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2617e9f9-7ba9-4f7c-b182-f7dbff771148 | Lymph from tongue not drained by following vessels | Central | Ventral | Posterior | Marginal | 1b
| single | null | Anatomy | null |
d8458f0b-fe46-465b-9f9d-85ff2379f6e1 | Term "Clean Tooth Never Decays" given by | Perrie Fauchard | Leon J Williams | Dean | MJ Rihanna | 1b
| single | null | Dental | null |
4a131164-eb3c-4152-9556-b81ae98e2066 | Which of the following is not an indication for evisceration? | Malignancy | Panophthalmitis | Severe globe trauma | Expulsive hemorrhage | 0a
| single | Ans: A. Malignancy(Ref Yanoff and Duker 4/e p1339)Evisceration of eye is not done in malignancy.Evisceration:Surgical technique removing entire intraocular eye contents.Simpler procedure than enucleation surgery.Advantages:Leaves scleral shell & extraocular muscle attachments intact.Offers better orbital anatomy preservation & natural motility of ophthalmic socket tissues.Contraindications:Documented or suspected intraocular malignant tumors. | Ophthalmology | null |
721d3b8f-c3a4-4f82-899a-db8078710935 | The one measurement of fetal maturity that is not affected by a 'bloody tap' during amniocentesis is: | L/S ratio | Phosphatidyl glycerol | α-fetoprotein | Bilirubin as a measured by DOD 450 | 1b
| single | The best test to detect fetal lung maturity in diabetic mothers is presence of phophatidyl glycerol (PG) in amniotic fluid. If PG is present in amniotic fluid fetal lungs are considered mature and vice versa. | Gynaecology & Obstetrics | null |
e99cd253-50f5-421d-a17b-eeb17ed1999c | A young male complains of burning sensation upon urination and a purulent urethral discharge. Gram stain of the specimen shows pus cells with Gram negative diplococci. What is not true about the organism? | Pili is a virulence factor | Intracellular obligate | Show twitching motility | It is both catalase and oxidase positive | 1b
| multi | The picture depicts Neisseria gonorrhea which have pili as a virulence factor and are both catalase and oxidase positive and show slow twitching (false kind of motility) But are not strict intracellular aerobes.it could be extracellular. | Microbiology | AIIMS 2019 |
f32e7596-5c32-4ea2-922d-d2c60d0e3097 | Hypogonadism, developmental delay, loss of taste and
smell is due to deficiency of: | Cu | Zn | K | Cr | 1b
| single | null | Pathology | null |
c605ec0d-1c44-4ac9-a57d-df54ba52bb0e | 16 year girl, Not sexually active, came for vaccination against cervical cancer. Which vaccine to be given | Gardasil | Rubavac | Biovac | Tdap | 0a
| multi | Quadrivalent Gardasil and the bivalent Cervarix against HPV subtypes 16 and 18. 97% to 100% efficacy for preventing cervical intraepithelial neoplasia (C1N) grades 2 and 3 caused by HPV 16 or 18 in females who were not previously infected However, efficacy was only 44% in those who were infected prior to vaccination. A third HPV vaccine, Gardasil-9, an additional five high-risk subtypes (HPV 31/33/45/52/58) | Gynaecology & Obstetrics | AIIMS 2019 |
2166e021-8b96-47ad-9e4d-fa55a623938b | Tuberculin test is a cheap and easily available test. In which of the following situations there is high failure in the interpretation of the test? | High percentage of immunized people | HIV cases are less | High prevalence of disease | Environmental mycobacterium infections are less | 0a
| single | Ans: A. High percentage of immunized people(Ref Park 24/e p195-196, 23/e p186)High failure of tuberculin test:High percentage of immunized people - Due to higher BCG coverage producing tuberculin hypersensitivity.Exaggerated responses:In presence of atypical mycobacteria infection & 'boosting effect' of second tuberculin dose producing larger reaction than 1st.Tuberculin test lost its sensitivity as an indicator of true prevalence of infection. | Social & Preventive Medicine | null |
51bdbdd1-de3d-45e7-8bfb-dbd36e1ae434 | 4yr boy absence of right testes, diagnostic laparoscopy done, a blind end vessel seen what to do next? | Open laprotomy | Nothing to be done | Scrotal approach | Inguinal approach | 3d
| single | Ans. D. Inguinal approachCryptorchidism is the most common congenital abnormality of the genitourinary tract.Cryptorchidism means hidden testis.An absent testis may be due to agenesis or atrophy secondary to intrauterine vascular compromise also known as the "vanishing testis syndrome".Bilaterally absent testes is anorchia which is 10% cases.More common on Right Side.Complications of undescended testesTorsion can be seen in incomplete testicular descentSterility is seen in bilateral cases (especially intra-abdominal testes)Incomplete testicular descent predisposes to malignant disease; cancer is more common in an incompletely descended testes-orchidopexy may or may not diminish the risk.Atrophy of an inguinal testes before pubey may possibly be caused by recurrent minor trauma.In patients with a unilateral nonpalpable testis, a descended testis that is larger than expected suggests an atrophic undescended testis; confirmation requires surgical intervention typically diagnostic laparoscopy to seek an intra-abdominal testis or confirm testicular agenesis. However, scrotal or inguinal exploration is sometimes done if a testicular remnant distal to the internal inguinal ring is suspected. | Pediatrics | null |
a30f9a2b-52f0-4880-980d-d56de2a88910 | Among the following propeies of dopamine, which of them is not helpful in acute shock? | Alpha-1 agonist action leading to peripheral vasoconstriction | Increase in renal perfusion due to agonist action on DI receptors | Releases noradrenaline and causes positive inotropic effect | Direct action on hea beta-1 receptors | 1b
| single | Ans: B. Increase in renal perfusion due to agonist action on DI receptors(Ref: Goodman Gilman 13Ie p1062, 12/e p355; KDT 71e p134, 6Ie p507)Dopamine at low concentrations (2 to 5 mug/kg per minute) primarily acts on vascular D, receptors, especially in the renal, mesenteric, and coronary beds.Increased renal perfusion caused by dopamine due to DI agonism (at low doses) doesn't improves survival in acute shock. | Pharmacology | null |
f1cbc766-a7ea-44ec-ba8b-997ffc3a028a | 3.5 kg term male baby, born of uncomplicated pregnancy, developed, respiratory distress at birth, not responded to surfactant, ECHO finding revealed nothing abnormal, X–ray showed ground glass appearance and culture negative. Apgars 4 and 5 at 1 and 5 minutes. History of one month female sibling died before. What is the diagnosis ? | TAPVC | Meconium aspiration | Neonatal pulmonary alveolar proteinosis | Diffuse herpes simplex infection | 2c
| single | "Respiratory distress in an infant along with a positive family history of similarly affected newborn infants strongly suggests, pulmonary alveolar proteinosis".
Pulmonary alveolar proteinosis
Pulmonary alveolar proteinosis is a disorder characterized by the intraalveolar accumulation of pulmonary surfactant.
Two clinically distinct forms of pulmonary alveolar proteinosis are seen -
Fatal form --> Presenting shortly after birth (congenital PAP)
u Gradually progressive form --> Presenting in older infants and children
Pathology
Although the mechanisms that lead to alveolar proteinosis are undefined, histological findings suggests that they result in a disruption of pulmonary surfactant metabolism.
The main surface tension lowering agent in surfactant is phospholipids le. primary dipalmitol phosphatidyl choline.
However DPCC needs surfactant protein (in endogenous and natural surfactants) for efficient dispersion which enables the formation of a phospholipid monolayer on the alveolar surface.
There are two surfactant proteins present in the body i.e., protein A and protein B.
In pulmonary alveolar proteinosis, there is absence of protein B.
In the absence of protein B, the rapid spread and absorption of the phospholipid (DPCC) does not take place so they cannot form a phospholipid monolayer on the alveolar surface.
This in turn leads to failure of expansion of alveoli leading to poor cardiorespiratory adaptation at birth.
Clinical manifestation -
This disorder is immediately apparent in the newborn period and rapidly leads to respiratory failure.
Congenital pulmonary alveolar proteinosis is clinically and radiographically indistinguishable from more common disorders of the newborn that lead to respiratory failure including pneumonia, generalized bacterial infection, respiratory distress syndrome and total anomalous pulmonary venous return with obstruction.
Diagnosis
Histopathological examination of lung biopsy specimen is the gold standard for diagnosis.
On histopathological examination distal air spaces are filled with a granular, eosinophillic material that stains
positively with periodic - acid schiff reagent and is diastase resistant.
Treatment
Untreated, alveolar proteinosis in newborns is rapidly fatal and no successful medical therapy has been developed.
Repeated bronchoalveolar lavage is a temporizing measure.
Lung transplantation is the only therapeutic option but its use is limited by concerns about disease recurrence. | Pediatrics | null |
c6f6754f-21ac-49d0-b8cd-8bf25049d813 | Elderly female present with pain and swelling in the thigh. Xray shows multiple lytic lesions in distal femur with no periosteal reaction. Aspirate from the swelling shows homogenous serosanguinous fluid with RBCs. Which investigation can confirm the diagnosis? | S. Calcium levels | S. PTH levels | MRI | CD1a IHC | 1b
| single | History is suggestive of blood filled bone tumor seen in Hyperparathyroidism. HYPERPARATHYROIDISM May be primary (due to adenoma or hyperplasia), secondary (due to persistent hypocalcemia) or tertiary (when secondary hyperplasia leads to autonomous overactivity). Fig. X-ray hand--hyperparathyroidism Fig. Brown tumor Figs. A and B: (A) Lamina dura and (B) Resorption of lamina dura Salt pepper skull Parathyroid adenoma Most common cause of primary hyperparathyroidism. Presents with subperiosteal resorption, and replacement of endosteal cavitation marrow by vascular granulation and fibrous tissue (osteitis fibrosa cystica). Classical and pathognomic feature of hyperparathyroidism is subperiosteal coical resorption of middle phalanges on radial aspect Clinical features- Abdominal groans (dyspepsia), psychic moans, renal stones and weak bones (Groans, moans, stones and Bones). Ix- Parathyroid hormone and S. alkaline phosphate are raised. Calcium is high, serum phosphate is low. | Orthopaedics | AIIMS 2019 |
36fbf017-4fe4-4eb2-b6e8-5cd677d31a5d | Which of following in not true about SLE? | IgA. IgU against basement of mucosa or increased collagen formation | ROR-2 gene mutation | Complement c3 activation and fibroblast formation | Positive antinuclear antibody test | 1b
| multi | null | Pathology | null |
fb4ea4bd-0f5f-40fa-b377-d0ae72b374a1 | In which of the following conditions oral screen should
not be used: | Nail biting habit | Tongue thrusting | Acute infection of tonsils and adenoids | Thumb sucking | 2c
| single | Oral screen was first introduced by NEWELL. It works on the principles of both force application and force elimination. | Dental | null |
17ac8fd0-4e2e-41f5-8a01-93d34668a77e | Which of the following event has little or no significance? | Mandibular incisor erupting before mandibular molar | Mandibular canine erupting before mandibular premolar | Mandibular 2nd premolar erupting before mandibular 2nd molar | Maxillary premolar and canine erupting before maxillary 2nd molar | 0a
| single | null | Dental | null |
63f0f575-0417-4352-94c2-2a8055fe3739 | Which of the following statements about high copper silver alloy compared to conventional alloy is not true? | It has increased tensile and compressive strength | It has poor tarnish and corrosion resistance | Its' edge strength is greater | Mercury content in the final restoration is less | 1b
| multi | null | Dental | null |
f22298ec-ab82-48ba-b238-b99bc3ea35d3 | Internal occlusal rest provided in partial denture does not provide: | Horizontal stabilization | Retention | Vertical stop | Occlusal support | 1b
| single | null | Dental | null |
105d2b03-08bf-44da-8372-2ddd2dc43326 | Hyperkalemia in children may occur in all except – | Insulin deficiency | Metabolic acidosis | Acute renal failure | Cushing's syndrome | 3d
| multi | Hyperkalemia
Hyperkalemia defined as serum K+ concentration > 5.5 meq/L. | Pediatrics | null |
8b3e79da-c35a-4d0c-8bb1-ba5bb9f20949 | Which of the following is not a technique for protein precipitation? | Trichloroacetic acid | Heat precipitation | Isoelectric point method | Titration with reducing sugar | 3d
| single | Ans: D. Titration with reducing sugar(Ref Harper 30/e p26)Titration with reducing sugar is not used for protein precipitation.Protein precipitation:Widely used to concentrate proteins & purify them from various contaminants.Used for isolating specific protein in quantities sufficient for analysis.Requires multiple successive purification techniques.Classic approaches:Based on,Isoelectric precipitation - Differences in relative solubility of individual proteins as pH function.Precipitation with ethanol or acetone - Polarity.Salting out with ammonium sulfate.Paper chromatography including TLCD. | Biochemistry | null |
fddbb54c-e463-437d-8bd6-f48e23002637 | A 12-years-old boy presents with a symmetric, expansile cystic lesion in the proximal humerus. All of the following can be done for his treatment except | Curettage | Intralesional steroids | Intralesional sclerosing agents | Radiotherapy | 1b
| multi | Ans. BSolitary bone cyst is the diagnosis of a 12 years old boy, who presents with a symmetric, expansile cystic lesion in the proximal humerus.Solitary Bone Cyst:Common in first two decades, primarily between 5-15 yearsMore common in malesMC site: Proximal humerus (50-60%) >Femur (25-30%)Cyst appears as centrally radioluscent lesions, on the metaphyseal side of the growth plate of a long boneTreatment:CurettageMethylprednisolone acetate injection into lesionRadiographic contrast injection into lesionIntralesional injection of sclerosing agentsSolitary Bone Cyst (Unicameral Bone Cyst)Common in first two decades, primarily between 5-15 yearsQMore common in malesQMC site: Proximal humerusQ (50-60%) >Femur (25-30%)It is not a true cystdeg because not lined by endothelial cells but lined by fibrous tissue and blood vesselsClinical Features:Asymptomaticdeg unless presents as a fractureRadiological Investigations:Cyst appears as centrally radioluscent lesionsQ, on the metaphyseal side of the growth plate of a long boneCoex is thinned but intactQFallen fragment sign" may present indication that the lesion is fluid filled rather than solidQOther tests are usually not required except in unusual locations such as pelvis. In such locations MRI or CT is indicatedMRI can document extent of the lesion and its cystic natureQMRI helps in distinguishing unicameral cyst (SBC) from aneurysmal bone cyst (ABC), giant celltumor (GCT) and fibrous dysplasiaQTreatment:CurettageQMethylprednisolone acetateQ injection into lesionRadiographic contrast injectionQ into lesionIntralesional injection of sclerosing agentsQ | Surgery | null |
14a9e3be-384f-4b56-99c5-dfd851243951 | Which is not associated with GDM (Gestational DM)? | Past history of fetal abnormality | Obesity | Hypeension | Macrosomia | 2c
| single | Answer- C. HypeensionA previous diagnosis of gestational diabetes or prediabetes, impaired glucose tolerance, or impaired fasting glycaemia.Being overweight, obeseA previous pregnancy which resulted in a child with a macrosomia. | Surgery | null |
0cd0e1c4-aabe-4ac3-ae2b-83b0633cb376 | A person on fat free carbohydrate rich diet continues to grow obese. Which of the following lipoproteins is likely to be elevated in his blood? | Chylomicron | VLDL | HDL | LDL | 1b
| single | As VLDL is the main transporter of endogenous triglycerides; all the conditions causing increased endogenous triglyceride synthesis will also increase VLDL secretion. And these are:-
Well fed state (not starved).
High level of circulating free fatty acids.
Carbohydrate rich diet (especially sucrose and fructose)
Present of high level of insulin and low level of glycogen.
Ethanol (alcohol) ingestion.
Key Concept: | Biochemistry | null |
b7dd1d97-3338-4b13-98f3-1b6c61c805b2 | Which of the following is false about Transfusion-Related Acute Lung Injury? | Develops within 24 hours | Mostly seen after sepsis and cardiac surgeries | It's a cause of non-cardiogenic pulmonary edema | Plasma is more likely to cause it than whole blood | 0a
| multi | Ans: A. Develops within 24 hours(Ref Harrison 19/e 138e-5, 18/e p1217)Transfusion-Related Acute Lung Injury (TRALI):MC cause of transfusion related fatalities.Cause:Usually results from transfusion of donor plasma.Risk factors:Smoking.Chronic alcohol useShockLiver surgery (transplantation).Symptoms development:During or within 6 hrs of transfusion.Develops symptoms of hypoxia (PaO2/FIO2 <300 mmHg).Non-cardiogenic pulmonary edema signs including bilateral interstitial infiltrates on chest X-ray. | Medicine | null |
ca5cb321-54b4-4b5f-a507-0493c19af96f | Which of the following statements about cystic fibrosis (CF) is not true – | Autosomal recessive disorder | Abnormality in CFTR which leads to defective calcium transport | Mutation in cystic fibrosis transport regulator | All of the above | 1b
| multi | Cystic fibrosis is an autosomal recessive disorder of ion transport in epithelial cells that affect fluid secretion in exocrine glands and the epithelial lining of the respiratory, gastrointestinal and reproductive tracts.
Cystic fibrosis occurs due to mutation in the CFTR gene.
CFTR was initially recognized as chloride conductance channel but it is now recognized that CFTR can regulate multiple ion channels and cellular processes. These include :
Chloride channels
Potassium channels
Gap junction channels
Bicarbonate ions | Pediatrics | null |
71905d50-bffe-468f-ada2-77d845d55daf | Which of the following histories is not an indication to perform oral glucose tolerance test to diagnose gestational diabetes mellitus? | Previous Eclampsia | Previous Congenital anomalies in the fetus | Previous Unexplained fetal loss | Polyhydramnios | 0a
| single | Indications for performing GCT: All those conditions in which there is risk of having diabetes.
On the basis of risk factors females are categorised into 3 category:
Low risk
All of the folowing:
Member of an ethnic group with a low prevalence of GDM
No known diabetes in first degree relatives
Age <25 years
Weight normal before pregnancy
Weight of previous baby normal at birth
No history of abnormal glucose metabolism
No H/o poor obstetrical outcome
Average risk
One or more of the following:
Member of an ethnic group with a high prevalence of GDM
Diabetes in a first degree relative
Age > 25 years
Overweight before pregnancy
Weight high at birth (previous baby)
High risk
Marked obesity
Strong family history of type II DM
Previous history of GDM impaired glucose metabolism or glucosouria
Unexplained stillbirth
H/o previous congenitally malformed baby | Gynaecology & Obstetrics | null |
15f7993b-1b86-400a-83c1-a91417ab640c | A person is criminally not responsible for his actions if at the time of doing it by reason of unsoundness of mind, in incapable of knowing the nature of the act or that he is doing what is either wrong or contrary to the law. | McNaughten rule | Curren's rule | Durham's rule | Irresistible impulse test | 0a
| multi | Mc Naughten rule states that person is criminally not responsible for his actions if he is unsound by mind and incapable of knowing the nature of the act. Curren's rule states the person do not have any capacity to regulate the conduct to the requirements of the law as a result of mental disease. Durham's rule is person's unlawful act is the product of mental disease or mental defect. Irresistsble impulse test states that even if the person knows that the nature and quality of the act and he Is wrong because the free agency of his will has been destroyed by mental disease. | Forensic Medicine | AIIMS 2017 |
e96fadd5-fac8-4cde-9957-d69ed40b3364 | Which of these is not a pa of catatonia? | Akathisia | Ambivalence | Ambitendency | Akinesia | 0a
| single | Ans: A. Akathisia(Ref Kaplan and Sadock 11/e p329, 871; Niraj Ahuja 7/e p59).Akathisia:Not a pa of catatonia.Characterized by a subjective & objective sense of restlessness, anxiety & agitation.Ambitendency:Example of negativism.Considered an ambivalence form.Ambivalence:Sign of Schizophrenia. | Radiology | null |
c27b2629-91ce-4214-820f-486a0f7d8add | Negative rake angle means: | Rake face is ahead of radial line. | Rake face coincides with radial line. | Rake face is behind the radial line. | None. | 0a
| multi | null | Dental | null |
0113aaf1-61d3-4d61-a9c7-b5b46e51e7e8 | A study finds no significant association between two variables but truly there exists a difference. What type of error is this? | Type I error | Type II error | Random error | Systematic error | 1b
| single | Ans: B. Type II error(Ref: High Yield Biostatistics/p46)Type I ErrorType II ErrorThe null hypothesis is true but rejected (False positive)degProbability of type I error is given by p valuedegSignificance (alpha) level is the maximum tolerable probability of type I errorsdegKeep type I error to be minimum; then results are declared to be statistically significantNull hypothesis is not false but is not rejected/accepted (false negative)degProbability of type II error is given by betadeg | Social & Preventive Medicine | null |
db26ae0d-84ba-41a5-be53-94723de58182 | While performing Burch operation there was significant bleeding and pooting of blood in the space of Retzius. The source of bleeding cannot be visualized. What is the next step in the management? | Call vascular stlrgeon | Give a generalized suture in bleeding area | Lift endopelvic fascia by putting fingers in vagina | Placing surgical drain | 2c
| multi | Ans. C. Lift endopelvic fascia by putting fingers in vaginaBurch colposuspension (retropubic urethropexy) involves the attachment of the fascia at the level of the bladder neck to the iliopectineal ligament (Cooper's ligantent).lt is an abdorninally perfbrmed surgery for stress urinary incontinence . | Gynaecology & Obstetrics | null |
faf1c5f2-3ab2-492c-b58b-1dd81fd5a6d7 | All of the following statements about insulin Afreeza are true except | Inhalational preparation of insulin | Not a substitute of injectable insulin | Needs to be given in multiple doses | Used in combination with sho acting insulin | 3d
| multi | AFREEZA insulin : Inhalational preparation of insulin. Sho and fast acting insulin Used incombination with long acting insulin. Needs to be given in multiple dose. Should be used in combination with a long-acting insulin. S/E- Cough and throat irritation. It should not be used in individuals who smoke and COPD | Medicine | AIIMS 2018 |
a4ae6ca7-78a0-48fd-956c-4259c141d158 | A man comes with aphasia. He is unable to name things and repetition is poor. However comprehension, fluency and understanding written words is unaffected. He is probably suffering from: | Anomic aphasia | Broca's aphasia | Transcoical sensory aphasia | Conduction aphasia | 3d
| single | Ans: D. Conduction aphasia(Ref Harrison 19/e p 1 76, 18/e p302)Typical case of conduction aphasia with normal comprehension & fluency, but impaired naming & repetition.Conduction aphasia:Due to damaged arcuate fasciculus.Arcuate fasciculus:Connection between Wernicke's (language comprehension) & Broca's (Language production) areas.Hence, connection lost.Clinical features:Hallmark finding - Inability to repeat words.Comprehension & language expression intact.Inability to transfer understood word to Broca 's area to be expressed.Results in meaningful fluent speech & relatively good comprehension but very poor repetition. | Medicine | null |
9d2bff20-7d45-402d-af8f-3eb0c1e1e404 | Sodium iodide sympoer is not present in | Pituitary gland | Placenta | Parotid | Thyroid | 0a
| single | Ans: A. Pituitary gland Sodium iodide sympoer - Not present in the pituitary gland.Sodium-Iodide Sympoer (NIS) is present inThyroiddegSalivary glandsdegGastric mucosadegPlacentaoCiliary body of the eyedegChoroid plexusdegMammary glandsdegCeain cancers derived from these | Physiology | null |
d1ba41d0-9b08-4fd4-a4fa-22315c0e8ceb | Myelinated nerve fibres have all of the following properties except | Conduction is slower in myelinated than in non-myelinated fibres | Current discharges at nodes of Ranvier | Outer layer is of lipids | Depolarisation occurs only at nodes of ranvier | 0a
| multi | null | Surgery | null |
81b6f78e-d617-455f-b0d6-fd9480077f70 | True about cow\'s milk are all except – | Cow's milk contains 80% whey protein not casein | Cow milk has less carbohydrate than mothers milk | Has more K+ and Na+ than infant formula feeds | All of the above | 0a
| multi | Whey protein constitutes 80% of the protein in human milk, while the main protein in cow's milk is casein
Table : Compariso, of human milk and cow's milk | Pediatrics | null |
6268aaa4-a6b7-4879-b15a-3861afd83e45 | Most commonly missing tooth is | Upper 3rd molar | Lower 3rd molar | Upper lateral incisor | Lower 2nd premolar | 1b
| single | null | Dental | null |
2b110e57-8338-4189-86e2-cbea7d761c30 | A diabetic patient presented with uncontrolled blood sugar level. He has history of pancreatitis and family history of urinary bladder carcinoma. He does not want to take injectable drugs. Which of the following drug can be added to control his blood sugar? | Liraglutide | Sitagliptin | Canagliflozin | Pioglitazone | 2c
| single | Linaglutide(-ide) is a peptide, so not given orally. It is a GLP 1(incretin) analogue and it can cause pancreatitis.Sitagliptin is a DPP 4(dipeptidyl peptidase 4) inhibitor; can cause pancreatitis.Pioglitazone(PPAR- gamma agonist) can cause urinary bladder carcinoma; so can't be given.So, canagliflozin (SGLT 2 inhibitor) can be added. | Pharmacology | AIIMS 2017 |
31579687-1448-4606-9db6-52f9d0cc8a7f | Which of the following is NOT the criteria to discharge a patient of dengue haemorrhagic fever? | Afebrile for 24 hours without antipyretics | Platelet count greater than 50,000 cells | Return of appetite | Atleast 24 hours since recovery from shock | 3d
| single | Normal urine output- 1.5 l/day For discharge patient should become afebrile 24 hrs from shock recovery would not be enough should be kept a little longer to know general well being of patient. Therefore, option a, b, d ruled out. Patients with dengue hemorrhagic fever or dengue shock syndrome may be discharged from the hospital when they meet the following criteria: Afebrile for 24 hours without antipyretics Good appetite, clinically improved condition Adequate urine output Stable hematrocit level Atleast 48 hours since recovery from shock No respiratory distress Platelet count greater than 50,000 cells. | Medicine | AIIMS 2019 |
781a68ce-0d78-4685-948b-4dbfa0740f1e | A mother is exposed to Diethyl stilbesterol during pregnancy. All the following features may be seen in the child after birth except : | Clear cell carcinoma | Microglandular hyperplasia | Malformation of the vagina and uterus | Vaginal adenosis | 1b
| multi | "Women who were exposed to diethylstilbestrol in utero have a high incidence of adenosis of the vagina and cervis. These patient also have, potential reproductive abnormalities, including infertility, habitual abortions and tubal and uterine cavity abnormality. Clear cell adenocarcinoma of the vagina and cervix is a rare sequaele of DES exposure in utero". | Pediatrics | null |
e742171b-eafc-4b8c-95e0-024b36b166b4 | According to wein if there is bone resorption but no tooth resorption then substract ……..from the radiographic length | 1mm | 1.5 mm | 2mm | 2.5 mm | 1b
| single | null | Dental | null |
05984a75-d9af-4a87-8ac5-824576bf0d9f | A girl is has white hair. 40% of her classmates are also suffering from the same problem. None of the other people from the same village have white hair. Her brother who is staying with an aunt in the neighbouring village is also normal and does not have white hair. Which of the following explains the probable cause of her white hair? | Environmental | Genetic | Nutritional | Infection | 0a
| multi | Ans. a. EnvironmentalA girl and 40% of her classmates are suffering from white hair. Her brother who is staying with an aunt in the neighboring village is normal and does not have white hair. In the given question, as the girl and many of her classmates (from a single geographical area, in this case, the school) have developed grey hair, the most likely cause would be environmental.Similarly, as many other children from the same school have white hair, the cause is also unlikely to be nutritional.As the girl's brother living in a different village does not have white hair, the cause of the white hair is unlikely to be genetic | Social & Preventive Medicine | null |
1cd8474b-6560-484d-b733-9ba499981029 | Which is not present in porcelain: | Silica | Feldspar | Calcium carbonate | Amorphous material | 3d
| single | null | Dental | null |
bccac3f6-359f-4795-93a7-1b32d014bce0 | Which of the following cannot be diagnosed without positive ANA? | Drug induced lupus | SLE | Sjogren syndrome | Scleroderma | 1b
| single | Repeated negative testing for ANA indicates least chances of having SLE. ANA is positive in 98% of patients with SLE Limited form of scleroderma known as CREST has anti centromere antibody positive and generalized form has anti topoisomerase positive antibody Anti histone antibodies are positive in drug induced lupus Anti SS-A (RO) antibodies and anti SS-B(LA) antibodies are positive in Sjogren's Syndrome | Pathology | AIIMS 2018 |
b69b1f70-e671-41d6-9f11-a788d34498db | Which amino acid does not include post translational modification? | Selenocystiene | Triiodothyronine | Hydroxy-proline | Hydroxy-lysine | 0a
| single | Selenocysteine (21st amino acid) & Pyrrolysine (22nd amino acid) Formed by co-translational modification Not by post-translational modifications. Selenocysteine and Pyrrolysine 21st amino acid-Selenocysteine- UGA 22nd amino acid - Pyrrolysine - UAG Both UGA, UAG are stop codon but co-translational modification can give rise to amino acid selenocysteine and pyrrolysine. co-translational modification. Enzymes that use selenocysteine as their active sites are called Seleno Proteins. Selenocysteine containing proteins: Glutathione peroxidase Thioredoxin reductase selenoprotein P 5' deiodinases | Biochemistry | AIIMS 2017 |
1a9cdc6b-3c9c-44a2-95d1-68461bf113fc | A politician is shot in the back during a rally at level of T8 veebral immediately after the shot he loses all the sensation below level of lesion. Chance of regeneration of spinal cord due to the fact that injured nerve is not able to regenerate is due to reason all except: | Lack of endoneural tubes | Lack of growth factors | Presence of glial scar | Lack of myelin inhibiting substance | 3d
| multi | Ans. d. Lack of myelin inhibiting substance(Ref GanonGr 90; Clinical Box 4-)Following CNS injuries several events which provide inappropriate environment for regeneration are: (Ganong 23/e p90) Astrocytic proliferation)Activation of microgliaScar formationInflammationInvasion of immune cellsCNS neurons do not have the growth promoting chemical needed for the regenerationCNS myelin is a potent inhibitor of axonal growthAxon Regeneration in CNSThe proximal stump of a damaged axon in the CNS will form sho sprouts, but distant stump recovery is rare, and the damaged axons are unlikely to form new synapses. This is because:CNS neurons do not have the growth promoting chemical needed for the regenerationCNS myelin is a potent inhibitor of axonal growth.That is why treatment of brain and spinal cord injuries frequently focuses on rehabilitation rather than reversing the nerve damage. Following CNS injuries, several events which provide inappropriate environment for regeneration are:Astrocytic proliferationActivation of microgliaformationInflammationInvasion of immune cellsNew research is aiming to identify ways to initiate and maintain axonal growth, to direct regenerating axons to reconnect with their target neurons and to reconstitute original neuronal circuit. | Physiology | null |
b7507844-7679-49f9-a915-6a242af404d9 | Sending the parents outside the operatory and threatening the child that they won't be back until he stops crying-is an example of which of the following behavior management techniques: | Omission | Negative reinforcement | Positive reinforcement | Modelling | 0a
| single | null | Dental | null |
d061fd99-52bd-470b-a2c6-09b66b66cc8b | A condition where there is loss of interdental bone on facial and lingual plate, without involvement of radicular bone is: | Ledge | Crater | Intrabony defect | Reverse architecture | 3d
| single | Reversed Architecture
Reverse (or negative) alveolar bone architecture is the result of a loss of interdental bone, without a concomitant loss of radicular (buccal or lingual/palatal) bone, thereby reversing the normal (or positive) architecture . Negative architecture is more common in the maxilla of patients with periodontitis.
Ledges
Ledges are plateau-like bone margins that are caused by the resorption of thickened bony plates .
Osseous Craters
Osseous craters are a specific type of two-wall defect; they present as concavities in the crest of the interdental bone that is confined within the facial and lingual walls. Craters have been found to make up about one-third (35.2%) of all defects and about two-thirds (62%) of all mandibular defects; they occur twice as often in posterior segments as in anterior segments.
Ref: Newman and Carranza’s Clinical Periodontology, thirteenth edition; page no 325 | Dental | null |
d671e7e4-0614-4b11-8be3-2f453b05e38f | Till what age tetracycline should not be given to prevent discoloration | 3 year | 8 year | 12 year | 18 year | 1b
| single | null | Dental | null |
b8fad18b-75df-42b6-b06d-8902a10f6e16 | Which of the following is not a feature of Juvenile Idiopathic Arthritis – | Rheumatoid nodule | Spikes of high fever | Uveitis | Raynaud's phenomenon | 3d
| single | Juvenile idiopathic arthritis
Juvenile idiopathic arthritis is broad term that describes a clinically heterogenous group of arthritides of unknown cause, which begin before 16 years of age.
This term encompasses several disease categories : -
1. Juvenile rheumatoid arthritis (see previous explanations) : -
i) Pauciarticular (oligoarticular) JRA
ii) Poly-articular JRA
RA. factor (+) ye
RA factor (-) ye
iii) Systemic JRA
Juvenile psoriatic arthritis
Juvenile enthesitis related arthritis (ERA)
Subgroups of Juvenile Idiopathic Arthritis (JIM | Pediatrics | null |
743f2305-10ed-4d66-b6fa-911cacdf2622 | Which type of Hb is not affected by Rh isoimmunisation: | Anti C | Anti E | Anti lewis | Anti D | 2c
| single | “An antigen frequently found in routine antenatal screening is the Lewis group (Lea and Leb). The Lewis antigens do not cause erythroblastosis fetalis and differ from all of the other red cell antigens in that they are not synthesized in the red cell membrane but are absorbed into it.”
Fernando Arias 2/e, p 116 | Gynaecology & Obstetrics | null |
e039fc9c-d96d-44e0-9933-b4c4d87bed58 | During diagnostic laparoscopy for undescended testis, there are absent testicular vessels. What should be done next? | Explore fuher | Nothing is to be done | Inguinal exploration | Scrotal examination | 2c
| single | Answer- C | Surgery | null |
954a6f85-767c-4b3a-b422-c5986e63f77b | Excessive occlusal forces can be superimposed in all cases, except | Normal periodontium with normal height of bone | Normal periodontium with reduced height of bone | Marginal periodontitis with reduced height of bone | Marginal periodontitis with normal height of bone | 3d
| multi | null | Dental | null |
d04b4139-513d-4b58-a73a-972e4f8d8031 | Failure of partial dentures due to poor clasp design can best be avoided by: | Using stress breakers | Using bar type clasps | Altering tooth contours | Clasping only those teeth with fairly long crowns and normal bone support | 2c
| single | null | Dental | null |
dbf438a0-20c0-4eb7-a94a-f337ffabf5af | Which of the following is not true about H. influenza? | Rarely presents as meningitis in children less than 2 months of age | Capsular polypeptide protein is responsible for virulence | Requires factor V and X for growth | Most common invasive disease of H. influenza is meningitis | 1b
| multi | null | Microbiology | null |
57593a1c-3f1a-46c3-91b9-cf9230080c97 | Which drug is not given in Wilson disease? | Trientine | Calcium | Penicillamine | Zinc | 1b
| single | Wilson disease Trientine- copper chelator Penicillamine- also chelator but less used due to nephrotic side effect. Zinc- is competitive inhibitor of copper in absorption of gut. Zinc acetate is DOC for Wilson disease. | Medicine | AIIMS 2019 |
39857f0f-9c6a-49b4-bb0c-9306c46a4c96 | Which of the following feature is not seen in tongue thrusting? | Spaced dentition | Crowding and crossbite | Open bite | Flush terminal plane | 1b
| single | Characteristics of tongue thrusting
Spaced dentition
Primate spaces
Deep bite
Flush terminal plane
Malocclusion
Various malocclusions have been reported to be caused due to tongue thrust. These can further be subdivided as:
a. Features pertaining to the maxilla
Proclination of maxillary anteriors resulting in an increase in overjet.
Generalised spacing between the teeth.
Maxillary constriction.
b. Features pertaining to the mandible
Retroclination or proclination of mandibular teeth depending on the type of tongue thrust present.
c. Intermaxillary relationships
Anterior or posterior open bite based on the posture of the tongue.
Posterior teeth crossbite. | Dental | null |
26af657d-76a3-44a6-9cd1-96ee335ef8fa | Best way to monitor perfusion of free flap: | Pulse oximeter | Laser doppler velocimetery | Prick test | Flourescin & dermo flourometer | 2c
| single | null | Surgery | null |
3b1d8bb2-5d19-4dc0-89b4-a8f94ac0e282 | Which of the following structures is not of ectodermal origin: | Hunter-schreger bands | Enamel spindles | Enamel tufts | Enamel lamellae | 1b
| single | Enamel spindles are odontoblastic process, which extend into enamel. Enamel spindles are mesenchymal in origin. | Dental | null |
e2883c94-00e1-42ef-b2c6-c1e3e9011038 | True about occulomotor nerve are all except | Carries parasympathetic fibres | Causes constriction of pupils | Supplies inferior oblique muscle | Passes through inferior orbital fissure | 3d
| multi | null | Anatomy | null |
7652722e-593d-470a-b2d5-30a15e4bae48 | In a free gingival graft, what happens to epithelium of the graft? It: | Remains as such | Proliferates | Degenerates | Has to be removed by the surgeon | 2c
| single | null | Dental | null |
04c8a800-af32-40fb-b60e-45d64d189679 | Placement of graft will be failure in which class of recession | class I | Class II | Class III | Class IV | 3d
| single | null | Dental | null |
41fac382-483b-4573-99c4-555b80dff3bc | All are true about rheumatic fever, except – | Common in poor socioeconomic group | Develops after streptococcal pharyngitis | Communicable disease | Seen in 5–15 years of children | 2c
| multi | Rheumatic fever
Rheumatic fever is an acute immunologically mediated multisystem inflammatory disease that occurs few weeks after an episode of group A streptococcal pharyngitis.
The disease is immune mediated, not a communicable disease.
Epidemiology ofAcute Rheumatic fever.
The epidemiology of acute Rheumatic fever is identical to that of group A streptococcal upper respiratory tract infection.
As is the case of streptococcal sore throat, acute rheumatic fever most often occurs in children, the peak age related incidence is between 5-15 years.
Epidemiological risk factor for rheumatic fever, include lower standards of living especially crowding, the disease has been more common among socially and economically disadvantaged populations.
Pathogenesis of Rheumatic fever
It is strongly suspected that acute Rheumatic fever is a hypersensitivity reaction induced by group A streptococci but the exact pathogenesis remains uncertain despite many years of investigation.
Although the precise factor or factors that confer this property are unknown, highly rheumatogenic strains, share certain biological characteristic.
It is believed that antibodies directed against the M proteins of certain strains cross reacts with glycoprotein antigens in the heart, joints and other tissues. These strains are (1, 3, 5, 6, 18).
The M proteins molecules has a particular surface exposed antigenic domain against which Rheumatic fever patients mount a strong antibody response. These antibodies against the M proteins cross reacts with glycoproteins antigens in the heart, joints and other tissues because these glycoproteins share similar features with M antigenic domain. | Pediatrics | null |
c9aa8c5b-b009-4c7e-a8d4-05cf46db9282 | The case of biliary duct stricture with retching and vomiting, given 3mg morphine epiduraly daily, one day 12 mg mistakenly dose of epidural, morphine given. Not present:- | Itching | Urinary retention | Increase vomiting | Overstimulation of respiratory centre | 3d
| single | Side effect of high dose epidural opioid: Nausea and vomiting Pruritis Urinary retention Respiratory depression High dose of opioid can spread centrally and stimulate CTZ center and can precipitate nausea and vomiting. Pruritis due to morphine is not due to histamine release, high dose morphine can spread centrally, act on trigeminal nerve and cause pruritis. Urinary retention in morphine use is due to it's action on sacral spinal cord, therefore it can happen even at normal dose and not related to high dose. Respiratory depression in morphine overdose due to migration of morphine centrally. | Anaesthesia | AIIMS 2019 |
fd5e72b2-ff85-4ad8-8457-50ae63f377db | A new marker for mantle cell lymphoma especially useful in Cyclin DI negative cases is: | SOX 11 | Annexin V | MYD88 | ITRA I | 0a
| multi | Answer- A. SOX 11SOXII expression h a highly specific for mantle cetl lymphoma and identifies the cyclin Dl-negative subtype.Mantle Cell Lymphoma (MCL)Immunophenotype:CD20 CD79a & PAX-5 positive establish B lineageCD5, CD43, FMC-7, cyclin Dl & SOX11 positiveSurface IgM & IgD positiveCDS+ve & CD23 -ve which help to distinguish it from CLL/SLL. | Pathology | null |
f229b847-b096-4925-ba33-f2a0427cea4d | Countercurrent mechanism is not seen in: | Kidney | Testes | Eye | Intestine | 2c
| single | Ans: C. Eye(Ref Ganong 25/e p417, 420, 685, 24/e p687, 419, 422) .Countercurrent mechanism:Not seen in eye.Inflow runs parallel to, counter to & in close proximity to outflow for some distance.Seen in kidney, limbs, testis & intestine.In renal system - Both loops of Henle & vasa recta in renal medulla.Intestine - Villi where oxygen directly diffuses from aerioles to vein. | Physiology | null |
0ba46472-54a7-4bb9-9802-a0546e24cede | A bank employee felt depressed with no interest in activities came to AIIMS OPD. He was staed on Escitalopram. Which of these adverse effects cannot be explained with escitalopram? | Vivid dreaming | Anorgasmia | Sialorrhea | Nausea | 2c
| single | Ans. C. SialorrheaEscitalopram belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRI).Improves your energy levels and feelings of well-being and decrease nervousness.Used to treat depression and anxiety.MOA: Works by helping to restore the serotonin balance in the brain.S/E:Headache, Nausea, Ejaculation disorder, Somnolence, Insomnia, Dry mouth, Constipation, Fatigue, Libido decreased, Inability to achieve orgasm, Gas (flatulence), Toothache, Weight gain, Menstrual disorder, Neck/shoulder pain, Runny nose & Flu-like syndrome. | Pharmacology | null |
fda4a6bd-3eb5-4641-88da-513b72c1d320 | A young healthy male patient presented with abdominal pain and history of altered bowel habits from the last 6 months. On CT examination, there was dilated distal pa of ileum, thickened ileocecal junction with thickened cecum with presence of sacculations on the antimesenteric border. The vascularity of adjoining mesentery is also increased and there is surrounding mesentery fat. Which of the following is not a differential diagnosis? | Ulcerative colitis | Crohn's disease | Tuberculosis | Ischemic bowel disease | 3d
| single | Answer- D. Ischemic bowel diseaseCT scans associated with bowel ischemia include dilation of the bowel lumen, bowel wall thickening abnormal bowel wall enhancement, aerial occlusion, venous thrombosis, and intramural or poal venous gasDilation of an ischemic bowel segment suggests interruption of normal peristaltic activity.Symmetrical bowel wall thickening greater than 3 mm in a distended segment. | Surgery | null |
fc3d5863-8850-4136-8bf9-8f7bb80ca2cb | Which of the following is not true for rifabutin as compared to rifampicin? | Rifabutin has the longer half-life than rifampicin | Rifabutin has lesser incidence of drug-interactions | Rifabutin is more efficacious against MAC as compared to rifampicin | Rifabutin is more efficacious for pulmonary TB as compared to rifampicin | 3d
| multi | Ans: D. Rifabutin is more efficacious for pulmonary TB as compared to rifampicin(Ref Goodman Gilman 12/e p1550, 1552, 1554, 1568; Katzung 12/e p845)Rifabutin:Stronger activity against Mycobacterium avium complex (compared to rifampicin).Ineffective against Mycobacterium tuberculosis. RifabutinRifampicin (Rifampin)RifapentineProtein binding 718597Oral 2068deg-tmax (hours)2.5-4.01.5-2.05.0-6.0degHalf-life (hours)32-67deg2-5deg14-18Intracellular/extracellular9524-60degAutoinduction40%deg38%20%CYP3A inductionWeakPronouncedModerateCYP3A substrateYesdegNoNo | Pharmacology | null |
f810f86c-2c67-44e8-b0df-0aafe73fa989 | Free gingival groove represents | Histologic depth of gingival sulcus | False pocket depth | Depth of gingival sulcus | None of the above | 0a
| multi | null | Dental | null |
9915c2b8-8f39-4e35-a9c0-08f2f825137a | All of the following are true regarding oxygenases except : | Incorporate 2 atoms of oxygen | Incorporate 1 atom of oxygen | Required for hydroxylation of steroids | Required for carboxylation of drugs | 3d
| multi | Ans. d. Required for carboxylation reaction (Ref Harper 2R/e p9R-102: Lehninger 5/e p8l 6).Oxygenase (which belongs to oxido-reductase class) cause incorporation of 2 atoms of 0, (dioxygenase) or 1 atom of 02 (monoxygenase or hydroxylase). Carboxylase enzyme, which belongs to ligase class is required for carboxylation.Cytochromes P450 are (heme containing) monoxygenasesdeg which take pa in hydroxylase cycledeg (NADH, NADPH and Fe2 S2 required), detoxify drugs in liver microsomesdeg (with cytochrome b5, Fe2 S2 not required). | Biochemistry | null |
1f6b3a83-ed5e-4d0e-90b3-f740ff95c763 | All are used for postpaum hemorrhage except - | Misoprostol | Dinoprostone | Prostaglandin F2 alpha | Oxytocin | 1b
| multi | Ans. B. DinoprostonePostpaum hemorrhage, the loss of more than 500 mL of blood after delivery, occurs in up to 18 percent of bihs and is the most common maternal morbidity in developed countries. Dinoprostone:Naturally occurring prostaglandin E2 (PGE2). It has impoant effects in labour.It also stimulates osteoblasts to release factors which stimulates bone resorption by osteoclasts.As a prescription drug it is used as a vaginal suppository, to prepare the cervix for labour and to induce labour. Indication:For the termination of pregnancy during the second trimester (from the 12th through the 20th gestational week as calculated from the first day of the last normal menstrual period), as well as for evacuation of the uterine contents in the management of missed aboion or intrauterine fetal death up to 28 weeks of gestational age as calculated from the first day of the last normal menstrual period.In the management of nonmetastatic gestational trophoblastic disease (benign hydatidiform mole).Other indications include improving the cervical inducibility (cervical "ripening") in pregnant women at or near term with a medical or obstetrical need for labor induction, and the management of postpaum hemorrhage. | Pharmacology | null |
067c672c-d753-487d-aa0b-d6e73f98aa2d | Risk factors for Coronary artery disease are all except | Smoking | Increased fibrinogen level | Hypertension | Alcohol consumption | 3d
| multi | null | Medicine | null |
4720c165-03b3-4a1a-9e51-1f36c0bcd1be | In esophageal varices bleeding, which of the following is not used? | Endoscopy banding | Octreotide | Platelet transfusion | TIPS | 2c
| single | Answer- C. Platelet transfusionBeta-blockersEndoscopic sclerotherapyEndoscopic variceal ligation (banding)A medication called octreotide - will lower the pressure in the swollen veins by tightening the blood vessels and reducing blood flow.Transjugular intrahepatic poosystemic shunt (TIPS) procedure is another potential treatment option for recurrent bleeding esophageal varices | Surgery | null |
2a9cc59f-8f5f-4035-8010-07d1cc7a2f64 | In SCHWARTZ formula for calculation of creatinine clearance in a child, the constant depends on the following except – | Age | Method of estimation of creatinine | Mass | Severity of renal failure | 3d
| multi | Schwartz formula (for creatine clearance in child).
Creatinine clearance = K x height./ creatinine.
K = constant
K depends upon --> Age, Muscle mass, Method of creatinine estimation | Pediatrics | null |
fd188bc0-c100-44ae-bd1e-ef51e94e6425 | False about enamel rods is | They are perpendicular to tooth surface | They are parallel to each other | Diameter of enamel rods is 30micrometer at DEJ | Diameter of enamel rod is 5 micrometer at DEJ | 2c
| multi | Option C is false as diameter of enamel rod (avg) is 5 micrometer at DEJ and 8 micrometer at surface. | Dental | null |
1a005431-798b-4360-83a1-01d29c494ca4 | Radiographs are of no help in the diagnosis of | Cementoma | Subluxation teeth | Acute alveolar abscess | Impacted canines | 2c
| single | null | Radiology | null |
914b925a-424d-4ca2-8a94-bdd73f14c65f | Which of the following does not complicate into CHF – | Co–relation of aorta | Transposition of great vessels | Tetralogy of fallot's | Patent ductus arteriorus | 2c
| multi | The ventricular septal defect of TOF is always large enough to allow free exit to the right to left shunt.
Since the right ventricle is effectively decompressed by VSD, Congestive cardiac failure never occurs in TOE
Exceptions to this rule are : -
Anemia
Infective endocarditis
iii) Systemic hypertension
iv) Myocarditis complicating TOF
V) Aortic or pulmonic regurgitation.
Remember:
Following do not occur in TOF --> o Cardiomegaly o CHF o Recurrent chest infections | Pediatrics | null |
5c1480fc-941a-40a6-895b-537be91bcadb | In a functional implant, bone loss seen annually after 1 year is: | 1.5 to 2 mm | Less than 0.1 mm | 1 to 2 mm | 1 to 1.5 mm | 1b
| multi | null | Dental | null |
fedcc613-e577-40ff-a801-5d57fba1548e | Which of the following vaccine is not included in EPI schedule | DPT | MMR | BCG | OPV | 1b
| single | null | Dental | null |
d8ca247a-27e4-4f88-b2f8-10492994b912 | All of the following are typically associated with the loss of 40% of the circulating blood volume except | A decrease in the blood pressure | A decrease in the central venous pressure | A decrease in the heart rate | A decrease in the urine output | 2c
| multi | null | Pathology | null |
84fe7359-1ad3-4031-bf62-e4474bb33a86 | All are signs of impending Eisenmenger except – | Increased flow murmur across tricuspid & pulmonary valve | Single S2 | Loud P2 | Graham steel murmur | 0a
| multi | Eisenmenger syndrome refers to patients with a VSD in which blood is shunted from right to left as a result of development of pulmonary vascular resistance. Initially shunt is from left to right as the systemic vascular pressure is greater than pulmonary vascular pressure. With time pulmonary vascular resistance increases due to change in pulmonary vessel wall as a result of increased flow in pulmonary vessels. When pulmonary vascular pressure exceeds the systemic vascular resistance, reversal of shunt into right to left shunt occurs.
This development of right to left shunt due to reversal of left to right shunt as a result of development of pulmonary vascular resistance and pulmonary hypertension is called Eisenmenger syndrome. | Pediatrics | null |
a97ea051-7425-4f6f-b909-c32f3801a91f | G-protein coupled receptor that does not act through opening of potassium channels is | Muscarinic M2 receptor | Dopamine D2 receptor | Serotonin 5 HT 1 receptor | Angiotensin 1 receptor | 3d
| single | * DGPCR which act through opening of K+ channels lead to hyper polarisation, thus leading to inhibition.So, receptor which causes stimulation will not act through opening of K+ channels. o Muscarinic M2 receptor, Dopamine D2 receptor and serotonin 5HT1 receptor act through opening of K+ channels.o Whereas Angiotensin 1 receptor act by increasing Ca+2. | Pharmacology | AIIMS 2019 |
9ccd0247-2723-4707-b569-ca0402842cd9 | Which of these is not a non-contraceptive use of levonorgestrel? | Endometriosis | Premenstrual tension | Complex endometrial hJperplasia | Emergencycontraception | 1b
| single | Ans: B. Premenstrual tension(Ref Williams 24/e p701: Goodman Gilman 12/e p1184, 1190)Pre-menstrual tension is not a non-contraceptive use of levonorgestrel.Therapeutic Uses - Levonorgestrel:Emergency contraception:Useful within 120 hours as emergency bih control.Idiopathic menorrhagia:Excessively heavy, regular menses in the absence of intracavitary pathology or coagulopathy.Menometrorrhagia:Excessive bleeding in amount prolonged in duration (regular or irregular intervals).An alternative delivery system - Protect against endometrial hyperplasia in women taking SERM.Management of recurrent pelvic pain secondary to multi- treated endometriosis.LNG-IUS is licensed for use in menorrhagia & to provide endometrial protection to perimenopausal & postmenopausal women on estrogen replacement therapy.LNG-IUS beneficial in endometriosis, adenomyosis, fibroids, endometrial hyperplasia & early stage endometrial cancere (where the patient is deemed unfit for primary surgical therapy). | Gynaecology & Obstetrics | null |
120b8b88-ef18-4c63-a24e-370065a02f25 | EDTA does not cause which of the following action | Chelating action | Irrigation | Remove smear layer | Pulp fixation | 3d
| single | null | Dental | null |
7a51e736-c9fd-452f-8d09-127583a42886 | Compament of leg without neurovascular bundle? | Anterior | Lateral | Deep posterior | Superficial posterior | 3d
| single | Ans. d. Superficial posteriorRef: Grays Anatomy, 4lst ed, pg- 1406-1412 and Last anatomy 12th ed, pg. 142Contents of flexor (posterior) compament:Superficial pa:Gastrocnemius, plantaris and soleus musclesDeep pa:Popliteus, Flexor digitorum longus, flexor hallucis longus and Tibialis posterior musclePosterior tibial and peroneal vesselsTibial nerve | Anatomy | null |
50aa2943-d234-4743-88e0-286d47774107 | V) hich of the following can change the gene expression by methylation and acetylation without affecting the content of the gene? | Epigenetics | Translocation | Inversion | Transduction | 0a
| single | Ans.: A. Epigenetics"Epigenetics is defined as changes that alter the pattern of gene expression that persist across at least one cell division but are not caused by changes in the DNA code. Epigenetic changes include alterations of chromatin structure mediated bymethylation of cytoosine residues in CpG dinucleotides, modification of histones by acetylation or methylation, or changesin higher-order chromosome structure- " Harrison" | Pathology | null |
85d37c8a-2bcc-48d9-bc5c-b63495f25ab3 | All are causes of subcortical dementia except - | Alzheimer's disease | Parkinson's disease | Supranuclear palsy | HIV associated dementia | 0a
| multi | Alzheimer’s disease is a cortical dementia. | Psychiatry | null |
a4d559cf-a0bb-4eab-9cd6-023fceb916ad | Which growth factor Is not present in PRP? | PDGF aa | PDGF bb | PDGF cc | PDGF Fab | 2c
| single | null | Dental | null |
eaa8c755-dc9b-4a75-ac66-4664ee83567a | A 18-year-old girl was brought to OPD, labia majora separated, labia minora flabby, fourchette tear present and vagina is roomy but Hymen is intact. What could be possible? | Virgin | False virgin | Premenstrual stage | Molestation | 1b
| multi | Ans: b. False virginRef: KSN Reddy's The Essentials of Forensic Medicine and Toxicology 33' edn; Page no. 392False VirginHymen is intact but thick and the woman has had sexual intercourse. Labia majora: Flabby, may gap on abduction of thighLabia minora: Loose, blackish-brown, cutaneousVagina deep, roomy, dilated and capacious with less rugosed wall Vagina easily admits two fingers.True VirginLabia majora: Firm, rounded and completeLabia minora: Soft, sensitive and pink in colorFourchette and posterior commissure: Intact * Vaginal wall: Closely approximatedVagina mucosa: Rugose, reddish, sensitive to touchHymen: Intact | Forensic Medicine | null |
6e3b014e-fe90-47f0-8e12-e176a809198f | Which of the following drugs can be given in renal failure safely? | Saxagliptin | Linagliptin | Vildagliptin | Sitagliptin | 1b
| single | Ans: B. Linagliptin(Ref Goodman Gilman 12/e p1264; Katzung 13/e p740, 12/e p761; FDA website: http://wwwfda.gov/ Safety/ MedWatch/Safetylnformation/ircm3 I 9215.htm)Linagliptin:Given safely in renal failure.Chronic kidney disease:Major complication in type 2 diabetes.Metformin usage is challenging.More severe renal disease - Less likely for metformin use.Due to safety concerns. | Pharmacology | null |
37332d92-237c-4846-84e5-27def7ec1805 | Gingival hyperplasia is caused by all except | Sodium valproate | Carbamazepine | Verapamil | Bleomycin | 1b
| multi | null | Pharmacology | null |
edcb831f-c060-498e-a756-c2047eb19c15 | Which is not seen in neuroimaging of patient of tuberous sclerosis? | White matter lesion | Ependymoma | Subependymal nodules | Giant cell astrocytoma | 1b
| single | null | Medicine | null |
12c9a1fb-87c9-4109-b4c1-9fa0babc98cc | The following cardiac defects are characterized by ductus dependent blood flow except – | Transposition of great arteries with intact septum | Interrupted aortic arch | Truncus arteriosus | Hypoplastic left heart syndrome | 2c
| multi | Congenital heart disease in the newborn can be broadly categorized by the relationship between the patients cardiac defect and the patent ductus arteriosus; this categorization yields four distinct groups:
I. Pulmonary flow ductal dependence.
Newborns with congenital heart disease who are dependent on the potency of their ductus for pulmonary blood flow present with varying degrees of cyanosis.
Critical Pulmonary Valve Stenosis with Intact Ventricular Septum.
Li Tricuspid Atresia:
Tetralogy of Fallot
Ni Systemic flow ductal dependence.
These newborns are dependent on their ductus arteriosus for systemic blood flow and unlike the babies who are pulmonary flow dependent, these newborns present with severely decreased cardiac output.
This decreased systemic flow is characterized by pallor, diminished peripheral pulses, low urine output, cool extremities and varying degrees of metabolic acidosis.
This includes newborns with left ventricular outflow tract obstruction at various levels.
Congenital Valvular Aortic Stenosis
Coarctation of the Aorta
Interrupted Aortic Arch
Hypoplastic Left Heart Syndrome (HLHS)
IlL xygenation ductal dependence.
These are babies who are born with congenital heart disease that requires a patent ductus for adequate mixi g of saturated and desaturated blood.
Transposition of the Great Vessels (TGV)
IV J uctal independence.
These are neonates who are not dependent on a patent ductus but still require urgent operation.
Total anomalous pulmonary venous return (TAPVR)
Truncus Arteriosus
Anomalous origin of the left main coronary alloy from the pulmonaly artery. | Pediatrics | null |
cfb81145-9c8a-41bf-975a-bd76f75be629 | Hypereosinophilic syndrome is a disease characterized by elevated eosinophil count in the blood for at least 6 months, without any recognizable cause, with involve-ment of either hea, nervous system or bone marrow. What should be the eosinophil count for diagnosis? | >500/mm3 | >1000/ mm3 | >1500/ mm3 | >2000/ mm3 | 2c
| single | Ans: C. >1500/ mm3(Ref Harrison 19/e p1686, 135e-8, 18/e p481 e-21.5)Eosinophil count for hypereosinophilia syndrome diagnosis = >1.5 x 109/L (>1500/mm).Blood Eosinophilia:Neither secondary or clonal.Cause: Idiopathic.Hypereosinophilic Syndrome (HES):Subcategory of idiopathic eosinophilia with persistent increase of AEC to >1.5 x 109/L (>1500/ mm3).Features:Presence of eosinophil-mediated organ damage -Cardiomyopathy, gastroenteritis, cutaneous lesions, sinusitis, pneumonitis, neuritis & vasculitis.Also thromboembolic complications, hepatosplenomegaly & either cytopenia or cytosis. | Medicine | null |
f31cf6f2-74fe-4d49-a8a7-ae85b1359d2b | An 8 year old female child following URTI developed maculopapular rash on the jaw spreading onto the trunk which cleared on the 3T day without desquamation and tender post auricular and suboccipital lymphadenopathy. The diagnosis is – | Kawasaki disease | Erythema infectiosiun | Rubella | Measles | 2c
| single | null | Pediatrics | null |
2860cd26-5fec-445c-904e-67095651fd15 | All the statements are true about standardization, except | Standardization allows comparison to be made between two different populations | The national population is always taken as the standard population | For direct standardization age specific rates of the study population are applied to that of the standard population | For indirect standardization age specific rates of the standard population are applied to the study population | 1b
| multi | Standard population: Is a population where numbers in each age and sex group are known
Two frequently used standard populations are:
Segi world population
European standard population
Choice of standard population is arbitrary:
Available standard populations may be used
Standard population may also be created using 2 populations
The national population need not always be taken as the standard population
Is commonly used in occupational studies: Comparison of mortality in an industry and general population
Can be used for occurrence of disease (rather than death) | Social & Preventive Medicine | null |
fb136952-1310-4610-aff7-95e8b923ffd9 | Which of the following is not removed in radical neck dissection | Sternocleidomastoid muscle | Digastric muscle | Spinal accessory nerve | Internal jugular vein | 1b
| single | Answer- B. Digastric muscle* The radical neck dissection consists of removal of all five lymph node groups of one side of the neck (levels I-V).* This includes removal of the sternocleidomastoid muscle, the internal jugular vein, and the spinal accessory nerve. | Surgery | null |
64fb619d-cfcf-450f-a317-cb760dca53e3 | Which is not a monosaccharide? | Glucose | Galactose | Maltose | Fructose | 2c
| single | null | Biochemistry | null |
82a21b84-e5d6-46d5-98bc-46fc75641f7b | A patient with cough was sputum AFB negative but chest X-ray was suggestive of TB. What should be the next step according to RNTCP? | Line probe assay | Culture | Nucleic acid amplification test | Tuberculin test | 2c
| multi | Answer- C. Nucleic acid amplification testCaridge Based Nucleic Acid Amplification Test (CB-NAAT): The CB'NAAT is known as the GeneXpeft in mostcountries other than India This is prefered first diagnostic test in children and people with TB and HIC co-infection | Social & Preventive Medicine | null |
98db720a-e70e-4db0-8df7-77da4048523e | A 42 years old woman from a dry state who ingested rye for long time presented with complaints of weakness in both lower limbs, nausea and fatigue. Over due course of time, she is completely unable to walk. What is the most likely cause? | Argemone mexicana | Amanita | Ergot alkaloids | Lathyrus sativus | 3d
| multi | Ans: D. Lathyrus sativus(Ref Park 24/e p682, 23/e p644, 657).This case is suggestive of food adulteration & neurolathyrism.Caused by Lathyrus sativus.Neurolathyrism:Crippling disease of CNS.Features:Characterized by gradually developing spastic paralysis of lower limbs.Mostly in adults consuming pulse, Lathyrus sativus. | Social & Preventive Medicine | null |