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e9ad821a-c438-4965-9f77-760819dfa155 | Chronic urethral obstruction because of urinary calculi, prostatic hyperophy, tumors, normal pregnancy, tumors, uterine prolapse or functional disorders cause hydronephrosis which by definition is used to describe dilatation of renal pelvis and calculus associated with progressive atrophy of the kidney due to obstruction to the outflow of urine Refer Robbins 7yh/9,1012,9/e. P950 | Anatomy | Urinary tract | Chronic urethral obstruction due to benign prismatic hyperplasia can lead to the following change in kidney parenchyma
A. Hyperplasia
B. Hyperophy
C. Atrophy
D. Dyplasia
| Atrophy |
e3d3c4e1-4fb2-45e7-9f88-247cc8f373b3 | Ans. (c) Vitamin B12 Ref: Harrison's 19th ed. P 640* Vitamin B12 (Cobalamin) is synthesized solely by microorganisms.* In humans, the only source for humans is food of animal origin, e.g., meat, fish, and dairy products.* Vegetables, fruits, and other foods of nonanimal origin doesn't contain Vitamin B12 .* Daily requirements of vitamin Bp is about 1-3 pg. Body stores are of the order of 2-3 mg, sufficient for 3-4 years if supplies are completely cut off. | Biochemistry | Vitamins and Minerals | Which vitamin is supplied from only animal source:
A. Vitamin C
B. Vitamin B7
C. Vitamin B12
D. Vitamin D
| Vitamin B12 |
dc6794a3-b108-47c5-8b1b-3b4931577249 | Ans. is 'b' i.e., IGI-1GH has two major functions :-i) Growth of skeletal system :- The growth is mediated by somatomedins (IGF). Increased deposition of cailage (including chondroitin sulfate) and bone with increased proliferation of chondrocytes and osteocytes.ii) Metabolic effects :- Most of the metabolic effects are due to direct action of GH. These include gluconeogenesis, decreased peripheral utilization of glucose (decreased uptake), lipolysis and anabolic effect on proteins. | Physiology | null | Growth hormone has its effect on growth through?
A. Directly
B. IG1-1
C. Thyroxine
D. Intranuclear receptors
| IG1-1 |
f3bf8583-231b-4b7a-828c-179b0f9ccdd9 | PILONIDAL SINUS/DISEASE (Jeep Bottom; Driver's Bottom) Pilus--hair; Nidus--nest It is epithelium lined tract, situated sho distance behind the anus, containing hairs and unhealthy diseased granula- tion tissue. It is due to penetration of hairs through the skin into subcutaneous tissue. It forms granuloma/unhealthy granulation tissue in the deeper plane. It is of infective origin and occurs in sacral region between the buttocks, umbilicus, axilla. Other indications of per rectal examination are:Carcinoma rectum, Stricture rectum, Polyps, BPH and carcinoma prostate, Secondaries in the rectovesical pouch (Blumer shelf), Sphincter tone, Pelvic abscess (is felt as boggy swelling), to feel the internal opening of anal fistulas, in bimanual palpation of the bladder or pelvic tumours, in acute abdominal conditions--it reveals dilated empty rectum with tenderness.Reference : page 967 and 952 SRB's manual of surgery 5th edition | Surgery | Urology | Per rectum examination is not a useful test for diagnosis of
A. Anal fissure
B. Hemorrhoid
C. Pilonidal sinus
D. Rectal ulcer
| Pilonidal sinus |
73515f05-e947-4801-8077-3abdeca95c84 | Remifentanil is the shortest acting opioid due to its metabolism by plasma esterase → dose adjustment is not needed in liver or kidney disease. It is more potent than alfentanil : Order of potency is Sufentanil > Fentanyl = Remifentanil > Alfentanil. | Anaesthesia | null | Characteristics of Remifentanyl – a) Metabolised by plasma esteraseb) Short half lifec) More potent than Alfentanyld) Dose reduced in hepatic and renal diseasee) Duration of action more than Alfentanyl
A. ab
B. bc
C. abc
D. bcd
| abc |
53f79833-21b0-4336-8ef4-404c687ec807 | Ans. C. Deficit of expression by gestureHypomimiaHypomimia or amimia is a deficit or absence of expression by gesture or mimicry.This is usually most obvious as a lack of facial expressive mobility (mask - like facies).This is a feature of frontal subcoical disease. | Psychiatry | null | Hypomimia is ?
A. Decreased ability to copy
B. Decreased execution
C. Deficit of expression by gesture
D. Deficit of fluent speech
| Deficit of expression by gesture |
b3d1eb6c-3909-4011-ad10-d55538b81456 | Nagler's reaction - when Clostridium perfringens is grown in media containing 6 % agar, 5% Fildes peptic digest of sheep blood and 20% human serum, with antitoxin spread on one half of plate, colonies in the other half without antitoxin will be surrounded by a zone of opacity. No opacity around the colonies on the half of plate with antitoxin, this is due to the specific neutralization of the alpha-toxin. This specific lecithinase effect, known as the Nagler's reaction. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 263 | Microbiology | Bacteriology | Naglers reaction is shown by
A. Clostridium tetani
B. Clostridium botulinum
C. Clostridium perfringens
D. Clostridium septicum
| Clostridium perfringens |
4e6de6fe-8c69-4553-827d-417ce597f3ac | One of the most impoant pharmacokinetic changes associated with aging is decreased renal elimination of drugs. After age 40, creatinine clearance decreases an average of 8 mL/min/1.73 m2/decade; however, the age-related decrease varies substantially from person to person. Serum creatinine levels often remain within normal limits despite a decrease in GFR because older adults generally have less muscle mass and are generally less physically active than younger adults and thus produce less creatinine. Maintenance of normal serum creatinine levels can mislead clinicians who assume those levels reflect normal kidney function. Decreases in tubular function with age parallel those in glomerular function. Refer katzung 11/e p1039 | Anatomy | General anatomy | The pharmakokinetic change occurring in geriatric patient is due to
A. Gastric absorption
B. Liver metabolism
C. Renal clearance
D. Hypersensitivity
| Renal clearance |
35a7eac4-fd96-4184-9a5f-86bba82a5b62 | Urine microscopy for malignant cytology "Painless haematuria is by far the most common symptom of bladder cancer and should be regarded as indicative of a bladder carcinoma until proven otherwise." Bailey & Love 25/e p1336 (24/e p1363) Cigarette smoking is the main etiological factor and accounts ,for about 50% of bladder cancers Among the given options 'urine microscopy' is the best choice for investigating a pt. with high suspicion for bladder ca. This is not a good screening test but a positive result is highly specific. The best investigation would be cystoscopy & biopsy. Investigations for bladder cancer 1. Urinary cytology - Exfoliated cells from both normal and neoplastic urothelium can be readily identified in voided urine. Examination of cytological specimens can detect the malignant cells either at the time of initial presentation or during follow-up. Cytological examination may be especially useful in screening high-risk population and assessing the response to treatment. 2. Cystourethroscopy and tumor resection - The diagnosis and initial staging of bladder cancer is made by cystoscopy and transurethral resection. 3.Imaging (IVP, CT, MRI) - Although various imaging techniques can detect bladder cancer, its presence is confirmed by cystoscopy & biopsy. - Therefore imaging modalities are used to image the upper urinary tract and, when infiltrating bladder tumors are detected to assess the depth of muscle wall infiltration and the presence of local & distant metastasis. - Intravenous urography remains one of the most common imaging tests for the evaluation of hematuria. However, intravenous pyelography is increasingly being replaced by computed tomography (CT) urography, which is more accurate, for evaluation of the entire abdominal cavity, renal parenchyma, and ureters in patients with hematuria. Bladder tumors may be recognized as pedunculated, radiolucent filling defects projecting into the lumen; nonpapillary, infiltrating tumors may result in fixation or flattening of the bladder wall. 4. Urinary tumor markers - - Several new tests have been developed in order to overcome the shocomings of urinary cytology such as the low sensitivity for low-grade superficial tumors and inter-observer variability. - Commercially available tests include, the BTA test, the BTA stat test, the BTA TRAK assay determination of urinary nuclear matrix protein (NMP22), Immunocyt and UroVysion . - These tests can detect cancer specific proteins in urine (BTA/NMP22) or augment cytology by identifying cell surface or cytogenetic markers in the nucleus. Other tests under investigation include identification of the Lewis X antigen on exfoliated urothelial cells, and the determination of telomerase activity in exfoliated cells. - These tests have been demonstrated to enhance detection of bladder cancer when used either individually or in combination with cytology. They have been used to detect both new index tumors as well as recurrent tumors. | Surgery | null | A 60 yr old chronic smoker presents with painless gross hematuria of 1 day duration. Investigation of choice to know the cause of hematuria
A. USG
B. X-ray KUB
C. Urine routine
D. Urine microscopy for malignant cytology cells
| Urine microscopy for malignant cytology cells |
f79a972f-3611-4cdc-837e-ce2f9393f592 | Ref William hematology 6/e p1268 The term cryoglobulinemia refers to the presence in the serum of proteins that precipitate at temperatures below 37 degrees C and redissolve on rewarming. ... The elective treatment for hyperviscosity syndrome, whether associated with monoclonal, mixed, or polyclonalcryoglobulinemia, is plasma exchange. | Anatomy | General anatomy | Hyper viscosity is seen in
A. Cryoglobulinemia
B. Multiple myeloma
C. MGUS
D. Lymphoma
| Cryoglobulinemia |
26ac2e3d-bbd7-44d6-968a-feeb54cf1a92 | Maturation (cement)—The process of hardening a cement matrix through hydration with oral fluids to achieve greater mechanical strength.
Ref: Phillip’s Science of Dental Materials ed 12 pg 309 | Dental | null | The process of hardening a cement matrix through hydration with oral fluids to achieve greater mechanical strength is known as:
A. Maturation
B. Setting
C. Hardening
D. Mineralization
| Maturation |
56b5a2d2-044c-4b80-b778-6fa762206f52 | Ans. C Cardinal veinRef; hangman's essesntial medical Embroyology pg. 57# During early embryonic development (through 4th week), paired cardinal veins drain the body. Anterior cardinal veins drain the head and upper limb buds, while posterior cardinal veins drain the body. Both the anterior and posterior veins on each side unite at the common cardinal veins that flow into the sinus venosus and ultimately into the common atrium (Image).# Anterior cardinal veins are retained. An anastomosis between the two forms the left brachiocephalic vein, and anterior segments from both form the jugular system for the head and neck (Image).# Most of the posterior segment on the left disappears except for that forming the left superior intercostal vein, whereas the right posterior segment forms the superior vena cava.Extra mileDefects of SVC Development* Double inferior vena cava occurs when the left supracardinal vein persists, thereby forming an additional inferior vena cava below the level of the kidneys.* Left superior vena cava occurs when the left anterior cardinal vein persists, forming a superior vena cava on the left side. The right anterior cardinal vein abnormally regresses.* Double superior vena cava occurs when the left anterior cardinal vein persists, forming a superior vena cava on the left side. The right anterior cardinal vein also forms a superior vena cava on the right side. | Anatomy | Embryology | Superior vena cava is derived from:
A. Aortic arch
B. Pharyngeal arch
C. Cardinal vein
D. Vitelline vein
| Cardinal vein |
2583b8c8-aeaa-47c0-86fb-5efc9f386de6 | The vocal fold of the excised larynx is known to be located at an intermediate position(the so-called cadaver position). | ENT | null | Position of vocal cord in cadaver is:
A. Median
B. Paramedian
C. Intermediate
D. Full Abduction
| Intermediate |
b77af8ce-2e9c-4979-a544-a2331f86f6b1 | WHO CUT-OFF POINTS OF WHR Indicator CUT-OFF points Risk of metabolic complications Waist circumference >94 cm (M) >80 cm (W) Increased Hip cirrcumference >102 cm (M) >88 cm (W) Substantially increased Waist-Hip ratio >= 0.95(M) >= 0.80(W) Substantially increased Ref: Park 23rd edition Pgno : 400 WC & WHR, WHO Consultation 2008 | Social & Preventive Medicine | Non communicable diseases | Normal waist hip ratio of a female is below
A. 0.7
B. 0.8
C. 0.9
D. 1
| 0.8 |
f5df7424-6485-43fa-ba98-6de498561a76 | Chronic pyelonephritis is characterized by renal inflammation and scarring induced by recurrent or persistent renal infection, vesicoureteral reflux, or other causes of urinary tract obstruction. VUR is a congenital condition that results from incompetence of the ureterovesical valve due to a sho intramural segment Ref Harrison20th edition pg 234 | Medicine | Kidney | The most common cause of renal scaring in a 3 year old child is -
A. Trauma
B. Tuberculosis
C. Vesicoureteral reflux induced pyelonephritis
D. Interstitial nephritis
| Vesicoureteral reflux induced pyelonephritis |
99ae24e6-10c3-48b5-8c69-a8784ce4a4fc | All patients with a history of snake bite should be observed for 8-12 h after the bite, if the skin is broken and the offending snake cannot be positively identified as non-poisonous. Ref: Krishnan vij ; 5th ed; Page no: 484 | Forensic Medicine | Poisoning | A 6hours old snake bite patient comes to emergency with mild local edema at the injury site. On examination no abnormalities detected and lab repos are normal. Most appropriate management is
A. Incision and suction
B. Wait and watch
C. Local subcutaneous antisnake venom
D. Intravenous antisnake venom
| Wait and watch |
a822c6ea-6cfd-44c1-890f-6fac4b97e16d | Intracranial CSF leaks cause bacterial meningitis, about 80% are caused by S. Pneumoniae. Other causative organisms are meningococcus, Hemophilus species and S.aurues. Ref: Clinical Pediatric Neurology By Ronald B. David, Page 217 | Pediatrics | null | Which of the following agents is most commonly associated with recurrent meningitis due to CSF leaks?
A. Meningococci
B. Pneumococci
C. Hemophilus Influenza
D. E. Coli
| Pneumococci |
69e9312c-9be5-4efe-a981-6bd7be0ef65b | (b) Facial nerve repair(Ref. Scott Brown, 6th ed., 1404)Since generally following trauma the facial nerve injury occurs as sudden onset. Facial decompression should be the best option. | ENT | Facial Nerve And Its Disorders | Treatment of choice in traumatic facial nerve injury is:
A. Facial sling
B. Facial nerve repair
C. Conservative management
D. Systemic corticosteroids
| Facial nerve repair |
108ff605-0712-4a5b-8a74-aa8cbefc3d07 | Ans. B i.e. Demonstrations Demonstration involves showing by reason or proof explaining or making clear by use of examples or experiments. Put more simply, demonstration means to clearly show | Social & Preventive Medicine | null | What is the best method of informing the rural population about Oral rehydration technique: March 2013 (d, f)
A. Chalk and talk/Lecture
B. Demonstrations
C. Role play
D. Flash cards
| Demonstrations |
7a14deed-5c09-443b-9221-10f3a70fb6a4 | Standard poals in knee ahroscopy Anterolateral poal Almost all the structures within the knee joint can be seen except- posterior cruciate ligament anterior poion of the lateral meniscus periphery of the posterior horn of the medial meniscus in tight knees. Anteromedial poal Additional viewing of lateral compament Posteromedial poal Used for viewing the posteromedial structures For repair or removal of the displaced posterior horn of meniscal tears Superolateral poal Used for diagnostically viewing the dynamics of patella-femoral joint, excision of medial plica. | Orthopaedics | Spos Injury | Anterolateral ahroscopy of knee is for:
A. To see patellofemoral aiculation
B. To see the posterior cruciate ligament
C. To see the anterior poion of lateral meniscus
D. To see the periphery of the posterior horn of medial meniscus
| To see patellofemoral aiculation |
d27fbb91-ef90-4092-9175-636be25c357f | Left lateral decubitus view demonstrates the air between dense shadow of liver and the abdominal wall. | Radiology | null | 25 year old patient Suspected to have a pneumoperitoneum. Patient is unable to stand. Best x-ray view is
A. Left lateral decubitus view
B. Right lateral decubitus view
C. Supine
D. Prone
| Left lateral decubitus view |
2b42ac45-27a8-4304-b28d-7554722e76ba | Aspergillus species are widely distributed on decaying plants, producing chains of conidia. Aspergillus species unlike Candida species do not form the pa of normal flora of humans. They are ubiquitous in the environment; hence transmission of infection is mostly exogenous. Aspergillus transmission occurs by inhalation of airborne conidia. Risk Factors for invasive aspergillosis are: Glucocoicoid use (the most impoant risk factor) Profound neutropenia or Neutrophil dysfunction Underlying pneumonia or COPD, tuberculosis or sarcoidosis Antitumor necrosis factor therapy. | Microbiology | Mycology | What is the most probable poal of entry of Aspergillus?
A. Puncture wound
B. Blood
C. Lungs
D. Gastrointestinal tract
| Lungs |
476a3ecd-7c42-4c85-9982-1ce80c95ab82 | Ans. is b' i.e., Mean-Mode Measures of Skewness o There are following measures of skewness 1. Karl pearson's measure The formula for measuring skewness is divided into a) absolute measure Skewness = Mean - Mode b) relative measure The relative measure is known as the Coefficient of Skewness and is more frequently used than the absolute measure of skewness. Fuher, when a comparison between two or more distributions is involved, it is the relative measure of Skewness which is used. | Social & Preventive Medicine | null | Pearsonian measure of skewness -
A. Mode - Mean/ SD
B. Mean - Mode/ SD
C. SD/Mode - mean
D. Mean - Mode/ SD
| Mean - Mode/ SD |
21ab1846-bbea-4bca-bd03-8933fa61ea5d | Ans. is 'a' i.e Rt. Leg and perineum Paracentral lobule:On the medial surface of cerebral hemisphere, the U shaped gyrus around the end of the central sulcus is the paracentral lobule.Motor cortex is located in the precentral gyrus on the superolateral surface of the hemisphere and in the anterior part of the paracentral lobule.Stimulation in this area results in movements in the opposite half of the body.The body is represented upside down in this area.A look at the motor homunculus in Ganong will show that the leg and perineum are represented in the paracentral lobule. | Anatomy | Cerebrum | During Sx for meningioma, the left paracentral lobule was injured. It would lead to paresis of
A. Rt. Leg and perineus
B. Left face
C. Right face
D. Right shoulder & trunk
| Rt. Leg and perineus |
af3f9375-99f2-4495-8e66-c875d70c9612 | Chronic Subdural Empyema It may be primary infection of subdural space from sinusitis focus causing suppuration and pus formation. It can be complication of the chronic subdural haematoma. It is due to secondary bacterial infection of collected clot/fluid. Infection is from sinusitis scalp (common)/through earlier trauma wound/haematogenous. Commonly Gram positive organisms cause empyema like streptococci (viridans/milleri) but other virulent organisms like Gram negative bacteria (H.influenzae) occasionally can cause. There is coical venous thrombophlebitis and coical infarction. Headache, fever, meningism and convulsions are the features. MRI is ideal than CT to diagnose. Treatment: Antibiotics, craniotomy and drainage; anticonvulsants, ICU care, proper monitoring, regular follow up. Condition has got 10% moality. Ref: SRB's Manual of Surgery 5th edition Pgno : 1097 | Surgery | Trauma | Which of the following bacterial meningitis is associated with sudural effusion?
A. H. influenza
B. Neisseria meningitits
C. Streptococcus pneumonia
D. Enterococcus
| H. influenza |
b801715b-75b9-41bd-8f3c-828469d01266 | Ans : B (NAD+) & C (NADPH) In chronic alcoholism rate limiting component for alcohol metabolism is NAD* & NADPHOxidation of ethanol by alcohol dehydrogenaseQ & NADQ leads to excess production of NADHSome metabolism of ethanol takes place via a cytochrome P450 dependent microsomal ethanol oxidising systme (MEOS) Q involving NADPH & O2:, This system increase in activity in chronic alcoholism & may account for the increased metabolic clearnce in this condition.Ethanol + NADPH + H+ O2 MEOS Acetaldehyde | Biochemistry | Biosynthesis of Fatty Acids and Eicosanoids | In chronic alcoholism the rate limiting component for alcohol metabolism excluding enzymes is/are : (PGI Dec 2008)
A. NADP
B. NAD+
C. NADPH
D. FADH
| NAD+ |
12b668e8-af03-47d7-bc80-41dec978da4d | National Iodine deficiency disorder programme , 1992: - National goitre control programme, 1962 is conveed to NIDDCP, 1992 - Impact indicators: Major indicator - Urinary iodine excretion levels ( generally measured in pregnant women over 24hrs) Others - Neonatal hypothyroidism , Goitre - Level of salt iodinisation: 30 ppm at production level 15 ppm at consumer level - Two-in-one salt: 40mcg iodine + 1mg iron/gm of salt MBI kits- Field Test Kits that allow Iodised salt manufacturers, quality controllers, health inspectors, social workers, NGO activists and even school children to assess the amount of iodine in iodised salt. | Social & Preventive Medicine | Other NHPs | Minimum level of iodine iodized salt reaching the consumer level according to iodine programme should be:-
A. 5 ppm
B. 30 ppm
C. 15 ppm
D. 20 ppm
| 15 ppm |
6d21ae16-b1b7-42d3-ba62-7e310d8b0198 | New recommended regimen/Schedule (New guidelines( Type of prophylaxis Regimen Post exposure Intramuscular Essen Regimen (1-1-1-1-1) Day 0,3,7,14,28 Post exposure intradermal Updated Thai Red Cross Regimen (2-2-2-0-2) Day 0,3,7,28 Post exposure in vaccinated individuals Day 0,3 Pre-exposure prophylaxis Day 0,7,21/28 Minimum potency: 2.5 IU per IM dose Zagreb regimen of rabies Vaccine (Intramuscular Post-exposure) : 1. 4-dose abbreted multisite regimen 2-0-1-0-1 (2 doses on Day 0,1 dose on Day 7, 1 dose on day 21 Ref: Park 25th edition Pgno : 297-298 | Social & Preventive Medicine | Communicable diseases | Pre-exposure prophylaxis for rabies is given on days
A. 0, 3, 7, 14, 28, 90
B. 0, 3, 7, 28, 90
C. 0, 3
D. 0, 7, 28
| 0, 7, 28 |
432ce240-2b6c-47aa-afd7-18bd49806239 | Ans. B i.e. Sickle cell anemia Splenomegaly Splenomegaly refers strictly to spleen enlargement, and is distinct from hyperspineism , which connotes overactive function by a spleen of any size. Splenomegaly and hypersplenism should not be confused. Each may be found separately, or they may coexist. Clinically if a spleen is palpable, it means it is enlarged as it has to undergo enlargement by at least two folds to become palpable. However, the tip of the spleen may be palpable in a newborn baby up to 3 months of age Early sickle cell anemia may present with splenomegaly | Pathology | null | Splenomegaly may be a feature of: March 2013
A. Megaloblastic anemia
B. Sickle cell anemia
C. Thalassemia
D. G6PD deficiency
| Sickle cell anemia |
3c3ba303-b196-45de-8ced-6c888c9e0d4e | An antigen is any substance that causes an immune system to produce antibodies against it. Antigens are usually peptides, polysaccharides or lipids. In general, molecules other than peptides (saccharides and lipids) qualify as antigens but not as immunogens since they cannot elicit an immune response on their own. Ref: Ananthanarayan & Panikers textbook of microbiology 9th edition pg:88 | Microbiology | Immunology | Which of the following is very difficult to induce antibody -
A. Polysaccharide
B. Protein
C. Antigen
D. Effector
| Polysaccharide |
9531838e-9009-47d8-8d6e-3880fab47804 | Ans. is 'a' i.e., 3rd left intercostal space o Best areas to auscultate for both components of the second heart sound (A2 and P2) are either the left sternal border at the level of second intercostal space (Pulmonic area) or the left sternal border at the level of third intercostal space (Erb s point). | Medicine | General | S2 is best appreciated in -
A. 3rd left intercostal space
B. 2nd right intercostal space
C. 4th left intercostal space
D. 5th left intercostal space
| 3rd left intercostal space |
764ad788-556b-49cd-b976-c93086492894 | Ans. is 'b' i.e., Flexion, adduction & internal rotation Hip conditionDeformitySynovitisArthritisPosterior dislocationAnterior dislocationFemoral neck fractureIntertrochantric fractureFlexion, abduction, external rotation, apparent lengtheningFlexion, adduction, internal rotation, true shorteningFlexion, adduction, internal rotation, apparent & true shorteningFlexion, abduction, external rotation, true lengtheningExternal rotation, later adduction & flexionMarked external rotation, later adduction & flexion | Orthopaedics | Congenital Dislocation of Hip (C.D.H.) | Position of limb in posterior dislocation of hip -
A. Flexion, abduction & external rotation
B. Flexion, adduction & internal rotation
C. Flexion, adduction & external rotation
D. Flexion, abduction & internal rotation
| Flexion, adduction & internal rotation |
52e6dc81-fb25-495d-b941-543e03158f7c | Ans. b. SuxamethoniumSuxamethonium is the drug most commonly responsible for causing malignant hyperthermia.'Drugs causing malignant hyperthermia are- succinylcholine (most common cause), halothane (MC inhalational agent), iso/des/sevo/methoxy- fluranes, lignocaine, TCA, MAO inhibitors and phenothiazines.''Thiopentone and pancuronium are protective drugs for malignant hyperthermia, as these raise the triggering threshold.''In malignant hyperthermia susceptible patients, safe anesthetics are N2O, Non-depolarizing muscle relaxants (atracurium), opiates, tranquilizers, etomidate, barbiturates (thiopentone) and propofol.'Malignant Hyperthermia* Autosomal dominant genetic disorder of skeletal muscle* Occurs in susceptible individuals due to exposure to some triggering agents, typically Suxamethonium or volatile agents, which cause an abnormal increase in intracellular calcium.* It is caused by dysregulation of excitation-contraction coupling in skeletal muscle.Triggering Agents:* Succinylcholine (most common cause)* Halothane (MC inhalational agent)* Halogenated Anesthesia:- Fluranes: Isoflurane, desflurane, sevoflurane. methoxy-flurane- Ether- Cyclopropane* Lignocaine* TCA* MAO inhibitors* PhenothiazinesClinical Features:* Rise in end tidal CO2 (1st sign)* Masseter muscle rigidity (MMR) and tachycardia are earliest sign* Hypermetabolic features, metabolic acidosis, fever, hyperthermia* Sympathetic over activity: Tachycardia, arrhythmia, unstable BP. initial hypertension* Muscle damage: Masseter muscle spasm, generalized rigidity, hyperkalemiaTretment:* Triggering agent must be stopped and hyperventilate with 100% oxygen* The mainstay of therapy is immediate administration of IV dantrolene.* Dantrolene is the only drug effective in reversing the symptoms and preventing the episode. | Anaesthesia | Complications Of Anaesthesia | Drug causing malignant hyperthermia:(Asked twice in the exam)
A. Cisatracurium
B. Suxamethonium
C. Propofol
D. Thiopentone
| Suxamethonium |
91d73a6d-7f5b-44bb-b0ac-477ea9338efb | Ans. is 'a' i.e., Malathion* Insectisides used for control of malaria are-i) Residual sprapy-# In residual spray, spraying of houses with residual insectisides is done. Residual insectisides remains active over extended periods i.e., they have residual action even after the time of spray.# Commonly used residual insectisides are - Malathion, DDT, Lindane, propoxure (OMS-33).ToxicantDosage in g/m2Average duration of effectiveness (months)DDT1 to 26 to 12Lindane0-53Malathion23OMS-3323ii) Space spray# Space sprays are those where the insecticidal formation is sprayed into the atmosphere in the form of a mist or fog to kill insect. Action is short lived and temporary since there is no residual action.# The most commonly used space spray insecticide is Pyrethrum.# New equipment has been developed to use residual insectiside as space spray by ultra low volume (ULV) technique. Malathions and fenthion are most commonly used. | Social & Preventive Medicine | Environment and Health | Household insectiside used for malaria-
A. Malathion
B. Pyrethrum
C. Paris green
D. Permethrin
| Malathion |
1d4ccb9d-1924-4aa6-b07c-0ed46fe31c20 | Electrical Fetal hea monitoring is useful as: (1) Provides accurate information, (2) Helpful in diagnosing fetal distress, (3) Directs about intervention to prevent fetal death or morbidity, (4) It is superior to intermittent monitoring methods. | Gynaecology & Obstetrics | Intra Uterine Growth Restriction, Intrapaum and Antepaum Fetal Surviellance | Which of the following is the best procedure done for intrapaum fetal monitoring:
A. Fetal echocardiography
B. Fetal scalp pH
C. Continuous electrical fetal hea monitoring
D. Physical examination
| Continuous electrical fetal hea monitoring |
236d1eb1-f2e1-43b0-90f3-f88deff358cb | The spirometer is a simple device for measuring gas volumes. The frequently used water spirometer, rolling seal spirometer and bellows spirometer. The last two are not water-filled and are more poable. The VT, IRV, ERV, IC, and VC can all be measured with a spirometer (as can the forced expiratory volume in 1 second , forced vital capacity , and forced expiratory flow ). The RV, the FRC, and the TLC, however, cannot be determined with a spirometer because the subject cannot exhale all the gas in the lungs. The lung volumes not measurable with spirometry can be determined by the nitrogen-washout technique, by the helium-dilution technique, and by body plethysmography. The FRC is usually determined, and RV (which is equal to FRC minus ERV) and the TLC (which is equal to VC plus RV) are then calculated from volumes obtained by spirometry. Ref: Levitzky M.G. (2007). Chapter 3. Alveolar Ventilation. In M.G. Levitzky (Ed), Pulmonary Physiology, 7e. | Physiology | null | Which of the following is measured by the device, Bellow's spirometer?
A. TLC
B. RV
C. Closing volume
D. ERV
| ERV |
a2630da3-17a1-4149-b424-4b04b2c42f1c | Ans: a (Salmonella typhimurium) Ref: Ananathanarayan,7th ed, p. 303Of the above given, S. typhimurium causes food poisoningSalmonella gastroenteritisS. typhimurium is the most common cause of food poisoning due to salmonella species.Incubation period--6-24 hrsFood poisoning is never caused by S. typhi. Source of transmission: poultry, meat, milk and milk products.C/F-nausea, vomiting, diarrhoea, abdominal cramps, fever.Blood culture is usually negativeNoteS. aureus is the most common cause of food poisoning in the westIP and clinical features of various bacteria causing food poisoiningIncubation period Organism responsible 1- hrs S. aureus-nausea, vomiting, diarrheaB. cereus-nausea, vomiting 8-16 hrs C. perfringes-abdominal cramps, diarrhoea (vomiting rare)B. cereus-abdominal cramps, diarrhoea, vomiting > 16 hrs Vibrio cholera-watery diarrhoeaETEC-watery diarrhoeaEHEC-bloody diarrhoeaSalmonella species-inflammatory diarrhoeaCamphylobacter jej uni-inflammatory diarrhoeaShigella species- dysentryV. parahaemolyticus-dysentry | Microbiology | Enterobecteriaceae | Which of the following is a newly emerging food poisoning organism
A. Salmonella typhimurium
B. Enterococcus
C. Diphtheria
D. Pseudomonas
| Salmonella typhimurium |
f94f9f8f-fb28-44f0-9381-3dca473e305d | Ans. is 'd' i.e., Endothelium The most acceptable hypothesis for the pathogenesis of atherosclerosis is "the response to injury hypothesis". According to this hypothesis, atherosclerosis is a chronic inflammatory response of the aerial wall initiated by injury to endothelium. Pathogenesis of atherosclerosis Following stages occurs in the pathogenesis of Atherosclerosis: Endothelial injury Earliest stages of the development of atherosclerosis are mediated by the inflammatory cascade. Inflammation mediated injury to endothelium is the cornestone in the development of atherosclerosis. After injury, endothelium is activated and there is increased expression of adhesion molecule-VCAM-1 and there is increased permeability to endothelium. TNF is the major cytokine to induce this expression. Migration of leukocytes When VCAM-1 is expressed on endothelium, leukocytes adhere to the endothelium. Leukocytes than cross the endothelial barrier and begin to accumulate in subendothelial intimal space. Macrophages engulf LDL cholesterol and form foam cells - formation of earliest lesion, i.e. fatty streak. Macrophages also form oxygen free radicals that cause oxidation of LDL to yield oxidized LDL (modified LDL). Smooth muscle cell migration and proliferation Inflammatory cells in subendothelial intimal space secrete cytokines, mainly PDGF, TGF-ct and FGF which cause migration of smooth muscle cells from media to subendothelial intimal space as well as their proliferation. Maturation of plaque Smooth muscle cells synthesize extracellular matrix (especially collegen) and conve a fatty streak into a mature fibrofatty atheroma, and contribute to the progressive growth of atherosclerotic lesions. | Pathology | null | Atherosclerosis initiation by fibroblast plaque is mediated by injury to ?
A. Smooth muscle
B. Media
C. Adventitia
D. Endothelium
| Endothelium |
bdf94942-49c0-4d9a-b990-a7bfb7099857 | Monocyte is considered as the second line of defence.
Phagocytosis by Macrophages.
Macrophages are the end-stage product of monocytes that enter the tissues from the blood. When activated by the immune system, they are much more powerful phagocytes than neutrophils, often capable of phagocytizing as many as 100 bacteria. They also have the ability to engulf much larger particles, even whole RBCs or, occasionally, malarial parasites, whereas neutrophils are not capable of phagocytizing particles much larger than bacteria. Also, after digesting particles, macrophages can extrude the residual products and often survive and function for many more months.
Reference: GUYTON AND HALL TEXTBOOK OF MEDICAL PHYSIOLOGY, THIRTEENTH EDITION(INTERNATIONAL EDITION ) page no 458 | Physiology | null | The WBC that is considered “second line of defence” is:
A. Neutrophil
B. Eosinophil
C. Basophil
D. Monocyte
| Monocyte |
2b7ff41e-66e4-467a-97ec-9ea4e5e98cbc | Pulse oxymetry-
Based on Beer Lambert law
Utilization of a probe that transmits red (640 mm) and infrared light
Photo detector as a receptor site
Different absorption ability of light by oxygenated and deoxygenated haemoglobin leads to changes in the amount of light differently absorbed by the vascular bed before reaching the photo detector. | Dental | null | Determination of Pulp vitality by pulse oximeter based on:
A. Beer's law.
B. Pascal's law.
C. Doppler law.
D. Poisslues law.
| Beer's law. |
b15c5039-0f3c-4195-8331-35b9632899c7 | "In epidemic dropsy, glaucoma is wide angle glaucoma, with normal chamber and angle. Outflow is within normal limits. The queous shows raised level of histamin, prostaglandin and protein suggesting that glaucoma is hypersecretory". _ Mukherjee | Ophthalmology | null | Hypersecretory glaucoma is seen in –
A. Epidemic dropsy
B. Marfan's syndrome
C. Hypertension
D. Diabetes
| Epidemic dropsy |
01b9f068-4db2-45e5-94b8-19d4f7d290f7 | Facial muscle involvement is not seen with Becker and Limb-girdle muscular dystrophy Emery Dreifuss and Becker are XLR disease so can't be present in a girl child. Hence by exclusion the diagnosis is Dx: Scapulo-Faciohumeraldystrophy. Facio-Scapulo-humeral dystrophy Autosomal dominant inheritance and has an onset in childhood or young adulthood. Facial weakness is the initial manifestation-->inability to smile, whistle or fully close the eyes. Weakness of the shoulder girdles-->makes arm elevation difficult. Scapular winging becomes apparent with attempts at abduction and forward movement of the arms. The serum CK level may be normal or mildly elevated. No specific treatment is available, ankle-foot ohoses are helpful for foot-drop. | Medicine | Myasthenia Gravis and Muscular dystrophy | A 14-year-old girl presents with quadriparesis, facial palsy, winging of scapula and ptosis. There is h/o similar illness in father and brother but less severe. Her CPK level is also raised (500IU/L). She is probably suffering from?
A. Emery-Dreifuss muscular dystrophy
B. Becker muscular dystrophy
C. Limb-girdle dystrophy
D. Scapulofaciohumeral dystrophy
| Scapulofaciohumeral dystrophy |
6a19df3c-6af0-4673-8e2b-02d86ddc7523 | Extensor digitorum Hybrid muscles are the muscles having more than one nerve supply Pctoralis major: lateral & medial pectoral nerves Brachialis: additional proprioceptive fibres from radial nerve, in addition to its muscular nerve, musculocutaneous nerve. Extensor digitorum is supplied by the posterior interosseous nerve only. | Surgery | null | Which of the following muscle is not a hybrid muscle
A. Pectoralis major
B. Extensor digitorum
C. Flexor digitorum profundus
D. Brachialis
| Extensor digitorum |
cdfbd205-6f98-4cdc-9d76-29c0e9887cef | Ref:Parks 23rd edition pg 849. 1SD : confidence limit = 68% 2SD : confidence limit = 95% 3SD : confidence limit = 99.7% | Social & Preventive Medicine | Biostatistics | One standard detion in normal standard curev includes value-
A. 50%
B. 68%
C. 95%
D. 100%
| 68% |
d000623f-eba6-4e64-8cc0-3ed932403fce | Ans. is 'b' i.e., EBV EBV encephalomyelitis shows :Abnormal white matter with perivascular infiltrates of inflammatory cells and foam cells.Some myelin is replaced by lipid-filled macrophages and hyperplastic astrocytes. | Microbiology | null | Foam cells are seen in infection with which virus ?
A. Measles
B. EBV
C. Molluscum contagiosum
D. RSV
| EBV |
ffa5b47b-7d02-489f-9bcf-f6753b2be449 | Option C = Rescue P.C.I. After thrombolysis ST Elevation begin to reduce If ST Elevation persisting in spite of thrombolysis. So it's failure of thrombolysis | within 90 minutes Rescue PCI Types of PCI Primary PCI done for STEMI (Door to device time < 90 minutes). Delayed PCI done for Unstable Angina NSTEMI Rescue PCI Failure of thrombolysis (within 90 minutes). | Medicine | Acute coronary syndrome | Rescue P.C.I is done for which of the following?
A. Persistent chest pain with ST elevation > 60 min after thrombolysis
B. Persistent chest pain with ST elevation > 30 min after thrombolysis
C. Persistent Chest pain with ST elevation >90 min after thrombolysis
D. Pain with ST elevation for >120minutes after thrombolysis
| Persistent Chest pain with ST elevation >90 min after thrombolysis |
fefb2a6d-129a-4ebd-9100-fcdb862c98a2 | Fever right shifts the oxygen dissociation curve, which allows for a greater release of oxygen to the tissue, making oxygen easily available to neutrophils and monocytes for use in the oxygen-dependent myeloperoxidase system of bactericidal killing. Having more oxygen available to tissue also enhances wound healing. In addition, fever interferes with bacterial and viral replication by providing a hostile environment for incubation. Fever is produced by the release of interleukin-I from macrophages. Interleukin-I, in turn, stimulates the hypothalamus to synthesize prostaglandins, which interact with the thermoregulatory center to produce fever. | Physiology | General physiology | Fever associated with infection
A. Accelerates bacterial and viral replication
B. Left shifts the oxygen dissociation curve
C. Is due to interleukin-1 released from CD4 T-helper cells
D. Increase oxygen release to tissue
| Increase oxygen release to tissue |
8cf45c14-9de1-4f72-a51c-e0ab03cd4518 | Ans. is 'b' i.e., Uterus Order of putrefactiono Order of appearance of putrefaction from earliest to last is : larynx, trachea > stomach, intestine > spleen, liver > brain, lungs > heart > kidney, bladder > uterus/prostate > bone.o Amongst the soft tissues uterus in female and prostate in malesm are last to undergo putrefaction, as uterus and prostate resist putrefaction. Otherwise bones are last to undergo putrefaction, overall. | Forensic Medicine | Injuries | Last organ to putrefy in females is?
A. Liver
B. Uterus
C. Brain
D. Breast
| Uterus |
567e1d6a-5444-4e1a-b07a-98417b051c28 | Ans. (d) Congenital cystic adenomatoid malformation(Ref: Robbins 9th/pg 670; 8th/pg 679)Congenital cystic adenomatoid malformation (CCAM): Hamartomatous Q or dysplastic lung tissue, usually confined to one lobe. | Pathology | Respiration | Hamartomatous lung tissue is?
A. Hypoplasia of lung
B. Congenital cyst
C. Lobar sequestration
D. Congenital cystic adenomatoid malformation
| Congenital cystic adenomatoid malformation |
c50f51df-27d7-43e6-9be6-4b89df294edb | ANSWER: (C) CSF examinationREF: Harrison 17th ed chapter 376The diagnosis of bacterial meningitis is made by examination of the CSF. The need to obtain neuroimaging studies (CT or MRI) prior to LP requires clinical judgment.A broad-range PCR can detect small numbers of viable and nonviable organisms in CSF and is expected to be useful for making a diagnosis of bacterial meningitis in patients who have been pretreated with oral or parenteral antibiotics and in whom Gram's stain and CSF culture are negative | Microbiology | Bacteria | Test for diagnosis of pyogenic meningitis is?
A. Widal
B. CSF PCR
C. CSF examination
D. PET scan
| CSF examination |
0210576a-e7fd-40c4-b51e-acd13de82132 | Ans. is 'b' i.e., Opposite side [Ref: Dhingra 5th/e p. 48}o Each ear is irrigated twice : once with cold water (70C below the body temperature, i. e. 300C) and then with warm water (70C above the body temperature, i.e. 440C).o Cold water provokes nystagmus towards the opposite ear, while warm water provokes nystagmus towardssame ear (COWS Cold - oppsite, Warm - same). | ENT | Assessment of Vestibular Function | In caloric test, cold water stimulation causes movement of eye -
A. Some side
B. Opposite side
C. Up
D. Do\vn
| Opposite side |
f6c9fd05-bcda-4397-bcaa-a17d65107ad3 | The history and findings are consistent with a lobar pneumonia. The most common etiologic agent of lobar pneumonia is Streptococcus pneumoniae. ESSENTIALS OF DIAGNOSIS Productive cough, fever, rigors, dyspnea, early pleuritic chest pain Consolidating lobar pneumonia on chest radiograph Lancet-shaped gram-positive diplococci on Gram stain of sputum Ref: Papadakis MA, McPhee SJ, "Pneumonia, Pneumococcal." Quick Medical Diagnosis & Treatment | Microbiology | null | A 12-year-old girl presents to the casualty with symptoms of fever, shoness of breath, and cough. A chest X-ray reveals complete consolidation of the lower lobe of the left lung. Cultures of the lower lobe of the left lung would most likely reveal which organism?
A. Streptococcus pneumoniae
B. Staphylococcus aureus
C. Klebsiella pneumoniae
D. Pseudomonas aeruginosa
| Streptococcus pneumoniae |
d0b35238-78a6-454d-9bc9-65180db85bbb | Ovulation occurs due to the effect of increased concentration of LH. In the pre-ovulatory phase of the menstrual cycle, the ovarian follicle will undergo a series of transformations called cumulus expansion, which is stimulated by FSH. This is followed by LH surge. | Physiology | null | Which of the following hormonal activity is expected immediately prior to Ovulation?
A. LH surge
B. FSH surge
C. Progestrone surge
D. Estrogen surge
| LH surge |
e2e8a056-13c0-457f-945f-da4fdb9afbd6 | B. i.e. Frontoparietal sutureSkull sutures (except sphen-occipital), vomer- sphenoid rostrum schindylesisQ, inferior tibiofibular syndesmosis and dentoalveolar gomphosis (tooth socket) joints are fibrous joints. A Schindylesis is a specialized suture where a rigid bone fits into a groove on a neighbouring element eg a cleft between the alae of vomer, which receives the rostrum of the sphenoid. (i.e. vomer - sphenoidal rostrum junction)Q- Epiphyseo-diaphyseal growth plateQ, costochondral, 1st chondrosternal and sphenoocipital joints are synchondrosis/ syncendrosis or primary cailaginous joints; whereas, symphysis pubis, symphysis menti, sacrococcygeal, interveebral and manubriosternal jointsQ are symphyses or secondary cailaginous joints.Aicular cailage of most (not all) synol joints are lined by hyaline cailage Q. In some synol joints the cavity is paially or completely subdivided into two by an aicular disc, made up of fibrocailage eg. Temporomadibular jt, sternoclavicular jt, menisci of knee joint. More mobile the joint the more commonly it discloates eg shoulder jtQ. MCP Jt. is a condylar - synol joint | Anatomy | null | Following are fibrous joints :
A. Pubic symphysis
B. Fronto parietal suture
C. Manubrio sternal joint
D. Inf. radio ulnar joint
| Fronto parietal suture |
df59eac7-87b1-4805-9c47-0caf96a3450d | The body is exhumed only when, there is written order from the executive magistrate. | Forensic Medicine | null | For exhumation the order should be passed by -
A. Chief judicial magistrate
B. Executive magistrate
C. Police officer
D. Session judge
| Executive magistrate |
aeb420c2-ede8-48bc-9400-a5ae531f15ee | Radiological signs:
The lesion presents as a chance radiographic finding. It is a round or an ovoid (<3 cm) uniform radiolucency with a well-defined, usually corticated, margin. Stafne’s bone cavity is non-expansile and is found below the mandibular canal just anterior to the angle of the mandible. The location of Stafne’s bone cavity distinguishes it from odontogenic lesions, whose origin is within the alveolar bone. | Radiology | null | The radiograph of a 32 year old patient is shown below. The patient is asymptomatic and the lesion revealed in the radiograph is an accidental finding. The most likely diagnosis is:
A. Stafne’s bone cavity
B. Radicular Cyst
C. Dentigerous cyst
D. Lateral periodontal cyst
| Stafne’s bone cavity |
2d3da5b6-6af9-49c5-9439-17fbc983657d | Agent factors :- * Caused by group B arbovirus (flavivirus) * The main reservoirs are Ardeid birds and pigs * Pigs are amplifiers of the virus and they do not manifest ove symptoms but circulates the virus Host factors :- * Most common in the age group of <15 years of age * Man - incidental dead end host * Affects other animals also and horse is the only animal which does not shows symptoms of encephalitis Vector:- * Transmitted by culex tritaeniorrhynchus - most impoant vector, others are C.Vishnuii and c. Gelidus * Incubation period is 5-15 days * Case fatality rate - 20-40% Ref:- K Park, 24th ed; pg num:- 302-303 | Social & Preventive Medicine | Communicable diseases | Which of the following disease with bird, ahropod and human chain
A. Malaria
B. Japanese encephalitis
C. Paragonimus
D. Plague
| Japanese encephalitis |
91cfdd64-e451-462f-b6a2-c5b338415892 | Since there is b/l kidney agenesis or cystic disease there is no urine production
leading to oligohydromnios | Surgery | null | Potter syndrome is not assoiated with
A. Bilateral renal agenesis
B. Bilateral multicystic kidney disease
C. oligohydromnios
D. Polyhydromnios
| Bilateral renal agenesis |
f1f94f1c-3d9d-4b68-9c3d-b6757a8a4fcd | Pauwel's classification - depending on angle (Pauwel's angle) formed by the line with the horizontal. More the Pauwell's angle, more unstable is the fracture with poorer prognosis Type I : <30deg Type II : 30-50deg Type III: >50deg(worst prognosis) | Orthopaedics | Lower Limb Traumatology | Increase in pauwel's angle indicate
A. Good prognosis
B. Impaction
C. More chances of displacement
D. Trabecular alignment displacement
| More chances of displacement |
e08402ae-00b1-4649-872f-dfa4df0f6eb2 | Disruption of the endothelium exposes subendothelial Von willebrand factor (VWF) and collagen, which promotes platelet adherence and activation.
Deficiency of Von willebrand factor (VWF) causes
↓ Platelet adhesion (↑ BT)
↓ Intrinsic pathway activity (↑ aPTT) | Pathology | null | A 28 year old female teacher is found to have a prolonged bleeding time and normal platelet count. She had a bleeding of "easy bleeding" with frequent bleeding of the gums, epistaxis, cutaneous bleeding and menorrhagia, further testing revealed a deficiency of Von willebrand factor. Which of the following thrombogenic processes involving platelets is most directly impaired?
A. Adhesion
B. Aggregation
C. Formation of fibrinogen bridges
D. Conformational change with activation of phospholipid surface
| Adhesion |
053c4aff-1541-4fbd-8f3c-32fa0921e82a | Xenobiotics are compounds which may be accidently ingested or taken as drugs or compounds produced in the body by bacterial metabolism. The cytochrome P-450 enzyme family is involved in the biotransformation reaction of xenobiotics. They are heme containing membrane proteins localized in the smooth endoplasmic reticulum of liver. They are so named because they absorb light at wavelength of 450nm, when exposed to carbon monoxide. Ref: Vasudevan Biochemistry, 3rd Edition, Pages 310-2 | Biochemistry | null | Which of the following is the main enzyme responsible for activation of xenobiotics?
A. Cytochrome P-450
B. Glucuronyl transferase
C. Glutathione S-transferase
D. NADPH cytochrome P-450-reductase
| Cytochrome P-450 |
fabc62e9-fb0e-472f-b241-0c4bcf67fb58 | LDL receptors
Familial hypercholesterolemia (type IIa) is due to deficiency of functional LDL receptors as a result of different types of mutations. | Biochemistry | null | In Familial hypercholesterolemia there is deficiency of
A. LDL receptor
B. Apoprotein A
C. Apo protein C
D. Lipoprotein lipase
| LDL receptor |
eeb3a5e2-a7c2-47da-9432-d862656581e7 | Ans. (C). Adequate liquor amniiThe photograph shows maceration, a sign of intrauterine death.Conditions favoring maceration: Intact membranes; adequate liquor amnii & NO air. | Forensic Medicine | Sexual Offenses | Which of the following condition is necessary prerequisite for this change?
A. Rupture of membranes
B. Scanty liquor amnii
C. Adequate liquor amnii
D. Air inside the uterine cavity
| Adequate liquor amnii |
d1fd564a-489c-4075-9f2d-fe1fcf5a93b3 | Higher Intakes of Vitamin D May Be Beneficial There is evidence that Vitamin D intake considerably higher than that required to maintain calcium homeostasis reduce the risk of insulin resistance, obesity, and the metabolic syndrome, as well as various cancers. There is growing evidence that higher vitamin D status is protective against various cancers, including prostate and colorectal cancer, and also against prediabetes and the metabolic syndrome. Desirable levels of intake may be considerably higher than current reference intakes, and ceainly could not be met from unfoified foods. While increased sunlight exposure would meet the need, it carries the risk of developing skin cancer. Reference: Harper; 30th edition; Page no: 552, 553 | Biochemistry | vitamins | Which of the following vitamin reduces the risk of insulin resistance, obesity, and the metabolic syndrome?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin B12
| Vitamin D |
e718f928-325c-4060-9148-a827bc5e985b | Answer is D (Coarctation of Aoa) Coarctation of Aoa is a high risk cardiac lesion fior the development of infective endocarditis and an indication fir antibiotic prophyloxis. | Medicine | null | Antiboiotic Prophylaxis for infective endocarditis is indicated in:
A. Isolated secundum ASD
B. Mitral valve prolapse without regurgitation
C. Prior coronary aery bypass graft
D. Coarctation of aoa
| Coarctation of aoa |
0745edd3-4f4f-4971-97c5-89e0880be160 | B. i.e. (Congenital dislocation of hip joints) (410 - Apley 8th)Important Tests**Ortolani's and Barlow's test Galeazzi test (604 CDT 4th)Congenital dislocation of hip joints** Apprehension testRecurrent dislocation of shoulder joints* Bryant's Call ways Hamilton ruler testHamilton ruler testAnterior dislocation of shoulder joints* **Pivot-shift testAnterior cruciate ligament* Lachman testAnterior cruciate ligament* Drawer testCruciate ligament (Ant & Post)* **Mc-Murray's testMeniscus injury* Appley's grinding testMeniscus injury* **Thomas testHip flexion deformity* ** Ankle joint has LEAST chances for recurrent dislocations | Orthopaedics | Congenital Dislocation of Hip (C.D.H.) | Ortolani's test is done for
A. Congenial dislocation of the knee joints
B. Congenital dislocation of the hip joints
C. Congenital dislocation of the shoulder joints
D. Congenital dislocation of the elbow joints
| Congenital dislocation of the hip joints |
7b859b05-5bd6-4dc0-828f-d5ff4da65f24 | In judicial hanging, a rope to allow a drop of five to seven metres according to the weight, build and age of the person, is looped round the neck, with the knot under the angle of the jaw. This causes fracture-dislocation usually at the level of the second and third, or third and fouh cervical veebrae. Ref: The essentials of forensic medicine and toxicology by Dr K S Narayan Reddy, 27th edition, Page 306. | Forensic Medicine | null | Where does the "knot" is put in the neck during judicial hanging?
A. The back of the neck
B. Under angle of jaw
C. Below the chin
D. Choice of hangman
| Under angle of jaw |
22e6e599-7193-4569-be03-a7a0a006faec | Popliteus rotates the tibia medially on the femur or, when the tibia is fixed, rotates the femur laterally on the tibia. At the beginning of flexion of the fully extended knee, lateral femoral rotation by popliteus muscle unlocks the joint.Must know:Locking of knee joint is due to the the action of quadriceps femoris, that brings about medial rotation of femur on tibia in later stages of extension. Ref: Snells, Clinical anatomy, 7th Edition, Page 650. | Anatomy | null | Which of the following muscle acts as unlocker of knee?
A. Gracilis
B. Popliteus
C. Saorius
D. Biceps femoris
| Popliteus |
7a9e4db6-6173-4fc2-8d5f-daf8061734a3 | A chronic smoker with painless gross hematuria should be suspected as having bladder cancer. The most common form of bladder cancer is transitional cell carcinoma (TCC). Tobacco use, followed by occupational exposure to various carcinogenic materials such as automobile exhaust or industrial solvents are the most frequent risk factors. Hematuria is the presenting symptom in 85-90% of patients with bladder cancer. It may be gross or microscopic, intermittent rather than constant. Exfoliated cells from both normal and neoplastic urothelium can be readily identified in voided urine. Ref: Scher H.I., Motzer R.J. (2012). Chapter 94. Bladder and Renal Cell Carcinomas. 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. | Surgery | null | A 60 yr old chronic smoker presents with painless gross hematuria of 1 day duration. Which is the investigation of choice to know the cause of hematuria?
A. USG
B. X-ray KUB
C. Urine routine
D. Urine microscopy for malignant cytology cells
| Urine microscopy for malignant cytology cells |
a3e2c40f-e525-4ee7-9740-5198788b345f | Ans. is 'c' i.e., Polymerase chain reactionRef: Harrison, 17th/e, p. 1074,19th/e, p. 1165 and Ananthanarayan, 9th/e, p. 415Amplification assays such as ligase chain reaction and polymerase chain reaction are the most sensitive chlamydial diagnostic method.Other methods are:(a) Cell culture: Sensitivity (60-80%).(b) Direct immunofluorescent antibody test: Sensitivity 70-80% and quite specific.(c) ELISA: 60-80%. | Microbiology | Bacteria | The most sensitive method for detecting cervical Chlamydia trachomatis infection is:
A. Direct fluorescent antibody test
B. Enzyme immunoassay
C. Polymerase chain reaction
D. Culture on irradiated McConkey cells
| Polymerase chain reaction |
fa2a40f5-7d07-473b-9175-f891e8923e19 | Congenital hydrocele is best treated with herniotomy if they do not resolve spontaneously. Established acquired hydrocele often have thick walls. They are treated by subtotal excision of the sac. If the sac is small, thin walled and contains clear fluid, Lord's operation is done. Jaboulay's operation where the sac is eveed with placement of testis in a pouch created by dissection in the fascial planes of the scrotum, is an alternative. Reference : page 1328 Bailey and Love's sho practice of surgery 25th edition and page 1072 SRB's manual of surgery 5th edition | Surgery | Urology | Congenital hydrocele is best treated by
A. Eversion of sac
B. Excision of sac
C. Lord's procedure
D. Herniotomy
| Herniotomy |
53ae491c-15c1-4c77-8dcb-fba7d3f5dd29 | Answer is A (Quinine) Quinine is not associated with discoloured urine. | Medicine | null | Coloured urine is not seen in :
A. Quinine
B. Rifampcin
C. Nitrofurantoin
D. Pyridium
| Quinine |
23b2d44a-f5e5-47b8-9004-ddd6e0c183d8 | Ans. A: Proptosis Graves' ophthalmopathy (also known as thyroid eye disease (TED), dysthyroid/thyroid-associated orbitopathy (TAO), Graves' orbitopathy) is an autoimmune inflammatory disorder affecting the orbit around the eye, characterized by upper eyelid retraction, swelling (edema), redness (erythema), conjunctivitis, reduce dpower convergence and bulging eyes (proptosis). | Ophthalmology | null | Grave's ophthalmopathy mostly presents as September 2010
A. Proptosis
B. Ptosis
C. Reduced intraocular tension
D. Increased power of convergence
| Proptosis |
6a48770d-2b73-46ee-a45f-151619ca08ad | Ans: A (Fatty streaks) Ref: Robbins Pathologic Basis of Disease, 8th edition.Explanation:Fatty streaks are the earliest lesions in atherosclerosis " Ref: RobbinsMorphology of AtherosclerosisFatty StreaksThese are the earliest lesions in atherosclerosis.They are composed of lipid-filled foamy macrophages.Beginning as multiple minute flat yellow spots, they eventually coalesce into elongated streaks 1 cm or more in length.These lesions are not significantly raised and do not cause any flow disturbanceAortas of infants less than 1 year old can exhibit fatty streaks, and such lesions are seen in virtually all children older than 10 years, regardless of geography, race, sex, or environment.The relationship of fatty streaks to atherosclerotic plaques is uncertainThey may evolve into precursors of plaques, not all fatty streaks are destined to become advanced lesions.Atherosclerotic PlaqueThe key processes in atherosclerosis are intimal thickening and lipid accumulationAtheromatous plaques impinge on the lumen of the artery and grossly appear white to yellow: superimposed thrombus over ulcerated plaques is red-brown.Plaques vary from 0.3 to 1.5 cm in diameter but can coalesce to form larger massesAtherosclerotic lesions are patchy, on cross- section, the lesions appear "eccentric"Local flow disturbances (e.g., turbulence at branch points) leads to increased susceptibility to plaque formation.In descending order, the most extensively involved vessels are theLower abdominal aorta (MC)The coronary arteries (Second MC)The popliteal arteriesThe internal carotid arteriesVessels of the circle of WillisVessels of the upper extremities are usually spared, as are the mesenteric and renal arteries, except at their ostia.Atherosclerotic plaques have three principal components:Cells, including smooth muscle cells, macrophages, and T cellsECM, including collagen, elastic fibers, and proteoglycansIntracellular and extracellular lipidSuperficial fibrous cap composed of smooth muscle cells and dense collagen.Beneath and to the side of the cap (the "shoulder") is a more cellular area containing macrophages, T cells, and smooth muscle cells.Deep to the fibrous cap is a necrotic core, containing lipid (primarily cholesterol and cholesterol esters), debris from dead cells, foam cells (lipid-laden macrophages and smooth muscle cells), fibrin, variably organized thrombus, and other plasma proteins and cholesterolThe periphery of the lesions show neovascularization (proliferating small blood vessels;Plaques generally continue to change and progressively enlarge due to cell death and degeneration, synthesis and degradation (remodeling) of ECM, and organization of thrombus.Atheromas often undergo calcificationAtherosclerotic plaques are susceptible to the following clinically important changes* Rupture, ulceration, or erosion of the intimal surface of atheromatous plaques exposes the blood to highly thrombogenic substances and induces thrombosis.* Such thrombosis can partially or completely occlude the lumen and lead to downstream ischemia.* If the patient survives the initial thrombotic occlusion, the clot may become organized and incorporated into the growing plaque.* Hemorrhage into a plaque. Rupture of the overlying fibrous cap, or of the thin-walled vessels in the areas of neovascularization, can cause intra-plaque hemorrhage; a contained hematoma may expand the plaque or induce plaque rupture.* Atheroembolism. Plaque rupture can discharge atherosclerotic debris into the bloodstream, producing microemboli* Alienism formation. Atherosclerosis-induced pressure or ischemic atrophy of the underlying media, with loss of elastic tissue, causes weakness resulting in aneurysmal dilation and potential rupture. | Pathology | Atherosclerosis and Arteriosclerosis | Earliest lesion seen in atherosclerosis is:
A. Fatty streaks
B. Intimal thickening
C. Fibrinoid necrosis
D. Plaque
| Fatty streaks |
fce5a305-66f4-4bcf-9ef7-30f40f13724d | When LDH-1 is greater than LDH-2, it is referred to as flipped LDH and is indicative of MI. LDH-1 isoenzyme is found primarily in hea muscle and is lesser in concentration than the LDH-2 Isoenzyme which is primarily found in RBC. When the concentration of LDH-1 is observed to be greater than LDH2. It is referred to as flipped LDH and is indicative of Myocardial infarction. LDH has five isoenzymes: LDH-1 LDH-1 is found primarily in hea muscle 17% to 27% LDH-2 LDH-2 is primarily found in Red blood cells 27% to 37% LDH-3 LDH-3 is highest in the lung 18% to 25% LDH-4 LDH-4 is highest in the kidney, placenta, and pancreas 3% to 8% LDH-5 LDH-5 is highest in the liver and skeletal muscle 0% to 5% The LDH test helps determine the location of tissue damage. Thus in Normal ratios LDH-1 is less than LDH-2 and LDH-5 is less than LDH-4. When LDH-1 is greater than LDH-2: It is referred to as flipped LDH. It is indicative of MI. When your LDH-5 is greater than your LDH-4: It could mean damage to the liver or liver disease. This includes cirrhosis and hepatitis. Ref: Harrisons 19th edition | Medicine | C.V.S | Flipped LDH indicating Myocardial Infarction is represented by:
A. LDH-1> LDH-2
B. LDH-2 > LDH-1
C. LDH-4 > LDH-5
D. LDH-5 > LDH-4
| LDH-1> LDH-2 |
39115fee-b58b-4020-ae8f-9a2653811340 | All the above mentioned are ultrasound findings associated with increased risk of aneuploidy although the highest association is seen with cystic hygroma Nuchal translucency and cystic hygroma are both measured in the first trimesterTrisomy 21 is the most common aneuploidy associated with increased NT and cystic hygroma While monosomy X presents as second-trimester hygroma. | Microbiology | All India exam | Which of the following ultrasound finding has the highest association with aneuploidy?
A. Choroid plexus cyst
B. Nuchal translucency
C. Cystic hygroma
D. Single umbilical aery
| Cystic hygroma |
a90571f1-9a01-4477-ab8a-5613d6dd48f9 | Functions: Transpo Systems An essential role of biomembranes is to allow movement of all compounds necessary for the normal function of a cell across the membrane barrier. These compounds include a vast array of substances like sugars, amino acids, fatty acids, steroids, cations and anions to mention a few. These compounds must enter or leave the cells in an orderly manner for normal functioning of the cell. A. 1. Ion Channels Ion channels are transmembrane channels, pore-like structures composed of proteins. Specific channels for Na+, K+, Ca++, and Cl- have been identified. Cation conductive channels are negatively charged within the channel and have an average diameter of about 5 to 8 nm. All ion channels are basically made up of transmembrane subunits that come together to form a central pore through which ions pass selectively. All channels have gates and are controlled by opening and closing. Types of Gates Two types of gated channels. They are a. Ligand-gated channels: In this, a specific molecule binds to a receptor and opens the channel. Example: Acetylcholine receptor is present in the postsynaptic membrane. It is a complex of five subunits, having a binding site for acetylcholine. Acetylcholine released from the presynaptic region binds with the binding site of the postsynaptic region, which triggers the opening of the channel and influx of Na+. b. Voltage-gated channels: These channels open or close in response to changes in membrane potential. Some propeies of ion channels * Composed of transmembrane protein subunits. * Highly selective. * Well regulated by the presence of "gates". * Two main types of gates: Ligand-gated and voltage-gated. * Activities are affected by ceain drugs. * Mutations of genes encoding transmembrane proteins can cause specific diseases. 2. Ionophores Ceain microorganisms can synthesize small organic molecules, called ionophores, which function as shuttles for the movement of ions across the membrane. Structure: These ionophores contain hydrophilic centres that bind specific ions and are surrounded by peripheral hydrophobic regions. Types: Two types: (a) Mobile ion carriers: Like valinomycin (Refer uncouplers of oxidative phosphorylation). (b) Channel formers: Like gramicidin. 3. Water Channels (Aquaporins) In ceain cells, e.g. in red blood cells, and cells of the collecting ductules of the kidney, the movement of water by simple diffusion is enhanced by movements of water through water channels, composed of tetrameric transmembrane proteins called aquaporins. About five distinct types of aquaporins have been recognised. CLINICAL ASPECT Recently mutations in the gene encoding AP-2 (Aquaporin 2) protein, have been shown to be the cause of one type of nephrogenic diabetes insipidus. 4. Gap Junction Ceain cells develop specialized regions on their membranes for intercellular communications which are in close proximity. Function: They mediate and regulate the passage of ions and small molecules upto 1000 to 2000 mol wt, through a narrow hydrophilic core connecting the cytosol of adjacent cells. Structure: They are primarily composed of protein, called connexon which contains four membrane-spanning a-helices. the mitochondrial membrane also has paicularly energy coupling mechanism.Ref: MN Chatterjea Textbook of Medical Biochemistry, 8th edition | Biochemistry | Respiratory chain | Which of the following is not a component of transpo system?
A. Receptor activation
B. Selective gate
C. Non-selective channel
D. Energy coupling system
| Receptor activation |
9f2fbb1d-f367-43da-9dd8-8571d1fafb84 | Comfo zones: In deg C of corrected effective temperature Pleasant and cool 20 Comfoable and cool 20-25 (69-76F) Comfoable 25- 27 (77-80F) Hot and uncomfoable 27-28 Extremely hot 28+ Intolerably hot 30+. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 792 | Social & Preventive Medicine | Environment and health | To feel comfoable and cool in a factory the conrrected effective temperature ( in degree Farenheit) should be -
A. Less tha 69
B. Between 69 and 76
C. Between 77 and 80
D. Between 81 and 82
| Between 69 and 76 |
fb2e4621-c209-4746-9c52-e8679882f93b | Ans. is 'b' i.e., APTT o Factor VIII is a part of the intrinsic pathway of coagulation. The test used to identity1 the defects in the intrinsic and common pathways of coagulation is PTT. Thus prolonged PTT is a feature of patient with factor VIII deficiency.o Patients with hemophilia have deficiency of factor VIII that results in prolonged PTT.o Tests used to evaluate different aspects of hemostasis.Bleeding timeo It is not a test for coagulation rathers it tests the ability of the vessels to vasoconstrict and the platelets to form a hemostatic plug.o It is the time taken for a standardized skin puncture to stop bleeding,o Normal reference value is between 2-9 minutes.o Prolongation generally indicates the defect in platelet number or function.Prothrombin time (PT)o This assay tests the extrinsic and common coagulation pathway.o So, a Prolonged PT can result from deficiency of factor V, VII. X, prothrombin or fibrinogen.Partial thromboplastin time (PTT)o This assay tests the intrinsic and common coagulation pathways.o So, a prolonged PTT. can results from the deficiency of factor V, VHI, IX, X, XI, XII, prothrombin or fibrinogen.Thrombin timeo It is the time taken for clotting to occur when thrombin is added to the plasma,o It tests the conversion of fibrinogen to fibrin and depends on adequate fibrinogen level,o Prolonged thrombin time results from decreased level of fibrinogen.Defective coagulation pathwayPTAPTTExtrinsicIntrinsicCommonIncreasedNormalIncreasedNormalIncreasedIncreased | Pathology | Bleeding Disorders | Test used for factor VIII deficiency identification is-
A. PT
B. APTT
C. D dimer
D. FDP
| APTT |
ee83bd7f-cd04-446e-b0a5-da98e920bc7c | Ans. A. (A)A. Anterior Talofibular ligamentAnkle sprains: Usually caused by the falls from height or twists of ankle. When the plantar-flexed foot is excessively inverted, the anterior and posterior talofibular and calcaneofibular ligaments are stretched and torn. The anterior talofibular ligament is most commonly torn. | Anatomy | Lower Extremity | A 27-year female wearing high heels stumbled and sustained inversion injury at ankle. Which ligament is most likely to be injured in the given case?
A. A
B. B
C. C
D. D
| A |
be77f10a-1e08-4ccb-9d32-23f49a68712d | Asymmetric tonic reflex (ATNR) diappears by 6-7 months postnatally The tonic neck reflex is produced by manually rotating the infant&;s head to 1 side and observing for the characteristic fencing posture (extension of the arm on the side to which the face is rotated and flexion of the conralateral arm) An obligatory tonic neck response, in which the infant becomes "stuck" in the fencing posture, is always abnormal and implies a CNS disorder Ref: Nelson 21st edition pgno: 3059 | Pediatrics | New born infants | Asymmetric tonic neck reflex (ATNR) disappears at ______
A. 6 months
B. 5 months
C. 9 months
D. 8 months
| 6 months |
1081d0b1-9e05-4d2a-8c52-1668deea11ac | Hypeension due to an occlusive lesion of a renal aery is renovascular hypeensionIn the initial stages, the mechanism of hypeension generally is related to activation of the renin-angiotensin system. Obstruction of the renal aery leads to decreased renal perfusion pressure, thereby stimulating renin secretion. Over time, possibly as a consequence of secondary renal damage, this form of hypeension may become less renin-dependent.As a screening test, renal blood flow may be evaluated with a radionuclide -ohoiodohippurate (OIH) scan, or glomerular filtration rate may be evaluated with a - diethylenetriamine pentaacetic acid (DTPA) scan before and after a single dose of captopril (or another ACE inhibitor).Contrast aeriography remains the "gold standard" for evaluation and identification of renal aery lesions.Harrison 19e pg: 1618 | Medicine | All India exam | Which of the following is the most specific and sensitive screening test for renovascular hypeension?
A. HRCT
B. CT Angiography
C. Captopril enhanced radionucleotide scan
D. Doppler ultrasound of renal aeries
| CT Angiography |
00ff4465-6c03-4e07-8986-8f169563b6fc | Propofol is an insoluble drug that requires a lipid vehicle for emulsification. Current formulations of propofol use a soybean oil as the oil phase and egg lecithin as the emulsifying agent. | Anaesthesia | Intravenous Anesthetic Agents | Role of egg lecithin in propofol formulation is?
A. Acts as emulsifying agent
B. Acts as preservative
C. Acts as carrier vehicle
D. Acts as antibacterial
| Acts as emulsifying agent |
97680640-ea40-4384-bdfb-b6ae47417707 | Even severe AS may exist for many years without producing any symptoms because of the ability of the hyperophied LV to generate the elevated intraventricular pressures required to maintain a normal stroke volume. Most patients with pure or predominant AS have gradually increasing obstruction over years, but do not become symptomatic until the sixth to eighth decades. Exeional dyspnea, angina pectoris, and syncope are the three cardinal symptoms. Dyspnea results primarily from elevation of the pulmonary capillary pressure caused by elevations of LV diastolic pressures secondary to reduced left ventricular compliance and impaired relaxation. Angina pectoris usually develops somewhat later and reflects an imbalance between the augmented myocardial oxygen requirements and reduced oxygen availability. Exeional syncope may result from a decline in aerial pressure caused by vasodilation in the exercising muscles and inadequate vasoconstriction in nonexercising muscles in the face of a fixed CO, or from a sudden fall in CO produced by an arrhythmia. ( Harrison&;s principle of internal medicine,18th edition,pg no.1939 ) | Medicine | C.V.S | A 63 year old man presents with a triad of angina, syncope and congestive hea failure. Which of the following valvular hea lesion can be suspected-
A. antral stenosis
B. Tricuspid regurgitation
C. Aoic stenosis
D. Aoic regurgitation
| Aoic stenosis |
e4d314d7-fe07-4bd3-ab11-21901e00f699 | Myoglobinuria REF: Harrison's Internal Medicine 17th edition chapter 382, Physiology and pathology of the urine by john dixon p. 49 Red color urine may be due to hemoglobin or myoglobin. In the question clue is given that patient is an athlete who competed in an event which lead to sternous exercise and hence increased myoglobin in the urine. "The states of energy deficiency cause activity-related muscle breakdown accompanied by myoglobinuria, appearing as light-brown- to dark-brown-colored urine" | Surgery | null | An athelete presented with red coloured urine after 2 days of history of severe exeion. The most probable cause is?
A. Hemoglobinuria
B. Hemosiderinuria
C. Hematuria
D. Myoglobinuria
| Myoglobinuria |
a0f71cba-c03d-4edd-859b-c5c33ada55af | There are 6 established hypothalamic releasing and inhibiting hormones :
Corticotropin-releasing hormone (CRH),
Thyrotropin releasing hormone (TRH),
Growth hormone releasing hormone (GRH),
Growth hormone inhibiting hormone (GIH),
Luteinizing hormone releasing hormone (LHRH) and
Prolactin inhibiting hormone(PIH). | Physiology | null | Which of the following is released from hypothalamus?
A. Orexin
B. Cortisol releasing hormone
C. Neuropeptide
D. Ghrelin
| Cortisol releasing hormone |
b9596ff7-85da-4b76-992a-3d853eb04bfd | Ans:A (Flocculonodular Lobe) Ref: Pal GK. Cerbellurn. In: Textbook of Medical Physiology. Ahuja Publishing House. 2007: 116: 871.Explanation:Functional Division of CerebellumVestibulo cerebellum/Arch-cerebellum (Flocculonodular lobe)Connections with vestibular apparatusConcerned with equilibrium and learning induced changes in vesiihulo-occular reflexSpino cerebellumVermis - controls muscle movements of axial bodyIntermediate zone - controls muscle movements of limbsCerbrocerbellum (Ponto cerebellum/Neo cerbellurn) Overall planning programming of motor activities | Physiology | Cerebellum and Brainstem | Vestibulo-Ocular Reflex Mediated by:
A. Flocculonodular Lobe
B. Vermal portion of Spinocerebel 1 um
C. Neocerebellum
D. Paravermal region of Spinocerebellum
| Flocculonodular Lobe |
5709cea6-ffc2-4d49-b423-28d815cec8da | Vitamin Functions Deficiency Disease D Maintenance of calcium balance Enhances intestinal absorption of Ca2+ and mobilizes bone mineral Regulation of gene expression and cell differentiation Rickets = poor mineralization of bone Osteomalacia = bone demineralization Reference: Harper; 30th edition; Page no: 550 | Biochemistry | vitamins | Which of the following vitamin enhances intestinal absorption of calcium?
A. Vitamin D
B. Vitamin K
C. Vitamin B1
D. Vitamin B2
| Vitamin D |
168e4c3a-95f4-42fe-9a7b-6e3bff6fd7b2 | Habitual aboion is the most impoant indication for surgical treatment of women who have a double uterus. The aboion rate in women who have a double uterus is to three times greater than that of the general population. Best diagnosis of the condition is made by laparohysteroscopy. Strassmans Metroplasty | Gynaecology & Obstetrics | Mullerian Abnormalities | Which of these is the most impoant indication for Strassmans Metroplasty done for a bicornuate uterus?
A. Infeility
B. Menorrhagia
C. Repeated early pregnancy losses
D. Associated vaginal atresia
| Repeated early pregnancy losses |
bf4e6c71-9fa8-4d6b-b5ed-20bb873383f1 | Cresol is an excellent coal-tar disinfectant. It is 3 to 10 times as powerful as phenol, yet no more toxic. Cresol is best used in 5 to 20 percent strength for disinfection of farces and urine. Cresol is an all-purpose general disinfectant. (refer pgno :128 park 23 rd edition) | Social & Preventive Medicine | Epidemiology | Best disinfectant of cholera stool is-
A. Bleaching powder
B. Cresol
C. Phenol
D. Lime
| Cresol |
fee1883d-f49b-43d6-99bc-07aabf7f2f9b | The synopsis of forensic medicine & toxicology ; Dr k.s.narayan reddy ; 28th edition ; Pg .no . 107 Black eye is the most common example for ectopic bruising or percolated contusion . | Forensic Medicine | Mechanical injuries | Black eye is a type of -
A. Patterend abrasion
B. Ectopic abrasion
C. Ectopic bruise
D. Friction abrasion
| Ectopic bruise |
edf8a6fd-63af-4c0e-8013-e3ba366dcec7 | Reference: Harpers illustrated biochemistry 30th edition page 275 | Biochemistry | Metabolism of lipid | In a patient with a type of familial dyslipidemias he presented with palmar Xanthomas and he ias at increased risk of atherosclerosis and CAD.In Lipid profile there was elevation of triacylglycerols and cholesterol.And the IDL and chylomicrons were elevated.What is the pathophysiology of the condition?
A. LDL deficiency
B. VLDL overproduction
C. Apo C-2 deficiency
D. Apo E deficiency
| Apo E deficiency |
1ab02ba4-f579-4542-b16f-a0df6a4f05c9 | Ans:A.)Subdural Perilymph drains into subarachnoid space through the aqueduct of cochlea... Endolymph is absorbed in subdural space. | Anatomy | null | Endolymphatic duct drains into :
A. Subdural space
B. External space
C. Subarachnoid space
D. Succulus
| Subdural space |
62f6d5bb-6085-4328-97a0-3e3776f9ae78 | Answer is C (Ca lung with ectopic ACTH production); Lack of suppression to dexamethasone challenge (ACTH producing tumor) and presence of hemoptysis (Carcinoma lung) in a patient with Cushinoid features suggests a diagnosis of Carcinoma lung with ectopic ACTH secretion. As a method of diagnostic workup of any patient with suspected Cushings we screen the patient with plasma coisol levels at 8:00 a.m. in the morning. Those with increased coisol levels are subjected to a dexamethasone supression test. In the given question there is lack of suppression to dexamethasone challenge so option (d) is out. Out of the choices remaining the presence of hemoptysis points towards the diagnosis of carcinoma lung with ectopic ACTH. | Medicine | null | A patient with cushinoid features presents with hemoptysis; he shows no response to dexamethasone suppression test; most likely diagnosis here is:
A. Adrenal hyperplasia
B. Adrenal adenoma
C. Ca lung with ectopic ACTH production
D. Pituitary microadenoma
| Ca lung with ectopic ACTH production |
b72c9d20-5b2a-4353-ab60-fa1a899fde6b | Since cannabis causes very mild withdrawal symptoms hence, no symptomatic treatment is required. LSD and other hallucinations also do not cause any withdrawal symptoms . | Psychiatry | Substance Related and Addictive Disorders | Symptomatic treatment is not required in withdrawal of:
A. Cannabis
B. Morphine
C. Alcohol
D. Cocaine
| Cannabis |
3ec267ef-dc91-4a47-81de-070ce0bf7213 | The Transplantation of Human Organs Act 1994, amended in 2011, and 2012 Chapter VI and VII deals with the trial and punishment of offences under this act. Under this act, doctors involved will be punished for a period of 2-5yrs. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr. PC IGNATIUS PAGE NO: 389 | Forensic Medicine | Medical Jurisprudence | Under transplantation of humans organs act, the punishment for the doctor involved is
A. < 1 year
B. < 2 years
C. 2-5 years
D. > 5 years
| 2-5 years |
688c3768-9fb8-4541-b844-f89b7c2c6af5 | Ref:Textbook of Forensic medicine and toxicology (V.V.Pillay) 17th edition, page no.388 Minimum age at which female can give consent for sex by what age is 18 years. As per Sec.375IPC unlawful sexual intercourse by man with a woman with or without her consent when she is under 18 years of age. The criminal law (Amendment) Act,2013 has increased the previous recomended age of consent from 16 to 18 years, which means any sexual activity irespective of presence of consent with a woman below the age of 18 will constitute statutory rape. | Forensic Medicine | Sexual offences and infanticide | Statuary rape is -
A. Less than 15 years
B. Less than 16 years
C. Less than 18 years
D. Less than 20 years
| Less than 18 years |
2a1c313d-df98-47f8-9d5c-bf439f33f228 | Cornea Verticillata
This is a whorl-like opacity in the corneal epithelium seen in patients on long-term treatment with medication such as amiodarone, chloroquine, phenothiazines and indomethacin.
It is also seen in patients with Fabry disease and its carrier state. The condition is generally asymptomatic, harmless and reversible on stopping the drug.
The whorl-like pattern shows the direction of migration of corneal epithelial cells. Occasionally the condition had been known to cause glare and surface discomfort which response to topical lubricants. | Ophthalmology | null | A patient on amiodarone is diagnosed to have cornea verticillata. What should be management –
A. Stop the drug
B. Penetrating keratoplasty
C. Lamellar keratoplasty
D. Observation
| Stop the drug |
becc6670-95ca-4530-a5ee-afcd3b4ca1b6 | Ans. is 'a' i.e., Lipopolysaccharide-1 Legionella are classified into serogroup on the basis ofgroup specific lipopolysaccharide (somatic antigen or 'O' antigen). Legionella pneumophila sero-group-1 (LP-1) is the most common infecting organism. Urine test detect LP-1. | Microbiology | null | In pontaic fever, which antigen is seen in urine?
A. Lipopolysaccharide-1
B. Lipopolysaccharide-2
C. Lipopolysaccharide-4
D. Lipopolysaccharide-6
| Lipopolysaccharide-1 |
7903a702-b0c9-42b8-aca5-1642a098ff81 | Ref:Robbins Basic Pathology (9th Edition),page no.478,479 Sarcoidosis Although sarcoidosis is considered here as an example of a restrictive lung disease, it is impoant to note that sarcoidosis is a multisystem disease of unknown etiology characterized by noncaseating granulomas in many tissues and organs. MORPHOLOGY The diagnostic histopathologic feature of sarcoidosis is the noncaseating epithelioid granuloma, irrespective of the organ involved. This is a discrete, compact collection of epithelioid cells rimmed by an outer zone of largely CD4+ T cells. The epithelioid cells are derived from macrophages and are characterized by abundant eosinophilic cytoplasm and vesicular nuclei. It is not uncommon to see intermixed multinucleate giant cells formed by fusion of macrophages. A thin layer of laminated fibroblasts is present peripheral to the granuloma; over time, these proliferate and lay down collagen that replaces the entire granuloma with a hyalinized scar. Two other microscopic features are sometimes seen in the granulomas: (1) Schaumann bodies, laminated concretions composed of calcium and proteins; and (2) asteroid bodies, stellate inclusions enclosed within giant cells. Their presence is not required for diagnosis of sarcoidosis--they also may occur in granulomas of other origins. Rarely, foci of central necrosis may be present in sarcoid granulomas, suggesting an infectious process. Caseation necrosis typical of tuberculosis is absent The lungs are involved at some stage of the disease in 90% of patients. The granulomas predominantly involve the interstitium rather than air spaces, with some tendency to localize in the connective tissue around bronchioles and pulmonary venules and in the pleura ("lymphangitic" distribution). The bronchoalveolar lavage fluid contains abundant CD4+ T cells. In 5% to 15% of patients, the granulomas eventually are replaced by diffuse interstitial fibrosis, resulting in a so-called honeycomb lung. Intrathoracic hilar and paratracheal lymph nodes are enlarged and calcification in 75% to 90% of patients, while a third present with peripheral lymphadenopathy. The nodes are characteristically painless and have a firm, rubbery texture. Unlike in tuberculosis, lymph nodes in sarcoidosis are "nonmatted" (nonadherent) and do not ulcerate. | Pathology | Respiratory system | Mediastinal lymph node calcification is seen in which one of the following-
A. Metastatic neoplasm
B. Lymphoma
C. Sarcoidosis
D. Bronchiectasis
| Sarcoidosis |
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