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f885e11a-4a80-464f-aa2a-9bdaa6baff55 | Repetitive vomiting leads to hypochloremic, hypokalemic metabolic alkalosis. The urine is alkaline initially but eventually it becomes acidic (paradoxical aciduria)
Cause of paradoxical aciduria
Initially the kidney compensate for metabolic alkalosis by reabsorbing hydrogen and chloride ions in exchange for sodium, potassium and bicarbonate. But gradually as the body stores of sodium and especially potassium become depleted, kidney starts retaining these ions in exchange of hydrogen ions, thus the urine becomes acidic and metabolic alkaline state is further aggravated. | Surgery | null | Persistent vomiting in G.O.O. causes -a) Hyponatremic hyperchloremia occurb) Hypernatremia without ↓ed Cl- alkalosisc) Hypokalemic metabolic alkalosisd) Paradoxical aciduria
A. cd
B. bc
C. bd
D. ac
| cd |
b2f91d4c-fb35-4117-a5a0-673197e79b72 | Flurouracil is used mainly for solid malignancies,i.e colon, rectum, pancreas, liver, urinary bladder, head, and neck. Genetic deficiency of dihydropyridine dehydrogenase(DPD) leads to Fluorouracil toxicity. Major toxicity is myelosuppression, mucositis, diarrhea, nausea, vomiting, peripheral neuropathy (hand-foot syndrome)also occurs. Other given drugs are anti-cancerous drugs without mucositis. ESSENTIALS OF MEDICAL PHARMACOLOGY-SEVENTH EDITION-K.D TRIPATHI Page; 864 | Pharmacology | Other topics and Adverse effects | Mucositis is caused by:
A. 5-Fluorouracil
B. Methotrexate
C. Paclitaxel
D. Cisplatin
| 5-Fluorouracil |
f8bbd265-100a-4cda-9ec7-c1e9f4dafc0a | Ans. is b i.e. Is due to increase in blood flow through the dilated uterine vessels Uterine souffle is a soft blowing systolic murmur The sound is synchronous with maternal pulse It is due to increase in blood flow through the dilated uterine vessels Heard low down at the sides of the uterus, best on the left side It can also be heard in big uterine fibroid. Note Soft blowing murmur synchronous with the fetal hea sound is called Fetal / Funic souffle. | Gynaecology & Obstetrics | null | Uterine souffle :
A. Is a soft blowing murmur synchronous with foetal hea sounds
B. Is due to increase in blood flow through the dilated uterine vessels
C. Is due to the active foetal movements
D. Indicates the underlying foetal distress
| Is due to increase in blood flow through the dilated uterine vessels |
d84bbbff-2835-4d0a-bd1f-2b8ee74e126c | HRCT chest is more specific for bronchiectasis and is the imaging modality of choice for confirming the diagnosis.CT findings include airway dilation(detected as parallel "tram tracks" or as the "signet-ring sign"-a cross sectional area of the airway with a diameter at least 1.5 times that of the adjacent vessel),lack of bronchial tapering(including the presence of tubular structures within 1 cm from the pleural surface.),bronchial wall thickening in dilated airways,inspissated secretions (eg.,the " tree-in-bud" pattern ),or cysts emanating from the bronchial wall(especially pronounced in cystic bronchiectasis.) Reference:Harrison's medicine-18th edition,page no:2143. | Medicine | Respiratory system | Investigation of choice in bronchiectasis is
A. Bronchoscopy
B. MRI thorax
C. HRCT lung
D. Chest X-ray
| HRCT lung |
f9305a4e-40ad-41fa-8be2-3fe7dc212bfa | Ans. is 'b' i.e., 200 mg/dl * The transport maximum for glucose is 375 mg/min whereas the filtered load of glucose is only 125 mg/min.* Therefore, in normal conditions 100% of glucose is reabsorbed in proximal tubules.* When plasma glucose concentration is 100 mg/dl the filtered load is at its normal level, 125 mg/min, there is no loss of glucose in the urine.* However, when the plasma concentration of glucose rises above about 200 mg/dl, increasing the filtered load about 250 mg/min, a small amount of glucose begins to appear in the urine.* This point is termed as threshold for glucose.* Note that this appearance of glucose in the urine occurs before the transport maximum is reached.* The reason for the difference between threshold and transport maximum is that not all nephron have same transport maimum for glucose, and some of the nephron therefore begin to excrete glucose before others have reached their transport maximum.* The overall transport maximum for the kidneys, which is normally about 375 mg/min, is reached when all nephrons have reached their maximal capacity to reabsorb glucose.* That means, above filtered load of 250 mg/min of glucose, some glucose will appear in the urine (threshold level), whereas above filtered load of 375 mg/min, all the glucose will be excreted because all the nephrons have reached to their transport maximum.* Thus, Renal threshold for glucosei) At plasma levels - 200 mg/dlii) At filtered load - 250 mg/min | Physiology | Kidneys and Body Fluids | Renal threshold for serum glucose level-
A. 100 mg/dl
B. 200 mg/dl
C. 300 mg/dl
D. 400 mg/dl
| 200 mg/dl |
7e4ff08e-29c7-47d1-9239-f79e6e0595d0 | Functional unit of muscle is : sarcomere It is the pa of myofibril present between two succsive z lines. Ref: Guyton and Hall textbook of medical physiology 12th edition, page number:86,87 | Physiology | Cardiovascular system | Functional unit of muscle:
A. Sarcomere
B. Actin
C. Myosin
D. Troponin
| Sarcomere |
4d147d09-ab73-40ed-814e-379b8d4df231 | Streptococcus group A can cause a toxic shock-like syndrome, and has been increasing in frequency in North America. Streptococcal toxic shock-like syndrome was so named because of its similarity to staphylococcal toxic shock syndrome. The illness includes fever, hypotension, renal impairment, and the respiratory distress syndrome. It is usually caused by strains that produce exotoxin. It may be associated with localized infection as well; the most common associated infection is a soft tissue infection such as necrotizing fasciitis. The mortality is high (up to 30%), usually secondary to shock and respiratory failure. The rapid progression of the disease and its high mortality demand early recognition and aggressive treatment. Management includes fluid resuscitation, pressor agents, mechanical ventilation, antibodies, and, if necrotizing fasciitis is present, surgical debridement. | Medicine | Infection | A 47-year-old man suddenly develops high fever and hypotension. He has a generalized erythematous macular rash, and over the next day, develops gangrene of his left leg. Which of the following is the most likely organism?
A. Corynebacterium diphtheriae
B. Streptococcus group C
C. Neisseria gonorrhoeae
D. Streptococcus group A
| Streptococcus group A |
37585fbd-5eda-48c4-8b39-761335c90b6e | The most frequent acute medical emergency associated with LSD use is a panic episode (the "bad trip"), which may persist up to 24 h.A trip is a period of intoxication from a hallucinogenic drug, such as lysergic acid (LSD) or magic mushrooms (psilocybin). It is called a trip because perceptions of the world change so dramatically, it can feel as if a trip to a strange, new land is taken. Unpleasant experience of hallucinogen intoxication is known as a bad trip.Harrison 19e pg: Cocaine and Other Commonly Abused Drugs | Microbiology | All India exam | Which of the following is the most common cause of emergency depament visit related to LSD and its related substances?
A. Bad trip
B. Flashbacks
C. Synaesthesia
D. Papillary dilatation
| Bad trip |
9f5413a7-dacf-4629-94f5-0e1ecc12dfbf | (C) Deficiency in interpretation of sounds # Lesion of auditory cortex leads to loss of recognition of total patterns with loss of analysis of properties of sound and sound localisation.> Thus lesion of auditory cortex leads to defect in interpretation of sounds. | Physiology | Special Senses: Hearing and Equilibrium | Bilateral destruction of auditory cortex in man causes
A. Almost total deafness
B. Hearing defect for higher frequency sounds
C. Deficiency in interpretation of sounds
D. Inability for the orientation of sounds
| Deficiency in interpretation of sounds |
db51ede8-e2b6-4637-9ff2-bc6efb98d662 | Ans. is 4b' i.e., E. multilocularis o The chief character of E. multilocularis cyst is its tendency to proliferate, thereby resembling a neoplasm.Hydatid disease of liver is caused byo Echinococcus granulosuso Echinococcus multiloculariso Echinococcus vogeli- Unilocular cystic lesions- Multi locular alveolar hydatid cyst- Polycystic hydatid disease. | Microbiology | Parasitology | The following infection resembles malignancy -
A. Echinococcus granulosus
B. E. multilocularis
C. E.vogeli
D. E. oligarthus
| E. multilocularis |
fc4ad074-28fe-4b8f-bde1-79c50dadad98 | This child is suffering from Phenylketonuria. Here there is inability to conve phenylalanine to tyrosine due to phenylalanine hydroxylase deficiency. The decreased pigmentation in this condition is due to reduced melanin formation. The treatment is a diet low in phenylalanine with tyrosine supplementation. Delay in initiation of treatment will lead to mental retardation. Ref: Essential revision notes for MRCP by Philip A Kalra, Edition 3, Page - 322 ; Harrison, Edition 17, Page - 2470 | Pediatrics | null | A 1 year old child is brought to you with delayed milestones. On examination you note that the child is very fair with hypopigmented hair and blue eye. He has also got eczemas. The child was also very irritable. What is your diagnosis?
A. Albinism
B. Phenylketonuria
C. Alkaptonuria
D. Cystinosis
| Phenylketonuria |
95e37320-0495-470b-ab41-fe26b8d4ec5c | HBs Ag is the first marker appear in the blood after infection. Anti HBc is the earliest antibody seen in blood. HBeAg indicates infectivity REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.546&547 | Microbiology | Virology | Serological testing of patient shows HBsAg, IgM Anti-HBc and HBeAg positive . The patient has-
A. Chronic hepatitis B with low infectivity
B. Acute hepatitis B with high infectivity
C. Chronic hepatitis with high in fectivity
D. Acute on chronic hepatitis
| Acute hepatitis B with high infectivity |
c33b030b-ec27-4d02-9508-ad96fb9d6559 | A i.e. Autosomal dominant (most likely) Waardenburg's Syndrome (WS) is a rare autosomal dominant syndrome characterized by pigmentary disturbances (skin, hair, iris), sensorineural hearing loss, and other developmental anomalies such as dystopia canthorum (widely spaced eyes) and blepharophimosis. The syndrome that closest matches the features provided in the question is Waardeburg syndrome type-I. This is inherited as an autosomal dominant fashion and hence is the answer of exclusion. As the question does not provide us with details as to the sex of the three children, a sex linked inheritance pattern cannot be worked out. Also the combined presentation of an affected father, unaffected mother and one affected child among three children is possible with both an autosomal dominant and an autosomal recessive inheritance pattern. In absence of any more details, the answer to this question cannot be deduced through the exploration of various permutations and combinations. How both autosomal dominant and autosomal recessive inheritance can be responsible for the above combination: Autosomal Dominant Autosomal recessive (A-affected allele and a normal allele) If the disease is transmitted in an Autosomal Dominant then :Father (affected) will be either 'AA' or 'Aa' Mother (unaffected) will be 'aa' If father is AA and mother aa, the offsprings will be 1. aA - 100% affected If father is Aa and mother aa, the offsprings will Aa - 50% affected aa - 50% not affected The scenario in the above question therefore is possible autosomal dominant inheritance if father is Aa and mother is aa (A'-affected allele and 'a' normal allele) If the disease is transmitted in an Autosomal recessive form :Father (affected) will be 'AA' Mother (unaffected) may be 'aa' or 'Aa' If father is AA and mother aa, the offsprings will be 1. aA - 100% not affected, (but carriers) If father is AA and mother Aa, the offsprings will be Aa - 50% not affected, carrier AA - 50% affected The scenario in the above question therefore is possible with autosomal recessive inheritance if father is aa and mother is Aa | Medicine | null | In a family, the father has widely spaced eyes, increased facial hair and deafness. One of the three children has deafness with similar facial features. The mother is normal. Which one of the following is most likely pattern of inheritance in this case?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive
| Autosomal dominant |
b06d4abd-e44c-4b39-9a59-c135ac716144 | The tigroid pattern/ leopard skin sign occurs on MRI head is seen in Pelizaeus-merzbacher disease, due to creation of islands of perivascular myelin due patchy myelin deficiency. It is a rare hypomyelination syndrome caused by mutation in proteolipid protein, PLP 1 gene at chromosome Xq22. Child will show slow psychomotor development with nystagmus(pendular eye movements), hypotonia, extrapyramidal symptoms and spasticity. Tigroid pattern is also seen in metachromatic leucodystrophy. | Radiology | Neuroradiology | Tigroid white matter on MRI is seen in?
A. Pantothenate kinase deficiency
B. Pelizaeus-merzbacher disease
C. Neuroferritinopathy
D. Aceruloplasminemia
| Pelizaeus-merzbacher disease |
07757400-13ed-48a3-819b-fb50789beddc | If a drug is active against the pre-erythrocytic stage of the malarial parasite it will be useful as a Causal prophylactic. Stage killed Clinical Use Pre-erythrocytic Causal Prophylaxis Erythrocytic Clinical cure Suppressive Prophylaxis Exo-erythrocytic Radical cure Gametocytic Prevention of transmission | Pharmacology | Anti-Malaria Drugs | If a drug is active against the pre-erythrocytic stage of the malarial parasite it will be useful as a:
A. Suppressive prophylactic
B. Causal prophylactic
C. Clinical curative
D. Radical curative
| Causal prophylactic |
ce5c0538-d1f0-4709-b043-eb99bad92073 | alpha blockers Pulmonary hypeension General management Diuretic therapy may be useful as it relieves pulmonary edema. Anticoagulant therapy is advocated for all patients. Specific management Calcium channel blockers Patients who have substantial reductions in pulmonary aerial pressure in response to sho acting vasodilators at the time of cardiac catheterization should he initially treated with calcium channel blockers. Endothelin receptor antagonist Bostenan is a non-selective endothelium receptor antagonist, is an approved t/t ,for patients who are NYHA .functional classes III and IV. Phosphodiesterase-5 inhibitors Slidenafil is used for patients who are NYHA functional classes II and Prostacyclins Iloprost is a prostacyclin analogue used in PAH patients who are NYHA functional classes III and IV. Pulmonary circulation is unique in that it accommodates a blood flow that is almost equal to that of all the other organs of body but still maintains low pressure. The factors responsible for low pressure in pulmonary circulation (even with large volume of blood) are:- - Larger diameter of pulmonary vessels due to thin wall of pulmonary aery and aerioles. | Medicine | All India exam | Drug NOT used in pulmonary hypeension is?
A. Calcium channel blocker
B. Endothelin receptor antagonist
C. Alpha blocker
D. Prostacyclin
| Alpha blocker |
6022af1f-be7a-4b78-8cda-43e0bac536e5 | This is a case of neurosyphilis. A positive nontreponemal CSF serologic test result (CSF VDRL) establishes the diagnosis of neurosyphilis (and an increased cell count in response to the spirochete documents the presence of active disease). In VDRL test, the inactivated serum is mixed with cardiolipin antigen on a special slide & rotated for 4 minutes. Cardiolipin remains as uniform crystals in normal serum but it forms visible clumps on combining with regain antibody. The reaction is read under low power microscope. By testing serial dilutions, the antibody titre can be estimated. The results are repoed as reactive, weak by reactive / not reactive. The VDRL test can be used for testing CSF also, but not plasma. A number of modification of VDRL test have been developed, of which the Rapid Plasma Reagin (RPR) is the most popular. In RPR test. VDRL antigen containing carbon paicles which make the result more clear cut & evident to the naked eye The RPR test is done with unheated serum / plasma but is not suitable for testing CSF. Ref: Ananthanarayanan & Paniker's textbook of microbiology Ed 8 Pg - 375; Klausner J.D., Hook III E.W. (2007). Chapter 20. Neurosyphilis. In J.D. Klausner, E.W. Hook III (Eds), CURRENT Diagnosis & Treatment of Sexually Transmitted Diseases. | Microbiology | null | A 28 year old labourer, 3 yrs back presented with penile ulcer which was not treated. Later he presented with neurological symptoms for which he got treated. Which is the test to monitor response to treatment?
A. VDRL
B. FTA ABS
C. TPI
D. RPR
| VDRL |
1ea18537-26ca-425e-a211-fe1cc09cb12b | Robbins basic pathology 10th edition page no 290. Wilms tumor or nephroblastoma is the most common primary tumor of the kidney in children. On microscopic examination, Wilms tumors are characterized by recognizable attempts to recapitulate different stages of nephrogenesis. The pattern of anaplastic cells within the primary tumor has impoant implications for prognosis. | Pathology | Pediatrics, environment and nutrition | The most impoant prognostic factor of Wilms tumor-
A. Histopathology
B. Ploidy of cells
C. Age < 1 y
D. Mutation of c 1p gene
| Histopathology |
be4163d5-5131-4c2c-9f8a-06c1c6847912 | Ans: a (Transport of long....) Ref: Vasudevan, 4th ed, p. 129The long chain fatty acyl CoA cannot pass through the inner mitochondrial membrane. There fore a transporter, carnitine is involved in transfer of fatty acids.Beta oxidation:Beta oxidation is absent in brain and erythrocytes (because erythrocytes lack mitochondria and fatty acids do not cross BBB).Carnitine acyl transferase -1 is inhibited by Malonyl CoA.Clinical correlate:Carnitine acyl transferase(CAT) deficiency (myopathic form)Although all tissues contain CAT most common form of genetic deficiency is myopathic form and due to a defect in muscle specific CAT gene.Features:Muscle aches, red urineRhabdomyolysis, myoglobinuriaProvoked by exerciseIncreased by high fat; low carbohydrate dietMuscle biopsy: increased muscle triglyceride in cytoplasmTreatment: Cease muscle activity, give glucose. | Biochemistry | Lipids | Acyl carnitine functions in:
A. Transport of long chain fatty acid
B. Transport of short chain fatty acid
C. Transport of NADH
D. Transport of FADH
| Transport of long chain fatty acid |
8080b3aa-ce1f-40d7-a1d4-4518f86a8206 | Answer- C. CapsulorhexisThe most commonly used technique for anterior capsulotomy during phacoemulsification is continuous curvilinear capsulorhexis (CCC). | Ophthalmology | null | Most common method of anterior capsulotomy in phacoemulsification
A. Can-opener capsulotomy
B. Intercapsular capsulotomy
C. Capsulorhexis
D. Envelop capsulotomy
| Capsulorhexis |
d1155e80-aa21-442e-bea1-3982ad2f31f4 | Ans. is 'a' i.e., Hirschsprung's disease * Surgery in Hirschsprung's disease aims to remove the aganglionic segment and 'pull-through' ganglionic bowel to the anus (e.g. Swenson, Duhamel, Soave and transanal procedures) and can be done in a single stage or in several stages after first establishing a proximal stoma in normally innervated bowel. | Surgery | Small & Large Intestine | Duhamel procedure is done for -
A. Hirschsprung's disease
B. HPSS
C. Meckels diverticulum
D. Volvulus
| Hirschsprung's disease |
6cfa1ab3-bd18-4fd5-9e40-42280bc13424 | Ans. is a i.e. Immunological defect Post coital test is a test for evaluation of the potential role of cervical factor in infeility. The couple is advised intercourse close to ovulation time, in the early hours of morning (preferably) The woman presents herself at the clinic within 2 hours after the intercourse. The mucus is aspirated from the cervical canal and posterior fornix (acts as control) and spread over a glass slide. Result : 10-50 motile Sperms with progressive movement/ HPF in cervical mucus seen Cervical factor ruled out Less than 10 sperms / HPF Need for proper semen analysis to see oligospermia Sperms immotile in mucus aspirated from cervical canal and motile in specimen from posterior fornix or Rotatory/ shaky movement seen in sperms aspirated from cervical canal Immunological defect | Gynaecology & Obstetrics | null | Post coital test showing non motile sperms in the cervical smear and Motile sperms from the posterior fornix suggests :
A. Faulty coital practice
B. Immunological defect
C. Hypospadias
D. Azoospermia
| Faulty coital practice |
b5fdabc9-3c15-4ccd-be8b-89f16e01fb2b | First-Generation Cephalosporins: include - Cefazolin, Cephalexin, Cephradine, Cefadroxil, Cephalothin and Cephapirin Cefazolin is good for skin preparation as it is active against skin infections from S.pyogenes and MRSA. It is administered Intramuscular or Intravenous (i.e Parenteral drug).It is a drug of choice for surgical prophylaxis.Cefazolin does not penetrate the CNS and cannot be used to treat meningitis. Cefazolin is better tolerated than Antistaphylococcal Penicillins, and it has been shown to be effective for serious Staphylococcal infections e.g Bacteremia. Oral First generation drugs may be used for the treatment of urinary tract infections and Staphylococcal or Streptococcal infections, including cellulitis or soft tissue abscess. | Pharmacology | Cell Wall Synthesis Inhibitors | Which of the following is a first-generation Cephalosporin used for surgical prophylaxis?
A. Ceftriaxone
B. Cefoxitin
C. Cefazolin
D. Cefepime
| Cefazolin |
4e093915-8d90-4a28-9acb-ad4080e82b56 | "Tennis racket" shaped Birbeck granules are seen in Langerhan cells, which are antigen presenting cells present in epidermis. | Dental | null | "Birbeck granules" are seen in
A. Melanosomes
B. Lamellar bodies
C. Keratohyalin granules
D. Langerhan cells
| Langerhan cells |
71723e91-54e3-4c7c-81d8-270e0a9b0522 | Felty syndrome consists of chronic RA, splenomegaly, and neutropenia. The increased frequency of infections is due to both decreased number and function of neutrophils. | Medicine | Immunology and Rheumatology | For each extra-articular manifestation of RA, select the most likely diagnosis.Associated with increased frequency of infections.
A. Felty syndrome
B. rheumatoid vasculitis
C. episcleritis
D. Sjogren syndrome
| Felty syndrome |
d37c8381-7042-41f1-aa7a-3322147d9acc | Baker's cyst:- It is a pulsion diveiculum of knee joint.- It usually found in the posterior aspect of the knee joint.- It is associated with medial meniscal injury. | Orthopaedics | Osteochondritis and Avascular Necrosis | Bakers cyst is a type of:
A. Pulsion diveiculum of knee joint
B. Retention cyst
C. Bursitis
D. Benign tumor
| Pulsion diveiculum of knee joint |
1e15b4c7-03d7-4ff0-95fe-53c7621cdc4a | (334) 1 in 200000 REF: Miller 6th ed p. 589 USES AND DOSES OF ADRENALINE: USE DOSE Anaphylaxis SC or IM injection is 0.3-0.5 mg 1:1,000 Croup Racemic adrenaline is a 1:1 mixture of the dextrototary (d) and levorotatory (1) isomers of adrenaline Local anesthetics 1 in 200000 | Anaesthesia | null | Concentration of adrenaline used with lidocaine is?
A. 0.180555556
B. 1.430555556
C. 1:20000
D. 1:200000
| 1:200000 |
f706d5a0-833c-4e31-becf-6727a173e6a7 | Ans. is 'a' i.e., Tolcapone o Both entacapone and tolcapone enhance and prolong the therapeutic effect of levodopa-carbidopa in advanced and fluctuating parkinsons disease. They may be used to smoothen off the 'wearing off', increase 'on' time and decrease loff' time, improve activities of daily living and allow levodopa dose to be reduced,o Treatment of on - off phenomenon in parkinsonism:Add one or two additional doses of levodopa.Continuous delivery of levodopa in duodenum.Avoid proteins in diet.Controlled release oral levodopa.'' peripheral decarboxylase inhibitor.Use of subcutaneous apomorphine. | Pharmacology | Anti-Parkinsonism | Patient on treatment on carbidopa + levodopa for 10 yrs now has weaning off effect. What should be added to restore action -
A. Tolcapone
B. Amantadine
C. Rasagiline
D. Benzhexol
| Tolcapone |
24b6f004-882c-4f5b-a92a-134f6a2a06da | The antibody can be demonstrated in 80-90% of patients, usually late in convalescence, and indicates relative or absolute immunity. In contrast, HBsAg occurs very early and disappears in < 6 months. Persistence of HBsAg indicates chronic infection. The pattern in this patient is also seen postvaccination, and perhaps as a consequence of remote infection. | Medicine | G.I.T. | A 33-year-old man has never been vaccinated for hepatitis B. Serologic tests reveal negative hepatitis B surface antigen (HBsAg) and positive antibody to surface antigen. Which of the following conditions does this serologic pattern best fit with?
A. previous hepatitis B infection
B. chronic active hepatitis
C. acute hepatitis B infection
D. poor prognosis
| previous hepatitis B infection |
59943834-1b81-422a-8fa4-a4097df69354 | b. Elevated sweat chloride levels(Ref: Nelson's 20/e p 2100)Because the function of sweat gland duct cells is to absorb rather than secrete chloride, salt is not retrieved from the isotonic primary sweat as it is transported to the skin surface; chloride and sodium levels are consequently elevated. So sweat chloride is usually 60mEq/L in cystic fibrosis. | Pediatrics | Respiratory System | Which of the following is seen in cystic fibrosis?
A. Low sweat chloride levels
B. Elevated sweat chloride levels
C. Low sweat sodium levels
D. Elevated sweat potassium levels
| Elevated sweat chloride levels |
0255b23e-45f6-4f9a-a407-cc8bcbc85cd3 | The occurrence of hyperglycemic ketoacidosis or hyperglycemic hyperosmolar coma is diagnostic of diabetes mellitus. Similarly, persistent fasting hyperglycemia , even if it is asymptomatic, has been recommended by the National Diabetes Data Group as a criterion for the diagnosis of diabetes. However, abnormal glucose tolerance-whether after eating or after a standard "glucose tolerance test" -can be caused by many factors (e.g., anxiety, infection or other illness, lack of exercise, or inadequate diet). Similarly, glycosuria may have renal as well as endocrinologic causes. Therefore, these two conditions cannot be considered diagnostic of diabetes. Gestational diabetes is diagnosed in women between the twenty-fouh and twenty-eighth weeks of gestation, first using a 50-g oral glucose load if the I-h glucose level >7.8 mmol/L (140 mg/dL); a 100-g oral glucose test is performed after an overnight fast. Gestational diabetes is initially treated with dietary measures; if the postprandial glucose level remains elevated, insulin therapy is often staed. About 30% of women with gestational diabetes will eventually develop true diabetes mellitus. | Medicine | Endocrinology | The diagnosis of diabetes mellitus is ceain in which of the following situations?
A. Abnormal oral glucose tolerance in a 24-yrs-old woman who has been dieting
B. Successive fasting plasma glucose concentrations of 8, 9, and 8.5 mmol/L in an asymptomatic, otherwise healthy businesswoman
C. A serum glucose level >7.8 mmol/L in a woman in her twenty-fifth week of gestation after a 50-g oral glucose load
D. Persistent asymptomatic glycosuria in a 30-yrs-old woman
| Successive fasting plasma glucose concentrations of 8, 9, and 8.5 mmol/L in an asymptomatic, otherwise healthy businesswoman |
7852f2d4-e399-4a5e-b2e2-ec313fe8a6b0 | Motor speech area of Broca (Brodmann's area 44, 45) occupies the opercular and triangular poions of the inferior frontal gyrus of the dominant hemisphere. Broca's area is formed of two minor gyri, called pars opercularis and pars triangularis, that lie in the posterior end of the inferior frontal gyrus. This area subserves expressive language function. | Anatomy | null | The opercular poion of the cerebral coex that contains Broca's area is which of the following?
A. Superior frontal gyrus
B. Inferior frontal gyrus
C. Cingulate sulcus
D. Insula
| Inferior frontal gyrus |
00e6c446-8079-46ca-920a-dcd09b7eb9b6 | Retinoblastoma and osteosarcoma both can occur due to mutation in common gene i.e RB gene. Hence both have strongest association. | Pathology | null | Which of the following has strongest association with osteosarcoma?
A. Wilms tumor
B. Retinoblastoma
C. Rhabdomyosarcoma
D. Ewings tumor
| Retinoblastoma |
596565b9-1e3c-4555-83d6-1fac5f979d26 | In early clinical septic shock, renal function was lower, which was accompanied by renal vasoconstriction, a lower renal oxygen delivery, impaired renal oxygenation, and tubular sodium reabsorption at a high oxygen cost compared with controls decrease or decline in the GFR implies progression of underlying kidney disease or the occurrence of a superimposed insult to the kidneys. This is most commonly due to problems such as dehydration and volume loss. An improvement in the GFR may indicate that the kidneys are recovering some of their function Ref Davidson 23rd edition pg 460 | Medicine | C.V.S | Features of shock
A. Decreased GFR
B. Increased renin
C. Decreased rennin
D. Decreased Coisol
| Decreased GFR |
6ffb5460-546d-493b-b123-737e6c763586 | Ans. is 'a' i.e., Ampicillin Treatment of listeria infectiono The antibiotic of choice for listeria infection is ampicillin or penicillin G.Antibiotic regimens for listeria infection||||First line regimensPenicillin allergic patientsAlternative drugso Ampicillin or Penicillin is the drug of choiceo Trimethoprim sulphame- thoxazoleo Imipenem and meropenemo Other antibiotic that are less effective# Vancomycin# Erythromycin# Chloramphenicol | Medicine | Bacteriology | DOC for listeria meningitis:
A. Ampicillin
B. Cefotaxime
C. Cefotriaxone
D. Ciprofloxacin
| Ampicillin |
7812f895-581e-4c47-a3c7-23734b04491b | The common peroneal nerve is extremely vulnerable to injury as it winds around the neck of the fibula if that happens, clinical features are:Motor loss-a)The foot drop is due to paralysis of muscles of anterior compament of the leg (dorsiflexors of the foot) {dorsiflexion not possible}.b)Loss of extension of toes due to the paralysis of extensor digitorum longus & extensor hallucis longus.c)Loss of eversion of the foot due to paralysis of peroneus longus & brevis.Sensory loss- Sensory loss on the anterior aspect of the leg & whole of the dorsum of foot except the cleft between the great & second toes, which is supplied by the branch from the deep peroneal nerve. | Anatomy | Abdomen and pelvis | A man is stuck with lathi on the lateral aspect of the head of the fibula. Which of the following can occur as a result of nerve injury
A. Loss of sensation of lateral foot
B. Loss of sensation of adjacent sides of 1st & 2nd toe
C. Inversion inability
D. Loss of dorsiflexion
| Loss of dorsiflexion |
cafbb28c-3a0d-436d-85c0-1eded8e44f55 | Ans. is 'c' i.e., IUCD o Actinomycosis may occur by use of IUCD.Side effects and complications of lUDs1. Bleeding - Most common2. Pain - Second major side effect3. Pelvic infection - PID4. Uterine perforation5. Pregnancy6. Ectopic pregnancy7. Expulsion8. Mortality' - extremely rare | Social & Preventive Medicine | Family Planning | Contraception with increased risk of actinomycosis -
A. OCPs
B. Condom
C. IUCD
D. Vaginal
| IUCD |
012fcc39-b037-46f3-8a0e-1dfe556a6165 | Wilms tumor is a rare kidney cancer that is highly treatable. Most kids with Wilms tumor survive and go on to live normal, healthy lives. Also known as nephroblastoma, Wilms tumor can affect both kidneys, but usually develops in just one Wilms' Tumor; Nephroblastoma) Wilms tumor is an embryonal cancer of the kidney composed of blastemal, stromal, and epithelial elements. Genetic abnormalities have been implicated in the pathogenesis, but familial inheritance accounts for only 1 to 2% of cases. Diagnosis is by ultrasonography, abdominal CT, or MRI The AMER1 gene is located on the X chromosome (one of the two sex chromosomes), so when Wilms tumor is caused by mutations in this gene, the condition follows an X-linked dominant pattern Ref Harrison20th edition pg 233 | Medicine | Kidney | A six year old male baby presents to a hospital with recurrent gross hematuria for 2 years. There is no h/o burning micturition or pyuria. Urine routine examination demonstrated no pus cells and urine culture was sterile. Serum C3 levels were normal. What is the most probable diagnosis-
A. Wilm's tumour
B. IgA nephropathy
C. Post-streptococcal glomerulonephritis
D. Urinaiy tract infection
| Wilm's tumour |
6d893f23-4404-4711-97df-e266c407ecdc | Answer is A (5HIAA): The diagnosis of typical carcinoid tumors is done by measurement of 5HIAA levels. Diagnosis of Carcinoid Tumors (Harrison) The diagnosis of carcinoid syndrome relies on measurement of urinary or plasma serotonin or its metabolites in the urine. Typical carcinoid syndrome (high level of serotonin) is characterized by high levels of 5HIAA. The measurement of 5HIAA is most frequently used for typical carcinoid syndrome. Most physicians' only use urinary 5HIAA levels / excretion rates however plasma and platelets serotonin levels if available provide additional information. Platelet serotonin levels (5-HT) are more sensitive than urinary 5HIAA levels but are not generally available. Atypical carcinoid syndromes (low levels of serotonin) may have normal or minimally elevated 5HIAA levels. In such patient's urinary levels of other tryptophan metabolites such as 5HTP should be measured. Elevated levels of urinary 5 HTP is suggestive of an atypical carcinoid syndrome. | Medicine | null | Diagnosis of carcinoid tumors is done by:
A. 5HIAA
B. DHEA
C. DHEA
D. Metanephrines
| 5HIAA |
413efacc-9e54-44e4-b93f-f089da1be4f7 | Ans. is 'a' i.e.Heimlich's maneuver The best option here is Heimlich's maneuver."Heimlich man oeuvre: stand behind the person and place your arms around his lower chest and give four abdominal thrusts. The residual air in the lungs may dislodge the foreign body providing some airway. "Heimlich's maneuveris actually performed for laryngeal foreign bodies and not for tracheal or bronchial foreign bodies.Heimlich's is performed for completed obstruction and should not be tried in partial obstructions (for fear of causing total obstruction )If Hemlocks m fails then cricothyrotomy or emergency tracheostomy is done.Once the emergency is over, foreign body can be removed by direct laryngoscopy or by laryngofissure (if body is impacted )Tracheal & Bronchial foreign bodiesEmergency removal is not indicated in these ( unless there is airway obstruction or they are of vegetable matter eg seeds likely to swell up)Removed by bronchoscopy with full preparation and under GA.Rigid bronchoscope is used. | Unknown | null | A 6 years child has foreign body in trachea .Best initial management is
A. Heimlich's maneuver
B. Cardiac massage
C. Intubation
D. Oxygen mask with IPPV
| Heimlich's maneuver |
8dcc696c-7f89-4cd2-851f-042d34b20d67 | Malleus and incus are derived from mesoderm of 1" arch. Stapes develops from second arch except its footplate and annular ligament which are derived from the otic capsule. | ENT | null | Stapes develops from:
A. 1st arch
B. 2nd arch
C. 3rd arch
D. 4th arch
| 2nd arch |
33073045-5925-4618-8c87-44951c55fd12 | ICD ICD mentions International classification of mental and behavioural disorders this was given by WHO( World health Organisation) ICD is used all over the world except America latest edition of ICD is ICD11 ICD 11 was released in 2018 DSM DSM mentions Diagnostic and Statistical manual of mental disorders this was given by APA( American Psychiatric Assosiation) DSM is used in America latest edition of DSM is DSM 5 ICD 11 was released in 2018 categorisation ofmental disorders in ICD 10 is mentioned below F00-F09 Organic, including symptomatic, mental disorders F10-F19 Mental and behavioural disorders due to psychoactive substance use F20-F29 Schizophrenia, schizotypal and delusional disorders F30-F39 Mood disorders ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992 | Psychiatry | Symptoms and signs in psychiatry and classification | Which category of ICD is associated with schizophrenia
A. F0
B. F1
C. F2
D. F3
| F2 |
a6cc2e3a-7c24-4ec8-bc91-ab000d9c6082 | Ans. is 'd' i.e., Apical o The apical group of axillary lymph node receives lymph from anterior (pectoral), posterior (subscapular), central and lateral (humeral) group of axillary lymph nodes. Hence apical group of lymph node is the terminal group of axillary lymph node.Axillary lymph nodeRelated vesselsAnterior (pectoral)Along lateral thoracic vesselsPosterior (scapular)Along subscapular vesselsLateralMedial to axillary veinApical (terminal or infraclavicular)Along axillary vessels | Anatomy | Pectoral Region, Axilla & Brachial Plexus | Terminal axillary draining lymph nodes -
A. Anterior
B. Posterior
C. Scapular
D. Apical
| Apical |
e0a36d91-11cf-4b05-a8e1-33eea89d1412 | Norms under Appropriate technology: Technology that is scientifically sound. adaptable to local needs. acceptable to those who apply it and those for whom it is used. can be maintained using the locally available resources. - Shakir's tape used to measure mid-arm circumference of child accept all the above norms. | Social & Preventive Medicine | PH Care, Elements & Principles | Shakir's tape is an example of:
A. Community paicipation
B. Intersectoral coordination
C. Equitable distribution
D. Appropriate technology
| Appropriate technology |
29ff1468-bf9c-442f-81b9-ab7524e294be | "Along with cryptogenic infections, infections from the biliary tree are presently the most common identifiable cause of the hepatic abscess. Biliary obstruction results in bile stasis, with the potential for subsequent bacterial colonization, infection and ascension into the liver. This process is k/a ascending suppurative cholangitis. The nature of biliary obstruction is mostly related to stone disease or malignancy. In Asia, intrahepatic stones and cholangitis (recurrent pyogenic cholangitis) is a common cause, whereas, in the Western world, malignant obstruction is becoming a more predominant factor" Ref : Sabiston 18/e p1485 | Anatomy | G.I.T | In pyogenic liver abscess commonest route of spread
A. Hematogenous through poal vein.
B. Ascending infection through biliary tract
C. Hepatic aery
D. Local spread
| Ascending infection through biliary tract |
64168483-ee9b-4e9f-9426-398295d8f02b | ANSWER: (D) Rota virusREF: www.ncbi.nlm.nih.gov, J Clin Microbiol v. 26(12); Dec 1988Though none of the text books specifically mention most common causes of acute infantile gastroenteritis, most of the literature search in pubmed , cochrane and medscape and major text books of pediatrics point to: Viruses are more common causes of gastroenteritits in children. Of the viruses most common is rotavirus.Other viruses implicated are calciviruses, Norwalk, adenovirus.Also E.coli is a major cause of diarrhea in children.Other bacteria are: campylobacterium, yersinia enterocolitica, A. hydrophillia . | Pediatrics | Stomach and Intestines | Most common cause for acute infantile gastroenteritis is?
A. Adenovirus
B. E coli
C. Norwalk virus
D. Rota virus
| Rota virus |
b0eb0a2d-7462-46a1-8057-05372c86bc19 | • High spinal cord injuries can also result in systemic hypotension because of loss of sympathetic tone.
• The patient will usually have hypotension and relative bradycardia and will show evidence of good peripheral perfusion on physical examination.
• The term neurogenic shock is used but is somewhat of a misnomer because these patients are typically hyperdynamic, with high cardiac output secondary to loss of sympathetic vascular tone.
Treatment
• Hypotension associated with high spinal injury can be treated by alpha-agonist phenylephrine. | Surgery | null | Hypotension in acute spinal injury is due to:
A. Loss of sympathetic tone
B. Loss of parasympathetic tone
C. Orthostatic hypotension
D. Vasovagal attack
| Loss of sympathetic tone |
c83df0f3-7835-4cf2-b569-fc5f257872fb | Ans. is 'c' i.e., Asbestosis "Ferruginous bodies are most commonly seen in asbestosis". ------------Chandrasoma Taylor* Ferruginous bodies represent foreign inorganic or organic fibers coated by complexes of iron and glycoproteins.* While ferruginous bodies are most commonly seen in asbestosis they are not diagnostic because it may be seen in other type of pneunoconiosis.* When asbestos fiber is coated by iron and glycoprotein, this ferruginous body is called asbestos body-characteristic of asbestosis.* Ferruginous bodies are best seen in section that have stained for iron with prussion blue.* Microscopically ferruginous bodies give a Sheikh Kebab appearance. | Pathology | Respiration | Ferruginous bodies are seen in?
A. Silicosis
B. Bysinosis
C. Asbestosis
D. Baggassosis
| Asbestosis |
f48f441c-aa4e-4633-85ec-23701bb7217f | Hydrocyanic acid is also used as cattle poison. Cattle poisoning has been known to occur from eating linseed plant because of the natural development of a cyanogenic glycoside which may liberate hydrocyanic acid. Ref: Essentials of Forensic Medicine and Toxicology By Dr K S Narayan Reddy, 27th Edition, Pages 559-60 | Forensic Medicine | null | Which type of cattle poisoning occurs due to ingestion of LINSEED plant?
A. Aconite
B. Atropine
C. Pilocarpine
D. Hydrocyanic acid
| Hydrocyanic acid |
29a74e03-0163-431c-a2e5-084902f25342 | Includes anaphylactic shock, septic shock and spinal cord injury (neurogenic shock).
Inadequate organ perfusion is associated with vascular dilatation and hypotension, low systemic vascular resistance, inadequate afterload and a resulting abnormally high cardiac output.
In anaphylaxis, vasodilatation is due to excess histamine release.
Neurogenic shock is caused by traumatic or pharmacological blockage of the sympathetic nervous system, producing dilatation of resistance arterioles and capacitance veins, leading to relative hypovolemia and hypotension.
In neurogenic shock, because of loss of vascular tone, JVP will fall. | Pathology | null | A 40 year old female patient complains of excessive bleeding and drowsiness. Patient gives a history of road traffic accident 5 hours ago and had a lacerated wound on lower back region. General physical examination reveals-
Blood pressure-80/60mmHg.
Juglar venous pressure- low.
Pulsus paradoxus- present.
Cardiac output- Increased.
The patient is in which type of shock?
A. Neurogenic
B. Obstructive
C. Distributive
D. Hypovolemic
| Distributive |
4f35d97f-70e7-40c9-befe-f9c759900efd | Ans. is 'b' i.e., Etomidate Effects of Etomidate on cardiovascular systemEtomidate has minimal effects on the cardiovascular system.It causes mild reduction in peripheral vascular resistance which may cause a slight decline in arterial blood pressure.Myocardial contractility and cardiac output are usually unchanged. Etomidate does not release histamine. Cardiovascular effect of Propofol:The major cardiovascular effect of propofol is a decrease in arterial blood pressure due to a drop in systemic vascular resistance (inhibition of sympathetic vasoconstrictor activity, cardiac contractility and preload).Propofol markedly impairs the normal arterial baroreflex response to hypotension. Sometimes there may be a marked drop in preload.Cardiovascular effect of barbiturates (Thiopental)The cardiovascular effect of barbiturates vary markedly depending on the volume status, bas line autonomic tone and preexisting cardiovascular disease.Normally, intravenously administered barbiturates cause a fall in blood pressure.Cardiac output is maintained due to increase in heart rate and increased myocardial contractility from compensatory baroreceptor reflexes.However, in the absence of adequate baroreceptor response (e.g., hypovolemia, congestive heart failure, b adrenergic blockade) cardiac output and arterial blood pressure may fall dramatically due to uncompensated pooling and unmasked direct myocardial depression.Effect of ketamine on cardiovascular systemKetamine causes central stimulation of sympathetic system which causes increased arterial blood pressure, heart rate and cardiac output. There is also increase in pulmonary artery pressure and myocardial work.Because of these effects, ketamine should be avoided in patients with coronary artery disease, uncontrolled hypertension, congestive heart failure and arterial aneurysms. | Anaesthesia | Anesthesia for Cardiovascular Disease and Surgery | Which of the following induction agent produce cardiac stability-
A. Ketamine
B. Etomidate
C. Propofol
D. Midazolam
| Etomidate |
6b4cc7c6-c1bc-4dba-b49c-34a9f1648bca | Ans. D i.e. Prostate carcinoma Metastases to bones are usually osteolytic. Osteoblastic lesions are uncommon. | Surgery | null | Osteoblastic secondaries arises from: March 2003
A. Renal carcinoma
B. Thyroid carcinoma
C. GIT carcinoma
D. Prostate carcinoma
| Prostate carcinoma |
c8985d5b-5424-40f6-b3bb-d20b9ac4800d | All of the medications listed as answer choices can be effectively used in the treatment of hypeension. Spironolactone is a "potassium-sparing" diuretic that exes its action primarily as a competitive inhibitor of aldosterone receptors in the distal nephron. One of the repoed side effects of spironolactone is gynecomastia. None of the other choices have gynecomastia as a side effect. Captopril is an angiotensin-conveing enzyme (ACE) inhibitor that causes a decrease in plasma angiotensin II concentration, resulting in decreased aldosterone secretion. Furosemide is a "loop diuretic" that acts by inhibiting the reabsorption of sodium and chloride ions in the loop of Henle as well as in the proximal and distal renal tubules. Hydrochlorothiazide is a "thiazide diuretic" that inhibits the reabsorption of sodium and chloride ions in the distal renal tubules. Ref: Snyder P.J. (2011). Chapter 41. Androgens. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | Pharmacology | null | A 52 year old male presents to his physician with a chief complaint of a substantial increase in the size of his breasts over the past few months. Three months ago he was diagnosed with hypeension, and placed on antihypeensive medication. Which of the following medications was most likely prescribed?
A. Captopril
B. Furosemide
C. Hydrochlorothiazide
D. Spironolactone
| Spironolactone |
e7748524-13f1-45f7-8fa8-c2ad528570ba | Prostate-specific antigen (PSA) and Digital rectal examination (DRE) Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years. Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65). Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age). | Surgery | Urology | 50 year old male with positive family history of prostate cancer has come to you for a screening test. The screening test done to pickup prostate cancer is
A. DRE
B. PSA
C. DRE + PSA
D. Endorectal coil MRI with T1 and T2 W images
| DRE + PSA |
d2562808-8c78-4dce-bfeb-7094dc1eaa0d | Ans. is 'a' i.e., Retinitis pigmentosa Associations of retinitis pigmentosa Ocular associations : These include myopia, primary open angle glaucoma, microphthalmos, conical cornea and posterior subcapsular cataract. Systemic associations : These are in the form of following syndromes :- i) Laurence-Moon-Biedl syndrome : It is characterised by retinitis pigmentosa, obesity, hypogenitalism, polydactyly and mental deficiency. ii) Cockayne's syndrome : It comprises retinitis pigmentosa, progressive infantile deafness, dwarfism, mental retardation, nystagmus and ataxia. iii) Refsum's syndrome : It is characterized by retinitis pigmentosa, peripheral neuropathy and cerebellar ataxia. iv) Usher's syndrome : It includes retinitis pigmentosa and labyrinthine deafness. v) Hallgren's syndrome : It comprises retinitis pigmentosa, vestibulo-cerebellar ataxia, congenital deafness and mental deficiency. | Ophthalmology | null | Refsum's syndrome is associated with ?
A. Retinitis pigmentosa
B. Xerophthalmia
C. Chalcosis
D. Diabetes retinopathy
| Retinitis pigmentosa |
3e897822-0a45-46b6-87d4-d643aac4b1f0 | Dry tap is usually defined as a "failure to obtain bone marrow on attempted marrow aspiration". The diagnosis and management of many haematological diseases depends on examination of the bone marrow, which involves two separate specimens i.e. a cytologic and a histologic preparation.Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called a trephine biopsy) and bone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, lymphoma, anemia, and pancytopenia. The bone marrow produces the cellular elements of the blood, including platelets, red blood cells and white blood cells. While much information can be gleaned by testing the blood itself (drawn from a vein by phlebotomy), it is sometimes necessary to examine the source of the blood cells in the bone marrow to obtain more information on hematopoiesis; this is the role of bone marrow aspiration and biopsy. | Pathology | General pathology | Bone marrow finding in myelofibrosis-
A. Dry tap (hypocellular)
B. Megaloblastic cells
C. Microcytic cells
D. Thrombocytosis
| Dry tap (hypocellular) |
06980865-1717-4a36-a03e-eb20a056d899 | .Locally Advanced Carcinoma of Breast (LABC) * It means locally advanced tumour with muscle/chest wall involvement, extensive skin involvement or fixed axillary nodes. It will be T3, T4a, T4b, T4c or T4d or N2 or N3. * It is investigated by FNAC of tumor, mammography of opposite breast, chest CT, CT abdomen or whole body bone scan. Biopsy is needed to assess receptor status. * Treatment of LACB is always palliative by simple mastectomy, toilet mastectomy, chemotherapy and therapy using tamoxifen. * Initial neoadjuvant chemotherapy; surgery; radiotherapy; adjuvant chemotherapy are other therapeutic plan. ref:SRB&;s manual of surgery,ed 3,pg no 491 | Surgery | Endocrinology and breast | 40 yr old female presented with breast lump of size 4 cm with involvement of skin and mobile palpable axillary LN, FNAC of lesion showed intrductal carcinoma. What is the initial management of for this pt?
A. Radiotherapy
B. Neo-adjuvant chemotherapy
C. Modified radical mastectomy
D. Simple mastectomy
| Neo-adjuvant chemotherapy |
316aa068-c56a-479e-97f8-12700093e966 | ANSWER: (A) ThoracolumbarREF: Apley 387-389, S M Tuli 3rd edition page 192Most common site of skeletal tuberculosis is spine followed by hip and knee SPINE (50%) > HIP > KNEECommonest spine involved in spine TB is Thoracolumbar/Dorsolumbar T12-L1 (Lower thoracic to be precise)LOWER THORACIC > LUMBAR > UPPER THORACICParaplegia due to pott s spine most commonly involves upper thoracic vertebrae as in upper thoracic vertebrae there is more acute kyphosis, spinal canal is narrow and spinal cord is relatively large.First symptom of TB spine is "Pain on movement"Commonest symptom of TB spine is "Back pain" | Orthopaedics | TB of the Spine | Pott's spine is commonest at which spine:
A. Thoracolumbar
B. Sacral
C. Cervical
D. Lumbosacral
| Thoracolumbar |
9d193952-cd22-4aab-a77e-c28dbfa697ea | This may be caused by haemorrhage from the colon, anal canal or small bowel. It is useful to distinguish those patients who present with profuse, acute bleeding from those who present with chronic or subacute bleeding of lesser severity .Severe acute lower gastrointestinal bleeding .This presents with profuse red or maroon diarrhoea and with shock. Diveicular disease is the most common cause and is often due to erosion of an aery within the mouth of a diveiculum. Bleeding almost always stops spontaneously, but if it does not, the diseased segment of colon should be resected after confirmation of the site by angiography or colonoscopy. Angiodysplasia is a disease of the elderly, in which vascular malformations develop in the proximal colon. Bleeding can be acute and profuse; it usually stops spontaneously but commonly recurs. Diagnosis is often difficult. Colonoscopy may reveal characteristic vascular spots and, in the acute phase, visceral angiography can show bleeding into the intestinal lumen and an abnormal large, draining vein. In some patients, diagnosis is achieved only by laparotomy with on-table colonoscopy. The treatment of choice is endoscopic thermal ablation but resection of the affected bowel may be required if bleeding continues. Bowel ischaemia due to occlusion of the inferior mesenteric aery can present with abdominal colic and rectal bleeding. It should be considered in patients (paicularly the elderly) who have evidence of generalised atherosclerosis. The diagnosis is made at colonoscopy. Resection is required only in the presence of peritonitis. Meckel's diveiculum with ectopic gastric epithelium may ulcerate and erode into a major aery. The diagnosis should be considered in children or adolescents who present with profuse or recurrent lower gastrointestinal bleeding. A Meckel's 99mTc-peechnetate scan is sometimes positive but the diagnosis is commonly made only by laparotomy, at which time the diveiculum is excised Primary prevention of variceal bleeding If non-bleeding varices are identified at endoscopy, b-adrenoceptor antagonist (b-blocker) therapy with propranolol (80-160 mg/day) or nadolol (40-240 mg/day) is effective in reducing poal venous pressure. Administration of these drugs at doses that reduce the hea rate by 25% has been shown to be effective in the primary prevention of variceal bleeding. In patients with cirrhosis, treatment with propranolol reduces variceal bleeding by 47% (number needed to treat for benefit (NNTB) 10), death from bleeding by 45% (NNTB 25) and overall moality by 22% (NNTB 16). The efficacy of b-blockers in primary prevention is similar to that of prophylactic banding, which may also be considered, paicularly in patients who are unable to tolerate or adhere to b-blocker therapy. Carvedilol, a non-cardioselective vasodilating b-blocker, is also effective and may be better tolerated at doses of 6.25-12.5 mg/day). For these, dose should be titrated, as tolerated, to achieve a hea rate of 50-55 beats/min, if possible.metrandazole can be given sigmoidal ulcer Ref Davidson edition23rd pg 869 | Medicine | G.I.T | A patient present with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers inthe sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment -
A. Intravenous ceftriaxone
B. Intravenous metronidazole
C. Intravenous steroids and sulphasalazine
D. Hydrocoisone enemas
| Intravenous metronidazole |
400e6742-bacc-4a9c-a429-59663de48fe7 | Ans. is 'd' ie. Peutz-jeghers syndrome Peutz-Jeghers syndorme consists of: hamaomatous polyps throughout the intestine with maximum density in the jejunum* melanosis of the oral mucous membrane and the lips. The melanosis takes the form of melanin spots sometimes presents on the digits and the perianal skin, but the pigmentation of the lips is the sine quanon. | Surgery | null | Lalita, a female pt. presents with pigmentation of the lips and oral mucosa and intestinal polyps. Her sister also gives the same history. Most probable diagnosis is -
A. Carcinoid tumor
B. Melanoma
C. Villous adenoma
D. Peutz-Jegher syndrome
| Peutz-Jegher syndrome |
4a6c9724-dec1-4fd3-a976-36de2d9f0dd4 | Ans. is 'a1 i.e., Zygomatic fracture o Zygoma fracture is also known as tripoid fracture.Clinical features of zygoma fractureo Considerable swelling over zygomatic arch is common and makes clinical diagnosis more difficult.o Flattening of malar prominence.o Step-deformit of infraorbital margin.o Anaesthesia in the distribution of infraorbital nerve.o Trimus, due to depression of zygoma on the underlying coronoid process.o Oblique palpebral fissure, due to the displacement of lateral palpebral ligament.o Restricted ocular movement, due to entrapment of inferior rectus muscle. It may cause diplopia.o Periorbital emphysema, due to escape of air from the maxillary sinus on nose-blowing.o The mucosa of the maxillary sinus may be lacerated and cause epistaxis on that side.o Fracture of the zygoma may or may not be painful to palpation and running a finger along the zygomatic arch may give a feel of a depressedfracture or a small dimple. The cheek may appear flattened; compared symmetry with the opposite side. This may be obvious immediately following trauma or several days later once swelling has subsided. | ENT | Nose and PNS | Tripod fracture is the name given for -
A. Zygomatic fracture
B. Maxillary fracture
C. Mandibularfracture
D. Temporal fracture
| Zygomatic fracture |
727a3efd-7dd0-4355-8073-514f975edb01 | SLE like syndrome is caused due to S-SULPHONAMIDES H-HYDRALAZINE I-ISONIAZIDE P-PROCAINAMIDE Ref-KDT 7/e p66 | Anatomy | General anatomy | SLE like reaction is caused by
A. Hydralazine
B. Rifampicin
C. Paracetamol
D. Furosemide
| Hydralazine |
e1cf7219-d88d-46d2-b1bb-5b1ee155fa99 | (IV Lignocaine): Ref: 463-KDT (514-KDT 6th)Treatment of digitalis induced ventricular arrhythmias* Lignocaine IV repeated as required is the drug of choice. It suppresses the excessive automaticity but does not accentuate A V block* Phenytoin is also useful but not preffered now (sudden death occurs)* Quinidine and procainamide are contraindicated. | Pharmacology | C.V.S | The drug of choice in digitalis induced ventricular arrhythmias is:
A. I.V. Lignocaine
B. Phenytoin
C. Quinidine
D. Procainamide
| I.V. Lignocaine |
43746273-1b76-4c58-97ac-7de0af6fdab0 | Tay-Sachs disease is a lethal, autosomal recessive disorder caused by an inborn deficiency of hexosaminidase A, which permits the accumulation of ganglioside GM1 in CNS neurons. The disease is fatal in infancy and early childhood. Retinal involvement increases macular transparency and is responsible for a cherry-red spot in the macula. On histologic examination, lipid droplets are seen in the cytoplasm of distended nerve cells of the CNS and peripheral nervous system. Electron microscopy reveals the lipid within lysosomes in the form of whorled "myelin figures." Swollen neurons that exhibit marked vacuolization of the perikaryon and contain lysosomes filled with lipid can also occur in other lipid-storage diseases (e.g., Gaucher disease, Niemann-Pick disease). The other diseases do not produce such neuronal changes.Diagnosis: Tay-Sachs disease | Pathology | Central Nervous System | A 1-year-old boy presents with a delay in motor development. Progressive muscle weakness and blindness ensue, and the patient dies within a year. The brain at autopsy shows swollen neurons that contain numerous lysosomes filled with lipid. Which of the following is the most likely diagnosis?
A. AL amyloidosis
B. Hurler syndrome
C. Phenylketonuria
D. Tay-Sachs disease
| Tay-Sachs disease |
3589876c-919b-4ce7-ba8b-598a71343f7d | Ans. is 'b' i.e., E. coli o E. coli & streptococcus agalactie (group B streptococci) are the two most common cause of neonatal sepsis and meningitis. | Pediatrics | null | Most common cause of neonatal meningitis-
A. Staphylococcus
B. E. coli
C. H. influenze
D. Pneumococcus
| E. coli |
69f8092f-1fd4-489f-818f-72c1bd562463 | Conjugation
Bacterial conjugation is the transfer of genetic material between bacteria through direct cell to cell contact or through a bridge- like the connection between two cells.
Conjugation is a process whereby a donor (male) bacterium makes physical contact with a recipient (female) bacterium.
Donor status is determined by the presence of plasmid.
This plasmid codes for specialized fimbria (sex pilus) and for self-transfer.
Sex pilus (conjugation tube) helps in transfer of genetic material from male bacterium to female bacterium.
The plasmid is known as transfer factor (sex factor or fertility factor).
The plasmid may be R factory which codes for transferrable multiple drug resistance.
The DNA of the plasmid replicates during transfer so that each bacterium receives a copy → Recipient becomes a donor and the donor retains its donor status. | Microbiology | null | R-factor in bacteria is transferred by
A. Transduction
B. Transformation
C. Conjugation
D. Vertical transmission
| Conjugation |
21ec65bc-a0f9-4c62-b8b0-0d3dc5f8b331 | D i.e. Bicarbonate Transpo of CO2 in the form of bicarbonate ions accounts for approximately 70% of transpoed carbon dioxide from the tissues to lungs Q. So CO2 is transpoed as plasma HCO3 - > RBC > HCO3- > Carbamino compound > dissolved CO2 Q &Transpo of Carbon Dioxide Carbon dioxide is transpoed in the blood as: HCO3- (70%) > carbamino compounds (23%) > dissolved CO2 (7%) Chloride Shift/ Hamburger Phenomenon When the negatively charged (HCO3-) bicarbonate ions move out of red blood cell into the plasma, to maintain the electrolytic equilibrium the negatively charged chloride ions move into the Red blood Cells from plasma (In plasma plenty of sodium chloride is present). This process is mediated by band 3 membrane protein Chloride shift occurs in: 1 secondQ Hematocrit of venous blood is: greater (by 3%)than that of aerial bloodQ PH of venous blood (7.36) is lower than that of aerial blood (7.40)Q * For each CO2 molecule added to RBC there is increase in one osmotically active paicle in cell either HCO3- or CI-. So RBC take up water & swell. For this reason plus a fact that some aerial fluid returns lymphatics rather than the veins, the hematocrit of venous blood is 3% greater than aerial bloodQ. Amount of 02 enters the body/min = 250 inVininQ Amount of CO2 excreted by lung/ min = 200 inVininQ (288 L/day)Q * CO2 is 20 times more soluble than 02 | Physiology | null | CO2 is primarily transpoed in the aerial blood as
A. Dissolved CO2.
B. Carbonic Acid.
C. Carbamino-hemoglobin.
D. Bicarbonate
| Bicarbonate |
f09c1184-52d9-481d-97be-018d1a798945 | The sequence of SPECIFIC events of Pubeal events in girls is thelarche, pubarche, linear growth spu, menarche. Please note: This is not to confuse with accelarated general physical growth which is the first event in pubey Pubey Specific events in girls Events in boys 1st Thelarche Testicular enlargement 2nd Pubarche Penile enlargement & pubic hairs 3rd Linear Growth,Height, spu Linear Growth spu 4th Menarche Axillary hair and facial hairs In girls, pubeal development typically takes place over 4.5 years. The first sign of pubey is accelerated growth, and breast budding is usually the first recognized pubeal change, followed by the appearance of pubic hair, peakgrowth velocity, and menarche.... Novaks Gyne | Gynaecology & Obstetrics | DNB 2018 | What is the sequence of development of pubey in girls ?
A. Thelarche, Pubarche, linear growth spu, Menarche,
B. Pubarche, Thelarche, Menarche, linear growth spu
C. Pubarche, Menarche, Thelarche, linear growth spu
D. Menarche, Thelarche, Pubarche, linear growth spu
| Thelarche, Pubarche, linear growth spu, Menarche, |
5fb4705e-3b44-41da-ad08-25688404bdab | Ans. is 'b' i.e. epinephrine injection Urticaria, swelling of lips, hypotension and bronchospasm within 5 minutes of i.v penicillin suggests anaphylactic reaction. It's a major problem with the use of penicillin.The t/t of choice for anaphylaxis is i.v epinephrine. | Pharmacology | Penicillin & Cephalosporin | A 70 - year- old man was administered penicilline intravenously. Within 5 minutes, he developed genralised urticaria, swelling of lips, hypotension and bronchospasm. The first choice of treatment is to administer:
A. chlorphenitramine inj.
B. Epinephrine inj.
C. High dose hydrocortisone tablet
D. nebulised salbutamol
| Epinephrine inj. |
663ce243-7b00-468a-b2cb-aea89130cc9b | Ans. is 'b' i.e., 1700 ml Fluid requirment in a child o It depends on the weight of a child :- Weight Water requirments < 10 kg o 100 ml/kg/day 10-20 kg o 100 ml / kg / day for first 10 kg (i.e. 1000 ml) + 50 ml / kg / d for every kg above 10 kg. >20 kg o 100 ml/kg/day for first 10 kg (i.e. 1000 ml) + 50 ml / kg / d for next 10 kg (i.e. 500 ml) + 20 ml / kg / d for every kg above 20 kg. o The child in question has weight of 30 kg. o So, fluid requirment will be :- i) 1000 ml for first 10 kg Plus ii) 500 ml for 10-20 kg Plus iii) 200 ml (20 x 10) for 20-30 kg o Total requirment will be 1700 ml. | Pediatrics | null | Daily water requirement in child weighing 30 kgs, height 123 m and BSA of 1 m2 is-
A. 1300 m1
B. 1700 ml
C. 2000 ml
D. 2500 ml
| 1700 ml |
b9aac52e-05c8-4feb-9869-ab57c9704bdd | The history is suggestive of delusion of persecution (fear that schoolmates may "harm" him) and delusion of reference (belief that classmates laugh at him and talk about him). Had they not used the term "harm" and "scared" a diagnosis of social anxiety disorder could have been enteained. | Psychiatry | Schizophrenia Spectrum and Other Psychotic Disorders | A 16 year old boy does not attend school because of the fear of being harmed by school mates. He thinks that his classmates laugh at him and talk about him. He is even scared of going out of the market. He is most likely suffering from:
A. Anxiety disorder
B. Manic depressive psychosis (bipolar disorder)
C. Adjustment reaction
D. Schizophrenia
| Schizophrenia |
9efce15d-8682-4927-b158-6927e4fd276e | WTl is the best characterized Wilms tumor gene. It is located at chromosome llp13 and encodes for a transcription factor that is critical for normal development of kidneys and gonads. WT2 is localized to a cluster of genes at llpl5. Reference: Essential paediatrics; O.P.Ghai; Childhood Malignancies; Page no: 617 | Pediatrics | Childhood tumors | Chromosome involved in Wilm's tumor is
A. 11
B. 13
C. 18
D. 22
| 11 |
79efe49b-5816-4588-a0d7-4f9433db2335 | Ans. is 'c' i.e., LGV * 'Groove sign of Greenblatt' is pathognomonic of LGV (secondary stage) - when inguinal lymph nodes are enlarged, they are separated by Poupart's ligment, producing a groove.Lymphogranuloma venerum (lymphogranuloma inguinale)* LGV is caused by chlamydia trachomatis, serotypes LI, L2, L3. Serotype L2 is the most common cause. The clinical course of LGV consist of following three stages : -i) First stage (Primary LGV): - Self limited, Single, asymptomatic, painless, non bleeding genital ulcer.ii) Secondary stage: - Painful inguinal lymphadenopathy (Remember - Ulcer is painless but lymphadenopathy is tender & painful). Swollen lymph nodes coalesce to form bubos, i.e., matted lymph nodes. Buboes may rupture to form discharging sinus.# Groove's sign - Enlarge lymph nodes both above and below inguinal ligament.iii) Tertiary LGV (genitorectal syndrome): - Characterized by proctocolitis.Complications of LGV* Esthiomene - Enlargement, thickening and fibrosis of labia.* Elephantiasis of the genitals* Rectal stricture* Systemic - Arthritis, pneumonitis, Perihepatitis | Skin | S.T.D. | Groove sign is seen in-
A. Syphilis
B. Dermatomyositis
C. LGV
D. SLE
| LGV |
5a2c6025-f375-422b-b787-a56ec6b23bca | The combination of hyperkalemia and hyperchloremic metabolic acidosis is often present, even at earlier stages of CKD (stages 1-3).In patients with diabetic nephropathy or in those with predominant tubulointerstitial disease or obstructive uropathy; this is a non-anion-gap metabolic acidosis. | Medicine | Fluid and electrolytes | Hyperchloremic acidosis is seen in-
A. A
B. Diarrhoea
C. DKA
D. Dehydration
| A |
13807e41-a89f-4da3-ab6b-7a64ec0fdb2e | The internal iliac aery divides into an anterior and a posterior trunk near the greater sciatic foramen.Branches of ANTERIOR TRUNKUmbilical aeryObturator aeryUterine aeryInferior vesical and vaginal aery (females)Middle rectal aeryInternal pudendal aeryInferior gluteal aeryBranches of POSTERIOR TRUNKIliolumbar aeryLateral sacral aerySuperior gluteal aery | Anatomy | null | The internal pudendal aery arises from which of the following aeries?
A. External iliac aery
B. Inferior vesical aery
C. Internal iliac aery
D. Inferior epigastric aery
| Internal iliac aery |
502328ba-6339-4d52-a737-4f7b57b333b5 | Serum IgA increased in - Alcoholic cirrhosis Serum IgM increased in -Primary biliary cirrhosis (Ref: Clin Exp Immunol.2009 Oct; 158(1): 115-124, Liver.1984 Jun;4(3): 214-8) | Pathology | G.I.T | Increased Ig A levels are seen in
A. Alcoholic hepatitis
B. Alcoholic cirrhosis
C. Microvescicular fatty change
D. Macrovesicular fatty change
| Alcoholic cirrhosis |
7217ed20-27bf-4bf1-84d2-6ddb18022234 | Rituximab is a monoclonal antibody against CD20. It is used for treatment of: Non-Hodgkin lymphoma Chronic lymphoid leukemia Rheumatoid ahritis SLE Auto-immune hemolytic anemia Idiopathic thrombocytopenic purpura | Pharmacology | Targeted Anticancer Drugs and Immunosuppressants | Rituximab is a monoclonal antibody used for treatment of:-
A. Non-Hodgkin's lymphoma
B. Gastrointestinal Stromal Tumors
C. Chronic Myeloid Leukemia
D. Acute Myeloid Leukemia
| Non-Hodgkin's lymphoma |
6b60772d-c91f-450a-92a3-4c26c3c8112a | Types of Intussusceptions (in decreasing order) Ileocolic (77%) Ileo-ileo-colic (12%) Ilioileal (5%) Colocolic (2%): MC in adults Multiple (1%) Retrograde (0.2%) | Surgery | Intestinal obstruction | The least common type of intussusceptions is:
A. Multiple
B. Colocolic
C. Ileoileal
D. Ileoileocolic
| Multiple |
33d6780f-f9b8-4528-bbd9-2b6c065ada10 | Sinuscopy is a method of Endoscopic sinus observation or surgery using Nose telescope. It involves the evaluation of nasal and sinus passages using the endoscope called Sinuscope. The Sinuscope has a narrow tube with a built-in camera so that the physician can see the internal details of the sinuses. By observing the sinus, it is possible to diagnose the problems and treat properly. | ENT | Nose and paranasal sinuses | Most definitive diagnosis of sinusitis is by
A. X- ray PNS
B. Proof puncture
C. Sinuscopy
D. Transillumination test
| Sinuscopy |
2d906c4a-16b9-494d-83d6-d6831dea8413 | Vascular malformation (VM) in bone occurs more frequently than the central hemangioma (CH) of bone. Some 35% of VMs occur in bone, whereas CHs of bone are rare. The CH of bone is a benign tumor that rarely occurs in the jaws; it occurs more frequently in the skull and vertebrae. It may be congenital or traumatic in origin and may be difficult to differentiate from VM. The usual complaint of a patient with a VM or CH is of a slow-growing asymmetry of the jaw or localized gingival bleeding. Numbness and tenderness or pain may also be described. This solitary tumor is found approximately twice as often in female patients, and about 65% occur in the mandible. Some tumors demonstrate pulsation and bruits. Paresthesia is occasionally a feature. | Radiology | null | An 18 year old male patient presented to the clinic with pain and swelling in the lower jaw. Intraoral examination
revealed localized gingival bleeding in the right posterior region. On palpation, pulsations can be appreciated. Lesions are also appreciated on the frontal bone on a radiograph. Which condition is present in this patient?
A. Vascular malformation
B. Cherubism
C. Eosinophilic granuloma
D. Brown tumor
| Vascular malformation |
224684fc-43a1-4ea2-b3c4-2137a5b092a9 | Ref: Bailey and Love, 26th edition, P 868Most common anterior mediastinum tumor is thymoma. Choice B is seen in posterior mediastinum. Choice C and D are found in middle mediastinum. | Pathology | Misc. | Most common anterior mediastinal tumor?
A. Thymoma
B. Neurofibroma
C. Pericardial cyst
D. Bronchogenic cyst
| Thymoma |
a11d6f28-7147-4a50-9745-41499c36a2b8 | Anatomical unit of liver - Hepatic Lobule Functional unit of liver- Liver Acinus | Anatomy | Systemic histology | Functional unit of Liver is
A. Hepatocytes
B. Poal Tracts
C. Liver Acinus
D. Hepatic Lobule
| Liver Acinus |
d6ed9456-f50e-4add-af7e-74ff49545af6 | Ans: a (320 IPC) Ref: Reddy, 21st ed, p. 244Grievous hurt is defined under IPC 320Some important IPC'sIPC 375 - definition of rapeIPC 376 - punishment of rapeIPC 320 - definition of grievous heartIPC 84 - deals with the criminal responsibility of insaneIPC304A - deals with criminal negligenceIPC 304B - dowry deathIPC 300 - defines murderIPC 299 - defines culpable homicideIPC 302 - punishment of murderIPC 304 - punishment of culpable homicide | Forensic Medicine | Introduction to Forensic Medicine and Medical Jurisprudence | Grievous hurt is defined under:
A. 320IPC
B. 318 IPC
C. 321 IPC
D. 375 IPC
| 320IPC |
6e90b215-167a-448f-89c5-4d05d26c9000 | Ans. is 'a' i.e., Raised intraocular pressure The most common risk factor known is increased intraocular pressure (lOP)o Glaucoma is a group of eye diseases causing optic nerve damage i.e., glaucoma is a chronic, progressive optic neuropathy caused by a group of ocular conditions which lead to damage of optic nerveo Optic neuropathy in glaucoma results in a characteristic appearance of optic disc and a specific pattern of irreversible visual field defects, called glaucomatous changes. It is worth noting that raised IOP without optic neuropathy is not referred to as glaucoma, it is simply called ocular hypertension.So, glaucoma is a type of optic neuropathy, which is usually caused by increased IOP. | Ophthalmology | General Considerations - Definition, Classification, Pathogenesis | Glaucoma is caused by -
A. Raised intraocular pressure
B. Raised intracranial Pressure
C. Intraocular infection
D. Orbital mass
| Raised intraocular pressure |
b93b305f-5080-4b89-b598-f20947050b76 | Rate of increase of height and weight is the best measure for nutritional status of a child. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. 500,501 | Social & Preventive Medicine | obstetrics,pediatrics and geriatrics | Best indicator for nutritional status for a child is -
A. Mid arm circumference
B. Head circumference
C. Rate of increase of height and weight
D. Chest circumference
| Rate of increase of height and weight |
5490fe0e-173c-482e-805b-0482ba08204d | PCR is an in vitro method for the polymerase-directed amplification of specific DNA sequences using two oligonucleotide primers that hybridize to opposite strands and flank the region of interest in the target DNA. The specificity and yield in amplifying a paicular DNA fragment by PCR reaction is affected by the proper setting of the reaction parameters (e.g., enzyme, primer, and Mg2+ concentration, as well as the temperature cycling profile). Ref: Feng X., Lin X., Brunicardi F.C. (2010). Chapter 15. Molecular and Genomic Surgery. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e. | Biochemistry | null | Amplification of DNA uses the polymerase chain reaction (PCR) technique. Cation used in PCR is:
A. Calcium
B. Lithium
C. Magnesium
D. Sodium
| Magnesium |
9a778c55-b44d-46f9-a387-07f4764a5ed4 | Ans. is 'a' i.e., Tick Babesiao Babesiosis is a protozoan disease caused by two species of Babesia : Babesia microti and Babesia divergens.o It is transmitted by loxdid tick.o Babesia infects the RBCs and resides inside the RBCs ( intraerythrocytic). Intraery throcytic infection of Babesiosis is characterised by maltese cross. Maltese cross is a characteristic arrangement of parasites within the erythrocytes - Parasites within erythrocytes are arranged such that pointed ends of four parasites come in contact thereby giving a tetrad configuration resembling a maltese cross. Tetrad forms or 'Maltese cross' appearance is considered pathognomic of Babesiosis.o Clinically Babesiosis presents with chills, fever, mild hepatosplenomegaly, and mild hemolytic anemia,o Treatment includes Atovaquone plus azithromycin or quinine plus clindamycin.o Babesiosis can easily be confused with P. falciparum malaria.Following two features distinguish Babesiosis from malariaPresence of maltese cross in Babesiosis (absent in malaria)Absence of pigment Hemozoin in Babesiosis (present in malaria)Note - Maltese cross is also seen in cryptococcus and aspergillus. | Microbiology | Parasitology | Babesiosis is transmitted by -
A. Tick
B. Mites
C. Flea
D. Mosquito
| Tick |
60506fc9-20d7-414b-a85f-de78719c10fa | Hepatitis is the most common preceding infection, and post hepatitis marrow failure accounts for about 5% of etiologies in most series. Patients are usually young men who have recovered from a bout of liver inflammation 1 to 2 months earlier; the subsequent pancytopenia is very severe. The hepatitis is seronegative (non-A, non-B, non-C, non-G) and possibly due to a novel, as yet undiscovered, virus. Ref: Harrison's principle of internal medicine 17th edition, chapter 102. | Medicine | null | Pancytopenia is most common after:
A. Hepatitis
B. Infective carditis
C. Pyelonephritis
D. Meningitis
| Hepatitis |
99f5d0ae-9123-44a6-a1c1-7eda87aba41b | Ans. is 'd' i.e., Cefuroxime Third generation cephalosporins include Parenteral OralCefotaxime - CefiximeCeftizoxime - Cefpodoxime proxetilCeftriaxone - CefdinirCeftazidime - Ceftibuten Cefoperazone Also knowFourth generation cephalosporinsCefepimeCefaparole | Pharmacology | Anti Microbial | Which is NOT a third generation Cephalosporin
A. Ceftriaxone
B. Cefotaxime
C. Ceftizoxime
D. Cefuroxime
| Cefuroxime |
12725f6c-3ce1-4ccc-9657-7c7e58a9aa6e | Ans: A (CT ?) Ref: Harrison !v Principles of internal medicine.18th edition.Explanation:CT is the best technique to detect pericardial calcification; however, overpenetrated films, conventional tomography, fluoroscopy, and MRI may be helpful.Plain radiographs have poor sensitivity for detection of coronary calcification and have a reported accuracy as low as 42%High-quality mammography is the best diagnostic tool for the identification of breast calcifications. | Radiology | Ultrasonography, CT, and MRI | Best investigation to see calcification is:
A. CT
B. MRI
C. X-ray
D. USG
| CT |
8fe8bc4d-d411-4281-98fa-f74eaf59212a | A nasal cannula is generally used wherever small amounts of supplemental oxygen are required, without rigid control of respiration, such as in oxygen therapy. Most cannulae can only provide oxygen at low flow rates--up to 5 litres per minute (L/min)--delivering an oxygen concentration of 28-44%. Rates above 5 L/min can result in discomfo to the patient, drying of the nasal passages, and possibly nose bleeds (epistaxis). Also with flow rates above 6 L/min, the laminar flow becomes turbulent and the oxygen therapy being delivered is only as effective as delivering 5-6 L/min. The nasal cannula is often used in elderly patients or patients who can benefit from oxygen therapy but do not require it to self respirate. These patients do not need oxygen to the degree of wearing a non-rebreather mask. It is especially useful in those patients where vasoconstriction could negatively impact their condition, such as those suffering from strokes. | Anaesthesia | Anesthesia Circuit | Maximum FiO2 which can be given through a nasal oxygen catheter:-
A. 1
B. 0.6
C. 0.2
D. 0.44
| 0.44 |
7b3a5354-653e-4558-b990-061ced67975b | Ref-KDT 6/e p146 Stimulation of Alpha 2 receptors located on ciliary epithelium reduces secretion of aqueous humor. | Anatomy | Other topics and Adverse effects | Agonistic action at which of the following adrenergic receptor result in the reduction of excess secretion
A. Beta 1 receptor
B. Beta 2 receptor
C. M2 receptor
D. Alpha 2 receptor
| Alpha 2 receptor |
977cfd21-baf1-4a64-a125-378d92fbdafb | -All patients with gastrinoma have an elevated gastrin level, and hypergastrinemia in the presence of elevated basal acid output (BAO) strongly suggests gastrinoma. -Patients with gastrinoma usually have a BAO >15 mEq/h or >5 mEq/h if they have had a previous procedure for peptic ulcer. -Acid secretory medications should be held for several days before gastrin measurement, because acid suppression may falsely elevate gastrin levels. 1). The diagnosis of Zollinger-Ellison syndrome (ZES) is confirmed by the secretin stimulation test. An intravenous (IV) bolus of secretin (2 U/kg) is given and gastrin levels are checked before and after injection. - An increase in serum gastrin of 200 pg/mL or greater suggests the presence of gastrinoma. Patients with gastrinoma should have serum calcium and parathyroid hormone levels determined to rule out multiple endocrine neoplasia type 1 (MEN1) and, if present, parathyroidectomy should be considered before resection of gastrinoma. | Surgery | Stomach & Duodenum | The most accurate diagnostic test for Zollinger-Ellison syndrome (ZES) is
A. Fasting serum gastrin
B. Computed tomography (CT) scan
C. Endoscopy
D. Secretin stimulation test
| Secretin stimulation test |
6c68e78f-09e1-4dc6-8a22-b2469804b24e | Ans: B i.e. 10 days The earliest sign to appear on the X-ray is a periosteal new bone deposition (periosteal reaction) at the metaphysis. It takes about 7-10 days to appear Osteomyelitis Earliest site of involvement: Metaphysis Diagnosis of acute OM: Blood culture (positive in 65% cases) Periosteal reaction seen in acute OM appears after: 10 days MC organism in acute OM: Staph. aureus Brodies abscess: - Equilibrium between host & organism; - Abscess cavity remains without fuher enlargement | Surgery | null | Periosteal reaction in a case of acute osteomyelitis can be seen earliest at: March 2012
A. 5 days
B. 10 days
C. 15 days
D. 20 days
| 10 days |
65aaa955-47b2-4791-b9c2-e3272ba7b4e1 | Ans. C: Pigmentation Acrodermatitis enteropathica is a rare inherited form of zinc deficiency, characterized by periorificial and acral dermatitis, alopecia, and diarrhea. Symptoms of Zinc Deficiency Poor Immune system Weight loss Intercurrent infections Hypogonadism in males Lack of sexual development in females Growth retardation Dwarfism Delayed pubey in adolescents Rough skin Poor appetite Mental lethargy Delayed wound healing Sho stature Diarrhea One easily recognized sign which may be caused by zinc deficiency is white spots, bands, or lines on fingernails (leukonychia). Some women may have multiple parallel white bands or lines on the fingernails marking menstrual cycles when marginal zinc deficiency was present. | Medicine | null | Which of the following is not associated with zinc deficiency: March 2005
A. Delayed wound healing
B. Loss of libido
C. Pigmentation
D. Sexual infantilism
| Pigmentation |
abf516bd-aeec-4fee-a74e-4fcaf83bdeec | Pre implantation genetic diagnosis is used for daignosis of single gene disorders such as cystic fibrosis, β - thalassemia and hemophilia. | Gynaecology & Obstetrics | null | Preimplantataion genetic diagnosis is used for
A. Fetal gender determination
B. Single gene mutation analysis
C. HLA typing
D. Karyotyping
| Single gene mutation analysis |
81697ce5-1551-43f9-a2c6-b41cf41fb01b | Ans. is 'd' i.e., Pleural surface Kerley's line Kerley's line is a linear opacity which, depending on its locaton, extent and orientation, may be be fuher classified as :? Kerley's A lines o These are thin, non-branching lines radiating from hilum. These lines are 2-6 cm in length. These lines are found in the mid and upper zones of the lung fields pleural. These lines are due to the thick interlobar septa. Kerley's B lines (septal lines) These are transverse (Horizontal) lines at the lung base pleural. These are 1-2 cm in length and are perpendicular to pleura. Kerley's B line is due to the thickening of interlobar septa due to edema caused by pulmonary venous hypeension (congestion), as occurs in left ventricular failure or mitral stenosis | Medicine | null | Kerley B line are seen at
A. Apex
B. Cardiophrenic angle
C. Lung fissure
D. Pleural surface
| Pleural surface |
79e04d67-af42-4b0e-b242-cd83473eed50 | Dr RP Centre for Ophthalmic Sciences, New Delhi has been designated as the apex national institute of ophthalmology. | Ophthalmology | Community Ophthalmology | Apex national institute of ophthalmology is
A. Advance eye care PGI Chandigarh
B. RIO
C. Dr. R P Centre for Ophthalmic Sciences , Delhi
D. Shankara Netralaya , Chennai
| Dr. R P Centre for Ophthalmic Sciences , Delhi |
c939bbeb-af27-43ec-8ad1-d7f70f5543eb | Ans. is 'a' i.e., Ofloxacin Drugs acting on M. leprae* Established agents used to treat leprosy include dapsone (50-100 mg/d), clofazimine (50-100 mg/d, 100 mg three times weekly, or 300 mg monthly), and rifampin (600 mg daily or monthly. Of these drugs, only rifampin is bactericidal.* The sulfones (folate antagonists), the foremost of which is dapsone, were the first antimicrobial agents found to be effective for the treatment of leprosy and are still the mainstay of therapy.* Other antimicrobial agents active against M. leprae in animal models and at the usual daily doses used in clinical trials include ethionamide/prothionamide; the aminoglycosides streptomycin, kanamycin, and amikacin (but not gentamicin or tobramycin); minocycline; clarithromycin; and several fluoroquinolones, particularly preferred is ofloxacin.* Next to rifampin, minocycline, clarithromycin, and ofloxacin appear to be most bactericidal for M. leprae, but these drugs have not been used extensively in leprosy control programs. Most recently, rifapentine and moxifloxacin have been found to be especially potent against M. leprae in mice. In a clinical trial in lepromatous leprosy, moxifloxacin was profoundly bactericidal, matched in potency only by rifampin. | Pharmacology | Anti Microbial | Preferred fluoroquinolone against m. leprae is -
A. Ofloxacin
B. Pefloxacin
C. Ciprofloxacin
D. Moxifloxacin
| Ofloxacin |
7d6c6949-7c51-44f2-9c75-3be538acae26 | DEGREES OF HEARING LOSS 0-25dB-Not significant impairment- no significant difficulty with faint speech 26-40dB-Mild impairment-Difficult with faint speech 41-55dB-Moderate impairment -Frequently difficult with normal speech 56-70dB-Moderately severe impairment-Frequently difficult with loud sound 71-91dB-Severe impairment-Can understand only shouted or amplified sound Above 91-Profound impairment-Usually cannot understand even amplified sound Ref: Diseases of EAR, NOSE AND THROAT by PL DHINGRA - 6th Edition. Page no. 39 | ENT | Ear | When the patient fails to understand normal speech but can understand shouted or amplified speech the hearing loss is termed as
A. Mild hearing loss
B. Moderate hearing loss
C. Severe hearing loss
D. Profound hearing loss
| Severe hearing loss |