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Peptidoglycans are found in large quantities in cell wall of the following microorganism: | The peptidoglycan layer is much thicker in gram-positive than in gram-negative bacteria. Comparison of Cell Walls of Gram-Positive and Gram-Negative Bacteria: Component Gram-Positive Cells Gram-Negative Cells Peptidoglycan Thicker; multilayer Thinner; single layer Teichoic acids Present Absent Lipopolysaccharide (endotoxin) Absent Present Ref: Levinson W. (2012). Chapter 2. Structure of Bacterial Cells. In W. Levinson (Ed), Review of Medical Microbiology & Immunology, 12e. | 2 | Virus | Gram positive bacteria | Gram negative bacteria | All of the above | Microbiology | null | 51294bdc-ce6a-4193-8d2c-70f282ee5d82 | multi |
A study was conducted to test if use of herbal tea played any role in prevention of common cold. Data was collected on the number of people who developed cold and those who did not develop cold and this data was tabulated in relation to whether they consumed Herbal tea or not.\r\n\r\n\r\n\r\n Herbal tea \r\nConsumed\r\nNot consumed\r\n\r\n\r\n Had cold \r\n12\r\n 23\r\n\r\n\r\n Did not have a cold \r\n 34\r\n38\r\n\r\n\r\n\r\n In order to study this above given test, which of the following analytical test can be used? | According to the question, the data that has to assessed is the nominal data which has been arranged in qualified categories and thus by using a non-parametric test, the Chi square test is used for the analytical study of the test. The student t-test (unpaired and paired t test) and the 'z' test are parametric tests that are used to test hypothesis for quantitative data (not qualitative data) Ref: Park's Texbook of Preventive and Social Medicine 19th edition; pages 705; High Yield Biostatistics by Anthony N. Glaser 2nd Edition, Pages 46 - 47; Methods in Biostatistics By Mahajan6th Edition, Pages 168 - 185 | 2 | 'Z' test | Chi square test | Student -1 test (paired) | Student -1 test (unpaired) | Social & Preventive Medicine | null | b6f6520e-b4a8-4acd-9621-bda51a06f76f | multi |
Involvement of sweat glands and hair follicles is typically seen in which TUBERCULID? | Lichen Scrofulosorum Lichenoid eruption of minute papules occurring in children and adolescents with TB Skin colored, closely grouped lichenoid papules occur in perifollicular distribution, mainly found on abdomen,chest, back and proximal limbs. Pathological examination: superficial dermal granulomas surrounding hair follicles and sweat ducts and occupy several dermal papillae, foreign body granuloma without caseation. Mycobacterium is not seen and cannot be cultured from biopsy material. Treatment Anti-Tuberculosis Therapy Lesions clear in 4-8 wks without scaring | 1 | Lichen Scrofulosorum | Military TB | Papulonecrotic type | Lupus vulgaris | Dental | Mycobacterial Infections | 1361b593-c39d-4161-9842-745ea3fbb1f7 | multi |
In general as consequences of tooth loss bone loss is more in mandible; more in posterior region than anterior region; | null | 1 | Both statements are true | Both statements are false | 1st statement is true, 2nd is false | 2nd statement is true, 1st is false | Dental | null | c684411d-aa41-44fc-ab98-20a50e77ef24 | multi |
A 5yr old child with diarrahoea, how much ORS is to be given according to plan A after each stool | PLAN A : Age Amount of ORS given after each stool amount of ORS to provide for use at home Less than 24 months 50-100ml 500ml/day 2-10 years 100-200 ml 1000ml/day 10 year or more asmuch as wants 2000 ml/day Ref : ESSENTIAL PEDIATRICS,O.P.GHAI,PG NO:264, 7TH EDITION | 2 | 50 ml | 100 ml | 200 ml | According to thirst | Pediatrics | Gastrointestinal tract | f3d9608a-9883-4bbe-aea3-a899a7f077f0 | single |
Ionoising radiation most sensitive in – a) Hypoxiab) S phagec) G2M phased) Activating cell | Cells that are rapidly growing and dividing are radiosensitive.
G2M phase is most radiosensitive. | 2 | ac | cd | ad | bc | Radiology | null | 6d627740-ed95-406c-ba44-db7522adaa09 | single |
False about Charcot's joint in diabetes mellitus is: | Treatment of Charcot's ahropathy- limitation of joint movements by bracing or casting, joint debridement (ahrocentesis) and fusion of joint (ahrodesis). Please remember that replacement is advocated now with advances in treatment but still it will be the least preferred treatment for ankle it can be carried for knee. | 3 | Limitation of movements with bracing | Ahrodesis | Total ankle replacement | Ahrocentesis | Orthopaedics | Joint Disorders | 43da65ef-65a8-4c89-a08d-73c92e80828b | multi |
In Endodontics Endotec is used | null | 1 | with lateral condensation and heated gutta percha | with cold lateral compaction | with vertical compaction | with Chloro Percha Technique | Dental | null | b3b461e8-3d75-41a7-abdd-2ff009ad2393 | single |
Right atrial isomerization syndrome is associated with all of the following except: | Ans. B. Always associated with dextrocardia Ref: Nelson Textbook of Pediatrics 20th/ed p2235ExplanationDetermination of viscera atrial situs (position of atria in relation to abdominal viscera) can be made by radiography demonstration of the position of the abdominal organs and the tracheal bifurcation for recognition of the right and left bronchi and by echocardiography.# Situs solitus: The viscera are in their normal positions (stomach and spleen on the left, liver on the right), the 3-lobed right lung is on the right, and the 2-lobed left lung on the left; the right atrium is on the right, and the left atrium is on the left.# Situs inversus: The abdominal organs and lung lobation are reversed, the left atrium is on the right and the right atrium on the left.If the viscera atrial situs cannot be readily determined, a condition known as situs indeterminus or heterotaxia/isomerism.# Right isomerism or bilateral right-sidedness (asplenia syndrome) is associated with a centrally located liver, absent spleen, and 2 morphologic right lungs/right atria.# Left isomerism or bilateral left-sidedness (Polysplenia syndrome), which is associated with multiple small spleens, absence of the intrahepatic portion of the inferior vena cava, and 2 morphologic left lungs/left atria. | 2 | Spleen is absent | Always associated with dextrocardia | Cyanosis is present | Bilateral right atria are present | Pediatrics | C.V.S. | 88a39258-9fa6-4ee2-bfcb-b444be562a5e | multi |
In which system, continuous enumeration of bihs and deaths by enumerator and an independent survey by investigator supervisor is done ? | Ans. is 'b' i.e., Sample Registration System | 2 | Decadal Census Enumeration | Sample Registration System | Model Registration System | National Family Health Survey | Social & Preventive Medicine | null | 4539e187-de12-4251-95ce-ae5b2d275e93 | single |
Valproic acid causes all EXCEPT | It causes Hirsutism REF: KDT 7th ed p. 408 Adverse effects of valproate: Anorexia, vomiting, hea burn are common Drowsiness, ataxia, tremor are dose related Alopecia, curling of hair Increased bleeding tendency, thrombocytopenia Rashes and hypersensitivity phenomenon Asymptomatic rise in serum transaminase Fulminant hepatitis in children below 3 yrs. of age Pancreatitis has been repoed Menstrual irregularities and PCOD and obesity in young girls Use in pregnancy has led to development of spina bifida and neural tube defects Interactions of valproate Valproate increases plasma levels of Phenobarbitone by inhibiting its metabolism Displaces phenytoin from its protein binding sites and decreases its metabolism causing thereby toxicity Valproate and carbamazepine induce each other's metabolism Concurrent administration of clonazepam is contra indicated because it precipitates seizures absence | 3 | It is an enzyme inducer | It causes obesity | It causes Hirsutism | It causes neural tube defects | Pharmacology | null | 572b8fd7-e45f-4021-ab0a-79ecdd111e00 | multi |
A patient comes to emergency opd with feeling of impending doom, intense anxeity and palpitations. All of the following investigations should be done in emergency except? | The symptoms of impending doom and palpitations are suggestive of a panic attack and it is important to rule out hyperthyroidism, hypoglycemia and myocardial infarction. Hence T3, T4, TSH, Glucose levels and ECG has to be done. | 3 | T3, T4, TSH | Glucose levels | Hemoglobin | ECG | Psychiatry | null | 4647523f-09ad-4bb5-b8c3-cf2b4fd17369 | multi |
Which of the following is not a complication of succinylcholine:- | The following are the side effects of succinyl choline: Cardiovascular effects: Sinus bradycardia Junctional rhythms Ventricular dysrhythmias Hyperkalemia Myalgia Masseter spasm- Succinyl choline can trigger malignant hypehermia Increased intracranial pressure: Succinylcholine may lead to an activation of the EEG and slight increases in CBF and ICP in some patients. Increased intraocular pressure Increased intragastric pressure | 3 | increased IOP | increased ICP | increased BP | decreased hea rate | Anaesthesia | Neuromuscular Blocker | 6f76b1df-3b3e-4785-a4eb-b8a66ceae429 | single |
Which of the following lesion has radiographic Soap bubble appearance, with a characteristic feature of 'Pumping action' | "Pumping action" is characteristic clinical feature. If tooth in the region of tumour is pushed into the tumor, it will rebound back to the original. | 2 | CGCG. | Central hemangioma. | Ameloblastoma. | OKC. | Radiology | null | 59938726-e479-485f-9cef-1757de76ee66 | single |
Phenylpyruvic acids in the urine is detected by: | Ferric chloride test is a quantitative test for the detection of phenylketonuria; the addition of ferric chloride to urine give rise to a blue green colour in the presence of phenylketonuria. This colour is due to phenylpyruvate. | 4 | Guthrie's test | VMA in urine | Gerhas test | Ferric chloride test | Biochemistry | null | 2fffea16-7ba6-432b-a7b2-88e12e0e0dff | single |
A 26-year-old woman has episodic hypeension with headache, diaphoresis, and palpitation. Which of the following diagnostic procedures would be most useful in evaluating the possibility that pheochromocytoma might be the cause of these findings? | - Urinary vanillylmandelic acid & metanephrines - metabolites of epinephrine & norepinephrine - markedly elevated in pheochromocytoma. - Serum C-peptide is elevated in insulinoma. - Serum calcitonin is sometimes used to screen for medullary carcinoma of the thyroid. | 3 | Serum C-peptide | Serum calcitonin | Urinary vanillylmandelic acid | Urinary aldosterone | Pathology | Adrenal Gland | 3f032a06-87ca-444e-8207-dee59edc29ed | single |
To avoid contraception, DMPA is given: | Ans. is b, i.e. 3 monthlyRef: Jeffcoate 7th/ed, p812; Dutta Obs 6th/ed, p548; Park 20th/ed, p433-434; Leon Speroff 7th/ed, p962-963DMPA i.e. depot medroxyprogesterone acetate (depot provera) and Net en are progesterone only injectable contraceptives | 2 | Monthly | 3 Monthly | 6 Monthly | Yearly | Gynaecology & Obstetrics | Contraceptives | b66c08b1-4e2b-4003-8f7e-7e3b13248644 | single |
Which one is not unourable for fetal development- | Ans. is 'a' i.e., Herpes Intrauterine rubella infection, and maternal use of alcohol and tetracycline can cause IUGR. Herpes simplex can cause intrauterine infection, but it does not cause IUGR. | 1 | Herpes | Rubella | Alcohol | Tetracycline | Pediatrics | null | e6988830-0ee9-4f8f-8010-0635b14e6067 | single |
Heparin helps in the release of the enzyme | The repeating disaccharide heparin contains glucosamine (GlcN) and either of the two uronic acids (Figure 50-11). Most of the amino groups of the GlcN residues are N-sulfated, but a few are acetylated. The GlcN also carries a sulfate attached to carbon 6.Heparin is found in the granules of mast cells and also in liver, lung, and skin.It is an impoant anticoagulant. It binds with factors IX and XI, but its most impoant interaction is with plasma antithrombin(discussed in Chapter 55).Heparin can also bind specifically to lipoprotein lipase present in capillary walls, causing a release of this enzyme into the circulation.Reference: Harper biochemistry, 30th edition, page no 637 | 2 | Hyluronidase | Lipoprotein lipase | Amylase | Invease | Biochemistry | miscellaneous | f99d0cfc-5e57-484d-b46b-e9d10fca18ff | single |
The following is not a Nerve gas - | Sarin, Soman, and Tabun are organophosphate nerve agents while Pyrolan is a carbamate. | 4 | Sarin | Tabun | Soman | Pyrolan | Social & Preventive Medicine | Environment and health | 1c09388c-eea9-441a-b135-00e0b36f3172 | single |
Which muscle is irritated by inflamed retrocaecal appendix | Answer- A. Psoas majorIn children with abdominal pain, who hold their right hip in a flexed position to obtain relief from the pain, one should suspect retrocaecal appendicitis causing irritation ofthe psoas muscle. | 1 | Psoas major | Gluteus maximus | Quadratus femoris | Obturator internus | Surgery | null | 1935e4c0-1499-4b8e-b868-5f083cdfe4cf | single |
Second pa of duodenum not related posteriorly to? | Ans. is 'c' i.e., Bile duct | 3 | IVC | Psoas major | Bile duct | Renal aery | Anatomy | null | cfd6fe12-a00a-4ebd-a109-6138961734eb | single |
Sequestration lung is best diagnosed by- | A pulmonary sequestration (bronchopulmonary sequestration)is a medical condition wherein a piece of tissue that ultimately develops into lung tissue is not attached to the pulmonary aerial blood supply.An angiogram/aeriogram has been considered vital in documenting the systemic blood supply,allowing definitive diagnosis as well as preoperative planning. | 4 | CT. scan | M.R.I. | Barium swallow | Angiography | Medicine | Respiratory system | 31430152-090e-4592-ad41-444836644981 | multi |
Chemical method of strengthening porcelain
involves | null | 3 | exchange of aluminium and sodium ions | exchange aluminium and potassium ions | exchange of sodium and potassium ions | none of the above | Dental | null | cf7beda5-2909-468d-8966-54036d60e07f | multi |
Blood supply of liver - | Ans. is 'b' i.e., 20 % hepatic artery, 80 % portal vein Blood supply of livero The liver has dual blood supply20% of blood supply is through the hepatic artery.80% of blood supply is through the portal vein.o Before entering the liver, both the hepatic artery and the portal vein divide into right and left branches and further subdivide to form segmental vessels within the liver.o The hepatic arterial blood mixes with portal venous blood in the sinusoids.o There are no anostomoses between adjoining hepatic arterial territories and hence each branch is an end artery.Other important abdominal organs an their blood supplyOrganBlood SupplyEsophagusInferior thyroid (branch of thyrocervical trunk)Branches from descending aortaLeft gastric artery' (branch of coeliac trunk)Bronchial arteryLeft inferior phrenic arteryStomachLeft gastric artery (branch of coeliac trunk)Right gastric artery' (branch of hepatic artery)Right gastroepiploic artery (branch of gastroduodenal artery)Left gastroepiploic artery' (branch of splenic artery)Short gastric artery (branch of splenic artery)DuodenumProximal to entry of bile ductSuperior pancreaticoduodenal artery (branch of gastroduodenal artery)Right gastric arteryRetroduodenal artery (branch of gastroduodenal artery)Right gastroepiploic artery (branch of gastroduodenal artery)Supraduodenal artery of wilkie (inconsistant supply)Distal to entry of bile ductInferior pancreatico-duodenal artery (branch of superior mesenteric artery)PancreasPancreatic branches of Splenic artery (major supply)The superior pancreaticoduodenal arteryThe inferior pancreaticoduodenal arterySpleenSplenic artery (largest branch of coeliac trank)KidneyRenal artery' (branch of the abdominal aorta)Suprarenal gland (Adrenal gland)Superior suprarenal artery- (branch of inferior phrenic artery)Middle suprarenal artery (branch of abdominal aorta)Inferior suprarenal artery (branch of renal artery) | 2 | 80% hepatic artery, 20% portal vein | 20% hepatic artery, 80% portal vein | 50% hepatic artery, 50% portal vein | 100% hepatic artery | Anatomy | Thorax | 06a552f0-da6f-4066-80fc-0c3145f38af5 | single |
Factors ouring fat embolism in a patient with major trauma : | A i.e. Mobility of | 1 | Mobility of | Hypovolemic shock | Resp. failure | All | Anaesthesia | null | 7def8478-67e9-4417-a99a-849eb92fb73a | multi |
X-ray sign of pneumoperitoneum | Rigler's sign - bowel wall outlined by intraluminal and free peritoneal gas. | 2 | Steeple sign | Rigler's sign | Golden 'S' sign | 'Bird of prey' sign | Surgery | All India exam | 1ea19cdd-f398-49d9-867b-1f742feffac0 | single |
The amino acid that acts as a precursor in the production of urea is | (Refer: Harper's Illustrated Biochemistry, 26th edition, pg no: 265) | 1 | Arginine | Aspaic acid | Ornithine | Glutamate | Anatomy | All India exam | e5b121a0-3de4-460f-a5c5-6ccbb891e970 | single |
Medial longitudinal arch is supported by- | Ans. is 'a' i.e., Plantar fascia Arches of the foot* The arches of the foot are well known features of the foot. There are two longitudinal arches, i.e. medial longitudinal arch and lateral longitudinal arch.* In addition there are two transverse arches, i.e. posterior transverse arch and an anterior transverse arch.* The medial longitudinal arch is the most important and is primarily affected in pes planus and pes cavus.# This arch is formed by the calcaneus, talus, navicular, three cuneiforms and medial three metatarsals.# Flattening of the arch is common and is assessed clinically.# The medial arch is supported byi) Spring ligament which supports the head of the talus.ii) Plantar fascia: Both these act as a tie beam.iii) Abductor hallucis and flexor digitorum brevis which act as spring ties.iv) Tibialis anterior which lifts the centre of the arch. This muscle also forms a stirrup like support with the help of peroneus longus muscle.v) Tibialis posterior adducts the mid-tarsal joint and supports the spring ligament.vi) Flexor hallucis longus extending between the anterior and posterior ends also supports the head of talus.vii) Flexor hallucis longus* The lateral longitudinal arch is formed by calcaneum, cuboid, 4th and 5th metatarsals. It is rather shallow and gets flattened on weight bearing.# This arch is supported by long plantar ligament, short plantar ligament. Plantar fascia acts as a tie beam.# Flexor digitorum brevis, flexor digiti minimi and abductor digiti minimi act as tie beam.# Peroneus longus, peroneus brevis and peroneus tertius support this arch.* Posterior transverse arch is formed by three cuneiforms and cuboid. This arch extends across the sole in a coronal plane. It is only a half arch, the other half gets completed by the other foot. This arch is supported by the ligaments binding the bones. It gets specific support form the tendon of peroneus longus as it extends form the lateral side to the medial side of the sole.* Anteior transverse arch also lies in coronal plane. It is formed by the heads of five metatarsals. During weight bearing, the metatarsal heads flatten out.# This arch is supported by intermetatarsal ligaments and the intrinsic muscles of the sole. The transverse head of adductor hallucis holds the heads of metatarsals together. | 1 | Plantar fascia | Sustentaculum tali | Peroneus longus | Peroneus brevis | Anatomy | Lower Extremity | 86498971-86b3-4ca5-94a6-c5a7fc8b777d | single |
True about OPV are all, EXCEPT: | Oral polio vaccine is live attenuated vaccine containing (type 1,2,3 polio strain) It was described by Sabin in 1957,i.e. it is also known as Sabin vaccine The vaccine progeny is excreted in the faeces and secondary spread occurs to household contacts and susceptible contacts in community. Non immunized persons may therefore, be immunized. Thus wide spread 'heard immunity' results even if only 66% of community is immunized. This propey of OPV has been exploited in controlling epidemics of polio by administrating the vaccine simultaneously ina sho period to all susceptibles ina community. Live vaccine stimulates antibody formation by inducing mild infection in epithelial cell and the payers patches. Then the virus spreads to the other areas of body and produce antibody.which prevent dissemination of the virus to the nesvus tissue and paralytic polio. The presence of circulating maternal antibodies may modify the infection created by the attenuated vaccine viruses and reduce both the serum and the gut response. Production of antibodies take some time thats why we cant get quick response. Ref: Park 22nd ed/p 187. | 1 | We get quick immune response | It is a live vaccine | It is used in epidemic | Maternal antibody interferes with immune response | Social & Preventive Medicine | null | ae52b60a-34ed-4d42-b81c-1d443c18f5d8 | multi |
Nutrient aery to fibula arises from | Nutrient aery to fibula:- The peroneal aery gives off nutrient aery to fibula.Enters the bone on its posterior surface.Nutrient foramen directed downwards. {Reference: BDC 6E} | 1 | Peroneal aery | Anterior- tibial aery | Posterior tibial aery | Popliteal aery | Anatomy | Lower limb | d1e4f345-cd9e-4a3f-8b37-3cfd44c75c43 | single |
Scabies in adults differs from that in children by – | Scalp, face, palm and soles are characteristically spared in adult, whereas these areas are involved in infants and young children. | 1 | Not involving face | Non involving genitals | Not involves areola | Involves whole body | Dental | null | 2a76f65d-a560-4d49-aa86-474ccb1ad558 | single |
A patient was brought to emergency with complaints of high-grade fever and altered sensorium. He was diagnosed to be suffering from meningococcal meningitis. Which of the following is the most appropriate empirical treatment option? | Answer- A. CeftriaxoneMeningococcal meningitisTreatment:3rd generation cephalosporin such as cefotaxime or ceftriaxone is DOC for initial therapyProphylaxis: Rifampicin is DOC for meningococcal prophylaxisANTIBIOTIC RECOMMENDATIONS FOR BACTERIAL MENINGITIS:BACTERIAANTIBIOTIC(IV)DURATIONStreptococcus PneumoniaVancomycin+3rd gen. Cephalosporin(Cefotaxime or ceftriaxone) 10-14 daysNesseria meningitidis3rd gen. Cephalosporin(Cefotaxime or ceftriaxone) orPenicillin G or Ampicillin 5-10 days H.influenza3rd gen. Cephalosporin(Cefotaxime or ceftriaxone) 7-10 days Listeria monocytogensPenicillin G or Ampicillin + Aminoglycocide14-21 days GBSPenicillin G or Ampicillin + Aminoglycocide 14-21 days E.coli 3rd gen. Cephalosporin(Cefotaxime or ceftriaxone) 21 days | 1 | Ceftriaxone | Piperacillin--Tazobactam | Penicillin | Cotrimoxazole | Microbiology | null | 80859c3e-539b-46b6-894d-10c3b14eccad | multi |
Sulfasalazine exes its primary action in ulcerative colitis by : | MOA* Inhibition of NF-KB Activation* Inhibition of PG synthesis* Scavenging of Free radicals 5-ASA compounds exe its local anti-inflammatory effect by inhibiting leukotriene production (PG synthesis) by inhibition of 5-lipooxygenase activity; also inhibits the production of IL-1 and TNF. Commonly Used 5-ASA Formulations in IBD Sulfasalazine Oral mesalamine agents Azo compounds: Balsalazide, Olsalazine | 3 | Folic acid synthesis | Formation of prostaglandins (PG) | Inhibition of NF-KB Activation | Formation of interleukins | Surgery | Inflammatory bowel disease | 49bde9a5-088c-4ea8-aab4-06658f5f0ea2 | single |
Inhibition of prolactin is caused by: (Repeat) | Ans: A (Dopamine) Ref: Pal GK, Pituitary Gland: The Anterior Pituitary. In: Textbook of Medical Physiology, Abuja Publishing House, 2007: 44:332Explanation:Regulation of Prolactin SecretionProlaction Increased by:PRFSleep, stress, breast feedingAlso released by TRH and hormones in the glucagon family (secretin, glucagon, VIP and gastric inhibitory polypeptide )AT-IIOxytocinDopamine antagonist (phenothiazine)Adrenergic blockersSerotonin agonistsProlactin Decreased by:DopamineSomatostatinProlactinGABA | 1 | Dopamine | Dobutamine | TRH | AT-II | Physiology | Pituitary | edf31927-1056-4bbd-83dc-9d6550f7ccd9 | single |
The first investigation of choice in a patient with suspected subarachnoid haemorrhage should be - | Investigation of choice for acute SAH is non-contrast CT scan. | 1 | Non-contrast computed tomography | CSF examination | Magnetic resonance imaging (MRI) | Contrast-enhanced computed tomography | Radiology | null | ec45fcb4-f964-4e27-af9c-6f88de25d6b9 | single |
In periodontitis maximum destruction is present in: | null | 1 | Lateral wall of pocket | Root surface | Junctional epithelium | None of the above | Dental | null | d7e8737d-982e-4999-90fb-d1804f227d5c | multi |
Triple bonds are found between which base pairs: | Triple bond is present between cytosine and guanosine. Ref: Harper's Biochemistry, 24th Edition, Page 403, 25th Edition, Page 404 ; Textbook of Biochemistry By DM Vasudevan, 3rd Edition, Pages 332, 344 | 2 | A-T | C-G | A-G | C-T | Biochemistry | null | 1f0a5f77-f592-412a-a10c-391a784d832d | single |
HMP shunt occurs in all organs except ? | Ans. is 'd' i.e., BrainHMP is an alternative route for the oxidation of glucose (beside glycolysis).It is also called as "pentose phosphate pathway", "Dickens - Horecker pathway", "Shunt pathway" or "phosphogluconate oxidative pathway".HMP shunt is required for provision of reduced NADPH and fiver-carbon sugars (Pentose phosphates) for nucleic acid synthesis.Normally, 90% of glucose is oxidized by glycolysis and 10% is oxidized by HMP shunt.However, in liver and RBCs HMP shunt accounts for oxidation of 30% glucose.HMP shunt occurs in the cytosol.It is highly active in liver, adipose tissue, adrenal coex, lens, cornea, lactating (but not the nonlactating) mammag gland, Gonads (testis, ovary) and erythrocytes.Activity of this pathway is minimal in muscle and brain, where almost all of the glucose is degraded by glycolysis. | 4 | Liver | Adipose tissue | RBC | Brain | Biochemistry | null | 1ba7c88c-e7d1-4379-a1df-9a94477e944b | multi |
A 6 year old boy has been complaining of a headache, ignoring to see the objects on the sides for four months. On examination he is not mentally retarded, his grades at school are good, and visual acuity is diminished in both the eyes. Visual charting showed significant field defect. CT scan of the head showed suprasellar mass with calcification. Which of the following is the most probable diagnosis? | Suprasellar calcification along with the presence of visual field defects and headache suggests the diagnosis of craniopharyngioma. | 2 | Astrocytoma | Craniopharyngioma | Pituitary adenoma | Meningioma | Radiology | null | e441837c-07d0-4eb3-946f-23cbfad66f59 | multi |
Which of the following statements about lepromin test is not true ? | Ans. is 'b' i.e., It is a diagnostic test | 2 | It is negative in most children in first 6 months of life | It is a diagnostic test | It is an impoant aid to classify type of leprosy disease | BCG vaccination may conve lepra reaction from negative to positive | Social & Preventive Medicine | null | 5c089444-bb6f-4efe-9f34-f906556b0cb7 | multi |
Test for visual acuity in a baby of age <1 year is | Test for visual acuity in an infant is Electro retinography. | 1 | Electro retinography | Electro oculography | Snellen's chart | Optical Coherence tomography | Ophthalmology | null | 961ff179-5a50-4f2f-9f5b-8811d9b52224 | single |
Inflammation of the perapical tissue is sustained by which of the following | null | 3 | Stagnant tissue fluid | Necrotic tissue | Microorganisms | Pus cells | Dental | null | 30d4c5b7-dc6e-4bd8-80cc-0ac0b03b92c9 | single |
Intrauterine growth retardation can be caused by all except – | Causes of LUG (small for date)
Environmental
Ethnic, racial and geographic
Social and economic status
Nutritional
Maternal
The short stature of mother
Primi or grand multipara
Young / adolescent mother (below 20 years)
Low pre-pregnancy weight
Smoking and tobacco or alcohol abuse
Maternal illness : anemia, heart disease, malaria
Complication of pregnancy : pre-eclampsia, hypertension
Previous similar baby
Placental factors
Disorders of implantation of the placenta, abruptio placenta
extensive placental infarcts and structural or function
abnormalities of the placenta. Single umbilical artery
vascular thrombosis also predispose to the birth of a small baby
Fetal factors
Firstborn babies are generally smaller
Genetics or chromosomal aberrations
Twining and multiple pregnancies
Intrauterine infections
Note:-
In CRF there is hypertension which is one of the causes of IUGR.
Propranolol also causes IUGR. | 4 | Nicotine | lcohol | Propranolol | Phenothiazine | Pediatrics | null | a672c535-8949-46c1-87ef-7d1e7f8b9385 | multi |
All of the following fluoroquinolones have been withdrawn Except | Except for Gemifloxacin, all others have been withdrawnTrovafloxacin due to hepatotoxicityGatifloxacin due to hypo/hyperglycemiaGrepafloxacin due to adverse cardiac events | 3 | Trovafloxacin | Gatifloxacin | Gemifloxacin | Grepafloxacin | Microbiology | All India exam | a47f81bd-6cab-4025-982c-555bd09ac819 | multi |
The term balanced anesthesia has been given by | Refer Goodman Gilman 12/e p 528 Term balanced anaesthesia was introduced by Lundy in 1926 | 3 | Simpson | Fischer | Lundy | Moan | Pharmacology | Anesthesia | 5ccaf367-a594-4445-8cfb-431757e9f3ac | single |
Treatment of a 6-year-old child with recurrent UI, mouth breathing, failure to grow with high arched palate and impaired hearing is | Mouth breathing with recurrent UI suggest adenoid hyperplasia, treatment is adenoidectomy. Hearing impairment and the option of myringotomy and grommet inseion suggests the patient is also suffering from serious otitis media (glue ear/secretory otitis media), which is one of the complications of adenoid hyperplasia. Treatment of glue ear requires myringotomy and grommet inseion. Ref: Textbook of disease of ENT, PL Dhingra,7th edition; pg no: 70 | 4 | Tonsillectomy | Grommet inseion | Myringotomy with grommet inseion | Adenoidectomy with grommet inseion | ENT | Ear | 713ee7dd-834b-4254-9e92-02b735561d96 | single |
The normal value of P50 on the oxyhaemoglobin dissociation curve in an adult is: | C i.e., 3.6 K Pa P50 is the P02 at which hemoglobin is half P50 is the index of affinity of hemoglobin for 02. Higher the P50, the lower the affinity of hemoglobin for 02. Under normal condition when: - Hb is normal - PaCO2 is 110 mm Hg - Temperature is 37degC - 2,3 DPG is 15 jtmol/gm of Hb. The value of P50 is 25 mm Hg - 3.6 KPaQ. (1 mm Hg = 0.14 KPa) | 3 | 1.8 kPa | 2.7 kPa | 3.6 kPa | 4.5 kPa | Physiology | null | 2962719d-df34-454b-8f8f-c1ae515b6054 | single |
All are the features of Korsakoff's syndrome except : | "Korsakoff syndrome is an irreversible chronic encephalopathy with antegrade and retrograde amnesia and confabulation". | 4 | Confabulation | Retrograde amnesia | Antegrade amnesia | Defective motor skill | Psychiatry | null | adbe30d9-233d-4587-8e76-90420b611388 | multi |
Amount of infectious waste among hospital waste is: | null | 1 | 1.50% | 4.50% | 25% | 12% | Dental | null | 26fed527-de10-4152-8235-27c40bf7befe | single |
MCardle's syndrome is due to | McArdle disease (also known as glycogen storage disease type V) is a disorder affecting muscle metabolism. The condition is caused by the lack of an enzyme called muscle phosphorylase. This results in an inability to break down glycogen 'fuel' stores. McArdle disease leads to pain and fatigue with strenuous exercise. Ref Robbins 9/e pg 153 | 1 | Deficiency of glucose-6-phosphatase | Absence of muscle phosphorylase | Deficiency of liver phosphorylase | Deficiency of liver phosphorylase kinase | Medicine | Genetics | e5eacb0a-0ae8-4d50-8c6a-64638542c62b | single |
All are characteristic features of drug induced hepatitis EXCEPT: | FARE : fever , ahritis , rash and eosinophilia indicates medication induced liver disease Ref : Schiff's diseases of liver , Edition -11 , Page - 5. | 4 | Fever | Ahritis | Rash | Neutrophilia | Medicine | null | 4dbf5da0-1d09-4686-aaa2-4f12d026784f | multi |
A woman aged 35 year with delayed cycles and a history of primary infeility. On laparoscopic examination she has a normal uterus with bilateral enlarged ovaries, normal fallopian tubes, chromotubation shows blue dye spillage. What is the most probable cause? | PCOS (polycystic Ovarian Syndrome) / Stein Leventhal syndrome Features of PCOD / PCOS Obesity Insulin resistance / hyperinsulinemia Hyperandrogenemia Anovulation Metabolic X syndrome Oligomenorrhea Amenorrhoea Rotterdam / Eshre /Androgen excess Society /ASRM criteria Diagnostic requisites : Any 2 out of 3 Anovulation/ oligo-ovulation Hyperandrogenism: clinical or laboratory evidence of androgen excess Polycystic ovaries on USG (12 or more follicles measuring less than 9 mm or ovarian volume of > 10 mL) In the image shown, ovaries are bulky in size (suggestive of PCOS) and patient has history of oligo ovulation as suggested by delayed cylces and infeility. There are no endometriotic cysts or peritoneal implants ruling out endometriotic cyst The tubes and ovaries show no ovarian cyst or tubo ovarian mass. | 2 | Endometriosis | PCOS | Ovarian cyst | Tubo Ovarian mass | Gynaecology & Obstetrics | Polycystic Ovarian Syndrome | 394dd1d1-eb43-464e-85c8-94ac62b799cc | multi |
True about social phobia is: | C i.e. Irrational fear of activities | 3 | Fear of closed spaces | Irrational fear of situation | Irrational fear of activities | Irrational fear of specified objects | Psychiatry | null | 13e4908a-c463-4d97-83de-f55da3e463f8 | multi |
Calabar swelling is produced by? | Ans. is 'b' i.e., Loa - Loa Loiasis . Loiasis is caused by L. Loa (the African eye worm) . Habitat of adult worms is subcutaneous connective tissue of man; often in the sub-conjuctival tissue of the eye. . The worm passes its life cycle in two hosts : - Man - Chrysops (Mango or deer flies) . C/Fs --> Asymptomatic microfilaremia Calabar (fugitive) swelling - subcutaneous swelling Nephropathy Encephalopathy rare Cardiomyopathy Calabar swelling is due to hypersensitivity reaction to the adult worm. | 2 | Onchocerca volvulus | Loa loa | Burgia malayi | Wuchereria bancrofti | Microbiology | null | fc7fa9e4-b4dd-4a61-afc9-6056e2c7e0e8 | single |
Modified Ferriman Gallway score is used to Grade | Modified Ferriman-Gallwey score is the most common method for grading the extent of hirsutism in clinical investigation. Scores hair growth from 0-4 in each of 9 androgen-sensitive areas, including the upper lip, chin, chest, upper and lower abdomen, upper arm, thighs, and the upper and lower back.Scores less than 8, 8-15, and greater than 15 generally indicate mild, moderate, and severe hirsutism, respectively. Approximately 95% of women have a modified Ferriman-Gallwey score less than 8. The frequency of self-treatment correlates positively with the Ferriman-Gallwey score.Reference: Clinical Gynecologic Endocrinology; 8th edition; Chapter 13; Hirsuitism | 1 | Hirsuitism | Abnormal Uterine bleeding | PCOD | Gestational Trophoblastic Neoplasia | Gynaecology & Obstetrics | PCOD, hirsutism and galactorrhea | 87781bca-3217-401d-9539-ec9ffea00c22 | multi |
True about nabothian cyst is all except - | Ans. is 'd' i.e., It is pre - malignant Nabothian cvsts# Seen in chronic inflammation of cervix.# It is the result of blockage of mouth of the glands of the cervix.# During the process of healing, the squamous epithelium replaces the columnar epithelium.# The blocked glands become distended with secretion and form small cysts which can be seen with the naked eye, the so-called nabothian follicles.# The condition is neither malignant nor pre-malignant. | 4 | Squamous epithelium occludes the mouth of the glands | It is seen in chronic irritation and inflammation | It is a pathology of the cervix | It is pre - malignant | Gynaecology & Obstetrics | Miscellaneous (Gynae) | fb826c77-3def-437c-b2a5-c4b651293944 | multi |
Which of the following is not used as a sedative, but causes sedation as a side effect : | First generation antihistaminics cause sedation and anticholinergic side effects.
Sedative action of TCAs appears immediately and these drugs (particularly clomipramine, maprotiline and bupropion) lower the seizure threshold.
Benzodiazepines are used as sedative drugs. | 2 | Digitalis, Antiarrhythmics | Antihistaminics, antidepressants | Macrolides | Benzodiazepines | Pharmacology | null | 5132236d-fc4d-46ce-9bf7-7a56ad3f5ee1 | single |
Half life of factor VIII - | Ans. is 'b' i.e., 8-12 hours o Half life of various clotting factors (in hours) :-* Firinogen - 100-150# Factor III -6# Factor X - 45-52* Prothrombin -60# FactorVIII-8-12# FactorXI -48-84* Factor V-24# Factor IX - 24# Factor XII - 150 # WVF-30 | 2 | 2-4 hours | 8-12 hours | 6 minutes | 60 days | Physiology | Blood: Hemostasis and Blood Coagulation | 63d27f7c-858a-4a66-aa81-04c3ee889fe3 | single |
Dopamine acts on D2 receptors that have an inhibitory effect on prolactin secretion. Now if D2 receptors are blocked, which of the following effects will not be seen: | null | 1 | Visual disturbance | Gonadal dysfunction | Headache | Excessive lactation | Pharmacology | null | 70fa63a7-e934-4b34-81bd-24228484e896 | single |
A 32 year old man presents to the emergency room with a severe headache. Nuchal rigidity is found on physical examination. Lumbar puncture demonstrates cerebrospinal fluid with markedly increased lymphocytes. Other cell populations are not increased. Which of the following agents is the most likely cause of his symptoms? | The clinically suspected diagnosis is meningitis, which is confirmed by the abnormal cerebrospinal fluid. The markedly increased lymphocytes suggests acute lymphocytic meningitis, which is distinguished from acute pyogenic meningitis (increased neutrophils as well as lymphocytes). Acute lymphocytic meningitis is usually viral in origin. Among the many viruses that have been implicated, mumps, herpes, Epstein-Barr, echovirus, and Coxsackievirus are the most common. Escherichia coli and Haemophilus influenzae cause acute pyogenic meningitis. Mycobacterium tuberculosis and Treponema pallidum cause chronic meningitis. Ref: Levinson W. (2012). Chapter 37. DNA Enveloped Viruses. In W. Levinson (Ed),Review of Medical Microbiology & Immunology, 12e. | 3 | Escherichia coli | Haemophilus influenzae | Herpes virus | Mycobacterium tuberculosis | Microbiology | null | f6b6c605-50ba-44a5-b0cb-872378a89a57 | single |
True about Nexplanon is all except | Nexplanon is progestin implant. | 3 | Suppress ovulation | Induces endometrial atrophy | Estrogen subdermal implant | Increases cervical mucus viscosity | Gynaecology & Obstetrics | null | 96996602-b2fb-46a4-a258-d1af3f1d99d6 | multi |
The virus, which spreads by both hematogenous and neural route is ? | Ans. is 'c' i.e., PolioVirus | 3 | Rabies virus | Varicella zoster virus | Poliovirus | E. B. virus | Microbiology | null | ef7f9fce-ca47-44c7-afc4-23f8f988b8fa | multi |
What instruction do you give to a mother who is lactating regarding intake of drug? | ANS. DPlasma concentration of drug varies with time follows the graph as shown below. Certain drugs can be secreted in breast milk and therefore transferred to the infant. Care should be taken to decrease this to the minimum possible levels.Least plasma concentration of the drug will be just before the next loading dose. Hence, the least chance for the drug to be concentrated in milk and thereby transferred to the infant would be at the time just before taking next dose. Hence advice mother to lactate just before taking next dosage of the drug. | 4 | No advice as most of drug are not secreted into breast milk | Give longer half-life drugs | Tell the mother to feed when it is least efficacious | Lactate Just before she take the next dose, when the plasma concentration of drug would be least. | Pharmacology | General Pharmacology | e8642b30-506f-4616-8349-869732011482 | single |
Which of the following is the richest source of Vitamin C? | Ans. is 'd' i.e., Amla | 4 | Orange | Guava | Cabbage | Amla | Social & Preventive Medicine | null | e01f6faa-0c36-41b2-bc03-d799b8ee1f32 | single |
A 85 yr old female developed multiple blisters on trunk and thighs. Nikolsky&;s sign is negative. The lesions came on and off. The most probable diagnosis is | Bullous Pemphigoid (BP) * Most common autoimmune bullous disorder with chronic nature; typically in patients over 60 Autoantigen: - * BPAG2 (collagen XVII): 180 kDa (NC16A domain), transmembrane hemidesmosomal protein * BPAG1: 230 kDa, cytoplasmic plaque protein Clinical features:- Often presents with initial uicarial lesions which evolve into large, tense bullae over medial thighs, groin, abdomen, and legs; +- pruritus initially with subsequent tenderness; no constitutional symptoms unless extensive disease; 10-35% with oral involvement Drug-induced:- Furosemide, NSAIDs, phenacetin, PCN-derivatives, gold, potassium iodide, captopril, enalapril, D-penicillamine, sulfasalazine Histology:- Subepidermal bulla with || eosinophils and lymphocytes in papillary dermis, +- neutrophils. Investigations:- * DIF: linear C3 and IgG (latter weaker) at BMZ * IIF: + in 60-80%; IIF on salt-split skin (SSS) shows binding to epidermal side of split (roof of blister) Treatment:- Oralcoicosteroid, steroid-sparing agent (azathioprine, mycophenolate mofetil, etc), TCN + nicotinamide, dapsone; good prognosis. Ref:- Sima Jain; pg num:- 130 | 3 | Lichen planus | Pemphigus vulgaris | Bullous pemphigoid | Lepra reaction | Dental | Vestibulobullous disorders | ab508393-9d3a-442e-970c-c11dc84088ec | single |
Rapid progressive juvenile periodontitis is seen usually at which age? | null | 2 | 6-10 years | 10-20 years | 30-40 years | At any age | Dental | null | f2d46e85-91ae-4b36-bdfe-15ba73c4aa01 | multi |
Compensatory mechanism in acute hemorrhage- | Ans. is 'c' i.e., Increased heart rate Compensatory mechanisms in acute hemorrhageo In acute hemorrhage there is compensatory sympathetic stimulation which causes1) Generalized vasoconstriction with increased total peripheral resistance (TFR).2) Increased heart rate (tachycardia).Increased cardiac contractility.Increased renin release causing sodium and water retention through RAA system.Shift of fluid from intracellular and interstitial space into vascular space. | 3 | Decreased myocardial contractility | Decreased heart rate | Increased heart rate | Increased respiratory rate | Physiology | Circulation: Circulatory Shock and Its Treatment | b4204556-5cea-4250-838b-9cf55761c302 | single |
ICDS stands for | Integrated Child Development Services (ICDS) scheme- Under ICDS scheme, there is an anganwadi worker for every 400-800 population- The beneficiaries include nursing mothers, pregnant women, other women (15-45 years), children below the age of 6 years and adolescent girls.Park 23e pg: 903 | 1 | Integrated child development services | Integrated child development scheme | International child development services | Indian child development scheme | Social & Preventive Medicine | Health care of community & international health | 9e28076f-844d-4a69-b195-dd548b77e278 | single |
A 45 - year old cirrhotic patient presented with severe haematemesis. The management of choice is : | Ans. is 'a' Whole Blood transfusion "Patients with significant hemorrhage, Anaemia or Intravascular volume depletion require Blood transfusion or colloid containing solutions (albumin, Dextran) but whole blood transfusion is the t/t of choice because colloidal solutions are expensive and they have some adverse effect"T/T of hypovolemia :The therapeutic goals are to restore normovolemia with fluid similar in composition to that lost and to replace ongoing losses.Mild volume contraction can usually be corrected via oral route. More severe hypovolemia requires intravenous therapy. Normonatremic or Mildly - Isotonic or normal saline (0.9% NaCl) and should be hyponatremic individuals administered initially in pts with hypotension or shock.Severe Hyponatremia - Hypertonic Saline (3.0% NaCl)Hypernatremia - Half Normal Saline(0.5% NaCl)If Hypokalemia also occurs - Add appropriate amount of KC1 to replacement solution.Significant haemorrhage, - Whole blood transfusion.Anaemia or IntravascularVolume depletion | 1 | Whole blood transfusion is the best | Colloids are preferred over crystalloids | Normal saline infusion | IV fluid with diuretics | Medicine | Cirrhosis and Alcoholic Liver Disease | cfae8c42-8199-46bf-ab8b-88c6701e5537 | multi |
Pulled up cecum is seen in - | Ans. is 'c' i.e.. Ileocecal tuberculosis Tuberculosis of the small intestine occurs in two forms.o Primary infection is usually due to bovine strain of mycobacterium tuberculosis and results from ingesting infected milk. In India the human strain may also cause such primary tuberculosis. This produces hyperplastic tuberculosis,o Secondary infection occurs due to swallowing of tubercle bacilli in a patient with pulmonary tuberculosis. This leads to ulcerative tuberculosis, the more common form of intestinal tuberculosis.Hyperplastic tuberculosiso Caused by ingestion of Mycobacterium tuberculosis by pts with a high resistance to the organism. The infection established itself in lymphoid follicles and the resulting chronic inflammation causes thickening of the intestinal wall and narrowing of the lumen. There is early involvement of the regional lymph nodes which may caseate.o Untreated sooner or later subacute intestinal obstruction will supervene often together with the impaction of an enterolith in the narrowed lumen,o It usually occurs in the ileocecal region.o Clinical featuresAttacks of acute abdominal pain with intermittent diarrhoea.Sometimes the presenting picture is of a mass in the rt iliac fossa in a pt with vague ill health.Features of blind loop syndrome may develop due to stasis, distention and chronic infection in the segment of ileum proximal to obstruction.o Barium meal radiography will revealPersistent narrowing of the affected segtnent ie the terminal ileum and the caecum.The caecum is pulled up and may become subhepatic,As the caecum is pulled up the ileo-caecal angle is widened. Normal ileo-caecal angle is 90" In ileocaecal tuberculosis this angle may increase upto 150dego Treatment: This depends on the presence or absence of obstructive symptoms.ATT is given in both cases.If obstruction is present ileocaecal resection is best method of tft (along with ATT)Ulcerative tuberculosiso It is usually secondary to pulmonary tuberculosis and results from swallowing tubercle bacilli in the sputum (cf. Hyperplastic tuberculosis is usually primary there is no pulmonary tuberculosis)o Usually longer parts of the terminal ileum is involved.o There are multiple ulcers in the terminal ileum lying transversely o Pt presents with diarrhoea and wt losso Barium meal shows - Absence of filling of the lower ileum, caecum and most ofthe ascending colon as a result of narrowing and hypermotility of the ulcerated segment,o Treatment:A course of A TT is adequate Operation is rarely required. in rare events of perforation or intestinal obstruction. | 3 | CA colon | Carcinoid | Ileocecal tuberculosis | Crohn's disease | Surgery | Miscellaneous (Small & Large Intestine) | 4246d36e-38dc-4855-a10c-734530d407c0 | single |
Extrapyramidal symptoms are seen with the use of: | null | 1 | Metoclopramide | Domperidone | Prolactin | All of the above | Pharmacology | null | 6d50a43d-3c46-4468-b575-5f9d67659420 | multi |
According to the WHO criteria, anaemia in infants of 6 months age is defined as Hb less than - | For children between 6months and 6 years, anemia is defined as defined as hb less than 11g/dl.REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 623 | 3 | 100 gm\/litre | 105 gm\/litre | 110 gm\/litre | 115 gm\/litre | Social & Preventive Medicine | Nutrition and health | 2d1c26fe-8e41-4205-b352-0c167f84679a | single |
The method of presenting data of geographic distribution is: | null | 4 | Histogram | Pie chart | Frequency polygon | Cartogram | Dental | null | f8cb8bd9-fbb6-4d25-a5e1-8cb342928f3d | single |
A patient suffering from thyrotoxicosis is given propanolol. Which of the following is not controlled by propranolol given to this patient? | The primary role of propranolol in thyrotoxicosis is to attenuate the effects of catecholamines, and it is also a weak inhibitor of extrathyroid conversion of T4 to T3. When given it is useful in reducing the hea rate, tremor, agitation, psychotic behavior, diarrhea, fever and diaphoresis. It doesn't alter the metabolic rate. | 4 | Anxiety | Tachycardia | Tremor | O 2 consumption | Pharmacology | null | d236cea6-50ce-43d5-9b1f-9659e7c20544 | single |
Excessive buying is termed as: DNB 08 | Ans. Oniomania | 2 | Kleptomania | Oniomania | Trichotillomania | Pyromania | Forensic Medicine | null | d1301ade-2434-441a-9cd6-f8ec57e70594 | single |
Drug of choice for Herpes simplex encephalitis is: | Acyclovir is active only against herpes group of viruses; H. simplex type I is most sensitive followed by H. simplex type II > varicella-zoster virus= Epstein-Barr virus; while cytomegalovirus (CMV) is practically not affected. Both H. simplex and varicella-zoster virus have been found to develop resistance to acyclovir during therapy; the former primarily due to mutants deficient in thymidine kinase activity and the latter primarily by change in specificity of virus directed enzyme so that its affinity for acyclovir is decreased. Use Acyclovir is effective in patients with normal as well as deficient immune status. 1 . Genital Herpes simplex Generally caused by type II virus; can be treated by topical, oral or parenteral acyclovir depending on stage and severity of disease. 2. Mucocutaneous H. simplex is a type I virus disease, remains localized to lips and gums; does not usually require specific treatment, but acyclovir skin cream may provide some relief 3. H. simplex encephalitis (type I virus): Acyclovir 10 to 20 mg/kg/8 hr i.v. for ;?.10 days is the drug of choice. Treatment is effective only if staed early: delay precludes salutary effect on moality and neurological complications. 4. H. simplex (type I) keratitis: Acyclovir is equally effective as idoxuridine in superficial dendritic corneal ulcer, and may be better for deep stromal infections because of good corneal penetration. Though acyclovir eye ointment acts slower than idoxuridine eye drops, blindness can be prevented. The eye ointment should be applied 5 times daily till 3 days after healing. 5. Herpes zoster: The varicella-zoster virus is less susceptible to acyclovir. As such, higher doses are needed and it should be used only in immunodeficient individuals or in severe cases: 10 mg/ kg/8 hr i.v. for 7 days. 6. Chickenpox: in patients with immunodeficiency and in neonates only calls for specific therapy. Acyclovir (15 mg/kg/day i.v. x 7 days) is the drug of choice: reduces fever, eruptions, hastens healing and prevents visceral complications ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:768,769 | 2 | 5-Hydroxy deoxyuridine (5-HU) | Acyclovir | Gancyclovir | None of the above | Pharmacology | Chemotherapy | cb15e48e-4197-458d-8b83-d8f3e16d4824 | multi |
An electrocardiogram (ECG) in a patient with a systolic ejection murmur that shows an incomplete bundle branch block in the precordial lead is most consistent with: | Many patients with secundum ASDs have an incomplete bundle branch block on their ECG. This is in contradistinction to patients with ostium primum defects, who often have a left axis detion. Although the ECG is not pathognomonic of the defect, the findings are sometimes helpful along with other clinical and diagnostic information toward elucidating the nature of the defect. | 1 | A secundum ASD. | A sinus venosus ASD with PAPVR. | An ostium primum ASD. | A complete AV canal defect | Surgery | Thorax And Mediastinum | 34533b10-05fb-4417-8703-82fda9a4d266 | single |
All of the following drugs can be used for intestinal ameobiasis except - | Ans. is 'b' i.e., Chloroquine | 2 | Metronidazole | Chloroquine | Diloxanide furoate | Tinidazole | Pharmacology | null | bb28fe8c-4a0c-4a53-82f7-d99baa889793 | multi |
A 60-year old female presented with decreased movements for the last 2 years with rigidity and veical large square wave jerks. The most likely diagnosis is: | Ans. d. Progressive supranuclear palsy The most likely diagnosis in a 60-year old female presenting with decreased movements for the last 2 years with rigidity and veical large square wave jerks is progressive supranuclear palsy. "Progressive supranuclear palsy should be considered whenever a middle aged or elderly person person presents with history of repeated falls and has an extrapyramidal syndrome accompanied by nuchal dystonia and paralysis of voluntary down gaze." Parkinson's disease A degenerative disorder caused by degeneration of substantia nigra (pars compacta), and idiopathic in etiology. Clinical feature: Tremors, rigidity and bradykinesia. Lewy body dementia Progressive cognitive decline and dementia are essential for diagnosis Other features: fluctuating cognition, recurrent well formed detailed visual hallucinations, spontaneous features of Parkinsonism Multisystem atrophy Characterized by: Autonomic failure involving urinary incontinence or an ohostatic decrease of blood pressure within 3 min of standing by at least 3o mm Hg systolic or 15 mm Hg diastolic, Poorly levodopa responsive parkinsonism Cerebellar syndrome (gait ataxia with cerebellar dysahria, limb ataxia or cerebellar oculomotor dysfunction) Progressive supranuclear palsy Marked impairment of voluntary downward gaze and horizontal gaze.Q Extended rather than flexed dystonic posturingQ Absence of tremorQ Poor response to antiparkinsonian medicationQ Supranuclear Gaze Palsy (Steel-Richardson syndrome) A degenerative disorder where in there occurs loss of neurons in midbrain, pons, basal ganglion and cerebellum "Progressive supranuclear palsy should be considered whenever a middle aged or elderly person person presents with history of repeated falls and has an extrapyramidal syndrome accompanied by nuchal dystonia and paralysis of voluntary down gaze Factors which distinguish this from Parkinson's Marked impairment of voluntary downward gaze and horizontal gaze.Q Extended rather than flexed dystonic posturingQ Absence of tremorQ Poor response to antiparkinsonian medicationQ | 4 | Parkinson's disease | Lewy body dementia | Multisystem atroph | Progressive supranuclear palsy | Medicine | null | 41334fc6-5020-4cf2-9ba0-a0deebe8676d | single |
The pacemaker potential is due to | . | 2 | Fast Na+ channel | Decrease in K+ permeability | Slow Ca++ channel | Rapid repolarization | Anatomy | All India exam | 064092b0-928b-44df-b714-eb6d926067a8 | single |
Which of the following acute-phase reactants is responsible for the anemia associated with chronic inflammation? | Acute-phase proteins are plasma proteins, mostly synthesized in the liver, whose plasma concentrations may increase several hundred-fold as part of the response to inflammatory stimuli.
Three of the best-known of these proteins are:
C-reactive protein (CRP).
Fibrinogen.
Serum amyloid A (SAA) protein.
Acute-phase proteins have beneficial effects during acute inflammation, but prolonged production of these proteins (especially SAA) in states of chronic inflammation can, in some cases, cause secondary amyloidosis.
Chronically elevated plasma concentrations of hepcidin reduce the availability of iron and are responsible for the anemia associated with chronic inflammation.
Systemic effects of inflammation:
Fever: Cytokines (TNF, IL-I) stimulate production of PGs in hypothalamus.
Production of acute-phase proteins: C-reactive protein, others; synthesis stimulated by cytokines (IL-6, others) acting on liver cells.
Leukocytosis: Cytokines (CSFs) stimulate production of leukocytes from precursors in the bone marrow.
In some severe infections, septic shock: Fall in blood pressure, disseminated intravascular coagulation, metabolic abnormalities; induced by high levels of TBF and other cytokines.
Reference-Robbins BASIC PATHOLOGY 10th edition pg-87 | 4 | Fibrinogen | Serum amyloid (SAA) | C-reactive protein (CRP) | Hepcidin | Pathology | null | de6ce662-36b2-4ac9-985f-f962bb0e0c9e | single |
All of the following immunosuppressives cause profound myelosuppression except- | Pharmacokinetics, mechanism of action, clinical efficacy in organ transplants, adverse effects, and dosage and administration of cyclosporine, a new immunosuppressant, are reviewed .Cyclosporine acts by blocking T-lymphocyte function without causing myelosuppression Ref Harrison 20th edition pg 578 | 2 | Sirolimus | Cyclosporine | Azathioprine | Mercaptopurine | Medicine | Oncology | 30d9b218-36b8-43ca-bde6-aacdf7dce99e | multi |
Hea rate increase with one of the following? | The baroreflex or baroreceptor reflex is one of the body's homeostatic mechanisms that help to maintain blood pressure at nearly constant levels. The baroreflex provides a rapid negative feedback loop in which an elevated blood pressure reflexively causes the hea rate to decrease and also causes blood pressure to decrease. Decreased blood pressure decreases baroreflex activation and causes hea rate to increase and to restore blood pressure levels. The baroreflex can begin to act in less than the duration of a cardiac cycle (fractions of a second) and thus baroreflex adjustments are key factors in dealing with postural hypotension, the tendency for blood pressure to decrease on standing due to gravity. The baroreceptors are stretch-sensitive mechanoreceptors. At low pressures, baroreceptors become inactive. When blood pressure rises, the carotid and aoic sinuses are distended fuher, resulting in increased stretch and, therefore, a greater degree of activation of the baroreceptors. At normal resting blood pressures, many baroreceptors are actively repoing blood pressure information and the baroreflex is actively modulating autonomic activity. Active baroreceptors fire action potentials ("spikes") more frequently. The greater the stretch the more rapidly baroreceptors fire action potentials. Many individual baroreceptors are inactive at normal resting pressures and only become activated when their stretch or pressure threshold is exceeded. Ref: guyton and hall textbook of medical physiology 12 edition page number:216,217,218 | 3 | Stimulation of trigeminal nerve pain receptor | Increased intracranial tension | Decreased stimulation of Baroreceptors | Increased parasympathetic stimulation | Physiology | Nervous system | b08340fc-5c0a-474e-b0df-8e24a8f0d3e6 | single |
Glutamine replaced by valine in sickle cell anaemia is characterized by | null | 2 | Non sense mutation of beta chain | Missense mutation of beta chain | Degradation of beta chain | Deletion of beta chain | Biochemistry | null | a0a53c3f-a1cd-4e7c-8c67-18050f795ab7 | single |
Pathologic calcification is seen in | Systemic sclerosis:
Characterized by ultimate induration and atrophy of skin and fixation of epidermis to deeper subcutaneous tissues. The skin becomes hardened and atrophic and cannot be wrinkled or picked up because of its firm fixation to the deep connective tissue. This contracture of skin gives a mask-like appearance to the face of claw-like appearance to hands.
Scleroderma can be circumscribed (morphea) or linear (Coup de sabre).
The tongue becomes stiff and board like, causing the patient difficulty in eating and speaking.
Reduced opening of mouth and fixation of jaw as a result of involvement of the peritemporo mandibular joint tissues making dental care very difficult.
Some times deposition of calcium in affected areas is also found.
Radiographic features:
- Extreme widening of PDL, two to four times normal thickness is diagnostic.
- Bone resorption of angle of mandibular ramus and partial or complete resorption of condyles and/or coronoid processes of the mandible are also seen.
Overall, increased collagen in tissues is characteristic feature of systemic sclerosis or scleroderma. | 1 | Scleroderma | Lichen planus | Dystrophic epidermolysis bullosa | Lupus erythematosus | Pathology | null | 78b9320b-760a-4344-ba07-3c32e0818461 | single |
Left sided lateral gaze is affected in lesion of - | Horizontal eye movements (Fast one or saccadic) are triggered by the centro lateral frontal lobes i.e. left lateral gaze palsy is caused by right frontal lobe Abducens nuclear lesions produces a complete lateral gaze palsy Ref | 1 | Right frontal lobe | Right occipital lobe | Left occipital lobe | Left frontal lobe | Ophthalmology | Ocular motility and squint | c0818f28-4816-47d1-8302-cc564ecad134 | single |
A patient presented with pus in urine. Urine culture was done which was negative. After a sudden onset renal failure the patient died. On autopsy the following finding was seen in kidney. What is the most likely diagnosis? | Ans. (a) TB kidneyThe clinical history is suggestive of sterile pyuria. The gross morphology shows greyish white are caseating necrotic material which is formed in patches, predominantly in the cortical areas involving the while circumference of the kidney. Hence, the first possibility is renal TB. | 1 | TB kidney | Infected renal cysts | Renal cell carcinoma | Renal stones | Pathology | Kidney | 69e9f8f7-262c-4a12-9f1f-aefb6f47af03 | single |
Vesicoureteric reflux is demonstrated by using | C i.e. MAG3 - Tc99 | 3 | DMSA | DTPA | MAG3 - Tc 99 | I123 iodocholesterol | Radiology | null | fcab10b0-b3d6-4b05-ac13-b166cc4837b1 | single |
29 yrs male was brought to OPD by his wife giving history of aggressive behaviour with decreased social interaction and lack of self care. O/E grasp reflex present, CT scan would be showing lesion of which lobe ? | Frontal lobe lesion manifest as: (Anterior Cerebral Aery occlusion) Aggressive and antisocial behaviour Abulia Apathy Urge incontinence Magnetic gait/Gait apraxia O/E: Primitive reflexes like grasp and rooting reflex are present. | 1 | Frontal lobe | Occipital | Temporal | Parietal | Medicine | Stroke and TIA | 0e53c7b1-799f-4418-8f1d-491d3c04d66e | single |
Left ureter is related to -a) Quadratus lumborumb) Left gonadal vesselsc) Superior mesenteric veind) Sigmoid mesocolone) Internal iliac artery | Left gonadal artery and sigmoid mesocolon are related to the anterior surface of the abdominal part of the left ureter.
Internal iliac artery is related to the posterior surface of pelvic part of the ureter.
Inferior mesenteric artery (not a superior mesenteric artery) is related to left ureter medially. | 2 | abc | bde | ace | bce | Anatomy | null | 299dba36-069a-4d07-8d10-43df68529660 | single |
Which of the following tumor is most commonly associated with superior vena cava syndrome | Small cell carcinomas are central or hilar in location and are highly associated with superior vena caval syndrome and paraneoplastic syndrome. Ref:Harsh Mohan-Pathology-6th edition,page no:500. | 2 | Lymphoma | Small cell carcinoma | Non small cell carcinoma | Metastasis | Medicine | Respiratory system | 24b5df39-1103-45d8-9d54-2ea92993293d | multi |
All are true about dengue fever, except: | Dengue can occur in epidemic and also as endemic. Mosquitoes kept at 260 C fail to transmit the DEN-2 virus so low incidence in ceain seasons explained. Ref: Park, 20th Edition, Pages 220-21 | 3 | Most common arboviral disease | Its both endemic and epidemic | Unaffected by ambient temperature | Self limiting | Social & Preventive Medicine | null | f3247b79-9a8c-481b-9cab-bd567b37a7f6 | multi |
A patient with cerebellar problems and spider angiomas is diagnosed with a combined T-cell and B-cell deficiency known as ataxia- telangiectasia. In addition to a defect in this patient's DNA repair enzymes, which immunoglobulin is the primary antibody in saliva, tears, and intestinal and genital secretions, and is also deficient in this illness? | IgA antibody is involved in local immunity at the level of the mucous membrane. It also arises early in disease, is short lived, and will disappear similarly as IgM. | 2 | IgG | IgA | IgM | IgD | Microbiology | Immunology | f43339d4-9256-480d-8622-3f23aa1c37d2 | single |
An ICU patient on atracurium infusion develops seizures after 2 days. The most probable cause is - | Ans: A | 1 | Accumulation of landonosine | Allergy to drug | Due to prolong infusion | All the above | Unknown | null | d49e91c6-6831-4171-b73e-e2164357ac09 | multi |
Body Mass Index is expressed as: March 2012, March 2013 (c, g) | Ans: C i.e. Kilogram/ metre2 Body Mass Index is defined as the weight in kilograms divided by the square of the height in metres (Kg/m2) | 3 | Gram/metre2 | Gram/ centimetre2 | Kilogram/ metre2 | Kilogram/centimetre2 | Social & Preventive Medicine | null | cad067c3-0686-4877-903d-c20d8ccc4ab4 | single |
Most common complication of chronic gastric ulcer is | Gastric ulcers like duodenal ulcers cause pain, bleeding, and obstruction and can perforate.The most frequent complication of gastric ulceration is a perforation. Most perforations occur along the anterior aspect of the lesser curvatureHaemorrhage occurs in approximately 35% to 40% of patients.The incidence of malignancy ranges from 6% to 30% and increases with the size of the ulcer.Sabiston 20e pg: 1233 | 3 | Tea pot stomach | Adenocarcinoma | Perforation | Haemorrhage | Surgery | G.I.T | 39964155-a6f0-43c8-bd39-47c87f08cdc7 | single |
Most effective agent to prevent motion sickness is- | Ans. is 'd' i.e., Hyoscine o Motion sickness is more easily prevented than cured.o Transdermal hyoscine (scopolamine) is the best agent for the prevention of motion sickness.o Antihistamines can also be used for prevention. | 4 | Ephedrine | Nedocromil | Cyproheptidine | Hyoscine | Pharmacology | Anti Cholinergic | 23971d51-8244-4d04-95ff-c54e908347af | single |
Acinic cell carcinomas of the salivary gland arise most often in the ? | Ans. is 'a' i.e., Parotid salivary gland Acinic cell tumor These are relatively uncommon tumors, representing only 2 to 3% of Salivary gland tumors. Composed of cells resembling the normal serous acinal cells of salivary glands. Most arise in the parotids - The remainder arise in submandibular glands. Minor Salivary glands are rarely involved because they have only a scant number of Serous Cells May be bilateral and multicentric. | 1 | Parotid salivary gland | Minor salivary glands | Submandibular salivary gland | Sublingual salivary gland | Pathology | null | 00566935-875a-4b28-86cd-f1ff68280fe5 | single |
A patient with major depressive disorder brought by her mother complaining that she tried hanging herself. She had so many attempts before and she talks more about deaths. Electroconvulsive therapy (ECT) is suggested. Which of the following is the absolute contraindication to ECT? | There are no absolute contraindications to the use of electroconvulsive therapy (ECT), but some conditions are relative contraindications, they are:Space-occupying intracerebral lesions (except for small, slow growing tumors without edema or other mass effect)Conditions with increased intracranial pressureUnstable vascular aneurysms or malformationsIntracerebral hemorrhagePheochromocytomaRecent myocardial infarctionRef: Loosen P.T., Shelton R.C. (2008). Chapter 18. Mood Disorders. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e. | 4 | Brain rumour | Myocardial disease | Aoic aneurysm | No absolute contraindication | Psychiatry | null | 3822a78e-88c3-48ba-9d75-8254220a3680 | single |
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