I RPGN is seen in
Type I RPGN is anti - GBM mediated and it is seen in Goodpasture's syndrome.
Pathology
null
Goodpasture's syndrome
Bradycardia is seen with:
Ans: C (Succinyl choline) Ref: Ajay Yadav, Short textbook of Pediatrics, 1st editionExplanation:Cardiac Sideeffects of Anesthetic DrugsDrugsCardiac Side effectsMidazolamMinimal reduction in Heart rate, Blood pressure and cardiac outputEpinephrineProduces tachycardia, hypertension and ventricular arrhythmiasSuccinyiCholineIt produces muscarinic effects, similar to Acetyl cholineIt causes Profound BRADYCARDIA, so atropine should be given prior to use of Succinylcholine Choline, especially in childrenDopamineProduces tachycardia, hypertension and ventricular arrhythmiasThiopentoneit causes Hypotension, which is more because of venodilatation and direct depression of vasomotor centreDirect myocardial depressant
Unknown
null
Succinyl choline
Infidelity & jealousy involving spouse is the thought content of which disorder -
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Psychiatry
null
Othello syndrome
Failure of migration of neural crest cells is seen in:
Ans: b (Congenital megacolon)Ref: Bailey & Love, 24th ed, p.l 153 & 23rd ed, p. 1027
Surgery
Small & Large Intestine
Congenital megacolon
The signs of malignant transformation in osteochondroma are all except
Ans. b. Weight loss
Surgery
null
Weight loss
The number 12 in a 3 unit formula 12-6-8 indicates the blade is
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Dental
null
1.2 mm in width
Prophylaxis for health personnel working in a plague ward is -a) Vaccineb) Tetracycline throughout the dutyc) A cource of tetracyclined) Vaccine and Erythromycine) Observation
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Social & Preventive Medicine
null
ab
Drugs known to cause Steven Johnson syndrome include the following except:
Drugs that most commonly cause SJS/TEN Antibiotics Antifungals Antivirals Sulfonamides, e.g., cotrimoxizole; beta-lactams i.e. penicillins, cephalosporins Imidazole antifungals Nevirapine (non-nucleoside reverse-transcriptase inhibitor) Allopurinol Nonsteroidal anti-inflammatory drugs (NSAID) (oxicam type mainly) Naproxen Ibuprofen Anti-convulsants Carbamazepine Phenytoin Phenobarbital Valproic acid Lamotrigine
Dental
Blistering disorders
Paracetamol
Best prognosis in nerve injury
Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery.Ref: Ganong&;s review of medical physiology 23rd edition
Physiology
Nervous system
Neuropraxia
Bedside test for mental status-
Ans. is 'a' i.e., MMSE o The most w idely used test for bedside evaluation of the mental status is folstein's mini mental state examination (MMSE).
Psychiatry
Organic Mental Disorder
MMSE
A 70-year-old man comes to casualty with urinary retention and back pain. Which investigation should be performed -
pt. is suspected to have Ca Prostate as Prostatic Ca is the most common malignant tumor in men over 65 yrs. of age. Symptoms of Bladder outlet obstruction and back pains (due to bony metastasis in the pelvis & lumbar veebra) indicate towards prostate Ca. Serum acid phosphates is a tumor marker of prostate Ca. But now serum acid phosphates assay has been superseded by PSA assay (Prostate specific antigen). Prostate-specific antigen It is a glycoprotein produced only in the prostatic cells (both benign & malignant). It facilitates liquefaction of semen. It is neither sensitive nor specific for early prostate carcinoma (it is prostate specific and not prostate cancer specific), neveheless it gives some help in making a diagnosis. Normal serum level - less than 4 mg/ml 4 - 10 mg/ml - this range is common for both BHP and Ca. More than 10 mg/ml - approx 75% will have cancer. Since PSA is not specific for Ca, PSA Velocity & PSA density is used to detect Prostate cancer. PSA velocity is the rate of change in PSA levels over time and is expressed most commonly as the PSA doubling time. For men with a PSA above 4, PSA velocity of more than .75 mg/ml year is suggestive of Ca. While for those with lower PSA levels, rates above 0.5 mg/ml, per year should be used to advise biopsy. PSA density is calculated by dividing the serum PSA by the estimated prostate weight (measured by TRUS). It was developed to correct for the contribution of BPH to the total PSA level. Values < 0.10 are consistent with BPH. > 0.15 suggest cancer Ref : Bailey & Love 25/e p1356
Anatomy
Urology
Serum acid phosphatase
Contraindications of circlage operation are all except:
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Gynaecology & Obstetrics
null
Pregnancy beyond 14 weeks
Elaboration of inactivating enzymes are the impoant mechanism of drug resistance among all of these antibiotics except
Refer KDT 6/e p688 Resistance to fluoroquinolone is mediated by mutation in DNA gyrase
Pharmacology
Chemotherapy
Quinolone
A patient presents with unconjugated hyperbilirubinemia and presence of urobilinogen in urine. Which amongst the following is the least likely diagnosis -
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Medicine
null
Dubin Johnson syndrome
Which among the following is TRUE about confounding factor?
A confounding factor is defined as one which is associated both with exposure and disease, and is distributed unequally in study and control groups. More specifically a confounding factor is one that, although associated with exposure under investigation, is itself, independently of any such association, a risk factor for the disease. Ref: Park's Textbook of Preventive and Social Medicine, 19th edition, Page 67.
Social & Preventive Medicine
null
It is itself a risk factor for the disease
Investigation of choice for esophageal rupture is
Gastrografin (water soluble) is preferred to prevent extravasation of barium into the mediastinum or pleura. If no leak is seen, a barium study should follow
Surgery
All India exam
Water soluble low molecular weight contrast swallow
Dobutamine differs from dopamine in that
Dopamine (DA):- It is a dopaminergic (D1 and D2) as well as adrenergic a and b1 (but not b2) agonist. Dobutamine:- A derivative of DA, but not a D1 or D2 receptor agonist. Though it acts on both a and b adrenergic receptors. Ref:- kd tripathi; pg num:-134
Pharmacology
Autonomic nervous system
It does not activate peripheral dopaminergic receptors
Garlicky odour in the gastric contents seen in which non metallic poisoning
Postmoem appearance Esophagus and stomach shows inflammatory changes and luminous material may be seen in the GIT. There may be garlicky odour in the gastric contents. There may be jaundice, and fatty change in the liver. Liver shows centrilobular steatosis and neurosis. If the person survived for one week or so, there may be yellow atrophy of liver and cloudy swellings of kidney. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 432
Anatomy
Poisoning
Phosphorus
Abnormal function of epithelial chloride channel protein is the cause of
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Medicine
null
Cystic fibrosis
The capsule of cryptococcus neoformans in a CSF sample is best seen by -
Cryptococcus is the capsulated yeast. Among the given staining techniques, India ink preparation is the best staining technique used for demonstration of capsule (negative staining) - sensitivity of the technique: 60–75%. Other capsular staining techniques are: 10% Nigrosin staining Modified India ink preparation with 2% chromium mercury Alcian blue staining Methanamine silver and Periodic acid- Schiff – used for tissue sample. Sensitivity of various diagnostic tests- Harrison 18/e p1652 Cryptococcal antigen detection in CSF—90% Blood culture: 10—30% in non-HIV patients and 60% in HIV patients Sputum culture: 10% Sputum antigen detection: 30%
Microbiology
null
India ink preparation
which is not a radiographic finding of CHF
ref : harrisons 21st ed
Radiology
All India exam
Oligemia
Alternating RBBB with Left anterior hemiblock is seen in
Ans. is 'd' i.e., Bi-fascicular block Bifascicular block - combination of RBBB with either left anterior hemiblock or left posterior hemiblock. Tri fascicular block - RBBB plus either LAHB/LPHB+ first degree AV block. Complete hea block destruction of - AV node leading to AV dissociation
Medicine
null
Bi-fascicular block
Which of the following is false about cholangiocarcinoma
Diagnosis is made by MRCP
Surgery
null
Staging is done by PET CT
All of the following heart sounds occur shortly after S2 except
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Medicine
null
Ejection click