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Ebstein anomaly is known teratogenic effect due to this drug: | (Ref: Katzung, 14th ed. pg. 527)* Lithium is DOC in manic disorder.* DOC for prophylaxis of mania: Lithium* DOC for acute attack of mania: Sedative + Atypical antipsychotics* DOC for mania in pregnancy: Atypical antipsychotics* Side effect of lithium (Mn: LITTH)# L: LEUCOCYTOSIS# I: Insipidus diabetes# T: Tremors (MC side effect- Coarse tremor)# T: Teratogenic (Ebstein anomaly)# H: HypothyroidismTherapeutic Plasma concentration of Lithium* Acute mania: 0.8-1.4mEq/L* Prophylaxis: 0.5-0.8mEq/L* Toxic plasma cone level:>2mEq/L | 3 | Clozapine | Phenytoin | Lithium | Lamotrogine | Pharmacology | C.N.S | c208136e-f01f-4dfd-9666-d6dfeadfd8c5 | single |
Recent nobel prize for - | null | 1 | RNA i | Lipoxin | T beta transcription factor | Mitochondrial DNA | Microbiology | null | 90148cb8-a5f2-418f-8af5-be80853e7e50 | single |
If a fibrinolytic drug is used for the treatment of acute myocardial infarction, the adverse effect most likely to occur is: | Bleeding is the most common adverse effect of anticoagulants, antiplatelets and fibrinolytic agents. Bleeding can manifest as hemorrhagic stroke in pts. on fibrinolytics therapy such as- Alteplase, Retaplase, Streptokinase. C/I of Fibrinolytics :- H/O Hemorrhagic Stroke H/O NON Hemorrhagic Stroke (within 1yr) Suspicion of aoic dissection Marked hypeension (SBP>180mm Hg and DBP>110mm Hg) Active internal bleed (Excluding menses) | 4 | Acute renal failure | Development of antiplatelet antibodies | Encephalitis secondary to liver dysfunction | Hemorrhagic stroke | Pharmacology | Hematology | 583294f9-4cc8-4b74-b445-6d38cd1fdfc3 | single |
Most impoant indicator of successful neonatal resuscitation: | Most impoant indicator of successful neonatal resuscitation - Increase in hea rate. | 3 | Color change | Improved air entry | Increase in hea rate | Bilateral chest movements | Pediatrics | Neonatal Resuscitation | bcffe1d6-16f0-4ceb-a7d8-efbd80de1c5d | single |
In an after coming head the following bone is perforated during decapitation: | null | 1 | Occiput | Parietal | Palate | Frontal | Gynaecology & Obstetrics | null | bb5756b8-129f-49a7-9565-db32001f9888 | single |
Courvoiser's law exception | Answer- A. Double impactionCourvoisier's law states that in the presence of an enlarged gall bladder which is nontender and accompanied with jaundice the cause is unlikely to be gallstones. This is because gall stones areformed over alonger period oftime, and this result in a shrunken, fibrotic gall bladder which does not distend easily.Exception to Courvoiser's law:Double impactionPancreatic calculus obstruction ampullaOiental cholangio hepaticMitizzisyndrome | 1 | Double impaction | Poal lymphademopathy | Periampullary CA | None | Surgery | null | 346a8a7b-20f4-461a-aec8-726a9f87a187 | multi |
Which drug is vassopressin V2 receptor selective agonist - | Ans. is 'b' i.e., Desmopressin o Lypressin - Agonist on V1 & V2.o Desmopressin - Selective V2 agonisto Terlipressin - Prodrug of vasopressin. | 2 | Lypressin | Desmopressin | Terlipressin | None | Pharmacology | Diuretic | 036bad02-0362-4fcd-8581-8303c9809768 | multi |
About Vi polysaccharide vacine, true is: | Ans. is (a) Can be given in patients with yellow fever and hepatitis B Yellow fever is not a contraindication for VICPS typhoid vaccine. | 1 | Can be given in patients with yellow fever and hepatitis B | Has many contraindications | Has many serious systemic side effects | Has many serious local side effects | Microbiology | null | 31ae221e-4db7-4f18-9d3b-ad022cd94e8a | multi |
Dental lamina cysts of new born are seen at: | "Bohn's nodules" are seen at the junction of hard and soft palate, whereas "Epstein pearls" are seen along the median raphae of hard palate. A third type known as "Dental lamina cysts of new born" are seen on the alveolar ridges. | 3 | The junction of hard and soft palate | Along the median raphae of hard palate | The alveolar ridges | None of the above | Pathology | null | 3c79b800-6b90-4dd1-a3fc-dd62972b6c15 | multi |
Anaerobic bacteria commonly found in cervix or vagina? | ANSWER: (A) LactobacilliREF: Shaw 13th ed p. 125"Lactobacillus or Doderlein's bacillus is the most common organism found in vagina" | 1 | Lactobacilli | Gardnerella | Mobilincus | Clostridium | Gynaecology & Obstetrics | Vigina | 2d70c5df-0049-460b-88c0-c88a581e657e | single |
Orally active hormone is: | null | 2 | TSH | Thyroxine | GH | Prolactin | Pharmacology | null | 52844af1-36f9-4bcf-9996-b3342f6c0c55 | multi |
A 26 yrs old male with restriction of eye movements in all directions &moderate ptosis but with no diplopia or squint. Diagnosis is | Chronic progressive external ophthalmoplegia Bilateral ptosis without diplopia is seen in chronic progressive external ophthalmoplegia (CPEO). Ptosis & diplopia are presenting symptoms in approx 50% of patients of Myasthenia gravis, & subsequently develop in 96% of patient during the course of the disorder. In thyroid-associated ophthalmopathy, proptosis & lid retraction is found. Pseudoptosis may be observed if contralateral lid retraction is present. Ptosis may occur if levator dehiscence is present b/o inflammation. Diplopia can occur in 5-10% of patients b/o severe muscle swelling . Multiple cranial nerve palsies as in cavernous sinus syndrome & orbital apex syndrome, present with diplopia along with ophthalmoplegia & other symptoms. Chronic progressive external ophthalmoplegia (CPEO): CPEO is the most common feature of mitochondrial myopathy. It occurs in > 50% cases of all mitochondrial myopathies. Typical presentation is B/L ptosis without diplopia in early adulthood Ophthalmoplegia is usually symmetrical & slowly progressive so diplopia is not often a complaint because all eye movements are reduced equally. The progressive ophthalmoplegia is unnoticed till decreased ocular motility limits peripheral vision. Ciliary muscles & iris muscles are often unaffected by CPEO Other variable symptoms are: - Exercise intolerance - Cataract - Hearing loss - Sensory axonal neuropathy - Ataxia - Clinical depression - Hypogonadism - Parkinsonism Diagnosis is made by muscle biopsy. Muscle fibres stained with "Gomori trichrome stain" give rise to dark red staining of muscle fibres k/a "ragged red fibers" This is b/o accumulation of enlarged mitochondria. PCR of blood or muscle tissue can determine a mutation of the mt DNA. There is no definitive treatment for CPEO. Ptosis may be corrected with lid surgery. Experimental treatment with tetracycline & coenzyme Q10 has been used. Also know Kearns - Sayre Syndrome (KSS): Is mutiorgan system, mitochondrial disorder with a triad of - Onset before age 20 - CPEO - Pigmentary retinopathy plus one or more of the following - Cardiac conduction defects - CSF protein > 1.0 gm/1 or - Cerebellar ataxia | 2 | Thyroid ophthaltnopathy | Chronic progressive external ophthalmoplegia | Myasthenia gravis | Multiple cranial nerve palsies | Ophthalmology | null | c5fb74f3-eb89-4d34-8198-313de0534645 | multi |
All are markers of Mantle cell lymphoma except - | null | 4 | CD5 | CD 19 | CD 20 | CD 23 | Pathology | null | a83ae59c-9f53-418b-a363-00fc556a9fe5 | multi |
Convulsions in a child with dehydration and vomiting can only be due to- | Ans. is 'a' i.e., Decreased serum sodium | 1 | Decreased serum sodium | Decreased serum magnesium | Decreased serum potassium | Decreased serum potassium | Pediatrics | null | 93f78fc7-8ce8-421e-9918-c4efdee0f961 | single |
Which among the following is highest risk factor for molar pregnancy | Strongest risk factors for molar pregnancy are age and prior history of molar pregnancy. | 3 | Prior C-section | Hypertension in pregnancy | Advanced age | Diabetes in pregnancy | Gynaecology & Obstetrics | null | b5483b81-c60b-4e23-a5f9-66a27556d2d1 | single |
Which of the following is not a difference between Centric relation and Centric occlusion? | Centric relation is present behind centric occlusion in natural dentition. | 4 | Centric relation is a bone to bone relationship. Centric occlusion is the relationship of upper and lower teeth to each other. | Centric relation is for denture occlusion, whereas centric occlusion is present in natural dentition. | For denture patients CR=CO. For natural dentition CR≠CO. | In natural dentition, the centric occlusion is usually posterior to centric relation | Dental | null | 33fee40c-5c53-4b81-b1f2-e0041cd8a2cb | multi |
Optimal front-line treatment of squamous cell carcinoma of the anal canal includes: | Combination radiation therapy and chemotherapy is now the treatment of choice for squamous cell carcinoma of the anus. The area of the primary lesion is biopsied, and the patient begins radiotherapy to the pelvis. If inguinal lymph nodes are enlarged, they are also biopsied, usually by fine needle aspiration, and if positive, they are included in the field of radiation. Following radiation therapy, patients receive intravenous 5-FU and mitomycin C. Patients who fail therapy have limited options, including additional chemotherapy or radiotherapy. Salvage therapy may also include abdominoperineal resection (APR), lymphadenectomy, or a diveing colostomy, depending on the nature of the recurrence. | 4 | Abdominal perineal resection. | Low anterior resection when technically feasible. | Radiation therapy. | Combined radiation and chemotherapy. | Surgery | Rectum and anal canal | 5180b0b3-8c20-4b17-9d39-b5096f91e3d8 | multi |
NOT a feature of Holt Oram Syndrome is | Holt Oram Syndrome Patient have normal blood picture. | 3 | Absent Radius | Atrial septal defect | Thrombocytopenia | Autosomal dominant inheritance | Pediatrics | null | 205aa6ee-1223-47f3-a1ff-7690eef22da4 | single |
Patient presents to casualty with sudden onset LMN facial palsy on right side and inability to abduct right eye. There is left sided hemiparesis. Whats your diagnosis? | Triad of ipsilateral 6th nerve palsy, ipsilateral 7th nerve palsy and contralateral hemiparesis constitutes milard gubler syndrome. | 2 | Fovilles syndrome | Milard gubler syndrome | Ramsay hunt syndrome | Tolosa hunt syndrome | Anatomy | null | 802f0634-768b-41fa-8db0-a21036a0135c | single |
Burst EEG pattern is seen in? | Burst suppression is an electroencephalography (EEG) pattern that is characterized by periods of high-voltage electrical activity alternating with periods of no activity in the brain. The pattern is found in patients with inactivated brain states, such as from general anesthesia, coma, or hypothermia EEG video monitoring demonstrates that clinical seizure manifestations may lag behind the sta of ictal EEG activity; bursts lasting less than 3 seconds are usually clinically silent. During the absence seizure, rhythmic eye blinks and mild clonic jerks may be present. As a seizure progresses, automatisms may be seen. Ref Harrison 20th edition pg 1543 | 2 | Herpes simplex encephalitis | Absent seizures | Myoclonic epilepsy | SSPE | Medicine | C.V.S | 3695ce48-9b9c-4155-9877-2e7866a7bc88 | single |
The coronal pulp has | null | 3 | Two surfaces | Five surfaces | Six surfaces | Four surfaces | Dental | null | c9d8d498-c53b-47a7-a74b-fbe649372d4b | single |
The most common site of osteoma is( REPEAT QUESTION) | Most osteomas are asymptomatic and are found incidentally when imaging the sinuses either for sinonasal symptoms or for unrelated complaints. Osteomas are frequently seen elsewhere in the head and neck paicularly the mandible and outer table of the skull vault. There is a paicular frequency distribution within the paranasal sinuses: frontal sinuses: 80%; ethmoid air cells: ~15%; maxillary sinuses: ~5 %; sphenoid sinus: rare. Osteomas are most commonly seen in the frontal sinus followed in turn by those of ethmoid and maxillary. They may remain asymptomatic, being discovered incidentally on X rays. Treatment is indicated when they become symptomatic, causing obstruction to the sinus sodium, formation of a mucocele, pressure symptoms due to their growth in the orbit, nose or cranium. (Ref: Textbook of Diseases of ENT, PL Dhingra, 7th edition, pg no. 231) | 3 | Maxillary sinus | Ethmoidal sinus | Frontal sinus | Sphenoid sinus | ENT | Nose and paranasal sinuses | e3fdfcda-450d-44fa-bbdf-244abb70e4c5 | single |
Investigation of choice in cholestasis of pregnancy ? | Ans. is 'b' i.e., Serum bile acid levels Obstetric cholestasis (also known as intrahepatic cholestasis of pregnancy or cholestasis of pregnancy) is a liver disease unique to pregnancy which presents with pruritus.Clinical featuresObstetric cholestasis most commonly presents in the third trimester (80% develop symptoms after 1st week).The pruritus is often severe and typically the palms of the hands and the soles of the feet are involved but the legs, thighs arms, backs, breasts and abdomen are also reported.The disease tends to recur in every pregnancy and so a part history of the condition is important.The disease is more common among multiple gestations.Other signs and symptoms of liver disease are not observed. Additional symptoms which may be reported in common with other forms of cholestasis are right upper quadrant pain, pale stools and dark urine.Changes in liver function in obstetric cholestasisThe most common abnormalities in liver function are:Increase in ALT (seen in 100% cases)Increase in AST (seen in 99% cases)Increase in bile acids (seen in 92%) cases)Elevated bilirubin (22%) of cases)Increased GGT (39% cases)Elevations in alkaline phosphatase are seen in cholestatic disease such as obstetric cholestasis as it is released from the damaged liver but because the enzyme is also released from the placenta in normal pregnancies, measurements are less helpful than outside the pregnancy.Serum bile acid test is the most accurate determinant of cholestasis of pregnancy.The problem with the bile acid test is that only a small number of labs around the world have the equipment necessary to perform it which can result in a considerable delay for women experiencing symptoms of the conditions.Liver biopsy in a case of obstetric cholestasis: -Liver biopsy demonstrates: -Acinar cholestasis with centrilobular bile staining and bile plugs in the canaliculi.Liver biopsy is the definitive diagnostic test of the disease.Postnatal course in obstetric cholestasisBiochemical abnormalities and pruritics in obsteric cholestasis persists until delivery following which resolution occurs.Pruritus is typically absent within 48 hour after delivery usually improved within 1 week.Liver function tests becomes normal within 6 weeks.Complications of obstetric cholestasisMeconium stained liquorPremature deliveryFetal distressPost-partum hemorrhageTreatment of obstetric cholestasis: -AntihistaminesChlorpheniramine can provide symptomatic relief in pruritus.Topical treatmentsIf the skin is well moisturized pruritus may be relieved.Ursodeoxycholic acidS-Adenosyl methionineDexamethasoneDexamethasone in high dose results in resolution of all pruritus cases and significant reduction in total bile acids and ALT.Vitamin KIn obstetric cholestasis there is malabsorption and subsequent deficiency of vitamin K. This will increase the risk of postpartum hemorrhage.Vitamin K injection is given to reduce the risk of PPH. | 2 | Serum bilirubin levels | Serum bile acids levels | Serum alkaline phosphatase levels | Serum glutathiones transferase levels | Gynaecology & Obstetrics | Hepatic, Biliary, and Pancreatic Disorders | a494bc66-0ed0-4340-8a17-a6434248e318 | single |
Half-life of basiliximab is:- | Half life of basiliximab is 7 days.Basiliximab* This is anti CD-25 antibody with higher affinity for the IL-2 receptor, but shoer plasma t 1/2 (1 week).* It is used to prevent renal and other transplant rejection reaction.* It can cause anaphylactic reactions and promote oppounistic infection. | 1 | 7 days | 7 hours | 15 days | 24 hours | Pharmacology | JIPMER 2019 | 780c5d75-8009-4c14-b9c0-d63c79a48abe | single |
Poiseuille’s hagen lawis | Poiseuille-Hagen Formula
The relation between the flow in a long narrow tube, the viscosity of the fluid, and the radius of the tube is expressed mathematically in the Poiseuille-Hagen formula: | 1 | F = (PA–PB) × 3.14 × r4/8nl | F = (PA+PB) × 3.14 × r4/8nl | F = (PA/PB) × 3.14 × r4/8nl | F = (PA × PB) × 3.14 × r4/8nl | Unknown | null | 6336772f-0a4c-44d3-96d5-ecabbdac91f2 | single |
A patient presented with a 3.5-cm size lymph node enlargement, which was hard and present in the submandibular region. Examination of the head and neck did not yield any lesion. Which of the following investigations should follow? | Suspected lymph node may have metastases from the upper aerodigestive tract. Since no lesion is found on physical examination of head and neck, triple endoscopy would be justified next. Supravital staining helps in selecting the site of biopsy in a lesion. As no lesion is discovered, it will not be very useful. | 2 | Chest X-ray | Triple endoscopy | Supravital oral mucosa staining | Laryngoscopy | ENT | Oral Cavity | 55b33c8a-2a0d-497d-96d0-234641a7438c | single |
Hour glass deformity is seen in - | Hour glass stomach is caused due to cicatracia contraction of a saddle shaped ulcer at the lesser curvature. | 2 | Carcinoma stomach | Peptic ulcer | Duodenal atresia | CHPS | Pathology | null | a7bf373a-3372-495d-a53e-c12a9142f8d6 | single |
Most common detion used in social medicine is- | Ans. is 'd' i.e., Standard detion "Standard detion is most common and generally most appropriate measure of dispersion (variation)". | 4 | Mean | Range | Variance | Standard detion | Social & Preventive Medicine | null | 9775593b-66b1-44a6-8c02-cba3e6e4eee1 | single |
Which of the following is an investigation of choice to diagnose gall stones? | Ans. B. Ultrasound abdomenCholelithiasis involves the presence of gallstones which are concretions that form in the biliary tract, usually in the gallbladder. Choledocholithiasis refers to the presence of one or more gallstones in the common bile duct (CBD) Patients with uncomplicated cholelithiasis or simple biliary colic typically have normal laboratory test results, however these children should be investigated with haemoglobin, reticulocyte count, peripheral blood picture and other investigations to exclude haemolytic disease. Ultrasonography is the procedure of choice in suspected gallbladder or biliary disease. MRCP and ERCP have better accuracy than ultrasonography in diagnosing common bile duct stones. | 2 | X ray abdomen | Ultrasound abdomen | ERCP | MRCP | Pediatrics | Gastro Intestinal System | f8a8f6c5-75bf-42f0-8e01-805144fba3a8 | multi |
The Most common complication in varicose vein surgery is | (A) Ecchymosis # Complications of varicose vein surgery: Bruising and discomfort are common following removal of varices, especially where the veins were of very large diameter. However, the pain usually requires only mild analgesics. | 1 | Ecchymosis | Deep vein thrombosis | Recurrence of varicosity | Venous ulcer | Surgery | Miscellaneous | 072290c4-b911-42df-852d-bc92f95f1c68 | single |
Females with orgasmic difficulties are advised following exercises to strengthen pubococcygealmuscles- | Ans. is 'a' i.e., Kegel's exercises o Kegels exercises are used to strengthen the pelvic floor muscles mainly pubococcygeal.o These exercises can thus be used to treat orgasmic difficulties and prevent genital prolapse. | 1 | Kegel's exercises | Jacobson's stent on top | Keeping muscle up exercises | Johnsons exercises | Gynaecology & Obstetrics | Management | e6becfc9-5431-4e30-8e64-b453a9e40d95 | single |
A 3 year old male presents with a skin rash and epistaxis. He has had several, severe sinopulmonary infections. A careful history reveals that his maternal uncle died of bleeding complications following an emergency cholecystectomy. What additional findings are likely in this case? | This clinical scenario is typical for Wiskott-Aldrich syndrome. This is a sex-linked recessive disorder presenting with the triad of thrombocytopenia, eczema, and recurrent sinopulmonary infections. Serum IgM levels are low but IgG, IgA, and IgE levels are increased. Patients have a defective response to polysaccharide antigens, which is due to a cytoskeletal defect in T cells that inhibits their binding to B cells. A CD4/CD8 ratio of < 1.5:1 is the pattern seen in AIDS due to selective tropism of the CD4+ T-helper cell population. Cerebellar ataxia is pa of the ataxia-telangiectasia syndrome. The ataxia develops between age 2 and 5. The defect is associated with a DNA repair enzyme deficiency. Elevated platelet count and increased serum levels of IgG, IgA, and IgE is not associated with a paicular syndrome. Polyclonal gammopathies result in an increase in immunoglobulin of more than one class. This benign alteration is frequently seen in viral or bacterial infections. Thrombocythemia may be associated with a myeloproliferative syndrome or with a secondary reactive process. Ref: Brooks G.F., Carroll K.C., Butel J.S., Morse S.A., Mietzner T.A. (2013). Chapter 8. Immunology. In G.F. Brooks, K.C. Carroll, J.S. Butel, S.A. Morse, T.A. Mietzner (Eds), Jawetz, Melnick, & Adelberg's Medical Microbiology, 26e. | 4 | A CD4/CD8 ratio of < 1.5:1 | Cerebellar ataxia | Elevated platelet count and high serum IgG, IgA, and IgE levels | Low platelet count and low serum IgM levels | Medicine | null | 8007ba1f-1ff9-4c2a-b9b1-f21ffeda9732 | single |
Age for regular mammography is | Screening mammography: For screening purpose it is done after 40 years. Early screening is indicated when there is family history of carcinoma breast or histological risk factor. Mammography before 35 years of age is usually not done unless there is a suspicious lump or a strong family history. Screening is done in asymptomatic female where even cancer is suspected. Ref; (page no; 515) 5th edition of SRB&;S manual of Surgery. | 3 | 20 | 30 | 40 | 50 | Surgery | Endocrinology and breast | a9fed167-929e-4a5a-a15d-863cb70919d8 | single |
The spine of the scapula can be palpated at which of the following level of veebrae? | Spine of the scapula lies at the level of T3 veebrae. Scapular spine is seen on the posterior surface of the scapula and it expands into a terminal process called acromion process. The scapulae overlie the posterior poion of the thoracic wall, and cover the upper seven ribs. The superior angle of scapula can be palpated at the T1 veebral level and the inferior angle lies at the level of T7 veebrae. | 2 | T 1 | T 3 | T 5 | T 7 | Anatomy | null | 5ff73f66-7493-4d62-b776-9b6de7d5b4ad | single |
NAD acts as a cofactor for | In the TCA cycle,Step 3. In the third step, isocitrate is oxidized and releases a molecule of carbon dioxide, leaving behind a five-carbon molecule--a-ketoglutarate. During this step, \text{NAD}^+NAD + N, A, D, sta superscript, plus, end superscript is reduced to form \text{NADH}NADHN, A, D, H. The enzyme catalyzing this step, isocitrate dehydrogenase, is impoant in regulating the speed of the citric acid cycle.Ref: DM Vasudevan, 6th edition, page no: 218 | 2 | Citrate synthetase | Isocitrate dehyrogenase | a ketoglutarate dehyrogenase | Malate dehydrogenase | Biochemistry | Metabolism of carbohydrate | 2438e28a-5db4-4f1e-bac9-b13a0567de8f | single |
Criteria for a pancreas donor include: | - Combined liver-pancreas procurement should be routine, even if the right hepatic aery arises from the superior mesenteric aery. - In this situation, since the transplanted liver is the life-saving organ, the proximal superior mesenteric aery should remain with the liver and the distal superior mesenteric aery supplying the head of the pancreas can be reconstructed on a Y-graft of iliac aery with the splenic aery. - Successful pancreas transplantation can be performed using donors who have previously undergone splenectomy; however, there should be no significant pancreatitis and no history of diabetes in the donor. | 1 | No history of diabetes | No liver donation | No replaced hepatic aery vessels arising from the superior mesenteric aery (SMA) | No previous splenectomy | Surgery | Transplantation | f96ed7ff-a25e-4357-9306-6b77f1bf1f68 | single |
Indication for intramuscular iron therapy is | Refer KDT 6/e p 868 Drug of choice for acute iron poisoning is desferroxamine, however it has to be admistered parentarally It is not effective by oral route In beta thalassemia major iron excess can result due to repeated blood transfusions and massive Hemolysis Cheating agent has to be admistered for long time OK this case | 2 | Oral desforaxamine | Oral deferiprone | Intramuscular EDTA | Oral succimer | Pharmacology | Respiratory system | b7d06c4c-1491-40b9-bb0e-9343e1dd98e8 | single |
Beta 2 selective agonist are often effective in | Ref-KDT 6/e p127 Beta 2 agonist are useful in premature uterine contraction to delay labour and not for delayed labour. Beta blockers are used in the treatment of the angina | 2 | Angina due to cornary insufficiency | Asthama | Delayed labour | All the above | Anatomy | Other topics and Adverse effects | ecc6fb58-587e-49a4-9e21-d059c182c641 | multi |
Which of the following refers to the occurrence of hypehyroidism following administration of supplemental iodine to subjects with endemic iodine deficiency goiter? | Jod Basedow Effect: Refers to induction of thyrotoxicosis by iodine in the form of dietary supplements or medication, especially especially in patients who are relatively iodide deficient. Treatment includes combination of antithyroid drugs and perchlorate paicularly in amiodarone-induced thyrotoxicosis. Ref: Harrison's Internal Medicine, 18th Edition, Pages 2914, 2917, 2927, 2928, 2930 and 2932, Chapter 341 ; Acute Endocrinology: From Cause to Consequence By Greet Van Den Berghe, Page 9 ; Werner and Ingbar's Tthe Thyroid : A Fundamental and Clinical Text, Volume 549 By Lewis E. Braverman, 9th Edition, Page 548 ; Textbook of Cardiovascular Medicine, Volume 355 By Eric J. Topol, 3rd Edition, Page 598. | 1 | Jod-Basedow effect | Wolff-Chaikoff effect | Thyrotoxicosis Factitia | De Quervain's Thyroiditis | Medicine | null | 07666a33-5e16-4d46-a1f9-e8219a56054b | single |
Seoli cells play a key role in which of the following process | Seoli cells are elongated cells in the seminiferous tubules that ensheathe spermatogenic cells, providing a microenvironment that suppos spermiogenesis and spermatocytogenesis; they secrete androgen-binding protein and establish the blood-testis barrier by forming tight junctions with adjacent Seoli cells.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-419 | 1 | Spermiogenesis | Testosterone secretion | Secretion of seminal fluid | Production of germ cells | Physiology | Endocrinology | 632e3de5-908a-4af2-a33b-1595137fc78f | single |
According to WHO, crede's method is applied for prophylactic use in ophthalmia neonatorum, is | (Silver nitrate solution): Ref: 164-65-P, 71-KHOPHTHALMIA - NEONATORUM: any discharge or even watering from the eyes in the first week of life should arouse suspion of ophthalmia neonatorum* Use of either 1% tetracycline ointment or 0.5% erythromycin ointment or 1% silver nitrate solution (Crede's method) into the eyes of the babies immediately after birth* Single injection of ceftriazone 50 mg/Kg IV or IV (not to exceed 125 mg) should be given to infants born to mothers with untreated gonococcal infections. | 1 | Silver nitrate solution | Erythromycin ointment | Tetracycline ointment | Penicilline injection | Ophthalmology | Conjuctiva | 5c9aed55-2802-46ae-8f55-7c96528e5deb | single |
A 6-week pregnant lady is diagnosed with sputum positive TB. Best management is - | Ans. is 'b' i.e., Start Category I ATT in first trimester * Tuberculosis during pregnancy should be diagnosed promptly and as early as possible. Late diagnosis and care is associated with 4-fold increase in obstetric morbidity and 9-fold increase in preterm labor.* Poor nutritional states, hypoproteinemia, anemia and associated medical conditions add to maternal morbidity and mortality.* True congenital TB is believed to be rare. A fetus can get TB infection either by hematogenous spread through umbilical vein or by ingestion or aspiration of infected amniotic fluid. The risk to neonate of getting TB infection shortly after birth is greater.* ATT should be started as soon as possible, as untreated disease is a hazard to the mother and fetus.* The regimens recommended for use in pregnancy are same as for the nonpregnant state except for withholding of streptomycin. Currently, an intermittent regimen (thrice weekly on alternate days) under the DOTS strategyof RNTCP is being increasingly used worldwide for pregnant women having TB.* None of the AKT drugs are teratogenic and AKT should be started as soon as the diagnosis is made. Sputum positive tuberculosis is category 1. | 2 | Wait for 2nd trimester to start ATT | Start Category I ATT in first trimester | Start Category II ATT in first trimester | Start Category III ATT in second trimester | Gynaecology & Obstetrics | Miscellaneous (Gynae) | 91dc1d58-1676-468e-b070-c57d648e9f2c | single |
Commonest cause of acute intestinal obstruction is: | SMALL BOWEL OBSTRUCTION - Adhesions secondary to previous surgery are the MC cause of SBO. - Causes: Adhesions (60%) > Malignant tumors (20%) >Hernia (10%) > Crohn's disease (5%)Q. - Primary colonic cancers (paicularly those arising from the cecum and ascending colon) may present as a SBO. | 1 | Adhesions | Volvulus | Inguinal hernias | Internal hernias | Surgery | Intestinal obstruction | 17f47413-489c-456f-95a4-d5d794aa601d | single |
The criteria for validity of a screening test are - | Ans. is 'b' i.e., Predictability Screening test to be applied o The screening test to be applied should fulfil the following impoant criteria before it is considered suitable for screening : ? 1. Acceptability The test should be acceptable to the people at whom it is aimed. In general painful or embarrasing tests e.g., per rectal or vaginal examination are not likely to be acceptable. 2. Repeatability (reliability) Repeatability means, the test must give consistent results when it is repeated more than once on the same individual under same conditions. That means the results of test are precise (exact), So repeatability is some time called precision, reliability or reproducibility. 3. Validity (accuracy) Validity refers to what extent the test accurately measures which is purpos to measures. That means a valid test distinguish the people who have the disease from those who do not. Validity has components ---> Sensitivity and specificity. | 2 | Accuracy | Predictability | Sensitivity & Specificity | Cost effectiveness | Social & Preventive Medicine | null | 8174ad90-afc8-4cc4-a906-87f9073a1f8b | single |
Aery supplying major pa of superolateral surface of brain is | The middle cerebral aery is the largest terminal branch of the internal carotid aery and it runs laterally in the lateral cerebral sulcus of the brain.It supplies the entire lateral surface of the cerebral hemisphere except the narrow strip along the superomedial border extending from the frontal pole to the parieto-occipital sulcus(which is supplied by the anterior cerebral aery) and the occipital pole and inferior temporal gyrus (both of which are supplied by the posterior cerebral aery). | 1 | Middle cerebral aery | Anterior cerebral aery | Posterior cerebral aery | Veebral aery | Anatomy | null | 503d8364-58ed-4605-9726-98f814409559 | single |
Double apical impulse is seen in? | ANSWER: (A) HOCMREF: Harrison's 17th ed chapter 227"Most HOCM patients demonstrate a double or triple apical precordial impulse and a fourth heart sound. Those with intraventricular pressure gradients may have a rapidly rising arterial pulse. The hallmark of HOCM is a systolic murmur, which is typically harsh, diamond-shaped, and usually begins well after the first heart sound. The murmur is best heard at the lower left sternal border as well as at the apex, where it is often more holosystolic and blowing in quality, no doubt due to the mitral regurgitation that usually accompanies HOCM"Some important points about apical impulse:Normal: visible in the midclavicular line at the fifth intercostal spaceHypokinetic:Hypovolumic shockCalcified mitral stenosisSchemic heart disease with failureMyxedemaCardiomyopathiesEmphysemaHyperkinetic: (Duration of impulse is normal, increased amplitude)Aortic regurgitationMitral regurgitationASDPDAHyperdynamic circulatory states like anemia 8c thyrotoxicosisHeaving apical impulse: Duration of apical impulse is more than one third of systole. It is seen inAortic stenosisCoarctation of aortaSystemic hypertensionTapping apical impulse: only seen in uncomplicated mitral stenosis characterized by hypokinetic apical impulse with palpable loud SI | 1 | HOCM | Cardiac tamponade | Aortic regurgitation | Pulmonary hypertension | Medicine | C.V.S. | 8cce8415-daa7-4079-a3a4-cd68f91c832d | single |
Tocilizumab used against Rheumatoid arthritis is a monoclonal antibody against : | Monoclonal antibody against IL-6 : Tocilizumab
Monoclonal antibody against IL-6 receptor : Sarilumab
Both are approved for Rheumatoid arthritis. | 1 | Interleukin-6 | Interleukin-6 receptor | Interleukin-5 | Interleukin-5 receptor | Pharmacology | null | ebb86720-905d-42e9-ae23-b852363cd97e | single |
One of the characteristic bedside features of Korsakoff's psychosis is- | null | 3 | Astereogenesis | Apraxia | Confabulation | Hallucination | Medicine | null | dda9ad60-1b6c-46d7-abf5-b112219fcf45 | multi |
Sequence which is responsible for retaining proteins in membrane | D i.e. Halt signal | 4 | Translocon | Sec 61 complex | Docking protein | Halt signal | Biochemistry | null | 3f6a5045-4eb4-4e3e-9697-c731710159e4 | single |
Most important amino-acid substrate for gluconeogenesis - | Ans. is 'd' i.e., Alanine o The major noncarbohydrate precursors (substrate) for gluconeogenesis are lactate, pyruvate, glycerol, glucogenic amino acids, propionate and intermediates of the citric acid cycle. All aminoacids, exceptfor leucine and lysine, are substrate for gluconeogenesis. Alanine is the most important gluconeogenic amino acid. | 4 | Leucine | Lysine | Histidine | Alanine | Biochemistry | Amino Acids Basics | dbe38f8b-26e8-4c5d-82a5-c2bfb32c8893 | single |
Investigation of choice in appendicitis in adults | Answer- A. CT Scan | 1 | CT Scan | USG | Serum ESR | MRI Abdomen | Surgery | null | f973a066-51eb-4914-8306-e7e125a332af | single |
Lack of Leucocyte adhesion molecules (LAM) is associated with - | null | 1 | Delayed closure of umblical cord | Normal chemotaxis | Compliment opsinization | Neutropenia | Medicine | null | b106fa7e-ab26-46f9-a3d5-84a8aa570f44 | single |
A 66 year old female is posted for subtotal gastrectomy for adenocarcinoma. The important procedure related complication: | Ans. (d) Bilious vomitingRef: Sabiston 20th Edition, Page 1212Complications of Gastric Surgeries:* Dumping syndrome* Afferent loop syndrome* Efferent loop syndrome* Malabsorption syndrome (Anemia, hypocalcemia, B12 deficiency)* Alkaline reflux gastritis* Bile reflux gastritis* Gastric atony* Duodenal stump blow out. | 4 | Pneumothorax | Constipation | Hemolytic anemia | Bilious vomiting | Surgery | Stomach & Duodenum | eb216a2d-ec98-4e03-8ac8-de3c93bc6d1b | single |
Treatment of TOF ? | Ans. is 'a' i.e., Modified BT shunt | 1 | Modified BT shunt | Fontan procedure | Glenn shunt | Rastelli operation | Pediatrics | null | 4638f8c0-9dd9-4d3a-afdc-a10b00029fc5 | single |
All of the following are cause of blood in stools in children except - | Ans. is 'b' i.e., Carcinoma | 2 | Meckels diveiculum | Carcinoma | Intussusception | Juvenile polyp | Surgery | null | 5286422d-9de6-4c71-a491-7267b79dc6ba | multi |
Seoli cells secrete ? | Ans. is 'd' i.e., InhibinLeydig cells have receptors for LH and secrete androgens, i.e. Testosterone, dihydrotestosterone (DHT), androstenedione, and dehydroepiandrosterone (DHEA).Seoli cells have receptors for FSH and secrete ABP, inhibin and MIS. seoli cells also have receptor for testosterone. | 4 | Testosterone | Androgen | FSH | Inhibin | Physiology | null | 444facf5-0bce-4548-821d-0cb8af2f2d15 | single |
The term 'psychoanalysis' is associated with: March 2009 | Ans. C: Sigmond Freud Psychoanalysis/Freudian psychology is a body of ideas developed by Austrian physician Sigmund Freud and continued by others. It is primarily devoted to the study of human psychological functioning and behavior, although it can also be applied to societies. Psychoanalysis has three applications: A method of investigation of the mind and the way one thinks; A systematized set of theories about human behavior; A method of treatment of psychological or emotional illness. | 3 | John Broadus Watson | Carl Gustav Jung | Sigmond Freud | Wilhelm Reich | Psychiatry | null | bc380d98-aad4-4e01-b466-fcbe853412c4 | single |
All the following can occur in a neonate for heat production except – | "Always remember that newborn cannot produce heat by shivering."
Thermogenesis in Newborn
A newborn is more prone to develop hypothermia because of a large surface area per unit of body weight.
A low birth weight baby has decreased thermal insulation due to reduced subcutaneous and brown fat. | 1 | Shivering | Breakdown of brownfat with adrenaline secretion | Universal flexion like a fetus | Cutaneous vasoconstriction | Pediatrics | null | 58ad4600-071d-4d42-a83a-e98b9f5c705f | multi |
Muscle not included in Anterior compartment of thigh | Gracilis is a muscle of Medial compartment | 3 | lliacus | Sartorius | Gracilis | Rectus femoris | Anatomy | null | 4d34f71e-b4cb-4b2f-b4ef-bc96bf049113 | single |
Ziemann's dots in RBC are seen in infection with | Ziemann dots in RBC-PL Malaria Schaffner dots in RBC- Pl vivax Accola rings-falciparum Ref: D.R. Arora. Medical parasitology 4th ed pg 108 | 3 | Pl vivax | Pl falciparum | Pl malaria | Pl ovale | Microbiology | parasitology | 52a0c3ef-8f2d-4999-8ed8-77de7d59982d | single |
Which of the following is not an example of Phase II drug metabolic reaction? | phase 1 reactions- oxidation, reduction, cyclization, decyclization and hydrolysis Phase II reactions: 1. Glucuronidation 2. Acetylation 3. Glutathione conjugation 4. Glycine conjugation 5. Sulfation 6. Methylation 7. Water conjugation Reference: Katzung Pharmacology; 13th edition; Chapter 4; Drug Biotransformation | 3 | Acetylation | Sulfation | Decyclization | Methylation | Pharmacology | General anatomy | bacf14d5-2ae8-4c46-99eb-fd6fd4156d1e | single |
Which of the following is not true about tabes Dorsalis - | Ans. is 'b' i.e., Deep tendon reflexes are brisk Tabes dorsaliso Usually develops 15 - 20 years after syphilis infectiono Major symptoms are- lightning pain, ataxia, urinary' incontinenceLightning paino Lightning or lancinating pain are sharp stabbing pain and brief like a flash of lightning.o More common in legs.o Are associated invariably with impairment of tactile pain and thermal sensation.Urinary incontinenceo Bladder is insensitive and hypotonic resulting in unpredictable overflow incontinenceo Sometimes constipation, megacolon as well as impotence can occurAtaxiao Purely sensory ataxiao Charcoat joints and trophic ulcers can occurPathology:There is involvement of:o Involvement of posterior root of lumbosacral regiono Posterior column involvedo Dorsal root gangliaNow, it is believed that inflammation is present all along the posterior root where as the dorsal ganglion cell los and posterior column degeneration are secondaryClinicopathological correlationClinical featureTract involvedo Hyptonia, areflexia ataxia-Destruction of proprioceptive fibres in sensory root gangliao Bladder involvement-Posterior root involvement of lumbosacral regiono Lightning pains-Incomplete posterior root lesions at different levelso Analgesia and joint insensitivity-Partial loss of A and C fibres in the root. | 2 | Seen in Neurosyphiilis | Deep tendon reflexes are brisk | Loss of vibration sense | Acute abdominal pain and visceral symptoms | Medicine | Spinal Cord Diseases | 22019df1-e844-4ee0-86b1-6e832c91d23a | multi |
Necrotising lymphadenitis is seen with | null | 2 | Kimura disease | Kikuchi disease | Castle Man disease | Hodgkin's lymphoma | Medicine | null | 78d08c3f-44b4-4b99-9389-30ebb087b04f | single |
'Scalloping' of the edge of sigmoid colon on barium enema seen in: | Ans. Pneumatosis intestinalis | 4 | Diveiculosis | Ulcerative colitis | Carcinoma colon | Pneumatosis intestinalis | Radiology | null | 80572ed3-2941-47e1-b341-cac1fc3b5107 | multi |
The cutoff point of serum estrogen level for the diagnosis of ovarian failure: | Diagnosis of menopause is from classical symptom of hot flush (50%) confirmed by elevated FSH levels to more than 100 mlU/ml and serum estradiol < 20 pg/ml. | 2 | 10 pg/ml | 20 pg/ml | 30 pg/ml | 40 pg/ml | Gynaecology & Obstetrics | null | c22d1d78-a64e-4066-b2cf-376bf07bdf62 | single |
Post term pregnancy is the pregnancy which continues beyond: September 2006 | Ans. C: 294 days The normal duration of pregnancy is approximately 37 to 42 weeks, with the estimated due date at 40 weeks or 280 days from the first day of the last menstrual period. A postterm pregnancy/prolonged pregnancy/post maturity is one that has extended beyond 2 weeks of the expected date of delivery (beyond 294 days). Nearly 10 percent of pregnancies are postterm. | 3 | 274 days | 284 days | 294 days | 304 days | Gynaecology & Obstetrics | null | 21410650-b6bf-4c3f-8bb0-007d0fa6b98b | single |
A 45-year-old man is admitted to the hospital with breathing problems. During physical examination the patient shows signs of airway obstruction. A CT scan examination reveals a nasal polyp obstructing the airway. Drainage from which of the following structures is also obstructed? | (b) Source: GAS 797, 879, 1018, 1020, 1022; GA 487, 518, 525 The nasal polyp also involved the maxillary sinus, located immediately laterally to the nasal cavity. The sphenoid sinus, located posterosuperiorly to the nasopharynx, is unlikely to be affected by a nasal polyp. The ethmoidal sinuses, located medially to the orbit and lateral to the nasal cavity, are also unlikely to be affected by a nasal polyp, although this possibility cannot be ruled out. The frontal sinuses located superomedially to the eyes are unlikely to be affected by the nasal polyp. The frontonasal ducts, the communication between the frontal sinus and the nasal cavity, are also unlikely to be affected. | 2 | Sphenoid sinus | Maxillary sinus | Ethmoidal sinus | Frontal sinus | Anatomy | Head & Neck | facfee90-11e8-4ce2-a5c0-82710b5261d7 | single |
Gene associated with autosomal dominant breast cancer? | Ans. B. BRCA 1. (Ref. Bailey and Love 26th/pg. 817)The BRCA1 gene has been associated with an increased incidence of breast (and ovarian) cancer and is located on the long arm of chromosome 17 (17q). The gene frequency in the population is approximately 0.0006. It does, however, occur with greater frequency in certain populations such as Ashkenazi Jews, in whom there is often a common (founder) mutation. BRCA2 .is located on chromosome 13q and there is an association with male breast cancer. Women who are thought to be gene carri- ers may be offered breast screening (and ovarian screening in the case of BRCA1, which is known to impart a 50 % lifetime risk of ovarian cancer), usually as part of a research programme, or genetic counselling and mutation analysis. Those who prove to be 'gene positive' have a 50-80 % risk of developing breast cancer, predominantly while premenopausal. Many opt for prophylactic mastectomy.GeneChromosomeAssociated tumourRb12qRetionablastoma, osteosarcomaBRCA-l and 217q, 13qBreast and ovarian cancerAPC5Colonic cancerP5317qMost human cancers, Li-Fraumeni syndromeHereditary cancer occurs in multiple family members due to germline mutations in high-risk genes which are inherited in autosomal dominant pattern. BRCA1 and BRCA2 are two major high-risk genes associated with hereditary breast cancer.Likelihood of genetic mutation with family history.No. of family cases <50 years oldBRCA1 (%)BRCA2 (%)243317134413355544BRCA1 is also associated with ovarian and, to a lesser extent, colorectal and prostate cancer. bBRCA2 is associated with familial male breast cancer.Genetics of breast cancer.The majority of breast cancers are sporadic, occur randomly, and carry somatic genetic alterations. Hereditary cancer occurs in multiple family members due to germline mutations in high-risk genes which are inherited in autosomal dominant pattern. BRCA1 and BRCA2 are two major high-risk genes associated with hereditary breast cancer. Mutations in CHEK2 contribute to a substantial fraction of familial breast cancer. Carriers of TP53 mutations develop Li-Fraumeni syndrome and are at high risk of developing early onset breast cancer, but these mutations are very rare. Susceptibility alleles in other genes, such as PTEN, ATM, STK11/LKB1, and MSH2/MLH1 are also very rare causes of breast cancer. ~ Devita. | 2 | PTEN and KAI | BRCA 1 and 2 | APC | P53 | Surgery | Breast | 4b27fc61-89bb-44bb-a286-ccb418622a3d | single |
A 35-year-old lady presents with vaginal discharge. Smears from vaginal discharge show presence of? | Ans-A Trichomonas VaginalisThe image shows the presence of the anaerobic flagellated protozoan parasite, which causes vaginitis in women with the development of greenish malodorous discharge. | 1 | Trichomonas | Entamoeba Histiolytica | Toxoplasma | Giardia | Unknown | null | 53357344-ac6c-4f51-b325-c57ef0148986 | single |
A mother brings her 1 year old child to the hospital with complaints that he turns blue while breastfeeding. It resolves when he assumes a squatting position. On examination, a cleft palate is seen. Labs show hypocalcemia. Which of the following abnormalities are expected to be seen in the lymphoid organs? | Decreased size of paracoical areas of lymph nodes is expected as this child has DiGeorge Syndrome. DiGeorge Syndrome: Deficient CMI is seen due to aplasia of thymus and hence deficiency of T cells. This leads to paracoical areas of lymph nodes and periaeriolar sheaths of the spleen being reduced in size. B cells are usually not affected. Clinical Features of DiGeorge Syndrome - DiGeorge syndrome is a cellular immunodeficiency disorder caused by the deletion of a small segment of chromosome 22 (22q11) leading to a developmental defect involving the endodermal derivatives of the third and fouh pharyngeal pouches. (Thymus and parathyroid glands) The clinical features can be remembered with the mnemonic - CATCH C - Cardiac defects A - Abnormal facies T - Thymic aplasia C - Cleft palate H - Hypocalcemia Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | 1 | Decreased size of periaeriolar lymphoid sheath of spleen | Increased size of spleenic follicles | Increased size of para coical areas of lymph nodes | Decreased size of germinal centres of lymph nodes | Microbiology | Immunology | 650debb1-0bee-4a55-a072-7f549690d93c | single |
Length of Posterior vaginal wall is | The anterior wall of the vagina is about 8 cm long and the posterior wall about 10 cm long. ref - BDC 6e vol2 pg 393 | 4 | Variable | Same as anterior vagina wall | Less than anterior vagina wall | More than anterior vagina wall | Anatomy | Abdomen and pelvis | 3b2c63e7-4da7-42d2-b8fb-67ff0cdf1c06 | multi |
Austin flint murmur is seen in cases of | The Austin Flint murmur of chronic severe AR is a low-pitched mid to late apical diastolic murmur that sometimes can be confused with MS. The Austin Flint murmur typically decreases in intensity after exposure to vasodilators, whereas the murmur of MS may be accompanied by an opening snap and also may increase in intensity after vasodilators because of the associated increase in cardiac output. | 2 | Aortic stenosis | Aortic regurgitation | Hypertrophic obstructive cardiac myopathy | Ventricular stenosis | Medicine | null | 20911c3b-6e7d-415d-822f-7165f1e27074 | single |
HBV replication is indicated by -a) HBV DNAb) DNA polymerasec) HBeAgd) Anti-HBe | null | 1 | abc | bc | acd | bcd | Medicine | null | e492f3b1-ffdc-4524-9ee3-fb0b76399e95 | single |
Pheochromocytoma is associated with - | Ans. is 'b' i.e., Cafe-au-lait spots o About 25-33% of patients with a pheochromocytoma or paraganglioma have an inherited syndrome.# Neurofibromatosis type 1 (NF1) was the first described pheochromocytoma-associated syndrome.o The NF1 gene functions as a tumor suppressor by regulating the Ras signaling cascade. Classic features of neurofibromatosis include:# Multiple neurofibromas# Cafe au lait spots# Axillary freckling of the skin# Lisch nodules of the iris.o Pheochromocytomas occur in only about 1% of these patients and are located predominantly in the adrenals. | 2 | Vitiligo | Cafe-au-lait spots | Ash leaf amelanotic macusles | Acanthosis Nigricans | Medicine | Endocrinology | 904f526a-6a9f-4e49-a7a5-d6bbbf449dde | single |
Not a feature of brain death | The structural and functional damage of brain-stem may be diagnosed depending upon the following observations: Dilated fixed pupils, not responding to sharp changes in intensity of incident light. Absence of motor responses within the cranial nerve distribution on painful stimulation. Absence of corneal reflexes. Absence of vestibulo-ocular reflexes. Absence of gag reflex or reflex response to bronchial stimulation by a suction-catheter passed down the trachea. Absence of spontaneous breathing. Ref : Krishnan vij Textbook of Forensic medicine and Toxicology 5th edtion ; pg no - 75 | 4 | Complete apnea | Absent Pupillary reflex | Absence deep tendon reflex | Hea rate un-responsive to atropine | Forensic Medicine | All India exam | 2472904e-ec5a-425e-82c3-7970030122dd | single |
Squamous cell carcinoma on tongue most common site is | null | 3 | Apex | Base | Lateral borders | Dorsum | Pathology | null | 786d23a7-7ed4-4f89-b62c-11ed1b16ad48 | single |
False statement regarding adductor pollicis muscle: | Ans: B (Supplied by Median nerve) Ref : Gray s Anatomy, 39th edition, 2008.Page.918Explanation:Adductor pollicis:Has 2 heads, i) Obi ique head ii) Transverse headOblique head: Origin from capitate, bases of 2nd, & 3rd metacarpal bonesTransverse head: Origin from palmar surface of 3rd metacarpal honeInsertion: Two heads united by a tendon which attached to the ulnar side of base of proximal phalanx of thumbBlood supply: Arteria princeps pollicis & Arteria radialis indicis and branches from deep palmar archNerve supply: Deep branch of ulnar nerve (C8 & T1 fibres)Action: Adduction of thumb i.e. approximates the thumb to the palm of handTesting: With the thumb lying along the palmar aspect of the index finger, the subject is asked to retain a strip of paper between the thumb and palm against resistance.To remember:There are 2(1 muscles in the hand. Out of this only 5 muscles supplied by median nerve and remaining 15 muscles are supplied by ulnar nerve.Muscles supplied by MEDIAN NERVE are:Flexor pollicis brevisAbductor pollicis brevisOpponens pollicisFirst lumbricalSecond lumbricalMuscles supplied by ULNAR NERVE are:By its superficial branchPalmaris brevis By its deep branchi Adductor pollicisFlexor digiti minimiAbductor digiti minimiOpponens digiti minimiThird & fourth lumbrical4 Dorsal interosseous4 Palmar interosseous | 2 | Has 2 heads | Supplied by Median nerve | Causes Adduction of thumb | Arterial supply is from Arteria priceps pollicis | Anatomy | Hand | cab9ac8a-cc6f-4d3f-bd27-38bf324b2813 | multi |
Testing for microdeletion of Y-chromosome is offered for which patient with a normal Karyotype | A patient with severely decreased sperm counts and a normal Karyotype is offered testing for microdeletion of Y chromosome. | 1 | Sperm concentration of 2 million/ml | Semen volume of 2 ml | Presence of fructose in semen | Normal morphology sperms >4% | Gynaecology & Obstetrics | null | b0665dd4-9301-45ba-842b-de34ba80abcf | single |
True statement regarding insulin: | Ref: Harper's Illustrated Biochemistry,28th editionExplanation:InsulinSecreted from pancreatic islet b cellsReleased regulated by blood (glycemic thresholdSynthesized as a single chain : pro-insulinInsulin is formed from proinsulin (removal of the connecting or "C" peptide)Insulin is thus made up of 2 chainsA (21 amino acids) and B (30 amino acids)Connected to each other by 2 inter disulfide bridges and 1 intra disulfide bridgeAll necessary for its hormone activity.ActionsStimulates glucose oxidation & storage and inhibits glucose productionStimulates glycogen synthaseInhibits phosph orylaseInhibits gluconeogenesisStimulates glucose transport into adipocytes, which is then converted intoTGInhibits hormone-sensitive lipase (HPL) (|cAMP) and lipoprotein lipaseActivates GLUT1Stimulates fatty acid and triglyceride synthesisInhibits I i poly sis and proteolysisShifts potassium ions from ECF to ICF | 2 | Produced by alpha cells of pancreas | Two polypeptide chains are bound by disulfide linkages | Shifts potassium outside the cell | S.c insulin tl/2 is 60 mins | Biochemistry | Chemistry of Carbohydrates, Amino sugars, and Mucopolysaccharides | 1e2ec312-45ca-487f-859b-2115f248ee1e | multi |
Internal carotid artery is derivative of | null | 2 | First pharyngeal arch | Third pharyngeal arch | Fourth pharyngeal arch | Sixth pharyngeal arch | Anatomy | null | 012f16b6-454e-47ea-be80-045e81ea4ba6 | single |
Nipple shadows in chest xray characteristically have a sharp | Miller et al proposed that solitary pulmonary nodules that reach some or all of the following criteria can be considered nipple shadows :Bilateral and symmetric"fuzzy" margins or radiolucent "halo"Sharp lateral border and poorly defined medial border (may be present only on pa projections 3)Nodules are in a characteristic position:Male: between fifth and sixth rib anteriorlyFemale: at the inferior aspect of the breast shadowWere not present on a very recent filmProminent nipples may be visible on a lateral projectionHowever, if there is doubt repeat chest x-ray with nipple markers should be performed.(Ref: Miller WT, Aronchick JM, Epstein DM et-al. The troublesome nipple shadow. AJR Am J Roentgenol. 1985;145 (3): 521-3.) | 2 | Medial margin | Lateral margin | Superior margin | Inferior margin | Radiology | All India exam | b2064efb-9890-49c3-8a47-7b3f51315c8a | multi |
What changes the conformation of alpha helix in collagen | Ans. (b) ProlineRef: Harper's Biochemistry, 30th ed. pg. 141, 298-99* Proline is the amino acid which changes the conformation of the alpha helix in collagen due to the nature of proline having a cyclical structure. It also forms the ends of the beta sheets in the secondary structures. | 2 | Methionine | Proline | Alanine | Tyrosine | Biochemistry | Proteins and Amino Acids | cadf8a35-bbee-49b9-a54c-b855ae257161 | single |
Disruption or disorganization of biological rhythm is observed in | Disturbance of biological functions is common with depression, with insomnia (or sometimes increased sleep), loss of appetite and weight (or sometimes hyperphagia and weight gain), and loss of sexual drive. When the disturbance is severe, it is called as melancholia ( somatic syndrome) The somatic syndrome in depression is characterised by: a. A significant decrease in appetite or weight b. Early morning awakening, at least 2 (or more) hours before the usual time of awakening c. Diurnal variation, with depression being worst in the morning d. Pervasive loss of interest and loss of reactivity to pleasurable stimuli e. Psychomotor agitation or retardation. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.72 | 3 | Schizophrenia | Anxiety | Depression | Mania | Psychiatry | Mood disorders | 80c83132-0c7b-452d-8218-757339c85c3d | single |
All of the following are features of musculocutaneous nerve injury at axilla except | Loss of flexion of shoulder* Flexion at shoulder is done by major muscles like pectoralis major, anterior fibres of deltoid, which are intact here. Musculocutaneous nerve (MCN)originates from the lateral cord of the brachial plexus of nerves. It pierces the coracobrachialis muscle and gives off branches to the muscle, as well as to brachialis and biceps brachii, the chief flexors at elbow joint. Coraco-brachialis is a flexor at shoulder joint Biceps brachii is a powerful supinator, hence supination is weakened. MCN terminates as the lateral cutaneous nerve of the forearm. | 1 | Loss of flexion of shoulder | Weak elbow flexion | Weak forearm supination | Loss of sensation on radial side of forearm | Surgery | null | 9fc273b2-34fa-4e59-8b46-7c0fe32fed5f | multi |
Material used in veebroplasty: | Ans. Polymethyl methacrylate | 1 | Polymethyl methacrylate | IsoMethyl Methacry]ate | Isoethyl Methacrylayte | Silicon | Radiology | null | fa78e93d-8507-4de8-80e2-10025371faa9 | single |
Paramesonephric duct in males remains as | The paramesonephric ducts remain rudimentary in the maleThe greater pa of each duct eventually disappearsThe cranial end of each duct persists as a small rounded body attached to the testis(appendix of testis)It has been considered that the prostatic utricle represents the uterovaginal canalRef: Inderbir Singh&;s Human embryology; Tenth edition; Pg 300 | 1 | Prostatic utricle | Prostatic uretha | Colliculus seminalis | Ejaculatory duct | Anatomy | General anatomy | bb9e9fc3-46aa-409a-bd4e-b18725e775d0 | single |
Following injury to the right temple region, patient complaints of pain in the right eye and loss of vision. On examination the eye movements are normal, and pupil normally reacts to light. The diagnosis is | (C) Traumatic glaucoma# Traumatic Glaucoma: Atraumatic separation to the iris root and citiary body. Is not an uncommon cause of trauma by blunt object or by penetrating injury to globe.> Symptoms: Pain, blurred vision, history of blunt and penetrating injury.> Sings: Hyphaema, an irregular pupil in acute phase, slightly reduced IOP due to Iris/increased aquous.> Transient elevated IOP due to hyphema or anteriorly dislocated lens.> Signs in Chronic Phase: Chronic pressure elevation due to obstruction of aquous outflow system Optic disc cupping Visual field loss. | 3 | Functional loss of vision | Optic nerve atrophy | Traumatic glaucoma | Sub-arachnoid haemorrhage | Surgery | Miscellaneous | 5aee74ad-3d07-4020-b50e-4d93d852b1d3 | multi |
Under EMCP launched in 1997,the criteria for selection of PHCs included the following EXCEPT: | Under EMCP (Enhanced Malaria Control Project) launched in 1997, the criteria for selection of PHCs (Primary Health Center) include API more than 2 for the last 3 years, Plasmodium falciparum more than 30% of total malaria cases and the area has been reporting deaths. | 4 | API more than 2 for the last 3 years | Plasmodium falciparum more than 30% of total malaria cases | The area has been reporting deaths | The area has been reporting epidemics | Unknown | null | c8801c78-9276-47ac-aa92-0ce05792dc4a | multi |
All of the following statements about purification of water are true except : | Spores of Cl. perfrignence (in the absence of coliform group) indicate remote fecal contamination of water.
Total coliform bacteria must not be detectable in any 100 ml of sample.
Sodium thiosulphate is used to dechlorinate tap water for aquariums or treat effluent from waste water treatments prior to release into rivers.
It is also used to lower chlorine levels in swimming pools and spas following superchlorination.
Presumptive coliform count is done by multiple tube method and membrane filtration technique.
After analysing presumptive coliform coutn, E coli count is confirmed by other tests litre Eijkmant test and indole production. | 1 | Presence of Clostridial spores indicate recent contamination of water | Coliforms must not be detectable in any 10 ml sample of drinking water | Sodium thiosulphate is used to neutralize chlorine. | Coliforms may be detected by multiple method & indole production | Social & Preventive Medicine | null | 6cfbc54b-6e9d-4284-8208-301a0c0c93f7 | multi |
In rhinosporidiosis the following is true: | (c) Surgery is the treatment(Ref. Scott Brown, 6th ed., 4/8/40)Rhinosporidiosis is managed by wide excision and cauterisation of base. Recurrence may occur if sporangium is left behind. Dapsone is given in the postoperative period to decrease the chances of recurrence. | 3 | Fungal granuloma | Greyish mass | Surgery is the treatment | Radiotherapy is treatment | ENT | Rhinosporidiosis | 28cf27d2-a2cf-4885-8bf1-35771a6545c5 | multi |
A 45-year-old woman is admitted to the emergency department with a complaint of severe abdominal pain. CT scan and MRI examinations reveal a tumor of the head of the pancreas involving the uncinate process. Which of the following vessels is most likely to be occluded? | The superior mesenteric artery arises from the aorta, deep to the neck of the pancreas, then crosses the uncinate process and third part of the duodenum. An uncinate tumor can cause compression of the superior mesenteric artery. The common hepatic artery arises superior to the body of the pancreas and is unlikely to be affected by a tumor in the uncinate region of the pancreas. The cystic artery and vein, supplying the gallbladder, are also superior to the pancreas. The inferior mesenteric artery arises at the level of L3, which is thus situated deep to and inferior to the head of the pancreas. The portal vein, formed by the confluence of the superior mesenteric vein and splenic vein, passes deep to the neck of the pancreas. | 3 | Common hepatic artery | Cystic artery and vein | Superior mesenteric artery | Inferior mesenteric artery | Anatomy | Abdomen & Pelvis | 1a5c58ea-02c5-444a-be0f-3a8d582b190b | single |
Among various glands, salivary gland secretion is unique in that, its secretions are controlled by | null | 2 | Hormones | Nerves | Chemicals | All of the above | Dental | null | c87967c4-06df-4c85-a2a2-0ecfb060fd61 | multi |
A 35-year-old man presents with following problem. Most likely diagnosis? | Ans. C. Gouta. Acute gout causing swelling, erythema and extreme pain and tenderness of the first metatarsophalangeal joint.b. This is also known as Podagra- Colchicine and indomethacin are the drug of choice in this acute attack. | 3 | Cellulitis | Deep vein thrombosis | Gout | PAN | Medicine | Immunology and Rheumatology | 7f1aea67-72b4-4833-94ff-f4562c59933a | single |
All of the following passthrough lesser sciatic foramen except: | Internal pudendal vessels | 2 | Pudendal nerve | Internal pudendal vessels | Nerve to obturatorinternus | Inferior gluteal vessels | Anatomy | null | 2331335a-1845-45b5-bf35-4dbc770018a4 | multi |
Extrapyramidal side effects of antipsychotics -a) Dystoniab) Akathisiac) Seizuresd) Diarrheae) Parkinsonism | Extrapyramidal side effects of antipsychotics
Extrapyramidal side effects are the major dose limiting side effects of antipsychotics.
Maximum extrapyramidal side effects are seen with haloperidol.
Least extrapyramidal side effects are seen with clozapine (amongst all antipsychotics).
Among typical antipsychotics, thioridazine has least extrapyromidal side effects (EPS).
Amongst atypical antipsychotics, resperidone has maximum tendency to cause EPS.
Different syndromes are : Parkinsonism, acute muscular dystonia, akathisia, malignant neuroleptic syndrome, tardive dyskinesia, rabbit syndrome. | 3 | abc | bcd | abe | acd | Psychiatry | null | 4d06b572-fb1a-46a0-903d-6a439ad69c8a | single |
Hard exudates are seen in the following except | Leukaemic retinopathy It is characterised by pale and orange fundus background with dilated and touous veins. In later stages, greyish white lines may be seen along the course of the veins (due to perivascular leukaemic infiltration). Aerioles become pale and narrow. Retinal haemorrhages with typical white centre (Roth spots) are very common. Occasionally large pre-retinal (sub hyaloid) haemorrhages may also be seen. Ref:- A K KHURANA; pg num:-264 | 4 | Hypeensive retinopathy | Diabetic retinopathy | Exudative retinopathy of Coat's | Leukemic retinopathy | Ophthalmology | Cornea and sclera | 10679cc4-20b7-4a3e-a10a-f273865c34b7 | multi |
A newborn child presents with inverted foot and the dorsum of the foot cannot touch the anterior tibia. The most probable diagnosis is: | Ans. c. CTEV (Ref: Apley's 9/e p291, 591-594; Turek's 6/e p658-661; Campbell's 11/e p1474-1475)The most probable diagnosis in a newborn child with inverted foot in whom the dorsum of the foot cannot touch the anterior tibia is CTEV.Congenital Talipes EquinoVarus (CTEV):Congenital deformity involving one foot or both.Affected foot appears rotated internally at the ankle.As heels are rotated internally patient is not able to touch tibia by dorsum of his foot.Congenital Vertical Talus (CVT):It is irreducible dorsal dislocation of the navicular on the talus with a fixed talo-navieular complex.CVT is a common cause of rigid flat foot, which can be isolated, or can occur with chromosomal abnormalities, myeloarthropathies (myelomeningocele) and neurologic disorders.Clinically talar head is prominent medially, sole is convex, forefoot is abducted and dorsiflexed, and the hind foot is equinovalgusSole of foot has a rocker-bottom (convex) deformityPatients demonstrate peg-leg gait (awkward gait with limited forefoot push off)Arthrogryposis Multiplex Congenita:Rare congenital disorder that is characterized by multiple joint contractures and can include muscle weakness and fibrosis.It is a non-progressive disease.The disease derives its name from Greek, literally meaning 'curved or hooked joints'.Cerebral Palsy:Includes the group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement.Divided into four major classifications to describe different movement impairments; also reflect the areas of the brain that are damaged.The four major classifications are:Spastic: MC type (70-80%)Ataxic: Caused by damage to the cerebellum (10%)Athetoid/dyskinetic: Mixed muscle tone, trouble holding in an upright, steady position for sitting or walking; often show involuntary motions.Hypotonic: Patients have musculature that is limp, and can move only a little or not at all.Congenital Talipes EquinoVarus (CTEV)/Club FootCongenital deformity involving one foot or both.Affected foot appears rotated internally at the ankle.As heels are rotated internally patient is not able to touch tibia by dorsum of his foot.CTE-V is classified into 2 groups: Postural TEV and Structural TEV.Incidence: 1 in 1,000 live births: More common in malesEtiology and Associated Anomalies:Idiopathic (MC)Q; Secondary club footSecondary club foot* Neurological disorders and neural tube defectsQ (myelomeningocele and spinal dysraphism)* Paralytic disorder (due to muscular imbalance) as polio. spina bifidaQ, myelodysplasia, and Freidreich's ataxia* Arthrogryposis multiplexaQ* Larsen syndrome* Freeman-Sheldon (Mobius) syndrome* Diasirophic dwarfism* Sacral agenesis, tibial deficiency, constriction rings and amniotic bands* Fetal alcohol syndrome* Down's syndrome Deformities affecting joints of the foot in CTEV* Inversion at subtalar jointQ* Adduction at talonavicular jointQ* Equinus at ankle jointQ"InAdEquate" for Inversion, Adduction and EquinusQ.Screening Methods:The foot of a newborn child normally can be dorsiflexed until the dorsal surface of foot touches the anterior aspect of shin of tibiaQ.It is a useful screening method for detecting the milder cases of CTEV, in which the foot cannot touch anterior tibia.Clinical Presentation:Classical appearance of CTEV is small size foot and small heel with characteristic CAVE deformity (Cavus, Adduction, Varus, Equinus) i.e. heel in equinuis with foot inverted on end of tibia giving the foot an upside down club appearance.Inability to bring the foot in opposite directions to deformity.Deep skin creases on medial side of foot and back of heel.Outer side of foot is convex and contains bony prominences (e.g. head of talus) and dimples.Prognosis:Prognosis of non-idiopathic syndromic club foot is generally worse than that for an idiopathic club foot, although there are certain exceptions like Down's syndrome or Larsen's syndrome: in which because of significant ligamentous laxity underlying the syndrome itself, correction may be achieved with non-operative treatment.Management of CTEVConservative managementOperative management* Clubfoot always requires treatment, which should begin at birthQ.* Manipulation should be frequently repeated, and after manipulation some form of splint or cast must be usedQ.* In the first month of life, manipulation should be repeated 6 times at each nappy change and adhesive strapping which maintains the correctionQ.* In place of strapping, splintage (Dennis Brown Splint) and even casting usually at one-week interval in the first month of lifeQ can also be used.* In infants >1 month, corrective manipulations and above knee cast (from toe to groin) is applied for 2 weeks.* Delaying surgery is suitable for severe, rigid deformities; for less severe cases it may be preferable to operate at around 6 months of ageQ.* Posteromedial soft tissue release is best done at 6 months-3 yearsQ.* Triple arthrodesis is necessary for recurrent or persistent club foot deformity in older children (chronic cases)Q. It is best done at 10-12 years of age when foot growth is completeQ. Pseudoarthrosis (most commonly of talonavicular joint) is commonest complicationQ.Kite's MethodPonseti Method (Method of choice)6 months-3 yearsPosteromedial soft tissue releaseOrder of correction of deformity:* Adduction of forefoot* Inversion (varus) of heel / hind foot and inversion (supination) of fore /mid foot* Equinus (plantar flexion) of ankleOrder of correction of deformity:* Cavus* Adductus* Varus* Equinus4-10 yearsRevision of soft tissue release together with shortening of lateral side of foot by:* Lichtblau's Procedure (<6 years)* Even-Dillwyn Procedure (>6 years)>10-12 yearsTriple arthrodesisQ | 3 | Congenital vertical talus | Arthrogryposis Multiplex | CTEV | Cerebral palsy | Orthopaedics | Lower Limb and Foot & Ankle Problems | 3b40b5c2-df3d-4b66-9db6-d55e9574b592 | single |
Increase in body temp during ovulation is by - | Ans. is 'b' i.e., Progesterone o Ovulation mav be inferred bv measuring the basal body temperature throuehout the menstrual cycle.o Temperature recordings are done on a chart and sustained upward shift of temperature (0.3degrees F for three days) infers that progesterone is being synthesized and released into circulation as a result of ovulation.Test Time ObservationTest for documenting ovulation1. Basal body tempThroughout cycleBiphasic pattern2. Cervical mucusDay 12 - 14 Day 21 -23Cervical mucus is clear watery, stretchabilitv present, derming present Cervical mucus is thick, viscid, tack present, feming absent3. Vaginal cytologyDay 12 - 14Estrogen dominated smears-efear, discrete comifined, polygonal, superficial cells (predominant cells)Day 21-23Progesterone dominanted smear - containing dirty, predominantly intermediate (Navicular) cells4. Endometrial biopsyDay 24 - 26Secretory' endometrium (confirming ovulation)5. Serum progesteroneD8 and D21D - 8 < 1 ng/mi D - 21 > 6 5 ng/ml6. Foil icular monitoringD10- D14Follicle is measured by USG7. LaparoscopySecretory phaseRecent corpus luteum is directly seen | 2 | Estrogen | Progesterone | LH | FSH | Gynaecology & Obstetrics | Pathology of Conception | 7d499d38-8956-41d8-841b-e7440b64d4c8 | single |
Replacement of etonogestrel implant(Implanon) is normally done after how many years? | Implanon is a single rod subdermal implant with 68 mg of the progestin etonogestrel (ENG), and an ethylene vinyl acetate copolymer cover. It can be used as contraception for 3 years and then replaced at the same site or opposite arm. It is placed in the medial surface of the upper arm 6 to 8 cm from the elbow in the biceps groove within 5 days of onset of menses. Prolonged and frequent bleeding is the most common adverse effect. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 32. Contraception. | 2 | 2 years | 3 years | 4 years | 5 years | Gynaecology & Obstetrics | null | 96f7144f-23c6-46bc-b5f0-7c3dfefb031e | multi |
True morbidity in a population can be calculated by | Active Surveillance Extra measures are taken to collect data and confirm diagnoses to ensure more complete repos for surveys and outbreak investigations. Active surveillance encompasses formal and informal communications. Eg: Malaria surveillance by a health worker Main objectives of Surveillance 1. Provide information about new and changing trends in the health status of population - morbidity, moality, nutritional status 2. Provide feedback 3. Provide timely warning Ref: Park's Textbook of Preventive and Social Medicine; 24th edition - Page no. 45 | 3 | Sentinel Surveillance | Passive Surveillance | Active Surveillance | Monitoring | Social & Preventive Medicine | Concept of health and disease | a6a1fb5c-28b8-431d-9be0-ffdb727b4aba | multi |
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