question
stringlengths
1
1.57k
exp
stringlengths
1
22.5k
cop
int64
1
4
opa
stringlengths
1
287
opb
stringlengths
1
287
opc
stringlengths
1
286
opd
stringlengths
1
301
subject_name
stringclasses
21 values
topic_name
stringlengths
3
135
id
stringlengths
36
36
choice_type
stringclasses
2 values
Haversian system is seen in
* Microscopically, the bone is of five types, namely lamellar (including both compact and cancellous), woven, fibrous, dentine and cement. 1. Lamellar bone: Most of the mature human bones, whether compact or cancellous, are composed of thin plates of bony tissue called lamellae. These are arranged in piles in a cancellous bone, but in concentric cylinders (Haversian system or secondary osteon) in a compact bone. 2. Woven Bone: seen in fetal bone, fracture repair and in cancer of bone 3. Fibrous bone is found in young foetal bones, but are common in reptiles and amphibia. 4. Dentine and 5. Cement occur in teeth. * Compact bone ( coical bone) In shaft (diaphysis) of long bone - lamellae arranged to form Haversian system - Bone marrow Yellow which stores fat after pubey. It is red before pubey - Hard and ivory-like * Cancelled bone spongy, or trabecular bone - In the epiphyses of long bone - arranged in a meshwork, so Haversian systems are not present - bone marrow red, produce RBCs, granular series of WBC and platelets - spongy * Nails are made of a tough protective protein called keratin - consists of the nail plate, the nail matrix and the nail bed below it, and the grooves surrounding it (Reference : BDC Handbook of General Anatomy , 5th edition, pg 39)
1
Coical bone
Cancellous bone
Teeth
Nail
Anatomy
General anatomy
23e42325-bd2d-49cf-a4c4-c502c82aa672
single
A 50-year-old woman presents with easy fatigability, a smooth sore tongue, numbness and tingling of the feet, and weakness of the legs. A complete blood count shows a megaloblastic anemia that is not reversed by folate therapy. Hemoglobin is 5.6 g/dL, WBC count is 5,100/mL, and platelets are 240,000/mL. This patient most likely has a deficiency of which of the following vitamins?
Except for a few rare situations, vitamin B12 (cyanocobalamin) deficiency is usually a result of pernicious anemia, an autoimmune disease of the stomach. Vitamin B12 is required for DNA synthesis, and its deficiency results in large (megaloblastic) nuclei.Diagnosis: Vitamin B12 deficiency, pernicious anemia
3
Vitamin B1 (thiamine)
Vitamin B2 (riboflavin)
Vitamin B12
Vitamin K
Pathology
Environment & Nutritional Pathology
cc40d3a2-ae63-4c4f-aa83-32d663267e66
single
Quadrivalent Meningococcal vaccine is not used for?
Ans. (b) Serotype BRef: Harrison 19th ed. /1002* There are currently three vaccines available in the USA to prevent meningococcal disease, all quadrivalent in nature, targeting serogroups A, C, W-135, and Y.* Meningococcal polysaccharide or conjugate vaccines provide no protection against serogroup B disease and MenB vaccines provide no protection against serogroup A, C, W or Y disease. For protection against all 5 serogroups of meningococcus it is necessary to receive both vaccines.* Only recently vaccine targeting serogroup B has also been created and is protein based.TRADE NAMETYPE OF VACCINESEROGROUPS INCLUDEDYEAR LICENSEDAPPROVED AGESMenomunePolysaqccharideA, C, W, Y19812 year and olderMenactraConjugateA, C, W, Y20059 months-55 yearsMenveoConjugateA, C, W, Y20102 months-55 yearsMenHibrixConjugateC, Y, and Hib20126 weeks-18 monthsTrumenbaProteinB201410-25 yearsBexseroProteinB201510-25 years
2
Serotype A
Serotype B
Serotype C
Serotype Y
Medicine
Bacteriology
23385633-8f8f-4f63-b064-25046cfb2f37
single
In systemic form of JIA, all are true EXCEPT:
RA factor may be positive in polyahritis, but not in systemic onset JIA. Systemic form of JIA: High fever with rash Hepatosplenomegaly Elevated ESR Types of JIA Systemic JIA- Systemic involvement seen Oligoaicular- Affects four or fewer joints, often the knee or ankle. Polyaicular ahritis, rheumatoid factor negative Polyaicular ahritis, rheumatoid factor positive Psoriatic ahritis Enthesitis-related ahritis Undifferentiated ahritis
1
RA factor positive
High fever with rash
Hepatosplenomegaly
Elevated ESR
Pediatrics
Other disorders of bone
345853dc-7475-49a8-adc3-dc05a7189b5b
multi
Which of the following is true regarding IUGR ?
All of the above
4
Asymmetrical IUGR: is far more common than symmetrical IUGR
Ponderal index is normal in symmetrical IUGR
Prognosis is better in asymmetrical IUGR than symmetrical IUGR
All of the above
Gynaecology & Obstetrics
null
32cc5f86-5af3-4630-b997-03fc8d4fbda4
multi
Duct of Bartholins gland opens
Duct of Bartholins gland opens on the inner side of Labium minus external of hymen.
4
On outer side of Labium minus
On inner side of Labium majus
On outer side of Labium majus
On inner side of Labium minus
Gynaecology & Obstetrics
null
97ca9bd4-a163-45db-95bf-6b9808be0659
single
For shield (mould) in eye tumors which of the following is preferred?
Ans. D. Phosphorous-32Some useful radionuclides used in clinical radiotherapyRadionuclideEnergy Half-life Medical uses* Radium-2260.83mv1625 yearsfor brachytherapy but not used now a days* Cobalt-601.25mv5.4 yearsteletherapy & brachytherapy* Caesium-1370.666mv30 yearsteletherapy & brachytherapy* Iridium-1920.380mv72 daysbrachytherapy only* Iodine-1250.030mv60 daysbrachytherapy* Iodine-1310.61mv8 daysunsealed radioiodine for thyroid cancer Rx* Gold-1980.412mv 2.7 days brachytherapy* Strontium-902.24mv30 yearsfor shield (mould) in eye tumors* Phosphorous-321.71mv14 daysintraperitoneal
4
Iodine-131
Gold-198
Strontium-90
Phosphorous-32
Radiology
Miscellaneous
f48f7c7f-c95f-439a-9a59-5b02414e31ae
single
Posterior limb of internal capsule is supplied by all except
Recurrent aery of Heubner does not supply posterior limb of internal capsule. Blood supply of internal capsule Anterior Limb Recurrent aery of Heubner Genu Recurrent aery of Heubner Charcot&;s aery (lenticulostriate aery or aery of cerebral hemorrhage) Posterior limb Charcot&;s aery (branch of middle cerebral aery) Anterior choroidal aery (branch of internal carotid aery) Posterolateral branches of posterior cerebral aery. Sublentiform pa Anterior choroidal aery Posterior cerebral aery Retrolentiiform pa Posterolateral branches of posterior cerebral aery Ref: Gray&;s Anatomy 41st edition Pgno: 286
2
Middle cerebral aery
Recurrent aery of Heubner
Anterior choroidal
Posterior cerebral aery
Anatomy
Brain
5fd8c106-75e0-4d62-a732-b84a83044688
multi
In prayer Willi syndrome, which of the following is increased
Ghrelin is a growth hormone secreatagogue and the only gut harmone with orexigenic propey It is primarily produced in the stomach. In children ,it's value is inversely related with body mass index and insulin values. robbins 8/e 441-2 9/e 444
4
A. LH
B. FSH
C. TSH
D. Ghrelin
Anatomy
General anatomy
254654bc-e37a-4fff-8c83-d291703a9fa0
single
Which of the following is associated with Madonna-Putana complex ?
Madonna-Putana complex Psychogenic male erectile disorder Can be organic or psychologic or both. Inability to have arousal towards a woman , the man desires. Men have arousal only with women whom they see as degraded.
3
Female arousal disorder
Male hypoactive sexual desire disorder
Male erectile disorder
Anorgasmia
Psychiatry
Sexual Disorders
bde66087-8329-4e46-b7ee-e8756bae2d88
single
Ductus arteriosus closes in response to:
b. Indomethacin therapy(Ref: Nelson's 20/e p 2197, Ghai 8/e p 417)Indomethacin, a Prostaglandin inhibitor is used in medical closure of Ductus arteriosus.
2
Decrease in peripheral oxygen saturation
Indomethacin therapy
Prostaglandin E1
Increase in pulmonary vascular resistance
Pediatrics
C.V.S.
99fde1c6-9563-4388-a59f-09f1c20691bb
single
Russel's periodontal index scores range from
null
4
0-2
0-4
0-6
0-8
Dental
null
7b9683cb-70bc-42e1-821d-1ee55352698e
single
A person has unprotected sex 3 weeks back, To rule out HIV infection the best test is
Laboratory diagnosis of HIV infection Laboratory diagnosis is made by: A. Antibody detection It is the most common method used for diagnosis of HIV infection. ELISA is the most sensitive test and therefore is the screening test of choice. Western blot is the most specific (Confirmatory) test and therefore is the’gold standard’ for diagnosis. Antibodies test usually nucleic acid or antigen. B. Detection of HIV nucleic acid or antigen P24 antigen detection by ELISA can be done 16 days after infection (earlier than antibody detection). Nucleic acid detection tests are the earliest to become positive (12 days after infection), Most commonly used test is reverse transcriptase PCR, (RT-PCR), other methods used are DNA-PCR, RNA-PCR, RNA-bDNA (branched DNA), and RNA-NASBA (nuclei acid sequenced based assay). C. Virus isolation Co-cultivation of the patient’s lymphocyte with uninfected lymphocytes in the presence of IL-2. Not suitable as a routine diagnostic procedure. In infected individual HIV can be isolated from Blood Semen Saliva Urine Lymphocytes Cervical secretions Tears Breast milk
1
P 24 antigen assay
ELISA
Western blot
Lymphnode biopsy
Microbiology
null
7686a2bb-8369-4e3d-a666-dcb780c43633
single
All are true about vocal cord nodule except:
Ans:B (Commonly occur at Junction of middle & posterior 1/3 ) VOCAL NODULES (SINGER'S OR SCREAMER S NODES)PL Dhingra 6th/303-04# Their size varies from tha t of pin-head to half a peaThey are the result of vocal trauma when person speaks in unnatural low tones for prolonged periods or at high intensitiesThey mostly affect teachers, actors, vendors or pop singers. They are also seen in school going children who are too assertive <PS# talkativePatients complains of hoarseness. Vocal fatigue & pain in the neck on prolonged phonation are other common symptomsEarly cases of vocal nodules can he treated conservatively by educating the patient in proper use of voice. With this treatment, many nodules in children disappear completelySurgery is required for large nodules or nodules of long standing in adults. They are excised with precision under operating microscope either with cold instruments or laser avoiding any trauma to the underlying vocal ligamentSpeech therapy & re-education in voice production are essential to prevent their recurrenceVocal nodules(Singer's or Screamer's nodes): They appear symmetrically on the free edge of vocal cord, at the junction of anterior one-third, with the posterior two-third, as this is the area of maximum vibration of cord & thus subject to maximum trauma P.L. Dhingra 6th/303Fig. .Vocal nodules. Typically, theyr form at the junction of anterior one- third with posterior two-thirds of vocal cards
2
Caused by phonotrauma
Commonly occur at Junction of middle & posterior 1/3
Common at junction of A 1/3 with P 2/3
Common in teachers
ENT
Larynx
1c706671-8ab5-4528-8872-ab2f005d0f89
multi
Brain abscess in cyanotic heart disease is commonly located in
Brain abscesses in congenital cyanotic heart diseases occur due to hematogenous seeding of bloodborne bacteria. These blood borne bacteria bypass the pulmonary capillary bed d/t right to left shunt. They commonly infect parietal & frontal lobes (territory of middle cerebral artery).
4
Cerebellar hemisphere
Thalamus
Temporal lobe
Parietal lobe
Surgery
null
cbc5f62f-3587-4936-9967-fef25b85fb10
single
Beta blockers are indicated in -
Ans. is 'b' Anxiety Antianxiety Drugs areBenzodiazepinesB BlockersBuspironeMeprobamate & Hydroxyzine
2
Phobic disorders
Anxiety
Schizophrenia
Mania
Psychiatry
Generalized Anxiety Disorder
a8d54e61-b164-450b-a2b8-6644ca290abc
single
All are waterborne diseases except -
Fish tapeworm(Diphyllobothrium latum) Infection is acquired when the person eats undercooked fish containing the parasite and not by drinking water! Park's Textbook of Preventive and Social Medicine, 25th Edition Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine
2
Typhoid
Fish tape worm
HAV
Cholera
Social & Preventive Medicine
Environment and health
f1ac306f-d382-4ea6-90bb-454e56f34cd7
multi
Not true about Fosphenytoin
Fosphenytoin, a more soluble phosphate prodrug of phenytoin, is well absorbed. Fosphenytoin sodium is available for intravenous or intramuscular use and replaces intravenous phenytoin sodium, a much less soluble form of the drug. Used in generalized Tonic-clonic seizures and paial seizures. Highly bound to plasma proteins.Reference: Katzung Pharmacology; 13th edition; Chapter 24; Antiseizure Drugs
3
Used for GTCS
Prodrug of Phenytoin
Lipid soluble
Highly protein bound
Pharmacology
Central Nervous system
193b42a5-b08b-4c48-8958-ca2aaa52485f
multi
All are duties of a medical practitioner except
Doctor should get informed consent from the patient or his relatives after explaining all procedures and risks before doing a surgery DUTIES OF REGISTERED MEDICAL PRACTITIONER TOWARDS PATIENT 1. Duty to exercise reasonable degree of skill and knowledge. 2. Duties in regard to attendance and examination. 3. Duty to furnish proper and suitable medicines. 4. Duty to give instructions. 5. Duties towards children and adults. 6. Consultation with a specialist. 7. Duties in regard to psychiatric patients. 8. Duties in regard to poisoning. 9. Duty to notify ceain diseases. to. Duties in regard to operative procedures. 11. Duties under Geneva convention. 12. Duties in convention with X-rays. 13. Professional Secrecy. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 377
2
A medical practitioner should uphold the dignity and honor of his profession
Doctor need not have to get consent from patient or his relatives regarding the procedures or surgery
In emergencies doctor should execute his moral and humanitarian duty to save the life of a patient
In medicolegal cases, doctor is bound to call the police
Anatomy
null
39737315-2ffa-4f00-b60e-d2b37c9d6425
multi
Which premolar resembles a canine:
null
2
Maxillary first premolar.
Mandibular first premolar.
Maxillary second premolar.
Mandibular second premolar.
Dental
null
84628e7d-4024-4a9c-9210-fdaa5b89c6ac
single
Which of the following drug's use alone is to be avoided in a patient with adrenaline producing pheochromocytoma?
Vasomotor Reversal Of Dale - Adrenaline has biphasic effect on blood pressure. - a1 - Strong receptor thus more effect. - b2 - Sensitive receptor thus stimulated at low dose too. When adrenaline is given IV at high doses 1st BP will increase due to stimulation of a1 > b2 & then BP will decrease due to b2 stimulation. When adrenaline is given IV at high dose with a blocker, exaggerated fall of BP occurs called as Vasomotor Reversal of Dale. In adrenaline producing pheochromocytoma, If person is treated by alpha blocker, then this phenomenon will occur and thus death can occur due to severe hypotension. Therefore alpha blocker is always combined with beta blocker in adrenaline producing tumor.
1
Phentolamine
Enalapril
Clonidine
Methyldopa
Pharmacology
ANS
38a8db59-5e9c-4932-97ad-7a45e05fe75c
single
Which one of the following is an Aldosterone antagonist?
(A) Spironolactone > Spironolactone is a steroid chemically related to the mineralocorticoid aldosterone> Spironolactone is an aldosterone antagonist.
1
Spironolactone
Amiloride
Triameterine
Acetazolamide
Pharmacology
Miscellaneous (Pharmacology)
3cab37ef-d13f-48b2-a541-ebe18e23f69a
single
Disinfection by autoclaving is NOT recommended for -
.sterilizers which operate at high temperatures and pressure are called autoclaves.they generate steam under pressure or saturated steam which is the most effective sterilizing agent.they fall in two categories,grvity displacement autoclaves and high speed pre-vaccum autoclaves.works on the same principle as that of a pressure cooker.widely used in the hospital and laboratry practice.it destroys all forms of life,including spores.most effective method for the sterilization of linen,dressings,gloves,syringes,and culture media.not suitable for sterilization of plastic and sharp instruments. ref:park&;s textbook,ed 22,pg no 120
3
Sputum
Linen
Sharp instrument
Glass syringes
Social & Preventive Medicine
Epidemiology
81456612-8165-4b7a-8400-8590c2718643
single
During bilateral adrenalectomy, intraoperative dose of hydrocoisone should be given after
"Patients undergoing surgery for a primary adrenal adenoma secreting glucocoicoids require preoperative and postoperative steroids due to suppression of the contralateral adrenal gland. Duration of steroid therapy is determined by the ACTH stimulation test. Exogenous steroids may be needed for up to 2 years but are needed indefinitely in patients who have undergone bilateral adrenalectomy. This latter group of patients also may require mineralocoicoid replacement therapy." "Perioperative and postoperative glucocoicoid administration is obviously essential in the care of patients with Cushing's syndrome. For patients undergoing adrenalectomy for Cushing's syndrome, perioperative "stress dose" steroids (hydrocoisone, 100 mg IV every 8 hours for 24 hours) are recommended."
4
Opening the abdomen
Ligation of left adrenal vein
Ligation of right adrenal vein
Excision of both adrenal glands
Anatomy
Endocrinology and breast
7a15499b-b053-476c-a7f0-8dafe5fde521
multi
Prolonged apnea may occur in patients with a genetically determined abnormal variant of cholinesterase following intravenous administration of
Both succinylcholine and mivacurium are completely and rapidly eliminated by plasma cholinesterase. Other nondepolarizing neuromuscular blockers, such as tubocurarine, pancuronium, and atracurium, are eliminated by renal or hepatic mechanisms or by spontaneous hydrolysis (atracurium). Patients with genetically determined atypical cholinesterase may be detected by measuring the inhibition of cholinesterase by dibucaine, a local anesthetic. Dibucaine inhibits the normal enzyme about 80%, but the abnormal variant is inhibited only 20%.
4
Pancuronium
Tubocurarine
Atracurium
Succinylcholine
Anaesthesia
Muscle relaxants
b4544fc6-c748-4378-981b-fb6b46287eb5
multi
Which proton pump inhibitor can be used IV ?
Ans. is 'c' i.e., Pantoprazole Pantaprazole - it is more acid stable and has higher oral bioavailability. It is also available for i.v. administration; paicularly employed in bleeding peptic ulcer and for prophylaxis of acute stress ulcers.
3
Omeprazole
Rabeprazole
Pantoprazole
Fomeprazole
Pharmacology
null
4fb9c253-7910-4396-a1b9-b638e800737a
single
A 25-year-old woman with amenorrhea has never had menarche. On physical examination, she is 145 cm (4 ft 9 in) tall. She has a webbed neck, a broad chest, and widely spaced nipples. Strong pulses are palpable in the upper extremities, but there are only weak pulses in the lower extremities. On abdominal MR imaging, her ovaries are small, elongated, and tubular. Which of the following karyotypes is she most likely to have?
The features described are those of classic Turner syndrome. Individuals who reach adulthood may have mosaic cell lines, with some 45, X cells and some 46, XX cells. A female carrier of the fragile X syndrome, X(fra), is less likely to manifest the disease than a male, but the number of triple repeat sequences (CGG) increases in her male offspring. The 47, XXY karyotype occurs in Klinefelter syndrome; affected individuals appear as phenotypic males. The "superfemale" karyotype (XXX) leads to mild mental retardation. Trisomy 16 is a cause of fetal loss early in pregnancy.
1
45, X/46, XX
46, X, X (fra)
47, XXY
47, XXX
Pathology
Genetics
b226c32d-02b3-4626-92d3-0aada5d3782b
multi
ALL are true about Colles fracture except -
Ans. is 'd' i.e., Garden spade deformity' COLLES FRACTUREo Colles fracture is an extra-articular fracture at the distal end of radius, at its corticocancellous junction. It is the most common fracture in person over 40 years of age and especially in women after menopause (Postmenopausal females). The association of the fracture with osteoporosis is now well established and it is one of the fragility fracture, seen in osteoporosis. The fracture nearly always caused by fall on outstretched hand.Displacement in Colles fractureo The fracture line runs transversely at the corticocancellous junction.o In the majority of the cases, one or more displacements of the distal fragment occuri) Dorsal displacement (Dorsal shift)ii) Dorsal tilt (Dorsal angulation)iii) Lateral displacement (lateral shift)iv) Lateral tilt (lateral angulation)v) Supination (external rotation)vi) Impaction (proximal migration)Clinical features of Colles fractureo Pain and swelling at the wrist.o Typical deformity : There is a dorsal hollow or depression just proximal to the fracture and immediately distal to this there is a marked prominence caused by lower fragment being displaced backwards, carrying with it the whole of the carpus and hand. This gives appearance of a fork, So named dinner fork/ silver fork / spoon shaped deformity.o There is local tenderness.Treatment of colles fractureo Treatment of code's fracture is essentially conservative,o For undisplaced fracture below-elbow cast is given in-situ.o For displaced fractures, the standard method of treatment is to undertake manipulative reduction under local or general anaesthesia.o Technique of closed manipulation involves reversing the typical deformities of Colle's fracture (in following sequence)Disimpaction (by traction) to correct impaction.Palmar flexion & ulnar deviation to correct dorsal tilt / shift and radial tilt / shift.Pronation (internal rotation) :- to correct supination (external rotation),o After reduction below elbow cast is given.
4
In old age
Dorsal shift
At cortico-cancellous junction
Garden spade deformity
Unknown
null
cbf73871-24bd-4f80-b92d-72aa915fc62d
multi
Which of the following is the most common renal vascular anomaly -
null
1
Supernumerary renal arteries
Supernumerary renal veins
Double renal arterires
Double renal veins
Anatomy
null
892576a5-3d68-46f3-baf1-6dffb72fc6f8
single
A 70 year old female with psychiatric symptoms diagnosed of having schizophrenia. Which is the poor prognostic factor in schizophrenia?
Predictors of poorer outcome in schizophrenia:Age below 20Dilated ventricles, brain atrophy in CT or MRINegative symptoms (e.g., flat affect, povey of thought, apathy, asociality); obsessive-compulsive symptomsIrregular occupational recordInsidious onsetSlow rate of progressionmalesYears of duration prior to assessmentCannabis useAbsence of precipitating factorsStressful lifeFamily history of schizophrenia (not affective disorder)Presence of other adverse social factorsPrenatal adverse eventsPresence of ceain gene polymorphism, e.g., COMT. NMDA2APRef: Meltzer H.Y., Bobo W.V., Heckers S.H., Fatemi H.S. (2008). Chapter 16. Schizophrenia. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds),CURRENT Diagnosis & Treatment: Psychiatry, 2e.
1
Acute onset
Middle age
Family history of affective disorder
Gradual onset
Psychiatry
null
faa86e89-7ffa-411c-a4fa-36d8e98c9bda
single
Occlusion of the LAD will lead to infarction of which area -
Occlusion of proximal LAD can result in large anterior wall infarction. If it is distal LAD, then anteroapical or anteroseptal infarction can occur.
2
Posterior part of the interventricular septum
Anterior wall of the left ventricle
Lateral part of the heart
Inferior surface of right ventricle
Anatomy
null
37522fed-eb07-4153-afae-7b1de2e051b6
multi
The slogan for WHO 2005 –
Year → World Health Day (WHD) Theme 2004 → Road safety is no accident 2005 → Make every mother and child count 2006 → Working together for health 2007 → International health security: Invest in health, build a safer future 2008 → Protecting health from climate change 2009 → Health facilities in emergencies
2
Road safety
Maternal and child health
Aging
Physical activity
Social & Preventive Medicine
null
07f998af-96f3-46a3-837a-e29439c9dead
single
Investigation of choice for esophageal rupture is?
ANSWER: (D) Water soluble low molecular weight contrast swallowREF: with textUse of non ionic water soluble contrast medium instead of barium is warranted when there is any risk of aspiration or esophageal leak. (Ref: Gastrointestinal Imaging: The Requisites By Giles W. Boland 4th ed page 2)Careful endoscopic assessment at the end of any procedure combined with a chest X-ray will identify many cases of perforation immediately. If not recognised immediately, then early and late suspected perforations should be assessed by a water-soluble contrast swallow. If this is negative, a dilute barium swallow should be considered. A CT scan can be used to replace a contrast swallow or as an adjunct to accurately delineate specific fluid collections. (Bailey 25th ed page 1015)Diagnosis of an esophageal perforation may be made radiographically. A chest roentgenogram may demonstrate a hydropneumothorax. A contrast esophagram is done using barium for a suspected thoracic perforation and Gastrografin for an abdominal perforation. Barium is inert in the chest but causes peritonitis in the abdomen, whereas aspirated Gastrografin can cause life-threatening pneumonitis. A surgical endoscopy needs to be performed if the esophagram is negative or if operative intervention is planned. (Ref: Sabiston 18th ed chapter 41)
4
Dynamic MRI
Rigid esophagoscopy
Barium contrast swallow
Water soluble low molecular weight contrast swallow
Surgery
Esophageal Perforation
5b3a4457-a5fe-47ac-b6c5-fce7f8ad7712
multi
The incidence of mental illness is the maximum if the causal factors affect a paicular period -
The incidence of mental illness is the maximum if the causal factors affect a paicular period of first five years of life crucial points in the life cycle of human being which are impoant from the view of mental health are prenatal period, first five years of life, school child , adolescence, old age. ref ;(page no;832)23rd edition of PARK&;s textbook of Preventive and Social medicine
2
Perinatal period
First five years of life
School age
Adolescence
Social & Preventive Medicine
Social science, Mental health & Genetics
9cd56341-0590-417b-81b6-36cdafa88d76
single
Brain dead individuals have all of the following features EXCEPT (* NIMHANS March-2017 Post-MBBS, NIMHANS - Feb. 2008)
(C) Only pain is preserved# BRAIN-DEAD> individual has no clinical evidence of brain function upon physical examination.> No response to pain and no cranial nerve reflexes.> Reflexes include pupillary response (fixed pupils), oculocephalic reflex, corneal reflex, no response to the caloric reflex test, and no spontaneous respirations.> In comatose patients, once it has been determined that the cervical spine is intact, a test of the vestibulo-ocular reflex (VOR), also known as the oculocephalic reflex or doll's eye reflex can be performed by turning the head to one side.> Positive response occurs when the eyes rotate to the opposite side to the direction of head rotation, thus indicating that the brain- stem (CN3,6,8) is intact.> Vertical oculo-vestibular eye responses can be assessed by irrigating both ears simultaneously.> If the brainstem is intact, cold water causes the eyes to deviate downwards and warm water causes the eyes to deviate upwards.
3
Dolls eye movement is absent
Oculo-vestibular reflex is absent
Only pain is preserved
Corneal reflex is absent
Anaesthesia
Miscellaneous
310eeb2b-2f15-481d-92f0-6f4b7c1e549a
multi
Miss folded proteins might be produced due to defect of:
Rough endoplasmic reticulum is associated with protein synthesis, protein folding and miss folded protein degradation. Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:10,11,12
3
Cholesterol
Mitochondrial
Rough endoplasmic reticulum
Smooth endoplasmic reticulum
Anatomy
General anatomy
8be51d84-561b-48b8-ada0-baa667efb3a8
single
APGAR score include A/E
Apgar score is an objective method of evaluating the newborn&;s condition. It includes Hea rate, Respiratory effo, Muscle tone, Reflex irritability and Color. It is generally performed at 1min and again at 5 min after bih. Reference : page 126 Ghai Essential Pediatrics 8th edition
3
Respiratory effo
Hea rate
Respiratory rate
Colour
Pediatrics
New born infants
4fa29ea9-bf76-4f1d-a099-a176bb6d76f0
single
Bloom Richardson staging is for?
Ans. (b) Breast cancer(Ref Internet source)Bloom and Richardson grading for cancer breast is based on* Tubules formation* Nuclear pleomorphisms* Mitotic counts
2
Prostate cancer
Breast cancer
Ovarian cancer
Penile cancer
Surgery
Breast
1843ee69-8b1b-412b-8399-e0a332048ce1
single
Which of the following is seen in idiopathic thrombocytopenic purpura:
null
3
Thrornbocytosis
Increased prothrombin time
Increased bleeding time
Increased clotting time
Pathology
null
66e5a34b-7902-4454-8c53-3682f53316af
single
Point B in treatment of Ca cervix corresponds to
B i.e. Obturator Lymph node
2
Mackenrodts ligament
Obturator Lymph node
Isheal tuberosity
Round ligament
Radiology
null
5a4e4b5e-84c7-41f0-92a8-5347a79b0ecb
single
Which is the MOST appropriate gestational age for performing amniocentesis?
Amniocentesis is ideally performed between 14-16weeks of gestation. Early amniocentesis can be carried out at 12-14 weeks under ultrasonographic guidance. The fetal cells so obtained are subjected for cytogenetic analysis. Fetal fibroblasts and fluid for biochemistry are used for study. Chorionic villus sampling : is carried out transcervically between 10 - 12 weeks and transabdominally from 10 weeks to term. Trophoblast cells are used for study. Cordocentesis: Is done between 18-20 weeks of gestation. Fetal WBCs are used for study. Ref: Textbook of Obstetrics By DC Dutta 6th edn page 107-8.
2
10-12 weeks
12-16 weeks
20-25 weeks
25-30 weeks
Gynaecology & Obstetrics
null
b238694b-0485-440c-90be-acbbaff1c551
single
In a 5 year old child, instead of the physiological splitting of second hea sound, expected only during inspiration, a wide and a fixed split of S2 is heard, both during inspiration, as well as expiration. Condition associated with this is?
WIDE FIXED SPLIT OF S2 IS SEEN IN: ASD Right Bundle Branch Block TAPVC WIDE VARIABLE SPITTING OF S2 IS SEEN IN: Pulmonic stenosis VSD Mitral regurgitation
1
Atrial septal defect
Ventricular septal defect
Mitral regurgitation
Pulmonary stenosis
Pediatrics
Acyanotic congenital hea diseases
01c33622-a8d8-4f45-a95e-96998ebbf473
multi
Which of the following drugs is used to treat both diabetes mellitus and diabetes insipidus
null
1
Chlorpropamide
Glibenclamide
Glicazide
Glipizide
Pharmacology
null
3b147043-2a85-4d1b-a67a-a280456bb2f6
multi
Deficiency of purine nucleoside phosphorylase causes
A combined T cell and B cell immunodeficiency that is a rare autosomal recessive metabolic disorder that has material basis in mutation in the PNP gene and characterized mainly by decreased T-cell function. Ref-Sathyanarayana 4/e
2
Complement deficiency
Cellular immunodeficeincy
Humoral immunodeficeincy
Combined immunodeficeincy
Biochemistry
Metabolism of nucleic acids
8569215f-996c-4919-8070-f7bcd5fdbe16
single
Cataracta brunescens result due to deposition of
Nuclear senile cataract: The usual degenerative changes are intensification of the age- related nuclear sclerosis associated with dehydration and compaction of the nucleus resulting in a hard cataract. It is accompanied by a significant increase in water insoluble proteins. However, the total protein content and distribution of cations remain normal. There may or may not be associated deposition of pigment urochrome and/or melanin derived from the amino acids in the lens. The nucleus may become diffusely cloudy (greyish) or tinted (yellow to black) due to deposition of pigments. In practice, the commonly observed pigmented nuclear cataracts are either amber, brown (cataracta brunescens) or black (cataracta nigra) and rarely reddish (cataracta rubra) in colour. Ref:- A K Khurana; pg num:- 176,178
3
Copper
Iron
Melanin
Keratin
Ophthalmology
Lens
5bbdce5d-aafa-4bae-86ad-701e3569c8f8
single
The role of plasmids in conjugation was first described by Lederberg and Tatum(46) in -
null
4
H.influenzae
Corynebacterium
Pseudomonas
Esch.Coli
Microbiology
null
e7d55fd0-47e3-411d-ac10-2dc4567a14a1
single
Viridans streptococci A Include Streptococcus mutans, mitis, sanguis and salivarious B Reliable produce haemolysis on blood Agar plates C Accounts for few cases of infective endocarditis D The men strains of cariogenic streptococcus E Can be isolated from the bloodstream in the majority of patients immediately after dental extraction
null
2
ADC is true
ADE is true
ABC is false
ADC is false
Pathology
null
eea0f062-94a5-4832-97ac-b69ece6cb346
multi
The least extrapyramidal side effects are seen with which of the following phenothiazine?
Side effects of impoant CNS drugs Midazolam Ataxia, Blackouts in elderlyTolcapone Hepatotoxic Phenytoin Hirsuitism , Gingival hyperplasia , Osteomalacia , Teratogen , Megaloblastic anemia , Ataxia, Lymphadenopathy, Hyperglycemia , Arrhythmias, Vitamin K deficiency Valproate Irreversible hepatic necrosis in older children, Acute pancreatitis Zonisamide,, Topiramate Renal stones VigabatrineIrreversible visual field defectsFelbamate Aplastic anemia Thioridazine Male sexual dysfunction, Retinal damage, Least extra pyramidal symptomsClozapine Agranulocytosis , Myocarditis Risperidone Extra pyramidal symptoms HaloperidolExtra pyramidal symptoms , Akathisia Olanzapine Risk of stroke and death Ziprasidone , Pimozide QT prolongation Quetiapine Cataract Iloperidone Ohostatic hypotension Lithium in expectant mothers Ebstein's anomalyFormic acid Retinal damage Opioids Tolerance & addiction (Refer: Rang and Dale's Clinical Pharmacology, 7th edition, pg no: 557-559)
4
Clozapine
Triflupromazine
Fluphenazine
Thioridazine
Anatomy
All India exam
620a2090-2315-4c74-b4f3-888bb0656f83
single
Which is not a variable of MDRD (Modification of Diet in Renal Disease) formula?
TEST : 1. CKD - EPI - cystatin C method (BEST) ; Cystatin - C is produced by nucleated cells 2. Modification of diet in renal disease formula GFR= 186.3 x (serum creatinine level ( mg/dl))-1.154 x age-0.203 x ( 0.742 if female ) x (1.21 if black) 3. Cockroft Gault formula 4. Creatinine clearance 5. Inulin clearance
4
Age
Gender
Race
Weight
Medicine
Chronic Kidney Disease & Diabetic Nephropathy
34f0c089-0cea-4465-8b44-ac596a6e019a
single
Feature of post ovulatory endometrium on ultrasound is:
Ans. is d, i.e. Prominent posterior enhancementRef: Transvaginal Ultrasound by Melvin G. Dodson 1st/ed, p86This is a very important QuestionIMPORTANT: The appearances of endometrium on transvaginal ultrasound during different stages of normal menstrual cycle has been summarized here.A. Just after menstruation (days 3-7)Single hyperechoic thin lines (central endometrial echo)B. At the time of ovulationHalo presentRelatively thin anterior posterior endometrial thickness (<6mm)No posterior enhancementQThree line sign.Q/Trilaminar appearanceC. Luteal phaseMaximum endometrial thicknessHyperechoic endometriumLoss of haloQLoss of three line signQProminent posterior enhancementQ
4
Single hyperechoic thin line
Three line sign
Prominent halo
Prominent posterior enhancement
Gynaecology & Obstetrics
Gynaecological Diagnosis
d7846780-47d2-4499-a96e-ffd79d5e3f3c
single
Kaposi sarcoma is commonly seen in ?
" It occurs predominantly on the skin and can involve viually any organ, perhaps except the brain. The initially described form, now known as classic KS, predominantly involves the lower extremities of elderly men. KS is now the most common tumor seen in HIV-infected patients Ref : Bailey and love surgery text book 27th Ed.
2
Upper limbs
Lower limbs
Head and Neck
Trunk
Surgery
All India exam
a685d38a-b695-48f7-a12e-f5f9631b3046
single
Tension band wiring is indicated in fracture of which of the following ?
Tension band wiring is indicated in the treatment of two types of olecranon fracture. First type is a clean break with separation of the fragments, and second type is comminuted fracture of the olecranon with displced fragments. A crack in the olecranon without displacement is treated by immobilising the elbow in an above elbow plaster slab in 30 degrees of flexion.
2
Fracture humerus
Olecranon
Fracture tibia
Fracture spine
Surgery
null
a0f97d39-a0d2-4734-92c0-21e220abde4f
single
Giant papillary conjunctivitis is seen
It is the inflammation of conjunctiva with formation of very large sized papillae. Etiology :It is a localised allergic response to a physically rough or deposited surface (contact lens, prosthesis, left out nylon sutures). Probably it is a sensitivity reaction to components of the plastic leached out by the action of tears. ref: A K KHURANA OPHTALMOLOGY,E4, Page-77
2
Trachoma
Contact lens
Phlytenular conjunctivitis
Vernal kerato conjunctivitis
Ophthalmology
Conjunctiva
aa618f4a-22da-4ec7-8c8c-cb96c4ca840c
single
Best investigation for pericardial effusion is -
Ans. is 'd' i.e., Echocardiography Investigations o Investiation of choice to identify individual cardiac chamber enlargement - 2D-echocardiography. o Inv estigation of choice for pericardial effusion - 2D-echocardiography. o Investigation of choice for valvular heart disease - 2D-echocardiography. o Investigation of choice for cardiomyopathy -2D-echocardiography. o Investigation of choice for cardiac temponade - 2D-echocardiography. o Investigation of choice for aortic dissection in stable patient - MRl. o Investigation of choice for aortic dissection in unstable patient - TEE. o Investigation of choice for ventricular function and size - Echocardiography o Investigation of choice for congenital heart disease - Echocardiography, o Investigation of choice for pericardial defect - MRI. o Investigation of choice for radiotherapy/chemotherapy induced myocardial damage - Endomyocardial biopsy o Investigation of choice for myocardial perfusion and viability (reversible ischemia) - Nuclear cardiac imaging (thallium scan or Technetium scan) o Most sensitive investigation for air embolism - Trans-esophageal echocardiography. o Second most sensitive investigation for air embolism - PrecordiaJ Doppler o Best x-ray view for right atrial enlargement - Left anterior oblique view, o Best x-ray view for left atrial enlargement - Right anterior oblique view with barium swallow
4
MRI
CT
X ray
Echocardiography
Radiology
Cardiac and Pericardiac Imaging
2fe98876-8ad2-48fa-a194-a2ae1c639f55
single
Histopathology showing large cells with plant like apperance with perinuclear halo is seen in which type of renal cell carcinoma ?
Ans. is 'd' i.e., ChromophobicHistopathological findings of perinuclear halo and plant cell appearance are seen in chromophobe cell carcinoma ofRCC.o Electron microscopic finding consisting of numerous 150-300 nm microvesicles is the single most distinctive and defining feature of chromophobe cell ca.
4
Onchocytoma
Granular cell carcinoma
Angiosarcoma
Chromophobic
Pathology
null
fe8a375f-60e8-4847-be60-00827ca4e430
single
Selective alpha 2 agoinst used in glaucoma -
Brimonidine (0.2% : 2 times/day). It is a selective alpha-2-adrenergic agonist and lowers IOP by decreasing aqueous production. Because of increased allergic reactions and tachyphylaxis rates it is not considered the drug of first choice in POAG. It is used as second drug of choice and also for combination therapy with other drugs Ref.AK Khurana 4th edition page no 223
4
Timolol
Epinephrine
Dipivefrine
Brimonidine
Ophthalmology
Glaucoma
becce6b6-3172-4498-a86f-a688db6c40fc
single
The rate of formation of CSF per day:
5000 c.c.
3
1000 c.c.
2000 c.c.
5000 c.c.
8000 c.c.
Anatomy
null
4c899eb3-f0c6-4bda-bf72-2397a36fbc5a
single
Cells are most sensitive to radiation in:
null
1
G2 phase
G1 phase
G1 phase and early S phase
G2 phase and late S phase
Radiology
null
970d27b0-6c4a-4636-b1e2-81f897da41b9
single
Which one of the following surgical procedures is considered to have a clean-contaminated wound ?
Ans. is 'a' i.e., Elective open cholecystectomy for cholelithiasis
1
Elective open cholecystectomy for cholelithiasis
Herniorrhaphy with mesh repair
Herniorrhaphy with mesh repair
Appendectomy with walled off abscess
Surgery
null
1c552dc4-e2aa-4f81-9f5a-347433c806fd
multi
Esthetics starts with:
null
1
Taking impression
Occlusal rims
Teeth setting
Selection of teeth
Dental
null
0c1c1338-aa15-451f-a378-d584a1e4a053
single
A 63-year-old man with insulin-dependent diabetes develops a black, crusting lesion in the nose and left maxillary sinus. Biopsy reveals nonseptate hyphae, which confirms the diagnosis of what? SELECT ONE.
Mucor is an opportunistic mold that causes mucormycosis. At least 50% of reported cases are associated with uncontrolled diabetes, and many of the remaining patients are immuno- suppressed. It appears as black crusting in the nose and sinuses and spreads rapidly to involve the cerebrum. Biopsy reveals nonseptate hyphae, which confirms the diagnosis. Treatment is directed toward control for diabetic ketoacidosis and use of amphotericin B.
4
Erysipelas
Eczema
Scarlet fever
Mucor mycosis
Surgery
Miscellaneous
f4802146-6def-4136-905e-6f2d462b0cf7
single
Coagulative necrosis is seen in
.
3
TB
Sarcoidosis
Gangrene
Cryptococcal infection
Pathology
All India exam
7f8ee29e-3ad0-4621-9c02-75d1d49e8653
single
Depigmenting agent of choice in in treatment of dermatological disorders is -
<p>DEPIGMENTING AGENTS:- Include agents like hydroquinone(2%-5%),azelaic acid (10%-20%), glycolic acid (6%-12%) and monobenzene. They act by inhibiting tyrosinase enzyme. Hydroquinone is most commonly used.It can be combined with steroids and retinoids in the treatment of melasma. Kligmans regimen- 5% hydroquinone+0.1% tretinoin +0.1% hydrophilic ointment. Newer agents-Arbutin and kojic acid.They lighten hyperpigmented patches. Used in melasma, freckles. {Reference: IADVL textbook of dermatology, vishalakshi Vishwanath pg no.379}</p>
1
Hydroquinone
Zinc
Kojic acid
Azelaic acid
Dental
miscellaneous
8990776d-3cfd-4fd1-9040-1295d4b684ea
multi
The sudden appearance Dumb-bell shaped swelling during third molar nerve block is mainly due to:
null
3
Injection in pterygoid plexus
Injection in parotid gland
Injection into internal maxillary artery
Injection into nasal cavity
Surgery
null
acad0ac8-47e8-470d-872b-4639b6323580
single
Which of the following is true regarding Okazaki fragment?
Ans. C. Several Okazaki fragments must be sequentially synthesized for each replication forka. Okazaki fragments are segments of DNA attached to an RNA initiator component.b. They are related to the lagging strand.c. Helicase acts on the lagging strand to unwind dsDNA.
3
Are segments of RNA attached to an RNA initiator component
Are related to the leading strand
Several Okazaki fragments must be sequentially synthesized for each replication fork
Helicase acts on the leading strand to unwind dsDNA
Biochemistry
Molecular Genetics
00396eba-267a-42cf-af1d-9b45e3dbddcb
multi
The hyperosmolarity of the renal meduila is due to increased content of -
B i.e. Na +
2
K+
Na +
Glucose
Na ++
Physiology
null
3bef0ede-ec7e-49ed-aca2-10c534e51357
single
Paradoxical respiration is seen in
Diaphragmatic palsy Bilateral diaphragmatic paralysisUnilateral diaphragmatic paralysisMost common cause of bilateral diaphragmatic paralysis are:High spinal cord injuryThoracic trauma (cardiac surgery)Multiple sclerosisAnterior horn disease Muscular dystrophyMost patients present with hypercapnic respiratory failure, frequently complicated by cor pulmonale and right ventricular failure, Atelectasis and pneumonia.The degree of diaphragmatic weakness is best quantitated by measuring trans diaphragmatic pressures.Treatment of choice is assisted ventilation for all or pa of each day.If the nerve to the diaphragm is intact, diaphragmatic pacing may be a ble alternativeUnilateral palsy is MC than bilateral, MC cause is nerve invasion from malignancy, usually a bronchogenic carcinoma.Diagnosis is suggested by an elevated hemidiaphragm on the CXR.Confirmation is best established with the "sniff test"(when the patient is observed with fluoroscopy while sniffing, then paralyzed diaphragm will move paradoxically upward due to the negative intrathoracic pressure).Patients with unilateral paralyzed diaphragm are usually asymptomatic, vital capacity and total lung capacity is reduced about 25%.No treatment if CXR is normal and patient is asymptomatic(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2221)
2
Multiple fracture ribs
Diaphragmatic palsy
Bulbar polio
Severe asthma
Pathology
All India exam
3ff98111-521c-49d1-adbe-94a61f36b4e2
single
In this child Which of the following enzymes is likely to be deficient?
Ans. A. HGPRTaseSlide 1 showing nibbling of lips and fingers; slide 2 showing bite marks on hand inflicted by self. Self-mutilation seen in Lesch Nyhan Syndrome; characteristic of the disease in children.Clinical signs and symptoms seen in Lesch Nyhan Syndrome:a. Biochemical: Hyperuricemia, can result ini. Gout (Joint pains)ii. Nephrolithiasis (abdominal pain, may be radiating in nature)iii. Tophib. Neurological:i. Mental Retardation (Poor performance in school)ii. Dystonia, variablec. Neuropsychiatric:i. Aggressive Behaviour (frequent fight, quarreling with siblings)ii. Self-Mutilation Tendency (associated with muscle loss; biting, chewing, etc.)d. Inheritance is XLR, enzyme absent is HGPRTase; in some patient, where the enzyme is not absent, but only diminished, have a less severe condition called Kelley Seegmiller Syndrome, where neurological and neuropsychiatric symptoms are either absent or very mild.
1
HGPRTase
Adenosine deaminase
APRTase
Acid maltase
Biochemistry
Miscellaneous (Bio-Chemistry)
dc3b5e3b-9a1d-4000-8747-8ff108aa2980
single
Musculature of first pharyngeal arch is supplied by which cranial nerve?
Musculature of the first pharyngeal arch includes the muscles of mastication (temporalis, masseter, and pterygoids), anterior belly of the digastric, mylohyoid, tensor tympani, and tensor palatini. The nerve supply to the muscles of the first arch is provided by the mandibular branch of the trigeminal nerveRef: Langman's embryology 11th edition Chapter 16.
1
V
VII
IX
X
Anatomy
null
44f0c695-f77a-4458-800a-e80df0764407
single
which of the following antidepressent causes hypeensive crisis
MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction Ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no, 955
4
dapoxetine
duloxetine
clomipramine
phenelezine
Psychiatry
Pharmacotherapy in psychiatry
e57a329a-1aa2-4b8b-96f6-587f69390031
single
All the following polyps are premalignant except:March 2011
Ans. C: Hyperplastic polypsIt is now appreciated that hyperplastic polyps are without malignant potentialJuvenile polyps that are single and have been completely excised carry no significant increased risk of malignancy. Multiple juvenile polyps can be a sign of the familial juvenile polyposis syndrome. This has a significant risk (approximately 10 per cent) of subsequent colon cancer and also a possible increased risk of cancers of the stomach and duodenum (first pa of the small intestine).Juvenile polyposis (JP)Autosomal dominant.Multiple hamaomatous polyps of the colorectum (98%), stomach (13%), small bowel (6%)Juvenile polyps are usually pedunculated, smooth, lobulated with a vulnerable surface.Diagnostic criteria:- 5 or more juvenile polyps in the colon or rectum; OR- One juvenile polyp and positive family history of JP; OR- Juvenile polyps outside the colon or rectum, i.e. stomach/small bowel.Family history positive in 20-50%, suggesting high incidence of spontaneous mutations or low penetrance.Children/ adolescents often presents with iron deficiency anemia, hypoproteinemia and retarded growth. Also rectal prolapse or other congenital abnormalities (15%) in CVS, Urogenital tract and CNS.Cancer risk:- Increased risk, lifetime risk of 20-60% for colorectal cancer.- Median age at diagnosis is 35-40 years.- Increased risk for gastric and duodenal cancersGenetic testing- Germline mutations of the SMAD4 and BMPR1A are detected in 11-25% and 18-30% of patients of JPC.- Gastric polyposis seems to be more frequent and severe in patients with SMAD4 mutations.Treatment- Colectomy and gastric surgery in severe polyposis.Familial adenomatous polyposis (FAP)<1% of all colorectal cancers.Autosomal dominant inherited disease, > 100 colorectal adenomas, caused by germline mutations of the tumor suppressor gene APC (detectable in 80-90% of patients with typical FAP) Prevalence 1:10000 with penetrance close to 100%.25% of patients with FAP do not have positive family history. These are de novo germline mutations.Polyp development stas in distal colorectum at an average age of 15Majority of patients become symptomatic with bloody diarrhea by the age of 25Extracolonic manifestation:- Up to 90% of patients with FAP develop polyps in upper GIT- 30-40% gastric fundic gland polyposis and 5-10% gastric adenomas- Risk for gastric cancer not increased.Major causes of death in colectomized FAP patients are duodenal and ampullary cancer.Spigelman classification for polyposis in upper GIT to allow adequate follow up.Extra-intestinal manifestation of FAP include:- Desmoid tumours (10-20%)- Epidermoid cysts (30-50%)- Fibromas- Osteomas (often in the mandibula)Congenital hyperophy of the retinal pigment epithelium (70%)- Dental abnormalities. Gardner's syndrome:- Polyposis, epidermoid cysts, osteomaTurcot's syndrome in FAP- Polyposis, CNS tumours (medulloblastoma)Increased risk observed for:- Hepatoblastoma, follicular thyroid cancer, brain tumours (usually medulloblastoma).Treatment:- Procedure: Proctocolectomy with ileal-pouch-anal anastomosis (IPAA): Gold standard.Peutz Jeghers syndrome (PJS)Autosomal dominant.Special type of hamaomatous GI polyp (PJ polyp) and mucocutaneous melanin pigmentations.PJ polyps occur throughout alimentary tract with predilection for the small bowel.Mostly jejunal. Esophagus is spared. Rarely nose, gallbladder and ureter.Polyps characterized by extensive smooth muscle aborization throughout polyp.Pigment lesions in 95% of patients but may disappear with age. Mostly lips, peri-oral and intra-oral mucosa.Diagnostic criteria:2 or more PJ polyps- One PJ polyp and mucocutaneous pigment lesion- One PJ polyp and positive family history of PJS.Endoscopic or surgical excision of large or symptomatic polyps is recommended.Family history is negative in up to 45% of index cases indicating de novo germline mutations.Recurrent colicky abdominal pain due to intussusception in adolescence or young adulthood. Also occult bleeding with iron-deficiency anemia. Pigmentation not always present in childhood and may fade later in life.Intra-epithelial neoplasia predisposes to cancer - hamaoma-adenoma-carcinoma sequenceCancer risk:- 85% by age 70 years- 57% GI cancer.- Colorectal cancer most common with lifetime risk of 39%. Lifetime pancreatic cancer risk is 11%.Extraintestinal cancers include breast risk (31-50%), endometrium and ovary.Cancer uncommon before age 30 years.Almost all female patients with PJS develop potentially malignant ovarian tumour, the sex cord tumour with annular tubules (SCTAT). Malignant transformation in 20% of all cases. Seoli cell tumours considered as male equivalent of SCTAT with gynaecomastia.Genetic testing- PJS is caused by germline mutation of the STKII tumour suppressor gene.
3
Juvenile polyposis syndrome
Familial polyposis syndrome
Hyperplastic polyps
Peutz Jegher syndrome
Pathology
null
55a8d7f0-9b62-4427-a647-ae70472e07a2
multi
In an elective lap cholecystectomy with no gross spillage, antibiotics required are
Elective lap cholecystectomy is a clean-contaminated surgery, single preoperative IV antibiotic during decisive period is sufficientThere is no evidence that fuher doses of antibiotics after surgery are of any value in prophylaxis against infectionWhen wounds are heavily contaminated or when an incision is made into an abscess, a 5-day course of therapeutic antibiotics may be justifiedRef: Bailey and Love 27e pg: 53
3
Single dose of Preoperative IV antibiotic followed by a 5 day course of oral antibiotics
Post operative IV antibiotics for 1 day followed by a 5 day course of oral antibiotics
Single dose of Preoperative IV antibiotic only
5 day course of oral antibiotics only
Surgery
General surgery
e57551b1-32bf-4f6c-b97a-d61c6d6e34f7
single
Glomerulonephritis is due to -
null
3
Type I hypersensitivity reaction
Type IV hypersensitivity reation
Immune complex deposition
Type V hypersensitivity reaction
Pathology
null
bab20f1d-ba62-432d-8dd9-84919ce532bf
single
All of the following may be used to treat Acute Hypercalcemia Except:
Answer is D (Gallium Nitrate) Gallium Nitrate exes s hypocalcemic effect by inhibiting calcium resorption from bone. Maximum hypocakemic effect of gallium nitrate may take 3-4 days to appear and it is not often used now because of availability of superior alternatives. Gallium nitrate is the single best answer of exclusion. Treatment of Hypercalcemia Onset of Action Hydration with Saline Hours Forced diuresis (saline + loop diuretic) Hours Calcitonin Hours Intravenous phosphate Hours Pheomycin / Mithromycin Hours Dialysis Hours Biphosphonates Days (1 to 2 days) Glucocoicoids Days Gallium Nitrate Days (3-4 days)
4
Hydration with saline
Calcitonin
Biphosphonates
Gallium Nitrate
Medicine
null
999d1c70-f7cf-4e71-9fd3-928ed7b9ae06
multi
Hampton's line is feature of
'Hampton's line' :- - is thin radiolucent line seen at the neck of a gastric ulcer in barium studies - it is seen in benign gastric ulcer - it's caused by thin line of mucosa overhaning ulcer's crater Hampton's line Carman Meniscus sign - (in Malignant gastric ulcer) Duodenal ulcer: - is associated with increased acid secretion caused by higher incidence of H.Pylori infection - duodenum is often deformed along its inferior margin - chronic gastric ulcer gives Trifoliate appearance
1
Benign ulcers
Malignant ulcers
Both
None of the above
Radiology
Gastrointestinal Radiology
010a4abd-0de8-4463-ad39-1e1fac9c021f
multi
Advantage of single chamber incinerator is
null
3
Effective for thermally resistant articles
Useful for cytotoxic drugs
Good disinfection efficiency
Low pollutant emissions
Social & Preventive Medicine
null
d4f9de55-b63f-4142-9c8d-495eb9a2bb50
multi
A patient developed breathlessness and chest pain, on second postoperative day after a total hip replacement. Echo-cardiography showed right ventricular dilatation and tricuspid regurgitation. What is the most likely diagnosis?
The clinical history corresponding to the diagnosis of pulmonary embolism. For a patient presenting with acute breathlessness and chest pain and in whom right ventricular dilatation with tricuspid regurgitation and mild elevation of pulmonary aery pressure is noted, a pulmonary embolus should be the initial diagnosis to be considered. Ref: Deep Vein Thrombosis and Pulmonary Embolism, Page 253, 254; Feigenbaum's Echocardiography, 7th Edition, Page 762.
2
Acute MI
Pulmonary embolism
Hypotensive shock
Cardiac tamponade
Surgery
null
1ef63795-7bef-4c88-8824-9d6ea36b147c
single
Dimorphic with subcutaneous Mycosis is
Sporotrichosis: Dimorphic fungi Causes subcutaneous infections.
3
Histoplasmosis
Rhinosporidiosis
Sporotrichosis
Blastomycosis
Microbiology
null
d8dbe580-286b-4b6a-bbe8-bc7c8a4a27d8
single
The phenomenon of conception of a woman due to deposition of semen on vulva without vaginal penetration is called as
FECUNDATION AB EXTRA: The conception of the female due to deposition of semen on the vulva, without penetration of the vagina - The insemination occurs due to the passage of spermatozoa from external genitalia to the uterus. Ref - Krishnan Vij 5th edition pg 395 , 404
3
Superfoetation
Superfecundation
Fecundation ab extra
Vaginismus
Forensic Medicine
Sexual offences and infanticide
781f2930-ccfc-4966-889e-4892519c48cd
multi
Pilocarpine reduce the intraocular pressure in person with closed angle glaucoma by
Refer kDT 7/e p 156 It has also been used in the treatment of chronic open-angle glaucoma and acute angle-closure glaucoma It acts on a subtype of muscarinic receptor (M3) found on the iris sphincter muscle, causing the muscle to contract -resulting in pupil constriction (miosis). Pilocarpine also acts on the ciliary muscleand causes it to contract. When the ciliary muscle contracts, it opens the trabecular meshwork through increased tension on the scleral spur. This action facilitates the rate that aqueous humor leaves the eye to decrease intraocular pressure
3
Reducing aqueous humour secretion
Contacting iris spincter muscle
Increasing aqueous humour outflow
Relaxin ciliary muscle
Pharmacology
Autonomic nervous system
eb77de2e-b112-48a9-a06f-17f6eb732342
single
48 year old male reported with the chief complaint of ulcer on the gums and on general examination headache, fever and malaise was observed. On oral examination, sharply punched out crater-like erosions of the interdental papillae of sudden onset were noted. The patient also complained of bad breath. Diagnosis is
null
1
ANUG
Pericoronitis
Chediak Higashi diseases
Desquamative gingivitis
Dental
null
f360e887-b066-4a7d-9231-c516a7ed6532
single
A variety of basic assays are used to detect autoantibodies. Nephelometry is based on the principle of:
Nephelometry measures the interaction of antibodies and antigens in solution, detecting immune complex formation by monitoring changes in the scattering of an incident light. Ref: Imboden J.B. (2007). Chapter 3. Laboratory Diagnosis. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Rheumatology Diagnosis & Treatment, 2e.
1
Light attenuated in intensity by scattering
Refraction of light
Reduced transmission of light
Filtration of solutes by kidney
Biochemistry
null
3b08b774-7629-472b-a942-12e036390577
single
Stocker&;s line is seen in
Pterygium It presents as a triangular fold of conjunctiva encroaching the cornea in the area of the palpebral apeure, usually on the nasal side, but may also occur on the temporal side. Deposition of iron seen sometimes in corneal epithelium anterior to advancing head of the pterygium called as stocker's line. Pas. A fully developed pterygium consists of three pas: i. Head (apical pa present on the cornea), ii. Neck (limbal pa), and iii. Body (scleral pa) extending between limbus and the canthus. Stocker's line in pterygium. Pterygium is a fibrovascular proliferative disorder in which conjunctival tissue grows medially to cover the clear cornea. On slit-lamp examination showed marked pterygium that extend from the nasal side of bulbar conjunctiva onto the cornea in the left eye Ref: Khurana; 4th ed; Pg 80
2
Pinguecula
Pterygium
Congenital ocular melanosis
Conjunctival epithelial melanosis
Ophthalmology
Conjunctiva
c60ee27b-cb30-4075-8c71-925f924f5ffe
single
For large country surveys the sampling method of choice is:
null
4
Multiple sampling
Multiphase sampling
Cluster sampling
Multistage random sampling
Dental
null
692c6007-583e-4064-8da3-cdc9e0e7eba3
single
Which one of the following congenital hea diseases has cyanosis without cardiomeglay and/ or congestive hea failure -
Ans. is 'b' i.e., Fallot's Tetralogy Cardiomegaly and CHF do not occur in Fallot's tetrology. No Cardiomegaly o First you should know the following facts : ? i) Pressure overload to ventricles causes concentric hyperophy without dilatation. ii) Volume overload to ventricles causes hyperophy with dilatation --> Eccentric hyperophy. o Due to pulmonary stenosis, there is pressure overload to right ventricle --> Concentric hyperophy of right ventricle without dilatation - No Cardiomegaly. No CHF o The VSD of TOF is always large enough to allow free exit to the right to left shunt. Since the right ventricle is effectively decompressed by the VSD, CHF never occurs in TOF.
2
Transposition of great aeries
Fallot's tetralogy
Congenital mitral regurgitaion
Congenital pulmonary stenosis
Pediatrics
null
2b8471ac-4de7-45a0-b962-609963eb110e
multi
True about stomach carcinoma -
Answer 'a' i.e. Weightloss is commonest feature Symptoms of gastric cancer Earliest symptom is usually vague postprandial abdominal heaviness Most common symptom is weight loss Other symptoms are: - anorexia - abdominal pain (usually not severe) vomiting may be present and becomes a major feature if pyloric obstruction occurs. It may have coffee-ground colour due to bleeding by the tumor. - dysphagia may be the presenting symptom if the lesion is at the cardia. Paraneoplastic symptoms such as - Trousseau's syndrome (thrombophlebitis) - Acanthosis nigricans (hyperpigmentation of the axilla and groin) - Peripheral neuropathy Option b & c Spread of gastric carcinoma - intramural spread within the submucosa - direct spread through the gastric walls - lymphatic spread hematogenous - transperitoneal through peritoneal seedlings about option 'b' - I am not very sure, but it appears to be uncorrect. Most common secondaries are noted in intrabdominal and supraclavicular lymphnodes. Liver is the most common site for hematogenous spread of tumor (Harrison 16/e, p 525) Option 'd' - Barium meal is -75% sensitive for gastric cancer and is the simplest study to perform but it is not confirmatory. Endoscopy with biopsy is always needed if gastric Ca is suspected, to confirm the diagnosis. Harrison 16/e, p 526 writes - "Gastric adenocarcinoma is a relatively radioresistant tumor and adequate control of the primary tumor requires doses of external beam irradiation that exceeds the tolerance of surrounding structures, such as the bowel mucosa and the spinal cord. As a result, the major role of radiation therapy in patients has been palliation of pain."
1
Weightloss is commonest feature
Secondaries are most commonly seen in peritoneum & omentum
Lymphatic & hematogenous spread are rare
Barium meal is diagnostic
Surgery
null
ff841224-49b7-48ad-8f23-764dd666f848
multi
The control for mastication is normally exercised by
null
2
Pontine centres
Sub cortical centres
Cerebellar centres
Medulla centres
Physiology
null
432cddb2-0b5d-4b6b-a83f-ce1e81004ef7
multi
Which of the following organism is most commonly considered responsible for SIDS especially after giving honey to the neonate or infant?
Ans. A. Clostridium botulinum.(Ref. Nelson Textbook of Pediatrics, 19th ed. Chapter 367)Sudden infant death syndrome# Sudden infant death syndrome (SIDS) is the unexpected, sudden death of a child under age 1 in which an autopsy does not show an explainable cause of death.# SIDS is most likely to occur between 2 and 4 months of age. SIDS affects boys more often than girls. Most SIDS deaths occur in the winter.# The following have been linked to a baby's increased risk of SIDS:# Sleeping on the stomach# Being around cigarette smoke while in the womb or after being bom# Sleeping in the same bed as their parents (co-sleeping)# Soft bedding in the crib# Multiple birth babies (being a twin, triplet, etc.)# Premature birth# Having a brother or sister who had SIDS# Mothers who smoke or use illegal drugs# Being bom to a teen mother# Short time period between pregnancies# Late or no prenatal care# Living in poverty situations# Honey is the one identified, avoidable source of C botulinum spores for susceptible infants.# Because botulinal toxin is the most potent poison known (about 10-9 mg per kg of body weight given intravenously being a lethal amount for man), it appeared possible that rapid in vivo production of botulinal toxin might in some infants lead to sudden death if upper airway obstruction or apnea resulted from flaccidity of airway and respiratory muscles.# In a British study released May 29, 2008, researchers discovered that the common bacterial infections Staphylococcus aureus and Escherichia coli appear to be risk factors in some cases of SIDS.
1
Clostridium botulinum
Staphylococcus aureus
E. coli
Clostridium perfringens
Pediatrics
Infection
fb542d69-0e84-4c23-b075-ba0fd87f35d0
multi
A patient consults a dermatologist about a skin lesion on her neck. Examination reveals a 1-cm diameter,red, scaly plaque with a rough texture and irregular margins. Biopsy demonstrates epidermal and dermal cells with large, pleomorphic, hyperchromatic nuclei. Which of the following conditions would most likely predispose this patient to the development of this lesion?
The lesion is a squamous cell carcinoma of the skin. Actinic keratosis, which is a hyperplastic lesion of sun-damaged skin, predisposes for squamous cell carcinoma. Another predisposing condition to remember is xeroderma pigmentosum, which predisposes for both squamous cell and basal cell carcinomas of skin. A nevus is a mole, containing characteristic cells called nevocellular cells. If the nevocellular cells are located at the dermal-epidermal junction (junctional nevus), in the dermis (dermal nevus), or both (compound nevus) they do not predispose for squamous cell carcinomas of the skin. Ref: Vujevich J.J., Goldberg L.H. (2012). Chapter 246. Cryosurgery and Electrosurgery. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick's Dermatology in General Medicine, 8e.
1
Actinic keratosis
Compound nevus
Dermal nevus
Junctional nevus
Skin
null
acd6b8e6-00d7-4195-bdb9-b2be3b5a842d
single
In Osteomalacia
Rickets / Osteomalacia Pathophysiology - Failure of calcification & mineralization of cailage and osteoid tissue Clinical featuresRadiological featuresGeneralized muscle weakness, lethargy, irritability and listlessness Protuberant abdomen Large head, open fontanelles and craniotabesThickening of knees, ankle & wrists due to physeal overgrowth Rachitic rosary Harrison's groove Pectus carinatumSho stature & bowing of long bones with genu valgum, coxa vara, kyphoscoliosis Elongation of physis & hazy appearance of provisional zone of calcification Widened growth plate Cupping of metaphysis Splaying and flaring of epiphysis Bowing of diaphysis with thinning of coices OsteopeniaLooser's zone Biconcave codfish veebra Thoracolumbar kyphosis Trefoil & Champagne glass pelvis (Refer: Tachdijian'spaediatric Ohopedics, 5th edition, pg no: 1685-1696)
2
Osteoid formation is defective
Mineralization of bone is defect
Both
None
Pathology
All India exam
9b7360d2-19d4-4652-bfa3-81dcb280c769
multi
Frotteurism:
Ans. (c) Pleasure in touching opposite sexRef: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. / 404* FROTTEURISM: rubbing the genitalia with the body of the person of other sex for sexual satisfaction.* Paraphilias: Abnormal 8c unorthodox sex play by using unusual objects or parts are know as paraphilia eg. Sadomasochism, Transvestism, Bestiality, Frotteurism, Homosexuality etc.* Bisexuality means hermaphrodite; an individual with both ovary 8c testis 8c external genitals of both sexes.Different Paraphilias/PerversionSexual perversionMode of sexual pleasureSadismPleasure in giving pain to sexual partnerMasochismPleasure on receiving painful stimulus from sexual partnerBondageSadism + masochism are found togetherFetischismSexual gratification by article of opposite sexFrotteurismSexual gratification by contact. Ex: rubbing genitalia on another personExhibitionismSatisfaction in exhibition of genitals with or without mastutbationTransvestism/ EonismPleasure in wearing clothes of opposite sexUranismSexual gratification by fingering, fellatio, cunnilingus etc.Buccal coitus or Sin of GomorrahFellatio is oral stimulation of penis by male or femaleCunnilingus is oral stimulation of female genitalsVoyeurism/ ScotophiliaAlso known as Peeping tomDesire to watch sexual intercourse or toobserve genitals of othersTrolismExtreme degree of voyeurism. Ex: A perverted husband enjoy watching his wife having sexual intercourse with another man.Urolangia/ CoprophiliaSexual excitement by sight or odor of urine or faeces.Tribadism/ LesbianismGratification of sexual desire of a women by another womenSodomy or Buggery of Greek Love* Anal sex* Gerantophilia -when passive agent is adult* Paederasty - when the passive agent is young boy (catamite)IncestSexual intercourse with close relativeBestialitySexual intercourse by a human being with a lower animal
3
Pleasure in watching intercourse
Pleasure in using article of opposite sex
Pleasure in touching opposite sex
Pleasure in wearing opposite sex clothes
Forensic Medicine
Sexual Offenses and Dowry Death
fb319f93-1dcd-4436-9e58-3510601e0035
single
A 23-year-old woman is noticed to have irregular pupils on routine examination. She has 1 large pupil, which has minimal response to light stimulation, but it does respond to accommodation. The eye movements are normal and she experiences no double vision.For the above patient with a pupillary abnormality, select the most likely diagnosis.
The tonic pupil (Holmes-Adie syndrome) is caused by a parasympathetic lesion at or distal to the ciliary ganglion. The pupil is large and usually unilateral, with absent response to light. A bright room, by causing constriction of the normal pupil, accentuates the anisocoria. The tonic pupil can be associated with Shy-Drager syndrome, amyloidosis, or diabetes. However, it is most commonly seen in otherwise healthy young women.
3
essential anisocoria
Horner syndrome
tonic pupils (Holmes-Adie syndrome)
Argyll Robertson pupils
Medicine
C.N.S.
f0e1adc0-eeb7-43ed-b013-27f0a855961f
multi
Which of the following is secreted by TRH stimulation?
TRH is derived from a pro-TRH peptide. Like other hypothalamic-releasing hormones, TRH reaches the anterior pituitary the hypothalamic-pituitary poal circulation. It interacts with specific receptors on pituitary thyrotrophs to release TSH and on mammotrophs to release prolactin. Ref: Textbook of Endocrine Physiology edited by William J. Kovacs, Sergio R. Ojeda, 2011, Page 324; Guyton's physiology, 22nd edition, Table 74-1 Page 907
3
Prolactin only
TSH only
Both
None
Physiology
null
1bd49804-a4fe-442d-9eb0-a8f312d821f6
multi
All of the following are components of withdrawl reflex except
Inverse stretch reflex is not component of withdrawl reflex.
3
Flexor reflex
Reciprocal reflex
Inverse stretch reflex
Crossed extensor reflex
Physiology
null
58a95510-6a04-40db-8ca9-7fab40b5a20c
multi
Nutrient and oxygen reach the chondrocytes across perichondrium by
an impoant fact about cailage matrix is that it is avascular, i.e. not supplied by capillariestherefore, chondrocytes within the matrix must receive nutrients and oxygen by diffusion from vessels that lie outside the cailagethis long-distance diffusion is possible because of the large volume of water trapped within the matrix(Refer: Manish Kumar Varshney's Essential Ohopedics Principles & Practice, 1st edition, pg no. 7, 347)
2
Capillaries
Diffusion
Along neurons
Active transpo
Orthopaedics
All India exam
5161f3fb-1046-47e2-916f-e7266c0fb377
single
A 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they say that he has been muttering to self and gesticulating. There is no of psychiatric illness. Likely diagnosis is:
B i.e. Acute psychosis- Delusions or hallucinations (suchas hearing voices in this case) with grossly disorganized speech and behavior (such as muttering to self, gesticulation, aggressiveness in this case) of acute onset with normal cognition & consciousness indicate the diagnosis of acute psychosis (i.e. psychosis of acute onset). This acute psychosis may be d/t psychotic disorder d/t general medical condition (such as high fever as in this case) or d/t brief psychotic disorder (DSMIVTR), or d/t acute and transient psychotic disorder (ICD-10). So here the term acute psychosis is used to depict the clinical picture not the cause of that clinical picture.Delirium can also present acute onset disorganized behavior (agitation) and speech (incoherent) with delusions or hallucinations but the delusions are poorly elaborated & transient, the course of disease is fluctuant (eg sun downing). And characteristically there is clouding of (disturbance in) consciousnesss (i.e. reduced clarity of awareness of the environment) and disorientation (change in cognition) in delirium. Just like psychosis clinical picture of delirium may also be d/t various reasons such as general medical condition / substance intoxication/ withdrawal.- Dementia is a chronic slow/insiduous process presenting with decrement in intellectual abilities (such as sho & long term memory, judgement, abstract thinking, impulse control, personal care and personality)Q.- Delusional disorder presents with nonbizarre delusions (involving situations that occur in real life) of at least 1 months durationQ. Apa from the impact of delusion (s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre (i.e. criteria. A of schizophrenia has never been met). However, tactile or olfactory hallucinations may be present if they are related to delusional theme.
2
Dementia
Acute psychosis
Delirium
Delusional disorder
Psychiatry
null
7c2228ca-b770-4cd6-b018-66056347cfb9
single
Spuriously high BP is seen in A/E :
A i.e. Auscultatory gap
1
Auscultatory gap
Small cuff
Thick calcified vessels
Obesity
Physiology
null
ae07a1ce-0a25-4c82-b449-3a1e5236d5d1
multi
All are Glucogenic hormones except?
Ans. A ADHRef: Ganong, 25th ed. pg. 442Glucagon, thyroxine, cortisol and growth hormone increase blood sugar levels and are glucogenic. ADH regulates water re-absorption via the collecting duct.
1
ADH
Glucagon
Thyroxine
Glucocorticoids
Physiology
Endocrinology metabolism
9c383034-fada-4007-90b1-1cfe243e153c
multi
Which type of Human papilloma virus is most commonly associated with Cervical cancer ?
Genital HPV infection is extremely common and most often cause no symptoms. A propoion of individuals infected with low-risk HPV types such as HPV-6 or HPV-11 will develop genital was, whereas a subset of women with high-risk HPVs such as HPV-16 or HPV-18 will develop preneoplastic lesions of cervical intraepithelial neoplasia (CIN). Low-grade cervical dysplasias are common and most regress spontaneously. In contrast, the minority of lesions that progress to high-grade dysplasias tend to persist and/or progress to carcinomas in situ before becoming invasive cancers. The majority of adenocarcinomas of the cervix and of squamous cell cancers (SCC) of the vulva, vagina, penis and anus are caused by HPV-16 and HPV-18 (together accounting for about 70% of cases globally), the remaining 30% being due to other high-risk HPV types (such as HPV-31, -33, -35, -39, -45,-51, -66). HPV is also associated with other cancers of the anus, head and neck, and rarely, recurrent respiratory papillomatosis in children.
1
HPV 16
HPV 24
HPV 32
HPV 36
Gynaecology & Obstetrics
null
bdb1d94e-5332-4c82-a219-5c5d3fc7dcbe
single
Ashley's rule is used to :
Ashley's rule States that male sternum lenth will be more than 149mm and female sternum lenth will be less than 149mm.
2
Determine age using sternum
Determine sex using sternum
Determine age using mandible
Determine sex using mandible
Forensic Medicine
null
a85372d9-9495-4123-a848-4af2e297a3d6
single