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A 24-year-old accountant complains of a white discharge from his breasts. He is most likely experiencing which one of the following? | The accountant has galactorrhea (inappropriate production of milk) caused by a prolactinoma (a tumor of the anterior pituitary that secretes PRL). Dopamine, the major regulator of PRL secretion, inhibits PRL production and release by the anterior pituitary. Bromocriptine is a drug that acts like dopamine to inhibit PRL release. While OT stimulates the ejection of milk from the mammary gland, PRL is necessary for milk to be produced in the gland. Neither glucagon nor testosterone will affect milk production. PRL is produced in the anterior pituitary, not the posterior pituitary. | 4 | A tumor of the posterior pituitary that could be surgically removed | Excessive production of OT in the hypothalamus | Deficient testosterone receptors in the mammary glands | A prolactinoma that would decrease its secretory activity in response to bromocriptine (an analog of dopamine) | Biochemistry | Endocrinology | 8c520c33-c15c-4261-8ac3-3a26d8e01bfc | multi |
Which of the following are supratentorial tumors? | Ans. A. CraniopharyngiomaTumors arising from the brain are common in children. Certain genetic syndromes and familial factors increase the risk of occurrence of brain tumors. Over 2/3 of brain tumors in children are infratentorial. They can be classified as:* Cerebellar Tumors: Medulloblastoma, Astrocytoma* Brainstem Tumors: Glioma of the brainstem, Ependymoma of the IV ventricle* Supratentorial tumors: Craniopharyngioma, Glioma of the cerebral hemispheres, hypothalamic glioma, Glioma of optic nerve. | 1 | Craniopharyngioma | Medulloblastoma | Astrocytoma | Ependymoma | Pediatrics | Childhood Tumors | 06c1eb6f-b385-44ec-bbf0-21ec594a095d | single |
All are actions of coisol on the skin and connective tissue except | It is antiproliferative for fibroblasts and keratinocytes. Glucocoicoids in excess inhibit fibroblasts, lead to loss of collagen and connective tissue, and thus result in thinning of the skin, easy bruising, stria formation, and poor wound healing. Hyperpigmentation is a direct effect of ACTH on melanocoin 1 receptors. | 4 | Antiproliferative for fibroblasts | Antiproliferative for keratinocytes | Loss of collagen | Hyperpigmentation | Physiology | Endocrinology | 7e3d608a-fd80-4ca9-bc55-873d961d55c6 | multi |
Lipoma becomes malignant commonly at which site: | RETROPERITONEAL LIPOMA These swellings sometimes reach an immense size Retroperitoneal lipoma is often malignant (liposarcoma) and may increase rapidly in size A retroperitoneal lipoma sometimes undergoes myxomatous degeneration Clinical Features Swelling or indefinite abdominal pain More common in women Diagnosis Diagnosis is usually by ultrasound and CT scanning. | 3 | Subcutaneous | Sub-aponeurotic | Retroperitoneal | Intermuscular | Surgery | Plastic Surgery and Skin Lesions | f2ae21f4-7c6c-4831-aa59-81123a0e86e4 | single |
A 9 month infant presents with a head circumference of 39 cm. All of the following can be the underlying causes EXCEPT? | Alexander disease- cause of Megalencephaly. Here, a 9 month infant has HC=39cm, so he/she has microcephaly, (Normal head circumference at bih = 33-35 cm) Rate of increase in HC 1st 3 months 2cm/month Next 3 months 1cm/month Next 6 months 0.5cm/month Next 2 years 0.2cm/month Megalencephaly causes:- Benign familial megalencephaly (Most common cause) Amino acid disorders Maple syrup urine disease glutaric aciduria Lysosomal storage disorder Weaver syndrome Achondroplasia Neurofibromatosis soto's syndrome Alexander disease Canavan disease Galactosemia The other 3 are causes of microcephaly. At 9 months ; ideally HC should be 43.5-45.5 cm. | 3 | Edward syndrome | Maternal smoking | Alexander disease | Congenital Toxoplasmosis | Pediatrics | Abnormalities of Head Size | b0f43e57-e3f6-40a1-a684-10e593e47f23 | multi |
. If blood gas analysis reveal pH = 7.52, pCO2=3O; pO2= 105.This will be compensated by? | As a compensatory mechanism, metabolic acidosis leads to alveolar hyperventilation with a fall in PaCO2. Normally, PaCO2 falls by 1-1.3 mm Hg for every 1-mEq/L fall in serum HCO3- concentration, a compensatory response that can occur fairly quickly Ref Davidson 23rd edition pg 345 | 3 | Compensatory respiratory acidosis | Compensatory respiratory alkalosis | Compensatory metabolic acidosis | Compensatory metabolic alkalosis | Medicine | Fluid and electrolytes | a48a15e7-1bb5-417a-a943-25e08552fd6e | single |
Corneal lesion seen in Hutchinson triad associated with congenital syphilis is: September 2006 | Ans. B: Interstitial keratitis Hutchinson's triad is named after Sir Jonathan Hutchinson. It is a common pattern of presentation for congenital syphilis, and consists of three phenomena: interstitial keratitis, Hutchinson incisors (notching of the two upper central incisors in the permanent dentition), and eighth nerve deafness | 2 | Disciform keratitis | Interstitial keratitis | Phylectenular keratitis | Mooren ulcer | Ophthalmology | null | 5f56ffb6-97b2-474b-9110-e76759b1ac88 | single |
Chemoprophylaxsis is..................... prevention - | Ans. is 'b' i.e., Primary | 2 | Primordial | Primary | Secondary | Teiary | Social & Preventive Medicine | null | 156c9c50-7769-43bc-812b-c869cef40f98 | single |
Which of the following is not a cause of hypermetropia: September 2009 | Ans. D: Anterior dislocation of the lens Factors responsible for hypermetropia: Sho axial length of the eyeball Curvature hypermetropia commonly occurs as a factor in astigmatism (corneal plana) Index hypermetropia accounts for the hypermetropia of old age due to increased refractive index of the coex of the lens relative to the nucleus so that overall refractive power of the lens decreases. It may be associated with diabetes, tumors, microphthalmia (a growth dysfunction during fetus development) and fovea hypoplasia, a condition that affects the blood vessels in the retina. While these conditions may result in hypermetropia, one of the most commonly cited causes of farsightedness is considered to be aging. | 4 | Sho axial length of the eyeball | Flat cornea | Increased refractive index of the coex of lens | Anterior dislocation of the lens | Ophthalmology | null | c8bed643-6f04-43f0-8bfc-b86552d35ce8 | multi |
An eight years old child is suffering from transient synovitis of the hip joint. Which of the following statement is false | Ans. C. The hip is typically held in adduction and internal rotationIn any type of synovitis, the joint will be held in flexion, abduction and external rotation because in this position joint capacity is maximum causing least pain (Minimal stretching of capsule) | 3 | May follow upper respiratory tract infection | WBC count and ESR are usually normal. | The hip is typically held in adduction and internal rotation | Widening of joint space will be seen on ultrasound. | Orthopaedics | Miscellaneous | 07f4bb0a-327e-4771-a8b1-2db15949309d | multi |
Half-life of T3 | Triiodothyronine, also known as T3, is a thyroid hormone. It affects almost every physiological process in the body, including growth and development, metabolism, body temperature, and hea rate. Production of T3 and its prohormone thyroxine (T4) is activated by thyroid-stimulating hormone (TSH), which is released from the pituitary gland.T3 is the true hormone. Its effects on target tissues are roughly four times more potent than those of T4. Of the thyroid hormone that is produced, just about 20% is T3, whereas 80% is produced as T4. Roughly 85% of the circulating T3 is later formed in the liver and pituitary by removal of the iodine atom from the carbon atom number five of the outer ring of T4. In any case, the concentration of T3 in the human blood plasma is about one-foieth that of T4. This is observed in fact because of the sho half-life of T3, which is only 2.5 days. This compares with the half-life of T4, which is about 6.5 days.Ref: Ganong&;s review of medical physiology; 24th edition | 2 | 10 hours | 2 day | 6 days | 10 days | Physiology | Endocrinology | 550e9be0-2b76-4f06-b5af-46923c33b94b | single |
Typhoid oral vaccine is given ? | Ans. is 'a' i.e., 1, 3, 5 days ANTI-TYPHOID VACCINES The old parenteral killed whole-cell vaccine was effective but produced strong side-effects. So, they are not used now. Two safe and effective vaccines are now licensed and available : - 1.The Vi polysachharide vaccine It is composed of purified Vi capsular polysaccharide from the Ty2 strain of S.Typhi. It is administered subcutaneously or intramuscularly. Only one dose is required. The vaccine confers protection 7 days after injection. To maintain protection, re-vaccination is recommended every 3 years. The vaccine is licensed for individuals aged 2 years. - It does not elicit immune response in children < 2 years. The vaccine is stable for 6 months at 37deg C and for 2 years at 20degC. The recommended storage temprature is 2-8degC. The Vi polysaccharide vaccine can be co-administered with other vaccines relevant for international travellers-such as yellow fever and hepatitis A Acyclovir is given to prevent the development of systemic disease in varicella infected immunosuppresed patients & can halt the progression of zoster in adults. Varicella zoster immunoglobulin given within 72 hrs of exposure can prevent chicken pox and is recommended in exposed immunocompromised persons. A live attenuated varicella vaccine is recommended for children between 12-18 months. It is effective even if given within 3-5 days after exposure. 2.The Ty 21a oral vaccine It is an orally administered, live attenuated Ty2 strain of S.Typhi in which multiple genes (including for Vi Capsular polysaccharide) have been mutated chemically. This lyophilized vaccine is available in 2 preparations : ? 1. Enteric coated capsules - Used for travellers to developing countries. It is used in individuals 5 years of age. 2.Liquid suspension - Used by public health programmes for young children in developing countries. It can be administered from the age of 2 years. Vaccine is administered on 1, 3 and 5the day, i.e., a 3-dose regimen is recommended. Vaccine confers protection 7 days after the last dose. The recommendation is to repeat this series (3 doses) every 3 years for people living in endemic areas, and every year for individuals travelling from non-endemic to endemic countries. Ty 21 a requires storage at 2-8degC, it retains potency for approximately 14 days at 25degC. Proguanil and antibacterial drugs should be stopped from 3 days before until 3 days after giving Ty 21 a, as these drugs may harm live bacteria. The vaccine is not efficacious if administered at the time of ongoing diarrhea. Avoided during diarrhoea as efficacy will reduce. Can be given to HIV +ve, asymptomatic persons with CD4 cell count of > 200/mm3 Well tolerated and has low rates of adverse events. Not recommended in congenital or acquired immunodeficiency, acute febrile illness, acute intestinal infection and in patients on antimitotic drugs May be given simultaneously with live vaccines of polio, cholera, yellow fever and MMR. | 1 | 1, 3, 5 days | 1, 2, 3 days | 1, 2, 4 days | 1, 7, 14 days | Social & Preventive Medicine | null | 52291eaf-2ced-4051-b033-ad1ecd788e8a | single |
Commonest site of lytic lesion in multiple myeloma is: | In multiple myeloma- bone lesions are most common in veebral column. The pain usually involves the back and ribs, and unlike the pain of metastatic carcinoma, which often is worse at night, the pain of myeloma is precipitated by movement. Persistent localized pain in a patient with myeloma usually signifies a pathologic fracture. The most common site of lytic lesion in multiple myeloma is veebra>skull>ribs. Distal to elbow and knee lesions are not seen. | 1 | Veebral column | Femur | Clavicle | Pelvis | Medicine | Lymphoma and Plasma cell disorder | f1c82e81-ab79-4bb0-835c-8c6686628a85 | single |
The length of the feeding tube to be inseed for transpyloric feeding is measured from the tip of | The feeding tube length can be measured by following the normal route for tube i.e. Nasal ala - to ear lobe - to epigastium Since the distance between the nasal ala and ear lobe is almost equal to the distance between the epigastrium and umbilicus, the length can be measured from ear lobe to umbilicus. | 2 | Nose to the umblicus | Ear lobe to the umblicus | Nose to the pelvis | Ear lobe to the pelvis | Anatomy | General surgery | 40e51276-aaf1-4cc8-8141-3905da5cbe9b | single |
Difference in expression of gene in the sibling as inherited by the father is termed as: | Difference in expression of gene in the sibling as inherited by the father is termed as mosaicism. It results from a mutation that occurs during embryonic, fetal, or extrauterine development. When mutation occur during from nondisjunction at an early embryonic mitotic division chromosomal mosaicism occurs. Somatic mosaicism is characterized by a patchy distribution of genetically altered somatic cells. Anticipation refers to an unusual pattern of inheritance in which symptoms manifest at earlier ages and with increasing severity as traits are passed to subsequent generations. Ref: Kopp P., Jameson J.L. (2012). Chapter 61. Principles of Human Genetics. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. Tsaic A.C., Manchester D.K., Elias E.R. (2012). Chapter 37. Genetics & Dysmorphology. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | 1 | Mosaicism | Anticipation | Mutation | Replication | Medicine | null | 5101bc72-2325-44e8-8086-ec73130153ed | single |
Infantile atopic dermatitis commonly involves | Infantile atopic dermatitis (2 months - 2 years): More commonly involves extensors.
Childhood atopic dermatitis (2 - 10 years): Commonly involves flexors
Adolescent atopic dermatitis (> 10 years): Commonly involves flexors, hand & feet. | 2 | Flexors | Extensors | Head & neck | Perianal area | Dental | null | 647a6092-baba-4abd-bb16-8723eef4fe1d | single |
Oligohydroamnios is AFI- | Ans. is 'b' i.e., < 5 cm Oligohydramnios1) AFI <5 cm or single largest vertical pocket < 2cm2) Amniotic fluid less than 100 mLEtiologyChromosomal AbnormalitiesUteroplacental Insufficiency* Congenital anomalies (e.g., renal agenesis and posterior urethral valves)* IUGR* Postdatism/postterm pregnancy* PROM* Twin-to-twin transfusion* Hypertension* Preeclampsia* NSAIDs, angiotensin-converting enzyme inhibitors* Idiopathic | 2 | <8cm | <5cm | <2 cm | <1 cm | Gynaecology & Obstetrics | Carcinoma Ovary | 63b79c3e-4652-4dcd-b5c8-acc1c922333f | single |
Thoracic duct opens into: | Thoracic duct is continuation of cysterna chyli. It passes through aoic hiatus beginning at lower border of T12 . At T5 it crosses to left side andopens into the left venous (jugulo-subclan) angle - junction of the left internal jugular and subclan vein, at the beginning of left brachio-cephalic vein. | 4 | Subclan vein | Internal jugular vein | Right brachiocephalic vein | Left brachiocephalic vein | Anatomy | Thorax- wall and Bronchopulmonary segment | 8353de61-7c64-4e09-8c60-54d33ddce638 | single |
The incidence rates of Clostridium difficile are measured in both hospitals and nursing homes throughout a particular county. Those with low rates of infection were marked as having an effective nosocomial infection prevention strategy, while those with high rates were marked as having an ineffective strategy
If the Department of Health Services wishes to determine whether hospitals or nursing homes have a more effective nosocomial infection prevention strategy, which of the following would be most appropriate? | null | 1 | Chi-squared test | One-way analysis of variance | Paired t-test | Pearson correlation | Social & Preventive Medicine | null | cb9e6fa9-2513-4f16-98d1-72f9dd62edf6 | multi |
All of the following are features of splenic rupture on plain X-ra3, abdomen except: | Ans. Obliteration of colonic air hubble | 3 | Obliteration of psoas shadow | Obliteration of splenic outline | Obliteration of colonic air hubble | Elevation of left hemidiaphragm | Radiology | null | b0950f33-a52d-43a5-a3a2-11c02834341e | multi |
Most common organism implicated in causation of necrotizing fascitis: | Streptococcus pyogenes | 2 | Staphylococcus aureus | Streptococcus pyogenes | Clostridium perfringens | Pneumococcus | Microbiology | null | bafcd3fb-ab46-4f94-b568-842a891aa617 | single |
Stature of an unknown person can be found out from long bones, by applying all the following formulas except | Hasses rule is for foetus age determination based on length . HASSE'S RULE For the first 5 months of the foetus - Square root of the length of the foetus in cm gives its age in lunar months After 5 months - 1/5th of the length of the foetus in cm gives the age in lunar months Ref : Krishnan vij Textbook of Forensic medicine and Toxicology 5th edtion ; pg no - 389 | 3 | Trotter and Glesser | Karl Pearson | Haase | Dupeuis and Hadden | Forensic Medicine | All India exam | 3025b9c9-8a7a-452a-8b51-e77250b51c87 | multi |
Pediatric fracture of mandible pattern is typically seen as: | A high tooth-to-bone ratio exists in the pediatric bone. Fractures frequently occur through developing tooth crypts, giving a zig-zag appearance of fracture line. | 3 | Downwards and forwards. | Downwards and backwards. | Zig zag pattern due to presence of tooth buds. | Comminuted fractures. | Surgery | null | 111693e4-7edb-4bba-98e0-b9b8021e6910 | multi |
Node of Ranvier is seen in | A cross-section of a typical small nerve has many large nerve fibers that constitute most of the cross-sectional area. However, a more careful look revealsmany more small fibers lying between the large ones. The large fibers are myelinated, and the small ones are unmyelinated. The average nerve trunk contains about twice asmany unmyelinated fibers as myelinated fibers. The central core of the fiber is the axon, and the membrane of the axon is the membrane that actually conducts the action potential. The axon is filled in its center with axoplasm, which is a viscid intracellular fluid. Surrounding the axon is a myelin sheath that is often much thicker than the axon itself. About once every 1 to 3 millimeters along the length of the myelin sheath is a node of Ranvier. The myelin sheath is deposited around the axon by Schwann cells in the following manner: The membrane of a Schwann cell first envelops the axon. The Schwann cellthen rotates around the axon many times, laying down multiple layers of Schwann cell membrane containing the lipid substance sphingomyelin. This substance is an excellent electrical insulator that decreases ion flow through the membrane about 5000-fold. At the juncture between each two successive Schwann cells along the axon, a small uninsulated area only 2 to 3 micrometers in length remains where ions still can flow with ease through the axon membrane between the extracellular fluid and the intracellular fluid inside the axon. This area is called the node of Ranvier.Ref: Guyton and Hall textbook medical physiology, 13th edition. | 3 | Cell body | Dendrites | Axons | Terminal butons | Physiology | Nervous system | 4e96a28e-a5e0-49a5-9b41-f93a08586580 | single |
Which one of the following test is used to detect malingering - | Malingering/Nonorganic hearing loss (also called pseudohypacusis)
Ocassionally patients wilfully or subconsciously exaggerate their hearing loss.
This is functional hearing loss or pseudohypacusis or malingering
– The signs in the test behavior that suggest functional component include:
a. Inconsistent responses
b. Significant differences between the threshold obtained using ascending and descending administration of test stimuli
c. A discrepancy of > 8 dB between the SRT (speech reception threshold) and the pure tone average of 500–2000 Hz
d. Positive Stenger test
Stenger Test
It is used to identify unilateral or asymmetrical functional hearing loss. It is based on the concept that when both ears are stimulated simultaneously by a tone equal in frequency and phase, the auditory percept is lateralized to the ear with better hearing.
If speech stimulus is used in Strenger test it is k/a Speech Stenger test or modified Stenger test.
Other objective tests which can diagnose functional involvement are:
––acoustic reflexes: Pt saying hearing loss but normal acoustic reflex indicates NOHL
––auditory brainstem response
––otoacoustic emission
Also Know
Other tuning fork tests which can be used to detect malingering but are now outdated are:
Teel’s test
Lombard’s test
Chamini-Moos test
Gault test | 1 | Stenger's test | Buinge's test | Weber 's test | Rinne's test | ENT | null | f1c81b43-99ef-4eca-87a4-e4b45eef4798 | single |
The thick filament is made up of Heavy chain of myosin Light chain of myosin Dystrophin Titin | The thick filament or the myosin is made up of the heavy chain of myosin and light chain of myosin The myosin molecule is composed of six polypeptide chains- Two heavy chains, each with a molecular weight of about 200,000 and four light chains with molecular weights of about 20,000 each. The two heavy chains wrap spirally around each other to form helix, which is called the tail of the myosin molecule. One each end of these chains is folded into a globular polypeptide structure called myosin head. These heads contain an actin-binding site and a catalytic site that hydrolyses ATP. Thus, there are two free heads at one end of the double-helix myosin molecule. The four light chains are also pa of the myosin head, two to each head. These light chains help control the function of the head during muscle contraction. Ref: Guyton and Hall Textbook of Medical Physiology 13th edition Pgno: 78-79 | 3 | 1, 3, and 4 | 2, 3 and 4 | 1 and 2 | 3 and 4 | Physiology | General physiology | 2373fcae-6c51-4afb-92c7-574f70259807 | single |
Megaloblastic anemia is caused by - | Ans. is 'a' i.e., PhenytoinSome important drugs causing megaloblastic anaemiao Methotrexateo Phenytoino Cytosine arabinosideo Phenobarbitoneo Pentamidineo Pyrimethamineo Zidovudineo 5-Fluorouracilo Sulfasalazineo Triamtereneo Primidoneo Trimethoprimo Azathioprine | 1 | Phenytoin | Lithium | Lead | Chloroquine | Pharmacology | Adverse Drug Effect | 342b67bf-2129-4bf8-8540-93deab81ccaf | single |
Endometriosis is common in : | Nullipara | 3 | Multiple | Peri menopausal age | Nullipara | Virgins | Gynaecology & Obstetrics | null | a025385d-fb73-428d-adb0-3f820cba2454 | single |
A 70-year-old female patient was readmitted to a local hospital with fever and chills following cardiac surgery at a major teaching institution. Blood cultures were taken and a Gram-positive coccus grew from the blood cultures within 24 hours. Initial tests indicated that this isolate was resistant to penicillin. The most likely identification is | Enterococci causes a wide variety of infections ranging from less serious, for example, urinary tract infections, to very serious, such as septicemia. A Gram-positive coccus resistant to penicillin must be assumed to be enterococcus until other more definitive biochemical testing places the isolate in one of the more esoteric groups of Gram-positive cocci. Once isolated, there are a variety of tests to speciate enterococci. However, penicillin-resistant, non-b-lactamase-producing, vancomycin-resistant, Gram-positive cocci are most likely Enterococcus faecium. There are a variety of mechanisms for vancomycin resistance in E. faecium and they have been termed Van A, B, or C. These isolates have become one of the most feared nosocomial pathogens in the hospital environment. Unfounately, no approved antibiotics can successfully treat vancomycin-resistant enterococci (VRE), only some experimental antibiotics such as Synercid. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | 4 | image_question | image_question | image_question | image_question | Microbiology | Bacteriology | a15da526-c1cc-4933-a4a2-54cbc36f7211 | single |
A girl falls in love with a film star & believes that he also loves her. It is best exemplified by? | Ans. is 'c' i.e., Erotomania* Erotomania (Delusions of love): - False belief that another person is in love with one (commoner in woman). In one form, termed de clerambault sydrome, a woman (usually) believes that a man, frequently older and of higher status, is in love with her. Erotomania is seen in Schizophrenia, delusional disorders and bipolar maniaAbout other options* Persecutory delusions (paranoid): - There is false belief that one is being harmed, threatened, cheated, poisoned, harassed or spied on or is a victim of conspiracy to damage his reputation.* Grandiose delusion (expansive delusions): - False belief that one is exceptionally powerful, talented or important.* Nymphomania : - excess sexual desire in females | 3 | Persecutory delusion | Grandiose delusion | Erotomania | Nymphomania | Psychiatry | Miscellaneous | 72395e86-bd98-4e2b-8505-faa60b5d33a6 | multi |
What is the recommended drug for treatment of leptospirosis? | Penicillin is the drug of choice for treatment of leptospirosis. Tetracycline or doxycycline may also be used. Ref: Park 21st edition, page 267. | 1 | Penicillin | Tetracycline | Azithromycin | Erythromycin | Social & Preventive Medicine | null | dce8cce5-13b0-4d8d-9431-a4227a2a8456 | single |
All are true about ESBL except - | Ans. is 'd' i.e., 3rd and 4th generation sensitivity is must Penicillins were the earliest antibiotics to be developed.Penicillins and their related group of antibiotics were called b lactam antibiotics because they contained a four carbon ring called b lactam ring.Within a few years of introduction of penicillin, bacterias started acquiring resistance against penicillins by producing penicillinase.To overcome this problem penicillinase resistant penicillins came into picture.Shortly afterwards, the broad spectrum penicillin and first gene- ration cephalosporins were introduced.They remained first line antibiotics for several years.Over a period of time bacterias developed resistance even against these organisms by producing b lactamase.b lactamase are enzymes that break open the b lactam ring and deactivate the antibiotic.The b lactamases hydrolyze penicillins and narrow spectrum cephalo- sporin, such as cephalothin or cefazolin, and are resistant to them.To counteract the problems against b lactamases new classes of b lactams were developed. These are cephalosporins containing ox imino side chain e.g. ceftizoxime, cefotaxime, ceftazidime, ceftriaxone (broad spectrum cephalosporins).Consequently, when these ox imino side chain containing com- pounds were introduced they were effective against a broad group of otherwise resistant bacterias.b lactamases cannot hydrolyze higher generation cephalosporins with an ox imino side chain (cefotaxime, ceftizoxime, ceftazidime).But not long ago after these cephalosporins came into use strains of klebsiella pneumonia were discovered which were resistant even to ox imino containing cephalosporins e.g. (cefotaxime, ceftazidime, ceftriaxone)The mechanism of this resistance was production of extended spectrum b lactamase enzyme (ESBL).These bacterias are called ESBL bacteriasBacterias are classified as extended spectrum b lactamase (ESBL) producing bacteria, when a simple point mutation occurs in genes normally responsible for beta lactamase mediated resistance. The mutation usually responsible is (TEM).As a result of the mutation, organisms, are able to produce novel beta lactamases that can hydrolyze all the b lactam containing antibiotics which includes even the ox imino group containing cephalosporins (ceftizoxime, cefotaxime, ceftazidime, ceftriaxone), Aztreonam and all the older b lactam drugs.Because of their greatly extended substrate range these enzymes were called extended spectrum b lactamaseESBLS are capable of efficiently hydrolyzingPenicillinsNarrow spectrum cephalosporinsMany extended spectrum cephalosporinsOxyimino group containing cephalosporins (cefotaxime, ceftazidime)Monobactams (aztreonams)Beta lactamase inhibitors (clavulanic acid sulbactam)An important pointNone of the ESBLS described till to date are able to hydrolyze cephamycin or carbapenems (imipenem, meropenem)ESBL producing organisms are associated with gram negative bacterias and most of these organisms are in the family. Enterobacteriaceae and has been discovered in almost all members of the Enterobacteriaceae family.The Enterobacteriaceae species most commonly associated with ESBL are Klebsiella (Klebsiella pneumonia predominantly) and E. coli.Laboratory diagnosis of ESBLsDetection of bacterias expressing ESBL is difficult.Although a particular ESBL will typically confer resistance to at least one particular extended spectrum cephalosporin or aztreonam, the minimum inhibitory concentration may not be high enough for the strain to be called resistant under current interpretations of the national committee for clinical laboratory standards.Because of the clinical significance of ESBL a specific guideline for the detection of ESBL expressing organisms were proposed in 1999 by NCCLS.The presence of an ESBL is suggested if:-Bacterial growth is observed despite a concentration of 1 m g/ml of at least one of three extended spectrum cephalosporins (ceftazidime, ceftriaxone, cefotaxime) or Aztreonam or growth occurs despite a concentration of 4 m g/ml of cefpodoxime.Classification of b lactamaseThe number of b lactamase enzyme is continuously increasing at an alarming rate.Various classifications have been proposed for b lactamases.The earliest classification by sawai was based on Antisera.b lactamases have also been classified based on substrate profile, "correlation of substrate and inhibitory properties".A modern system of classification by ambler is based on the "molecular" structure.Recently a new classification system has been developed by Bush Jacoby medeiors to integrate functional and molecular characteristics. This scheme puts 178 b lactamases from naturally occurring bacterial isolates into four groups based on substrate and inhibitor profiles.Treatment of ESBL'SOf all the available b lactams carbapenems are the most effective and reliable as they are highly resistant to the hydrolytic activity of the b lactamase.None of the ESBLS described till to date are able to hydrolyze cephamycin or Carbapenem (imipenem,. meropenem) Meropenem is the most active with MIC generally lower than those of imipenem.Beta lactamase inhibitors (Clavulanic acid, sulbactam, Tazobactam)Although ESBL activity is inhibited by clavulanic acid the only infections that may be treated safely with b lactam /b lactamase inhibitor combinations are those involving the urinary tractIn this instance b lactamase inhibitor concentration is high enough to counteract the hydrolytic activity of ESBL's clavulanic acid appears more efficient than sulbactam (It takes about eight times more sulbactam to obtain a protection similar to that given by clavulanic acid).Non b lactam antibioticsNon b lactam antimicrobial agents (aminoglycosides, fluoro- quinolones) may be beneficial however, coresistance rates against these agents are frequent. | 4 | Sensitive to carbapenems | Ambler classification is based on molecular structure | Classification is based on 3rd g. cefalosporin sensivity | 3rd & 4* g. cefalosporin sensivity testing is must to confirm the ESBL | Pharmacology | D.O.C | 41d7713f-2a98-477f-9dc5-49ca2c1c521e | multi |
Most common symptom of posterior uveitis - | Posterior uveitis(choroiditis) is a painless condition,usually characterised by visual symptoms due to associated vitreous haze and involvement of the retina. | 4 | Pain | Photophobia | Lacrimation | Diminished vision | Ophthalmology | Uveal tract | ddbafd09-7344-4f74-a726-934e0b7a4bdd | single |
The enzyme used for the mapping of hypersensitive sites in recombinant DNA research is? | Ans. C. DNase Ia. DNA ligase is used for joining of DNA molecules.b. DNA polymerase I is used for synthesis of double stranded cDNA.c. Polynucleotide kinase is used for T-32 end labeling of DNA or RNA. | 3 | DNA ligase | DNA polymerase I | DNase I | Polynucleotide kinase | Biochemistry | Molecular Genetics | 2dd15eef-7099-4cf6-b99f-7b7322c84b41 | single |
As a general rule, veins carry | All veins carry deoxygenated blood from the body to the heart with the exception of the pulmonary vein
which carries oxygenated blood from the lungs to the heart. | 4 | Urine | Lymph fluid | Oxygenated blood | Deoxygenated blood | Pathology | null | 1130ac3f-006b-444a-8eec-5630f3350828 | single |
Which of the following is associated with Down syndrome: March 2010 | Ans. D: Decreased AFP level Alpha-fetoprotein is made in the pa of the womb called the yolk sac and in the fetal liver, and some amount of AFP gets into the mother's blood. In neural tube defects, the skin of the fetus is not intact and so larger amounts of AFP is measured in the mother's blood. In Down syndrome, the AFP is decreased in the mother's blood, presumably because the yolk sac and fetus are smaller than usual. Estriol is a hormone produced by the placenta, using ingredients made by the fetal liver and adrenal gland. Estriol is decreased in the Down syndrome pregnancy. This test may not be included in all screens, depending on the laboratory. Human chorionic gonadotropin hormone is produced by the placenta, and is used to test for the presence of pregnancy. A specific smaller pa of the hormone, called the beta subunit, is increased in Down syndrome pregnancies. Inhibin A is a protein secreted by the ovary, and is designed to inhibit the production of the hormone FSH by the pituitary gland. The level of inhibin A is increased in the blood of mothers of fetuses with Down syndrome. PAPP-A, which stands for pregnancy-associated plasma protein A, is produced by the covering of the newly feilized egg. In the first trimester, low levels of this protein are seen in Down syndrome pregnancies. It is impoant to keep in mind that even the best combination of ultrasound findings and other variables is only predictive and not diagnostic. For true diagnosis, the chromosomes of the fetus must be examined. Amniocentesis is usually carried out between the 14th and 18th week of pregnancy. CVS is usually carried out between the 10th and 12th weeks of pregnancy. | 4 | Raised PAPP-A level | Decresed beta-HCG level | Raised estriol level | Decreased AFP level | Pediatrics | null | 3d03c4a0-ca11-400c-a61c-4710d36867d5 | single |
Right anterior quadrant of the scalp is supplied by the following arteries EXCEPT | null | 4 | Right supra orbital artery | Right supra trochlear artery | Right superficial temporal artery | Right maxillary artery | Anatomy | null | 4e19b317-403e-4592-8575-8d222a8215fc | multi |
One of the following groups of enzymes does not exhibit stereospecificity | All enzymes (except isomerases) exhibit stereospecificity, that reacts only with one set of stereoisomers.Whereas isomerases conve substrate from one isomerase to another. Harper 30th edition pg: 60 | 2 | Oxidoreductases | Isomerases | Lyases | Transferases | Biochemistry | Enzymes | 03fa88dd-6887-445c-a283-5aa7bd49bd90 | single |
RDA cover of nutrient requirement of- | Ans. is 'c' i.e., 98% of individuals Recommended Dietary allowance (RDA) o Also know as recommended daily allowance. o The RDA is the average daily dietary intake level that is sufficient to meet the nutrient requirments of nearly all (97 to 98%) individuals in a life stage and gender group. o The RDA applies to individuals, not to groups. o The estimated average requirement (EAR) serves as the foundation for setting RDA. If the standard detion (SD) of the EAR is available and the requirement for the nutrient is normally distributed, the RDA is set at 2 SDs above the EAR. RDA EAR 4- 2 SDFAR Adequate intake (AD o The adequate intake is set instead of an RDA if sufficient scientific evidence is not available to calculate an EAR. o The AI is based on observed or experimentally determined estimates of average nutrient intake by a group (or groups) of healthy people. o For example. the "adequate intake" for young infants for whom human milk is the recommended sole source of food for the first 4 to 6 months, is based on the estimated daily mean nutrient intake supplied by human milk for healthy, full term infants who are exclusively breastfed. RIM Vs Adequate intakes (Al) Although RDA and Al are used for the same purpose - setting goals for intake by individuals - The RDA differs from the Al. RDA is expected to meet the needs of 97 to 98% of the individuals, while it is not known what percentage of individuals arc covered by the adequate intake. o The adequate intake does not bear a consistent relationship to the EAR or the RDA because it is set without being able to estimate the average requirement. It is assumed that adequate intake is at or above the RDA if one could be calculated. o The adequate intake for a nutrient is expected to exceed the average requirement for that nutrient, and it should cover the needs for more than 98% of the individuals, but it might cover the needs of far fewer. o The degree to which adequate intake exceeds the average requirements is likely to differ among nutrients and population groups. For people with diseases that increases requirements or who have other special health needs, the RDA and adequate intake may serve as the basis for adjusting individual recommendations, qualified health professionals should adapt the recommended intake to cover the higher or lower needs. Tolerable upper intake level (UL) : - The highest average daily nutrient intake level that is likely to pose no risk of adverse health effects for almost all individuals in the general population. As intake increases above UL, the potential risk of adverse effect increases. | 3 | 50% of individuals | 75% of individuals | 98% of individuals | Same as adequate intake | Social & Preventive Medicine | null | 11bc5e56-5033-42bf-98f5-f01c744511a1 | single |
Sandfly transmitts which disease- | Ans. is 'd' i.e., All of the above Diseases transmitted by sandflyo Kala-azaro Sand-fly fevero Oriental soreo Oraya fever | 4 | Oraya fever | Oriental sore | Kala-azar | All of the above | Microbiology | Arthropod born diseases | a6151ab4-b5e5-4778-bba9-2a6515b1e1be | multi |
H pylori causes all except | Infection with H. pylori plays a key pathogenic role and the infection has been classified by the International Agency for Research on Cancer (IARC) as a definite human carcinogen. It is associated with chronic atrophic gastritis, gastric mucosal atrophy and gastric cancer . It has been estimated that H. pylori infection may contribute to the occurrence of gastric cancer in 70% of cases. Although the majority of H. pylori-infected individuals have normal or increased acid secretion, a few become hypo- or achlorhydric and these people are thought to be at greatest risk. H. pylori-induced chronic inflammation with generation of reactive oxygen species and depletion of the normally abundant antioxidant ascorbic acid are also impoant. There is strong evidence that H. pylori eradication, especially if achieved before irreversible pre-neoplastic changes (atrophy and intestinal metaplasia) have developed, reduces the risk of cancer development in high-risk populations and is cost-effective. Diets rich in salted, smoked or pickled foods and the consumption of nitrites and nitrates may increase cancer risk. Carcinogenic N-nitroso-compounds are formed from nitrates by the action of nitrite-reducing bacteria that colonise the achlorhydric stomach. Diets lacking in fresh fruit and vegetables, as well as vitamins C and A, may also contribute. . No predominant genetic abnormality has been identified, although cancer risk is increased two- to threefold in first-degree relatives of patients, and links with blood group A have been repoed. Some host genetic factors related to inflammatory genes and prostate stem cell antigen have recently been associated with increased risk of gastric caner. Rarely, gastric cancer may be inherited in an autosomal dominant manner in association with mutations of the E-cadherin (CDH1) gene. H pylori infection also causes peptic ulcer,maltoma, gastric lymphomas Ref Davidson edition23rd pg782 | 3 | Peptic ulcer | Maltoma | Carcinoid tumor | Gastric carcinoma | Medicine | G.I.T | 26536f95-d092-46f6-a732-77e503067488 | multi |
Investigation of choice for diagnosis of splenic rupture – | "CT has become the gold standard for the assessment of abdominal trauma particularly solid parenchymal injury". | 3 | Peritoneal lavage | Ultrasound | CT scan | MRI | Radiology | null | 9af5809d-a617-49a5-a9d8-526611306970 | single |
True about shunt vessels | Shunt vessels are sho, low resistance connection between aerioles and veins,allowing blood to bypass capillaries in ceain areas These vessels are especially found in skin of finger, toes, and earlobes where they play a major role in thermoregulation Ref: Medical Physiology Indu Khurana 2015 edition, Page No:237 Shunt vessels can control blood flow by constriction and dilatation . In endotherms the shunt vessels dialate in response to cold,this cause more heat to be carried by blood to the skin where it can be lost to the air and preventing heat loss through the skin once body temperature has returned to normal. | 3 | Evenly distributed throughout the skin | Role in nutrition | Play a role in thermoregulation | No autonomic nervous regulation | Physiology | Cardiovascular system | a3b9f641-7e52-4ce3-bf7c-56d35d4ae9ed | multi |
All of the following may be present in Duane&;s retraction syndrome except | RESTRICTIVE SQUINT Duane's retraction syndrome : It is a congenital ocular motility defect occurring due to fibrous tightening of lateral or medial or both rectus muscles. Its features are: 1) Limitation of abduction (type I) or adduction (type II) or both (type III). 2) Retraction of the globe and narrowing of the palpebral fissure on attempted adduction. 3) Eye in the primary position may be ohotropic, esotropic or exotropic. Ref:- A K KHURANA; pg num:-335 | 3 | Suppression | Head turn | Narrowing of palpebral apeure in abduction | Limitation of abduction | Ophthalmology | Ocular motility and squint | 502172e8-f88a-45a1-a688-37e63230d513 | multi |
Fracture of talus without displacement in x-ray would lead to -a) Osteoarthritis of ankleb) Osteonecrosis of head of talusc) Avascular necrosis of body of talusd) Avascular necrosis of neck of taluse) Non union | Complicatiosn of Talar neck fracture
Malunion
Avascular necrosis (osteonecrosis) of body.
Non-union
Secondary osteoarthritis of ankle and subtalar joint. | 1 | ac | bc | ad | b | Orthopaedics | null | 7e713303-4b10-4822-88bd-5f7c19c1e07c | single |
Chelating agent used in mercury poisoning is - | Ans. is 'd' i.e., BAL Use of different chelating agentsDimercaprol (BAL)o Poisoning by As, Hg, Au, Bi, Ni, Sbo As an adjuvant to EDTA in lead poisoningo As an adjuvant to penicillamine in Cuo Contraindicated in iron and cadmium poisoning.Calcium disodium edetate (Ca Na,EDTA)o Lead poisoningo Also used in Zn, Cd, Mn, Cu, Fe poisoningo Mot used in mercury poisoningDesferrioxamine (obtained from an actinomycete)o Acute iron poisoningo Transfusion siderosiso Available only in injectable formPenicillamineo Wilson's disease (Hepatolenticular degeneration)o Copper/mercury poisoningo Chronic lead poisoningo Cystinuria and cystine stoneso Sclerodermao RADeferiproneo Acute iron poisoningo Iron load in liver cirrhosiso Both oral and injectable preparation available | 4 | Calcium disodium edetate | Desferrioxamine | Penicillamine | BAL | Unknown | null | d2261cdf-564b-4b53-bce6-e379a650bb5d | single |
Drug used in irritable bowel syndrome with constipation is | -Lubiprostone acts by stimulating Cl- channel opening in the intestine, increasing liquid secretion in gut and decreasing transit time, therefore used for chronic constipation. -It has also been approved for constipation dominant irritable bowel syndrome in women. -Irritable bowel syndrome is a condition characterized by abdominal pain, bloating and altered bowel habits (diarrhea or constipation) For diarrhea dominant IBS, drugs that can be used are Loperamide or diphenoxylate New kappa opioid receptor antagonist- Fedotozine Reserpine analog - Mebeverine 5 HT3 antagonist - Alosetron (also reduces pain) Clonidine (also reduces distension induced pain ) For constipation dominant IBS, drugs effective are 5 HT4 agonists (tegaserod, prucalopride) Loxiglumide Lubiprostone Plecanatide | 1 | Lubiprostone | Loperamide | Alosetron | Clonidine | Pharmacology | Gastro-Intestinal Tract | e5f159bf-3ec9-4ba9-8c0e-de8ff0df4fed | single |
Which of the following malignancy is MOST sensitive to radiotherapy? | Dysgerminomas are usually unilateral and are the most common type of germ cell tumor seen in patients with gonadal dysgenesis. They are highly radiosensitive and chemosensitive. Serous cystadenoma is the most common epithelial cell neoplasm. 70% of these tumors are benign and surgery is the treatment of choice. Mucinous cystadenoma is the second most common epithelial cell tumor of the ovary. Surgery is the treatment of choice. Cystic teratoma: comprise approximately 10 to 25 percent of all ovarian neoplasms and 60 percent of all benign ovarian neoplasms. Surgical excision is the treatment of choice. Ref: Obstetrics and Gynecology By Charles R. B. Beckmann page 443. | 2 | Serous cystadenoma | Dysgerminoma | Mucinous cystadenoma | Teratoma | Gynaecology & Obstetrics | null | 9fcc4663-56b6-4a6e-a535-caf7b16d65db | single |
An epidemiologic study evaluates the rate of dental caries and tooth abscesses among children living in communities within a metropolitan area. Investigators discover that the rate is high among children living in an upper-middle-class community but low in children living in a community below the poverty level. The levels of trace elements in the water supplies for those communities are measured. A higher level of which of the following minerals in the water is most likely to be associated with a lower rate of dental decay among the children living in the poor community? | Water in some areas naturally contains fluoride, and dental problems in children are fewer in these areas because tooth enamel is strengthened. Fluoride can be added to drinking water, but opposition to this practice, from ignorance or fear, is common. Copper deficiency can produce neurologic defects. Iodine deficiency can predispose to thyroid goiter. Selenium is a trace mineral that forms a component of glutathione peroxidase; deficiency may be associated with myopathy and heart disease. Serious illnesses from trace element deficiencies are rare. Zinc is a trace mineral that aids in wound healing; a deficiency state can lead to stunted growth in children and a vesicular, erythematous rash. | 2 | Copper | Fluoride | Iodine | Selenium | Pathology | Environment & Nutritional Pathology | cd6ef7dd-345d-44f7-8c57-193e747f7bb1 | single |
The diagnosis of gout is best established by the presence of | Gout / Hyperuricemia Gout refers to the disease that occurs in response to the presence of monosodium urate (MSU) crystals in joints, bones, and soft tissues.Causes of GoutIncreased productionDecreased renal excretionHypoxanthine-guanine phosphoribosyltransferase (HGP) deficiencyPhosphoribosylpyrophosphate (PRPP) synthetase overactivityGlucose -6-phosphatase deficiencyMyeloproliferative disorderLymphoproliferative disorderMalignanciesHemolytic disorderPsoriasisObesityEthanol abuseExcessive dietary purine ingestionCytotoxic drugsInherited isolated renal tubular defectRenal failureLead poisoningDiabetic ketoacidosisLactic acidosisHypothyroidismDrugs- thiazides, pyrazinamide, cyclosporineClinical featuresDiagnosisAcute gout -ahritis ( MP joint of big toe), bursitis (olecranon bursa )Chronic gout - increase in frequency of acute gouty attacksTophi - collection of solid urate in connective tissues, irregular firm painless nontender nodules on extensor surfaces of finger, hand, and elbow.Polarizing microscopy - identification of monosodium urate crystals Histology - birefringent urate crystals on biopsy Elevated uric acid levels24-hour urinary uric acid excretion Radiology - narrowing of joint space, sclerosis, cysts, osteophytes & calcified tophi.Treatment:Acute attack - NSAIDsChronic stage - Allopurinol, Probenecid, benzbromarone Definitive diagnosis of gout requires aspiration of the involved joint and demonstration of intracellular monosodium urate crystals in synol fluid. Under polarized light, these are demonstrated as "strongly negative birefringent needle-shaped crystals."(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2836-2839) | 2 | Synol uric add crystals | Intracellular uric acid crystals | Elevated serum uric acid | Involvement of the first metatarsal phalangeal joint | Medicine | All India exam | 0f3af128-25e2-4000-8ad7-1b3078efe483 | single |
Obesity indices are - | Body mass index(quetelet&;s index) Ponderal index Broca index Lorentz&;sformula Corpulence index. Among these BMI and Broca index are widely used. BMI is used an index for obesity. Ref- Park&;s textbook of Preventive and Social Medicine 24th edition. | 1 | Broca's index | Ponderal index | Quetelet index | Corpulence index | Social & Preventive Medicine | Non communicable diseases | b8d695f8-fee7-4700-87e5-de58da4a31ce | single |
Organised glomemler deposits in kidney is present in- | Ans. is 'c' i.e., IgA NephropathyOrganized glomerular deposits are seen in : Mesangial proliferative GN Memranous GN Membranoproliferative GNo IgA nephropathy is a type of mesangioproliferative GN. | 3 | Amyloidosis | Diabetes millitus | IgA nephropathy | Cry oglobulinemia | Pathology | null | a6d6e5e5-d124-4b67-aa49-c20498776f74 | single |
Drug of choice for severe Falciparum malaria in pregnancy is: | As Artemesinin compunds are contraindicated in pregnancy, Quinine is used for severe Falciparum malaria. | 4 | Aresunate | Artemether | Chloroquine | Quinine | Pharmacology | null | e899ec1b-56b3-4f27-b8f6-1fa8ebef77bc | single |
A 37-yrs-old man in DKA has yellowish papules scattered over his trunk and extremities. A tube of plasma that is collected from the patient develops a turbid supernate. This is consistent with which type of hyperlipoproteinemia? | The patient most likely has a type V hyperlipoproteinemia, which is associated with eruptive xanthomas secondary to increased triacylglycerol. Type V hyperlipoproteinemia is a combination of type I, characterized by elevated chylomicrons, and type IV, characterized by increased very-low-density lipoproteins (VLDL). Diabetic ketoacidosis and alcoholism are two of the most common factors that promote type V hyperlipoproteinemia. The absence of insulin characteristic of diabetic ketoacidosis decreases capillary lipoprotein lipase activity, so neither chylomicrons nor VLDL are properly metabolized in the liver. The increased triacylglycerol concentration that results from the accumulation of chylomicrons and VLDL in the blood produces a turbid specimen. Because chylomicrons have the lowest density, they form a turbid supranate in plasma left at 4°C overnight. The density of VLDL is slightly higher than that of chylomicrons, so it forms a turbid infranate. Presence of a supranate and infranate, as in this case, indicates type V hyperlipoproteinemia. A supranate without an infranate occurs in type I hyperlipoproteinemia, and an infranate without a supranate occurs in type IV hyperlipoproteinemia. Another feature of type V disease is hyperchylomicronemia. Clinical features include eruptive xanthomas caused by the deposition of triacylglycerol in the subcutaneous tissue. Once the triacylglycerol concentration is reduced, the xanthomas disappear. | 4 | Type I | Type II | Type III | Type V | Unknown | null | a50748bd-c510-44a1-ac54-96cc82b7ed59 | single |
Radiation exposure during infancy has been linked to | Ans. (c) ThyroidRef: Robbin's pathology 9th ed. /109* The most radio-sensitive organ sites in children in the order of sensitivity are thyroid, breasts, bone marrow and brain.* Exposure to ionizing radiation in first 2 decades predisposes a person for development of papillary CA. | 3 | Breast | Melanoma | Thyroid | Lung | Pathology | Etiology: Carcinogenic Agents | edca7269-11e7-4fe8-8130-f784cd61acad | single |
Chemical labyrinthectomy by transtympanic route is done in Meniere's disease using which drug- | Ans. is 'b' i.e., Gentamicin o Has been explained in previous sessions. | 2 | Amikacin | Gentamicin | Amoxycillin | Cyclosporine | ENT | Menier's Disease | a41db06b-1ebb-4e2e-824e-f1a62f7e996d | single |
True statements regarding Depolarizing muscle relaxant are all EXCEPT: March 2013 (a) | Ans. C i.e. Reversed by neostigmine Muscle relaxants Depolarizing muscle relaxants (Succinylcholine): - Usually sho acting, - No tetanic fade, - No post tetanic facilitation Non-depolarizing muscle relaxant (Mivacurium): Post tetanic facilitation seen, - Diaphragm is resistant to non-depolarizing agents, - Train of four fade present - Muscle fasciculation absent | 3 | Cause muscle fasciculation | No fade | Reversed by neostigmine | No post tetanic facilitation | Anaesthesia | null | 78a66891-c22f-45e8-b7c2-c2b3ddcbed3f | multi |
Which of the following statements best describes 'Background Radiation'? | Background radiation refers to those coming from the environment of natural radioactivity at the eahs surface and the those from direct cosmic radiation that arrives at the eahs surface. Ref: Radiation Biophysics By Edward L. Alpen, Page 432; The Biological Basis of Nursing : Cancer By William T. Blows, Page 54, 56 | 3 | Radiation in the background of nuclear reactors | Radiation in the background during radiological investigations | Radiation present constantly from natural sources | Radiation from nuclear fall out | Radiology | null | b9cf5f1c-d8f8-48f0-bed3-d12554934917 | multi |
Umbilical cord has ____________ | Umbilical cord contain two aeries & one vein. Ref : Ghai essential of pediatrics, 19th edition, p.no402 ; Davidson principal and practice of internal medicine, 22nd edition, p.no:630 | 1 | 1 vein and 2 aeries | 2 vein and 2 aeries | 1 vein and 1 aery | 2 veins and 1 aery | Pediatrics | C.V.S | c973957e-8a58-42c7-9ed0-07ddafc05069 | single |
All of following are true about measles except- | <p>MEASLES:- An acute highly infectious disease of childhood caused by a specific virus of group myxovirus. Clinically characterised by fever and catarrhal symptoms of the upper respiratory tract( coryza,cough), followed by a typical rash. Incubation period-10 days from exposure to onset of fever and 14 days of appearance of rash. Secondary attack rate-infection confers life long immunity as there is only one antigenic type. Vaccine- live attenuated subcutaneous vaccine. Age-before 9 months.The age can be lowered to 6 months if there is measles outbreak in community.For infants immunised between 6 and 9 months,second dose administered as soon as possible after the child reaches 9 months provided that at least 4 weeks have elapsed since the last dose. Route-subcutaneous/intramuscular. {Reference: park&;s textbook of preventive and social medicine, 23rd edition, pg no.149}</p> | 3 | Maximum incidence in 6m - 3 year age group | Best age for immunization is 9-12 months | Secondary attack rate is 30% | I.P= 7-14 days | Social & Preventive Medicine | Communicable diseases | e88a3e19-4037-4cce-a0f0-493536f85f50 | multi |
Which of the following is not a large vessel vasculitiis ? | Ans. is 'c' i.e., Churg strauss syndrome | 3 | Takayasu aeritis | Cogan syndrome | Chrug strauss syndrome | Giant cell aeritis | Pathology | null | 425e336f-37e3-4677-bd84-1f998339d263 | single |
Solid and largest lymphatic organ of the body is | (A) Spleen# Largest lymphatic organ in the human body is the spleen.> Primary function of the spleen is to purify the blood and store blood cells. It helps the immune system identify and combat foreign antibodies.> The spleen consists of white pulp and red pulp. The white pulp generates blood cells and synthesizes antibodies, and the red pulp removes old blood cells and filters the blood. | 1 | Spleen | Thymus | Lymph node | Liver | Anatomy | Misc. | 41585522-f8c5-4f30-b48e-a37af93c0819 | single |
False regarding Health For All by 2000 A.D is - | Foremost among the goals to be achieved by 2000 AD were Reduction of infant moality from the level of 125 to below 60 To raise the expectation of life at bih from the level of 52 years to 64 To reduce the crude death rate from the level of 14 per 1000 population to 9 per 1000 To reduce crude bih rate from the level of 33 per 1000 population to 21 To achieve a net reproduction rate of 1 To provide poable water to entire rural population (refer pgno:893 park 23rd edition) | 1 | All people will be healthy by 2000 A.D | All people are accessible to health care services | All will have socially and economically productive life | Equal health status for people and countries | Social & Preventive Medicine | Health care of community & international health | 24313fed-2bff-4c8d-955a-6016eb59a411 | multi |
All of _the following may be seen in patient of cardiac tamponade exceptAll of _the following may be seen in patient of cardiac tamponade except- | Kussmaul sign is a paradoxical rise in jugular venous pressure (JVP) on inspiration, or a failure in the appropriate fall of the JVP with inspiration. It can be seen in some forms of hea disease and is usually indicative of limited right ventricular filling due to right hea dysfunction Ref Harrison 20th edition pg 1456 | 1 | Kussmaul's sign | Pulsus paradoxus | Electriciaalten alternans | Right ventricular diastolic collapse on echocardiogram | Medicine | C.V.S | 87390311-9c5b-4cc2-b63e-4b87f3589b2b | multi |
True about mummification is: | D i.e. All of above Mummification is dessication/ dehydration or drying & shriveling of body tissue & viscera after death.Q Mummification is drying or dehydrationQ of cadaver & is modification of putrefactionQ. In which body features and appearances are preservedQ but face is greatly distoedQ High temperature, dry (devoid of moisture) environment with free circulation of airQ are ideal conditions for mummification. | 4 | External features are preserved | High atmospheric temperature is needed for | Occurs in dry air | All of the above | Forensic Medicine | null | 62246d1f-3284-4972-9e2c-17e603fc9566 | multi |
Gynaecomastia and infertility is caused by? | ANSWER: (B) CimetidineREF: APPENDIX-39 below for "DRUGS CAUSING GYNAECOMASTIA"Repeat Pharmacology 2013 Session 2Indirect repeat Pharmacology 2012 Session II, 2006 APPENDIX - 39Causes Of Gynecomastia:IdiopathicDrugs (partial list)Physiologic causesNeonatal periodPubertyAgingObesityAlcoholAlkylating agentsAmiodaroneAnabolic steroidsAndrogensBicalutamideBusulfanChorionic gonadotropinCimetidineCiomipheneCyclophosphamideDiazepamDiethylstilboestro!Digitalis preparationsEstrogens (oral or topical)EthionamideFinasterideFlutamideGoserelinHAARTHaloperidolHydroxyzineIsoniazidKetoconazoleLeuprolideMarijuanaMethadoneMethyldopaMetoclopramideOmeprazoleOpioidsPenicillaminePhenothiazinesProgestinsProtease inhibitorsReserpineRisperidoneSomatropin (growth hormone)SpironolactoneTestosteroneThioridazineTricyclic antidepressants | 2 | Flutamide | Cimetidine | Ranitidine | Methotrexate | Pharmacology | Adverse Drug Effect | a873ee82-b46b-492e-b623-d4ca72682332 | single |
Exfoliative cytology is useful in | Ans. is 'd' i.e., All of the above Exfoliative cytology is used for ? Cervical Ca. 3. Bronchogenic Ca. 5. Prostatic Ca. Endometrial Ca. 4. Bladder Ca. 6. Stomach Ca. | 4 | Carcinoma stomach | Carcinoma bronchus | Carcinoma cervix | All of the above | Pathology | null | 131942a7-80f8-46b5-8ef3-85fc5c91e334 | multi |
Transvestism is : | A i.e. Wearing clothes of opposite sex | 1 | Wearing clothes of opposite sex | Touching ones own private pas to others | Desire for sexual intercourse with dead bodies | Orgasm from visualisation pa of the body of a woman | Psychiatry | null | ecf6f648-4e63-4ba7-b375-d3f4c8ca6e2b | single |
Apixaban is a new drug that acts by | Rivaroxaban and Apixaban are newer oral anticoagulants that act by inhibiting factor Xa. Newer oral anticoagulants that are currently being asked in the exams are: Direct thrombin inhibitor- Dabigatran Direct factor Xa inhibitors Apixaban Rivaroxaban Edoxaban Betrixaban | 2 | Inhibiting TNF alpha | Inhibiting coagulation factor Xa | Inhibiting platelet aggregation | Activating plasminogen | Pharmacology | Hematology | 6741fb1f-da35-472b-b6e8-baf898663b9d | single |
A child presents with acute diarrhea with signs of dehydration; On investigation, Na+ 125 mEq/L, K+ 3 meq/L, HCO3- 16 mEq/L and pH is 7.23. IV Fluid to be given is? | * Hyponatremic dehydration is treated by correction of intravascular volume with isotonic fluid (NS or LR). * An overly rapid (>12 mEq/L over the first 24 hr) or overcorrection of serum sodium concentration (>135 mEq/L) is associated with an increased risk of central pontine myelinolysis. | 1 | Normal saline | 3% saline | N/2 saline + 10% dextrose | N/3 saline + 5% dextrose | Pediatrics | Disorders of Gastrointestinal System Including Diarrhea | be987604-79fd-4499-b753-4eac67f3ab2c | single |
Iron requirement in lactating mother is: | Ref: Park s Textbook of Preventive and Social Medicine, 22nd edition. Pages 578,590Explanation:"The ICMR recommended daily allowance (RDA) for Iron is 38 mg/day during pregnancy and 30 mg/ day during lactation." (ICMR - Old Guideline)IRON REQUIREMENT DURING LACTATIONThere is no increase in iron requirement during lactation.Older ICMR guideline prescribed 30 mg/day.There is no additional tissue growth, so no additional need for iron.NOTEAs per recent ICMR guidelines (2010) Indian pregnant women needs 35 mg/day.Non pregnant women needs 21 mg/day.During lactation, 21 mg/day which is equal to pre-pregnancy requirement.During infancy iron requirement is fully met if baby is breastfed.Iron requirement in Indian Men - 17 mg/day. Iron Requirement Recent ICMR guidelines (2010)Iron Requirement ICMR (2M0M>ldMen17 mg/day28 mg/dayWomen-Non pregnant21 mg/day30 mg/dayPregnancy35 mg/day38 mg/dayLactation21 mg/dav30 mg/day | 1 | 30 mg/day | 34 mg/day | 36 mg/day | 38 mg/day | Social & Preventive Medicine | Nutrition and Health | 8a9efb57-c3c6-43aa-9d15-6b56667ab4f5 | single |
Seibert’s class IV defect is | Seibert’s Classification
Class 0 defects- no defect
Class I defects- faciolingual loss of tissue width with normal ridge height.
Class II defects- loss of ridge height with normal ridge width.
Class III defects- a combination of loss in both dimensions. | 4 | Faciolingual loss of tissues with normal ridge height | Normal ridge width with loss of ridge height | Loss of height and width | None of the above | Dental | null | 80cd973a-8998-4f3d-ba13-c5f2177c034c | multi |
What is the power of a lens if the focal length is 0.75 m? | ANSWER: (A) 1.3 DREF: Khurana 4th Ed Pg 23The focal length (f) of a lens is the distance between the optical centre and the principal focus.Power of a lens (P) is defined as the ability of the lens to converge a beam of light falling on the lens. For a converging (convex) lens the power is taken as positive and for a diverging (concave) lens power is taken as negative.It is measured as reciprocal of the focal length in metres i.e. P = 1/f.The unit of power is dioptre (D). One dioptre is the power of a lens of focal length one metre.Hence, substituting in the formula, P=l/0.75 = 1,3 D | 1 | 1.3 D | 2.3 D | 3.3 | 4.3 D | Ophthalmology | Elementary Optics | 7a20cf92-9b6d-4582-82a2-8a7965d98503 | single |
Reaction occuring in conversion of norepinephrine to epinephrine? | Ans. D. Methylation | 4 | Hydroxylation | Oxidation | Glucuronidation | Methylation | Biochemistry | null | aa569ee4-969e-4b2e-9b10-c4900a873447 | single |
. In case of pelvic fracture with urethral injury, the most important first step in management is- | null | 3 | Repair in injured urethra | Fixation of pelvic fracture | Treatment of shock and haemorrhage | Splinting urethra with catheters | Surgery | null | 37f827c3-3ab6-425a-90e1-29642013ad66 | multi |
Most commonly used vector for DNA cloning ? | A cloning vector is a carrier DNA molecule to which human DNA fragment is attached. Normally, foreign DNA fragments cannot self-replicate within host cell. Therefore, they are joined to a vector DNA, that can replicate within host cell.The five major types of cloning vectors used are -i) Plasmidsii) Viral vectors/Bacteriophagesiii) Cosmidsiv) Bacterial Aificial Chromosomes (BACs)v) Yeast aificial chromosomes (YACs) | 1 | Plasmid | Virus | Cosmid | Phage | Biochemistry | null | 097eb4b5-86b9-48f3-9f4d-30cb51e3697e | single |
Pedophile is having anal intercourse with : | B i.e. Children | 2 | Older women | Children | Homosexual adult | Hijra | Forensic Medicine | null | 572fa0e2-8103-4251-bc5a-65c33534629b | single |
A young person presents with self mutilating behaviour and impulsivity. What is he most likely suffering from? | The primary features of borderline personality disorder (BPD) are unstable interpersonal relationships, affective distress, marked impulsivity, and unstable self-image. Individuals with BPD tend to experience frequent, strong and long-lasting states of aversive tension, often triggered by perceived rejection, being alone or perceived failure. They may show changeability between anger and anxiety or between depression and anxietyand temperamental sensitivity to emotional stimuli. The negative emotional states specific to BPD fall into four categories: destructive or self-destructive feelings; extreme feelings in general; feelings of fragmentation or lack of identity; and feelings of victimization. | 2 | Dependent personality disorder | Borderline personality disorder | Adjustment disorder | Paranoid personality disorder | Psychiatry | null | c6b2a296-9253-4903-b67b-a0eaa1a03df1 | single |
A woman complains of excessive vomiting and mild vaginal bleeding for two weeks at a POA of 12 weeks. The fundal height corresponds of 16 weeks. The cervical os is closed. Ultrasound scan demonstrates a snowstorm appearance in part of the uterus together with a foetus. The crown-rump length corresponds to 10 weeks. The fetal heart beat is absent. What is the best management option? | Ans. is c, i.e. Perform suction evacuationSuction evacuation is the method of choice, for evacuation of a partial molar pregnancy. | 3 | Carry out medical termination with vaginal misoprostol | Carry out medical termination with an oxytocin infusion | Perform suction evacuation | Perform a total abdominal hysterectomy | Gynaecology & Obstetrics | Gestational Trophoblastic Disease | 48f8875b-69ee-4ac5-ad14-f9e58c478cfc | multi |
Which of the following approach of brachial block is most suitable for catheter placement:- | The infraclavicular brachial plexus blocks are an alternative to axillary block for anaesthetizing the elbow, forearm, and hand when positioning is compromised by limited abduction at the shoulder, for example, rheumatoid ahritis or an immobilized/traumatized arm. It is also an alternative to supraclavicular block for anaesthetizing the upper arm. The veical infraclavicular is better than the lateral approaches in this respect and has similar rates of pneumothorax but less frequent phrenic nerve paresis. The lateral approach performed with ultrasound control has a minimal risk of phrenic nerve paresis or pneumothorax and so may be a better choice in those with respiratory compromise, but provides less reliable upper arm anaesthesia. Complications are rare and less frequent than supraclavicular approaches and vary depending on the specific infraclavicular technique used. Although the axillary block provides safe and straightforward regional anaesthesia of the arm, the infraclavicular approach does offer an alternative in some specific situations and can be considered a ble routine alternative in experienced hands. It has some advantages in providing upper arm anaesthesia, securing infusion catheters to the chest wall, and ease of patient positioning | 2 | Supraclavicular | Infraclavicular | Axillary | All | Anaesthesia | Regional Anesthesia | 843dadcd-43cd-43c0-a74c-9efd7bafffd4 | multi |
Protein level more than 4-5grms/100ml seen in all except: | null | 2 | Dentigerous cyst. | OKC. | Radicular cyst. | None. | Pathology | null | 33495b1d-0c62-4ebd-86f0-175868dd6e06 | multi |
Which is not a heterophile agglutination test ? | Ans. is 'b' i.e., Widal test Heterophilic agglutination reaction . Some organisms of different class or species share closely related antigens. . When serum containing agglutinin (antibody) of one organism gives agglutination reaction with antigen of other organism, it is called heterophilic agglutination test. Examples are . Streptococcus M.G. agglutination test for primary atypical pneumonia. . Weil - Felix reaction for typhus fever . Paul Bunnell test fin- IMN. | 2 | Weil Felix test | Widal test | Paul Bunnell test | Streptococcus | Microbiology | null | f583f579-a273-4ac1-a539-9a4a02502ba4 | single |
Traumatic eye lesion can cause: | A. i.e. Vitreous hemorrhage; B. i.e. Corneal opacity; C i.e. Exudative retinal detachment | 4 | Vitreous haemorrhage | Corneal opacity | Exudative retinal detachment | All | Ophthalmology | null | 46d48cbc-83b0-402e-b0ed-2400d3ababc2 | multi |
Innate immunity involves ? | Ans. is 'c' i.e., Macrophages Macrophages and neutrophils are phagocytic cells that engulf a microbial pathogen after it has been identified by the innate immune system | 3 | T-cells | B-cells | Macrophages | Antibodies | Microbiology | null | 49ee36ba-e4ba-43d6-88a5-68aac31166d1 | single |
Boundaries of foramen of Winslow are all EXCEPT: | ANSWER: (D) 4th part of DuodenumREF: Gray s anatomy 39th edition, page 3136 Repeat from June 2009 and June 2011In human anatomy, the omental foramen (Epiploic foramen, foramen of Winslow, or uncommonly aditus) is the passage of communication, or foramen, between the greater sac (general cavity of the abdomen), and the lesser sac.Borders of Epiploic foramen:It has the following borders:Anterior: the free border of the lesser omentum, known as the hepatoduodenal ligament. This has two layers and within these layers are the common bile duct, hepatic artery, and hepatic portal vein.Posterior: the peritoneum covering the inferior vena cavaSuperior: the peritoneum covering the caudate lobe of the liverInferior: the peritoneum covering the commencement of the duodenum and the hepatic artery, the latter passing forward below the foramen before ascending between the two layers of the lesser omentum.Left lateral: Gastrosplenic ligament and Splenorenal ligament. | 4 | Caudate lobe of liver | Inferior vena cava | Free border of lesser omentum | 4th part of Duodenum | Anatomy | Hepatobiliary System | d847733a-23b3-42b2-85d9-8832365bd0ad | multi |
Malt workers lung is associated with: | Aspergillus clavatus | 1 | Aspergillus clavatus | Aspergillus fumigatus | Micropolyspora faeni | Actinomyces israeli | Microbiology | null | 29dfee05-7ff3-47f9-9a3b-19fa0ba04254 | single |
Mechanism of hypoxemia in asthma is | Pathophysiology Airway hyper-reactivity (AHR) - the tendency for airways to narrow excessively in response to triggers that have little or no effect in normal individuals is integral to the diagnosis of asthma and appears to be related, although not exclusively, to airwayinflammation . Other factors likely to be impoant in the behaviour of airway smooth muscle include the degree of airway narrowing and neurogenic mechanisms. The relationship between atopy (the propensity to produce IgE) and asthma is well established and in many individuals there is a clear relationship between sensitisation and allergen exposure, as demonstrated by skin-prick reactivity or elevated serum-specific IgE. Common examples of allergens include house dust mites, pets such as cats and dogs, pests such as cockroaches, and fungi. Inhalation of an allergen into the airway is followed by an early and late-phase bronchoconstrictor response . Allergic mechanisms are also implicated in some cases of occupational asthma . In cases of aspirin-sensitive asthma, the ingestion of salicylates results in inhibition of the cyclo-oxygenase enzymes, preferentially shunting the metabolism of arachidonic acid through the lipoxygenase pathway with resultant production of the asthmogenic cysteinyl leukotrienes. In exercise-induced asthma, hyperventilation results in water loss from the pericellular lining fluid of the respiratory mucosa, which, in turn, triggers mediator release. Heat loss from the respiratory mucosa may also be impoant. In persistent asthma, a chronic and complex inflammatory response ensues, characterised by an influx of numerous inflammatory cells, the transformation and paicipation of airway structural cells, and the secretion of an array of cytokines, chemokines and growth factors. Examination of the inflammatory cell profile in induced sputum samples demonstrates that, although asthma is predominantly characterised by airway eosinophilia, neutrophilic inflammation predominates in some patients while in others scant inflammation is observed: so-called 'pauci- granulocytic' asthma. Ref Davidson edition23rd pg 568 | 4 | Hypoventilation | Diffusion decreased | Shunting | Ventilation perfusin mismatch | Medicine | Respiratory system | d5578ae7-8a16-4944-a3f0-d6c5304488e0 | single |
A patient with a recent history of convulsions, presented to emergency in subconscious state with blood pressure 60/90 mm/Hg, bradycardia & slow gasping respiration. There is increased lacrimation, salivation & sweating. On examination there is pin point pupil. Which of the following poisoning should be suspected? | Ans. is 'c' i.e., Organophosphorus [Ref Parikh 6Th /e p. 10.43; Reddy 33`d% p. 5231Organophosphorus poisoning compounds are irreversible inhibitors of enzyme cholinesterase, an enzyme which hydrolyzes acetylcholine.Thus organophosphates inhibit cholinesterase and protect acetylcholine from hydrolysis. This results in increased concentration of acetylcholine and excessive cholinergic activity.They inhibit cholinesterase by phosphorylating the catalytic site of enzyme. Less than 50% of cholinesterase activity is indicative of poisoning.Clinical features of poisoning are due to excessive cholinergic activity. Local muscarinic manifestations at the site of exposure (skin, eye, GIT) occur immediately and are followed by complex, systemic effects due to muscarinic, nicotinic and central actions | 3 | Opioids | Phenobarbitone | Organophosphorus | Dhatura | Forensic Medicine | null | c7f9ccf9-02b1-4ae5-bce3-e44daa174541 | single |
An elderly male presented with longstanding progressive increase in nose size with hardened. On clinical examination it was thought to be end stage of chronic acne rosacea. Your diagnosis is NOT RELATED - ENT | . | 2 | Rhinosporidiosis | Rhinophyma | Atrophic rhinitis | Strawberry nose | Pharmacology | All India exam | 423b037d-8bb7-43fd-9d44-45cbc27c15b2 | single |
The plane of the axial wall of an M.O. cavity prepared for silver amalgam should be | null | 4 | A flat straight plane bucolingually | Parallel to the long axis of the teeth | Concave to allow greater bulk of amalgam | Parallel to the long axis of the teeth and should follow the buccolingual contour of the tooth | Dental | null | cd676134-bf22-4a92-87f7-f0158a29c381 | multi |
Treatment of phlyctenular conjunctivitis is? | ANSWER: (B) Topical steroidsREF: Parson's 20th ed p. 173Treatment of phlyctenular keratoconjuctivit is:Topical steroids are drugs of choiceTopical antibiotics and atropine are used when cornea is involved Phlyctenular conjunctivitis:Delayed type IV hypersensitivity response to endogenousstaphylococcus proteins ( most common )tuberculous proteinsmoraxella and worm infestationusually unilateral, more common in girlsItching is most common symptomPhlycten or nodule near limbus is seen , pinkish, ulcerates at apexMiliary, ring, fascicular, sacrofulous ulcers are seenRemember spring catarrh is type I hypersensitivity to exogenous proteins like pollens and it is more common in boys. | 2 | Systemic steroids | Topical steroids | Antibiotics | Miotics | Ophthalmology | Inflammations of Conjunctiva - Allergic and Granulomatous | 403ad4bc-29dd-407a-8a2a-1176b6c39db1 | single |
Pain and temperature are carried by | The lateral spinothalamic tract is located in the lateral funiculus towards the medial side, i.e.e near the grey matter. The spinothalamic tracts are formed by the axons of the chief sensory cells of posterior grey horn, which form the second order sensory neurons. After taking origin from the chief sensory cells, the fibres of lateral spinothalamic tract cross within the same segment of spinal cord and reach the lateral column of the same segment. All spinothalamic fibres running in the spinal lemniscus terminate in the ventral posterolateral nucleus of thalamus. The neurons of this thalamic nucleus form the third order neurons of this sensory pathway and relay the impulses to the somesthetic area of the cerebral coex. The lateral tracts carry sensations of pain and temperatures. Guyton and hall textbook of medical physiology 12 edition page number:691,692,693 | 2 | Anterior spinothalamic tract | Lateral spinothalamic tract | Dorsal column | None | Physiology | Nervous system | 66b21fd9-0203-4a3e-aabc-fe745fefa0df | multi |
Microdermasion is done with: | Microdermabrasion is resurfacing technique with superficial skin wound achieved with aluminium oxide crystals. Ref: Textbook of dermatosurgery & cosmetology, Satish S savant, E-2, P-620. | 1 | Aluminium oxide crystals | Aluminium trihydrate crystals | Ferrous oxide crystals | Ferric oxide crystals | Skin | null | 918e6157-4ed4-4a0a-9314-05d7d8675b65 | single |
Defect in collagen formation is seen in | Scurvy is caused due ti deficiecy of ascorbc acid. Ascorbic acid is necessary for the post-transltional hydroxylation of proline and lysine residues. Hyroxyproline and hydrolysine are essential for the formation of crosslinks in the collagen, which gives the tensile strength to the fibers. This process is absolutely necessary for the normal production of suppoing tissues such as osteiod, collagen and intercellular cement substance of capillaries. REFERENCE: DM VASUDEVAN SEVENTH EDITION ; PAGE NO:497 | 1 | Scurvy | Hunter's syndrome | Marfan's syndrome | Osteogenesis imperfecta | Biochemistry | Structure and function of protein | de1630df-7b39-43e1-b1fe-2435585188c5 | single |
All are features of Trachoma stage Ill, except: | Ans. Pannus | 2 | Herbe's pits | Pannus | Necrosis in scar | Scar on tarsal conjunctiva | Ophthalmology | null | 4121c83c-4c8d-43d1-a50e-d5570de2e9fe | multi |
Which of the following is true about shunt vessels? | Ans. c. Plav a role in thermoregulation Cutaneous (anterior-venous anastomosis) shunt vessels play an important role in temperature thermoregulation.Functional Classification of Vessel WaltVesselIncludeFeatureElastic ArteriesAorta, pulmonary artery and major branches* Elastic recoil maintains continuous blood flow and diastolic arterial pressure0Conduct (muscular) ArteriesMain arteries e.g. cerebral, coronary, popliteal, radial* Thicker muscle in tunica mediaResistance vesselsSmallest terminal arteries and arterioles* Single layer of muscle in tunica media* Regulate local blood flow to match local demandsArteriovenous anastomosisShunt vessels* Connect arteriole to venule by passing capillaries* Present in skin and nasal mucosa* Regulate temperatureExchange vesselsCapillaries* Largest cross section area* Provide O2 and nutrition to tissues0Capacitance vesselsVeins* Store large volumes of bloodArteriovenous Anastomosis {Shunt Vessels)* Shunt vessels are short muscular vessels that connect arterioles and venules, by passing the capillaries,* Like other vascular smooth muscles the shunt vessels are under the control of sympathetic nervous system (and receive sympathetic innervation)* Uneven distribution: shunt vessels are mainly concentrated in tissue with a small surface area / volume ratio e.g. fingers, toes, ears, and nose.Shunt vessels are found in skin and nasal mucosa especially inHandsPalm and fingersFeetSole and toesFaceEar, nose and lips* No nutritive only thermoregulatory function: Nutrition is provided by capillaries since capillaries deliver O2 to tissues. Because shunt vessels bypass capillaries, these have no nutritive function.* Shunt vessel have important role in thermoregulation. These provide an important site of hodV heat transfer between skin and blood stream. By dilating in cold conditions and directing large volumes of blood through these vessels, it provides a valuable mechanism to prevent tissue freezing and cold damage to the extremitiesQ | 3 | Evenly distributed throughout the skin | Role in nutrition | Play a role in thermoregulation | No autonomic nervous regulation | Physiology | Heart, Circulation, and Blood | f7eea7f4-970a-40f0-90b2-dd36e3062669 | multi |
Wire loop lesions are often characteristic for the following class of lupus nephritis - | null | 3 | Mesangial proliferative glomerulonephritis( WHO class II) | Focal proliferative glomerulonephritis (WHO class III) | Diffuse proliferative glomerulonephritis (WHO class IV) | Membranous glomerulonephritis (WHO class V) | Medicine | null | 2f3c4b18-418c-4205-b461-8309489ba645 | single |
A 56-year-old woman has not passed stools for the last 14 days. Xray shows no air fluid levels. Probable diagnosis is - | The information provided in the question is too less, but we have to come to a diagnosis based on the provided information. Lets see each option one by one.
Paralytic ileus
multiple air fluid levels are noted, hence ruled out.
Aganglionosis of the colon or Hirshprung's ds.
presents in infancy or childhood hence ruled out
Duodenal obstruction
multiple air-fluid levels are not noted, but the dominant symptom is recurrent, vomiting, which is not mentioned, hence ruled out.
Intestinal pseudo-obstruction
it's the most likely diagnosis, as air-fluid levels are not seen in it.
Harrison writes - "The symptom of chronic pseudo-obstruction are chronic or intermittent constipation, crampy abdominal pain, anorexia and bloating. Abdominal x-rays reveal gaseous distention of the large and small bowel and occasionally of the stomach. Air-fluid levels are unusual and should raise the possibility of mechanical obstruction."
Acute pseudoobstruction involves only the colon and presents with features of colonic obstruction (as described before). Air-fluid level is also not a feature of colonic obstruction.
About the fluid levels remember the following points
up to 3 to 5 fluid levels less than 2.5 cm in length may be normal.
multiple air-fluid levels are a feature of mechanical small intestinal obstruction and paralytic liens. They are not seen in colonic obstruction and pseudo-obstruction.
They may be seen in colonic obstruction if the ileocecal valve is incompetent. | 3 | Paralytic ileus | Aganglionosis of the colon | Intestinal pseudo-obstruction | Duodenal obstruction | Surgery | null | b052b33f-9f4b-4637-9e3a-c4d9a0ec9650 | single |
Xantheurenic acid is produced in - | Ans. is 'b' i.e., Tryptophan metabolism o Serotonin secretion is increased in carcinoid syndrome which causes flushingQ. VasoconstrictionQ, diarrheaQ and bronchospasm (respiratory distress),Metabolism of tryptophano Tryptophan is an essential amino acidQ, containing indol ringQ. Tryptophan is oxidized to produce alanine (which is glucogenic) and acetyl-CoA (which is ketogenic). Therefore, tryptophan is both glucogenic and ketogenic. Tryptophan is precursor for the biosynthess of niacinQ (a vitaminQ), serotonin (a neurotransmitter) and melatoninQ (a hormone).o Tryptophan metabolism occurs by two pathways: (i) kinurenine pathwayQ and (ii) serotonine pathway.1) Kynurenine pathway :- Tryptophan is oxidized to kynurenine, which is then converted to either niacin (nicotinic acid) or acetyl-CoA. In the reaction alanine is also produced. o Deficiency of tryptophan can cause deficiency of niacin (if also deficient in diet). This can leads to Pallegra: dermatitis, diarrhea and dementia.o For every 60 mg of tryptophan, 1 mg. equivalent of niacin can be generatedQ.o In vitamin B6 deficiency the metabolism is shuted to xanthurenic acid. Therefore, xantheurenic acid excretion is increased in urine.2) Serotonin pathway:- Tryptophan is first oxidized to serotonine which is further converted to melatonin. | 2 | Tyrosine metabolism | Tryptophan metabolism | Cysteine metabolism | Valine metabolism | Biochemistry | Amino Acid Metabolic Disorder | 89556543-fa48-4987-b63b-faaef1603692 | single |
The only reliable symptom of hypoglycemia in a patient on beta blocker therapy is | * All the symptoms of hypoglycemia are blocked by beta blockers except sweating as it has cholinergic innervation * Beta blockers (non selective) are contraindicated in : ABSOLUTE C/I Pheochromocytoma Decompensated hea failure symptomatic bradycardia AV block Asthma RELATIVE C/I Peripheral vascular disease | 2 | Tremor | Sweating | Tachycardia | Palpitations | Pharmacology | Sympathetic System | 1ba6892b-c757-420a-9221-7cbd5e0b3ff7 | single |
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