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Serum does not contain
Serum has essentially the same composition as plasma, except that its fibrinogen and clotting factors II, V, and VIII (Table 32-5). (Ref: Ganong's review of medical physiology 23rd Edition page no.530)
1
Fibrinogen
Cerruloplasmin
Albumin
Globulin
Physiology
General physiology
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Renal threshold for glucose is:
null
3
80 mg%
100 mg%
180 mg/dl
200 mg%
Biochemistry
null
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Forbe&;s disease is due to deficiency of
Glycogen storage disease type III is an autosomal recessive metabolic disorder and inborn error of metabolism characterized by a deficiency in glycogen debranching enzymes. It is also known as Cori&;s disease in honor of the 1947 Nobel laureates Carl Cori and Gey Cori. Other names include Forbes disease in honor of clinician Gilbe Burnett Forbes (1915-2003), an American Physician who fuher described the features of the disorder, or limit dextrinosis, due to the limit dextrin-like structures in cytosol. Limit dextrin is the remaining polymer produced after hydrolysis of glycogen. Without glycogen debranching enzymes to fuher conve these branched glycogen polymers to glucose, limit dextrinosis abnormally accumulates in the cytoplasm.Ref: DM Vasudevan, 7th edition, page no: 129
2
Branching enzyme
Debranching enzyme
Myophosphorylase
Hepatic phosphorylase
Biochemistry
Metabolism of carbohydrate
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single
Adult worm of Echinococcus is found in:
Ref. Textbook of Microbiology and Immunology BY Parija. – Compiled from Various chapters
1
Dog
Humans
Domestic animals
Felines
Unknown
null
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All of the following are except- advantages of LMA
LMA is also called Brain mask .It is a supraglottic airway device.It is intermediate between face mask and ETT. Used in difficult airway,in minor and day care surgeries,no muscle relaxant is necessary Disadvantage is it doesn&;t prevent aspiration of gastric contents.
2
More reliable than face mask
Prevent aspiration
Alternative to Endotracheal intubation
Does not require laryngoscop & Visualization
Anaesthesia
Anaesthetic equipments
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In herpes simplex encephalitis, drugs used are, EXCEPT:
The most effective drug for herpes simplex encephalitis is acyclovir, given intravenously at a dosage of 10 to 15 mg/kg every 8 hours, with each dose given over 1 hour. Ganciclovir is an analogue of acyclovir which is active against all herpes viruses including Herpes simplex. Vidarabine is a purine nucleoside analogue with activity against HSV-1, HSV-2, VZV, and EBV. Vidarabine inhibits viral DNA synthesis through its 5'-triphosphorylated metabolite Amantadine is an antiviral agent whose dopaminergic propeies make it effective in the treatment of Parkinson's disease and for prophylaxis against the parkinsonian side effects of neuroleptic agents. It is not used in herpes simplex encephalitis. Ref: Baden L.R., Dolin R. (2012). Chapter 178. Antiviral Chemotherapy, Excluding Antiretroviral Drugs. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
4
Acyclovir
Vidarabine
Ganciclovir
Amantadine
Pharmacology
null
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NOT a hypolipidemic drug:
Ans. (c) SomatostatinRef. KDT 6th ed. / 235SOMATOSTATIN* Somatostatin inhibits the secretion of GH, TSH and prolactin by pituitary, insulin and glucagon by pancreas and most importantly. It inhibits most of G.I secretions gastrin and HC1.* It can be used in controlling esophageal varices and bleeding peptic ulcer.* Drugs like simvastatin, atorvastatin, fluvastatin, lovastatin and rosuvastatin are statins, which are hypolipidemic drugs. They act by inhibiting HMG-CoA Reductase.* Fenofibrate are from fibrates category, which has maximum triglyceride lowering activity.Also know* Statins end with "vastatin"* Maximum LDL lowering activity is by: STATINS* Longest acting statin: ROSUVASTATIN
3
Simvastatin
Fenofibrate
Somatostatin
Fluvastatin
Pharmacology
Hypolipidemic Drugs
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Factors that produce acute pancreatitis include all of the following except
The two leading causes associated with acute pancreatitis are alcoholism and cholelithiasis, both of which are implicated in more than 80% of cases. Less common causes of acute pancreatitis include trauma, ischaemia, shock, extension of inflammation from the adjacent tissues, bloodborne bacterial infection, viral infections, ceain drugs (e.g. thiazides, sulfonamides, oral contraceptives), hypothermia, hyperlipoproteinaemia and hypercalcaemia from hyperparathyroidism. Rarely, familial pancreatitis is encountered. In a propoion of cases of acute pancreatitis, the etiology remains unknown (idiopathic pancreatitis). TEXTBOOK OF PATHOLOGY 6TH EDITION HARSH MOHAN PAGE NO:646
4
Alcohol
Hypercalcemia of parathyroid origin
Gall stones
Haemochromatosis
Pathology
G.I.T
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Carbenicillin:
Ans. (A) Is effective in pseudomonas infection(Ref: KDT 8/e p773)Carbenicillin is a penicillin congener effective against pseudomonas and indole positive proteus which are not inhibited by penicillin G or ampicillin/amoxicillin.It is inactive orally and excreted rapidly in urine. It is sensitive to penicillinase and acid, so administered parenterally as sodium salt.
1
Is effective in pseudomonas infection
Has no effect in Proteus infection
Is a macrolide antibiotic
Is administered orally
Pharmacology
Chemotherapy: General Principles
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Topical immunomodulator used for the treatment of genital was is:
Genital wa treatments that can be applied directly to your skin include: Imiquimod (Aldara, Zyclara). This cream appears to boost the immune system's ability to fight genital was. Avoid sexual contact while the cream is on your skin. It may weaken condoms and diaphragms and may irritate. One possible side effect is redness of the skin. Other side effects may include blisters, body aches or pain, cough, rashes, and fatigue. Podophyllin and podofilox (Condylox). Podophyllin is a plant-based resin that destroys genital wa tissue. Podofilox contains the same active compound but can be safely applied. Trichloroacetic acid (TCA). This chemical treatment burns off genital was. TCA must always be applied by a doctor. Side effects can include mild skin irritation, sores or pain. REF KD Tripathi 8th ed
1
Imiquimod
Podophylline
Interferon
Acyclovir
Pharmacology
Immunomodulators
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Within an hour after cementation of cast gold onlay patient complains of shooting pain every time the teeth comes together. Most probable explanation is?
null
4
Supraocclusion of restoration
Retained cement in gingival sulcus
Excess acid in mix
Galvanic current caused by gold onlay occluding with a large restoration
Dental
null
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All are true regarding staphylococcal toxin except ?
Ans. is 'b' i.e., Mainly endotoxin Impoant facts about virulence factors . Clumping factor is bound coagulase which is responsible for the slide coagulase test. . Coagulase (free coagulase) - Acts along with a coagulase reacting factor (CRF) in plasma. - Eight type of coagulase have been identified, most human strains form coagulase A. - Most constant association of virulence is production of enzyme coagulase and to lesser extent with mannitol fermentation. . Heat stable nuclease (DNAase) is a characteristic feature of staph aureus. . Staphylococcus produces five cytolytic toxins, consisting of four hemolysins (alpha, beta, gamma and delta) and a leucocidin. . a - hemolysin is the most impoant hemolysin. . Beta - hemolysin is a sphingomyelinase. It exhibits a hot-cold phenomenon, the hemolysis being initiated at 37degC, but becoming evident only after chilling. . Leucocidin is also called the Panton-valentine toxin. . Staphylococcal leucocidin and gamma lysin have been grouped as synergohymenotropic toxins. . Toxic shock syndrome toxin (TSST) and enterotoxins are superantigens which are potent activators of T lymphocytes and lead to an excessive and dysregulated immune response with release of cytokines IL-1, IL-2, TNF-a and IFN - y. . Enterotoxin is responsible for food poisoning. . Exfoliative (epidermolytic toxin) - Responsible for staphylococcal scalded skin syndrome (S.S.S.S.). - Severe form of SSSS is known as Ritter disease in newborn and toxic epidermal necrolysis in older patients. Milder forms are pemphigus neonatorum and bullous impetigo. . Staphylococcus does not produce endotoxin. Endotoxin is produced by gram (-) ye organisms, the only gram (+) ye organism secreting endotoxin is listeria.
2
Beta haemolysin shows hot cold phenomenon
Mainly endotoxin
Enterotoxin causes food poisoning
Exfoliative toxin causes Reiter's syndrome
Microbiology
null
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Staph. aureus causes vomiting in 2 hours after eating contaminated milk product . The mechanism of action is -
Option 1, 3 Increase in cyclic AMP/GMP-accumulation of sodium chloride in the intestinal lumen- Diarrhea. Option 2 Toxin Stimulates the vagus nerve and vomiting center of brain. Acts directly on the autonomic nervous system rather than on gastrointestinal mucosa. Option 4 Cholera toxin: binds to GM1 ganglioside receptors present on the intestinal epithelium
2
Stimulation of C AMP
Vagal stimulation
Stimulation of C GMP
Acts through ganglioside GM receptor
Microbiology
Systemic Bacteriology Pa 1 (Gram Positive Cocci, Gram Negative Cocci)
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A patient presents with Hb of 8 gm% , WBC count of 2000/mm3 and platlet count of 60000/mm3. What is your likely diagnosis?
ANSWER: (C) Aplastic anemiaREF: Harrison's 18th ed Ch: 107It's a straight forward diagnosis of Aplastic anemia since all the three cell lines of blood are reduced. The very basic question tests your knowledge of normal blood counts
3
Thalassemia
Sickle cell anemia
Aplastic anemia
Anemia of chronic disease
Medicine
Anemia and RBC Disorders
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Holt-Oram syndrome is characterized by?
Holt-Oram syndrome: - Autosomal dominant disorder - Characterized by - skeletal abnormalities of hands and arms like: Hypoplastic/ absent thumbs, radii Triphalangism Phocomelia - Cardiac anomalies ASD 1st degree hea block TRIPHALANGISM phacomelia
1
ASD
VSD
TGA
TAPVC
Pediatrics
Acyanotic congenital hea diseases
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Branch of facial nerve in facial canal
A. i.e. Greater petrosal nerve; C. i.e. Chorda tympani; B . i.e. N. to stapedius
4
Greater petrosal nerve
Nerve to Stapedius
Chordatympani
All
Anatomy
null
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Ca Vulvaof the anterior pa will spread primarily to which of the following lymph nodes?
Vulval Lymphatics: Superficial component - drains the anterior two-thirdvulva, to the superficial inguinal lymph nodes Deep drainage system - draining the posterior one-third vulva is to deep inguinal nodes, external iliac, and femoral nodes In Ca Vulva the lymphatic spread is usually to the inguinal lymph nodes, which are located between Camper's fascia and the fascia lata. From these superficial groin nodes, the disease spreads to the deep femoral nodes, which are located medial to the femoral vessels Cloquet's or Rosenmuller's node, situated beneath the inguinal ligament, is the most cephalad of the femoral node group.
2
Para-aoic
Inguinal
Obturator
Femoral
Gynaecology & Obstetrics
Vulvar cancer
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Protein di sulphide isomerase is involved in
Disulfide bonds between and within polypeptides stabilize teiary and quaternary structures. However, disulfide bond formation is nonspecific. Under oxidizing conditions, a given cysteine can form a disulfide bond with the --SH of any accessible cysteinyl residue. By catalyzing disulfide exchange, the rupture of an S--S bond and its reformation with a different paner cysteine, protein disulfide isomerase facilitates the formation of disulfide bonds that stabilize a protein&;s native conformationPeptidyl cis-trans isomerase, protein disulphide isomerase and chaperones are involved in protein folding
3
Protein synthesis
Protein degradation
Protein folding
Protein quaernary structure formation
Biochemistry
All India exam
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single
Most common precipitating factor for COPD is
null
2
Environment
Smoking
Allergen
All of the above
Medicine
null
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The differential diagnosis for pancytopenia with cellular bone marrow include the following except -
null
4
Megaloblastic anemia
Myelodysplasia
Paroxysmal Nocturnal Hemoglobinuria
Congenital dyserythropoietic anemia
Pathology
null
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Facial nerve palsy can be caused by -
Ans. is 'd' i.e., Ail of the above Causes of facial paralysis1. Central :-Brain abscess, pontine glioma, Polio, multiple sclerosis2. Intracranial part (cerebellopontine angle) :- Acoustic neuroma, meningioma, congenital cholesteatoma, metastatic carcinoma, meningitis3. Intratemporal part:-Idiopathic :- Bell's palsy, Melkersson's syndromeInfections:- ASOM, CSOM, Herpes zoster oticus, malignant otitis externaTrauma:- Surgical (mastoidectomy, stapedectomy), accidental (fractures of temporal bone)Neoplasms :- Malignancies of external and middle ear, glomus jugular, facial nerve neuroma, metastasis (from breast, lung etc).4. Extracranial part :- Malignancies or surgery or injury to parotid gland5. Systemic diseases :- Diabetes, hypothyroidism, uremia, PAN, Sarcoidosis (Heerfordt's syndrome), leprosy, leukaemia, demyelinating disease
4
Cholesteatoma
Multiple sclerosis
Mastoidectomy
All of the above
ENT
Facial Nerve And Its Disorders
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Which is the thinnest pa of the lens of eye?
The lens is thinnest at the posterior pole. The crystalline lens is surrounded by a lens capsule. Lens capsule is a thin transparent elastic membrane secreted by the lens epithelial cells largely composed of type IV collagen. The capsule is 11- 15microm thick at the anterior pole. The posterior capsule thickness decreases to a minimum at the posterior pole to about 4microm. Ref: Adler's Physiology of the Eye: Expe Consult by Leonard A Levin, Page 47
2
Anterior pole
Posterior pole
Posterior capsule
Apex
Ophthalmology
null
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A 60 year old man presented with watering from his left eye since 1 year. Syringing revealed a patent drainage system. Rest of the ocular examination was normal. A provisional diagnosis of lacrimal pump failure was made. Confirmations of the diagnosis would be by:
Ans. Dacryoscintigraphy
1
Dacryoscintigraphy
Dacryocystography
Pressure syringing
Canaliculus irrigation test
Ophthalmology
null
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The type of mammary ductal carcinoma in situ (DCIS) most likely to result in a palpable abnormality in the breast is -
Carcinoma of the breast is divided into : Carcinoma in situ → neoplastic cells is limited to ducts and lobules by the basement membrane. Invasive carcinoma (infiltrating carcinoma) → cells invade beyond the basement membrane. Caricnoma in situ : It is of two types A. Ductal carcinoma insitu (DCIS, intraductal carinoma ) Most frequently present as manzmographic calcification. Rarely palpable mass may also occur in comedocarcinoma. DCTS is of two types - i. Comedocarcinoma ii. Noncomedo DCTS → Solid, cribriform, papillary or micropapillary B. Lubular carcinoma in Situ (LCIS) Always an incidental finding in a biopsy performed for another reason. LCIS is not associated with calcification → Therefore, it remains infrequent with or without mammography (in contrast to DCIS) Frequently multicentric and bilateral Signet ring cells are common.
4
Apocrine DCIS
Neuroendocrine DCIS
Well differentiated DCIS
Comedo DCIS
Pathology
null
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Not a complication of gallstone
Effects and complications of Gallstones In gallbladder In Bile duct In Intestine Silent stones Acute cholecystitis Chronic cholecystitis Mucocele Empyema Perforation Gangrene Carcinoma Obstructive jaundice Cholangitis Acute pancreatitis Gallstone ileus Ref: Sabiston 20th edition Pgno : 1492-1493
2
Mucocele
Diveiculosis
Acute cholangitis
Empyema of the gallbladder
Surgery
G.I.T
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Ujjwala is for -
Ujjawala ,a comprehensive scheme to combact trafficking was launched in infia by the Ministry of Women and Child Development.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-542
2
Child abuse
Child trafficking
Child labour
None
Social & Preventive Medicine
obstetrics,pediatrics and geriatrics
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Which of the following drug is useful in the prophylaxis of meningococcal meningitis?
Minocycline is used in acne and for prophylaxis of meningococcal meningitis.Ref: HL Sharma 3rd ed Pg:
1
Minocycline
Doxycycline
Cephalexin
Rifabutin
Pharmacology
Antibiotics
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A 40 year old female patient presents with 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 Anti A antibody, Anti B antibody, Anti H antibody and Anti Rh D antibody in the serum. The blood group of this patient is?
→ Apart from A< B and O RBC of type O contains large amount of another antigen called H substance. → H substance is genetically different from ABO but is a precursor of A and B antigens. → An O group individual who inherits A or B genes but fails to inherit H gene from either parent is called Oh phenotype or Bombay blood group.
4
O positive
O negative
AB positive
Bombay blood group
Pathology
null
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IOC for Bronchiectasis -
The best test to evaluate the destruction and dilatation of large airways which are filled with pus in Bronchiectasis is HRCT. Spiral CT is preferred for pulmonary embolism. Pulmonary angiography is done for lung sequestration and is gold standard for pulmonary embolism.
1
HRCT scan
Spiral CT
Bronchoscopy
Pulmonary angiography
Medicine
null
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All of the following are neurologic channelopathies except -
null
4
Hypokalemic periodic paralysis
Episodic ataxias
Familial hemiplegic migraine
Huntington's disease
Medicine
null
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M/C ovarian cancer associated with endometriosis:
Ans. is b, i.e. Clear cell tumorM/C ovarian cancer associated with endometrial cancer: Endometrioid tumorM/C ovarian cancer associated with endometriosis: Clear cell carcinoma
2
Endometroid tumor
Clear cell tumor
Germ cell tumor
Brenner tumor
Gynaecology & Obstetrics
Carcinoma Ovary
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The only Sugar normaly absorbed in the intestine against a concentration gradient is :
C i.e. GlucoseFinal products of carbohydrate digestion in intestinal chyme are glucose & fructoseQ.The glucose transpo in intestine is an example of secondary active transpo i.e., the energy of glucose transpo is provided indirectly by active transpo of Na+ out of cell. Because glucose & Na+ share the same cotranspoer (sympo) the sodium dependent glucose transpoer (SGLT, Na+ - glucose cotranspoer, cross cell membrane 12 times), the high concentration of Na+ on mucosal surface of cells facillitate & low concentration inhibit hexose sugar influx into epithelial cells.
3
Xylose
Mannose
Glucose
Ribose
Physiology
null
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A young patient with a headache, epiphora, bilateral nasal obstruction but no fever. Diagnosis is
CLINICAL FEATURES 1. Age and sex. Tumour is seen almost exclusively in males in the age group of 10-20 years. Rarely, it may be seen in older people and females. 2. Profuse, recurrent and spontaneous epistaxis. This is the most common presentation. The patient may be markedly anaemic due to repeated blood loss. 3. Progressive nasal obstruction and denasal speech. It is due to the mass in the postnasal space. 4. Conductive hearing loss and otitis media with effusion. It occurs due to obstruction of the eustachian tube. 5. Mass in the nasopharynx. Tumour is sessile, lobulated or smooth and obstructs one or both choanae. It is pink or purplish in colour. Consistency is firm but digital palpation should never be done until at the time of operation. 6. Other clinical features like broadening of the nasal bridge, proptosis, swelling of the cheek, infratemporal fossa or involvement of IInd, IIIrd, IVth and VIth cranial nerves will depend on the extent of the tumour (Ref: Diseases of Ear, Nose and Throat, P.L Dhingra, 7th edition, page 279 )
2
Nasal polyp
Juvenile angiofibroma
Nasal carcinoma
Rhinoscleroma
ENT
Pharynx
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What is the recommended illumination for general office work?
The recommended illumination for casual reading is 100 lux, 400 lux for office work, 900 lux for fine assembly and for watch making 2000 - 3000 lux is recommended. Ref: Park's Textbook of Preventive Medicine, 17th Edition, Page 519.
2
100 lux
400 lux
900 lux
1000 lux
Social & Preventive Medicine
null
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All reduce lactation except - a) Maternal anxiety b) Retracted nipple c) Dehydration d) Diabetes e) Antibiotics
null
3
abc
abd
cde
ace
Medicine
null
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multi
Lucio phenomenon is treated with:
Lucio phenomenon seen in leprosy- recurrent crops of large, sharply marginated, ulcerative lesions paicularly on the lower extremities. These are frequently fatal as a result of secondary infection and consequent septic bacteremia. Neither glucocoicoids nor thalidomide is effective against this syndrome. Optimal wound care and therapy for bacteremia are indicated. Ulcers tend to be chronic and heal poorly. In severe cases exchange transfusion is indicated. Extra edge : Lenalidomide (thalidomide derivative) is the drug of choice in MDS patients with 5q deletion, MDS with 5q deletion is lenalidomide responsive.
4
Steroids
Lenalidomide
Clofazimine
Exchange transfusion
Medicine
Bacterial infection
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Complications of prematurity are all except
Retinopathy of prematurity is complication of prematurity.
3
Intra - ventricular hemorrhage
Necrotising enterocolitis
Retinitis Pigmentosa
Periventricular leukomalacia
Gynaecology & Obstetrics
null
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WHO definition of normal sperm count:
Normal sperm count/ml i.e. sperm concentration is 20 million/ml.
2
10 million/ml
20 million/ml
40 million/ml
50 million/ml
Gynaecology & Obstetrics
null
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Center of rotation for tipping is present at:
Uncontrolled tipping: A single force is applied at the crown, whereby the tooth rotates around a point just apical to the CRes. The crown moves in the direction of the force and the apex of the root moves in the opposite direction. The CRes of the tooth also moves in the direction of the force. Controlled tipping: Example of a healthy maxillary The force but the root apex does not move forward in the opposite direction. The CRes also moves in the direction of the force. This kind of movement may be indicated when retracting excessively proclined maxillary incisors. Key concept: Center of rotation of single rooted teeth for tipping is present along the long axis of tooth.
1
Long axis of tooth
Between B-L axis of tooth
Between M-D axis of tooth
Infinity
Dental
null
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Relative polycythemia are caused by all of the following, EXCEPT:
High altitude is associated with physiological increase in erythropoietin levels resulting in secondary polycythemia and not relative polycythemia. Polycythemia refers to increase in RBCs, WBCs, and platelets, but in common practice is used to describe increased red cells or erythrocytosis. It can be primary, secondary or relative. In relative polycythemia, the red cell mass is normal, but the plasma volume is decreased resulting in elevated hemoglobin and hematocrit values. Ref: Current Diagnosis and Treatment Emergency Medicine, 7th Edition, Chapter 41; Essentials of Pathophysiology: Concepts of Altered Health States By Carol Mattson Poh Page 293
2
Dehydration
High altitude
Gaisbock syndrome
Dengue haemorrhagic fever
Medicine
null
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multi
Body fluids are classified under which catogory of waste
null
3
Humanized waste
Infectious waste
Pathological waste
Anatomical waste
Social & Preventive Medicine
null
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Physical quality of life index is measured by all, Except
(Refer: K. Park's Textbook of Preventive and Social Medicine, 24th edition, pg no: no: 17, 18)Human Development Index (HDI) Vs Physical Quality of Life Index (PQLI)HDIPQLIComponentsLongevity - Life expectancy at bih (LEdeg/LEdeg)Income (Real GDP per capita in PPP US$)Knowledge (Mean years of schooling - Gross enrolment ratio & Literacy rate)Life expectancy at 1 year age (LE)Infant moality rate (IMR)Literacy rateRange0 to +10 to 100Value of India0.547 (2011)Ranking - 131 in 2017130 as medium development category (2015) among 188 countries65 (old index, now not used)
4
Infant moality
Life expectancy at age one
Literacy
Per capita income
Pathology
All India exam
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multi
All are synonymous to radial styloid fracture except
null
4
Chauffer's fracture
Hutchinson fracture
Backfire fracture
March fracture
Orthopaedics
null
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multi
Which of the following doesn't occur during the processing of RNA?
Precursor tRNA is processed to form mature tRNA. Alterations during processing are of three types: nucloelytic reactions, nucleoside modifications, terminal additions of nucleotides. Chemical hydrolysis is not a pa of RNA processing. Poly A tailing and 5'capping occurs in the processing of RNA. Methylation and deamination are known to occur. Introns will be removed after cleavage in the process.
4
Terminal addition
Nucleoside modification
Nucleoside cleavage
Chemical hydrolysis
Biochemistry
null
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Which cranial nerve supplies lateral rectus muscle?
Ans. C Abducens* All the extraocular muscles are supplied by CN III except lateral rectus and superior oblique.* Lateral rectus supplied by--CN VI* Superior oblique supplied by--CN IVRemember- LR6;SO4
3
Trochlear
Trigeminal
Abducens
Glossopharyngeal
Anatomy
Neuroanatomy
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single
Treatment of recently sputum positive case of pulmonary TB is
Ans. c (RMP + INH + PZM + ETM); (Ref. Park PSM 22nd/pg. 175)Treatment categories and sputum examination schedule in DOTS chemotherapy in IndiaTREATMENT REGIMENSPUTUM EXAMINATIONS FOR PULMONARY TBCategory of treatmentType of patientRegimenPret- reat- ment sputumTest at monthIF: result is-----THEN:New cases Category I Red BoxNew sputum smear-positiveNew sputum smear-negativeNew extra-pulmonary**New others2(HRZEE)3+4(HR)3+2-Start continuation phase, test sputum again at 4 and 6 months +Continue intensive phase for one more monthComplete the treatment in 7 monthsPreviouslyTreatedCategory IIBlue BoxSputum smear positiveRelapse***Sputum smear-positiveFailure***Sputum smear-positive treatment after default others2(HRZES)3+1(HRZE)3+5(HRE)3+3-Start continuation phase, test sputum again at 5 months 6 months, completion of treatment + + Continue intensive phase for one more month, test sputum again at 4 months if sputum is positive send sputum for culture and drug sensitivity as it might be a case of MDR-TB* The number before the laetters refers to the number of months of treatment. The subcript after the letters refers to the number of doses per week. H; Isoniazid (600 mg), R: Rifampi (450 mg), Z: pyrazinamide (1500 mg), E: Ethambutol (1200 mg), S: Streptomycin (750 mg).Patients who weigh more than 60 kg receilve additional Rifampicin 150 mg. Patients more than 50 years old receive streptomycin 500 mg.Patients in categories I and II, who have a positive sputum smear at the end of the initial intensive phase, receive an additional month of intensive phase treatment.** Examples of seriously ill extra-pulmonary TB cases are meningitis, disseminated TB, tuberculous pericarditis, peritonitis, bilateral or extensive pleurisy, spinal TB with neurological complications and intestinal and genito-urinary TB.*** In rare and exceptional cases, patients who are sputum smear-negative or who have extra-pulmonary disease can have relapse or failure. This diagnosis in all such cases should always be made by an MO and should be supported by culture or histological evidence of current, active tuberculosis. In these cases, the patient should be categorized as 'Other' and given Category II treatment. Any patient treated with Category I who has a positsive smear at 5 months of treatment should be considered a failure and started onCategory II treatment, afresh. If category I sputum smear-ve case fails to improve or if patient develops pulmonary signs and positive smear at the end of intensive phase, it is considered treatment failure. Start category II treatment and confirm failure by culture and perform DST.
3
RMP + INH + PZM
RMP + INH + PZM + SMC
RMP + INH + PZM + ETM
RMP + INH + ETM
Social & Preventive Medicine
Communicable Diseases
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single
RBC cast in the microscopic examination of the urine is an indicator of -
null
1
Acute glomerulonephritis
Acute Pyelonephritis
Chronic glomerulonephritis
Nephrotic syndrome
Medicine
null
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single
In a 27 yr old male most common cause of a colo-vesical fistula would be:
Diveicular disease is the most common cause of colovesical fistula, followed by colon cancer and Crohn disease. Diveicular disease and colon cancer are rare in people younger than 40 years. Here this patient is young; hence the most suitable answer is Crohn's disease. Ref: ACP Medicine: Volume 1, 2007, Page 816.
1
Crohns disease
Ulcerative colitis
TB
Cancer colon
Surgery
null
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Number of structural gene in Lac operon
Lactose operone or Lac operon The lac operon is a region of DNA in the genome of E. coli that contains following genetic elements ? i) Three structural genes :- These code for 3 proteins that are involved in catabolism of lactose. These genes are 'Z' gene (codes for P-galactosidase), 'Y' gene (codes for galactoside permease), and 'A' gene (codes for thiogalactoside transacetylase). ii) Regulatory gene (lac i) It produces repressor protein. iii) A promotor site (P) :- It is the binding site for RNA polymerase. It contains two specific regions ? a) CAP site (Catabolite activator protein binding site). b) RNA polymerase binding site iv) An operator site (0) :- Repressor binds to this site and blocks transcription. 3 Structural genes are expressed only when '0' site is empty (repressor is not bound) and the CAP site is bound by a complex of cAMP and CAP (catabolite gene activator protein).
1
3
4
5
6
Biochemistry
null
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Chondroblastoma most commonly occurs in :
Ans. is 'c' ie Epiphysis Apley's orthopedics writes - "Chondroblastoma is one of the few lesion to appear primarily in the epiphysis"
3
Metaphysis
Diaphysis
Epiphysis
Medullary cavity
Orthopaedics
Bone Tumour
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Laudanosine is metabolic end product of
Laudanosine is metabolic end product of atracurium.
4
Mivacurium
Doxacurium
Rocuronium
Atracurium
Anaesthesia
null
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single
Cephalic index 75- 80 is seen in
Cephalic index 1.Dolicocephalic ( long headed) 70-75 2.Mesaticephalic(medium headed) 75- 80 3. Brachycephalic( sho headed) 80-85 Present study aimed at working outcephalic index in Indian students. 100 students were taken as subjects and head length, head breadth were measured. Indian males had meancephalic index of 77.92 and they were mesocephalic and females had mean cephalic index of 80.85 and they were brachycephalic. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS PAGE NO 67
1
Indians
Europeans
Chinese
Mongolians
Forensic Medicine
Identification
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single
Airway noise originating in the nose, nasopharynx and oropharynx is known as:
Stridor is a harsh noise produced by turbulent airflow through a paially obstructed airway. It may be inspiratory, expiratory, or both (biphasic). The term steor is used to describe airway noise originating in the nose, nasopharynx, and oropharynx; therefore, stridor is generally of laryngeal or tracheal origin.
2
Stridor
Steor
Both of the above
None of the above
ENT
null
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Hot flushes are experienced as a result of
Hot flushes are caused by noradrenaline, which disturbs the thermoregulatory system. Oestrogen deficiency reduces hypothalamic endorphins, which release more norepinephrine and serotonin. This leads to inappropriate heat loss mechanism. Other causes that can be associated with the symptom of hot flushes include: thyroid disease, epilepsy, pheochromocytoma, carcinoid syndromes, autoimmune disorders, mast cell disorders, insulinoma, pancreatic tumours and even leukemias. REF : Shaw book of gynecology
3
Increased noradrenaline
Decreased estrogen
Increased noradrenaline and decreased estrogen
Increased noradrenaline and estrogen
Gynaecology & Obstetrics
All India exam
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single
In Alzheimer's disease (AD) which of the following is not seen:
B i.e. Acalculia
2
Aphasia
Acalculia
Agnosia
Apraxia
Psychiatry
null
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Parietal cells in the stomach secrete a protein crucial for the absorp on of vitamin B12 by the ileum. What is this protein?
.
1
Intrinsic factor
Gastrin
Somatostatin
Cholecystokinin (CCK)
Pathology
All India exam
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How many parathyroid glands do humans have?
Parathyroid glands: The parathyroid glands are small, yellowish-brown, ovoid or lentiform structures, usually lies between the posterior lobar borders of the thyroid gland and its capsule. They are commonly 6 mm long, 3-4 mm across, and 1-2 mm from back to front, each weighing about 50 mg. Usually, there are two on each side, superior and inferior. Variations: There may be only three or many minute parathyroid islands scattered in connective tissue near the usual sites. Normally the inferior parathyroids migrate only to the inferior thyroid poles, but they may descend with the thymus into the thorax or not descend at all, remaining above their normal level near the carotid bifurcation. To help identification, the anastomotic connection between the superior and inferior thyroid arteries along the posterior border of the thyroid gland usually passes very close to the parathyroids. The inferior pair are more variably situated, and may be within the fascial thyroid sheath, below the inferior thyroid arteries and near the inferior lobar poles; or outside the sheath, immediately above an inferior thyroid artery; or in the thyroid gland near its inferior pole. The superior parathyroids are usually dorsal, the inferior parathyroids ventral, to the recurrent laryngeal nerves. Vasculature: The parathyroid glands have a rich blood supply from the inferior thyroid arteries or from anastomoses between the superior and inferior vessels. Approximately one-third of human parathyroid glands have two or more parathyroid arteries. Lymph vessels are numerous and associated with those of the thyroid and thymus glands. Nerve supply:The nerve supply is sympathetic, either direct from the superior or middle cervical ganglia or via a plexus in the fascia on the posterior lobar aspects. Parathyroid activity is controlled by variations in blood calcium level: it is inhibited by a rise and stimulated by a fall. The nerves are believed to be vasomotor but not secretomotor Histology : Contains two types of cells Active cells or chief cells which produce parathormone. Chief cells differ ultrastructurally according to their level of activity: active chief cells have large Golgi complexes with numerous vesicles and small membrane-bound granules. Glycogen granules are most abundant in inactive cells, which appear histologically as ‘clear' cells. In normal human parathyroid glands, inactive chief cells outnumber active cells in a ratio of 3-5:1 Second cell type, the oxyphil (eosinophil) cell, appears just before puberty and increases in number with age. Oxyphil cells are larger than chief cells and contain more cytoplasm, which stains deeply with eosin. Their nuclei are smaller and more darkly staining than those of chief cells, and their cytoplasm is unusually rich in mitochondria. The functional significance of oxyphil cells and their relationship to chief cells are uncertain
1
4
3
2
1
Anatomy
null
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single
A 45-year-old man is worried about a dark pigmented skin lesion on his arm. The "mole" is 3 mm wide, symmetric with a regular border and even pigmentation. He reports no change in size or other symptoms. Which of the following is the most appropriate next step in management?
(a) Source: (Kasper, pp. 500-502) Observation alone is adequate for this lesion. The "ABCD" rules are helpful in distinguishing benign skin lesions from malignant melanoma. (A) asymmetry, benign lesions are symmetric; (B) border irregular, most nevi have clear-cut borders; (C) color variation, benign lesions have uniform color; (D) diameter, >6 mm is more likely to be malignant. In addition, recent rapid change in size is also helpful in distinguish benign from malignant lesions. Thickness of the tumor is the most important prognostic factor in the majority of cases, and ulceration indicates a more aggressive cancer with a poorer prognosis. Although cumulative sun exposure is a major factor in melanoma (e.g., more frequent near the equator), it cannot explain such things as the more common occurrence of some types in relatively young people. It is possible that brief, intense exposure to sunlight may contribute to, or initiate, carcinogenic events.
1
observation only
excisional biopsy
punch biopsy
chemotherapy, then surgical excision
Medicine
Oncology
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Unconjugated hyperbilirubinemia-
Normal adults contain less than 1mg/dL of total bilirubin out of which less than 0.25 mg/dL is conjugated bilirubin. Unconjugated bilirubin is estimated by substracting direct bilirubin value (Harsh mohan page 593)
1
85% of the total should be indirect
Hemolytic anemia
Haemoglobin destruction ( bilirubin production)
50% of the total should be indirect
Medicine
G.I.T
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single
An epidemiological investigation undertaken to test the hypothesis regarding the causation of a disease is called
null
1
Case control study
Cohort study
Prospective study
Descriptive study
Dental
null
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multi
Diagnostic procedure for basal cell Ca -
null
1
Wedge biopsy
Shave
Incisional biopsy
Punch biopsy
Surgery
null
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single
All are first generation cephalosporins except :
null
4
Cefadroxil
Cefazolin
Cephalexin
Cefaclor
Pharmacology
null
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Uveoparotitis is seen in -
null
4
SLE
Sjogren's syndrome
Rheumatoid arthritis
Sarcoidosis
Medicine
null
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25 years old gentleman has repeated thoughts that he has not locked his car door properly and frequently checks it while driving. He also repeatedly checks locks in his house. Diagnosis is
Obsessive compulsive disorder (OCD) and obsessive compulsive personality disorders a(OCPD)two different types of disorders OCD is classified under anxiety disorders whereas OCPD is classified under personality disorder Patients with OCD have recurrent, irresistible, irrelevant and intrusive thoughts that are EGO DYSTONIC. They will present with repeated doubts wheather they have locked the door and vehicles, repeated contamination thoughts and does acts to counter this obsessions. These acts are called as compulsions. OCPD , a type of cluster C personality which is characterized by Preoccupied with rules Perfectionism that interferes with task completion Inflexibility Devoted to work Stubbornness EGO SYNTONICITY IS THE CHARACTERISTIC FEUTURE Key note. OCD= EGO DYSTONIC OCPD= EGO SYNTONIC Ref. Kaplan and sadock synopsis of psychiatry, 11e, Pg.756.
1
OCD
OPCD
Phobia
Somatoform disorder
Psychiatry
Personality disorders
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Most common false neurological sign is:
Diplopia REF: Journal of Neurology, Neurosurgery Psychiatry 2003; 74:415-418 Doi:10.1136/ jnnp.74.4.415, Neurological signs have been described as "false localizing" if they reflect dysfunction distant or remote from the expected anatomical locus of pathology. False localizing signs occur in two major contexts: as a consequence of raised intracranial pressure, and with spinal cord lesions. Cranial nerve palsies (especially sixth nerve palsy), hemiparesis, sensory features (such as truncal sensory levels), and muscle atrophy, May all occur as false localizing signs. Sixth nerve palsies are the most common false-localizing sign of raised intracranial pressure. In one series of 101 cases of IIH, 14 cases were noted, 11 unilateral and 3 bilateral. Sixth nerve palsy, or abducens nerve palsy, is a disorder associated with dysfunction of cranial nerve VI (the abducens nerve), which is responsible for contracting the lateral rectus muscle to abduct (i.e., turn out) the eye. The inability of an eye to turn outward results in a convergent strabismus or esotropia of which the primary symptom is double vision or diplopia in which the two images appear side-by-side. The condition is commonly unilateral but can also occur bilaterally.
3
Wasting of hands
Abnormal unilateral pupil
Diplopia
Unilateral papilledema
Surgery
null
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multi
Umami taste is evoked by
Glutamic acid is responsible for umami taste Ref: guyton and hall textbook of medical physiology 12 edition page number: 713,714,715
2
Glucose
Glutamic acid
Quinine
Sodium chloride
Physiology
Nervous system
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single
The following anti T.B. drug should not be given to AIDS patient-
Ans. is 'a' i.e., Rifampicin
1
The following anti T.B. drug should not be given to AIDS patient-
Ethambutol
Streptomycin
Pyrazinamide
Pharmacology
null
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single
Banding technique most commonly employed for cytogenetic analysis
G-banding (most common) R-banding Q-banding C-banding T-banding G stands for Giemsa R stands for "reverse" Q stands for Quinacrine Fluoroescent dye C stands for Constitutive heterochromatin or Centromere T stands for telomeres to produce a visible karyotype Dark regions are heterochromatin (AT) Light regions are Euchromatin (GC) Dark regions are euchromatin Bright regions are heterochromatin
1
G banding
C banding
R banding
Q banding
Biochemistry
Techniques in molecular biology
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In a CA lung patient is suffering from dyspnoea, the palliation of dyspnoea is achieved by
Morphine is used for dyspnea in terminally ill cancer patients by : Both endogenous (b-endorphin) and exogenous (morphine) opioids modulate the perception of dyspnea by binding to opioid receptors. Proposed mechanisms whereby opioids relieve refractory dyspnea include decreasing respiratory drive with an associated decrease in corollary discharge; altering central perception; altering the activity of peripheral opioid receptors located in the lung and decreasing anxiety. Ref KD Tripathi 8th ed
1
Morphine patch
Diazepam
Clobazam
Haloperidol
Pharmacology
Respiratory system
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multi
True about Moorens ulcer: March 2007, March 2013
Ans. B: Affects cornea Mooren's ulcer is a rare, painful, inflammatory condition affecting one or both eyes that results in the destruction of corneal tissue. The cause of Mooren's ulcer is unknown. It is generally agreed that it is an autoimmune condition. Pain is almost always associated with the onset of Mooren's ulcer. One or both eyes may be involved at either the same time or one following the other. Approximately two thirds of cases affect one eye only. Mooren's ulcer is more common in men than women. Damage begins at the edge of the cornea and may progress to involve the central cornea. A serious complication of Mooren's ulcer is formation of a perforation or hole, in the cornea. Conditions that can cause similar eye problems are rheumatoid ahritis, systemic lupus erythematosus and Wegener's granulomatosis.
2
Painless condition
Affects cornea
Sudden loss of vision
Bilateral in majority of cases
Ophthalmology
null
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multi
Thanatology deals with
Ans) a (Death in all aspects) Ref.KNS Reddy 20th ed p 122Thanatology deals with death in all aspects.There is a progression from clinical death to brain death, biological death, biological death and then cellular death. Brain death follows immediately clinical death due to lack of oxygen. First the cerebral cortex, then cerebellum and then lower brain centres die. Ultimately the brain stem and vital centres die. There after the process of cellular death begins.Types of deatha) Somatic death- complete, irreversible stoppage of circulation breathing and brain functionb) Brain death-Characterized by deep unconsciousness with no response to external stimuli, no breathing, no cardiac function, no reflexes (except spinal), fixed dilated pupil and flat EEG for atleast 24 hrs with body temperate more than 32i c in the absence of metabolic and endocrine dysfunction.c) Molecular death- death of cells or tissues individually
1
Death in all aspects
Postmortum findings
Exhumation
Body of offence
Forensic Medicine
Death and Medicolegal Aspects
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multi
Spontaneous CSF leak associated with all except
spontaneous cerebrospinal fluid leak (SCSFL) is a medical condition in which the cerebrospinal fluid (CSF) surrounding the human brain and spinal cord leaks out of the surrounding protective dural sac for no apparent reason. A spontaneous CSF leak, as opposed to traumatically caused CSF leaks, arises idiopathically Connective tissue theory Various scientists and physicians have suggested that SCSFLS may be the result of an underlying connective tissue disorder affecting the spinal dura It may also run in families and be associated with aoic aneurysms and joint hypermobility. Marfan syndrome, Ehlers-Danlos syndrome, and autosomal dominant polycystic kidney disease are the three most common connective tissue disorders associated with SCSFLS.] Roughly 20% of patients with SCSFLS exhibit features of Marfan syndrome, including tall stature, hollowed chest (pectus excavatum), joint hypermobility and arched palate. However, these patients do not exhibit any other Marfan syndrome presentations. Spinal drainage theory Some studies have proposed that issues with the spinal venous drainage system may cause a CSF leak. According to this theory, dural holes and intracranial hypotension are symptoms caused by low venous pressure in the epidural space. When inferior limb muscles pump blood towards the hea and pressure in the inferior vena cava vein becomes negative, the network of epidural veins is overdrained, causing CSF to be aspirated into the epidural space. True leaks can form at weak points in the spinal meninges. Therefore, the observed CSF hypotension is a result of CSF hypovolemia and reduced epidural venous pressure. Other causes Cranial CSF leaks result from intracranial hypeension in a vast majority of cases. The increased pressure causes a rupture of the cranial dura mater, leading to CSF leak and intracranial hypotension.] Patients with a nude nerve root, where the root sleeve is absent, are at increased risk for developing recurrent CSF leaks.] Lumbar disc herniation has been repoed to cause CSF leaks in at least one case.Degenerative spinal disc diseases cause a disc to pierce the dura mater, leading to a CSF leak Ref Harrison20th edition pg 2345
1
Increased intracranial tension
Paial or complete empty sella syndrome
Pseudotumour cerebri
Low risk encephalocoele
Medicine
C.N.S
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multi
Which of the following substances play a major role in regulating cell-cell and cell-matrix interaction in cementum?
null
3
Sharpey's fibers
Intrinsic fibers
Proteoglycans
Phosphoproteins
Dental
null
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single
The enzyme which transcripts a double stranded DNA copy from a single stranded RNA template molecule is:
Reverse transcriptase transcripts a double stranded DNA copy from a single stranded RNA template. This enzyme is programmed to use a single-stranded RNA template, and to synthesize a complementary DNA (cDNA) strand. Ref: Measuring Gene Expression, Matthew B. Avison, 2007, Page 135
3
DNA polymerase
RNA polymerase
Reverse transcriptase
Phosphokinase
Biochemistry
null
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single
Most important element in treatment of diphtheria -
null
1
Antitoxin
Tetracycline
Erythromycin
Penicillin
Microbiology
null
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single
What is the rationale behind xenobiotic metabolism by CYP enzymes?
the aim of xenobiotics metabolism is to increase water solubility so that these compounds can be exceed through urine. (Ref-Goodman Gillman 12th/e p124/125)
1
increases water solubility
increases lipid solubility
conversion to an active metabolite
makes it suitable to evaporate through skin surface
Anatomy
General anatomy
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single
Treatment of C. difficile infection
Ans. d (All of the above) (Ref H-17th/820; KDT 6th!731; Table 123-2)Pseudomembranous enetrocolitis is associated with use of:Rx of Pseudomemb colitis:# Clindamycin# Metronidazole and vancomycin-drug of choice.# Aminoglycosides# Oral Rx for Cl. difficile-Asso Disease include:# Tetracyclines- Placebo or discontine offending antibiotics# Cotrimoxazole- Metronidazole# Ampicillin- Vancomycin# More common after colorectal surgery.- Teicoplanin- Nitazoxanide- Fusidic acid- Bacitracin.Drug reactions--GIDrug reactionCausal agentsAcute cholestatic hepatitis, jaundiceErythromycinDiarrheaMetformin, Erythromycin, Colchicine, Orlistat, AcarboseFocal to massive hepatic necrosisHalothane, Amanita phalloides (death cap mushroom), Valproic acid, AcetaminophenHepatitisINHPancreatitisDidanosine,Corticosteroids,Alcohol,Valproicacid, Azathioprine, Diuretics(furosemide, HCTZ)Pseudomembranous colitisClindamycin, ampicillin, cephalosporin's(predispose to superinfection by resistant C. difficile)
4
Metronidazole
Bacitracin
Nitazoxanilide
All of the above
Pharmacology
Anti Microbial
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multi
All are true about SALK vaccine except -
Ans. is 'c' i.e., It is contraindicated in immunocompromised patients Advantages of IPV 1) Being an inactivated vaccine, it is safe to administer in - i) Persons with immunodeficiency ii) Persons undergoing coicosteroid or radiotherapy iii) During pregnancy 2) One or two doses of live vaccine (OPV) can be given safely as booster after an initial course of immunization with TV. 3) Does not require stringent conditions during storage and transpoation. Has a longer shelf life. 4) No risk of vaccine associated paralytic polio.
3
It prevents paralysis
Oral polio can be given as booster
It is contraindicated in immunocompromised patients
Easily transpoed
Social & Preventive Medicine
null
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multi
All are associated with chronic osteomyelitis except-
Complications of chronic osteomyelitis Following complications can occur : - Acute exacerbation Growth abnormalities due to damage to adjacent growth plate: - Shortening, Deformities. Pathological fracture Joint stiffness Sinus tract malignancy (very rare): - Squamous cell carcinoma Amyloidosis
4
Amyloidosis
Sequestrum
Metastatic abnormality
Myositis ossificans
Orthopaedics
null
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multi
Relationship between the disease and social conditions
null
3
Political science
Social Psychalogy
Social Pathology
Social Sciences
Social & Preventive Medicine
null
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single
Barbed broach is used for:
null
1
Extirpation of pulp
Enlargement of canal
Obturation of canals
All of the above
Dental
null
f010cfa1-2d79-4d77-829f-1068cba240d4
multi
Stapedius nerve is a branch of ?
Ans. is 'b' i.e., Facial nerve Branches of facial nerve In fallopian (facial canal) :- Greater petrosal (greater superficial petrosal) nerve, nerve to stapedius, chorda tympani.At its exit from stylomastoid foramen :- Posterior auricular, digastric nerve, stylohyoid nerve.Terminal branches :- Temporal, zygomatic, buccal, marginal mandibular, and cervical.
2
Trigeminal nerve
Facial nerve
Vagus nerve
None
Anatomy
null
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multi
'Intermediate form' of Non Hodgkin's lymphoma is -
Working formulation of NHL for clinical use is as follows: Low grade :       small lymphocytic Follicular, predominantly small cleaved cell Follicular mixed Intermediate Grade :         1. Follicular predominantly large cell 2. Diffuse small, mixed, as well as large cell. High grade :                        Large cell immunoblastic Lymphoblastic Small non-cleaved cell. Note that all varieties of diffuse fall in the intermediate grade category only.
2
Small noncleaved cell
Diffuse, small cleaved cell
Lymphoblastic
Large cell immunoblastic
Pathology
null
846ab131-5aee-4f5d-8e6c-4aa454f08ed6
multi
When a person stands suddenly from lying down posture, there is
(A) Increased tone of capacitance vessels. > It occurs due to noradrenergic impulses causing venoconstriction via their action on a1 and a2 - adrenergic receptors on systo veins.
1
Increased tone of capacitance vessels.
Increase efferent discharge from IX cranial nerve
Decreased heart rate
All of the above
Physiology
Nervous System
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multi
True about Trendelenburg operation is
Tredelenburg Operation Consists of saphenofemoral junction flush ligation & Greater saphenous vein (GSV) stripping All four tributaries (superficial Inferior epigastric, superficial circumflex iliac, deep & superficial external pudendal veins) is divided Ligate the GSV deep to all tributaries flush with the common femoral vein Greater saphenous vein should only be stripped to just below the knee to avoid damage to the accompanying saphenous nerve Ref: Sabiston 20th edition Pgno :1832
3
Stripping of superficial varicose vein
Ligation of perforators
Flush ligation of superficial varicose veins
Ligation of sho saphenous vein
Surgery
Vascular surgery
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multi
Sub-valvular Aoic Stenosis is known to be associated with all of the following, except:
Answer is C (Tricuspid valve atresia) Tricuspid Valve Atresia is not associated with Subvalvular Aoic Stenosis. Subvalvular Aoic Stenosis (Subaoic Stenosis) Subaoic stenosis is defined as obstruction to left ventricular outflow below the aoic valve. It is the second most common form of fixed aoic stenosis. The most common form of subaoic stenosis is 'Discrete' Subaoic Stenosis is fuher classified into 'Discrete' type and 'Diffuse Tunnel-Type' narrowing Types of Subaoic Stenosis `Discrete' (85 to 90 percent) : Most common form of subaoic stenosis `Diffuse' or 'Long Segment Tunnel-Type'(10%to 15% ) Some have attempted to subdivide the discrete form into membranous and fibromuscular but such distinction is difficult Boys are more frequently affected than girls at a ratio of approximately 2:1. Subaoic stenosis is associated with other cardiac abnormalities in 50% to 70% of patients The two most_ frequently associated defects with subaoic stenosis are Ventricular Septal Defect and Coarctation of Aoa. Aoic regurgitation is the most common complication of subaoic stenosis occurring in as many as 50 percent of patients Cardiac Anomalies Associated with subaoic stenosis Aoic regurgitation Aoic valve stenosis Patent ductus aeriosus Coarctation of the aoa Interrupted aoic arch Mitral valve abnormalities Ventricular septal defect Repaired a trioventricular septal defects Double-chambered right ventricle
3
Aoic Regurgitation
Coarctation of Aoa
Tricuspid Valve Atresia
Ventricular Septal Defect
Medicine
null
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multi
Incubation period of Nipah virus
Ref:Park's Textbook of Preventive and Social Medicine 25th Ed Pg.310
1
4 -14 days
2 - 6 days
3 -8 days
5 - 10 days
Social & Preventive Medicine
Communicable diseases
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single
Drug indicated in case of subarachnoid hemorrhage:
Ans. A. NimodipineNimodipine is cerebro selective calcium channel blocker. Given in patients with hemorrhagic stroke. Nicardipine also have similar effects. This drugs reverse the cerebral vasospasm.
1
Nimodipine
Amlodipine
Diltiazem
Verapamil
Pharmacology
C.V.S
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single
Ayushman Bharat is
Ayushman Bharat is National Health Protection Scheme, which will cover over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to 5 lakh rupees per family per year for secondary and teiary care hospitalization. Ayushman Bharat - National Health Protection Mission will subsume the on-going centrally sponsored schemes - Rashtriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS).
2
Health education program
Health protection scheme
Health personnel training
Health practicing guidelines
Social & Preventive Medicine
Communicable diseases
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single
Autoimmune hemolytic anaemia is seen in:
About 15% of patients develop autoantibodies ( IgG )against their own red cells or platelets which leads to autoimmune hemolytic anemia.
4
All
AML
CML
CLL
Pathology
Chronic Lymphocytic Leukemia
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multi
A 56-year old man presented with bony pain. X-ray skull lateral view shows:
Ref. Grainger and Allison's Diagnostic Radiology. Page. 483   Pagets disease of bone affects each person differently . It includes : 1 Bones : Pain in the affected bones is the most common symptom of pagets disease of bone.   Skull in Pagets disease osteoporosis circumscripta: large, well-defined lytic lesion cotton wool appearance: mixed lytic and sclerotic lesions of the skull diploic widening: both inner and outer calvarial tables are involved, with the former usually more extensively affected Tam o'Shanter sign: frontal bone enlargement, with the appearance of the skull falling over the facial bones, like a Tam o' Shanter hat
2
Pagets disease
Hyper osteosis frontalis
Fibrous dysplasia
Osteopetrosis
Unknown
null
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single
Agoraphobia is -a) Fear of open spacesb) Fear of closed specesc) Fear of heightsd) Fear of crowded places
Formerly the term agoraphobia was used to denote phobias of open spaces alone but it is now used in a wider sence, i.e. irrational fear of places and situations from where escape might be difficult. Such places are public places, stores, crowd, travelling alone in bus, train or plane or in lift.
3
b
c
ad
ab
Psychiatry
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single
Trapping parasites using NETs is assisted by
NEUTROPHILS AND EOSINOPHILS EMPLOY NETS TO ENTRAP PARASITESIn addition to ingesting small microorganisms such as bacteria by phagocytosis, neutrophils and eosinophils can assist in the elimination of larger invaders by trapping them within webs called neutrophil extracellular traps or NETsRef: Harper&;s Biochemistry; 30th edition; Chapter 54 White Blood Cells
1
Neutrophils and Eosinophils
Neutrophils and Monocytes
Eosinophils and Monocytes
Nk cells
Biochemistry
miscellaneous
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single
a-helix of protein is
a-Helix: A peptide chain forms regular helical coils called a-helix. Type of secondary protein structure. These coils are stabilized by hydrogen bonds between carbonyl O of 1st amino and amide N of 4th amino acid residues. Thus in a aa aa-helix intrachain hydrogen bonding is present. The a aa aa-helices can be either right handed or left handed. Left-handed a-helix is less stable than right-handed a helix because of the steric interference between the C = O and the side chains. Only the right-handed a-helix has been found in protein structure. Each amino acid residue advances by 0.15 nm along the helix, and 3.6 amino acid residues are present in one complete turn. The distance between two equivalent points on turn is 0.54 nm and is called a pitch. Small or uncharged amino acid residues such as alanine, leucine, and phenylalanine are often found in a-helix. More polar residues such as arginine, glutamate, and serine may repel and destabilize a-helix. Proline is never found in a-helix. The proteins of hair, nail, skin contain a group of proteins called keratins rich in a -helical structureRef: Textbook of medical biochemistry, MN Chatterji, 8th edition, page no: 89
2
Primary structure
Secondary structure
Teiary structure
Quaery structure
Biochemistry
Structure and function of protein
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single
Common sites for mongolian spot are -
Ans. is 'c' i.e., Lumbosacral area Mongolian spots are blue or slate - gray macular lesions which occur most commonly in pre-sacral area (mainly in lower back & buttocks) but may be found over the posterior thighs, legs, and shoulders.
3
Face
Neck
Lumbosacral area
All
Pediatrics
null
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multi
Threshold level for neuronal action potential-
Ans. is 'c' i.e., -55 mv * The action potential, which is recorded using an intracellular electrode, has following phases : -1) Resting stage:# This is the resting membrane potential before the action potential. At rest, membrane is said to be "polarized" because - 70 mV negative membrane potential (RMP) that is present. Strictly speaking, it is not a part of the action potential.2) Depolarization phase:# The potential shoots up to + 35 mV in less than a millisecond. It is due to opening of "voltage gated" Na+ channels which causes influx of sodium, so inside negative charge becomes positive.# From -70 mV to -55 mV (firing Ivel or threshold point) the voltage gated sodium channles open partially. This portion of AP (-70 mV to -55 mV) is called "prepotential" or "foot ofAP".# Once the threshold level (-55 mV) is reached voltage gated Na+ channels open completely and the potential shoots up suddenly. It is called depolarization, since it represents loss of the original polarity of cell membrane.3) Repolarization phase:# The potential drops to near resting level, i.e., reversal to original polarity (repolarization). At the start of repolarization (end of depolarization), Voltage - gated Na+ channels close and Voltage - gated K+ channels open which cause efflux of K+ out of the cell. So, inside positive charge once again becomes negative due to efflux of positive charge (K+).4) After depolarization:# The repolarization is very fast till 70% of repolarization has been acheived. After that it is slows down. This slower phase of repolarization is called 'after depolarization\5) After-hyperpolarization:# During repolarization phase K+ channels open and there is K+ efflux. The membrane voltage falls back (repolarizes) to resting potential, i.e., -70 mV. At this voltage, K+ channels close, but quite slowly.# Therefore, more K+ ions leak out, causing a brief period in which the voltage falls below -70 mV, i.e. hyperplorization. Then, K+/Na+ pump works to re-establish resting potential by pumping Na+ ions back out and K+ ions back into the cells.
3
-70 mv
+70 mv
-55 mv
+55 mv
Physiology
General
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single
Which of the following includes the classical triad of ' enlarged upper part of uterus, soft lower part of body and firm cervix 'during early pregnancy?
Ans. a (Hegar's sign). (Ref Dutta, Obstetrics, 6th ed., p 65)SIGNS OF EARLY PREGNANCY1Jacquemier's or Chadwick's sign (eighth week)Dusky hue of vestibule and anterior vaginal wall.2Osiander's sign (eighth week)Increased pulsations felt through lateral fornices.3Goodell's sign (sixth week)Softening of cervix.4Piskacek's signasymmetrical enlargement of uterus if there is lateral implantation.5Hegar's sign (6--10th week)Variation in uterine consistency due to the enlargement of upper part of the body of uterus and soft and empty lower part of the body with cervix being firm.6Palmer's sign (4--8th week)Regular and rhythmic uterine contractions elicited during bimanual examination.7Palpation of fetal parts can be distinctly made by 20th week of gestation.8Fetal heart may not be audible in cases of maternal obesity, polyhydramnios, IUD and OPP.9Placental signCyclic bleeding up to 12th week of pregnancy until decidual space obliterated.
1
Hegar's sign
Jacquemier's sign
Osiander's sign
Goodell's sign
Gynaecology & Obstetrics
Miscellaneous (Gynae)
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single
All are true about Experimental trials except:
null
1
Can’t double blind in animal trials
All animal trials are unethical
Can’t do interim analysis
Are always prospective
Dental
null
b9a29ef8-a3a6-4b9c-b484-aecc49535526
multi
Acute Hepatitis B can be earliest diagnosed by ?
Ans. is 'a' i.e., IgM anti HBc Ab . This is controversial question. . Some people (including me) are in our of IgM anti HBc abs, while other think HBs Ag is the correct answer. . With HBs Ag one can make the diagnosis of HBV infection, but to confirm acute infection, IgM anti HBc is required. See following question of AIIMS 2006. "A 30 years old patient presented with history of jaundice for 10 days. His liver function tests showed bilirubin of 10 mg/dl, SGOT/SGPT - 1100/1450, serum alkaline phosphatase - 240 IU. He was positive for Hbs Ag. What should be the confirmatory test to establish acute hepatitis B infection ?" a) Ig M anti-HBc antibody (correct answer) b) Hbe Ag c) HBV DNA by PCR d) Anti - HBc antibody . When examinar himself giving us answer in the question, why should we create controversy ? . For confirmation of acute infection, we have to do Ig M anti HBc.
1
IgM anti HBc ab
Hbs Ag
IgC anti HBc abs
Anti HBs Ag ab
Microbiology
null
2a640a66-0b7d-4b21-a3c8-a42a480d005f
single
Recommended reflection factors include each of the following, except –
null
2
Ceilings 80%
Roofs 40%
Walls 50 to 60%
Furnitures 30 to 40%
Social & Preventive Medicine
null
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multi