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1d50bde8-e79f-4f6b-a02c-5d510257d4ad | A VDRL reactive mother gave bih to an infant. All of the following would help in determining the risk of transmission to the infant, Except | TPHA test on the serum sample of the mother | TPHA test on the serum sample of the infant | VDRL on the paired serum sample of the infant and mother | Time interval between the treatment of the mother and her delivery | 1b
| multi | Positive TPHA mother is responsible for transmission of infection to the infant In infants, no test (even TPHA) can show the difference between asymptomatic infected and noninfected. VDRL -- detect antibody titer raised in both infants and mother suggests the transmission 4 weeks before delivery treatment should be completed so time interval is the impoant factor. Ref: Ananthanarayana textbook of Microbiology 9th edition Pgno : 374 | Microbiology | Bacteriology |
1fefc27f-ddd6-4f6d-b2e9-35e828c30dc7 | The components of the respiratory control pattern generator is responsible for automatic respiration. Pacemaker regulating the rate of respiration is: | Pneumotaxic centre | Dorsal group of nucleus | Apneustic centre | Pre-Botzinger Complex | 3d
| single | Rhythmic respiration is initiated by a small group of synaptically coupled pacemaker cells in the pre-Botzinger complex (pre-BOTC) on either side of the medulla between the nucleus ambiguus and the lateral reticular nucleus. These neurons discharge rhythmically, and they produce rhythmic discharges in phrenic motor neurons that are abolished by sections between the pre-Botzinger complex and these motor neurons. They also contact the hypoglossal nuclei, and the tongue is involved in the regulation of airway resistance. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 36. Regulation of Respiration. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | Physiology | null |
6077d7db-8c4d-45fe-ac3b-d22b71909045 | Mizuo phenomenon is seen in: | Fundus albipunctatus | Oguchi's disease | Fundus amaculateus | Choroidermia | 1b
| single | Ans. b. Oguchi's disease Mizuo phenomenon is seen in Oguchi \ disease."In Oguchis disease the characteristic golden yellowish metallic sheen (color) of posterior pole (fundus) in light adapted state reverts to normal after prolonged dark adaptation, a phenomenon described by and named after Japanese ophthalmologist Mizuo Re-exposure to light results in the return of golden yellow metallic sheen.** Female carriers of X-linked (XL) retinitis pigmentosa may have normal fundi or show a golden metallic (tapetal) reflex at macula and/or small peripheral patches of hone spicule pigmentation. The inverse Mizuo phenomenon seen in XL-RP is characterized by appearance of golden sheen in dark (hut no golden sheen in light)."Oguchi's Disease* Oguchi's disease is a rare autosomal recessive trait characterized by congenital stationary night blindness and a unique morphological and functional abnormality of the retina.* Show Mizuo phenomenon^* Mizuo phenomenon: Fundus is golden yellow in light adapted state which becomes normal after prolonged dark adaptation. Reexposure to light results in the return of the metallic y ellow sheeny.* Rod function is absent after 30-minutes of dark adaptation but recovers to a near normal level after a long period of dark adaptation (i.e. -- normal rod thresholds reached only after 4 hours or longer instead of normal 30 minutes).Etiopathogenesis:* A null allele in genes for each of rhodopsin kinase and arrestin (proteins responsible for terminating phototransduction cascade) is responsible for Oguchi's disease.* Therefore, the persistent low level of light may desensitize the rods continually.* Mizuo phenomenon suggest an abnormality in rod pigment, rhodopsin.* Cone function is normal because cone adaptation, final cone thresholds and photopicERG response are normal.* Rod function is abnormal with delayed dark adaptation and scotopic ERG showing only a small electronegative response, even when the rod threshold have reached normal.Clinical Features:* Patients have non-progressive night blindness since young childhood writh normal day vision, but they often claim improvement of light sensitivities w hen they remain long in the dark environment* The fundus oculi presents a most peculiar appearance. | Ophthalmology | Retina |
4d763287-175d-457c-a1ad-404b4d528d9d | Hypophosphatemia is seen in all except: | Acute renal failure | Resolving phases of diabetic ketocidosis | Respiratory alkalosis / COPD | Chronic alcoholism | 0a
| multi | Answer is A (Acute renal failure): Renal insufficiency is associated with hyperphosphatemia due to impaired renal phosphate excretion. Acute renal failure: 'Mild Hyperphosphatemia is an almost invariable complication of Acute Renal Failure. Severe hyperphosphatemia may develop in highly catabolic patients or following rhabdomyolysis, hemolysin or tumor lysis.' -- Harrison 16th / 1650 Diabetic ketoacidosis or Metabolic acidosis from any other causes may be associated with hyperphosphatemia from transcellular phosphatic shifts. However resolving phases of diabetic ketoacidosis are associated with hypophosphatemia and not hyperphosphatemia. This is a result of insulin therapy for diabetic ketoacidosis. Causes of hyperphosphatemia Causes of hypophosphatemia Metabolic acidosis Insulin therapy of diabetic ketoacidosis or prolonged (Lactic acidosis / Diabetic Ketoacidosis) hyperglycemia. Laboratory values in DKA / Harrison 6th / 323 - 324 Phosphate values are : decreased (large changes occurs during treatment of DKA Also note that total body stores of phosphorus (Also potassium, sodium, chloride, magnesium) are reduced in DKA, but are not accurately reflected by their levels (serum values may be increased) because of dehydration and hyperglycemia. -- Harrison Respiratory alkalosis is associated with hypophosphatemia by causing intracellular shift of phosphorus into cells. Hypophosphatemia * Hyperphosphatemia Metalbolic alkalosis * Metabolic acidosis Respiratory alkalosis * Respiratory acidosis Chronic alcoholism / Alcoholism is known to cause hypophosphatemia. -- Harrison 16th / 881 Severe hypophosphatemia is common and multifactorial in alcoholic patients. Chronic alcohol use results in a decrease in the renal threshold of phosphate excretion.' -- CMDT Patients with COPD and Asthma commonly have hypophosphatemia. This is attributed to xanthine derivatives causing shifts of phosphate intracellularly and the phosphaturic effects of beta -- adrenergic agonists, loop diuretics, xanthine derivatives and coicosteroids. -- CMDT 2006 / 88 | Medicine | null |
abf7c64f-4fd8-41ba-bdf1-279ead18a024 | Crepitus over skin of the swollen limb should ale on possibility of: KCET 13 | Air embolism | Gas gangrene | Fat embolism | DIC | 1b
| single | Ans. Gas gangrene | Forensic Medicine | null |
85576357-e227-41da-b188-1c4b1fd547a1 | Mutation seen in malignant melanoma is | N-MYC | RB gene | CDKN2A | p53 | 2c
| single | CDKN2A is a complex locus that encodes three different tumor sup- pressors, p15/INK4b, p16/INK4a, and p14/ARF. Of these, loss of p16/INK4a is clearly implicated in human melanoma, and experimental evidence also suppos a role for loss of p14/ARF. As already mentioned, p16/ INK4a inhibits cyclin-dependent kinase 4 (CDK4) and cyclin-dependent kinase 6 (CDK6), thus reinforcing the ability of the RB tumor suppressor to block cells in the G1 phase of the cell cycle. By contrast, p14/ARF enhances the activity of the p53 tumor suppressor by inhibiting MDM2, an oncoprotein that stimulates p53 degradation. CDKN2A is mutated in approximately 10% of sporadic melanomas, and these mutations uniformly abolish the production of p16/INK4a and more variably affect p14/ ARF. However, it is suspected that these mutations are the tip of the "oncogenic iceberg" with respect to molec- ular lesions affecting the G1 checkpoint. For example, 30% to 70% of melanomas show loss of p16/INK4a expression though varied mechanisms, and other famil- ial and sporadic melanomas have mutations in CDK4 | Pathology | dermatology and infectious disease |
1a74e837-e474-43df-9318-c8ebaa81f3dd | Sample registration is done | Every 3 months | Every 6 months | Every 9 months | Every 12 months | 1b
| single | Sample registration system (SRS) SRS is taken once every 6 months It is a dual record data collection system of India Therefore, it is the most accurate data collection system of India | Social & Preventive Medicine | FMGE 2017 |
d4ee5f31-93ea-4ca2-9f91-3af6e223f78c | Renal osteodystrophy differs from nutritional osteomalacia by having______. | Increased phosphates | Increased calcium | Decreased calcium | None of the above | 0a
| multi | Ans. a (Increased phosphates) (Ref. H-17th/2694)In addition to measuring serum calcium, it is useful to determine albumin, phosphorus, and magnesium levels. As for the evaluation of hypercalcemia, determining the PTH level is central to the evaluation of hypocalcemia. A suppressed (or "inappropriately low") PTH level in the setting of hypocalcemia establishes absent or reduced PTH secretion (hypopar- athyroidism) as the cause of the hypocalcemia. Further history will often elicit the underlying cause (i.e., parathyroid agenesis vs. destruction). By contrast, an elevated PTH level (secondary hyperparathyroidism) should direct attention to the vitamin D axis as the cause of the hypocalcemia. Nutritional vitamin D deficiency is best assessed by obtaining serum 25-hydroxyvitamin D levels, which reflect vitamin D stores.PRINCIPAL SYSTEMIC MANIFESTATIONS OF CHRONIC RENAL FAILURE AND UREMIAFluid and ElectrolytesCalcium Phosphate and Bone# Dehydration# Hyperphosphatemia# Edema# Hypocalcemia# Hyperkalemia# Secondary hyperparathyroidism# Metabolic acidosis# Renal osteodystrophy | Medicine | Kidney |
713f7b67-d93b-4e61-a704-b35aa06ff8a4 | True or false
1. Bronchoscopy with BAL is mainstay of diagnosis for pneumocystic pneumonia
2. Pneumatoceles are seen in all cases of pneumocystic pneumonia
3. CD4 count < 350 /µL is indication for prophylaxis against pneumocyctis carini pneumonia
4. Trimethoprim - sulfamethoxazole is drug of choice for prophylaxis. | 1 - True, 2 - False, 3 - False, 4 - True | 1 - False, 2 - True , 3 -True , 4 - False | 1 - True, 2 -True, 3 - False, 4 - True | 1 - False, 2 - False , 3 -True , 4 - False | 0a
| multi | CD4 count <200 /µL is indication for prophylaxis.
Pneumatoceles may be seen, but not in all cases. | Medicine | null |
1cf0f1e5-2269-4501-af7d-d1cf62e4569c | All are ture about innate immunity except ? | Non-specific | First line of defence | Not affected by genetic affected | Includes complement | 2c
| multi | Ans. is 'c' i.e., Not affected by genetic affected | Microbiology | null |
7f493cce-32bd-4e31-8c0d-b45b8823d4b1 | 68-year-old male with hypeension presents for annual examination. On review of systems he repos urinary hesitancy and nocturia. Your examination reveals a nontender but enlarged prostate without nodules. On review of his blood pressure logs and clinic readings he is averaging values of 150/80 mm Hg. Wof medication offer treatment of HTN and prostatic symptoms | Aliskiren | Propranolol | Furosemide | Terazosin | 3d
| single | a-ADRENERGIC BLOCKERS Terazosin, Doxazosin These are long-acting congeners of prazosin with similar propeies but suitable for once daily dosing. advantages include * Does not impair carbohydrate metabolism; suitable for diabetics, but not if neuropathy is present, because postural hypotension is accentuated. * Has a small but ourable effect on lipid profile: lowers LDL cholesterol and triglycerides, increases HDL. * Affords symptomatic improvement in coexisting benign prostatic hyperophy. Ref:- kd tripathi; pg num:-564,565 | Pharmacology | Cardiovascular system |
7e2209b8-36f2-46c0-b8d8-8d07063bdc21 | Which of the following is not capsulated - | Pneumococcus | Cryptococcus | Meningococcus | Proteus | 3d
| single | Ans. is 'd' i.e., Proteus Capsuleo Many bacteria secrete a viscid material around the cel! surface,o When this is organized into a sharply defined structure, it is known as capsule,o Capsules are protective and protect the bacteria from phagocytosis and from lytic enzymes.o Some bacteria loose their capsules on repeated subcultures.Cansulated oroanismso Pneumococcuso Yersiniao Bacillus anthraxo V. parahemolyticuso Bordetellao H. influenzaeo Meningococcio Fresh strains of staphylococci, streptococci and E coli.o CL perfringens and CL butyricumo Bacteroideso Klebsiellao Cryptococcus. | Microbiology | Bacteria |
ac2f91a2-9631-4ad0-a31c-172c515e3615 | In osteogenic sarcoma predominant histological finding is - | Giant cells | Osteoid forming tumor cells | Fibroblastic proliferation | Chondroblasts | 1b
| single | Ans. is 'b' i.e.. Osteoid forming tumor ceils [Ref: Apley's 9th/e p. 208}Histologic appearance of osteosarcomao It appears pale and extending through the cortex on gross cut section examination,o On histological sections it consists of malignant stromal tissue showing osteoid formation.o Osteoid bone formation by tumor cells is diagnostic of OGS. | Orthopaedics | Osteogenic Sarcoma |
4d5e444c-4ecd-479d-aa2c-6d7efa2e0353 | Word substitute used for alginate is: | Tooth paint | Statue | Pudding | Cavity fighter | 2c
| single | Euphemisms | Dental | null |
0629e556-2426-4d1f-91aa-1807f146d7b7 | A 55-year-old female presents to the surgeon with breast symptoms. Her right breast is swollen, red and tender. The physician palpates a firm area in the breast and suspects inflammatory breast cancer. Which of the following best describes the histological changes observed in this disorder? | Acute inflammation in breast carcinoma | Chronic inflammation in breast carcinoma | Dermal lymphatic invasion by cancer cells | Epidermal invasion by cancer cells | 2c
| single | Inflammatory breast cancer is a pattern of invasive breast cancer in which the neoplastic cells infiltrate widely through the breast tissue. The cancer involves dermal lymphatics and therefore has a high incidence of systemic metastasis and a poor prognosis. If the lymphatics become blocked, then the area of skin may develop lymphedema and "peau d'orange" or orange peel appearance. The overlying skin in inflammatory breast cancer is usually swollen, red, and tender. Acute inflammation is a rare finding in breast cancer and may be associated with secondary infection or abscess. Chronic inflammation in breast cancer is a non-specific finding. In medullary breast cancer, a type of invasive ductal carcinoma, there are a large number of lymphocytes around the tumor and a desmoplastic reaction is often absent in the surrounding tissue. This type of cancer carries a somewhat better prognosis. Epidermal invasion by cancer cells is a poor prognostic indicator. Intraepidermal malignant cells are called Paget cells. Paget's disease of the nipple is a type of ductal carcinoma that arises in large ducts and spreads intraepidermal to the skin of the nipple and areola. There is usually an underlying ductal carcinoma. | Pathology | null |
15877737-c030-4831-bfc2-cd2291c5fa88 | The poor prognostic factor associated with ALL in children is | Total leucocytle count 4000-100000 | Age less than 2 years | Testicular involvement | Blast in Peripheral Smear | 2c
| multi | The standard features are age and WBC at diagnosis, with infants (less than one year), adolescents (greater than nine years), and children with WBC above 50,000/ml being at higher risk. Ceain chromosomal abnormalities are also strong predictors; in paicular, the Philadelphia chromosome and MLL gene rearrangements (especially in infants) are adverse features, while TEL-AML1 is orable. It is impoant to note, however, that even the most impoant known predictors explain only a small propoion of the variability in outcome. Testicular involvement Is a poor prognostic factor for ALL Reference: GHAI Essential pediatrics, 8th edition | Pediatrics | Childhood tumors |
f6b9e281-b40f-4e89-b2ea-360b6c56d75a | Multiple intrahepatic bile duct dilation with bile lakes and concurrent sepsis is suggestive of | Caroli's disease | Watson Algali syndrome | Primary sclerosing cholangitis | Klatskin tumor | 0a
| single | Caroli's disease Clinical features : Symptoms include cholangitis (64%), poal hypeension (22%) and abdominal pain(18%) More common in males Septa containing poal veins protrude into the lumen of the ecstatic bile ducts (central dot sign) The main and often the only symptom of bacterial cholangitis secondary to caroli's disease is fever without abdominal pain and jaundice Frequent episodes of cholangitis indicates poor prognosis Most stones are pigmented in caroli's disease Ref: Sabiston 20th edition Pgno :1511 | Anatomy | G.I.T |
06477366-22f3-4ac1-9954-ee6899a28f7b | Vitamin that acts like a hormone | Vitamin K | Vitamin B1 | Vitamin B12 | Vitamin D | 3d
| single | (D) Vitamin D # Vitamin D is a fat-soluble vitamin that acts as a steroid hormone.> Several hormones, including adrenal and gonadal steroid hormones, thyroid hormones, retinoid hormones, and vitamin D, bind with protein receptors inside the cell rather than in the cell membrane. Because these hormones are lipid soluble, they readily cross the cell membrane and interact with receptors in the cytoplasm or nucleus.> The activated hormone-receptor complex then binds with a specific regulatory (promoter) sequence of the DNA called the hormone response element, and in this manner either activates or represses transcription of specific genes and formation of messenger RNA (mRNA) | Biochemistry | Miscellaneous (Bio-Chemistry) |
faeb3ef8-076c-4156-96d2-4bb02c7f23c0 | Rivastigmine & donepezil are drugs used predominantly in the management of - | Depression | Dissociation | Delusions | Dementia | 3d
| single | Ans. is 'd' i.e., Dementia o Rivastigmine, Donepezil, Galantamine and tacrine all are central cholinesterase inhibitors and are used in senile dementia of Alzheimer's desease. | Psychiatry | Pharmacotherapy Management of Children and Adolescents |
07afc237-6176-40bf-8759-1d9f4541c7cf | Zellweger syndrome is due to | Absence of peroxisome | Absence of cytochrome | Absence of COX | Absence of LOX | 0a
| single | Zellweger syndrome is due to absence of peroxisomes in all most all tissues, as a result of which long chain fatty acids are not oxidized and accumulated in live and brain. So this syndrome is also called as cerebrohepatorenal syndrome. | Biochemistry | null |
ed9de848-3ccb-43aa-8ac3-04201f269917 | Which of the following is a VEGF inhibitor? | Bevacizumab | Omalizumab | Adalizumab | Abciximab | 0a
| single | Cetuximab, Bevacizumab, Sunitinib, Sorafenib acts as VEGF inhibitors inhibiting angiogenesis.Ref: Sharma and Sharma 3rd ed/pg 875 | Pharmacology | Immunomodulators |
f15ae2c7-1544-4939-a275-a87b889956b7 | One virus particles prevents multiplication of 2nd virus. This phenomena is: | Viral interference | Mutation | Supervision | Permutation | 0a
| single | Viral interference
Interference in which infectionof a cell by one virus inhibits simultaneous or subsequent infection by another virus.
Most important mediator of interference is interferon.
Interference produced by destruction of cell receptors is seen with myxoviruses and enterovirus.
It is applied in the field in controlling poliomyelitis outbreaks by in controlling poliomyelitis outbreaks by introducing into the population, the live attenuated poliovirus vaccine. | Unknown | null |
65f9768d-ab40-4443-bb02-e64242ea3724 | 'Presacral fascia' is derivative of | Colle's fascia | Scarpa's fascia | Pelvic fascia | Hypogastric sheath | 3d
| single | . | Pathology | All India exam |
e533be12-2db1-4855-8315-6695f6d22bed | Which are first order neuron in optic pathway- | Bipolar cells | Ganglionic cells | Cells of lateral geniculate body | Astrocytes | 0a
| single | in visual sensation first order neurons lies in the bipolar cell layer of retina. Reference: textbook of comprehensive Opthalmology by AK Khurana. | Ophthalmology | Neuro-ophthalmology |
f056ee0a-bc85-4f92-a065-9a89c16e18f1 | Which is more common in primigravida than multigravida : | PPH | Placenta pre | Malpresentation | Hyperemesis | 3d
| single | Hyperemesis | Gynaecology & Obstetrics | null |
e697b4de-883b-4fe0-a518-9c7e4af4917c | Local anaesthesia causing metheaEUR' moglobinemia | Procaine | Prilocaine | Etiodicaine | Ropivacaine | 1b
| single | Prilocaine | Anaesthesia | null |
086e848b-0cd0-434c-afe6-48a0b45d8461 | What is the name of this retractor? | Deavers | Langenbacks | Czerny | Thomson | 0a
| single | Ans. (a) Deavers retractorDeavers retractor* Used to retract liver without any damage to liver parenchyma.* Used during Cholecystectomy to retract liver.* Used during Pancreatico jejunostomy to retract Stomach* Used in places where a careful retraction without organ damage is needed.Other RetractorsThompson Self Retaining Liver Retractor* Thompson retractor has multiple arms which can be fixed to a rod which is attached to the Operating table.* Adjustable and Self retaining in nature.Balfours Abdominal Self Retaining retractor:* It's used to retract the lateral abdominal walls.* The third limb-used to retract the bladder downwards. Joll's self retaining Thyroid retractor:* Used during thyroidectomy to retract the platysma.* It's a self retaining retractor.Doyen's Mouth gag:* Used to open mouth during intra oral operations like glossectomy, Cleft palate operations and Ranula surgery.* Used to retract tissues during hernia surgery, Appendectomy etc,* Available in various sizes.Morris retractor:* Used to retract the abdominal wall in a wide manner.* It is the instrument of choice for retraction in left subcostal region because it avoids the risk of splenic injuryCzerny retractor:* Serves the same purpose of a Langenback retractor, but has another limb with a double hook with space in between.* Sutures can be made in the tissues between the gap of hooks.Volkmann's Retractor: (Cat Paw retractor)* Has multiple hooks on one limb* Used to retract the skin flaps and fascia during operations on the surface level- Eg. Sebaceous cyst, Lipoma and Dermoid cyst. | Surgery | Hernia |
294fbabf-d326-4fae-9372-857bb5c197f9 | FK 506 is a type of: | Immunoglobulin antibody | Non-depolarizing muscle relaxant | Macrolide antibiotic | Opioid anaesthetic | 2c
| single | Tacrolimus (FK506)- structurally a macrolide antibiotic which is a newer immunosuppressant chemically different from cyclosporine, but having the same mechanism of action, and is -100 times more potent. It binds to a different cytoplasmic immunophilin protein labeled 'FKBP', but the subsequent steps are the same, i.e. inhibition of helper T cells calcineurin. Tacrolimus is administered orally as well as by i.v. infusion. Oral absorption is variable and decreased by food. It is metabolized by CYP3A4 Section 14 and excreted in bile with a longer tlh of 12 hour. Therapeutic application, clinical efficacy as well as toxicity profile are similar to cyclosporine. It is paicularly valuable in liver transplantation because its absorption is not dependent on bile. Because of more potent action, itis also suitable for suppressing acute rejection that has set in. Hypeension, hirsutism and gum hyperplasia are less marked than cyclosporine, but tacrolimus is more likely to precipitate diabetes, cause neurotoxicity, alopecia, and diarrhea. Dose-limiting toxicity is renal. ESSENTIALS of MEDICAL PHARMACOLOGY SIXTH EDITION -K. D TRIPATHI Page:853 T | Pharmacology | Immunomodulators |
dbe9bdb3-1aff-476b-b03d-e5c460650cac | A potent inhibitor of protein synthesis that acts as an analogue of aminoacyl t-RNA is | Mitomycin C | Streptomycin | Nalidixic acid | Puromycin | 3d
| single | Puromycin is an aminonucleoside antibiotic, derived from the Streptomyces alboniger bacterium, that causes premature chain termination during translation taking place in the ribosome. Pa of the molecule resembles the 3&; end of the aminoacylated tRNA. It enters the A site and transfers to the growing chain, causing the formation of a puromycylated nascent chain and premature chain release. The exact mechanism of action is unknown at this time but the 3&; position contains an amide linkage instead of the normal ester linkage of tRNA. That makes the molecule much more resistant to hydrolysis and stops the ribosome.Puromycin is selective for either prokaryotes or eukaryotes.Also of note, puromycin is critical in mRNA display. In this reaction, a puromycin molecule is chemically attached to the end of an mRNA template, which is then translated into protein. The puromycin can then form a covalent link to the growing peptide chain allowing the mRNA to be physically linked to its translational product.Antibodies that recognize puromycylated nascent chains can also be used to purify newly synthesized polypeptides and to visualize the distribution of actively translating ribosomes by immunofluorescence.Ref: https://en.wikipedia.org/wiki/Puromycin | Biochemistry | Metabolism of nucleic acids |
1206b10c-b8aa-476f-bf91-c684f9253b15 | All of the following are true of Reye's syndrome, except - | It frequently complicates viral infections | Prothrombin time is prolonged | Disease may be precipitated by salicylates | Deep jaundice is present | 3d
| multi | Reye's syndrome , a serious complication in children that is associated with influenza B and to a lesser extent with influenza A virus infection as well as with varicella-zoster virus infection. An epidemiologic association between Reye's syndrome and aspirin therapy for the antecedent viral infection has been noted, and the syndrome's incidence has decreased markedly with widespread warnings regarding aspirin use by children with acute viral respiratory infections. (Harrison's Principles of internal medicine, 20th edition) | Medicine | Infection |
e3e90be1-6499-4b02-ada2-7aec95db5500 | The protein found in the amyloid deposits in senile systemic amyloidosis is | AL protein | â2 microglobulin | â-amyloid protein | Transthyretin | 3d
| single | null | Pathology | null |
0f8af4df-d387-423d-99cf-57f8b78e63aa | Along a pleasant stimulus, noxious stimuli are given in treatment of alcohol dependence or sexual disorder is which of the following type of behaviour therapy | Negative reinforcement | Aversion therapy | Punishment | Flooding | 1b
| single | Aversion TherapyAversion therapy is used for the treatment of conditions which are pleasant but felt undesirable by the patient, e.g. alcohol dependence, transvestism, ego-dystonic homosexuality, other sexual detions. The underlying principle is the pairing of the pleasant stimulus (such as alcohol) with an unpleasant response (such as brief electrical stimulus), so that even in absence of unpleasant response (after the therapy is over), the pleasant stimulus becomes unpleasant by association. The unpleasant aversion can be produced by electric stimulus (low voltage), drugs (such as apomorphine and disulfiram) or even by fantasy (when it is called as cove sensitization). Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 215 | Psychiatry | Treatment in psychiatry |
aca7a804-bdf9-4cfe-9861-49590b3117b7 | Which of the following is the etiological agent for the given case below: | Congenital | Neurofibromatosis | Degenerative arthritic | Idiopathic | 0a
| single | Ans. (A) Congenital(Ref: Apley's System of orthopedics and Fracture 9th Ed; Page No- 465-66)Presence of a hemivertebra- Congenital Scoliosis.Neurofibromatosis: It is associated with scoliosis. The scoliotic curve is typically 'short and sharp and is associated with skin lesions.Idiopathic: It usually resolves spontaneously, measurement of the rib-vertebra angles at the curve apex in the early stages of the deformity is a good prognostic factor.Neuromuscular: The typically paralytic curve is long, convex towards the side with weaker muscles (spinal, abdominal, or intercostal), and at first is mobile. An X-ray obtained with traction would show the extent to which the deformity is correctable. | Radiology | Miscellaneous |
a2b2c180-2f07-482a-b2fe-b49fdfe409d6 | Avascular necrosis of which of the following bone result in Kohler's Disease? | Lunate bone | Femoral neck | Navicular Bone | Medial cuneiform bone | 2c
| single | Osteochondritis of Navicular bone is known as Kohler's Disease. It results in avascular necrosis of Navicular bone. | Surgery | null |
6b3276f2-6c61-46ae-b6de-9a7077613c55 | All of the following drains into coronary sinus, EXCEPT? | Great cardiac vein | Anterior cardiac vein | Middle cardiac vein | Left posterior ventricular vein | 1b
| multi | The coronary sinus receives blood mainly from the small, middle, great and oblique cardiac veins. It also receives blood from the left marginal vein and the left posterior ventricular vein. It drains into the right atrium. The anterior cardiac veins do not drain into the coronary sinus but drain directly into the right atrium. Some small veins known as smallest cardiac veins drain directly into any of the four chambers of the hea. | Anatomy | null |
1b9bc78d-3579-4904-aef6-854d97a395d8 | Gates Glidden drill is used to: | Remove the lingual shoulder | Enlarge the canal orifice | For the preparation of post space | Both 1 and 2 | 3d
| multi | The Gates-Glidden drill is used to:
Remove the lingual shoulder during access preparation of the anterior teeth
Enlarge root canal orifices.
Textbook of Endodontics Nisha GARG 3rd ED | Dental | null |
6c571d02-593c-4b7c-9067-07a254d696b3 | MCARDLE's maximum allowable sweat rate for 4 hours is | 3.5 ltr | 21 ltrs | 2.5ltrs | 4.5 ltrs | 3d
| multi | Mc Ardle's maximum allowable sweat rate:4.5 litre/ 4 hours. Predicted 4 hr sweat rate (P4SR) in comfo zone is 1-3 L Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 792 | Social & Preventive Medicine | Environment and health |
67e3c03b-bb69-4b6f-ad91-d13e742aa65b | A 50-year-old lady presented with a 3-month history of pain in the lower third of the right thigh. There was no local swelling; tenderness was present on deep pressure. Plain X-rays showed an ill-defined intra medullary lesion with blotchy calcification at the lower end of the right femoral diaphysis, possibly enchondroma or chondrosarcoma. Sections showed a cailaginous tumor. Which of the following histological features (if seen) would be most helpful to differentiate the two tumours? | Focal necrosis and lobulation | Tumor permeation between bone trabecuae at periphery | Extensive myxoid change | High cellularity | 1b
| single | Ans. is 'b' i.e., Tumour permeation between bony trabeculae at periphery Chondroma (enchondroma) Vs Chondrosarcoma o The term chondroma is used for benign neoplasm composed of cailage. It is of two types : - i) Enchondroma : - Cailage tumors occuring within the bone. ii) Periosteal chondroma : - Cailage tumors occuring on the surface of the bone. o Chondrosarcoma is the malignant tumor of cailage. Growth potential of chondroma is limited and mostly remain stable, but they have a potential to undergo malignant (sarcomatous) change to become chondrosarcoma. lnfact, enchondromas are considered to be a low grade chondrosarcoma. o A painful chondroid neoplasm in a large bone in an adult patient can be either enchondroma or chondrosarcoma o The differentiation between a low grade chondrosarcoma and an enchondroma can be difficult. o To make distinction between these two neoplasms, one has to make use of Cytological changes Myxoid quality of stroma Permeative characteristics Among these permeation, maifested as marrow spaces filled with the neoplasm and entrapment of preexisting bony trabeuculae is the most impoant sign of malignancy. | Pathology | null |
f0c5a957-2631-44b2-8427-06b22b985afc | Pseudomonal infection, not cleaned by - | Dettol | Hypochlorite | Chlorine | Betadine | 0a
| single | null | Microbiology | null |
49357d41-ccbf-4f95-bdb9-7ac72beaa1ba | Diagnostic criteria for ARDS include all except | Bilateral alveolar infiltrates | PaO2 / FiO2 >=300 mm Hg | Acute onset | Pulmonary capillary wedge pressure <= 18 mm Hg | 1b
| multi | Diagnostic Criteria for ARDSSeverity: OxygenationMild: Pao2/Fio2 300-2 00 mmHgModerate: Pao2/Fio2 200-100 mmHgSevere: Pao2/Fio2 <= 100 mmHgOnsetAcuteChest RadiographBilateral alveolar or interstitial infiltratesAbsence of Left Atrial HypeensionPCWP <=18 mmHg or no clinical evidence of increased left atrial pressureRef: Harrison 19e pg: 1736 | Medicine | Respiratory system |
9afa2c84-c458-453e-9c8b-98809c7adbae | Which of the following is true about Rotavirus - | Commonly affects children | Double Stranded DNA | Can be grown easily on cell culture | Egg shell appearance under electron microscope | 0a
| multi | rota virus are the commonest cause of diarrhea in infants and children the world over and account for half of the cases of children hospitalised for diarrhea REF:ANANTHANARYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.561 | Microbiology | Virology |
d706647c-7c3e-475d-a29d-1bb0ab85192f | Severe chronic MR is associated with - | H3 | H4 | Left atrial enlargement | Atrial fibrillation | 0a
| single | Even in people with severe MR, there may be no signs or symptoms until the left ventricle fails, an abnormal hea rhythm develops (atrial fibrillation), or pulmonary hypeension occurs. Pulmonary hypeension occurs when the blood pressure in the pulmonary aery is increased Ref Davidson 23rd edition pg 455 | Medicine | C.V.S |
20347f82-5020-45d5-b45f-58f76ee792b9 | Oligohydramnios causes include - | DM | Oesophageal atresia | Rh isoimmunisation | Renal agenesis | 3d
| single | Ans-Di.e., Renal agenesis Oligohydramnioso In this condition, liquor amnii is deficient in an amount to the extent of fewer than 200 ml at term,o Sonographically it is defined as when the max vertical pocket of liquor amnii is less than 2 cm or when the amniotic fluid index is less than 5 cm (< 10 centiles). With AFI < 8 cm (below 5th centile) or> 24 cm (above 95 centile) was considerd abnormal at gestational age. from 28-40 weeks.Etiologyo Fetal causesFetal chromosomal or structural anomaliesRenal AgenesisObstructed uropathySpontaneous rupture of membraneIntrauterine infectionsDrugs:- PG inhibitors, ACE inhibitorspostmaturity1UGRAmnion nodosum ( failure of secretion by the cells of the amnion covering the placenta)o Maternal causesHypertensive disordersUteroplacental insufficiencyDehydrationIdiopathic | Unknown | null |
5368f4ec-9139-4e05-a994-ba4e1d765d21 | Which of the following disorder is characterised by intense nihilisim, somatization and agitation in old age? | Bipolar depression | Atypical depression | Somatized depression | Involutional melancholia | 3d
| single | Involutional melancholia refers to manic depressive disorder occuring during old age. Age of first presentation is 50 for women and 55 for men. Early symptoms include weight loss, insomnia, lack of interest in activities, poor concentration and low spirits. They also experience dejection, agitation, nihilistic delusions, hypochondriacal delusions and paranoid features.Ref: Abnormal Psychology By Page Mn page 279; Kaplan & Sadock's Comprehensive Textbook of Psychiatry, 9th edition page 1707. | Psychiatry | null |
1fb281ae-93f1-45b7-b7a3-6a6de6979f9d | A 35 year old female, with post coital bleeding, next step : | Clinical examination and pap smear | Visual inspection with acetowhite | Visual inspection with lugol's iodine | Colposcopy directed biopsy | 0a
| multi | Ans. is a i.e. Clinical examination and pap smear Well friends first I want you to read what Williams has to say on Postcoital bleeding. "Bleeding following intercourse most commonly develops in women aged 20 to 40 years and in those who are multiparous. No underlying pathology is identified in up to two thirds. If an identifiable lesions is found, however, it typically is benign. In a review of 248 women with postcoital bleeding. Selo-Ojeme and co-workers (2004) found that a fouh of cases were caused by cervical eversion. Other causes included endocervical polyps, cervicitis, and less commonly, endometrial polyps. In the cases of cervicitis. Chlamydia trachomatis is a frequent cause. In some women, postcoital bleeding may be from cervical or other genital tract neoplasia. The epithelium associated with cervical intraepithelial neoplasia (CIN) and invasive cancer is thin and friable and readily detaches from the cervix. In women with postcoital bleeding. CIN was found in to 10 percent, invasive cancer in about 5 percent, and vaginal or endometrial cancer in <1 percent. In another study, Jha and Sabharwal (2002) repoed that a number of women with postcoital bleeding had pathologic lesions identified at colposcopic evaluation that had been missed by Pap smear screening. Thus, most women with unexplained postcoital bleeding should undergo colposcopic examination if no other obvious souce of bleeding is identified." So after reading the above text it is clear that - Colposocopy is the most definitive procedure for diagnosis of postcoital bleeding. But here question is specifically saying - a 35 years old female is coming with postcoital bleeding, what is the next step - so obviously in this age group we will first examine the patient, rule out other causes, perform a pap's and still if no diagnosis is made we will go for colposocpy to rule out CIN and Ca cervix. | Gynaecology & Obstetrics | null |
cf6bdfe2-9691-4791-8870-d5af2e9ea5ff | Which of the following is NOT an alpha-adrenoceptor agonist? | Clonidine | Methyldopa | Guanabenz | Isoxsuprine | 3d
| single | Clonidine, apraclonidine, brimonidine are selective alpha 2 agonists. Guanfacine and guanabenz are central alpha 2 agonists. Isoxsuprine is a selective beta-2- receptor agonist used to relax uterus. From medical pharmacology Padmaja 4th edition page no 101 | Pharmacology | Autonomic nervous system |
dbac00eb-e48c-4974-a207-1cfac899f2b0 | Female patient with injury on her scalp, hair was shaved and sutures were put. On which day sutures should be removed? | 8-10 days | 2 weeks | 3 weeks | 1 month | 0a
| single | Ans. (a) 8-10 daysRef Sabiston 18th ed. 12134Scalp suture should be removed on 6th to 8th day. Given these options, 8-10 days is the best choice.Day of suture removal from different body areasBody areaSuture removal on* Scalp6-8 days* Face3-5 days* Chest, Abdomen8-10 days* Ear10-14 days* Extremities, back12 -14 days | Surgery | General Management of Wounds |
6ebd0378-843f-4198-9df8-b22a7c4c990a | A lady with 8 wks pregnancy presented with random blood glucose of 177mg/dl. The treatment is : | Phenformin | Sulfonylurea | Insulin | Glipizide | 2c
| single | Ans. is 'c' is insulin (Ref Dutta 6/e, p 288 (5/e, p. 304); Holland and Brews, 16/e, p. 107).Insulin is the only antidiabetic drug given in pregnancy to control increased blood sugar.Oral hypoglycemics are contraindicated in pregnancy because they cross placenta and have teratogenic effect on fetus.They cause fetal hypoglycemia and increase m fetal bilirubin.Moreover the increase demand in pregnancy cannot be met by oral hypoglycemics. | Gynaecology & Obstetrics | Pharmacology in Gynaecology |
03a1d84e-7df7-4425-9544-5dcaf5adf222 | Preferred drug for alcohol withdrawal seizures is: | Diazepam | valproate | Phenobarbitone | Carbamazepine | 0a
| single | Benzodiazepines (Chlordiazepoxide,diazepam) are the preferred drugs due to long duration of action and can be gradually withdrawn later. Ref KD Tripati 8th ed. | Pharmacology | Central Nervous system |
d180322d-fa0c-4040-a92f-683fab03afdd | Estimated mean Hemoglobin (Hb) of 100 women is 10g%. Standard detion is 1 gm%. Standard error of estimated will be - | 0.001 | 1 | 10 | 0.1 | 3d
| single | <p>standrad error of mean= standard detion/[?]n =1/[?]100 =1/10 =0.1 Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 850 </p> | Social & Preventive Medicine | Biostatistics |
65f10f1e-b37a-409a-a7d0-5e39cfd2a5fe | HLA associated with psoriasis | HLA-B27 | HLA-DR4 | HLA-CW6 | HLA-B8 | 2c
| single | Psoriasis is a long-lasting autoimmune disease which is characterized by patches of abnormal skin.] These skin patches are typically red, itchy, and scaly. They may vary in severity from small and localized to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenonType 1 has a positive family history, stas before the age of 40, and is associated with the human leukocyte antigen, HLA-Cw6. Conversely, type 2 does not show a family history, presents after age 40, and is not associated with HLA-Cw6. Type 1 accounts for about 75% of persons with psoriasis. | Pathology | General pathology |
d0385d28-2282-443a-9eb6-8aef120b39c2 | Which of the following is a cause of unilateral hyperlucent lung on chest radiography? | Poland syndrome | Asthma | Acute bronchiolitis | Pleural effusion | 0a
| single | Poland's syndrome (unilateral congenital absence of pectoral muscles) causes unilateral hypertranslucency.
Asthma & acute bronchiolitis cause bilateral hypertranslucency. | Radiology | null |
55b1ba9f-8247-4fb2-863e-d43347636895 | PGs in semen is secreted by | Prostate | Seminal vesicle | Sperms | Testes | 1b
| single | The seminal vesicles secrete a significant propoion of the fluid that ultimately becomes semen. Lipofuscin granules from dead epithelial cells give the secretion its yellowish color. About 50-70% of the seminal fluid in humans originates from the seminal vesicles, but is not expelled in the first ejaculate fractions which are dominated by spermatozoa and zinc-rich prostatic fluid.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-419 | Physiology | Endocrinology |
c41da94d-70b6-4b02-9856-d871893a8a21 | Who gave the term ECC (Early Childhood Caries)? | Davies | Moss | Winter | Dilley | 0a
| single | null | Dental | null |
4872d070-ff0e-40da-a01c-fbf763b2c0b1 | During examination of parotid gland, parotid duct can be palpated at the following except: | Anterior border of masseter | At the opening just opposite to lower second molar | Pierced to the buccinator | At the anterior border of parotid gland | 1b
| multi | Parotid Duct (Stenson’s Duct)
Parotid duct, about 5 cm long, emerges from the middle of the anterior border of the gland and opens into the vestibule of the mouth opposite the crown of upper second molar tooth. | Anatomy | null |
d934adff-6436-4d36-b729-a3678cf44a1d | A farmer presents with pustules showing gram positive cocci, beta hemolysis, catalase negative. To show it is group A streptococci, which of the following test is done - | Bacitracin | Optochin | Novobiocin | Bile solubility | 0a
| single | null | Microbiology | null |
6fe9edfd-e8aa-4a7b-a84b-f8375fb98742 | In ARDS all are seen EXCEPT - | Dilated bronchioles | Edema | Fibrosis | Alveolar damage | 0a
| multi | null | Medicine | null |
5fdd0dce-352f-4582-a600-d85f29fdb96e | Which is a glycoprotein, produced by many mammalian cells, and used in the treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma? | Interferon | Idoxuridine | Zidovudine | Zalcitabine | 0a
| single | All the above agents are synthetic analogues, except Interferon which is a glycoprotein produced by many types of mammalian cells. It has been shown to be useful in treatment of hepatitis, papillomaviruses, hairy-cell leukemia and AIDS-related Kaposi's sarcoma. Idoxuridine, as its name implies, is a synthetic pyrimidine analog, which inhibits viral DNA polymerase. Zidovudine and zalcitabine are also synthetic pyrimidine analogs but they inhibit reverse transcriptase and act as chain terminators. Ref: Baden L.R., Dolin R. (2012). Chapter 178. Antiviral Chemotherapy, Excluding Antiretroviral Drugs. 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. | Pharmacology | null |
106df13c-90d4-443a-94a8-a7b5a8c5e1c1 | The most likely cause of bihilar lymphadenopathy is | Histoplasmosis | Tuberculosis | Sarcoidosis | Aspergillosis | 2c
| single | Sarcoidosis Chronic multisystem disorder of unknown cause characterized by accumulation of TH 1 lymphocytes and mononuclear phagocyte in various tissuesof body.Non-caseating sarcoid Granuloma in affected organsLungs (90%)Lymph nodesSkinOthersInterstitial lung disease (fibrosis of lung parenchyma)Pleura is involved, in 1-5% cases unilateral pleural effusion Cavitation is rare B/L hilar lymphadenopathy is the hallmark of Sarcoidosis B/L parotid enlargement Erythema nodosum Lupus pernio (purple blue shiny swollen lesion on nose, cheeks, lips, ears)UveitisRenal hypercalcemia with or without hypercalciuriaAhritisPeripheral neuropathyCor-pulmonale(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2805-2813) | Pathology | All India exam |
f67d6cb1-27c6-4619-a205-ededfe114769 | Modifiers are added to gypsum mainly to | Modify setting time | Modify setting expansion | Modify strength | Decrease the porosity | 0a
| single | null | Dental | null |
2ec770fb-61d6-4a87-bff1-896187b04fa5 | In a surgical post-op ward, a pt. developed wound infection. Subsequently 3 other pts. developed smilar infections in the ward. What is the most effective way of preventing the spread of infection - | Give IV antibiotics to all pts. in the ward | Proper handwashing of all ward personnels | Fumigation of the ward | Wash OT instrumens with 1% perchlorate | 1b
| multi | Ans. is 'b' ie. Proper hand washing of all ward personnels "Given the prominence of cross infection, hand washing is the single most impoant preventive measure in the hospital" - Harrison 15/e Harrison 17/e writes- "Given the prominence of cross-infection, hand hygiene is the single most impoant preventive measure in hospitals. Use of alcohol hand rubs between patient contacts is now recommended for all health care workers except when the hands are visibly soiled, in which case washing with soap and water is still required." | Surgery | null |
0a3458db-1ab6-4bc5-a9b6-e7882847b6eb | Cold spot is seen in all the following except: | Fibrous Cortical defect | Pseudarthrosis | Multiple myeloma | Eosinophilic granuloma | 3d
| multi | Eosinophilic granuloma - shows osteoblastic activity - hotspot. | Radiology | null |
e117ceba-9d46-4320-beba-73675089ee32 | Propranolol is contraindicated in diabetes mellitus because it: | Causes hyperglycemia | Causes seizures | Masks the hypoglycemic symptoms | Causes hypotension | 2c
| single | null | Pharmacology | null |
e5f1496b-c209-488b-a55a-855792aa5ede | False about short bowel svndrome- | Hypergastrinemia & high gastric secretion is seen | Diarrhea, dehydration and malnutrition | Hirsutism | Chronic TPN dependence | 2c
| multi | Ans. is 'c' i.e., Hirsutism Short bowel syndrome -o Presence of less than 200 cm of residual small bowrel in adult patients.o Insufficient absorptive capacity of small intestine results in diarrhea, dehydration and malnutition.Causes - Small intestine resection (massive) due toMassive resection in singleCumutative effect of multipleoperation as in acute mesentericoperations of small intestineischemia, malignancyresected as in Crohn's diseaseo In pediatric patients, MC etiologies are intestinal atresia, volvulus and necrotizing enterocolitis. Resection of less than 50% of small intestine is generally well tolerated.o Clinically significant malabsorption occurs when more than 50 to 80% of small intestine has been resected.o Resection ofjejunum is better tolerated than resection of ileum.o Presence of healthy colon, intact ileocecal valve and healthy residual small bowel are factors associated with decreased severity of malabsorption.o Malabsorption in short bowel syndrome is exacerbated by a characteristic hypergastrinemia associated gastric acid hypersecretion which persists for 1 to 2 years post operatively.Management -1. Medical- a)TPNHigh dose H-, reseptor antagonist/PPLAntimotility agents - Loperamide.Octreotide - reduces volume of GI secretions.o Levels of Iron, Magnesium, Zinc, Copper and vitamins must be monitored closely and deficienc ies prevented.1 Surgery -Non transplant surgery : Goal is to increase nutrient and fluid absorption by slowing intestinal transit or increasing intestinal length.Segmental reversal of small bowel.Colon interpositionSmall intestinal valves construction.Electrical pacing of small intestine.Bianchi's Intestinal lengthening operation (generally used in pediatric patients with dilated small bowel).Serial transverse enteroplasty (2003).Intestinal transplantation : Indicated for life threatening complications of intestinal failure or chronic TPN therapy -Impending/overt liver failure.Thrombosis of major central veins.Frequent cathater related sepsis.Frequent episodes of severe dehydration. | Surgery | Miscellaneous (Small & Large Intestine) |
2d544ca3-1909-4ac0-bce9-a44031ab3837 | antipsychotic which has anti suicidal propey is | clozapine | chlorpromazine | aripiprazole | amisulpride | 0a
| single | CLOZAPINE * Impoance * First SGA * TREATMENT FOR TREATMENT RESISTANT SCHIZOPHRENIA * TOC for TD * Anti suicidal * Psychosis in parkinsonian patients Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, 935 | Anatomy | Pharmacotherapy in psychiatry |
77cfd4fd-678f-4d36-add2-8647fe61ee9d | Which is not a minor diagnostic criteria for multiple myeloma? | Lytic bone lesions | Plasmacytosis greater than 20% | Plasmacytoma on biopsy | Monoclonal globulin spike on serum melectrophoresis of >2.5 G/DL for IgG,>1.5 G/DL for IGA) | 2c
| single | . Plasmacytoma on biopsy | Pathology | null |
b0e1c035-1968-4efe-a73c-934009e1e4fa | A 17 year old boy presented with total count of 138 x 109 /L with 80% blasts on the peripheral smear. Chest X-ray demonstrated a large mediastinal mass. Immunophenotyping of this patient's blasts would most likely demonstrate: | No surface antigens (null phenotype) | An immature T cell phenotype (Tdt/D34/CD7 positive) | Myeloid markers, such as CD13, CD33 and CD15 | B cell markers, such as CD19, CD20 and CD22 | 1b
| single | . An immature I$? cell phenotype (Tdt/D34/CD7 positive) | Pathology | null |
980919d7-2fee-4ec7-af1e-d6853139e647 | Drug of choice of typhoid - | Chloramphenicol | Ampicillin | Azithromycin | Ciprofloxacin | 3d
| single | Ans. is 'd' i.e., Ciprofloxacin o The older agents used for the treatment of typhoid were;ChloramphenicolAmpicilinTrimethoprim Sulfamethoxazoleo These drugs are not used nowdays because o f widespread resistance.o Nowdays the drug of choice for Typhoid all over the world is a "Fluroquinolone" (Ciprofloxacin, ofloxacin).An important point to remembero High level of fluoroquinolone resistance (ciprofloxacin) have been reported from India and other parts of South East Asia in S, paratyphi and S.typhi infection.# Nalidixic acid resistant S.typhi (NARST) have decreased ciprofloxacin sensitivity-1 and are less effectively- treated with fluoroquinolones.# The fluroquinolones should not be used as first line treatment for typhoid fevers in patients from India and other parts of South Asia with high rates offluroquinolone resistance unless antibiotic susceptibility data demonstrates fluoroquinolone or nalidixic acid sensitivity>.Alternative drugs for patients with fluoroquinolone resistance are : -o Beta lactam Parenteral - Ceftriaxone Oral - Cefiximeo Azithromycino ChloramphenicolAntibiotic Therapy for Enteric Fever in AdultsIndicationAgentEmpirical treatmento Ceftriaxoneo AzithromycinFully susceptibleo Ciprofloxacinb (first line)o Amoxicillin (Second line)o Chloramphenicolo Trimethoprim-sulfamethoxazoleMutlidrng-Resistanto Ciprofloxacino Ceftriaxoneo AzithromycinNalidixic Acid-Resistanto Ceftriaxoneo Azithromycino High-dose ciprofloxacin | Medicine | Drugs |
ac442492-3f37-4130-ba8d-da4fc5824a02 | Retrobulbar injection is given in - | Inside muscle cone | Outside muscle cone | Subtenon space | Subperiosteum | 0a
| single | It is given in the central space Central space : also called, muscular cone or retrobulbar space. It is bounded anteriorly by the Tenon's capsule lining back of the eyeball and peripherally by the four recti muscles and their intermuscular septa in the anterior pa. In the posterior pa, it becomes continuous with the peripheral space. Tumors lying here produces axial proptosis. Ref:AK Khurana 6thE pg 403 | Ophthalmology | Miscellaneous |
76d49db1-b82a-479f-8696-72656de9e907 | Which of the following is not a tumor marker for hepatocellular carcinoma | AFP | PIVKA II | CEA | Glycipin 3 | 2c
| single | CEA is raised in colon ca. | Surgery | null |
5bd77d25-b671-4902-b918-aa33439d9a48 | Erysipelas is caused by ? | Staph aureus | Staph albus | Strep pyogenes | Hemophilus | 2c
| single | Ans. is 'c' i.e., Strep pyogenes Erysipelas - is due to S. pyogenes and - is characterized by an abrupt onset of fiery-red swelling of the face or extremities. the distinctive features of erysipelas are well-defined indurated margins, paicularly along the nasolabial fold; rapid progression; and intense pain. extension to deeper soft tissues is rare. treatment with penicillin is effective | Surgery | null |
79d66eee-b9b9-46d3-a504-e10c560fa6b4 | Which among the following is the least common cause of infective endocarditis? | ASD | MS | VSD | AR | 0a
| single | Among the following, ASD is the least common cause of infective endocarditis. Here the low turbulence is responsible for decreased incidence of IE. | Medicine | null |
944f95f8-7738-4533-b25b-f00f7bf8c742 | Which of the following is a new ILI antagonist used in rheumatoid ahritis? | Anakinra | Rituximab | Teriparatide | Adalimumab | 0a
| single | Ans. is 'a' i.e., Anakinra | Pharmacology | null |
1a22d1c5-4ec9-4210-b478-e3194483ac0c | The liquid component of hybrid ionomer cements usually contains a water solution of: | HEMA | Polyacrylic acid | Polyacrylic acid modified with methacrylate | All of the above | 3d
| multi | The liquid component of hybrid ionomer cements usually contains a water solution of polyacrylic acid, HEMA, and polyacrylic acid modified with methacrylate.
The powder component contains fluoroaluminosilicate glass particles of a conventional GIC plus initiators, such as camphorquinone, for light curing and/or chemical curing. The acid-base reaction begins upon mixing and continues after polymerization at a much slower rate than for conventional GICs, because less water is present and the reaction is much slower in the solid phase than in the liquid phase.
Ref: Phillip’s Science of Dental Materials ed 12 pg 326 | Dental | null |
43e1a4c1-5c5d-4c77-9be1-755b59000526 | The clasps for partial dentures should be made of | Gold | Iridoplatinum | Platinum | Silver | 0a
| single | null | Dental | null |
091dd017-bc7a-4fc5-9442-4ec18db3c007 | Rorschach test measures : | Intelligence | Creativity | Personality | Neuraticism | 2c
| single | C i.e. Personality | Psychiatry | null |
116624cd-0b33-436b-b042-32a303368e9c | Colour of urine in phenol poisoning: | Red | Green | Yellow | Blue | 1b
| single | Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy. 29th edition. 2010. Pg: 478Explanation:Phenol poisoning can lead to green or black urine due to carboluria.Carboluria is due to oxidation of phenol to hydro- quinone and pyrocatechol.Poisonings affecting Urine ColorRed Coloured Urine - CausesMyoglobinuria- there will be a brownish-red colour. Often associated with ischemic muscle damage, crush injuries, and after vigorous exercises and toxinsGreen Coloured Urine - CausesOxalate Poisoning Phenol poisoning.Black Coloured Urine - CausesCarbolic acid poisoning.Phenol poisoningBlue Coloured Urine - CausesPresence of indigo or of methylene blue (used as an antidote to certain types of poisoning). | Forensic Medicine | Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques |
0efa8065-47b9-4f58-9760-e67ff13443fb | A child can Count 4 pennies accurately by the age of ? | 30 months | 36 months | 48 months | 60 months | 2c
| single | Emerging patterns for language behaviour from 1-5years of age 15months Jargon Follows simple commands May name a familiar object (e.g., ball) Responds to his/her name 18months 10 words (average) Names pictures Identifies 1 or more pas of the body 24months Puts 3 words together (subject, verb, object) 30months Refers to self by the pronoun "I" Knows full name 36months Knows age and sex Counts 3 objects correctly Repeats 3 numbers or a sentence of 6 syllables Most of the speech intelligible to strangers 48months Counts 4 pennies accurately Tells story 60months Names 4 colours Repeats sentence of 10 syllables Counts 10 pennies correctly Ref: Nelson paediatrics; Table 11-1 | Pediatrics | Growth and development |
e5dca100-4dd3-4570-9ad3-eb23524ae78c | Coiled spring appearance - | Intusseption | Achalasia | Duodenal perforation | Chronic pancreatitis | 0a
| single | Ans. is 'a' i.e., Intusseption Radiological investigations and signs seen in IntussusceptionPlain filmo Features of small intestinal obstruction o Abdominal soft tissue density in some cases which may showTarget sign - soft-tissue mass with concentric area of lucency due to mesenteric fatMeniscus sign - crescent of gas within colonic lumen that outlines the apex of intussusceptionBarium EnemaClaw sign - rounded apex of intussusception protrudes into the contrast column Coiled spring sign - edematous mucosal folds of returning limb of intussusceptum outlined by contrast material.Ultrasoundo Target signo Bull's eye signo Pseudokidney signAlso knowo Dance sign - feeling of emptiness in rt. iliac fossa on palpation | Surgery | Small Intestine - Small Bowel Obstruction |
c82e72e6-de13-4d1d-95d0-34fca534267f | Which of the following is the best indicator of long term nutritional status - | Mid arm circumference | Height for age | Weight for age | Weight for height | 1b
| single | Ans. is 'b' i.e., Height for age Stunting (deficit in height for age) generally points towards a chronic course of malnutrition. Ghai "Height is a stable measurement of growth as opposed to body weight. Whereas weight reflects only the present health status of the child, height indicates the events in the past also". | Pediatrics | null |
edcf31b8-495c-4d9f-9245-1acac5594be9 | Carbon monoxide diffusion capacity decreases in all, Except - | Emphysema | Primary pulmonary hypertension | Alveolar haemorrhage | Infiltrative lung disease | 2c
| multi | null | Medicine | null |
8acf11b5-fbf2-4efb-b395-a4937482f67b | Non keratinized areas in gingiva is/are: | Sulcular epithelium. | Junctional epithelium. | Interdental col. | All of the above. | 3d
| multi | null | Dental | null |
e7957e3d-dcf7-45aa-a632-a76be7f9eb8d | A drug that can be used for producing alkalinization of urine is? | Hydrochlorothiazide | Furosemide | Acetazolamide | Spironolactone | 2c
| single | null | Pharmacology | null |
d50b2943-45ba-48fb-a8c2-e702d1fb3ad8 | Investigation of choice for entrapment neuropathy is ? | CT SCAN | Clinical examination | Ulrasonography | EMG NCV | 3d
| single | Ans. is 'd' i.e., EMG NCV The diagnosis of mononeuropathy in entrapment neuropathy is based on electrodiagnostic studies (EMG/ NCV) and Magnetic resonance imaging (MRI). Entrapment neuropathy is a medical condition caused by entrapment and compression of a peripheral nerve wherever it traverses fibro-osseous tunnels. Sites of entrapment neuropathy are : - Carpal tunnel :- Median nerve (carpal tunnel syndrome) Cubital tunnel :- Ulnar nerve (cubital tunnel syndrome) Guyan's canal :- Ulnar nerve (Guyan's canal syndrome) Tarsal tunnel :- Posterior tibial nerve (Tarsal tunnel syndrome) Inguinal ligament :- Lateral cutaneous nerve of thigh (meralgia paraesthetica). Suprascapular notch :- Suprascapular nerve Neck of fibula :- Common peroneal nerve Fascial tunnel of superficial peroneal nerve :- Superficial peroneal nerve Arcase of Frohse :- Posterior interosseous syndrome Thoracic outlet :- Lower trunk of brachial plexus Compression in the foot :- Digital nerve (Moen's metatarsalgia) | Surgery | null |
71f96eeb-8005-41e6-a85a-f5080b2fcb9b | Which of the following takes place during the stationary phase of growth curve? | Bacterial cell number increases | Bacterial cell size decreases | Bacterial cell size increases | Sporulation | 3d
| single | Growth curve:Lag phase: maximum cell size is obtained towards the end of the lag phaseLog phase: cells are smaller and stain uniformlyStationary phase: cells are frequently Gram-variable and show irregular staining due to the presence of intracellular storage granules. Sporulation occurs at this stage. Also, many bacteria produce secondary metabolic products such as exotoxins and antibioticsPhase of decline: involution forms are common Ref: Ananthanarayan 9th edition, p22-23 | Microbiology | general microbiology |
11652335-371c-4ff1-8d87-fb3bb5e179e1 | Ramesh met an accident with a car and has been in &;deep coma&; for the last 15 days. The most suitable route for the administration of proteins and caloriesis by? | Jejunostomy tube feeding | Gastrostomy tube feeding | Nasogastric tube feeding | Central venous hyperalimentation | 0a
| single | Unless the GI tract is non-functional, its use for nutritional suppo is preferable as compared to TPN. In a patient who is comatose either NG feeding or feeding through a gastrostomy tube may lead to vomiting and aspiration. This can be avoided by using a nasoenteric tube with the tip placed in jejunum under fluoroscopic guidance or endoscopic control. Alternatively, a catheter may be placed directly into the proximal jejunum through a small upper abdominal incision. Enteral Nutrition Enteral feeding means delivery of nutrients into the GIT. The alimentary tract should be used whenever possible. This can be acheived with oral supplements (sip feeding) or with a variety of tube-feeding techniques delivering food into the stomach, duodenum or jejunum. Advantages of Enteral route over Parenteral route Maintains integrity of gastrointestinal tract. Reduces translocation of gut bacteria that may lead to infection. Reduces levels of pro inflammatory cytokines generated by the gut that contribute to hypermetabolism. Enteral Nutrition Indication Contraindication Protein-energy malnutrition with inadequate oral intake Dysphagia except for fluids Major trauma (Or surgery) when return to required dietary intake is prolonged Inflammatory bowel disease Distal, low-output (<200 ml/day) enterocutaneous fistula To enhance adaptation after massive enterectomy Small bowel obstruction or ileus Severe diarrhoea Proximal small intestinal fistula Severe pancreatitis Ref: Sabiston 27th edition Pgno: 112 | Surgery | General surgery |
dda4d7ed-1f10-48ec-b8ba-a0485fc00f41 | If only one terminal aldehyde group of glucose is oxidized, the product is - | Glucuronic acid | Gluconic acid | Gluchosaccharic acid | Gluconalactone | 1b
| single | Ans. is 'b' i.e., Gluconic acid Oxidation of sugaro When aldose sugars are oxidized they may form three different sugar acid, depending upon oxidation of aldehyde group (at C-l) or terminal alcohol group (at C-6).i) Aldonic acid:- Oxidation of an aldose with hypobromous acid (HOBr) oxidises only aldehyde group and convert it to carboxyl group to form aldonic acid. For example, glucose is oxidized to gluconic acid.ii) Saccharic acid:- Oxidation of aldoses with nitric acid convert both aldehyde and terminal primary alcohol groups to carboxyl group, formic saccharic acid. For example, glucose is oxidize to glucosaccharic acid.iii) Uronic acid:- When an aldose is oxidized in such a way that the terminal primary alcohol is converted is to carboxyl without oxidation of aldehyde group, a uronic acid is produce. For example, glucose is oxidized to glucuronic acid. | Biochemistry | Chemistry of Carbohydrates, Amino sugars, and Mucopolysaccharides |
f3b65c32-10e7-4f5b-a84d-caedaa7fd843 | As per RCH, the community health centre is a ? | First referral unit | Secondary referral unit | Teritary referral unit | Not a referral unit | 0a
| single | Ans. is 'a' i.e., First referral unit First Referral Units (FRU) under the RCH programe 3 Community Health Cetres and Subdistric Hospitals that provide the following services can be declared as FRUs under the RCH programme. Three critical determinants for a facility to be declared as an FRU o Availibility of surgical interventions. o Availibility of new born care. o Availibility of blood storage facility on a 24 hour basis. o To be able to perform the full range of FRU functions a health facility (CHC or subdistrict hospital or otherwise) must have the followine facilities. Facilities required (not critical) to perform full range of FRU functions : a)A minimum bed strength of 20-30. However in difficult areas, as the Noh-East states and the under-served areas. this could initially be relaxed to 10-12 beds. b) A fully functional operation theatre c) A fully functional labour room d) An area equipped for new-born care in the labour room, and in the ward. e) A functional laboratory f) Blood storage facility g) 24-hour water supply and electricity supply h) Arrangements for waste disposal and i)Arnbulance facility | Social & Preventive Medicine | null |
cf0077f2-55fd-4640-9667-5cb43db86ef3 | Condom vending machine at petrol pump in high prevalence area is example of:- | Appropriate technology | Social marketing | Socialization | Community paicipation | 1b
| single | Social marketing Concept: Seeks to develop and integrate marketing concepts with other approaches to influence behaviors that benefit individuals and communities for the greater social good - Social marketing seeks to influence social behaviors not to benefit the marketer, but to benefit the target audience and the general society Example: installation of condom vending machines at parks, pay and use toilets, railway stations, bus stations, petrol pumps, wine shops, bars, restaurants, STD/PCO booths, tea-shops, paan-shops. | Social & Preventive Medicine | Allied Health Sciences |
d9744a5e-27eb-4c40-a225-fccfa82348fc | A 24-year-old male presented with a 4-year history of abdominal pain, periodic diarrhea, low-grade fever, and easy fatigability is found to have an entero-enteric fistula on contrast radiography. Colonoscopy shows "cobblestone" mucosa that has linear ulcerations with "skip areas" of normal bowel wall. Which of the following is most likely explanation of fistula formation in this patient? | Intramural granulomas | Transmural inflammation | Marked lymphoid reaction | Skip lesions of the intestinal wall | 1b
| multi | - Given clinical features suggests the diagnosis of Crohn's disease - Transmural inflammation explains 2 most common complications of Crohn's disease - i.e Strictures & fistulas. Necrosis of the intestinal wall causes ulcer formation which can penetrate entire thickness of affected intestinal wall, leading to formation of fistula Chronic inflammation causes edema & fibrosis leading to narrowing of intestinal lumen - strictures | Pathology | Diagnostic procedures |
705cc524-5c3e-4707-812d-a9cf74bf4809 | Regarding obesity syndromes, determine the true / false statements: a) Prader-Willi syndrome has normal stature with truncal obesity b) Laurence-Moon-Biedl is autosomal; polydactyly is seen c) Ahlstrom's syndrome patients has moderate mental retardation d) Cohen's syndrome- Patients will have craniofacial anomalies and delayed pubey e) Carpenter's syndrome have secondary hypogonadism | b,d,e-True & a, c- False | a,c,d,e-True & b- False | b,c,d,e-True & a- False | b,c,d-True & a,e- False | 0a
| multi | Prader-Willi syndrome is sporadic inheritance, sho statured with generalised obesity. Primary gonadism and moderate mental retardation is seen. Ahlstrom's patients will have normal intelligence. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 626 Table 77-2 A Comparison of Syndromes of Obesity--Hypogonadism and Mental Retardation. | Medicine | null |
195cca0c-0e14-4554-a8b3-dbd8f2f7d97d | Young male with painless induration of penis, enlarged non tender genital lymph nodes. Cause is - | Chancroid | Herpes genitalis | Primary syphilis | Donovanosis | 2c
| single | null | Medicine | null |
57aec219-f16a-41c4-b099-5e196c96d78e | A 30 year old male presents with history of abnormal excessive blinking and grunting sounds. He has no control of these symptoms which have increased in frequency. Which of the following medications can be used for treatment of this person? | Carbamazepine | Imipramine | Risperidone | Methylphenidate | 2c
| single | The history of the patient suggests the presence of the tic disorder. Treatment of Tic Disorder: *Dopamine depleter: Tetrabenazine (drug of choice) *Dopamine receptor blockers: Haloperidol,Fluphenazine, Pimozide *Atypical antipsychotics: Aripiprazole, Risperidone *Clonazepam *Carbamazepine *Botulinum toxin (Local injection) REF:KATZUNG 14TH ED. | Pharmacology | Central Nervous system |
5fadf683-43d4-4c16-952a-f16651d05682 | Which of the following causes highest risk of nosocomial infection to a patient | Patient admitted for elective surgery | HIV patient coming in follow up OPD | Patient undergoing endoscopy | Patient admitted for normal delivery | 0a
| single | While all hospitalized patients are at risk for HAI, ceain subpopulations are at increased risk. These include the elderly, the immune-compromised, the very young or premature, and burn and surgical patients. Ref: Ananthanarayana & panikers 9th edition | Microbiology | miscellaneous |
dd6a450a-02dd-4fe3-b995-b47fdcc9a743 | Action of 1-2mcg/kg.min of dopamine is | Renal vasodilatation | Increased blood pressure | Inotropic action | Vasoconstriction | 0a
| single | Dopamine at dose 1-2mcg/kg.min- renal vasodilatation2-10mcg/kg/min : beta 1 stimulationMore than 10 mcg/kg/min - vasoconstriction - alpha stimulationRef: Harrison; 17th ed. Pg 1453 | Pharmacology | Cardiovascular system |
3ef36a99-a305-4eb6-884d-ba434a4a5213 | A 70 years old male develops pneumonia and septicaemia. Patient goes into renal failure and has a B.P of 70/50 mm of Hg. Drug that should be used to maintain B.P is | Adrenaline | Ephedrine | Phenylephrine | Nor epinephrine | 3d
| single | null | Medicine | null |
144b9ddd-2b1a-4497-8f60-d8796dbe48f7 | Number of Bones in adult skull are: | 18 | 20 | 22 | 40 | 2c
| single | The skull at birth contains 45 bones.
The adult skull consists of 22 bones (OR 28 bones including 3 paired ear ossicles).
Calvaria/brain box - 8 bones (OR 14 bones, including 6 ear ossicles).
Facial skeleton - 14 bones. | Anatomy | null |
246bc720-f40f-4de1-a6c4-5e11cac97ae3 | All of the following are modes to decrease pain on injection caused by propofol cxcept | Mix lignocaine with propofol | Give fentanyl prior to propofo | Use vein on the dorsum of hand | Cooling of the drug | 2c
| multi | Propofol is formulated as a lipid emulsion which causes pain during injection that can be decreased by using a large vein, avoiding veins in the dorsum of the hand, prior injection of lidocaine or by mixing lidocaine with propofol prior to injection (2 mL of 1% lidocaine in 18 mL propofol). prior injection of opioid Thicker vein decreases pain on injection caused by propofol. | Anaesthesia | Intravenous Anesthetic Agents |
399d6493-1970-4e1e-bde5-90a0bbd1db3f | True about veebral aery | Enter skull throught condylar canal | Branch of internal carotid aery | Branch of subclan aery | Accompany sympathetic ganglion | 2c
| multi | The veebral aery is one of the two principal aeries which supply the brain In addition,it also supplies the spinal cord,the meninges and the suurounding mscles and bones It arises from the posterosuperior aspect of the first pa of the subclan aery It runs a long course and ends in the cranial cavity by supplying the brain The veebral aery is divided in to four pas Ref BDC volume 3,sixth edition pg 162 | Anatomy | Head and neck |
971f8998-15e1-4416-94e5-156e4322828b | The severity of mitral regurgitation is decided by all of the following clinical findings except | Presence of mid- diastolic murmur across mitral valve | Wide split second heart sound. | Presence of left ventricular S3 gallop. | Intensity of systolic murmur across mitral valve | 3d
| multi | null | Medicine | null |
Subsets and Splits