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Ans. A. Tinea schoenleiniiFavous usually affect scalp, but occurring occasionally on any part of the skin and even at times on mucous membrane, caused by Tinea schoenleinii.

Skin

Fungal Infection

Causative agent of Favus is: A. Tinea schoenleinii B. Tinea rubrum C. Malassezia furfur D. Epidermophyton floccosum

Tinea schoenleinii

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Zona pellucida is thick membranous covering made up of glycoprotein, the microvilli of oocyte and follicular cells project into zona pellucida for nutrition. it prevent polyspermy and implantation. Blastocyst forms at 4th day and by the end of 5th day, zona pellucida disappears and implantation takes place at 6th -7th day after feilization.

Anatomy

Development period- week 1,2,3,4

Zona Pellucida disappears by:- A. Before ferilisation B. During feilization C. 5th day after feilization D. 7th day after feilization

5th day after feilization

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The synthesis and storage of thyroid hormones occurs between the follicular cells and the colloid. The storage form of thyroid hormone is thyroglobulin. Thyroglobulin is a large glycoprotein synthesized in the follicular cells and has a molecular weight of around 650 000 with about 140 tyrosine residues, depending on the form of thyroglobulin. Approximately one quaer of these residues is iodinated at the apical-colloid interface. Once iodinated, thyroglobulin is taken up into the colloid of the follicle where, still incorporated in the protein, a coupling reaction between pairs of iodinated tyrosine molecules occurs. The coupling of two tyrosine residues each iodinated at two positions (di-iodotyrosine, DIT) produces tetra-iodothyronine or thyroxine (T4 ) whilst the combination of DIT with mono-iodotyrosine (MIT) produces tri-iodothyronine (T3 ). Such coupling can occur within a single molecule of thyroglobulin or between dimerized molecules of the protein. This coupling is catalyzed by TPO. Thyroid hormones are stored in this state and are only released when the thyroglobulin molecule is taken back up into the follicular cells. Stimulated by TSH, thyroglobulin droplets are captured by the follicular cells by a process of pinocytosis. Fusion of the droplets with lysosomes results in hydrolysis of the thyroglobulin molecules and release of T3 and T4. Reference : page 2285 Harrison's Principles of Internal Medicine 19th edition

Medicine

Endocrinology

Storage form of thyroid hormone- A. Tri-iodo tyrosine B. Tri - iodo thyronine C. Thyroglobulin D. Di-iodo tyrosine

Thyroglobulin

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Infantile and Iuvenile forms are associated with congenital Hepatic fibrosis.

Pathology

Congenital hepatic fibrosis is a characteristic feature of A. Multicystic renal dysplasia B. ARPKD C. Familial juvenile nephronophthisis D. Medullary sponge kidney

ARPKD

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D i.e. Mid diastole- During cardiac imaging (such as MRI, CT, electron beam tomography), mid diastolic phase (or diastasis) of cardiac cycle is usually (but not always) associated with lowest (minimum) mean motion of hea.Q- Optimum phase (i.e. with minimum cardiac motion) for cardiac and coronary vessel imaging is mid-diastole (diastasis) at low or intermediate hea rates; but is variable and may occur in late systole at high hea rates.Cardiac Motion and Imaging- Radiological imaging by CT and MRI can detect coronary aery disease in early stage. However, the use of these tools to cardiac imaging is severely limited because of motion aifacts produced by constantly in motion hea completing an entire cycle of contraction and relaxation in about 1 second.- So radiological cardiac imaging requires a 'window' of minimum cardiac motion to reduce motion aifacts and achieve meaningful images. The phase of minimum cardiac motion is although variable and depends on several factors especially hea rate and the chamber (i.e. right /left - atrium or ventricle) to be specifically imaged. However, the phase of minimum cardiac motion (= optimum phase for cardiac & coronary vessel imaging).

Physiology

During cardiac imaging the phase of minimum motion of hea is: A. Late systole B. Mid systole C. Late diastole D. Mid diastole

Mid diastole

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Ans. A: Panel discussion In panel discussion there is a chairman/moderator and 4-8 speakers. Each speaker prepares separately, the other speakers hear one another for the time at the session itself. Panel discussions, however, differ from team presentations. Their purpose is different. In a team presentation, the group presents agreed-upon views; in a panel discussion, the purpose is to present different views. Also in a team presentations, usually speakers stand as they speak; in panel discussions, usually speakers sit the whole time. Technically, a panel discussion consists of questions and answers only, and a symposium consists of a series of prepared speeches, followed by questions and answers. The chairman/ moderator must monitor time and manage questions. If each paicipant is making a speech for a set period of time, he should signal the speakers at the one minute to go mark and at the stop mark. If a speakers goes more than one or two minute he can stop them to gave the equal rights to each speakers. The chairman/ moderator must be a biased person; he is neither in our nor against the topic. At the end the compare should summarize the discussion and thank the panel members.

Social & Preventive Medicine

A group of expes discussing a topic in front of the audience without any specific order. This mode of communication is known as: September 2008 A. Panel discussion B. Group discussion C. Team presentation D. Symposium

Panel discussion

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A i.e. Increase in glucagons/ insulin ratio, increased C- AMP & increased blood sugar.In diabetes little glucose is oxidized as fuel, except by the brain. The rest of tissues burn a large amount of fat, paicularly the liver where the amount of acetyl COA formed from fatty acids exceeds the capacity of the tricarboxylic acid cycle to oxidize it. The excess acetyl COA is conveed to ketone bodies l/t ketonemia, ketonuria & ketoacidosisDiabetics not only have a defect in the tissue utilization of glucose but also appears to be metabolically poised to produce maximum amount of glucose from amino acids (gluconeogenesis) and to prevent glucose from being utilized to to form fat. (fat synthesis)Insulin is decreased & glucagons is increased 1/t Dglucagon/ insulin ratioQ. Glucagon acts elevation in C- AMPQ

Biochemistry

Starvation and diabetes mellitus can lead on to ketoacidosis which of the following features is in our of ketoacidosis due to diabetes mellitus. A. Increase in glucagon/insulin ratio, increased CAMP and increased blood glucose B. Decreased insulin, increased free fatty acid which is equivalent to blood glucose C. Decreased insulin, increased free fatty acid which is not equivalent to blood glucose D. Elevated insulin and free fatty acid, equivalent to blood glucose

Increase in glucagon/insulin ratio, increased CAMP and increased blood glucose

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Dysplasia is reversible Anaplasia is irreversible

Pathology

Reversible loss of polarity with abnormality in size and shape of cells is known as? A. Metaplasia B. Anaplasia C. Dysplasia D. Hyperplasia

Dysplasia

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Vagina has inhabitant bacteria called as Doderleins bacteria which is a lactobaccilli, and converts the glycogen present in vaginal epithelium into lactic acid. Thus, pH of the vagina is acidic The pH of the vagina in an adult woman is 4 -5.5 with an average of 4.5. The pH of vagina varies with age — for further details see preceding text.

Gynaecology & Obstetrics

The protective bacterium in the normal vagina is: A. Peptostreptococcus B. Lactobacillus C. Gardenella vaginalis D. E. coli

Lactobacillus

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Ans. (b) Light chain globulins(Ref: R 9th/pg 598-602)Excretion of light chains in the urine has been referred to as Bence Jones proteinuria.Light chains includes k and l (kappa and lambda)

Pathology

Misc. (W.B.C)

Bence jones proteinuria is derived from? A. Alpha globulins B. Light chain globulins C. Gamma globulins D. Delta globulins

Light chain globulins

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Pradhan mantra swasthya suraksha yojana was approved in 2006 with the objective of correcting imbalances in availability of affordable teiary level healthcare in the country. Ref: National Health Programmes in India, J.Kishore, 10th edition pg: 84

Social & Preventive Medicine

Pradhan mantra swasthya suraksha yojana was launched in: A. 2003 B. 2006 C. 2007 D. 2008

2006

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Ans. Collection of sero-sanguineous fluid in the scalp

Forensic Medicine

Caput succedaneum in a newborn is: Karnataka 07 A. Collection of blood under the pericranium B. Collection of sero-sanguineous fluid in the scalp C. Edema of the scalp due to grip of the forceps D. Varicose veins in the scalp

Collection of sero-sanguineous fluid in the scalp

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Circulating levels of leukocytes and their precursors may occasionally reach very high levels (>50,000 WBC/mL). These extreme elevations are sometimes called leukemoid reactions because they are similar to the white cell counts observed in leukemia, from which they must be distinguished. The leukocytosis occurs initially because of accelerated release of granulocytes from the bone marrow (caused by cytokines, including TNF and IL-1) There is a rise in the number of both mature and immature neutrophils in the blood, referred to as a shift to the left. In contrast to bacterial infections, viral infections (including infectious mononucleosis) are characterized by lymphocytosis Parasitic infestations and ceain allergic reactions cause eosinophilia, an increase in the number of circulating eosinophils. Leukopenia is defined as an absolute decrease in the circulating WBC count.

Pathology

Basic Concepts and Vascular changes of Acute Inflammation

A 40-year-old man presents with 5 days of productive cough and fever. Pseudomonas aeruginosa is isolated from a pulmonary abscess. CBC shows an acute effect characterized by marked leukocytosis (50,000/mL) and the differential count reveals shift to left in granulocytes. Which of the following terms best describes these hematologic findings? A. Leukemoid reaction B. Leukopenia C. Myeloid metaplasia D. Neutrophilia

Leukemoid reaction

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C. albicans and Candida tropicalis are opportunistic fungi, and as part of the normal flora are not transmitted by inhalation. C. immitis is a dimorphic fungus and inhalation of the spores transmits the infection. Sprothrix is also a dimorphic fungus but its portal of entry is cutaneous. Trychophyton is a dermatophyte and one of the causes of athlete's foot.

Microbiology

Mycology

Inhalation of fungal spores can cause primary lung infections. Of the following organisms, which one is most likely to be associated with this mode of transmission? A. C. immitis B. S. schenckii C. C. albicans D. T. tonsurans

C. immitis

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Fleeting skin lesions are often presents in patients with hepatitis B. Ref: Schiff's diseases of liver, Edition -11, Page - 3.

Medicine

Fleeting skin lesions are often present in patients with: A. Viral hepatitis B B. Acute cholangitis C. Viral hepatitis A D. Carcinoma head of pancreas

Viral hepatitis B

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The angiotensin-converting enzyme normally helps in conversion of angiotensin I to angiotensin II, which acts as a vasoconstrictor in case of hypovolemia. In addition to that, ACE also helps in the breakdown of bradykinin. When ACE inhibitors (captopril) are given, it inhibits ACE and in addition inhibits the breakdown of bradykinin also, which leads to accumulation of bradykinin level in the body. This increased level of bradykinin presents with a Dry cough, rashes, urticaria and angioedema.

Pharmacology

A Patient who is on antihypertensive drug develops a dry cough. Which of the following drug might be responsible for the condition: A. Diuretics B. ACE inhibitors C. Calcium channel blockers D. Beta blockers

ACE inhibitors

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Mad cow disease or bovine spongiform encephalopathy i.e. Caused by “prions” “PRIONS” are unconventional transmissible agents, proteinaceous in nature.” Diseases caused by prions are Kuru Creutzfeldt Jakob Disease. Gerstmann Straussler Scheinker Syndrome Fatal Familial Insomnia. Scrapie Of Sheep Transmissible Encephalopathy of Mink. Bovine Spongiform Encephalopathy (Mad Cow Disease)

Microbiology

Mad Cow disease (Spongiform disease) occurs due to A. C J virus B. Arena Virus C. Kuru Virus D. Parvo Virus

C J virus

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Diuretics (thiazide, furosemide) by causing Na+ loss promote proximal tubular reabsorption of Na+ as well as Li+ --plasma levels of lithium rise. ref : KD Tripati 8th ed.

Pharmacology

Central Nervous system

A patient on lithium therapy was found to be hypeensive also. Which of the following antihypeensive drugs is contraindicated in a patient on lithium therapy in order to prevent toxicity? A. Clonidine B. Beta blockers C. Calcium channel blockers D. Diuretics

Diuretics

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Edema is a feature of Kwashiorkor, not seen in marasmus. Kwashiorkor Marasmus Edema Present absent appetite poor Voracious appetite CNS involvement apathy Active child Hepatomegaly seen Not seen Skin and hair changes More common Less common

Pediatrics

FMGE 2019

In marasmus, which of the following is not seen? A. Edema B. Voracious appetite C. Hepatomegaly not seen D. Child is active

Edema

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Ans. is 'b' i.e., Posterior Essential otolaryngology 2"d/e p. 1139] Disease affects the posterior third of larynx more commonly than anterior pa. The pas affected in descending order of frequency are :- i) Interarytenoid fold, ii) Ventricular band, iii) Vocal cords, iv) Epiglottis.

ENT

Most common pa of larynx involved in TB ? A. Anterior B. Posterior C. Middle D. Anywhere

Posterior

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Pyogenic granuloma is a misnomer as there is no granuloma. It is a benign vascular lesion that bleeds easily on trauma. It is associated with Inflammatory Bowel disease (Ulcerative colitis > Crohn's disease).

Dental

Pyogenic granuloma is associated with A. Gastric adenocarcinoma B. Pseudomonas infection C. Ulcerative colitis D. Intestinal tuberculosis

Ulcerative colitis

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As Atracurium and Cis-atracurium are inactivated by Hoffman's elimination, they are the muscle relaxants of choice for both liver and renal failure.

Anaesthesia

Muscle relaxants

Muscle relaxant used in renal failure - A. Ketamine B. Atracurium C. Pancuronium D. Fentanyl

Atracurium

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Ans. A: Glandular Glandular hypospadias is common and does not usually require treatment Hypospadias: The external meatus opens on the underside of the penis or the perineum, and the inferior aspect of the prepuce is poorly developed (hooded prepuce) Meatal stenosis occurs Bifid scrotum 6 - 10 months of age is the best time for surgery

Surgery

Most common type of hypospadias is: September 2011 A. Glandular B. Penile C. Coronal D. Perineal

Glandular

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Suprarenal glands drain into para-aortic nodes.

Anatomy

Lymphatics of suprarenal gland drain into lymph nodes - A. Internal iliac B. Para-aortic C. Superficial inguinal D. Coeliac

Para-aortic

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First web space of foot is supplied by deep peroneal nerve (L5)

Anatomy

Pain felt between great toe and 2nd toe is due to involvement of which nerve root - A. L5 B. S2 C. S1 D. S3

L5

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Ans. d (L-Phenylalanine) (Ref. Biochemistry by Vasudevan, 4th ed., 57; 5th ed., 55-56)ALKALINE PHOSPHATASE# The pH optimum for the enzyme reaction is between 9 and 10.# It is activated by magnesium and manganese.# Zinc is a constituent ion of ALR# It is produced by osteoblasts of bone, and is associated with the calcification process.# It is localised in cell membranes (ecto-enzyme), and is associated with transport mechanisms in liver, kidney and intestinal mucosa.# For estimation, sodium phenyl phosphate is used as the substrate, pH is adjusted to 9.9, serum sample is added as the source of ALP and incubated.# Normal serum value of ALP is 40-125 U/L.# Raised Levels:Mild increasepregnancy.Moderate (2-3 times) increaseIn infective hepatitis, alcoholic hepatitis or hepatocellular carcinoma, Hodgkin's lymphoma, congestive cardiac failure or ulcerative colitis.Very high levels of ALP (10-12 times)In extrahepatic obstruction (obstructive jaundice) or cholestasis.Drastically high levels of ALP (10-25 times)Bone diseases where osteoblastic activity is enhanced such as Paget's disease, rickets, osteomalacia, osteoblastoma, metastatic carcinoma of bone, and hyperparathyroidism.Iso-enzymes of Alkaline Phosphatase# Alpha-1 ALP moves in alpha-1 position, it is synthesized by epithelial cells of biliary canaliculi. It is about 10% of total activity and is increased in obstructive jaundice and to some extent in metastatic carcinoma of liver.# Alpha-2 heat labile ALP is stable at 56degC; but loses its activity when kept at 65degC for 30 minutes. It is produced by hepatic cells. Therefore, exaggerated alpha-2 band suggests hepatitis. This liver iso-enzyme forms about 25% of total ALP.# Alpha-2 heat stable ALP will not be destroyed at 65degC, but is inhibited by phenylalanine. It is of placental origin, which is found in blood in normal pregnancy. An iso-enzyme closely resembling the placental form is characteristically seen in circulation in about 15% cases of carcinoma of lung, liver and gut and named as Regan iso-enzyme (after the first patient in whom it was detected) or carcinoplacental iso-enzyme. Chronic heavy smoking also increases Regan iso-enzyme level in blood. Normal level is only 1% of the total ALP.# Pre-beta ALP is of bone origin and elevated levels are seen in bone diseases. This is most heat labile (destroyed at 56degC, 10 min). Wheat germ lectin will precipitate bone isoenzyme. This constitutes about 50% of normal ALP activity.# Gamma-ALP is inhibited by phenylalanine and originates from intestinal cells. It is increased in ulcerative colitis. About 10% of plasma ALP are of intestinal variety.# Leucocyte alkaline phosphatase (LAP) is significantly decreased in chronic myeloid leukemia. It is increased in lymphomas and leukemoid reactions.ALANINE AMINO TRANSFERASE (ALT)# It is also called as serum glutamate pyruvate transaminase (SGPT).# The enzyme needs pyridoxal phosphate as co-enzyme.# Normal serum level of AL T for male is 13^4-0 U/L and for female is 10-28 U/L.# Very high values (100 to 1000 U/L) are seen in acute hepatitis, either toxic or viral in origin.# Both ALT and AST levels are increased in liver disease, but ALT > AST.# Moderate increase (25 to 100 U/L) may be seen in chronic liver diseases such as cirrhosis, Hepatoma.# A sudden fall in ALT level in cases of hepatitis is very bad prognostic sign.NUCLEOTIDE PHOSPHATASE# It is also known as 5' nucleotidase.# It is a marker enzyme for plasma membranes and is seen as an ecto-enzyme (enzyme present on the cell membrane).# Serum samples contain both ALP and NTP.# These are distinguished by Nickel ions which inhibit NTP but not ALP.- Normal NTP level in serum is 2-10 IU/L. It is moderately increased in hepatitis and highly elevated in biliary obstruction.# Unlike ALP, the level is unrelated with osteoblastic activity and therefore unaffected by bone disease.GAMMA GLUTAMYL TRANSFERASE (GGT)# The old name was gamma glutamyl transpeptidase.# It can transfer gamma glutamyl residues to substrate.# In the body it is used in the synthesis of glutathione.# It is seen in liver, kidney, pancreas, intestinal cells and prostate gland.

Biochemistry

Enzymes

Which of the following is non-competitive inhibitor of intestinal alkaline phosphatase? A. L-Alanine B. L-Tyrosine C. L-Tryptophan D. L-Phenylalanine

L-Phenylalanine

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Ans: D (Thrombophlebitis of superficial veins of breast) Ref: Bailey dt Love's Short Practice of Surgery, 25th Edition,833-4Explanation:Mondor's diseaseThrombophlebitis of the superficial veins of the breast and anterior chest wallCan also involve armCauseIdiopathicClinical featuresThrombosed subcutaneous vessel , usually attached to the skin - pathognomonic feature.When the skin over the breast is stretched by raising the arm. a narrow, shallow subcutaneous groove alongside the cord becomes apparent.Differential DiagnosesLymphatic permeation from occult carcinomaManagementConservativeRestriction of arm movements is advised.Resolv es within few months without any complicationAssociation with breast carcinoma is Coincidental

Surgery

Miscellaneous (Breast)

Mondors disease is: A. Migratory thrombophlebitis seen in pancreatic Ca B. Thromboangitis obliterans C. Thrombosis of deep veins of the leg D. Thrombophlebitis of superficial veins of breast

Thrombophlebitis of superficial veins of breast

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(A) Continuous positive pressure ventilation# Sleep apnea: Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep.> The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal (a 3-second or greater shift in EEG frequency, measured at C3, C4, O1, or O2), a blood oxygen desaturation of 3-4deg/: or greater, or both arousal and desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a "Sleep Study".> Treatment: The most common treatment and arguably the most consistently effective treatment for sleep apnea is the use of a continuous positive airway pressure (CPAP) device, which 'splints' the patient's airway open during sleep by means of a flow of pressurized air into the throat. However the CPAP machine only assists inhaling whereas a BiPAP machine assists with both inhaling and exhaling, and is used in more severe cases. Medications like Acetazolamide lower blood pH and encourage respiration. Low doses of oxygen are also used as a treatment for hypoxia but are discouraged due to side effects.

Psychiatry

Miscellaneous

Treatment of Choice in Sleep Apnea Syndrome: A. Continuous positive pressure ventilation. B. Sedatives. C. Antidepressants. D. Antiepileptics

Continuous positive pressure ventilation.

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.LOWER GI BLEED- * Bleeding in the GIT below the level of the ligament of Treitz. * Normal faecal blood loss is 1.2 ml/day. A loss more than 10 ml/day is significant.* Angiodysplasia. * Diveicular disease - commonest cause in Western countries. * Tumours of colon or small bowel. * Anorectal diseases--Haemorrhoids, fissure in ano. * Ulcerative colitis * Crohn's disease. * Colorectal polyps; rectal carcinomas. * Intussusception ref:SRB&;s manual of surgery,ed 3,pg no 925.

Surgery

G.I.T

Rectal polyp most commonly presents as A. Obstruction B. Bleeding C. Infection D. Changes into malignancy

Bleeding

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Ans. is d, i.e. Selective progesterone receptor modulatorRef: Harrison's Principles of Internal medicine 19th/ed, p2391Ulipristal acetate (trade name Ella One in the European Union, Ella in the US for contraception, and Esmya for uterine fibroid) is a selective progesterone receptor modulator (SPRM).PharmacodynamicsAs an SPRM, ulipristal acetate has partial agonistic as well as antagonistic effects on the progesterone receptor. It also binds to the glucocorticoid receptor, but is only a weak anti-glucocorticoid relative to mifepristone, and has no relevant affinity to the estrogen, androgen and mineralocorticoid receptors. Phase II clinical trials suggest that the mechanism might consist of blocking or delaying ovulation and of delaying the maturation of the endometrium.Medical Uses* Emergency contraception: For emergency contraception, a 30mg tablet is used within 120 hours (5 days) after an unprotected intercourse or contraceptive failure. It has been shown to prevent about 60% of expected, pregnancies, and prevents more pregnancies than emergency contraception with levonorgestrel.* Treatment of uterine fibroids: Ulipristal acetate is used for preoperative treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age in a daily dose of a 5mg tablet. Treatment of uterine fibroids with ulipristal acetate for 13 weeks effectively controlled excessive bleeding due to uterine fibroids and reduced the size of the fibroids.InteractionsUlipristal acetate is metabolized by CYP3A4 in vitro. Ulipristal acetate is likely to interact with substrates of CYP3A4, like rifampicin, phenytoin, St John's wort, carbamazepine or ritonavir. Therefore, concomitant use with these agents is not recommended. It might also interact with hormonal contraceptives and progestogens such as levonorgestrel and other substrates of the progesterone receptor, as well as with glucocorticoids.Adverse EffectsCommon side effects include abdominal pain and temporary menstrual irregularity or disruption. Headache and nausea were observed under long-term administration (12 weeks), but not after a single dose.ContraindicationsUlipristal acetate should not be taken by women with severe liver diseases because of its CYP-mediated metabolism. It has not been studied in women under the age of 18.Pregnancy: Unlike levonorgestrel, and like mifepristone, ulipristal acetate is embryotoxic in animal studies. Before taking the drug, a pregnancy must be excluded.

Gynaecology & Obstetrics

Physiology & Histology

Ulipristal acetate is a/an: A. GnRH agonist B. Androgen antagonist C. Selective estrogen receptor modulator D. Selective progesterone receptor modulator

Selective progesterone receptor modulator

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Hepatitis C This is caused by an RNA flavivirus. Acute symptomatic infection with hepatitis C is rare. Most individuals are unaware of when they became infected and are identified only when they develop chronic liver disease. Eighty per cent of individuals exposed to the virus become chronically infected and late spontaneous viral clearance is rare. There is no active or passive protection against hepatitis C virus (HCV). Hepatitis C infection is usually identified in asymptomatic individuals screened because they have risk factors for infection, such as previous injecting drug use , or have incidentally been found to have abnormal liver blood tests. Although most people remain asymptomatic until progression to cirrhosis occurs, fatigue can complicate chronic infection and is unrelated to the degree of liver damage. Hepatitis C is the most common cause of what used to be known as 'non-A, non-B hepatitis'. If hepatitis C infection is left untreated, progression from chronic hepatitis to cirrhosis occurs over 20-40 years. Risk factors for progression include male gender, immunosuppression (such as co-infection with HIV), prothrombotic states and heavy alcohol misuse. Not everyone with hepatitis C infection will necessarily develop cirrhosis but approximately 20% do so within 20 years. Once cirrhosis has developed, the 5- and 10-year survival rates are 95% and 81%, respectively. One-quaer of people with cirrhosis will develop complications within 10 years and, once complications such as ascites develop, the 5-year survival is around 50%. Once cirrhosis is present, 2-5% per year will develop primary hepatocellular carcinoma. Ref Davidson edition23rd pg877

Medicine

G.I.T

A patient presented with ahritis and purpura. Laboratory examination showed monoclonal and polyclonal cryoglobulins. Histopathology showed deposits of cryoglobulins around the vessels. The patient should be tested for which of the following ? A. HBV B. HCV C. EBV D. Parvovious

HCV

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Marfan Syndrome Is Caused by Mutations in the Gene for Fibrillin-1. It is inherited as an autosomal dominant trait. It affects the eyes (eg, causing dislocation of the lens, known as ectopia lentis), the skeletal system (most patients are tall and exhibit long digits and hyperextensibility of the joints), and the cardiovascular system (eg, causing weakness of the aoic media, leading to dilation of the ascending aoa). Abraham Lincoln may have had this condition. Most cases are caused by mutations in the gene (on chromosome 15) for fibrillin-1.Mutations in the fibrillin-1 gene have also been identified as the cause of acromicric dysplasia and geleophysic dysplasia, which are characterized by sho stature, skin thickening, and stiff joints. Congenital contractural arachnodactyly is associated with a mutation in the gene for fibrillin-2.Ref: Harper&;s Biochemistry; 30th edition; Chapter 50; The Extracellular Matrix

Biochemistry

miscellaneous

Marfans Syndrome affecting eyes, skeletal system, and the cardiovascular system is caued by the mutation in the gene A. Fibrillin 1 B. Fibrillin 2 C. Fibulin D. Elastin

Fibrillin 1

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Ans. is 'c' i.e., DNA primase ProteinFunctionDNA polymerasesDeoxynucleotide polymerizationHelicasesProcessive unwinding of DNATopoisomerasesRelieve torsional strain that results from helicase-induced unwindingDNA primaseInitiates synthesis of RNA primersSingle-strand binding proteinsPrevent premature reannealling of dsDNADNA ligaseSeals the single strand nick between the nascent chain and Okazaki fragments on lagging strand

Biochemistry

Transcription

RNA primer is synthesized by - A. Topoisomerase B. Helicase C. DNA primase D. DNA ligase

DNA primase

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The Silverman Anderson retraction score of respiratory distress syndrome (RDS): Upper chest Lower chest Xiphoid retraction Nares dilatation Expiratory grunt Grade 0 Synchronised No retraction None None None Grade 1 Lag on inspiration Just visible Just visible Minimal By stethoscope Grade 2 See-saw Marked Marked Marked Without stethoscope Mild RDS: Score 1-3 Moderate RDS: 4-7 Severe RDS: 7-10 Ref: Advances in Pediatrics by Dutta By Jaypee Brothers, Medical Publishers, 2007, Page 89.

Pediatrics

A preterm baby is born with synchronised upper chest movement, minimal nasal flare, expiratory grunting heard by the stethoscope, but has no chest or xiphoid retractions. The Silverman score is: A. 1 B. 2 C. 3 D. 4

2

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on  A child with severe dehydration will have at least two of the following four signs: sensorium is abnormally sleepy or lethargic, sunken eyes, drinking poorly or not at all, and a very slow skin pinch. A child with some signs of dehydraon will have two of the following: restlessness or irritability, sunken eyes, drinking eagerly or slow skin pinch. A child with either one or none of these signs is classified as having no signs of death

Pediatrics

3-year-old child comes in ER with Hv'o vomiting, loose watery motion for 3 days, on examination, the child was drowsy, sunken eye. Hypothermia and skin pinch take time to revert back, diagnosis A. No dehydration B. Mild dehydration C. Some dehydration D. Severe dehydration

Severe dehydration

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Fibroadenoma - it occurs in 2nd to 3rd decade of life Galactocele - it occurs in 3rd to 4th decade of life. Breast cancer - there is no associated family history and lump has developed suddenly hence breast cancer is ruled out. Breast cyst - it occurs in 5th to 6th decade of life. Examination revealed fluctuant lesion which point towards breast cyst. - Often multiple, may be bilateral & can mimic malignancy. Typically present suddenly - Diagnosis can be confirmed by aspiration and / or ultrasound.

Surgery

Breast

A 50 years old lady presented with lump in the left breast, which has developed suddenly in weeks. Perimenstrual symptoms are present. No associated family history. On examination, the lump is well circumscribed, fluctuant, 1.5 cm oval in shape. Most likely diagnosis: A. Breast cyst B. Galactocele C. Fibroadenoma D. Breast cancer

Breast cyst

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it can cross blood brain barrier and cause cns infection REF:ANANTHANARAYANAN TEXT BOOK OF MICROBIOLOGY 9EDITION PGNO.576

Microbiology

Virology

HIV can - A. Cross blood brain barrier B. RNA virus C. Inhibited by 0.3% H2O2 D. Thermostable

Cross blood brain barrier

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Otitis externa haemorrhagica It is characterized by for mation of haemorrhagic bullae on the tympanic membrane and deep meatus. It is probably viral in origin and may be seen in influenza epidemics. The condition causes severe pain in the ear and blood-stained discharge when the bullae rupture. Treatment: with analgesics is directed to give relief from pain. Antibiotics are given for secondary infection of the ear canal, or middle ear if the bulla has ruptured into the middle ear. Ref:- Dhingra; pg num:-52

ENT

Ear

Heamorrhagic external otitis media is caused by A. Influenza B. Proteus C. Streptococcus D. Staphylococcus

Influenza

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In pneumoconiosis, the most dangerous paicles range from 1-5 micron in diameter, because they may reach the terminal small airway and settle in there lining notes The solubility and cytotoxicity of paicles ,modify the nature of pulmonary response

Anatomy

Respiratory system

Most dangerous paicles causing pneumoconiosis are of size A. A. 1-5 micron B. B. <1 micron C. C. 5-15 micron D. D. 10-20 micron

A. 1-5 micron

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Iron deficit = Bodyweight(kg) x 2.3 x (15 - Hb) + 1000       = 60 x 2.3 x (15 - 5) + 1000       = 2380 (close to 2500)

Medicine

Calculate the deficit for a 60 kg person,with Hb - 5 g/dl add 1000 mg for iron stores. A. 1500 B. 2500 C. 3500 D. 4000

2500

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Multiple myeloma is characterized by tubular proteinuria. The Bence Jones proteins induce tubular damage Increased beta-2-microglobulin levels in urine is an prognostic indicator of Multiple myeloma Diabetes Mellitus and amyloidosis lead to damage to basement membrane of the kidney leading to glomerular proteinuria in form of albuminuria Nil Lesion is also called as minimal change disease and presents as glomerular cause of proteinuria leading to nephrotic presentation . Multiple Myeloma: SPEP will demonstrate a sharp peak ("church spire" orM band) in the gamma globulin region as shown below:

Medicine

Nephrology

Which of the following is not a cause of glomerular proteinuria? A. Diabetes Mellitus B. Amyloidosis C. Multiple myeloma D. Nil Lesion

Multiple myeloma

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Ans. is 'a' i.e., Rosiglitazone o Oral hypoglycemic drugs may be divided into two groups. 1. Group 1 These drugs reduce plasma glucose by stimulating insulin production, therefore called insulin secretogogues. Hypoglycemia is a well known side effect. Examples are: i) Sulfonylureas: first generation (chlorpropamide, tobutamide); second generation (Glimipiride, glyburide, glipizide, gliclazide). ii) Megalitinnide/D-phenylalanine analogues: Nateglinide, Rapaglinide. 2. Group 2 These drugs reduce blood glucose without stimulating insulin production, therefore are insulin nonsecretogogues. These durgs do not cuase hypoglycemia when used alone and can cause hypoglycemia, only when used with other oral hypoglycemics. Examples are: i) Biguanides: Metformin, Phenformin ii) Thiazolidinediones: Rosiglitazone, Pioglitazone, Troglitazone. iii) alpha-glucosidase inhibitors: Acarbose, miglital.

Pharmacology

Which of the following does not cause Insulin release- A. Rosiglitazone B. Nateglinide C. Glimipiride D. Tobutamide

Rosiglitazone

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In MEN 1 : * Gastrinoma (>50%) * Insulinoma (10-30%) * Glucagonoma (<3%) * Somatotrophinoma (25%) Reference : page 2336 Harrison's Principles of Internal Medicine 19th edition

Medicine

Endocrinology

Which of the following endocrine tumors is most commonly seen in MEN I ? A. Insulinoma B. Gastrinoma C. Glucagonoma D. Somatotrophinoma

Gastrinoma

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Answer is C (Bone scan) Bone scans are least useful for diagnosis of Multiple Myeloma. Cytokines secreted by myeloma cells suppress osteoblastic activity therefore typically no increased uptake is observed. In multiple myeloma the osteohlastic response to bone destruction is negligible. The bone scan therefore is often normal or may show areas of decreased uptake (photopenia).It has been found to be less useful in diagnosis than plain radiography. Ig protein /24 hour is a major ciriteria for diagnosis " align="left" height="133" width="100"> Note : Serum M component is most commonly IgG Q (IgG (53%), IgA (25%), IgD (I%) Bence Jones proteins are light chain protein only Q.

Medicine

The following is the least useful investigation in multiple myeloma : A. ESR B. X-Ray C. Bone scan D. Bone marrow biopsy

Bone scan

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Low CD4 count correlated with risk of PCP (p < 0.0001); 79% had CD4 counts less than 100/microl and 95% had CD4 counts less than 200/microl. Bacterial pneumonia has been linked to several HIV-related factors, including CD4 counts, having an uncontrolled viral load, and not being on antiretroviral therapy. HIV-positive people with a weak immune system, paicularly a CD4 count below 200 cells/mm3, are at greatest risk. Ref Harrison20th edition pg 1107

Medicine

Infection

prophylaxis for Pneumocystis carinii is indicated in HIV positive patents When CD4 count is- A. <300 cells/mm3 B. < 200 cells / mm3 C. < 100 cells/mm3 D. < 50 cells / mm3

< 200 cells / mm3

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Ans. is 'a' i.e., Thenar space o Thenar space communicates w'ith the index finger while the mid palmar space communicates with the middle, ring and little fingers.o Thus infection of index finger leads to thenar space infection while the infection of middle, ring or little finger leads to mid palmar space infection.FeaturesMidpalmar spaceThenar space1. ShapeTriangular.Triangular2. SituationUnder the inner half of the hollow of the palm.Under the outer half of the hollow of the3. ExtentProximalDistalDistal margin of the flexor retinaculum.Distal palmar crease.Distal margin of the flexor retinaculum.Proximal transverse palmar crease.4, CommunicationsProximalDistalForearm space.Fascial sheaths of the 3rd and 4th lumbricals; occasionally 2nd.Fascial sheath of th first lumbrical, occasionally 2nd.5. BoundariesAnteriorPosteriori) Flexor tendons of 3rd, 4th. and 5th fingersii) 2nd, 3rd and 4th lumbricalsiii) Palmar aponeurosisFascia covering interossei and metacarpals.Intermediate palmar septumi) Short muscles of thumb.ii) Flexor tendons of the index finger.iii) First Lumbricalsiv) Palmar aponeurosis.Transverse head of adductor pollicis.Laterali) Tendon of flexor pollicis longus with radial bursa.ii) Lateral palmar septum.Intermediate palmar septum.MedialMedial palmar septum6. DrainageIncision in either the 3rd or 4th web space.Incision in the first web. posteriorly.

Orthopaedics

Management In Orthopedics

index finger infection spreads to - A. Thenar space B. Mid palmar space C. Hypothenar space D. Flexion space

Thenar space

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Ans. A. 4 monthsFINE MOTOR MILESTONES: AgeMilestone4 monthsBidextrous reach6 monthsUnidextrous reach9 monthsImmature pincer grasp12monthsMature pincer grasp15monthsImitates scribbling, tower of 2 blocks18monthsScribbles, tower of 3 blocks2 yearsTower of 6 blocks, veical & circular stroke3 yearsTower of 9 blocks, copies circle4 yearsCopies cross, bridge with blocks5 yearsCopies triangle

Pediatrics

Bidextrous grip is seen at what age? A. 4 months B. 5 months C. 6 months D. 7 months

4 months

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PTSD is characterised by recurrent and intrusive recollections of the stressful event, either in flashbacks (images, thoughts, or perceptions) and/or in dreams. There is an associated sense of re-experiencing of the stressful event. There is marked avoidance of the events or situations that arouse recollections of the stressful event, along with marked symptoms of anxiety and increased arousal. The other impoant clinical features of PTSD include paial amnesia for some aspects of the stressful event, feeling of numbness, and anhedonia (inability to experience pleasure). Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 112

Psychiatry

Anxiety disorders stress disorders and grief

A victim of Tsunami has difficulty in overcoming the experience. She still recollects the happening in dreams and thoughts. The most likely diagnosis is A. Post traumatic stress disorder B. Conversion disorder C. Panic disorder D. Phobia

Post traumatic stress disorder

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Ref: Clinical ophthalmology 5th/e p.670 *Cavernous hemangioma is the most common benign, intraconal tumor in adults. *Hemangiopericytoma is also retrobulbar intraconal lesion found in adults but is a rare tumor. Moreover owing to its tendency to invade the adjacent tissues, its margins are less distinct than cavernous hemangioma. *Rest 2 options i.e. Dermoid and Capillary hemangioma are primarily extraconal lesions.

Ophthalmology

Diseases of orbit, Lids and lacrimal apparatus

A tumor has the following characteristic retrobulbar location within the muscle cone, well defined capsule, presents with slowly progressive proptosis, easily resectable, occurs most commonly in the 2nd to 4th decade. Most likely diagnosis is - A. Capillary hemangioma B. Cavernous hemangioma C. Lymhangioma D. Hemangiopericytome

Cavernous hemangioma

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All forms of scleroderma are thought to have a strong autoimmune component, and glucocoicoids and azathioprine are used to suppress the inflammatory complications of scleroderma. (Other drugs that can be used in therapy include penicillamine, which inhibits collagen cross-linking, NSAIDS for pain, and ACE inhibitors to protect the kidney if hypeension or renal damage occurs). The anti-centromere antibody is quite specific for CREST syndrome (96% of cases), and is only seen in a minority of patients with diffuse scleroderma (mainly those with Raynaud's phenomenon) and rarely in systemic lupus erythematosus and mixed connective tissue disease.Also know:Anti-DNA topoisomerase I , also called anti-Scl-70 occurs commonly (64-75%) in diffuse scleroderma, but only rarely in CREST syndrome.Anti-double-stranded DNA is fairly specific for systemic lupus erythematosus, although it only occurs in 50-60% of lupus cases.Anti-Golgi antibodies are seen most often in systemic lupus erythematosus and Sjogren syndrome. Ref: Hellmann D.B., Imboden Jr. J.B. (2013). Chapter 20. Musculoskeletal & Immunologic Disorders. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds),CURRENT Medical Diagnosis & Treatment 2013.

Pathology

More than 90% patients of CREST syndrome with the limited cutaneous form of this disorder make which of the following autoantibodies? A. Anti-centromere B. Anti-DNA topoisomerase l C. Anti-double-stranded DNA D. Anti-Golgi

Anti-centromere

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Widely used live attenuated mumps vaccine include the jeryl Lynn, RIT 4385, Leningrad-3, L-Zagreb and Urable strains. The current mumps strain (jeryl Lynn) has the lowest associated incidence of post-vaccine aseptic meningitis.

Social & Preventive Medicine

Epidemiology

Name of mumps vaccine is A. Jeryl Lynn B. Edmonshon Zagreb C. Schwatz D. Moraten

Jeryl Lynn

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(A) Ankylosing spondylitis # ANKYLOSING SPONDYLITIS (AS, from Greek ankylos, crooked; spondylos, vertebrae; -itis, inflammation), previously known as Bekhterev's disease, Bekhterev syndrome, and Marie-Strumpell disease, is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures. AS is a form of spondyloarthritis, a chronic, inflammatory arthritis where immune mechanisms are thought to have a key role. It mainly affects joints in the spine and the sacroiliac joint in the pelvis, and can cause eventual fusion of the spine.> The typical patient is a young male, aged 20-40; however, the condition also presents in females.> The condition is known to be hereditary. Symptoms of the disease first appear, on average, at age 23 years. These first symptoms are typically chronic pain and stiffness in the middle part of the spine or sometimes the entire spine, often with pain referred to one or other buttock or the back of thigh from the sacroiliac joint.

Orthopaedics

Miscellaneous

Sacro-Iliac joint involvement is common in which condition? A. Ankylosing spondylitis B. Rheumatoid arthritis C. Reiter's syndrome D. Osteoarthritis

Ankylosing spondylitis

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GnRH agonist treatment is approved for treating infertility associated with fibroid uterus.

Gynaecology & Obstetrics

Infertility issues with leiomyoma can be addressed by A. Combined oral contraceptive pills B. DMPA C. GnRH agonist D. Ulipristal

GnRH agonist

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Answer: a) ATPase (KS NARAYAN REDDY 33rd ED P-327)In antemortem burns, skin adjacent to the burnt area will show increase in the following enzymes after certain time intervalEnzymeAge of wounds (hour)ATPases1Esterases1Aminopeptidases2Acid phosphatase4Alkaline phosphatase8

Forensic Medicine

Injuries

An adult male sustained accidental burns and died 1 hour later. Which of the following enzymes will be increased in the burn area? A. ATPase B. Aminopeptidase C. Acid phosphatase D. Alkaline phosphatase

ATPase

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Ans. is 'a' i.e., 80-120 mg Recommended daily allowances of folic acid are:- Healthy adults - 200 micro gm.(mcg) Pregnancy - 500 mcg Lactation - 300 mcg Children - 80-120 mcg

Social & Preventive Medicine

Recommended daily dietary requirment of folate (folic acid) in children ? A. 80-120 mg B. 200 mg C. 400 mg D. 600 mg

80-120 mg

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In weil-felix test, host antibodies to various rickettsial species cause agglutination of Proteus bacteria because they cross-react with bacterial cell surface antigens. Reference: Harrison20th edition pg 1011

Medicine

Infection

A four-fold increase in the titre obtained in Weil- Felix reaction is diagnostic of - A. Rickettsial infection B. Fungal infection C. Spirochetal infection D. Viral infection

Rickettsial infection

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ValveDiameter of OrificePulmonary2.5cmAoic2.5cmMitral3cmTricuspid4cmRef: BD Chaurasia; Volume 1; 6th edition; Table 18.1

Anatomy

Thorax

The diameter of Tricuspid orifice is A. 2cm B. 2.5cm C. 3cm D. 4cm

4cm

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As explained earlier PCOD is the most common cause of hirsutism. PCOD most common affects teenage girls (15–25 years). Therefore, In teenage girls most common cause of hirsutism is PCOD.

Gynaecology & Obstetrics

Most common cause of hirsutism in a teenage girl: A. Ovarian disease B. Pheochromocytoma C. Obesity D. Adrenogenital syndrome

Ovarian disease

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ANSWER: (C) Dorsal mesogastriumREF: Langman's Medical Embryology 9th edition 293The gastrosplenic ligament (ligamentum gastrosplenicum or gastrolienal ligament) is part of the greater omentum. Embryonically the gastrosplenic ligament is derived from the dorsal mesogastrium. The gastrosplenic ligament is made of peritoneum that connects the greater curvature of stomach with the hilum of the spleen. Contains: Short gastric vessels and left Gastro-Epiploic vessels

Anatomy

Abdomen & Pelvis

Gastrosplenic ligament is derived from? A. Splenic artery B. Splenic vein C. Dorsal mesogastrium D. Ventral mesogastrium

Dorsal mesogastrium

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Symptoms not caused by either local or metastatic effects of tumors are called paraneoplastic syndromes. Bronchogenic carcinomas are associated with the development of many different types of paraneoplastic syndromes. These syndromes are usually associated with the secretion of ceain substances by the tumor cells. For example, ectopic secretion of ACTH may produce Cushing's syndrome, while ectopic secretion of antidiuretic hormone (syndrome of inappropriate ADH secretion) may produce hyponatremia. Hypocalcemia may result from the production of calcitonin, while hypercalcemia may result from the production of parathyroid hormone-related peptide (PTHrP), which is a normal substance produced locally by many different types of tissue. PTHrP is distinct from parathyroid hormone (PTH) patients with this type of paraneoplastic syndrome have increased calcium levels and decreased PTH levels. As a result of decreased PTH production, all of the parathyroid glands in these patients are atrophic. Other tumors associated with the production of PTHrP include clear cell carcinomas of the kidney, endometrial adenocarcinomas, and transitional carcinomas of the urinary bladder. Lung cancers are also associated with multiple, migratory venous thromboses. This migratory thrombophlebitis is called Trousseau's sign and is more classically associated with carcinoma of the pancreas. Hyperophic osteoahropathy is a syndrome consisting of periosteal new bone formation with or without digital clubbing and joint effusion. It is most commonly found in association with lung carcinoma, but it also occurs with other types of pulmonary disease. Erythrocytosis is associated with increased erythropoietin levels and some tumors, paicularly renal cell carcinomas, hepatocellular carcinomas, and cerebellar hemangioblastomas. It is not paicularly associated with bronchogenic carcinomas. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.

Pathology

miscellaneous

A 59-year-old male is found to have a 3.5-cm mass in the right upper lobe of his lung. A biopsy of this mass is diagnosed as a moderately differentiated squamous cell carcinoma. Workup reveals that no bone metastases are present, but laboratory examination reveals that the man's serum calcium levels are 11.5 mg/dL. This patient's paraneoplastic syndrome is most likely the result of ectopic production of A. Parathyroid hormone B. Calcitonin C. Parathyroid hormone-related peptide D. Calcitonin-related peptide

Parathyroid hormone-related peptide

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Ans. is 'a' i.e., Carcinoma breasto Bloom Richardson Grading and its variants are used to grade breast cancers.

Pathology

Breast

Bloom Richardson grading - A. Carcinoma breast B. Carcinoma lung C. Carcinoma prostate D. Cercinoma ovary

Carcinoma breast

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Major causes of Papillary Necrosis1. Analgesic nephropathy2. Sickle cell nephropathy3. Diabetes with UTI4. Prolonged NSAID use Reference: Harrison&;s Principles of Internal Medicine; 19th edition; Chapter 340; Tubulointerstitial Diseases of the Kidney

Medicine

Kidney

Most common cause of Papillary necrosis is A. Diabetes Mellitus B. Sickle cell anaemia C. Analgesics D. Pyelonephritis

Analgesics

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Chelolymphalic cyst : It is commonest type of mesentric cyst. It has congenital misplaced lymphatic tissue.

Surgery

Most common type of mesentric cyst is A. Entergenous cyst B. Chelolymphalic cyst C. O mental cyst D. Urogenital cyst

Chelolymphalic cyst

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Ans. is 'b' i.e., 4 years o A child hops on one foot by 4 years and skips by 5 years. o As this child can not hop, the age of this child is less than 4 years.

Pediatrics

When a child is not able to perform the following motor functions such as skipping, walking on heels, hopping in place or going forwards in tandem gati, his motor development is considered to be below ? A. 3 years B. 4 years C. 6 years D. 8 years

4 years

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• ‘Bacterial invasion of the lung parenchyma causes the alveoli to be filled with an inflammatory exudate, thus causing consolidation (“solidification”) of the pulmonary tissue’…..Robbins definition of pneumonia

Pathology

The alveoli are filled with exudate. The air is displaced, converting the lung into a solid organ. This description suggests- A. Chronic bronchitis B. Bronchial asthma C. Bronchiectasis D. Lobar pneumonia

Lobar pneumonia

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Schwannoma *Distinctive histologic patterns seen within the peripheral nerve sheath tumor Schwan noma include the Antoni A and Antoni B regions oThese are the classic microscopic appearances of a schwannoma, which is benign. oNote the more cellular "Antoni A" pattern on the left with palisading nuclei surrounding pink areas (Verocay bodies). On the right is the "Antoni B" pattern with a looser stroma, fewer cells, and myxoid change. oNotice the whirly swirly pattern and how the cell nuclei are closely bunched together ... almost as if they're forming a fence (Verocay bodies). oSchwannomas are benign spindle cell tumors that occur along the edges of peripheral nerves.They can usually be removed without damaging the nerve itself.

Surgery

Antoni A & Antoni B Pattern's are seen in A. Schwannoma B. Neurofibroma C. Meningioma D. Teratoma

Schwannoma

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Ans. is 'c' i.e., Margins are inveed Margins are eveed, clear, and clean cut.

Forensic Medicine

Incised wound which is not a feature ? A. Length is the greatest dimention B. Width is more than the thickness of the blade C. Margins are inveed D. Hesitation cuts are seen in suicidal attempt

Margins are inveed

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(C) Chondrosarcoma # MALIGNANT PRIMARY BONE TUMORS include osteosarcoma, chondrosarcoma, Ewing's sarcoma, malignant fibrous histiocytoma, fibrosarcoma, and other sarcoma types. Multiple myeloma is a hematologic cancer which also frequently presents as one or more bone tumors.# CLASSIFICATION of BONE TUMOURS:> Cartilage tumors Osteochondroma: Chondromas Enchondroma Periosteal chondroma Chondroblastoma Chondromyxoid fibroma Chondrosarcoma Dedifferentiated Mesenchymal Clear cell Periosteal> Osteogenic tumors: Osteoid osteoma (B), Osteoblastoma> Fibrogenic tumors: Desmoplastic fibroma of bone, Fibrosarcoma of bone> Fibrohistiocytic tumors: Histiocytoma of bone> Ewing sarcoma/Primitive neuroectodermal tumor> Giant cell tumors: Giant cell tumor> Notochordal tumors: Chordoma> Vascular tumors: Haemangioma and related lesions, Angiosarcoma> Myogenic, lipogenic, neural and epithelial tumors: Leiomyosarcoma of bone, Lipoma of bone, Adamantinoma and osteofibrous dysplasia> Tumors of undefined neoplastic nature: Aneurysmal bone cyst Simple bone cyst; Fibrous dysplasia (B); Langerhans cell histiocytosis (LCH)

Orthopaedics

Miscellaneous

Which one of the following is a malignant bone tumour? A. Osteoid osteoma B. Chondroma C. Chondrosarcoma D. Osteochondroma

Chondrosarcoma

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Ans. is 'b' i.e., Diaphragmatic hernia o Diaphragmatic Hernia is defined as a communication between abdominal & thoracic cavities with or without abdominalContents in thorax.MC Bochdalek type.More common on left (85%)30% of CDH have associated anomalesCardiac anomalis is MC anomalis.In cardiac (Hypoplastic left heart syndrome most common).o X ray showing multiple gas locales within the lower left chest, the majority of the rest of the left lung opacified. The left hemidiaphragm can not be seen. The mediastinum and the heart are deviated to the contralateral right side.

Pediatrics

Disorders of the Respiratory Tract

New born term baby born by vaginal delivers' had respiratory' distress, grunt, with scaphoid abdomen -Most probable diagnosis is - A. HMD B. Diphragmatic hernia C. Pneumothorax D. Meconium aspiration syndrome

Diphragmatic hernia

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The synthesis and secretion of hCG begins about day 6 of pregnancy, presumably from the trophoblast cells. Pregnancy tests utilize the measurement of hCG for detection of the embryo. Endothelial growth factor (EGF) is synthesized by the cytotrophoblast cells in the early placenta, then is synthesized by the syncytiotrophoblast cells later (6-8 week old placenta). EGF maintains the trophoblast. Relaxin is synthesized by decidual cells at the time of paurition and acts to "soften" the cervix and pelvic ligaments. IGF act similarly to EGF by stimulating differentiation of the cytotrophoblast cells. HCS is synthesized by syncytiotrophoblast cells and will promote general growth. It is essential in the stimulation of mammary duct proliferation in development of the breast during pregnancy. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 22. Reproductive Development & Function of the Female Reproductive System. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e.

Physiology

The placenta secretes a hormone that is utilized in the early detection of pregnancy. This hormone is: A. Endothelial growth factor (EGF) B. Human chorionic gonadotropin (hCG) C. Human chorionic somatotropin (HCS) D. Relaxin

Human chorionic gonadotropin (hCG)

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B i.e. Venous return to hea increases immediately In standing posture, 300- 500m1 of blood pools in venous capacitance vessels of lower extremities, which is immediately returned towards heaQ on assuming lying down posture. Cardiovascular system Onlying On standing - Stroke volume - Cardiac output - Venous return - Central blood pool Increase Decrease - Central venous pressure - Aerial BP - Abdominal & limb flow - Hea rate - Peripheral venous pooling - Total peripheral resistance Decrease Increase - Abdominal & limb resistance - Small vein pressure

Physiology

When a person changes position from standing to lying down, following change is seen: A. Hea rate increases B. Venous return to hea increases immediately C. Cerebral blood flow increases D. Blood flow at apices of lung decreases

Venous return to hea increases immediately

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The term intermenstrual bleeding is updated nomenclature for metrorrhagia.

Gynaecology & Obstetrics

Metrorrhagia is A. Heavy menstrual bleeding B. Intermenstrual bleeding C. Break through bleeding D. Post coital bleeding

Intermenstrual bleeding

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Answer: (C) Thalassemia minor anemia may present with normal RBC diameter (265-68-Hrshmohon 7th) (630= Rabbins- basis disease)Red blood cell distribution width (RDW or RCDW) is a measure of the variation of red blood cell (RBC) volume that is reported as part of a standard complete blood count. Usually red blood cells are a standard size of about 6-8 pm in diameter. Certain disorders, however, cause a significant variation in cell size. Higher RDW values indicate greater variation in size. Normal reference range in human red blood cells is 11.5-14.5%. If anemia is observed, RDW test results are often used together with mean corpuscular volume (MCV) results to determine the possible causes of the anemia. It is mainly used to differentiate an anemia of mixed causes from an anemia of a single cause. Deficiencies of Vitamin Bl2 orfolate produce a macrocytic anemia (large cell anemia) in which the RDW is elevated in roughly two- thirds of all cases; however, a varied size distribution of red blood cells is a hallmark of iron deficiency anemia, and as such shows an increased RDW in virtually all cases. In the case of a mixed iron and B!2 deficiency, there will normally be a mix of both large cells and small cells, causing the RDW to be elevated. An elevated RDW (red blood cells of unequal sizes) is known as anisocytosis. An elevation in the RDW is not characteristic of all anemias; anemia of chronic disease,hereditary spherocytosis, acute blood loss, aplastic anemia (anemia resulting from an inability of the bone marrow to produce red blood cells), and certain hereditary hemoglobinopathies (including some cases of thalassemia minor) all may present with a normal RDW* The human erythrocyte is a biconcave disc, 7-2 pm in diameter, and has a thickness of 2-4 pm at the periphery and 1 mm in the centre* More than 90% of the weight of erythrocytes consists of haemoglobin. The life span of red cell is 120 +- 30 day.* Range of normal red cell count in health in 5.5 +- 1.0 x1012/L in men and 4.8 +- l.0x 1012/l in women* Packed cell volume (PCV) or haematocrit- 0.47 + 0.07L/L (40-54%) in men- 0.42 +- 0.05 L/L (37-47%) in women* Reticulocyte count (%)0.5-l .5* Red cell distribution width-11.5-14.51. Mean corpuscular volume (MCV) =PCV in L/LRBC Count/L Normal value is 85 +- 8fl (77-93 fl)2. Mean corpuscular haemoglobin (MCH) =Hb/LRBC Count/L Normal range is 29.5 +2.5pg (27-32 Pg)3. Mean corpuscular haemoglobin concentration (MCHC) =Hb /dlPCV in L/LNormal value is 32.5 +2.5 g/dl (30-35 g/dl)* The size of the RBC is measured by MCV. MCHC is independent of red cell count and size *** Monocyte is the largest mature leucocyte in peripheral blood* Flow cytometry is done on - Lymphocytes* The anticoagulant used in Wintrobe ESR- Double oxalate1. Alkaline phosphatase is specific to Neutrophils cells2. Acid phasphatase is found in all hematopoitic cells but the highest levels are found in macrophages and osteoclasts (Monocytes)* Anticoagalant of choice for coagulation test is 3.2% sodium citrate *** Potassium oxalate + sodium fluoride is anticoagulant used in collection of blood sugar.Increases Leucocyte Alkaline phosphateDecreased Leucocyte Alkaline phosphate* Infections* Leukamoid reactions* Polycythemia- vera* Paroxysmal nocturnal hemoglobinuria (PNH)* CMLBlood group A is associated with1. Carcinoma stomach, cervix salivary gland pancreas2. Pernicious anemia3. Thrombosis in OCP users

Pathology

Blood

Effective red cell diameter A. Different in males and females B. Diameter of 500 microns C. Thalassemia minor anemia may present with normal RBC diameter D. Mixed iron and folic deficiency anemia produce microcytic

Thalassemia minor anemia may present with normal RBC diameter

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The most impoant indication for surgical repair of a Bicornuate Uterus is Recurrent aboions Recurrent aboions occur due to - Decreased space for embryo to grow and Relatively less blood supply

Gynaecology & Obstetrics

Aboions, Spontaneous & Induced Emergency Contraception (Hey,whats the hurry !)

The most impoant indication for surgical repair of a Bicornuate Uterus is - A. Infeility B. Dysmenorrhoea C. Menorrhagia D. Recurrent aboions

Recurrent aboions

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Park&;s textbook of preventive and social medicine 23rd edition. * Maternal moality rate is the no of maternal deaths in a given period per 100,000 women of reproductive age during the same time period.

Social & Preventive Medicine

obstetrics,pediatrics and geriatrics

Maternal moality rate is - A. Maternal deaths / 100000 live bihs B. Maternal death /100 live bihs C. Maternal death /1000 bihs D. Maternal death /1000 live bihs

Maternal deaths / 100000 live bihs

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Ref:The essential of forensic medicine and toxicology Dr.K.S NARAYAN REDDY 32nd edition pg no 415 the stain is estracted by 10% HCL and a drop is placed on a glass slide and allow to dry a cover slip is place dover this , and a drop of florence solution(KI,iodide and water) this allowed to run under the cover slip .if the semen is present, dark brown crystals of choline iodide appeared immediately , they are rhombic or needle shaped crystals resembling haemin but are larger, arranged in clusters,rossettes, crosses etc... Choline orginate from the seminal vessicles,the test is not a proof of seminal fluid but only of presence of some vegetables or animal substances . a negative reaction is proof that the stain is not seminal

Forensic Medicine

Special topics

Colour of crystals in positive Florence test is - A. Yellow B. White C. Purple D. Dark Brown

Dark Brown

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Ans: A (Cuffed endotracheal tube) Ref: Bailey, 24th ed, p. 46; Ajay Yadav, p. 101A cuffed endotracheal tube is used to:1. Facilitate artificial airway ventilation or surgery around face or airway.2. Protection of lung if there is a risk of pulmonary aspiration.Predisposing factors for aspiration:1. Full stomach-- single, most important factor.2. | Level of consciousness.3. Conditions which reduce the tone of LES:Pregnancy (acid aspiration in late pregnancy- Mendelson syndrome)Abdominal tumorsObesity, hiatus herniaPresence of nasogastric tubeDrugs-Atropine, glycopyrrolate, opioids, thiopentone.4. Conditions delaying gastric emptyingDiabetes, hypothyroidism, pain, anxiety, anticholinergics, opium.Management:Prevention:Management - full stomach patients:1. Empty stomach2. H2blockers- to reduce acid production.3. Metoclopramide4. Neutralisation of gastric contents by antacids1. Regional anesthesia is preferred2. Awake intubation3. Rapid sequence intubation- Sellick maneuver

Unknown

What is an ideal method to prevent aspiration pneumonia? A. Cuffed endotracheal tube B. Inhalational anaesthesia C. Increased intra abdominal pressure D. Full stomach

Cuffed endotracheal tube

9d401433-8335-487e-8723-fcfc3b43c520

Missense mutations are those in which a single base change (point mutation) results in a codon that encodes for a different amino acid residue. The effects of these types of mutations can range from very minor or even undetectable to major, depending on the impoance of the altered residue to protein folding and function. Nonsense mutations are also point mutations in which the affected codon is altered to a stop (nonsense) codon, resulting hi a truncated protein. Frame shift mutations are due to one or two base "pair inseions or deletions such that the reading frame is altered. These mutations generally lead to truncated proteins as well, since in most protein coding regions the unused reading frames contain numerous stop codons.

Biochemistry

A mutation that results in a value replacement for glutamic acid at position 6 of the B chain of hemoglobin 5 hinders normal hemoglobin function and results in sickle-cell anemia when the patient is homozygous for this mutation. This is an example of which of the following types of mutation? A. Deletion B. Frameshift C. Inseion D. Missense

Missense

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The left gonadal vein drains into the left renal vein which crosses the midline to join inferior vena cava. All the other options (Left renal vein, left brachiocephalic vein and hemiazygous vein) cross the midline.Ref: Human Anatomy, B D Chaurasia, 4th Edition, Volume 2, Chapter 24, Page 297, 307, 316; Clinical Anatomy by Systems, Richard S. Snell, 2007 Edition, Page 166, 167, 840.

Anatomy

Which of the following vessel does not cross the midline of the body: A. Left gonadal vein B. Left renal vein C. Left brachiocephalic vein D. Hemiazygous vein

Left gonadal vein

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Fluid requirement in a child in this child weighing 24 kg is:1540 mL. For first 10 kg: 100ml/kg For next 10 kg : 50ml/kg For each kg. above 20 : 20 ml/kg (1-10 kg) 100 x 10 = 1000 mL (11-20 kg) 50 x 10 = 500 mL; For next 4 kg (21-24 kg) 20 x 4= 80 mL

Pediatrics

Fluid, Electrolyte

Daily maintenance fluid for a child weighing 24 kg is: A. 1000 mL/day B. 800 mL/day C. 1540 mL/day D. 1580 mL/day

1580 mL/day

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i.e. (Mitochondria) : (301-Harsh Mohan 6th ) (625-Robbins & Cotran-Pathologic basis of disease 8th)Ringed sideroblasts is characteristic of sideroblastic anemia /Myelodysplastic SyndromeRinged sideroblast in which haem synthesis is disturbed as occurs in sideroblastic anaemiasRinged sideroblasts containing numerous large granules, often forming a complete or partial ring around the nucleus. These ringed arrangement of these granules is due to presence of iron laden mitochondria around the nucleus

Pathology

Blood

Ring sideroblasts, with iron laden occurs in A. Endoplasmic reticulum B. Nucleus C. Mitochondria D. Nuclear membrane

Mitochondria

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The stomach also adds a significant volume of digestive juices to the meal. Like salivary secretion, the stomach actually readies itself to receive the meal before it is actually taken in, during the so-called cephalic phase that can be influenced by food preferences. The gastric secretions arise from glands in the wall of the stomach that drain into its lumen, and also from the surface cells that secrete primarily mucus and bicarbonate to protect the stomach from digesting itself, as well as substances known as trefoil peptides that stabilize the mucus-bicarbonate layer. The glandular secretions of the stomach differ in different regions of the organ. The most characteristic secretions derive from the glands in the fundus or body of the stomach. These contain two distinctive cell types from which the gastric secretions arise: the parietal cells, which secrete hydrochloric acid and intrinsic factor; and the chief cells, which produce pepsinogens and gastric lipase. The acid secreted by parietal cells serves to sterilize the meal and also to begin the hydrolysis of dietary macromolecules. Intrinsic factor is impoant for the later absorption ofvitamin B12 or cobalamin. Pepsinogen is the precursor of pepsin, which initiates protein digestion. Lipase similarly begins the digestion of dietary fats.REF: GANONG&;S REVIEW OF MEDICAL PHYSIOLOGY, KIM BARRETT, HEDDWEN BROOKS, SCOTT BOITANO, SUSAN BARMANTWENTY THIRD EDITIONPAGE NO:432

Physiology

G.I.T

Intrinsic factor of castle is secreted by which of the following cells in gastric glands A. Chief cells B. Parietal cells C. Enterochromaffin cells D. B cells

Parietal cells

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Ans. is 'b' i.e., Valproate Steatosiso Accumulation of triglyceride fat droplets within the heaptocytes is known as steatosis or fatty liver. It may be of two types -1. Microvesicular steatosis - Multiple tiny droplets accumulate that do not displace the nucleus.2. Macrovasicular steatosis - A single large droplet accumulates that displaces the nucleus.Causes of steatosisMicrovesicularMacrovesicularo Reye's syndromeo Acute fatty liver of pregnancyo Jamaican vomiting sicknesso Drugs - valproic acid, tetracycline, nucleoside analogueo Wolman's diseaseo Lysosomal acid lipase deficiencyo Congenital defects of urea cycle enzymeso Early stage of alcoholic cirrhosiso Chronic viral hepatitiso Alcoholic liver diseaseo DM - insulin resistanceo Lipodystrophyo PEM, starvationo Dysbetalipoproteinemiao TPN, Jejunoileal bypasso Inflammatory bowel diseaseo Syndrome x (obesity, DM, hypertriglyceridemia)o Drugs - CCBs, synthetic estrogens, nucleoside analogues

Pathology

Liver

Microvesicular fatty liver is caused by - A. DM B. Valproate C. Starvation D. IBD

Valproate

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Ans. is 'c' i.e., Ministry of women and child developmento In 2006 the Ministry' of Women and Child Development (MWCD) proposed adoption of Integrated Child Protection Scheme (ICPS).o In 2009 the central government take the scheme its approval and has begun the extensive task of providing children with a protective and safe environment to develop and florish.o The purpose of the scheme is to provide for children in difficult circumstances, as well as to reduce the risks and vulnerabilities children have in various situations and actions that lead to abuse, neglect, exploitation, abandonment and separation of children.

Social & Preventive Medicine

Health Programmes in India

Child protection scheme is under which ministry - A. Ministry of health and family welfare B. Ministry' of Social welfare C. Ministry' of women and child development D. Ministry of education

Ministry' of women and child development

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Case control studies often retrospective studies are a common first approach to test causal hypothesis. In recent years case control study has emerged as a permanent method of epidemiological investigation. Both exposure and outcome has occurred before the study. Study proceeds backwards from effect to cause. It uses a control or comparison group to suppo or refute an inference (refer pgno:71 park 23 rd edition)

Social & Preventive Medicine

Epidemiology

In case control study of buccal carcinoma- A. CA is commoner in zarda pan users than non users B. Zarda pan is a cause of buccal CA C. Zarda pan is associated with buccal CA D. If use of zarda pan is stopped, number of cases will reduce

Zarda pan is associated with buccal CA

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Ghrelin: Anorexigenic and somatotrophic signal from the stomach Akio Inui1 About the author top of page Abstract Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor, is synthesized principally in the stomach and is released in response to fasting. Ghrelin is structurally related to motilin and, together, they represent a novel family of gut-brain regulatory peptides. In addition to having a powerful effect on the secretion of growth hormone, ghrelin stimulates energy production and signals directly to the hypothalamic regulatory nuclei that control energy homeostasis. The study of ghrelin has extended our understanding of how growth is controlled and has shown that the stomach is an impoant component of this system.

Physiology

General physiology

Which of the following is orexigenic? A. Serotonin B. Ghrelin C. OCX D. GA

Ghrelin

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(Ref:KDT 6/e p269) Metformin is the drug of choice for the treatment of obese diabetic patients, as it causes weight loss. It does not cause release of insulin, therefore less chances of hypoglycemia.

Anatomy

Other topics and Adverse effects

Metformin is NOT effective in lowering of blood sugar level in which of the following patients? A. Non diabetics B. Obese diabetics C. Type 2 diabetics D. Diabetics not responding to sulfonylureas

Non diabetics

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Kuppuswamy's socio economic status scale takes into account education, occupation and monthly family income. Since he is a post graduate he gets 6 points for education. His job as a clerk gives him 5 points and a monthly family income of 20000 Rs gives him 12 points which gives him a total of 23 points and so he belongs to upper middle socioeconomic class. Socio economic status Total score Upper socio economic status 26 - 29 Upper middle socioeconomic status 16 - 25 Lower middle socioeconomic status 11 - 15 Upper lower socioeconomic status 5 - 10 Lower socioeconomic status <5 Ref: Park, Edition 21, Page 639

Social & Preventive Medicine

You are conducting a survey in your village and the person you are interviewing is a 32 year old post graduate working as a clerk. His total family income is 20,000 Rs per month. According to Kuppuswamy's socio economic status scale, he belongs to: A. Upper socioeconomic class B. Upper socioeconomic class C. Lower middle socioeconomic class D. Upper lower socioeconomic class

Upper socioeconomic class

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Ans. B (Acetaminophen) "Gastric mucosal damageQ: Gastric pain, mucosal erosion/ ulceration and blood loss are produced by all MSAIDs to varying extents: relative gastric toxicity is a major consideration in the choice of MSAIDs. Paracetamol", a very weak inhibitor of COX is practically free of gastric toxicity and selective (misoprosto) administered concurrently with NSAIDsanatgonise their gastric toxicity"- KDT 6th/186Aspirin is acetylsalicylic acid KDT 6th/187

Pharmacology

Prostaglandins

Gastric irritation is least with following NSA1D: (PGI June 2008) A. Diclofenac B. Acetaminophen C. Ibuprofen D. Naproxen

Acetaminophen

64f80edc-9494-4b09-b361-0d50d21ff9cb

Ans. a (Phenylketonuria) (Ref. Harrison's Internal Medicine 17th/Ch. 358)Inborn errors of amino acid metabolism associated with abnormal odourInborn error of metabolismUrine odorGlutaric acidemia (type II)Sweaty feet, acridHawkinsinuriaSwimming poolIsovaleric acidemiaSweaty feet, acridMaple syrup urine diseaseMaple syrup/Burnt sugarHypermethioninemiaBoiled cabbageMultiple carboxylase deficiencyTomcat urineOasthouse urine diseaseHops-likePhenylketonuriaMousy or mustyTrimethylaminuriaRotting fishTyrosinemiaBoiled cabbage, rancid butterTHE HYPERPHENYLALANINEMIAS# result from impaired conversion of phenylalanine to tyrosine.# The most common and clinically important is phenylketonuria (frequency 1:10,000), which is an autosomal recessive disorder characterized by an | concentration of phenylalanine and its by-products in body fluids and by severe mental retardation if untreated in infancy.# It results from | activity of phenylalanine hydroxylase (phenylketonuria type I).# The accumulation of phenylalanine inhibits the transport of other amino acids required for protein or neurotransmitter synthesis, reduces synthesis and increases degradation of myelin, and leads to inadequate formation of norepinephrine and serotonin.# Phenylalanine is a competitive inhibitor of tyrosinase, a key enzyme in the pathway of melanin synthesis, and ac- counts for the hypopigmentation of hair and skin.# Untreated children with classic phenylketonuria are normal at birth but fail to attain early developmental milestones, develop microcephaly, and demonstrate progressive impairment of cerebral function.# Hyperactivity, seizures, and severe mental retardation are major clinical problems later in life.# EEG abnormalities; "mousy" odor of skin, hair, and urine (due to phenylacetate accumulation); and a tendency to hypopigmentation and eczema are devastating clinical picture.# In contrast, affected children who are detected and treated at birth show none of these abnormalities.Treatment# To prevent mental retardation, diagnosis and initiation of dietary treatment of classic phenylketonuria must occur before the child is 3 weeks of age.# Dietary phenylalanine restriction is usually instituted if blood phenylalanine levels are >250 pmol/L (4 mg/dL).# Treatment consists of a special diet low in phenylalanine and supplemented with tyrosine, since tyrosine becomes an essential amino acid in phenylalanine hydroxylase deficiency.# With therapy, plasma phenylalanine cone should be maintained between 120 and 360 pmol/L (2 and 6 mg/dL).# Dietary restriction should be continued and monitored indefinitely..# Pregnancy risks can be minimized by continuing lifelong phenylalanine-restricted diets and assuring strict phenylalanine restriction 2 months prior to conception and throughout gestation.ConditionEnzyme DefectClinical FindingsInheritance1. Phenylketonuria type IPhenylalanine hydroxylaseMental retardation, microcephaly, hypopig- mented skin and hairs, eczema, "mousy" odorAR2. Phenylketonuria type IIDihydropteridine reductaseMental retardation, hypotonia, spasticity, myoclonusAR3. Phenylketonuria type III6-Pyruvoyl- tetrahydropterin synthaseDystonia, neurologic deterioration, seizures, mental retardationAR4. GTP cyclohydrolase I deficiencyGTP cyclohydrolase IMental retardation, seizures, dystonia, temperature instabilityAR5. Carbinolamine dehydratase deficiencyPterin-4-carbinolamine dehydrataseTransient hyperphenylalaninemia (benign)AR

Pediatrics

Inborn Errors of Metabolism

Abnormal mousy/mushy odour of urine is associated with A. Phenylketonuria B. Tyrosinemia C. Maple syrup urine disease D. Hawkinsuria

Phenylketonuria

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Tubercular ulcers typically have undermined edges. Reference: Bailey & Love&;s Sho Practices of Surgery 27th Edition, Page no. 78

Surgery

General surgery

Ulcer with undermined edges is seen in A. Malignant ulcer B. Tubercular ulcer C. Venous ulcer D. Diabetic ulcer

Tubercular ulcer

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Prostatic Intraepithelial Neoplasia ( PIN) is a precancerous condition; not detected by rectal examination, TRUS , or MRI; does not cause rise in PSA level . It is usually identified after TURP for BPH with final histology or by prostatic biopsy.Reference: page1048 SRB&;s manual of surgery 5th edition

Surgery

Urology

Which of the following is NOT associated with elevation of prostatic specific antigen? A. Acute prostatitis B. BPH C. Prostatic intraepithelial neoplasm D. Prostatic needle biopsy

Prostatic intraepithelial neoplasm

3a963c53-2aa9-4e2c-96e4-4570516f18fb

Diarrhoea is due to hypergastrinaemia.It is associated with severe ulcers,not superficial SRB's manual of surgery,5th edition,710.

Surgery

G.I.T

Gastrinoma a/w A. Diarrhoea B. Constipation C. Achlorhydria D. Multiple superficial gastric ulcers

Diarrhoea

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Ans. (a) CaExocytosis is a calcium dependent process where in the cellular contents are moved out of the cell in the form of vesicles (Cell Vomiting)

Physiology

General

Which of the following is used in exocytosis? A. Ca B. Mg C. Na D. K

Ca

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Theophylline is having a narrow margin of safety so therapeutic drug monitoring is essential If levels increase more than 20mg/L- side effects occurs ESSENTIAL OF MEDICAL PHARMACOLOGY SEVENTH EDITION KD TRIPATHI PGNO.226

Pharmacology

Respiratory system

Therapeutic blood range of theophylline in microgram per L is: A. 0-5 B. 10-May C. 15-May D. 20-May

20-May

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Ans. is 'b' i.e., Subscapularis TestMuscle TestedLift off testSubscapularisJobe testSupraspinatusSpeed testBicepsYergason testBicepsBelly press testSubscapularis

Orthopaedics

Injuries Around Shoulder

Lift off test is used for which of the following muscles? A. Supraspinatus B. Subscapularis C. Infraspinatus D. Biceps Breachii

Subscapularis

26b146ff-0f13-4e9d-b4fe-d3aac7fd1f7d

Sigmoid notch (or) mandibular notch forms the sharp upper border of the ramus the condyle and coronoid process.

Dental

Which of the following is not a structural element of TMJ? A. Sigmoid notch B. Articular disc C. Capsular ligament D. Joint cavities

Sigmoid notch

e11268cf-9f08-491b-8937-3875cbd26f46

The correct sequence is Catatonic schizophrenia followed by Paranoid schizophrenia followed by Disorganised schizophrenia followed by Simple Schizophrenia Please remember in both DSM-5 and ICD-11, these subtypes have been removed

Psychiatry

Schizophrenia Spectrum and Other Psychotic Disorders

Arrange the following subtypes of schizophrenia, in order of prognosis, with the best prognosis first and the worst prognosis last, 1. Paranoid schizophrenia2. Catatonic schizophrenia3. Simple schizophrenia4. Disorganised schizophrenia A. 4-2-1-3 B. 2-1-3-4 C. 2-1-4-3 D. 1-2-4-3

2-1-4-3

da060f81-4590-4c94-a8e7-76d29351bb61

When composite is light cured, oxygen in the air causes an interference in the polymerization resulting in the formation of an oxygen inhibition layer on the surface of the composite.The oxygen-inhibited layer is the sticky, resin-rich uncured layer that is left on the surface.Thickness is about 50-500 micrometer. Reference- Sturdevant 6th ed P:237

Dental

Thickness of oxygen inhibition layer in composite curing is: A. 1-50 micrometer B. 15-150 micrometer C. 50-500 micrometer D. 1000-2000 micrometer

50-500 micrometer

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Inhibitors of renal epithelial Na+ channel Include Triamterene and amiloride. Triamterene:- It is incompletely absorbed orally, paly bound to plasma proteins, largely metabolized in liver to an active metabolite and excreted in urine. Plasma t 1/2 is 4 hours, effect of a single dose lasts 6-8 hours. Side effects:- consist of nausea, dizziness, muscle cramps and rise in blood urea. Impaired glucose tolerance and photosensitivity are repoed, but urate level is not increased. Ref:- kd tripathi; pg num:-590

Pharmacology

Kidney

Triamterene causes A. Better glucose tolerance B. Muscle cramps C. Decrease in urea level D. Hypokalemia

Muscle cramps