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Drug used for kala-azar | Ans. is 'c' i.e.,Paromomycin Drugs used for kala-azarParentral : Amphotericin-B (iv), Paromomycin (im), sodium stibogluconate (iv or im).Oral : Miltefosine | 3 | Diloxanide furoate | Metronidazole | Paromomycin | Spiramycin | Pharmacology | null | 195e8e2c-5d3b-46e3-96e8-05cd3fad31a0 | single |
A 70 kg old athlete was posted for surgery, Patient was administered succinylcholine due to unavailability of vecuronium. It was administered in intermittent dosing (total 640 mg). During recovery patient was not able to respire spontaneously & move limbs. What is the explanation ? | B i.e. Phase 2 blockade produced by succinylcholine - Sch is depolarizing/ non competitiveQ M.R. with shoest duration of actionQ (3-5 min) d/t rapid hydrolysis by pseudo cholinesteraseQ. It causes dual/ biphasic blockQ. It increases K. (ie hyperkalemiaQ 1/t diastolic cardiac arrest), intraocular & intragastric pressure and temperature (l/t) malignant Hypehermia)Q - Depolarizing block (phase I & II) caused by Succinyl cholineQ is also called Dual or Biphasic Block. In contrast to phase II depolarization block & Non depolarizing block, phase I depolarization block does not exhibit fade during tetanus or train-of-four, neither does it demonstrate post tetanic potentiation. Phase I block is potentiated by isoflurane, Mg, Li & Anticholine-esterase while phase II block is potentiated by enflurane. - The onset of paralysis by succinylcholine is signaled by visible motor unit contractions called fasciculation.Q Patients who have received suxamethonium have an increased incidence of postoperative myalgiaQ. This is more common in healthy female outpatients. Pregnancy & extremes of age seem to be protective. Succinylcholine releases a metabolite succinylmonocholine, causing excitation of the cholinergic receptors in the sinoatrial node resulting in bradycardia. Q Intravenous atropine is given prophylactically (paicularly in children, who are more susceptible) in children and always before a second dose of sch. - Prolonged apnea after suxamethonium is best managed by providing mechanical ventilation, maintaining anesthesia and continuous monitoring until muscle function returns to normal.Q Transfusion of fresh frozen plasma is beneficial (as it provides pseudocholinesterase) its infectious risks outweigh its potential benefits -Morgan Administration of purified pseudocholinesterase, blood or plasma may antagonize the block. However because of the risk associated with their use, infusion of banked blood or fresh frozen plasma cannot be recommended - Churchill. - Succinylcholine & mivacurium are metabolized by pseudocholinesterase, while esmolol and remifentanyl are metabolized by RBC es terase.(2 - Pseudo cholinesterase deficiency causes prolonged residual paralysis at normal Sch dose (1-2 mg/kg)Q whereas, phase 2 non-depolarization blockade occurs after administration of higher doses >6 (7-10) mg/kgQ Despite large decrease in pseudo cholinesterase activity (level) there is only moderate increase in duration of action of Sch. In contrast to the doubling or tripling of blockade duration seen in patients with low pseudo cholinesterase enzyme levels or hetozygous atypical enzyme, patients with homozygous atypical enzyme will have a very blockade (4-8 hrs) following Sch administration. | 2 | Pseudocholinesterase deficiency increasing action of syccinylcholine | Phase 2 blockade produced by succinylcholine | Undiagnosed muscular dystrophy and muscular weakness | Muscular weakness due to fasciculation produced by succinylcholine | Anaesthesia | null | b4f4f84c-26a8-443b-a3ef-909b1ed32d5c | single |
An 18-year-old presents with a well- circumscribed 2 cm mass in her right breast. The mass is painless and has a rubbery consistency and discrete borders. It appears to move freely through the breast tissue. What is the likeliest diagnosis? | Fibroadenomas are most often found in teenage girls. They are firm in consistency, clearly defined, and very mobile. The typical feature on palpation is that they appear to move freely through the breast tissue ("breast mouse"). | 3 | Carcinoma | Cyst | Fibroadenoma | Cystosarcoma phyllodes | Surgery | Breast | 20d211b9-a4b1-4b39-8fc4-163bb59cccd6 | single |
Definition of Blindness when visual acuity is less than ___________ in better eye according to NPCB and WHO respectively | null | 3 | < 3/60 and < 6/18 | < 6/18 and < 3/60 | < 3/60 and < 3/60 | < 6/18 and < 6/18 | Social & Preventive Medicine | null | d993e760-8563-4c69-ade3-55a0fc6ce368 | single |
A group tested for a drug shows 60% improvement as against a standard group showing 40% improvement. The best test to test the significance of result is- | Ref: Parks 23rd edition pg 852 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. Ref:Parks 23rd edition pg 852 Tests of significance: Qualitative: Chi- square : 2 or more than 2 groups Mc Nemar test : 1 group. ( before and after intervention) Quantitative: Paired T test: 1 group Student T test/ unpaired T test: 2 groups Anova: more than 2 groups. | 2 | Student T test | Chi square test | Paired T test | Test for variance | Social & Preventive Medicine | Biostatistics | 3224c26b-8f9e-4dac-9bcb-de5473f2a3c1 | single |
Most common malignant tumor of kidney: | Ans. (c) Renal cell CARef: Robbins 9th ed. 1952* Robbins 9th ed. States: "by far the most common malignant tumor is renal cell carcinoma, followed by Wilms tumor, which is found in children.* Incidence of RCC is: 85%* M > F (2:1)* Most of the RCC are sporadio AD (familial)Must KnowKIDNEY CA (extract from Robbins 9th ed)* MC benign tumor of kidney: Renal papillay adenoma* MC malignant tumor of kidney: RCC > Wilms tumor* MC kidney tumor associated with tuberous sclerosis: Angiomyolipoma* MC type of RCC: Clear cell CA (70 - 80%)* MC type of renal CA associated with dialysis: Papillary CA* MC renal CA associated with sicke cell trait: Medullary CA* Renal CA having best prognosis: Chromophobe I | 3 | Papillary carcinoma | Papillary adenoma | Renal cell CA | Wilms tumor | Pathology | Miscellaneous (Kidney) | c7c97ac0-5fd8-4b9f-b757-d9b2b8f3d6b2 | single |
A 6 day old newborn infant develops lectonuria seizures and hypoglycemia. The likely diagnosis is? | Ans. is 'a' i.e., Aromatic amino aciduria | 1 | Aromatic amino aciduria | Phenyl ketonuria | Intrauterine infectious | Tyrosinemia | Pediatrics | null | 74ba5150-6106-44e1-aaea-6d65f7b5b8c3 | single |
The PHP index is designed to | null | 2 | Evaluate plaque and calculus on specific tooth surfaces | Score plaque on specific tooth surfaces | Scores plaque and gingivitis | Scores plaque, calculus, gingivitis | Dental | null | 9ab843c6-180f-47c7-8863-dc57b7f0016b | single |
Following acute failure of the left ventricle is the hea is man, pulmonary edema generally begins to appear when left atrial pressure approaches | Pulmonary edema is one of the most serious consequences of left ventricular cardiac failure. When the left ventricle fails or when the mitral valve fails, left atrial pressure (LAP) may increase substantially. The resulting increase in pulmonary capillary pressure (Pc) forces excess fluid filtration through the pulmonary capillary walls and into the lung tissue. At first, the fluid collects within the lung interstitial space. If LAP exceeds a critical level of ~25 mmHg, the volume of edema fluid will overwhelm the capacity of the interstitial spaces and fluid will flood the airways and alveoli (8). This airway edema directly interferes with gas exchange, and it can kill the patient. However, many people live for months or years with modestly elevated LAP (<25 mmHg). We believe that sustained, subcritical LAP elevations lead to two phases of change in the lungs. The first phase is the acute edema that develops in the first few hours of elevated LAP. The second phase concerns the effect of long-term (7 days or more) increases in LAP below the critical level. This review deals with the acute phase and long-term phase changes in the lung caused by modestly elevated LAP. The acute phase of pulmonary edema has been the subject of intense investigation for many years. In 1896, Starling (7) laid the foundation for our current understanding of pulmonary edema with his famous fluid filtration equation. The equation relates the rate of fluid filtration through the capillary wall (Jv) to the pressures across the capillary wall and to the filtration characteristics of the capillary membrane Ref: guyton and hall textbook of medical physiology 12 edition | 3 | 7 mm Hg | I5 mm Hg | 20 mm Hg | 30 mm Hg | Physiology | G.I.T | 337f2e15-52cc-431a-b07a-fd2df4975297 | multi |
Chocking is constricting device within the barrel at the muzzle end of - | The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ; 28th edition ; pg.no 122 The choke bore present in a shot gun ,the distal 7-10 cm of the barrel is narrow . There are some shotguns which have a small poion of their bore near the muzzle end rifled ,which are called "paradox gun" . | 3 | Revolver | 303 rifle | Shot gun | Semiautomatic pistol | Forensic Medicine | Mechanical injuries | 960cee8e-863f-4b4e-9cce-77db6f1cf92a | single |
Which of the following is lined by transitional epithelium | INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:321 Both in the male and female,the greater pa of urethra is lined by pseudo stratified columnar epithelium.a sho pa adjoining the urinary bladder us lined by transitional epithelium | 3 | Stomach | Colon | Urethro verical junction | Prostate | Anatomy | General anatomy | 34866b06-b190-4ba3-9a0c-758c738fcede | single |
Most common cause of death in amyloidosis is ? | Ans. is 'a' i.e., Hea Failure `Most common cause of death is hea failure and/or abnormal cardiac rhythm' Essentials pathology | 1 | Hea failure | Renal failure | Sepsis | None | Pathology | null | aaf9c02a-5b8c-4258-8f1d-969a816af061 | multi |
Who proposed the classification of primary dentition based on distal surface of second molar? | Classification of Primary Dentition given by Baume, 1959 | 2 | Angle | Baume | Simon | Dewey | Dental | null | 3b410d03-6a6a-4a5f-9087-f8aedc953fc7 | single |
Paragonismus westermani is commonly called: March 2005 | Ans. A: Lung fluke Paragonismus westermani Preferred definitive host: Carnivores (e.g. felids, canids, viverids, and mustelids), rodents, and pigs. Reservoir hosts: Humans Vector/intermediate hosts: Snail of Family Thieridae; - Crab-Eriocheir japonicus. Organs affected: Mainly the bronchioles of the lungs, but the worms may wander into the brain or mesentery. Symptoms and clinical signs: Victim suffers from breathing difficulties and chronic cough. Worm is often fatal due to penetration of the brain, spinal cord, or hea. Treatment: Bithionol, Praziquantel Tapeworms: Impoant ones are D. latum, Taenia solium and saginata, Echinococcus, Hymenolepis etc. Intestinal flukes: Small intestine: fasciolopsis buski, Hetreophyes, Metagonimus yokogawai, Watsonius watsoni and Echinostoma Large intestine: gastrodiscoides hominis Liver flukes: Fasciola hepatica and less often opisthorcis species Flukes in the biliary tract: Clonorchis sinensis | 1 | Lung fluke | Tapeworms | Intestinal flukes | Liver flukes | Microbiology | null | 36b7ca5a-f9e8-4da6-bbcb-61e74391d9e9 | multi |
In pregnancy : | Plasma fibrinogen levels are increased | 1 | Plasma fibrinogen levels are increased | Fibrinogen levels are decreased | Thyroglobulins are decreased | IgD are markedly increased | Gynaecology & Obstetrics | null | 9bf8af40-2639-48a8-af94-f518936d696e | single |
Singer&;s Alkali denatuaion test is performed for: | Singer&;s alkali denaturation test is performed for Vasa Pre. Detection of nucleated RBCs using apt test or Singer&;s alkali denaturation test is diagnostic of vasa pre. It is based on the fact that fetal hemoglobin is resistant to alkali denaturation. Both Apt and Kleihauer-Betke Test can be used to detect the presence of fetal blood within a sample. Apt Test Kleihauer Betke Test Reagent NaOH Citric acid Phosphate buffer Assessment Qualitative Quantitative Ref: DC Dutta&;s textbook of Obstetrics 8th edition Pgno: 301 | 2 | Rh incompatibility | Vasa Pre | Abruptio placenta | Preterm labour | Gynaecology & Obstetrics | General obstetrics | 9503f3ca-1816-4287-bf94-b2668feea13f | single |
Regarding phenytoin all are true except | At lower concentration it follows zero order kinetics A child with respiratory infection and membrane over peritonsillar area is suspected of having Diptheria. Both Blood Tellurite media & Loeffler serum slope can be used for culture but Diptheria is one emergency so the media in which it can be cultured quickly is used (Loeffler serum slope). Loeffler serum yield colony in 6-8 hrs Blood Tellurite yield colony in --3 36-48 hrs | 3 | Potent microsomal enzyme inducer | Highly protein bound | At lower concentration it follows zero order kinetics | With increasing dose, the T 1/2 increases | Pharmacology | null | a2416775-9869-4134-a6dc-1168d8e7527e | multi |
True about follicular cysts of ovary are all except | Follicular cysts are dependent on gonadotropins for growth. | 3 | Functional cyst of ovary | Most-common in young, menstruating women | Independent of gonadotropins for growth | Women with cystic fibrosis have increased propensity to develop follicular cysts. | Gynaecology & Obstetrics | null | 993f2f24-3605-41cc-97b9-d93cebb086d1 | multi |
IUGR babies on delivery are called: | Small for date | 2 | Growth retarded | Small for date | Low bih weight | Preterm | Social & Preventive Medicine | null | 7ee27761-3c84-42fd-84d2-3cbaeb5f0bfa | multi |
Heterophile antibody test is done for: September 2010 | Ans. B: Infectious mononucleosis A heterophile agglutination is a test that measures the agglutination of the red blood cells of sheep by the serum of patients with infectious mononucleosis. Diagnostic tests are used to confirm infectious mononucleosis but the disease should be suspected from symptoms prior to the results from hematology. These criteria are specific; however, they are not paicularly sensitive and are more useful for research than for clinical use. Only half the patients presenting with the symptoms held by mononucleosis and a positive heterophile antibody test (monospot test) meet the entire criteria. One key procedure is to differentiate between infectious mononucleosis and mononucleosis-like symptoms | 2 | Rickettsial infections | Infectious mononucleosis | Smallpox | Japanese encephalitis | Microbiology | null | e3ebc846-8f46-4601-a94d-7513106a59b5 | multi |
Gallstone are associated with which Neuro Endocrine Tumour :- | Somatostatinoma syndrome is a triad of diabetes mellitus, diarrhea and gallstones, but also includes weight loss and hypochlorhydria. | 3 | Insulinoma | VIPoma | Somastostatinoma | Glucagonoma | Surgery | Gallbladder | e3292ae9-466e-4837-912e-64e6fe0a32c1 | multi |
A 69 year old male presents with an episode of slurring of speech which lasted for 12 hours and then resolved.He is heavy smoker having smoked 60 cigarettes per day for 40 years. He had a single episode of haemoptysis 4 weeks previously and has underlying lung cancer with brain metastases and is referred for an urgent CT chest. An ECG was performed which showed new AF. All blood tests including cardiac biomarkers were normal. Chest CT is shown. Which of the following is most probable diagnosis? | The axial image from a contrast enhanced CT scan, in aerial phase, shows a filling defect in the left atrial appendage layered along the anterior wall. Given the clinical history and the CT appearance, the most likely diagnosis is of thrombus in the LA as a consequence of AF. Myxomas generally arise from interatrial septum projecting into the left atrium Vegetation, abscess and new dehiscence of a prosthetic valve are the three major echocardiographic criteria for the diagnosis of infective endocarditis. | 2 | Left atrial myxoma | Left atrial thrombus | Infective endocarditis | Rhabdomyoma | Radiology | Cardiovascular Radiology | 3a6b4569-defb-49b4-8430-ff9ea210a929 | multi |
The patho-physiological phenomenon that occurs during atheromatous plaque formation and is used for screening of 'asymptomatic coronary plaques' on CT scan is: | C i.e. Calcium deposition in the atheromatous plaque Screening of asymptomatic coronary plaques on. CT scan (EBCT & MDCT) uses calcium depositionQ as a surrogate marker for detecting the presence & amout of atherosclerosis. CT attenuation within non calcified fibrous pique (91-116) is greater than within noncalcified lipid-rich plaques (47-71 HU). However, large variability currently prevents accurate classification of non calcified plaques by CT. Agatston Coronary Aery Calcification Scoring Coronary calcium is used as a surrogate marker to detect the presence and quantify the amount of atherosclerosis. Both electron beam (EB) CT and MD-CT permit accurate detection and quantification of coronary aery calcium. With the exception of renal failure patients, calcification occurs almost exclusively in the context of atherosclerosis. Agatston developed a scoring system, which takes into account the area (in pixels) and the CT density of calcified lesion (defining calcification as densities >130 Hounsfield units) for quantifying coronary aery calcification in patients evaluated with EB-CT scans using 3mm slice thickness. Each lesion in each slice is scored based on maximum density with a paicular scale i.e. 1 = 130 to 199 HU; 2 = 200-299 HU; 3 = 300-399HU; 4 = 400HU or greater. Then a total score is obtained by summing the scores from all slices, broadly indicating grade of coronary aery disease (& risk of cardiovascular events +- . 0 = No; 1 to 10 = Minimal; 11 to 100 = Mild; 101 to 400 = Moderate; >400 = Severe. Currently, MDCT calcium scoring is widely used to calculate coronary clacium load, using 2.5 to 3 mm norienhanced axial CT images obtained with a prospective ECG gated acquisition. Modified Agatston score equivalent, takes into account the area of each calcified lesion and the maximum CT value within the lesion. The volumetric and absolute mass quantfication scoring algorithms are also available, showing increased accuracy, consistency and reproducibility (however, not been validated in clinical setting). It is impoant to understand that the amount of coronary calcium correlates moderately to overall atherosclerotic plaque burden. On the other hand, not every atherosclerotic coronary plaque is calcified and calcification is a sign of neither stability nor instability of an specific plaque. The absence of coronary calcium rules out the presence of coronary aery stenoses with high predictive value. However, even pronounced coronary calcification is not necessarily a/whemodynamically relevant luminal narrowing. So even the detection of large amounts of calcium does not indicate the presence of significant stenoses & it should not prompt invasive coronary angiography in otherwise asymptomatic individuals. | 3 | Increased outer diameter of coronary aery | Decreased inner diameter of coronary aery | Calcium deposition in the atheromatous plaque | Lipoid degeneration in the plaque. | Radiology | null | 8f5871c7-a373-4f4b-8185-78e298dc42dc | single |
Screening test used in first trimester for aneuploidy - | Ans. is'c'i.e., PAPP-A &beta HCG1st trimester aneuploidy screening:Human chorionic gonadotropin (either intact or free (b-hCG).Pregnancy-associated plasma protein A (PAPP-A).Fetal Down syndrome in 1st trimester:Higher serum free beta-hCG level.Lower PAPP-A levels.Trisomy 18 & 13:Lowered levels of both HCG PAPPP-A.2nd trimester analytes:Serum integrated screening.Accuracy of aneuploidy detection:Greater on combination with,Sonographic NT measurement. | 3 | PAPP-A &estradiol | PAPP-A & AFP | PAPP-A &beta HCG | Beta HCG & inhibin | Gynaecology & Obstetrics | null | a7546f5c-c78a-4021-9e5f-6af608e99c67 | single |
Which of the following is most dependent on vasovagal reflex? | Ans. c (Receptive relaxation). (Ref. Ganong, Physiology, 21st ed., 498)Receptive Relaxation# When food enters stomach, fundus and upper part of the body relax and accommodate food with little if any increase in pressure known as receptive relaxation.# It is vagally mediated and triggered by pharyngeal and esophageal movement.Segmentation# Segmentation are ring-like contractions of small intestine that appear at regular interval and then disappear and move chyme to and fro and increase exposure to mucosal surface.# They are initiated by focal increase in ca+ influx.Swallowing# Swallowing is a reflex response triggered by afferent impulse in 5th, 9th and 10th cranial nerves.# These impulses are integrated in NTS and nucleus ambigus. | 3 | Chewing | Swallowing | Receptive relaxation | Segmentation of intestine | Physiology | Nervous System | e78dc09d-3366-42c3-9bc2-02dcb1afe7f0 | multi |
Position of mid-inguinal point is ? | Ans-B | 2 | Midpoint of Anterior Superior Iliac Spine (ASIS) and pubic tubercle | Mid point of ASIS and pubic symphysis | Mid point of both ASIS | Mid-point of inguinal ligament | Unknown | null | 78414896-96de-45c7-9d8a-550b79a56eaf | multi |
A woman develops chickenpox at 39 weeks. She has a single fetus in the cephalic presentation. She has no other pregnancy complications.What is the best method to prevent neonatal infection? | Ans. is a, i.e. Continue the pregnancy for at least one weekIf delivery can be postponed for at least 7 days, the mother will develop antibodies and there will be transplacental transfer of antibodies to the neonate. The neonate will have passive immunity and will not develop the infection. Therefore, the best method to prevent neonatal infection is to continue the pregnancy for at least one week after the mother develops the rash. If delivery occurs within one week, the baby should be given VZIG soon after birth. | 1 | Continue the pregnancy for at least one week. | Give varicella zoster vaccine to the neonate soon after birth | Give VZIG to the neonate soon after birth | Induce labor immediately | Gynaecology & Obstetrics | Medical & Surgical Illness Complication Pregnancy | 8707a5b8-8fbc-445c-9c56-31d78521d3bc | single |
Which organs do not utilise ketone bodies? | In the fasting state, glucose must be spared for use by the central nervous system (which is largely dependent on glucose) and the red blood cells (which are wholly reliant on glucose). Therefore, tissues that can use fuels other than glucose do so; muscle and liver oxidize fatty acids and the liver synthesizes ketone bodies from fatty acids to expo to muscle and other tissues.Ref: Harper&;s Biochemistry; 30th edition; chapter 14; overview of Metabolism & the Provision of Metabolic Fuels | 4 | Skeletal muscles | Cardiac muscles | Liver | RBC | Biochemistry | Metabolism of lipid | 2c931453-2e94-4640-a41a-982e70a7c6ae | single |
'Hair on end' appearance is characteristically seen in | Ans. a (Thalassemia major) (Ref. Radiology Review Manual, 5th/pg.174)Causes of "hair on end" or "crew hair cut" skull are# Thalassemia (Characteristic)# Hereditary spherocytosis# Sickle cell disease# G-6-PD deficiency# Iron deficiency anaemia# Neuroblastoma | 1 | Thalasemia major | Sickle cell anaemia | G 6PD deficiency | Hereditary spherocytosis | Radiology | Skeletal System | fb3c010a-ca72-4a08-9851-0295c2da6eda | multi |
Insulinoma is most commonly located in which part of the pancreas - | “Insulinomas invariably occur only in the pancreas, distributed equally in the pancreatic head, body and tail". — Harrison 17/e
Insulinomas are a β cell endocrinal tumur of the pancreas.
Insulinomas are the most common pancreatic endocrine neoplasms.
The symptoms are produced due to excessive secretion of insulin causing hypoglycemia
Most of the insulinomas are solitary and benign,
Only about 10-15% of insulinomas are malignant. (keep in mind that all other endocrine tumours of pancreas are usually malignant).
Symptoms of insulinoma
The most common symptom is due to the effect of hypoglycemia on the central nervous system.
These symptoms are - confusion, disorientation, visual difficulties, irrational behaviour, coma
Other symptoms are due to increased secretion of catecholamines which includes sweating, tremor and palpitations.
Classic diagnostic criteria is - Whipple's triad
Signs and symptoms of hypoglycemia during fasting.
Blood glucose below 2.8 mmol/L (50mg/dl) during symptomatic episodes.
Relief of symptoms by intravenous administration of Glucose.
The most useful diagnostic test and the only one indicated in almost all patients is demonstration Wasting hypoglycemia in the presence of inappropriately high level of insulin.
The patient is fasted for 72 hrs or till the symptoms of hypoglycemia develop.
When hypoglycemia develops, serum level of insulin is measured. A ratio of plasma insulin to glucose > 0.3 is diagnostic.
Localization of the tumour
Once the diagnosis has been made, localization of the tumour is must for surgery.
The most important examination for localization of tumour is intraoperative ultrasound, which can indentify pancreatic tumour in all cases.
It is more sensitive than any other method
Other important methods of localization -
High resolution CT and MN.
Endoscopic ultrasound examination of pancreas.
Selective arteriography
T/T - Surgical excision is the t/t of choice -
Since most insulinomas are benign simple enucleation is done. | 4 | Head | Body | Tail | Equally distributed | Surgery | null | c8b99824-b041-4b00-ab09-0d7289c19324 | multi |
A child comes with cyanotic spells and chest X-ray was as shown below; What is the most probable diagnosis? | a. Tetralogy of Fallot(Ref: Nelson's 20/e p 2211-2217,, Ghai 8/e p 420-423)The given history along with chest X-ray finding of Boot shaped heart suggests a diagnosis of Tetralogy of Fallot. | 1 | Tetralogy of Fallot | Tricuspid atresia | Pulmonary atresia with intact ventricular septum | TAPVC | Pediatrics | C.V.S. | 9c545cc6-5217-4737-a1c9-c6e31942ca2b | multi |
Which morphological type of cataract is most visually handicapping ? | Cupuliform (Posterior subcapsular) cataract lies right in the pathway of the axial rays and thus causes an early loss of visual acuity. | 3 | Cortical | Nuclear | Posterior subcapsular | Zonular | Ophthalmology | null | 0ebf2809-2cd1-43c4-bf6f-d985236e8ce3 | multi |
A 16 yr old boy is brought to the emergency room by ambulance after suffering a concussion during a football game. When he awoke he had difficulty expressing himself verbally but was able to understand and follow commands. His condition is most likely caused by damage to which of the following? | Aphasia is a language disorder in which a person is unable to properly express or understand ceain aspects of written or spoken language. It is caused by lesions to the language centers of the brain, which, for the majority of persons, are located within the left hemisphere in the poions of the temporal and frontal lobes known as Wernicke's and Broca's areas, respectively Language disorders caused by memory loss, which could be the result of a hippocampal lesion, are not classified as aphasias. | 2 | The hippocampus | The temporal lobe | The parietal lobe | The limbic system | Surgery | null | 565b756b-e493-4809-a735-9f3135c5bcd1 | multi |
Which of the following procedures is used as a routine technique in karyotyping using light microscopy? | null | 1 | G banding | C banding | Q banding | Brd V-staining | Pathology | null | 734f67fe-18c8-4b8b-ade8-d49c4f7b682a | single |
Atheroma resulting in angina has following characteristic except - | Ans. is 'c' i.e., Lack of macrophage o Atherosclerotic plaque is composed of three major components. Cellular component --> Predeminantly smooth muscle cells and macrophages. Others are lymphocytes. Connective tissue matrix (ECM) --> Collegen, elastic fibers, proteoglycans. Lipids --> Both intracellular and extracellular. The major lipid is cholesterol and cholesterol esters. o From initiation to the development, atheromatous plaque progresses from the following stages. Type I (Initial) lesion o These are due to accumulation of isolated lipid filled macrophages (foam cells) and begins as fatty dots. o These are not visible. Type II lesion (fatty streaks) o These lesions are due to accumulation of multiple lipid-filled macrophages (foam cells). o These are the earliest visible lesion of atherosclerosis. o They are not significantly raised and thus do not cause any disturbance in blood flow. Type III (intermediate) lesion o These are same as type II with small extracellular lipid pool. Type IV (atheroma) lesion o Type II change with core of extracellular lipid. Type V lesion (fibroatheroma or mature atherosclerosis) o This lesion is mature atherosclerotic plaque which has following structure. A.Fibrous cap It may be thin or thick. It contains-Smooth muscle cells, macrophages, foam cells, lymphocytes, collegen, elastin and proteoglycans. B.Necrotic core It is deep to the fibrous cap. Contains disorganised mass of lipid (primarily cholesterol and cholesterol esters), cell debris, some foam cells, fibrin, and other plasma proteins. | 3 | Thin fibrous cap | Thick fibrous cap | Lack of macrophage | Lack of smooth muscle cell | Pathology | null | 28042c9e-4e90-4dde-b643-20278486db4f | multi |
Cyanosis is not seen in- | Ans. is 'c' i.e., CO poisoing Hypoxic hypoxia (hypoxemia)Anemic hypoxiaStagnant hypoxiaHistotoxic hypoxiao Cyanosis presentCauses :* Hypoventilation as seen in interstitial lung disease & COPD* Cyanotic CHD* Reduced diffusion capacity* Right to left shunt, e.g. A V malformation* V/Q mismatch* High altitudeo Cyanosis absent Causes :* Anemia* CO poisoningo Cyanosis presento Causes :* CHF* Shock* Peripheral vasoconstrictiono Cyanosis absento Causes:* Cyanide poisoning | 3 | CHF | COPD | CO poisoning | High altitude | Physiology | Heart, Circulation, and Blood | b025f103-728c-45d6-ab7c-52b655ba9244 | single |
Make the diagnosis of a 26 day old Infant presenting with recurrent nonbilious vomiting with costipation and loss of wt? | Ans is 'd' ie Pyloric stenosis This is a typical picture of pyloric stenosis a) Infant presenting in 4th week b) Non-bilious vomitting. c) With constipation and wt. loss. Lets see other options. Esophageal atresia a) Infant presents soon after bih with complaints of regurgitation of milk, saliva pours almost continuously from its mouth. Attempt to feed are met with 'Spitting up' or frank vomitting. b) Persistence in feeding may produce aspiration, choking and respiratory distress. c) Diagnosis can be confirmed by passing a rubber catheter into the esophagus through the mouth which will encounter an obstruction. Thus point (a) helps in ruling out oesophageal atresia. Choledochal cyst a) Presentation is not so early in infancy. Though its a congenital anomaly only 1/2 the cases present before 20yrs. of age and only 1/3 present in the 1st decade of life. b) Classical triad of symptoms --> i) Obstructive jaundice * ii) Upper abdominal pain* iii) Fever* (c) A palpable epigastric mass may be discovered. Beal atresia a) Vomitting will be bilious b) Infant presents in the 1st week of life. | 4 | Oesophageal atresia | Choledochal cyst | Ileal atresia | Pyloric stenosis | Surgery | null | cd7568d9-eaa3-49ae-b52a-7d99331dda43 | single |
Which of the following is seen in cryoglobulinemia | Abnormal Ig Bence Jones proteins Light chain of Ig ( Kappa or Lambda )WaldenstormmacroglobulinemiaIg M Heavy chain disease Fc pa of heavy chain CryoglobulinemiaPrecipitate at low temperature (Ref: Ananthanarayan 9th edition, 96-98) | 2 | IgG | IgM | IgA | IgE | Microbiology | Immunology | f64021c3-272b-4a12-927c-8f53cab837f2 | single |
Malleus is derived from | i.e. (Meckel's Cartilage): (316-109 IBS- Embryology 8th)* Malleus and Incus are derived from the dorsal end of the Meckel's cartilage (First arch)*** Stapes is formed from the dorsal end of the cartilage of second pharyngeal archNerves of pharyngeal arches and muscles supplied by themArchNerve of ArchMuscles of ArchCartilage of ArchFirstMandibularMedial and lateral pterygoids, MasseterTemporalis, Mylohyoid,Anterior belly of digastricTensor tympani, Tensor palatiMalleus Incus Sphenomandibular ligamentSecondFacialMuscles of face, Occipito frontalis, Platysma,Stylohyoid, Posterior belly of digastric, Stapedius,\Auricular muscles* Stapes* Styloid process* Stylohyoid ligament* Smaller (lesser) comu of hyoid bone* Superior part of body of hyoid boneThirdGlossopharyngealStylopharyngeus* Greater comu of hyoid bone* Lower part of the body of hyoid boneFourthFifthSuperior laryngealRecurrent laryngealMuscles of larynx and pharynx* The cartilages of the larynx are derived from the fourth and sixth arches with a posible contribution from the fifth arch, but their exact derivation is controversial | 1 | Meckel's cartilage | Reinche's cartilage | Third pharyngeal arch | Second pharyngeal arch | Anatomy | Embryology | 6de0a632-e173-4b39-9c6e-4e933326b0e7 | multi |
On otological examination all of the following will have positive fistula test except: | (a) Dead ear(Ref. Shambaugh, 6th ed., page 181)If there is a fistula on the medial wall but inner ear is dead (not responding to pressure changes), then in spite of presence of fistula, fistula test will be negative. This is false negative fistula test.If the footplate of stapes is hypermobile, it results in false positive fistula test.Fenestration operation is an iatrogenic cause of positive fistula test. | 1 | Dead ear | Labyrinthine fistula | Hypermobile stapes footplate | Following fenestration surgery | ENT | Assessment of Vestibular Function | ad5ab233-d381-46c9-a57c-14d08cb38540 | multi |
All are characteristics of Autism except | These are some of the characteristics of ASD: problems with social interaction with others. This may include problems talking back and foh, working, or playing with others. unusual interest in objects need for sameness great variation in abilities under or over reaction to one or more of the five senses: sight, touch, taste, smell, or hearing repeated actions or body movements unusual emotional reactions and expressions Children with ASD usually have difficulty with social interaction. Some parents have said that before their child's diagnosis of ASD, they thought their child was just very shy. Children with ASD may have an unusual interest in objects. They may play with toys in different or unusual ways. For example, they may be able to tell you everything you need to know about car engines. Or they may be able to sit for hours spinning the wheels on a toy vehicle. Children with ASD often have a need for sameness. They may have difficulty with changes in routines, clothes, food, caregivers, and other pas of their environment. Children with ASD may have great ability in one area and great difficulty in another. But not all children with ASD have the same abilities. For example: A child with ASD may have difficulty holding a pencil but have a strong memory for the words of songs or movies. On the other hand, they could be fabulous aists or have perfect pitch. A child may have difficulty knowing how to play a game with a peer but may have a very good understanding of how computers work. A child who does not speak may be able to build complex structures out of Lego. Children with ASD may also have unusually strong reactions to one or more of their five senses. For example, some children with ASD may react to bright sunlight. Others are excessively bothered by tags on their clothing or by loud noises. Many children may be bothered by these things, but children with ASD often have a stronger reaction to them. Children with ASD often have difficulty with the colour, smell, or texture of ceain foods. This may limit what they will eat to only a few foods. Children with ASD may also do the same thing over and over again. For example, they may repeatedly flap their hands, jump, or walk on tiptoes. This is common. It is something that many parents talk about when they describe their children. Your child may be doing these things to help calm themself during stressful situations or to help occupy or enteain themself. Children with ASD may also have unusually intense and prolonged emotional reactions. For example, they may get very angry when asked to stop playing and get ready for lunch. These emotions do not match the situation they find themselves in. These reactions may occur as a result of anxiety they feel when making changes in routine. Children with ASD may talk constantly about specific things that interest them and be unaware that other people might not have the same level of interest. Reference: GHAI Essential pediatrics, 8th edition | 1 | Onset often age of 6 years | Repeatitive behaviour | Delayed language development | Severe deficit in social interaction | Pediatrics | Central Nervous system | a9db0a8c-2857-4897-9d5f-801c1b2f4d68 | multi |
Which apoprotein is the most impoant to activate lipoprotein lipase - | Ans. is 'c' i.e., Apo-C IIMajor activator of lipoprotein lipase is apo-CII | 3 | Apo-A I | Apo B48 | Apo-C II | Apo-E | Biochemistry | null | 9c91e766-bd52-4467-8b1f-e59a343ff751 | single |
Risk of the damage of fetus by maternal rubella is maximum if mother gets infected in | Congenital Rubella Syndrome (CRS):
CRS is said to have occurred if:
– Infant has IgM rubella antibodies shortly after birth, or
– IgG antibodies persist for more than 6 months
Major determinant of extent of fetal infection in CRS: Gestational age at which fetal transmission occurs,
– Infection in I trimester: MOST DISASTROUS TIME
1. Abortions
2. Still births
3. Skin lesions: blueberry muffin lesions
4. ‘Triad of Congenital Rubella Syndrome’
i. Sensorineural deafness
ii. Congenital heart defects (MC is PDA)
iii. Cataracts
– Infection in early part of II Trimester: Deafness (only)
– Infection after 16 weeks POG: No major abnormalities
Risk of fetal damage in CRS: | 4 | 20-24 weeks of pregnancy | 24-28 weeks of pregnancy | 32-36 weeks of pregnancy | 6-12 weeks of pregnancy | Social & Preventive Medicine | null | a1421c4e-071b-4e2b-928e-c8b8e38fe80f | single |
In organophosphorous poisoning, following are seen except - | null | 1 | Pupillary dilatation | Salivation | Bronchospasm | Sweating | Forensic Medicine | null | 242abd9d-6d57-444c-8f05-295b35d2ac69 | multi |
TGF-β is involved in all of the process of angiogenesis except: | TGF-β stimulates fibroblast migration and proliferation, increases the synthesis of collagen and fibronectin, and decreases the degradation of ECM by inhibiting metalloproteinases. TGF-β is involved not only in scar formation after injury but also in the development of fibrosis in lung, liver, and kidneys that follows chronic inflammation.TGF-β also has anti-inflammatory effects that serve to limit and terminate inflammatory responses. It does this by inhibiting lymphocyte proliferation and the activity of other leukocytes.
VEGFs, mainly VEGF-A, stimulates both migration and proliferation of endothelial cells, thus initiating the process of capillary sprouting in angiogenesis. It promotes vasodilation by stimulating the production of NO and contributes to the formation of the vascular lumen.
Robin’s Textbook of pathology 10th ed Page 91 | 2 | Stimulates fibroblast migration and proliferation | Formation of the vascular lumen | Increases the synthesis of collagen | Decreases the degradation of ECM | Pathology | null | 16011078-7d67-423e-9357-c8aace697cc0 | multi |
Cavallo's sign is seen in - | Ans. A. Tricuspid Regurgitation | 1 | Tricuspid Regurgitation | Mitral Stenosis | Aoic Stenosis | Aoic Regurgitation | Medicine | null | 7ddfe7cc-82f1-4d7d-a2d4-b0a6ed3cc59c | multi |
Sympathetic ophthalmitis usually results due to: | Ans. (c) Penetrating injury to Ciliary bodyRef.: A.K. Khurana 6th ed. /163, 437* Sympathetic ophthalmitis is a serious bilateral granulomatous panuveitis which usually occurs due to penetrating trauma to ciliary body.* The injured eye is called exciting eye.* Fellow eye which also develops uvieitis is called sympathizing eye.Features* Always follows a penetrating wound.* More common in children than in adults.* It doesn't occur when actual suppuration develops in the injured eyePathologies* Uveal pigment acts as allergen and excites plastic uveitis in the sound eye.* Dalen-Fuchs' nodules are formed due to proliferation of the pigment epithelium (of the iris, ciliary body and choroid) associated with invasion by the lymphocytes and epitheloid cells.Clinical Picture* Prodromal stage: Sensitivity to light (photophobia) transient indistinctness of near objects is the earliest symptoms.* First sign may be presence of retrolental flare or the presence of a keratic precipitates (KPs) at back of cornea. * Fully-developed stage: has typical signs and symptoms consistent with acute plastic iridocyclitis.* Dalen Fuch's Nodules are characteristic of SO.* Exciting (injured) eye: Keratic precipitates may be present at the back of cornea* Sympathizing (sound) eye: usually involved after 4-8 weeks of injury in the other eye.* Treatment - Early excision of the injured eye.# Topical cycloplegics + IV/oral steroids are also used for treatment. | 3 | Glaucoma | Trachoma | Penetrating injury to Ciliary body | Uveitis | Ophthalmology | Ocular Trauma | 4517b17f-3651-4b3e-b487-ffbb10030f57 | multi |
Wermer syndrome is - | Ans. is 'a' i.e., MEN 1 | 1 | MEN 1 | MEN HA | MEN IIB | AIP | Pathology | null | ef3b0a33-b76e-4083-b2f0-cee3b3483365 | single |
If hardness level of water is 50-150 mg/L, the water is defined as - | Ans. is 'b' i.e., Moderately hard Classification of hardness in waterClassificationLevel of hardness (mEq./litre)a) Soft waterb) Moderately hardc) Hard waterd) Very hard waterLess than 1 (< 50 mg/L)1 - 3 (50 - 150 mg/L)3 - 6 (150 - 300 mg/L)Over 6 (> 300 mg/L) | 2 | Soft | Moderately hard | Flard | Very hard | Social & Preventive Medicine | Environment and Health | ead7d7aa-60a7-4d01-939b-b457f69cc21c | single |
Berson and yellow 1st described the following test | Berson and Yalow discovered RIA in 1959 by which we can quantify antigens or hormones upto picograms-v sensitive than ELISA RIA /ELISA-indirect immunofluorescence tests Ref: Textbook of Microbiology Baveja 5th ed Pg 115 | 1 | RIA | ELISA | Immuno chromatography | Chemiluminescence assay | Microbiology | Immunology | 7055e62b-fc08-48ee-8522-348275eadf0a | single |
Little&;s are is | The anteroinferior pa or vestibule of the septum contains anastomoses between the septal ramus of the superior labial branch of facial aery,branch of sphenopalatine aery,greater palatine and of anterior ethmoidal aery These form a large capillary network called kiesselbachs plexus. This is a common site of bleeding from nose or epistaxis and known as littles area. Ref BDC volume3,Sixth edition pg 241 | 2 | Anteroinferior lateral wall | Anteroinferior nasal septum | Posteroinferior lateral wall | Posterinferior nasal septum | Anatomy | Head and neck | 4f2dc108-00d1-43e1-ba83-48b236d81b7c | multi |
Pyrimidine overproduction results in all except | Defective enzyme of pyrimidine metabolism Signs and symptoms Dihydropyrimidine dehydrogenase Can develop toxicity to 5-fluorouracil, also a substrate for this dehydrogenase Orotate phosphoribosyl transferase and orotidylic acid decarboxylase Orotic acid aciduria type 1, megaloblastic anemia Orotidylic acid decarboxylase Orotic acid aciduria type 2 Pyrimidine overproduction is not the causal factor in Reye's syndrome. Reye's syndrome results in secondary pyrimidine overproduction. Reference: Harpers illustrated biochemistry 30th edition | 1 | Hyperuricemia | Reye syndrome | orotic aciduria | Megaloblastic anemia | Biochemistry | Metabolism of nucleic acids | cfacb602-e63d-455a-8c59-94254816cbce | multi |
Characteristic features of a lesion in the lateral part of the medulla include all except - | Ans. is 'b' i.e., Contralateral loss of proprioception to the body and limbs | 2 | Ipsilateral Homer's syndrome | Contralateral loss of proprioception to the body and limbs | Nystagmus | Dysphagia | Medicine | C.N.S. | f05c4efc-1f54-4095-bd8a-1bf62920a476 | multi |
Peripheral blood smear in Plasmodium falciparum infection may show all of the following except- | Examination of Giemsa-stained peripheral blood smear is the standard test for the diagnosis of malarial infection. Classic ring-shaped/headphone-shaped trophozoites,malegamates,female gamates are seen in case of Plasmodium falciparum infection. Ref Harrison20th edition pg 1078 | 4 | Male gametocyte | Trophozoite | Female gamatocyte | Schizont | Medicine | Infection | 3854b037-32ab-45a8-b823-51f5a1cb4bc6 | multi |
Main vascular supply of Little's area is all, except | The anteroinferior pa or vestibule of the septum contains anastomoses between the septal ramus of the superior labial branch of the facial aery, branch of sphenopalatine aery, greater palatine and of anterior ethmoidal aery. These form a large capillary network called kiesselbachs plexus. This is a common site of bleeding from the nose or epistaxis, and is known as little's area. Ref BDC volume3,6th edition pg 241 | 4 | Septal branch of superior labial aery | Nasal branch of ethmoidal aery | Anterior ethmoidal nerve | Palatal branch of sphenopalatine | Anatomy | Head and neck | 3fb13ff3-6fce-4e65-b55c-ca506e617d6c | multi |
Active agent of cannabis resemble which endogenous compound | Anandamide is a neurotransmitter produced in the brain that binds to the THC receptors. It's been called the "bliss molecule," aptly named after ananda, the Sanskrit word for "joy, bliss, or happiness." It is considered an endocannabinoid -- a substance produced in the body that binds to cannabinoid receptors Ref: guyton and hall textbook of medical physiology 12 edition page number:699,700,701 | 3 | Endorphin | Endomorphins | Anandamine | Enkaphalin | Physiology | Nervous system | 75068f4f-0ec8-45d1-99ad-1fd188fda199 | single |
Quick Reduction of blood pressure is done in | null | 2 | Cerebral infarct | Hypertensive encephalopathy | Myocardial infarction | Any patient with hypertension | Medicine | null | 653aa324-b8fc-437d-b8f3-de9413473b60 | single |
All are vector born diseases except ? | Ans. is 'c' i.e., Brucella In vector born diseases, an ahropad or any living carrier acts as a vector and transpos an infectious agent to susceptible individual. KFD, JE, and plague are transmitted by ahropods. | 3 | KFD | JE | Brucella | Plague | Social & Preventive Medicine | null | 5652e6fe-251a-41ba-8f9b-597ce8549e47 | multi |
All are true regarding CMV except - | Acyclovir is useful in prophylaxis but not in treatment. Ganciclovir and foscarnet have been found to be effective and are used in patients with AIDS. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:474 | 3 | Double stranded DNA virus | Rarely causes problems in immunocompetent person | Foscarnet can eliminate CMV | Tretinitis rare when CD4 count >200/mm3 | Microbiology | Virology | 5863a94d-e8ed-4fc5-9c24-ff3bb1bc64e9 | multi |
Which of the following is not seen in chronic renal failure: September 2010 | Ans. C: Hypophosphatemia CKD (Chronic kidney disease) is initially without specific symptoms and can only be detected as an increase in serum creatinine or protein in the urine. As the kidney function decreases: Blood pressure is increased due to fluid overload and production of vasoactive hormones, increasing one's risk of developing hypeension and/or suffering from congestive hea failure. Urea accumulates, leading to azotemia and ultimately uremia (symptoms ranging from lethargy to pericarditis and encephalopathy). Urea is excreted by sweating and crystallizes on skin ("uremic frost"). Potassium accumulates in the blood (hyperkalemia with a range of symptoms including malaise and potentially fatal cardiac arrhythmias) Erythropoietin synthesis is decreased (potentially leading to anemia, which causes fatigue) Fluid volume overload - symptoms may range from mild edema to life-threatening pulmonary edema Hyperphosphatemia - due to reduced phosphate excretion, associated with hypocalcemia (due to vitamin D3 deficiency). The major sign of hypocalcemia is tetany. Later this progresses to teiary hyperparathyroidism, with hypercalcaemia, renal osteodystrophy and vascular calcification that fuher impairs cardiac function. Metabolic acidosis, due to accumulation of sulfates, phosphates, uric acid etc. | 3 | Hyperkalemia | Metabolic acidosis | Hypophosphatemia | Hypocalcemia | Medicine | null | 5fa39fef-a320-421a-949e-21023988ea7e | single |
Carotid aery stenosis in -vivo screening choice is | Most carotid imaging is now performed with Doppler ultrasound, CTA, MRA performed without exogenous contrast injection such as 2- or 3-dimensional time-of-flight (TOF) methods or contrast-enhanced MRA (CEMRA) performed dynamically after an intravenous bolus of gadolinium-based contrast.CEMRA is the most accurate method of carotid stenosis evaluation(Grainger and Allison&;s diagnostic radiology 6th edition, page 1475) | 4 | USG | CT | MRI | Doppler | Radiology | All India exam | 0070d4f2-e496-4894-bcf2-6ac1e0b06114 | single |
True statement about inheritence of an X linked recessive trait is - | Ans. is 'a' i.e., 50% of boys of carrier mother are affected | 1 | 50% of boys of carrier mother are affected | 50% of girls of diseased father are carrier | Father transmits disease to the son | Mother transmits the disease to the daughter | Pathology | null | 14f5b028-ae3d-49a4-897a-a2f7e84f3be5 | multi |
Most common cause of subarachnoid hemorrhage is:- | MC cause of subarachnoid hemorrhage : Trauma > Spontaneous rupture of Berry Aneurysm | 3 | Hypeension | AV malformation | Berry aneurysm | Tumors | Surgery | Cerebrovascular Diseases | 259bf5d7-9628-4e76-932a-f65597d8b310 | single |
True about 1gM: | Activates complement | 2 | Is dimeric | Activates complement | Is not synthesized by fetus | Is the last to cross | Microbiology | null | 51a6ee0e-ce05-4d49-b378-65229964b62d | multi |
True regarding GERD is all except - | Gastro-oesophageal reflux disease Gastro-oesophageal reflux resulting in heaburn affects approximately 30% of the general population. Pathophysiology Occasional episodes of gastro-oesophageal reflux are common in healthy individuals. Reflux is normally followed by oesophageal peristaltic waves that efficiently clear the gullet, alkaline saliva neutralises residual acid and symptoms do not occur. Gastro- oesophageal reflux disease develops when the oesophageal mucosa is exposed to gastroduodenal contents for prolonged periods of time, resulting in symptoms and, in a propoion of cases, oesophagitis. Abnormalities of the lower oesophageal sphincter The lower oesophageal sphincter is tonically contracted under normal circumstances, relaxing only during swallowing (p. 766). Some patients with gastro-oesophageal reflux disease have reduced lower oesophageal sphincter tone, permitting reflux when intra-abdominal pressure rises. In others, basal sphincter tone is normal but reflux occurs in response to frequent episodes of inappropriate sphincter relaxation. Hiatus hernia Hiatus hernia causes reflux because the pressure gradient is lost between the abdominal and thoracic cavities, which normally pinches the hiatus. In addition, the oblique angle between the cardia and oesophagus disappears. Many patients who have large hiatus hernias develop reflux symptoms but the relationship between the presence of a hernia and symptoms is poor. Hiatus hernia is very common in individuals who have no symptoms, and some symptomatic patients have only a very small or no hernia. Neveheless, almost all patients who develop oesophagitis, Barrett's oesophagus or peptic strictures have a hiatus hernia. Delayed oesophageal clearance Defective oesophageal peristaltic activity is commonly found in patients who have oesophagitis. It is a primary abnormality, since it persists after oesophagitis has been healed by acid-suppressing drug therapy. Poor oesophageal clearance leads to increased acid exposure time. Ref Davidson edition23rd pg791 | 3 | Avoid coffee & tea | Transient lower esophageal relaxation | Lower esophageal sphincter length and its pressure is impoant | Proton pump inhibitor is the treatment of choice | Medicine | G.I.T | b3729b3d-c934-435d-ac67-7ee4557a3e79 | multi |
Abductor of the larynx is: | Abduction (opening) of the vocal folds: The posterior cricoarytenoid muscles pull the muscular processes posteriorly, rotating the vocal processes laterally and thus widening the rims glottides. Adduction (closing) of the vocal folds : The lateral cricoarytenoid muscles pull the muscular processes anteriorly, rotating the arytenoids so their vocal processes swing medially. When this action is combined with that of the transverse arytenoid muscles, which pull the arytenoid cailages together, the gap between the vocal folds is decreased. Air pushed through the rima glottidis causes vibration of the vocal ligaments. | 1 | Crico-arytenoideus posterior | Crico-arytenoideus lateralis | Arytenoideus transversus | Vocalis muscle | ENT | null | 427b35b9-c757-43ad-aeed-a30c18125aa8 | single |
A patient died during surgery. The relatives allege that death was due to negligence, According to a recent Supreme Court judgment, doctor can be charged for Medical Negligence under section 304-A, only if: | Ans. c. There is gross negligence (Ref: Reddy 33/e, p40, 29/e p34)A physician can be charged with criminal negligence in Section 304 A, when a patient dies from the effects of anesthesia during, an operation or other kind of treatment, if it can be proved that the death was the result if malicious intention, or gross negligence."Section 304-A deals with criminal negligence. Criminal negligence occurs when the doctor shows gross lack of competence or inaction, gross recklessness or wanton indifference to the patient's safety, or gross negligence in the selection and application of remedies. It involves an extreme departure from the ordinary standard of care."Inadvertent Negligence (Accidental negligence):Inadvertent negligence can be called simple negligence.In this case, the harm done is neither foreseen nor willed.Corporate Negligence:It occurs when a health care corporation failed to perform those duties, it owes directly to a patient or anyone else to whom it may extend.If such a duty is breached and patient is injured due to result of the breach, the organization can be held under the theory of corporate negligence.Res Ipsa Loquitur:Latin meaning of phrase is- the things or facts speaks for itself.This rule is applied when the following conditions are satisfied:That in the absence of negligence the injury would not have occurred ordinarily.That doctor had exclusive control over injury producing instrument or treatment That the patient was not guilty of contributory negligence. | 3 | There is corporate negligence | Negligence is from inadvertent error | There is gross negligence | It falls under the doctrine of Res Ipsa Loquitor | Forensic Medicine | Medical Negligence | c31b2297-8d11-46c7-b8d4-3a81b15c71c0 | multi |
Kala azar is spread by - | Kala azar or visceral leishmaniasis is a protozoal disease.It is transmited from person to person by bite of female Phlebotomus argentipus.Transmission also occurs by contamination of bite wound or by crushing the insect during act of feeding.it may transmit by blood transfusion also. C/f : fever,splenomegaly,hepatomegaly along with anemia and weight loss.Darkening of the skin of face,hands,feet,and abdomen. Parks textbook of preventive and social medicine.K Park. Edition 23. page no:305,306 | 3 | House fly | Black fly | Sand fly | Tse tse fly | Social & Preventive Medicine | Environment and health | 1271e620-fafd-413f-b74d-83f8d648c354 | single |
In which of the following condition is OCP contraindicated ? | ABSOLUTE CONTRAINDICATIONS OF OCP: *Known or suspected breast cancer *Severe hyperiglyceridemia/hypercholestrolemia *Undiagnosed vaginal bleeding *Thrombophlebitis/thromboembolism , cerebral and cardiac disorders *Pregnancy *Hypeension (moderate to severe) *Impaired liver RELATIVE CONTRAINDICATIONS OF OCP: *Migraine with aura *Diabetes mellitus/gestational diabetes *Hypeension *Smoking *Uterine lieomyoma *Elective surgery *Seizure disorder *Sickle cell disease *Gall bladder disease *SLE *Mitral valve prolapse *Hyperlipidemia *Hepatic disease | 4 | Hea disease | Thromboembolism | Breast cancer | All of the above | Gynaecology & Obstetrics | null | 096bead7-9d30-4410-ad72-4f96eb774844 | multi |
Polio virus is shed in stool up to - | - the polio is transmitted by faecal oral route by contaminmates food , water or hands. - in faeces, the virus is excreted as long as 3-4 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:205 <\p> | 4 | 6 weeks | 8 weeks | 10 weeks | 12 weeks | Social & Preventive Medicine | Communicable diseases | 23dd7dc8-d134-411c-b3db-1327a5b00d11 | single |
During normal conversation sound heard at 1meter distance is | At a distance of 1 m , intensity of Whisper - 30 dB Normal conversation - 60 dB Shout - 90 dB Discomfo of the ear - 120 dB Pain in the ear - 130 dB Ref: Dhingra 7e pg 21. | 1 | 60 dB | 80 dB | 90 dB | 120 dB | ENT | Ear | 6b54cc85-9c17-40ee-acb4-df2c5e0c17e5 | single |
When porcelain is baked against metal, it should possess a | null | 3 | high fusion expansion | high fusion temperature | linear coefficient of thermal expansion less than, but close to that of metal | linear coefficient of thermal expansion greater than, but close to that of the metal | Dental | null | b53814c5-58d5-4860-b4e5-ce32d5dfa5eb | single |
Wagon wheel effect is due to: | When buccal crown torque is incorporated in the wire, the roots of anterior teeth tend to converge towards centre like spokes of wheel. It has been often called wagon wheel effect. Following final space closure required torque is attained by incorporation of active root torque in the anterior segment. Due to wagon wheel effect, incorporation of palatal root/buccal crown torque during retraction causes loss of tip.
Orthodontics: Diagnosis and Management of Malocclusion and Dentofacial Deformities
THIRD EDITION Om P. Kharbanda | 1 | Less tip more torque | Less torque more tip | More tip and torque | Tipping and retraction of anterior teeth | Dental | null | d77f0d8f-819f-40b3-af7b-d0ac8de446a4 | single |
Macula densa in kidney is located in relation to - | B i.e. DCT | 2 | PCT | DCT | Afferent aeriole | Efferent aeriole | Physiology | null | dadd176d-9e55-46f6-b8bb-424b6e9821df | single |
Griseofulvin is not useful in one of the following: | Ans. (C) Tinea versicolor(Ref: CMDT -2010/110)Griseofulvin is used for dermatophytoses including Tinea capitis, Tinea cruris, Tinea pedis, Tinea unguum and Tinea corporis etc.Tinea versicolor is caused by a yeast Malassezia furfur. It is treated by selenium sulfide and ketoconazole shampoo. | 3 | Tinea capitis | Tinea cruris | Tinea versicolor | Tinea pedis | Pharmacology | Chemotherapy: General Principles | 9abee11b-6ff8-4a3a-972b-7dd32a2f3348 | single |
Drugs used for prophylaxis in BPD -a) Chlorpromazineb) Lithiumc) Carbamazepined) Zolpideme) Sodium valproate | Three drugs are commonly used for maintenance treatment to prevent recurrence of BPD:- Lithium (DOC), Valproate, and Carbanzezapine. Topiramate and Gabapentine can also be used. | 3 | ab | bc | bce | ace | Psychiatry | null | 9584453c-729d-4386-89c4-9f612b2c66e3 | single |
Urachus fistula is a remanant of ? | Urachus fistula is a remnant of allantoic diveiculum If patent urachus in adults, urine dribbles from umbilicus known as wheeping umbilicus Inderbir Singh's Human embryology Pg 97 | 2 | Yolk sac | Allantois | Chorion | Amnion | Anatomy | General anatomy | 4311ea2c-2242-4d69-82ef-30ca49849f29 | multi |
The odontogenic neoplasm, which is composed of loose, primitive-appearing connective tissue that resembles dental pulp, microscopically is known as _____. | Odontogenic myxomas are connective tissue neoplasms that contain little collagen. This gives them an embryonic look microscopically | 4 | Odontoma | Ameloblastoma | Ameloblastic fibroma | Odontogenic myxoma | Pathology | null | d803ce5b-29a9-4d59-a897-665d73778d51 | multi |
Food poisoning is an example of: | 1. Point source epidemic ( single exposure ) Sudden rise sudden fall. Cluster of cases in single IP. All cases develop within one incubation period of the disease E.g. Food poisoning , Bhopal gas tragedy. 2. Common source , continuous or repeated exposure epidemics Sharp rise Fall is interrupted by secondary peaks Eg. Contaminated well in a village,Water Borne Cholera. 3. Propagated source epidemic Gradual rise & gradual fall over long time. Person to person transmission E.g:- HEP. A, POLIO. | 1 | Point source epidemic | Propagated source epidemic | Common source epidemic | Pandemic | Social & Preventive Medicine | Time Distribution, Epidemics | 308ce2fc-5ac5-4f76-9ae1-6b6fca955189 | single |
Classify the following according to Kennedy's classification | null | 2 | Class III maxillary arch | Class III mandibular arch | Class II mandibular arch | Class IV mandibular arch | Dental | null | 37d27b24-aac8-41d0-87df-93e0f4816ccf | single |
Stemmer's sign is | Skin over the dorsum of foot cannot be pinched because of subcutaneous fibrosis in filariasis = STEMMER'S SIGN. | 3 | Swelling in the foot seen with lymphoedema | Loss of normal perimalleolar shape in lymphoedema | Subcutaneous fibrosis which makes skin over dorsum of foot not pinchable | Pitting Oedema in filariasis | Surgery | null | ed7ebdf9-28f2-4350-b76b-e008b7ac4c4e | multi |
Which muscle of larynx is not supplied by recurrent laryngeal nerve - | Ans. is 'c' i.e., Cricothyroid o All intrinsic muscles are supplied by the reccurrent laryngeal nerve except cricothyroid which is supplied by the external laryngeal nerve.Nerve supply of larynxo The main cranial nerve innervating the larynx is the vagus nerve via its branches; superior laryngeal nerve (SLN) and recurrent laryngeal nerve (RLN).Sensory supply of larynxo Above the level of vocal cords, larynx is supplied by internal laryngeal nerve, a branch of superior laryngeal nerve.o Below the vocal cord, larynx is supplied by recurrent laryngeal nerve.Motor supply of larynxo All the intrinsic muscles of larynx are supplied by recurrent laryngeal nerve except for cricothyroid muscle.o Cricothyroid is supplied by external laryngeal nerve, a branch of superior laryngeal nerve. | 3 | Vocalis | Thyroarytenoid | Cricothyroid | Interarytenoid | ENT | Larynx | cb50cded-1a26-469f-9df2-87be1173706c | single |
SEPS is a procedure used for : | Subfascial Endoscopic Perforator Vein Surgery (SEPS) SEPS is a new endoscopic technique for the management of chronic venous insufficiency due to incompetent perforator veins. SEPS involves inseion of a rigid endoscope through the skin and superficial fascia to a plane above the muscle, such that perforator veins are visible as they exit the muscles. These perforator veins are dissected free from surrounding tissue and closed with the help of metal clips. Ref: Sabiston 20th edition Pgno: 1809 | 1 | Veins | Aeries | Lymphatics | AV fistula | Surgery | Vascular surgery | 4907cdb7-d768-4c4e-bfb0-76afdb03f0e6 | single |
Deficiency of which of the following vitamin is most commonly seen in sho bowel syndrome with ileal resection: | Answer is A (Vitamin B12) Cyanocobalarnine (Vitamin B12) deficiency is the most common deficiency in patients with sho bowel syndrome associated with loss of ileum (ileal resection) since vitamin B12 is absorbed only in the ileum. `Cyanocobalamine (Vitamin B12) is the most common deficiency and occurs predictably after resection of 50-60 cm of the terminal ileum'. -- 'Complications in Surgery' (Lippincott Williams) 2"" (2011)/469 `Vitamin B12 and Bile acids are absorbed only in the ileum. Loss of ileum results in malabsorption of bile acids and vitamin B12 and consequent vitamin B12 deficiency'-- 'Sleisenger and Fordtran's Gastrointestinal Diseases' 81h/2258, 2264 Vitamin Deficiencies in Sho Bowel Syndrome Sho Bowel Syndrome with Extensive Jejunal Resection This is associated primarily with deficiency of fat soluble vitamins (A, D, E. K) The most common fat-soluble vitamins that are deficienci are vitamin A and D and to a lesser extent vitamin E followed by vitamin K. Vitamin A, D > Vitamin E >> Vitamin K Deficiency of vitamin K is uncommon as vitamin K is synthesized by colonic bacteria 60% of vitamin K is synthesized by colonic bacteria 40% of vitamin K is received by dietary intake Deficiency of vitamin K is therefore uncommon in patients with sho bowel syndrome who have an intact colon. Deficiency of vitamin K is however common in those patients with sho bowel syndrome who do not have a residual colon. Sho Bowel Syndrome with Extensive ileal resection This is associated primarily with deficiency of vitamin B12 since vitamin B12 is only absorbed in the terminal ileum. Fat soluble vitamin deficiencies may also occur due to fat malabsorption from decrease in concentration of bile acids / salts. (Bile acids are absorbed only from tr..; ileum) Vitamin B12 > Fat solubleVitamin The ileum has the capacity to adapt and compensate for jejunal resection. The jejunum does not have the capacity to adapt and compensate for ileal resection (as the terminal ileum has the exclusive capacity to reabsorb bile salts &vit BO | 1 | Vitamin B12 (Cyanocobalamine) | Vitamin B1 (Thiamine) | Folic Acid | Vitamin K | Medicine | null | 1aaeab68-7822-4f8c-a2b6-67df3f623962 | single |
A 30 year old G1P1001 patient comes to see you In office at 37 weeks gestational age for her routine OB visit. Her 1st pregnancy resulted in a vaginal delivery of a 9-lb, 8-02 baby boy after 30 minutes of pushing. On doing Leopold maneuvers during this office visit codetermine ttwt the fetus is breech. Vaginal exam demonstrate that the cervix is 50% effaced and 1-2 cm dilated. The presenting breech is high out of pelvis. The estimated fetal weight, is about 7 lb. yn the patient- for a USG, which confirms a fetus frank breech prestation. There is a normal am &; amniotic fluid present, and the head is well-felt the patient&;s obstetrician, you offer all the following possible mgmt plans except | definite indications for elective Caesarean section all complicated breech pregnancy Contracted or borderline pelvis Large babies Severe IUGR Hyper extension of fetal head Footling or knee presentation Previous Caesarean section Lack of an obstetrician experienced in assisted breech delivery can also be considered an indication for for elective Caesarean section (refer pgno:378 sheila textbook of obstetrics 2 nd edition) | 2 | Allow the patient to undergo a vaginal breech delivery whenever she goes into labor | Send the patient to labor and delivery immediately for an emergen CS | Schedule a CS at or after 39 weeks gestation a | Schedule an ext cephalic version In next few days | Gynaecology & Obstetrics | Abnormal labor | d2c083fb-c7d7-40a9-8802-59bf29188590 | multi |
Which of the following is true regarding lattice formation? | Marrack proposed the lattice hypothesis to explain the mechanism of precipitation. Precipitation results when a large lattice is formed consisting of alternating antigen and antibody molecules. This is possible only in the zone of equivalence. The lattice hypothesis holds good for agglutination also.Ref: Ananthanarayan 9th edition, p105 | 3 | Associated with precipitation and not agglutination | Associated with agglutination and not precipitation | Associated with both | Neither associated with precipitation nor agglutination | Microbiology | general microbiology | dea11c86-5df3-4eb8-be6f-acf57fc0e7f0 | multi |
Calcium channel blockers are used in all except | Calcium channel blockers prevent calciumfrom entering cells of the hea and blood vessel walls, resulting in lower blood pressure. Calcium channel blockers, also called calcium antagonists, relax and widen blood vessels by affecting the muscle cells in the aerial walls Refer kDT 6/e p 502,551 | 3 | Angina | Arrythymia | Congestive hea failure | Hypeension | Pharmacology | Cardiovascular system | 79d0c61c-76c1-4fb2-9112-618c3235081c | multi |
A patient presented with abdominal pain, jaundice and melena. The diagnosis is | Clinical features of Hemobilia Characterised by Quinck's triad (Sandblom's triad) : GI hemorrhage +biliary colic +jaundice Presentation: Melena (90 %), hemetemesis (60%), biliary colic (70%), and jaundice (60%). Tendency for delayed presentation (upto weeks) and recurrent brisk but limited bleeding over months and even years Ref : Sabiston 20th edition Pgno :1472-1474 | 1 | Hemobilia | Acute cholangitis | Carcinoma gallbladder | Acute pancreatitis | Anatomy | G.I.T | 5c5ad07d-9c1c-4f0b-b60a-967182ae19a4 | multi |
Diabetes mellitus is associated with all except - | Ref -researchgate.net | 1 | Pendred syndrome | Down's syndrome | Turner's syndrome | Klinefelters syndrome | Medicine | Endocrinology | 18809fc3-640b-47c5-a7cf-09978e3f8159 | multi |
AFP is raised in all except: | As we have discussed earlier – AFP levels are raised in :
Under estimated gestational age
Decreased liqour
Decreased birth weight of infant and decreased maternal weight
IUD
Multifetal pregnancy (The amount of AFP entering the maternal circulation is proportional to the number of fetuses).
Defects which permit more release of AFP into maternal serum
– Neural tube defects
– Abdominal wall defects :
omphalocele
gastroschisis
– Pilonidal cysts
– Congenital skin defects
Maternal causes:
– Preeclampsia
– Maternal hepatoma, teratoma, endodermal sinus tumor
Shaw 14/e, p 380
Placental causes:
– Chorioangioma of placenta
– Placenta accreta
– Abruptio placentae | 2 | Polycystic kidney | Trisomy | IUD | Oesophageal atresia | Gynaecology & Obstetrics | null | bdcc57e3-a2e0-49af-a01d-e73c5d710321 | multi |
Treatment objective for serial extraction: | Benefits of Serial Extraction
Serial extraction guides or encourages eruption of permanent teeth in a favorable position.
Reduces malposition of individual teeth.
Avoids loss of labial alveolar bone.
Reduces treatment time when active orthodontic treatment is required.
Textbook of ORTHODONTICS Sridhar Premkumar | 1 | To intercept a developing arch-length deficiency and to reduce or eliminate the need for extensive appliance therapy | Reduce arch-length deficiency | To plan for extensive appliance therapy | To reduce arch-length deficiency & to plan for extensive appliance therapy | Dental | null | 59237c3a-24ca-4557-a1c9-ec62de152b89 | single |
Kwashiorkor is similar to marasmus in that both diseases have | Both marasmus and kwashiorkor are associated with anemia.
Marasmus is characterized by a low calorie intake. Dietary deficiencies are compensated for by the breakdown of protein and fats. Key findings include:
Growth failure, Alertness, Hunger, Monkey-like appearance , Broomstick extremities , Muscle wasting, Mild anemia
Kwashiorkor is characterized by a normal total caloric intake but a decreased intake of protein (minimum protein intake is 8% of the total calories). Key findings are as follows:
Growth failure
Apathy and irritability with difficulty in feeding
Hepatomegaly (fatty liver)à apoprotein deficiency
Pitting edema
Flaky paint dermatitis (looks like paint coming off a building)
Areas of depigmentation
Diarrhea due to the loss of brush border enzymes
("use it or lose it") and parasitic diseases
Flag sign in hair (alternating dark and light areas)
Protuberant abdomen (fatty liver from decreased apoproteins, ascites, bowel distention with air) | 4 | A normal total caloric intake | A fatty liver | An apathetic affect | Anemia | Unknown | null | 7fa10659-a9dd-4037-8e99-b3f2b9e6d2b1 | multi |
In varicocele surgery, venous drainage is done by: | Treatment* High inguinal ligation (near deep ring) of pampiniform plexus of veins* Microvascular sub inguinal ligation (best results)* Palomo's operation: ligation of Left Gonadal Vein in retroperitoneum * Alternative venous drainage cremasteric veins | 4 | IVC | Aoa | Superior epigastric vein | Cremasteric vein | Surgery | Testis and scrotum | da904c5f-5665-45f9-8bb2-739b107fc9c0 | single |
Ventouse is contraindicated in all except : | Anemia | 4 | Fetal distress | Face presentation | Transverse lie | Anemia | Gynaecology & Obstetrics | null | 96384d84-a951-4fad-98a7-aa4953a08730 | multi |
Cholangiocarcinoma ? | Ans. is 'b' i.e., Opistorchissinensis infectionCholangiocarcinomaCholangiocarcinoma is malignancy of the biliary tree, arising from bile ducts within or outside the liver.Risk factors : -Primary sclerosing cholangitisCongenital fibropolycystic disease of the biliary system (caroli disease, choledochal cyst).Exposure to thorotrast.Opisthorchis sinensis infection.PathologyCholangiocarcinoma are adenocarcinoma arising from bile ducts epithelium.Most are well to moderately differentiated.Markdly desmoplastic, with dens collegenous stroma separating the glandular elements.Cells are not bile stained, because bile is synthesized by hepatocytes and not by bile duct epithelium. | 2 | Obesity | Opistorchissinensis infection | Salmonella carrier state | HBV infection | Pathology | null | d5e9c322-0861-4b2c-afa4-0369d52c8c73 | single |
Hormone responsible for decidual reaction and arias Stella reaction in ectopic pregnancy is - | Hormone responsible for decidual reaction and arias Stella reaction in Ectopic as well as Intrauterine pregnancy is Progesterone Arias stella reaction is the localized hypersecretory endometrium seen in ectopic pregnancy. | 2 | Oestrogen | Progesterone | HCG | HPL | Gynaecology & Obstetrics | Obstetrics | 8a928b7f-2bf0-4ef0-a4fa-12fc088586ea | single |
Treatment of erythematous skin rash with multiple pus lakes in a pregnant woman is: | A i.e. Coicosteroids | 1 | Coicosteroids | Retinoids | Methotrexate | Psoralen with PUVA | Skin | null | e0784d18-13f3-4b50-9701-689f5022d917 | single |
|A 65-year-old male complains of severe back pain and inability to move his left lower limb. Radiographic studies demonstrate the compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which structure is most likely responsible for this space-occupying lesion? | Compression of nerves at the intervertebral foramen indicates a disk herniation. A disk herniation is characterized by protrusion of the nucleus pulposus from the anulus fibrosus posterolaterally into the spinal canal or intervertebral foramen. The ligaments may be affected by the herniation but are not responsible for the compression of the spinal nerve roots. | 2 | Anulus fibrosus | Nucleus pulposus | Posterior longitudinal ligament | Anterior longitudinal ligament | Anatomy | Upper Extremity | b23fac5c-30bc-4734-8d33-ba1a8ed8414b | single |
A patient presents with a unilateral ca breast of 4 cm size with skin ulceration involving the nipple. On palpation axillary lymph nodes are positive. Management would involve: | Here this patient is having Stage III disease (T4, N1 or N2, M0) according to the TNM table given above. Hence the management would be - Neoadjuvant chemotherapy + MRM + adjuvant radiation therapy + chemotherapy + antiestrogen therapy | 3 | Breast conserving procedure | Simple mastectomy | Modified radical mastectomy | Palliative treatment | Surgery | null | e8baa38c-c4f1-4e2c-8571-238d48014198 | multi |
Following changes are seen during capacitation of a sperms except ? | Ans. is 'b' i.e., Decreased permeability to calcium Capacitation of sperm (spermatozoa) Spermatozoa leaving the testis (seminiferous ubules) are not fully mobile. They continue their maturation and acquire their mobility during their passage through epididymis. From epididymis they come to vas deference, distal end of which also receives the secretions of seminal vesicle, and continues as the ejeculatory duct. The ejeculatory duct joins the prostatic urethra. Once ejeculated into the the female, vaginal secretions improve the motility and feilizing ability of sperms. Fuher exposure to secretions of female genital tract (in uterus and/or fallopian tube) fuher improves the mobility and feilizing ability of the sperms. The beneficial effects of stay in the female genital tract are collectively called capacitation, from the isthmus, capacitated sperms move rapidly to the ampullas, where feilization takes place. Following changes occur during capacitation :- i) Uterine and fallopian tube fluids wash away the various inhibitory factors that suppress sperm activity in male genital tract. ii) Removal of cholesterol vesicle from acrosome so that acrosomal membrane becomes weak and can release enzyme at the time of feilization. iii) Increase membrane permeability to calcium ion. | 2 | Increased permeability to calcium | Decreased permeability to calcium | Removal of cholesterol from acrosome | Increased motility | Physiology | null | a5a19042-e6d7-4a15-80d7-76902132c6c6 | multi |
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