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During the following procedure, optimum interval between uterine incision and delivery should be less than ______ seconds.
Ans. D 90 secondsRef: Datta, 8th ed. pg. 673The image shows LSCS being performed, with the head being delivered by hooking fingers carefully between the lower uterine flap. The head is delivered by elevation and flexion using the palm as fulcrum and the optimum time between the uterine incision and delivery should be less than 90 seconds.
4
30 seconds
45 seconds
60 seconds
90 seconds
Physiology
Heart, Circulation, and Blood
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single
Ivermectin is indicated in all of the following except:
Ans: C (Malaria) Ref: The Pharmacological basis of therapeutics by Goodman dc Gilman - 12th edition, page no. 1455-1456 & Malaria Journal 2013: 12:153Explanation:Ivermectin has a beneficial therapeutic effect inOnchocerciasisLvmphatic filariasisStrong lyloidiasisAscariasisEnterobiasis.Ivermectin is also effective in head lice infection, cutaneous larva migrans and scabiesIt does not have any proven beneficial effect in malaria.Since ivermectin can act on the GABA receptors in the CNS, it should be avoided in patients with meningitis and African trypanosomiasis that are associated with breached blood brain barrier.Ivermectin should not be given to pregnant and lactating women, children less than 5 years of age and severely ill patient.Note:However ivermectin has been recently found to have a beneficial effect in reducing the risk of malaria transmission by its vector control activity by targeting the anopheles mosquito.However this is still needs to be verified with the help of large studies. (Ref: Malaria Journal 2013; 12:153)
3
Ascaris
Filariasis
Malaria
Oncocerciasis
Pharmacology
Anti-Helminths
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Reinsch test is used in diagnosis of poisoning due to: UP 11; COMEDK 12
Ans. Arsenic
1
Arsenic
Lead
Iron
Copper sulphate
Forensic Medicine
null
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single
Groove sign is seen in –
Groove sign of Greenblatt' is pathognomonic of LGV → when inguinal lymph nodes are enlarged, they are separated by Poupart's ligment, producing a groove.
2
Donovanosis
LGV
Chancroid
Genital herpes
Dental
null
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single
Drug of choice for absence seizures: March 2011
Ans. C: Valproate Sodium valproate is effective in absence/petit-mal seizures, combined grand mal and petit mal, myoclonic epilepsy, paial epilepsy, maniac depressive psychosis and as a prophylactic in febrile convulsion Absence seizures/Petit mal seizures (from the French for "little illness", a term dating from the late 18th century). Absences seizures are brief (usually less than 20 seconds), generalized epileptic seizures of sudden onset and termination. They have 2 essential components: - Clinically the impairment of consciousness (absence) - EEG generalized spike-and-slow wave discharges Absence seizures are broadly divided in typical and atypical absence seizures. Typical absence seizures usually occur in the context of idiopathic generalised epilepsies and EEG shows fast >2.5 Hz generalised spike-wave discharges. Atypical absence seizures: - Occur only in the context of mainly severe symptomatic or cryptogenic epilepsies of children with learning difficulties who also suffer from frequent seizures of other types such as atonic, tonic and myoclonic - Onset and termination is not so abrupt and changes in tone are more pronounced - Ictal EEG is of slow less than 2.5 Hz spike and slow wave. - The discharge is heterogeneous, often asymmetrical and may include irregular spike and slow wave complexes, fast and other paroxysmal activity. - Background interictal EEG is usually abnormal. Treatment of patients with absence seizures only is mainly with sodium valproate or ethosuximide, which are of equal efficacy controlling absences in around 75% of patients. Sodium valproate as a single drug is the DOC if tonic clonic seizures are also present or emerge during the therapy with ethosuximide Lamotrigine monotherapy is less effective with nearly half of the patients becoming seizure free.
3
Carbamazepine
Lamotrigine
Valproate
Phenytoin
Pharmacology
null
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Least common cause of pericarditis/pericardial effusion in children:
b. Sarcoidosis(Ref: Nelson's 20/e p 2269-2271, Ghai 8/e p 433-443)Important causes of pericarditis/pericardial effusion in children:Infectious* Viral (Coxsackie virus B, EBV, Influenza, Adenovirus); Fungal (Histoplasmosis, Actinomycosis)* Bacterial (TB, Streptococcus, Pneumococcus, Staphylococcus, Meningococcus, Mycoplasma, Tularemia, Listeria, Leptospirosis)* Immune complex (Meningococcus, Hemophilus influenzae)* Parasitic (Toxoplasmosis, Echinococcosis) Connective tissue diseasesMetabolic-endocrineRheumatoid arthritisRheumatic feverSystemic lupus erythematosusSystemic sclerosisSarcoidosisWegener granulomatosisUremiaHypothyroidismChylopericardiumOut of the causes given in the options, Sarcoidosis is the least common.
2
Rheumatic fever
Sarcoidosis
Rheumatoid arthritis
SLE
Pediatrics
C.V.S.
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Actions of Bradykinin include all of the following, EXCEPT:
Kinins cause marked bronchoconstriction and not bronchodilatation. Their effect on other smooth muscles is not prominent. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Pages 455 - 456; Textbook of Medical Physiology By Guyton and Hall, 10th Edition, Pages 181, 290, 399, 552, 725, 742.
2
Vasodilatation
Bronchodilatation
Increased vascular permeability
Pain
Pathology
null
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The lack of ability of an individual to do his routine activity is -
Disability defined as lack of ability of an individual to do his routine activity Disease defined as a condition in which body health is impaired, a depaure from a state of health, an alteration of human body interupting the performance of vital functions Impairment is defined as any loss or abnormality of psychological, physiological,or anatomical structure or function Handicap defined as a disadvantage for a given individual,resulting from an impairment or disability , that limits or prevents the fulfilement of a role that is normal for that individual ref ;(page no;44) 23rd edition of PARK&;s textbook of Preventive and Social medicine
3
Disease
Impairement
Disability
Handicap
Social & Preventive Medicine
Social science, Mental health & Genetics
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Most common affected tissue in cysticercosis is:
Ans. is 'c'Rarely neurocysticercosis happens and most common site is Parenchymal and associate with Ingestion of infected eggs of Taenia solium with food and water.
3
Brain
Eye
Muscles
Liver
Microbiology
Misc.
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A child is taken to a pediatrician because his mother notices that his eyes appear very puffy. The mother said that the boy's eyes appeared normal two days ago, and pa of what caused her concern was that her child seemed to be rapidly becoming ill. On physical examination, the boy is noted to have generalized edema. No hypeension or jaundice is noted. Blood urea nitrogen and serum creatinine are within normal limits. A urine sample is collected, and the nurse notices that the top of the urine has a small amount of foam at the top. Urinalysis is negative for glucose, red cells, white cells, casts, crystals, and bacteria. A 24-hr-urine specimen is collected, which demonstrates proteinuria of 55 mg/h/m2. Which of the following is the most likely diagnosis?
Proteinuria greater than 40 mg/h/m2 in a child or 3.5 g/d/1.73 m2 in an adult produces nephrotic syndrome, which is characterized by generalized edema, often most noticeable in the face. The condition develops when large amounts of protein are spilled through the glomeruli into the duct system of the kidneys. In contrast, nephritic syndrome is accompanied by lower levels of proteinuria, together with microscopic or macroscopic hematuria (red cells and blood in urine). Acute and chronic renal failure are characterized by rising serum levels of BUN and creatinine. The findings seen do not suggest lower urinary tract disease, which is typically due to a lower urinary tract infection (which would show bacteria and white cells), calculi (crystals would likely be present), or tumor (which would show abnormal bladder epithelial cells).
4
Acute renal failure
Chronic renal failure
Lower urinary tract disease
Nephrotic syndrome
Pediatrics
null
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Maximum regenerative capacity is of ?
Ans. is 'c' i.e., Intestinal epitheliumCells with good regenerative capacityi) Surface epithelium (stratified squamous) of skin, oral cavity, vagina and cervix.ii) Lining mucosa of all excretory ducts of glands (Salivary gland, pancreas, biliary duct).iii) Columinar epithelium of GIT (Intestinal mucosa) and uterus.iv) Transitional epithelium of the urinary tract.v) Bone marrow cells and hematopoietic cells.vi) Basal cells of epithelia.Cells with limited regenerative capacity i) Parenchymal cells of liver, kidney and pancreas.ii) Mesenchymal cells, e.g., fibroblast and smooth muscles.iii) Vascular endotheliumiv) Osteoblast, chondroblastv) Resting lymphocytes and other leukocytes.Cells with no regenerative capacity i) Neuronsii) Cardiac muscleiii) Skeletal muscle.
3
Liver cells
Kidney cells
Intestinal epithelium
Neurons
Physiology
null
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Drugs used for anaesthesia in hypotensive is
Ketamine raises the BP, therefore is the induction agent of choice in hypotensive states and shock.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)
2
Propofol
Ketamine
Thiopentone
None
Anaesthesia
All India exam
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multi
Syncytium formation is a propey of ?
Ans. is 'c' i.e., Measles virus
3
Herpes virus
Adenovirus
Measles virus
Rabies virus
Microbiology
null
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single
Which of the following is most common type of congential cardiac cyanotic anamoly?
Ans. is 'a' i.e., Tetralogy of Fallot o TOF is the commonest cyanotic congenital heart disease.
1
Tetralogy of Fallot
TAPVC
Transposition of great vessels
Ebstein's Anamoly
Pediatrics
Cyanotic Congenital Heart Disease
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The commonest cranial nerve palsy in tabes dorasalis is:
Ans. III nerve
1
III nerve
IV nerve
VI nerve
Total ophthalmoplegia
Ophthalmology
null
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single
The commonest cancer of oral cavity is
Ans. (d) Squamous cell carcinomaRef: Devita 9th edition, page 729* Most common site oral Cancer: Carcinoma Tongue > Carcinoma Lip* Most common histological type: Squamous Cell Cancer* Most common site of oral Cancer in India: Cancer of Buccal Mucosa* Max Risk of L.N. Metastasis: Carcinoma Tongue* Min Risk of L.N Metastasis: Carcinoma lip > hard palate* Most common age: 50-60 years
4
Adenocarcinoma
Melanoma
Sarcoma
Squaous cell carcinoma
Surgery
Oral Cavity
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Point Prevalence is defined as-
Ans. is 'd' i.e., Number of total cases at a given point of time * Prevalence refers specifically to all current cases (old and new) existing at a given point in time or over a period of time in a given population.* Prevalence is of two types: (i) Point prevalence, and (ii) Period prevalencei) Point prevalence# Point prevalence is defined as the number of all current cases (old and new) of a disease at one point of time, in relation to a defined population.Point prevalence =No. of all current cases (old & new) of a specified disease existing at a given in time------------------------------------Estimated population at same point in timex 100# When the term prevalence rate is used, without any further qualification it is taken to mean "point prevalence"ii) Period prevalence# It measures the frequency of all current cases (old 8c new) existing during a defined period of time (e.g. annual prevalence) expressed in relation to a defined population.# It includes cases arising before but extending into or through to the year as well as those cases arising during the year.Period prevalence =No. of existing cases (old 8c new) of a specified disease during a given period oftime interval------------------------------------------Estimated - mid - interval population at riskx 100* Prevalence is a proportion.* Prevalence is determined by cross sectional study.
4
Number of new cases at a given point of time
Number of new cases in a given year
Number of total cases in a given year
Number of total cases at a given point of time
Social & Preventive Medicine
Epidemiology
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single
In Post radical neck dissection shoulder syndrome, all are seen except:
Ans. is 'd' i.e. Normal electromyographic finding In Radical neck dissections the most crippling complication is the "Shoulder Syndrome" arising from denervation and atrophy of the trapezius muscle due to sacrifice of the spinal accessory nerve (SAN).Shoulder syndrome is characterized by:inability to abduct the shoulder beyond 90 degrees cephaladlong standing pain in the shoulderdeformity of the shoulder girdle drooping of the shoulder and shoulder abduction, and external rotation
4
Restricted range of movement
Pain
Shoulder drooping
Normal electromyographic finding
Surgery
Miscellaneous (Neck)
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Lysosomal transpo defect is seen in
Answer- A. CystinosisTwo disorders are caused by a proven defect in carrier-mediated transpo of metabolites: cystinosis end the group of sialic acid storage disorders (SASD).
1
Cystinosis
Goucher's disease
Metachromatic leukosytrophy
Tay Sach's disease
Pathology
null
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single
An 18-year-old man moves from sea level to an elevation of 2,400 m to train as a skier. The increased requirement for oxygen delivery to tissues at the higher elevation stimulates the synthesis of a renal hormone (erythropoietin), which targets hematopoietic stem cells in the bone marrow. Erythropoietin promotes the survival of early erythroid progenitor cells primarily through which of the following mechanisms?
- Recent studies indicate that erythropoietin promotes survival of early erythroid progenitor cells through inhibition of default apoptosis pathway. - Thus, this hormone rescues stem cells that are otherwise fated to undergo programmed cell death. - None of the other choices are known to control the expansion of hematopoietic stem cell colonies in bone marrow.
4
Altered cell-matrix adhesion
Downregulation of p53
Enhanced glucose uptake
Inhibition of apoptosis
Pathology
Hematopoeisis: Basic concepts
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Sunflower cataract is caused by
Chalcosis is copper alloy in the eye Refer: Khurana 6th edition page number 194
2
Siderosis
Chalcosis
Lead intoxication
Silicosis
Ophthalmology
Lens
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Notochord develops from -
Ans. is 'a' i.e., Epiblast cells o Notochord is a bud like structure formed by epiblast cells extending from cranial end of primitive streak to caudal end of prochordal plate, in between the ectoderm and endoderm.o Siginificances of notochord includes followingi) It defines the axis of embryoii) It functions as the primary inductor, inducing the overlying ectoderm to develop into neural plate (the primordium of CNS).iii) It serves as the basis for development of axial skeleton. The notochord is an intricate structure around which vertebral column is formed and indicates future site of vertebral bodies. However, the notochord does not give rise to vertebral column, after development of vertebral bodies, the notochord degenerates and disappears, but parts of it persist as the nucleus pulposus of intervertebral disc.
1
Epiblast cells
Hypoblast cells
Syncytiotrophoblasts
Cytotrophoblasts
Anatomy
Nervous System
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Scalp and face are involved in ?
Ans. is 'c' i.e., Infantile scabies Type Feature o Infantile scabies Scalp, face, palms and soles are involved o Norwegian scabies Crusted hyperkeratotic lesions on face , palms, soles, nails. Itching is not prominent. Mites are found in thousand, most severe form of scabies Crusted scabies Extensive crusts Nodular scabies Extensive crusts Genital scabies Extensive crusts Animal scabies History of contact with cat or dog. Atypical presentation
3
Adult scabies
Nodular scabies
Infantile scabies
None
Skin
null
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multi
False about Neurotic disorders
null
4
Aware of reality
Delusion absent
Hallucination absent
Loss of insight
Psychiatry
null
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multi
Dosage of Albendazole given as per National deworming program in <2years old child.
null
1
200mg
400mg
500mg
2 tablets of 400 mg
Social & Preventive Medicine
null
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single
Muscle forming anterior and posterior faucial folds of tonsillar fossa, respectively
Palatoglossus-palatopharyngeus form the boundary of the tonsillar fossaReference: Chaurasia; 6th edition
2
Levator veli palatine-tensor veli palatine
Palatoglossus-palatopharyngeus
Palatopharyngeus-salpingopharyngeus
Styloglossus-stylopharyngeus
Anatomy
Head and neck
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GTT in pregnancy is indicated when if fasting blood sugar is above-
Ans. is 'd' i.e., 95gm/100ml Indications of GITo Fasting glycosuria on one occasion before 20th week & 2 or more occasions thereafter,o Following a positive screening test.o If fasting blood sugar exceeds 95mg / 100ml or if that after 2 hours of ingestion of lOO'gm (WHO-75) glucose is more than 120mg/100ml.o However if plasma glucose value is 126mg / 100 ml or more & is confirmed on repeated test, there is no need to perform GTT as the woman is diabetic.
4
80gm/100ml
85gm/l00ml
90gm/l00ml
95gm/100ml
Gynaecology & Obstetrics
Diabetes Mellitus
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Patient came with complaints of Polydipsia, hypercalciurea, nephrolithiasis, metabolic alkalosis. Possible cause is
Answer- A. Baters syndromeBater syndrome is an autosomal recessive disorder caused by mutation in gene coding for basolateral chloride channel (ClC-kb). There is loss of sodium, chloride, potassium and calcium in urine.The major clinical findings are hyponatremia, hypokalemia, polyurea, polydipsia, metabolic alkalosis, normal to lowBP, hypomagnesemia (only in some patients), hypochloremia, hypercalciuria (causing nephrocalcinosis), and growth
1
Baters syndrome
Gittlemans syndrome
Addisons disease
Chronic diuretic use
Medicine
null
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single
Clathrin is used in:
Clathrin and megalin are associated with endocytosis Endocytosis is a vesicular transpo system, it is an active process
1
Receptor mediated endocytosis
Exocytosis
Cell adhesion
All
Anatomy
General anatomy
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multi
Hockey stick appearance on echo is a feature of
Echocardiographic features of mitral stenosis:-Thickened and calcified mitral leaflets and subvalvular apparatus -Decreased E-F slope (M-mode)-Hockey stick appearance of the anterior mitral leaflet in diastole(long axis view)-Immobility of the posterior mitral leaflet (a similar appearance can be seen in hypereosinophilia or ergot use)-Fish mouth orifice in the sho axis view-Increased LA size, with the potential for thrombus formationDynamic CT: the Restricted opening of the thickened valve from commissural fusion (especially with rheumatic valve disease), valve calcification, or both results in a "fish-mouth" appearance on sho-axis images. Bowing of a thickened and fibrotic anterior leaflet during diastole may result in a "hockey-stick" appearance which is best seen on two- or four-chamber images(Ref: The echo manual by Jae K Oh; J B Seward; A Jamil Tajik, page no 202)
1
Mitral stenosis
Mitral incompetence
Aoic stenosis
Aoic regurgitation
Radiology
All India exam
aeb677ed-4e3d-42a2-bc16-d26a4fc90b34
single
All the following features our ventricular tachycardia as the cause of broad-complex tachycardia, except -
Ventricular tachycardia can be classified based on its morphology: Monomorphic ventricular tachycardia means that the appearance of all the beats match each other in each lead of a surface electrocardiogram (ECG). Scar-related monomorphic ventricular tachycardia is the most common type and a frequent cause of death in patients having survived a hea attack, especially if they have weak hea muscle. RVOT tachycardia is a type of monomorphic ventricular tachycardia originating in the right ventricular outflow tract. RVOT morphology refers to the characteristic pattern of this type of tachycardia on an ECG. The source of the re-entry circuit can be identified by evaluating the morphology of the QRS complex in the V1 lead of a surface ECG. If the R wave is dominant (consistent with a right bundle branch block morphology), this indicates the origin of the VT is the left ventricle. Conversely, if the S wave is dominant (consistent with a left bundle branch block morphology, this is consistent with VT originating from the right ventricle or interventricular septum. Polymorphic ventricular tachycardia, on the other hand, has beat-to-beat variations in morphology. This may appear as a cyclical progressive change in cardiac axis, previously referred to by its French name torsades de pointes ("twisting of the spikes"). However, at the current time, the term torsades de pointes is reserved for polymorphic VT occurring in the context of a prolonged resting QT interval. Another way to classify ventricular tachycardias is the duration of the episodes: Three or more beats in a row on an ECG that originate from the ventricle at a rate of more than 120 beats per minute constitute a ventricular tachycardia Ref Harrison 20th edition pg 1423
3
Fusion beats
Extreme left axis detion
Very broad QRS complexes
Response to carotid sinus massage
Medicine
C.V.S
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multi
An elderly patient complains of recurrent episodes of amaurosis fugax. This is attributable to microembolization of which of the following?
Amaurosis fugax, one type of TIA, is a manifestation of carotid bifurcation atherosclerotic disease. It is manifested by unilateral blindness, being described by the patient as a window shade across the eye, lasting for minutes or hours. It is caused by micro emboli from a carotid lesion lodging in the retinal artery, the first intracerebral branch of the internal carotid artery.
2
Facial artery
Retinal artery
Occipital artery
Posterior auricular artery
Surgery
Arterial Disorders
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A 44-year-old renal transplant patient develops severe cough and shortness of breath on exertion. On examination, he appears dyspneic, respirations 24/min, pulse 110/min, and oxygen saturation 88%. His lungs are clear on auscultation and heart sounds are normal. CXR shows bilateral diffuse perihilar infiltrates. Bronchoscopy and bronchial brushings show clusters of cysts that stain with methenamine silver. Which of the following is the most appropriate next step in management?
The patient is infected with Pneumocystis organisms invading an immunocompromised host. The treatment of choice is trimethoprim-sulfamethoxazole. Alternate therapies include pentamidine (highly toxic) and trimetrexate plus folinic acid.
3
amphotericin B
cephalosporins
trimethoprim-sulfamethoxazole
aminoglycosides
Medicine
Infection
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A 21yrs. old pt. attended a party the previous night and gives the following symptoms pain in abdomen radiating to back, pulse 100/ min, BP 100/76temp 39deg C and vomiting before coming Most probable dx is :
Ans. is 'd' ie Acute Pancreatitis * The signs and symptoms exhibited by the pt. correlate with that of acute pancreatitis, most characterstic of which is - Radiation of pain to back and party in previous night (ie. h/o alcohol)Other imp. diagnostic clue (not given in question) is- Relief from pain on sitting in upright posture.*Some imp, points about Acute PancreatitisEtiology - Gall stones (50 - 70% i.e. MC cause)*Alcohol (25%) OthersGrey Turner sign or Cullens sign* :Bleeding into the fascial planes in acute pancreatitis can cause 1 discolouration of - flanks* in Grey Turner sign*Mnemonic : Cullen's -Umbilicusumbilicus* in Cullens sign* Plain abdominal x-ray findings -include a sentinel loop*a colon cut off sign*a renal 'halo ' sign *
4
Acute appendicitis
Acute cholecystitis
Acute diverticulitis
Acute pancreatitis
Surgery
Pathophysiology - Acute Pancreatitis
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Which of the following disease can be associated with sho QT interval on ECG ?
Sho QT syndrome (SQTS) is an inherited cardiac channelopathy characterised by an abnormally sho QT interval and increased risk for atrial and ventricular arrhythmias. Diagnosis is based on the evaluation of symptoms (syncope or cardiac arrest), family history and electrocardiogram (ECG) findings multiple myeloma shows sho QT interval Ref Harrison 20th edition pg 1534
2
Chronic myeloid leukemia
Multiple myeloma
Chronic lymphocytic leukemia
Hodgkin's disease
Medicine
C.V.S
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An indicator is said to valid if
Ans) b (It measures the thing.. ) Ref park 20th ed p 226The term validity refers to what extent the test accurately measures which it purports/ intended to measure.Validity expresses the ability of a test to separate or distinguish those who have the disease from those who do not have.Validity has two components - Sensitivity and specificitySensitivity and specificity together with "predictive accuracy" are inherent properties of a screening test.
2
It also measures the thing it didn't suppose to measure
It measures the thing it expected to measure
Over value when measured by different method
Under value when measured by different method
Social & Preventive Medicine
Biostatistics
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single
Presence of hemiplegia with diminution of vision in the contralateral eye suggests occlusion of: September 2012
Ans. D i.e. Internal carotid aery
4
Middle cerebral aery
Basilar aery
Anterior cerebral aery
Internal carotid aery
Medicine
null
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In increased ICT, agent used for anesthesia
D i.e. Isoflurane
4
N20
Trilene
Ether
Isoflurane
Anaesthesia
null
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Malignant cell in Hodgkin's lymphoma is
Reed-Sternberg cells (also known as lacunar histiocytes for ceain types) are distinctive, giant cells found with light microscopy in biopsies from individuals with Hodgkin's lymphoma (a.k.a. Hodgkin's disease, a type of lymphoma). They are usually derived from ,B lymphocytes classically considered crippled germinal center B cells, meaning they have not undergone hypermutation to express their antibody. Seen against a sea of B cells, they give the tissue a moth-eaten appearance. Reed-Sternberg cells are large (30-50 microns) and are either multinucleated or have a bilobed nucleus with prominent eosinophilic inclusion-like nucleoli (thus resembling an "owl's eye" appearance)
1
Reed stenberg cell
Lymphocytes
Histocytes
Reticulum cells
Surgery
Vascular surgery
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single
PR interval in ECG shows?
Normal ECG waves and Intervals: ECG wave/Interval Characteristics 1. P Wave Reflects Atrial Depolarization (activation) 2. QRS complex Depolarization of ventricles 3. T Wave Repolarization of ventricles 4. PR Interval Atrial depolarization and conduction through AV node 5. QT Interval Total duration of Ventricular depolarization and repolarization 6. ST segment Plateau phase of ventricular action potential
3
Ventricular depolarization
Ventricular Repolarization
Conduction through AV node.
Atrial Repolarization
Anatomy
FMGE 2019
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single
Which of the following is a radiolucent stone?
Ans: a (Uric acid) Ref: Bailey and Love, 24th ed, p. 1317Pure uric acid stones are radiolucent and appear in an excretory urogram as filling defects.Uric acid stones if contain calcium, will cast a faint radiological shadow.Examples for radiolucent stones* Uric acid* Dihydroxy adenine* Orotic acid* Xanthine* Allopurinol* Triamterine and Indinavir induced stones.
1
Uric acid
Oxalate
Cysteine
Triple phosphate
Radiology
Genito Urinary System
4669e0a7-a634-4ffd-8c63-db50d725b420
single
Pain of musculoskeletal origin is all except
Pain of musulo skeletal origin MPDS TMJ arthritis Stylohyoid eagles’s syndrome
3
MPDS
TMJ arthritis
Pos traumatic pain
Stylohyoid eagle’s syndrome
Pathology
null
64783cc6-70ae-47ba-9770-4089555661fc
multi
Milk ejection is facilitated by:March 2007, March 2013
Ans. A: OxytocinHormonal control of Breast development and secretion and ejection of milkProgesterone -- influences the growth in size of alveoli and lobes.Oestrogen -- stimulates the milk duct system to grow and become specific.Follicle stimulating hormoneLuteinizing hormoneProlactin -- contributes to the increased growth of the alveoli during pregnancy and formation of milkOxytocin -- oxytocin contracts the smooth muscle layer of band-like cells surrounding the alveoli to squeeze the newly-produced milk into the duct system. Oxytocin is necessary for the milk ejection reflex, or let-down to occur.Human placental lactogen (HPL) --This hormone appears to be associated with breast, nipple, and areola growth before bih.Colostrum contains higher amounts of white blood cells and antibodies than mature milk, and is especially high in immunoglobulin A (IgA), which coats the lining of the baby's immature intestines, and helps to prevent germs from invading the baby's system.
1
Oxytocin
Growth hormone
FSH
LH
Physiology
null
bac8823b-af87-4b48-a1b4-f799da696f57
single
Anterior spinal artery is a branch of
null
3
Internal carotid artery
Basilar artery
Vertebral artery
Labyrinthine artery
Anatomy
null
c0bdddf8-c648-4d17-9972-ea2902839814
single
Most common cause of decrease in incidence of H.pylori in the western countries is due to
null
1
Change in life style
Increased use of PPI
Chemotherapy
Mutation in organism
Medicine
null
366c244a-1c55-416d-ab00-04c84a01107d
single
Following a myocardial infarct, a 40-year-old man is being treated prophylactically with propranolol. You would be concerned about the use of this drug if the patient also had what comorbid condition
Metabolic actions:- Propranolol inhibits glycogenolysis in hea, skeletal muscles and in liver, which occurs due to Adr release during hypoglycaemia--recovery from insulin action is delayed. Warning signs of hypoglycaemia mediated through sympathetic stimulation (tachycardia, tremor) are suppressed in patients taking beta blockers like propranolol, so it should be cautiously used in patients with diabetes. Ref:- kd tripathi; pg num:-145,146
3
Glaucoma
Essential tremor
Diabetes
Supraventricular tachycardia
Pharmacology
Autonomic nervous system
d446048b-0034-4303-8417-5ef013eb95af
multi
Which of the following describes Satyriasis?
Ans. B. Increased sexual drive in male* Nymphomaniac: excessive sexual desire in females.* Satyriasis: excessive sexual desire in males
2
Decreased sexual drive in male
Increased sexual drive in male
Decreased sexual drive in female
Increased sexual drive in female
Psychiatry
Sexual Disorders
df2c9db2-b2d9-4f10-be2b-07493135d300
single
Dose of Human anti-rabies immunoglobulin is
Management guidelines for rabies apa from vaccination Anti Rabies Serum Horse Rabies serum: 40 IU/Kg on Day 0 (50% in wound, 50% I'M) Human Rabies Immunoglobulin : 20 IU/Kg (Maximum in wound, rest IM gluteal) (Concentration 150 IU/ml) Serum sickness with Horse serum : 15-45% Person under Antirabic Treatment should avoid Alcohol (during and 1 month after treatment) Undue physical and mental strain and late nights Coicosteroids and other immunosuppressive agents Intramuscular injections of cell culture and purified Duck Embryo Vaccines : Deltoid (Not in Buttocks) Rabies Vaccine dosages Intramusculae dose of Rabies Vaccine for post exposure prophylaxis: 1ml Intradermal dose of Rabies Vaccine for Post-exposure prophylaxis : 0.1 ml Intramuscular dose of Rabies Vaccine for Pre-Exposure prophylaxis : 1 ml Intradermal dose of Rabies Vaccine for Pre-Exposure prophylaxis : 0.1 ml Rabies Immunoglobulin Dosages Dose of Human Rabies Immunoglobulin (HRIg): 20 IU/Kg body wt Dose of Equine Rabies Immunoglobulin (ERIg) : 40 IU/Kg body wt Ref: Park 25th edition Pgno : 297-298
2
10 IU/kg
20 IU/kg
30 IU/kg
40 IU/kg
Social & Preventive Medicine
Communicable diseases
e074a5c9-3f07-4549-a9f3-ca09d8d160c5
single
Baroreceptors stimulation would result in
Baroreceptor stimulation results in Inhibition of sympathetic activity Excitation of parasympathetic activity Decrease in heart rate Decrease in blood pressure
4
Inhibition of para sympathetic activity
Excitation of sympathetic activity
Increase in heart rate
Decrease in blood pressure
Physiology
null
1aac741e-cf86-47b1-a2b7-b16d1ec1c2d5
single
All are side effects of steroid EXCEPT
Mineralocoicoids cause cause edema, hypokalemia, sodium and water retention. Glucocoicoid cause Cushing's habitus, fragile skin, telangiectasis, hirsutism, hyperglycemia, muscular weakness, susceptible to infection, osteoporosis, HTN, poor wound healing, thin arms due to muscle wasting (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 286)
4
Skin atrophy
Telengectasia
Folliculitis
Photosensitivity
Pharmacology
Endocrinology
b98ad989-230f-489a-b7eb-e93003350328
multi
Paul Bunnel test is done for?
EBV REF: Textbook of Microbiology & Immunology by Parija 2009 Page 504 Heterophil antibodies, which is an antibody against EBV cross reacts with red blood cells of different animal species. This can be used as a rapid screening test for mononucleosis (Monospot test and Paul Bunnell tests) The Paul-Bunnell test uses sheep erythrocytes; the Monospot test, horse red cells.blood cells. In infectious mononucleosis, IgM heterophil antibodies are usually detectable for the first 3 months of infection.
2
HBV
EBV
CMV
HIV
Microbiology
null
3e9677d6-d332-4a57-9c25-10be6cdf24b9
single
The largest trematode infecting masn is -
large or giant intestinal fluke Largest trematode infecting humans Pig serves as reservoir of infection (refer pgno:127 baveja 3 rd edition)
2
F. Hepatica
F. Buski
E. Granulosus
Clonorchis sinensis
Microbiology
parasitology
be5e5c9f-3c38-4cb3-b1ca-702113709d63
single
True regarding respiratory centre
The respiratory center is located in the medulla oblongata and is involved in the minute-to-minute control of breathing. Unlike the cardiac system, respiratory rhythm is not produced by a homogeneous population of pacemaker cells Ref: guyton and hall textbook of medical physiology 12 edition page number: 371,372,373
2
Directly simulated by fall in PaO2
Connected with cardiac center
Inhibited during swallowing
Situated in midbrain
Physiology
Respiratory system
33b9afa9-c8af-4f96-9399-55a561768239
multi
The occurrence of hyperthyroidism following administration of supplemental iodine to subjects with endemic iodine deficiency goitre is known as -
null
1
Jod-Basedow effect
Wolff-Chaikoff effect
Thyrotoxicosis factitia
De Quervain's thyroiditis
Medicine
null
ef332ca7-d2f6-4d9f-8209-eeb3d5944054
single
Lymphadenopathy is seen is A/E
B i.e. Donovanosis
2
Syphlis 1st Stage
Donovanosis
LGV
Chancroid
Skin
null
7fa93804-ff71-4c69-bfa1-076db50de5ef
single
Fluconazole differs from ketoconazole in all the following except (REPEAT)
Ketoconazole and fluconazole both are used in candidiasisRef: KDT 6/e p 762
4
Route of administration
Metabolism inhibition
Anti androgenic side effects
Usage in candidiasis
Pharmacology
All India exam
165abca8-fe14-43df-8911-d52db96f1da1
multi
Amount of chlorine needed to kill cyclops in drinking water is: September 2007
Ans. C: 5 ppm Park's PSM, 21st ed., p- 723 states: Chlorine destroys cyclops and larvae of the guineaworm in a strength of 5 ppm Cyclops may be controlled by the use of the physical, chemical or biological methods: Physical methods - Straining - Boiling at 60 degree Celsius Chemical methods - Chlorine in a strength of 5 ppm - Lime - Abate Biological - Barbel fish and gambusia fish The most satisfactory and permanent method of controlling Cyclops in drinking water is to provide piped water supply or tube wells. Abolition of step wells and provision of sanitary wells should receive attention in rural areas.
3
3 ppm
4 ppm
5 ppm
6 ppm
Social & Preventive Medicine
null
01c13267-d2e8-4648-8a1e-8ac7af4f7d62
single
A 16 year old student reported for the evaluation of multiple hypopigmented macules on the trunk and limbs.All of the following tests are useful in making a diagnosis of leprosy, except –
null
2
Sensation testing
Lepromin test
Slit smears
Skin biopsy
Dental
null
fa2967bb-485f-4dad-9d6c-71db16a5b2e5
multi
Type-1 hypersensitivity includes all of the following except:
Ans. (a) Autoimmune hemolytic anemia HSN involving blood components are usually Type II HSN.
1
Autoimmune hemolytic anemia
Anaphylaxis
Extrinsic asthma
Hay fever
Microbiology
null
ded1c02c-8ff3-4e57-8661-62f2397cffb6
multi
A 80 year old patient presents with a midline tumor of the lower jaw, involving the alveolar margin. He is edentulous. Rx of choice is:
Segmental mandibulectomy recommended for alveolar lesions, tumors adherent to the mandible, or for radiographic evidence of bone involvement. Ref: Craniomaxillofacial Reconstructive and Corrective Bone Surgery: Principles of Internal Fixation By Alex M. Greenberg, Joachim Prein, 2002, page 411.
3
Hemi mandibulectomy
Commando operation
Segmental mandiblectomy
Marginal mandibulectomy
Surgery
null
38477486-f22f-41e9-9921-5084b525abda
single
Which of the following is not a derivative of amino acid tyrosine
Melatonin and serotonin are derivatives of Tryptophan.
2
Thyroxine
Melatonin
Melanin
Epinephrine
Biochemistry
null
5236c1f1-48f6-4447-bcc8-c35a8134e5c5
single
A 28 Years old white female presents with a 15-day history of malodorous vaginal discharge and pruritus. She reports that the smell is worse after intercourse and is accompanied by a white discharge. No significant medical or gynecological history. She is in a stable monogamous relationship and has never been pregnant. Which of the following diagnostic features is consistent with Bacterial vaginosis?
Answer: b) Vaginal fluid pH > 4.5, presence of clue cells on the smear and fishy odor on KOH mountVAGINAL INFECTIONSDiagnosticCriteria Differential Diagnosis of Vaginal infectionsNormalBacterialvaginosisCandidiasisTrichomoniasisBacterial (strep, staph, E.coli)Vaginal pH3.8-4.2>4.5<4.5>4.5>4.5DischargeClear,FlocculentThin, gray or white, adherent HomogenousWhite, curdy, Cottage- Cheese likeYellow to green Frothy adherentPurulentAmine odor (KOH,"whiff" test)AbsentPresent(Fishy)AbsentAbsentAbsentMicroscopicLactobacilliClue cells, coccoid Bacteria, No WBCMycelia,buddingYeast,pseudohyphaeTrichomonads WBC> 10/hpfMany WBCsMain patient ComplaintsNoneDischarge, bad odour- possibly worse after intercourseltching\burningdischargeFrothy discharge, bad odour, vulval pruritis, dysuria & multiple small punctuate strawberry spots on the vaginal vault and portio vaginalis of the cervix (strawberry vagina)Thin, watery discharge,pruritus
2
Vaginal fluid pH > 6, scanty secretions with increased para basal cells
Vaginal fluid pH > 4.5, presence of clue cells on the smear and fishy odor on KOH mount
Vaginal fluid pH > 4, presence of hyphae on KOH mount
Vaginal fluid pH > 5, motile trichomonads on microscopy
Gynaecology & Obstetrics
Miscellaneous (Gynae)
f318db83-43d6-4977-ab14-e29a91b15583
single
Valvulae conniventes are seen in
The valvulae conniventes, also known as Kerckring folds or plicae circulares, are the mucosal folds of the small intestine, staing from the second pa of the duodenum, they are large and thick at the jejunum and considerably decrease in size distally in the ileum to disappear entirely in the distal ileal bowel loops. p Ref - radiopedia.org
1
Jejunum
Ileum
Stomach
Colon
Anatomy
Abdomen and pelvis
49860c53-f494-45ba-ae72-f62ac3234dd0
single
A girl aged 20 yrs complains of headache while studying. Her vision is found to be normal. All of the following should be further evaluated except
Family h/o headache is important in any headache to rule out organic cause of headache. Menstrual history Menstrual history is important in any female presenting with headache to rule to premenstrual syndrome. Detailed menstrual history should be taken to find out headache is due to hormonal imbalance. Interest in studies The patient might not be interested in studies. Studies might be acting as stressors and she must be faking headache to avoid it. Self esteem Self-worth or self-esteem is analyzed to rule out depression. But with depression, headache won’t only occur during studies, it would be pervasive. It the self-esteem of the girl is low it won 7 only manifest during studies; it would affect all her performances.
1
Self worth
Family history of headache
Menstrual history
Her interest in studies
Medicine
null
5dd291de-91e6-4bf6-a98c-bde4daec476b
multi
Congenital hypertrophic pyloric stenosis usually presents –
The symptoms vomiting usually starts after 3 weeks of age but symptoms may develop as early as1st week of life and as late as 5 months of life. - Nelson Congenital hypertrophic pyloric stenosis Hypertrophic pyloric stenosis is the commonest surgical disorder of the stomach during infancy. Pylorus is thickened and elongated and its lumen is narrowed due to hypertrophy of circular muscle fibers of pylorus. More common in boys. More common in infants of blood group 'B' and 'O'. Associated congenital defects are → Tracheoesophageal fistula and hypoplasia or agenesis of inferior labial frenulum. May be associated with Turner syndrome, Trisomy 18. Symptoms are not present at birth. The vomiting usually starts after 3 weeks of age.
3
Within 2 days after birth
Around 1 week after birth
Around 2 weeks after birth
Around 2 months after birth
Pediatrics
null
e01b9378-72f3-4875-aa4c-dceaf8bd4982
multi
Prophylaxis against spontaneous bacterial peritonitis ( SBP) in case of cirrhosis with ascites is indicated in:
The risk factors for SBP are 1.Ascitic fluid protein < 1 g/dl 2.Variceal hemorrhage 3.Prior episode of SBP Acute variceal bleeding patients need prophylaxis against SBP & Drugs used for prophylaxis are: 1.Inj.Ceftriaxone 1 g/day 2. Oral. Ofloxacin 400 mg/day or Norfloxacin 400 OD Primary prophylaxis is indicated in patients with features of : Ascitic fluid protein < 1.5 g/dl With at least one of the following 1. Serum creatinine > 1.2 mg/dl 2. BUN > 25 mg/dl 3. Serum Na < 130 mEq/L 4. CTP > 9 points with bilirubin > 3 mg/dl 5. DRug is Norfloxacin 400 mg OD for long time. Ref: AASLD practice guidelines:Hepatology, Vol.49 ,No.6 ,2009.
2
Patients with high protein ascites
Prior history of SBP
Serum creatinine 1 mg/dl
Child pugh < 8
Medicine
null
979aaf88-2be5-4485-b647-ca09d41d00e5
single
Radiation induced thyroid cancer is -
Radiation-induced thyroid cancer Authors: Section Editors: Deputy Editor: INTRODUCTION Radiation exposure of the thyroid during childhood is the most clearly defined environmental factor associated with benign and malignant thyroid tumors. The risk of thyroid cancer following irradiation is related to radiation dose and age (greater for children exposed early in life), and the risk persists throughout life. Radiation exposure during childhood also increases the risk of benign thyroid nodules and hypothyroidism. The purpose of this topic is to review the evaluation of a patient with a history of childhood radiation exposure and how such a history affects treatment of patients with thyroid tumors. Radiation injury to other organs is reviewed separately. (See and .) RADIATION EXPOSURE Type of exposure -- Radiation exposure may be external or internal. *External - The predominant types of external radiation are diagnostic radiographs, therapeutic radiation for the treatment of cancer, and historical use of external radiation to treat a wide variety of nonmalignant conditions. External radiation also includes brachytherapy, whereby a sealed radiation source is placed adjacent to a treatment area. *Internal - Internal radiation exposure includes ingestion of foods or liquids contaminated with radioactivity or by inhalation of radioactive gases or paicles. Internal radiation occurs after exposure to nuclear fallout (from testing and accidents at operating nuclear power plants or above ground nuclear explosive testing) or after ingestion of radioiodine for diagnostic tests and for therapy of hypehyroidism.
1
Papillary
Follicular
Anaplastic
Medullary
Pathology
Endocrinology
dc66ca91-10dd-4a3b-837e-6604434bd306
single
Significant value of `p' is ?
Ans. is 'd' i.e., 0.05 P is the probability that the difference seen between 2 samples occurs due to chance". If p . .05 it is considered statistically significant. It means that There is 5% probability that the result could have been obtained by chance. or The investigator can be 95% sure that the result was not obtained by chance.
4
0.01
0.02
0.04
0.05
Social & Preventive Medicine
null
35fa0e73-f3a4-4a45-92c3-2addf6870f04
single
Complications of Colles' fracture are all except
B i.e. Nonunion
2
Malunion
Non union
Sudeck's dystrophy
Rupture of extensor policis longus
Surgery
null
8709cb4e-5dc0-4058-8973-d2349dbd8fb4
multi
Lecithin/Sphingomyelin ratio is done to assess the maturity of:
Ref: Cloherty's Manual of Newborn Care. 6th edition, Page 323Explanation:THE LECITHIN -SPHINGOMYELIN (L/S) RATIOAssessment of fetal lung maturity (FLM) prenatally by testing amniotic fluid obtained by amniocentesis.It is performed by thin-layer chromatography.The risk of RDS is very low if the L/S ratio is >2.Exceptions to L/S ratio >2 are:o Infants of diabetic mothers (IDMs)o Intrapartum asphyxiao Erythroblastosis fetalis.Other possible exceptions are intrauterine growth restriction (IUGR), abruptio placentae, preeclampsia and hydrops fetalis.Blood and meconium tend to elevate an immature L/S ratio and depress a mature L/S ratio.OTHER METHODSThe TDx-FLM 11 measures the surfactant- albumin ratio.Measured using fluorescent polarization technology.A value of >45 mg/g indicates maturity.Lamellar body counts in the amniotic fluid.Lamellar bodies are '"packages" of phospholipids produced by type II alveolar cells.A count of >50,000 lamellar bodies/microliter predicted lung maturity.
1
Lung
Fetal circulation
Brain
Gonad
Pediatrics
Disorders of the Respiratory Tract
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single
One of the following activities is not mediated through β2 adrenergic receptors:
null
1
Stimulation of lipolysis
Increased hepatic gluconeogenesis
Increased muscle glycogenolysis
Smooth muscle relaxation
Pharmacology
null
f12274b3-6301-4b2d-a12b-09f37bf8b6f2
single
At which level sound is painful -
Intensity Whisper - 30 dB Normal conversation - 60 dB Shout - 90 dB Discomfort of ear - 120 dB Pain in ear -130 dB Ref. Dhingra, 6/e, p 19
1
100-120dB
80-85dB
60-65dB
20-25dB
ENT
null
410bd82b-db45-48b6-a283-ced1a065c031
single
All of the following are included as causes of maternal death except -
Maternal moality rate is total no.of female deaths due to complications of pregnancy,childbihor within 42 days of delivery from puerpeural causes.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-514
3
Following aboion
During lactation 1 st month (Puerperal)
During lactation 8th month
During the last trimester due to APH
Social & Preventive Medicine
obstetrics,pediatrics and geriatrics
22ecf627-8fa2-4deb-b74b-6e3469d8bb43
multi
Trypsinogen to trypsin is conveed by
Trypsin, a proteinase, is secreted as an inactive zymogen form trypsinogen, which is activated to form active Trypsin, which has strong proteolytic activity and an inactive hexapeptide which is produced and liberated during the process of activation. Activation is brought about by * A glycoprotein enzyme called as enterokinase of the intestinal juice at a pH of 5.5 * Also by trypsin itself once it is formed, autocatalytically, at a pH of 7.9. *C a++ also is required for the activation. In the process of activation, the "active site" of the enzyme trypsin, which is histidylserine residue is unmasked. Hence trypsin belongs to the group of serine proteases. Trypsin acts in an alkaline medium pH 8 to 9 (optimum pH-7.9) and has low Michaelis constant.Ref: Textbook of medical biochemistry, MN Chatterji, 8th edition, page no: 464
1
Enteropeptidase
Acidic pH
Elastase
None
Biochemistry
Structure and function of protein
3f5456f8-916f-459e-86b5-bfbea27f98a6
multi
Which of the following is used to represent continuous (quantitative) data ?
Ans. is `c' i.e., Histogram
3
Bar diagram
Pie cha
Histogram
Map diagram
Social & Preventive Medicine
null
8846b690-5fc4-4984-9439-30f405b5314b
single
What is the most probable poal of entry for Aspergillus
Aspergillosis is caused by the inhalation of Aspergillus conidia or mycelial fragments which are present in the decaying matter, soil or air, resulting in aspergillus asthma, bronchopulmonary aspergillosis and aspergilloma. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition
3
Puncture wound
Blood
Lungs
Gastrointestinal tract
Microbiology
mycology
a1a73572-997e-4e72-94df-85b924188e63
single
Obstruction to the flow of CSF at the aqueduct of Sylvius will most likely lead to enlargement of -
CSF is produced by choroid plexus in the lateral and III ventricles. Then it flows through the aqueduct of Sylvius into the 4th ventricle and from there into the subarachnoid space to be absorbed by the arachnoid Obviously, any obstruction in the aqueduct of Sylvius will lead to enlargement of the proximal ventricles (i.e. both lateral and IIIrd ventricles).
4
All of the ventricles
Only lateral ventricle
Only fourth ventricle
Both lateral and third ventricles
Pathology
null
f583007f-e11f-49a5-96a5-16c6b3509e3d
multi
Dinner fork deformity is seen in -
Ans. is 'a' i.e., Colles fracture DeformityAssociated fracture / conditionGarden Spade DeformitySmiths FractureGun stock deformityCubitus varus commonly due supracondylar humerus fractureDinner fork deformityColles FractureGenu VarumBlounts disease
1
Colies fracture
Supracondylar fracture of Humerus
Smith's fracture
Volar Barton Fracture
Orthopaedics
Injuries of the Forearm
2523d6a1-2ee2-4d9e-bb95-979aad656d7a
single
Ministry covering ESI:
ESI act is an impoant measure of social security and health insurance in India. Administration: The Union Ministry of Labour is the Chairman of ESI corporation. Secretary to Govt. of India Ministry of Labour is Vice-Chairman of ESI.
4
Ministry of health
Ministry of Home
Ministry of Human Resource Development
Ministry of Labour
Social & Preventive Medicine
Occupational Health
f2473863-cd83-4434-83cc-e108d3b0d95c
single
A 22yrs female was admitted in emergency with c/o nausea, vomiting, and watery diarrhoea since 4 days. He is also having low grade fever. He was hospitalised and treated symptomatically and was being relieved and discharged. His blood samples were sent for culture; repos of which pt. brought during his follow up - which showed the presence of clostridium perfringens. Being his physician what should be your next instruction to such patient -
Clostridia Spore bearing, obligate anaerobes and gram positive organisms. Reside normally in GI tract; although they have the propensity to cause fulminant bacteremia, but it is rare. In this question, pt. is well after an acute episode of illness; rules out fulminant course. So, a transient self-limited bacteraemia due to transient gut translocation could occur mostly during an episode of gastroenteritis and doesn't require treatment and fuher workup. So, among the given options returning for penicillin therapy is the best answer.
3
IV penicillin therapy plus colonoscopy.
Return for blood culture.
Return for IV penicillin therapy.
IV penicillin therapy plus echocardiography.
Medicine
Bacterial infection
afbda94b-6400-4be6-945e-2ad31f11546f
multi
Leukocytoclastic vasculitis as an extrahepatic manifestation is noticed in:
Extrahepatic complications of chronic hepatitis B Extrahepatic complications of chronic hepatitis B, is associated with deposition of circulating hepatitis B antigen-antibody immune complexes. They are; Ahralgias and ahritis - common, Purpuric cutaneous lesions (leukocytoclastic vasculitis) - Rare Immune-complex glomerulonephritis Generalized vasculitis (polyaeritis nodosa) Ref: Harrison, Edition-18, Page-2568.
1
Chronic hepatitis B
Chronic Hepatitis C
Autoimmune hepatitis
Wilson's disease
Medicine
null
8ac6f3df-cb8c-4c9c-af4a-f52f6d67ae68
single
An antihelmenthic drug that is effective against blood fluke, liver fluke, lung fluke and cysticercus is:
- Drug of choice for treatment of flukes (except liver fluke) and tapeworms (except dog tapeworm) is praziquantal. - Drug of choice for treatment of liver fluke is triclabendazole. - Drug of choice for dog tapeworm (Echinococcus) is albendazole - Drug of choice for all nematodes (see exceptions below) is albendazole - Drug of choice for treatment of filariasis is diethylcarbamezine. - Drug of choice for treatment of onchocerca and strongyloides is ivermectin.
2
Albendazole
Praziquantal
Ivermectin
Thiabendazole
Pharmacology
Anti-Parasitic Drugs
89a362ca-fe4b-47ad-a781-e5de47f5a2f4
single
All of the following are good prognostic factors for childhood Acute Lymphoblastic Leukemia, except:
Hyperdiploidy, Female sex and pre B cell ALL are associated with good prognosis. t (12 : 21) translocation may be associated with a poor prognosis and is the single answer of exclusion. Ref: Pediatric Oncology: A Comprehensive Guide By Paul Imbach, Thomas R. Kuhne, Robe Arceci, 2004, page 23.
4
Hyperdiploidy
Female sex
Pre B cell ALL
t (12 : 21) translocation
Pediatrics
null
2b303174-cc39-4a0b-b0dd-77d7b913f7ee
multi
Radiological feature of Mitral stenosis is are
A, B, C i.e. Double contour of right hea border, Straightening of left hea border, Splaying of carinal angle
4
Double contour of right hea border
Straightening of left hea border
Splaying of carinal angle
All
Radiology
null
a726117d-a9b9-40df-90b5-ca43dd637e04
multi
Which of the following hormone doesn't use the adenylyl cyclase-cAMP as a second messenger ?
Hormones That Use the Adenylyl Cyclase-cAMP as Second Messenger System Adrenocoicotropic hormone (ACTH) Angiotensin II (epithelial cells) Calcitonin Catecholamines (b receptors) Coicotropin releasing hormone (CRH) Follicle-stimulating hormone (FSH) Glucagon Growth hormone releasing hormone (GHRH) Human chorionic gonadotropin (hCG) Luteinizing hormone (LH) Parathyroid hormone (PTH) Secretin Somatostatin Thyroid-stimulating hormone (TSH) Vasopressin (V2 receptor, epithelial cells) Insulin acts on tyrosine kinase receptor pathway.
3
TSH
Epinephrine
Insulin
Glucagon
Physiology
Endocrine System
91539529-af93-464a-adf7-f0a80d95f610
single
A 3 years old boy presented with fever with pain in the throat and difficulty in deglutition. On examination following findings are seen. What is the most likely diagnosis?
PERITONSILLAR ABSCESS(QUINSY) Collection of pus between the fibrous capsule of the tonsil, and the superior constrictor muscle of the pharynx. Condition is generally unilateral. Tonsil is swollen, red, hot & congested. Uvula and soft palate are pushed to opposite side. Uvula Points towards Normal side as shown in the image. Organism involved are Streptococcus, Staph aureus, anaerobic organism, more often mixed growth is seen. Parapharyngeal abscess (abscess of lateral pharyngeal space, pterygomaxillary, space, pharyngomaxillary space: Swelling is on lateral wall of Pharynx pushing tonsils towards midline. Patient may also have a swelling in neck, posterior to SCM muscle. Patient may also present with Trismus. Ludwig's angina is cellulitis of submandibular space.
1
Peritonsillar abscess
Parapharyngeal abscess
Ludwig's angina
Retropharyngeal abscess
ENT
NEET Jan 2020
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single
Brinzolamide is a
Ans is 'd' i.e. Highly specific reversible and noncompetitive carbonic anhydrase inhibitor o Carbonic anhydrase inhibitors act by a non-competitive, reversible inhibition of the enzyme carbonic anhydrase. o Brinzolamide is a highly .specific inhibitor of carbonic anhydrase II (CA II), which is the main carbonic anhydrase isoenzyme involved in the secretion of aqueous humour. o Inhibition caused by brinzolamide is reversible and non-competitive.
4
Highly specific irreversible and noncompetitive carbonic anhydrase inhibitor
Highly specific irreversible and competitive carbonic anhydrase inhibitor.
Highly specific reversible and competitive carbonic anhydrose inhibitor
Highly specific reversible and non-competitive carbonic anhydrase inhibitor.
Pharmacology
null
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Cholesteatoma commonly associated with:
(a) Atticoantral CSOM(Ref. Scott Brown, 8th ed. Vol 2; 989)Tympanosclerosis is hyalinisation and calcification of the fibrous layer of tympanic membrane. It is not associated with cholesteatoma. Foreign body in ear does not lead to cholesteatoma formation.Keratosis obturans is the collection of desquamated keratin debris in the external auditory canal. This keratin debris comes from the external auditory canal stratified squamous epithelium.
1
Atticoantral CSOM
Tubotympanic CSOM
Tympanosclerosis
Foreign body in ear
ENT
Ear
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single
A child presenting with localized patches of complete hair loss with normal appearance of scalp. Diagnosis is -
alopecia areata develops as single or multiple oval or round patches of hair loss on the scalp, beard area,eyebrows, eyelashes and other hairy areas of the body. Telogen effluvium- generalized and diffuse hair loss over scalp and body Cradle cap - infantile seborrhoeic dermatitis characterized by yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of recently born babies. Tinea capitis-a dermatophytosis caused by trichophyton and microsporum fungi , can be either an ectothrix or endothrix type of infection. Ectothrix involves both inside and outside of hair shaft. Endothrix involves only inside of hair shaft. Page no.241,242,55,169 ref Harrison20th edition
3
Tinea capitis
Cradle cap
Alopecia areata
Telogen effluvium
Dental
Anatomy of skin
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single
An 8-hour-old term infant develops increased respiratory distress, hypothermia, and hypotension. A complete blood count (CBC) demonstrates a white blood cell (WBC) count of 2500/mL with 80% bands. The chest radiograph is shown below. Which of the following is the most likely diagnosis?
(c) Source: (Hay et al, pp 1163-1166. Kliegman et al, pp 925-928. McMillan et al, pp 482-483, 501-506. Rudolph et al, pp 1097-1099.) The radiograph shows diffuse that infiltrates bilaterally; this can be seen with neonatal pneumonia or primary surfactant deficiency. The rapid onset of the symptoms, the low WBC count with left shift, and the depicted chest x-ray findings, however, are typical of a patient with group B streptococcus (GBS) pneumonia. Appropriate management would include rapid recognition of symptoms, cardiorespiratory support, and prompt institution of antibiotics. Despite these measures, mortality from this infection is not uncommon. The other infectious causes listed do not present so early, and the noninfectious causes listed do not cause elevations in the band count. GBS disease in the infant is decreasing in incidence with better prevention strategies in the perinatal period; early screening in pregnancy and treatment with antibiotics just prior to delivery to eliminate GBS colonization markedly decreases the risk to the infant. Congenital syphilis can cause pneumonia, but it is diagnosed at birth along with other features including hepatosplenomegaly, jaundice, rashes, hemolytic anemia, and others. Diaphragmatic hernia presents with early respiratory distress, but the diagnosis is confirmed clinically with bowel sounds heard in the chest and a radiograph that has loops of bowel located above the normal placement of the diaphragm. Transient tachypnea of the newborn (TTN) causes an increase in respiratory rate and occasionally a low oxygen requirement; the history is often positive for a cesarean delivery, and the radiograph shows retained fluid in the fissures. TTN does not cause temperature instability nor an abnormal CBC. Chlamydial pneumonia is not a condition that occurs in an 8-hour-old infant; it is generally a mild pneumonia that can develop in an exposed infant at several weeks of life.
3
Congenital syphilis
Diaphragmatic hernia
Group B streptococcal pneumonia
Transient tachypnea of the newborn
Pediatrics
Growth, Development, and Behavior
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single
In the gr'cii circuit, the arc! flow pressure is 100 mm Hg and the outward flow pressure is 10 mm Hg. Each of the parallel circuit has a resistance of 5 mm Hg/mL/min. Calculate the flow across the circuit:
Ans. b. 90 mL
1
45 mL
90 mL
3.6 mL
135 mL
Physiology
null
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multi
Bochdalek hernia is related to -
Ans. is 'b' i.e., Pleuroperitoneal canal Bochdalek herniao Most Bochdalek hernia are on the left side (~80%) and may rarely be bilateral.o Compression of the lung results in pulmonary hypoplasia, involving both the lungs (ipsilateral > contralateral)o Pulmonary vasculature is also abnormal leading to pulmonary hypertension.o Thus the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertension.o The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemia,o The anteroposterior diameter of the chest may be large along with a scaphoid abdomen,o The diagnosis of CDH can be made prenatally by ultrasound.o The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gastric air bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the side of the hernia.o Historically, the surgical repair of a CDH was considered to be a surgical emergency' because it was believed that the abdominal viscera within the chest prevented the ability to ventilate. More recently with the recognition of the role of pulmnary hypertension and pulmonary hypoplasia and the adverse effects of early operative repair on the pulmonary function has caused a policy of delayed repair.o Thus most pediatric surgeons wait for a variable period (24 to 72 hrs) to allow for stabilization of the infant before doing surgical repair.Congenital diaphragmatic herniao It is the herniation of abdominal contents into the thoracic cavity through the diaphragmatic defecto The defect may be:Posterolateral (Bochdalek hernia)Retrosternal (Morgagni hernia)At the esophageal hiatus (hiatal hernia)Adjacent to the hiatus (paresophageal hernia)o Although all these defects are congenital, the term congenital diaphragmatic hernia is generally used for Bochdalek hernia.
2
Inguinal canal
Pleuroperitoneal canal
Femoral canal
Obturator foramen
Surgery
Unusual Hernias
bad555df-d202-4de6-957f-c976fa530600
single
A 4 yr old partially immunized boy came to OPD with history of bouts of coughing. On staining the sputum sample an organism with bipolar staining was seen. Which among the following organism it would be?
REF: (B) B. pertussisREF: Jawetz Microbiology, 24th Ed Ch. 19BORDETELLA PERTUSSIS:The organisms are minute gram-negative coccobacilli resembling H influenzae. With toluidine blue stain, bipolar metachromatic granules can be demonstrated. A capsule is present. After an incubation period of about 2 weeks, the "catarrhal stage" develops, with mild coughing and sneezing. During this stage, large numbers of organisms are sprayed in droplets, and the patient is highly infectious but not very ill. During the "paroxysmal" stage, the cough develops its explosive character and the characteristic "whoop" upon inhalation. This leads to rapid exhaustion and may be associated with vomiting, cyanosis, and convulsions. The "whoop" and major complications occur predominantly in infants; paroxysmal coughing predominates in older children and adults. The white blood count is high (16,000-30,000/ uL), with an absolute lymphocytosis. Among provided options, T. pestis and B. pertussis produce bipolar metachromatic appearance, but considering the partial immunization status and age of patient, b. pertussis is answer of choice.
2
Y. Pestis
B. pertussis
S. Agalactae
K. Pneumonae
Microbiology
Bordetella
be974814-2aff-477c-a340-343672d6f055
multi
What is true in case of perforation of pars flaccida?
Ans. B Associated with cholesteatomaTympanic membrane can be divided in 2 pas:Parstensa : It forms most of the tympanic membrane. Its periphery is thickened to form fibro cailaginous ring called as annulus tympanicus.Pars Falccida : It is situated above the lateral process of malleus between the notch of Rivinus and the anterior and posterior malleolar folD. Perforation in tympanic membrane can be in Central* Occurs in tubotympanic type ofCSOM* Not associated with cholesteatoma* Considered safe Marginal (Perforation destroys even the annulus) theraby reaching sulcus tympanicusMost common is posterio superiormarqinal?- occur in attico antral type of CSOM- associated with cholesteatoma- considered unsafe / dangerous Attic perforation NoteMost common cause of perforation is chronic otitis mediaMnemonicFamousF - Perforation of Pars FlaccidA.A - Seen in Atticoantral/marginal perforationM - Associated with CSOM (of atticoantral type) or acute necrotizing otitis mediao - Associated with CholesteatomaU - Unsafe typeS - Surgery is TOe.
2
CSOM is a rare cause
Associated with cholesteatoma
Usually due to trauma
All of the above
ENT
null
d602d653-716f-4148-8fa3-959b48cf20b4
multi
Adam's apple seen in boys is because of:
Prominance of Thyroid cailage (because of sharp angle) in males is called Adam's apple. Thyroid cailage with right and left lamina both meet at midline and form an angle of 90deg in males, 120deg in females. At rest it lies at level of C3
3
Hyoid bone
Tracheal rings
Thyroid cailage
Cricoid cailage
ENT
FMGE 2018
c3e5f7f1-b752-4ff4-929b-0cb46463c7bb
single
Site of placement of tension free vaginal tapes in stress urinary incontinence
Tension-free vaginal tape A knitted 11 mm x 40 cm polypropylene mesh tape is inseed transvaginally at the level of the midurethra Complications: Sho term Voiding difficulties , Bladder perforation, de novo Urgency and Bleeding Ref: SHAW&;S TEXTBOOK OF GYNAECOLOGY; 15th edition; Pg no:194
4
Ureterovaginal junction
Urethrovaginal junction
Upper pa of urethra
Middle pa of urethra
Gynaecology & Obstetrics
Urogynecology
2b3ce6e8-b033-45af-8317-05a736e4cd26
single
The amount of water absorbed in the intestine in a day is :
D i.e. 8 lit
4
5 lit.
1 lit
1 lit
8 lit.
Physiology
null
67fddd3c-c80c-46e1-b28e-90b27214be8d
single
Most impoant from of carbon-dioxide transpo in the blood
The route by which most of the carbon dioxide is carried in the bloodstream. Once dissolved in the blood plasma, carbon dioxide combines with water to form carbonic acid, which immediately ionizes into hydrogen and bicarbonate ions. The bicarbonate ions serve as pa of the alkaline reserve.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 644
3
It is mostly transpoed as carboxy hemoglobin
As dissolved CO2
As bicarbonates
Due to CO2 molecules attached to hemoglobin
Physiology
Respiratory system
c43ce7d9-b54b-4d22-9c53-5409e3d99a25
single
A patient presents to the emergency department with uniocular diplopia. Examination with oblique illumination shows golden crescent while examination with coaxial illumination show a dark crescent line. Which of the following is the most likely diagnosis –
Presence of uniocular diplopia together with the finding of the golden crescent on oblique illumination (edge of subluxated lens) or black crecent line on coaxial illumination (edge of subluxated lens) suggests a diagnosis of `subluxation' of the crystalline lens. Ectopic lens refers to the displacement of shows lens from its normal position (subluxation, dislocation).
4
Lenticonus
Coloboma
Microspherophakia
Ectopia lentis
Ophthalmology
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13c6d74a-cbb1-4455-a2d8-c23314b84072
single
Alkaptonuria an inherited metabolic disorder is due to the deficiency of
null
1
Homogentisate oxidase
Cystathionase
Pheylalanine hydroxylase
Tyrosine transaminase
Biochemistry
null
e1b79076-7ec8-41bd-b2c3-749be073e8a4
single