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Skin test based on neutralization reaction is/are - | Small amount (0.1 ml) of diluted (1/50 MLD) diphtheria toxin is injected intradermally into one arm of the person and a heat inactivated toxin on the other as a control. If a person does not have enough antibodies to fight it off, the skin around the injection will become red and swollen, indicating a positive result. This swelling disappears after a few days. If the person has an immunity, then little or no swelling and redness will occur, indicating a negative result. Ref: Ananthanarayan & Panikers textbook of microbiology 9th edition pg:112 | 4 | Casoni test | Lepromin test | Tuberculin test | Schick test | Microbiology | Immunology | 1e03a4fd-8f38-4d02-b45f-668936bf3ef5 | single |
Treatment of choice for Eale’s disease | 1. Medical treatment. Course of oral corticosteroids for extended periods is the main stay of treatment during active inflammation.
A course of antitubercular therapy has also been recommended in selective cases.
2. Laser photocoagulation of the retina is indicated in stage of neovascularizion.
3. Vitreoretinal surgery is required for non- resolving vitreous haemorrhage and tractional retinal detachment. | 1 | Corticosteroids | Antibiotics | Antihistaminics | Surgery | Ophthalmology | null | b10fb5e5-94ea-4787-b790-bebe6612508c | single |
Risk factors for Placenta Accreta include all of the following, except: | In placenta accreta, there is a failure of normal decidua to form which causes the placenta to be directly anchored to the myometrium either paially or completely without any intervening decidua. Placenta prae in the present pregnancy is a risk factor for placenta accreta but previous placenta prae is not a risk factor. Ref: Manual of Pathology of the Human Placenta By Rebecca N. Baergen, Ku Benirschke; 2nd edition, Pages 192-97; Dutta textbook of Obstetrics 6th edition, Pages 420-21 | 4 | Previous LSCS scar | Previous curettage | Previous myomectomy | Previous placenta prae | Gynaecology & Obstetrics | null | 720bd9af-1cfb-42e3-b200-29e88044abb9 | multi |
Most common site of lentigo maligna subtype of malignant melanoma is ? | Most common site of lentigo maligna subtype of malignant melanoma is face- Hutchinson's melanotic freckle. It is more common in elderly women. It ia slow growing, variegated, brown macule/ lentigo; also seen in neck and hands. Reference : page 295-96 SRB's manual of surgery 5th edition | 3 | Palms & soles | Trunk | Face | Buttocks | Surgery | Urology | 2932f223-5449-4cfc-a477-9e1871e9d492 | single |
Foaming liver is seen in - | null | 3 | Organophosphorus Poisoning | Actinomycosis | Gas gangrene | Anthrax | Surgery | null | 0e0c983c-8f97-4568-9023-5ae41c8eb03c | single |
A patient presents with intermittent headache. On examination there is hypeension and a thyroid nodule. Which of the following steps is to be taken next - | Ans is option 2.. Urine VMA and aspiration of thyroid nodule. Intermittent headache (common symptom of pheochromocytoma) and thyroid nodule points towards Pheochromocytoma with medullary carcinoma thyroid Which inturn is a feature of MEN || syndrome Pheochromocytoma is diagnosed by demonstrating excretion of Catecholamines or its metabolites in urine Medullary Ca of thyroid is diagnosed by aspiration of thyroid nodule Ref Harrison 17/e p 2361 | 2 | Urine HIAA levels | Urine VMA and aspiration of the thyroickiodule | Ultrasound abdomen | Echocardiography | Medicine | Endocrinology | 34c744aa-d976-4256-b48d-aa1c59b1d93d | multi |
Low molecular weight heparin mainly inhibits which factor: September 2009 | Ans. C: Factor Xa | 3 | Factor Ilia | Factor VIIIa | Factor Xa | Factor XIIa | Pharmacology | null | 0cdc0edc-2a8c-4090-ba00-ac57178f5342 | single |
Exarticulation of teeth means: | Avulsion
Term used to describe the complete displacement of tooth from its alveolus. It is also called as exarticulation and most often involves the maxillary teeth. | 4 | Intrusion | Extrusion | Sublimation | Avulsion | Dental | null | 16c7e8db-8265-402e-b597-f0f17d67fff7 | single |
Serotonin is sexreted by | platet seretonin normally the seratonin secreted from the enterochromaffin cells enters the blood stream . the platelets when bind to the clot release seratonin where it xan help in vaso constriction or dilation and hels in hemostasis Ref: Katzung 12 th ed. | 3 | Leukocytes | RBCs | Platelets | Vessel wall | Pharmacology | All India exam | dcb93de9-a6ed-4201-aa28-160fffaaeda5 | multi |
A 9 year old girl is presenting with non productive cough and mild stridor for 2.5 months duration. Patient is improving but suddenly developed wheeze, productive cough, mild fever and on X-ray hyperlucency is seen and PFT shows obstructive curve. The MOST probable diagnosis is? | Bronchiolitis obliterans is a rare chronic obstructive lung disease characterized by complete obliteration of the small airways following a severe insult. The most common form in children is postinfectious, following a lower airway tract infection with adenovirus, although influenza, rubeola, Bordetella, and Mycoplasma are also implicated. Persons with bronchiolitis obliterans usually experience dyspnea, coughing, and exercise intolerance. This diagnosis should be considered in children with persistent cough, wheezing, crackles, or hypoxemia persisting longer than 60 days following a lower respiratory tract infection. Chest X-ray shows hyperlucency and patchy infiltrates. PFT shows airway obstruction. Ventilation-perfusion scans show a pattern of ventilation and perfusion mismatch. Classic findings on chest high-resolution CT include a mosaic perfusion pattern, vascular attenuation, and central bronchiectasis. This finding along with pulmonary function testing showing airway obstruction unresponsive to bronchodilators may be diagnostic in some patients with the appropriate clinical history. Diagnosis is by open lung biopsy or transbronchial biopsy. No specific treatment is required. Administaion of coicosteroids may be benifical. Ref: Federico M.J., Stillwell P., Deterding R.R., Baker C.D., Balasubramaniam V., Zemanick E.T., Sagel S.D., Halbower A., Burg C.J., Kerby G.S. (2012). Chapter 19. Respiratory Tract & Mediastinum. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e. | 1 | Bronchiolitis obliterans | Hemosiderosis | Pulmonary alveolar microlithiasis | Follicular bronchitis | Pediatrics | null | 11782a0a-44e3-4ac1-bf84-ec304a63094a | single |
Which of the following is best suited for detection of calculi in the submandibular gland? | null | 1 | Lower true occlusal | Lower topographic occlusal | Lower oblique occlusal Vertex occlusal | Vertex occlusal | Radiology | null | 0ef1160e-0357-4d9f-bf1d-6745c49c37a9 | multi |
Posterior capsulotomy after cataract is done using | (Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 214 - 215)After cataract, if thin, can be cleared centrally by Nd: YAG laser capsulotomy. Dissection with cystitome or Zeigler&;s knife also be used. Thick membranous after cataract needs surgical membranectomy. | 2 | Argon Laser | Nd YAg | Holmium | Diode laser | Ophthalmology | Lens | 596f1db8-1aa5-4890-ba12-ac6eb12536f3 | single |
Microalbuminuria is defined as albumin | null | 2 | <30 microgms/24 hrs. urine collection | 30-300 microgms/24 hrs. urine collection | 300-550 microgms/24 hrs. urine collection | >550 microgms/24 hrs. urine collection | Medicine | null | da0881b1-066b-4d1f-804f-ee6cc396aebd | single |
Inclined plane is used in the treatment of | null | 2 | Developing cross bite | Developed cross bite | Deep bite | Open bite | Dental | null | a3301f9a-d5a9-4edb-9209-1f40ee9be1d1 | single |
The gene for folic acid transporter is located on which chromosome | null | 3 | 5 | 15 | 21 | X | Biochemistry | null | 2b299b63-e0bb-4cb4-898f-3214928a90f5 | single |
Which of the following is an autosomal dominant disorder? | Answer is D (Huntington's chorea): Huntington's chorea is inherited as autosomal dominant Disorder Inheritance Fragile X syndrome X Linked Fanconi's syndrome Autosomal recessive Duchene's dystrophy X Linked | 4 | Duchenes muscular dystrophy | Fragile X syndrome | Fanconi's syndrome | Hutington's chorea | Medicine | null | ec0b19fd-ccb6-4517-886f-566c9e23939d | single |
Best advantage of doing transcranial Doppler ultrasound? | - Transcranial Doppler ultrasound It uses low frequency probe as it has higher penetration Using low frequency probe and a proper acoustic window the vessels of Circle of Willis can be evaluated. The acoustic windows are: 1. Transtemporal 2.Submandibular 3.Transorbital 4.Suboccipital window It is very sensitive and the first line investigation to know the flow dynamics in middle cerebral aery It is used to detect vasospasm especially in SAH as during vasospasm there is increased flow velocity in the MCA Acoustic windows of Skull | 3 | Detect AV malformation | Detect emboli | Detect vasopasm | Detect brain blood vessels stenosis | Radiology | JIPMER 2019 | 7b64c0db-a59f-4e7a-b711-224d2af45a70 | single |
Trimming and fuher modification of N-linked glycoproteins takes place at | Ans: a) Golgi apparatus N-Glycosylation begins in the ER and completed in Golgi. Trimming and fuher addition of sugars take place in Golgi. There are 3 types of N-glycosylation. 1. High-mannose type 2. Complex type 3. Hybrid type To form high-mannose chains, the glucose and some of the peripheral mannose residues are removed by glycosidases in Golgi. To form complex type, the glucose residues and four of the mannose residues are removed by glycosidases in the endoplasmic reticulum and Golgi, then N-acetyl glucosamine, galactose, and N-Acetylneuraminic acid are added in reactions catalyzed by glycosyltransferases in the Golgi apparatus. Hybrid chains are formed by paial processing, forming complex chains on one arm and mannose units on the other arm. | 1 | Golgi apparatus | Endoplasmic reticulum | Peroxisomes | Lysosomes | Biochemistry | Organelles | ad91b07f-fdfd-4196-9d34-b7616c929ddc | single |
who gave the concept of latent and manifest dreams | CONTRIBUTIONS OF FREUD o Father of psychoanalysis He founded a type of psychotherapy called psychoanalysis. It is nothing but analyzing the psych(MIND) o Interpretation of dreams According to Freud dreams are royal road to unconscious In dreams several conflicts that are present in the unconscious comes to the consciousness in the form of dreams Thus by analyzing ones dreams we could understand the unconscious conflicts o Psychosexual stages of life o Freud divided development into 5 stages namely psycho sexual development o It is divivded namely oral , anal , phallic, latent, genital phase. o Conversion disorders conversion disorder is conveing a psychological pain to physical symptoms present physical symptoms which has some connection with unconscious conflict is called SYMBOLIZATION present physical symptoms which has some resemblance with illness in family members, which is called MODELLING patient has illness like neurological deficit but they have apparent in concern towards their own illness which is known as LA BELLE INDIFFERENCE main defense mechanism in conversion disorder is REPRESSION o Repression defence mechanism * REPRESSION is called QUEEN of defense mechanisms o COUCH and FREE ASSOSIATION * He introduced a technique called as a couch technique where he makes the patient lie on the couch, he asks the patient to speak from 'cabbages to kings. This method is called FREE ASSOSIATION. By allowing the patient to speak whatever that comes to their mind randomly so that by analyzing their thoughts we could understand the conflict in the unconscious. o Topographical theory of mind Freud gave topographical theory mind It is divided into pre conscious, unconscious, conscious Later he disregarded topographical theory of mind and gave structural theory of mind o Structural theory of mind It is divided into id, ego, super ego Id= instinctual desires like anger, hunger, sexual instinct Ego= function of mind to work based on ego to avoid guilt from super ego Super ego= based on moral principle, obtained from family members and relatives, teachers Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition pg no. 845 | 1 | freud | master and johnson | benedict morel | erik erikson | Anatomy | Treatment in psychiatry | 720d854f-f942-45bc-b194-fd4785835ee4 | single |
Patient is on autocoids for 1 year complains of severe pain epigasrium relieved iv antacids now complains of pain in right iliac fossa and epigastrium with fever and loss of liver dullness diagnosis | Answer- A. Duodenal perforationLong term therapy with autocoids led to an ulcer that eventually perforated and now the patient has presented early signs of peritonitis.Clinical features of perfontion of duodenal ulcerPerforated duodenal ulcer is characterized by sever constant onset epogastric painPatient looks ill and lies unusually stillTachycardiaShallow respirationTender with intense guarding and rigidityIf the air has escaped into peritoneal cavity then liver dullness may be absentPeptic ulcer perforation leads to chemical peritonitis initially. | 1 | Duodenal perforation | Diveiculitis | Gastroenteritis | Enteric perforation | Surgery | null | 5de33d00-7267-4c32-ba12-4c9d6598d9af | single |
Prokaryote among the following is? | Based on differences in cellular organisation and biochemistry this kingdom has been divided into two groups: prokaryotes and eukaryotes. Bacteria and blue-green algae are prokaryotes while fungi, other algae, slime moulds and protozoa are eukaryotes. Bacteria are prokaryotic microorganisms that do not contain chlorophyll. They are unicellular and do not show true branching except in the so-called higher bacteria (Actinomycetes). Ref: Textbook of Microbiology; Ananthanarayan and Paniker; 9th edition. | 1 | Bacteria | Mycoplasma | Fungi | Blue green algae | Microbiology | general microbiology | d0ecc061-5478-442a-9b20-b8c8b3558069 | single |
Tongue muscles are derived from - | Musculature of the tongue is mainly derived from myoblasts originating in the occipital somites. Thus, the tongue musculature is innervated by hypoglossal nerve. | 1 | Occipital somites | Pharyngeal pouch | Hypobranchial emminence | Neural crest Palate | Anatomy | null | 7dda38e3-853f-43b2-8975-d2d244084280 | single |
After 3 wks of duration pancreatic pseudocyst 5 cm in size should be managed by which method | Ans. is 'd' ie. USG and follow up Management of Pancreatic Pseudocyst A pancreatic pseudocyst may resolve spontaneously so it is followed with serial ultrasound studies. Indications of Surgical intervention: (Ref: Bailey and Love 25/e 1145; CSDT 13/e p583; Harrison 17/e p) i) Age of cyst more than 12 weeks without resolution ii) Size of cyst greater than 6 cm. iii) Symptomatic iv) Development of complications (eg. haemorrhage, perforation, g.i. obstruction) But note that these indications for intervention are just a generalization used for teaching the undergraduates. These are not specific indications for interventions. Therapeutic interventions are advised (irrespective of size and duration) when - the pseudocyst is symptomatic or - increasing is size on follow up studies, or - any complication (rupture, hemorrhage, or abscess) arise or - there is suspicion of malignancy. Thus expectant management is adequate (irrespective of size) if the patient is asymptomatic and serial u/s studies show that the cyst is resolving. Surgical methods a) Internal Drainage - most preferred surgical management in uncomplicated pseudocyst is internal drainage. The three options are Cystojejunostomy Cystogastrostomy Cystoduodenostomy Internal drainage can be done either open surgical or laparascopic or by percutaneous catheter-based methods (transgastric puncture and stent placement to create a cystogastrostomy) b) Excision of Pseudocyst - is hardly done and is usually limited to pseudocyst involving the tail of the pancreas. c) External drainage - is done in:? - infected pseudocyst - for immature pseudocyst with thin nonfibrous walls that does not allow safe internal drainage. - in an unstable pt. in whom more complex surgical intervention is precluded. d) Transpapillary pancreatic duct stent : Because pseudocysts often communicate with the pancreatic ductal system, two newer approaches to pseudocyst management are based on main duct drainage, rather than pseudocyst drainage per se. A stent is passed into the pseudocyst through the papilla of Vater. this drainage, paicularly when incomplete, can allow bacteria to enter the pseudocyst and lead to development of an infected pseudocyst. Another transpapillary approach involves placing a stent across the duct defect rather than into the cyst through the defect. By excluding pancreatic juice from the pseudocyst, this bridging intraductal stent may permit the duct disruption to heal and the pseudocyst to resolve without drainage (analogous to the use of common bile duct stents in the setting of a cystic duct leak). | 4 | Cystogastrostomy | Needle aspiration | External drainage | USG and follow up | Surgery | null | 50f93d83-ad0c-420e-8242-ff48870adb1a | single |
Gall blader stone formation in influenced by A/E ? | Ans is 'd' i.e., Hypercholesterolemia Hyperalimentation - decreases gall bladder motility, promotes stasis Primary biliary cirrhosis - decreases bile salt secretion into bile Clofibrate therapy - increases biliary cholesterol - thus these factors predispose to cholesterol stone formation. Predisposing factors for cholesterol gall stone formation are 1. Demographic/genetic factors Prevalence highest in Noh American Indians, Chilean Indians and Chilean Hispanics, greater in Nohern Europe and Noh America than in Asia, lowest in Japan; familial disposition; hereditary aspects. 2. Obesity a. Normal bile acid pool and secretion but increased biliary secretion of cholesterol 3. Weight loss a. Mobilization of tissue cholesterol leads to increased biliary cholesterol secretion while enterohepatic circulation of bile acid is increased 4. Female sex hormones a. Estrogens stimulate hepatic lipoprotein receptors, increases uptake of dietary cholesterol, and increase biliary cholesterol secretion b. Natural estrogens, other estrogens, and oral contraceptives lead to decreased bile salt secretion and decreased conversion of cholesterol to cholesteryl esters. 5. Increasing age a. Increased biliary secretion of cholesterol, decreased size of bile acid pool, decreased secretion of bile salts. 6. Gallbladder hypomotility leading to stasis and formation of sludge Prolonged parenteral nutrition Fasting Pregnancy Drugs such as octreotide 7. Clofibrate therapy a. Increased biliary secretion of cholesterol 8. Decreased bile acid secretion Primary biliary cirrhosis Genetic defect of the CYP7A1 gene 9. Decreased phospholipid secretion a. Genetic defect of the MDR3 gene 10. Miscellaneous High-calorie, high fat diet Spinal cord injury | 4 | Clofibrate therapy | Hyperalimentation | Primary biliary cirrhosis | Hypercholesterolemia | Surgery | null | 65141c6a-e579-4edb-9845-329be41f383f | multi |
A 3-year-old male child presents with multiple laryngeal papillomas with hoarse voice and slight airway distress. Papillomas are involving the glottis. The best treatment is: | Preferred treatment is microlaryngoscopy and excision. As the recurrence is common, repeated excisions may be required. Tracheostomy is avoided to prevent distal spread. Interferon therapy has not shown sustained benefit. | 4 | Tracheostomy and observation | Steroids | Interferon therapy | Microlaryngoscopy and excision | ENT | Larynx | 05c0c6fd-8ee4-471f-9789-50a4ac2ed9c0 | single |
All are true regarding coup injury except | Features of coup injury Injury at the site of impact External injury like contusion, laceration on scalp or skull fracture Due to the direct impact on brain May occur when head is fixed Less severe than contre coup Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 168 | 3 | Injury at the site of impact | Occur when head is fixed | Severe than cotre- couple injury | External injury like contusion, laceration on scalp or skull fracture seen | Anatomy | Special topics | 839bce3c-59fa-404c-bc89-6092d4f1a45c | multi |
Gout is a disorder of- | Gout is the most common inflammatory ahritis in men and in older women. It is caused by deposition of monosodium urate monohydrate crystals in and around synol joints due to abnormal purine metabolism . Ref Davidsons 23e p1013 | 1 | Purine metabolism | Pyriniidine metabolism | Ketone metabolism | Protein metabolism | Medicine | Immune system | 8191969b-3ee1-4cfa-acd0-2111b8dab3db | single |
The most common site of lymphangiosarcoma is | Lymphangiosarcoma is a rare tumor that develops as a complication of long-standing (usually more than 10 years lymphedema. | 3 | Liver | Spleen | Post mastectomy edema of arm | Retroperitoenum | Surgery | null | d72d010c-c6b1-4139-b56c-5b2bddbc74cf | single |
Most common tumor of vertebral spine in adults | (A) Secondary deposits> Most common secondary deposits from visceral primary malignancy occurs in the site of vertebral spine.> Most common primary bone marrow malignancy is multiple myeloma> Most common primary malignant bone tumor is osteosarcoma. | 1 | Secondary deposits | Multiple myeloma | Lymphoma | Hemangioma | Orthopaedics | Miscellaneous | 508df2ff-a2b3-4308-933a-44f79bd1ac39 | single |
General visceral fibres do not supply | Skeletal muscle is not supplied by general visceral fibres Inderbir Singh&;s textbook of human Histology Seventh edition | 2 | Smooth muscles | Skeletal muscles | Cardiac muscles | Glands | Anatomy | General anatomy | a80adf07-5438-4436-a8e1-c2bd790f6393 | single |
An infant born at 35 weeks' gestation to a mother with no prenatal care is noted to be jittery and irritable, and is having difficulty feeding. You note coarse tremors on examination. The nurses repo a high-pitched cry and note several episodes of diarrhea and emesis. You suspect the infant is withdrawing from | Infants born to narcotic addicts are more likely than other children to exhibit a variety of problems, including perinatal complications, prematurity, and low bih weight. The onset of withdrawal commonly occurs during an infant's first 2 days of life and is characterized by hyperirritability and coarse tremors, along with vomiting, diarrhea, fever, high-pitched cry, and hyperventilation; seizures and respiratory depression are less common.The production of surfactant can be accelerated in the infant of a heroin-addicted mother. | 3 | Alcohol | Marijuana | Heroin | Cocaine | Surgery | null | ac21efef-cc53-470c-a10f-0cbfb21fcea8 | single |
Which of the following is a definite indication for systemic steroids in rheumatoid ahritis? | Disease modifying antirheumatic drugs (DMARDs) represent the most impoant measure in the successful treatment of rheumatoid ahritis. When symptoms are not improved by DMARDs, systemic steroids can be introduced. Mononeuritis multiplex is due to small vessel vasculitis and it can be prevented with steroids. | 4 | a) Mononeuritis multiplex | b) Carpel tunnel syndrome | c) Lung involvement | Both 'a' & 'c' | Medicine | null | 3f23f720-1e86-4a63-bce5-f882b95fa58d | multi |
Which of the following amino acid can produce oxaloacetate directly in a single reaction? | Alanine, Cysteine and Threonine can also produce oxaloacetate but pyruvate only. Aspaate can directly produce oxaloacetate in a single step, i.e. transamination reaction. | 4 | Alanine | Cysteine | Threonine | Aspaate | Biochemistry | Classification and metabolism of amino acids | 36c00e39-a06f-48b5-9893-114a9545f1d8 | single |
Blunt injury abdomen, patient was hemodynamically stable, next investigation | .evaluation of blunt trauma of abdomen ultrasound-useful,simple,non invasive method of evaluating the abdomen. advantages of ultrasound-no danger of radiation,can be done bedside,can be repeated many times,it is cost effective. focused abdominal sonar trauma(FAST)-it is rapid ,non invasive,poable bedside method of investigation focusing on pericardium, splenic , hepatic and pelvic areas.blood more than 100ml in cavities can be identified. (Ref: SRB&;s Manual of Surgery ,5th edition ,pg no. 146) | 3 | X-ray abdomen | Barium smallow | FAST | DPL | Surgery | Trauma | c37df03d-aef8-40e9-a43f-559fced75cfe | multi |
Which element is required by phosphofructokinase? | Phosphofructokinase (PFK) is --300 amino acids in length, and structural studies of the bacterial enzyme have shown it comprises two similar (alpha/beta) lobes: one involved in ATP binding and the other housing both the substrate-binding site and the allosteric site (a regulatory binding site distinct from the active site, but that affects enzyme activity). The identical tetramer subunits adopt 2 different conformations: in a 'closed' state, the bound magnesium ion bridges the phosphoryl groups of the enzyme products (ADP and fructose-1,6- bisphosphate); and in an 'open' state, the magnesium ion binds only the ADP, as the 2 products are now fuher apa | 1 | Magnesium | Inorganic phosphate | Manganese | Copper | Biochemistry | null | daf6dadd-6bc3-4ca9-a1b6-ceb2cd266d0f | single |
World health day - | The constitution came into force on 7 th April 1948 which is celebrated every year as "world health Day ".A world health day theme is chosen each year to focus attention on a specific aspect of public health (refer pgno:919 park 23rd edition) | 1 | 7th April | 7th July | 7th Dec | 7th Feb | Social & Preventive Medicine | Health care of community & international health | 61e9c5b9-2004-4871-bd24-f71a493fd437 | single |
A 50 year old male chronic smoker complaints of hoarseness of voice for the past 4 months. Microlaryngoscopic biopsy shows it to be keratosis of the larynx. All are suggested treatment modalities for this condition, EXCEPT: | Laryngeal keratosis is a precancerous condition. Treatment modalities includes avoidance of aetiological factors such as smoking, stripping of vocal cords and examination of tissues for malignancy and use of laser vaporization. The treatment of Keratosis of the larynx is conservative involving microsurgical excision. Paial laryngectomy may be used in the presence of ceain T1 stage malignancy of Larynx. | 3 | Stop smoking | Laser vaporizer | Paial laryngectomy | Stripping of vocal cord | ENT | null | 34f8f078-91cc-4f8a-8cf6-3b341640ad5a | multi |
CRP increases in all EXCEPT: | ANSWER: (A) OsteoarthritisREF: Harrison's 17th ed chapter 325CRP raisedCRP not raisedChronic inflammatorv arthritisChronic non inflammatory arthritis* Pauciarticular JRA* Osteoathrtis* Reactive arthritis* Osteonecrosis* Psoriatic arthritis* Charcot's arthritis* Rheumatoid arthritis | 1 | Osteoarthritis | Rheumatoid arthritis | Reactive arthritis | Psoriatic arthritis | Medicine | Osteoarthritis | bcaee2b9-6f4e-4381-8e7b-7b084877b2f5 | multi |
Right anterior oblique view of chest X–ray true is/are – a) Cassette near right shoulderb) Cassette near left shoulderc) Arch of Aorta best seend) Left atrial enlargement can be diagnosede) Mitral & tricuspid valves better seen | In RAO view of chest, the patient is rotated 45° to the left (right side is more forward) and the cassette is close to the right front (right shoulder) of the patient. The RAO view is generally used for the assessment of the pulmonary artery, right ventricle, and size of the left atrium. | 1 | ad | c | ac | ab | Radiology | null | f1541fe0-0ad1-48d4-b903-fed5720ffd6f | multi |
Milk borne diseases are all except t- | Ecole is not a milk borne infection. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 605 | 2 | Salmonellosis | E. Coli | Streptococcus | Tuberculosis | Social & Preventive Medicine | Nutrition and health | 0c6d6ec4-8290-4f99-a74d-a3b6575b2ac4 | multi |
Pre anaesthetic medication glycopyrrolate is used for all of the following except | Preanaesthetic medications cause sedation and decrease basal metabolic rate. | 3 | To relieve anxiety | Sedation | Increase BMR | Decrease secretion | Anaesthesia | null | 851e3a26-ea54-41d5-bc29-3aa81411390c | multi |
Which of the following is not used for thrombo prophylaxis | Refer Katzung 10/e p 544 Anticoagulants are mainly used for venous thrombosis and are highly effective in treatment and prophylaxis of deep vein thrombosis Warfarin is most commonly used drug in a patient with chronic atrial fibrillation Aspirin and heparin in combination are recommended for unstable angina | 3 | Heparin | Warfarin | Antithrombin 3 | Aspirin | Pharmacology | Respiratory system | 0e684e09-0bed-4689-b42d-924f2947be1e | single |
The triad of diabetes, gallstones and steatorrhoea is associated with which one of the following tumours? | null | 2 | Gastrinomas | Somatostationomas | VIPomas | Glucagonomas | Medicine | null | e6bcb907-98bb-4509-8c1e-2ce826c2975f | multi |
Laryngeal mirror is warmed before use by placing - | Laryngeal mirror is warmed by:
Dipping the mirror in warm water.
Heating the glass surface against some heat such as bulb or spirit lamp. | 1 | Glass surface on flame | Back of mirror on flame | Whole mirror into flame | Mirror in boiling water | ENT | null | d4e2f0d4-ae66-4976-b62a-82d38bb3acfd | single |
Coartaction of aorta is associated with - | Ans. is 'c' i.e.. Bicuspid aortic valve o Coarctation of the Aorta -Constrictions of the aorta of varying degrees may occur at any point from the transverse arch to the iliac bifurcation, but 98% occur just below^ the origin of the left subclavian artery at the origin of the ductus arteriosus (juxtaductal coarctation).The anomaly occurs twice as often in males as in females.Coarctation of the aorta may be a feature of Turner syndrome and is associated with a bicuspid aortic valve in more than 70% of patients.Mitral valve abnormalities (a supravalvular mitral ring or parachute mitral valve) and subaortic stenosis are potential associated lesions.When this group of left-sided obstructive lesions occurs together, they are referred to as the Shone complex. | 3 | VSD | PDA | Bicuspid aortic valve | None of above | Pediatrics | C.H.D. | c9850b35-f368-4149-9948-5179487af70e | multi |
Most common fungal infection in non-HIV (immuno-competent) individuals? | . | 4 | Mucor | Histoplasmosis | Aspergillosis | Candidiasis | Microbiology | All India exam | e5324c21-4809-4ad3-985e-17fcd1a26c8d | single |
When observations are made before and after the exposure to the factor, it is | Ans. is 'c' i.e., Paired T-test o Paired T - test : is applied to paired data when each individual gives a pair of observation, such as when observations are made both before and after the play of a factor. e.g. Pulse rate before and after administration of a drug. | 3 | Chi-square test | Unpaired T-test | Paired T-test | Paired T-test | Social & Preventive Medicine | null | b1c7f572-c1ec-4e7f-922b-4ea300a9196d | single |
Most common form of leptospirosis: | Ans. (d) Anicteric form | 4 | Weil's disease | Icteric form | Hepatorenal form | Anicteric form | Microbiology | null | cbdd325a-71c6-4984-ae13-0069702f945f | single |
Structure crossing dorsal surface of ischial spine are all except | Pudendal nerve, internal pudendal vessels, and nerve to obturator internus after leaving the pelvis through greater sciatic foramen, cross the dorsal aspect of the ischial spine and then re-enter the pelvis through the lesser sciatic foramen. | 3 | Internal pudendal vessel | Pudendal nerve | Obturator nerve | Nerve to obturator internus | Anatomy | null | c4fd7d4f-55f0-4a22-ba57-be8c6f90f875 | multi |
Which of the following is not due to complement deficiency? | PNH is due to complement regulatory protein deficiency (DAF and CD59). | 2 | SLE | PNH | Glomerulonephritis | Neisseria infection | Microbiology | null | a9b3e1b3-39a8-49ce-bcd3-c8a45776b9c1 | single |
A scatter diagram was plotted as shown below to study the relationship between two variables. This is an example of: | null | 4 | High positive correlation | High negative correlation | Low positive correlation | Low negative correlation | Dental | null | 907ec828-519d-4839-bc38-02563294371c | single |
Which of the following drugs is used for the prophylaxis of migraine but not for angina pectoris | Ref -KDT 6/e p172 Flunarizine, sold under the brand name Sibelium among others, is a drug classified as a calcium antagonist which is used for various indications. It is not available by prescription in the United States or Japan. The drug was discovered at Janssen Pharmaceutica in 1968 | 3 | Verapamnil | Diltiazem | Flunarizine | Amlodipine | Anatomy | Other topics and Adverse effects | 6e28c1d2-224b-44d4-9bfd-0c72a12a595e | single |
Which of the following scoring system is used to see chest involvement in Sarcoidosis? | Pulmonary sarcoidosis is classified on a chest radiograph into 5 stages based on Scadding criteria:- Stage 0: Normal chest radiograph Stage I: Hilar or mediastinal nodal enlargement only Stage II: Nodal enlargement and parenchymal disease Stage III: Parenchymal disease only Stage IV: End-stage lung (pulmonary fibrosis) Rest 3 scoring systems are used for the assessment of Cystic fibrosis. | 4 | Brasfield scoring system | Wisconsin scoring system | Shwachman-Kulczycki scoring system | Scadding scoring system | Medicine | Sarcoidosis | 25ffd786-6fc8-482e-9968-83e1686aca68 | single |
Not a cause of primary amenorrhea- | Ans. B Asherman's syndrome Primary Amenorrhea is defined as: 1. In absence of secondary sexual characters No menses till the age of 14 years or 2. In presence of secondary sexual characters no menses till the age of 16 years. 3. Secondary amenorrhea is defined as absence of menses for 6 consecutive months (or length of time equivalent to total of 3 previous cycles) in a female who had previously regular menses. 4. MC cause of primary amenorrhea is ovarian dysgenesis/Turners syndrome. 5. Mullerian agenesis (Rokitansky Mayer Kustner Hauser/ R.M.K.H Syndrome) is the secondMC cause and Androgen insensitivity syndrome or Testicular feminizing syndrome (A.I.S./T.F.S) is the 3rd MC of primary amenorrhea . 6. Patients with classic Kallmann syndrome or idiopathic hypogonadotropic hypogonadism may not experience puberty or may experience incomplete puberty and have symptoms associated with hypogonadism. 7. For men, these symptoms include decreased libido, erectile dysfunction, decreased muscle strength, and diminished aggressiveness and drive. 8. For women, symptoms include amenorrhea and dyspareuniA. Notably, patients with Kallmann syndrome or idiopathic hypogonadotropic hypogonadism do not experience hot flashes. 9. All patients with Kallmann syndrome have either anosmia or severe hyposmia and may exhibit symptoms of associated conditions including those of congenital heart disease (eg, fatigue, dyspnea, cyanosis, palpitations, syncope) or neurologic manifestations (eg, color blindness, hearing deficit, epilepsy, paraplegia). 10. Pregnancy in the MC cause of secondary amenorrhea 11. "Asherman's Syndrome" is a condition characterized by adhesions and/or fibrosis of the endometrium particularly but can also affect the myometrium. It is often associated with dilation and curettage of the intrauterine cavity. A number of other terms have been used to describe the condition and related conditions including: intrauterine adhesions (IUA), uterine/cervical atresia, traumatic uterine atrophy, sclerotic endometrium, endometrial sclerosis, and intrauterine synechiae | 3 | Turner's syndrome | Kallmann syndrome | Asherman's syndrome | Rokitansky syndrome | Gynaecology & Obstetrics | Primary Amenorrhea | 3aa72b03-b4b0-41f3-bfce-d7fca4516e80 | multi |
Basanthi, a 29 yrs aged female from Bihar presents with active tuberculosis, delivers baby. All of the following are indicated, EXCEPT: | Treatment of tuberculosis is not a contraindication for breast feeding. Breastfeeding should not be discouraged for women being treated with first-line anti-tuberculosis drugs because the concentrations of these drugs in breast milk are too small to produce toxicity in the nursing newborn. The child cannot be infected by the mother breast milk, unless she has tuberculous mastitis. Ref: Manual of Neonatal Care By John P. Clohey, Eric C. Eichenwald, Ann R. Stark, Page 303. | 2 | Administer INH to the baby | Withhold breast feeding | Give ATT to mother for 2 years | Ask mother to ensure proper disposal of sputum | Social & Preventive Medicine | null | 0bb62d9a-7426-40c5-9b32-2f518d1e7340 | multi |
Which ofthe following statements is true about rabies virus - | null | 3 | It is double stranded RNA virus | Contains a DNA-dependent RNA polymerase | RNA has a negative polarity | Affects motor neurons | Microbiology | null | b7139be4-f3e6-443f-97a9-e9f65d85a6e2 | multi |
A 20 month old female child is brought for routine check-up. Complete blood count (CBC) shows moderate neutropenia. Child looks healthy, eats well and within expected parameters for age and sex. Other parameters of blood count are within normal range expected for age. Family history is unremarkable. CBC after 1 and 2 weeks shows same results. Bone marrow examination is normal. Next step | Answer: c) Watch and wait strategyBENIGN NEUTROPENIAA rare disease usually found in young children that is self-limiting.Despite low neutrophil count, the cells are functional, so infections in these children are not more common than in children with normal neutrophil count.Neutropenia is expected to get better on its own after several weeks to several months.Corticosteroids would not help with the neutrophil count and would be potentially dangerous because of all the side effects they have.Benign neutropenia is not a result of vitamin deficiency, so multivitamin therapy would not be helpful.Despite low neutrophil count, severe infections are not expected in these children, so antibiotics administration is not necessary. | 3 | Corticosteroid administration | Multivitamin administration | Watch and wait strategy | Antibiotics to prevent infection | Pediatrics | Blood | ddbe2008-30f0-40d2-92ac-45ca60ce2246 | multi |
Fracture scaphoid is usually seen in: | C i.e. Young active adult | 3 | Elderly male | Elderly postmenopausal female | Young active adult | Children | Surgery | null | f19ce742-f1be-49bf-aee5-facabb34ce87 | multi |
Following is a type of physical uicaria - | Dermographism:-Type of physical uicaria- induced by mechanical stimulus also called as Skin writing Rapid appearence of wheal flare at the site of brisk firm stroke made with a firm object.Lesions are often linear/ assume the shape of eliciting stimulus.Local erythema followed by edema.Most common physical uicaria seen in young adults sometimes symptomatic pruritus is present before the onset of lesions IADVL textbook of dermatology, cutaneous vascular responses, page 661 | 1 | Dermographism | Uicaria pigmenthosa | Uicaria vasculitis | Auto-immune uicaria | Dental | Dermatitis | 4ea9ae26-fdc7-4898-873c-805416fde5e2 | single |
A 20 yrs old young girl, presents with history of rapidly developing hirsutism and Amenorrhea with change in voice. To establish a diagnosis you would like to proceed with which of the following tests in blood: | Rapidly' progressing hirsutism points to developing androgen secreting tumors, which could be a Leydig seoli tumor of the ovary. For which estimation of androgens specifically serum testosterone should be an initial investigation along with a pelvic scan A 17 OH progesterone should be estimated as well to rule out a late onset Congenital adrenal hyperplasia. | 3 | 17-OH progesterone | DHEA | Testosterone | LH +FSH estimation | Gynaecology & Obstetrics | Polycystic Ovarian Syndrome | 917d7923-d50a-4ba8-86ff-7e58c75a1935 | single |
Disease caused by virus of family of RNA paramyxovirus, with incubation period of 14-21 days with high secondary attack rate with most common complication of aseptic meningitis. Live attenuated vaccine is available for disease with strain JeryII Lynn strain. Name of disease is? | Mumps Caused by virus of family of RNA paramyxovirus Incubation period of 14-21 days Mode of transmission : Respiratory / air droplets Source of infection: Cases Period of communicability: 4-6 days before symptoms & 7days after symptoms High secondary attack rate = 86% Most common complication is aseptic meningitis ; orchitis Live attenuated vaccine is available for disease ,with strain Jeryll Lynn strain | 2 | Measles | Mumps | Rubella | Chicken pox | Social & Preventive Medicine | VBDs, Arboviral & Viral Infections, Surface Infections | 13869871-09e6-4f51-9137-2e3252fdc06a | single |
The superior and inferior ophthalmic veins drain into the: | The superior and inferior ophthalmic veins drain into the facial vein and cavernous sinus. | 4 | Internal jugular vein | Pterygoid plexus | Frontal vein | Facial vein | Anatomy | null | efa4b086-82c1-4139-86c8-6e07ba764f2b | single |
All of the following are hormonal agents used against breast cancer except - | Ans. is 'c' i.e., Taxol | 3 | Latrazole | Exemestane | Taxol | Tamoxifen | Pharmacology | null | b5cc032f-89f5-45fd-a062-7354af78df3c | multi |
All are true about Renal tubular acidosis except. | *Renal tubular acidosis type 2 is characterized by PCT damage and inability to reabsorb bicarbonate resulting in bicarbonaturia. * The damage to DCT in A 1 leads to an inability to acidify urine due to damage to H+ K+ antipoer * The concomitant calcium loss in urine leads to nephrolithiasis and rickets. | 1 | Impaired acid production | Impaired bicarbonate resorption | Inability to acidify urine | Nephrolithiasis | Medicine | Kidney Stones & Renal Tubular Acidosis | 9bbb19db-8c1c-4de2-bc8a-f14ebc1095ce | multi |
Peripheral level health workers are all except? | Ans. is 'c' i.e., Gram Sevak | 3 | Anganwadi workers | DAIS | Gram Sevak | VHNS | Social & Preventive Medicine | null | 759f7a02-5fcb-4bd5-b712-6637cc1f9ab3 | multi |
In narcolepsy, the polysomnographic recording typically shows which of the following patterns? | REM intrusion during inappropriate periods | 1 | REM intrusion during inappropriate periods | An absence of REM sleep in midcycle | Spike-and-wave EEG recording | Extreme muscular relaxation | Psychiatry | null | 83f64c57-9f60-4a05-8dc9-f3c9d317060e | multi |
All of the following are the classical presentation of Cranioverebral junction anomalies except | . Pupillary asymmetry | 4 | Pyramidal signs | Low hairline | Sho neck | Pupillary asymmetry | Pathology | null | a109e0a3-ef58-4546-ac04-d4f0f500081b | multi |
Diabetes melitus is diagnosed if fasting blood glucose is ? | Criteria for the diagnosis of Diabetes mellitus : * Symptoms of diabetes plus random blood glucose concentration >= 11.1 mmol/L (200 mg/dL) or * Fasting plasma glucose >= 7.0 mm/L (126 mg/dL) or * Glycosylated haemoglobin >= 6.5% or * 2-hr plasma glucose >= 11.1 mmol/L (200 mg/dL) during an oral glucose tolerance test. Normal fasting blood glucose : 70-110 mg/dL Reference : page 2401 Harrison's Principles of Internal Medicine 19th edition | 2 | >100 | >126 | >110 | >116 | Medicine | Endocrinology | a07fdb39-ea23-4b28-b06d-2e4ffe1d6a2e | single |
In ETC cmplex-4 is inhibited by all except ? | Ans. is 'd' i.e.,BAL Complex I :- Barbiturates (amobarbital), piercidin A, rotenone, chlorpromazine, guanithidine. | 4 | CO | CN | H2S | BAL | Biochemistry | null | 94fc9973-f820-43cb-a2ce-1f2bbeed7ccc | multi |
All of the following nutritional assessment methods indicate inadequate nutrition except - | Ans. is 'a' i.e., Hb < 11.5 gm/dl during 3rd trimester of pregnancy | 1 | Hb < 11.5 g/dl during 3rd trimester of pregnancy | Increased 1-4 year moality rate | Bih weight < 2500 gm | Decreased weight for height | Pediatrics | null | d0a68884-f053-48e3-bed5-944618616376 | multi |
The mortality rate in Acute hemorrhagic pancreatitis is | (20%) (1896-H) (628-CMDT-09) (2011-H17th)* The term hemorrhagic pancreatitis is less meaningful in a clinical sense because variable amounts of interstitial hemorrhage can be found in pancreatitis as well as in other disorders such as pancreatic trauma, pancreatic carcinoma, and severe CHF (1896-H)* Prognosis (674-CMDT-05)Mortality rate for acute pancreatitis have declined from at least 10% to around 5% in the past 20 years, but the mortality rate of severe acute pancreatitis (more than three Ranson criteria) remains at least 20%, especially when hepatic cardiovascular or renal impairment is present in association with pancreatic necrosis.* Recurrence are common in alcoholic pancreatitis* Mortality rate for undrained pancreatic abscess approaches 100% (1900-H) | 1 | 20% | 40% | 50% | 60% | Medicine | G.I.T. | 74fec65f-0b0e-4d6a-a249-ef7910925e73 | single |
A 65 year old woman after total knee implant surgery complains of calf pain and swelling in the leg from last 2 days. Later she
complains of breathlessness and dies suddenly in the ward. Probable cause? | • PE is the most common preventable cause of death among hospitalizedpatients.PE and DVT occurring after total hip or knee replacement is currently taken as unacceptable, and steps are taken to prevent it by giving subcutaneous fondaparinux.
• For patients who have DVT, the most common history is a cramp in the lower calf that persists for several days and becomes more uncomfortable as time progresses. For patients who have PE, the most common history is unexplained breathlessness. | 2 | Myocardial infarction | Pulmonary embolism | Stroke | ARDS | Medicine | null | 9e778c0c-9852-4c40-b8ef-514f8c7621c0 | single |
A patient with recent onset primary generalized epilepsy, develops drug reaction and skin rash and neutropenia due to phenytoin sodium. The most appropriate course of action is: | (Ref: Katzung, 14th ed. pg. 418-19; KDT 6th ed. pg. 405)Hypersensitivity reactions like rashes, DLE, lymphadenopathy and neutropenia require that phenytoin to be stopped. | 1 | Shift to sodium valproate | Shift to clonazepam | Shift to ethosuximide | Restart phenytoin after 2 weeks | Pharmacology | C.N.S | 2be74c37-de9e-4323-94a3-256cc16237b3 | single |
All the following are true about Japanese Encephalitis except - | Ans. is 'c' i.e. 90% - 100% moality rate o Case fatality rate of JE is 20-40% (not 90-100%). o Man is dead end host, there is no man to man transmission. o Culex mosquito is the vector. o There is no rash at the site of mosquito bite. | 3 | Man to man transmission is not repoed | Culex mosquito is the vector | 90%-100% moality rate | There is no rash or local lesion | Social & Preventive Medicine | null | 02cd504c-0eed-4b7b-af84-c6618fbe5d29 | multi |
Methicillin-resistant S. aureus (MRSA) was isolated from 7 patients in a 14-bed intensive care unit. All patients were isolated and the unit closed to any more admissions. Which one of the following reasons best explains these rigorous methods to control MRSA? | Oxacillin- and methicillinresistant S. aureus (MRSA) has been rapidly increasing in incidence. MRSA and methicillin-sensitive S. aureus (MSSA) coexist in heterologous populations. Treatment of a patient harboring this heterologous population may provide a selective environment for the MRSA. Prior to changing therapy, the susceptibility of the isolate should be determined. Vancomycin has often been used effectively for MRSA, but it is expensive and nephrotoxic. There is no evidence that MRSA is any more virulent or invasive than susceptible strains. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | 2 | MRSA is inherently more virulent than other staphylococci | The alternative for treatment of MRSA is vancomycin, an expensive and potentially toxic antibiotic | MRSA causes toxic shock syndrome | MRSA spreads more rapidly from patient to patient than antibiotic-susceptible staphylococci do | Microbiology | Bacteriology | 37bbcf96-57ac-4793-b9ed-afd2b658618a | multi |
Eutrophication of water bodies is mainly caused by - | Eutrophication or hyperophication, is when a body of water becomes overly enriched with minerals and nutrients which induce excessive growth of algae. This process may result in oxygen depletion of the water body. One example is an "algal bloom" or great increase of phytoplankton in a water body as a response to increased levels of nutrients. Eutrophication is often induced by the discharge of nitrate or phosphate-containing detergents, feilizers, or sewage into an aquatic system. Ref: https://en.m.wikipedia.org/wiki/Eutrophication | 4 | Carbonates and oxides | Hydrocarbons and mentals | Carbonates and sulphates | Phosphates and nitrate | Social & Preventive Medicine | Environment and health | 715d906a-f9e6-4edb-a642-c2f5cf41ce6c | single |
Chronic Hemolysis from which of the following conditions may be associated with iron deficiency: | Answer is A (Paroxsmal cold Haemoglobinuria) Chronic hemolysis due to paroxysmal cold Haemoglobinuria may be associated with iron deficiency 'In chronic extravascular hemolysis iron is tenaciously conserved. In chronic intravascular hemolysis large amounts of iron are lost in the urine as free haemoglobin, muthemoglobin and hemosiderin and the patient may become iron deficient'- Hematology for Students. Amongst the options provided paroxysmal cold haemoglobinuria is a cause for intravascular hemolysis and hence the single best answer of choice Thalassemia, Hereditary spherocytosis and G6-PD deficiency are all associated with extravascular hemolysis and are likely to present with iron overload and not iron deficiency | 1 | Paroxysmal cold Haemoglobinuria | Thalassemia | Hereditary spherocytosis | G 6PD deficiency | Medicine | null | bb72b999-cd89-4f65-bd5d-25a655dd6b12 | single |
Characteristic lesion of scabies is - | SCABIES:-Caused by Sarcoptes scabiei var hominis.Clinical features:Itching- generalised, worse at night.this is due to delayed type 4 hypersensitivity reaction. Classic lesion: Burrow-Thread like wavy tunnel in stratum corneum.They appear as serpiginous or S shaped greyish,thread like elevations with a vesicle at one end indicating the presence of mite.seen at interdigital web, feet areola,scrotum. Burrows are pathognomic of scabies. iadvl textbook of dermatology page429 | 1 | Burrow | Fissure | Vesicle | Papule | Dental | Fungal infections, Scabies, Pediculosis | 304f635a-2806-4c4e-989d-9897de109bc0 | single |
Ridge lap design of ponticis indicated for the replacement
of a | null | 2 | Maxillary first molar | Maxillary central incisor | Mandibular first molar | Mandibular second premolar | Dental | null | 42ba7c94-562c-4b9f-8c9f-e699c1d82934 | single |
Many rashes and skin lesions can be found first in the newborn period. For each of the descriptions listed below, select the most likely diagnosis. Each lettered option may be used once, more than once, or not at all. An adolescent boy complains of a splotchy red rash on the nape of his neck, discovered when he had his head shaved for football season.The rash seems to become more prominent with exercise or emotion. His mother notes that he has had the rash since infancy, but that it became invisible as hair grew. He had a similar rash on his eyelids that resolved in the newborn period. | Salmon patches (aka nevus simplex or nevus flammeus) are flat vascular lesions that occur in the listed regions and appear more prominent during crying. The lesions on the face fade over the first few years of life. Lesions found over the nuchal and occipital areas often persist. No therapy is indicated. | 2 | Sebaceous nevus | Salmon patch | Neonatal acne | Pustular melanosis | Pediatrics | Growth, Development, and Behavior | 874e45c8-1b40-41c2-9fe5-3e9329a84653 | multi |
For detection of intrinsic pathway of coagulation which one is used? | Ans. (a) aPTTRef: Robbins and Cotran Pathologic Basic Disease 9th Ed; Page No-119* The extrinsic pathway is clinically evaluated by the prothrombin time (PT), which is a measure of factors II, V, VII, X, and fibrinogen.Diatheses* The intrinsic pathway can be evaluated by the partial thromboplastin time (PTT), which is a measure of factors II, V, VIII, IX, X, XI, XII, and fibrinogen.Coagulation cascadeIntrinsic pathwayExtrinsic pathway* Mainly in vitro pathway of coagulation but it may be activated in vivo also.* This pathway may involve contact activation with interactions of the so- called contact factors: factor XII (Hageman factor), prekallikrein, and high- molecular weight kininogen, as well as factor XI.* In vivo activation occurs due to contact activation of factor XII from subendothelial collagen and other components like platelets following endothelial injury.* It is probably initiated by the tissue factor-factor Vila complex (from the extrinsic pathway), activating factor IX to factor IXa. Factor IXa, in turn, leads to the conversion of factor X to factor Xa, catalyzed by factor Villa.* It is mainly in vivo pathway but it may be activated in vitro also.* In vivo it is initiated by tissue factor, which activates factor VII and forms a Vila tissue factor complex.* The Vila tissue factor complex initiates coagulation through the activation of factor X to factor Xa (and additionally factor IX to factor IXa).* Factor Xa converts prothrombin (factor II) to thrombin (factor lla).* In the conversion of prothrombin to thrombin factor-Va acts as a cofactor.* In vitro activation occurs due to exposure of blood to tissue derived thromboplastin reagents (tissue factor).Extra MileLaboratory Assessment of Coagulation Pathways* Prothrombin time (PT):* Normal range is 11-16 seconds.* Used for assessment of extrinsic and the common coagulation pathways.* It is prolonged by:o Deficiency of VII, X, V, prothrombin (II) and Fibrinogen (I).o Warfarin treatment* Activated Partial Thromboplastin Time (aPTT):# Normal range is 30-40 seconds# Used for intrinsic and the common coagulation pathways.# It is prolonged by:o Deficiency of XII, XI, IX, III, X, V, prothrombin (II) and Fibrinogen (I).o Heparin treatment* Thrombin Time (TT):# Normal range is 11-14 seconds# Use for assessment of conversion fibrinogen into fibrin.# It depends upon adequate fibrinogen levels.# It is elevated in dysfibrino genemia, afibrinio genemia, DIC and heparin like inhibitors. | 1 | aPTT | PT | BT | CT | Pathology | Blood | d89538b7-6ed4-4b06-b822-736f459c5da5 | single |
Maximum first pass metaboilsm is seen by which route ? | Ans. is 'd' i.e., Oral First pass metabolism is seen with oral and rectal routes. Maximum first pass metabolism is seen with oral route. In rectal route, drug absorbed into external hemorrhoidal veins bypasses liver, but not that absorbed into internal haemorrhoidal veins -First pass metabolism occurs, but less than oral route (avoids first pass metabolism to 50%). Most rapid onset of action is seen with I. route. Bioavailability by I. V route is 100%. | 4 | Intravenous | Interaaerial | Rectal | Oral | Pharmacology | null | bea1c269-dc6e-4ee2-ab28-9f235aa28947 | single |
A 50 years old male with 2 diabetes mellitus is found to have 24 hour urinary albumin of 250 mg. Which of the following drugs may be used to retard progression of renal disease - | Ans is option 2 - Enalapril ACE inhibitors and ARB&;s are specifically indicated to reduce progression of renal disease. Ref Harrison 19 /2428 | 2 | Hydrochlohiazide | Enalapril | Amiloride | Aspirin | Medicine | Endocrinology | 23ce684b-1841-4777-97d7-6efa101ae951 | single |
Distal colitis with respect to ulcerative colitis refers to: | Distribution of ulcerative colitis: 1. Proctitis - involvement limited to the rectum 2. Distal colitis - Left-sided involvement limited to the colon distal to the splenic flexure 3. Pancolitis -Extensive involvement extends proximal to the splenic flexure, including pancolitis This classification known as the Montreal classification Ref: Journal of Crohn's and Colitis (2012) 6, 965-990. | 2 | Proctitis | Left sided colon distal to splenic flexure is only involved | Mid transverse colitis | None of the above | Medicine | null | f143f99c-84a2-4d87-a4c9-6e89f033edcf | multi |
All of the following drugs are used in the management of acute Myocardial infarction except- | Ref : harrisons-manual-of-medicine-16th-edition pg no: 622-624 TREATMENT Initial Therapy Initial goals are to: (1) quickly identify if patient is candidate for reperfusion therapy, (2) relieve pain, and (3) prevent/treat arrhythmias and mechanical complications. * Aspirin should be administered immediately (162-325 mg chewed at presentation, then 162-325 mg PO qd), unless pt is aspirin-intolerant. * Perform targeted history, exam, and ECG to identify STEMI (1 mmST elevation in two contiguous leads or new LBBB) and appropriateness of reperfusion therapy , which reduces infarct size, LV dysfunction, and moality. * Primary PCI is generally more effective than fibrinolysis and is preferred at experienced centers capable of performing procedure rapidly , especially when diagnosis is in doubt, cardiogenic shock is present, bleeding risk is increased, or if symptoms have been present for 3 h. * Proceed with IV fibrinolysis if PCI is not available or if logistics would delay PCI 1 h longer than fibrinolysis could be initiated (Fig. 123-1). Dooo- needle time should be 30 min for maximum benefit. Ensure absence of contraindications before administering fibrinolytic agent. Those treated within 1-3 h benefit most; can still be useful up to 12 h if chest pain is persistent or ST remains elevated in leads that have not developed new Q waves. Complications include bleeding, reperfusion arrhythmias, and, in case of streptokinase (SK), allergic reactions. Heparin should be initiated with fibrinolytic agents other than SK ; maintain aPTTT at 1.5-2.0 control (50-70 s). * If chest pain or ST elevation persists 90 min after fibrinolysis, consider referral for rescue PCI. Later coronary angiography after fibrinolysis generally reserved for pts with recurrent angina or positive stress test. The initial management of NSTEMI (non-Q MI) is different . In paicular, fibrinolytic therapy should not be Additional Standard Treatment (Whether or not reperfusion therapy is undeaken): * Hospitalize in CCU with continuous ECG monitoring. * IV line for emergency arrhythmia treatment. * Pain control: (1) Morphine sulfate 2-4 mg IV q5-10min until pain is relieved or side effects develop ; (2) nitroglycerin 0.3 mg SL if systolic bp 100 mmHg; for refractory pain: IV nitroglycerin (begin at 10 g/min, titrate upward to maximum of 200 g/min, monitoring bp closely); do not administer nitrates within 24 h of sildenafil or within 48 h of tadalafil (used for erectile dysfunction); (3) -adrenergic antagonists * Oxygen 2-4 L/min by nasal cannula (maintain O2 saturation 90%). * Mild sedation (e.g., diazepam 5 mg PO qid). * Soft diet and stool softeners (e.g., docusate sodium 100-200 mg/d). * -Adrenergic blockers reduce myocardial O2 consumption, limit infarct size, and reduce moality. Especially useful in pts with hypeension, tachycardia, or persistent ischemic pain; contraindications include active CHF, systolic bp 95 mmHg, hea rate 50 beats/min, AV block,or history of bronchospasm. Administer IV (e.g., metoprolol 5 mg q5-10min to total dose of 15 mg), followed by PO regimen (e.g., metoprolol 25-100 mg bid). * Anticoagulation/antiplatelet agents: Pts who receive fibrinolytic therapy are begun on heparin and aspirin as indicated above. In absence of fibrinolytic therapy, administer aspirin, 160-325 mg qd, and low-dose heparin (5000 U SC q12h for DVT prevention). Full-dose IV heparin (PTT 2 control) or low-molecular-weight heparin (e.g., enoxaparin 1 mg/kg SC q12h) followed by oral anticoagulants is recommended for pts with severe CHF, presence of ventricular thrombus by echocardiogram, or large dyskinetic region in anterior MI. Oral anticoagulants are continued for 3 to 6 months, then replaced by aspirin. * ACE inhibitors reduce moality in pts following acute MI and should be prescribed within 24 h of hospitalization for pts with STEMI--e.g., captopril (6.25 mg PO test dose) advanced to 50 mg PO tid. ACE inhibitors should be continued indefinitely after discharge in pts with CHF or those with asymptomatic LV dysfunction ; if ACE inhibitor intolerant, use angiotensin receptor blocker (e.g., valsaan or candesaan). * Serum magnesium level should be measured and repleted if necessary to reduce risk of arrhythmias. | 4 | Tissue plasminogen activator | Intravenous beta blockers | Acetylsalicylic acid | Calcium channel blockers | Medicine | C.V.S | ed4e18ea-543a-4c93-9f72-472295045029 | multi |
H4-biopterin (tetrahydrobiopterin) is required for metabolism of | Conversion of phenylalanine to tyrosine: The reaction involves hydroxylation of phenylalanine at p-position in benzene ring. Enzyme: Phenylalanine hydroxylase. Present in liver and the conversion occurs in Liver. Coenzymes and cofactors: The enzyme requires the following for its activity: * Molecular oxygen * NADPH *F e++ and * Pteridine (folic acid) coenzyme: Tetrahydrobiopterin- FH4 The reaction is complex and takes place in two stages as shown below: I. Reduction of O2 to H2O and conversion of phenylalanine to tyrosine. Reduced form of pteridine, FH4 acts as H-donor to the molecular O2. II. Reduction of dihydrobiopterin, FH2 by NADPH, catalyzed by the enzyme Dihydrobiopterin reductase.Ref: Textbook of medical biochemistry, MN Chatterji, 8th edition, page no: 495 | 3 | Arginine | Lysine | Phenylalanine | Tryptophane | Biochemistry | Structure and function of protein | 364fcc68-4071-444e-bcbe-45e8ccad8849 | single |
Cardiac polyp is seen in | Chicken fat and red current jelly seen in post moem clot | 4 | Acute nephritis | Endocarditis | Septicaemia | Postmoem clot | Anatomy | All India exam | 03f7c9c2-7ec9-471c-ace8-a1093f79e913 | single |
Rigor mortis in fetus is: | Ans: a (Usually not seen before 7 months)Ref: Krishan, Vij 4th ed., Pg. 1201. Rigor does not occur in foetus of less tha seven months, but is commonly found in still bom infants at full term. Intensity of rigor depends on the decedent's muscular development. The very young, very old, and debilitated have poorly developed rigor. Children who had died after chronic illness, who had mostly confined to bed for weeks or months, also showed frequently little or no postmortem stiffness because their musculature had faded away during that time. Some expert belive that the low degree of but perceptible stiffness as absence of rigor mortis.Variables affecting onset and duration of rigor:* Variables which accelerate the onset of rigor oExogenous heat, violent exertion prior to death, seizure activity, alkaloid poisoning.* Factors which delay the onset of rigor:a. Exogenous coldb. Exsanguination haemorrhagec. Asphyxial deathsd. Poisoning by arsenicConditions simulating rigor1. Cadaveric spasm: This is a rare form of muscular stiffening which occurs at the time of death. It usually affects groups of muscles in the arms.2. Heat stiffening: This process is seen in fire deaths and involves actual cooking of the muscle fibers. Because the fibers shorten, one sees a typical "pugilistic" appearance.2. Cold stiffening: Fat and muscle become solid at temperatures less than 40deg F. Rigor will develop if a body which was frozen before rigor developed is subsequently thawed. | 1 | Usually not seen before 7 months | Seen in upper limb & not in lower limb | Seen in lower limb & not in upper limb | Established but too faint to be appreciated | Forensic Medicine | Death and Medicolegal Aspects | c0b83a9f-cd8e-47d4-8be5-03ec250cc848 | multi |
Recurrent ischaemic events following thrombosis have been pathophysiologically linked to | Ans. (c) Lipoprotein A(Ref: Circulation June 29, 2004 vol. 109)Novel Biomarkers in the Prediction of Future Cardiovascular EventsLipoprotein(a)HomocysteineHigh-sensitivity C-reactive protein (hsCRP) | 3 | Antibodies to thrombolytic agents | Fibrinopeptide A | Lipoprotein A | Triglycerides | Pathology | C.V.S | 543a80e5-7159-4a02-adb6-79bcb8d8688a | multi |
Which of the following drug can cause cartilage damage in children ? | null | 3 | Cotrimoxazole | Penicillin | Ciprofloxacin | Metronidazole | Pharmacology | null | aee3444f-3788-4ef1-8490-5315afa7f84a | single |
The slender rhabditiform larvae of which of the following helminths move about in water and are ingested by species of cyclops - | null | 2 | D. latum | D. medinensis | W.bancrofti | S. mansoni | Microbiology | null | 1ae01a97-53af-4b8c-bd9a-48401523c5ed | single |
Pheochromocytoma produces all except? | Pheochromocytoma secrets Norepinephrine VIP- Secretory diarrhea in pheochromocytoma is due to VIP, VIP opens water channels which result in development of secretory Diarrhea Calcitonin- Pheochromocytoma associated with MEN 2a syndrome MEN 2a - Medullary carcinoma of the thyroid(calcitonin), pheochromocytoma, parathyroid hyperplasia | 2 | Nor-epinephrine | Secretin | Vaso-active intestinal polypeptide | Calcitonin | Medicine | FMGE 2018 | 64638fe2-9837-4d3e-9e98-c23dfab953ad | multi |
Telecanthus is: | Increases in intercanthal distance with normal interpupillary distance | 4 | Narrow medial epicanthus | Widely separated medial orbital wall | Lateral epicanthal fold thickened | Increases in intercanthal distance with normal interpupillary distance | Ophthalmology | null | 8959892b-285b-4f32-8a3d-85963976651c | multi |
A patient was advised Treadmill test, but he had lost both his limbs and then he was advised a stress test. The drug used for this test is: | Uses of dobutamine Sho-term treatment of cardiac decompensation that may occur after cardiac surgery or in patients with congestive hea failure or acute myocardial infarction An infusion of dobutamine in combination with echocardiography is useful in noninvasive assessment of patients with coronary aery disease Stressing of the hea with dobutamine may reveal cardiac abnormalities in carefully selected patients. | 3 | Dopexamine | Dopamine | Dobutamine | Dipevefrine | Pharmacology | CHF, Angina Pectoris and Myocardial Infarction | 4338acda-d12f-476f-881b-f7ba8b29e1cb | multi |
The presence of multiple cavities in the lung with hematuria is suggestive of- | Wegener's granulomatosis is characterised by granulomatous vasculitis of the upper and lower respiratory tracts together with glomerulonephritis.Lung involvement typically appear as multiple,bilateral,nodular cavitary infiltrates and clinically expressed as cough,hemoptysis,dyspnea,and chest discomfo.Renal involvement can appear as proteinuria,hematuria,and red blood cell casts,and progressing to renal functional impairment and renal failure. Ref:Harrison's medicine-18th edition,page no:2789,2790. | 1 | Wegener's granulomatosis | Tuberculosis | Renal cell carcinoma | Systemic lupus erythematosus (SLE) | Medicine | Respiratory system | 782d6938-7b95-4e1b-aff7-4311aa025fbd | single |
Granulomtous condition showing hypercalcemia A/E | Sarcoidosis is a multisystem non caseous granulomatous disorder associated with hypercalcemia in about 10 % of patients .due to increased production of vitamin D by granuloma itself. Ref Davidson edition23rd pg 608 | 2 | TB | Sarciodosis | Berylliosis | SLE | Medicine | Respiratory system | a388695c-040b-4f2d-99d4-e2a3628246fc | single |
True about Atosiban: | Ans. a (is an oxytocin receptor antagonist). (Ref. KDT, Pharmacology, 6th ed., p 323)ATOSIBAN# Atosiban is an oxytocin receptor antagonist with high uterine specificity.# It is effective in inhibiting preterm uterine contractions, and is at least as effective as conventional beta-agonist therapy in treating preterm labour, but with significantly fewer maternal and fetal side effects.# The incidence of maternal/fetal side effects is significantly higher with beta-agonists, and serious maternal CV side effects, such as pulmonary edema and myocardial ischemia, were also associated with beta-agonist but not atosiban therapy.# The favourable safety profile of atosiban in combination with equivalent tocolytic effectiveness would appear to represent an advance over current tocolytic therapy. Sr .no.Tocolytic Agents Comments1IsosuprineS/E--hypotension, pulmonary edema, ARDS, hypokalaemia, hyperglycemia.2RitodrineS/E-hypotension, pulmonary edema, ARDS, hypokalemia, hyperglycemiaQ3Salbutamol-4Ethanol-5MgSO4 (UP 2002)- Monitor respiration, urine output and deep reflexes.- Antidote is calcium gluconate.- Therapeutic levels = 4-7 mEq/L6AspirinProstaglandin inhibitor7Nifedipine-8AtosibanOxytocin analogue,oxytocin receptor antagonist - Counteracts effects of endogenous oxytocin.9Sodium nitroprussideNitric oxide donor, increases cGMPQ10Potassium channel opener | 1 | is an oxytocin receptor antagonist | is an progesterone receptor antagonist | is least effective in inhibiting preterm uterine contractions | is a anti-tocolytic drug | Pharmacology | Pregnancy | 7f6c5cf4-5a3e-4f84-9470-9bb02892f7e5 | multi |
Anastomotic leaks are most commonly seen in | Since there is end to end gastroduodenal anastomosis in billroth 1 there are more chances of anastomotic leak | 1 | Billroth 1 | Roux en y gastrojejunostomy | Polya gastrectomy | Antral gastrectomy | Surgery | null | c3ca2ec8-36c4-47d0-b1b5-c89172443acc | single |
In a thyroid crisis with hyperpyrexia, tachycardia, vomiting, dehydration and shock the following are usually indicated | A thyroid crisis requires emergency treatment with intravenous fluids, propranolol, hydrocortisone, oral iodine and propylthiouracil or carbimazole | 4 | Metaraminol | Glucocorticoids | Intravenous saline | Propranolol | Pharmacology | null | 40e1e8f6-1eba-48f3-8f62-bbdf9bbb8d6c | multi |
Early diagnosis of active hepatitis B infection is done by- | null | 1 | IgM HBcAg antibody | HBsAg | HBcAg | IgE HBsAg antibody | Medicine | null | 0a24dade-3ff3-4e18-af4a-97976b5a3c3f | single |
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