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135
e8f722e7-50d4-4719-be1b-7653bd9eaf3a
Which of the following is false with regards to bupivacaine
Bupivacaine concentration for epidural anaesthesia is 0.5%
Bupivacaine concentration for spinal anaesthesia is 0.5%
Bupivacaine is used frequently for i.v regional anaesthesia
Bupivacaine is most potent local anaesthetic
2c
multi
Bupivacaine is contraindicated in Bier’s block or IVRA.
Anaesthesia
null
66f6d998-ca24-4603-ae1d-217d375d3f69
Bains' circuit is Mapelson type - circuit -
Type A
Type B
Type D
Type E
2c
single
Type A - Magills circuit Type C - Water,'s (to and from) circuit Type D - Bain's circuit Type E - Sure's T piece Type F -Jackson-Rees circuit.
Anaesthesia
Anaesthetic equipments
cacc0a5d-ff7c-472d-a663-4a88cdc038fc
Iris lesion is seen in
Utricaria
Scabies
Lichen planus
Erythema multiformae
3d
single
Erythema multiforme(EM) is an acute ,self limiting skin disease charecterised by the abrupt onset of symmetrical target lesions. Erythema multiforme is a skin reaction that can be triggered by an infection or some medicines. The classic lesions are iris or target lesions which are less than 3 cm in diameter, rounded and have 3 zones:central area of dusky erythema, middle paler area of oedema and an outer ring of erythema with well defined margin. Sites: commonly the extremities and the face, but face,trunk ,oral and genital mucosa may be affected. There are two forms: EM major and EM minor. Ref Harrison 20th edition pg 1235, Fitzpatrick 8thednpg 434)
Dental
All India exam
57e22dec-64b3-4f7a-9274-de3621a865c1
Monro's abscesses are seen in all of the following except:
Psoriasis.
Pemphigus.
Reiter syndrome.
Benign migratory glossitis.
1b
multi
null
Pathology
null
5f90e12b-bc3c-4c6c-8b7e-845ad602d3c4
All are true about thiopentone except –
NaHCO3 is a preservative
Contraindicated in porphyria
Agent of choice in shock
Has cerebroprotective action
2c
multi
Thiopentone causes hypotension → contraindicated in shock & hypotensive states.
Anaesthesia
null
8a332a16-8f02-47c4-92f2-d651be084748
Deposition of calcium in dying tissue is called
Metastatic calcification
Dystrophic calcification
Heterotropic calcification
Normal calcification
1b
multi
Dystrophic calcification is encountered in areas of necrosis of any type. It is viually inevitable in the atheromas of advanced atherosclerosis, associated with intimal injury in the aoa and large aeries and characterized by the accumulation of lipids Metastatic calcification can occur in normal tissues whenever there is hypercalcemia( Robbins Basic Pathology, 9th edition, page 26 )
Pathology
General pathology
46171954-5f6e-429a-b883-869c814add1d
The statement“The parietal layer develops gradually, becoming prominent when root formation is complete”Is
FALSE
TRUE
Partially True
Can be completely True or False.
1b
multi
null
Dental
null
579c1135-eab6-4927-a139-bad749e23e46
Heat rupture can be differentiated from incised wound by -
Intact blood vessels & nerves at the floor of the wound
Seen in front of thing
Small in back of thing
Small and multiple
0a
multi
HEAT RUPTURE: If heat applied is very great skin contracts and heat rupture occurs either before or after death. heat rupture is differentiated from incised wounds by 1. absence of bleeding in the wound and surrounding tissues, since heat coagulates 2. intact vessels and nerves are seen in the floor 3. irregular margins 4. bruising and other signs of vital reactions are not present in the margins REF: The Synopsis of Forensic Medicine and Toxicology 29th edition page no:161.
Forensic Medicine
Thermal injury
29671dd8-a42b-401e-a831-ade026608bde
Vitamin K is involved in the post translational modification of
Glutamate
Aspaate
Glycine
GABA
0a
single
Refer Katzung 11/e p 595 Vitamin K causes gamma carboxylation of glutamate reduces in many clotting factors that result in their activation
Pharmacology
Respiratory system
0b492117-da6a-4231-ac9d-e03c92b27681
Double stranded RNA is seen in -
Reovirus
Adenovirus
Parvovirus
Retrovirus
0a
single
In reoviruses the double stranded RNA is transcribed into mRNA by viral polymerase REF:ANANTHANARAYAN AND PANIKER'S TEXTBOIK OF MICROBIOLOGY 9TH EDITION PAGE NO:433
Microbiology
Virology
03f56962-fb05-42fd-af7b-74e673a0cb31
Which of the following viruses produce disease or sequelae that is/are more severe if the infection occurs at a very young age?
Epstein-Barr virus
Hepatitis B virus
Measles virus
Poliovirus
1b
single
Infection with Hepatitis B virus (HBV) at bih or a very young age is associated with chronic HBV infection and the development of hepatocellular carcinoma later in life. In fact, infants born to Hepatitis B surface antigen (HBsAg)-positive mothers are commonly infected, and approximately 90% become chronic carriers of the virus. Chronic carriers suffer from hepatocellular carcinoma at an incidence over 200 times higher than a noncarrier. The current recommendation for infants born of HBsAg-positive mothers is administration of hepatitis B immunoglobulin (HBIg) in the delivery room, with the first dose of the hepatitis B vaccine given at the same time or within 1 week. The second and third dose of the vaccine are then given at 1 and 6 months. With this protocol, 94% protection is achieved. The Epstein-Barr virus is the agent of heterophile-positive infectious mononucleosis. In children, primary EBV infection is often asymptomatic. The measles virus often causes a more severe disease in adults. Over the age of 20, the incidence of complications, including pneumonia, bacterial superinfection of the respiratory tract, bronchospasm and hepatitis, is much higher than in children. Poliovirus causes asymptomatic or inapparent infections 95% of the time. Frank paralysis occurs in approximately 0.1% of all poliovirus infections. However, the probability of paralysis increases with increasing age.
Microbiology
null
f64f3300-2a32-4df7-a5f8-6ab724ec9e05
All of the following are inducers of the microsomal enzyme system except?
Carbamazepine
Phenytoin
Phenobarbitone
Ticlopidine
3d
multi
.
Pathology
All India exam
3448a0bd-571b-4200-b357-6868acacec9e
Increased alanine during prolonged fasting represents-
Increased breakdown of muscle proteins
Impaired renal function
Decreased utilization of amino acid from Glucogenesis
Leakage of amino acids from cells due to plasma membrane leakage
0a
single
During prolonged fasting there is increased gluconeogenesis. Alanine is provided by the muscle is one of the substrates for gluconeogenesis and is called Glucose Alanine cycle. So plasma level of alanine increases in prolonged starvation.
Biochemistry
null
d382e57b-f281-4ccf-9993-7ef724dd74c6
X-ray were discovered by -
Roentgen
Madam curie
Becqueral
Houndsfield
0a
single
(A) (Roentgen) (16 Apley 9th)* X-ray discovered by Roentgen in 1895.X-ray are produced by firing electrons at high speed onto a rotating anode. The resulting beam of X-rays is attenuated by the patient's soft tissues and bones, casting what are effectively, shadows, which are displayed as images on an appropriately sensitize plate or stored as digital information, which is than available to the transferred throughout the local information (IT) network.* Electromagnetic waves, non particulate, a beam of photons* Penetration power in air is 200 meters* Penetration power in lead is 0.3mmX-rays films are least sensitive to RED light* CT scan was invented by Geofiery hounds field* MRI - described fist by Bloch and Purcell, but applied as human analytical by Damadian and Lauterbur.* Radioactivity was discovered by - Henri - Becqueral
Medicine
Miscellaneous
e3c42b9e-ddf9-4268-8123-05cb31e58da8
Serum marker indicating active viral replication in hepatitis-B is: September 2006, March 2013
HBsAg
HBeAg
HBcAg
HBV DNA
1b
single
Ans. B: HBeAg, D: HBV DNA The first detectable viral marker for hepatitis-B is HBeAg, followed by hepatitis B, e-antigen (HBeAg) and HBV DNA. Titers may be high during the incubation period, but HBV DNA and HBeAg levels begin to fall at the onset of illness and may be undetectable at the time of peak clinical illness. Core-antigen does not appear in blood, but antibody to this antigen (anti-HBc) is detectable with the onset of clinical symptoms. The immunoglobulin M (IgM) fraction is used in an impoant diagnostic assay for acute hepatitis B, infection. Before current molecular assays were available, it was the only marker detectable in the window period, the time between the disappearance of HBsAg and the appearance of anti-HBs. Patients who clear the virus lose HBsAg and develop anti-HBsAb, a long-lasting antibody associated with immunity. The presence of anti-HBsAb and anti-HBcAb (IgG) indicates recovery and immunity in a previously infected individual, whereas a successful vaccination response produces antibody only to HBsAg. HBeAg is another viral marker detectable in blood and correlates with active viral replication and therefore high viral load and infectivity. The-antigen is synthesized from a strand of DNA immediately preceding the area that codes for the core-antigen.
Pathology
null
119ea7d4-43f0-4001-876a-ebe7b37744ee
What is true about volume control ventilation:
Lung inflated at constant flow rate
Peak alveolar pressure equal to plateau pressure
There is decelerating flow rate
Plateau pressure fixed
0a
multi
With volume control ventilation, the inflation volume is preselected, and the lung are inflated at a constant flow rate until desired volume is delivered.
Anaesthesia
Modes of Ventilation
06277027-48a9-4e9f-b9d5-a20e6513633e
In which of the following intensive management of diabetes needed except -
Autonomic neuropathy causing postural hypotension
Pregnancy
Post kidney transplant in diabetic nephropathy
DM with acute MI
0a
multi
null
Medicine
null
ec909278-98e6-48e2-a826-185805cae175
Most common cataract in a newborn is –
Zonular
Morgagnian
Anterior Polar
Posterior Polar
0a
single
A most common type of congenital cataract → punctate (blue dot) cataract. A most common type of cataract which is clinically (visually) significant → zonular or lamellar cataract.
Ophthalmology
null
783f7cdc-2d26-4b6e-9274-75c04d9ae75c
Accessory organ which may be found in stomach ?
Spleen
Pancreas
Liver
Kidney
1b
single
Ans. is 'b' i.e., PancreasEctopic (Accessory) pancreatic tissue may be found in submucosa of :?Stomach Meckel's diveiculumDuodenum Gall bladderSmall intestine (jejunum, ileum) Spleen
Anatomy
null
ee1798f2-1a64-4c86-9e96-c3ad57bdae91
True about trisomies is -
Increased maternal age > 35 years
Downs causes MR
Most common trisomy is trisomy 21
All
3d
multi
Trisomy 21 or Down syndrome is the most common of the chromosomal disorder. The most common cause of trisomy and therefore of Down syndrome is meiotic nondisjunction (type II Meiosis error). a Maternal age has a strong influence on the incidence of trisomy 21. It occurs once in 1550 live births in women under age 20 in contrast to 1 in 25 live births for mothers over age 45. The correlation with maternal age suggests that in most cases the meiotic nondisjunction of chromosome 21 occurs in the ovum. Approximately 40% of the patients with trisomies have associated congenital heart disease, most common defects of the endocardial cushion including. Ostium premium atrial septal defects. A-V valve malformations and VSDS Down syndrome is an important cause of mental retardation in children
Medicine
null
0ad2f7da-05b9-42d0-b93f-bc9b156b4b1e
All of the following therapies may be required in a 1-hour-old infant with severe bih asphyxia except-
Glucose
Dexamethasone
Calcium gluconate
Normal saline
1b
multi
Ans. is 'b' i.e., Dexamethasone Coicosteroids should not be used' - Paediatrics for doctors - Frankshann & John Vince Management Protocol The management protocol of babies with asphyxia : Oxygen. In the absence of continuous oxygen saturation monitoring, it is reasonable to give nasopharyngeal oxygen (0.5 litre/min) until the baby recovers. If monitoring is available, oxygen is given as appropriate. Thermal control. Baby's body temperature should be kept in the normal range of 36.5-37.2degC (sometimes the babies become hyperpyrexic). Correction of shock, If peripheral perfusion is poor, it is reasonable to give 20 ml/kg of normal saline initially. If perfusion remains poor, the use of dopamine should be considered. Fluid balance. Give IV fluids at 2/3 maintenance. Use 10% dextrose. Monitor blood glucose with dextrostix and do not let it fall below 2.2 mmol (explains glucose administration) Prevent/control convulsions. In less severely affected babies, phenobarbitone should be given when there is anyuspicion of actual or impending convulsions (phenobarbitone loading dose 20 mg/kg IM or 10mg/kg slowly IV, then 5 mg/kg daily orally). Treat hvpocaleaemia if it occurs (or more practically, if the baby has uncontrollable fitting with anormal dextrostix). (explains calcium gluconate administration) Notes I. Coicosteroids should not be used, and although many paediatricians use mannitol, there is no evidence for its effectiveness. 2. Babies with severe asphyxia may appear to settle relatively quickly after the resuscitation - but there is likely to be a deterioration after 6-12 hours or so as cerebral oedema develops.
Pediatrics
null
63893941-cbe4-4eb0-b099-41185abda5a3
Condyloma acuminatum is caused by ?
HSV
HPV
HIV
VZV
1b
single
Ans. is 'b' i.e., HPV Was . Was are caused by human papilloma virus (HPV)
Microbiology
null
900afe1c-ba0c-485e-b0e0-4e99a1cf8c01
The most common form of PSVT?
Tachycardia originating from the atrium
AV nodal reentry tachycardia
WPW syndrome
Focal atrial tachycardia
1b
single
Pathologic supraventricular tachycardia A. Tachycardia originating from the atriumDefining feature: tachycardia may continue despite beats that fail to conduct to the ventricles, indicating that the AV node is not paicipating in the tachycardia circuitB. AV nodal reentry tachycardiaDefining feature: paroxysmal regular tachycardia with P waves visible at the end of the QRS complex or not visible at allThe most common paroxysmal sustained tachycardia in healthy young adults; more common in womenC. Tachycardias associated with accessory atrioventricular pathwaysDefining feature: paroxysmal sustained tachycardia similar to AV nodal reentry; during sinus rhythm, evidence of ventricular preexcitation may be present (Wolff-Parkinson-White syndrome) or absent (concealed accessory pathway)Harrison 19e pg: 1476
Medicine
C.V.S
19ab5337-6b86-4aab-9de6-2eb84f33a1ce
A female having carcinoma cervix stage IIIb. What is the treatment:-
Weheims hysterectomy
Schauta's radical vaginal hysterectomy
Chemotherapy
Intracavitary brachytherapy with external beam radiotherapy
3d
single
Rx of Cervical cancer NOTE: THERE IS NO ROLE OF SURGERY IN TREATMENT OF STAGE IIB AND ABOVE - Stage I - IIA - Surgical management: Radical Hysterectomy (aka type 3 hysterectomy) - Structures removed in radical hysterectomy are : Uterus, cervix, upper 1/3 - 1/2 of vagina, entire parametrium, uterine aery ligated at its origin from internal iliac aery, uterosacral ligament at most distal attachment (rectum) - Stage >= IIB - Chemoradiation - Radiotherapy alone is effective Rx in all stages. - Maximum radiation given at Point A 2cm above and 2 cm lateral to external os Ureter crosses the uterine aery (bridge over water) here ureter is under the uterine aery Parametrium seen here Upto 7500 to 8000 RADs given here Point B 3cm lateral to point B Obturator lymph nodes at the pelvis side walls Obturator lymph nodes -sentinel group of LN Upto 6000 RADS given here.
Gynaecology & Obstetrics
Cervical Carcinoma
67b658f7-a9a0-41e1-8163-6778d231eb2b
The bottle feeding should be discontinued by the age of:
12 months
8 months
18 months
20 months
0a
single
Prolonged bottle feeding more than 1 year can lead to ECC.
Dental
null
8331f967-1fc5-479b-8af9-ae34f153e0de
A 1-year-old girl is brought to the emergency room by her parents who report she has had a fever and diarrhea for 3 days. Her temperature is 38degC (101degF). The CBC shows a normal WBC count and increased hematocrit (48 g/dL). Which of the following is the most likely cause of increased hematocrit in this patient?
Acute phase response
Dehydration
Diabetes insipidus
Malabsorption
1b
single
Increased hematocrit in this patient reflects hemoconcentration caused by dehydration, secondary to diarrhea. This hematologic condition, termed relative polycythemia, is characterized by decreased plasma volume with a normal red cell mass. When patients suffer from burns, vomiting, excessive sweating, or diarrhea, they not only lose fluid but also suffer electrolyte disturbances. Systemic blood pressure falls with continuous dehydration, and declining perfusion eventually leads to death. Diabetes insipidus (choice C) may cause dehydration but is an unlikely choice because the patient has a history of diarrhea. None of the other choices cause relative polycythemia.Diagnosis: Dehydration, relative polycythemia
Pathology
Hemodynamics
25fc3284-c2ab-43f5-b16a-e5b35d97aad5
In XLR diseases, a modified inheritance pattern called 'pseudodominance' occurs when
One parent is affected homozygote and another is unaffected homozygote
One parent is unaffected heterozygote and another is affected homozygote
One parent is normal and another is unaffected het- erozygote
Both parents are unaffected
1b
multi
Ans. b (One parent is unaffected heterozygote and another is affected homozygote). (Fig. Harrison 18th/61/l 1)In most instances of AR inheritance, an affected individual is the offspring of heterozygous parents. In this situation, there is a 25% chance that the offspring will have a normal genotype, a 50% probability of a heterozygous state, and a 25% risk of homozygosity for the recessive alleles, in the case of one unaffected heterozygous and one affected homozygous parent, the probability of disease increases to 50% for each child. In this instance, the pedigree analysis mimics an autosomal dominant mode of inheritance (pseudodominance). In contrast to autosomal dominant disorders, new mutations in recessive alleles are rarely manifest because they usually result in an asymptomatic carrier state.PSEUDODOMINANCE# The sudden appearance of a recessive phenotype in a pedigree, due to deletion of a masking dominant gene.# The phenomenon in which a recessive allele shows itself in the phenotype when only one copy of the allele is present, as in hemizygous alleles or in deletion heterozygotes.# An autosomal recessive condition present in individuals in two or more generations of a family, thereby appearing to follow a dominant inheritance patterns.Common explanations include:# A high carrier frequency.# Birth of an affected child to an affected individual and a genetically related (consanguinous) reproductive partner.# In populations with high frequencies of heterozygotes for autosomal recessive conditions, such as in geographically isolated communities, the mating of a homozygote with a heterozygote may result in an inheritance pattern mimicking dominant inheritance (pseudodominance).Examples of diseases with pseudodominance# Storgordt disease (caused by ABCR mutations)# Pseudoxanthoma elasticum (is caused by mutations in the ABCC6 gene, inherited in an autosomal recessive manner and presence of disease in two generations is due to pseudodominance.)# Glycogen storage disease type VII (Tarui's) - it is autosomal recessive, although a few cases with pseudodominance or sumptomatic heterozygous individuals have been found.
Unknown
null
daa4ca98-15c4-456e-8642-660301bc31cf
In a contaminated, puctured wound of the leg of a non-immune child of 10, which one of the following measures would give the best protection against the development of tetanus -
Active immunization and antibiotics
Active immunization, antibotics and immobilisation
Active immunization, wound excision and primary closure
Active and passive immunization along with antibiotics
3d
single
null
Medicine
null
12e8b938-a435-4457-9c8d-9f556b1730d1
A 2hyr old women who had home delivery 2wks back now presents with complete perineal tear whats the next line of the management
repair immediately
repair after 3wks
repair after 3months
repair after 6 months
2c
single
complete prineal tear <24HRS= Repair immediately >24HRS - schedule after 3months REF : SHAW GYNECOLOGY
Gynaecology & Obstetrics
All India exam
5cb09b22-97b5-43b1-a48c-bbb0b3c04202
Osmolality of plasma in a normal adult: September 2005, March 2012, September 2012
320-330 mOsm/L
300-310 mOsm/ L
280-290 mOsm/ L
260-270 mOsm/ L
2c
single
Ans. C: 280-290 mOsm/L Plasma osmolality is a measure of the concentration of substances such as sodium, chloride, potassium, urea, glucose, and other ions in blood Osmolal concencentration of plasma is 290 mOsm/L Osmolality of blood increases with dehydration and decreases with overhydration. In normal people, increased osmolality in the blood will stimulate secretion of antidiuretic hormone (ADH). This will result in increased water reabsorption, more concentrated urine, and less concentrated blood plasma. A low serum osmolality will suppress the release of ADH, resulting in decreased water reabsorption and more concentrated plasma.
Physiology
null
352841d1-85db-4066-9d6a-f454f3080ecd
Post gonococcal stricture urethra is most commonly situated in the -
Bulbar Urethra
Penoscrotal Jn.
Distal pa of spongy urethra
Just distal to external meatus
0a
single
Ans. is 'a' i.e., Bulbar Urethra
Surgery
null
052307d8-6d76-41e3-89dd-21c19906d6c7
Not a second messenger:
cAMP
cGMP
Ca
None
3d
multi
None
Biochemistry
null
43bd3f7a-8ad1-4e31-95ae-1068263fd406
Conduction in which type of nerve fibres is blocked maximally by pressure
C fibres
A- alpha fibres
A - Beta
A- gamma
1b
multi
The velocity of conduction through a nerve fiber is directly proportional to the thickness of the axon. Thickest and fastest is A fibers. Among A fibers, the thickest is Aα. Hence the maximum affected by pressure will be Aα.
Physiology
null
0139045a-6eac-4daa-8373-26abb85259a9
How long does it take for incipient caries to develop into clinically evident smooth surface caries?
9 ± 6 months
2 + 6 months
18 + 6 months
24 ± 6 months
2c
multi
null
Dental
null
90135651-e561-4789-b144-39c740f1f834
Clozapine is used in:
Depression
Resistant schizophrenia
Mania
Delirium
1b
single
Ans: b (Resistant schizophrenia) Ref: Katzung, 10th ed, p. 457Clozapine is an atypical antipsychotic. It has weak D2 blocking action and produces few extrapyramidal side effects.lt inhibits 5-HT, receptor.The main adverse effects are agranulocytosis and other blood dyscrasias. It reduces seizure threshold. It is reserved for resistant cases of schizophrenia.
Psychiatry
Treatment
62ef9384-16ef-455c-bcf7-a693c33060d6
Most sensitive and specific marker for MI is?
Troponin
Cytokeratin
Myoglobin
CPK-MM
0a
single
Ref: Harrison 20th edition, P 384Cardiac specific markers of myocardial damage include quantitative determination of CK-MB, Troponin I and Troponin T. Troponins can become elevated by 3 hours. The circulating values remain elevated up to a week.
Pathology
C.V.S
f7033ab3-d74a-422e-ba6c-3c498d4da0c3
Human development index includes A/E :
Crude death rate
Education
Life expectancy at birth
GDP
0a
single
Ans. is 'a' i.e. Crude Death Rate Human development index : includesLongevity (Life expectancy at birth)knowledge (adult literacy rate and mean years of schooling)Income (reveal GDP per capita in purchasing power parity in US Dollars).* HDI values ranges between 0 to 1. the HDI value for a country shows the distance that it has already travelled towards maximum possible value to 1.Physical quality of life index includes*infant mortalitylife expectancy at age oneliteracy
Social & Preventive Medicine
Concept of Health and Disease
94566a9e-828c-4005-9a50-0b14c2413cac
T/t used for lower ureteric stone is:
Endoscopic removal
Diuretics
Drug dissolution
Laser
0a
single
Answer is A (Endoscopic removal): Stones in the lower pa of ureter within 5-6 cm of ureteric orifice (that are small in size) are best managed by Ureteroscopic (Endoscopic) removal.
Medicine
null
a1953f4e-e132-4bdb-962c-d60818fb79dc
Spot the diagnosis
Lead poisoning
Macrocytic anemia
Howell-Jolly bodies
Heinz bodies
0a
single
Ref: Harsh Mohan, Textbook of Pathology, 7th ed. pg. 236The image shows basophilic stippling of red blood cells. The causes are:Mnemonic: LUNATIC* Lead poisoning* Unstable hemoglobin* Nucleotidase deficiency* Anemia due to B12 deficiency* Thalassemia* Infections* CirrhosisThe closest answer Pappenheimer bodies are basophilic erythrocytic inclusions that are usually located at the I periphery of the cell. They contain iron and stain with Prussian blue. Prussian blue is the stain that is used to identify that these Pappenheimer bodies are pure iron deposits, and not heme as in Heinz bodies.
Pathology
Blood
c06a3024-15ec-449c-acc8-6640e16b977f
Prophylactic cranial irradiation is indicated in the treatment of all of the following, except:
Small cell Ca of lung
ALL
Hodgkin's lymphoma
NHL
2c
multi
All malignancies except hodgkin's lymphoma given in the question show discrimination CSF pathway and therefore require prophylactic Craniospinal irradiation. Ref: Harrison's Principles of Internal Medicine, 15th Edition, Page 2449
Radiology
null
9a0c22ae-b1c4-4977-8372-0df38e32cd61
Thermophile bacteria grow at -
20deg C
20-40deg C
40-60deg C
60-8CTC
3d
single
Ans. is 'd' i.e., 60-80deg C Temperature requirement of bacteriao Bacteria vary in their requirements of temprature for growth.Psvchrophilic bacteria grow best at temperature below 20degCThermophilic bacteria grow best between 55-80degCMesophilic bacteria grow best between 25-40degC
Microbiology
Morphology and Physiology of Bacteria
2fcbbf9f-ea2e-4600-a83e-d7ff0dba700a
FAST is used for:
Fast assessment of major visceral injuries
To look for free intraperitoneal fluid at specific sites
Fast assessment by CT scan to detect intraabdominal injuries
Quick clinical assessment to decide about laprotomy
1b
single
null
Surgery
null
ee16bdaf-efd5-4675-8a6c-6f0ca45135a6
Drug which inhibits GPIIb/IIIa and is platelet anti Aggregatory:
Clopidogrel
Enoxaparin
Fondaparinux
Tirofiban
3d
single
Ans. D. TirofibanGP IIb/IIIA are the fibrogen activator receptor. On stimulating they activates the aggregation of platelets. Abciximab and tirofiban are the drugs which block these receptors and inhibit the platelet aggregation.
Pharmacology
Hematology
b5319c83-f130-4625-92f1-3f0a823a719f
Furcation involvement with no radio graphic evidence is
Grade II
Advanced grade II
Grade I
Early grade III
2c
single
null
Dental
null
8ebf2e32-41c9-409f-aad6-ac9414ede114
Provision of integrated preventive, curative and promotional health services are part of
Comprehensive health care system
Primary healthcare system
Universal healthcare
Basic health care
0a
single
null
Dental
null
821f41f3-7bae-4c7d-87c7-2b1f86daa915
Feto maternal transfusion is detected by:
Kleihauer test
Spectrophotometry
Benzidine test
None of the above
0a
multi
Kleihauer-Betke test may be performed on maternal blood to assess the amount of fetomaternal bleed.The maternal blood is subjected to an acid solution.Acid will elute the adult hemoglobin,but not the fetal hemoglobin from the red cells.Hence fetal red cells appear dark red,adult red cells appear pale(ghost cells). TEXT BOOK OF OBSTETRICS,Sheila Balakrishnan,2nd edition,page no.311
Gynaecology & Obstetrics
Medical, surgical and gynaecological illness complicating pregnancy
0da9c048-54e3-4ba3-b2cd-9d9772115d1b
Which of the following tubes is used in surgery for cleft palate
Flexometallic tube
RAE tube
Robert shaw double lumen tube
None
1b
multi
RAE tube is used for surgery of cleft palate.
Anaesthesia
null
a237c2a6-d3c9-4a76-ad41-b0cc7fe2a909
All of the following are composite muscles except?
Pectineus
Rectus femoris
Adductor magnus
Biceps femoris
1b
multi
null
Anatomy
null
25d17943-885a-4d0e-841f-147ed7a05d3a
A 72-year-old woman has had difficulty with vision in her right eye for 3 months. She also has pain in the right upper chest. The findings on physical examination include unilateral enophthalmos, miosis, anhidrosis, and ptosis on the right side of her face. A chest radiograph shows right upper lobe opacification and bony destruction of the right first rib. Which of the following conditions is most likely to be present in her?
Bronchopneumonia
Bronchiectasis
Bronchogenic carcinoma
Sarcoidosis
2c
single
Horner syndrome is a result of sympathetic autonomic nerve involvement by invasive pulmonary carcinoma. Such a neoplasm in this location with these associated findings is called a Pancoast tumor. Infectious processes such as pneumonia are unlikely to impinge on structures outside the lung. Bronchiectasis destroys bronchi within the lung. Sarcoidosis can result in marked hilar adenopathy with a mass effect, but involvement of the peripheral nervous system is unlikely. Likewise, tuberculosis is a granulomatous disease that can lead to hilar adenopathy, although usually without destruction of extrapulmonary tissues.
Pathology
Respiration
5533127c-9b47-4d0b-b5cd-0c37686097a1
Which of the following is used to show the base of the skull, sphenoid sinus, position and orientation of the condyles, and fractures of the zygomatic arch?
The TMJ surgery
Submentovertex projection
Reverse-Towne projection
The facial profile survey
1b
single
null
Radiology
null
e6368577-0cf2-425b-8f33-9c2e8df7e8e5
Most common cause of bone malignancy -
Secondaries
Osteosarcoma
Ewing's sarcoma
Osteoclastoma
0a
single
OSTEOLYTIC SECONDARIES Tumor cells produce growtl factors that stimulate bone destruction i.e. RANK &;igen& Osteoclasts are activated and break down bone Osteoblasts cannot build bone back fast enough Decreased bone density and strength: high risk for fracture OSTEOBLASTIC SECONDARIES Osteoblasts are stimulated by tumors to lay down new bone Bone becomes abnormally dense and stiff Paradoxically bones are also at risk of breaking REF : MAHESWARI 9TH ED
Orthopaedics
Tumors
aa8d52cd-8e0e-465e-a3eb-6ff53c981edc
CrPC sec. 61-69 deals with
Coroner inquest
Summons
Police inquest
Magistrate inquest
1b
single
Summons/Subpoena is a document compelling the attendance of a witness in a cou of law, under penalty, on a paicular day, time and place for the purpose of giving evidence. Code of Criminal Procedure, from section 61 to 69 deals with the topic of summons. Ref: Krishnan vij Textbook of Forensic Medicine and Toxicology; 5th ed; Page no: 10
Forensic Medicine
Medico legal procedures
df199f3c-7a70-4dd4-99d5-58dc107df534
Integrated Management of Childhood Illness (IMCI) was taken to prevent morbidity and moality from all except:
Malaria
Malnutrition
Otitis media
Neonatal tetanus
3d
multi
INTERGRATED MANAGEMENT OF CHILDHOOD ILLNESS (IMCI): IMCI is a 'strategy for reducing morbidity and moality associated with major causes of childhood illness' Curative component includes management of: Diarrhoea Measles (&otitis media) Pneumonia Malaria Malnutrition
Social & Preventive Medicine
Paediatric Care in RCH: BW, BL, PEM, Breast Feeding
ae770a4f-0b05-4619-9d4d-467fd9764ba3
Oroya fever is caused by:
B. bacilliformis
B. henselae
B. quintana
B. elizabethae
0a
single
Ans: a. B. bacilliformis Baonellosis, or Carrion's disease, is caused by B. bacilliformisBaonellosis, or Carrion's disease, is caused by B. bacilliformis. The disease is characterized by two distinct phases:an acute febrile hematic phase, known as Oroya fever; andan eruptive phase manifested by cutaneous lesions, known as verruga peruana
Microbiology
null
9e6679da-326f-4161-9229-fc34cbef61bd
A 30 year old male presented with insidious onset of diarrhea, steatorrhea, abdominal pain, weight loss, migratory large joint ahropathy, fever and dementia. The most probable diagnosis is:
Chronic calcific pancreatitis
Whipple's disease
Tropical sprue
Celiac sprue
1b
single
Whipple's disease is a chronic multisystem disease caused by tropheryma whipplei bacteria. Dementia is a late symptom. Diagnosed by PAS positive macrophages in small intestinal biopsy. DOC is double strength trimethoprim / sulfamethoxazole. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2479
Medicine
null
895f4932-6852-4dba-9106-0a31e8b63545
End tracheostomy is performed in patients undergoing surgery for
Laryngectomy
Laryngofissure surgery
Oropharyngeal growth
Obstructive sleep apnea with stridor
0a
single
Answer: a) Laryngectomy (DHINGRA 6th ED, P-316)TRACHEOSTOMY* Emergency tracheostomy* Elective or tranquil tracheostomy* Permanent tracheostomy* Percutaneous dilatational tracheostomy* Mini tracheostomy (cricothyroidotomy)Emergency tracheostomy* It is employed when airway obstruction is complete or almost complete and there is an urgent need to establish the airway.* Intubation or laryngotomy are either not possible or feasible in such cases.Elective tracheostomy (tranquil, orderly or routine tracheostomy)* Almost all operative surgical facilities are available, endotracheal tube can be put and local or general anaesthesia can be given.* Elective tracheostomy is often temporary and is closed when indication is over.* It is of two types:> Therapeutic, to relieve respiratory obstruction, remove tracheobronchial secretions or give assisted ventilation.> Prophylactic, to guard against anticipated respiratory obstruction or aspiration of blood or pharyngeal secretions such as in extensive surgery of tongue, floor of mouth, mandibular resection or laryngofissure.Permanent tracheostomy* This may be required for cases of bilateral abductor paralysis or laryngeal stenosis.* In laryngectomy or laryngopharyngectomy, lower tracheal stump is brought to surface and stitched to the skin.High tracheostomy* Above the level of thyroid isthmus (isthmus lies against II, III, IV tracheal rings)* It violates the I tracheal ring* Can cause perichondritis of the cricoid cartilage and subglottic stenosis* Always avoided* Only indication: carcinoma larynxMid tracheostomy* Preferred one* Through II or III rings (isthmus either divided or retracted)Low tracheostomy* Below the level of isthmus
ENT
Larynx
68b42e90-199d-4be5-a9b9-211d58715a97
Maximum "Endocapillary Proliferation" is seen in:
Membranous glomerulonephritis
Mesangioproliferative glomerulonephritis
Focal segmental glomerulonephritis
Post streptococcal
3d
single
Post streptococcal
Pathology
null
cc2b1c4f-d4a2-460e-bade-38746a3e081a
Regarding adhesive intestinal obstruction, TRUE is ?
Avoid surgery for initial 48-72 hours
Never operate
Operate after minimum 10 days of conservative treatment
Immediate operation
0a
multi
Ans. is 'a' i.e., Avoid surgery for initial 48-72 hours There are three main measures in the tit of acute intestinal obstruction. These are 1) Gastro intestinal drainage (Nasogastric suction) 2) Fluid and electrolyte replacement 3) Surgery for relief of obstruction The first two steps are always necessary prior to the surgical relief of obstruction. Surgical treatment is necessary for most cases of intestinal obstruction, but it should always be delayed until resuscitation is complete. The timing of surgical intervention is dependent on clinical picture. The classical clinical advice on a case of unrelieved intestinal obstruction is that "Sun should not both rise and set" i.e., the operative procedure should not be delayed beyond 24 hrs. But, there are ceain exceptions to this rule. In some cases operation is delayed in the hope of spontaneous resolution. In adhesive intestinal obstruction, usually occuring after surgery the upto 72 hours in the hope of spontaneous resolution. In these cases continued radiological evidence of obstruction. Also know the four types of obstruction, where operation should be done a) Stangualtion b) Closed loop obstuction c) Colon obstruction d) Early simple mechanical obstruction More about adhesive intestinal obstruction - Commonest cause of intestinal obstruction, usually follows pelvic operations Obstruction due to postoperative adhesions commonly involve the lower small bowel.
Surgery
null
a2097f97-a39a-48e7-8edd-2a930720aad0
PGE2 cause all except -
Water retention
Uterine contraction
Flushing
Diuresis
0a
multi
Ans. is 'a' i.e.. Water retention o Prostaglandins and thromboxanes are synthesised from arachidonic acid cobtained from membrane phospholipids due to action of phospholipase A2, rate limiting enzyme. A summary of the actions of major prostaglandins, prostacyclin and thromboxane Organ Prostaglandin E2 (PGE2a) Prostaglandin F2a (PGF2a) Prostacyclin (PGI2) Thromboxane A2 (TXA2) 1. Blood vessels Vasodilatation. X BP Vasodilatation, larger veins constrict, little effect on BP Vasodilatation (marked and widespread), || BP Vasoconstriction 2. Heart Waek inotropic, reflex cardiac stimulation Weak inotropic -- -- 3. Platelets Variable effect -- Antiaggregatory Aggregation and release reaction 4. Uterus Contraction (in vivo), relaxes nongravid human uterus in vitro, so fining of cervix contraction (in vivo and in vitro, softening of cervix 5. Bronchi Dilatation. Inhibit histamine release Constriction Dilatation (mild), inhibit histamine release Constriction 6. Stomach | acid secietion, | mucus production -- | acid secretion (weak), mucosal vasodilatation -- 7. Intestine Contracts longitudinal & relaxes circular muscles, | peristalsis, | Cl & water secretion Spasmogenic, | fluid &. Electrolyte secretion (weak) Weak spasmogenic, inhibit toxin-induced fluid secretion Weak spasmogenic 8. Kidney Natriuresis, | Cl reabsorption, inhibit ADH action, vasodilatation, renin release -- Natriuresis, vasodilatation, renin release Vasoconstrict ion 9. CNS Pyrogenic, variety of effects on i.v. inj.
Pharmacology
Prostaglandins
fcc9b6fe-5204-45db-9028-77df21026641
A middle aged woman presented to the OPD with dull abdominal pain for 6 months. CT scan of pelvis showed a 7cm mass involving left ovary with irregular calcifications. The right fallopian tube & ovary are excised. What is the likely diagnosis?
Mucinous cystadenoma
Choriocarcinoma
Dysgerminoma
Mature cystic teratoma
3d
multi
.
Pathology
General pathology
643995c8-253d-4fce-95b6-f29a98f59381
Hypovitaminosis D causes –
Zonular cataract
Blue – Dot cataract
Rosette cataract
Cupuliform cataract
0a
single
Hypocalcaemia (Hypoparathyroidism, hypovitaminosis D) causes zonular (lamellar) cataract.
Ophthalmology
null
a504fbed-692b-49d9-96dd-aa78868d5dad
A 30 years old man presents with cramping gluteal pain after walking 500 meters. Which is the vessel involved?
Aerial disease with aoo-iliac involvement
Aerial disease with femoral aery involvement
Femoral venous insufficiency
Saphenous venous insufficiency
0a
single
Aoo-iliac disease - Tissue distal to aery occlusion becomes ischemic - as this aery supplies muscles - causes Intermittent claudication like Buttock, thigh, calf claudication andLeriche syndrome - Erectile dysfunction - Impotence
Surgery
NEET Jan 2020
1707f3c0-400e-427e-b96d-4ec03a1f0f55
Slit shaped nipple seen in
Duct ectasia
Duct pappiloma
Paget's disease
CA breast
0a
single
Answer- A. Duct ectasiaDuct ectasia is dilatation of lactiferous ducts associated with periductal inflammation.Chronic inflammation and scarring will lead to indrawing and slit-shaped inversion of the nipple.If secondary infection supervenes, a mammary duct fistula can also develop.
Surgery
null
4c26706a-35d8-46d7-a836-ceeefb5fe066
A 27-yrs-old librarian has been worried that the small lymph nodes she can palpate in her groin are a sign of lymphoma. She also worries about developing laryngeal cancer due to the second-hand smoke she is exposed to at home. For a diagnosis of hypochondriasis, her symptoms should have been present for at least what period of time?
1 month
3 month
6 months
1 year
2c
multi
Hypochondriasis is defined by DSM-IV as a persistent fear, despite medical reassurance, that one has a serious physical illness. The patient's beliefs are based on misinterpretation of benign bodily symptoms. The belief is not of delusional propoions, and the condition must persist for 6 months for this diagnosis to be made. It is estimated that from 3 to 14% of patients seen in a general medical practice may suffer from hypochondriasis.
Psychiatry
null
4c1cdb26-fcf3-40ba-85b1-309c3453b402
Post-exposure immunization is done for
Measles
Polio
Rabies
Chicken pox
0a
single
*MMR vaccine if administrate within 72 hours of exposure or immunoglobulin if administrate within 6 days of exposure provide some protection or modify the clinical course of disease. Measles vaccine Prepared in chick embryo cell line Thermolabile Injected subcutaneously Indication: Under national immunisation schedule of India , measles vaccine is given at 9 months of age along with vit A supplements. Side effects: Toxic shock syndrome ,mild measles like illness may develop in 15 -20% of vaccines. REF:Anantha Narayanan and paniker's textbook of microbiology 9th edition.
Microbiology
Virology
611c0b23-7d07-427e-95e3-e36fcbfcc71e
In which of the following conditions the lead pipe appearance of the colon on a barium enema is seen?
Amoebiasis
Ulcerative colitis
Tuberculosis of the colon
Crohn's involvement of the colon
1b
single
Ans. Ulcerative colitis
Radiology
null
396ecdab-dfef-40c4-ace8-f4fb57367ef7
Epoophoron is a remnant of
Wolffian duct
Mullerian duct
Gubernaculum
None
0a
multi
Human embryology Inderbir Singh's; Tenth edition; Pg 315 We have seen that most of the mesonephric tubules disappear. Some persist to form the vasa deferentia. Other mesonephric tubules persist to form some vestigial structures that are seen near the testes Epoophron: This consists of a longitudinal duct running parallel to the uterine tube and a number of transverse ductules that open into the longitudinal duct. It corresponds to the epididymis and vasa efferentia of male. It develops from remnants of the mesonephric tubules (Wolffian duct)
Anatomy
General anatomy
ed7fa3a7-9745-4f54-bb30-f61784574b8f
Triad following massive blood transfusion includes: March 2012
Acidosis, hypehermia, hyperkalemia
Acidosis, hypothermia, hyperkalemia
Alkalosis, hypothermia, hyperkalemia
Alkalosis, hypehermia, hyperkalemia
2c
single
Ans: C i.e. Alkalosis, hypothermia, hyperkalemia The complications usually seen with massive blood transfusion are: i) hyperkalemia, ii) Hypocalcemia, iii) Hyperammonemia, iv) Hypothermia, v) Metabolic alkalosis, vi) Dilutional coagulopathies, DIC & vii) ARDS.
Surgery
null
4e5313db-d176-4750-b149-c7bec4364fc1
Unconjugated hyperbilirubinemia is seen in
Rotor syndrome
Dubin-Johnson syndrome
Gilbe syndrome
Bile duct obstruction
2c
single
Classification of jaundice A. Predominantly unconjugated hyperbilirubinemia 1. increased production of bilirubin Hemolytic anemias Resorption of blood from intestinal hemorrhages(eg: gi bleeding, hematomas) Ineffective erythropoiesis 2. Reduced hepatic intake Drug that interfere with the membrane carrier systems Diffuse liver disease ( hepatitis, cirrhosis) Some cases of Gilbe syndrome 3. Impaired bilirubin conjugation Physiological jaundice of the new born Crigler-Najjar syndrome types I and II Gilbe syndrome Diffuse liver disease ( hepatitis, cirrhosis) B. Predominantly conjugated hyperbilirubinemia 1. Decreased hepatocellular excretion Deficiency of canalicular membrane transpoers - Dubin- Johnson syndrome - Rotor syndrome Liver damage or toxicity 2. Impaired intra/extra hepatic bile flow Inflammatory destruction of bile ducts( eg: primary biliary cirrhosis) Gallstones Carcinoma of pancreas GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PGNO.429
Pathology
G.I.T
04feebb1-60ae-4ad7-8b50-c10168b4e493
Sappey's line denotes a line -
Encircling the neck at C6 veebra level
Encircling the trunk just above the umbilicus
Encircling the salpigian tubes
None of the above
1b
multi
Ans. is 'b' i.e., Encircling the trunk..... Sappey's line defines a horizontal line around the waist extending from the umbilicus, along the iliac crests over to Ll. Lymphatic drainage of the skin above this line is to the axillary lymph nodes and below this line to the inguinal.
Surgery
null
fcf25fe9-eff7-4d73-8655-3ce439b4e4a6
Which of the following is characteristically not associated with the development of interstitial lung disease ?
Organic dusts
Inorganic dusts
Toxic gases e.g. chlorine, sulphur dioxide
Inhalation of tobacco smoke
3d
multi
Ref: Textbook of pathology (Harsh Mohan) 6th edition, page No.483 BRONCHIAL ASTHMA Asthma is a disease of airways that is characterised by increased responsiveness of the tracheobronchial tree to a variety of stimuli resulting in widespread spasmodic narrowing of the air passages which may be relieved spontaneously or by therapy. Asthma is an episodic disease manifested clinically by paroxysms of dyspnoea, cough and Wheezing. However, a severe and unremitting form of the disease termed status asthmaticus may prove fatal.
Pathology
Respiratory system
1436051e-1da7-4b88-aa16-e5ae92435172
Which nephritogenic antigen is detected in subepithelial humps of PSGN?
Streptococcal pyrogenic exotoxin B
Nephritis associated plasmin receptor
M antigen
P antigen
0a
single
RF: Type II HSR PSGN: Type III HSR
Medicine
Nephrotic and Nephritic syndrome
6cd8eea4-e9d2-4c6c-96b1-e0f8b5d83450
The most common type of intussuception is
Multiple
Colocolic
Ileoileal
Ileoilecolic
3d
single
.It is telescoping or invagination of one poion (segment) of bowel into the adjacent segment. Types 1. Antegrade--Most common. 2. Retrograde--Rare (jejunogastric in gastrojejunostomy stoma). In elderly intussusception: * Colocolic is most common type * Apex is formed usually by growth * No role of hydrostatic reduction * It can be single or multiple (rare). * It can be ileo-colic (most common type, 75%), colocolic, ileoileocolic, colocolic. *It is common in weaning period of a child (common in male), between the period of 6-9 months. ref:SRB&;S manual of surgery,ed 3,pg no 863
Surgery
G.I.T
5b645940-1862-40b5-82cf-3729d8effd04
A 34-year-old man presents to OPD with gynecomastia and erectile dysfunction. Physical examination reveals a palpable, non-tender testicular mass within the body of testis. His serum testosterone and estradiol levels were elevated. What is the most likely diagnosis?
Leydig cell tumour
Granulosa cell tumour
Spermatocytic tumour
Yolk sac tumour
0a
single
Leydig Cell Tumor Sex-cord stromal type of testicular tumor Age- usually at 5-10 years of age or in middle adulthood (30-60 years). Tumors of Leydig cells may secrete androgens, estrogens and coicosteroids. In males , testicular swelling is the most common presenting feature. Children usually present with precocious pubey due to excess of testosterone secreted by the tumor. Adults usually present with gynaecomastia, loss of libido, erectile dysfunction and infeility Histology : Large, closely packed cells with eosinophilic cytoplasm, bland nuclei, and small nucleoli. Reinke crystals are pale-staining, cylindrical, eosinophilic cytoplasmic inclusions that are pathognomonic for Leydig cell tumors and are found in up to 30% of patients .
Pathology
Testicular Tumors
9399c7a6-6707-452c-bfc8-9389968ed54b
Which of the following organism is the most common cause of acute meningitis in an AIDS patient?
Streptococcus pneumoniae
Streptococcus agalactiae
Cryptococcus neoformans
Listeria monocytogenes
2c
single
Oppounistic infections of the CNS generally occur in HIV infected patients with CD4 counts below 200. Most common organism that causes acute meningitis in an AIDS patients is Cyptococcus neoformans. Cryptococcus neoformans is an encapsulated budding yeast that is found worldwide in soil and on dried pigeon dung. Infections are acquired by inhalation. In the lung, the infection may remain localized, heal, or disseminate. Progressive lung disease and dissemination occur in cases of cellular immunodeficiency. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 36
Microbiology
null
517ed9a4-788e-43f7-985c-1412a8fcb3bc
This patient presented with chest pain. What is the diagnosis?
Acute pulmonary embolism
Hypertrophic cardiomyopathy
Ascending aortic aneurysm
Coarctation of the aorta
2c
single
Answer C. Ascending aortic aneurysmA widened mediastinum is visible on chest radiography. The patient was diagnosed with a 9.5-cm ascending aortic aneurysm.
Medicine
C.V.S.
df77a283-968d-4bee-a46c-503204b2dafb
Fatty acids are the main source of energy for
Muscles
Heart
Liver
RBC
1b
single
Fed state Preferred fuel Starvation preferred fuel RBC Glucose Glucose Heart Fatty acids Ketone bodies Brain Glucose Ketone bodies Liver Glucose Fatty acids / protein Muscle Glucose Fatty acids Adipose tissue Glucose  Fatty acids.
Biochemistry
null
ede34bce-a372-4e69-9299-1b08ddfa120b
Steroid is contraindicated in -
Herpetic keratitis
Atopic dermatitis
Fungal corneal ulcer
Exposure Keratitis
2c
single
Steroids overwhelm the fungal infection,it also causes immunosuppression. Ref khurana 6/e p243
Ophthalmology
Cornea and sclera
fefbbb9f-3f10-46ce-8c94-5e6d377db87f
Concerning normal expiration during resting conditions:
Expiration is generated by the expiratory muscles
Alveolar pressure is less than atmospheric pressure
Intrapleural pressure gradually falls (becomes more negative) during the expiration
Flow velocity of the gas (in cm/sec) in the large airways exceeds that in the terminal bronchioles
3d
multi
The velocity of the gas in the large airways exceeds that in the terminal bronchioles because the latter have a very large combined cross-sectional area. The other choices are incorrect: Under resting conditions, expiration is passive it is associated with an alveolar pressure that exceeds atmospheric pressure intrapleural pressure gradually increases (becomes less negative) during expiration and the diaphragm moves up as expiration proceeds.
Physiology
Respiratory System Pa 1
0be58ffb-50af-41c1-b0a3-a7912c9cbc7c
Shoest acting non depolarising muscle relaxant
Succinylcholine
Rapacuronium
Atracurium
Pancuronium
1b
single
Refer Miller's anesthesia 5/e p 892 Among the given options Rapacuronium IA the shoest acting drug Rapacuronium has been withdrawn from the market because it produces intense bronchospasm in a significant number of patients Mivacurium is shoest acting NDMR
Pharmacology
Anesthesia
3e2783b0-3ef8-423b-8b55-72b90f1f427a
Cretinism is -
Dispropoionate dwarfism
Sho stature with long trunk
Sho stature with sho trunk
Long stature with long trunk
0a
single
Ans. is 'a' i.e., Dispropoionate dwarfism Note - Patient has sho stature with sho limbs.
Pediatrics
null
459e06ea-07be-439b-8973-c3a6c8449889
Commonest cause of lung abscess:
Aspiration
Hematogenous spread from distant site
Direct contact
Lymphatic spread
0a
single
Lung Abscess Lung abscess refers to a microbial infection of the lung that results in necrosis of the pulmonary parenchyma MC cause of primary lung abscess: Anaerobic bacteria Etiology of anaerobic lung abscess: Aspiration
Surgery
Thorax And Mediastinum
0f72e1af-9e98-45af-86bd-37e2aa1e3ea1
Amount of bile produced (ml/ day): September 2012
100 - 500
500 -1000
1000 -1500
1500 - 2000
1b
single
Ans. B i.e. 500 - 1000
Physiology
null
30a12f31-4c50-4bae-9d54-8fa7b1b07186
Spermatogenesis
Starts at birth
Maximum in 37degC
Occurs in seminiferous tubules
Time required for a spermatogonium to develop into mature spermatozoan is 6 weeks
2c
single
i.e. (Occurs in seminiferous tubules): (11-12-IBS-Embryology 8th)Spermatozoa are formed in the walls of the seminiferous tubules of the testesSPERMATOGENESIS - formation of gametes (spermatozoa) takes only during the reproductive periods which begins at the age of puberty (12 to 16 years) and continue even though old age* The process of spermatogenesis, including spermiogenesis requires about two months** for its completion.Difference between Spermatogenesis and SpermiogenesisSpermatogenesis is the complete process of formation of a spermatozoon from a spermatogonium. It includes first and second meiotic division and spermiogenesisSpermiogenesis - is the process of transformation of a rounded spermatid into a spermatozoanSERTOLI CELLSSertoli cells are specialized cells within the seminiferous tubules and are involved in the orchestration and coordination of all of the key events in spermatogenesis (including spermiogenesis)Function of Sertoli cells1. Provide support, nutrition to developing spermatozoa2. Protect developing germ cells by forming the blood testes barrier (BTB)3. Secretion of important substances - Androgen binding protein (ABP)*, Inhibin*, Mullerian Inhibiting substance (MIS)*, contain aromatase (CYP)*4. Presence of FSH receptors5. Important role in the final maturation phase of spermiogenesis which is characterized by shedding of excess or residual cytoplasm of the spermatids (Phagocytosis)
Anatomy
Embryology
9550e307-07a6-45d5-bce6-b1f2147d2e0e
All of the following statements about clonidine are true EXCEPT
It is an alpha adrenergic agonist
It can cause dry mouth as an adverse effect
Prazosin completely antagonizes its action
It inhibits sympathetic outflow.
2c
multi
Clonidine is a central sympatholytic. It is an agonist to alpha2 receptors. But prazosin is a selective alpha1 blocker selective alpha 2 blocker is yohimbine Clonidine can cause dryness of mouth, nose, and eyes due to central sympatholytic action. (REF. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D TRIPATHI-6th edition. Page No.545,546)
Pharmacology
Cardiovascular system
6d983206-297f-42b4-9509-aba979b95f97
Virulence factor of the group A beta-hemolytic streptococcus is
Protein M
Protein T
Protein R
Lipotechoic acid
0a
single
The virulence factors of group A streptococcus or Streptococcus pyogenes: 1. Capsule 2. Carbohydrate antigen 3. Protein antigen M, T, R proteins 4. Pili M protein - acts as virulence factor by inhibiting phagocytosis. Heat and acid stable but susceptible to tryptic digestion. Antibody to M proteins promote phagocytosis of cocci and is protective. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 213
Microbiology
Bacteriology
c0fee16f-b436-47b8-8b7e-63945e310fd8
Ideal contraceptive for a couple living in different cities meeting only occasionally :
Barrier method
IUCD
OCP
DMPA
0a
multi
The advantages of condom are: 1 they are easily available 2 safe and inexpensive 3 easy to use 4 no side effects 5 light ,compact and disposable 6 provides protection not only against pregnancy but also against STD PARKS TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23 rd EDITION PAGE NO 494
Gynaecology & Obstetrics
Contraception
379671a7-fcf0-4b71-8675-54ec9d0c3dd0
Obligate intracellular parasite among the following is
Naegleria fowleri
Acanthamoeba
Toxoplasma
Balamuthia
2c
single
Obligate intracellular parasites cannot reproduce outside their host cell, meaning that the parasite's reproduction is entirely reliant on intracellular resources. Toxoplasma,Cryptosporidium Bacteria-chlamydia ,Rickettsia
Microbiology
parasitology
e76b7c6e-348c-4b4a-a505-34dc9d708600
Fetal hea can be detected earliest with trans-vaginal sonography at (from the last menstrual period) :
35 days
38 days
53 days
46 days
3d
single
46 days
Gynaecology & Obstetrics
null
ab585561-0b84-47b4-a2bf-7b546a3ffaef
What is the clearance of a substance, if its concentration in plasma is 10 mg%, concentration in urine is 100 mg % and urine flow is 2 ml/min ?
0.02 ml/min.
0.2 ml/min
2 ml/min
20 ml/min.
3d
single
Ans. is 'd' i.e., 20 ml/min.
Pharmacology
null
e0e5e2b7-32fc-4762-8317-3f61f4d72701
Which of the following is a minor criteria for diagnosis of Rheumatic fever (RP) according to modified Jones criteria –
ASO titre
Past history of Rheumatic fever
Fever
Subcutaneous nodules
2c
single
Fever is a minor criteria
Pediatrics
null
4f4ebfaf-0a18-4ed9-b5a1-41b9f86741fc
In a normal ECG which lead does it represent?
aVL
aVR
V1
V6
1b
single
The aVR is often neglected lead. It is an unipolar lead facing the right superior surface. As all the depolarization are going away from lead aVR, all waves are negative in aVR (P, QRS, T) in normal sinus rhythm.
Medicine
ECG and Arrhythmias 1
87a212d0-ce24-406a-9a0c-a8c94570ebeb
Which among the following is true statement regarding breast cancer metastasis?
Metastases occur after breast cancers acquire their own NEW blood supply.
Batson plexus facilitates metastasis to the lung.
Natural killer cells have no role in breast cancer immunosurveillance.
20 % of women who develop breast carcinoma metastases will do so within 60 months of treatment.
0a
multi
Metastases occur after breast cancers acquire their own blood supply.(neovascularization). Thereafter, cancer cells may be shed directly into the systemic venous blood to seed the pulmonary circulation the axillary and intercostal veins or the veebral column Batson plexus of veins, which courses the length of the veebral column. These cells are scavenged by natural killer lymphocytes and macrophages. 60% of the women who develop distant metastases will do so within 60 months of treatment.
Surgery
Breast
b72bf6d5-3726-49f9-b4a8-e1b2644152fe
One of the following rules explains about the grinding of certain cusps to produce balance in lateral movements:
Ante's rule
Bull rule
Wolfs rule
Cieszynski's rule
1b
single
null
Dental
null
ea23123c-f239-4e3f-a24f-91c661458bc6
A 70 yrs pt. is refusing for angiography but he has an episode of chest pain on walking upstairs not progressed for last 4 year what shall be done in this patienta) Aspirin lowdose givenb) Nitroglycerine sublingual before walking upstairsc) Continue exercise even after chest paind) Stop exercise if chest pains
ab
a
ad
bc
0a
multi
null
Medicine
null
f18019de-1c8b-40c8-91e6-a60d43404b24
Maximum cell size in bacterial cell growth cycle?
Lag phase
Log phase
End of plateau phase
Early stage of decline
0a
single
Ans. is 'a' i.e., Lag phase The various phases of growth curve are associated with morphological and physiological alterations of the cells.
Microbiology
null
fe9eb926-eacb-4487-ad10-594e3d349a4b
Irradiation can be used to sterilize A/E ?
Bone graft
Suture
Aificial tissue graft
Bronchoscope
3d
single
Ans. is 'd' i.e., Bronchoscope Endoscops are sterilized by chemical methods :? i) Rigid endoscope ---> Autoclave ii) Flexible endoscope --> Glutaraldehyde Bone & tissue graft, and cat gut suture are sterilized by ionizing radiation ('y - rays)
Microbiology
null
8e718c27-9fec-4fc4-b624-15db0f89a44a
On chronic use Linezolid leads to which of the following ?
Thrombocytopenia
Deranged LFT
Nephrotoxicity
Ototoxicity
0a
single
Linezolid is Oxazolidinone. MOA: It inhibits protein synthesis by preventing formation of the ribosome complex that initiates protein synthesis by binding to 23S ribosomal RNA of the 50S subunit. It is active against Gram positive organisms including Staphylococci, Streptococci, Enterococci, Gram positive Anaerobic cocci and Gram positive bacilli such as Corynebacteria, Nocardia sp. and L.monocytogenes. It is primarily a Bacteriostatic agent but is Bactericidal against Streptococci. It is also active against Mycobacterium Tuberculosis. Thrombocytopenia is the most common complication seen with its chronic use , also Optic and Peripheral Neuropathy and Lactic acidosis can occur (due to inhibition of mitochondrial protein synthesis). Anemia and Neutropenia can also occur .
Pharmacology
Protein Synthesis Inhibitors
2b23af86-f86a-4f85-bcb0-1a943c1586e6
The following acute respiratory response to ascent to high altitude, there is normalization of blood pH. The mechanism is
Increased erythropoesis leads to increased buffering by hemoglobin
Increased excretion of HCO3 - by the kidneys
Increased levels of 2, 3--DPG
Retention of bicarbonate by the kidneys
3d
single
The lung response to acute altitude exposure is mainly hyperventilation which, together with elevated hea rate, aims at achieving an adequate supply of oxygen to the tissues. At rest, ventilation increases by firstly increasing the tidal volume, at least up to 3500 m. Ref: guyton and hall textbook of medical physiology 12 edition page number:365,376,377
Physiology
Respiratory system
4f9e76c0-0a6c-4d95-973a-28e44d8d0054
Poikilocytosis is due to difference in:
Size
Shape
Number
Width
1b
single
Ans: b (Shape) Ref: Harshmohan,ed, p. 336Increase variation in shape of red cell is termed as poikilocytosis. Poikilocytes are produced in various types of abnormal erythropoesis.Eg:Megaloblastic anaemiaIron deficiency anaemiaThalassaemia. MyelosclerosisMicroangiopathic haemolytic anaemiaVariation in size is anisocytosis.
Pathology
Blood