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344d849d-fe32-41d8-853f-b02b41028d71 | A 35 years old male comes with complain of baldness. On examination, well-defined bald patches were seen with no scarring. Small broken hairs were seen in the surrounding area. What is the likely diagnosis? | Androgenetic alopecia | Alopecia areata | Anagen effluvium | Telogen Effluvium | 1b
| multi | Ans: B. Alopecia areata(Ref Rooks 8/e p66.13, Fitzpatrick 6/e p732)Findings are highly suggestive of alopecia areata.The scalp appears normal in alopecia areata.In affected areas, anagen is abruptly terminated prematurely and affected hairs move prematurely into telogen, with resultant often precipitous hair shedding.The near pathognomonic 'exclamation point' hairs may be present, paicularly at the periphery of areas of hair loss.These sho broken hairs, whose distal ends are broader than the proximal ends, illustrate their inherent sequence of events: follicular damage in anagen and then a rapid transformation to telogen. White or graying hairs are, frequently spared and probably account, in cases offulminant alopecia areata, far the mysterious phenomenon of 'going gray overnight.' | Skin | null |
52f7f99f-7b39-4c16-97c3-df2c2229c041 | One of the following is not an amino acid: | Glycine | Hydroxy proline | Glutamic acid | Choline | 3d
| single | null | Biochemistry | null |
ed8cb5ce-10b7-4f7f-82b9-78d81ca404e0 | Which of the following is not true regarding trigeminal nerve? | Roots of trigeminal nerve are attached to Pons | It has three main divisions | Trigeminal nerve supplies the dura mater of middle cranial fossa | The trigeminal ganglion contributes to the sensory root only | 3d
| multi | null | Anatomy | null |
678018c2-3154-4411-937e-0e5d4116739f | Which of the following does not or permissive euchromatin due to changes occurring at cytosine residues at CpG islands in DNA? | Methylation | Alkylation | Phosphorylation | Sumoylation | 0a
| single | Ans: A. Methylationref: Harper's illustrated biochemistry, 30th editon., pg. 560.Methylation of cpG sites in the promoter of a gene may inhibit gene expression.There is also evidence that low folate status results in impaired methylation of cpG islands in DNA, which is a factor in the development of colorectal and other cancers. | Biochemistry | null |
c54f6d65-4afa-4778-8c98-b32ff9a9782d | An adult came to casualty with complaints of rapid hea rate. On examination everything else was normal except for episodic tachycardia and occasional extra-systole and amblyopia. Which of the following is the cause of it? | Nicotine | Cannabis | Atropine | Cocaine | 0a
| multi | Answer- A. NicotineNicotine chronic poisoning can lead to cough, wheezing, dyspnoea, anorexia, vomiting, diarrhea, anaemia, faintness,tremors, impaired memory, amblyopia, blindness, irregularities, of the hea with extra-systoles and occasionally attacks pain suggesting angina pectoris. | Forensic Medicine | null |
57336e68-8096-4fa9-89f5-36c05dcd5482 | In which one of the following mixed dentition analysis of deciduous dentition, there is no use of radiographs? | Carey's analysis | Moyer's analysis | Nance Carey's analysis | Pont's index | 1b
| single | Moyer’s analysis
This mixed dentition analysis utilises Moyer’s prediction tables. Prediction is based on the premise that there is a reasonably good correlation between the size of erupted permanent incisors and the unerupted canines and premolars.
It is a non-radiographic method. The main advantage of non-radiographic prediction methods is that they can be performed by measuring the erupted mandibular incisor(s) without the need of additional measurements from radiographs.
Reference: Orthodontics: Diagnosis and Management of Malocclusion and Dentofacial Deformities 3rd O P Kharbanda, pdf no 841 | Dental | null |
f7da4d3a-cd77-4744-a67a-720973e1eb12 | All are true about CRISPR cas 9 Except | gRNA ensures that the Cas9 enzyme cuts at the right point in the genome | NHEJ repair & HDR pathway | C9 enzyme is used in CRISPR gene editing | All of these | 3d
| multi | Answer-D. All of theseCRISPR-Cas9 was adapted from a naturally occurring genome editing system that can generate double standard Breaks (DSBs).Cas9 is the enzyme that is used most often, other enzymes (for example Cpf1) can also be used- these enzymes can can repair by homologus repair system or by non-homologous end joining in the absence of DNA template.Two general repair pathways:The efficient but error-prone non-homologous end joining (NHEJ) pathwayThe less efficient but high-fidelity homology directed repair (HDR) pathway | Biochemistry | null |
8ecb4d6b-8ab1-40d7-af48-fa8fe50bd21f | Centrineuraxial (spinaland epidural) anaesthesia is not contraindicated in | Platelets <80,000 | Patient on aspirin | Patient on oral anticoagulants | Raised intracranial pressure | 1b
| single | null | Pharmacology | null |
5a7cda67-bf66-44be-95b0-ff347d55c01a | Fetal alcohol syndrome is characterized by all except – | Microcephaly | Low intelligence | Large proportionate body | Septal defects of heart | 2c
| multi | Fetal alcohol syndrome
High level of alcohol ingestion in pregnancy can cause damage to fetus, known as fetal alcohol syndrome.
The harmful effects may be due to alcohol itself or due to one of its breakdown products. Some evidence suggests that alcohol may impair placental transfer of essential amino acids and zinc, both necessary for protein synthesis, which may account for IUGR.
Characterististics of fetal alcohol syndrome include : -
HIG1? (not large proportionate body)
Microcephaly
Congenital heart defects (ASD, VS )
Mental retardation
Facial abnormalities -3 Short palpebral fissures, epicanthal folds, maxillary hypoplasia, micrognathia, low set ears, smooth philthrum, thin smooth upper lip.
Minor joint anomalies
Hyperkinetic movements | Pediatrics | null |
31a240fd-6563-4450-a2c1-9dd108c57a84 | Which of the following is not used in polymerase chain reaction? | DNA Polymerase | Taq polymerase | Dideoxyribonucleotides | DNA template | 2c
| single | PCR is an in vitro DNA amplification procedure in which millions of copies of a paicular sequence of DNA can be produced within a few hours.The reaction cycle has the following steps:Step 1: Separation (Denaturation): DNA strands are separated (melted) by heating at 95degC for 15 seconds to 2 minutes.Step 2: Priming (Annealing): The primers are annealed by cooling to 50degC for 0.5 to 2 minutes. The primers hybridize with their complementary single-stranded DNA produced in the first step.Step 3: Polymerization: New DNA strands are synthesized by Taq polymerase. This enzyme is derived from bacteria Thermus aquaticus that are found in hot springs.The steps of 1,2 and 3 are repeated. In each cycle, the DNA strands are doubled. Thus, 20 cycles provide for 1 million times amplifications. These cycles are generally repeated by automated instrument, called Tempcycler.5. After the amplification procedure, DNA hybridization technique or Southern blot analysis with a suitable probe shows the presence of the DNA in the sample tissue.Dideoxyribonucleotides are not used in the polymerase chain reaction. | Biochemistry | null |
185c4942-7886-4e49-b242-6634e83b0efb | Which of the following amino acids does not include post-translational modification? | Selenocysteine | Triiodothyronine | Hydroxyproline | Hydroxylysine | 0a
| single | Ans. A. SelenocysteinePeptidyl selenocysteine is not the product of a posttranslational modification, but is inseed directly into a growing polypeptide during translation. Selenocysteine is commonly termed as the "21st amino acid." However, incorporation of selenocysteine is specified by a large and complex genetic element for the unusual tRNA called tRNASec which utilizes the UGA anticodon that normally signals STOP. | Biochemistry | null |
1fe1bd49-93cd-4bea-8beb-fdf6cc819421 | Absence of which of the following milestone in 3 yr old chitd is called delayed development? | Hopping on one leg | Drawing a square | Feeding by spoon | Passing a ball to someone | 2c
| multi | Ans: C. Feeding by spoonRef: Ghai Essentiul Pediatrics, 8"' ed., pg. 49Hopping on one leg - Should be attained by 4 years ofageDrawing a square - Should be attained by 4Il2 years of ageFeeding by spoon Should be attained by l8 months of agePassing a ball to someone- Should be attained by 3 years | Pediatrics | null |
d43fc90d-cbde-4b19-8b2d-a82f66c58186 | All of the following are good progonostic factor for ALL except – | Age of onset between 2-8 years | Initial WBC count less than 50000 | Hyperdiploidy | t (9 : 22), t (8 : 14), t (4 : 11) | 3d
| multi | Acute Myelogenous leukemia | Pediatrics | null |
80b1797f-6a00-42e2-92a1-6f913e5deded | In which of the following, viral load done by Real Time PCR is of no role in investigative procedures? | Person with hepatitis B on Tenofovir therapy | HSV causing temporal encephalitis | BK virus in patient of allograft renal transplant | CMV PCR in blood of patient of liver transplant | 1b
| multi | In person with Hepatitis B on Tenofovir therapy along with patients infected with BK virus in patient of allograft renal transplant and in cytomegalovirus PCR in blood of patient of liver transplant viral load is necessary so viral load is done by real time PCR but it in hsv causing temporal aeritis there is a search no role of viral load so there is no such need of real time PCR This is replaced by HSV DNA in CSF by PCR | Microbiology | AIIMS 2018 |
832c9aa4-702e-49ba-b63b-8044bc8fbd9f | Which of the following cements are not be used to cement acrylic temporary crown: | Zinc oxide eugenol | Zinc phosphate | Glass ionomer | None of the above | 2c
| multi | null | Dental | null |
1821da63-79b6-4ad9-bae2-f3565b857f97 | In hemorrhagic shock, hypotension occurs when blood loss is more than: | 10% - 15% | 15% - 30% | 30% - 40% | More than 40% | 3d
| single | null | Surgery | null |
28edac0b-502c-4aa9-a4ad-8ed4b20f9154 | A patient underwent extraction of 3rd molar experiences pain in socket on 3rd day; socket is tender with no fever and swelling: what treatment should be done | Irrigation of socket with sedative placement and analgesic | Curettage of socket and induces bleeding | Left untreated and observe for few days | Start antibiotics followed by curettage of socket | 0a
| single | null | Surgery | null |
5fd61c9e-450e-415b-a055-24f62de4cdd6 | In case of wider osteotomy planned happen which should not be done | Press buccal and lingual plate | Wider implant | Bone graft plus implant | Deep osteotomy | 1b
| single | null | Dental | null |
d5070ff9-a3de-4f6c-a9ba-12918fa6ef04 | Which among the following is not a risk factor for contrast-induced nephropathy? | Diabetic nephropathy | High osmolar agent | Obesity | Dehydration | 2c
| single | Ans. CSide effects of iodinated contrast material are:Idiosyncratic - Anaphylactoid reaction. They are complement-mediated reactions and not IgE. The patient develops bronchospasm and hypotension.Dose-dependent side effect - Contrast-induced nephropathy and seen especially with high osmolar agents.Contrast-induced nephropathy:The patient has non-oliguric transient nephropathy and occurs due to tubular damage. It is defined as the impairment of renal function and is measured as either a 25% increase in serum creatinine from baseline or 0.5 mg/dl increase in absolute value, within 48-72hrs of intravenous contrast administration.Risk Factors for Contrast Medium-Induced Nephropathy:Patient-related:eGFR < 60 mL/min/1.73 m2 before intra-aerial administrationeGFR < 45 mL/min/1.73 m2 before intravenous administrationIn paicular in combination with:Diabetic nephropathyDehydrationCongestive hea failure (NYHA grade 3-4) and low LVEFRecent myocardial infarction (Intra-aoic balloon pumpPeri-procedural hypotensionLow hematocrit levelAge over 70Concurrent administration of nephrotoxic drugsKnown or suspected acute renal failureProcedure-related:Intra-aerial administration of contrast mediumHigh-osmolality agentsLarge doses of contrast mediumMultiple contrast medium administrations within a few daysIf the patient is on Metformin and is having de-arranged RFT, then before giving contrast agent metformin should be stopped since it can precipitate lactic acidosis | Radiology | null |
7754fac4-e0d5-4ae7-9df8-9fd6bef4e4db | Which of the following statements is not true about incidence? | Incidence decreases when a programme is effective | Vaccination strategies decrease the incidence of a disease | Newer and effective treatment modalities decrease the incidence | Incidence implies number of new cases detected over a fixed time | 2c
| multi | Ans: C. Newer and effective treatment modalities decrease the incidenceRef: Park 24Ic p67, 23Ie p62, 22/c p59).Newer and effective treatment modalities do not decrease the incidence.Improvements in treatment may decrease the duration of illness and may decrease prevalence.Relation between Incidence & PrevalenceGiven the assumption that population is stable & incidence and duration are not changing.Prevalence = Incidence x Mean duration of diseasePrevalence describes balance between incidence, moality & recoverye.Incidence reflects causal factorse.Duration reflects prognostic factorse | Social & Preventive Medicine | null |
081b84ad-60a8-4c82-b570-8297ffd15934 | According to American association of Endodontics, which of following terminology is not mentioned in the glossary of terms: | Chronic apical periodontitis | Acute apical abscess | Chronic apical abscess | Symptomatic apical periodontitis | 0a
| single | null | Dental | null |
cb562414-2015-43ec-88f7-78a52605b511 | In the management of anaphylaxis, which action of adrenaline is not observed? | Bronchodilation by beta-receptors | Cardiovascular effects of beta-receptors | Action on blood vessels by alpha-receptors | Action on presynaptic alpha-receptors | 3d
| single | Ans: D. Action on presynaptic alpha-receptors(Ref: Goodman Gilman 12/e p209, 302, 308)Activation of presynaptic ?2 receptors inhibits the release of NE and other co-transmitters front peripheral sympathetic nerve endings.Activation of ?2 receptors in the pontomedullary region of the CNS inhibits sympathetic nervous system activity and leads to a full in blood pressure.Action on presynaptic alpha-receptors (a2 receptors) is not helpful in management of anaphylactic shock. | Pharmacology | null |
92b9ce44-5d98-4f45-9366-e83649016e84 | Mark true or false among the following:Content 's of Carotid Sheath areA. Internal jugular veini) trueii) falseB. Cervical sympathetic trunki) trueii) falseC. Vagus nervei) trueii) falseD. Internal carotid aeryi) trueii) falseE. Deep cervical lymph nodesi) trueii) false | A. ii) B. ii) C. i) D. i) E. i) | A. i) B. ii) C. ii) D. i) E. i) | A. i) B. ii) C. i) D. i) E. ii) | A. i) B. ii) C. i) D. i) E. i) | 3d
| multi | Ans. D: A. i) B. ii) C. i) D. i) E. i)The carotid sheath also is a tubular fascial investment that extends superiorly between the cranial base and inferiorly to the root of the neck. The carotid sheath contains the common and internal carotid aeries, internal jugular vein, and vagus nerve . In addition, the carotid sheath contains deep cervical lymph nodes, sympathetic fibers, and the carotid sinus nerve. The cervical sympathetic trunk lies behind the sheath but is not included within it. | Anatomy | null |
6ba7a8b3-b653-4208-8815-75c03f1088b4 | In biopsy true about formalin as fixative is all except | To prevent autolysis | To make tissue rigid | To kill micro organisms | 2% forrnaline is used | 3d
| multi | null | Pathology | null |
6944b9e7-b49f-46ac-ac6f-b748f2c4cc46 | Which of the following is not done for antenatal diagnosis of Down's syndrome: | Amniotic fluid volume estimation | Alpha-fetoprotein estimation | Cordocentesis | Chorionic villous biopsy | 0a
| single | null | Gynaecology & Obstetrics | null |
561aefb5-77c7-433e-8029-096d77ad3099 | A 5 years old child brought to the hospital with history of loose stools but no history of fever or blood in stools. Mother says he is irritable and drinks water hastily when given. On examination eyes are sunken and in skin pinch test, the skin retracted within two seconds but not immediately. What is the treatment for this child? | Administer the first dose of IV antibiotic and immediately refer to hither center | Give oral fluids and ask the mother to continue the same and visit again next day | Consider severe dehydration, sta IV fluids, IV antibiotics and refer to higher center | Give Zinc supplementation and oral rehydration solution only and ask mother to come back if some danger signs develop | 3d
| single | Answer- D. Give Zinc supplementation and oral rehydration solution only and ask mother to come back if some danger signs developThe child in this given scenario is having some dehydration, as the child is restless and irritable, drink water readilyand skin pinch goes back slowly (< 2 seconds) with sunken eyes. Treatment includes oral rehydration therapy, zincsupplementation and continued breastfeeding according to the WHO IMNCI protocol plan B. | Pediatrics | null |
23cdcc3c-aabd-403a-b2f7-59ecfab6ed23 | Palpable purpura is seen in all. except – | H.S. Purpura | Mixed cryoglobulinemia | Giant cell arteritis | Drug induced vasculitis | 2c
| multi | null | Pediatrics | null |
2e81781f-8c3e-4d9a-86b3-a2651e07dce9 | Blood brain barrier is absent in all of the following areas except | Subfornical region | Habenuclear trigone | Area posterma | Neurohypophysis | 1b
| multi | null | Physiology | null |
4d60bdc9-a192-424b-96f8-8ce60b75208b | Which of the following is not a major maxillary metal partial denture frame work: | Lingual U plate | Palatal strap | Palatal plate | Single palatal plate | 0a
| single | null | Dental | null |
89e4fd81-0a6a-4702-8229-b393fcf8bf91 | Which of the following antihypertensives is not safe in pregnancy: | Clonidine | ACE inhibitors / Enalapril | α − Methyldopa | Amlodipine | 1b
| single | null | Gynaecology & Obstetrics | null |
605c9835-95d4-4a5e-b400-09bf38e75e4c | An adolescent school girl complaints of dropping objects from hands, it gets precipitated during morning and during exams. There is no history of loss of consciousness and her cousin sister has been diagnosed with epilepsy. EEG was done and was suggestive of epileptic spikes. What is the diagnosis? | Juvenile myoclonic epilepsy | Atypical absence | Choreo - athetoid epilepsy | Centrotemporal spikes | 0a
| single | - History given suggests the diagnosis of Juvunile myoclonic epilepsy Juvunile myoclonic epilepsy ( Janz Syndrome ) - Most common generalized epilepsy in young adults. - Stas in early adolescence with 1 or more of: Myoclonic jerks in morning, causing patient to drop things Generalized tonic-clonic seizures upon awakening Juvenile absences. - Sleep deprivation and photic stimulation can act as precipitants. - EEG shows generalized 4-5 Hz polyspike and slow wave discharge. OTHER OPTIONS: Atypical absence seizures - Less abrupt onset and offset of loss of awareness - Associated myoclonic components and tone changes of head and body - Precipitated by drowsiness - Accompanied by 1 to 2 hz spike and slow wave discharge. Benign childhood epilepsy syndrome with centrotemporal spikes - Rolandic epilepsy - Stas during childhood and is outgrown in adolescence. - Child wakes up at night owing to focal seizures causing buccal and throat tingling and tonic clonic contractions of 1 side of face, with drooling and inability to speak but with preserved consciousness and comprehension. - EEG shows typical broad based centrotemporal spikes that are markedly increased in frequency during drowsiness and sleep. - MRI is normal. - Patient respond well to carbamazepine. | Pediatrics | AIIMS 2018 |
6bfb7ced-ef9e-4df7-ae35-ce5699bbc7a5 | Not a monomeric intermediate filament: | Vimentin | Keratin | Tubulin | Desmin | 2c
| single | Filamentous protein - Are of 3 types based on their diameter. Diameter Microfilaments Intermediate filaments Microtubules <8 nm 8 - 25 nm >25 nm Function Involved in contractility Provide structural suppo Involved in motility (beating of cilia, flagella) Examples Actin Vimentin, keratin, Desmin. Tubulin (a & b tubulin constitutes microtubules) | Physiology | AIIMS 2019 |
7aa4c76d-e28b-480d-86b5-5a3c2ab2e6f3 | A 24 years old college student while playing hockey injured his right knee. This patient presents after 3 months with instability of knee joint in it full extension without instability at 90 degree of flexion. The structure most commonly damaged is: | Posterolatilal pa of anterior cruciate ligament | Anteromedial pa of anterior cruciate ligament | Posterior cruciate ligament | Anterior hom of medial meniscus | 0a
| single | Ans. a. Posterolateral pa of anterior cruciate ligament | Surgery | null |
db481d43-eaa9-45e9-8e23-4416d4894eb4 | A 56yr old underwent transsphenoidal hypophysectomy for pituitary tumour. Now he has low ACTH, TSH, FSH, LH. Which of the hormone will not be given to the patient? | Glucocoicoids | Mineralocoicoids | Levothyroxine | Estradiol | 1b
| single | Answer- B. MineralocoicoidsThis patient does not need supplementation with mineralocoicoids.It is due to the fact that post-hypophysectomy, the basal levels of mineralocoicoids (principally aldosterone) remain normal as the renin-angiotensin-aldosterone feedback loop remains intact. | Medicine | null |
153520b6-6e0a-4180-9416-9a7417bc76f9 | Peg-shaped incisors which taper towards the indsal edge
are typically seen in all of the following conditions EXCEPT | Congenital syphilis | Rickets | Anhyirotic ectodermal dysplasia | Supernumerary teeth | 1b
| multi | null | Pathology | null |
3171c368-25b8-4025-b7ae-ef22cc2f3f8c | Which of the following is not a post transcriptional modification of RNA? | Splicing | 5' capping | 3' polyadenylation | Glycosylation | 3d
| single | null | Biochemistry | null |
5a2f9e25-3acb-4830-9f18-009480595be1 | Not a side effect of Escitalopram? | Nausea | Vivid dreams | Anorgasmia | Sialorrhoea | 3d
| single | Side effects of Escitalopram GI side effects: MC Vivid Dreams Sexual dysfunction on long term intake Sialorrhea is a side effect of clozapine | Psychiatry | AIIMS 2019 |
2bbccb20-80ef-4575-9a4f-ff88b33d34ff | False statement about Thyroglossal Duct cyst is- | Infected thyroglossal cyst from sinus | Lined by pseudostratified columnar epithelium | 40% cases have sub hyoid location | It is due to congenital | 0a
| multi | Answer- A. Infected thyroglossal cyst from sinusThyroglossal cysts are the most common cause of midline neck masses and are generally located caudal to (below) the hyoid bone.Thyroglossal Duct Cysts are a bih defect.A thyroglossal cyst is lined by pseudostratified, ciliated columnar epithelium while a thyroglossal fistula is lined by columnar epithelium.A thyroglossal duct cyst may rupture unexpectedly, resulting in a draining sinus known as a thyroglossal fistula. | Surgery | null |
9f529003-8d44-442b-8dfc-f839e7f96a72 | A 56 years old patient came to casualty with history of massive hemoptysis. His routine investigations and chest X-ray was normal. Which of the following is not done to prevent hemoptysis? | Bronchial aery embolization | Pulmonary aery embolization | Bronchoscopic laser cauterization | Lobectomy of the affected segment | 3d
| single | Answer- D. Lobectomy of the affected segmentAll of the given options are used for control of hemoptysis in the following order: Bronchoscopic laser cauterization +Bronchial aery embolization + Pulmonary aery embolization + Lobectomy of the affected segment."Large-volume hemoptysis, referred to as massive hemoptysis, is variobly defined as hemoptysis of >200-600 mL in 24h. Massive hemoptysis should be considered a medical emergency. | Surgery | null |
7aa31059-c5b9-44c9-ad4e-8ebe58dca18a | Fill the missing data in the common risk factor approach diagram. | Diet and smoking | Smoking and disease | Smoking and prevention | Prevention and diet | 0a
| single | null | Dental | null |
c5cb18f5-77e4-443a-820e-5c5759aa5439 | All are true regarding Pseudotumour cerebri except – | Ventricular system is of normal size or small | CT Scan shows punctate hypodense areas | No focal neurological deficit | Intracranial pressure is raised | 1b
| multi | Pseudotumor cerebri
Pseudotumor cerebri is characterized by increased intracranial pressure in the absence of an identifiable intracranial mass or hydrocephalus.
Cardinal features of pseudotumour cerebri
Headache, Clinically resembling that of brains tumor
Normal cerebrospial fluid
Normal or sin all ventricular size
CT & 111R1 Normal
No focal neurological deficit
Transient visual obscurations and papilledema with enlarged blind spots. | Pediatrics | null |
62b4984a-2bd0-47b0-ab7c-8cc7027c8303 | Which one of the following is not a criterion for making a diagnosis of chronic myeloid leukemia in accelerated phase: | Blasts 10-19% of WBC's in peripheral blood | Basophils 10-19% of WBC'S in peripheral blood | Increasing spleen size unresponsive to therapy | Persistent thrombocytosis (>1000 x 109/L) unresponsive to therapy | 3d
| single | Answer is D (Persistent thrombocytosis > 1000 x 109/L positive to therapy)Accelerated phase is associated with thrombocytopenia (9/L) and not thrombocytosis.Although multivariate analysis derived criteria also place blood or marrow basophils > 20% in disease criteria, other criteria do consider marrow and peripheral basophils > 10% as a criteria and hence option (D) is the single best answer here.Accelerated phase of CML: It is defined by the development of increasing degrees of anemia unaccounted for by bleeding or chemotherapy and is defined by several criteria. Multivariate analysis derived criteria Other commonly used criteriaCytogenetic clonal evolution Blood or marrow blasts between 10 and 20% Increasing drug dosage requirementBlood or marrow basophils > 20% Marrow reticulum or collagen fibrosis Platelet count < 100 x 10deg/L unrelated to therapy Marrow or peripheral blasts > 10%Marrow or peripheral basophils eosinophils - 10% Triad of WBC > 50 x 109/L, haematocrit < 25% and Mai,100 liP/L not controlled ii1111 therapy Unexplained fever or bone pain | Pathology | null |
02b97bc8-316d-45fb-b372-606a62db2218 | All of the following about Vitamin D metabolism are true except | 25–α hydroxylation takes place in liver | 1–α hydroxylation takes place in kidney | Daily requirement in the absence of sun–light is 450-6001U/day | Williams syndrome is associated with obesity, mental retardation, precocious puberty | 3d
| multi | In Williams syndrome there is failure to gain weight (not obesity) and delay in development (not-precocious puberty)
Williams syndrome
Williams syndrome is a rare neurodevelopmental disorder characterized by:
Unusual facial features: Elfin facial appearance, widely spaced teeth, a long philthrum along with a low nasal bridge, an unusually cheerful demeanor and ease with strangers.
Heart defects: Supravalvular aortic stenosis.
Development delay: Mental retardation, failure to gain weight (failure to thrive), low muscle tone.
Transient hypercalcemia
Other features include GI problems (Colic, abdominal pain, diverticulitis), nocturnal enuresis, dental irregularities, hypothyroidism, hyperacussis and photophobia.
Vitamin D
It occurs mainly in two forms
Vit D3 —> Cholecalciferol - synthesized in skin under the influence of UV rays from 7-dehydrocholesterol.
Vit D2 —) Calciferol - present in irradiatiate food-yeast, fungi, bread.
Activation of Vit D takes place in following manner. | Pediatrics | null |
5641b32f-91e7-4a52-bd8a-a1db071d0d45 | Which of the following is not a general compartment of body fluid ? | Peritoneal | Intracellular | Interstitial | Blood plasma | 1b
| single | null | Physiology | null |
8ad384bd-4443-4440-aab0-3766aa07e450 | A G6+0+0 lady with h/o recurrent missed aboions at 14-16 weeks comes to you with a missed aboion at 12 weeks. Which of the following tests is not warranted? | Lupus anticoagulant | VDRL for husband and wife | Anticardiolipin antibody | Fetal karyotype | 1b
| single | Ans: B. VDRL for husband and wife(Ref Williams 24/e p358-359; Dutta 8/e p343, 7/e p167)VDRL:Simple test.Performed in initial work-up for all multiple aboion cases.All aboions are by 16th week while in syphilis, usually there is a improvement in the duration of pregnancy (Kassowitz Law).Kassowitz law:For untreated syphilis woman with series of pregnancies - Have lesser likelihood of infection of fetus from later pregnancies. | Gynaecology & Obstetrics | null |
1e8c037d-b7d9-48c9-8aba-39b01a178619 | Optic atrophy is not seen in: | Retinitis pigmentosa | Methanol poisoning | Central retinal aerial occlusion (CRAO) | Polypoidal choroidal vasculopathy | 3d
| single | Answer- D. Polypoidal choroidal vasculopathyRetinitis pigmentosa, Methanol poisoning and Central retinal aerial occlusion (CRAO) can lead to optic atrophy.Occurs secondary to retinal disease (disease of inner retina or its blood supply)Its ascending type of optic atrophy.Causes:Retinitis pigmentosaCRAOExtensive retino choroiditis | Ophthalmology | null |
f361defb-1a36-496f-b195-9dcb6bb31ea5 | An individual with a known psychiatric disorder or on treatment and is not a minor can chose to decide the care taker and the course of treatment according to mental health act. This is called: | Advance directive | Treatment directive | Mental will | Future directive | 0a
| multi | MENTAL HEALTH CARE ACT 2017 (1) Mental health establishment (2) Capacity to make mental health care and treatment decisions Patient Should be able to understand information given to him Should be able to know about consequences about the decision Should be able to express their decision any form (3) Advanced directive - legal document in which a patient write what action should be taken when they are not able to make decision about their health (4) Nominated representative (5) Ban on direct ECT (6) Ban on ECT in minors (7) Ban on psychosurgery (8) Decriminalisation of suicide | Psychiatry | AIIMS 2018 |
39b3ec62-cf74-489a-b61c-8615b27e3e48 | Which of the following is not a behavioral theory: | Cognitive theory. | Hierarchy of needs. | Social learning. | Classical conditioning. | 0a
| single | null | Dental | null |
1b85e9fd-770f-4114-8336-515675db46c9 | If there is absence of precursor cell of an organ with the subsequent non development of the organ, what is the condition is called as? | Agenesis | Aplasia | Atresia | Atrophy | 0a
| multi | Aplasia: - Failure of organ to develop with only rudiment of organ present. It occurs, when precursor cells are there but they do not differentiate into the organ.
Agenesis: - Complete failure of organ to develop, i.e. e complete absence of the organ, with no rudiment. It occurs when there is not precursor cell of an organ.
Atresia: - Ducts in the body or their openings or any orifice or passage is abnormally closed or absent.
Atrophy: - Shrinkage in the size of an organ by a decrease in cell size and number. | Anatomy | null |
6e74627b-cb5d-44f2-8200-d62bfa69ec85 | A 10-year-old girl presents with a mass in lower abdomen involving umbilical and the hypogastrium. On examination it is cystic and mobile and the examiner is unable to insinuate fingers between the mass and the pelvic bone. What is the likely diagnosis? | Duplication of small intestine | Omental cyst | Ovarian cyst | Mesenteric cyst | 2c
| multi | Ans: C. Ovarian cyst(Ref Shaw 16/e p83, 448, 15/e p79, 385)* Accoording to examination, swelling is typically arising from pelvis & hand cannot be insinuated between mass & pelvic bone.* Best option is only ovarian cyst arises from pelvis.* Swellings arising from pelvis - Identified by abdominal palpation. - Sensitive ulnar border of left hand - Used from above downwards to palpate swellings arising from pelvis. - Upper & lateral margins felt. - Lower border unreached, i.e. the hand cannot be insinuated between mass & pelvis. | Gynaecology & Obstetrics | null |
5a6d126f-f4cd-4cf2-b58d-6390a88f80f1 | Most commonly missing primary teeth are: | Maxillary central incisors | Mandibular central incisors | Maxillary lateral incisors | Maxillary canines | 3d
| single | Developmental agenesis of primary teeth is relatively rare. When several primary teeth fail to develop, other ectodermal deficiencies are usually evident. Most commonly missing primary teeth are maxillary canines.
Reference: McDONALD AND AVERY’S DENTISTRY for the CHILD and ADOLESCENT, 10th ed page no 64 | Dental | null |
713b94cf-fc1e-4c32-b28e-f187cf86562d | IOTN is not used for which malocclusion? | Open bite | CLP | Bimaxillary protrusion | Crowding | 2c
| single | Index of Orthognathic Functional Treatment Need
This index applies to those malocclusions that are not amenable to orthodontic treatment alone, due to skeletal deformity, and will ordinarily apply to those patients who will have completed facial growth prior to surgery (commonly 18 years of age and older) It relates only to the functional need for treatment and should be used in combination with appropriate psychological and other clinical indicators. | Dental | null |
4f2d9080-e4cc-48f7-a4d1-b06e0a207a76 | A girl comes with symptoms of involuntary movements. Sydenham's chorea and acute rheumatic fever is suspected. Other major criteria of rheumatic fever (ahritis, skin rashes, subcutaneous nodules and carditis) were absent. No evidence of sore throat. Best investigation to prove rheumatic etiology is: | Antistreptolysin S | Antistreptolysin O | Throat culture | PCR for M protein | 1b
| single | Ans: B. Antistreptolysin OAntistreptolysin O(ASLO):Marker for recent streptococcal infection.Best investigation to prove rheumatic etiology. Suppoing evidence:Preceding streptococcal infection within last 45 days.Elevated or rising anti-streptolysin O/other streptococcal antibodies.A positive throat culture.Rapid antigens test for group A streptococcus.Recent scarlet fever."Revised Jones" criteria do not include recent scarlet fever as suppoing evidence of recent streptococcal. | Medicine | null |
a3cbc052-9644-4a98-85de-c4f18d88b9c7 | Klenow fragment is formed by loss of fragment having which activity: | 5'- 3' polymerase | 3'- 5' exonuclease | 5'- 3' exonuclease | 3'- 5' polymerase | 2c
| single | Klenow fragment Large fragment produced by Subtilisin mediated proteolytic cleavage of E.Coli DNA polymerase I. Proteolysis removes the 5' -->3' exonuclease activity from N-terminal. Klenow fragment - Functions : Remove 3' overhang Fills 5' overhangs Synthesis of double-stranded DNA from single-stranded templates Preparation of radioactive DNA probes Was used in PCR | Biochemistry | AIIMS 2018 |
c0bb2d77-4a90-410c-a7c3-2398f59e3b81 | A 45 years old female presented with a history of pain!less breast lump of size 6 x 5 cm in left upper quadrant with no axillary lymph nodes. A true-cut biopsy was suggestive of ductal carcinoma in situ. She undergoes surgery with resection of all tumor tissue with adequate margins and postoperative HPE showing DCIS with high grade necrosis with 4 mm clearance on margins. Which of the following is needed? | Adjuvant chemotherapy | Adjuvant chemoradiotherapy | Adjuvant radiotherapy | No additional treatment | 2c
| multi | Answer- C. Adjuvant radiotherapyIn this case, patient is 45 years old (Score 2) with size 5 cm (Score 3), margin of 4 mm (Score 2), necrotic features withouthigh grade (Score 2), the total score is 9. Usually for score 7-9, if local excision is done radiotherapy should be given,If simple mastectomy is done, there is no need of adjuvant trcatment In this patient next best step would be adjuvant radiotherapy.DCIS is predominantly seen in the female breast (accounts for 5% of male breast cancers)DCIS carries a high risk for progression to an invasive cancer.DCIS is classified on the basis of nuclear grade & presence of necrosis | Surgery | null |
974aa4db-e3d2-49eb-900b-12664edeec0b | A 4-year-old child has a normal complement of primary teeth, but they are grey and exhibit extensive occlusal and incisal wear. Radiographic examination indicates extensive deposits of secondary dentin in these teeth. Most likely this condition is: | Neonatal hypoplasia | Amelogenesis imperfecta | Cleidocranial dysplasia | Dentinogenesis imperfecta | 3d
| single | null | Pathology | null |
a8683027-bf0c-459a-99d6-7b4676278072 | A healthy volunteer was taken for a blood experiment. A history was taken from the volunteer before the experiment regarding exposure of NSAlDs, which he specifically denied. But on testing, the BT was found to be increased All of the following can be causative agent except: | Theophylline | Cephalosporin | Anti-depressants | Multivitamins containing Vitamin K | 3d
| multi | Ans: D. Multivitamins containing Vitamin K(Ref. Goodman Gilman 12/e p1043, 1499; Katzung 13/e p1145)Routine use of multivitamins with Vitamin K doesn't cause thrombocytopenia.Vitamin K:Used as Warfarin antidote (anticoagulant) excess.Drug-induced immune thrombocytopenia (DITP):In acute thrombocytopenia patients.Most Common Causes of DITPAntiplateletAbciximab, Eptifibatide, TirofibanAnalgesicsAcetaminophen, Ibuprofen, NaproxenAntibioticAmpicillin, Piperacillin, Ethambutol, CephalosporinsDrugs acting on CNSCarbamazepine, Haloperidol, Phenytoin, AntidepressantsAnti-CancerIrinotecan, Oxaliplatin (selective thrombocytopenia apa from pancytopenia) | Pharmacology | null |
b55cdaad-1107-4491-b7dc-64a2a939838b | Steroids do not have a role in management of which of these tumors? | Kaposi sarcoma | Chronic lymphoid leukemia | Hodgkin's lymphoma | Multiple myeloma Gram-stain, oropharynx | 0a
| single | Ans: A. Kaposi sarcoma(Ref Harrison 19/e p1270, 716; Goodman Gilman I2/e p1755; Katzung 13/e p954-955, 12/e p706: KDT 7/e p284-285, 6/e p285)Steroids - Therapeutic uses in cancer:Used as cytotoxic agents in treatment of acute leukemia in children & malignant lymphoma in children & adults.Component of curative regimens for Hodgkin's & non-Hodgkin's lymphoma, multiple myeloma & CLL.Glucocoicoids - Extremely helpful in controlling autoimmune hemolytic anemia & thrombocytopenia associated with CLL.Dexamethasone - Used in conjunction with radiotherapy - Reduces edema related to tumors in critical areas such as superior mediastinum, brain & spinal cords. | Pharmacology | null |
7c4a40cb-8e92-43fb-9404-8888ff65ad3b | A 12 year old child complains of recurrent pain over right maxillary posterior tooth but clinically no caries can be found. He also reports of cold and fever spells. What should be advised to the patient? | Extract the primary retained tooth i.e., 54, 55 | Extract the tooth 16, 54, 55 | Refer to physician for the evaluation of maxillary sinus | Do nothing | 2c
| multi | null | Dental | null |
139d03ab-9bd0-4bb7-a076-8b3b2ff2528e | Which of the following is not a cross-linking fixative? | Osmium tetroxide | Glutaraldehyde | Methanol | Formaldehyde | 2c
| single | Chemical fixation This utilizes organic or non-organic solutions to maintain adequate morphological preservation. Chemical fixatives can be considered as members of three major categories: coagulant, cross-linking, and compound. Coagulant fixatives: Both organic and non-organic solutions may coagulate proteins making them insoluble. Cellular architecture in vivo is maintained primarily by lipoproteins and fibrous proteins such as collagen. Coagulating these proteins maintains tissue histomorphology at the light microscope level. Unfounately, because coagulant fixatives result in cytoplasmic flocculation and poor preservation of mitochondria and secretory granules, these fixatives are not useful in ultrastructural analysis. Examples: Ethanol, methanol, acetone, picric acid and trichloroacetic acid Cross-linking fixatives: Several chemicals were selected as fixatives secondary to their potential actions of forming cross-links both within and between proteins and nucleic acids. Examples include formaldehyde, glutaraldehyde and other aldehydes, e.g. chloral hydrate and glyoxal, as well as metal salts, e.g. mercuric and zinc chloride, and other metallic compounds, e.g. osmium tetroxide. useful for electron microscopic examination - Glutraldehyde (best one)/formaldehyde/osmium tetraoxide Compound fixatives: Alcoholic formalin | Pathology | AIIMS 2020 |
928c6efd-d481-4323-83f0-721dae436451 | Cholinomimetic is not used in which of the following? | Bradycardia | Glaucoma | Myasthenia gravis | Post-surgical atony or ileus | 0a
| single | Ans. a. BradycardiaCholinomimetic is used for open-angle glaucoma, cobra bite, and myasthenia gravis but not in bradycardia. Uses of CholinomimeticDiseases of eye Glaucoma and accommodative esotropiaAtropine overdosesGastrointestinal and urinary tract Alzheimer's diseasePostoperative atony, neurogenic bladderCobra bite: Neostigmine and edrophoniumHea: Ceain atrial arrhythmiasNeuromuscular junction: Myasthenia gravis, Curare induced neuromuscular paralysis | Pharmacology | null |
4653fb7a-ddbf-493b-b4ef-92205582a27a | Which of the following tooth is not having 5 cusps? | Mandibular 2nd Molar | Mandibular 1st Molar | Mandibular 3rd Molar | Maxillary 1st Molar | 0a
| single | null | Dental | null |
f128aaa7-d0df-4339-8682-8172862d2da5 | In non immune hydrops which of the following is NOT seen: | Skin oedema | Ascites | Large placenta | Cardiomegaly | 3d
| single | “Hydrops is characterized by excess fluid in two or more body areas such as thorax, abdomen or skin. It is often associated with hydraminos and a hydropic thickened placenta”.
It is characterised by:
Increased skin thickness (> 5 mm) / skin oedema (first sign seen on USG).
Placental enlargement
Pleural effusion
Ascites
The fetus is in Buddha position with a halo around the head. | Gynaecology & Obstetrics | null |
e7c38fa0-1301-44a8-a1b2-825d59afb25a | During implant placement maximum torque should not be above? | 100 N | 50 N | 60 N | 70 N | 3d
| multi | Once the final osteotomy diameter and depth is prepared, a bone tap is used in a low-torque hand (i.e., 30rpm, 70 N-cm) to form the threads within the bone for the implant | Dental | null |
ca59647e-62f5-4b2e-a0fd-e85f05af60c4 | A 27 year primigravida presents with pregnancy induced hypertension with blood pressure of 150/100 mm of Hg at 32 weeks of gestation with no other complications. Subsequently, her blood pressure is controlled on treatment. If there are no complications, the pregnancy should be terminated at: | 40 completed weeks | 37 completed weeks | 35 completed weeks | 34 completed weeks | 1b
| single | The patient in the question has BP = 150/100 mm of Hg i.e. mild hypertension (severe hypertension is when systolic BP is > 160 mm or diastolic BP > 110 mm of Hg) and has no other complications. Her BP is controlled on treatment i.e. she is being managed expectantly.
In such patients pregnancy should be terminated at 37 weeks.
“If Pregnancy is beyond 37 completed weeks termination is to be considered without delay.”
... Dutta Obs. 7/e, p229
Management of Mild Preeclampsia:
Fernando Arias 3/e, p 419
Detailed examination for symptoms indicative of severe preeclampsia should be done daily. | Gynaecology & Obstetrics | null |
57749b9a-2d16-403c-b69f-bcab6b998f88 | Although standarize technique is simple and rapid but not used frequently because: | Inaccurate technique. | Relies on inherent shape of file to give shape of canal. | Accessory canals are not removed efficiently. | All of the above. | 1b
| multi | null | Dental | null |
8af37c2e-e39c-4751-a9c0-71bc9f3c10c1 | Features of cardiac rest pain are all, except | Compressive. | Radiating | Excruciating | None of the above | 3d
| multi | null | Medicine | null |
b1cd5c0a-0f81-40eb-88e6-06d69054daae | Which of the following is not a risk factor for malignancy | DNA aneuploidy | Male gender | Invasive candidiasis | Leukoplakia in non smokers | 1b
| single | null | Pathology | null |
03c0bb07-92b8-4345-9b47-84b1172804ff | A person met with road traffic accident and came to casualty with contusion on anterior chest wall with Pulse rate-90/minute, BP-120/80 mm Hg, respiratory rate-16/minute. Normal hea sounds are heard but breath sounds were decreased on the left side and trachea was deted towards right. Which of the following is the first line management? | Needle thoracostomy | Pericardiocentesis | Chest tube inseion and drainage | Immediate exploratory thoracotomy | 2c
| multi | Answer- C. Chest tube inseion and drainageThis case is a classical description of post RM traumutic pneumothorax of left hemithorax, with decreased breath sound and trachea shifted to the right. Presence of hea sounds indicstes absence of cardiac tamponade. Tension pneumothoro-r is ruled out, as the patient is not having hypotension (BP-120/80 mm Hg). So the first line management is chest tube inseion and drainage. | Surgery | null |
b64edf88-505f-4eed-a95c-0bb506eaddf1 | Office personnel who are at higher risk of NO toxicity, to prevent this, the most sensitive test for nitrous oxide detection is | Laminar flow | Dosimeter | Infrared spectrophotometer | High suction speed | 2c
| single | Periodic (i.e. semi-annual) sampling is done of dental personnel, especially chair-side personnel exposed to nitrous oxide (e.g. with a diffusive sampler, such as a dosimeter or infrared spectrophotometer)
Office personnel who are at higher risk of NO toxicity, to prevent this most sensitive test for nitrous oxide detection is Infrared spectrophotometer.
Reference: Pediatric Dentistry by Nikhil Marwah 3rd ed, page no 250 | Dental | null |
39b9975c-107c-403e-8a63-810e41148a11 | Free way space of less than normal, in complete denture
has the following adverse result: | Mucosal irritation | Irresistible alveolar ridge resorption | Nonspecific ulcerations | None of the above | 1b
| multi | null | Dental | null |
73cbdaba-1321-4765-a9f4-ec0b0dbc9994 | A newborn with eyes closed 6 hrs after birth lustily crying, no chest retraction and movements of all four limbs. Neonatal behavioral response grading – | State 1 | State 3 | State 5 | State 6 | 3d
| multi | Neonatal behavioral assessment scale
Neonatal Behavioural Assessment Scale (NBAS) is used to support parents in the neonatal unit, especially around discharge home. The aim is to increase parents' confidence in understanding their baby.
An infant's reaction are state related. So it is extremely important that observations of state be considered as a starting point from which all other observations are made.
The ideal time to administer the examination is when the infant is asleep and midway between feeding cycles.
Scores
Sleep states
State 1 : Sleep with regular breathing, eyes closed, no spontaneous activity except startles or jerky movements at quite regular intervals.
a State 2 : Sleep with eyes closed; rapid eye movements can often be observed under closed lids; low activity level with random movements and startles.
Awake states
State 3 : Drowsy or semidrowsy; eyes may be open but dull and heavy lidded, or closed, eyelids fluttering; activity level minimal, Movements are usually smooth, although there may be startles. Some infants may also show fuss/cry vocalizations in this state. What distinguishes state 3 from state 5 when both are accompanied by fuss/cry vocalizations is the minimal movement in state 3 and considerable movement in state 5.
State 4 : Alert, eyes open with bright look. Motor activity is minimal; there can be a glazed look that is easily changed into a brighter look with appropriate stimulation.
State 5 : Eyes likely to be open; considerable motor activity, with thrusting movements of the extremities, and even a few spontaneous startles; reactive to external stimulation with increase in startles or motor activity.
State 6 : Crying : characterized by intense, loud, rhythmic, and sustained cry vocalizations that are difficult to break through with stimulation; motor activity is high.
Coming to the question
According to above staging, the newborn in our question comes under state 6 (crying lustily, and moving all 4 limbs).
If you have any confusion, read the following facts on crying (state 6) :-
"it is important to distinguish between crying as a state (stage 6) from the fuss/ay vocalization that can occur in state 5 and even state 3. Some infants show repeated episodes of fuss /cry vocalization in state 5 but may not reach state 6. This may also be a maturational issue, because some preterm infants may not have energy reserves to sustain state 6. In general, state 6 Can be distinguished from state 5 by the intensity and sustained quality of the crying (at least 15 seconds) and unavailability of infant in state 6. Repeated brief episodes of cry /fuss in state 5 do not mean that the infant has moved into state 6. Examiners need to give the infant the opportunity to show state 6"
So, crying lustily with all limbs moving (child in question), straight away goes in state 6. | Pediatrics | null |
6bf17841-327f-4f2a-b012-93976b9af6a1 | Burning tongue might not be associated with | Ranula | Diabetes mellitus | Pernicious anaemia | Local irritation | 0a
| single | null | Pathology | null |
a6b3c5be-da0e-428e-97a1-f69189e1e845 | A 7-years child having very deep carious lesions in multiple teeth with no pain what should he the treatment plan: | Indirect pulp capping | pulpotomy of all teeth | RCT of all teeth | Extraction of teeth | 0a
| multi | Indirect pulp treatment is a procedure performed in a tooth with a deep carious lesion approximating the pulp but without signs or symptoms of pulp degeneration.
The caries surrounding the pulp is left in place to avoid pulp exposure and is covered with a biocompatible material. Indirect pulp capping has been shown to have a higher success rate than pulpotomy in long term studies.
It also allows for a normal exfoliation time. | Dental | null |
f06f787a-ac63-41ec-b508-2b6d9848264d | Which of the following is a negative acute phase reactant? | Ferritin | Haptoglobin | Albumin | C-reactive protein | 2c
| single | Answer- C. AlbuminAlbumin is a negative acute phase reactant whereas ferritin, CRP and haptoglobin are positive phase reactants."The serum levels of most proteins either increase or decrease during the acute phase response. Serum proteins that decrease levels during inflammation are called negative acute phase reactants.C-reactive protein, fibrinogen, protein S, and fibronectin are examples of positive acute phase reactants.Positive Acute Phase ReactantsC-reactive protein (CRP)Serum amyloid AHaptoglobinCeruloplasminalpha 2-Macroglobulinalpha l-Acid glycoproteinFibrinogenComplement (C3, C4) | Pathology | null |
96c67a06-4ef0-4473-8d1c-6c31fd617a5e | Which of the following will lead to spread of communicable disease during disaster, except | Diarrhoea | Acute Respiratory infection | Measles | Malnutrition | 3d
| multi | null | Dental | null |
b7899c5a-8bd2-4a87-8082-0ad7980f3886 | Comprehensive emergency obstetric care does not include: | Manual removal of placenta | Hysterectomy | Blood transfusion | Cesarean section | 1b
| single | Setting standards of emergency obstetrics and newborn care:
Basic emergency obstetric and newborn care provided in health centres, large or small include the facilities for:
Administration of antibiotics, oxytocics and anticonvulsants.
Manual removal of the placenta.
Removal of retained products following miscarriage or abortion.
Assisted vaginal delivery preferably with vacuum extractor.
Comprehensive emergency obstetric and newborn care, typically delivered in district hospital, includes all basic functions above, plus cesarean section, safe blood transfusion and care to sick and low birth weight newborns including resuscitation.
It is recommended that for every 5,00,000 people there should be 4 facilities offering comprehensive essential obstetric care. | Gynaecology & Obstetrics | null |
34d4d029-e35a-4f34-832a-6129654cd239 | A person is HBsAg positive, but Anti- HBc Ab is negative. What should he the next step? | Repeat test after 6 months | Check HBV DNA load | Check HBeAg, if positive sta interferon | Reassure patient that he does not have any disease | 1b
| multi | Ans: B. Check HBV DNA load(Ref Harrison 19/e p2032, 18/e p2551)Chronic Hepatitis B - Parameters:HBsAg positive; Anti- HBc Ab negative.Presence or absence of serum hepatitis Be antigen (HBeAg).HBeAg-reactive & HbeAg negative.HBV DNA level correlate with liver injury level & has progression risk.Treatment pre-requisites:HBV-DNA load should be done before initiating treatment. | Medicine | null |
ad0f4284-cf88-4196-89d4-75c75cdae0f9 | Not a part of ethmoid bone is | Inferior turbinate | Agar nasi cells | Uncinate process | Crista galli | 0a
| multi | The ethmoid bone is cuboidal in overall shape and contains the ethmoidal cells (ethmoidal sinuses). It is composed of
Two rectangular box-shaped ethmoidal labyrinths, one on each side.
They are united superiorly across the midline by a perforated sheet of bone - the cribriform plate.
The perpendicular plate - A second sheet of bone descends vertically in the median sagittal plane from the cribriform plate to form part of the nasal septum.
Ethmoidal labyrinth:
Each ethmoidal labyrinth is composed of two delicate sheets of bone, which sandwich between them the ethmoidal cells.
■ The lateral sheet of bone (the orbital plate) is flat and forms part of the medial wall of the orbit.
■ The medial sheet of bone forms the upper part of the lateral wall of the nasal cavity and is characterized by two processes and a swelling—
The two processes are curved shelves of bone (the superior and middle conchae), which project across the nasal cavity and curve downward ending in free medial margins, while inferior to the origin of the middle concha, the middle ethmoidal cells form a prominent bulge (the ethmoidal bulla), on the medial wall of the labyrinth.
Agger nasi - runs forward and downwards from upper end of anterior border of middle concha.
TO NOTE: Inferior concha/ inferior nasal turbinate is an independant bone, not a projection of ethmoidal labyrinth.
Ethmoidal infundibulum:- Extending anterosuperiorly from just under the bulla is a groove (the ethmoidal infundibulum), which continues upward, and narrows to form a channel that penetrates the ethmoidal labyrinth and opens into the frontal sinus. This channel is for the frontonasal duct, which drains the frontal sinus.
Uncinate process:- A delicate irregularly shaped projection (the uncinate process) on the anterior aspect of the inferior surface of the ethmoidal labyrinth.
Cribriform plate:
The cribriform plate is at the apex of the nasal cavities and fills the ethmoidal notch in the frontal bone and separates the nasal cavities below from the cranial cavity above.
Small perforations in the bone allow the fibers of the olfactory nerve to pass between the two regions.
A large triangular process (the crista galli) at the midline on the superior surface of the cribriform plate anchors a fold (falx cerebri) of dura mater in the cranial cavity.
Perpendicular plate of ethmoid:
The perpendicular plate of the ethmoid bone is quadrangular in shape, descends in the midline from the cribriform plate, and forms the upper part of the median nasal septum. | Anatomy | null |
ca4a3fbe-1441-4f97-84d8-568aa04c4fa8 | In which of the inheritance, if father is affected no offspring is affected, but if mother affected, all offspring affected? | Mitochondrial | X linked recessive | Autosomal dominant | Autosomal recessive | 0a
| multi | Mitochondrial Inheritence Mitochondria is derived only from mother Mitochondrial disease has high incidence as : - Mitochondrial DNA repair cannot occur - Introns are not present - Continuous exposure to the oxygen free radicals Therefore have more chances of mutations in mitochondrial DNA Mitochondrial Inheritence Affected mother will transmit disease to all offsprings X linked disease No male to male transmission Y linked disease Affected father will transmit disease to all son Autosomal disease Equal frequency of these disease in male and female | Biochemistry | AIIMS 2019 |
7cacd6ea-ee7d-481d-bc66-467c47dc315c | DPT Vaccine is not contraindicated in? | Progressive neurological disorder | Severely immunocompromised patient | High allergic response to 1st dose | Severe convulsions in a patient | 1b
| multi | null | Microbiology | null |
027df73a-b277-4ad7-aba2-824c58fc78e1 | According to WHO guidelines for excess sugar control by all except | Fiscal policies | Chair side council | Marketing | Food Labelling | 1b
| multi | null | Dental | null |
21b1c2e4-dd6c-49c6-b432-ca5633eca31d | Unconjugated bilirubin is increased in all, except – | Criggler Najjar syndrome | Dubin Johnson syndrome | Gilbert syndrome | Hemolytic anaemia | 1b
| multi | Dubin Jhonson syndrome is a cause of congenital conjugated hyperbilirubinemia.
Congenital conjugated hyperbilirubinemia
1)Dubin Jhonson syndrome
DJS is a type of congenital conjugated hyperbilirubinemia.
It is autosomal recessive.
Conjugated bilirubin is increased because of defective biliary excretion of bilirubin glucuronides due to mutation in canalicular multidrug resistance protein 2 (MRP 2).
Liver function tests are normal
A cardinal feature of DJS is the accumulation in the lysosome of centrilobular hepatocytes of dark, coarsely granular pigment. As a result, the liver is black in appearance. This pigment is thought to be derived from epinephrine metabolites that are not excreted normally.
There is increased urinary excretion of coproporphyrine I (normal coproporphyrine III is more excreted), but total coproporphyrine level is normal.
Gall bladder is not visualized on oral cholecystography.
After iv administration, there is reflux of conjugated sulfobromophthalein (Bromsulphalein, BSP) from liver to circulation.
2)Rotor syndrome
Rotor syndrome is a type of congenital conjugated hyperbilimbinemia.
It is autosomal recessive.
It is due to decreased biliary excretion of conjugated bilirubin and also due to decrease hepatic uptake & storage of bilirubin.
Differentiating features of rotor syndrome (from DJS) -
Liver is not pigment
Coproporphyrine I is increased in urine but total coproporphyrine level is also increased.
Gall bladder is visualized
There is no reflux of conjugated BSP. | Pediatrics | null |
77455482-e309-477c-a662-c2d26da66b19 | Which of these is not a cofactor for glycogen phosphorylase, an impoant enzyme of the glycogenolysis pathway? | Calmodulin | c-AMP | Protein Kinase A | Glycogenin | 3d
| single | Ans: D. Glycogenin(Ref Harper 30/c p 181)Glycogenin:An enzyme involved in glucose conversion to glycogen.Acts as a primer - By polymerizing first few glucose molecules a enzymes take over.Involved in glycogen synthesis pathway rather than glycogenolysis. | Biochemistry | null |
1cf99105-7487-4c44-8c8b-8f8caa90225c | Which of the following drug is not used for medical management of ectopic pregnancy: | Potassium Chloride | Methotrexate | Actinomycin D | Misoprostol | 3d
| single | A number of chemotherapeutic drugs have been used either systemically or directly (surgically administered medical management - SAM under sonographic or laparoscopic guidance) for the medical management of ectopic pregnancy.
Drugs commonly used for medical management: | Gynaecology & Obstetrics | null |
893ad532-01e8-421e-ac71-d5e8dfb882e5 | Which is not a feature of wilson\'s disease in a child – | Fanconi syndrome | Sensory changes | Hemolytic anemia | Chronic active hepatitis | 1b
| single | Clinical features of wilson disease in children
Acute or chronic liver disease o KF ring
Psychiatric disturbances o Hemolytic anemia
Neurological --> Rigidity, tremer, Parkinsonism, cerebellar ataxia. o Fanconi syndrome | Pediatrics | null |
376472be-1031-446f-abbd-f35a14669d7f | 8 year-old child had fractured his maxillary central incisor
10-months ago. The pulp shows no response. There is no periapical lesion in the radiograph. The treatment of choice is: | Ca(OH)2 pulp capping | Formocresol pulpotomy | Conventional root canal treatment | Complete debridement and apexification | 3d
| single | Apexification
Definition
“Apexification is defined as chemically induced root formation by calcium hydroxide or CMCP in nonvital immature, blunderbuss canals of young permanent teeth.”
APEXIFICATION
It is a method of inducing apical closure by formation of mineralized tissue in the apical region of a nonvital permanent tooth with an incompletely formed root apex.
It is defined as a method to induce development of the root apex of an immature pulpless tooth by formation of osteocementum/bone-like tissue (Cohen).
Apexification is a method of inducing apical closure through the formation of mineralized tissue in the apical pulp region of a nonvital tooth with an incompletely formed root and an open apex (Morse et al. 1990). | Dental | null |
dfe219a6-198c-476c-9d38-195856bc9b00 | A traumatized tooth nonvital with or without crown
fracture is classified as | Class-III | Class-IV | Class -V | Class-VII | 1b
| single | null | Dental | null |
cf0999e9-859a-493a-9746-bd5bbdc4f664 | Injection of Glucagon is effective for management of persistent hypoglycemia in all EXCEPT – | Large for date baby | Galactosemia | Infant of diabetic mother | Nesidioblastosis | 1b
| multi | Hypoglycemia in hyperinsulinmic state require IM glucagon as treatment.
Glucagon increases glucose level in blood by Glycogenolysis and Gluconeogenesis.
But in galactosemia - Liver is the first organ to be affected, so glucagon will unable to increase glucose as glycogenolysis and gluconeogensis can not occur ion already damaged liver.
Nesidioblastosis :
It is persistent hyperinsulinemic hypoglycemia occurs due to 0 - cell hypertrophy in infant of diabetic mother due to continuous maternal hyperglycemia.
Glucagon is effective in controlling such a hypoglycemic condition. | Pediatrics | null |
a1a5bb6c-c9f8-4c6f-874c-8be9255e7314 | Not true about vibrio cholera is | Increase water and sodium loss by debilitating diarrhoea | Toxic protein is cholera toxin | Activate adenylatecyclase | Gram positive rod | 3d
| multi | null | Microbiology | null |
ca2561d2-80a5-439b-949c-98d7c9dfb448 | What is NOT a major criteria for Rheumatic heart disease – | Arthritis | Carditis | Subcutaneous nodule | Raised ASLO titer | 3d
| single | null | Pediatrics | null |
af165621-880c-4bde-9256-f9283df3344e | Which of the following is not used as an antiflux? | Graphite | Boric acid | Iron oxide | Calcium carbonate with alcohol | 1b
| single | The flow of the flux and hence the solder can be limited by the use of an antiflux, which should be applied to the surface before the flux is applied.
Zinc oxides in alcohol, rouge (iron oxide) in chloroform, whiting (calcium carbonate) in alcohol and graphite suspension are the commonly used antifluxes.
Key comment :
The boric acid/borax acts as flux. | Dental | null |
dc8d9432-3981-45b5-b559-6cfaccb013f4 | Which of the following does not occur in High Copper Amalgam? | Electrochemical Corrosion | Chemical Corrosion | Penetrating Corrosion | Corrosion does not occur at all | 2c
| multi | null | Dental | null |
4391391c-04bb-4ca1-abba-9f4b3a6c2a81 | A 76 - year - old female presented with non - healing ulcer on labia majora for 6 months measuring 2 x 3 cm with no palpable lymphadenopathy. Biopsy shows Squamous cell carcinoma. Management of this patient includes? | Radical vulvectomy with sentinal LN biopsy | Wide excision | Simple vulvectomy | Chemoradiation with resection | 0a
| single | Non- Healing Ulcer, 2x3 cm, no palpable lymphadenopathy concludes to stage Ib of Ca Vulva. Staging of Ca vulva Stage I Limited to vulva IA IB Size - < 2 cm, Invasion - < 1 mm Size - < 2 cm, Invasion - > 1 mm Stage II Adiacent organ femoral LN involvement Lower 1/3rdvagina Lower 1/3rdof urethra, anus Stage III Inguinal femoral LN involvement IIIAi Aii One LN - > 5mm One or Two LN - < 5m IIIBi Bii Two LN - > 5mm More than 3 LN - < 5mm III C LN involvement ?, with extra capsular spread Stage IV IV Ai Aii Upper urethra, upper vagina, rectal involvement Growth stuck to pelvic bone Fixed or ulcerated LN IV B Distant metastasis Pelvic LN Treatment: Stage IA- Wide excision Stage I & II- Radical vulvectomy with sentinal LN biopsy If negative- Radical vulvectomy alone If positive- Radical vulvectomy + LN removal Stage III & IV- Chemoradiation with resection | Gynaecology & Obstetrics | AIIMS 2018 |
189b5073-7b54-4050-a030-0a519558f18e | Mass Drug Administration is helpful is used/effective for all except | Lymphatic Filariasis | Vit A Deficiency | Worm Infestation | Scabies | 3d
| multi | Answer. D. Scabies * Mass chemoprophylaxis, i.e, chemoprophylaxis given to a large number of people, is recommended in yaws, pinta, bejel, trachoma,Vit A Deficiency, Worm Infestation, malaria and filaria. | Social & Preventive Medicine | null |
f681a332-bcb8-4fdf-98da-ca4e560f00d2 | A researcher wants to (to a study of blood levels of lipids among people who smoke and those who do not. But he is now concerned that the smokers might differ from non-smokers in their diet, exercise, etc as well. This concern is known as: | Recall bias | Information bias | Selection bias | Interviewer bias | 2c
| multi | Ans: C. Selection bias(Ref Park 24/e p78, 88, 23/e p73, 22/e p71; en.wikipedia.org/wiki/Bias_(statistics); http://sphweb. hume.hu.echdollt/mph-modules)Selection bias:Groups to be compared are differentially susceptible to outcome of interest, even before experimental maneuver is performed.Also referred as "Susceptibility bias".In the given question, researcher is concerned that the smokers might differ from non-smokers in their diet, exercise, etc.Hence, this concern is known as selection bias. | Social & Preventive Medicine | null |
99f0588d-fd2b-405a-ac4e-5615d0533fff | Patient underwent surgery at the lateral pa of the skull. Postoperatively patient had aspirations without voice change | Vagus | RLN | Glossopharyngeal | SLN | 3d
| single | Ans. D (Superior Laryngeal nerve)* Vagus, RLN involvement leads to hoarseness of the voice* SLN divide into internal and external laryngeal* External laryngeal nerve supplies only one muscle- cricothyroid - tensor* Internal laryngeal nerve- safety nerve of larynx- prevents aspiration and supplies supraglottic pa of larynx. | ENT | null |
8c5c9f90-f367-4a1c-84d2-50a39833588d | A man has 1x1.5cm pedunculated lesion on the soft palate which has a rough, "warty" surface but is the same colour as adjacent mucosa. Appropriate management of this lesion is to: | Perform an incisional biopsy | Perform excisional biopsy | Scrape for exfoliative cytology | Observe for two weeks | 1b
| single | null | Surgery | null |
ce105c22-1b50-4921-8dc6-da85a4000133 | Hypertonic salt solutions are used in all, except | Burn | Brain injury patient | Prolonged bowel surgery | Cardiac type IV shock | 3d
| multi | null | Surgery | null |
9323af0c-ce73-4fcd-9646-88c87ea5d0f7 | 20-year-old female had abdominal pain previous week, USG and clinically normal. Again she presented with loss of vision, examination is normal. Diagnosis is:AIIMS 13 | Malingering | Masochist | Hypochondriac | Anxiety disorder | 0a
| multi | Ans. MalingeringMalingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of 'secondarygain' motives, which may include financial compensation (often tied to fraud); avoiding school, work or military service;obtaining drugs; getting lighter criminal sentences; or simply to attract attention or sympathy. | Forensic Medicine | null |