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Hypotension in acute spinal injury is due to:

• High spinal cord injuries can also result in systemic hypotension because of loss of sympathetic tone. • The patient will usually have hypotension and relative bradycardia and will show evidence of good peripheral perfusion on physical examination. • The term neurogenic shock is used but is somewhat of a misnomer because these patients are typically hyperdynamic, with high cardiac output secondary to loss of sympathetic vascular tone. Treatment • Hypotension associated with high spinal injury can be treated by alpha-agonist phenylephrine.

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What overlies the lateral wall of the mastoid antrum?

BOUNDARIES: SUPERIORLY-Tegmen tympani and beyond it the temporal lobe of the cerebrum INFERIORLY-Mastoid process containing the mastoid air cells ANTERIORLY-It communicates with the epitympanic recess through the aditus. The aditus is related medially to the ampullae of the superior and lateral semicircular canals. and posterosuperiorly to the facial canal POSTERIORLY-It is separated by a thin plate of bone from the sigmoid sinus. Beyond the sinus, there is the cerebellum MEDIALLY-Petrous temporal bone LATERALLY-It is bounded by pa of the squamous temporal bone. This pa corresponds to the suprameatal triangle seen on the surface of the bone. Ref:BDC VOLUME 3,sixth edition pg 281

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Ferruginous bodies are seen in?

Ans. is 'c' i.e., Asbestosis "Ferruginous bodies are most commonly seen in asbestosis". ------------Chandrasoma Taylor* Ferruginous bodies represent foreign inorganic or organic fibers coated by complexes of iron and glycoproteins.* While ferruginous bodies are most commonly seen in asbestosis they are not diagnostic because it may be seen in other type of pneunoconiosis.* When asbestos fiber is coated by iron and glycoprotein, this ferruginous body is called asbestos body-characteristic of asbestosis.* Ferruginous bodies are best seen in section that have stained for iron with prussion blue.* Microscopically ferruginous bodies give a Sheikh Kebab appearance.

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Which type of cattle poisoning occurs due to ingestion of LINSEED plant?

Hydrocyanic acid is also used as cattle poison. Cattle poisoning has been known to occur from eating linseed plant because of the natural development of a cyanogenic glycoside which may liberate hydrocyanic acid. Ref: Essentials of Forensic Medicine and Toxicology By Dr K S Narayan Reddy, 27th Edition, Pages 559-60

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A 40 year old female patient complains of excessive bleeding and drowsiness. Patient gives a history of road traffic accident 5 hours ago and had a lacerated wound on lower back region. General physical examination reveals- Blood pressure-80/60mmHg. Juglar venous pressure- low. Pulsus paradoxus- present. Cardiac output- Increased. The patient is in which type of shock?

Includes anaphylactic shock, septic shock and spinal cord injury (neurogenic shock). Inadequate organ perfusion is associated with vascular dilatation and hypotension, low systemic vascular resistance, inadequate afterload and a resulting abnormally high cardiac output. In anaphylaxis, vasodilatation is due to excess histamine release. Neurogenic shock is caused by traumatic or pharmacological blockage of the sympathetic nervous system, producing dilatation of resistance arterioles and capacitance veins, leading to relative hypovolemia and hypotension. In neurogenic shock, because of loss of vascular tone, JVP will fall.

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Which of the following induction agent produce cardiac stability-

Ans. is 'b' i.e., Etomidate Effects of Etomidate on cardiovascular systemEtomidate has minimal effects on the cardiovascular system.It causes mild reduction in peripheral vascular resistance which may cause a slight decline in arterial blood pressure.Myocardial contractility and cardiac output are usually unchanged. Etomidate does not release histamine. Cardiovascular effect of Propofol:The major cardiovascular effect of propofol is a decrease in arterial blood pressure due to a drop in systemic vascular resistance (inhibition of sympathetic vasoconstrictor activity, cardiac contractility and preload).Propofol markedly impairs the normal arterial baroreflex response to hypotension. Sometimes there may be a marked drop in preload.Cardiovascular effect of barbiturates (Thiopental)The cardiovascular effect of barbiturates vary markedly depending on the volume status, bas line autonomic tone and preexisting cardiovascular disease.Normally, intravenously administered barbiturates cause a fall in blood pressure.Cardiac output is maintained due to increase in heart rate and increased myocardial contractility from compensatory baroreceptor reflexes.However, in the absence of adequate baroreceptor response (e.g., hypovolemia, congestive heart failure, b adrenergic blockade) cardiac output and arterial blood pressure may fall dramatically due to uncompensated pooling and unmasked direct myocardial depression.Effect of ketamine on cardiovascular systemKetamine causes central stimulation of sympathetic system which causes increased arterial blood pressure, heart rate and cardiac output. There is also increase in pulmonary artery pressure and myocardial work.Because of these effects, ketamine should be avoided in patients with coronary artery disease, uncontrolled hypertension, congestive heart failure and arterial aneurysms.

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Which of the following statement regarding Septic tank is true ?

SEPTIC TANK It is water-tight masonry tank into which household sewage is admitted for treatment. It is satisfactory means of disposing excreta & liquid wastes from individual dwellings, small groups of houses & institutions which have adequate water supplies but do not have access to a public sewerage system. Main design features of septic tank are: - Capacity : Depends on number of users. A capacity of 20-30 gallons or 2 and half to 5 c.ft. / person is recommended for household septic tanks. Minimum capacity of a septic tank= at least 500 gallons. - Length is usually twice the breadth. - Depth = 1.5 to 2 m (5-7 ft.). - Recommended liquid depth = 1.2 m (4 ft.). - There should be a minimum air space of 30 cm (12 in.) b/w level of liquid in tank & undersurface of cover. - There are submerged inlet & outlet pipes. - In some septic tanks, bottom is sloping towards inlet end, facilitating retention of solids as sludge. - Septic tank is covered by a concrete slab of suitable thickness & provided with manhole. - These are designed in this country to allow a retention period of 24 hours. Too long retention period will result in undue septicity of effluent. Too sho period gives insufficient treatment. - Sewage is purified by anaerobic digestion in tank f/b aerobic oxidation outside the tank. - De-sludging should be done atleast once/ year.

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Following are adverse effects of Clofazimine except

Clofazimine is a brick red, fat-soluble crystalline dye. It has weakly bactericidal action against M. leprae It has an anti-inflammatory effect, which is useful in the management of ENL reactions. High drug concentrations are found in the intestinal mucosa, mesenteric lymph nodes and body fat. The most noticeable side effect is skin discoloration, ranging from red to purple-black The degree of discoloration depending on the dose and amount of leprous infiltration. Urine, sputum and sweat may become pink. Clofazimine also produces a characteristic ichthyosis on the shins and forearms. Gastrointestinal side effects, ranging from mild cramps to diarrhoea and weight loss, may occur as a result of clofazimine crystal deposition in the wall of the small bowel.

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Osteoblastic secondaries arises from: March 2003

Ans. D i.e. Prostate carcinoma Metastases to bones are usually osteolytic. Osteoblastic lesions are uncommon.

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A 52 year old male presents to his physician with a chief complaint of a substantial increase in the size of his breasts over the past few months. Three months ago he was diagnosed with hypeension, and placed on antihypeensive medication. Which of the following medications was most likely prescribed?

All of the medications listed as answer choices can be effectively used in the treatment of hypeension. Spironolactone is a "potassium-sparing" diuretic that exes its action primarily as a competitive inhibitor of aldosterone receptors in the distal nephron. One of the repoed side effects of spironolactone is gynecomastia. None of the other choices have gynecomastia as a side effect. Captopril is an angiotensin-conveing enzyme (ACE) inhibitor that causes a decrease in plasma angiotensin II concentration, resulting in decreased aldosterone secretion. Furosemide is a "loop diuretic" that acts by inhibiting the reabsorption of sodium and chloride ions in the loop of Henle as well as in the proximal and distal renal tubules. Hydrochlorothiazide is a "thiazide diuretic" that inhibits the reabsorption of sodium and chloride ions in the distal renal tubules. Ref: Snyder P.J. (2011). Chapter 41. Androgens. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.

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True about treatment of nocturnal enuresis

A i.e. Imipramine

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50 year old male with positive family history of prostate cancer has come to you for a screening test. The screening test done to pickup prostate cancer is

Prostate-specific antigen (PSA) and Digital rectal examination (DRE) Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years. Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65). Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

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Refsum's syndrome is associated with ?

Ans. is 'a' i.e., Retinitis pigmentosa Associations of retinitis pigmentosa Ocular associations : These include myopia, primary open angle glaucoma, microphthalmos, conical cornea and posterior subcapsular cataract. Systemic associations : These are in the form of following syndromes :- i) Laurence-Moon-Biedl syndrome : It is characterised by retinitis pigmentosa, obesity, hypogenitalism, polydactyly and mental deficiency. ii) Cockayne's syndrome : It comprises retinitis pigmentosa, progressive infantile deafness, dwarfism, mental retardation, nystagmus and ataxia. iii) Refsum's syndrome : It is characterized by retinitis pigmentosa, peripheral neuropathy and cerebellar ataxia. iv) Usher's syndrome : It includes retinitis pigmentosa and labyrinthine deafness. v) Hallgren's syndrome : It comprises retinitis pigmentosa, vestibulo-cerebellar ataxia, congenital deafness and mental deficiency.

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All are synonyms for PM staining seen in dependant pas of the body during postmoem, except: PGI 13

Ans. Algor mois

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All viruses can be cultured in

Viruses can be cultivated in living systems only.

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Bone marrow finding in myelofibrosis-

Dry tap is usually defined as a "failure to obtain bone marrow on attempted marrow aspiration". The diagnosis and management of many haematological diseases depends on examination of the bone marrow, which involves two separate specimens i.e. a cytologic and a histologic preparation.Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called a trephine biopsy) and bone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, lymphoma, anemia, and pancytopenia. The bone marrow produces the cellular elements of the blood, including platelets, red blood cells and white blood cells. While much information can be gleaned by testing the blood itself (drawn from a vein by phlebotomy), it is sometimes necessary to examine the source of the blood cells in the bone marrow to obtain more information on hematopoiesis; this is the role of bone marrow aspiration and biopsy.

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40 yr old female presented with breast lump of size 4 cm with involvement of skin and mobile palpable axillary LN, FNAC of lesion showed intrductal carcinoma. What is the initial management of for this pt?

.Locally Advanced Carcinoma of Breast (LABC) * It means locally advanced tumour with muscle/chest wall involvement, extensive skin involvement or fixed axillary nodes. It will be T3, T4a, T4b, T4c or T4d or N2 or N3. * It is investigated by FNAC of tumor, mammography of opposite breast, chest CT, CT abdomen or whole body bone scan. Biopsy is needed to assess receptor status. * Treatment of LACB is always palliative by simple mastectomy, toilet mastectomy, chemotherapy and therapy using tamoxifen. * Initial neoadjuvant chemotherapy; surgery; radiotherapy; adjuvant chemotherapy are other therapeutic plan. ref:SRB&;s manual of surgery,ed 3,pg no 491

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Pott's spine is commonest at which spine:

ANSWER: (A) ThoracolumbarREF: Apley 387-389, S M Tuli 3rd edition page 192Most common site of skeletal tuberculosis is spine followed by hip and knee SPINE (50%) > HIP > KNEECommonest spine involved in spine TB is Thoracolumbar/Dorsolumbar T12-L1 (Lower thoracic to be precise)LOWER THORACIC > LUMBAR > UPPER THORACICParaplegia due to pott s spine most commonly involves upper thoracic vertebrae as in upper thoracic vertebrae there is more acute kyphosis, spinal canal is narrow and spinal cord is relatively large.First symptom of TB spine is "Pain on movement"Commonest symptom of TB spine is "Back pain"

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A patient present with lower gastrointestinal bleed. Sigmoidoscopy shows ulcers inthe sigmoid. Biopsy from this area shows flask-shaped ulcers. Which of the following is the most appropriate treatment -

This may be caused by haemorrhage from the colon, anal canal or small bowel. It is useful to distinguish those patients who present with profuse, acute bleeding from those who present with chronic or subacute bleeding of lesser severity .Severe acute lower gastrointestinal bleeding .This presents with profuse red or maroon diarrhoea and with shock. Diveicular disease is the most common cause and is often due to erosion of an aery within the mouth of a diveiculum. Bleeding almost always stops spontaneously, but if it does not, the diseased segment of colon should be resected after confirmation of the site by angiography or colonoscopy. Angiodysplasia is a disease of the elderly, in which vascular malformations develop in the proximal colon. Bleeding can be acute and profuse; it usually stops spontaneously but commonly recurs. Diagnosis is often difficult. Colonoscopy may reveal characteristic vascular spots and, in the acute phase, visceral angiography can show bleeding into the intestinal lumen and an abnormal large, draining vein. In some patients, diagnosis is achieved only by laparotomy with on-table colonoscopy. The treatment of choice is endoscopic thermal ablation but resection of the affected bowel may be required if bleeding continues. Bowel ischaemia due to occlusion of the inferior mesenteric aery can present with abdominal colic and rectal bleeding. It should be considered in patients (paicularly the elderly) who have evidence of generalised atherosclerosis. The diagnosis is made at colonoscopy. Resection is required only in the presence of peritonitis. Meckel's diveiculum with ectopic gastric epithelium may ulcerate and erode into a major aery. The diagnosis should be considered in children or adolescents who present with profuse or recurrent lower gastrointestinal bleeding. A Meckel's 99mTc-peechnetate scan is sometimes positive but the diagnosis is commonly made only by laparotomy, at which time the diveiculum is excised Primary prevention of variceal bleeding If non-bleeding varices are identified at endoscopy, b-adrenoceptor antagonist (b-blocker) therapy with propranolol (80-160 mg/day) or nadolol (40-240 mg/day) is effective in reducing poal venous pressure. Administration of these drugs at doses that reduce the hea rate by 25% has been shown to be effective in the primary prevention of variceal bleeding. In patients with cirrhosis, treatment with propranolol reduces variceal bleeding by 47% (number needed to treat for benefit (NNTB) 10), death from bleeding by 45% (NNTB 25) and overall moality by 22% (NNTB 16). The efficacy of b-blockers in primary prevention is similar to that of prophylactic banding, which may also be considered, paicularly in patients who are unable to tolerate or adhere to b-blocker therapy. Carvedilol, a non-cardioselective vasodilating b-blocker, is also effective and may be better tolerated at doses of 6.25-12.5 mg/day). For these, dose should be titrated, as tolerated, to achieve a hea rate of 50-55 beats/min, if possible.metrandazole can be given sigmoidal ulcer Ref Davidson edition23rd pg 869

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Lalita, a female pt. presents with pigmentation of the lips and oral mucosa and intestinal polyps. Her sister also gives the same history. Most probable diagnosis is -

Ans. is 'd' ie. Peutz-jeghers syndrome Peutz-Jeghers syndorme consists of: hamaomatous polyps throughout the intestine with maximum density in the jejunum* melanosis of the oral mucous membrane and the lips. The melanosis takes the form of melanin spots sometimes presents on the digits and the perianal skin, but the pigmentation of the lips is the sine quanon.

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Tripod fracture is the name given for -

Ans. is 'a1 i.e., Zygomatic fracture o Zygoma fracture is also known as tripoid fracture.Clinical features of zygoma fractureo Considerable swelling over zygomatic arch is common and makes clinical diagnosis more difficult.o Flattening of malar prominence.o Step-deformit of infraorbital margin.o Anaesthesia in the distribution of infraorbital nerve.o Trimus, due to depression of zygoma on the underlying coronoid process.o Oblique palpebral fissure, due to the displacement of lateral palpebral ligament.o Restricted ocular movement, due to entrapment of inferior rectus muscle. It may cause diplopia.o Periorbital emphysema, due to escape of air from the maxillary sinus on nose-blowing.o The mucosa of the maxillary sinus may be lacerated and cause epistaxis on that side.o Fracture of the zygoma may or may not be painful to palpation and running a finger along the zygomatic arch may give a feel of a depressedfracture or a small dimple. The cheek may appear flattened; compared symmetry with the opposite side. This may be obvious immediately following trauma or several days later once swelling has subsided.

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For diagnosis of carcinoma cervix, PAP smear screening is done to

C. i.e. (Prevents progress of the disease) (721- Basic pathology 8th)* PAP smear is highly effective screening tool in the detection of cervical dysplasia and carcinoma and has reduced the incidence of cervical carcinoma* Flow cytometry is used routinely in the classification of leukemias and lymphomas* Pap smear is 90- 95% accurate in detecting early lesions such as CIN but is less sensitive in detecting cancer when frankly invasive cancer or fungating masses are present. Inflammation, necrosis and hemorrhage may produce false- positive smears (608 - Harrisons 17th)* Annual cervical smear in all sexually active women (above the age of 18 years) having any risk factors

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SLE like reaction is caused by

SLE like syndrome is caused due to S-SULPHONAMIDES H-HYDRALAZINE I-ISONIAZIDE P-PROCAINAMIDE Ref-KDT 7/e p66

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The drug of choice in digitalis induced ventricular arrhythmias is:

(IV Lignocaine): Ref: 463-KDT (514-KDT 6th)Treatment of digitalis induced ventricular arrhythmias* Lignocaine IV repeated as required is the drug of choice. It suppresses the excessive automaticity but does not accentuate A V block* Phenytoin is also useful but not preffered now (sudden death occurs)* Quinidine and procainamide are contraindicated.

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Deformity in transient synovitis of Hip ?

Ans. is 'd' i.e., All of the above Transient synovitis of Hip Transient synovitis of hip is also known as observation hip, toxic synovitis or irritable hip. Its a self-limiting, inflammatory condition of the synovium, that lasts only a sho time (therefore known as transient) It is the most common cause of hip pain and limp in children under 10 yrs of age. Cause is not known but association has been seen with a recent history of an upper respiratory tract infection. Presentation is with hip pain or limp. The limb is in attitude of slight flexion, abduction and external rotation. The child may have low grade fever. The ESR, C-Reactive protein & WBCs count are normal (This differentiates Transient synovitis from Septic ahiritis a serious condition, in which patient has high grade fever and elevated ESR, C-Reactive protein and WBC count). Radiograph or ultrasound may show widening of the joint space However, most of the time x-ray is normal. Usually the treatment of a clinically suspected case of transient synovitis of hip is Bed rest, NSAIDS and observation. USG guided aspiration is indicated for :- Temperature > 99.5deg F ESR > 20 (Raised ESR) Severe hip pain with ROM

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Thin filament consists of all except:

Myosin is thick filament. All others  in the options are thin filaments.

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A 1-year-old boy presents with a delay in motor development. Progressive muscle weakness and blindness ensue, and the patient dies within a year. The brain at autopsy shows swollen neurons that contain numerous lysosomes filled with lipid. Which of the following is the most likely diagnosis?

Tay-Sachs disease is a lethal, autosomal recessive disorder caused by an inborn deficiency of hexosaminidase A, which permits the accumulation of ganglioside GM1 in CNS neurons. The disease is fatal in infancy and early childhood. Retinal involvement increases macular transparency and is responsible for a cherry-red spot in the macula. On histologic examination, lipid droplets are seen in the cytoplasm of distended nerve cells of the CNS and peripheral nervous system. Electron microscopy reveals the lipid within lysosomes in the form of whorled "myelin figures." Swollen neurons that exhibit marked vacuolization of the perikaryon and contain lysosomes filled with lipid can also occur in other lipid-storage diseases (e.g., Gaucher disease, Niemann-Pick disease). The other diseases do not produce such neuronal changes.Diagnosis: Tay-Sachs disease

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Most common cause of neonatal meningitis-

Ans. is 'b' i.e., E. coli o E. coli & streptococcus agalactie (group B streptococci) are the two most common cause of neonatal sepsis and meningitis.

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R-factor in bacteria is transferred by

Conjugation Bacterial conjugation is the transfer of genetic material between bacteria through direct cell to cell contact or through a bridge- like the connection between two cells. Conjugation is a process whereby a donor (male) bacterium makes physical contact with a recipient (female) bacterium. Donor status is determined by the presence of plasmid. This plasmid codes for specialized fimbria (sex pilus) and for self-transfer. Sex pilus (conjugation tube) helps in transfer of genetic material from male bacterium to female bacterium. The plasmid is known as transfer factor (sex factor or fertility factor). The plasmid may be R factory which codes for transferrable multiple drug resistance. The DNA of the plasmid replicates during transfer so that each bacterium receives a copy → Recipient becomes a donor and the donor retains its donor status.

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CO2 is primarily transpoed in the aerial blood as

D i.e. Bicarbonate Transpo of CO2 in the form of bicarbonate ions accounts for approximately 70% of transpoed carbon dioxide from the tissues to lungs Q. So CO2 is transpoed as plasma HCO3 - > RBC > HCO3- > Carbamino compound > dissolved CO2 Q &Transpo of Carbon Dioxide Carbon dioxide is transpoed in the blood as: HCO3- (70%) > carbamino compounds (23%) > dissolved CO2 (7%) Chloride Shift/ Hamburger Phenomenon When the negatively charged (HCO3-) bicarbonate ions move out of red blood cell into the plasma, to maintain the electrolytic equilibrium the negatively charged chloride ions move into the Red blood Cells from plasma (In plasma plenty of sodium chloride is present). This process is mediated by band 3 membrane protein Chloride shift occurs in: 1 secondQ Hematocrit of venous blood is: greater (by 3%)than that of aerial bloodQ PH of venous blood (7.36) is lower than that of aerial blood (7.40)Q * For each CO2 molecule added to RBC there is increase in one osmotically active paicle in cell either HCO3- or CI-. So RBC take up water & swell. For this reason plus a fact that some aerial fluid returns lymphatics rather than the veins, the hematocrit of venous blood is 3% greater than aerial bloodQ. Amount of 02 enters the body/min = 250 inVininQ Amount of CO2 excreted by lung/ min = 200 inVininQ (288 L/day)Q * CO2 is 20 times more soluble than 02

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What is the sequence of development of pubey in girls ?

The sequence of SPECIFIC events of Pubeal events in girls is thelarche, pubarche, linear growth spu, menarche. Please note: This is not to confuse with accelarated general physical growth which is the first event in pubey Pubey Specific events in girls Events in boys 1st Thelarche Testicular enlargement 2nd Pubarche Penile enlargement & pubic hairs 3rd Linear Growth,Height, spu Linear Growth spu 4th Menarche Axillary hair and facial hairs In girls, pubeal development typically takes place over 4.5 years. The first sign of pubey is accelerated growth, and breast budding is usually the first recognized pubeal change, followed by the appearance of pubic hair, peakgrowth velocity, and menarche.... Novaks Gyne

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A 70 - year- old man was administered penicilline intravenously. Within 5 minutes, he developed genralised urticaria, swelling of lips, hypotension and bronchospasm. The first choice of treatment is to administer:

Ans. is 'b' i.e. epinephrine injection Urticaria, swelling of lips, hypotension and bronchospasm within 5 minutes of i.v penicillin suggests anaphylactic reaction. It's a major problem with the use of penicillin.The t/t of choice for anaphylaxis is i.v epinephrine.

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Daily water requirement in child weighing 30 kgs, height 123 m and BSA of 1 m2 is-

Ans. is 'b' i.e., 1700 ml Fluid requirment in a child o It depends on the weight of a child :- Weight Water requirments < 10 kg o 100 ml/kg/day 10-20 kg o 100 ml / kg / day for first 10 kg (i.e. 1000 ml) + 50 ml / kg / d for every kg above 10 kg. >20 kg o 100 ml/kg/day for first 10 kg (i.e. 1000 ml) + 50 ml / kg / d for next 10 kg (i.e. 500 ml) + 20 ml / kg / d for every kg above 20 kg. o The child in question has weight of 30 kg. o So, fluid requirment will be :- i) 1000 ml for first 10 kg Plus ii) 500 ml for 10-20 kg Plus iii) 200 ml (20 x 10) for 20-30 kg o Total requirment will be 1700 ml.

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Drug of choice for ADHD is

.

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Double bubble sign is seen in -

Ans. is 'd' i.e., All of the above o Double bubble sign is seen in duodenal atresia, duodenal web, deudenal stenosis, Ladd's band, Annular pancreas, Malrotation of gut, preduodenal vein.Single Bubble signCongenita] hypertrophic pyloric stenosisDouble Bubble signDuodenal atresiaDuodenal webDuodena] stenosisLadd's bandAnnular pancreasMalrotation of gutPreduodenal veinTriple Bubble signJejunal or proximal ileum atresiaMultiple Bubble signIleal atresia

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A 16 year old boy does not attend school because of the fear of being harmed by school mates. He thinks that his classmates laugh at him and talk about him. He is even scared of going out of the market. He is most likely suffering from:

The history is suggestive of delusion of persecution (fear that schoolmates may "harm" him) and delusion of reference (belief that classmates laugh at him and talk about him). Had they not used the term "harm" and "scared" a diagnosis of social anxiety disorder could have been enteained.

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Bad trip is seen with which of the following drugs?

LSD is a type of hallicinogen LSD means lysergic acid diethylamide LSD was introduced and first used by ALBE HOFFMANNBad trip is seen with LSD and cannabis but common with LSD Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg 330-336

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Chromosome involved in Wilm's tumor is

WTl is the best characterized Wilms tumor gene. It is located at chromosome llp13 and encodes for a transcription factor that is critical for normal development of kidneys and gonads. WT2 is localized to a cluster of genes at llpl5. Reference: Essential paediatrics; O.P.Ghai; Childhood Malignancies; Page no: 617

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Groove sign is seen in-

Ans. is 'c' i.e., LGV * 'Groove sign of Greenblatt' is pathognomonic of LGV (secondary stage) - when inguinal lymph nodes are enlarged, they are separated by Poupart's ligment, producing a groove.Lymphogranuloma venerum (lymphogranuloma inguinale)* LGV is caused by chlamydia trachomatis, serotypes LI, L2, L3. Serotype L2 is the most common cause. The clinical course of LGV consist of following three stages : -i) First stage (Primary LGV): - Self limited, Single, asymptomatic, painless, non bleeding genital ulcer.ii) Secondary stage: - Painful inguinal lymphadenopathy (Remember - Ulcer is painless but lymphadenopathy is tender & painful). Swollen lymph nodes coalesce to form bubos, i.e., matted lymph nodes. Buboes may rupture to form discharging sinus.# Groove's sign - Enlarge lymph nodes both above and below inguinal ligament.iii) Tertiary LGV (genitorectal syndrome): - Characterized by proctocolitis.Complications of LGV* Esthiomene - Enlargement, thickening and fibrosis of labia.* Elephantiasis of the genitals* Rectal stricture* Systemic - Arthritis, pneumonitis, Perihepatitis

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Hyperchloremic acidosis is seen in-

The combination of hyperkalemia and hyperchloremic metabolic acidosis is often present, even at earlier stages of CKD (stages 1-3).In patients with diabetic nephropathy or in those with predominant tubulointerstitial disease or obstructive uropathy; this is a non-anion-gap metabolic acidosis.

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A patient with cervix cancer is missed by a screening test and later diagnosed with advanced disease. This time interval is called ?

Ans. is 'a' i.e. Lead time

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The internal pudendal aery arises from which of the following aeries?

The internal iliac aery divides into an anterior and a posterior trunk near the greater sciatic foramen.Branches of ANTERIOR TRUNKUmbilical aeryObturator aeryUterine aeryInferior vesical and vaginal aery (females)Middle rectal aeryInternal pudendal aeryInferior gluteal aeryBranches of POSTERIOR TRUNKIliolumbar aeryLateral sacral aerySuperior gluteal aery

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Increased Ig A levels are seen in

Serum IgA increased in - Alcoholic cirrhosis Serum IgM increased in -Primary biliary cirrhosis (Ref: Clin Exp Immunol.2009 Oct; 158(1): 115-124, Liver.1984 Jun;4(3): 214-8)

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Rituximab is a monoclonal antibody used for treatment of:-

Rituximab is a monoclonal antibody against CD20. It is used for treatment of: Non-Hodgkin lymphoma Chronic lymphoid leukemia Rheumatoid ahritis SLE Auto-immune hemolytic anemia Idiopathic thrombocytopenic purpura

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The least common type of intussusceptions is:

Types of Intussusceptions (in decreasing order) Ileocolic (77%) Ileo-ileo-colic (12%) Ilioileal (5%) Colocolic (2%): MC in adults Multiple (1%) Retrograde (0.2%)

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Most definitive diagnosis of sinusitis is by

Sinuscopy is a method of Endoscopic sinus observation or surgery using Nose telescope. It involves the evaluation of nasal and sinus passages using the endoscope called Sinuscope. The Sinuscope has a narrow tube with a built-in camera so that the physician can see the internal details of the sinuses. By observing the sinus, it is possible to diagnose the problems and treat properly.

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An 18 year old male patient presented to the clinic with pain and swelling in the lower jaw. Intraoral examination revealed localized gingival bleeding in the right posterior region. On palpation, pulsations can be appreciated. Lesions are also appreciated on the frontal bone on a radiograph. Which condition is present in this patient?

Vascular malformation (VM) in bone occurs more frequently than the central hemangioma (CH) of bone. Some 35% of VMs occur in bone, whereas CHs of bone are rare. The CH of bone is a benign tumor that rarely occurs in the jaws; it occurs more frequently in the skull and vertebrae. It may be congenital or traumatic in origin and may be difficult to differentiate from VM. The usual complaint of a patient with a VM or CH is of a slow-growing asymmetry of the jaw or localized gingival bleeding. Numbness and tenderness or pain may also be described. This solitary tumor is found approximately twice as often in female patients, and about 65% occur in the mandible. Some tumors demonstrate pulsation and bruits. Paresthesia is occasionally a feature.

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Most common anterior mediastinal tumor?

Ref: Bailey and Love, 26th edition, P 868Most common anterior mediastinum tumor is thymoma. Choice B is seen in posterior mediastinum. Choice C and D are found in middle mediastinum.

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Functional unit of Liver is

Anatomical unit of liver - Hepatic Lobule Functional unit of liver- Liver Acinus

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Grievous hurt is defined under:

Ans: a (320 IPC) Ref: Reddy, 21st ed, p. 244Grievous hurt is defined under IPC 320Some important IPC'sIPC 375 - definition of rapeIPC 376 - punishment of rapeIPC 320 - definition of grievous heartIPC 84 - deals with the criminal responsibility of insaneIPC304A - deals with criminal negligenceIPC 304B - dowry deathIPC 300 - defines murderIPC 299 - defines culpable homicideIPC 302 - punishment of murderIPC 304 - punishment of culpable homicide

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Glaucoma is caused by -

Ans. is 'a' i.e., Raised intraocular pressure The most common risk factor known is increased intraocular pressure (lOP)o Glaucoma is a group of eye diseases causing optic nerve damage i.e., glaucoma is a chronic, progressive optic neuropathy caused by a group of ocular conditions which lead to damage of optic nerveo Optic neuropathy in glaucoma results in a characteristic appearance of optic disc and a specific pattern of irreversible visual field defects, called glaucomatous changes. It is worth noting that raised IOP without optic neuropathy is not referred to as glaucoma, it is simply called ocular hypertension.So, glaucoma is a type of optic neuropathy, which is usually caused by increased IOP.

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Best indicator for nutritional status for a child is -

Rate of increase of height and weight is the best measure for nutritional status of a child. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. 500,501

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Amplification of DNA uses the polymerase chain reaction (PCR) technique. Cation used in PCR is:

PCR is an in vitro method for the polymerase-directed amplification of specific DNA sequences using two oligonucleotide primers that hybridize to opposite strands and flank the region of interest in the target DNA. The specificity and yield in amplifying a paicular DNA fragment by PCR reaction is affected by the proper setting of the reaction parameters (e.g., enzyme, primer, and Mg2+ concentration, as well as the temperature cycling profile). Ref: Feng X., Lin X., Brunicardi F.C. (2010). Chapter 15. Molecular and Genomic Surgery. In F.C. Brunicardi, D.K. Andersen, T.R. Billiar, D.L. Dunn, J.G. Hunter, J.B. Matthews, R.E. Pollock (Eds), Schwaz's Principles of Surgery, 9e.

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Which of the following statements about mycosis fungoides is not true?

C i.e. It has indolent course and good prognosis

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Babesiosis is transmitted by -

Ans. is 'a' i.e., Tick Babesiao Babesiosis is a protozoan disease caused by two species of Babesia : Babesia microti and Babesia divergens.o It is transmitted by loxdid tick.o Babesia infects the RBCs and resides inside the RBCs ( intraerythrocytic). Intraery throcytic infection of Babesiosis is characterised by maltese cross. Maltese cross is a characteristic arrangement of parasites within the erythrocytes - Parasites within erythrocytes are arranged such that pointed ends of four parasites come in contact thereby giving a tetrad configuration resembling a maltese cross. Tetrad forms or 'Maltese cross' appearance is considered pathognomic of Babesiosis.o Clinically Babesiosis presents with chills, fever, mild hepatosplenomegaly, and mild hemolytic anemia,o Treatment includes Atovaquone plus azithromycin or quinine plus clindamycin.o Babesiosis can easily be confused with P. falciparum malaria.Following two features distinguish Babesiosis from malariaPresence of maltese cross in Babesiosis (absent in malaria)Absence of pigment Hemozoin in Babesiosis (present in malaria)Note - Maltese cross is also seen in cryptococcus and aspergillus.

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Manifestation of Acute Dissection include all of the following, Except:

Answer is C (MR) Mitral Regurgitation is not a feature of Aoic dissection Aoic Regurgitation and Pericardial Tamponade may be seen in proximal dissection Hemopericardium and cardiac tamponade may complicate a dissection involving the ascending aoa (type A lesion with retrograde dissection): Acute Aoic Regurgitation (AR) is an impoant and common complication of proximal dissection - Acute Myocardial Ischemia may be associated with Aoic dissection 'Bowel Ischemia, hematuria and myocardial Ischemia have all benn observed with Aoic dissection'

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Pancytopenia is most common after:

Hepatitis is the most common preceding infection, and post hepatitis marrow failure accounts for about 5% of etiologies in most series. Patients are usually young men who have recovered from a bout of liver inflammation 1 to 2 months earlier; the subsequent pancytopenia is very severe. The hepatitis is seronegative (non-A, non-B, non-C, non-G) and possibly due to a novel, as yet undiscovered, virus. Ref: Harrison's principle of internal medicine 17th edition, chapter 102.

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Which is NOT a third generation Cephalosporin

Ans. is 'd' i.e., Cefuroxime Third generation cephalosporins include Parenteral OralCefotaxime - CefiximeCeftizoxime - Cefpodoxime proxetilCeftriaxone - CefdinirCeftazidime - Ceftibuten Cefoperazone Also knowFourth generation cephalosporinsCefepimeCefaparole

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Rigor moritis devolops ..... after death :

B i.e. 1 - 2 hours

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All of the following murmurs may be heard in patients with aoic regurgitation except:

Answer is D (Pansystolic murmur)

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Best investigation to see calcification is:

Ans: A (CT ?) Ref: Harrison !v Principles of internal medicine.18th edition.Explanation:CT is the best technique to detect pericardial calcification; however, overpenetrated films, conventional tomography, fluoroscopy, and MRI may be helpful.Plain radiographs have poor sensitivity for detection of coronary calcification and have a reported accuracy as low as 42%High-quality mammography is the best diagnostic tool for the identification of breast calcifications.

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Maximum FiO2 which can be given through a nasal oxygen catheter:-

A nasal cannula is generally used wherever small amounts of supplemental oxygen are required, without rigid control of respiration, such as in oxygen therapy. Most cannulae can only provide oxygen at low flow rates--up to 5 litres per minute (L/min)--delivering an oxygen concentration of 28-44%. Rates above 5 L/min can result in discomfo to the patient, drying of the nasal passages, and possibly nose bleeds (epistaxis). Also with flow rates above 6 L/min, the laminar flow becomes turbulent and the oxygen therapy being delivered is only as effective as delivering 5-6 L/min. The nasal cannula is often used in elderly patients or patients who can benefit from oxygen therapy but do not require it to self respirate. These patients do not need oxygen to the degree of wearing a non-rebreather mask. It is especially useful in those patients where vasoconstriction could negatively impact their condition, such as those suffering from strokes.

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True about neuropraxia

Neuropraxia is due to compression of the nerve,the nerve conduction velocity is increased. It has good prognosis Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:74,75,76

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Agonistic action at which of the following adrenergic receptor result in the reduction of excess secretion

Ref-KDT 6/e p146 Stimulation of Alpha 2 receptors located on ciliary epithelium reduces secretion of aqueous humor.

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All of the following features are seen in the viral pneumonia except:

Typical Pneumonia Atypical pneumonia -Bacterial etiology -Alveolar exudate + neutrophilic infilitration -C/F - High grade fever productive Cough Pleuritis Signs of consolidation -Non - bacterial etiology (e.g. Virus) -Interstitial tissue inflammation -C/F- Low grade fever Dry cough Malaise no signs of consolidation

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Which of the following causes BOTH superior and inferior rib-notching in a chest radiograph?

Superior rib notching -Polio -Restrictive lung disease -Neurofibromatosis -Connective tissue disease -Osteogenesis imperfecta Inferior rib notching -Thrombosis of aoa -Coarctation of aoa -Blalock Taussig shunt -Occlusion of subclan aery -Pulmonary AV malformation Both Superior and inferior rib notching -NF-1 -Hyperparathyroidism

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The most accurate diagnostic test for Zollinger-Ellison syndrome (ZES) is

-All patients with gastrinoma have an elevated gastrin level, and hypergastrinemia in the presence of elevated basal acid output (BAO) strongly suggests gastrinoma. -Patients with gastrinoma usually have a BAO >15 mEq/h or >5 mEq/h if they have had a previous procedure for peptic ulcer. -Acid secretory medications should be held for several days before gastrin measurement, because acid suppression may falsely elevate gastrin levels. 1). The diagnosis of Zollinger-Ellison syndrome (ZES) is confirmed by the secretin stimulation test. An intravenous (IV) bolus of secretin (2 U/kg) is given and gastrin levels are checked before and after injection. - An increase in serum gastrin of 200 pg/mL or greater suggests the presence of gastrinoma. Patients with gastrinoma should have serum calcium and parathyroid hormone levels determined to rule out multiple endocrine neoplasia type 1 (MEN1) and, if present, parathyroidectomy should be considered before resection of gastrinoma.

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What is the average number of fleas of each species per rodent called -

<p> It is the average number of each species per rat/rodent. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:294. <\p>

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Periosteal reaction in a case of acute osteomyelitis can be seen earliest at: March 2012

Ans: B i.e. 10 days The earliest sign to appear on the X-ray is a periosteal new bone deposition (periosteal reaction) at the metaphysis. It takes about 7-10 days to appear Osteomyelitis Earliest site of involvement: Metaphysis Diagnosis of acute OM: Blood culture (positive in 65% cases) Periosteal reaction seen in acute OM appears after: 10 days MC organism in acute OM: Staph. aureus Brodies abscess: - Equilibrium between host & organism; - Abscess cavity remains without fuher enlargement

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Which of the following is not associated with zinc deficiency: March 2005

Ans. C: Pigmentation Acrodermatitis enteropathica is a rare inherited form of zinc deficiency, characterized by periorificial and acral dermatitis, alopecia, and diarrhea. Symptoms of Zinc Deficiency Poor Immune system Weight loss Intercurrent infections Hypogonadism in males Lack of sexual development in females Growth retardation Dwarfism Delayed pubey in adolescents Rough skin Poor appetite Mental lethargy Delayed wound healing Sho stature Diarrhea One easily recognized sign which may be caused by zinc deficiency is white spots, bands, or lines on fingernails (leukonychia). Some women may have multiple parallel white bands or lines on the fingernails marking menstrual cycles when marginal zinc deficiency was present.

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Preimplantataion genetic diagnosis is used for

Pre implantation genetic diagnosis is used for daignosis of single gene disorders such as cystic fibrosis, β - thalassemia and hemophilia.

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Which of the following about phenytoin is true ?

Ans. is 'a' i.e., It follows zero order kinetics Phenytoin is metabolized in liver by hydroxylation and glucuranide conjugation (option 'c' is incorrect) o This drug follows saturation kinetics (kinetics changes from first order to zero order within therapeutic concentrations) Phenytoin is an enzyme inducer and induces the metabolism of many drugs. Phenytoin is a known teratogenic and produces fetal hydantoin syndrome.

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False about stagardt's disease

Stagardt's disease is autosomal recessive.

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All of the following are killed vaccines, EXCEPT:

17-D vaccine is a live attenuated vaccine used to control yellow fever. Killed vaccines are used to control typhoid, cholera, peusis, plague, rabies, salk (polio), influenza, hepatitis A, B, japanese encephaltis and KFD. Ref: Park's Textbook Of Preventive and Social Medicine 20th edition page 98.

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Kerley B line are seen at

Ans. is 'd' i.e., Pleural surface Kerley's line Kerley's line is a linear opacity which, depending on its locaton, extent and orientation, may be be fuher classified as :? Kerley's A lines o These are thin, non-branching lines radiating from hilum. These lines are 2-6 cm in length. These lines are found in the mid and upper zones of the lung fields pleural. These lines are due to the thick interlobar septa. Kerley's B lines (septal lines) These are transverse (Horizontal) lines at the lung base pleural. These are 1-2 cm in length and are perpendicular to pleura. Kerley's B line is due to the thickening of interlobar septa due to edema caused by pulmonary venous hypeension (congestion), as occurs in left ventricular failure or mitral stenosis

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All of the following are true about BCG vaccine except.

Site of injection should be cleaned with soap but not with disinfectant or spirit.

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Commonest etiology of erythema multiforme is -

A. i.e. Viral

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Apex national institute of ophthalmology is

Dr RP Centre for Ophthalmic Sciences, New Delhi has been designated as the apex national institute of ophthalmology.

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Which laser is used in the management of after cataracts:

Ans. Nd-YAG

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Which of the following statements about Kaposi sarcoma is not true?

Ans. A. The most common site is scalpKaposi sarcoma is mostly seen in extremities: most commonly on feet and occasionally on hands, ears, and nose.* Lesions are usually dark blue or purple and they may blanchewhen tumid (swollen).* Locally aggressive lesions can ulcerate, fungate or leave pigmented scars.* Lesions are usually multifocal which eventually fuse to form plaques and tumors of several centimeters in size.* Lymph nodes, mucosae and viscera may be involved as the disease progresses, although this can occur without skin involvement.Characteristic purple-colored plaques on the alar and tip of the nose in an HIV-positive female patient.

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All of the following veins lack valves except

Veins which do not have valves are:IVCSVCHepatic, ovarian, uterine, renal, emissary, cerebral, pulmonary, and umbilical veinsPoal venous system is a valveless system

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Risk factor for melanoma are all of the following EXCEPT: March 2013

Ans. B i.e. Black people Melanoma is commoner in fair complexion Malignant melanoma/ MM Mode of spread of MM: Lymphatic channels or hematogenous Cutaneous melanoma arises from: Epidermal melanocytes MC site involved in lentigo maligna (least common): Face MC type of MM: Superficial spreading Most malignant type of MM: Noduar melanoma

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Preferred fluoroquinolone against m. leprae is -

Ans. is 'a' i.e., Ofloxacin Drugs acting on M. leprae* Established agents used to treat leprosy include dapsone (50-100 mg/d), clofazimine (50-100 mg/d, 100 mg three times weekly, or 300 mg monthly), and rifampin (600 mg daily or monthly. Of these drugs, only rifampin is bactericidal.* The sulfones (folate antagonists), the foremost of which is dapsone, were the first antimicrobial agents found to be effective for the treatment of leprosy and are still the mainstay of therapy.* Other antimicrobial agents active against M. leprae in animal models and at the usual daily doses used in clinical trials include ethionamide/prothionamide; the aminoglycosides streptomycin, kanamycin, and amikacin (but not gentamicin or tobramycin); minocycline; clarithromycin; and several fluoroquinolones, particularly preferred is ofloxacin.* Next to rifampin, minocycline, clarithromycin, and ofloxacin appear to be most bactericidal for M. leprae, but these drugs have not been used extensively in leprosy control programs. Most recently, rifapentine and moxifloxacin have been found to be especially potent against M. leprae in mice. In a clinical trial in lepromatous leprosy, moxifloxacin was profoundly bactericidal, matched in potency only by rifampin.

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When the patient fails to understand normal speech but can understand shouted or amplified speech the hearing loss is termed as

DEGREES OF HEARING LOSS 0-25dB-Not significant impairment- no significant difficulty with faint speech 26-40dB-Mild impairment-Difficult with faint speech 41-55dB-Moderate impairment -Frequently difficult with normal speech 56-70dB-Moderately severe impairment-Frequently difficult with loud sound 71-91dB-Severe impairment-Can understand only shouted or amplified sound Above 91-Profound impairment-Usually cannot understand even amplified sound Ref: Diseases of EAR, NOSE AND THROAT by PL DHINGRA - 6th Edition. Page no. 39

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A child with three days history of upper respiratory tract infection presents with stridor, which decreases on lying down postion. What is the most probable diagnosis -

Ans. is 'b' i.e., Laryngotracheobronchitis This child has : - i) 3 days history of upper respiratory tract infection. ii) Followed by stridor These features suggest the diagnosis of croup. Clinical manifestations of Croup Most patients have an upper respiratory tract infection with some combination of - Rhinorrhea Pharyngitis Mild cough Low grade fever o After 1-3 days signs and symptoms of upper respiratory tract obstruction become apparent - Barking cough Hoarseness Inspiratory stridor

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Most common movemnet force involved in fractures of the spine is which of the following?

Flexion injury is the commonest spinal injury. Ref: Essential ohopedics by Maheshwari 3rd Edition, Page 144,259,260.

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Which arm of tRNA binds it to vibosomal surface

Pseudoridine arm of tRNA is involved in binding of aminoacyl tRNA to ribosomal surface.

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Benefits of LNG lUCD are all except :

Mirena now used as first line of treatment of menorrhagia, in addition to the contraceptive effect. Another use is in providing progestogens component of hormone replacement therapy after menopause. THE TEXTBOOK OF GYNAECOLOGY SHEILA BALAKRISHNAN SECOND EDITION PAGE NO 379

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Most common drug induced Extra Pyramidal Syndrome includes

(A) Dystonia # Drug Induced & Tardive Movement Disorders> Movement disorders secondary to pharmacological agents represent a large number of extrapyramidal disorders seen by neurologists and psychiatrists in the outpatient setting.> Involuntary movements, including tremor, chorea, athetosis, dyskinesias, dystonia, myoclonus, tics, ballismus and akathisia, may be symptoms of primary neurologic disease or occur secondary to pharmacotherapy CHARACTERISTICS* TremorRhythmic. Oscillatory movement categorized according to its relationship to activity or posture* ChoreaIrregular, unpredictable brief jerky movements* AthetosisSlow, writhing movements of distal parts of limbs* DyskinesiasRecessive abnormal involuntary movements* DystoniaSlow sustained, posturing or contractions of a muscle or group of muscles* MyoclonusRapid, brief shock like muscle jerks* TicRepetitive, irregular stereotype movements or vocalizations* BallismusWild flinging or throwing movements* AkathisiaSubjective sensation of restlessness often associated with inability to keep still. Easily confused with psychiatric symptoms such as agitation, hyperactivity and anxiety> Central stimulants that act as indirect dopamine agonists such as amphetamine> Levodopa, a precursor of dopamine> Direct dopamine agonists such as bromocriptine> Presynaptic dopamine antagonists (dopamine depleting agents) such as reserpine> Neuroleptics such as haloperidol (Haldol) or chlorpromazine (Thorazine), and other medications such as metoclopramide (Reglan) which antagonize or block central dopamine receptors> By far, the most common cause of drug-induced and tardive syndromes are those that block or antagonize dopamine receptors, usually the neuroleptics.

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The earliest manifestation of increased intracranial pressure following head injury is:

Early signs of elevated iCP include drowsiness and a diminished level of consciousness (altered mental status). Coma and unilateral papillary changes are late signs and require immediate intervention. Ref: Harrison's Internal Medicine, 16th Edition, Page 1633; Clinical Hepatology: Principles and Practice of Hepatobiliary Diseases By Henryk Dancygier, Scott L. (FRW) Friedman, H. D. (CON) Allescher, U. (CON) Beuers, Volume 2, 2010, Page 938

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Function of external oblique muscle:

External oblique: Most superficial muscle which originates from the outer pa of the 5th to 12th ribs on each side of the rib cage. This muscle then runs diagonally down each side and connects to the iliac crest, linea alba, and the pubis. Function: External oblique contributes to the maintenance of abdominal tone, increasing intra-abdominal pressure (as in active expiration), and lateral flexion of the trunk against resistance. Bilateral contraction flexes the trunk forward and aid in movement of spine and back. Contraction of external oblique muscle approximates the two crura (medial and lateral) of superficial inguinal ring like a slit valve to maintain the integrity of inguinal canal.

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P wave is absent in-

Absence of the P wave with a flat baseline may indicate: Fine atrial fibrillation Sinoatrial arrest (with a secondary escape rhythm ) in ventricular fibrilation ,ventriculat tachycardia and atrial asystole,a waves are present Ref Harrison 20th edition pg 1423

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A Poly A base sequence would be most likely found at the

The addition of a poly A tail to the 3' end is one of the post-transcriptional modifications that occurs in the processing of eukaryotic messenger RNA (mRNA). A cap consisting of a guanosine derivative is attached to the 5' end. Intervening sequences (introns) are removed by splicing. All of these processing events occur in the nucleus of eukaryotes. Prokaryotic mRNA undergoes none of these modifications.

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Type I RPGN is seen in

Type I RPGN is anti - GBM mediated and it is seen in Goodpasture's syndrome.

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Bradycardia is seen with:

Ans: C (Succinyl choline) Ref: Ajay Yadav, Short textbook of Pediatrics, 1st editionExplanation:Cardiac Sideeffects of Anesthetic DrugsDrugsCardiac Side effectsMidazolamMinimal reduction in Heart rate, Blood pressure and cardiac outputEpinephrineProduces tachycardia, hypertension and ventricular arrhythmiasSuccinyiCholineIt produces muscarinic effects, similar to Acetyl cholineIt causes Profound BRADYCARDIA, so atropine should be given prior to use of Succinylcholine Choline, especially in childrenDopamineProduces tachycardia, hypertension and ventricular arrhythmiasThiopentoneit causes Hypotension, which is more because of venodilatation and direct depression of vasomotor centreDirect myocardial depressant

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Failure of migration of neural crest cells is seen in:

Ans: b (Congenital megacolon)Ref: Bailey & Love, 24th ed, p.l 153 & 23rd ed, p. 1027

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The signs of malignant transformation in osteochondroma are all except

Ans. b. Weight loss

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Drugs known to cause Steven Johnson syndrome include the following except:

Drugs that most commonly cause SJS/TEN Antibiotics Antifungals Antivirals Sulfonamides, e.g., cotrimoxizole; beta-lactams i.e. penicillins, cephalosporins Imidazole antifungals Nevirapine (non-nucleoside reverse-transcriptase inhibitor) Allopurinol Nonsteroidal anti-inflammatory drugs (NSAID) (oxicam type mainly) Naproxen Ibuprofen Anti-convulsants Carbamazepine Phenytoin Phenobarbital Valproic acid Lamotrigine

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Best prognosis in nerve injury

Neurapraxia is a disorder of the peripheral nervous system in which there is a temporary loss of motor and sensory function due to blockage of nerve conduction, usually lasting an average of six to eight weeks before full recovery.Ref: Ganong&;s review of medical physiology 23rd edition

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Bedside test for mental status-

Ans. is 'a' i.e., MMSE o The most w idely used test for bedside evaluation of the mental status is folstein's mini mental state examination (MMSE).

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