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Which of the following drugs DOES NOT cause Sicca Syndrome? | {
"A": "Atropine",
"B": "Nicotine",
"C": "Olanzapine",
"D": "Clonidine"
} | Olanzapine | 2C
| Sicca syndrome is charecterised by Xerostomia (subjective feeling of mouth dryness) and xerophthalmia (subjective feeling of eye dryness) are the key symptoms in the diagnosis of Sjogren syndrome, occurring in more than 95% of patients. Drugs known to cause sicca syndrome Anticholinergic drugs (atropine, scopolamine) Sympathomimetic drugs (ephedrine) Benzodiazepines Selective serotonin reuptake inhibitors Tricyclic antidepressants Phenothiazines Antihistamines Nicotine Opioids a1 antagonists (terazosin and prazosin) a2 agonists (clonidine) b blockers (atenolol, propranolol) Diuretics Ref: Primary Sjogren syndrome ; BMJ 2012;344:e3821. | Ophthalmology | None |
Mechanism of action of metoclopramide: | {
"A": "Increase the lower esophageal sphincter",
"B": "Decrease the acid secretion",
"C": "Increase gastric peristalsis",
"D": "Ulcer healing agent"
} | Increase the lower esophageal sphincter | 0A
| Ans. A. Increase the lower esophageal sphincterMetoclopramide is prokinetic drug. It acts on D2 and 5Ht3 receptor. There is increase in acetylcholine level and there is increase in LES and gastric motility. | Pharmacology | G.I.T |
The following Thiazide diuretic is active even if GFR is less than 30-40 mm Hg? | {
"A": "Metolazone",
"B": "Benzthiazide",
"C": "Chlorothiazide",
"D": "Chlohalidone"
} | Metolazone | 0A
| Although most thiazide diuretics lose their effectiveness in renal failure, metolazone remains active even when the glomerular filtration rate (GFR) is below 30-40 mL/min (moderate renal failure). This gives it a considerable advantage over other thiazide diuretics since renal and hea failure often coexist and contribute to fluid retention(Refer: K. D. Tripathi&;s Essentials of Medical Pharmacology, 7th edition, pg no: 583) | Anatomy | All India exam |
Retinitis pigmentosa forms a constituent of all the following syndromes except: | {
"A": "Lowe's syndrome",
"B": "Refsum's syndrome",
"C": "Usher's syndrome",
"D": "Hallgren's syndrome"
} | Lowe's syndrome | 0A
| Ans. Lowe's syndrome | Ophthalmology | None |
What is intermediate cementum: | {
"A": "Cementum present between acellular and cellular cementum.",
"B": "Narrow zone of highly calcified tissue between cementum and dentin.",
"C": "It is formed before tooth eruption.",
"D": "None of the above."
} | Narrow zone of highly calcified tissue between cementum and dentin. | 1B
| Intermediate cementum
-Hyaline layer of Hopewell Smith
-Narrow zone of Highly calcified tissue b/w cementum & dentin | Dental | None |
A 36 year-old female complains of sudden onset of feeling of pounding hea, apprehension and excessive sweating. She fears that she is about to die. Which of the following is the likely diagnosis? | {
"A": "Conversion Disorder",
"B": "Generalised Anxiety Disorder",
"C": "Panic attack",
"D": "Specific Phobia"
} | Panic attack | 2C
| Panic attack is a discrete period of intense fear or discomfo. It is characterised by some of the following symptoms of palpitation, sweating, shaking, shoness of breath, fear of impending death, chest pain or discomfo, nausea or abdominal pain, feeling unreal (realization) and detached (depersonalisation), fear of loosing control, hot flushes and other physical symptoms like paraesthesias. Women are 2-3 times more likely to suffer from a panic disorder. Ref: Dissociation and the Dissociative Disorders: DSM-V and Beyond, Edited by Paul F. Dell, John A. O'Neil, 2009, Pages 430-431; Loewenstein & Putnam, 2004. | Psychiatry | None |
Charcteristic pathological finding in carcinoid hea disease is: | {
"A": "Fibrous endocardial thickening of Right ventricle, Tricuspid valve & Pulmonary valve",
"B": "Endocardial thickening of Tricuspid valve with severe Tricuspid Stenosis",
"C": "Collagen rich, elastic deposits in endocardium of right ventricle and Pulmonary valve",
"D": "Calcification of Tricuspid and Pulmonary valve"
} | Fibrous endocardial thickening of Right ventricle, Tricuspid valve & Pulmonary valve | 0A
| When there is cardiac involvement of the carcinoid syndrome it can lead to endocardial fibrosis (mainly right ventricle), pulmonic and tricuspid valve thickening. Ref: Robbin's Basic Pathology, 7th Edition, Page 587; Harrison's Principles of Internal Medicine, 16th Edition, Page 1413. | Pathology | None |
Mechanism of action of vancomycin is | {
"A": "Inhibit protein synthesis",
"B": "Inhibit cell wall synthesis",
"C": "Inhibiting bacterial DNA replication",
"D": "Inhibit DNA dependent RNA synthesis"
} | Inhibit cell wall synthesis | 1B
| (Inhibit - Cell wall synthesis) (732-KDT6th)VANCOMYCIN - bactericidal and acts by interfering with cell wall synthesis, inhibits the release of peptido glycah units from their site of assembly on cell membrane phospholipids. Thus these residues are not available for cross linking to form the cell wall* Clindemycin, Spectinomycin - inhibits protein synthesis* Nalidixic acid - acts by inhibiting bacterial DNA replication* Rifampicin - inhibits DNA dependent RNA synthesis | Pharmacology | Anti Microbial |
Most common complication of Caldwell-Luc operation is | {
"A": "Oroantral fistula",
"B": "Orbital cellulitis",
"C": "Hemorrhage",
"D": "Infraorbital nerve palsy"
} | Infraorbital nerve palsy | 3D
| M/C Complication of Caldwell-Luc operation is injury to infraorbital nerve which occurs is 21 % cases. Ref:- Scott Brown 7th edition; pg num:- 1494 | ENT | Diagnostic and operative ENT |
Isotope which is replacing radium is: | {
"A": "Cesium",
"B": "Iridium",
"C": "Gold",
"D": "Californium"
} | Iridium | 1B
| Ans. Iridium | Radiology | None |
A factory worker presented with tremors, personality change and a blue line in gum. Probable diagnosis is chronic poisoning with: | {
"A": "Lead",
"B": "Mercury",
"C": "Arsenic",
"D": "Thallium"
} | Mercury | 1B
| Ans. (B). Mercury.Mad hatter disease is an occupational disease among hatmakers, caused by chronic mercury poisoning.Mental confusin, emotional disturbances, and muscular weakness, Intentional tremor (Hatter's shakes) | Forensic Medicine | Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques |
Which of the following does not conduct spermatozoa? | {
"A": "Ampulla of the ductus deferens",
"B": "Duct of the seminal vesicle",
"C": "Epididymis",
"D": "Prostatic Urethra"
} | Duct of the seminal vesicle | 1B
| The duct of the seminal vesicle carries seminal fluid, a basic fluid containing fructose. The contents of the seminal fluid buffers the acid in the vagina and provides nutrients for sperm. The duct of the seminal vesicle joins with the ampulla of the ductus deferens (which is carrying sperm) to form the ejaculatory duct. This is the first place where seminal fluid mixes with sperm. Sperms are first formed in the seminiferous tubules. They then travel from the head to the tail of the epididymis, through the ductus deferens, into the ejaculatory duct where they mix with seminal fluid, into the prostatic urethra, through the rest of the urethra, and then out the penis. So, all of the other answer choices are places that are impoant for the passage of sperm. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 19. Evaluation of the Infeile Couple. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. | Gynaecology & Obstetrics | None |
True negative means - | {
"A": "Sensitivity",
"B": "Specificity",
"C": "Positive predictive value",
"D": "Negative predictive value"
} | Specificity | 1B
| .true negative means specificity.it is defined as the ability of a test to identify correctly those who do not have the disease that is true negatives. ref:park&;s textbook,22nd edition,pg no 112 | Social & Preventive Medicine | Screening |
Tardy ulnar nerve palsy is seen in: | {
"A": "Cubitus varus",
"B": "Cubitus valgus",
"C": "Genu varus",
"D": "Genu valgus"
} | Cubitus valgus | 1B
| Ref: Apleys System of orthopaedic and fractures, 9th edition, page 761 to 763.Explanation:Tardy Ulnar Nerve PalsyIt refers to the nerve involvement, gradually over a period of time, not immediately after the primary injury.This is demonstrated in the Cubitus Valgus deformity that complicates fractures of the lateral condyle of the humerus resulting in damage to the lateral half of the distal humeral epiphysis.This causes an increasing valgus of the elbow during growth which gradually stretches the ulnar nerve medially with a late ulnar nerve involvement. | Orthopaedics | Humerus Fractures |
Delirium tremens is characteristically seen in | {
"A": "Chronic alcoholism",
"B": "B2 deficiency",
"C": "B12 deficiency",
"D": "Niacin deficiency"
} | Chronic alcoholism | 0A
| Chronic alcoholism | Psychiatry | None |
Granulosa cell tumour secretes : | {
"A": "Progesterone",
"B": "Oestrogen",
"C": "HCG",
"D": "Calcitonin"
} | Oestrogen | 1B
| Oestrogen | Gynaecology & Obstetrics | None |
In a case of Paucibacillary leprosy, treatment is considered adequate if the patient has received the six monthly doses of combined therapy within:- | {
"A": "6 months",
"B": "9 months",
"C": "12 months",
"D": "15 months"
} | 9 months | 1B
| Adequate treatment: Patients has received 6 months of PBL therapy in 9 months or 12 months of MBL therapy within 18 months Multi drug therapy (MDT) of Leprosy: Paucibacillary Leprosy (PBL) Multibacillary Leprosy (MBL) No. of skin lesions <= 5 >= 5 Nerve involvement 0-1 nerve >= 1 nerve Treatment Day 1: Supervised monthly Rifampicin 600 mg Clofazimine 300 mg Dapsone 100 mg Day 1: Supervised monthly Rifampicin 600 mg Clofazimine 300 mg Dapsone 100 mg Day 2-28: Daily Dapsone 100 mg Clofazimine 50 mg Day 2-28; Daily Clofazimine 50 mg Dapsone 100 mg Duration of treatment 6 months 12 months Duration of follow up 2 years 5 years | Social & Preventive Medicine | NVBDCP, NLEP |
Apexification is done with | {
"A": "Ca(OH)2 at the apex",
"B": "Ca(OH)2 direct pulp capping",
"C": "Indirect pulp capping",
"D": "None"
} | Ca(OH)2 at the apex | 0A
| None | Dental | None |
Monospot test is used to diagnose: | {
"A": "Pernicious anemia",
"B": "Sickle cell anemia",
"C": "Infectious mononucleosis",
"D": "Leukemia"
} | Infectious mononucleosis | 2C
| None | Pathology | None |
Number of vascular segments present in kidney are | {
"A": "5",
"B": "7",
"C": "9",
"D": "11"
} | 5 | 0A
| Five vascular segments of kidney were seen based on the branching pattern of the renal aery by angiography and corrosion cast techniques. The renalaery was divided into anterior and posterior branches.The origins of segmental aeries were variable. image Ref - eahslab.om | Anatomy | Abdomen and pelvis |
Which of the following is true about direct filling gold | {
"A": "Properly condensed mat gold has no voids",
"B": "Whatever may be the type voids are inherent",
"C": "Voids can be avoided with manual condensation",
"D": "None of the above"
} | Whatever may be the type voids are inherent | 1B
| None | Dental | None |
Chronic burrowing ulcer is caused by? | {
"A": "Microaerophilic streptococci",
"B": "Peptostreptococcus",
"C": "Streptococcus viridians",
"D": "Streptococcus pyogenes"
} | Microaerophilic streptococci | 0A
| None | Surgery | None |
Iodine requirement during lactation is | {
"A": "100 mcg per day",
"B": "150 mcg per day",
"C": "220 mcg per day",
"D": "290 mcg per day"
} | 290 mcg per day | 3D
| IODINE REQUIREMENT India has adopted WHO guidelines of Iodine requirement 150 mcg per day in Adults, 250 mcg per day in pregnancy and Lactation US recommended daily allowances (RDA) for iodine intake are 150 mcg in adults, 220-250 mcg in pregnant women, and 250-290 mcg in breastfeeding women. Ref: Park 25th edition Pgno : 662 | Social & Preventive Medicine | Nutrition and health |
Most common cause of sudden death | {
"A": "Ventricular fibrilation",
"B": "Atrial fibrilation",
"C": "PSVT",
"D": "A-V block"
} | Ventricular fibrilation | 0A
| None | Medicine | None |
Not an ideal amputation stump | {
"A": "Non-Tender",
"B": "Adherent",
"C": "Healed",
"D": "Non-bullous"
} | Adherent | 1B
| Ideal Amputation stump
Non Tender
Non-adherent
Well healed
Non-bullous
Skin at end of stump mobile sensate skin.
Properly constructed to allow satisfactory fitting of prosthesis. | Orthopaedics | None |
Which statement is true regarding pneumothorax? | {
"A": "Absent breath sounds",
"B": "Decreased percussion note",
"C": "Always needs chest tube inseion",
"D": "Tracheal tug"
} | Absent breath sounds | 0A
| Tracheal tug is an abnormal downward movement of the trachea during systole that indicates an aneurysm of the aoic arch. Pneumothorax shows hyper-resonance to percussion, and absent breath sounds Tension pneumothorax must be treated as a medical emergency. A large-bore needle should be inseed into the pleural space through the second anterior intercostal space. If large amounts of gas escape from the needle after inseion, the diagnosis is confirmed. The needle should be left in place until a thoracostomy tube can be inseed. | Medicine | Pneumothorax |
Arrange the following forces in order to reduce Dislocated shoulder using Modified Kocher's technique a. Adduction b. Traction c. External rotation d. Internal rotation | {
"A": "b-c-d-a",
"B": "b-c-a-d",
"C": "c-b-a-d",
"D": "b-a-d-c"
} | b-c-a-d | 1B
| KOCHER METHOD::::'TEAM' is the mnemonic used for forces required for reduction of shoulder using Kocher method. TRACTION force is given along elbow at first,then EXTERNAL ROTATION is given, ADDUCTION is given and then a click sound is heard as shoulder gets reduced,MEDIAL ROTATION (Internal rotation) and then splintage is given with shoulder | Orthopaedics | Ohopaedics Q Bank |
Catabolism of long chain fatty acids occurs in? | {
"A": "Peroxisome",
"B": "Mitochondria",
"C": "Golgi bodies",
"D": "Endolysosome"
} | Mitochondria | 1B
| Mechanism of catabolism Chief organelle Fatty Acids Beta oxidation mitochondria Long chain fatty acids, Medium chain fatty acids,S ho chain fatty acids Beta oxidation Peroxisomes Ver long chain fatty acids Omega oxidation Endoplasmic reticulum Only when oxidation does not occur in mitochondria Alpha oxidation Peroxisomes Branched chain fatty acids Reference: Lippincotts illustrated Reviews,6th edition | Biochemistry | Metabolism of lipid |
Which among the following is the most common mode of lead poisoning? | {
"A": "Ingestion",
"B": "Dermally",
"C": "Inhalation",
"D": "None of the above"
} | Inhalation | 2C
| Lead poisoning (Plumbism) may occur in 3 ways: Inhalation - Most cases of industrial lead poisoning is due to inhalation of fumes and dust of lead or its compounds. Ingestion - Small quantities of lead trapped in the upper respiratory tract may be ingested. Contaminated hands may also lead to ingestion. Skin - Only organic lead (e.g., tetraethyl lead) is absorbed dermally. Ref: Park's Textbook of Preventive and Social Medicine, 19th edition, Page 662. | Social & Preventive Medicine | None |
Which one of the following is not a feature of irritable bowel syndrome - | {
"A": "Abdominal pain",
"B": "Constipation",
"C": "Rectal bleeding",
"D": "Bloating"
} | Rectal bleeding | 2C
| Clinical features The most common presentation is that of recurrent abdominal discomfo . This is usually colicky or cramping in nature, felt in the lower abdomen and relieved by defecation. Abdominal bloating worsens throughout the day; the cause is unknown but it is not due to excessive intestinal gas. The bowel habit is variable. Most patients alternate between episodes of diarrhoea and constipation but it is useful to classify them as having predominantly constipation or predominantly diarrhoea. Those with constipation tend to pass infrequent pellety stools, usually in association with abdominal pain or proctalgia. Those with diarrhoea have frequent defecation but produce low-volume stools and rarely have nocturnal symptoms. Passage of mucus is common but rectal bleeding does not occur. Patients do not lose weight and are constitutionally well. Physical examination is generally unremarkable, with the exception of variable tenderness to palpation . Ref Davidson edition23rd pg 825 | Medicine | G.I.T |
Organ of locomotion in bacteria is | {
"A": "Fimbria",
"B": "Flagella",
"C": "Capsule",
"D": "Cell wall"
} | Flagella | 1B
| None | Microbiology | None |
A youngster presented with fever (100degF), nausea and vomiting. He also complained of vague abdominal discomfo. On general examination icterus was present and also hepatic tenderness. One of his family member also had the same symptoms and had diagnosed hepatitis E. Which of the following can be the route of transmission of hepatitis-E virus to this patient? | {
"A": "Skin",
"B": "Faeco oral",
"C": "Blood",
"D": "Sexual contact"
} | Faeco oral | 1B
| Hepatitis E virus (HEV) is a major cause of hepatitis transmitted by the fecal-oral route, second only to HAV. It is a common cause of waterborne epidemics of hepatitis in Asia, Africa, India, and Mexico but is uncommon in the United States. Must know: HEV is a nonenveloped, single-stranded RNA virus classified as a member of the hepevirus family. Clinically the disease resembles hepatitis A, with the exception of a high moality rate in pregnant women. Chronic liver disease does not occur, and there is no prolonged carrier state. Ref: (2012). Chapter 41. Hepatitis Viruses. In Levinson W (Eds), Review of Medical Microbiology & Immunology, 12e. | Microbiology | None |
AH the following cause Metabolic syndrome EXCEPT | {
"A": "Clozapine",
"B": "Olanzapine",
"C": "Respperidone",
"D": "Ziprasidone"
} | Ziprasidone | 3D
| (D) Ziprasidone > Weight gain and its associated long-term complications can occur with extended treatment with most antipsychotic and antimanic drugs. Weight gain is especially prominent with clozapine and olanzapine; somewhat less with quetiapine; even less with fluphenazine, haloperidol, and risperidone; and is very low with aripiprazole, molindone, and ziprasidone . Adverse effects of weight gain likely include increased risk of new-onset or worsening of type 2 diabetes mellitus, hypertension, and hyperlipidemia. | Pharmacology | Miscellaneous (Pharmacology) |
A 3-year-old male is admitted to the pediatric clinic with a palpable mass in the right side of his scrotum, and a preliminary diagnosis is made of a congenital, indirect inguinal hernia. Which of the following is the most likely cause of an indirect inguinal hernia in this patient? | {
"A": "The deep ring opens into an intact processus vaginalis.",
"B": "Congenital hydrocele",
"C": "Ectopic testis",
"D": "Epispadias"
} | The deep ring opens into an intact processus vaginalis. | 0A
| Congenital inguinal hernias occur when a large patency of the processus vaginalis remains so that a loop of intestine herniates into the inguinal canal. A congenital hydrocele is also caused by a patent segment of a processus vaginalis filled with fluid, but it does not cause an indirect hernia. Ectopic testes occur when the gubernaculum does not migrate correctly during development and the testis does not reach the scrotum, but this does not cause a hernia. Epispadias occurs when the external urethral orifice opens onto the dorsal surface of the penis and is generally associated with exstrophy of the bladder. A rupture, or tear, of the transversalis fascia would not cause the intestines to herniate through the deep inguinal ring and therefore would not cause an indirect inguinal hernia. | Anatomy | Abdomen & Pelvis |
A 30-year old male presents with flaccid bullae on an erythematous base and erosions over the oral mucous membrane. The blisters developed painful erosions rupture. What would be the most likely finding on an immunofluorescent examination of the skin biopsy of this patient? | {
"A": "Lincear IgA deposition in dermopeidermal junction",
"B": "Linear IgG deposition in dermoepidermal junction",
"C": "Fish net IgG deposition in epidermis",
"D": "Granular deposits of IgA in dermal papillae"
} | Fish net IgG deposition in epidermis | 2C
| Ans. c. Fish net IgG deposition in epidermis (Ref: Fitzpatrick ~ e p432-441: Rooks 8/ep40.27, 13.19, 10.12-10.28)A 30-year-old male presents with flaccid bullae on an erythematous base and erosions over the oral mucous membrane. The blisters developed painful erosions rupture. The clinical features point towards a diagnosis ofpermphigus vulgaris, which is characterized by fish net pattern of intraepidermal IgG deposition on immunofluorescence.DisorderImmunofluorescencePatternTarget antigenPemphigus vulgarisIntercellular, intraepidermalQIgG, fish netQDesmoglein 3QPemphigus foliaceusIntercellular, intraepidermalQIgG, fish netQDesmoglein 1QParaneoplastic pemphigusIntercellular and subepidermalQIgG, fish netQPlakins (desmoplakin, envoplakin, periplakin, BP 230)Bullous pemphigoidBasement membrane zoneQIgG, linearQBP230> BP180Herpes gestationalisBasement membrane zoneQIgG, linearQBP230 > BP 180Dermatitis herpetiformisDermal papillaeQIgA, granularQ(?) Epidermal tissue trnasgl utam inaseQLinear IgA diseaseBasement membrane zoneQIgA, linearQBP180PemphigusAutoimmune disease characterized by acantholysis induced by deposition oflgG antibodies in the intercellular area of epidermisQCommonest variant is Pemphigus vulgaris, seen in adults mainlyQMainly involve upper part of the bodyQCharacterized by cutaneous (thin walled, delicate and flaccid bullae)Q and mucosal blistersMucosal lesions are present in all patients, oral mucosa most frequently involved, painful erosions extend peripherally with shedding of mucosaQErosions are frequently secondarily infectedQ (by bacteria in skin and Candida in mucosa), extensive lesions are associated with water and electrolyte imbalanceQAssociated with Nikolsky signQ and Bulla spread sign or Asboe Hansen signQ.Histology (Biopsy is best taken from the edgeQ, from perilestonal skinQ)Bulla is intra-epidermalQ, the split being suprabasalQPresence of acantholytic cells (rounded keratinocytesQ present in the blister cavity and at the edge of the blister)Row of tombstone appearanceQDirect Immunofluorescence (DIF):Done on skin, shows intercellular deposits of IgG and C3 giving a fish net appearanceQTreatment:Systemic steroids and immunosuppressants. | Skin | Vesiculobullous & Erosive Diseases in the Newborn and Infant |
Termination is caused by all EXCEPT: | {
"A": "48 S complex",
"B": "UAA",
"C": "RF-1",
"D": "Peptidyl transferase"
} | 48 S complex | 0A
| 48 s ribosome complex is involved in initiation of translation, not termination. Termination of translation, Stop codons are UAA, UAG & UGA, which do not code for any amino acid. Peptidyl transferase is responsible for the release of polypeptide chain from the P-site of ribosome. | Biochemistry | Translation |
Tyrosine deficiency causes ? | {
"A": "Depression",
"B": "Hypehyroidism",
"C": "Hyperpigmentation",
"D": "Phenylketonuria"
} | Depression | 0A
| Ans. is 'a' i.e., Depression Tyrosine deficiency causes hypothyroidism (lethargy, weight gain) as tyrosine is required for T3 & T4; depression (due to dopamine deficiency); albinism & hair hypopigmentation (due to deficiency of melanin); and stunted growth (as tyrosine is a component of proteins). | Biochemistry | None |
Root end preparation in teeth with short root is called as: | {
"A": "Matsura preparation.",
"B": "Trephination",
"C": "Window preparation.",
"D": "Cone shaped preparation."
} | Matsura preparation. | 0A
| In teeth with short root, vertical preparation is done fir root end, which is through nad through from buccal to lingula side, this is known as matsura preparation. | Dental | None |
The mechanism of action of sodium nitroprusside is? | {
"A": "Increased cAMP",
"B": "Increased guanylate cyclase",
"C": "Calcium channel blockage",
"D": "IC channel opener"
} | Increased guanylate cyclase | 1B
| Ans. is 'b' i.e., Increases Guanyl Cyclase o "Nitroprusside dilates both aerial and venous vessels, resulting in reduced peripheral vascular resistance and venous return. The action occurs as a result of activation of guanylyl cyclase, either release of nitric oxide or by direct stimulation of enzyme. The result is increased intracellular cGMP, which relaxes vascular smooth muscle". | Pharmacology | None |
In diagnosis of AIDS, criteria include the following except - | {
"A": "CD4<200",
"B": "CD8<500",
"C": "CD4 : CD8 = 1",
"D": "Presence of any of the oppounistic infections tuberculosis, pneumosystic carinii, cytomegalovirus"
} | CD8<500 | 1B
| CD4<200,CD4-CD8 ratio is reversed&presence of oppounistic infection. REF:MICROBIOLOGY ANANTHA NARAYANAN NINTH EDITION PAGE.577 | Microbiology | Virology |
A pregnant lady comes with itchy hand lesions as shown. Her husband also gets it. The best treatment that can be given is ? | {
"A": "Permathrin",
"B": "Ivermectin",
"C": "GBH",
"D": "Benzyl benzoate"
} | Permathrin | 0A
| Permethrin 5% cream is considered the drug of choice for treating scabies in patients, including pregnant women. Other scabicides considered safe for use during pregnancy are sulfur 5-10% in petrolatum and crotamiton 10%. Sulfur is effective and it has a good safety profile; however, sulfur preparations can stain clothing and they are odorous. Crotamiton 10% cream is not absorbed percutaneously and is considered safe in pregnancy although it is not effective as other therapies. Ref : Thomas b Habif 6th Ed. | Dental | All India exam |
All of the following are true statements regarding the regulation of cholesterol synthesis, EXCEPT? | {
"A": "Binding of SREBP to SRE enhances the transcription of HMG-CoA reductase",
"B": "HMG-CoA reductase is active in phosphorylated form",
"C": "Insig1 is involved in the degradation of HMG-CoA reductase",
"D": "Mevalonate inhibit the HMG-CoA reductase"
} | HMG-CoA reductase is active in phosphorylated form | 1B
| Transcription of HMG-CoA reductase gene is regulated by a transcription factor known as sterol regulatory element binding protein (SREBP).Binding of this protein to DNA sequences known as sterol regulatory element (SRE) which is located 5' to the HMG-CoA reductase gene increases the transcription (option 1 is true). When the amount of cellular cholesterol is adequate, SREBP remains inactive in endoplasmic reticulum (ER) bound to SREBP cleavage activating protein (SCAP). Binding of SCAP to SREBP is facilitated by another transmembrane protein known as Insig (Insulin induced gene). SCAP is a cholesterol sensor. When cholesterol levels fall, SCAP escos SREBP to the Golgi complex In golgi, SREBP is cleaved by proteases. This releases the DNA-binding domain of SREBP which can go to nucleus and increase the HMG-CoA reductase transcription. Insig1 helps in degradation of HMG-CoA reductase by ubiquitin degradation system (Option 3 is true). Mevalonate is feedback inhibitor of HMG-CoA reductase (RLE of cholesterol biosynthesis)(Option 4 is True). Cholesterol synthesis is an anabolic pathways and anabolic enzymes are active in dephosphorylated state (Option 2 is false). | Biochemistry | Cholesterol synthesis and bile acids |
Which organism grows in alkaline pH? | {
"A": "Vibrio",
"B": "Klebsiella",
"C": "Pseudomonas",
"D": "E.coli"
} | Vibrio | 0A
| Ans. is 'a' i.e., Vibrio VIBRIO CHOI.ERAEo MorphologyGram negativeBacilliNon capsulatedComma shapedS-shaped or spiral form may be seen.Arranged in parallel rows - Fish in stream appearanceMotile by polar flegellum - Darting type motility.Actively motile vibrios suggest a 'Swarm of gnats'o Culture characteristicStrongly aerobic (obligate aerobe)# Growth is better in alkaline medium (pH 6-4-9.6)0.5-1% Nacl is required for optimal growth.MaConkevs agar -->> Initial colourless colonies, later become reddish due to late lactose fermentation.Blood agar -->> Initially sorrounded by a zone of greening, which later become clear due to hemodigestion.In gelatin stab culture, infundibuliform (funnel shaped) or napiform (turnip shaped) liquefaction occur.Remembero While 0.5-1% NaCl is required for optimal growth. 6% or above NaCl inhibits the growth.Cholera toxino V. cholerae produces cholera toxin, the model for enterotoxins. whose action on the mucosal epithelium is responsible for the characteristic diarrhoea of the cholera.o Cholera toxin is a protein complex made up of six subunits -->> a single copy of 'A' subunit (Port A) and five copies of'B' subunit (Part B). 'A' subunit has two fragments; A1 and A2.o cAMP inhibits the absorptive sodium transport system (decreases sodium & chloride reabsorption) and activates the secretory chloride transport system (increases chloride and bicarbonate secretion),o This leads to accumulation of sodium choride in the intestinal lumen.o Accumulated sodium chloride draws water into the lumen due to increased osmolality leading to watery diarrhoea. | Microbiology | Bacteria |
Aspirin causes mucosal injury by: | {
"A": "Ion trapping",
"B": "Ionization in stomach",
"C": "Biotransformation",
"D": "Increase in H+ secretion"
} | Ion trapping | 0A
| Ans: a (Ion trapping) Ref: Tripathi, 6th ed,p. 188Aspirin remains unionized and diffusible in the acid gastric juice, but it ionizes on entering the mucosal cell and also becomes indiffusible. This "ion trapping" in the gastric mucosal cell enhances gastric toxicity. Furthur, aspirin particle coming in contact with gastric mucosa promotes local back diffusion of acid leading to focal necrosis of mucosal cells and capillaries which in turn leads to acute ulcers, erosive gastritis, congestion and microscopic haemorrhages. | Pharmacology | Miscellaneous (Pharmacology) |
Definitive diagnosis of oral cancer is made by | {
"A": "Complete radiographic survey",
"B": "Biopsy",
"C": "Exfoliative cytology",
"D": "Pantograph"
} | Biopsy | 1B
| None | Pathology | None |
Most common mechanism for transfer of resistance in staphylococcus aureus | {
"A": "Conjugation",
"B": "Transduction",
"C": "Transformation",
"D": "Mutation"
} | Transduction | 1B
| Refer Goodman Gilman 11/e p 1098 Transduction is paicularly impoant in transfer of resistance among staphylococci Multidrug resistant is transferred by conjugation | Pharmacology | Chemotherapy |
A lady cannot speak but can tell by writing. Which of the following brain areas is affected? | {
"A": "Broca's area",
"B": "Wernicke's area",
"C": "Paracentral lobule",
"D": "Insula"
} | Broca's area | 0A
| Ans. A. Broca's Area* Broca's area damage is called expressive aphasia (non- fluent aphasia).* Pattern has loss of the ability to produce language (spoken or written).* Patient has insight to his problem and is frustrated.* Broca is broke. Speaks broken words.* Damage to paracentral lobule would lead to loss of control over urination and lead to urge incontinence.* Damage to insula leads to loss of hand eye coordination and loss of social skills. | Medicine | C.N.S. |
Which of the following drug may cause hypertensive crisis in a patient on MAO inhibitor therapy ? | {
"A": "Tyramine",
"B": "Guanethidine",
"C": "Phenobarbitone",
"D": "Nor–epinephrine"
} | Tyramine | 0A
| None | Pharmacology | None |
Under the RNTCP, sputum culture for MDR TB is to be examined for at least: | {
"A": "4 weeks",
"B": "8 weeks",
"C": "10 weeks",
"D": "12 weeks"
} | 8 weeks | 1B
| All cultures should be examined 48-72 hours after inoculation to detect gross contaminants. Thereafter cultures are examined weekly, up to 8 weeks on a specified day of the week. Ref: | Social & Preventive Medicine | None |
An ultrasound examination shows dilated intrahepatic biliary channels with a small gall bladder. The most likely possibility is | {
"A": "Gall bladder stone",
"B": "Pancreatic calculus",
"C": "Common bile duct stone",
"D": "Carcinoma of the head of the pancreas"
} | Common bile duct stone | 2C
| In obstruction of the CBD due to a stone,distension of gallbladder seldom occurs.The organ is usually shrivelled.In obstruction from other causes ,distension of gallbladder is common by comparison. Reference:Bailey & Love's sho practise of surgery,25th edition,page no:1125 | Surgery | G.I.T |
All of the following are TRUE about dyskeratosis congenita, EXCEPT: | {
"A": "Cutaneous depigmentation",
"B": "Leukoplakia",
"C": "Nail dystrophy",
"D": "Shoened telomere length in leukocytes"
} | Cutaneous depigmentation | 0A
| Dyskeratosis congenita, the Zinsser-Cole-Engman syndrome, is an X-linked multisystem disease with cutaneous, mucosal, ocular, gastrointestinal, and hematologic abnormalities and an increased incidence of cancer. The most common features are a triad of reticulated hyperpigmentation, dystrophic nails, and mucosal leukoplakia. Nail dystrophy is present in viually all patients. Leukoplakia may be present in any mucosal site. Shoened telomere length in leukocytes can be assessed by flow cytometric fluorescence in situ hybridization studies. Ref: Runger T.M., DiGiovanna J.J., Kraemer K.H. (2012). Chapter 139. Hereditary Disorders of Genome Instability and DNA Repair. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick's Dermatology in General Medicine, 8e. | Skin | None |
A cardiologist wants to study the effect of an antihypeensive drug. He notes down the initial systolic blood pressure (mmHg) of 50 patients and then administers the drug on them. After a week's tretment, he measures the systolic blood pressure again. Which of the following is the most aproprate statistical test of significance to test the statistical significance of the change in blood pressure ? | {
"A": "Paired t-test",
"B": "Unpaired or independent t-test",
"C": "Analysis of variance",
"D": "Chi-square test"
} | Paired t-test | 0A
| Ans. is 'a' i.e., Paired t-test In this question :- i) Data is quantitative (BP) ii) Paired sample from same patients, before and after treatment. o So, Paired t-test is the best. | Social & Preventive Medicine | None |
In high risk population , HCC is best detected by | {
"A": "USG",
"B": "CT",
"C": "MRI",
"D": "PET scan"
} | USG | 0A
| Diagnosis Focal lesion 1-2 cm: Two imaging techniques with aerial hypervascularization and venous wash out Focal lesion> 2cm: One imaging technique with aerial hypervascularization and venous washout Techniques to be considered : Dynamic CT and MRI Screening is based on regular ultrasound scanning in high risk population Biopsy proof of HCC is not required Ref: Sabiston 20th edition 1458-1463 | Anatomy | G.I.T |
Gastric Lavage is contraindicated in poisoining with: (PGI Dec 2008) | {
"A": "Kerosene",
"B": "Organophosphorus",
"C": "Arsenic",
"D": "Morphine"
} | Kerosene | 0A
| Ans: A ( Kerosene) Gastric lavage Is C/l in kerosene poisoningGastric evacuation for pure petroleum distillate or turpentine ingestion is not recommended" - Reddy 27th/522Gastric Lavage (G. L) - C/l or Precautions# The only absolute C/l for G. L. is corrosive poison ingQ (except carbolic acidiy}, owring to the danger of perforation# In following conditions - stomach wash can be done by taking proper precautionsi. Convulsant poisonsQ - As itmay lead to convulsion, lavage should be done after controlling convulsionii. Comatose patientQ - There is risk of aspiration of fluid into the air passage. The airway should be sealed by cuffed endotracheal tube(8 to 9 no.) & then lavage doneiii. Volatile poison' - Which may be inhalediv. Upper alimentaryfi disease - Like oesophageal variesv. In patient with marked hypothermia & haemorrhagic diastbesisGastric LavageIt is useful any time within 3hr after ingestion of poison (Reddy)It is life saving if undertaken within 4-6 hr after ingestion of poison {ParikhjGL most effective if done within 2-3 hr after ingestion of poison (modi)In case of irritent poison, the stomach should be passed with caution (modi),As poisoning - "Stomach should be repeatedly washed by warm water & milk" (Reddy 27th/473)Morphine poisoning - Wash stomach with 1:5000 solution of KMnOf" (Reddy 27th/516)Datura poisoning - "Wash stomach repeatedly with a weak solution of tannic acid"(Reddy 27th/533)Organophosphorus poisoning - "Stomach should be %vashed with 1 : 5000 KMn04 solution"(Reddy 27th/459)C/I of Emetics# Same as for stomach wash &Severe heart & lung diseaseAdvanced pregnancy'After ingestion of a CNS stimulant, because further stimulation associated with vomiting may produce convulsion. | Forensic Medicine | Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques |
The parasympathetic nervous system has central connections with the brain through all of the following cranial nerves, except? | {
"A": "III",
"B": "VII",
"C": "X",
"D": "V"
} | V | 3D
| The cranial nerves containing preganglionic general visceral efferent components of the parasympathetic system are the oculomotor, facial, glossopharyngeal, and vagus or III, VII, IX, and X, respectively. | Anatomy | None |
Stenosis of aqueduct of sylvius results in? | {
"A": "Enlargement of lateral ventricles",
"B": "Enlargement of fouh ventricles",
"C": "Enlargement of lateral and third ventricles",
"D": "Enlargement of lateral and fouh ventricles"
} | Enlargement of lateral and third ventricles | 2C
| Aqueduct of sylvius connects 3rd ventricle to the 4th one. Obstruction to Aqueduct of sylvius Enlargement of 3rd ventricle Dilatation of the ventricle proximal to the obstruction(3rd ventricle) | Medicine | Intracranial Space Occupying Lesion |
IDDM patient presents with septa perforation of nose with brownish black discharge probable diagnosis is - | {
"A": "Rhinosporidiosis",
"B": "Aspergillus",
"C": "Leprosy",
"D": "Mucormyocis"
} | Mucormyocis | 3D
| None | ENT | None |
Which of the following act on both Her-1 and Her-2 receptors - | {
"A": "Imatinib",
"B": "Erlotinib",
"C": "Lapatinib",
"D": "Gefitinib"
} | Lapatinib | 2C
| Ans. is 'c' i.e., Lapatinib | Pharmacology | None |
All are Markers of bone formation except | {
"A": "Osteocalcin",
"B": "Alkaline phosphatase",
"C": "Procollagen residue",
"D": "Hydroxyproline"
} | Hydroxyproline | 3D
| Osteocalcin,Alkaline phosphatase & Procollagen residue are Markers of bone formation. Refer robbins 9/e p774 | Pathology | Breast |
Which of the following amino acid responsible for buffering action of hemoglobin is a major intracellular buffer of blood? | {
"A": "Histidine",
"B": "Arginine",
"C": "Valine",
"D": "Lysine"
} | Histidine | 0A
| Hemoglobin is the major intracellular buffer of blood which is present in erythrocytes. Histidine residues of albumin and hemoglobin play a significant role in buffering action. Histidine is a semi essential basic amino acid and its pK value is 6.1; and hence in proteins, histidine is responsible for the maximum buffering action. In addition, the iron of the heme moiety of hemoglobin is attached to globin through two specific histidine residues. Ref: Textbook of Biochemistry for Medical Students By D. M. Vasudevan, M.D., Dm, 2010, Page 201. | Physiology | None |
You treat a 27-year-old infertile patient with bromocriptine. What should be the diagnosis? | {
"A": "Hyperpituitarism",
"B": "Hypopituitarism",
"C": "Polycystic ovarian disease (PCOD)",
"D": "Hyperprolactinemia"
} | Hyperprolactinemia | 3D
| ANS. DClinical manifestations of hyperprolactinemiaWomenMen* Galactorrhea 30-80%* Galactorrhea <30%* Menstrual irregularity* Impotence* Infertility Other manifestations* Visual field abnormalities* Headaches* Extraocular muscle weakness* Anterior pituitary malfunctionHypogonadism in both women and men by suppressing gonadotropin-releasing hormone (GnRh) secretion and pulsatility, resulting in low level of LH and FSH.Medical therapeutic options for the management of hyperprolactinemia* Dopamine agonists are currently the first therapeutic option* Dopamine agonists have proven efficacy in reducing prolactin levels, restoring ovulation in premenopausal women and restoring gonadal function in men* Bromocriptine has been used the longest* Cabergoline has greater affinity and selectivity for pituitary dopamine D2 receptor and longer duration of action. | Gynaecology & Obstetrics | Disorders in Menstruation |
Penalty awarded according to dowry prohibition act? | {
"A": "15000 Rs and 5 years",
"B": "30000 Rs and 7 years",
"C": "Life imprisonment",
"D": "Imprisonment for 10 years"
} | 15000 Rs and 5 years | 0A
| Ans. is 'a' i.e., 15000 Rs and 5 years According to Dowry Prohibition act (1961), if any person gives or takes or abets the giving or taking dowry is punishable with imprisonment for a term which shall not be less than 5 years and with a fine which shall not be less then 15000 rupees or the amount of the value of such dowry, whichever is more. Note - According to section 304 B IPC punishment for dowry death is imprisonment for atleast 10 years, which may be extended to life imprisonment. | Forensic Medicine | None |
Absent moro's reflex is seen in which of the following conditions | {
"A": "Neonatal hypoglycemia",
"B": "Erb's Palsy",
"C": "Fracture clavicle",
"D": "Stage III hypoxic Ischaemic Encephalopathy (HIE)"
} | Stage III hypoxic Ischaemic Encephalopathy (HIE) | 3D
| Absent Moro's reflex seen in:
Stage III HIE
Kerincterus
Down syndrome
Brisk / Exaggerated Moro's reflex seen in;
Stage I HIE
Neonatal hypoglycemia
Asymmetric moro's reflex seen in:
Fracture clavicle
Erb's palsy
Congenital hemiplegia. | Pediatrics | None |
Duodenal aspirate is used in diagnosis of: | {
"A": "E histolytica",
"B": "Giardia lamblia",
"C": "Taenia solium",
"D": "Leishmania"
} | Giardia lamblia | 1B
| Ans. b. Giardia lamblia | Microbiology | None |
Gustatory hallucinations are most commonly associated with: | {
"A": "Temporal lobe epilepsy",
"B": "Grand mal epilepsy",
"C": "Anxiety disorders",
"D": "Tobacco dependence"
} | Temporal lobe epilepsy | 0A
| Gustatory hallucinations are most commonly associated with temporal lobe lesions, especially uncinate gyrus seizures. Patients repo experiencing bitter, sweet, salty, tobacco-like, metallic or indescribable strange tastes. They are found in 4% of seizure patients with temporal lobe foci. Ref: Clinical neuropsychology 4th Ed By Kenneth M.Heilman, Page 488. | Psychiatry | None |
Hyperacusis is due to the damage to which of the following muscles: | {
"A": "Orbicularis oris",
"B": "Styloglossus",
"C": "Stylopharyngeus",
"D": "Stapedius"
} | Stapedius | 3D
| None | Anatomy | None |
A 40 years old male was brought to the emergency with severe abdominal pain. On examination, pulse rate was 112/minute and systolic BP was 80 mm Hg. Chest X-ray is given below. What is the most appropriate management? | {
"A": "Exploratory laparotomy",
"B": "Intercostal tube drainage",
"C": "Saline wash of stomach",
"D": "IV antibiotics"
} | Exploratory laparotomy | 0A
| X-ray - Gas under right dome of diaphragm - secondary bacterial peritonitis Secondary bacterial peritonitis (SBP) Due to perforation Spillage of intestinal contents Polymicrobial E. coli + Bacteroides Mx: Exploratory laparotomy. + Drain | Surgery | GIT |
According to "Integrated disease surveillance programme (IDSP)", which disease or condition does not come under regular surveillance? | {
"A": "Polio",
"B": "Typhoid",
"C": "Hepatitis - B",
"D": "Road traffic accidents"
} | Hepatitis - B | 2C
| Regular surveillance 1. Malaria 2. Acute diarrheal disease (Cholera), 3. Typhoid 4. Tuberculosis 5. Measles 6. Polio 7. Road traffic accidents 8. Plague 9. Meningoencephalitis Ref : Park 23rd edition Pgno : 474 | Social & Preventive Medicine | Concept of health and disease |
All of the following are features of absence seizures except: | {
"A": "Usually seen in childhood",
"B": "3-Hz spike wave in EEG",
"C": "Postictal confusion",
"D": "Precipitation by hyperventilation"
} | Postictal confusion | 2C
| Typical absence seizures are characterized by sudden, brief lapses of consciousness without loss of postural controlThe seizure typically lasts for only seconds, consciousness returns as suddenly as it was lost, and there is no postictal confusion.Onset usually in childhood (ages 4-8 years) or early adolescenceThe electrophysiologic hallmark of typical absence seizures is a generalized, symmetric, 3-Hz spike-and-wave discharge that begins and ends suddenly, superimposed on a normal EEG background.Harrison 19e pg: 2543 | Medicine | C.N.S |
The severity of Mitral stenosis is clinically best decided by - | {
"A": "Length of diastolic murmur",
"B": "Intensity of diastolic murmur",
"C": "Loudness of first heart sound",
"D": "Split of second heart sound"
} | Length of diastolic murmur | 0A
| None | Medicine | None |
Differentiation of Neisseria gonorrhoeae and Neisseria meningitides is by | {
"A": "Glucose fermentation",
"B": "Maltose fermentation",
"C": "V. P. reaction",
"D": "Indol test"
} | Maltose fermentation | 1B
| Ans. is. b. Maltose fermentation | Microbiology | None |
The following drug is not helpful in the treatment of ectopic pregnancy: | {
"A": "Methotrexate",
"B": "Misoprostol",
"C": "Actinomycin-D",
"D": "RU486"
} | Misoprostol | 1B
| Misoprostol (PGE1) has been used for cervical ripening which is used for induction of labour. It doesn't have any role in management of ectopic pregnancy. Ref:Text Book of Obstetrics By Dutta, 6th Edition, Pages 175, 189, 505 | Gynaecology & Obstetrics | None |
pBest result for large capillary (port wine) hemangioma is - | {
"A": "Tattooing",
"B": "Cryosurgery",
"C": "Laser",
"D": "Excision with split thickness grafting"
} | Laser | 2C
| Ans. is 'c' i.e., Laser ablation Pulsed dye laser (PDL) therapy is considered the standard of care for the treatment of capillary malformations. It is based on the concept of selective photothermolysis.. The beam is selectively absorbed by red- pigmented material such as hemoglobin in the blood vessels of the lesion. This produces selective heat destruction of capillary vessel walls with minimal damage to the overlying epidermis, which leads to lightening of the port wine stain without scarring."The best treatment to date for early and intermediate port wine stains is with the pulsed dye laser. The method of treatment is termed selective photothermolysis. The beam is selectively absorbed by red- pigmented material such as hemoglobin in the blood vessels of the lesion. This produces selective heat destruction of these structures, and the treated area becomes whiter. "-- CSDT 13/eCapillary malformations (port wine stains or nevus flammeus)o Capillary malformations (port wrine stains or nevus flammeus) are 3owr-flow vascular malformations of dermal capillaries and postcapillary venules.o They are present at birth as bianchable pink to red patches.o They may be located anywhere on the body, most commonly on the face, typically with a unilateral or segmental distribution that respects the midline.o On the face, they tend to follow the distribution of the trigeminal nerve branches (segments VI , V2 , and V3 )o Capillary malformations do not regress, but grow in proportion to the child's growth and become thicker and darker in color during adulthood.Port wine stainStraw berry angiomasSalmon patcho Isa vascular malformation.o Baby is normal at birtho Also k/a Macular stain or stork biteo It is present at birtho Appears at the age of 2 - 3 weekso Present at birtho Grows along with the childo Grows at a rapid rate upto 4-6 monthss of age and then ceases to grow and spontaneous involution begins.o Seen over the forehead in the midline and over the occiputo Do not regress. o Disappear by the age of 1 year o Involution is slow but is complete by 5-7 years of age. o Emptying sign is demonstrable in strawberry angioma. Tip to remembero patch can be removed.o Strawberry decays.o Wine does not decay, (so port wine stain remains for whole life)o Treatment includes pulse day laser or surgical excision. | Surgery | Plastic & Reconstructive Surgery |
Consider the following in a new born : Hea rate of 110 Slow and irregular respiratory effo Flaccid muscle tone No reflex irritability Blue colour What is the Apgar score in this case ? | {
"A": "1",
"B": "3",
"C": "5",
"D": "7"
} | 3 | 1B
| Ans.i s b i.e. 3 Signs 0 1 2 Respiratory effo Absent Slow, irregular Good, crying Hea rate Absent Slow (< 100) > 100 Muscle tone Flaccid Flexion of extremities Active body movement Reflex irritability No response Grimace Cry Colour Blue, pale Body pink, extremities blue Complete pink Total score = 10 No depression = 7-10 Mild depression = 4 - 6 Severe depression = 0 - 3 In this case : Hea rate = 110 means score of 2 Respiratory effo = slow and irregular means a score of 1 Muscle flaccid score 0 Blue color score 0 Reflex irratibility none = 0 Total score in this case = 3 | Gynaecology & Obstetrics | None |
A 70-year-old male presented with severe confusion, shoness of breath and obtundation. Patient was stable. Lab findings revealed, Serum calcium - Moderately raised Serum creatinine- Mildly raised BUN- Mildly raised PTH- normal PTHrP - Elevated Chest x-ray All of the following drugs can be given for the treatment of hypercalcemia except: - | {
"A": "Calcitonin",
"B": "Furosemide",
"C": "Normal Saline",
"D": "Prednisolone"
} | Prednisolone | 3D
| The chest x-ray is suggestive of metastatic deposits, meaning it is a case of HHM (Humoral hypercalcemia of malignancy) Seen in cancers of: - Lung Head and neck Skin Esophagus Breast Most common cause - Overproduction of parathormone related peptide. Management: - Saline rehydration Forced diuresis with furosemide Oral phosphorous Bisphosphonate infusions Calcitonin Indication of steroids in hypercalcemia: - Lymphomas Multiple myeloma Leukemia | Unknown | Integrated QBank |
A child has got a congenital cataract involving the visual axis which was detected by the parents right at bih. This child should be operated: | {
"A": "Immediately",
"B": "At 2 months of age",
"C": "At 1 year of age when the globe becomes normal sized",
"D": "After 4 years when entire ocular and orbital growth becomes normal"
} | Immediately | 0A
| Ans. Immediately | Ophthalmology | None |
Which of the following is not characteristically associated with sarcoidosis? | {
"A": "Schaumann bodies",
"B": "Asteroid bodies",
"C": "Non caseating granulomas",
"D": "Grossly bullous appearance"
} | Grossly bullous appearance | 3D
| Sarcoidosis is a systemic granulomatous disease. origin- unknown Involve many different tissues and organs. It appears in many clinical patterns, but bilateral hilar lymphadenopathy is most common, occuring in 90% of cases Pathogenetic factors involved are: Immunologic Factors Intra-alveolar and interstitial accumulation of CD4+ T cells, resulting in CD4/CD8 T-cell ratios ranging from 5:1 to 15:1 Increased levels of cytokines - IL-2 and IFN-g Dendritic cell function is impaired. Genetic Factors Familial and racial clustering of cases and the association with HLA-1 and HLA-B8 Histologically, Nonnecrotizing granulomas - containing aggregates of tightly clustered epithelioid macrophages, often with giant cells It is unlikely to see central necrosis With chronicity the granulomas gets enclosed within fibrous rims or gets replaced by hyaline fibrous scars Laminated concretions composed of calcium and proteins known as Schaumann bodies and stellate inclusions known as asteroid bodies are found within giant cells. The lungs - most common sites of involvement. Other organs affected are: Lymph node Spleen Liver Bone marrow Skin Eye Muscle | Pathology | Systemic Pathology |
The common cause of subarachnoid hemorrhage is: | {
"A": "Aerio-venous malformation",
"B": "Cavernous angioma",
"C": "Aneurysm",
"D": "Hypeension"
} | Aneurysm | 2C
| Answer is C (Aneurysm): `The most common cause of subarachnoid haemorrhage is rupture of a saccular aneurysm (excluding head trauma)' - Harrison. Previously asked frequently as follows: (Excluding hand trauma) Most common cause of subarachnoid haemorrhage is rupture of a saccular aneurysmQ Most common cause of subarachnoid haemorrhage is rupture of a Berry aneurysmQ Most common cause of subarachnoid haemorrhage is rupture of 'Circle of Willis' aneurysmQ. (Saccular aneurysms are synonymous with Berry Aneurysms and most commonly occur in the anterior circulation on the Circle of Willis). | Medicine | None |
In 3-glass urine test, there is thread in the first glass. What is the probable diagnosis: September 2010 | {
"A": "Cystitis",
"B": "Prostatitis",
"C": "Urethritis",
"D": "Pyelonephritis"
} | Prostatitis | 1B
| Ans. B: Prostatitis | Surgery | None |
A person is consuming alcohol since 10 years is brought to hospital emergency with complains of fearfulness, misrecognition, self talking and seeing snakes and reptiles all around him. Physical dependence is present since last 2 years. He has an intense craving for alcohol and from last 1 year, he is having behavioural changes and experiencing different family and social issue. Sometimes he is said to have few tremors during night. The person is suffering from:March 2013 (b, d, f) | {
"A": "Alcoholic psychosis",
"B": "Delirium tremens",
"C": "Wernicke's Korsakoff syndrome",
"D": "Schizophrenia"
} | Delirium tremens | 1B
| Ans. B i.e. Delirium tremens | Psychiatry | None |
Drugs used to control post–operative vomitinga) Diazepamb) Phenobarbitonec) Aprepitantd) Droperidole) Ondansetron | {
"A": "acde",
"B": "bde",
"C": "abcd",
"D": "abde"
} | acde | 0A
| Drugs used in PONY
For prevention :- Propofol, droperidol, metoclopramide, ondansetron.
For control (Treatment) :- Anticholinergics (Hyoscine), H1 antihistaminics (Promethazine), Neuroleptics (Droperidole), Prokinetics (Metoclopramide, domperidone, cisapride), 5-HT3 antagonists (ondansetron), SPA (Apretitant), Adjuvants (Dexamethasone, BZDs, Cannabinoids, Clonidine & ephedrine). | Anaesthesia | None |
An 82 year old man develops a round, fluid-filled cystic structure on the back of his knee that limits the knee's mobility. This most likely represents an enlargement of which of the following structures? | {
"A": "Deep infrapatellar bursa",
"B": "Prepatellar bursa",
"C": "Semimembranosus bursa",
"D": "Superficial infrapatellar bursa"
} | Semimembranosus bursa | 2C
| The lesion is commonly called a Baker's cyst, and anatomically represents an enlarged semimembranosus bursa. Baker's cysts are more commonly seen at the extremes of age. The deep infrapatellar bursa is on the anterior aspect below the knee. The prepatellar bursa is anterior to the patella. The superficial infrapatellar bursa is on the anterior aspect of the leg below the knee. Ref: O'Keefe K.P., Sanson T.G. (2011). Chapter 278. Hip and Knee Pain. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. | Surgery | None |
True statement about Streptococcus is: | {
"A": "Non-motile, non sporing cocci",
"B": "Grows only in media containing blood or serum",
"C": "Ferment sugar to produce acid but no gas",
"D": "All of the above"
} | All of the above | 3D
| Ans. D. All of the above.Streptococcusa. Gram positive, non sporingcoccci; some species may be capsulatedb. Cell division occurs in one plane and cells do not separate. Therefore, are arranged in pairs or chainsc. Aerobes and facultative anaerobes (some are obligate anaerobes)d. Grow poorly on basal media, growth enhanced on enriched media (addition of blood or serum)e. All species are catalase and oxidase negative;f. Ferment sugars with production of acid but no gas. | Microbiology | Bacteria |
Diuretic used in essential hypeension is - | {
"A": "Hydrochlohiazide",
"B": "Amiloride",
"C": "Furosemide",
"D": "Acetazolamide"
} | Hydrochlohiazide | 0A
| Low dose thiazide diuretics may be used alone or in combination with other anti hypeensive agents . mechanism of action:they inhibit the Na/cl pump in distal convoluted tubule and increase sodium excretion. Drugs used are :Hydrochlohiazide,chlohalidone(long acting and more potent than hydrochlohiazide but potassium loss is greater. ) They provide additive bp lowering effects with ace inhibitors ,arb's, beta blockers. Addition of diuretic to calcium channel blocker is less effective . Ref:Harrison 20 th edition pg no 1901 | Medicine | Kidney |
Which of the following shows crescent shaped deposits under light microscope? | {
"A": "RPGN",
"B": "Acute GN",
"C": "Membranous GN",
"D": "Membranoproliferative GN"
} | RPGN | 0A
| Rapidly progressive glomerulonephritis (RPGN) is also referred to as crescentic glomerulonephritis. Under light microscope, crescents of proliferating parietal cells in combination with invading monocytes and fibrin are seen in Bowman space. Three types: Type I RPGN: Linear pattern of immunofluorescence are seen due to causative IgG binding directly to glomerular basement membrane antigens. Type II RPGN: Immune complex mediated. Type III RPGN: Type III RPGN is referred to as pauci-immune (i.e., no immune complexes). ANCA is positive (e.g., Wegener granulomatosis) in up to 80% of cases. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 16. Pathology of the Kidney and Bladder. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture. | Pathology | None |
At a PHC, vaccine storage is done in | {
"A": "Vaccine carrier",
"B": "ILR",
"C": "Walk in Cold rooms",
"D": "Cold box"
} | ILR | 1B
| - At PHC level vaccine is stored in small ILR & small deep freezer ILR Cold chain components & level in India STORAGE LEVEL STORAGE DEVICES DURATION OF STORAGE STATE/ REGIONAL LEVEL walk in cold rooms walk in freezer 3 months CHC/ DISTRICT LEVEL Large ILR Large deep freezer 1 month PHC Small ILR Small deep freezer 1 month SUBCENTER LEVEL Vaccine carriers 24-48hrs VILLAGE LEVEL Ice packs 2-4hrs | Social & Preventive Medicine | FMGE 2018 |
Normal pregnancy can be continued in : | {
"A": "Primary pulmonary hypeension",
"B": "Wolf-Parkinson-White syndrome",
"C": "Eisenmenger syndrome",
"D": "Marfan syndfome with dilated aoic root"
} | Wolf-Parkinson-White syndrome | 1B
| Ans. is b i.e. Wolf Parkinson white syndrome | Gynaecology & Obstetrics | None |
Most specific and sensitive for identification is - | {
"A": "Anthropometry",
"B": "Dactylography",
"C": "Skull",
"D": "Pelvis"
} | Dactylography | 1B
| None | Forensic Medicine | None |
A 20 year average weight old female complains of Oligomenorrhea along with facial hair. Preliminary investigation reveal raised free testosterone levels. Which of the following could be likely etiology aEUR' | {
"A": "Idiopathic hursutism",
"B": "PCOD",
"C": "Adrenal hyperplasia",
"D": "Testosterone secreting tumour"
} | Adrenal hyperplasia | 2C
| Adrenal hyperplasia [Ret Shaws text book of Gynae 14/e p. 102-103; Harrison 17/e p. 3011 Hirsutism is defined as presence of excessive terminal hair in androgen dependent areas of woman's body. - The disorder is a sign of increased androgen action on hair follicles. Polycystic ovarian disorder is the most common cause of hirsutism. - PCOS is characterized by chronic anovulation and hyperandro- genemia (increased testosterone). - Patients often repo menstrual irregularities, infeility obesity and symptoms associated with androgen excess. - Polycystic ovarian syndrome can be ruled out in this patient because of normal ultrasound. - Ultrasound examination in polycystic ovarian disease will reveal presence of 12 or more .follicles in each ovary measuring 2-9 mm in diameter. Androgen secreting tumours of ovary may also present with hirsutism -Androgen secreting tumours of the ovary are usually heralded by virilisation (i.e., development of male characteristics in women) and rapid progression of hirsutism and cessation of menses. - Signs of virilizations are : - Acne, clitoromegaly, deepening of voice, Hirsutism, increased libido. - Normal ultrasound rules out ovarian tumours is this case. Idiopathic hirsutism It is also called end organ hirsutism. Occurs in small propoion of women with hirsutism. Niether a familial form nor any detectable hormonal abnormality usually is diagnosed. These patients have normal menses, normal sized ovaries no evidence of adrenal or ovarian tumour dysfunction and normal plasma level of serum testosterone, 17 a OHP and DHEAS. It is thought to be related to disorders in peripheral androgen activity. Adrenal cause of Hirsutism Congenital adrenal hyperplasia in children may cause hirsutism along with classical features of CAH. Late onset congenital adrenal hyperplasia usually occurs as an incomplete version of congenital adrenal hyperplasia and affects approximately 1-5% of women who are hyperandrogenic. Late onset CAH is an inherited disorder of adrenal steroidogenensis with decreased coisol L production resulting in overproduction of androgenic steroids (testosterone). These patient present in adolescence or adult age with menstrual irregularities and Hirsutism. | Gynaecology & Obstetrics | None |
Function of hepatic kupffer cells is: | {
"A": "Formation of sinusoids",
"B": "Vitamin-A storage",
"C": "Increases blood perfusion",
"D": "Phagocytosis"
} | Phagocytosis | 3D
| None | Pathology | None |
Which of the following is not true about Acute Retropharyngeal abscess? | {
"A": "Dysphonia is common symptom",
"B": "Usually swelling is seen on posterolateral wall of pharynx",
"C": "Toicollis is not uncommon",
"D": "Caries of cervical spine is usually a common cause"
} | Caries of cervical spine is usually a common cause | 3D
| Caries of cervical spine is usually a common cause of chronic retropharyngeal abscess. Ref : ENT textbook by Dhingra 6th edition Pgno : 394-395 | ENT | All India exam |
Relaxation of Detrusor occurs which receptors? | {
"A": "b-1 sympathetic",
"B": "b-2 sympathetic",
"C": "a-1 sympathetic",
"D": "a-2 sympathetic"
} | b-2 sympathetic | 1B
| Ans. is 'b' i.e., b-2 sympatheticRelaxation of detrusor is through beta-2 receptors. | Physiology | None |
Which one of the following was the major outcome of the famous Eah summit in Rio de Janeiro in 1992 - | {
"A": "Setting up of bio-safery standards",
"B": "Global strategy for control of pandemics",
"C": "Framework convention on climate change",
"D": "Framework on strategies for sustainable development"
} | Framework convention on climate change | 2C
| Ans. is 'c' i.e., Framework convention on climate change | Social & Preventive Medicine | None |
Following is true about C reactive protein - | {
"A": "Detected by precipitation with cabohydrate",
"B": "Raised in acute pneumococcal infection",
"C": "It is antibody",
"D": "Detected by agglutination test"
} | Raised in acute pneumococcal infection | 1B
| S. pneumoniae contain a nucleoprotein deep inside the cell and a somatic C antigen. An abnormal beta globulin that precipitates with the somatic C antigen of S. pneumoniae is called CRP. It appears in acute-phase of pneumonia but disappears during convalescence. ref:Textbook of microbiology, Ananthanarayan an, Paniker. Page no.: 222 | Microbiology | Immunology |
All are true about pancreatic fistula except: | {
"A": "Occasionally results in resolution of pseudocyst",
"B": "Fistula may be associated with severe bleeding",
"C": "Management depends upon GI organ involved",
"D": "They will never erode into duodenum"
} | They will never erode into duodenum | 3D
| Ans. (d) They will nerve erode into duodenumRef: Sabiston 19/e p 1525; Schwartz 9/ep 1204Fistula from Pancreatic duct:* Pseudo cyst can erode into the small intestine, Duodenum, Stomach, Bile duct or Splenic flexure can form Fistula.* Rarely it results in resolution of fistula and healing of the tract.* Most of the time it will result in sepsis, bleeding and may need surgical intervention. | Surgery | Pancreas |
Which method is used for standardization testing of waxes: | {
"A": "Infrared lamp.",
"B": "Water bath.",
"C": "Bunsen burner.",
"D": "Nd-Yag laser."
} | Infrared lamp. | 0A
| The method of softening used in standardization testing of waxes involves the use of 250 Watts infra-red lamps. | Dental | None |
Blood supply of stomach: | {
"A": "Rt. Gastric aery",
"B": "Lt. Gastric aery",
"C": "Splenic aery",
"D": "All"
} | All | 3D
| A. i.e. Rt. gastric aery; B. i.e. Left gastric aery; C. i.e. Splenic aery | Anatomy | None |
A 10-year-old child presents with Anemia. His peripheral smear finding is shown below. What is the most probable type of anemia, this child is suffering from? | {
"A": "Hemolytic anemia",
"B": "Megaloblastic anemia",
"C": "Aplastic anemia",
"D": "Iron deficiency anemia"
} | Megaloblastic anemia | 1B
| b. Megaloblastic anemiaPeripheral smear shows macro-ovalocytes & hypersegmented neutrophils, which are seen in Megaloblastic anemia | Pediatrics | C.V.S. |
Lightly anaesthetized patient in the lithotomy position (?spontaneously breathing):which of the following is true? | {
"A": "Marked reduction in vital capacity",
"B": "Increased FRC",
"C": "Normal alveolar ventilation",
"D": "Residual volume & closing volume equal"
} | Residual volume & closing volume equal | 3D
| no change to VC decrease in FRC decreased alveolar ventilation CV approaches FRC | Anaesthesia | Preoperative assessment and monitoring in anaesthesia |
Medial rotator of thigh at hip joint is | {
"A": "Obturator externus",
"B": "Obturator internus",
"C": "Gluteus maximus",
"D": "Gluteus minimus"
} | Gluteus minimus | 3D
| Gluteus medius, Gluteus minimus, Tensor fascia lata (collectively referred to as TRIO muscles)- Medial rotators of thigh Obturator internus, Obturator externus, Gluteus maximus -lateral rotators of thigh. | Anatomy | Muscles of Lower Limb |