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Enlargement of pituitary tumor after adrenalectomy is called as? | ANSWER: (A) Nelson s syndromeREF: Schwartzs Principles of Surgery 9th edition chapter 38. Thyroid, Parathyroid, and Adrenal "Nelson's syndrome is the rapid enlargement of a pituitary adenoma that occurs after the removal of both adrenal glands"Approximately 30% of patients who undergo bilateral adrenalectomy for Cushings disease are at risk of developing Nelson s syndromefrom progressive growth of the pre-existing pituitary tumor. This leads to increased ACTH levels, hyperpigmentation, visual field defects, headaches, and extraocular muscle palsies. | 1 | Nelson s syndrome | Steel Richardson syndrome | Hamman rich syndrome | Job s syndrome | Surgery | Physiology and Pathophysiology - Secondary & Tertiary Hyperparathyroidism | c40f804e-9532-4d88-b93e-d95656808408 | multi |
Drug not used for Pseudomembranous colitis | All except streptogramins are used. Drug of choice for pseudomembranous colitis is metronidazole,in resistant cases vancomycin given orally. Fidaxomycin is newer class of macrolide type of antibiotic used specially for PMC Ref:KDT 6/e p799 | 4 | Metronidazole | Vancomycin | Fidaxomycin | Streptogramins | Pharmacology | All India exam | d39d5666-ddc7-4ac6-928f-8bbb6ea122bf | single |
False about xenon anesthesia | It has been shown that, compared to other anesthetic regimens, Xenon anesthesia produces the highest regional blood flow in the brain, liver, kidney and intestine. In conclusion, the most impoant positive effectsof Xenon are cardiovascular stability, cerebral protection and ourable pharmacokinetics. Ref ganong's review of medical physiology 25e 976 | 2 | Slow induction and slow recovery | Minimal cardiovascular side effects | Low solubility in blood | Explosive in nature | Physiology | All India exam | 344ae15f-80eb-446b-a513-d309ae6ca197 | multi |
Which of the following is the most common congenital cardiac defect? | VSD is the most common congenital hea diseaseTOF is the commonest cyanotic congenital hea disease(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2194 - 2195) | 3 | TOF | Transposition of great aeries | Ventricular septal defect | Atrial septal defect | Pediatrics | All India exam | 32942fa1-4d1a-45b9-9504-b9fbad4bc125 | single |
All of the following are Light's criteria for exudative I pleural effusion: | Answer is D (Pleural fluid ADA and Serum ADA <16): Ratio of Pleural fluid ADA and Serum ADA <16 is not pa of Light's Criteria. Light's criteria, rely on a comparison of the chemistries in the pleural fluid to those in the blood, to establish the cause of the effusion as transudate or exudates. According to Light's criteria a pleural effusion is likely exudative if at least one of the following exists The ratio of pleural fluid protein to serum protein is greater than 0.5 The ratio of pleural fluid LDH and serum LDH is greater than 0.6 Pleural fluid LDH is greater than 0.6 or Y3 times the normal upper limit for serum. Note: Exudative Pleural Effusions meet at least one of the above criteria while transudative effusions meet None These criteria misidentify around 25 percent of transudates as exudates | 4 | Pleural fluid protein to serum protein > 0.5 | Pleural fluid LDH to serum LDH > 0.6 | Pleural fluid LDH is > 2/3 times the normal upper limit for serum | Pleural fluid ADA to Serum ADA <16 | Medicine | null | 9f2baccf-6a72-4f3a-89b0-6a005aa35fd2 | multi |
Pulsus bisiferiens is seen in all, except - | pulsus bisferiens, , is a sign where, on palpation of the pulse, a double peak per cardiac cycle can be appreciated. Bisferious means striking twice. Classically, it is detected when aoic insufficiency exists in association with aoic stenosis, but may also be found in isolated but severe aoic insufficiency and hyperophic obstructive cardiomyopathy. Normally, aerial pulses are best felt in radial aeries but character is better assessed in carotid aery. Pulsus bisferiens is best felt in brachial and femoral aeries. Ref Harrison 20th edition pg 1432 | 4 | Aoic regurgitation + Aoic stenosis | obstructive cardiomyopathy | Hyperophic cardiomyopathy | Tetralogy of Fallot | Medicine | C.V.S | 1770927c-cf5d-4b5a-b963-a80fe7d4c55e | multi |
A 45 years Female came with a 4 cm nodule in thyroid which on FNAC revealed papillary cell carcinoma. Level III lymphnodes are also involved. How do you treat this patient? | null | 3 | Hemithyroidectomy + Central lymph node dissection | Subtotal thyroidectomy | Total thyroidectomy + Modified radical neck dissection | Only total thyroidectomy | Surgery | null | 0c894a47-8101-4bdd-8f2a-f2028d1b592f | single |
A 69-year-old man comes to the physician because of the gradual onset of pain, tingling and hyperesthesia in the medial aspect of his right arm. Shortly thereafter, he develops erythema and then an outbreak of vesicles on the medial aspect of his right arm extending from his medial epicondyle to the wrist. After several days. the lesions crust over and eventually resolve. However, he is left with a residual “burning” pain in the same distribution as the lesions with occasional episodes of sharp.1O/1O pain that is provoked by touch. He uses ice packs to suppress the pain at night but it has persisted despite this.
The infectious agent responsible for this condition resides in which part of the neuraxis? | null | 2 | Brainstem | Dorsal root ganglion | Sensory nerve axon | Sensory nerve root | Medicine | null | 234c6833-b1e3-4452-88bf-cfd490dc5bad | multi |
WHO defi nes adolescent age between - | Ans. is 'a' i.e., 10-19 years o Adolescence is usually the period 10 to 20 yr. | 1 | 10-19 years | 10-14 years | 10-25 years | 9-14 years | Pediatrics | Development and Epidemiology | d1c476cb-ab66-4448-9fb0-8b5f5f02f647 | single |
All of the following can be administrated in acute hypertension during labour EXCEPT | Nitroprusside can cause severe hypotension. It is powerful arteriolar and venodilator. It is contraindicated in eclampsia. | 4 | IV Labetalol | IV Esmolol | IV Hydralazine | IV Nitroprusside | Pharmacology | null | 9a3026e9-a6e8-4ea6-9ce4-73470ee8e6dc | multi |
Difference between neurosis and psychosis is | B i.e. Insight | 2 | Severity | Insight | Clinical features | Duration | Psychiatry | null | db82a20c-ea92-4159-a43d-bd56b4ce5c93 | single |
Which of the following is / are autoimmune disease: | Rheumatoid arthritis is reported in about 15 percent cases of Sjogren’s syndrome. | 4 | Sjogren's syndrome. | Mikulicz's disease. | Rheumatoid arthritis. | All of the above. | Pathology | null | a82dff36-43ee-4669-89a0-a17663afd6ed | multi |
Fatty change is seen in? | * Fatty change is particularly common in the liver but may occur in other non - fatty tissues as well e.g. in the heart, skeletal muscle, kidneys (lipoid nephrosis or minimum change disease) and other organs.* Fatty change, steatosis or fatty metamorphosis is the intracellular accumulation of neutral fat within parenchymal cells.* It includes, now abandoned, terms of fatty degeneration and fatty infiltration because fatty change neither necessarily involves degeneration nor an infiltration. The deposit is in the cytosol and represents and absolute increase in the intracellular lipids. | 2 | Brain | Kidney | Adrenal | Bladder | Pathology | Kidney | 7df377b7-9c68-4188-97e9-8c79a310ce27 | single |
Health education charts serially flashed to the group as the talk is being given is called as | null | 3 | Flannel graph | Flash cards | Flip charts | Exhibition charts | Social & Preventive Medicine | null | 80da6fdf-7057-4845-8c70-4b40cb9a39d5 | multi |
All are structures passing between base of skull and superior constrictor except (Repeat Q 2008 ) | Ans: a (Glossopharyngeal nerve) Ref: Chaurasia 4th ed pg 223 fig. 14.18, pg 225The structures passing between the superior constrictor and the base of skull (sinus of morgagni):A-L-A-auditory tubelevator veli palateascending palatine artery"Auditory tube is about 3.6 cm long and is divided into an outer bony part which is 12 mm long and an inner cartilagenous part which is 24 mm long.The levator veli palati is attatched to its inferior surface. Ascending palatine artery is a branch of facial artery"Also note:Structures passing through the superior orbital fissureupper part:middle part:R/c meningeal branch of the ophthalmic artery lacrimal nerve frontal nerve superior ophthalmic vein trochlear nerve lower part:inferior ophthalmic veinoculomotor nerve naso ciliary nerve abducent nerveThe structures passing between superior and middle constrictors-stylopharyngeusglossopharyngeal nerveBetween middle and inferior constrictors:internal laryngeal nerve-Superior laryngeal vesselsBetween lower border of inferior constrictor and esophagusRecurrent laryngeal nerveInferior laryngeal vessels | 1 | Glossopharyngeal nerve | Pharyngobasilar fascia | Eustachian tube | Levator veli palate\ | Anatomy | Pharynx | 0aabd48c-c9a6-4dd6-a9e0-0932e3f5801d | multi |
Inhaled sodium cromoglycate : | null | 3 | Prevents the antigen antibody combination | May cause cardiac arrhythmias | Is of benefit in preventing exercise induced bronchial spasm | Is effective in alleviating an acute episode of allergic asthma | Pharmacology | null | 8a2320d3-f9cf-43e7-8d5a-4a6a442a9fb6 | multi |
A 45 year old male presented with palpitations, tachycardia & anxiety. His BP is 158/90 mmHg. The patient also has mild depression and is presently taking citalopram, labetalol & amlodipine to control his blood pressure. 24-hour urine total metanephrines are ordered and show an elevation of 1.5 times the upper limit of normal. What is the next best step? | Investigations done in pheochromocytoma 24 hour urinary fractionated metanephrine 24 hour urinary catecholamines 24 hour urinary vanillylmandelic acid level IOC- Plasma fractionated metanephrine levels 24-hour urine total metanephrines has high sensitivity & value of three times the upper limit of normal is highly suggestive of pheochromocytoma. Borderline elevation- likely to be false positives. Drugs related- include levodopa, sympathomimetics, diuretics, TCA, and a- and b-blockers (Labetalol) Therefore, hold labetalol for 1 week and repeat testing is the best next step | 1 | Hold labetalol for 1 week and repeat testing | Hold citalopram for 1 week and repeat testing | Refer immediately for surgical evaluation | Measure 24-hour urine vanillylmandelic acid level | Medicine | Disorders of Adrenal Gland | 153eb6d2-2430-4054-8c7a-5c0f3da4c493 | multi |
Which of the following is not useful for coagulation | null | 1 | Plasmin | Thrombin | Calcium | Fibrin | Physiology | null | cfa8f1bb-40a3-4289-81c7-77f3955e8340 | single |
Area number for Motor area include | 4 & 6 {Description: Bradman's areas of Cerebral cortex) | 1 | 4 & 6 | 1, 2 & 3 | 5 & 7 | 16 & 18 | Physiology | Miscellaneous Nervous System | c77b8255-f7ad-4191-8fe6-955799542e7b | single |
First sound by child is: | Most children are able to produce the bilabial sounds (made with the lips) of “b, p, m, w” first, since these are sounds visible on the lips.
They may also produce sounds (linguo-alveolar) such as “d, n, t” early on as well.
These sounds are called linguo-alveolar, since they are produced with the tongue behind the teeth against the alveolar ridge in the mouth. | 2 | Sibilant | Bilabial | Fricative | Monolabial | Dental | null | d04c91ec-91b8-4ed7-8249-0a0af15341cd | single |
Function of coenzyme is to | Enzymes may be simple proteins , or complex enzymes, containing a non -protein pa, called the prosthetic group. The prosthetic group is called the co-enzyme.It is heat stable. The protein pa is named as apoenzyme.It is heat labile.The two poions combined together are called the HOLOENZYME. First group of co-enzymes: In the first group , the change occuring in the substrate is counter balanced by the co-enzymes.Therefore,such co-enzymes may be called as co-substrates or secondary substrates. These takes pa in reactions catalyzed by oxido-reductases by donating or accepting hydrogen atoms or electrons. Second group of coenzymes : These coenzymes take pa in reactions transferring groups other than hydrogen. A paicular group or radical is transferred from the substrate to another substrate. REFERENCE :DM VASUDEVAN TEXTBOOK EIGHTH EDITION , Page no :54 | 3 | Enhance the specificity of apoenzyme | Accept one of the cleavage products | Activate the substrate | Increase the active sites of apoenzyme | Biochemistry | Enzymes | f89e32d4-f61d-44a9-a285-c8ac6f1d21d1 | single |
Auto antibody in Sjogrens syndrome is? | Robbins basic pathology 9th edition page no 131,(green box=Pathogenesis) Most patients with primary sjogren syndrome have auto antibodies to the ribo-nucleoprotien (RNP) antigensSS-A(RO) and SS-B(la). | 2 | Anti centromere antibody | Anti Ro & anti La | Anti ds DNA | Anti RNP | Pathology | General pathology | 6e779578-ddd5-4969-aad2-949916f38726 | single |
An 85-year old male cigar smoker with no notable medical history presented with black discoloration and hairy appearance ofthe tongue, which had lasted several years. He said he did not use bismuth- containing compounds. This condition could be treated with all of the following except - | Treatment is by reassurance, as the condition is benign, and then by correction of any predisposing factors.This may be cessation of smoking or cessation/substitution of implicated medications or mouthwashes, applying topical retinoids. Generally direct measures to return the tongue to its normal appearance involve improving oral hygiene, especially scraping or brushing the tongue before sleep.This promotes desquamation of the hyperparakeratotic papillae.Keratolytic agents (chemicals to remove keratin) such as podophyllin are successful, but carry safety concerns. Other repoed successful measures include sodium bicarbonate mouthrinses, eating pineapple, sucking on a peach stone and chewing gum Ref Davidson 23rd edition pg 714 | 1 | Topical antibiotics | Discounting smoking | Application of 40 percent urea | Applying topical retinoids | Medicine | Miscellaneous | 25d18235-12a7-4216-906e-10123380291d | multi |
Politzer bag maneuver used to test: | Politzer bag maneuver used to test Eustachian tube Designed for those who can`t perform Valsalva test Politzer bag is connected to rubber tube- Tube is placed in one nostril and other is closed-Air is blown with pressure by pressing the bulb-Air enters nasopharynx - opens eustachian tube & enters middle ear- pops out TM | 1 | Eustachian tube | Larynx | Esophagus | Nasal cavity | ENT | Anatomy of Middle Ear | f10dfda8-256a-403f-b570-96cebed67748 | single |
Poisoning by irritants may be mistaken for : | C i.e. Gastroenteritis | 3 | Peritonitis | Cholera | Gastroenteritis | Intestinal obstruction | Forensic Medicine | null | c0a68c10-e28a-4372-8ebb-09ca19afe66d | single |
Argon laser trabeculoplasty is done in: | In Argon Laser Trabeculoplasty (ALT) Laser beam is focused on trabecular meshwork Opens up the pores of trabecular meshwork. So that more Aqueous can flow through it in faster time Lowers Intra ocular pressure Typically done in open angle glaucoma Trabecular meshwork After ALT | 4 | Angle closure glaucoma | Angle recession glaucoma | Secondary glaucoma | Open angle glaucoma | Ophthalmology | FMGE 2018 | eb149b88-c1b7-4925-838b-a5f6fd7c0fc9 | single |
PANDAS are associated with which of the following infection? | PANDAS is sho for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. A child may be diagnosed with PANDAS when: Obsessive-compulsive disorder (OCD), tic disorder, or both suddenly appear following a streptococcal (strep) infection, such as strep throat or scarlet fever. Reference: GHAI Essential pediatrics, 8th edition | 2 | Pseudomonas | Streptococcus | Staphylococcus | Neisseria | Pediatrics | All India exam | 7c856a1f-cd7d-443a-8449-b3282a170f0f | single |
Which of the following is absolutely essential for wound healing | refrobbins 7/e p 114;9/e p106 synthesis of collagen. It is also a highly effective antioxidant protecting cells from damage by free radicals. Studies have shown that the vitamin can help speed thehealing process of wounds. | 3 | Vit D | Carbohydrates | Vit C | Balanced diet | Anatomy | General anatomy | 86a7ce90-2b3c-42d6-a3d8-5a00b35be9ef | single |
Binocular single vision is tested by ? | Ans. is 'b' i.e., Synoptophore Grades of binocular single vision There are three grades of binocular single vision, which are best tested with the help of a synoptophore. 1. Grade-I - Simultaneous perception It is the power to see two dissimilar objects stimultaneously. It is tested by projecting two dissimilar objects (which can be joined or superimposed to form a complete picture) in front of the two eyes. For example, when a picture of a bird is projected onto the right eye and that of a cage onto the left eye, an individual with presence of simultaneous perception will see the bird in the cage. 2. Grade-II - Fusion It consists of the power to superimpose two incomplete but similar images to from one complete image. The ability of the subject to continue to see one complete picture when his eyes are made to converge or diverge a few degrees, gives the positive and negative fusion range, respectively. 3. Grade-III - Stereopsis It consists of the ability to perceive the third dimension (depth perception). It can be tested with stereopsis slides in synoptophore. | 2 | Amsler grid | Synoptophore | Maddox rod | Cardboard test | Ophthalmology | null | c22edee9-131f-420c-990f-c7817284f194 | single |
Final centre for horizontal movement of eye is: | Ans. Abducent nucleus | 1 | Abducent nucleus | Trochlear nucleus | Oculomotor nucleus | Vestibular nucleus | Ophthalmology | null | e26b7a4f-a9e8-4161-a1b1-aab2c6fc18e8 | single |
ACRTI-RADS scan for thyroid nodule characteristics include all except: | Ans: (c) VascularityColl Radiol 2017 May, 14(5), Page 587-595ACR TI-RADS is a reporting system for thyroid nodules on ultrasound proposed by the American College of Radiology.It is based on the following characteristic of the lesion:CompositionEchogenicityShapeMarginEchogenic fociRecommendationsTR1: No FNAC requiredTR2: No FNAC requiredTR3: >=1.5 cm follow up, >=2.5 cm FNACFollow up: 1, 3 and 5 yearsTR4: >=1.0 cm follow up, >=1.5 cm FNACFollow up: 1,2,3 and 5 yearsTR5: >=0.5 cm follow up, >=1.0 cm FNACAnnual follow up for up to 5 years | 3 | Margin | Echogenicity | Vascularity | Shape | Radiology | Endocrine System | 0192a28a-7adf-4478-a0a4-20c9bcd9e7ce | multi |
For cephalometric projection, what should be the distance between source and the subject? | Distance between source and the subject = 5 feet.
Distance between film and the subject = 15 cm. | 1 | 5 feet | 6 feet | 7 feet | 9 feet | Radiology | null | 70a9ab9e-bd73-40fe-9119-55f5f3885f45 | single |
In meiosis chromosome number is | .Ans b: (Ref: NCERT text book) | 2 | Doubled | Halved | Reduced to one fourth | Will not alter | Pathology | Genetics | 44c7890c-90e0-43af-8445-fd1e6caa022e | single |
Ocular manifestations of neurofibromatosis | Ocular - a,b,c
Cutaneous - cafe-au-lait spots to neurofibromota. | 4 | Neurofibromas of lids & Orbit | Glioma of optic nerve | Congenital glaucoma | All the above. | Ophthalmology | null | 7a742a39-c36b-47bd-9fb8-319aa1d35c95 | multi |
Triple deformity of knee joint is seen in | TB KNEE has two stages. In late stage it shows TRIPLE DEFORMITY- Posterior Subluxation External Rotation Flexion Other condition showing triple deformity of knee-Rheumatoid Ahritis REF : MAHESWARI 9TH ED | 1 | Tuberculosis | Trauma | Malignant tumour | Sarcoidosis | Orthopaedics | Skeletal infections | 64cb3d4d-f7d0-4efd-902e-b010dbd1749c | single |
The rate of mixed whole stimulated saliva increases with age in which of the following age group (according to Crossner) | Crossner reported that in children from 5 to 15 years of age, the rate of mixed whole stimulated saliva increases with age, and boys have consistently higher rates than girls. Saliva substitutes, as well as fluoride and chlorhexidine rinses, are reported to enhance remineralization and promote resistance to demineralization of tooth surfaces, and may help prevent radiation-induced caries. | 2 | 1-2 year of Age | 5-15 year of Age | 3-4 year of Age | Above 15 years | Dental | null | 13f570d3-4f26-4a46-a789-4a92da5169cb | multi |
Following are radiological evidence of Achalasia cardia except not related -radiology | . | 4 | Smooth narrowing of esophagus | Dilated touous esophagus | Absence of air in the fundus | Exaggerated peristalsis | Pharmacology | All India exam | 82bc60bb-fe7e-41e6-bb45-7e69335f0edc | multi |
Most common cause of acute intestinal obstruction in children is | null | 3 | Volvulus | Inguinal hernia | Intussusception | None | Surgery | null | 3d55ff3b-ebc9-45c0-a3fa-bf15db5853ca | multi |
Optic tract is related to : | B. i.e. Lateral geniculate body | 2 | Olivary mucleus | Lat. Geniculate body | Medial geniculate body | Trapezoid body | Anatomy | null | 617bd44f-cd27-4c7c-83ae-3c09ef2a3b1b | single |
The T wave on an ECG tracing represents which of the events in the cardiac cycle? | The T wave represents ventricular repolarization and is longer in duration than depolarization (i.e., conduction of the repolarization wave is slower than the wave of depolarization). The P wave represents the wave of depolarization that spreads from the SA node throughout the atria, and is usually 0.08 to 0.1 seconds (80-100 ms) in duration. The QRS complex represents ventricular depolarization. The Q-T interval represents the time for both ventricular depolarization and repolarization to occur, and therefore roughly estimates the duration of an average ventricular action potential. | 4 | Atrial depolarization | Atrial repolarization | Ventricular depolarization | Ventricular repolarization | Physiology | null | 39565d89-bc72-46cf-8afd-2b8030a5c879 | single |
Which of the following is a specific risk factor for development of adenocarcinoma of ethmoid sinus? | Ans. is 'd' i.e., Wood workers * Paranasal sinus cancer is uncommon and represents only 0.2 to 0.8% of all malignancies.* Cancer of paranasal sinus constitutes 3% of all carcinomas of the aerodigestive tract.* The majority of paranasal sinus malignancies (50-80%) originate within the maxillary sinus antrum. Malignancies rarely occur within the other sinuses and originate in the ethmoid, frontal, and sphenoid sinuses in 10%, 1% and 1% respectively.* The cause of parasinus malignancy is unknown. However several risk factors have been associated and therefore it is seen more commonly in people working in hardwood furniture industry, nickel refining, leather work, and manufacturer of mustard gas.* More than 80% of the malignant tumours are of squamous cell variety. Rest are adenocarcinoma, adenoid cystic carcinoma, melanoma, and various type of sarcomas.* Workers of furniture industry (wood workers) develop adenocarcinoma of the Ethmoids and upper nasal cavity. While those engaged in Nickel refining get squamous cell and Anaplastic carcinoma. | 4 | Smoking | Nickel industry worker | Mustard gas exposure | Wood workers | ENT | Nose and PNS | fa96201f-057c-40af-99ec-942e387539b5 | single |
A pharmaceutical company develops a new antihypertensive drug. Samples of 24 hypertensive patients, randomly selected from a large population of hypertensive people, are randomly divided into 2 groups of 12. One group is given the new drug over a period of 1 month; the other group is given a placebo according to the same schedule. Neither the patients nor the treating physicians are aware of which patients are in which group. At the end of the month, measurements are made of the patient’s blood pressures. This study | Here, a pharmaceutical company develops a new anti-hypertensive drug; samples of 24 hypertensive patients, randomly selected from a large population of hypertensive people, are randomly divided into 2 groups of 12, and one group is given the new drug over a period of 1 month & the other group is given a placebo according to the same schedule,
Since a new drug (intervention) is given it is an experimental/ interventional study (not a prospective study which is only observational in design)
Also, there are 2 groups, i.e. experimental group (Intervention – new drug is given) and reference group (no intervention is given – only placebo is given) which are compared concurrently, thus it is a ‘Concurrent parallel design of RCT’ (there is no cross-over)
Also, neither the patients nor the treating physicians are aware of which patients are in which group, thus it is a ‘double blinded RCT’. | 1 | Is a randomized controlled clinical trial | Uses a crossover design | Is a single blind experiment | Is a prospective study | Social & Preventive Medicine | null | 5bedaef6-8d34-446e-b094-f42fca1dbd12 | single |
Chlamydia are isolated by : | Isolation of chlamydiae can done by :
Inoculationinto yolk sac/embryonated eggs of 6-8 day old chick embryo which may be pretreated by streptomycin or polymyxin
Inculation into experimental animals (mice)
Tissue/cell culture :
Preferred mode
Commonly used cell lines are McCoy and HeLa cells.
Cell cultures are pretreated by irradiation or chemicals such as 5-iodo – 2 deoxyuridic or cycloheximide to enhance replication and detection of inclusion bodies.
Pretreatment with DEAE dextrax or centrifugation after inoculation, promotes contact between chlamydiae particles and cell monolayer. | 2 | Enzyme immune assay | Yolk sac inoculation | Direct immunofluorescence | Micro immunofluorescence | Unknown | null | 8b22779e-e655-42f6-847d-cfb2bbf8dafd | single |
Indirect pulp capping procedures on primary molars are
indicated when: | null | 4 | Removal of decay has exposed the pulp | A tooth has a Larger long-standing lesion with a history of continuous pain | The carious lesion has just penetrated the dentinoenamel junction | The carious lesion is suspected of producing an exposure of the pulp | Dental | null | ba340d20-fca6-4f23-b6e0-b00eed271ad8 | single |
A 50 yr. old male presented with chronic breathlessness and intermittent jaundice. He denies smoking and alcohol abuse. Lung and liver specimens revealed the following findings respectively What is the most probable diagnosis? | The lung specimen reveals diffusive panacinar emphysema. The liver biopsy shows PAS positive diastase resistant deposits. Both the above clues point towards option C. - Option A hemochromatosis would show pearls stain on liver biopsy. - Cystic fibrosis would show bronchiectasis. | 3 | Hemochromatosis | Cystic fibrosis | Alpha 1 antitrypsin deficiency | Wilsons disease | Unknown | Integrated QBank | 673357fb-4a08-4e56-b846-b67c0cb8ec3b | single |
Peripheral neuropathy can be as a side effect of all of the following anti-retroviral drugs, EXCEPT: | Peripheral neuropathy is a rare side effect of Lamivudine. Side effects of lamivudine are headache, fatigue, nausea, anorexia and abdominal pain. Predominant side effect of stavudine is peripheral neuropathy. Predominant side effect of Zalcitabine is peripheral neuropathy, other side effects asssociated with it are pancreatitis, thrombocytopenia, neutropenia, hepatotoxicity and cardiomyopathy. Prominant dose related toxicity of Didanosine is pancreatitis and peripheral neuropathy. | 1 | Lamivudine | Didanosine | Stavudine | Zalcitabine | Pharmacology | null | ca9f5c37-ec36-4200-9bbd-577fe2151c98 | multi |
Apical lung tumor causes | Apical lung cancer/ Pancoast tumor causes - 2deg neuron injury (Preganglionic sympathetic fibres) I/L horner syndrome (Cervical sympathetic chain and ganglion involved) Loss of sweating on same side of face 1deg sympathetic neuron injury occurs in Wallenberg syndrome 2deg sympathetic neuron (preganglionic fibers) injury occurs in Apical lung cancer 3deg sympathetic neuron (postganglionic fibers) injury occurs in Internal carotid aery disection | 4 | C/L horner syndrome | Post ganglionic fibres involved | 1deg neuron injury | Loss of sweating on same side of face | Anatomy | Neuroanatomy 3 | 4e243378-60a0-4085-94d9-e1a7b4b97259 | single |
Recurrence is common in pleomorphic adenoma because of: | Pleomorphic Adenoma:
Local enucleation should be avoided because the entire tumor may not be removed or the capsule may be violated, resulting in seeding of the tumor bed. With adequate surgery the prognosis is excellent, with a cure rate of more than 95%. The risk of recurrence appears to be lower for tumors of the minor glands. Conservative enucleation of parotid tumors often results in recurrence, with management of these cases made difficult as a result of multifocal seeding of the primary tumor bed. In such cases, multiple recurrences are not unusual and may necessitate adjuvant radiation therapy. Tumors with a predominantly myxoid appearance are more susceptible to recur than those with other microscopic patterns.
Key Concept:
One of the characteristic is the microscopic presentation of tumour outside the Incomplete Capsule. So, the recurrence of pleomorphic adenoma is due to Incomplete Capsule.
Reference: ORAL AND MAXILLOFACIAL PATHOLOGY, Neville, FOURTH EDITION page no 446,447 | 2 | Metastasis | Incomplete capsule | Highly aggressive nature | All of the above | Pathology | null | 0db75b2f-f296-4407-8fe4-7b1e0753fc38 | multi |
Drug used in alzheimer's disease are all EXCEPT: | Ans. (a) BiperidinRef.: Harrison 19th ed. / 2601-02Alzheimer's disease is most common cause of dementia.Drugs Used in the Treatment of Alzheimer's are:* Acetycholine esterase inhiitors:# Donepezil# Tacrine# Galantamine* Rivastigmine: Carbamate derivative of physostigmine* Memantine: NMDA glutaminergic antagonist* Biperidin is an anti cholinergic drug used to treat parkinsonism. | 1 | Biperidin | Donepezil | Rivastigmine | Memantine | Psychiatry | Degenerative Disorders | 4391cae4-5734-4bac-bd6f-1369c3f40511 | multi |
Which of the following is an intermediate-acting local anaesthetic which is an amino amide causing methemoglobinemia? | Prilocaine causes methemoglobinemia, hence it is largely limited to dentistry. This effect is a consequence of the metabolism of the aromatic ring to o-toluidine. Development of methemoglobinemia is dependent on the total dose administered, usually appearing after a dose of 8 mg/kg. Methemoglobinemia is more common in neonates due to decreased resistance of fetal hemoglobin to oxidant stresses and the immaturity of enzymes in the neonate that conve methemoglobin back to the ferrous state. Ref: Catterall W.A., Mackie K. (2011). Chapter 20. Local Anesthetics. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | 2 | Procaine | Prilocaine | Etidocaine | Ropivacaine | Anaesthesia | null | 8e2543a2-c9c7-445d-8151-7e6502ba87ed | single |
Multidrug therapy is given for | B i.e. Leprosy | 2 | Syphilis | Leprosy | Herpetiformis | Icthyosis Vulgaris | Skin | null | 8b5a2c72-1464-4a86-8449-0dd80b05b6ac | single |
What is phacoanaphylactic Uveitis? | Ans. is 'a' i.e., Uveitis as a result of lens tissue induced inflam mation following cataract surgery o Due to cataract extraction or lens trauma, lens matter induces inflammation in the uveal tissue, called phacoanaphylactic/phacotoxic uveitis:# Phacoanaphylaxis/lens-induced uveitis occurs in the setting of a ruptured or degenerative lens capsule and is characterized by a granulomatous antigenic reaction to lens protein.# Lens proteins are most likely immunologically privileged, and they may initiate an immunologic sensitization only after entering the aqueous humor. This privilege is probably because of numerous factors, as follows: lens proteins are isolated from the fetal circulation early in embryonic life, the lens is devoid of innervation, and the adult lens is completely avascular. | 1 | Uveitis as a result of lens tissue induced inflam mation following cataract surgery | Uveitis following cataract extraction in automiimune diseases like rheumatoid arthritis | Uveitis seen with phacoemulsification cataract surgery | Uveitis associated with fungal comeal ulcer | Ophthalmology | Uveal Tract | c86c11e1-8855-410b-8a66-e27d513e5ef3 | single |
Point source epidemic tends to -a) Continue over one incubation periodb) Produce multiple peaks in the epidemic curvec) Be explosived) Tail gradually | null | 2 | bd | ac | bcd | da | Social & Preventive Medicine | null | cee1223a-2da7-4b34-bdae-2f56465734ca | multi |
Laryngeal papilloma- | Ans. is 'a' i.e., Single; 'b' i.e., Multiple & 'c' i.e., Seen in children Laryngeal papilloma o Most common benign tumor of larynx Single or multiple irregular, wa like glottic masses. HPV-6 & 11 may be the causative factor. Treatment is with CO2 laser ablation. a-IFN and indole - 3 - carbinole may also be used. | 4 | Single | Multiple | Seen in children | All | Pediatrics | null | bf468b2e-efb9-4de7-8358-38836e58f7ae | multi |
Which of the following drug must always be available for emergency use in labour ward if a patient on opoid analgesia? | Opoids are used during labor for analgesia. It may cause newborn respiratory depression. Naloxane is a narcotic antagonist capable of reversing this respiratory depression | 2 | Fentanyl | Naloxone | Morphine | Bupivacaine | Gynaecology & Obstetrics | Labour - III | 29a2bc81-1a45-4296-8e1c-44fb8c0ec595 | single |
Quincke's disease is | Angioedema is an area of swelling of the lower layer of skin and tissue just under the skin or mucous membranes.The swelling may occur in the face, tongue, larynx, abdomen, or arms and legs. Often it is associated with hives, which are swelling within the upper skin.Onset is typically over minutes to hours Ref Harrison20th edition pg 1567 | 2 | Norwegian scabies | Angioneuritic edema | Seborrhea olessa | Saddle nose | Dental | Bacterial infections | cb657fff-7821-4b85-97d2-a2c4eca32abc | single |
'Mission Indradhanush' includes all of the vaccines except: | c. Typhoid(Ref: Nelson's 20/e p 1246, 1292-1293, Ghai 8/e p 197-198)Mission IndradhanushIncludes vaccination against 7 life-threatening diseases (diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis B) in the entire country | 3 | BCG | Japanese Encephalitis | Typhoid | Measles | Pediatrics | Immunization | 0d13e5ec-bdec-4fe5-acbe-570cc041a53a | multi |
Typhoid carriers harbor bacteria in | Salmonella typhi or Salmonella typhimurium can infect the gallbladder. Acute cholecystitis can occur. More frequently, chronic cholecystitis occurs, the patient becoming a typhoid carrier excreting the bacteria in the bile.Ref: Bailey and love 27e pg: 1202 | 1 | Gallbladder | Urinary bladder | Pancreas | Spleen | Surgery | General surgery | c734412a-5672-4c27-a6e9-2f8c85e20ac0 | multi |
Maximum tourniquet time for the upper limb is ? | Ans. is 'c' i.e., 1-1/2 hr. In experiment animals tourniquets have been retained for three hours without lasting ill effect but in practice an hour and a half is probably a wise limit. | 3 | 1/2 hour | 1 hr | 1-1/2 hrs. | 2 hrs | Surgery | null | d8e7df88-427e-4209-8706-b183d38efbd6 | single |
Preferred treatment in a 60years old patient with Maxillary carcinoma involving anterolateral pa of maxilla is | Treatment of maxillary carcinomas: Early cases with Stage I and II squamous cell carcinomas are treated with surgery or radiation with equal results. T3 and T4 lesions are treated by combined modalities of radiation and surgery. Radiation in such cases may be given preoperatively or postoperatively Ref: Dhingra 7e pg 233. | 3 | Radiotherapy only | Total/extended Maxillectomy followed by radiotherapy | Radiotherapy followed by total/extened maxillectomy | Total/extended maxillectomy alone | ENT | Nose and paranasal sinuses | b293f3d7-ae14-4e09-97fd-71568f827539 | single |
Splicing Activity is a functions of | Sn-RNA is involved in RNA splicing.
Sno-RNA → r-RNA modification
mi-RNA & St-RNA → Regulation of gene expression
SP-RNA → RNA-interference (RNA i) | 2 | m RNA | Sn RNA editing | r RNA | t RNA | Biochemistry | null | b46b66bf-9575-4482-a7b1-58fc4422b345 | single |
In rheumatic hea disease, infective endocarditis is detected by echocardiogram and the largest vegetations seen are due to - | Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:161-162 Acute infective endocarditis: Caused by highly virulent organisms mainly S. aureus (20-30%), seeding a previously normal valve 2D Echo * The smallest size of vegetation that can be picked up by echo is 2 mm. * Transoesophageal echocardiography is more sensitive in detecting vegetations in the aoic valve (90%) and mitral valve (100%) than transthoracic echocardiography | 2 | Streptococcus viridans | Staphylococcus aureus | Candida albicans | Salmonella typhi | Medicine | C.V.S | 619e7e3b-c74e-46a8-8c19-8af49d13dc2f | single |
Kaposi sarcoma is caused by - | Ans. is 'd' i.e., Human herpes virus-8 Important virusesDisease causedo HHV-8Kaposi sarcomaoHHV-6Roseola infantum, multiple sclerosiso VZVChicken pox, herpes zostero EBVIMN, burkitis lymphoma, oral hairy leukoplakia, nasopharyngeal carcinomao Enterovirus-72Hepatitis Ao Coxsackie-AHerpangina, hand-foot-mouth diseaseo Coxsackie-BPleurodynia, myocarditis, pericarditis, Bornholm diseaseo OrthomyxovirusInfluenzao ParamyxovirusesMumps, measles, parainfleuenzao HIVAIDSo JC virusProgressive multifocal leukoencephalopathyo RhabdovirusRabiesoHPVWarts, condyloma accuminatum, cervical cancero ParvovirusErythema infectiosum, aplastic anemia, fetal hydrops | 4 | Human herpes virus-2 | Human herpes virus-4 | Human herpes virus-6 | Human herpes virus-8 | Microbiology | Herpesviruses | cc9035c1-7a04-44d8-9a1f-071bbf6b4002 | single |
All are true about acute acalculous cholecystitis except | Distended GB is seen in scintigraphy Cholescintigraphy demonstrates absent gallbladder filling in acalculous cholecystitis Acalculous cholecystitis Acute inflammation of gallbladder without stones Clinical features Similar to acute calculous cholecystitis Patients may present with only unexplained fever, leucocytosis and hyperamylasemia and RUQ tenderness If untreated, rapid progression to gangrene and perforation may occur Ref: Sabiston 20th edition Pgno : 1508 | 1 | Distended GB | Vascular cause | Seen in bed ridden patients | Rapid course | Anatomy | G.I.T | bfa8c646-79e5-4dab-9357-c024d413e8f1 | multi |
. All of the following forms of porphyria are associated with peripheral neuropathy except | Porphyria is a group of inherited disorders caused by defects in heme biosynthesis. Three forms of porphyria are associated with peripheral neuropathy: acute intermittent porphyria (AIP), hereditary coproporphyria (HCP), and variegate porphyria (VP). The acute neurologic manifestations are similar in each, with the exception that a photosensitive rash is seen with HCP and VP but not in AIP. Attacks of porphyria can be precipitated by ceain drugs (usually those metabolized by the P450 system), hormonal changes (e.g., pregnancy, menstrual cycle), and dietary restrictions. Ref Harrison 20th edition page 3211 | 3 | acute intermittent porphyria | hereditary coproporphyria | porphyria cutanea tarda | variegate porphyria | Medicine | C.N.S | 4dbd3614-9a32-4ad3-9c8b-98c1f5ca7c21 | multi |
True about subendocardial hemorrhages are all, except AIIMS 10; UPSC 11 | Ans. Involves the right ventricular wall | 2 | May be seen after head injury | Involves the right ventricular wall | Continuous pattern | Flame shaped hemorrhages | Forensic Medicine | null | d4207816-e1cc-43fb-84ba-cb74e3ae90dd | multi |
Pulse deficit more than 10 is seen in- | Atrial fibrillation (AF or A-fib) is an abnormal hea rhythm characterized by rapid and irregular beating of the atrial chambers of the hea.Often it stas as brief periods of abnormal beating which become longer and possibly constant over time.Often episodes have no symptoms. Occasionally there may be hea palpitations, fainting, lightheadedness, shoness of breath, or chest pain.The disease is associated with an increased risk of hea failure, dementia, and stroke.It is a type of supraventricular tachycardia Leads V4 and V5 of an electrocardiogram showing atrial fibrillation with somewhat irregular intervals between hea beats, no P waves, and a hea rate of about 150 BPM. Pulse deficit occurs when there are fewer pulses than there are heabeats. Atrial fibrillation and atrial flutter can cause pulse deficit because they cause the hea to beat so fast, and often irregularly, that the force of blood out of the hea is sometimes not strong enough to create a pulse. Ref Harrison 20th edition pg 1576 | 3 | Ventricular premature contraction | Atnal flutter | Atrial fibrillation | Ventricular fibrillation | Medicine | C.V.S | b6bf4a8e-16e2-4baf-99a0-b48e2bc80747 | single |
Recontouring and selective grinding procedures are carried out in complete denture to: | null | 4 | Decrease the vertical dimension of occlusion | Decrease cuspal height | Enhance curve of spee | Remove occlusal disharmony | Dental | null | 4e981d19-05e9-4366-a4e6-bcb5e06a32bd | single |
Anti U1 RNP is a feature of: | MCTD | 2 | SLE | MCTD | Sclerorema | CREST | Pathology | null | e6a26933-67b7-43de-9661-5ee1b11763fb | single |
Rideal-Walker coefficient is related with ? | Ans. is 'a' i.e., Disinfecting power Traditional testing of disinfectants Two traditional tests for determining the efficiency of disinfectants are :? 1) Rideal-Walker test : Phenol is taken as the standard with unit as phenol coefficient (pheno1=1) 2) Chick-Main test : The disinfectant acts in the presence of organic matter (dried yeast or feces). | 1 | Disinfecting power | Parasitic clearance | Dietary requirement | Statistical correlation | Microbiology | null | 9becf270-8e35-4f0c-97ba-7aa955050b9b | single |
30-year-male with chronic diarrhoea, anemia, raised liver enzymes. Most likely associated with - | null | 2 | Antimitochondrial antibody | Anti-endomysial antibody | Anti-smooth muscle antibody | Antinuclear antibody | Medicine | null | a0d4edbe-5bf0-4bca-a1d8-25b9406ed567 | single |
Feature (s) of DiGeorge syndrome is/are all except: | D. B cell defectDiGeorge Syndrome {Thymic Hypoplasia) Robbins 9th/24lDiGeorge syndrome is a T-cell deficiency that results from failure of development of the third and fourth pharyngeal pouches. The latter give rise to the thymus, the parathyroids, some of the C cells of the thyroid, and the ultimobranchial body. Thus, individuals with this syndrome have a variable loss of T cell-mediated immunity (resulting from hypoplasia or lack of the thymus), tetany (resulting from lack of the parathyroids), and congenital defects of the heart and great vessels.Absence of cell-mediated immunity is caused by low numbers of T lymphocytes in the blood and lymphoid tissues and poor defense against certain fungal and viral infections.The T-cell zones of lymphoid organs--paracortical areas of the lymph nodes and the periarteriolar sheaths of the spleen--are depleted. Ig levels may be normal or reduced, depending on the severity of the T-cell deficiency."Patients who survives the neonatal period show enhanced susceptibility to viral, fungal and bacterial infections, which ultimately prove fatal"- Ananthanarayan 10th/175Patients with DGS may have poor T-cell production compared to their peers, and as a result, have an increased susceptibility to viral, fungal and bacterial infections- primaryimmune.orgDiGeorge Syndrome Harrison I9th/2483A form of hypoparathyroidism associated with defective development of both the thymus and the parathyroid glands is termed the DiGeorge syndrome, or the velocardiofacial syndrome.Congenital cardiovascular, facial, and other developmental defects are present, and patients may die in early childhood with severe infections, hypocalcemia and seizures, or cardiovascular complications.Most cases are sporadic, but an autosomal dominant form involving microdeletions of chromosome 22q11.2 has been described. | 4 | Results from failure of development of the third and fourth pharyngeal pouches | Absent thyroid | Absent parathyroid glands | B cell defect | Pathology | Immunity | 6b675bc3-bbca-43ea-94ba-3bd6569acef5 | multi |
The following are part of Hamstrings -a) Semitendinosusb) Semimembranosusc) Gracilisd) Short head of biceps femorise) Sartorius | Hamstrings
- Semimembranosus
- Semitendinosus
- Long head of biceps femoris
- Ischial head of adductor magnus | 2 | ac | ab | ad | bc | Anatomy | null | c2ee0fef-7bc1-4247-9b41-252801e8fa3c | single |
A person is having painless lymphadenopathy. On biopsy, binucleated owl shaped nuclei with clear vacuolated area is seen. On IHC CD 15 and CD 30 were positive. What is the most probable diagnosis? | Ans. (a) Nodular sclerosis(Ref: Robbins 9th/pg 606-611)Binucleated owl shaped nuclei with clear vacuolated area refers to Lacunar cells.Lacunar cells are seen in the nodular sclerosis subtype of Hodgkin's diseaseLacunar cells have delicate, folded, or multilobate nuclei and abundant pale cytoplasm that is often disrupted during the cutting of sections, leaving the nucleus sitting in an empty space (lacuna) | 1 | Nodular sclerosis | Large granular lymphocytic lymphoma | Lymphocyte depletion type | Lymphocyte predominant HD | Pathology | Misc. (W.B.C) | 15b61168-9e7f-4e0f-b54e-3ba562a3e9f3 | single |
Bone marrow finding in myelofibrosis - | Ans. is 'a' i.e., Dry tap (hypocellular) Myelofibrosiso The hallmark of primary myelofibrosis is rapid development of obliterative marrow fibrosis,o Myelofibrosis suppresses bone marrow hematopoiesis, leading to peripheral blood cytopenias.o This results in extensive extramedullary hematopoiesis in the spleen, liver and lymphnode - Splenomegaly and hepatomegaly.o Blood cell production from sites of extramedullary hematopoisis is disordered and ineffective - Persistent cytopenia.Peripheral blood pictureLeukoerythroblastosis - Presence of erythroid and granulocytic precursors in the peripheral blood.Tear-drop erythrocytes (dacrocytes) - Fibrotic marrow distorts and damages the membranes of erythroid proginators.Bone marrow findingso Initially marrow is hypercellular.o With progression marrow becomes hypocellular and diffusely fibrotic --> Bone marrow aspiration is a dry tap.o There is increase laying down of reticulin fibril network.o Cellularity of bone marrow is decreased, but megakaryocytes are increased and demonstrate features of dysmegakaryopoiesis.o Dilated marrow sinusoids. | 1 | Dry tap (hypocellular) | Megaloblastic cells | Microcytic cells | Thrombocytosis | Pathology | Myeloproliferative Disorder | c6a9401e-712e-4366-bee9-2473b3dd6bc2 | single |
A 60-years old male patient operated for cataract 6 months back now complains of floaters and sudden loss of vision. The diagnosis is – | Late complications of cataract surgery are cystoid macular oedema, retinal detachment, epithelial in growth, fibrous in growth, vitreous touch syndrome, after cataract.
Retinal detachment (rhegmatogenous) presents with sudden painless loss of vision with floaters and photopsia. | 2 | Vitreous hemorrhage | Retinal detachment | Central retinal artery occlusion | Cystoid macular edema | Ophthalmology | null | 3b314d7f-d412-44d3-933a-a2c4500ac825 | single |
Which of the following can cause an increase in the prevalence of the disease- | Ref: Parks 23rd edition Disease will be Prevalent so long it exist in the community. Longer the duration of the illness, longer will it persist in the community and hence higher will be its prevalence. | 3 | Immigration of healthy persons | Increased cure rate of disease | Longer duration of illness | Decrease in population | Social & Preventive Medicine | Epidemiology | 0a646d07-8d7a-4833-9d1e-152ab3711bc2 | single |
Commonest thyroid tumor in MEN (multiple endocrine neoplasia) - | Ans. is 'd' i.e., Medullary o Thyroid tumor is seen in MEN II, and is medullary carcinoma of thyroid. | 4 | Follicular | Papillary | Anaplastic | Medullary | Pathology | null | c5e30232-3f06-49ed-80f7-798c51d5f6d7 | single |
What is a placental cotyledon: | Functional unit of the placenta is called a fetal cotyledon or placentome,which is derived from a major primary stem villus. These stem villi pass down through the intervillous space to anchor onto the basal plate.About 60 stem villi persist in human placenta. Thus each cotyledon(totalling 15-29) contains 3-4 major stem villi. Reference : Dutta Textbook of Obstetrics &th edition page no 31 | 1 | All branches from one stem villi | Area supplied by one spiral aery | Quaer of placenta | Area drained by one terminal villi | Gynaecology & Obstetrics | General obstetrics | c7fcbe6b-29d0-49ad-8fa3-a33dfe9c237a | multi |
Thrombosis is initiated by | ref : robbins 10th ed | 2 | platelet activation | endothelial damage | Coagulation cascade | vasoconstriction of vessels | Pathology | All India exam | 3913032f-884a-4390-ada5-c30cab7939f4 | single |
Investigation of choice for diagnosis and staging of renal cell carcinoma | IOC - CECT.
IOC if renal vein or IVC involved - MRI. | 2 | USG | CECT | IVP | MRI | Radiology | null | 150819c0-cc18-464a-815a-2e4f89505df5 | single |
Which of the following amino acid takes a role in detoxification of ammonia normally in the human body? | Ammonia is produced in the body during normal protein metabolism and by intestinal bacteria, primarily those in the colon. The liver plays a role in the detoxification of ammonia by conveing it to urea, which is excreted by the kidneys. Striated muscle also plays a role in detoxification of ammonia, which is combined with glutamic acid to form glutamine. Ref: Kaplan M.M. (2012). Chapter 302. Evaluation of Liver Function. 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. | 1 | Glutamine | Alanine | Methionine | Glycine | Biochemistry | null | 58e56199-76bd-4ed1-bbab-eaf88f01deb8 | multi |
Delusion of Nihilism and Early morning insomnia are characteristic features of - | Nihilistic delusion, insomonia and early morning awakening are seen in depression | 2 | Mania | Major depression | Personality disorder | Schizophrenia | Psychiatry | null | 9f2e2d91-8944-4875-ad05-8d4f7ced21a4 | single |
Reliability means - | Repeatability (reliability)
Repeatability means, the test must give consistent results when it is repeated more than once on the same individual under same conditions.
That means the results of test are precise (exact), So repeatability is some time called precision, reliability or reproducibility. | 1 | Number of times the same results on repeated trials | Number of times variation is seen | Extent of accuracy | Level of simplicity | Social & Preventive Medicine | null | e7fc3844-6dca-4cc8-9d5d-61767efb6994 | single |
A pregnant female has past history of embolism in puerperium. What medical management she should take in next pregnancy to avoid this | Ans. is b i.e. To take Warfarin after delivery Friends venous thromboembolism in pregnancy, is one of those topics which we donot study in detail during undergraduation. So, I am giving in brief, all the impoant points you need to remember : Venous thromboembolism in pregnnacy : Venous thromboembolism is the leading cause of maternal deaths in developed countries. Pregnancy increases the risk of thromboembolism 6 times as all components of virchow's triad are increased.deg A. Deep vein thrombosis : Left sided DVT is more common than Right sided DVT. Clinical features : swelling / redness / pain and calf muscle tenderness and oedema. Investigations - Recommended method during pregnancy : Doppler ultrasound - Gold standard (in conditions other than pregnancy) : venography Mangement : Therapeutic The treatment should be staed on clinical grounds if confirmatory tests are not available. Drug of choice - Heparin (as it doesnot cross the placenta) Initially intravenous Heparin is given with the aim to prolong APTT (activated paial thromboplastic time) by 1.5 to 2 times the control followed by subcutaneous Heparin. Monitoring is done by APTT and platelet count (as Heparin causes Thrombocytopenia). Oral anticoagulants like Warfarin cross the placenta and cause teratogenesis therefore should be avoided in pregnancy. Treatment is continued for 6 weeks following which prophylactic subcutaneous heparin is given throughout pregnancy. Heparin is stopped just before delivery. Regional anaesthesia should be avoided at the time of delivery in patients on heparin due to the risk of hematoma formation. Heparin is restaed about 6 - 8 hours after delivery as the puerperium is the time of greatest risk for VTE. Warfarin is commenced simultaneously and thereafter monitoring is done by prothrombin time (PT). Once the prothrombin time INR is between 2 and 3, heparin can be discontinued. Usually warfarin is continued for 6 to 18 weeks and is safe for breast feeding mothers. Thromboprophylaxis : Thromboprophylaxis is considered for women who are at increased risk of thromboembolism (TE). Risk category Risk factors High risk Recurrent TE Previous TE with thrombophilia Previous TE with family history TE in current pregnancy Low risk One episode of previous TE without thrombophiiia or family history Thrombophilia without previous thrombosis Additional risk Cesarean section, obesity, grand multiparity, age above 35, pre-eclampsia, prolonged immobilization etc. High risk patients need antepaum heparin, intrapaum heparin and postpaum prophylaxis for 6 weeks. Low risk patient require intrapaum and postpaum low dose prophylaxis for 6 weeks. Well, now that you have a detailed knowledge of thromboembolism, lets have a look at the question. It says : a female with previous history of embolism becomes pregnant,what medical management should be given to her? Option 'a. i.e. Compulsory prophylaxis with warfarin at 10 weeks. It is absolutely wrong as warfarin is not given during pregnancy. Option 'b Le to take warfarin after delivery - According to William obs. 22/e, p 1077 table 47-3, 23/e, p 1028 - table 47.6 In case of prior VTE associated with a non recurring risk factor and no known thrombophilia? During pregnancy : Only surveillance is required as per American college of chest physicians. Prophylaxis with low molecular weight heparin is required as per American college of obs & gynaecology (which also explains option 'd is paly correct). Postpaum : warfarin is given for 6 weeks. So, option 'b' is absolutely correct i.e. warfarin should be given in the post paum period for six weeks. | 2 | Cumpulsory prophylaxis with warfarin sta at 10 weeks | To take warfarin after delivery | Chance of thromboembolism increases by 12% in next pregnancy | Does not need anything | Gynaecology & Obstetrics | null | 6fb380b5-8239-4fa9-b596-4e89147f213b | single |
A woman trying to get pregnant has a sister whose child has an autosomal recessive disease characterized by dysfunction of mucus-secreting cells. As a result, this child has abnormally thick mucus that tends to precipitate into dense plugs that obstruct the pancreatic ducts, bronchi, and bronchioles, as well as the bile ducts. Which of the following tests could be performed to determine if this woman and her husband are carriers of this disease? | The disease described is cystic fibrosis, which phenotypically presents with meconium ileus, deficiencies of pancreatic enzymes, pulmonary obstruction and infection leading to progressive pulmonary damage and ultimate respiratory failure. The most frequent mutation in this autosomal recessive disorder is a small deletion of a phenylalanine at position 508. An amplification of this region using PCR can be done and then that poion sequenced to see how it compares to the normal sequence. Nohern blot is used to determine RNA levels inside a cell and would not help us determine if this person is a carrier. Southern blots are used to study genomic DNA on a gross level and could not be used to see a single base-pair deletion. Western blots are used to look for the presence or absence of a paicular protein, but since the protein is produced, though defective, this technique would not give the information needed. | 2 | Nohern blot | PCR and sequencing | Southern blot | Western blot | Biochemistry | null | fc1d4b5c-bc39-46f4-8e40-526b3f556ddb | multi |
Bacterial cell wall is composed of all except -? | Bacteria are usually single-celled, except when they exist in colonies. ... The major component of the bacterial cell wall is peptidoglycan or murein. This rigid structure of peptidoglycan, specific only to prokaryotes, gives the cell shape and surrounds the cytoplasmic membrane. Ref:Ananthanarayan & panikers Textbook of microbiology 9th edition page no 15,16 | 2 | Muramic acid | Teichoic acid | Glucosamine | Mucopeptide | Microbiology | general microbiology | b853d316-c23a-412d-93cc-d83fa516ade8 | multi |
A 27-yrs-old woman has been feeling low for the past 2 weeks. She has little energy and has trouble concentrating. She states that 6 weeks ago she had been feeling very good, with lots of energy and no need for sleep. She states this pattern has been occurring for at least the past 3 years, though the episodes have never been so severe that she couldn't work. Most likely diagnosis is? | Cyclothymic disorder *Cyclothymic disorder is characterized by recurrent periods of mild depression alternating with periods of hypomania. *This pattern must be present for at least 2 years (1 year for children and adolescents) before the diagnosis can be made. *During these 2 years, the symptom-free intervals should not be longer than 2 months. Cyclothymic disorder usually stas during adolescence or early adulthood and tends to have a chronic course. *The marked shifts in mood of cyclothymic disorder can be confused with the affective instability of borderline -, personality disorder or may suggest a substance abuse problem. | 3 | Borderline personality disorder | Seasonal affective disorder | Cyclothymic disorder | Major depression, recurrent | Surgery | null | 43647b60-760f-4f7a-bbef-9c3fb997e9b6 | single |
Which of the following condition is associated with hepatomegaly with liver pulsation? | Characteristic features of Tricuspid regurgitation are marked hepatomegaly and systolic pulsations of the liver. Hepatic pulsation in tricuspid regurgitation is caused by reversed systolic blood flow in the great veins. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 10; The Cleveland Clinic Cardiology Board Review By Brian P. Griffin, Page 290 | 3 | Mitral Stenosis | Mitral Regurgitation | Tricuspid Regurgitation | Pulmonary Hypeension | Medicine | null | 5f3fb73b-4f72-4378-92a3-06a0cc39c796 | single |
Which of the follwing gas given off in a fire is most commonly known to cause metabolic poisoning? | Ans. B. CO. (Ref. Bailey & Love 26th ed. Pg. 386; Summary box 28.3)Metabolic poisoning in burns:# There are many poisonous gases that can be given off in a fire, the most common being carbon monoxide, a product of incomplete combustion that is often produced by fires in enclosed spaces. This is the usual cause of a person being found with altered consciousness at the scene of a fire.# Carbon monoxide binds to haemoglobin with an affinity 240 times greater than that of oxygen and therefore blocks the transport of oxygen. Levels of carboxyhaemoglobin in the bloodstream can be measured. Concentrations above 10% are dangerous and need treatment with pure oxygen for more than 24 hours. Death occurs with concentrations around 60%.# Another metabolic toxin produced in house fires is hydrogen cyanide, which causes a metabolic acidosis by interfering with mitochondrial respiration.Additional educational points:The shock reaction after burns# Bums produce an inflammatory reaction# This leads to vastly increased vascular permeability# Water, solutes and proteins move from the intra- to the extravascular space# The volume of fluid lost is directly proportional to the area of the bum# Above 15% of surface area, the loss of fluid produces shockASPHYXIANTS# Include CO, CO2, Hydrogen sulphide and some war gases.- CO reduces the oxygen carrying capacity of the blood;- Carbon dioxide produces oxygen lack in the tissues;- Hydrogen sulphide paralyses the respiratory centre.Cause of death in burns:# Primary neurogenic shock - instantaneously from fear or pain or within 24-48 hrsfrom severe pains or from injury to vital organ from burning, or from oligemic shock.# If a victim survives this stage, this stage merges rapidly into the stage of secondary shock due to depletion of blood (serum) volume.# Apart from actual burning, death may occur from asphyxia (suffocation) due to inhalation of smoke containing carbon dioxide, carbon monoxide, and other products of combution, which may be poisonous (in recent yrs cyanide intoxication has been recognized as important, especially where plastics and paints are burning), or accidental injuries from falling structures whle trying to escape from abuming house, or from fat embolism. | 2 | HCN | CO | CO2 | H2S | Surgery | Burns | 65f7d156-ab6a-41ef-a616-6fc7afda8fa9 | single |
Roll back malaria programme focused mainly on ? | Ans. is 'b' i.e., Insecticide treated bed nets The main strategies of Roll Back Malaria initiative are : a) Strengthen health system to ensure better delivery of health care, especially at district and community level. b) Ensure the proper and expanded use of insecticide treated mosquito nets. c) Ensure adequate access to basic health care and training of health care workers. d) Encourage the development of simpler and more effetive means of administering medicines, such as training of village health workers and mothers on early and appropriate treatment of malaria, especially in children. e) Encourage the development of more effective and new anti-malaria drugs and vaccines. | 2 | IEC campaigns for community awareness | Insecticide treated bed nets | Development of larvivorus fishes for eradication of larvae. | Presumptive treatment of malaria case | Social & Preventive Medicine | null | dcffb592-bae2-4b01-8b5d-e3e7fa831b3b | single |
Influenza vaccine cause ? | Ans. is 'd' i.e., All of above Mild problems following inactivated flu vaccine: Soreness, redness, or swelling where the shot was given Hoarseness Sore, red or itchy eyes Cough Fever Aches Headache Itching Fatigue If these problems occur, they usually begin soon after the shot and last 1 or 2 days. Moderate problems following inactivated flu vaccine: Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure. Problems that could happen after any vaccine: Brief fainting spells can happen after any medical procedure, including vaccination. Sitting or lying down for about 15 minutes can help prevent fainting, and injuries caused by a fall. Tell your doctor if you feel dizzy, or have vision changes or ringing in the ears. Severe shoulder pain and reduced range of motion in the arm where a shot was given can happen, very rarely, after a vaccination. Severe allergic reactions from a vaccine are very rare, estimated at less than 1 in a million doses. If one were to occur, it would usually be within a few minutes to a few hours after the vaccination. | 4 | Local swelling | Fever | Itching | All of above | Pediatrics | null | c265425d-638c-4850-bdb5-40e483cbf367 | multi |
The following rodent is the natural reservoir of plague - | - the reservoir of plaque is wild rodents, filed mice gerbils and skunks. - in India, the wild rodent Tatera indica is the main reservoir. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:293 <\p> | 2 | Mus musculus | Tatera indica | Rattus Rattus | Rattus norvegicus | Social & Preventive Medicine | Communicable diseases | 455ad9be-d492-4923-b412-24c530c6f3c8 | single |
A 35-year-old man developed headache, nausea, vomiting, and sore throat 8 weeks after returning from a trip abroad. He eventually refused to drink water and had episodes of profuse salivation, difficulty in breathing, and hallucinations. Two days after the patient died of cardiac arrest, it was learned that he had been bitten by a dog while on his trip. Which of the following treatments, if given immediately after the dog bite, could have helped prevent this disease? | Rabies is caused by a rhabdovirus, a minus-sense, single-stranded, non-segmented RNA virus with an enveloped, bullet-shaped virion). The virus infects a wide range of warm-blooded animals, including humans. The virus is widely disseminated within the infected animals, with high levels in saliva. If the animal is captured or killed, examination of its brain for rabies virus can be done in time to determine whether rabies prophylaxis is necessary. The best means to prevent rabies begins with scrupulous wound care, including washing and probing for any foreign bodies (e.g., broken teeth) in the wound. If the animal is not available, or tests positive for rabies, and if the person has not been immunized with rabies vaccine, the treatment of choice is to give human rabies immunoglobulin (HRIg) plus rabies vaccine at separate sites (d). The HRIg should be infused into the wound and the remainder given as a deep IM injection. After onset of symptoms, neither of these should be given. Broad-spectrum antibiotics (a) may be given as part of wound care to prevent bacterial infection, but they will not prevent rabies. Acyclovir (b) and ribavirin (c), regardless of dosage or route of administration, have no role in rabies prophylaxis. Tetanus immune globulin and/or tetanus toxoid vaccine (e) may also be part of the wound care regimen, but are given to prevent tetanus, not rabies. | 4 | Broad-spectrum antibiotics | High-dose acyclovir | IV ribavirin | Rabies immune globulin plus rabies vaccine | Microbiology | Virology | 1a93d1b1-43e5-4e0f-9c9e-45f7b054874d | multi |
A 22-year-old primigravida at 11 weeks of gestational age has a blood pressure reading of 150/100 mm Hg obtained during a routine visit. . The patient denies any headache, visual changes, nausea, vomiting, or abdominal pain. Her repeat BP is 160/90 mm Hg, and urinalysis is negative for protein. Which of the following is the most likely diagnosis? | Chronic hypeension is defined as BP >140/90 mmHg before pregnancy or diagnosed before 20 weeks of gestation, or hypeension first diagnosed after 20 weeks of gestation and persistent after 12 weeks postpaum. The average prevalence of hypeension in women aged 18 to 39 years is approximately 5-7 percent. | 2 | Preeclampsia | Chronic hypeension | Eclampsia | Gestational hypeension | Gynaecology & Obstetrics | Obstetrics | 7efc8789-126c-487d-abe8-7a5e172213c6 | single |
Height of children in 2-10 years of age is increased by- | Ans. is 'c' i.e., 6 cm/year "After 4 years, the child gains about 5 cm in height every year, until the age of 10 years" -- O.P. Ghai. "An average child gains approximately 7-8 cm in height between the age of 2-6 years and 6-7 cm in height between 6-12 years". -- Nelson Amongst given option, 6 cm/year is the best answer. | 3 | 2 cm/year | 4 cm/year | 6 cm/year | 10 cm / year | Pediatrics | null | 5f99829d-90b2-4e68-9fe6-8f67027e5d14 | single |
Air-borne contact dermatitis can be diagnosed by: | Ans: B (Patch test) Ref: Eczema. In: Thappa DM. editor. Essentials in Dermatology, 2nd,edn.. New Delhi: jaypee brothers medical publishers (P) Ltd 2009:99-113. & Atopic dermatitis. Eczema and non infectious immunodeficiency disorders. In: James WD. Berger TG, Elston DM. editors. Andrew's diseases of the skin: Clinical Dermatology, 11th edn., China: Saunders Elsevier 2011: 62-87.Explanation:Patch test - Application of allergens suspected to be the cause of allergic contact dennatitis to intact uninflamed skin in non irritating concentrationDiagnostic of allergic contact dermatitis (airborne contact dermatitis is a type of allergic contact dermatitis wherein the allergens are airborne like pollen, cement, etc)Patch test - Delayed hypersensitivity (type IV hypersensitivity)Reading done two days laterPrick testType I hypersensitivity reaction, used to detect allergy to a host of allergens like food, dust, insects, drugs, etcDone in atopic dermatitis, chronic urticaria, allergic rhinoconjunctivitis, bronchial asthmaReading done in 15 minutesSerum IgE levels are non specifically elevated in allergic conditions characteristically high levels are seen in atopic dermatitis and very high levels in hyper IgE syndromeSkin biopsy reveals nonspecific features of spongiosis seen in all cases of dermatitis and not specific for airborne contact dermatitis. | 2 | Skin biopsy | Patch test | Prick test | Estimation of serum IgE levels | Skin | Disorder of Pigmentation | efefa614-35a4-49b1-bdca-0f254edcef23 | single |
Children with apathy, general weakness, loosening of the skin, marasmic features also has X3B Xerophthalmia features. Eye finding will be | (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 467 - 470)X3A Corneal ulceration/keratomalacia affecting less than a one-third corneal surfaceX3B corneal ulceration/keratomalacia affecting more than a one-third corneal surfaceXS corneal scar due to xerophthalmia XF Xerophthalmic fundus | 2 | Corneal ulcer with thickening | Corneal ulcer with full thickness | Hyperemia | Conjunctival xerosis | Ophthalmology | Cornea and sclera | 7901b015-8182-4e64-acf7-4a88a950489b | single |
A perforated peptic ulcer is treated by all except | The most impoant component of the operation of perforated peptic ulcer is a thorough peritoneal toilet to remove all of the fluid and food debris. If the perforation is in the duodenum it can usually be closed by several well-placed sutures, closing the ulcer in a transverse direction as with a pyloroplastyIf the perforation is difficult to close primarily itis frequently possible to seal the leak with an omental patch (Graham patch) alone, and many surgeons now employ this strategy for all perforations.In the past, many surgeons performed definitive procedures such as either truncal vagotomy and pyloroplasty or, more recently and probably more successfully, highly selective vagotomy during the course of an operation for a perforation.Following operation,gastric antisecretory agents should be staed immediately. H.pylori eradication is mandatory.Under-running of a vessel is done in peptic ulcer bleedingBailey and love pg: 1126 | 1 | Under running of vessel | H.pylori eradication | Highly selective Vagotomy | Omental patch | Surgery | G.I.T | 23b911e7-ca5d-4db2-b81b-02749e6d6d75 | multi |
Hyperkalemia with no ECG finding. The drug that should not be used is - | calcium gluconate immediately antagonises the cardiac effects of hyperkalemia, whereas the others are used to correct hyperkalemia. (reference : harrisons principles of internal medicine,19E page- 312) | 2 | Sodium bicarbonate | Calcium gluconate | Glucose with insulin | Resins | Medicine | Fluid and electrolytes | 3eaff76e-ac66-409b-9154-7a3bb8b4f539 | single |
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