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The most common cause of Macular edema is
Macular edema refers to the collection of fluid in the outer plexiform(Henle's layer) and an inner nuclear layer of the retina, centered around the foveola.EtiologyIt is associated with a number of disorders. A few common causes are as follows:1. As postoperative complication following cataract extraction and penetrating keratoplasty.2. Retinal vascular disorders e.g., diabetic retinopathy and central retinal vein occlusion.3. Intraocular inflammations e.g., pars planitis, posterior uveitis, Behcet disease.4. As a side-effect of drugs e.g., following use of adrenaline eyedrops, especially for aphakic glaucoma.5. Retinal dystrophies e.g., retinitis pigmentosa.Ref: Khurana; 4th edition; Pg.No. 273
2
Secondary glaucoma
Cataract surgery
Retinitis pigmentosa
Uveitis
Ophthalmology
Vitreous and retina
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Drug of choice for attention deficit hyperactivity disorder is:-
Methylphenidate is the preferred drug for the treatment of attention deficit hyperkinetic disorder (ADHD). Other drugs used for this indication are amphetamines, atomoxetine and pemoline. Pemoline has been withdrawn due to life threatening hepatotoxicity.
4
Haloperidol
Imipramine
Alprazolam
Methylphenidate
Pharmacology
Sympathetic System
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Yaws is caused by
Nonvenereal TreponemesDiseaseCauseBejelT.endemicumYawsT.peenuePintaT.carateumRef: Sherris Microbiology; 6th edition; Page no: 660
3
T.pallidum
T. Endemicum
T. Peenue
T. Carateum
Microbiology
Bacteriology
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A child attending classes in a preschool is noted by his teacher to have several skin lesions on his arms. The lesions are pustular in appearance and some have broken down and are covered with a yellow crust. Which of the following protects the most likely etiologic agent of this child's infection from phagocytosis and provides serologic specificity?
Streptococcus pyogenes, or Group A Streptococcus (GAS), produces a number of virulence factors. The M protein (d) is the organism's most important antiphagocytic factor, and it conveys serologic specificity-over 100 serotypes are now known. In the early stages of growth, the bacteria have hyaluronic acid (b) capsules. This capsule (similar to human hyaluronic acid structure) is rapidly destroyed by the organism's own hyaluronidase. Also known as spreading factor, hyaluronidase plays a role in GAS cellulitis. Erythrogenic toxin (a) is a superantigen produced by some strain of GAS lysogenized by a bacteriophage carrying the toxin gene; it causes the rash of scarlet fever. A second superantigen, streptococcal pyrogenic toxin, causes streptococcal toxic shock syndrome. Streptolysin O (e) an oxygen-labile hemolysin is useful for identification of the organism and is antigenic so antistreptolysin antibodies can be used to diagnosis rheumatic fever, a sequelae of GAS infection. Lipoteichoic acid (c) is a component of the cell wall that is involved in binding of the bacterium to host fibronectin.
4
Erythrogenic toxin
Hyaluronic acid
Lipoteichoic acid
M protein
Microbiology
General
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Conduit in gastric pull up is based on:
Ans. (a) Right gastric and right gastroepiploic arteryRef: Shackelford 7th Edition, Pages 518-520* Best conduit for esophagus after esophagectomy is stomach* This is based on the greater curvature part of stomach: So carefully preserve the Right gastro epiploic artery and Right gastric artery shown below.
1
Right gastric and right gastroepiploic artery
Right gastric and left gastroepiploic artery
Left gastric and right gastroepiploic artery
Left gastric and left gastroepiploic artery
Surgery
Oesophagus
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After 20 weeks of gestation main contribution of amniotic fluid is by:
Ans: a (Fetal urine) Ref: Dutta, 6th ed, p. 37After 20 weeks of gestation the main contribution of amniotic fluid is by fetal urine. The fetal daily urine output at term is about 400-1200 ml.Theories on origin of amniotic fliud1. Asa transudate from maternal serum2. As a transudate across umbilical cord or from the fetal circulation in the placenta or secretion from amniotic epithelium3. Transudate of fetal plasma through fetal skin4. Fetal urineVolume50 ml at 12 wks400 ml at 20 wks1000 ml at 36-38 wks800 ml at termAbnormal colors of amniotic fluid1. Green- meconium stained, seen in fetal distress2. Golden colour- Rh incompatibility3. Saffron- post maturity4. Dark colour- concealed accidental hemorrhage5. Dark brown (tobacco j uice)-IUD
1
Fetal urine
Maternal serum filtered through placenta
Transudate of fetal plasma through fetal skin
Transudate across umbilical cord
Gynaecology & Obstetrics
Miscellaneous (Gynae)
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An 18-year-old male presented with acute onset a history of blurring of vision for the same duration on examination, the patient has quadriparesis with areflexia. Both the pupils are non-reactive.The most probable diagnosis is -
Ans. b. Botulism
2
Poliomyelitis
Botulism
Diphtheria
Porphyria
Medicine
null
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Which of the following is not true about atherosclerosis?
Atherosclerosis plaques develop inElastic aeries (aoa, carotid & iliac aeries )Large and medium-size aeries ( coronary & popliteal aeries )Systemic atherosclerosis - aeries supplying hea, brain, kidneys, lower extremities Consequences - Myocardial infarction , cerebral infarction, aoic aneurysms, peripheral vascular disease Small aeriesLarge aeriesOcclude lumens, compromise blood flow to distal organs & cause ischaemic injury Plaque encroach on subjacent media and cause aneurysms that may rupture (Refer: Robbins & Cotran's - Pathologic Basis of Disease, SAE, 1st edition, Vol I-pg no: 493-496)
3
Deposition of lipids on vessels
Necrosis of Vessels
Does not involve small aerioles
It is an inflammatory response to endothelial injury
Anatomy
All India exam
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HOME should be carried out for:
null
2
1 minute.
20-30 sec.
10 sec.
15-20 sec.
Dental
null
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In civil cases, conduct money is decided by -
CONDUCT MONEY: It is the fee paid to a witness in civil cases at the time of serving the summons, to meet the expenses for attending a cou. If d fee is not paid, or if he feels that the amount is less, the witness can bring this fact to the notice of the Judge before giving evidence& Jude will decide the amount to be paid. In criminal cases, no conduct money is paid. Ref: The synopsis of forensic medicine and Toxicology by Dr. K.S. Narayan Reddy 28th edition pg no-5.
2
Opposite pay
Judge
Doctor
Witness
Forensic Medicine
Medico legal procedures
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A child speaks sentences at the age of ?
At 2 years, a child can make simple sentences and uses pronouns.
4
6 months
1 year
18 months
2 years
Pediatrics
null
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All of the following hereditary conditions predispose to CNS tumors, except -
null
4
Neurofibromatosis 1 & 2
Tuberous sclerosis
Von-Hippel-Lindau syndrome
Xeroderma pigmentosum
Medicine
null
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Urine flow rate is 10 ml/min, plasma inulin is 2 mg/ ml and urine inulin is 25 mg/ml. Which of the following statement is true ?
Ans. is 'a' i.e., Inulin clearance = GFRMeasurement of GFRIf a substance is designated by letter 'X', the GFR is equal to the concentration of 'X' in urine (Ux) times the urine flow per unit time (v) divided by aerial plasma level of X (Px).
1
Inulin clearance = GFR
Inulin clearance > GFR
Inulin clearance > GFR
GFR cannot be calculated by above data
Physiology
null
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What is the new name for mental retardation in ICD-11?
Mental retardation name DSM V: Intellectual disability ICD 11: Disorder of intellectual development
2
Intellectual disability
Disorders of intellectual development
Mental instability
Intellectual deterioration
Psychiatry
Schizophrenia Spectrum and Other Psychotic Disorders
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Dystrophic calcification means-
Amyloidosis is the extracellular deposition of insoluble protein fibrils. AL- Primary systemic amyloidosis AA- Secondary amyloidosis AF- Familial Aβ2M- In ESRD Diagnosed by abdominal fat pad aspiration showing apple green birefringence by polarized light microscopy with Congo red stain High ESR, High ALP Serum Immunofixation electrophoresis (SIFE), UIFE-sensitive to detect light chains (Lamda more common) Kidneys- most common involved. Nephrotic range proteinuria, azotemia seen Heart- second common organ; restrictive cardiomyopathy, low voltage complexes in ECG, sparkly appearance on ECHO heart Peripheral sensory neuropathy,carpal tunnel syndrome Large tongue, raccoon-eye sign-Factor X deficiency^ bleeding) Treatment- AL- Melphalan. dexamethasone, lenalidomide & bortezomib; HDM/SCT- Autologous stem cell transplantation after high-dose melphalan High BNP. pro-BNP, troponin T & I in cardiac involvement, used for prognosis too. AA Amyloidosis: secondary to chronic infections - tuberculosis, SABE or inflammatory conditions like RA, IBD, Castleman's disease Treat the primary disease, TNF & IL -1 antagonist. The new drug - Eprodisate for renal AA AF Amyloidosis: AD, mutant TTR (transthyretin/prealbumin) ° Peripheral & autonomic neuropathy ° Cardiac conduction defects Aβ2M/ Amyloidosis: associated with ESRD. on hemodialysis Carpal tunnel syndrome, joint effusions, cystic bone lesions Decreases with stopping dialysis
1
Calcification in destroyed tissue with normal calcium level in blood
t level of Ca++ deposits
Calcification in normal tissue seen in hyperparathyroidism
Calcification in destroyed tissues with hyper calcemia
Pathology
null
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Drug used in RSV infection in children-
null
2
Rituximab
Palivizumab
Penicillin
None of the above
Medicine
null
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All of the following are acquired causes of hypercoagulability, except:
Infection is not an acquired cause of hypercoagulability. Hypercoagulability represents an exaggerated form that predisposes to thrombosis and blood vessel occlusion. Acquired causes of hypercoagulability includes: ? Cancer ? Immobility ? Lupus anticoagulant ? Nephrotic syndrome ? Estrogens, pregnancy ? Anticardiolipin antibodies ? Congestive hea failure ? Heparin-induced thrombocytopenia ? Paroxysmal nocturnal hemoglobinuria ? Disseminated intravascular coagulation ? Inflammatory disorders, eg, ulcerative colitis ? Myeloproliferative disorder, eg, polycythemia vera, essential thrombocytosis Ref: Harrison Internal Medicine, 18th Edition, Chapter 262
1
Infection
Inflammatory Bowel disease
Myeloproliferative disorders
Prolonged surgery > 1 hour
Medicine
null
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A pharma agent wants to introduce vaccine for 1 yr old and see its efficacy. The study design should be ?
Ans. is 'c' i.e., Field trial Experimental epidemiology (Epidemiological Experiments) Experimental epidemiology is also called trial. Broadly speaking, a trial refers to putting something to a test. This allows the term to be used in reference to a test of a treatment for the sick or a test of a preventive measure intended to ave illness, injury or disease. Therefore, the defining feature of an experimental study is its ability to allocate or assign interventions or treatment to experiment unit. In simple words, the study of a treatment (Drugs, surgical intervention) or preventive measure (e.g. vaccination) on living subjects is known as experimental study or trial. Assignment of treatments may be based on Randamization - In randomized controlled trials Non-randmization trails There are following types of experimental trials Clinical trials: Used to evaluate treatment for people who are ill (e.g. a clinical trial of a chemotherapeutic agent) Field trails: Used to evaluate interventions to prevent disease in healthy people (e.g. a field trial of a vaccine). Community trial: Used to evaluate community-wide intervention (e.g. a community trail of the effects of fluoridation of public water supply). Animal Study: When clincial trails are done on animals (instead of human) is called animal study. In an experimental study, the investigator assign individuals in experimental group and reference group and then follows the two groups for the outcome of interests. Therefore, experimental study is prospective study. Before staing any experimental study the approval of ethics committee is required. The poocol of study is submitted to ethics committee and ethics committee gives approval to the studies which are ethical. So, all experimental studies are considered ethical (after taking approval of ethics committee). There are fewer ethical restrains on experimental study in animals than in human.
3
Coho study
Clinical trial
Field trial
None
Social & Preventive Medicine
null
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A 20-year-old woman has an ovarian tumor removed. The surgical specimen is 10 cm in diameter and cystic. The cystic cavity is found to contain black hair and sebaceous material. Histologic examination of the cyst wall reveals a variety of benign differentiated tissues, including skin, cailage, brain, and mucinous glandular epithelium. What is the diagnosis?
Teratomas are benign tumors composed of tissues derived from all three primary germ layers: ectoderm, mesoderm, and endoderm. They are most common in the ovary but also occur in the testis and extragonadal sites. Adenoma (choice A) is a benign tumor of epithelial origin. Chondroma (choice B) is a benign cailaginous tumor. Hamaoma (choice C) is disorganized normal tissue.
4
Adenoma
Chondroma
Hamaoma
Teratoma
Pathology
General Concepts
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Ovulation occurs after the extrusion of:
Ans. (c) 1st polar bodyRef.: D.C. Dutta 8th ed. / 21-22, 8th ed. / 21, 7th ed./17,19
3
Primary oocyte
Female pronucleus
lstpolar body
2nd polar body
Gynaecology & Obstetrics
Endocrinology in Relation to Reproduction
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Most common cause of death in chronic dialysis patient is:
Answer is A (Cardiovascular Disease): The most common cause of death in patients on chronic dialysis is Cardiovascular Disease. After cardiovascular disease, infections are the second most common cause of death of patients receiving long-term dialysis. Cardiovascular disease is the most common cause of death among patients with chronic kidney disease (ESRD) Cardiovascular disease is the most common cause of death in patients requiring renal replacement therapy (RR T) Cardiovascular disease is the most common cause of death among patients receiving long-term dialysis Infection is the most common cause of death in patients dialyzed for acute renal failure.
1
Cardiovascular Disease
Infection
Malignancy
Anemia
Medicine
null
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Distal renal tubular acidosis is associated with
null
3
Oxalate stones
Citrate
Calcium stones
Uric acid
Medicine
null
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1-3 beta-D-glucanassay for fungi is not used for?
Ans. (c) Cryptococcus s(j. journal of ,\\,11crobiology 2013 Nov. 3478-3484 13-D-glucan is the component of fungal cell-wall of all fungus (except cryptococcus, zygomycetes and blastomyces dermatidis) which is detectable in case of invasive infection. Currently Fungitell assay is a FDA approved 13-DG assay which is positive in invasive candidiasis, Aspergillism and pneumocystis jirovecii. False positive reaction may be seen with ceain hemodialysis filters, beta lactam antimicrobials and immunoglobulins
3
Aspergillus species
Candida species
Cryptococcus species
Pneumocystis jirovecii
Microbiology
null
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The drug of choice in an 80-year-old patient presenting with hyperglycemia and ketoacidosis -
Diabetic ketoacidosis is characterized by a serum glucose level greater than 250 mg per dL, a pH less than 7.3, a serum bicarbonate level less than 18 mEq per L, an elevated serum ketone level, and dehydration. Insulin deficiency is the main precipitating factor. Diabetic ketoacidosis can occur in persons of all ages, with 14 percent of cases occurring in persons older than 70 years, 23 percent in persons 51 to 70 years of age, 27 percent in persons 30 to 50 years of age, and 36 percent in persons younger than 30 years. The case fatality rate is 1 to 5 percent . Appropriate treatment includes administering intravenous fluids and insulin, and monitoring glucose and electrolyte levels. Cerebral edema is a rare but severe complication that occurs predominantly in children. Physicians should recognize the signs of diabetic ketoacidosis for prompt diagnosis, and identify early symptoms to prevent it. Ref <a href="
4
Oral hypoglycemic drugs
Intermediate acting insulin
Oral drug with intermediate acting insulin
Sho acting insulin
Medicine
Endocrinology
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On barium swallow the downhill esophageal varices appear as -
null
2
Mucosal folds above the carina
Mucosal folds below the carina
Mucosal folds at the carina
A thick band
Surgery
null
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All are caused by RNA viruses, EXCEPT:
Fifth disease also known as erythema infectiosum is caused by erythovirus (Parvovirs) B19. Parvoviruses are linear, non segmented single stranded DNA virus. The various manifestations of human parvovirus B19 infection is; Erythema infectiosum (fifth disease) Polyahritis Aplastic crisis Chronic anemia Congenital infection (anemia or hydrops fetalis) Ref: Oski's Pediatrics: Principles And Practice, edited by Julia A. MacMillan, Ralph David Feigin, 4 th Edition, Page 1230
4
HIV
Dengue
Herpangina
Fifth disease
Microbiology
null
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Opening of nasolacrimal duct is situated in:
Also remember other structures opening in different meatuses.Superior meatus: Posterior ethmoid cellsMiddle meatus: Frontal sinus, maxillary sinus and anterior group of sinusesEthmoid infundibulum: A part of middle meatus, maxillary and sometimes the frontal sinus opens in itInferior meatus: Nasolacrimal ductSphenoethmoid recess: Sphenoid sinus
4
Superior meatus
Middle meatus
Ethmoid infundibulum
inferior meatus
ENT
Nose and PNS
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Not a pyrethram derivative?
park's textbook of preventive and social medicine 23rd edition *synthetic pyrethroids devoloped so far are tetramethrin,resethrin,prothrin and propahin *they are now being devoloped to replace natural pyrethrins some are found to be as much as 10ttimes as effective as naturally occuring pyrethrins .
3
Cypermethrin
Permithrin
DDT
Resmethrin
Social & Preventive Medicine
Environment and health
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A 23-year-old female presents with pelvic pain and is found to have an ovarian mass of the left ovary that measures 3 cm in diameter. Grossly, the mass consists of multiple cystic spaces. Histologically, these cysts are lined by tall columnar epithelium, with some of the cells being ciliated. What is your diagnosis of this ovarian tumor, which histologically recapitulates the histology of the fallopian tubes?
The surface epithelial tumors of the ovary are derived from the surface celomic epithelium, which embryonically gives rise to the Mullerian epithelium. Therefore these ovarian epithelial tumors may recapitulate the histology of organs derived from the Mullerian epithelium. For example, serous ovarian tumors are composed of ciliated columnar serous epithelial cells, which are similar to the lining cells of the fallopian tubes. Endometrioid ovarian tumors are composed of nonciliated columnar cells, which are similar to the lining cells of the endometrium. Mucinous ovarian tumors are composed of mucinous nonciliated columnar cells, which are similar to the epithelial cells of the endocervical glands. Other epithelial ovarian tumors are similar histologically to other organs of the urogenital tract, such as the clear cell ovarian carcinoma and the Brenner tumor. Clear cell carcinoma of the ovary is similar histologically to clear cell carcinoma of the kidney, or more accurately, the clear cell variant of endometrial adenocarcinoma or the glycogen-rich cells associated with pregnancy. The Brenner tumor is similar to the transitional lining of the renal pelvis or bladder. This ovarian tumor is associated with benign mucinous cystadenomas of the ovary Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition
1
Serous tumor
Mucinous tumor
Endometrioid tumor
Clear cell tumor
Pathology
miscellaneous
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Ovarian tumor limited to true pelvis with Negative nodes histological confirmed seeding of abdominal poioned surface. The exact grading :
III A
1
III A
III B
III C
IV
Gynaecology & Obstetrics
null
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Which of the following is NOT a grass-root level worker?
GRASS ROOT LEVEL WORKERS Anganwadi worker: Works at village level Traditional bih attendant: Works at village level Village health guide: Works at village level ASHA: Works at village level Multipurpose worker: Works at sub-centre (5 villages) level.
4
Anganwadi worker
Traditional bih attendant
Village health guide
Health administrator
Social & Preventive Medicine
Rural & Urban Health Centres, Workers, Norms
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Hydrogen ion is eliminated by: September 2005
Ans. A: Kidney Cells of proximal and distal tubules secrete hydrogen ions which comes from carbonic acid For each hydrogen ion secreted, one sodium ion and one bicarbonate ion enters the interstitial fluid.
1
Kidney
Lungs
Liver
Stomach
Physiology
null
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What is the action of marked muscle:
Ans. C. Protraction of scapula forward around the thoraxa. The muscle marked is Serratus anterior, it originates by nine or ten slips from either the first to ninth ribs or the first to eighth ribs. Because two slips usually arise from the second rib, the number of slips is greater than the number of ribs from which they originate.b. The muscle is inserted along the medial border of the scapula between the superior and inferior angles along with being inserted along the thoracic vertebrae,c. It is innervated by the long thoracic nerve (Nerve of Bell).The serratus anterior is occasionally called the "big swing muscle" or "boxer's muscle" because it is largely responsible for the protraction of the scapula -- that is, the pulling of the scapula forward and around the rib cage that occurs when someone throws a punch.
3
Supination of the forearm and flexion of the elbow
Flexion & Adduction of Shoulder joint
Protraction of scapula forward around the thorax
None of the above
Anatomy
Upper Extremity
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Multiple radio opacities are seen in
null
4
Multiple myeloma
Cherubism
Osteopetrosis
Odontomas
Radiology
null
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Contraindication of Beta blockers include
Beta blockers cause bronchospasm, vasospasm absolutely contraindicated in acute or decompensated CCF except for carvedilol, hea blocck,COPD,DM.Raynauds syndrome Ref: KD Tripathi; 6th ed; Pg 139.
4
Bronchial asthma
Variant angina
Decompensated hea failure
All the above
Pharmacology
Cardiovascular system
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Which of the following hormone have a GENOMIC action?
Several hormones, including adrenal and gonadal steroid hormones, thyroid hormones, retinoid hormones, and vitamin D, bind with protein receptors inside the cell rather than in the cell membrane. Because these hormones are lipid soluble, they readily cross the cell membrane and interact with receptors in the cytoplasm or nucleus. The activated hormone-receptor complex then binds with a specific regulatory (promoter) sequence of the DNA called the hormone response element, and in this manner either activates or represses transcription of specific genes and formation of messenger RNA.
4
Thyroid hormone
1,25 DHCC
Coisol
All of these
Physiology
Endocrine System
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Most common site for impaction of gell stones in gall stone lieus is :
Answer is C (Terminal ileum):'Classically there is obstruction / impaction about 60 cm proximal to ileocaecal valve'- Bailey'The site of obstruction by the impacted gall stone is usually at the ileocaecal valve" provided that the more proximal S.I. is of normal calibre. - HarrisonsIf both choices come simultaneously in a question go for 60 cm proximal to ileacoecal valve, as, it has been defined as the narrowest pa of small intestine.
3
Ist pa of duodenum
IInd pa of duodenum
Terminal ileum
Colon
Medicine
null
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When vagus is cut. the undesirable effect is-
Ans. is 'c' i.e., Delayed gastric emptying After vagotomyo Acid secretion in decreaseso Gastric emptying for solids is delayed and hastened for liquids (due to loss of receptive relaxation of proximal stomach).o Diarrhoea & increase in frequency of stool is seen.
3
Decreased gastric acid
Increased constipation
Delayed gastric emptying
Recurrent ulcer
Surgery
Postgastrectomy Complications
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Which of the following finding is shown in the chest leads?
The hea rate is nearly 125bpm. Notice the predominant T wave inversion in V1-V3. This is seen in myocardial ischemia. Diagnosis of myocardial injury needs elevated cardiac biomarkers. Digoxin leads to ST segment depression Digoxin toxicity leads to Ventricular Bigeminy Causes of T wave inversion Normal in children Myocardial ischemia Bundle branch block Ventricular hyperophy Pulmonary embolism Hyperophic obstructive cardiomyopathy Raised intracranial pressure
1
Myocardial ischemia
Myocardial injury
Digoxin
Digoxin toxicity
Medicine
Acute coronary syndrome
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Which one of the following is the most common problem associated with the use of condom :
Contact dermatitis
3
Increased monilial infection of vagina
Premature ejaculation
Contact dermatitis
Retention of urine
Gynaecology & Obstetrics
null
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Little's area is situated in nasal cavity in:
LITTLE'S AREA (Anterior inferior pa of nasal septum) - Usual site for epistaxis in children. Four Aeries anastomose here and form Kiesselbach's Plexus. Anterior ethmoidal aery(Ophthalmic aery) Sphenopalatine(Maxillary aery) Septal branch of superior labial(Facial aery) Greater palatine aery(Maxillary aery) Ref: Dhingra 7e pg 197.
1
Anteroinferior
Anterosuperior
Posteroinferior
Posteriorsuperior
ENT
Nose and paranasal sinuses
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Which pa of the brain gets activated first to initiate skilled movements?
Neocoex. FUNCTIONAL DIVISION OF CEREBRAL COEX: Divided into 2 areas - Primary coical area Both motor & sensory areas Includes Primary auditory coex, Primary olfactory area, Primary gustatory areas & Primary motor areas Association areas: Higher functions are related to association areas Other functions: First center activated to initiate skilled movements is "Neocoex".
3
Pons
Basal ganglia
Neocoex.
Cerebellum
Physiology
null
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single
All of the following statements about carbohydrateantigen are true except aEUR'
Memory response is seen Antigen Antigen is a substance that stimulates the production of antibody, when introduced into the body. Type of antigen A. Based on chemical nature - Based on chemical nature, antigens can be : - i) Proteins ii) Polysaccharide (Carbohydrates) iii) Lipids iv) Nucleic acids - Proteins are most immunogenic, while lipids & nucleic acids are least immunogenic. - Polysaccharides (carbohydrates) are less immunogenic than protein antigens, but are more antigenic than lipids & nucleic acids. B. Based on immune response - On the basis of immune response, antigens can be divided into : - i) T-cell dependent antigens ii) T-cell in dependent antigens i) T-cell dependent antigens Most of the protein antigens are T-cell dependent. Their immune response is dependent on T-cell activation. After exposure, these antigens are presented to T-cells (helper T-cells) by antigen presenting cells. These primed T-cells then secret cytokines that induce B-cells to produce antibody against that paicular antigen. T-cell dependent reaction has memory response, i.e., subsequent exposure to same antigen result in :? a) A more rapid production of antibodies b) Produced in greater amounts c) Produced for a longer period of time. T-cell independent antigens carbohydrate (Polysaccharide) antigens are T- cell independent. Their immune response does not require activation of T-cells. These antigens directly stimulate B-cells without processing by antigen presenting cells. There is no memory response Protein antigen Carbohydrate antigen * More immunogenic * Less immunogenic * T-cell dependent * T-cell independent * No tolerence * Immunological tolerance occurs * Induce Production of all type of antibodies * Induce production of IgM and IgG only * Memory response is seen * No memory response * Require processing by antigen presenting cells. * Do not require processing * Quickly metabolized * Slowly metabolized
2
It has lower immunogenicity
Memory response is seen
Cause polyclonal B cell stimulation
Does not require stimulation by T cells
Microbiology
null
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multi
One gray of radiation is equal to:
Ans. 100 rad
3
1 rad
10 rad
100 rad
1000 rad
Radiology
null
cb8f62a7-b171-4ed5-a0fc-41060c9ec39c
single
The single most important laboratory test for determining the virulence of staphylococci is
null
3
Mannitol fermentation
Hemolysis of sheep erythrocytes
Detection of coagulase
The catalase test
Microbiology
null
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single
20-year-old female present with features of anemia. Blood tests: Hb-5g/dL, MCV - 52 fL, MCH-22 pg, PCV - 15%. Diagnosis?
The findings in the question are suggestive of iron deficiency anemia. Among given options, Hookworm infection can cause iron deficiency anemia due to chronic blood loss. Associated with megaloblastic anemia (vitamin B12/folate Deficiency): Phenytoin toxicity, Blind loop syndrome and Fish tapeworm (D. latum) infection.
3
Phenytoin toxicity
Fish tapeworm infection
Hookworm infection
Blind loop syndrome
Pathology
Iron deficiency anemia
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single
Which among the following drugs produces a dose ceiling effect?
Buprenorphine is a paial mu receptor agonist. Unlike other opiates buprenorphine has a dose ceiling effect to its respiratory depressant dose response curve. Due to this effect, after the ceiling dose is reached additional dose of the drug will not elicit more respiratory depression. Reference: Clinical Anaesthesia edited by Paul, 6e page 490.
4
Morphine
Alfentanyl
Remifentanyl
Buprenorphine
Pharmacology
null
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single
The dose of anti-D immunoglobulin to be given to non- immune Rh D negative women after delivery is:
Ans. (c) 300 mgmRef : D. C Dutta 8th ed.l 387, 721
3
50 mgm
150 mgm
300 mgm
450 mgm
Gynaecology & Obstetrics
Pregnancy in Rh-negative Women
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single
Bacteriostatic anti TB drug ?
Ans. is 'c' i.e., Ethambutol Remember the following facts All cell wall synthesis inhibitors are bactericidal. All antibacterial drugs that act on cell membrane are bactericidal. All first line antitubercular drugs are bactericidal except ethambutol that is bacteriostatic. All protein synthesis inhibitors are bacteriostatic except aminoglycosides & streptogramins which are bactericidal. All drugs affect intermediary metabolism are bacteriostatic. Now, it will be very easy to remember the following table
3
INH
Rifampicin
Ethambutol
Pyrazinamide
Pharmacology
null
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single
Which of the following is the psychological defense mechanism by the virtue of which an individual blames others for his mistake?
Placing unacceptable impulses in yourself onto someone else, i.e. placing blame for the unwanted event upon other is seen in projection.
3
Rationalization
Compensation
Projection
Regression
Psychiatry
null
fdc60e36-ad13-4147-8a37-4839425cb458
single
Which of the following drug is used for smoking cessation?
DOC for smoking cessation : Varenicline Nicotine patch and gum are also used. Bupropion is also used in smoking cessation. Varenicline: is paial agonist at neuronal nicotinic acetylcholine receptor in CNS. Patient taking varenicline should be monitored for suicidal thoughts, vivid nightmares and mood changes. Acamprosate : agent used in alcohol dependent treatment programs with an as yet poorly understood mechanism of action. Gabapentin: analog of GABA: Does not act at GABA receptor. It's precise mechanism is not known. It is approved as adjunct therapy for focal seizure and treatment of post herpetic neuralgic. Nalmefene :- is opioid antagonist use for opioid poisoning
1
Varenicline
Acamprostate
Nalmefene
Gabapentim
Pharmacology
NEET 2019
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single
The cause for contact ulcer of vocal cord
null
1
Voice abuse
Smoking
TB
Valignancy
ENT
null
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single
Familial polyposis coli is due to
.desmoid tumour is often associated with the familial polyposis colon (FAP), osteomas, odontomes epidermal cysts-- Gardner's syndrome.it is usually due to genetic abnormality involving chromosome 5. ref:SRB&;s manual of surgery ,ed 3,pg no 776
1
Abnormality of chromosomes five
Abnormality of chromosomes
Intestinal tuberculosis
Intussusception
Surgery
G.I.T
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single
A 33 year old woman has experienced episodes of fatigue, pleural effusion, pericardial effusion and carpal tunnel syndrome and macrocytic anemia. Best test for diagnosis shall be -
ANSWER- D. Assay for thyroid hormonesCarpel tunnel syndrome is a common complication of hypothyroidism and is often reversible with thyroid hormone therapy.Normally hypothyroidism is associated with normochromic anemia but may sometimes also cause macrocytic anemia.
4
Anti-beta 2 phospholipid antibodies
Anti-smith antibody
Antinulear antibody
Assay for thyroid hormones
Medicine
null
76d6750b-a693-46c8-8fff-67b84167f330
multi
An otherwise healthy, 30-year-old man is brought to the emergency department after being thrown off the back of a motorcycle. During the assessment, blood is noted at the urethral meatus. Which of the following statement is TRUE?
Initially, advanced trauma life support (ATLS) protocol requires that airway, breathing, and circulation (ABC) to be maintained. Blood at the urethral meatus is an indication of lower urinary tract (bladder, urethra, penis) injury. Foley catheter should not be inserted until the integrity of urethra is assessed (usually by performing a retrograde urethrogram). Trauma x-ray panel includes a pelvic study to evaluate the extent of injury to pelvic brim and pubic symphysis. Fracture of the pubic rami or diastasis of pubic symphysis are commonly associated with dislocation of the sacroiliac joint as well as direct or indirect injury to the bladder and bulbous urethra.
2
A foley catheter should be inserted immediately.
Dislocation of the sacroiliac joint is usually associated with a fracture of the pubic ramus or separation of the symphysis.
Open lavage is a useful indication for the need to perform laparotomy.
Fracture of the coccyx requires surgical excision in most patients.
Surgery
Urethra & Penis
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multi
Stereoanesthesia is due to lesion of
(C) Cerebral cortex # Stereognosis:> The ability to identify objects by handling them with out looking at them is called stereognosis.> Ability obviously depends upon relatively intact touch & pressure sensation & is compromised when the dorsal columns are dam- aged.> It also has a large cortical component; impaired cortex & sometimes occurs in the absence of any detectable defect in touch & pressure sensation when there is a lesion in the parietal lobe posterior to the postcentral gyrus.
3
Nucleus Gracilis
Nucleus cuneatus
Cerebral cortex
Spinothalamic tract
Physiology
Nervous System
56baa643-0eb4-4dd2-9cbb-a2be4f42e1a4
single
Caries estimated by all except
null
3
Family member
Genetic factors
Cephalometric analysis
Salivary flow
Dental
null
219ef587-bc42-47c3-9805-998bc5ee8f07
multi
Which of he following is not a fibrous joint?
Sutures of the skull, tooth socket and inferior tibiofibular joints are examples of fibrous joints. In fibrous joints bones are joined by fibrous tissue without any cavity. 3 types of fibrous joints are sutures, syndesmoses and gomphoses. Sutures occur between bones of the skull. In syndesmoses bones are connected by a ligament or band of fibrous tissue eg: inferior tibiofibular joint. Gomphoses is a peg in socket fibrous joint eg: aiculation of a tooth with its bony socket.
2
Sutures of the skull
First costochondral joint
Tooth socket
Inferior tibiofibular joints
Surgery
null
56c4db57-05f5-4c33-a9e6-58b54b893d69
single
Prokinetic drug with extrapyramidal side effect is?
Ans. (d) MetoclopramideRef KDT 6/e, p 642
4
Cisapride
Domperidone
Ondansetron
Metoclopramide
Pharmacology
Anti-Emetic
eff72e53-a976-4e2e-a0d3-66810e8b93e1
single
Which of the following is a derivative of Reichert's Cartilage?
Ans. is 'a' i.e., Stapes * Carilage of the second pharyngeal arch is called Reichert's Cartilage.* Derivatives of the Reichert's Cartilage includei) Stapesii) Styloid processiii) Stylohyoid ligamentiv) Small cornua of hyoidv) Superior part of the body of hyoid
1
Stapes
malleus
Incus
Sphenomandibular joint
Anatomy
Head & Neck
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multi
Parietal branch of middle meningeal artery, which is closely related to cerebrum, it's involvement results:
Middle meningeal artery enters the middle cranial fossa through the foramen spinosun. In middle cranial fossa, it has an extradural course and divides into anterior frontal branch and posterior parietal branch. The frontal branch is closely related to the motor area of cerebral cortex. It is the commonest source of extradural hemorrhage, and results in hemiplegia of opposite side. The parietal branch is closely related to cerebrum and its involvement results in contralateral deafness.
3
Hemiplagia of contralateral side.
Ipsilateral drafness.
Contalateral deafness
All of the above.
Anatomy
null
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multi
Indication of poor prognosis of systemic sclerosis is:
* Patients with diffuse, rapid skin involvement have the highest risk of developing scleroderma renal crisis. Renal crisis occurs in about 10% of all patients with systemic sclerosis and is indicative of bad prognosis. * Renal crisis presents as accelerated hypeension, oliguria, headache, dyspnea, edema, and rapidly rising serum creatinine levels. * Renal crisis is observed within 4 years of diagnosis in about 75% of patients but may develop as late as 20 years after diagnosis. * Avoid high doses of coicosteroids since this is a significant risk factor for renal crisis.
2
Calcinosis cutis
Renal involvement
Alopecia
Telangiectasia
Medicine
Scleroderma
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single
All are true about Neuroendocrine tumor of pancreas except:
“Insulinomas are the most common pancreatic endocrine neoplasms and present with a typical clinical syndrome known as Whipple’s triad" - Schwartz Gastrinoma (Zollinger-Ellison Syndrome); The most common presenting symptoms are an abdominal pain (70-100%), diarrhea (37-73%). and gastroesophageal reflux disease (GERD) (30- 35%); 10-20% have diarrhea only"-Harrison Table: GI Neuroendocrine Tumor Syndrome
3
Insulinoma is MC
VIP cause diarrhea
Diarrhea is MC symptom of gastrinoma
Somatostatinoma cause gall stone formation
Pathology
null
98f3eaa0-3cb7-4532-bef7-c0855015db22
multi
Vestibulo ocular reflex is concerned with
The flocculonodular lobe is phylogenetically the oldest pa of cerebellum has vestibular connections and is concerned with equilibrium and eye movements (vestibulo ocular reflex). Ref: Ganong&;s review of medical physiology; 23rd edition; pg:257.
2
Archicerebellum
Flocculonodular lobe
Neocerebellum
Occipital lobe
Physiology
Nervous system
c5a9dc2b-3a58-4e8f-a355-a326c917537a
single
A patient presented in casualty with a history of sudden onset palpitation, sensation of impending doom and constriction in his chest. This lasted for about 10-15 minutes after which he became all right. What is the MOST likely diagnosis?
This patient having typical symptoms lasting for about 15 minutes and becoming alright after that indicates that he is suffering from panic attack. In panic attack patients usually suffers from shoness of breath, tachypnea, tachycardia, tremor, dizziness, hot or cold sensations, chest discomfo, and feelings of depersonalization or derealization. These symptoms usually reaches its severity in 10 minutes. At least 4 of these symptoms should be present for the diagnosis to be made and it most commonly diminishes in 30 minutes. Generalised anxiety disorder is a syndrome of persistent worry coupled with symptoms of hyperarousal. It begins in early adult life and is slightly more common in women. Ref: Shelton R.C. (2008). Chapter 19. Anxiety Disorders. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e
4
Phobia
Personality disorder
Generalized Anxiety disorder
Panic attack
Psychiatry
null
0616c548-a40e-4ad3-952d-a1f3a9d67ecf
multi
The term "id" in the structural model of the mind refers to
sigmund Freud was a pioneer in psychiatry he introduced the new school called PSYCHOANALYSIS he introduced the TOPOGRAPHICAL THEORY OF MIND he gave the concept of structural theory of mind he gave the concept of interpretation of dreams Reference: Kaplon and sadock, 11 th edition, synopsis of psychiatry, 11 th edition, pg no. 447
1
Emotional pa of mind
Rational pa of mind
Moral pa of mind
Conscience pa of mind
Psychiatry
All India exam
5c82b8ea-2239-4ebe-bc42-f873173a9860
single
The term universal tumor refers to:
Lipomas are most common SUBCUTANEOUS LIPOMAS Also known as UNIVERSAL TUMOUR MC site: Trunk BRACKET CALCIFICATION is seen in lipoma of corpus callosum SURGICAL EXCISION is required for removal
4
Adenoma
Papilloma
Fibroma
Lipoma
Surgery
Plastic Surgery and Skin Lesions
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single
What is the cause for luteal phase defect?
Luteal phase defect- In this condition, there is inadequate growth and function of the corpus luteum. There is inadequate progesterone secretion. The lifespan of corpus luteum is shoened less than 10days.As a result, there is inadequate secretory changes in the endometrium which hinder implantation.LPD is due to defective folliculogenesis which again may be de to varied reasons. Reference- DC Dutta's textbook of gynaecology -7th edition- page no 188
1
Progesterone is inadequately secreted
Excess estrogen is secreted
Excess progesterone is secreted
Both estrogen and progesterone are in excess
Gynaecology & Obstetrics
Infertility
5a072d86-34bc-4c32-940c-30a09213ce71
multi
Necrotising aerioritis with fibrinoid necrosis is characteristic of
Fibrinoid necrosis is a special form of necrosis, visible by light microscopy , usually in immune reaction in which complexes of antigens and antibodies are deposited in the walls of aeries. The deposited immune complexes together with fibrin that has leaked out of vessels produce a bright pink and amorphous appearance on H & E preparation called fibrinoid. Type 3 hypersensitivity disorder Robbins 9th edition page 111,11
3
Immediate hypersensitivity
Cell mediated immunity
Ag-Ab complex mediated
Cytotoxic mediated
Pathology
Cardiovascular system
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single
Test of association between two variables is done by-
Ref:Parks 23rd edition pg 852 In order to find out whether there is significant association or not between the two variables , coefficient or Corelation is calculated . r lies between -1 and +1 r near -1 : indicates strong negative correlation . r = 0 : indicates no association r near +1: indicates strong positive correlation. Note: correlation does not necessarily prove causation . Chi-square test offers an alternate method of testing the significance of difference between two propoions.Advantage: it can also be used when more than 2groups are to be compared.
2
X2
Correlation
Regression
None
Social & Preventive Medicine
Biostatistics
36f9e01c-90be-4901-a14c-277027119c46
multi
A person on anti-tubercular drugs complained of deafness and tinnitus in one ear. Drug implicated is?
ANSWER: (A) StreptomycinREF: KDT 7th ed p. 743Streptomycin causes nephrotoxicity and ototoxicity
1
Streptomycin
Isoniazid
Ethambutol
Rifampicin
Pharmacology
Anti-Tuberculosis
8b1ef2ba-0a15-4869-98bd-53cdf96fca27
single
Aerial enhancement and venous phase washout in a liver mass larger than 2 cm is diagnostic for
.
4
Hemangioma
Focal nodular hyperplasia
Adenoma
Hepatocellular carcinoma
Surgery
All India exam
b5882156-9c5b-480d-a63b-adbf127ec110
single
NADA's criteria are used for:
Answer is C (Assessment of child for presence of Hea disease) NADA's criteria are used for assessment of child for presence of hea disease. The assessment of a child for the presence or absence of hea disease can be done with the help of some guidelines suggested by 'V -I DA. These guidelines are called NAT) criteria. Major Minor * Systolic murmur, grade III or more, especially with a thrill * Systolic murmur < grade III * Diastolic murmur * Abnormal 2nd hea sound * Abnormal ECG * Cyanosis * Abnormal X Ray Presence of one major and two minor criteria are essential for indicating the presence of hea disease.
3
Assessment of child for degree of dehydration
Assessment of child for degree of malnutrition
Assessment of child for presence of hea disease
Assessment of child for degree of mental
Medicine
null
3e4245ed-fbe0-4a43-9dd7-08795b10c8d6
single
True about Alphal antitrypsin deficiency is?
ANSWER: (D) All of the aboveREF: Robbins 7th ed p. 913Alpha 1 antitrypsin deficiency:Due to protease inhibitor deficiencyIncreased neutrophill elastaseNeonatal cholestasis may occur,Hepatocellular carcinoma may also developPulmonary disease may occur in form of emphysemaGene located on chromosome 14
4
Deficiency of protease inhibitor
Autosomal recessive
May cause cholestatic jaundice
All of the above
Pediatrics
Stomach and Intestines
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multi
Most common cause of upper GI bleed -
Ans. is 'c' i.e., Peptic ulcer disease o Upper G1 bleed refers to GI bleed refers to GI bleed occuringproximal to the ligament ofTreitz (.Ligament ofTreitz is a fibromuscular band extending from the right crus of diaphragm to the duodeno-jejunal flexure)Causes of upper GI bleed (in descending order)o Peptic ulcery Duodenal ulcersy Gastric ulcerso Oesophageal variceso Gastritis, erosionso Mallory-Wess terso Uncommon causesy Gastric carcinomay Esophagitis y Pancreatitisy Hemobiliay Vascular lesions
3
Esophageal varices
Erosive gastritis
Peptic ulcer disease
Trauma
Surgery
Benign Gastric Disease
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single
Following are the characteristics of vincent’s angina, except:
null
4
Ulcerative gingivostomatitis
Caused due to malnutrition
A symbiotic infection
Caused by Leptospira interrogans
Pathology
null
440717d8-73f6-4a06-9147-8fb7924468e3
multi
Which appendix pain is referred to suprapubic region?
Ans. (c) PelvicRef: Internet SourcesDifferent positions of appendix will produce some typical symptoms:* Pelvic appendix -- suprapubic pain* Retroileal appendix -- can cause testicular pain due to irritation of spermatic artery or ureter
3
Preileal
Postileal
Pelvic
Paracolic
Surgery
Small & Large Intestine
aa3914b3-3d97-422b-b93c-96a2039d35a0
single
All are true about microscopic appearance of pilocytic astrocytoma, EXCEPT:
Pilocytic astrocytomas (grade I/IV) are distinguished from the other types by their pathologic appearance and relatively benign behavior On macroscopic examination, a pilocytic astrocytoma is often cystic; if solid, it may be well circumscribed or, less frequently, infiltrative. On microscopic examination the tumor is composed of bipolar cells with long, thin "hairlike" processes that are GFAP-positive and form dense fibrillary meshworks; Rosenthal fibers and eosinophilic granular bodies, are often present. An increase in the number of blood vessels, often with thickened walls or vascular cell proliferation, is seen but does not imply an unorable prognosis; necrosis and mitoses are uncommon. Ref: Robbins 8th edition Chapter 28.
4
Bipolar cells
Rosenthal fibers
Eosinophilic granular bodies
Decrease in the number of blood vessels
Pathology
null
9c5796a3-bce0-4a2a-ab24-c53cc4774661
multi
A child presents with barotrauma pain.There is no inflammation of middle ear, management is:
Treatment consists of teaching the patient valsalva manoeuvre. If this fails, politzerization or Eustachian tube catheterization is carried out. If fluid is present a myringotomy may be necessary and occasionally in resistant cases, grommet inseion may be required until the middle ear mucosa has returned to normal.
3
Antibiotics
Paracetamol
Suppurative
Grommet tube inseion
ENT
null
f5853623-05be-4de1-86fd-cd62096a3307
single
Mallory's hyaline is seen in -
null
3
Hepatitis C infection
Amoebic liver abscess
Indian childhood cirrhosis
Autoimmune hepatitis
Pathology
null
3f3ce8cf-cc06-44ec-b8d2-a5d3bd38a315
multi
Which of the following beta adrenergic agonist is used as an aerosol for treatment of bronchial asthma?
Ans: a (Salbutamol) Ref: KDT, 5 ed, p. 217Salbutamol (albuterol) is a highly selective beta 2 agonist.Inhaled salbutamol produces bronchodilation within 5 min and the action lasts for 2-4 hours.Drugs used tor bronchial asthma:Bronchodilators:a. Sympathomimetic-AdrenalineEphedrineIsoprenalinesalbutamolterbutalineb. Methylxanthines-Theophyllineaminophyllinec. Anticholinergics-AtropineIpratropium bromideTiotropium bromideLeukotriene antagonist:MonteleukastzafirleukastMast cell stabilizers:Sodium cromoglycateNedocromil, ketotifenLipoxygenase inhibitors:ZileutonPhosphodiesterase III/ IV inhibitor:PiclamelastCorticosteroids:a. Systemic-HydrocortisonePrednisoloneb. Inhalational-Beclomethesone dipropionateBudesonideFluticasone propionateFlunisolide
1
Salbutamol
Ketotifen
Fluticasone
Monteleukast
Pharmacology
A.N.S.
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single
Onion skin spleen is seen in
Onion skin patten is due to Concentric Fibrosis seen in SLE.
1
SLE
Sjogren's syndrome
Thrombotic thrombocytopenic purpura
Henoch shonlein purpura
Medicine
null
f1753687-f74a-48b3-a666-94e4c40d2422
single
Superficial Plamar arch is related to the?
Superficial palmar arch is a direct continuation of the ulnar aery. The curve of the arch lies across the palm, in level with the distal border of the fully extended thumb. The arch is completed by anastomosing with the superficial palmar branch of the radial aery.
1
Distal end of fully extended thumb
Distal end of fully flexed thumb
Proximal end of the fully flexed thumb
Proximal end of fully extended thumb
Anatomy
null
7886543f-3256-4162-b134-75874ca9d4d7
single
All are TRUE regarding health planning, except -
Steps of health planning analysis of health situation Establishment of objectives and goal Assessment of resources Fixing priorities Write up formulated plan Programming and implementation Monitoring Evaluation (refer pgno: 870 park 23 rd edition)
3
Resiource planning and implementation
Eliminating wasteful expenditure
Creating demands for needs
To develop best course of action for best results
Social & Preventive Medicine
Health education & planning
ae31c3a0-a1e0-4d15-99a1-d03c9df7dcc9
multi
Walsham's forceps are used to:
null
4
Remove teeth
Remove root
Clamp blood vessels
Reduce nasal bone fractures
Surgery
null
038ebd15-c83f-4320-9440-14d19a15b8a5
single
A known case of TB is now resistant to Rifampicin and Isoniazid. Which of the following would be most appropriate in treating this patient?
Ans. C. 6 drugs for 6 months; 4 drugs for 18 months* Resistance to rifampicin and isoniazid is termed as multiple-drug-resistant TB (MDR-TB). In such a case, 6 drugs are used for 6-9 months in an intensive phase followed by 4 drugs for 18 months in a continuous phase.* The number of drugs used for specific duration in a particular type of TB is given below:Type of TBNumber of Drugs UsedNon-drug resistant - New case4 drugs for 2 months + 3 drugs for 4 monthsNon-drug resistant - Previously treated5 drugs for 2 months + 4 drugs for 1 month + 3 drugs for 5 monthsRifampicin resistance + Isoniazid sensitive7 drugs for 6-9 months + 5 drugs for 18 monthsMDR-TB6 drugs for 6-9 months + 4 drugs for 18 monthsXDR-TB7 drugs for 6-12 months + 6 drugs for 18 months
3
6 drugs for 4 months; 4 drugs for 12 months
4 drugs for 4 months. 6 drugs for 12 months
6 drugs for 6 months; 4 drugs for 18 months
5 drugs for 2 months; 4 drugs for 1 month; 3 drugs for 5 months
Social & Preventive Medicine
Communicable Diseases
5fa8e4f1-786d-4b7a-ac5c-c7d463401a08
single
All of the following drugs act by increasing the secretion of insulin except?
Exenatide ->GLP-1 analogue - incretin which release insulin. S/E: Pancreatitis Saxagliptin -> DPP4 inhibitor which inhibit the metabolism of GLP-1, therefore increase insulin. Rosiglitazone acts PPAR gamma receptor. Reverse insulin resistance, associated with increase cardiovascular risk, Fluid retention,edema, anemia, weight gain, macular edema,bone fractures in women Glipizide is a sulfonylurea that increase release of insulin
3
Exenatide
Saxagliptin
Rosiglitazone
Glipizide
Pharmacology
Pancreas
8a858d99-3194-4606-947f-ec25c5eb697d
multi
Which of the following is not a feature of Heat stress
Effect of Heat stress Heat stroke: Body temperature >110degF, Delirium, Convulsions, Absence of sweating Heat hyperpyrexia Heat exhaustion Heat cramps Heat syncope Ref : Park 25th edition Pgno : 784
4
Hyperpyrexia
Syncope
Cramps
Numbness
Social & Preventive Medicine
Environment and health
8b604a79-e75a-4e80-b78a-41edba668631
single
A patient of alcohlic liver faliure requires general anesthesia AOC is
C i.e. Isoflurane - IsofluraneQ is volatile anesthetic agent of choiceQ in patients with liver disease because it has the least effect on hepatic blood flow. - CisatracuriumQ is neuromuscular blocking agent of choiceQ owing to its unique non hepatic metabolism.
3
Ether
Halothane
Isoflurane
Methoxyflurane
Anaesthesia
null
b83a2d85-f499-4a91-90d2-df77443654fa
single
All are true regarding cryptococcal infection except -
1. Capsular antigen detection from CSF or serum by latex agglutination test is a rapid and sensitive (95%). 2. Cryptococcus gives Urease test positive. 3. Anticapsular Abs is not protective 4. Predisposing factors: Patients with advanced HIV infection with CD4 T-cell counts < 200/ml is the most impoant risk factor for C.neoformans. However, C.gattii is not associated with HIV. It usually causes infection in immunocompetent individuals. Patients with hematologic malignancies. Transplant recipients Patients on immunosuppressive or steroid therapy.
3
Occurs in immune-deficient states
Capsular Ag in CSF is a rapid method of detection
Anticapsular Abs is protective
Urease test +ve
Microbiology
Mycology
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multi
Neonatal hypothermia can be prevented by all of the following EXCEPT?
Neonatal hypothermia induces peripheral vasoconstriction leading to increased metabolism- Hypoxia Hypoglycemia Metabolic acidosis. Components of the warm chain 1. Thermal care in delivery room 2. Warm resuscitation 3. Immediate drying 4. Skin-to-skin contact 5. Breast feeding 6. Bathing postponing 7. Clothing and bedding 8. Rooming in 9. Warm transpoation 10. Training and awareness rising
2
Warm chain
Cold chain
Kangaroo Mother care
Radiant warmer
Pediatrics
Neonatal hypothermia
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multi
Most common route of infection of Kidneys in T.B. is
null
2
Direct invasion
Hematogenous
Lymphatic
Ascending
Surgery
null
2c20f389-9172-4870-b89a-38fcae1a30d6
single
Substrate level phosphorylation is seen in reaction catalyzed by which enzyme of citric acid cycle?
The reaction involves a substrate level phosphorylation whereby a high energy phosphate is generated from the energy trapped in the thioester bond of succinyl CoA. The enzyme is succinate thiokinase (step 5, Fig.18.2). A molecule of GDP is phosphorylated to GTP and succinate is formed. The GTP can be conveed to ATP by reacting with an ADP molecule: GTP + ADP - GDP + ATPRef: DM Vasudevan, Page no: 218
2
Pyruvate kinase
Succinate thiokinase
Phosphoglycerate kinase
All of the above
Biochemistry
Enzymes
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Rickets is due to -a) Loss of calcium in urineb) Increased mobilisation of calcium from bonec) Decreased absorption of calciumd) Loss of phosphate in Urine
Rickets is a metabolic disorder characterized by deficient mineralization of bone. Rickets may be due to : - Vit D deficient → ↓ absorption of calcium (Vit D dependent rickets). Increased phosphate excretion due to defective reabsorption → Vit D resistant rickets.
4
ab
bc
bd
cd
Pathology
null
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single
7-Methyl guanosine cap is present in
Eukaryotic mRNA synthesis results in a pre-mRNA precursor that contains extensive amounts of excess RNA (introns) that must be precisely removed by RNA splicing to generate functional, translatable mRNA composed of exonic coding and 5' and 3' noncoding sequences. # All steps--from changes in DNA template,Ref: Harpers Illustrated Biochemistry, 30th edition, page no:
1
M-RNA
t-RNA
r-RNA
DNA
Biochemistry
Metabolism of nucleic acids
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single
All of the following are true about peritonsillar abscess, except:
(c) Abscess is collected lateral to the superior constrictor(Ref. Scott Brown, 8th ed., Vol 3; 626)The abscess is collected in the peritonsillar space medial to the superior constrictor.Rest all are true.
3
Bulge in soft palate
Does not involve floor of mouth
Abscess is collected lateral to the superior constrictor
Trismus is commonly associated
ENT
Pharynx
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multi
What is Falanga:
Beating on ear with both palms
1
Beating on soles with blunt object
Beating on ear with both palms
Beating on the abdomen
Suspension by wrists
Forensic Medicine
null
c37a4dd5-40bf-4973-9681-e99426c77961
multi
Which of the following type of wa is treated by local application of podophyllin?
Treatment of anal condyloma depends on the location and extent of disease. Small was on the perianal skin and distal anal canal may be treated by the topical application of bichloracetic acid or podophyllin. Imiquimod is an immunomodulator that recently was introduced for topical treatment of several viral infections, including anogenital condyloma. Ref: Bullard Dunn K.M., Rothenberger D.A. (2010). Chapter 29. Colon, Rectum, and Anus. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.
2
Plantar wa
Genital wa
Verruca Wa
All of the above
Pharmacology
null
7229df94-1b64-45b0-b143-375e2439ffb0
multi
The following statements regarding insulin resistance in diabetic patients are true except:
Insulin resistance in diabetic patients has been defined as insulin requirement of more than 2 U/kg/day for control of hyperglycemia or prevention of ketosis for more than 3 days in the absence of any complications. Stressful conditions (when there is excess of glucocorticoids and other hyperglycemic hormones) like trauma, surgery, and infections can oppose insulin action and  produce short-term insulin resistance. In few patients, it may be due to development of antibodies of the IgG type to minor contaminants or to some components (e.g. Zinc, protamine, etc.,) added to insulin, hence it is less commonly seen with purer preparations of insulin or with human insulin  (huminsulin).  In case the resistance persists, a short-term course with prednisolone (immunosuppressant) may bring down the insulin requirement.
1
It is more common with huminsulin
It may occur in the presence of infections
It may be due to antibodies to insulin
Use of glucocorticoids may be useful in severe cases
Pharmacology
null
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multi
True statement about Vi polysaccharide vaccine is:
Can be administered with yellow fever and hepatitis A vaccine "The Vi polysaccharide vaccine can be co-administered with other vaccines relevant for international travelers such as yellow fever and hepatitis A and with vaccines of the routine child hood immunization programs"- Park There are two anti typhoid vaccines in use: Vi polysaccharide vaccine Subunit vaccine Composed of purified Vi capsular polysaccharide from the Ty 2 S. Typhi strain Administered subcutaneously or intramuscularly Stable for 6 months at 37degC and for 2 yrs at 22degC. The recommended storage temp. is 2-8degC. Schedule: Only Single dose of vaccine is required. To maintain protection revaccination every 3 yrs is recommended. Licensed for use in individuals 2 yrs. Immunity develops 7 days after injection of vaccine. No serious adverse events and a minimum of local side effects are associated with it. No contraindications except severe hypersensitivity reaction in previous vaccine injection. It is safe for HIV positive individuals. Ty 21a vaccine Orally administered live attenuated (Ty 2 strain of S. typhi) vaccine. / * Available as enteric coated capsules. Storage at 2-8degC, retains potency for 14 days at 25degC. Licensed for use in individuals 5 yrs. 3 dose regimen - Day 1, Day 3 and Day 5 Immunity develops 7 days after last dose. This series to be repeated every 3 yrs. in endemic areas and every year for travelers from non endemic to endemic countries. May be given simultaneously with live vaccines of polio, cholera, yellow fever and MMR. Proguanil and antibacterial drugs should be stopped 3 days before and 3 days after vaccine administration as these drugs may harm live bacterial vaccines. Avoided during diarrhoea as efficacy will reduce. Can be given to HIV +ve, asymptomatic persons with CD4 cell count of > 200/mm3 Well tolerated and has low rates of adverse events. Not recommended in congenital or acquired immunodeficiency, acute febrile illness, acute intestinal infection and in patients on antimitotic drugs.
4
Has many serious systemic adverse reactions
Has many serious local side effects
Has many contraindications
Can be administered with yellow fever and hepatitis A vaccine
Social & Preventive Medicine
null
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