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Example of asymmetric mixed-onium chlorofumarate is: | Gantacurium represents a new class of nondepolarizing neuromuscular blockers called asymmetric mixed-onium chlorofumarates. Ref: Miller's anesthesia-7th ed , Chapter 29. | 3 | Rocuronium | Vecuronium | Gantacurium | Atracurium | Anaesthesia | null | 54fa918b-28dd-4e10-8f60-d76dea9266cc | single |
The optic cup is an evagination of which of the following? | The optic cup and its derivatives--the retina and optic nerve--develop from the diencephalon. | 2 | Telencephalon | Diencephalon | Mesencephalon | Metencephalon | Anatomy | Eye, Nose and Ear | c7c86bc0-c79c-4afc-b2e7-1e08bb0e507e | single |
Best treatment for gas gangrene | "High-dose penicillin G and clindamycin, along with third-generation cephalosporins, should be given intravenously until the patient's toxicity abates. The mainstay of management is early surgical excision of the necrotic tissue " Bailey and love 26th edition Pg 430 | 3 | Surgical debridement | Debridement with tetanus toxin | Debridement with iv penicillin | Debridement with polyvalent antitoxin | Surgery | General surgery | afd86569-9254-475f-be0f-d6c8db0a29f1 | single |
Radium emits which of the following? | Ans. is 'b' i.e., a, b, g o Radium emits a, b and g rays. Radium also produces neutrons when mixed with beryllium. | 2 | b, g | a, b, g | a, b | Neutrons | Radiology | Physics of Radiotherapy | 8356d9a0-27b4-4931-9f3f-0953c5ca0887 | single |
The attachment of the Actinomyces species to the tooth surface is facilitated by: | null | 1 | Fimbriae. | Cillia | Flagella. | Capsule. | Pathology | null | 10a0fac9-5df1-4254-86c2-d1df911e8be9 | single |
A 45 year old male presents with 4 X 4 cm, mobile right solitary thyroid nodule of 5 months duration. The patient is euthyroid. The following statements about his management are true except | Malignancy is present in 15% to 20% of cold nodules and in less than 5% of hot nodules. Although suggestive, malignancy of a nodule can be neither confirmed nor excluded based on radionuclide uptake. Note :Option "Patient should undergo hemithyroidectomy if FNAC repo is inconclusive " is controversial. Close surveillance with ultrasound, genetic and molecular testing or other alternatives to diagnostic thyroidectomy. Even after diagnostic thyroidectomy, patient still requires survelliance for other lobe or may require total thyroidectomy if biopsy proves malignancy. | 1 | Cold nodule on thyroid scan is diagnostic of malignancy | FNAC is required in fuher management of patient | The patient should undergo hemithyroidectomy if FNAC repo is inconclusive | Indirect laryngoscopy should be done in the preoperative period to assess mobility of vocal cords | Surgery | Endocrinology and breast | 5db0fb80-9ec6-499d-9dd9-c6a71c3eccfb | multi |
Duration of action of flumazenil is: | Flumazenil is absorbed orally ;oral bioavailability is ~16% but its not used orally .On I.v .injection ,action of flumazenil stas in seconds &last for 1-2 hours ;elimination t1/2 is 1 hour due to rapid metabolism. REF: KD Tripathi 8th ed. | 4 | 5 minute | 10 minute | 20 minute | 1-2 hours | Pharmacology | Central Nervous system | 59b9cdbb-7839-4348-9985-2d19d0726e8b | single |
Cryptococcal meningitis is common in: | Ans. is 'a' i.e., Renal transplant recipientPredisposing factors of cryptococcal meningitis are AIDS, hematologic malignancies, transplant recipients and patients on immunosuppressive or steroid therapy. | 1 | Renal transplant recipient | A gamma globulinemia | Neutropenia | IgA deficiency | Microbiology | Mycology | 29a59fba-6225-4d49-a0cc-ffc1324506f8 | single |
All of the following structures can be viewed through a bronchoscope, EXCEPT: | Subcarinal lymph nodes are mediastinal lymph nodes located around the carina on the other side of the tracheal wall and hence not visualized on bronchoscopy. Involvement of subcarinal nodes may be suspected on bronchoscopy by widening and fixity of the carina and/or paralysis of the vocal cords but these nodes cannot be 'directly visualized'. | 3 | Trachea | Vocal cords | Subcarinal lymph nodes | First segmental division of bronchi | ENT | null | ec889555-41a2-4c14-a232-092ab263610f | multi |
Hyperesthesia over the region of 12th is called | Boa's sign is present in acute cholecystitis | 2 | Murphy’s sign | Boa's sign | Moynihan's sign | Aaron's sign | Surgery | null | 44ea921b-acb4-4949-8ea1-b53bd50c402c | multi |
With regard to the malignant behavior of leiomyosarcoma, the most impoant criterion is | Option 4 is correct=the number of mitosis per high power field Leiomyosarcomas typically take the form of soft, hemorrhagic, necrotic masses. The diagnostic features of ove leiomyosarcoma include tumor necrosis, cytologic atypia, and mitotic activity. Robbins basic pathology 9th edition page no 694,heading=leiomyosarcomas..box=Morphology ref img | 4 | Blood vessel penetration by tumor cells | Tumor cells in lymphatic channels | Lymphocyte infiltration | The number of mitoses per high power field | Pathology | Breast | 0ad73f37-daf5-4eb9-877e-ba9d75a05e5a | single |
In which case Immunoguided surgery is done | Ans is 'a' ie Ca Colon Radioimmunoguided surgery (RIGS) is a new technology capable of detecting minimal neoplastic lesions using radiocolloids, intraoperatively. It has numerous uses in oncology, it uses colloid radiotracers, monoclonal antibodies or non-immunological tracers. Its uses are Radioguided Occult Lesion Localization (ROLL) and Sentinel Lymph-Node Biopsy (SLNB).The malignancies mentioned in the above given web addresses of Pubmed, in which RIGS is being used are:Breast cancerColorectal cancerNon-small cell lung cancer | 1 | CA colon | CA pancreas | CA jejunum | CA anal canal | Surgery | Colon and Rectum - Polyps and Carcinoma | b3d0114f-293f-4a86-bd39-fc55069b4f7e | single |
The maxillary sinus open intlo middle meatus at the level of: | Ref: Dhingra 7e pg 151,209. | 1 | Hiatus semilunaris | Bulla ethmoidalis | Infundibulum | None of the above | ENT | Nose and paranasal sinuses | 7a042f90-ab00-4c1d-a1fd-a5e2fdaaa64a | multi |
Dutcher bodies are seen in? | Ans. is 'd' i.e., Bone marrow * In multiple myeloma plasma cells can infiltrate the bone marrow diffusely or may be present in sheet like masses that completely replace normal elements.* Plasma cells may be normal plasma cells but mostly they are atypical plasma cells (variants of plasma cell) produced by intracellular accumulation of intact or partially degraded immunoglobulins. These atypical plasma cells are :i) Flame cellsii) MOTT cells* Intracellular inclusions are Russel bodies (cytoplasmic), Dutcher bodies (nuclear), crystalline rods and fibrils.* Dutcher bodies, which are attributed to immunoglobulin filled cytoplasm invaginating into the nucleus creating the appearance of an intranuclear inclusion. | 4 | Brain | Liver | Spleen | Bone marrow | Pathology | Blood | b396b65b-e4bf-4db9-9270-4c5d317a4af2 | single |
Treatment of choice for placental site trophoblastic disease is - | Ans. is 'b' i.e., SurgeryPlacental Site Trophoblastic TumorArises from the placental bed trophoblasts and invades the myometrium.Most of these tumors run a benign course, malignancy is rare.Tumor is resistant to chemotherapy.Hysterectomy is the recommended treatment. | 2 | Observation | Surgery | Chemotherapy | Radiotherapy | Gynaecology & Obstetrics | null | 8ba14fb8-4711-4acd-8362-fe2ac5d583f7 | single |
Most common site of GIST is | Gastrointestinal Stromal Tumors Gastrointestinal stromal tumors (GISTs) are the most common sarcomatous tumors of the GI tract. Originally thought to be a type of smooth muscle sarcoma, they are now known to be a distinct tumor derived from the interstitial cells of Cajal, an intestinal pacemaker cell. They can appear anywhere within the GI tract, although they are usually found in the stomach (40% to 60%), small intestine (30%), and colon (15%). GISTs vary con- siderably in their presentation and clinical course, ranging from small benign tumors to massive lesions with necrosis, hemorrhage, and wide metastases | 1 | Stomach | Small intestine | Large intestine | Spleen | Anatomy | G.I.T | 24eb90aa-ab2f-4b49-9d4d-5f9f0214c66e | multi |
PSA is measured in which units | Ans. is 'd' i.e., ng/ml Prostate specific antigen* It is a glycoprotein produced only in the prostatic cells (both benign & malignant). It facilitates liquefaction of semen.* It is neither sensitive nor specific for early prostate carcinoma (it is prostate specific and not prostate cancer specific)y nevertheless it gives some help in making a diagnosis.# Normal serum level - less than 4 ng/ml# 4-10 ng/ml - this range is common for both BHP and Ca.# More than 10 ng/ml - approx 75% will have cancer.* Since PSA is not specific for Ca, PSA Velocity & PSA density are used to detect Prostate cancer.* PSA velocity is the rate of change in PSA levels over time and is expressed most commonly as the PSA doubling time. For men with a PSA above 4, PSA velocity of more than .75 ng/ml year is suggestive of Ca. While for those with lower PSA levels, rates above 0.5 ng/mL per year should be used to advise biopsy.* PSA density is calculated by dividing the serum PSA by the estimated prostate weight (measured by TRUS). It was developed to correct for the contribution of BPH to the total PSA level.# Values <0.10 are consistent with BPH.# >0.15 suggest cancer | 4 | gm/ml | mg/ml | mcg/ml | ng/ml | Surgery | Prostate & Seminal Vesicles | 3dce91ab-2d5c-4ba2-a16f-85047dca6cf4 | single |
In Angle's classification for malocclusion, key tooth is: | Angle’s postulate was that the upper first molars were the key to occlusion and that the upper and lower molars should be related so that the mesiobuccal cusp of the upper molar occludes in the buccal groove of the lower molar. If the teeth were arranged on a smoothly curving line of occlusion and this molar relationship existed , then normal occlusion would result.
Angle then described three classes of malocclusion, based on the occlusal relationships of the first molars:
Class I: Normal relationship of the molars, but line of occlusion incorrect because of malposed teeth, rotations, or other causes.
Class II: Lower molar distally positioned relative to upper molar, line of occlusion not specified.
Class III: Lower molar mesially positioned relative to upper molar, line of occlusion not specified.
Reference: Contemporary orthodontics, Proffit 6th ed page no 2 | 1 | MB cusp of Permanent Max. 1st molar | DB cusp of Permanent Max. 1st molar | MB cusp of Permanent Max. 2nd molar | MB cusp of Permanent Mand. 1st molar | Dental | null | 387a397a-b143-40af-9633-1b2f94991ac7 | single |
Which is the most common type of persistent delusional disorder ? | Ans. A. Delusion of persecution Delusion of persecution is the most common type of persistent delusional disorder. | 1 | Delusion of persecution | Somatic delusion | Delusion of jealousy | Delusion of grandeur | Psychiatry | null | 487bedd7-1bd7-4fda-a516-b9dbd60dda9a | single |
All age groups are included in numerator of dependency ratio except - | Numerator in dependency ratio includes:-
i) 0-14 years (option a & b)
ii) > 65 years (option d) | 3 | 0-5 years | 5-10 years | 20-60 years | > 65 years | Social & Preventive Medicine | null | d99c40cc-dedf-4767-a272-cbfc8f492fca | multi |
True about Type 1 diabetes mellitus | * Patients may become hyperglycemic in poorly controlled type 1 diabetes mellitus . The reason being - due to lack of insulin to stimulate uptake and utilization of glucose and also because in the absence of insulin which antagonize the actions of glucagon, there is increase in gluconeogenesis from amino acids in liver. * Lack of insulin (which antagonize the actions of glucagon) results in increased lipolysis in adipose tissue , and the resultant NEFAs become substrates for ketogenesis in the liver. There is defect in the utilization of ketone bodies in muscle because of lack of oxaloacetate . * In uncontrolled diabetes, ketosis is severe enough to cause pronounced acidosis (ketoacidosis). * Coma results from both the acidosis and also the considerably increased osmolality of extracellular fluid (mainly as a result of the hyperglycemia, and diuresis resulting from the excretion of glucose and ketone bodies in the urine). Ref:- Harper 30/e; pg num:- 149 | 3 | Decreased hepatic Glucose output | Increase glucose uptake | Increased lipolysis | Decreased protein catabolism | Biochemistry | Metabolism of carbohydrate | d043103e-7fb1-4308-bf51-749be1cdab13 | multi |
Vitamin k associated clotting factors are | Ref Robbins 8/e 118-119 ; 9/e p 119 Physiologic Effects of Vitamin K Vitamin K serves as an essential cofactor for a carboxylase that catalyzes carboxylation of glutamic acid residues on vitamin K-dependent proteins. The key vitamin K-dependent proteins include: Coagulationproteins: factors II (prothrombin), VII, IX and X. | 1 | 9,10 | 1,5 | 7,8 | 1,81 | Anatomy | General anatomy | 301be874-e1b4-469c-89ee-f44aa1fee33b | single |
Anti-parkinsonism drug that is selective COMT inhibitor? | Ans. a (Entacapone) (Ref. KDT 6th/pg. 415)ADRENERGIC DRUGSSr NoStep/siteActionDrugResponse1.Synthesis of NAInhibition Utilization of same synthetic pathwaya-methyl-p-tyrosine a-methyl dopaDepletion of NAReplacement of NA by a-methyl NA(false transmitter)2.Axonal uptakeBlockadeCocaine, desipra- mine, guanethidine, antihistaminics, ephedrinePotentiation of NA (endo- and exogenous), inhibition of tyramine3.Granular uptakeBlockadeReserpineDepletion of NA (degraded by MAO)4.Nerve impulse coupled release of NAInhibitionGuanethidine, bretyliumLoss of transmission5.Granular NADisplacementGuanethidineInitially sympathomimetic, depletion later.6.Membrane NA poolExchange diffusionTyramine, ephedrineIndirect sympathomimetic7.MetabolismMAO inhibition COMT inhibitionNialamid tranylcy- promine Tolcapone, entacaponePotentiation of NA (slight),| Of tyramine (marked) Potentiation of NA (slight)8.ReceptorsMimickingPhenylephrine Clonidinea1 sympathomimetica2-inhibition of NA release, |sympathetic outflow IsoprenaiineSalbutamolb1+ b2 - sympathomimeticb2-sympathomimetic BlockadePhenoxybenzaminePrazosinYohimbinePropranololMetoprolola1 + a2 - blockadea1- blockadea2 - blockadeb1 + b2 - blockadeb1 - blockadePergolidePergolide, another ergot derivative, directly stimulates both D1 and D2 receptors.It too has been widely used for parkinsonism, and comparative studies suggest that it is more effective than bromocriptine in relieving the symptoms and signs of parkinsonism, increasing "on-time" among response fluctuators, and permitting the levodopa dose to be reduced.PramipexolePramipexole, which is not an ergot derivative, has preferential affinity for the D3 family of receptors. It is effective when used as monotherapy for mild parkinsonism.RopiniroleRopinirole, another nonergoline derivative, is a relatively pure D2 receptor agonist that is effective as monotherapy in patients with mild disease and as a means of smoothing the response to levodopa in patients with more advanced disease and response fluctuations.RasagilineRasagiline, another monoamine oxidase B inhibitor, is more potent than selegiline in preventing MPTP- induced parkinsonism and is currently under study as a neuroprotective agent.TolcaponeSelective COMT inhibitors such as tolcapone and entacapone also prolong the action of levodopa by diminishing its peripheral metabolism. | 1 | Entacapone | Ropinirole | Pergolide | Pramipexole | Pharmacology | C.N.S | 152bf82f-5a4d-4ddd-8bbe-e2af0e936b49 | single |
Loop of Henle handles the following ions except: | D i.e. UreaIn the thick ascending limb, a carrier co-transpos one Na+, one K.' and 2C1-Q from the tubular lumen into the tubular cells. | 4 | Na+ | K+ | CI? | Urea | Physiology | null | 8bde25f6-b875-4180-a04b-77092ba8f5c5 | multi |
A 25 year old man undergoes orchiectomy for a testicular tumor. Microscopically, the tumor shows a variety of patterns, including lobules containing large cells with watery cytoplasm, structures resembling primitive glomeruli, syncytiotrophoblast, and shafts of undifferentiated cells with focal glandular differentiation. Which of the following terms most accurately describes this tumor? | This is a mixed testicular tumor. Mixed patterns occur in 60% of testicular tumors, with the most common pattern being teratoma (not present in this patient), embryonal carcinoma, yolk sack tumor, and hCG-containing syncytiotrophoblast. This patient's tumor also contains elements of seminoma. The prognosis of these tumors is determined by the presence or absence of more aggressive elements, notably choriocarcinoma. Choriocarcinoma contains both syncytiotrophoblast and cytotrophoblast. Embryonal carcinoma is characterized by sheets of undifferentiated cells with focal glandular differentiation. Seminoma shows lobules containing large cells with watery cytoplasm. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds),Pathology: The Big Picture. | 3 | Choriocarcinoma | Embryonal carcinoma | Mixed tumor | Seminoma | Pathology | null | 1dcde66d-58f8-4c4b-9b96-ea75ccb79beb | multi |
Following antimicrobials are termed as type I calcimimetics that mimic the stimulatory effect of calcium, on the calcium sensing receptor to inhibit PTH secretion by the parathyroid gland EXCEPT: | null | 2 | Streptomycin | Hamycin | Neomycin | Gentamicin | Pharmacology | null | 4bcd2c3f-2ce4-4ba4-bdc4-23614d87ba09 | multi |
Hormone synthesized as peptide precursor is/are | Insulin- A polypeptide hormone secreted by the islets of Langerhans and functioning in the regulation of the metabolism of carbohydrates and fats, especially the conversion of glucose to glycogen, which lowers the blood glucose level.Ref: Ganong&;s review of medical physiology; 24th edition; page no: 431 | 1 | Insulin | PTO | Renin | Thyroid hormone | Physiology | Endocrinology | 9a580e1a-b525-4a65-9935-a0619feb7d29 | single |
The derivative of midgut among the following is | HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:188Caecum and appendixThe caecal bud is a diveiculum that arises from the post aerial segment of the midgut Loop. The caecum and appendix are formed by the enlargement of this bud. The proximal pa of the bud grows rapidly to form the caecum. Its distal pa remains narrow and forms the appendix | 2 | Rectum | Appendix | Liver | Stomach | Anatomy | General anatomy | 64907cdc-3ef0-475b-b78b-2633c05c2711 | single |
Kidney cortex contains: | Ans. C Collecting tubule and ductRef: BDC, 6th ed. vol. II pg. 315-16* The kidney consists of an outer renal cortex and an inner renal medulla that contains the renal pyramids which drain into - Calyx - Pelvis.* Cortex forms a continuous smooth outer zone with a number of projections (cortical columns) that extend down between the pyramids.* It contains the renal corpuscles and the renal tubules except for parts of the loop of Henle which descend into the renal medulla. It also contains blood vessels and cortical collecting ducts.* The renal cortex is the part of the kidney where ultrafiltration occurs. | 3 | Loop of henle | Pyramids | Collecting tubule and duct | Calyces | Anatomy | Abdomen & Pelvis | 6f15d9bf-48c6-4a16-af29-9c6e865e48b4 | single |
X-linked muscular dystrophy is? | Ans. is 'd' i.e., Duchenne's muscular atrophy X-linked Recessive disordersMusculoskeletalHematologicalImmuneMetabolicNervous* Duchene muscular dystrophy* Chronic granulomatous disease* Hemophilia A & B* G-6-PD deficiency* Agamma - globulinemia* Wiskott - Aldrich synd.* Diabetes insipidus* Lesch Nyhan syndrome* Fragile - X- syndrome* Colour blindnessX-linked dominant disorders* Vitamim D resistant (X-linked hypophosphatemic) Rickets.* Familial hypophosphatemia.* Incontinentia pigmenti. | 4 | Myotonic dystrophy | Spinal muscular atrophy | Neurogenic muscular atrophy | Duchene muscular dystrophy | Pathology | Genetics | 7c49853e-b89a-4f3c-8191-83ae435071fb | single |
The diagnostic test for rickettsial infection is: | Weil-felix reaction | 1 | Weil-felix reaction | WIDAL | Sabin test | Culture | Microbiology | null | 8f163e42-b08f-48ec-b031-79a59882983b | single |
Synchysis refers to | VITREOUS LIQUEFACTION (SYNCHYSIS) Vitreous liquefaction (synchysis) is the most common degenerative change in the vitreous. Causes of liquefaction: 1. Degenerations such as senile, myopic, and that associated with retinitis pigmentosa. 2. Post-inflammatory, paicularly following uveitis. 3. Trauma to the vitreous which may be mechanical (blunt as well as perforating). 4. Thermal effects on vitreous following diathermy, photocoagulation and cryocoagulation. 5. Radiation effects may also cause liquefaction. Ref:- A K KHURANA; pg num:-244 | 3 | Collapse of the vitreous | Black spots in front of the eyes | Liquefaction of the vitreous | Detachment of the vitreous | Ophthalmology | Vitreous and retina | 024fa1a0-4c04-4a69-aea9-f26b971df0cb | single |
Subclinical infection is seen in all except | null | 3 | Mumps | Poliomyelitis | Measles | Rubella | Social & Preventive Medicine | null | aaabb6e9-661c-4073-a6cc-67c56dff62b4 | multi |
A 52 year old female presents with groin pain. Physical examination reveals a bulge in the groin area immediately inferior to the inguinal canal. The physician suspects that the patient has a femoral hernia containing a loop of small intestine. Which of the following structures is located immediately medial to the hernia sac? | A femoral hernia exits the abdominal cavity through the femoral ring to enter the femoral canal. The femoral ring is bounded medially by the lacunar ligament. Compression of the herniated intestine against the sharp edge of the lacunar ligament may cause strangulation of the intestine. The other borders of the femoral ring are the inguinal ligament anteriorly, the pubis posteriorly, and the femoral vein laterally.The femoral aery is within the femoral sheath along with the femoral hernia, but is lateral to the femoral vein, which separates the aery from the hernia. The femoral nerve is not inside of the femoral sheath, but is lateral to the sheath. The femoral vein is lateral to the femoral canal within the femoral sheath. Ref: Deveney K.E. (2010). Chapter 32. Hernias & Other Lesions of the Abdominal Wall. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e. | 4 | Femoral aery | Femoral nerve | Femoral vein | Lacunar ligament | Anatomy | null | ddbda64a-d153-412b-b85e-3520f3458726 | multi |
Vitamin D from the skin or diet is metabolized primarily in the liver to 25-hydroxyvitamine D3. What is the rate limiting enzyme in Vitamin D synthesis? | Vitamin D from the skin or diet is metabolized primarily in the liver to 25-hydroxyvitamine D3. 25D is the 'storage' form of vitamin D and is used to determine the vitamin D status of individuals. The last and rate limiting step in the synthesis of 'active' 1,25D is catalyzed by the mitochondrial enzyme 1 hydroxylase and is conventionally known to take place in kidneys. | 2 | 25 cholecalciferol | 1, 25-dihydroxycholecalciferol | 24, 25- dihydroxycholecalciferol | 7-dehydrocholesterol | Biochemistry | null | 89801c30-6f2a-4a30-8b12-cc14876c9791 | single |
Features of Von Willebrand disease are - | Ans. is 'a' i.e., | BT and | PTT Von willebrand diseaseo Von willebrand disease is characterized by the deficiency of vWF, while the synthesis of factor VIIIc is normal,o vWF has two major function: -i) Helps in platelet adhesionii) Stabilizes factor VIIIc.o So, deficiency of vWF results in manifestation of both.Platelet adhesion defecto Bleeding from small venules and capillaries of skin and mucous membrane e.g., epistaxis.o Menorrhagia and GI bleeding,o Proioged bleeding time (TBT)Coagulation defect (due to factor VIII dysfunction)o Bleeding into weight bearing joints.o Large post traumatic ecchymoses or hematoma,o Prolonged bleeding after any form of surgical procedure or a laceration,o Prolonged PTT.o vWF can be assayed by restocetin agglutination test which measures the ability of restocetin to promote the interaction between vWF and platelet membrane glycoprotein Ib-IX.o Von willebrand disease is of follow ing types: -Type I (most common 70%) - Autosomal dominant, with reduced quantity of vWF.Type II (25%) - Autosomal dominant, with qualitative defect of vWF.Type III - Autosomal recessive, with reduced quantify of vWF.Hemophilia A & Hemophilia B|PTT Normal BT Normal PTVon-Willebrand disease| PTT |BT Normal PTPlatelet dysfunction| BTo Bemard-soulier syndrome o Glanzmann's thrombastheniaNormal PT & PTTo ITP Henoch Schonlein purpuraNormal BT, PT & PTT | 1 | | BT and | PTT | | PT and | PTT | | PT | | CT | Medicine | Platelet Disorders | 95aefc1d-3f4b-49b0-bb84-445d18d25138 | single |
The design of choice for endodontic microsurgery is the: | The design of choice for endodontic microsurgery is the sulcular full-thickness flap
The mucogingival flap or Luebke-Ochsenbein flap is preffered for crowned anterior teeth for esthetic reasons. This flap which includes scalloped horizontal incision provides a guide for meticulous repositioning of the flap.
The first known record for endodontic flaps was by Partsch. He is credited with the Partsch incision or semilunar incision. It is a submarginal curved flap. There is limited surgical access, proor wound healing, and laximum disruption of the blood supply to the adjacent tissues. | 3 | Sulcular flap. | Sulcular partial-thickness flap. | Sulcular full-thickness flap. | Envelope flap. | Dental | null | d237cc57-eef2-45f4-83b5-3b8b43bab93b | single |
All of the following can cause DIC during pregnancy except: | Ans. is a, i.e. Diabetes mellitusDIC is a pathological condition associated with inappropriate activation of coagulation and fibrinolytic system. It is a secondary phenomenon resulting from an underlying disease state.Obstetric conditions associated with DIC:More commonLess common* Intrauterine fetal death* Chorioamnionitis* Amniotic fluid embolism* Pyelonephritis in pregnancy* Pre eclampsia- Eclampsia* H. mole* HELLP syndrome* Instillation of intraamniotic hypertonic saline* Placenta Abruption* Feto maternal bleed* Septic Abortion* Incompatible blood transfusion* Viremia -HIV, varicella, CMV hepatitis. COGDT p 997Pathogenesis: | 1 | Diabetes mellitus | Amniotic fluid embolism | Intrauterine death | Abruptio placentae. | Gynaecology & Obstetrics | Antepartum Haemorrhage | a2cba597-3313-4eb2-a461-1dfca7333cc7 | multi |
The ideal treatment for fracture of the angle of
mandible is | null | 4 | Transosseous wiring | Intermaxillary fixation | Plating on the Lateral side of the body of the mandible | Plating at the inferior border of the mandible | Surgery | null | 8b64aecd-0d6a-41b0-91ae-0c008bb1d22b | single |
The mother of a newborn boy is alarmed that her baby regurgitates at every feeding. An endoscopic examination reveals that the child's esophagus is almost completely occluded. This finding represents an example of which of the following errors of morphogenesis? | Atresia refers to defects caused by the incomplete formation of a lumen. Many hollow organs originate as strands and cords of cells whose centers are programmed to die, thus forming a central cavity or lumen. Atresia of the esophagus is characterized by partial occlusion of the lumen, which was not fully established in embryogenesis. Dysplasia (choice C) is caused by abnormal organization of cells into tissues, which is a situation that results in abnormal histogenesis. Tuberous sclerosis is a striking example of dysplasia, in which the brain contains aggregates of normally developed cells arranged into grossly visible "tubers." Ectopia (choice E) is an anomaly in which an organ is outside its normal anatomic site.Diagnosis: Esophageal atresia | 2 | Aplasia | Atresia | Dysplasia | Dysraphic anomaly | Pathology | Genetics | 6acf39b0-a165-4b78-90fe-ec999c8d0ccd | single |
Investigation of choice for pericardial effusion is | Transthoracic echocardiography (TTE) is usually the initial investigation of suspected pericardial disease. It is cheap and widely available and has high accuracy for detecting pericardial effusions and signs of tamponade. TTE is also helpful for guiding diagnostic or therapeutic pericardiocentesis. Restricted acoustic windows limit its evaluation of the entire pericardium; loculated collections, intrapericardial blood clot, and pericardial thickening may be difficult to assess.CT and MR are indicated when TTE is inconclusive or when loculated or hemorrhagic effusion or pericardial thickening is suspectedIOC for aoic dissection-- MRI IOC for pericardial effusion= M- mode ECHOIOC for valvular disease = 2 D - ECHO IOC FOR RADIOTHERAPY CAUSED FIBROSIS= BIOPSY(Grainger and Allison&;s diagnostic radiology 6th edition, page 240) | 4 | MRI | CT | X ray | Echo | Radiology | All India exam | 27a37d0c-501f-409a-a9c0-916de9b0e467 | single |
True about hepatocelluar ca is - | Answer is 'a' i.e. Associated with HBV & HCV; 'b' i.e. Cirrhosis is a predisposing factor; 'c' i.e. Fibrolamellar variety is not associated with cirrhoris "All patterns of hepatocellular carcinomas have a strong propensity for invasion of vascular channels." - Robbins | 4 | Associated with HBV and HCV | Cirrhosis is predisposing factor | Fibrolamellar variety is not associated with cirrhosis | All | Surgery | null | bc0fee27-9e9f-49a1-a5b6-9a8716356455 | multi |
A patient is having thick, gray coating on the throat and tonsils, followed with fever, chills and swollen glands in the neck. Microscopic examination of nasopharyngeal or pharyngeal swab showed gram positive organism with a special stain. The constitutes of the stain are:- | Gram positive organism causing gray colored coating (pseudomembrane) is Corynebacterium diphtheriae . So the specific stain is Albe stain. Contents of Albe stain:-Stain A- glacial acetic acid, malachite green ,toluidine blueStain B- KI + I2 | 2 | Crystal violet. Gram's iodine | Toluidine blue, malachite green, glacial acetic | Carbol fuchsin, acid alcohol, and methylene blue | Methylene blue | Microbiology | Systemic Bacteriology (Gram Positive Bacilli, Gram Negative Bacilli) | a49d4ba7-61f5-45fc-8a8c-6a9921bd13df | single |
Which of the following is known as abdominal policeman? | In the early twentieth century, the British surgeon Rutherford Morison noted that the omentum tended to wall off areas of infection and limit the spread of intraperitoneal contamination. He termed the omentum the abdominal policeman. Ref: Schwaz's principle of surgery 9th edition, chapter 35. | 1 | Omentum | Spleen | Liver | None of the above | Surgery | null | 8cda4aeb-4ed5-45f7-b08b-34e29ebadfb1 | multi |
Hernia with highest rate of strangulation is? | Femoral hernia REF: Sabiston 18th ed chapter 44 The likelihood of strangulation and need for hospitalization also increase with aging. Strangulation, the most common serious complication of a hernia, occurs in only 1% to 3% of groin hernias and is more common at the extremes of life. Most strangulated hernias are indirect inguinal hernias; however, femoral hernias have the highest rate of strangulation (15%-20%) of all hernias, and for this reason, it is recommended that all femoral hernias be repaired at the time of discovery. | 3 | Direct inguinal hernia | Indirect inguinal hernia | Femoral hernia | Incisional hernia | Surgery | null | eaaac980-c33a-46d8-a316-02e213207922 | single |
A 63-year-old man with hearing loss in his left ear complains of a loss of taste and drooling from the left side of his mouth. A CT scan shows a tumor compressing the nerve entering the skull through which of the following openings? | The tumor is compressing the facial nerve, which runs through the internal acoustic meatus along with the vestibulocochlear nerve, which provides sense of taste to the anterior two thirds of the tongue via the chorda tympani and also mediates all of the facial muscles, except the muscles of mastication. The mandibular branch of the trigeminal nerve courses through the foramen ovale and mediates motor to the muscles of mastication and sensory to the lower third of the face. The maxillary branch of the trigeminal passes through the foramen rotundum and is sensory to the middle third of the face. The jugular foramen has the glossopharyngeal, vagus, and accessory nerves coursing through it. Finally, the superior orbital fissure has the ophthalmic branch of the trigeminal nerve coursing through it, along with the oculomotor, trochlear, and abducens nerves. | 3 | Foramen ovale | Foramen rotundum | Internal acoustic meatus | Jugular foramen | Anatomy | Head & Neck | 65177662-775b-4ebe-9a44-4da3b44784ad | single |
Which of the following statements regarding ANB angle is false? | The ANB angle indicates the magnitude of the skeletal jaw discrepancy. The magnitude of the ANB angle, however, is influenced by two factors other than the anteroposterior difference in jaw position. One is the vertical height of the face. As the vertical distance between nasion and points A and B increases, the ANB angle will decrease. The second is that, if the anteroposterior position of nasion is abnormal, the size of the angle will be affected.
Ref: Contemporary orthodontics, William Proffit, 4th edition page 209 | 3 | It measures the magnitude of skeletal jaw discrepancy | Vertical height of the face influences this angle | Position of the sella influences this angle | Position of the nasion influences this angle | Dental | null | 5b464f2e-5b66-4bcd-996a-d489bae097ae | multi |
Cholinomimetic drugs can be used for the treatment of all the following conditions except. | Ans. (B) Bradycardia(Ref KDT 8th/e p114)Cholinomimetic drug will cause bradycardia as an adverse effect and thus cannot be used for its treatment. | 2 | Closed angle Glaucoma | Bradycardia | Cobra bite | Myasthenia gravis | Pharmacology | A.N.S. | 3245f196-bcc0-4c7c-8abf-b702d4fdbce8 | multi |
A 19 year old young girl with previous history of repeated pain over medial canthus and chronic use of nasal decongestants, presented with abrupt onset of fever with chills & rigor, diplopia on lateral gaze, moderate proptosis & chemosis. On examination optic disc is congested. Most likely diagnosis is: | Patient is suffering from cavernous venous thrombosis, as a complication of chronic ethmoidal sinusitis. The facial veins make clinically impoant connections with the cavernous sinus through the superior ophthalmic veins. Cavernous sinus thrombosis usually results from infections in the orbit, nasal sinuses, and superior pa of the face. Think Detail: Cavernous sinus: is located on the side of the body of sphenoid. The cavernous sinuses consist of extradural venous plexuses surrounded by a dural fold. Structures Within its cavity Internal carotid aery Abducent nerve Carotid sympathetic plexus Lateral wall Oculomotor nerve Trochlear nerve Opthalmic division of trigeminal nerve Maxillary division of trigeminal nerve Tributaries: Anteriorly Opthalmic veins (connects with the facial vein) Posteriorly Superior petrosal sinus (connects with transverse sinus) Inferior petrosal sinus (conncets with internal juglar vein) Medially Anterior and posterior intercavernos sinuses (connects the two cavernous sinuses) Superiorly Superficial middle cerebral vein (from latwral surface of the brain) Cerebrsl veins from inferior surface of brain Cavernous sinus thrombosis (CST) is a late complication of facial or paranasal sinus infection, resulting in thrombosis of the cavernous sinus and inflammation of its surrounding anatomic structures, including cranial nerves. Clinical features: Infection of the cavernous sinus is characterized by sepsis, orbital pain, chemosis, proptosis, and ophthalmoplegia. Cavernous sinus thrombosis results in paresis of cranial nerves III, IV, and VI and the opthalmic and maxillary divisions of the cranial nerve V. The diagnosis is based primarily on clinical data. CT and MR imaging can provide diagnostic information.Treatment is with broad spectrum antibiotics and should be staed early .This has high moality. Cavernous sinus syndrome: is characterized by multiple cranial neuropathies. The clinical presentation includes impairment of ocular motor nerves, Horner's syndrome, and sensory loss of the first or second divisions of the trigeminal nerve in various combinations. The pupil may be involved or spared or may appear spared with concomitant oculosympathetic and parasympathetic involvement. Ref: 1) Comprehensive opthalmology,by AK Khurana,4th Edition, Page 384-389; 2) Parsons ' Diseases of the Eye, 20th Edition, Page 456-459; | 1 | Cavernous sinus thrombosis | Orbital cellulitis | Acute Ethmoidal sinusitis | Orbital apex syndrome | Ophthalmology | null | 37e100e7-52d2-4744-aa7a-daa3992d56e0 | single |
Following sign is seen in which condition: | Ans. A. Medial medullary syndromeImage shows one sided deviation of tongue, i.e. paralysis of XIIth nervea. This occurs in Medial Medullary syndrome or Dejerine syndromeb. It occurs due to occlusion of anterior spinal arteryc. It is characterized by Ipsilateral XIIth nerve paralysis with contralateral hemiplegia. | 1 | Medial medullary syndrome | Lateral medullary syndrome | Benedict syndrome | Millar Gubler syndrome | Medicine | C.N.S. | 69644927-c705-4384-868e-c400a82d4966 | single |
ESR in increased in - | Ans. is 'b' i.e., Multiple myelomaFactors affecting ESR 1. Plasmao RBCs carry a negative electric charge, whereas plasma carries a postive charge.o Any condition in plasma that increases its positive charge, increases rouleaux formation and increases ESR by lengthening stage I.o Following factors increase positive charge and ESR : -i) Fibrinogen ----> Any condition which increases fibrinogen level will increase ESR - e.g.,a) Infectionb) Inflammationc) TBii) Globulin --> Conditions which increases globulin level will increase ESR.a) Kala azarb) Multiple myelomac) Some lymphoproliferative disordersd) Rheumatic feveriii) Cholesterol --> Hypercholesterolemia increases ESR.o Any condition in plasma that decreases its positive charge, decreases rouleaux formation and decreases ESR.i) Albumin --> Hyperalbuminemia decreases ESR.ii) Decreased fibrinogen ---> In afibrinogenemia, ESR is zero.2. RBCso Increase in blood count as in polycythemia decreases ESR due to the jostling (or pushing one another) effect on the cells.o Anemia increases the ESR by opposite effect, there are two exceptions.i) Sickle cell anemiaii)Microcytic hypochromic anemia (iron deficiency, Thalassemia)o In last two types of anemia, ESR decreases because altered red cell shape prevents rouleux formation.3. Physiological variationso ESR is low in infancyo ESR is high at pubeyo ESR is greater in women than man.4. Ohterso ESR is decreased in congestive hea failureo ESR is increased in acute myocardial infarction. | 2 | Sickle cell anemia | Multiple myeloma | Polycythemia vera | Thalassemia | Pathology | null | 4dd294a3-7283-48b3-9d33-09f043ebad8a | single |
Signature fracture of skull is seen in - | Ans. is 'b' i.e., Depressed fracture | 2 | Gutter fracture | Depressed fracture | Ring fracture | Sutural separation | Surgery | Traumatic Brain Injury | 61202db0-3d61-45e2-948e-cdd0e006aade | single |
Light entering the eye passes through which retinal layer first? | The most anterior layer of the retina, through which light passes first, is the retinal ganglion layer. Light then passes through the other cell layers of the retina until it reaches the photoreceptors in the posterior region of the retina. Visual processing/Phototransduction occurs in the opposite direction(Photoreceptors- ganglion cell layer) | 4 | Inner nuclear layer | Outer nuclear layer | Outer plexiform layer | Retinal ganglion layer | Physiology | Special Senses | a2b365ff-3410-452a-8658-902bf6df89ea | single |
Paltauf's hemorrhages are seen in: AP 11; NEET 13 | Ans. Lungs | 2 | Brain | Lungs | Hea | Liver | Forensic Medicine | null | 31e9183a-a1af-4cb0-aa7f-8c2cfa1d2584 | single |
Least common quadrant for breast carcinoma is | Most common quadrant for breast carcinoma upper outer quadrant. | 4 | Upper outer | Upper inner | Lower outer | Lower inner | Surgery | null | d119ce91-883a-4ae9-ba51-44de27d95efd | single |
All of the following are features of mumps except _______ | *Mumps is an acute viral infection characterised by painful enlargement of the salivary glands,most commonly the parotid glands.It is caused by an RNA virus of the genus paramyxovirus in the family paramyxoviridae. *It follows an incubation period of 2-4 weeks. Complications include epididymoorchitis in adolescent boys or postpubeal men.Aseptic meningitis is seen in 1-10% patients with parotitis.The risk of encephalitis is between 0.02-0.3% cases.Other neurological manifestations include deafness,cerebellar ataxia,facial neuritis,transverse myelitis and guillain barre syndrome. Reference: Essential pediatrics,op ghai, 9 edition,pg no: 213 | 4 | Caused by paramyxovirus | Aseptic meningitis is a complication | Orchitis is a complication in adults | Incubation period is less than 2 weeks | Pediatrics | Infectious disease | e154bbf5-d4a9-4fb7-9a46-c7d7ac76c8ed | multi |
Which of the following does not changes in the old age: | C i.e. Hematocrit | 3 | GFR | Glucose tolerance | Haematocrit | Blood pressure | Physiology | null | eea79fd1-5aec-4597-ab05-c456add7f31c | single |
A 16-year-old male complains of nasal obstruction, nasal blockage, a mass is seen in the nasopharynx with minimal extension into sphenoid sinus. What is the stage of nasopharyngeal fibroma? | Ans. B. IB* Angiofibroma is the most common benign tumor of the nasopharynx.* It is typically seen in young adolescent males, i.e. occurs near puberty, hence called juvenile nasopharyngeal angiofibroma.Clinical features:* Recurrent episodes of profuse epistasis* Unilateral nasal obstruction* Nasal bones leading to broadening of nasal bridge* Red fleshy mass can be seen in the nasal cavityInvestigations* CECT: It is the golden test* Antral sign/Holman Miller sign seenStaging of angiofibromaRadkowski ClassificationsIALimited to nose and/or nasopharyngeal vault BExtension into 1 paranasal sinusIIAMinimal extension through sphenopalatine foramen into sphenopalatine/pterygomaxillary fossa BFills sphenopalatine fossa bowing the posterior wall of the maxillary antrum anteriorly or extending into the orbit via the inferior orbital fissure CExtends beyond sphenopalatine fossa into infratemporal fossaIIIAErosion of skull base--minimal intracranial extension BErosion of skull base--extensive intracranial extension with or without cavernous sinus invasionTreatment:* Surgical excision* Radiotherapy is indicated in stage III, when tumor has intracranial extension. | 2 | IA | IB | IIA | IIB | ENT | Nose and PNS | 6ea031de-d4a8-4be6-984d-a0ca40be1080 | single |
Which antimalarial drug is known to cause neuropsy-chiatric adverse reaction? | Adverse effects :Mefloquine is bitter in taste; common reaction is dizziness, nausea, vomiting, diarrhoea, abdominal pain and sinus bradycardia. These are usually mild and largely dose related, but may be severe in some. Major concern has been a variety of neuropsychiatric reactions (disturbed sense of balance, ataxia, errors in operating machinery, strange dreams, anxiety, hallucinations, rarely convulsions) occurring in some recipients. These are dose related and subside in 1-3 weeks. Rare events are haematological, hepatic and cutaneous toxicity. Mefloquine appears to be safe during pregnancy, but should be avoided in 1st trimester unless absolutely essential. ESSENTIALS OF PHARMACOLOGY page no.824 | 4 | Aesunate | Aimisnin | Quinine | Mefloquine | Pharmacology | Chemotherapy | 8543f2ce-ec1f-44bc-baca-421f6b8c1730 | single |
The most sensitive indicator of environmental iodine deficiency is | Ans. d. Neonatal hypothyroidism | 4 | Serum T4 levels | Serum T3 levels | Urine iodine excretion | Neonatal hypothyroidism | Social & Preventive Medicine | null | 7c7996cf-aa19-4f35-8b16-a67fd1bb3897 | single |
Dementia is produced by deficiency of vitamin | (C) Thiamine # DEMENTIA is the progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging.> Although dementia is far more common in the geriatric population, it may occur in any stage of adulthood.> This age cutoff is by definition, as similar sets of symptoms due to organic brain dysfunction are given different names, such as developmental disorders, in populations younger than adulthood.> In dementia, affected areas in cognition may be memory, attention, language, and problem solving.> Especially in the later stages of the condition, affected persons may be disoriented in time (not knowing what day of the week, day of the month, or even what year it is), in place (not knowing where they are), and in person (not knowing who they are).> Symptoms of dementia can be classified as either reversible or irreversible depending upon the etiology of the disease. Less than 10 percent of cases of dementia are due to causes which may presently be reversed with treatment. | 3 | Vitamin A | Vitamin D | Thiamine | Pyridoxine | Psychiatry | Miscellaneous | 08fd1340-756c-46ef-b8a8-10c66ede7188 | single |
Local anaesthetic injected directly into the tissue - | Ans. is 'a' i.e., Infiltration anaesthesia Infiltration anaesthesiao It is the injection of local anaesthetic directly into tissue without taking into consideration the course of cutaneous nerve.o It can be so superficial as to include only the skin, it also can include deeper structureso It is used for minor surgeries, e.g. incision & drainage, suturing etc.o Adrenaline can be used along with LA to prolong its duration of action and to prevent its systemic absorptiono However adrenaline containing solution should not be used into tissues supplied by endarteries, e.g. in fingers and toes, ear, nose, and penis because vasoconstriction may lead to gangrene.Conduction blockA. Field blocko Is produced by subcutaneous injection of a solution of local anaesthetic in order to anaesthetize the region distal to the injection.o For example, subcutaneous infiltration of the proximal portion of the volar surface of the forearm results in extensive area of cutaneous anaesthesia that starts 2 to 3 cm distal to the site of injection.B. Nerve blocko LA is injected around a peripheral nerve or a plexus. Examples are -Upper limb - brachial plexus and wrist blockHead & Neck - Stellate ganglion block, trigeminal nerve block.Thorax & abdomen - Interc4ostal nerve & celiac plexuso Note - Most common complication of brachial plexus block is pneumothorax. | 1 | Infiltration anaesthesia | Nerve block | Field block | Bier's block | Anaesthesia | Miscellaneous (Local and Regional Anesthesia) | fe50a882-04a1-45b4-a8fb-6fed0b2eb168 | single |
A 40 year old female patient complains of excessive bleeding. Patient gives a history of road traffic accident 5 hours ago and had a lacerated wound on lower back region. Blood grouping test reveals presence of antigen A and antigen B. This system for blood grouping consists of 3 major allelic genes which are located on: | → This system consists of 3 major allelic genes; those are A, B and O.
→ They are located on long arm of chromosome 9.
→ These genes control the synthesis of blood group antigens A and B.
→ Based on the presence or absence of antigen A and antigen B, blood is divided into 4 groups i.e A, B, AB and O. | 2 | Chromosome 8 | Chromosome 9 | Chromosome 10 | Chromosome 7 | Pathology | null | 0d53908a-f831-46eb-97a0-f764c477e1a8 | multi |
Fibrous pericardium in supplied by | Fibrous pericardium in supplied by phrenic Nerve. Visceral pericardium does not have somatic sensation. | 2 | Pericardiophrenic Nerve | Phrenic Nerve | T2 to T6 intercostal nerves | Vagus nerve | Anatomy | null | 7ac725b5-a59d-48cc-ac6a-242ec2ce1826 | single |
A 70-years-old retired military person with good previous medical record complains of bi-temporal headache which is decreased in lying down position. He states that he gets relief by giving pressure over bilateral temples. The patient also complains of loss of appetite with feeling feverish. Diagnosis is: | Ans. a. Chronic tension headache (Ref: Harrison 19/e p107t, p2587t, 2593-2594, 18/e p122, 2849)Tension-type Headache:Tension-type headache (TTH) is commonly used to describe a chronic head-pain syndrome characterized by bilateral tight, bandlike discomfortQ.Pain typically builds slowly, fluctuates in severity, and may persist more or less continuously for many daysQ.Headache maybe episodic or chronic (present >15 days per month)Q.A useful clinical approach is to diagnose TTH in patients whose headaches are completely without accompanying features such as nausea, vomiting, photophobia, phonophobia, osmophobia, throbbing, and aggravation with movementQ.Such an approach neatly separates migraineTemporal arteritis:Women account for 65% of casesMigraine:Pain often preceded by auraQFibromyalgia:Fibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and tenderness.Patients with FM have an increased prevalence of other syndromes associated with pain and fatigueQ.More common in womenQCommon Causes of HeadachePrimary HeadacheSecondary Headache* Tension-type (69%)* Migraine (16%)* Idiopathic stabbing (2%)* Exertional (1%)* Cluster (0.1%)* Systemic infection (63%)* Head injury (4%)* Vascular disorders (1%)* SAH (<1%)* Brain tumor (0.1%)Tension-Type Headache (TTH)Tension-type headache (TTH) is commonly used to describe a chronic head-pain syndrome characterized by bilateral tight, handlike discomfortQ.Pathophysiology:Pathophysiology is incompletely understoodQ.It seems likely that TTH is due to a primary disorder of CNS pain modulation alone, unlike migraine, which involves a more generalized disturbance of sensory modulation.Clinical Features:TTH: Chronic head-pain syndrome characterized by bilateral tight, bandlike discomfortQ.Pain typically builds slowly, fluctuates in severity, and may persist more or less continuously for many daysQ.Headache maybe episodic or chronic (present > 15 days per month)Q.A useful clinical approach is to diagnose TTH in patients whose headaches are completely without accompanying features such as nausea, vomiting, photophobia, phonophobia, osmophobia. throbbing, and aggravation with movementQ.Such an approach neatly separates migraine.Treatment: Tension-Type HeadacheAnalgesics (acetaminophen, aspirin, or NSAIDs).Behavioral approaches including relaxation can also be effective.Chronic TTH: Amitriptyline is the only proven treatmentQThere is no evidence for the efficacy of acupuncture.MigraineCluster Headache* LateralizedQ usually frontotemporal, can be generalized* All age groupsQ are affected* FemalesQ are affected more than males* Family history presentQPresentation:* Pain often preceded by auraQ* Builds up graduallyQ* May lasts for several hoursQ or longer* Usually throbbingQ but maybe dull* Onset is after awakeningQ and quietened by sleepQ* Lateralized, periorbitalQ or less commonly temporal* All ages >10 yearsQ with peak at 30-50 yrsQ* Male preponderanceQ (90%): Men affected 7-8 times more than females.* Hereditary factors usually absentQPresentation:* Pain (periodic attacks 1-2/day)* Begins without warningQ* Reaches crescendo within 5 minutesQ* Lasts for 45 minutesQAssociated symptoms:* Nausea, vomiting, diarrheaQ* Photophobia and visual disturbance in the form of photopsia and fortification spectraQ* Paraesthesia with tingling and numbnessQ* Other focal neurological symptoms such as clumsiness and weaknessQ.* Excruciating, deep, explosive pain but only rarely pulsatileQ* Commonly awakens patients from sleepQAssociated symptoms:* Homolateral lacrimationQ* Reddening of eyeQ* Nasal stuffinessQ* PtosisQ* NauseaQTemporal ArteritisAverage age of onset is 70 yearsQWomen account for 65% of cases.Typical presenting symptoms: Headache, polymyalgia rheumatica, jaw claudication, fever, and weight lossQ.Headache is the dominant symptom, often appears in association with malaise and muscle achesQ.Head pain maybe unilateral or bilateralQ and is located temporally in 50% of patients but may involve any and all aspects of the cranium.Pain usually appears gradually over a few hours before peak intensity is reached; occasionally, it is explosive in onset.The quality of pain is only seldom throbbing; it is almost invariably described as dull and boring, with superimposed episodic stabbing pains similar to the sharp pains that appear in migraine.Most patients can recognize that the origin of their head pain is superficial, external to the skull, rather than originating deep within the cranium (the pain site for migraineurs).Scalp tenderness is present, often to a marked degree; brushing the hair or resting the head on a pillow maybe impossible because of painQ.Headache is usually worse at night and often aggravated by exposure to coldQ.Additional findings may include reddened, tender nodules or red streaking of the skin overlying the temporal arteriesQ, and tenderness of the temporal or, less commonly, the occipital arteries.ESR is often, though not always, elevatedQ; a normal ESR does not exclude giant cell arteritis.A temporal artery biopsy followed by immediate treatment with prednisone 80 mg dailyQ for the first 4-6 weeks should be initiated when clinical suspicion is high.FibromyalgiaFibromyalgia (FM) is characterized by chronic widespread musculoskeletal pain and tenderness.Patients with FM have an increased prevalence of other syndromes associated with pain and fatigueQ.More common in womenQClinical Features:MC presenting complaint: "Pain all over."QPain is typically above and below the waist on both sides of the body and involves the axial skeletonQ (neck, back, or chest).Pain is poorly localized, difficult to ignore, severe in its intensity, and associated with a reduced functional capacity.QFibromyalgia classification criteriaHistory of chronic widespread pain > 3 monthsQ>11 of 18 tender pointsQNeuropsychological Symptoms: Fatigue, stiffness, sleep disturbance, cognitive dysfunction, anxiety, and depressionQ. | 1 | Chronic tension headache | Temporal arteritis | Migraine | Fibromyalgia | Medicine | Headache | fa39bc4c-eb92-4bd1-9331-02c0440326ce | single |
In basal body temperature method, after the rise of temperature, the unsafe period lasts for :- | - In BBT, the rise of temperature signifies ovulation. - Since maximum survival of ovum post ovulation is 3 days, the unsafe period is 3 days post rise of body temperature. Other natural methods of contraception are: Calender method / feile period method/ safe period method/ rhythm method Cervical mucus method Symptothermic method Coitus interruptus Abstinence - most effective method | 3 | 24 hours | 48 hours | 72 hours | 120 hours | Social & Preventive Medicine | Natural Methods, Barrier Methods, IUDs, OCPs | 7273f0e1-d1aa-472b-89de-7cfbc9e87a67 | single |
Hypercalcemia is associated with all Except: | Answer is D (Celiac disease): Celiac disease is not a cause for hypercalcemia. Hyperparatlzyroidism, Sarcoidosis and Milk alkali syndrome, may all lead to hypercalcemia. | 4 | Hyperparathyroidism | Sarcoidosis | Milk alkali syndrome | Celiac disease | Medicine | null | 7634268e-6f3b-466b-a905-812682eb3ab2 | multi |
Which is the best screening test to evaluate hearing in a neonate? | Otoacoustic emissions (OAEs) are objective, noninvasive, and rapid measures (typically less than 2 minutes) used to determine cochlear outer hair cell function. OAE testing is commonly used in newborn hearing screening because of its speed and noninvasive nature. It is also used in confirming pure-tone test results obtained from young children, in patients for whom a functional hearing loss is suspected, for audiometric configuration confirmation, for ototoxic drug monitoring, and in hearing aid candidacy. More recently, OAEs, in conjunction with ABR, can be used in identifying individuals with auditory neuropathy, also termed auditory dyssynchrony. Ref: Sweetow R.W., Sabes J.H. (2012). Chapter 45. Audiologic Testing. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e. | 3 | Pure Tone Audiometry | Stapedial Reflex | Otoacoustic Emissions | Brainstem evoked auditory response | Pediatrics | null | 6e9e2952-e746-4c28-bd65-e1e4dc89ecc8 | single |
A Toxic doses, zero order kinetics is seen in | Phenytoin follows nonlinear (or zero-order) kinetics at therapeutic concentrations, because the rate of metabolism is close to the maximum capacity of the enzymes involved Ref-KDT 6/e p31 | 2 | Pencillin | Phenytoin | Valproate | Carbamazepine | Anatomy | General anatomy | 33411849-200f-4a5c-85a6-3d69fd9a312a | single |
The use of combined oral contraceptive pill is associated with an increased incidence of: | There is an overall reduction in the incidence of PID with OCPs but Chlamydial PID may increase. This is classically an indolent PID where the patient has no pain, no discharge. | 2 | Bacterial vaginosis | Chlamydial endocervicitis | Vaginal was | Genital herpes | Gynaecology & Obstetrics | Contraceptives | 9d6dab05-675e-42b8-96ac-f5aba868555f | single |
Post-moem staining' is distinguished from bruise by all except | Extravasation of blood into surroundings tissues is not possible in postpaum staining. Ref synopsis of forensic medicine laxminarayana 4e | 4 | Occurs in dependent pas | Edges are clearly Defined | Absent in areas of body under pressure | Extravasation of blood into surrounding tissues occur | Forensic Medicine | Medico legal procedures | a689e89a-f0bf-4a9b-a5d9-b7fef65eef4a | multi |
All are true about Glomus body tumor except: (PGI May 2010) | Ans: D (Brain..) Chemodectomas (Glomus Body Tumors) Dewta 7th/720-22# These are uncommon group of neoplasms that may originate anywhere glomus bodies are found.# The lesions are rare before the age of 20, there is a female predominance in some series, and the lesions may occur in multiple sites in about 10% to 20% of cases, especially in families with a history of this tumor.# These tumors usually occur later in life, around age 60 or 70, but can appear at any age. www.livestrong.com/glomus- jugulare-tumor# Carotid body tumors are associated with conditions producing chronic hypoxia, such as high-altitude habitation.# The normal glomus bodies in the head and neck vary from 0.1 to 0.5 mm in diameter. Tumors arising in glomus bodies {i.e., chemodectomas or nonchromaffin paragangliomas) arise most often from the carotid and temporal bone glomus bodies, with rare reports of tumors arising in the orbit, nasopharynx, larynx, nasal cavity, paranasal sinuses, tongue, and jaw.# The temporal bone glomus bodies are not found consistently in any location. At least one half of the glomus bodies are found in the general region of the jugular fossa and are located in the adventitia of the superior bulb of the internal jugular vein. The remainings are distributed along the course of the nerve of Jacobson (a branch of cranial nerve X).# The carotid bodies are located in relation to the bifurcation of the common carotid.Orbit bodies are in relation to the ciliary nerve, and vagal bodies are adjacent to the ganglion nodosum of the vagus nerve.Pathology# Chemodectomas are histologically benign tumors resembling the parent tissue and consist of nests of epithelioid cells within stroma-containing, thin-walled blood vessels and nonmyelinated nerve fibers. The tumor mass is well circumscribed, but a true capsule is not seen.# The criterion of malignancy is based on the clinical progress of the disease rather than the histologic picture. Chemodectomas without cellular atypia may metastasize to regional nodes or to distant organ sites.Patterns of SpreadThese lesions usually grow slowly; it is usual to have a history of symptoms fora few years and occasionally for 20 years or longer.LymphaticLymphatic metastases occur in about 5% of carotid body tumors but are very rare for temporal bone tumors. An upper neck mass may be an inferior extension of a jugular fossa or vagal tumor rather than a lymph node metastasis.Distant MetastasesDistant metastases have been rarely reported for temporal bone tumors; carotid body tumors have a low risk for distan t metastases, probably in the range of 5% or less. | 4 | Also k/a chemodectoma | Also k/a paraganglinoma | Common in older age | Brain Metastasis is common | Medicine | Oncology | b65a3e7b-a4d6-4c8d-87e9-ba3b4f1e296b | multi |
Blood supply of premolars comes from: | null | 4 | Same source as that of molars | Same source as that of anteriors | Posterior superior alveolar artery | Both 1 and 3 | Dental | null | f30117b4-a6c6-4a9d-8a13-b06ecb6d8249 | multi |
The most common site of implantation in ectopic pregnancy is - | Ans-A Ampulla .The most common site of ectopic pregnancy is a fallopian tube (as if and in fallopian tube the most common site is Ampulla (55%).Sites of ectopic pregnancy in fallopian tube in decreasing order of frequency :AmpullaIsthmusInfundibulumInterstitial | 1 | Ampulla | Fimbriae | Body | Infundibulum | Unknown | null | 6e3ec920-eff1-4912-9e61-3181e3e947b4 | single |
An epidemiologic study observes increased numbers of respiratory tract infections among children living in a community in which most families are at the poverty level. The infectious agents include Streptococcus pneumoniae, Haemophilus influenzae, and Klebsiella pneumoniae. Most of the children have had pneumonitis and rubeola infection. The study documents increased rates of keratomalacia, urinary tract calculi, and generalized papular dermatosis in these children as they reach adulthood. These children are most likely to have a deficiency of which of the following vitamins? | Vitamin A is important in maintaining epithelial surfaces. Deficiency of this vitamin can lead to squamous metaplasia of respiratory epithelium, predisposing to infection. Increased keratin buildup leads to follicular plugging and papular dermatosis. Desquamated keratinaceous debris in the urinary tract forms the nidus for stones. Ocular complications of vitamin A deficiency include xerophthalmia and corneal scarring, which can lead to blindness. Vitamin B1 (thiamine) deficiency causes problems such as Wernicke disease, neuropathy, and cardiomyopathy. Vitamin D deficiency in children causes rickets, characterized by bone deformities. Vitamin E deficiency occurs rarely; it causes neurologic symptoms related to degeneration of the axons in the posterior columns of the spinal cord. Vitamin K deficiency can result in a bleeding diathesis. | 1 | Vitamin A | Vitamin B1 | Vitamin E | Vitamin D | Pathology | Environment & Nutritional Pathology | c4d050b6-9c49-4370-9e33-cf93a6c99b95 | single |
Bullous impetigo is caused by ? | Ans. is 'b' i.e., Staphylococcus Impetigo Impetigo is a highly contagious, Gram-positive bacterial infection of superficial layer of epidermis. Impetigo occurs in Two forms : ? 1. Non - bullous impetigo (Impetigo contagiosa) It is the most common bacterial infection of children (occurs mainly in children in contrast to Bullous impetigo which occurs in infants). It is caused by both staphylococcus aureus and hemolytic group A streptococcus (Str. pyogens), though it is mostly caused by staph aureus. Most commonly occurs on face, i.e., around nose & mouth; and exposed pas, i.e., arms, legs. Presents erythematous macule/papule which changes into vesicle which soon ruptures with formation of crusting. Crust has characteristic features : - Honey-yellow colour in streptococcal impetigo. Waxy in staphylococcal impetigo. Lesion heal without scarring. Mucous membrane involvement is rare. Lymphadenopathy is common 2. Bullous impetigo It is caused by staphylococcus aureus most often phage type 71. It usually occurs in infants and manifests as vesicle that develop into bulla and later a pustule without any surrounding erythema. It mainly occurs on face. Mucous membrane may be involved (in contrast to impetigo contigiosa). Lymphadenopathy is rare. | 2 | Streptococcus | Staphylococcus | Staphylococcus | Y. Pestis | Skin | null | 3b71f9a9-a205-4ba2-8554-2d5d98acbca5 | single |
Hand over mouth exercise (HOME) is an effective behavioral modification technique in the age group of: | null | 1 | 3 to 6 years | Under 3 years | 6 to 9 years | Above 9 years | Dental | null | 828951b0-52c8-44c0-ad77-cf896d26e156 | multi |
Which of the following are the objective tests of refraction ? | Ans. is 'd' i.e., All the above | 4 | Retinoscopy | Refractometry | Keratometry | All the above | Ophthalmology | null | a45bdfaf-f9fe-40ed-a380-076009d548fb | multi |
In substantia nigra, the major neurotransmitter is: | Ans. A. Dopaminergica. There is a system of dopaminergic neurons in nigrostriatal dopaminergic system with cell bodies in substantia nigra and axon endings in caudate nucleus.b. In Parkinson's disease there is loss of dopaminergic cells in the substantia nigrawhich leads to striatal dopamine depletion.c. As DOPAMINE activates excitatory D1 receptors in the direct pathway and represses inhibitory D2 receptors in the indirect pathway, this depletion leads to decreased activity of the direct pathway and increased activity of the indirect pathway | 1 | Dopaminergic | Acetylcholine | Noradrenaline | GABA | Physiology | Nervous System | b0a1ac53-3bf5-43a3-ab0f-7b77a0ff9fa6 | single |
Rh negative mother, ICT negative was given Anti D at 28 week of pregnancy. Which of the following is the follow up schedule? | Anti D in Rh negative women: Anti-D immune globulin is given prophylactically to all D negative, unsensitized women at approximately 28 weeks' gestation, and a second dose is given after delivery if the newborn is D-positive. There are various recommendations regarding a second dose after 6 weeks of the first injection (i.e. at 34 weeks) but it is not being practiced. Following delivery, anti-D immune globulin should be given within 72 hours. 40 percent of neonates born to D-negative women are also D negative,so Anti-D given only if newborn is confirmed to be D positive Post-natally, within 72 hours all women who deliver an Rh (D) positive baby should have quantification of feto-maternal haemorrhage to guide the appropriate dose of anti D prophylaxis If immune globulin is missed following delivery, it should be given as soon as the omission is recognized, because there may be some protection up to 28 days postpaum | 1 | Give another dose of Anti D within 72 hour postpaum depending on the baby blood group and DCT | Give another dose of Anti D 72 hour postpaum irrespective of baby blood group | Anti-d immuno globulin has no effect on the status of the Indirect coombs test | Next dose of anti D at 34 weeks | Gynaecology & Obstetrics | RH Incompatibility | 1bac9c7a-4d6b-4dc2-9a52-b9db24579498 | single |
Which of the following pigments accumulates in liver in Dubin-Johnson syndrome? | Ans. b (Epinephrine metabolite) (Ref. Robbins Pathologic basis of disease 7th/ 887-888; Table 18-4)Dubin-Johnson syndrome# Hereditary defect in hepatocellular excretion of bilirubin glucuronides across the canalicular membrane due to absence of the canalicular protein, the multidrug resistance protein 2 (MRP2; located on chromosome 10q24), that isresponsible for transport of bilirubin glucuronides and related organic anions into bile.# The liver is darkly pigmented owing to coarse pigmented granules within the cytoplasm of hepatocytes.# Electron microscopy reveals that the pigment is located in lysosomes, and it appears to be composed of polymers of epinephrine metabolites., not bilirubin pigment.# The liver is otherwise normal.# Apart from chronic /recurrent jaundice (fluctuating intensity), patients are asymptomatic and have normal life span.OTHER HEREDITARY HYPERBILIRUBINEMIASCrigler-Najjar syndrome type I# The enzyme UGT1A1 is completely absent.6# The liver is incapable of synthesizing a functional enzyme, and the colorless bile contains only trace amounts of unconjugated bilirubin.# The liver is morphologically normal by light and electron microscopy.# However, serum unconjugated bilirubin reaches very high levels, producing severe jaundice and icterus.# Without liver transplantation, this condition is invariably fatal.Crigler-Najjar syndrome type II# It is a less severe, nonfatal disorder in which UGT1A1 enzyme activity is greatly reduced, and the enzyme is capable of forming only monoglucuronidated bilirubin.# Almost all patients develop normally and the only major consequence is extraordinarily yellow skin from high levels of circulating unconjugated bilirubin; but there is a risk of neurologic damage from kemicterus.# Phenobarbital improves bilirubin glucuronidation by inducing hypertrophy of hepatic endoplasmic reticulum.Gilbert syndrome# It is a relatively common, benign, somewhat heterogeneous inherited condition presenting with mild, fluctuating hyperbilirubinemia.# Main cause is reduction in hepatic bilirubin glucuronidating activity (UGT1A1) to about 30% of normal.# Gilbert syndrome has no clinical consequence except for the anxiety.Rotor syndrome# It is a rare form of asymptomatic conjugated hyperbilirubinemia with multiple defects in hepatocellular uptake and excretion of bilirubin pigments.# The liver is not pigmented.# As with Dubin-Johnson syndrome, patients with Rotor syndrome exhibit jaundice but otherwise live normal lives. | 2 | Monoglucuronate bilirubin | Epinephrine metabolite | Bilirubin pigment | Melanotic pigment | Pathology | Liver & Biliary Tract | a655c4fb-d4ea-4a6a-b77c-5f7ab5cc4b75 | single |
Floor of 4th ventricle has ? | Floor of 4th ventricle (Rhomboid fossa) It is diamond or rhomboidal shaped and is formed by posterior surface of pons (upper triangular pa or pontine pa) and dorsal surface of medulla (lower triangular pa or medullary pa) junction of pons and medulla forms intermediate pa. Features of 4th ventricle are :? Median sulcus (a midline groove) divides the floor into two symmetrical halves. Medial eminence is present an each side of median sulcus. It presents facial colliculus formed by genu (recurving fibers) of facial nerve looping around abducent nucleus. Facial colliculus lies in pons (i.e. in pontine pa of floor). Hypoglossal triangle overlying hypoglossal nucleus and vagal triangle overlying dorsal nucleus of vagus. Both of these triangle lie in the medulla (medullary pa of floor). Vestibular area overlies vestibular nuclei, paly in pons and paly in medulla. Sulcus coeruleus, a bluish area due to presence of pigmented neurons containing substantia ferruginea. Superior and inferior ea. | 2 | Infundibulum | Vagal triangle | Mammillary body | Tuber cincrium | Anatomy | null | 6cd5b8b6-92de-4d4f-948a-edc28912e378 | single |
Visual acuity is a measure of: | Ans. Form sense | 2 | Light sense | Form sense | Contrast sense | All of the above | Ophthalmology | null | eb690583-32cc-4d8b-b97b-52f14a23d31c | multi |
Precancerous lesion of gall bladder is | Ans is 'a' ie Porcelain gall bladder "The calcified porcelain' gallbladder is associated with more than a 20% incidence of gallbladder carcinoma. These gallbladders should be removed, even if the patients are asymptomatic" - Schwartz SurgeryMirizzi SyndromeBiliary obstruction may occur in cases of acute cholecystitis, as a result of external compression of the CBD by a large stone impacted in the Hartman pouch and the associated intense pericholecystic inflammatory process; this is termed Mirizzi Syndrome. (Washington Manual of Surgery, 4/e, p 310) | 1 | Porcelain gall bladder | Mirrizi syndrome | Cholesterosis | Acalculous Cholecystitis | Surgery | Gallbladder Cancer | 38c0a29a-7cec-48f6-b80e-63400c23e194 | multi |
A 35 yr old male female singer presents with complains of hoarseness, vocal fatigue & pain in neck on prolonged phonation. Direct laryngoscopy shows bilateral pin head size swelling on Ant.1/3 & post 2/3 junction of vocal cord. What could be the probable diagnosis ? | Vocal nodule (singer's or screamer's node) Seen symmetrically on the free edge of vocal cord, at the junction of anterior one third, with the posterior two thirds (i.e. area of maximum vibration of cord). Vocal nodules are bilateral. Mostly seen in teachers, vendors, actors or pop singers as they speak in unnatural low tones or at high intensities for prolonged periods. symptoms include: hoarseness breathlessness a "rough" voice a "scratchy" voice a harsh-sounding voice shooting pain from ear to ear feeling like you have a "lump in your throat" neck pain less ability to change your pitch voice and body tiredness Vocal polyp is typically unilateral but arising from the same position as vocal nodule. Treatment Voice rest and speech therapy (Speech therapy re-education in voice production are essential in preventing recurrence) Microlaryngoscopic excision of nodules--Using microsurgical instruments or laser differential diagnosis is VOCAL CORD POLYP- Usually unilateral at the junction of anterior and middle third of vocal cord. caused by Voice abuse, chronic irritation like smoking Sudden shouting results in hemorrhage and submucosal edema. Treatment is Microlaryngeal excision. Acute laryngitis is a temporary condition caused by overusing the vocal cords. It can also be caused by an infection. Acute laryngitis may be caused by viral infections. Acute pharyngitis is inflammatin of the pharynx causing Pain or irritation in the throat that can occur with or without swallowing, often accompanies infections, such as a cold or flu. | 2 | Vocal polyp | Vocal nodule | Acute laryngitis | Acute pharyngitis | ENT | ENT Q Bank | fbe5853c-1451-4c8b-a6ab-f5b573f17e50 | single |
Lowest risk of malformations is seen with which of the following antiepileptic drug? | A metanalysis of 31 studies found lamotrigine and levetiracetam to carry the lowest risk of malformations(Ref: William's Obstetrics; 25th edition) | 3 | Phenobarbitone | Valproate | Lamotrigine | Carbamazepine | Gynaecology & Obstetrics | All India exam | ae18677d-998c-4d9c-8a58-901d395d32fc | single |
Column concept of spine stability was given by - | REF : textbook of ohopedics, John ebnezer, 4th edition ,pg.no.311 Three column concept of spine stability was given by Denis *The anterior column consists of anterior half of the veebral body , anterior pa of the disk & anterior longitudinal ligament. * The middle column consists of posterior half of the body & the disk , posterior longitudinal ligament. *The posterior column consists of the posterior veebral arch consisting of transverse process , spinous process & the accompanying ligaments. One column injury is stable , 2 column injury is unstable - it is a dangerous spine for it may injure the spinal cord. | 1 | Denis | Frenkel | Wilson | Todd | Orthopaedics | Spinal injuries | 6a3f485a-48ca-4cee-bf08-ae07feddf874 | single |
Kernig's sign is seen in: September 2009 | Ans. B: Pyogenic Meningitis The main clinical signs that indicate meningism are nuchal rigidity, Kernig's sign and Brudzinski's signs. None of the signs are paicularly sensitive; in adults with meningitis, nuchal rigidity was present in 30% and Kernig's or Brudzinski's sign only in 5%. Nuchal rigidity is the inability to flex the head forward due to rigidity of the neck muscles; if flexion of the neck is painful but full range of motion is present, nuchal rigidity is absent. Kernig's sign is positive when the leg is fully bent in the hip and knee, and subsequent extension in the knee is painful (leading to resistance).This may indicate subarachnoid haemorrhage or meningitis.Patients may also show opisthotonus --spasm of the whole body that leads to legs and head being bent back and body bowed backwards. The most commonly used sign (Brudzinski's neck sign) is the appearance of involuntary lifting of the legs in meningeal irritation when lifting a patient's head off the examining couch, with the patient lying supine. | 2 | Viral encephalitis | Pyogenic meningitis | Brain abscess | All of the above | Medicine | null | a320b0ed-abfe-4a6a-b5be-e1400f0a1d7d | multi |
In osteogenesis imperfecta the defect is in the: | Ans; a (Synthesis of type I collagen) Ref: Robbins, ed, p. 1279Osteogenesis imperfecta is due to deficiency in the synthesis of Type I collagen structures affected are - bone, joints,eyes, ear, skin and teethCytogenetic abnormality:Mutation in the genes that codes for a1, and a2 chains of collagen autosomal dominant inheritanceClinical features:All types are characterized by extreme skeletal fragilityOther features are blue sclera, hearing impairment,Dentiogenesis imperfecta, growth retardation etcREMEMBER:Type of osteogenesis imperfecta incompatable with life = type IIType of osteogenesis imperfecta with normal sclera = type IVBRIDGE:Van der hoeve's syndrome - AD osteogenesis imperfecta, blue sclera, hearing loss | 1 | Synthesis of type I collagen | Mineralisation of osteoid | Osteoclast function | Osteoblast formation | Pathology | Osteology | 6e0ac85f-9a0c-433c-8b18-9625d484a699 | single |
A 28-year-old lady has put on weight (10 kg over a period of 3 years) and has oLigomenorrhoea followed by amenorrhoea for 8 months. The blood pressure is 160/100 mm of Hg. Which of the following are the most appropriate investigations - | null | 2 | Serum electrolytes | Plasma cortisol | Plasma testosterone and ultrasound evaluation of pelvis | T3, T4 and TSH | Medicine | null | 61bb9e94-7ea8-4de4-ad6e-ee95a08717d9 | single |
Which of the following muscles is responsible for abduction of vocal cord | null | 1 | Posterior cricoarytenoid | Lateral cricoarytenoid | Cricoarytenoid | Transverse arytenoid | ENT | null | 254378b3-a343-46d2-a847-58efe34cb24d | single |
A 30 year old male patient was on Isoniazid therapy for Tuberculosis.He developed rashes on exposed pas of body.He has disoriented memory. Family members gives history of diarrhea also.What is the diagnosis? | Isoniazid inhibits the endogenous syntheisis of Niacin so,the patient developed dermatitis,diarrhea,dementia. Prolonged treatment with Isoniazid leads to Pyridoxine deficiency,which is required for endogenous synthesis of niacin Reference: Harpers illustrated biochemistry 30th edition | 3 | Isoniazid neuropathy | Tuberculosis skin lesions | Niacin deficiency | Some other drugs has caused this | Biochemistry | Metabolism of protein and amino acid | 30fee938-7827-45b8-9db7-4d7b71d0cd20 | single |
Rokitansky Kuster Hauser syndrome is associated with: | Ans. is b, i.e. Absent fallopian tubeTo understand why distal part of fallopian tube is present:Mullerian ducts grow downward, therefore there will be cases where there will be well formed abdominal ostia associated with hypoplasia or absence of the remainder of the tubes, uterus and vagina or the tubes and uterus may be present and the vagina absent.As discussed, vaginal atresia means urogenital sinus fails to develop. Hence both vaginal atresia and mullerian agenesis are different."Typically, a portion of the distal fallopian tube are present". | 2 | Ovarian agenesis | Absent fallopian tube | Vaginal atresia | Bicornuate uterus | Gynaecology & Obstetrics | Malformation of the Female Generative Organs | 5c451cce-f4fe-474a-b7d5-1f5df653b855 | multi |
What is the most common cause of failure of radiotherapy for stage II cervical carcinoma? | In stage II cervical cancer, the incidence of nodal involvement is 25%-40%. Most tumors are not radioresistant, and distant metastasis (i.e., a more advanced stage) are a late complication of more advanced stages of the disease. | 3 | Liver metastasis | Bone metastasis | Para-aortic node metastasis | Resistance of the central tumor | Surgery | Urethra & Penis | 3caa1963-12c3-4399-87a7-7f6dc029b1a5 | single |
A young male presented with dyspnea, bleeding and petechial hemorrhage in the chest after 2 days following fracture shaft of the femur right side. Most likely cause is: | Ans. (b) Fat embolism* Fat embolism usually manifests following Long bone fractures* MC after Closed fractures > Open fractures* MC in Young (more bone marrow) > Old* MC in Long bones (Femur) > Pelvis> Smaller bones* 90% will develop fat emboli after traumatic fracture but only 1-5% develop fat embolism syndrome* Also seen in other causes like- Pancreatitis, Fatty liver, Steroid therapy, Liposuction etc.* Fat embolism is a clinical diagnosis and not a Chemical diagnosis.* It manifests in 24-72 hours. Rare in < 24 hours and > 72 hours* Classic Triad- Hypoxemia + Petechial Rash + neurological abnormalities* Hypoxemia early finding, Petechial rash is late finding* Platelet count - Normal* Purtschers Retinopathy +* Lipiduria+* Treatment: Immobilization of fracture, Mechanical Ventilation, Steroids. | 2 | Air embolism | Fat embolism | Pulmonary thromboembolism | Amniotic fluid embolism | Surgery | Acute Arterial Occlusion | 7effcd3e-b1a2-43cb-9168-d9ef4cce9915 | single |
Which is not an endogenous catecholamine ? | null | 2 | Dopamine | Dobutamine | Adrenaline | Noradrenaline | Pharmacology | null | b7c44394-91fc-46f4-bd6e-f7e1433c7511 | single |
The patient is being administered i.v. quinine following which he developed restlessness and sweating, the most likely cause is : | null | 1 | Hypoglycemia | Cinchonism | Arrhythmias | Sweating | Pharmacology | null | 3aa631c4-ef46-4ca4-8598-d3337f221de8 | single |
A female with H/o oligohydramnios during her pregnancy, brings her newborn baby to OPD, on noticing asymmetric thigh folds in her child. The examiner performs flexion, IR and abduction, which produces a click sound. Which is the test done by the examiner? | Clinical Diagnosis - DDH based on the following 1. Abduction is limited (especially in flexion) 2. Asymmetric thigh folds Oolani's Test--the first two alphabets O and R (Oolani for Reduction) and for Reduction we do abduction of hip. It is similar to 2nd pa of Barlow's test McMurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee | 1 | Oolani test | Von Rosen test | Mc Murray's test | Barlow's test | Orthopaedics | Pediatric Ohopedics | 2730f920-08de-4a6e-8a59-e045aa4cfb95 | single |
Most desirable structure to anastomose with esophagus is: | Ans. (a) StomachRef Schackelford Page 256 7th edition* Best conduit for esophageal replacement-- Stomach* Best conduit for short segment replacement of esophagus-- Jejunum* Best conduit in cases of corrosive injury to stomach and esophagus-- Colon | 1 | Stomach | Jejunum | Colon | Duodenum | Surgery | Oesophagus | d0cdb418-5640-4797-99dc-4f662352b236 | single |
WHO recommended dose of misoprostol in the treatment of post partum hemorrhage is | Ans. (C) 800 mcg sublingual(Ref: WHO recommendations for prevention and treatment of PPH 2012)According to WHO 2012 recommendationsOxytocin is drug of choice for treatment and well as prevention of post partum hemorrhage.Alternatives are ergometrine, fixed dose combination of oxytocin and ergometrine and misoprostolMisoprostol is recommended as 600 microgram orally for prevention of PPH and 800 microgram sublingually for treatment of PPH.The use of tranexamic acid is recommended for the treatment of PPH if oxytocin and other uterotonics fail to stop bleeding or if it is thought that the bleeding may be partly due to trauma. | 3 | 400 mcg oral | 600 mcg sublingual | 800 mcg sublingual | 1000 mcg oral | Pharmacology | Endocrinology | 78133f9a-c5f7-4f6b-8037-70231bf030d2 | single |
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