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Anemia is greater in which of the following gastric resection - | {
"A": "Billoh II",
"B": "Billoh I",
"C": "Both of the above are equal",
"D": "Neither of the above"
} | Billoh II | 0A
| Ans. is 'a' i.e., Billoh II | Surgery | None |
A young female presents with a history of dyspnoea on exertion. On examination, she has wide, fixed split S2 with ejection systolic murmur (III/VI) in left second intercostal space. Her ECG shows left axis deviation. The most probable diagnosis is – | {
"A": "Total anomalous pulmonary venous drainge.",
"B": "Tricuspid atresia.",
"C": "Ostium primum atrial septal defect.",
"D": "Ventricular septal defect with pulmonary arterial hypertension."
} | Ostium primum atrial septal defect. | 2C
| Wide fixed splitting of S2 in association with ejection systolic murmur suggests the diagnosis of Atrial septal defect.
Ideally, with hypertrophy of the right side of the heart, right axis deviation should be present, but sometimes left axis deviation is also seen in A.S.D.
The explanation for the presence of left axis deviation in A.S.D
Atrial septal defects are of two types
Ostium primum atrial septal defect
Ostium secundum atrial septal defect
This division depends upon the development of interatrial septum and related structures.
Ostiutn secundum type atrial septal defect is the classical atrial septum defect.
Presence of interatrial septum is the only developmental anomaly in ostium secundum type and associated with right axis deviation.
In contrast, the ostium primum defects are characterized by the presence of certain other developmental abnormalities, besides the interatrial septum.
Once such abnormality is the malformation or lack of development of the anterosuperior division of the left bundle branch.
Maldevelopment of antero superior division of the left bundle branch is responsible for abnormal left axis deviation. | Pediatrics | None |
What is the treatment of threshold ROP: | {
"A": "Laser photocoagulation",
"B": "Slow reduction in oxygen",
"C": "Retinal reattachment",
"D": "Antioxidants"
} | Laser photocoagulation | 0A
| A i.e. Laser photocoagulation | Ophthalmology | None |
A 5 year boy has multiple asymptomatic oval and circular faintly hypopigmented macules with fine scaling on his face. The most probable cilinical diagnosis is – | {
"A": "Ptyriasis versicolor",
"B": "Indeterminate leprosy",
"C": "Pityriasis alba",
"D": "Acrofacial vitiligo"
} | Pityriasis alba | 2C
| None | Dental | None |
Swelling between tonsillar area of superior constrictor muscle is known as - | {
"A": "Quinsy",
"B": "Dental abscess",
"C": "Parapharyngeal abscess",
"D": "Retropharyngeal abscess"
} | Quinsy | 0A
| None | ENT | None |
In the body, metabolism of 10 g of protein would produce approximately | {
"A": "1 Kcal",
"B": "41 Kcal",
"C": "410 Kcal",
"D": "4100 Kcal"
} | 41 Kcal | 1B
| None | Biochemistry | None |
Which modality is the mainstay in trauma imaging? | {
"A": "Plain radiograph",
"B": "CT",
"C": "MRI",
"D": "Radionuclide imaging"
} | Plain radiograph | 0A
| Ans AThough not sensitive for subtle undisplaced or early fractures, plain radiographs even today due to their widespread availability, less radiation (as compared to CT scan), mobility (can be taken in any OPD/IPD/ICU) remain the mainstay of trauma imaging. | Radiology | Miscellaneous |
Treatment of choice for sputum positive pulmonary tuberculosis detected in 1st trimester of pregnancy- | {
"A": "Defer till second trimester",
"B": "Sta cat. I immediately",
"C": "Sta cat. II immediately",
"D": "Sta cat. III immediately"
} | Sta cat. I immediately | 1B
| Park&;s Textbook of Preventive and Social Medicine 23rd edition Page no: 196 Tuberculosis in pregnancy is usually treated with isoniazid, rifampicin and ethambutol for 2 months, followed by isoniazid and rifampicin for an additional 7 months. Ethambutol can be stopped after the first month if isoniazid and rifampicin susceptibility is confirmed. | Social & Preventive Medicine | Communicable diseases |
Which is a noveneral form of treponemal infection-a) Yawsb) Pintac) Syphilisd) GV | {
"A": "ac",
"B": "a",
"C": "ab",
"D": "bc"
} | ab | 2C
| None | Social & Preventive Medicine | None |
Compare the intestinal biopsy specimen of patient before and after diet restriction. All the true about the condition shown except: | {
"A": "The most impoant complication of celiac disease is the development of cancer.",
"B": "Most sensitive test is anti-tissue transglutaminase antibody",
"C": "Classic changes in celiac sprue occur in submucosa",
"D": "Associated with dermatitis herpetiformis"
} | Classic changes in celiac sprue occur in submucosa | 2C
| (Atrophy of villi) (Regeneration of villi) IgA tissue transglutaminase (IgA tTG) antibody is recommended; has a 95% sensitivity and 95% specificity for detecting celiac disease. Antigliadin antibodies are not recommended because of their lower sensitivity and specificity .IgA antiendomysial antibodies are no longer recommended due to the lack of standardization among laboratories. Celiac disease is associated with dermatitis herpetiformis (DH), but this association has not been explained. Patients with DH have characteristic papulovesicular lesions that respond todapsone. Almost all patients with DH have histologic changes in the small intestine consistent with celiac disease, although usually much milder and less diffuse in distribution. The most impoant complication of celiac disease is the development of cancer. The incidences of both gastrointestinal and nongastrointestinal neoplasms as well as intestinal lymphoma are elevated among patients with celiac disease. The classic changes seen on duodenal/jejunal biopsy are restricted to the mucosa and include An increase in the number of intraepithelial lymphocytes; absence or a reduced height of villi a cuboidal appearance and nuclei that are no longer oriented basally in surface epithelial cells; and increased numbers of lymphocytes and plasma cells in the lamina propria . | Medicine | Malabsorbtion Syndrome |
Fungus which cannot be cultured is: | {
"A": "Pencillium",
"B": "Aspergillus",
"C": "Rhinosporodium",
"D": "Sporothrix"
} | Rhinosporodium | 2C
| Rhinosporodium | Microbiology | None |
Test of historical impoance to detect respiration: MAHE 09 | {
"A": "I-card test",
"B": "Winslow test",
"C": "Magnus test",
"D": "Diaphanous test"
} | Winslow test | 1B
| Ans. Winslow test | Forensic Medicine | None |
True about Patey mastectomy is | {
"A": "Pectoralis major is removed",
"B": "Axillary lymph nodes are preserved",
"C": "Pectoralis minor is divided",
"D": "Nerve to Serratus anterior divided"
} | Pectoralis minor is divided | 2C
| Patey mastectomy The breast and associated structures are dissected en bloc and the excised mass is composed of:The whole breast.A large poion of skin, the centre of which overlies the tumour but which always includes the nipple.All of the fat, fascia and lymph nodes of the axilla.The pectoralis minor muscle is either divided or retracted to gain access to the upper two-thirds of the axilla. The axillary vein and nerves to the serratus anterior and latissimus dorsi (the thoracodorsal trunk) should be preserved. The intercostal brachial nerves are usually divided in this operation and the patient should be warned about sensation changes postoperatively.Ref: Bailey and Love, 27e, page: 876 | Surgery | Endocrinology and breast |
Antimalarial(s) to be avoided in pregnancy:a) Chloroquineb) Quininec) Primaquined) Anti-folatese) Tetracyclines | {
"A": "a",
"B": "b",
"C": "ce",
"D": "ae"
} | ce | 2C
| Malaria is life threatening in pregnancy, therefore benefits of treatment outweigh the potential risk of antimalarials.
The commonly used antimalarials are not contraindicated in pregnancy.
Chloroquine is the drug of choice for treatment and prophylaxis (even in pregnancy) of all varieties of malaria.
Harrison 17/e, p 1293, Williams Obs. 24/e, p 1257
According to Williams 24/e cloroquine should be used throughout pregnancy and primaquine should be used during postpartum period for malaria in pregnant moment.
In cloroquine resistant P. vivax malaria-mefloquine is the DOC.
In cloroquine resistant P. falciparum malaria-mefloquine or quinine is the drug of choice.
Chemoprophylaxis:
Pregnant women in endemic areas are candidates for chemoprophylaxis.
It is also recommended for travel to endemic areas.
Chloroquine is the drug of choice for prophylaxis in pregnancy.
Mefloquine is the only drug adviced for pregnant women who travel to areas with drug resistant malaria. This drug is generally considered safe in 2nd and 3rd trimester of pregnancy and the limited data on 1st trimester exposure are reassuring.
Harrison 17/e, p 1293
“Proguanil is considered safe for antimalarial prophylaxis in pregnancy.”
Harrison 17/e, p 1293
Antimalarials contraindicated in pregnancy:
“Tetracycline and doxycycline cannot be given to pregnant women”.
Harrison 17/e, p 1291, 1289
“Primaquine should not be given to pregnant women and neonates.
Harrison 17/e, p 1293
“Primaquine and doxycycline are contraindicated in pregnancy”.
Williams 24/e, p 1257 | Gynaecology & Obstetrics | None |
Which muscle will be paralyzed when radial nerve is injured in just below be spiral groove ? | {
"A": "Lateral head of triceps",
"B": "Medial head of triceps",
"C": "Long head of triceps",
"D": "ECRL"
} | ECRL | 3D
| Ans. is 'd' i.e., ECRLRadial nerve injury Radial nerve injury may be high or low. 1. High radial nerve palsyInjury is before the spiral grooveAll muscles supplied by radial nerve are paralysed. 2. Low radial nerve palsyInjury is after the spiral groove.Low radial nerve palsy may be of two types.Injury occurs between the spiral groove and elbow joint. Muscles involvement is : ?Elbow extensors (Triceps, anconeus) are spared.Wrist, elbow and finger extensors are paralysed.Sensory loss in first web space (on dorsal side)Injury occurs below the elbow joint.Elbow extensors (triceps, anconeus) and wrist extensors (ECRL) are spared.Finger extensors (extensor digitorum, extensor digiti minimi, extensor indicis) and thumb extensors (extensor pollicis longus & brevis) are paralysed.Sensory loss in first web space ( on dorsal side). | Anatomy | None |
Which of the following are AFB positive with 5% sulphuric acid - | {
"A": "M. avium",
"B": "M. leprae",
"C": "M. tuberculosis",
"D": "Nocardia"
} | M. leprae | 1B
| Procedure : 1. The smear is stained by a strong solution of carbon fuchsin with the application of heat 2. It is then decolorized with 20% SULPHURIC ACID and counterstained with a contrasting dye such as methylene blue 3. The acid-fast bacteria retain the fuchsin color while others take the counterstain Mycobacterium leprae resists decolorization with 5% SULPHURIC ACID Ref: Ananthanarayan & paniker's Textbook of Microbiology 9th edition pg no 14 | Microbiology | general microbiology |
In patients who underwent appendicectomy there is less chances for the following | {
"A": "Ulcerative colitis",
"B": "Chron's disease",
"C": "Both",
"D": "None"
} | Ulcerative colitis | 0A
| (A) Ulcerative colitis# Appendectomy for an inflammatory condition (appendicitis or lymphadenitis) but not for nonspecific abdominal pain is associated with a low risk of subsequent ulcerative colitis. This inverse relation is limited to patients who undergo surgery before the age of 20 years.> A significant risk of Crohn's Disease following an appendectomy, though heterogeneity was observed between the studies. The elevated risk early after an appendectomy, which diminishes thereafter, likely reflects diagnostic problems in patients with incipient CD." | Surgery | Miscellaneous |
Antiparkinson drug known to cause cardiac valvular fibrosis is: | {
"A": "Levodopa",
"B": "Ropinirole",
"C": "Pramipexole",
"D": "Pergolide"
} | Pergolide | 3D
| None | Pharmacology | None |
Phantom Tumor is name given to | {
"A": "Loculated Pleural Effusion",
"B": "Subpulmonic effusion",
"C": "Interlobar effusion",
"D": "Pericardial effusion"
} | Interlobar effusion | 2C
| *Fissural Interlobar effusion is called as Phantom Tumor *It appears biconvex sharply marginated along the fissural lines viewed on a Lateral view | Radiology | Respiratory Radiology |
A 37-year-old small business manager receives a gunshot wound in the pelvic cavity, resulting in a lesion of the sacral splanchnic nerves. Which of the following nerve fibers would primarily be damaged? | {
"A": "Postganglionic parasympathetic fibers",
"B": "Postganglionic sympathetic fibers",
"C": "Preganglionic sympathetic fibers",
"D": "Preganglionic parasympathetic fibers"
} | Preganglionic sympathetic fibers | 2C
| The sacral splanchnic nerves consist primarily of preganglionic sympathetic neurons and also contain GVA fibers. None of the other fibers listed are contained in these nerves. | Anatomy | Development of GU system and Neuro-vascular supply of pelvis & perineum |
Auditory toxicity is maximum with : | {
"A": "Streptomycin",
"B": "Kanamycin",
"C": "Tobramycin",
"D": "Amikacin"
} | Amikacin | 3D
| None | Pharmacology | None |
A surgeon removed section of tissues how would he confirm that cut margin doesn't contain any suspicious tissue intraoperatively? | {
"A": "Punch biopsy",
"B": "Brush biopsy",
"C": "Frozen section",
"D": "Exfoliative cytology"
} | Frozen section | 2C
| None | Pathology | None |
Which of the following is not a predisposing factor for Esophagus Ca | {
"A": "Tylosis",
"B": "Achalasia",
"C": "Barrett's esophagus",
"D": "Esophageal varices"
} | Esophageal varices | 3D
| Diet heavy smoking Alcohol Food contaminated with fungus Vitamin deficiency Oesophageal disorders oesophagitis Achalasia Hiatus hernia Diveicula Plummer-Vinson syndrome Others Race japanese and chinese Family history tylosis Genetic factors coeliac disease, epidermolysis bullosa, tylosis HPV infection TEXTBOOK OF PATHOLOGY HARSH MOHAN 6TH EDITION PAGE NO:541 | Pathology | G.I.T |
Which of the following is true -a) HSP is associated with IgG depositionb) HUS causes thrombocytopeniac) Inulin clearance is best measure of GFRd) PSGN is associated with increased complement | {
"A": "a",
"B": "c",
"C": "bc",
"D": "ad"
} | bc | 2C
| None | Medicine | None |
All of the following are true about minimal change nephrotic disease except | {
"A": "Response to steroids",
"B": "Selective proetinuria",
"C": "IgG deposition in the mesangium",
"D": "Common in the age group 2-9 years"
} | IgG deposition in the mesangium | 2C
| Reference Robbins page no Pg 923Minimal change disease is the most frequent cause of nephrotic syndrome in children; it is manifested by protein- uria and effacement of glomerular foot processes without antibody deposits; the pathogenesis is unknown; the disease responds well to steroid therapy. | Pathology | Urinary tract |
A male infant presented with distension of abdomen shortly after birth with the passing of less meconium. Subsequently, a full–thickness biopsy of the rectum was performed. The rectal biopsy is likely to show – | {
"A": "Fibrosis of submucosa",
"B": "Lack of ganglion cells",
"C": "Thickened muscularis propria",
"D": "Hyalinisation of the muscular coat"
} | Lack of ganglion cells | 1B
| "Whenever neonate presents with delayed passage of stool, Hirschsprung's disease should be suspected".
Diagnosis of Hirschsprung's disease
The diagnosis of Hirschsprung's disease is confirmed by rectal suction biopsies
Rectal suction biopsies demonstrate —
Hypertrophied nerve bundles
The absence of ganglion cells
Other diagnostic procedures in Hirschsprung's disease
Rectal manometry
Anorectal manometry measures the pressure of internal anal sphincter while a balloon is distended in the rectum. The results are interpreted as —Normal individual → Reflex decline in internal sphincter pressure.
Hirschsprung's disease → Pressure fails to drop, the Paradoxical rise in pressure with rectal distention.
Radiography (Barium enema)
It demonstrates the presence of the transition zone between the normal dilated proximal colon and a smaller calibre obstructed distal colon caused by non-relaxation of aganglionic bowel.
Delayed passage of stool (meconium) and abdominal distension suggests low intestinal obstruction. | Pediatrics | None |
The enzyme primarily responsible for protein degradation in the stomach is | {
"A": "Trypsin",
"B": "Pepsin",
"C": "Chymotrypsin",
"D": "Endopeptidase"
} | Pepsin | 1B
| Secretions from the Oxyntic (Gastric) Glands:It is composed of three types of cells: (1) mucous neck cells, which secrete mainly mucus; (2) peptic (or chief) cells, which secrete large quantities of pepsinogen; and (3) parietal (or oxyntic) cells, which secrete hydrochloric acid and intrinsic factor. When pepsinogen is first secreted, it has no digestive activity. However, as soon as it comes in contact with hydrochloric acid, it is activated to form active pepsin.Pepsin functions as an active proteolytic enzyme in a highly acidic medium (optimum pH 1.8 to 3.5), but above a pH of about 5 it has almost no proteolytic activity and becomes completely inactivated in a sho time.Ref: Guyton; 13th edition; Chapter 65 Secretory Functions of the Alimentary Tract | Biochemistry | nutrition and digestion |
Which is not affected in lesion of posterior column of spinal cord? | {
"A": "Romberg's",
"B": "Temperature sense",
"C": "Vibration sense",
"D": "Ataxia"
} | Temperature sense | 1B
| *Lesion in the posterior column of spinal cord and posterior nerve roots in syphilitic degenerative disease called tabes dorsalis *Characterised by impairment of proprioceptive sensibility,vibration,passive movement and appreciation of posture .patient become ataxic ,paicularly if he closes his eyes ,because he has lost his position sense for which he can paially compensate by visual knowledge of his spatial relationship(Romberg's sign) Ref Harrison20th edition pg 2766 | Medicine | C.N.S |
A patient with ITP has a platelet count of 50,000 and is being planned for splenectomy. What is the best time for platelet infusion in this patient? | {
"A": "2 hours before surgery",
"B": "At the time of skin incision",
"C": "After ligating the splenic aery",
"D": "Immediately after removal of spleen"
} | After ligating the splenic aery | 2C
| In the acute cases with severe bleeding which cannot be brought under control by steroid therapy, fresh blood transfusion or transfusion with platelet concentrates before operation is necessary, and is administered only after the splenic aery has been clamped. Platelets administered before this point in the surgery are unlikely to be effective owing to their rapid clearance by the spleen. Ref: Harrison's Internal Medicine, 17th Edition, Page 721; Bailey and Love's Sho Practice of Surgery, 24th Edition, Page 1089 and 25th Edition, Page 1106 | Surgery | None |
A 75-year-old male develops a cough that produces blood-tinged sputum. He has a fever of 104degF. Gram-positive cocci in clusters are found in a sputum smear. A chest x-ray shows increased density in the right upper lobe. Of the following penicillins, which is most likely to be ineffective? | {
"A": "Oxacillin",
"B": "Cloxacillin",
"C": "Ticarcillin",
"D": "Nafcillin"
} | Ticarcillin | 2C
| Ticarcillin resembles carbenicillin and has a high degree of potency against Pseudomonas and Proteusorganisms but is broken down by penicillinase produced by various bacteria, including most staphylococci. Oxacillin, cloxacillin, nafcillin, and dicloxacillin are all resistant to penicillinase and are effective against staphylococci. | Surgery | None |
Which of the following does not stimulate peripheral chemoreceptors? | {
"A": "Hypoxia",
"B": "Hypocapnia",
"C": "Acidosis",
"D": "Low perfusion pressure"
} | Hypocapnia | 1B
| Hypercapnia is a stimulus not hypocapnia.
Low perfusion produces hypoxia and hypercapnia at the level of chemoreceptors; thus stimulating them.
Peripheral arterial chemoreceptors in the carotid and aortic bodies have very high rates of blood flow. These receptors are primarily activated by a reduction in partial pressure of oxygen (PaO2), but they also respond to an increase in the partial pressure of carbon dioxide (PaCO2) and pH.
Reference: Ganong’s Review of Medical Physiology T W E N T Y - F I F T H E D I T I O N page no 593 | Physiology | None |
Replacement of Mirena a progestin releasing intrauterine device should be done after how many years? | {
"A": "1 year",
"B": "3 year",
"C": "5 year",
"D": "10 year"
} | 5 year | 2C
| Mirena is a progestin releasing device, it releases levonorgestrel into the uterus at a rate of 20 microgm/d. It has a T-shaped radiopaque frame, with its stem wrapped with a cylinder reservoir, composed of a polydimethylsiloxane-levonorgestrel mixture. It has to be replaced every 5 years. Cu T 380A is another progestin releasing device. It has a polyethylene and barium sulfate, T-shaped frame wound with copper. It has to be replaced every 10 years. Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 32. Contraception. | Gynaecology & Obstetrics | None |
If the 4th infralabial is larger than others on either side, the snake may be | {
"A": "Cobra",
"B": "Krait",
"C": "Viper",
"D": "Coral snake"
} | Krait | 1B
| If the 3rd supra labial is not touching eye and nasal shield, then look at the ventral aspect of head. If the 4th infra labial is larger than the others on either side, it is poisonous (krait) Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 511 | Anatomy | Poisoning |
Which of the following is an example of Type E adverse drug reaction? | {
"A": "Withdrawal reaction",
"B": "Teratogenesis",
"C": "Augmented response",
"D": "Toxicity"
} | Withdrawal reaction | 0A
| Adverse Drug Reactions are noxious or unintended effects produced by drugs. These may be classified as Type A: Augmented pharmacologic effects - Dose dependent and predictable e.g. hypoglycemia caused by anti-hyperglycemic drugs like sulfonylureas Type B: Bizarre effects (or idiosyncratic) - Dose independent and unpredictable e.g. allergic reactions caused by penicillins Type C: Chronic effects e.g. peptic ulcer caused by chronic use of NSAIDs Type D: Delayed effects e.g. teratogenicity caused by thalidomide Type E: End-of-treatment effects e.g. withdrawal response to morphine Type F: Failure of therapy | Pharmacology | Pharmacodynamics |
On a given day, a hospital had 50 admissions with about 20 girls and 30 boys, out of which 10 girls and 20 boys needed surgery. What is the possibility of picking up a person requiring surgery- | {
"A": "6-Feb",
"B": "5-Mar",
"C": "2-Jan",
"D": "25-Jun"
} | 25-Jun | 3D
| Ans. is 'b' i.e., 3/5 | Social & Preventive Medicine | None |
The biochemical changes in established cases of Stein-Leventhal syndrome are as mentioned except: | {
"A": "Marked elevation of LH in contrast to FSH",
"B": "Insulin resistance",
"C": "Elevation of plasma testosterone",
"D": "Elevation. in the level of sex hormone binding globulin (SHBG) level"
} | Elevation. in the level of sex hormone binding globulin (SHBG) level | 3D
| In PCOS (stein leventhal syndrome) the levels of SHBG decrease. | Gynaecology & Obstetrics | None |
In complete mullerian duct aplasia all of the following are likely to be absent except: | {
"A": "Ovaries",
"B": "Fallopian tubes",
"C": "Uterus",
"D": "Vagina"
} | Ovaries | 0A
| Ovaries develop from gonadal ridge Fallopian tubes, Uterus and upper third of vagina develops from Mullerian ducts Lower third of vagina from urogenital sinus SHAW&;S TEXTBOOK OF GYNAECOLOGY, pg no;94,15th edition | Gynaecology & Obstetrics | Congenital malformations |
IUD is not inserted during | {
"A": "During menturation",
"B": "Within 10 days of beginning of menstruation",
"C": "After 1 week of delivery",
"D": "During 6-8th weeks after delivery"
} | After 1 week of delivery | 2C
| Best time for IUD insertion are
During mensturation.
Within 10 days of beginning of mensturation.
Within 1 week after delivery.
during 6-8th week after delivery. | Social & Preventive Medicine | None |
16 yr old, obese female presented with history of bilateral hip pain from a long duration. Endocrinology tests show hypothyroidism. She has a painful limping gait. Which of the following investigation is of no use in diagnosis of this condition? | {
"A": "X-Ray",
"B": "MRI",
"C": "CT",
"D": "USG"
} | USG | 3D
| History given is suggestive of SCFE( Slipped capital femoral epiphysis). X-Ray showsa Trethowan's sign CT is used for Acute/Chronic slip MRI is IOC. USG has no role in diagnosing this condition. | Radiology | Radiology Q Bank |
The Mantaux of a 40-year-old man who had presented with fever, weight loss and cough reads 18 x 19 mm. Sputum cytology is negative for AFB. What is the most likely condition? | {
"A": "Pneumococcal Pneumonia",
"B": "Pulmonary Tuberculosis",
"C": "Cryptococcal Infection",
"D": "Viral Infection"
} | Pulmonary Tuberculosis | 1B
| All the given features (low-grade fever, cough and weight loss) above were ourable for pulmonary tuberculosis, and the fact that a sputum cytology doesn't negate the possibility for a detection of pulmonary tuberculosis. A negative PCR from a smear which is positive for acid fat bacilli makes diagnosis of tuberculosis highly unlikely. Cell culture identification of Mycobacterium tuberculosis and Mycobacterium bovis is required for diagnosis of tuberculosis. Ref: Siegenthaler's Differential Diagnosis in Internal Medicine By Walter Siegenthaler, 2007 ; Oxford Textbook of Medicine, Volume 1, By D. A. Warrell, Timothy M. Cox, John D. Fih, 2003, Page 560 | Medicine | None |
Erythematous lesions seen in axilla with coral red fluorescence in woods lamp is: | {
"A": "Tinea",
"B": "Lichen planus",
"C": "Erythrasma",
"D": "Vitiligo"
} | Erythrasma | 2C
| Ans: c (Erythrasma) Ref: Pavithrans Textbook 56Erythrasma is a chronic infection of skin caused by Corynebacterium minutissimum and affects the intertrigenous areas like the axillae, toe, webs and groin.It is asymptomatic in nature and absence of central clearing helps to differentiate it from tinea.Extensive lesions may occur in patients with diabetes mellitus.Underwoods light the affected area shows a coral red fluorescence. This is due to the presence of porphyrins produced by the coryne bacterium minutissimum.Wood's lamp lightMade up of nickel oxide and silica. It generates 360nm UV-A light.* Corynebacterium minutissimum-coral red colour.* Pseudomonas, psoriasis-pale blue.* Tuberous sclerosis-ash leaf spots(blue white)* Vitiligo-chalky white.* Porphyria cutanea tarda-pinkish red (urine)* Tinea versicolor-golden fluorescence.* Tinea capitis-yellow fluorescence* Sq cell ca-red fluorescence.* Albinism&leprosy-blue white | Skin | Bacterial Infection of Skin |
This is a specimen of | {
"A": "FAP",
"B": "Ulcerative colitis",
"C": "Crohns disease",
"D": "Peutz jeghers syndrome"
} | FAP | 0A
| This is a specimen of familial adenomatous polyposis with multiple polyps.Polyps are usually visible on sigmoidoscopy by the age of 15 years and will almost always be visible by the age of 30 years.Carcinoma of the large bowel develops 10-20 years after the onset of the polyposis.If over 100 adenomas are present at colonoscopy, the diagnosis can be made confidently.Ref: Bailey and love, 27e, page: 1260 | Surgery | G.I.T |
A 17 Year old male complains of recurrent episodes of cough, wheeing and shoness of breath paicularly at night for the last 3 days. His sibling has a history of similar symptoms. A skin test with pollen produces immediate wheal and flare. He should be treated with | {
"A": "Bronchodilators",
"B": "Steroids",
"C": "Antibiotics",
"D": "cough sedative"
} | Bronchodilators | 0A
| The patient is having atopic asthma,with sensitization to allergens like pollen,dust mites,etc.The primary modality of treatment for asthma is bronchodilators,which give rapid relief of symptoms mainly through relaxation of airway smooth muscle and relieving bronchoconstriction.Beta agonists(sho acting and long acting),anticholinergics and theophylline are three classes of bronchodilators in current use,of which beta agonists like salbutamol,terbutaline,salmeterol are the most effective. Ref:Harrison's medicine-18th edition,page no: 2109,2110. | Medicine | Respiratory system |
Which of the following is not administered by intradermal route | {
"A": "BCG",
"B": "Insulin",
"C": "Mantoux",
"D": "Drug sensitivity injection"
} | Insulin | 1B
| Refer KDT 6/e p259 Insulin is admistered by s,.c route Insulin is a peptide hormone produced by beta cells of the pancreatic islets; it is considered to be the main anabolic hormone of the body. | Pharmacology | Kidney |
Which weight loss regime decreases risk of gall bladder stone | {
"A": "2 -3 Lt water per day",
"B": "2 - 3 Kg wt loss / month",
"C": "Very low calorie diet",
"D": "High fat diet"
} | 2 - 3 Kg wt loss / month | 1B
| Answer- B. 2 - 3 Kg wt loss / monthRkk of gall stone formation in obese persons during active weight loss seems to increase in an exponential fasion. The data suggest that rates of weight loss should not exceed an average of 7.5 kg per week | Surgery | None |
The following statement about Gomez classification is True ? | {
"A": "Based on height retardation",
"B": "Based on median weight for age",
"C": "Between 75 and 89% implies mild malnutrition",
"D": "This classification has prognostic value for hospitalization of children"
} | Based on median weight for age | 1B
| Gomez classification of Undernutrition Index Grading 90-75% Grade I <75-60% Grade 2 <60% Grade 3 Ref: Nelson Textbook of Paediatrics; 20th edition; Chapter 46 Nutrition, Food Security, and Health | Pediatrics | Nutrition |
A non-symmetrical frequency distribution is known as - | {
"A": "Skewed distribution",
"B": "Normal distribution",
"C": "Cumulative frequency distribution",
"D": "All"
} | Skewed distribution | 0A
| Ans. is 'a' i.e., Skewed distribution o There are variations in naturally occuring data (e.g. heights of the individuals) or when data collected to formulate or test, the cause and effect hypothesis. o It is impoant to know the frequencies of value where they are distributed, i.e. frequency distribution. | Social & Preventive Medicine | None |
In hypovolemic shock: | {
"A": "The central venous pressure is high",
"B": "The extremities are pale, cold and sweating",
"C": "There is always a site of bleeding",
"D": "Urine output is unaffected"
} | The extremities are pale, cold and sweating | 1B
| None | Pathology | None |
The absolute CONTRAINDICATION to lithium is March 2004 | {
"A": "Renal failure",
"B": "Glaucoma",
"C": "Epilepsy",
"D": "Angina"
} | Renal failure | 0A
| Ans. A i.e. Renal failure | Pharmacology | None |
Which of the following cause osteonecrosis - | {
"A": "Sickle cell anemia",
"B": "Coicosteroid use",
"C": "Die",
"D": "SLE"
} | SLE | 3D
| Osteonecrosis is a disease caused by reduced blood flow to bones in the joints. In people with healthy bones, new bone is always replacing old bone. In osteonecrosis, the lack of blood causes the bone to break down faster than the body can make enough new bone . The most common causes of osteonecrosis are: Serious trauma (injury), which interrupts a bone's blood supply Coicosteroid medications (such as prednisone, coisone or methylprednisolone), mainly when a high dose is used for a prolonged period of time Excess alcohol consumption SLE Other less common risk factors for osteonecrosis include: Decompression disease (also called the "Bends" that can occur with scuba diving) Blood disorders such as sickle cell anemia, antiphospholipid antibody syndrome (APS) and lupus anticoagulant HIV infection (the virus that causes AIDS) Radiation therapy Bisphosphonates, which may be linked to osteonecrosis of the jaw Organ transplants REf - Harrisons internal medicine 20e p2617t , 225, 677, 2936, 2955 , 1441 | Medicine | Endocrinology |
All are features in Treacher-collin syndrome except: | {
"A": "Coloboma of inferior lid",
"B": "Mandibular hypoplasia",
"C": "Low intelligence",
"D": "Cleft palate"
} | Low intelligence | 2C
| Intelligence is not affected in Treacher-Collin syndrome(like Turners syndrome) Treacher-Collins syndrome/Franceschetti syndrome Autosomal dominant Facial appearance: downward sloping palpebral fissures, colobomas and drooping of the lower eyelids, sunken cheekbones, deformed pinnae, atypical hair growth extending towards cheeks Facial clefts, malformed ears, deafness Hypoplastic mandible Ref: Nelson textbook of pediatrics 21st edition Pgno: 1917 | Pediatrics | Genetic and genetic disorders |
Ocular manifestation of ankylosing spondylitis is: March 2013 | {
"A": "Cataract",
"B": "Retinal detachment",
"C": "Anterior uveitis",
"D": "Glaucoma"
} | Anterior uveitis | 2C
| Ans. C i.e. Anterior uveitis Acute anterior uveitis Associated with: - Juvenile rheumatoid ahritis & - Anklyosing spondylitis Miotic pupil, Treatment: - Steroids (DOC) followed by - Mydriatics, Steroids reduces inflammation & scarring; Dilation of the pupil by atropine: - Reduces pain & - Prevents synechiae formation | Ophthalmology | None |
Which of the following is a syndesmosis? | {
"A": "Superior tibiofibular joint",
"B": "Inferior tibiofibular joint",
"C": "Superior radioulnar joint",
"D": "Inferior radioulnar joint"
} | Inferior tibiofibular joint | 1B
| Syndesmosis: The bones are connected by the interosseous ligament example: inferior tibiofibular joint Description Ref BD CHAURASIA S Handbook of General Anatomy Fouh edition Pg no 61 | Anatomy | General anatomy |
Green color at bruise site is due to: | {
"A": "Hemotidin",
"B": "Bilirubin",
"C": "Hemosiderin",
"D": "Biliverdin"
} | Biliverdin | 3D
| Ans. (d) Biliverdin* Bruise is a skin contusion which is also known as hematoma of skin* Capillaries and sometimes venules are damaged by trauma, allowing blood to seep, hemorrhage, or extravasate into the surrounding interstitial tissues.* Larger bruises may change color due to the breakdown of hemoglobin from within escaped RBC in the extracellular space.* The striking colors of a bruise are caused by the Phagocytosis and sequential degradation of hemoglobin to biliverdin to bilirubin to hemosiderin* The color changes noted at the site of bruise is secondary to:# Hemoglobin itself producing a red-blue color# Biliverdin producing a green color# Bilirubin producing a yellow color# Hemosiderin producing a golden-brown color | Skin | General |
Treatment of choice in a patient of acute pulmonary embolism with right ventricular hypokinesia and a compromised cardiac output but normal blood pressure is : | {
"A": "Thrombolytic agent",
"B": "Low molecular weight heparin",
"C": "IV filters",
"D": "Warfarin"
} | Thrombolytic agent | 0A
| None | Pharmacology | None |
Smith Noguchi's media is used for | {
"A": "Salmonella",
"B": "Klebsiella",
"C": "Spirochetes",
"D": "Bacillus"
} | Spirochetes | 2C
| Smith-Noguchi Medium (by using living tissue) - Anaerobic media. Used for Cultivation of nonpathogenic treponemes E.g. Reiter strain of Treponema phagedenis - Spirochetes) Salmonella - Wilson and Blair bismuth sulphite medium is best selective medium Klebsiella - On MacConkey Agar, these are lactose fermentors Bacillus - PLET media is best for culture | Microbiology | General Microbiology Pa 1 (History, Microscopy, Stains and Structure and Physiology of Bacteria) |
Trident hand is seen in _______ | {
"A": "Achondroplasia",
"B": "Mucopolysaccharidosis",
"C": "Osteopetrosis",
"D": "Cleidocranial dysostosis"
} | Achondroplasia | 0A
| Trident hand is seen in achondroplsia; sho with stubby fingers, with a seperation between the middle and ring fingers. Achondroplasia: Autosomal-dominant chondroplasia; most common condition chracterized by dispropoionate sho stature. Caused by mutations in the gene coding for fibroblast growth factor receptor type 3 (FGFR3) Clinical features: Sho stature, extreme joint laxity, bowing of legs, macrocephaly, frontal bossing, midfacial hypoplasia, small chest, redundant skin folds, recurrent infections, cor pulmonale, and restrictive pulmonary disease. Radiological features in achondroplasia Champagne glass pelvic inlet Trident hand Shoening of tubular bones with metaphyseal flaring Chevron deformity Ref: Nelson textbook of pediatrics 21st edition Pgno: 3726 | Pediatrics | Genetic and genetic disorders |
Imprisonment for a term extending to seven years and also fine as punishment for voluntarily causing grievous hu is under | {
"A": "321 I.P.C",
"B": "322 I.P.C",
"C": "324 I.P.C",
"D": "325 I.P.C"
} | 325 I.P.C | 3D
| 325 IPC; Punishment for voluntarily causing grievous hu. Imprisonment for a term extending to seven years and also fine | Microbiology | All India exam |
Cetrimide culture media used in which infection- | {
"A": "E. coli",
"B": "V. cholerae",
"C": "Staph aureus",
"D": "Pseudomonas"
} | Pseudomonas | 3D
| Ans. is 'd' i.e., Pseudomonas OrganismSelective/Enrichment mediaPlating media for V choleraeTCBS (Thiosulfate Citrate Bile Salt sucrose), BSA (alkaline bile salt agar), GTTA (Gelatin Taurocholate Tellurite Agar)Enrichment media for V choleraeAlkaline peptone water, Monsur's taurocholate peptone waterLegionellaBCYL (Buffered Charcol Yeat Extract)BordetellaRegan Low medium, Bordet-Gengou medium, Lacey's DFP mediumM. TuberculosisLJ medium, Middle brook's medium, Dorset egg mediumS. aureusMannitol salt agar, Milk salt agar, Ludlanvs mediumNeisseria (gonococcus/meningococus)Thayer Martin medium, chocolate agarCorynebacterium DiphthertaeLoeffer's serum slope, Potassium tellurite agarBacillus CereusMYPA (Mannitol egg Yolk Phenol red polymixin agar)Bacillus AnthracisPLET (Polymyxin Lithium EDTAthallous acetate)LeptospiraEMJH medium. Fletcher medium. Korthof medium, Stuart's mediumCampylobacterSkirrow's medium. Campy BAP medium, Butzlers mediumReiter's TreponemaSmith Noguchi mediumSalmonellaTetrathionate broth. Selenite F. brothPseudomonasCetrimide AgarAnaerobesRobertson cooked meat broth, Thioglycollate, Smith-NogucbiLactose fermenting Enteric pathogens (E. colt & others)MacConkey agar, Eosine-methylene blue (EMB), Deoxvcholate agarHemophilusBlood agar with staph streak, Levin dial's medium. Fildes agar, chocolate agarListeriaPALCAM agarBurkholderiaAshdown's mediumSalmonella, ShigellaDeoxyeholate medium, Hektoen enteric agar (Salmonella-Shigella agar)Streptococcus agalactiaeTodd Hewitt broth with antibioticsMycoplasma pneumoniaePPLG mediumFor culturing urine sampleCLED (Cysteine Lactose Electrolyte Deficient) mediumClostridium difficileCCFA (Cefoxitin Cycloserine Fructose Agar).CCEY (Cefoxitin Cycloserine Egg-Yolk agar)YersiniaCIN (Cefsulodin-lrgasan-Novobiocin) mediumEnterococcusBile esculin agarActinomycesThioglycoliate medium. Brain heart infusion agar | Microbiology | Culture media and method |
Disseminated intravascular coagulation (DIC) differs from thrombotic thrombocytopenic purpura. In this reference the DIC is most likely characterized by: | {
"A": "Significant numbers of schistocytes",
"B": "A brisk reticulocytosis",
"C": "Significant thrombocytopenia",
"D": "Decreased coagulation factor levels"
} | Significant thrombocytopenia | 2C
| In DIC, the levels of coagulation factors are decreased. Whereas in TTP, coagulation factor levels are normal. Ref :Harrison's Principles of Internal Medicine 21st ed. | Medicine | All India exam |
Aschoff bodies in Rheumatic heart disease show all of the following features, except | {
"A": "Antischkow cells",
"B": "Giant cells",
"C": "Epitheloid cells",
"D": "Fibrinoid necrosis"
} | Epitheloid cells | 2C
| Aschoff bodies do not contain epitheloid cells or Langhan's giant cells. | Pathology | None |
Which of the following is not an established antimicrobial drug synergism at the clinical level? | {
"A": "Amphotericin B and flucytosine in cryptococcal meningitis",
"B": "Carbenicillin and gentamicin in pseudomonal infections",
"C": "Penicillin and tetracycline in bacterial meningitis",
"D": "Trimethoprim and sulfamethoxazole in coliform infections"
} | Penicillin and tetracycline in bacterial meningitis | 2C
| Combination of a bacteriostatic and a bactericidal drug in most cases is antagonistic. Bactericidal drugs act on fast multiplying organisms whereas bacteriostatic drugs inhibit the growth. Here, penicillin is bactericidal whereas tetracyclines are bacteriostatic. | Pharmacology | None |
In a study every fouh student is selected in a class while sampling. This is a type of:- | {
"A": "Simple random sampling",
"B": "Systematic random sampling",
"C": "Stratified random sampling",
"D": "Cluster random sampling"
} | Systematic random sampling | 1B
| Systematic Random Sampling:- Based on sampling fraction: Every Kth unit is chosen in the population list, where K is chosen by sampling internal. Sampling interval (K) : Total no. of units in population / Total No of units in sample. | Social & Preventive Medicine | Sampling |
A 65-year old woman complains of leakage of urine. The most common cause of this condition in such patient is | {
"A": "Anatomic stress urinary incontinence",
"B": "Urethral diverticula",
"C": "Overflow incontinence",
"D": "Unstable bladder"
} | Unstable bladder | 3D
| Ans. D. Unstable bladderAs patients age, the incidence of vesicle instability or unstable bladder increases dramatically. Although estrogen has been reported to decrease urgency, frequency, and nocturia in menopausal women, its effect on correction of stress urinary incontinence or vesicle instability is unclear. In the elderly population there are also many transient causes of incontinence that the physician should consider. These include dementia, medications (especially a-adrenergic blockers), decreased patient mobility, endocrine abnormalities (hypercalcemia, hypothyroidism), stool impaction, and urinary tract infections. | Gynaecology & Obstetrics | Miscellaneous (Obs) |
Patient of exudative retinopathy of coats presents with leukocoria, needs to be differentiated from - | {
"A": "Retinoblstoma",
"B": "Retinitispigmentosa",
"C": "Retinal detachment",
"D": "Congenital cataract"
} | Retinoblstoma | 0A
| Ans. is 'a' i.e., Retinoblastoma EXUDATIVE RETINOPATHY OFCOATSo Coats' disease is a severe form of retinal telengiectasia (idiopathic congenital vascular malformation), which typically affects one eye of boys in their first decade of life.o In early stages it is characterised by large areas of intra and subretinal yellowish exudates and haemorrhages associated with overlying dilated and tortuous retinal blood vessels and a number of small aneurysms near the posterior pole and around the disc.o It may present with visual loss, strabismus or leukocoria (whitish pupillary reflex) and thus needs to be differentiated from retinoblastoma. The condition usually progresses to produce exudative retinal detachment and a retrolental mass.o In late stages complicated cataract, uveitis and secondary' glaucoma occur, which eventually end in phthisis bulbi.Treatmento Photocoagulation or cryotherapy may check progression of the disease if applied in the early stage. However, once the retina is detached the treatment becomes increasingly difficult and success rate declines to 33 percent. | Ophthalmology | Retinal Detachment |
which of the following is not used as an EMERGENCY contraception | {
"A": "Danazole",
"B": "CuT 200B",
"C": "RU486",
"D": "High dose Estrogen"
} | Danazole | 0A
| Emergency Contraception 1=Low High OCP&;s 2=LevonsgestroL 3=Ru4861/ MEFIPRISTONE 4=cuT/ ULIPRISTOL REF : SHAW GYNECOLOGY | Gynaecology & Obstetrics | All India exam |
Garre's osteomyelitis commonly involve - | {
"A": "Jaw",
"B": "Femur",
"C": "Ribs",
"D": "Small bones of hand"
} | Jaw | 0A
| Sclerosing osteomyelitis of Garre typically develops in the jaw and is associated with an extensive new bone formation that obscures much of the underlying osseous structure. | Pathology | None |
A male aged 60 years has foul breath. He regurgitates food that is eaten 3 days ago : Likely diagnosis is - | {
"A": "Zenkers diverticulum",
"B": "Meckels diverticulum",
"C": "Scleroderma",
"D": "Achalasia cardia"
} | Zenkers diverticulum | 0A
| None | Surgery | None |
Following drugs have abuse liability except | {
"A": "Alprazolam",
"B": "Buprenorphine",
"C": "Dextropropoxyphene",
"D": "Fluoxetine"
} | Fluoxetine | 3D
| The answer for this question can be easily understood by just having an idea about the outline of pharmacology Among the choices fluoxetine is an antidepressant used in the management of depression and it has no abuse potential Ref.Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 1013 | Psychiatry | Pharmacotherapy in psychiatry |
Which of the following is the most common content in 'Hernia en glissade'? | {
"A": "Omentum",
"B": "Urinary bladder",
"C": "Caecum",
"D": "Sigmoid colon"
} | Sigmoid colon | 3D
| Hernia en glissade or sliding hernia It is defined as any hernia in which pa of the sac (usually the post. is formed by the wall of viscus. In this type of hernia viscera is liable to be injured if the hernial sac is resected during surgery. It should be clearly understood that the caecum, appendix or pa of colon wholly within a hernial sac does not constitute a sliding hernia (The viscera must form a wall of the sac to be termed as sliding hernia) Sliding hernia occur almost exclusively in men and is seen nearly always over 40 years of age. Most common content On right side Caecum On left side Sigmoid colon Since left sided hernia is common than right side ( 5:1 ), sigmoid colon is the obvious choice for the most common content. Other contents may be appendix, urinary bladder, uterus, fallopian tube, ovary or ureter. Ref: Bailey & Love 25/e, Page 977. | Surgery | None |
Which of the following amino acid can have o-Glycoxylation linkage in oligosaccharide molecule: | {
"A": "Asparagine",
"B": "Glutamine",
"C": "Serine",
"D": "Cysteine"
} | Serine | 2C
| Ans. C. SerineMajor Classes of Glycoproteins O-linked GlycoproteinO-glycosidic linkage between hydroxyl side chain of serine or threonine and N-acetyl galactosamine is presentN-linked GlycoproteinN-glycosidic linkage between amide nitrogen of asparagine and N-acetyl glucosamine is present.Glycosyl phosphatidylinositol-anchored (GPI-anchored, or GPI-linked) glycoproteinsThird major class of Glycoproteins.They link several proteins to Plasma membrane.Linked to the carboxyl terminal amino acid of a protein via a phosphoryl-ethanolamine moiety joined to an oligosaccharide (glycan), which in turn is linked via glucosamine to phosphatidylinositol(PI). | Biochemistry | Proteins and Amino Acids |
Blepharitis acarica is caused by - | {
"A": "Streptococcus",
"B": "Ascaricus",
"C": "Propionibacterium",
"D": "Demodex folliculorum"
} | Demodex folliculorum | 3D
| REF IMG | Ophthalmology | Diseases of orbit, Lids and lacrimal apparatus |
Which among the following malignancy is MOST SENSITIVE to radiotherapy? | {
"A": "Serous cystadenoma",
"B": "Dysgerminoma",
"C": "Mucinous cystadenoma",
"D": "Teratoma"
} | Dysgerminoma | 1B
| Ans. B. DysgerminomaNormally, dysgerminomas are unilateral. They are considered to be the most common kind of germ cellular tumor found in patients suffering with gonadal dysgenesis. They are highly radiosensitive and chemo-sensitive.Serous cystadenoma: The most common epithelial cell neoplasm. About 70% of these tumors are benign. The treatment of choice in such cases is surgery.Mucinous cystadenoma: Considered to be the second most common epithelial cell tumor of the ovary. Again, surgery being the treatment of choice.Cystic teratoma: Comprises about 60% of all benign ovarian neoplasms and 10-25% of all ovarian neoplasms. Surgical excision is the treatment of choice in such cases. | Gynaecology & Obstetrics | Gynaecological Disorders in Obs. |
Genital swelling in male differentiate into : | {
"A": "Glans penis",
"B": "Penile urethra",
"C": "Ishiocavernosus of penis",
"D": "Scrotum"
} | Scrotum | 3D
| None | Anatomy | None |
Which of the following is the new drug for the treatment of multi drug resistant tuberculosis? | {
"A": "Bedaquiline",
"B": "Linezolide",
"C": "Levofloxacin",
"D": "Cefepime"
} | Bedaquiline | 0A
| Ans. (A) Bedaquiline(Ref: Harrison 19th/e p1115, KDT 8th/e p823)Ref: Bedaquiline is a new drug approved for MDT tuberculosis. It acts by inhibiting ATP synthase in mycobacteria. Major adverse effect of this drug is QT prolongation. | Pharmacology | Chemotherapy: General Principles |
Sister Mary Joseph nodule is most commonly seen in which of the following malignancies? | {
"A": "Ovarian cancer",
"B": "Stomach cancer",
"C": "Colon cancer",
"D": "Pancreatic cancer"
} | Stomach cancer | 1B
| Sites for spread of gastric cancer most commonly involve the following: Supraclavicular sentinel lymph node Virchow node Periumbilical lymph nodes Sister Mary Joseph nodule Left axillary lymph node Irish node The pouch of Douglas Blumer shelf Ovary Krukenberg tumor | Pathology | Stomach |
Mucin layer tear film deficiency occurs in - | {
"A": "Keratoconjunctivitis sicca",
"B": "Lacrimal gland removal",
"C": "Canalicular block",
"D": "Herpetic keratitis"
} | Keratoconjunctivitis sicca | 0A
| Also known as sjogrens syndrome or aqueous deficiency dry eye. Ref : ak khurana 6th edition | Ophthalmology | Diseases of orbit, Lids and lacrimal apparatus |
Injury to the medial meniscus is rather impossible when the knee joint does not | {
"A": "Extend",
"B": "Flex",
"C": "Rotate",
"D": "All"
} | Rotate | 2C
| C i.e. Rotate | Surgery | None |
Professional secrecy can be divulged - | {
"A": "If the doctor feels so",
"B": "On demand by a court",
"C": "Both",
"D": "None"
} | On demand by a court | 1B
| If a court of law demands, professional secrecy can be divulged as part of privileged communication. | Forensic Medicine | None |
The non-sedative antihistamines are all except one | {
"A": "Cinnarizine",
"B": "Desloratadine",
"C": "Levocetirizine",
"D": "Fexofenadine"
} | Cinnarizine | 0A
| HIGHLY SEDATIVE
Diphenhydramine
Dimenhydrinate
Promethazine
Hydroxyzine
MODERATELY SEDATIVE
Pheniramine
Cyproheptadine
Meclizine
Cinnarizine
MILD SEDATIVE
Chlorpheniramine
Dexchlorpheniramine
Triprolidine
Clemastine
SECOND GENERATION ANTIHISTAMICS
Fexofenadine
Loratadine
Desloratadine
Cetirizine
Levocetirizine
Azelastine
Mizolastine
Ebastine
Rupatadine | Pharmacology | None |
Round tapered blank of Stainless steel is used and multiaxis grinding process is done for following | {
"A": "K file",
"B": "Reamer",
"C": "Hedstroem File",
"D": "All of the above"
} | Hedstroem File | 2C
| None | Dental | None |
Ipsilateral supraclavicular lymph nodes are positive in a patient of Ca Breast. Which of the following represents the stage of malignancy in this patient? | {
"A": "II",
"B": "III B",
"C": "III C",
"D": "IV"
} | III C | 2C
| Stage IIIC: Any T, Metastasis in ipsilateral supraclavicular lymph node(s) and M0. Patients with disseminated metastases should be considered for palliative systemic treatment. Ref: Hunt K.K., Newman L.A., Copeland E.M., Bland K.I. (2010). Chapter 17. The Breast. 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. | Surgery | None |
All of the following muscles of the shoulder girdle helps in abduction of the upper limb, EXCEPT? | {
"A": "Deltoid",
"B": "Supraspinatus",
"C": "Latissimus dorsi",
"D": "Long head of biceps brachii"
} | Latissimus dorsi | 2C
| Latissimus dorsi helps in adduction of the upper limb. Muscles involved in abduction of the upper limb are:DeltoidSupraspinatusLong head of biceps brachiiSerratus anterior and trapezius helps in this movement by producing slight rotation of the scapula.Adductors of the upper limb are:Teres majorLatissimus dorsiPectoralis majorLong head of the triceps brachiiSho head of the biceps brachiiClavicular and spinal pas of the deltoid | Anatomy | None |
Picking every 5th or 10th unit at regular intervals is: | {
"A": "Random sampling",
"B": "Systematic sampling",
"C": "Stratified sampling",
"D": "Quota sampling"
} | Systematic sampling | 1B
| A systematic sample is obtained by selecting one unit at random and then selecting additional units at evenly spaced interval till the sample of required size has been achieved. | Dental | None |
Non union is a common feature of fracture of | {
"A": "Supracondylar humerus",
"B": "Clavicle",
"C": "Lower tibia",
"D": "Coracoid process"
} | Lower tibia | 2C
| C i.e. Lower tibia Fracture through the lower third of tibia. is more liable to go onto delayed union because the lower fragment becomes relatively avascular dlt poor vascularityQ. | Surgery | None |
All are true regarding optic neuritis except - | {
"A": "Decreased visual acuity",
"B": "Decreased pupillary reflex",
"C": "Abnormal electroretinogram",
"D": "Abnormal visual evoked response retinogram"
} | Abnormal electroretinogram | 2C
| Electroretinogram indicates the activity of retinal (esp. rods & cones) function and has no role in assessing the functional integrity of the optic nerve. So it can't be abnormal in optic neuritis.
There is decreased visual acuity and abnormal pupillary reflex in optic neuritis. VER shows reduced amplitude and delay in transmission time. | Ophthalmology | None |
Response to iron in iron deficiency anemia is denoted by - | {
"A": "Restoration of enzymes",
"B": "Reticulocytosis",
"C": "Increase in iron binding capacity",
"D": "Increase in hemoglobin"
} | Reticulocytosis | 1B
| Oral iron therapy is continued long enough both to correct anaemia and to replenish the body iron stores. The response to oral iron therapy is observed by reticulocytosis which begins to appear in 3-4 days with a peak in about 10 days. References: Textbook of Pathology Seventh edition Author: Harsh Mohan Page No.276 | Pathology | Haematology |
"L-form" phenomenon is most likely to occur in ? | {
"A": "Mycobacterium tuberculosis",
"B": "Pseudomonas",
"C": "Proteus",
"D": "Mycoplasma"
} | Mycoplasma | 3D
| Ans. is 'd' i.e., Mycoplasma | Microbiology | None |
Which of the following statements best describes the intestinal amebae? | {
"A": "They are usually nonpathogenic",
"B": "They are usually transmitted as trophozoites",
"C": "They can cause peritonitis and liver abscesses",
"D": "They occur most abundantly in the duodenum"
} | They can cause peritonitis and liver abscesses | 2C
| Of the intestinal amebae, Entamoeba hamanni, E. coli, E. polecki, and E. nana are considered nonpathogenic. E. histolytica is distinctively characterized by its pathogenic potential for humans, although infection with this protozoan is commonly asymptomatic (causing "healthy carriers"). Symptomatic amebiasis and dysentery occur when the trophozoites invade the intestinal wall and produce ulceration and diarrhoea. Peritonitis can occur, with the liver the most common site of extraintestinal disease. The life cycle of the amebae is simple. There is encystment of the trophozoites, followed by excystation in the ileocecal region. The trophozoites multiply and become established in the cecum, where encystation takes place and results in abundant amebae, cysts, and trophozoites. Infection is spread by the cysts, which can remain for weeks or months in appropriately moist surroundings. | Microbiology | Parasitology Pa 1 (Protozoology) |
Drug X is normally administered to patients at a rate of 50 mg/hour. Elimination of the drug X from body takes place as: - Hepatic Metabolism 10% - Biliary Secretion 10% - Renal Excretion 80% This drug has to be administered to a 65 years old patient Uttaam Singh, with a GFR of 60 ml/min. (assuming normal GFR is 120ml/min). Liver and biliary functions are normal in this patient. What should be the dose rate of drug X in this patient? | {
"A": "50 mg/hour",
"B": "30 mg/hr",
"C": "25 mg/hr",
"D": "100 mg/hr."
} | 30 mg/hr | 1B
| * In this question 80 percent of drug is eliminated by renal route and 20 percent by non-renal routes (10 percent by hepatic metabolism and 10 percent by biliary secretion). * This patient has 50 percent renal function (60 ml/min of GFR instead of 120 ml/min). Thus, the drug that can be eliminated in this person is 20 percent (Non-renal route) + 40 percent (Renal route; 50 percent of 80 percent) = 60 percent * Thus, the dose rate should be 60 percent of the original. i.e. 50 mg/hr x 60 percent = 30 mg/hr. | Pharmacology | Pharmacokinetics |
A 70-year-old male presented to the OPD with progressive jaundice for 6 weeks, fever, pruritis along with abdominal pain and significant weight loss. Lab findings reveal, Total S. bilirubin - 22 mg/dL Minimally elevated SGOT/SGPT Increased alkaline phosphatase CT abdomen was done along with ERCP. What is the most common site of this pathology: - | {
"A": "Intrahepatic bile duct",
"B": "Distal CBD",
"C": "Proximal CBD",
"D": "Hilum"
} | Hilum | 3D
| This is a case of Cholangiocarcinoma. CT scan shows dilated intrahepatic biliary ducts. Cholangiocarcinoma is a malignant tumor arising from cholangiocytes in the biliary tree. It tends to have a poor prognosis and high morbidity. Most common presentation - Painless jaundice > Pruritis > Abdominal pain, weight loss and fever. Most common site - Hilum > Distal CBD > Intrahepatic bile ducts. | Anatomy | Integrated QBank |
During normal quite breathing, maximum work is done in which of the following? | {
"A": "To overcome chest and lung elastic recoil",
"B": "To overcome airway resistance during inspiration",
"C": "To overcome airway resistance during expiration",
"D": "To overcome tissue resistance"
} | To overcome chest and lung elastic recoil | 0A
| Ans. a. To overcome chest and lung elastic recoil. (Ref. Guyton & Hall's Textbook of Medical Physiology 1 l,h/pg. 471; Fig. 37-1).During normal quiet breathing, all respiratory muscle contraction occurs during inspiration; expiration is almost entirely a passive process caused by elastic recoil of the lungs and chest cage. Thus, under resting conditions, the respiratory muscles normally perform "work" to cause inspiration but not to cause expiration.The work of inspiration can be divided into three fractions:(1) that required to expand the lungs against the lung and chest elastic forces, called compliance work or elastic work;(2) that required to overcome the viscosity of the lung and chest wall structures, called tissue resistance work; and(3) that required to overcome airway resistance to movement of air into the lungs, called airway resistance work.Mechanics of Pulmonary VentilationMuscles That Cause Lung Expansion and ContractionThe lungs can be expanded and contracted in two ways: (1) by downward and upward movement of the diaphragm to lengthen or shorten the chest cavity, and (2) by elevation and depression of the ribs to increase and decrease the anteroposterior diameter of the chest cavity.Normal quiet breathing is accomplished almost entirely by the first method, that is, by movement of the diaphragm. During inspiration, contraction of the diaphragm pulls the lower surfaces of the lungs downward. Then, during expiration, the diaphragm simply relaxes, and the elastic recoil of the lungs, chest wall, and abdominal structures compresses the lungs and expels the air.During heavy breathing, All the muscles that elevate the chest cage are classified as muscles of inspiration, and those muscles that depress the chest cage are classified as muscles of expiration. The most important muscles that raise the rib cage are the external intercostals, but others that help are the (1) sternocleidomastoid muscles, which lift upward on the sternum; (2) anterior serrati, which lift many of the ribs; and (3) scaleni, which lift the first two ribs. The muscles that pull the rib cage downward during expiration are mainly the (1) abdominal recti, which have the powerful effect of pulling downward on the lower ribs at the same time that they and other abdominal muscles also compress the abdominal contents upward against the diaphragm, and (2) internal intercostals. | Physiology | Respiratory System |
E coli causing hemolytic uremic syndrome - | {
"A": "Enteropathogenic",
"B": "Enterotoxigenic",
"C": "Enteroinvasive",
"D": "Enterohemorrhagic"
} | Enterohemorrhagic | 3D
| Ans. is 'd' i.e., Enterohemorrhagic ESCHERICHIA COLIAt least six distinct "pathotypes" of intestinal pathogenic E. coli exist:o Enteropathoaenic E. coli [Entcroadherent E. colilIt causes diarrhoea in infants and children usually occuring as institutional out breaks.It does not produce enterotoxin, nor are they invasive. They adhere to the mucosa of small intestine and cause disruption of the brush border microvilli.These strains can be identified by their adhesion to HEP - 2 cells.o Enterotoxigenic E.coliIt causes traveller's diarrhoea [ETEC is the most common cause of traveller's diarrhea).It produces enterotoxins. They can produce heat labile toxin (LT) or heat stable toxin or both.Toxin production alone may not lead to illness. The strain should first be able to adhere to intestinal mucosa. This adhesiveness is medicated by fimbrial or colonisation factor antigen (CFA).o Enteroinvasive E. coliThey themselves resemble shigella and their infection resembles shigellosis (remember : shiga like toxin is elaborated by enterohemorrhagic E. coli).They produce mild diarrhoea to frank dvsentry and occur in adult as well as in children.They have been termed enteroinvasive because they have the capacity to invade intestinal epithelial cells in vivo and penetrate HeLa or HEP - 2 cells in tissue culture.This ability of penetration is plasmid determined which codes for outer membrane antigens called the Hirulence marker antigen" (VMA). The detection of plasmid can be diagnostic.For laboratory diagnosis of EIEC, the sereny test used to be employed.These strains are non motile, do not ferment lactose or ferment it late with acid without producing any gas.o Enterohemorrhagic E. coli or verotoxigenic E. coliThese strains produce verocytotoxin (VT) or shiga like toxin (SLT)They can cause mild diarrhoea to fatal hemorrhagic colitis.Shiga like toxin belongs to class ribosome inactivating proteins (RIPs). It inhibits protein synthesis by inhibiting ribosomal function.This toxin also acts on vascular endothelium to promote the synthesis of coagulation factor VIII, vWF - Platelet aggregation.They can cause hemolytic uremic syndrome particularly in young children and the elderly.O 157 : H 7 is the most prominent serotype of EHEC, associated with HUS, but 06,026,055,091,0103,0111,0113 and OX3 have also been associated with this syndrome.The primary target for V.T is vascular endothelium.The typical EHEC is serotype O157 : H7 which does not ferement sorbital unlike majority of E. coli (but Harrison writes that few species of this serotype can ferment sorbital).Some other serotype like O26 : H1 also belongs to this group.Laboratory diagnosis of VIEC diarrhea is established by demonstration of the bacilli or VT in feces directly or in culture.o Enteroaggrecative E. coli}# In developing countries and young children.# Can cause traveller's diarrhea and persistent diarrhea.# In vitro, thev exhibit a "stacked - brick" adherence pattern on Hep - 2 cells.o Diffusely adherent E. coli# Enteroaggregative E. coli forms a low molecular weight heat stable enterotoxin EAST -1 (enteroaggregative heat stable enterotoxin -1). | Microbiology | Bacteria |
Following are seen in polycythemia vera except: | {
"A": "Most common cause of polycythemia",
"B": "Increased erythropoietin",
"C": "Erythropoietin independent growth of red cell progenitors",
"D": "Intrinsic abnormality of hematopoietic precursors"
} | Erythropoietin independent growth of red cell progenitors | 2C
| Polycythaemia Polycythaemia vera (PV) is a clonal disorder characterized by increased production of all myeloid elements resulting in pancytosis (i.e increased red cells, granulocytes, platelets) in the absence of any recognizable cause. The term 'polycythemia vera' or 'polycythemia rubra vera' is used for primary or idiopathic polycythemia only and is the most common of all the myeloproliferative disorders. Secondary polycythemia or erythrocytosis, on the other hand, may occur secondary to several causes e.g. high altitude, cardiovascular disease, a pulmonary disease with alveolar hypoventilation, heavy smoking, inappropriate increase in erythropoietin (renal cell carcinoma, hydronephrosis, hepatocellular carcinoma, cerebellar hemangioblastoma, massive uterine leiomyoma); clinical features: headache, veigo, tinnitus, visual alterations syncope or even coma. Increased risk of thrombosis due to accelerated atherosclerosis. Increased risk of hemorrhages due to increased blood volume and intrinsic platelet dysfunction e.g. epistaxis, peptic ulcer disease Splenomegaly producing abdominal fullness. Pruritus, especially after a bath REF: ROBBINS pathology 10th edition | Pathology | All India exam |
True about Carotid body tumour is all except | {
"A": "Benign",
"B": "Hereditary predisposition",
"C": "Lyre sign on aeriography",
"D": "First-bite syndrome is a known complication"
} | Hereditary predisposition | 1B
| Usually benign & unifocal Nonhereditary Manifested as a nonpainful mass at the carotid bifurcation Characteristic lyre sign on carotid aeriography Highly vascular nature- biopsy is contraindicated. Preoperative embolization is performed for tumours larger than 3 cm. The term first-bite syndrome was coined to describe the phenomenon of pain with the initiation of mastication; it is believed to be caused by removal of the sympathetic nerves surrounding the carotid bifurcation and reinnervation of the parotid secretory glands by parasympathetic fibers Ref : ENT textbook by Dhingra 6th edition Pgno : 392,393 | ENT | All India exam |
PICA is associated with poisoning of ? | {
"A": "Lead",
"B": "Arsenic",
"C": "Mercury",
"D": "Phosphorus"
} | Lead | 0A
| Ans. is 'a' i.e., Lead Pica involves repeated or chronic ingestion of non-nutritive substances, which includes plaster, charwal, clay, wool, ashes, patent & eah. It can result in serious health problems like iron deficiency anemia and lead poisoning. | Forensic Medicine | None |
A patient with compensated liver cirrhosis presented with a history of variceal bleed. What is the preferred mode of treatment in this patient? | {
"A": "Propranolol",
"B": "Liver transplantation",
"C": "TIPS",
"D": "Endoscopic sclerotherapy"
} | Endoscopic sclerotherapy | 3D
| Whenever cirrhotic patient presents with upper GI bleed, the single most impoant diagnostic as well as therapeutic procedure to be performed is endoscopy. If varices are found they are treated either with Endoscopic variceal ligation or Endoscopic Sclerotherapy Endoscopic variceal ligation is preferred method. Since endoscopic variceal ligation has not been provided in option so endoscopic sclerotherapy is the answer of choice here in the question. Ref: Schwaz 9/e, Page 1113; Harrison 17/e, Page 1977 | Surgery | None |
Which of the following is the most abundant glycoprotein present in basement membrane? | {
"A": "Laminin",
"B": "Fibronectin",
"C": "Collagen type 4",
"D": "Heparan sulphate"
} | Laminin | 0A
| Laminin is a large extracellular glycoprotein found in basal membrane. It is the most abundant glycoprotein in basement membrane. It is typically cross shaped, formed by 3 disulphide bonded polypeptides. It binds to collagen (type IV), heparin sulphate and enactin. Ref: Robbins Pathologic Basis of Disease 6th Edition, Page 98, 100 ; Heparin and Heparan Sulfate Edited by Hari G. Gar, Page 700 | Pathology | None |
In all of these pathways ATP is produced, EXCEPT: | {
"A": "Urea cycle",
"B": "Electron transpo chain",
"C": "TCA cycle",
"D": "Anaerobic glycolysis"
} | Urea cycle | 0A
| The urea cycle utilises 4 ATPs. 2 ATPs are needed to make carbamoyl phosphate, one is needed to make argininosuccinate and one is needed to restore AMP to ATP. Thus urea cycle does not produce ATP it only utilises ATP. The net yield of ATP from anaerobic glycolysis is 2. TCA cycle generate 3 NADH2, 2 FADH2 and 1 GTP. Hence, each TCA cycle yields 12 ATP molecules. As two acetyl CoA molecules are generated from each glucose this cycle occur twice yielding 24 ATP molecules. Complete oxidation of glucose glycolysis, pyruvate dehydrogenase, Krebs cycle, and the oxidative phosphorylation pathway yields 38 ATP. Since two ATPs were used during stage I reactions of glycolysis the net yield is 36 ATP. Ref: Textbook of Medical Biochemistry,3e By Dinesh Puri PAGE 175. Essentials of Biochemistry By Pankaja Naik Page 233. | Biochemistry | None |
Membrane potential of hair cell is | {
"A": "-20mV",
"B": "-40mV",
"C": "-60mV",
"D": "-80mV"
} | -60mV | 2C
| The resting membrane potential of the hair cell is about -60mV. When the stereocilia are pushed toward the kinocilium, the membrane potential is decreased to about -50mV.Ref: Ganong&;s Review of medical physiology;25th edition; pg: 204 | Physiology | Nervous system |