Question: Generation time for E.coli is

Ans: b) 20mts Generation time of E COLI 20 MIN M TB 16-18 HOURS M LEPRAE 14 DAYS


Question: The immunity responsible for to control epidemic spread of a pathogen

Herd immunity-
Overall immunity of a community to a pathogen
If Herd immunity is good- chance of epidemic is less
Eradication of a communicable disease- depends on good Herd immunity
Provided by mass vaccination by live vaccination to all individual at same time.


Question: Comment on this CTG


Question: Splenic auto infarction is seen in

Sickle cell disease
As the largest unit of the mononuclear phagocyte system, the spleen is involved in all systemic inflammations, generalized hematopoietic disorders, and many metabolic disturbances. In each, the spleen undergoes enlargement (splenomegaly), which is the major manifestation of disorders of this organ. It is rarely the primary site of disease. Splenic insufficiency due to splenectomy or autoinfarction (as in sickle-cell disease) has one major clinical manifestation, an increased susceptibility to sepsis cause by encapsulated bacteria such as pneumococcus, meningococcus, and Haemophilus influenzae. The loss of filtering and antibody production functions both contribute to the increased risk of sepsis, which may be fatal. All asplenic individuals should be vaccinated against these agents to reduce the risk of this tragic complication.


Question: Halban disease is due to

Irregular shedding (Halban's disease)
It is rare and self-limited. It is due to persistent corpusluteum. The menstruation comes on time, is prolonged but not heavy. Progestogen can suppress the bleeding, but needs to be taken on tapering dose for 20 days to complete the cycle.


Question: The gold standard for diagnosing the Cystic fibrosis is

In most cases, the diagnosis of cystic fibrosis is based on persistently elevated sweat electrolyte concentrations (often the mother makes the diagnosis by recognizing her infant's abnormally salty sweat), characteristic clinical findings (sinopulmonary disease and gastrointestinal manifestations), an abnormal newborn screening test, or a family history. A minority of patients with cystic fibrosis, especially those with at least one “mild” CFTR mutation, may have a normal or near-normal sweat test (<60 mM/L). Measurement of nasal transepithelial potential difference in vivo can be a useful adjunct test under these circumstances; individuals with cystic fibrosis demonstrate a significantly more negative baseline nasal potential difference than controls. Sequencing the CFTR gene is, of course, the “gold standard” for diagnosis of cystic fibrosis. Therefore, in patients with suggestive clinical findings or family history (or both), genetic analysis may be warranted.

Nasal transepithelial potential difference


Question: During Acute tonsillitis Pain in the ear is due to Involvement of

Ref. Diseases of Ear, Nose and Throat. Pg 258
Below is a compiled pic of referred pain to ear


Question: Commonest site of Morgagni hernia

Morgagni hernias are related to maldevelopment of the embryologic septum transversum and to failed fusion of the sternal and costal fibrotendinous elements of the diaphragm. These hernias are generally asymptomatic and usually detected as incidental findings on radiographs.


Question: On accident there is damage of cervical spine, first line of management is

Ans. is 'd' i.e stablise the cervical spine According to ATLS in case of spinal injuries spinal stabilization done at 1st...after dt maintain airway...


Question: Anemia of advanced renal insufficiency is best treated by

• A normocytic, normochromic anemia attributable to CRD is observed beginning at stage 3 CRD and is almost
universal at stage 4.
• The primary cause of anemia in patients with CRD is insufficient production of EPO by the diseased kidney.
• Management guidelines for correction of anemia of chronic renal disease—
1.Recombinant human EPO, epoetinalfa.
2. Darbepoetinalfa is a hyperglycosylated analog of recombinant human EPO that possesses greater biologic
activity and prolonged half-life.
Iron supplementation is usually essential to ensure an adequate response to EPO in patients with CRD because the
demands for iron by the erythroid marrow frequently exceed the amount of iron that is immediately available for erythropoiesis as well as iron stores.


Question: A 7years old boy has progressive difficulty in climbing the stairs and walks with waddling gait also has calf muscle hypertrophy diagnosis is

(D) (Becker's muscular dystrophy) (3492-95 H 18th)* Becker muscular dystrophy differ from Duchene muscular dystrophy by its (595- Ghai 8th)* Later age of onset (usually >6 years of age)* Later age of wheelchair confinement (>15 years)* More incidence of myalgias* Occasional rhabdomyolysis following exercise and early cardiomyopathyPresence of muscular weakness in association with positive Gower's sign, hypertrophy of calves (pseudohypertrophy) and elevated CPK values in a young male suggests a diagnosis of Duchenne's muscular dystrophy.Essentials of Diagnosis; Duchenne Muscular Dystrophy; Current Diagnosis & Treatment Neurology * Typically affects males* Positive family History (X-linked recessive inheritance)* Onset before 5 years of age with delayed motor milestones* Proximal muscle weakness, positive Gower's sign and calf muscle pseudohypertrophy (common)* Elevated CK levels (>10 fold increase)* Severely reduced or absent dystrophin in muscle biopsy or genetic testing provides definitive diagnosisDuchenne Muscular Dystrophy (pseudohypertrophic Muscular Dystrophy; ReviewDuchenne's muscular dystrophy is the most common hereditary neuromuscular disease affecting all races and ethnic groupInheritance and pathology* Duchenne's muscular dystrophy is inherited as an x-Linked Recessive disorder9* It is caused by a multation in the gene responsible for producing dystrophin9* Dystrophin is a subsarcolemmal protein9 localized to the inner surface of the sarcolemma9 of the muscle fibre* Lack of dystrophin protein results in weakness of sarcolemma, causing membrane tears and muscle fibre necrosis, therepy resuiting in muscle weaknessPresentation & clinical Manifestations* Typically affects males & family histoy is positive (X Linked recessive inheritance)* Typically present between ages 3 and 5 (Disorder docs not present at birth9 or infancy) (Delayed motor milestones may be apparent after the first year of life)* Gower's sign is positive9* Pseudohypertrophy of calf is seen9 (muscle is replaced by fat & connective tissue)* Loss of muscle strength is progressive9* Proximal muscle and neck flexors are involved more9* Leg involvement is more severe than arm involvement* Contractures of heel cords and iliotibial band occurs (by age of 6 years)* Progressive scoliosis developsComplicationsChest deformity9 (Scoliosis)9;Impairs pulmonary function9By age of 16 and 18 years patients are predisposed to serious pulmonary fatal infectionsCardiacCardiomyopathy9 and CHF may be seenCardiac cause of death is uncommonIntelectual impairment;is common9 (IQ is one SD below the mean)Remember: Onset9Before age of 59 Confined to wheel chairInability to walkAfter age of 129 Respiratory failureIn second or third decade (after 16-18years)9 Progressive Musclear DystrophiesTypeInheritanceDefective Gene/proteinOnset AgeClinical featuresOther organ system involvedDuchenne'sXRDystrophinBefore 5 yearsProgressive weakness of girdle muscles unable to walk after age 12 progressive kyphoscoliosis Respiratory failure in 2nd or 3rd decadeCardiomyopathy Mental impairmentBecker'sXRDystrophinEarly childhood to adultProgressive weakness of girdle muscle Able to walk after age 15 Respiratory failure may develop by 4th decadeCardiomyopathyLimb-girdleAD/ARSeveralEarly childhood to early adultSlow progressive weakness of shoulder and hip girdle muscles+- CardiomyopathyEmery-DreifussXR/ADEmerin/Lamins A/C Nesprin-1, Nesprin 2, TMEM43Childhood to adultElbow contractures, umeral and peroneal weaknessCardiomyopathyCongenitalARSeveralAt birth or within first few monthsHypotonia, contractures, delayed milestones progression to respiratory failure in some; static course in othersCNS abnormalities (hypomyelination,malform ation) Eye abnormalitiesMyotonic (DMI,DM2)ADDM1; Expansion CTG repeat DM2; Expansion CCTG repeatChildhood to adult Maybe infancy if mother affected (DMI Only)Slowly progressive weakness of face, shoulder girdle, and foot dorsiflexion preferential proximal weakness in DM2Cardiac conduction defectsMental impairment cataracts frontal baldness Gonadal atrophyFacioscapulohumeralADDUX44qChildhood to adultSlowly progressive weakness fo face, shoulder girdle, and foot dorsiflexionDeafness coats (eye)diseaseOculopharyngealADExpansion, poly- A RNA binding protein5th to 6th decadeSlowly progressive weakness of extraocular, pharyngeal, and limb muscles


Question: The operation of choice for the below condition

The treatment of annular pancreas is duodenojejunostomy or gastrojejunostomy either of which bypasses the obstruction.
According to Bailey and Love duodenoduodenostomy or duodenojejunostomy are usual operation. Obstructing pancreatic ring must not be simply divided. Since this may not relieve the obstruction and pancreatic fistula may result.
Annular pancreas is formed by a thin band of normal pancreas tissue that completely encircles the second portion of duodenum and is continuous with head of pancreas anteriorly and posteriorly. 40% patients have associated duodenal stenosis or atresia.
Symptoms of duodenal obstruction (gastric distention and vomiting) occur in about one third of cases in the first week of life and about one half of cases in the first year. Rests are asymptomatic until adulthood, when abdominal pain, nausea and vomiting may occur.


Question: The pH of vagina in adults is

The vaginal secretion is small in amount in healthy women and consists of white coagulated material. When it is examined under the microscope, squamous cells which have been shed from the vaginal epithelium and Doderlein's bacilli alone are found. Doderlein's bacillus is a large gram-positive rod-shaped organism, which grows anaerobically on acid media. The vaginal secretion is acidic due to the presence of lactic acid, and this acidity inhibits the growth of pathogenic organisms. The pH of the vagina averages about 4.5 during reproductive life. The acidity, which is undoubtedly oestrogen-dependent, falls after menopause to neutral or even alkaline. Before puberty, the pH is about 7. This high pH before puberty and after menopause explains the tendency for the development of mixed organism infections in these age groups.


Question: Retention of urine in a pregnant women, retroverted uterus is seen at

Retroverted gravid uterus - As a result of retention, the bladder gets distended and becomes an abdominal organ reaching' even up to umbilicus.
As pressure from the full bladder increases, small amounts of urine are passed involuntarily, but the bladder never empties entirely - paradoxical incontinence


Question: Carcinoma endometrium involving uterine cavity more than 10 cms long with early myometrial involvement is

Ans- The International Federation of Gynecology and Obstetrics(FIGO) staging system for carcinoma of corpus uteri is as follows:Stage IA-Tumor limited to endometrium <8 cm)Stage IB-Invasion to less than one half the myometrium (>8 cm)Stage IC-Invasion to more than one half the myometriumStage IIA-Endocervical glandular involvement onlyStage lIB-Cervical stromal invasionStage IlIA-Tumor invades serosa and/or adnexa and/or positive peritoneal cytologyStage IIIB-Vaginal metastasisStage IUC-Metastases to pelvic and/or para-aortic lymph nodesStage IVA-Tumor invasion of bladder and/or bowel mucosaStage IVB-Distant metastases including intra-abdominal and/or inguinal lymph nodesCases of carcinoma of the corpus should be classified (or graded) according to the degree of histologic differentiation. The histopathology and degree of differentiation is as follows:i. Class G1-Non squamous or non morular solid growth pattern of 5% or lessii. Class G2-Non squamous or non morular solid growth pattern of 6-50%iii. Class G3-Non squamous or non morular solid growth pattern of more than 50%Please note the new staging and use this for answering mcqsCARCINOMA OF THE ENDOMETRIUMIA Tumor confined to the uterus, no or < 1/2 myometrial invasionIB Tumor confined to the uterus, > 1/2 myometrial invasionII Cervical stromal invasion, but not beyond uterusIIIA Tumor invades serosa or adnexaIIIB Vaginal and/or parametrial involvementIIIC1 Pelvic node involvementIIIC2 Para-aortic involvementIVA Tumor invasion bladder and/or bowel mucosaIVB Distant metastases including abdominal metastases and/or inguinal lymph nodes


Question: Placenta previa should be suspected in 3rd trimester in case of

Ans-A (Painless vaginal bleeding)Ref: William's Obstetrics, 23rd ed. chapter 35Placenta previa is used to describe a placenta that is implanted over or very near the internal cervical os.There are several possibilities: total placenta previa, marginal placenta previa, partial placenta previa.The most characteristic event in placenta previa is painless hemorrhage, which usually does not appear until near the end of the second trimester or after. However, bleeding may begin earlier, and some abortions may result from such an abnormal location of the developing placenta.Digital cervical examination is never permissible unless the woman is in an operating room with all the preparations for immediate cesarean delivery--even the gentlest digital examination can cause torrential haemorrhage.The simplest, safest, and most accurate method of placental localization is provided by transabdominal sonography. Accordingly, the average accuracy is 96 percent, and rates as high as 98 percent have been obtained. False-positive results are often a result of bladder distension. Therefore, scans in apparently positive cases should be repeated after emptying the bladder.Cesarean delivery is necessary in practically all women with placenta previa. Most often, a transverse uterine incision is possible. However, because foetal bleeding may result from a transverse incision into an anterior placenta, a vertical incision is sometimes employed. But, even when the incision extends through the placenta, maternal or fetal outcomes are rarely compromised.


Question: Proper management of a child with an absolute neutrophil count (ANC) of 100/mm3 would be

A child with an absolute neutrophil count (ANC) of 100/mm3 is severely neutropenic and is at risk of death from overwhelming septicemia. Because most signs of infection (e.g., pneumonitis, pyuria) depend on the presence of neutrophils, serious infection may be present in such a patient without producing characteristic physical, radiologic, or laboratory findings. Thus, broad spectrum antibiotics (to treat a variety of possible infections) must be initiated promptly after cultures are obtained. Deferring treatment until culture results are available may result in overwhelming septicemia and death. Granulocyte transfusions usually are not beneficial in these patients because of the short survival time of the cells in the bloodstream (plasma half-life is approximately 7 hours). Iron and vitamin B12 are treatments for nutritional anemias and are of no therapeutic' value in neutropenia.

The start of broad-spectrum intravenous antibiotics

Careful physical examination and chest radiograph; close observation pending result of blood cultures

Nutritional support with oral iron and intramuscular injection or vitamin B12


Question: Following blunt abdominal trauma, A 2 year old girl develops upper abdominal pain and vomiting. An upper gastrointestinal series reveals a total obstruction of the duodenum with a coiled spring appearance in the second and third portions. Appropriate management is

Duodenal hematomas result from blunt abdominal trauma. They present as a high bowel obstruction with abdominal pain and occasionally a palpable right upper quadrant mass An upper gastrointestinal series is almost always diagnostic with the classic coiled. spring appearance of the second and third portions of the duodenum secondary to the crowding of the valvulae conniventes (circular folds) by the hematoma. Nonsurgical management is the mainstay of therapy because the vast majority of duodenal hematomas resolve spontaneously Simple evacuation of the hematoma is the operative procedure of choice. However, bypass procedures and duodenal resection have been performed for this problem. In patients with duodenal obstruction from the superior mesenteric artery syndrome, the obstruction is usually the result of a marked weight loss and, in conjunction with this, loss of the retropentoneal fat pad that elevates the superior mesenteric artery from the third and fourth portions of the duodenum. Nutritional repletion and replenishment of this fat pad will elevate the artery off the duodenum and relieve the obstruction.


Question: In autonomic nervous system, parasympathetic outflow is mainly by


Question: Typical bodies in Bronchial mucosa from Sputum of Patient is seen in

Bronchial asthma (Body shown: Creola body)


Question: Kuttner Tumour is a lesion of following gland

• Kuttner tumor is also called as Chronic sclerosing sialadenitis
• Benign inflammatory lesion (fibro inflammatory)
• Associated with submandibular glands in most of the cases.
• Is basically a chronic inflammatory disease of salivary glands.
• Positive for cytokeratin CK 7, 8, 13, 19.


Question: Streptolysin O is inactivated by

Streptococci produce 2 types of Streptolysin ( O&S) based on oxygen dependency. Streptolysin O is oxygen labile. It is inactive in the presence of Oxygen. Streptolysin O is antigenic and ASO titre is a standard serological diagnosis of Acute Rheumatic fever. Streptolysin O & S both can cause hemolysis.


Question: Absorption of glucose is intestine is by

Ref. Guyton. 13th edition. Page. 840
Primary and secondary transport

In primary active transport, ATP is consumed directly by the transporting protein, (e.g., the Na/K-ATPase pump, or the calcium-dependent ATPase of the sarcoplasmic reticulum).

Secondary active transport depends indirectly on ATP as a source of energy, as in the co-transport of Na-glucose in the proximal tubule. This process depends on ATP utilized by the Na/K-ATPase pump.

Glucose moves up a concentration gradient via secondary active transport.


Question: In comparing laparoscopic salpingostomy vs. laparotomy with salpingectomy for the treatment of ectopic pregnancy, laparoscopic therapy results in

Conservative laparoscopictreatment of ectopic pregnancy is now commonplace, although not yet universal.
With increasing sophistication of techniques and fiberoptics, many microsurgical procedures can be done through the laparoscope.
Recent studies suggestthat the fertility rates for laparoscopy and laparotomy are comparable, as are the implications of repeat ectopic pregnancies.
Certainly laparoscopy, because of its small incision, results in fewer breakdowns and shorter hospital stays, but the incidence of complications due to retained ectopic tissue is higher.

Comparable persistent ectopic tissue rate


Question: The first gene to be knocked out in the carcinogenesis of endometrium is

The primary gene involved in transformation of a normal or a hyperplastic endometrium to a neoplastic endometrium is loss of PTEN gene function.


Question: In Glanzmann thrombasthenia, the defect is

It is due to defective aggregation because of surface deficiency of GP II b- IIIa.