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135
47a7e08c-e3a3-46bf-8927-d9e194a385c1
Which of the following is freely filtered by kidney across glomerular capillariesa) Albumin (across glomerular capillaries)b) Globulinc) Creatinined) HCO3 e) Glucose
cde
acd
bde
ade
0a
single
Freely filterable substances by glomerulus -        Water -        Na+ -        Cl- -        HCO3- -        Inulin -        Glucose -        Creatinine   -        Free Calcium or phosphate
Physiology
null
de848149-c145-4341-95fd-5e7fb647e705
Antibodies associated with GTCS in SLE :
Anti neuronal ab
Anti-Ro ab
Anti-Sm ab
None
0a
multi
Ans.A Anti neuronal ab (Ref: Harrison's Internal medicine 18th/Table 319-1; 17th edition, P. 2076). Autoantibodies in Systemic Lupus Erythematosus (SLE) Antibody Prevalence, % Antigen Recognized Clinical Utility Antinuclear antibodies 98 Multiple nuclear Best screening test; repeated negative tests make SLE unlikely Anti-dsDNA 70 DNA (double-stranded) High titers are SLE-specific and in some patients correlate with disease activity, Anti-Sm 25 Protein complexed to 6 species of nuclear U1 RNA Specific for SLE; no definite clinical correlations; most patients also have anti Anti-RNP 40 Protein complexed to U1 RNA Not specific for SLE; high titers associated with syndromes that have overlap blacks than whites Anti-Ro (SS-A) 30 Protein complexed to hY RNA, primarily 60 kDa and 52 kDa Not specific for SLE; associated with sicca syndrome, predisposes to subacute cutaneous with decreased risk for nephritis Anti-La (SS-B) 10 47-kDa protein complexed to hY RNA Usually associated with anti-Ro; associated with decreased risk for nephritis Antihistone 70 Histones associated with DNA (in the nucleosome, chromatin) More frequent in drug-induced lupus than in SLE Antiphospholipid 50 Phospholipids, 2 glycoproteins 1 cofactor, prothrombin Three tests available ELISAs for cardiolipin and 2G1, sensitive prothrombin Antierythrocyte 60 Erythrocyte membrane Measured as direct Coombs' test; a small proportion develops overt hemolysis Antiplatelet 30 Surface and altered cytoplasmic antigens on platelets Associated with thrombocytopenia but sensitivity and specificity are not good; Antineuronal (includes anti-glutamate receptor) 60 Neuronal and lymphocyte surface antigens In some series a positive test in CSF correlates with active CNS lupus. Antiribosomal P 20 Protein in ribosomes In some series a positive test in serum correlates with depression or psychosis Also remember: Antibody Best screening test for Antibody ANA SLE Anti-Histone Drug-induced lupus Antinuclear antibodies SLE, nonspecific Anti-dsDNA; Anti-Sm Specific for SLE Anti-sm (Nelson's Paediatric Textbook) Marker of CNS lupus Anti-DNA Level of which correlates with disease activity Anti-Ro (SS-A) SACL, neonatal lupus Anti-Ro and Anti-La ie risk of nephritis (protective against nephritis) Antiphospholipid Hematological and Fetal Loss Antiribosomal protein Depression and Psychosis Anti-basement membrane Goodpasture syndrome Anticardiolipin, lupus anticoagulant SLE, antiphospholipid syndrome Anticentromere Limited scleroderma (CREST syndrome) Anti--Scl--70 (anti--DNA topoisomerase 1) Scleroderma (diffuse) Anti--SSA, anti--SSB (anti-Ro, anti--La) Sjogren syndrome Anti--Jo--1, anti--SRP, anti--Mi--2 Polymyositis, dermatomyositis Anti--TSH receptor Graves disease Anti--U1RNP (ribonucleoprotein) Mixed connective tissue disease c-ANCA (PR3-ANCA) Granulomatosis with polyangiitis (Wegener) IgA antiendomysial, IgA anti--tissue transglutaminase Celiac disease p-ANCA (MPO--ANCA) Microscopic polyangiitis, Churg--*JStrauss syndrome Anti--ACh receptor Myasthenia gravis Rheumatoid factor (antibody, most commonly IgM, specific to IgG Fc region), anti--CCP Rheumatoid arthritis Anti--glutamate decarboxylase Type 1 diabetes mellitus Anti--desmoglein Pemphigus vulgaris Anti--hemidesmosome Bullous pemphigoid Antimicrosomal, antithyroglobulin Hashimoto thyroiditis Antimitochondria! 1*< biliary cirrhosis Anti--smooth muscle Autoimmune hepatitis ALSO KNOW: LE cells Neutrophils with LE bodies seen in SLE, RA Penicillamine drug induced Hematoxilin bodies SLE endocarditis (Libmann-Sack) 'Wire-loop' lesions SLE type IV nephritis
Unknown
null
b90b1e07-21e0-4760-a2dc-8edd5fddac7d
Tonsillar fossa is bounded anteriorly by
Pharyngobasilar fascia
Palatopharyngeal fold
Buccopharyngeal fascia
Palatoglossal fold
3d
single
Tonsilar fossa is bounded by Anterior - Palatoglossal fold containing palatoglossal muscle Posterior - Palatopharyngeal fold containing palato pharyngeal muscle Apex - Soft palate, where both arches meet Base - Dorsal surface of posterior one-third of tongue. (Ref: Anatomy of head, neck and brain. Vishram Singh. P 227 )
ENT
Pharynx
8ae09b49-665e-45e3-ac3d-869ff1a96a44
"Castration anxiety" is seen in which phase of Sigmond Freud's psychosexual stages of development
Oral
Anal
Phallic
Genital
2c
multi
Phallic phase (3-5years): Male child develops Oedipus complex (sexual feeling towards mother) and will be afraid that father may castrate him for this termed as "Castration anxiety".
Psychiatry
null
04c2701f-e97b-451d-a824-49d4c35c4ffb
Shock causes:
Stagnant hypoxia
Anemic hypoxia
Hypoxic hypoxia
Histotoxic hypoxia
0a
single
Ans: A (Stagnant hypoxia)Ref: Pat GK, Hypoxia and Oxygen Therapy, In: Textbook of Medical Physiology, 2nd ed, Abuja Publishing House 2011: 94: 754-55Explanation:Refer the explanation of previous question
Physiology
Circulation: Circulatory Shock and Its Treatment
a8b60e51-39fd-45f3-bc37-6b0ab6126430
Two or more parallel vertical surfaces of abutment teeth shaped to direct the prosthesis during placement and removal, are known as:
Orientation plane
Parallel block out
Survey lines
Guiding planes
3d
multi
null
Dental
null
2b84d3c8-a571-4f34-aaea-b58afabb9ee5
Calcium silicate based material is:
MTA
Geristore
Dieket
Retroplast
0a
single
Mineral trioxide aggregate was developed by Dr Torabinejad in 1993.  It contains tricalcium silicate, dicalcium silicate, tricalcium aluminate, bismuth oxide, calcium sulfate and tetracalcium aluminoferrite. pH of MTA is 12.5. Textbook of Endodontics Nisha Garg 3rd Ed
Dental
null
d364fa9c-b9f9-4328-bf4c-070339d50af1
Which of the following statements about Total Infra–Venous Anaesthesia (TIVA) is true –
Causes More Renal Toxicity
Reduces Cerebral Metabolic Rate
Risk of Malignant Hyperthermia is high
Inhibits Hypoxic Pulmonary Vasconstriction
1b
multi
Total intravenous anaesthesia refers to a technique in general anaesthesia using a compination of agents given solely by IV route and in the absence of all inhalation agents. TIVA (Total intravenous anaesthesia) is produced by IV propoful. Propofol decreases the cerebral metabolic rate. Propofol does not impair renal function, does not trigger malignant hyperthermia and does not inhibit hypoxic pulmonary vasoconstriction.
Anaesthesia
null
4eafd9d8-b2ea-4f44-ac7f-a12103f61945
In Profound MR, IQ is
50-69
35-49
20-34
< 20
3d
single
IQ range for categoriesICD-10DSM-IVMild50-6950-55 to 70Moderate35-4935-40 to 50-55Severe20-3420-25 to 35-40ProfoundBelow 20Below 20-25Reference: Oxford Textbook of Psychiatry; 3rd edition; Chapter 18; Learning Disability
Psychiatry
Child psychiatry
f0a88604-cf9c-4181-87f8-e3daccd3d389
Which of the following iodinated compound is present in a maximum concentration in the thyroid?
Monoiodotyrosine (MIT)
Diiodotyrosine (DIT)
T3
Reverse T3
1b
single
THYROID HORMONE SYNTHESIS AND SECRETIONThyroid hormones are synthesized in the colloid, near the apical cell membrane of the follicular cells. Catalyzed by the enzyme thyroidal peroxidase, iodide in the thyroid cell is oxidized to iodine.The iodine enters the colloid and is rapidly bound at the 3 position to tyrosine molecules attached to thyroglobulin, forming monoiodotyrosine (MIT).MIT is next iodinated at the 5 position, forming diiodotyrosine (DIT).Two DIT molecules then condense in an oxidative process ("coupling reaction") to form one thyroxine (T4) molecule.Some T3 is probably formed within the thyroid gland by condensation of MIT with DIT. A small amount of reverse T3 (rT3) is also formed.In the normal thyroid, the average distribution of iodinated compounds is 23% MIT, 33% DIT, 35% T4, 7% T3, and 2% reverse T3.
Microbiology
All India exam
7a6581e6-e0e5-4135-a642-cb80351a063c
Silicosis caused by ?
Gold
Coal
CO
Silica
3d
single
Ans. is 'd' i.e., Silica
Social & Preventive Medicine
null
e3b9ae95-2b0e-42af-a27a-f6c0b51af476
Human development index includes -
Crude death rate
Life expectancy at one year
Life expectancy at bih
All
2c
multi
Ans. is 'c' i.e., Life expectancy at bih According to 22nd/e of Park, options 'd & e' are not the components of HDI. o Expected years of schooling (not adult literacy rate) and GNI per capita (not GDP) are the components of HDI.
Social & Preventive Medicine
null
4d8ea9c6-e243-4402-8393-ac53373773ce
One of the constituents of the commonly used metered dose inhalers in bronchial asthma which is an air pollutant & dangerous to earth's stratosphere is -
Flurocarbons
Salbutamol
Ozone
Oxygen
0a
single
null
Medicine
null
8f5f61e2-a8ea-4d15-ba76-823918e49d3b
H. capsulatum, a dimorphic fungus, is found in soil heavily contaminated with bird droppings. Which of the following statements best describes the presence of the organism in tissue biopsies?
Yeasts with broad-based bud
Single-cell yeasts with pseudohyphae
Arthrospores
Oval budding yeasts inside macrophages
3d
multi
Histoplasma capsulatum is a dimorphic fungus that forms two types of spores: tuberculate macroconidia and microconidia. Inhalation of the microconidia transmits infection. Inhaled spores (microconidia) are engulfed by macrophages and develop into yeast forms. Most infections remain asymptomatic; small granulomatous foci heal by calcification. However, pneumonia can occur. The heterophile antibody test is useful for early diagnosis of infectious mononucleosis. The figure below illustrates the oval budding yeasts.
Microbiology
Mycology
940903a9-03dd-4900-bf86-2a421380958b
Budding reproduction in tissue is seen in
Cryptococcus, candida
Candida, rhizopus
Rhizopus, mucor
Histoplasma, candida
0a
single
Cryptococcus is a yeast, candida is a yeast-like fungus. Both are reproduced by budding Histoplasma is a dimorphic fungus Mucor and Rhizopus are produced by asexual means sporangiospores Reference: Textbook of Microbiology; Baveja; 4th edition
Microbiology
mycology
e6b8da32-0a36-4ef8-8d82-e1eb2a517c9b
True about polio:
Paralytic polio is most common
Spastic paralysis seen
IM injections and increased muscular activity lead to increased paralysis
Polio drops in pulse polio immunisation given only in <3 years old children
2c
multi
False 90-95% of polio infections are asymptomatic False Acute flaccid paralysis is seen in Polio & not spastic paralysis True Risk of paralytic polio is increased by tonsillectomy, strenous physical exercise, tooth extraction,Injection (intramuscular) False OPV drops are given to all children less than 5 yr age in pulse polio immunisation
Pediatrics
Impoant Viral Diseases in Children
c853613f-ef01-4ea6-afc6-2a467d44aecc
The retention of dowel in a pin retained crown is increased by
Increased length, smooth surface and increased taper.
Increased length, serrated surface and increased taper.
Increased length, smooth surface and parallel sides.
Increased length, serrated surface and parallel sides.
3d
multi
Post should be at least 2/3 the root length, parallel sided and serrated for increased retention in the canal
Dental
null
08531c7b-c9f3-49f2-a8f2-e64ac23974e7
Which of the following drugs can be administered by subcutaneous route?
Albuterol
Metaproterenol
Terbutaline
Pirbuterol
2c
single
terbutaline can be given as s.c (0.25mg) in asthma.
Pharmacology
null
f00410d1-d829-45fa-8643-4dcc815bb0e6
Mycosis fungoides which is not true:
It is the most common form of cutaneous lymphoma.
Pautriers microabscess.
Indolent course and easily amenable to treatment.
Erythroderma seen and spreads to peripheral.
2c
multi
Mycosis Fungoides: Mycosis fungoides is synonymous with Cutaneous T cell lymphoma.
Medicine
null
ccb6817f-6a6b-49c6-879b-0bd13daf314d
Bacterial pyogenic parotitis affecting the parotid gland is most common after: March 2008
Uveo-parotid fever
Mumps
Debilitation after major surgery
After administration of iodine
2c
single
Ans. C: Debilitation after major surgery Acute bacterial parotitis is now infrequent, but its historical impoance. Mumps and bacterial parotitis were differentiated by 1800, but neither was effectively treated. The moality rate for bacterial parotitis was 80%. Before antibiotics and intravenous administration of fluids were available, bacterial parotitis occurred in postoperative patients or other severely ill patients who became dehydrated and contributed to their demise as an incurable sepsis.
Surgery
null
f2bed904-d182-4df2-97d4-3e5d9186bc39
Patient diagnosed as squamous cell intraepithelial lesion which of the following has the highest risk for progression to carcinoma;
Low grade squamous intraepithelial neoplasia
High grade squamous intraepithelial neoplasia
Squamous intraepithelial associated with HPV 16
Squamous intraepithelial neoplasia associated with HIV
1b
single
High grade squamous intraepithelial lesion have a propensity to progress and become invasive, therefore need investigations and treatment Ref: Shaw Gynecology 17 e pg 410.
Gynaecology & Obstetrics
Gynaecological oncology
a2cc3df8-77f3-4290-a580-d66398b9439d
Autosomal recessive polycystic kidney disease features include:
Can be diagnosed intrauterine
Proceeds to renal failure till children reaches school going age
Can be palpated abdominally
Hypertension doesn't develop until late stages of the disease
0a
multi
Ans. A. Can be diagnosed intrauterineExplanationClinical features of ARPKD (Autosomal recessive polycystic kidney disease) are:Classic ARPKD is generally diagnosed in utero or within the neonatal period and characterized by greatly enlarged echogenic kidneys in diseased fetuses. (Option a)Reduced fetal urine production may contribute to oligohydramnios and pulmonary hypoplasia.About 30% of affected neonates die shortly after birth due to respiratory insufficiency. Close to 60% of mortality occurs within the first month of life.In the classic group, most patients are bom with renal insufficiency and ESRD (End stage renal disease). (Option b)However, infants often have a transient improvement in their GFR; death from renal insufficiency at this stage is rare.Some patients are diagnosed after the neonatal stage and form the older group. Morbidity and mortality in this group often involve systemic hypertension, progressive renal insufficiency, and liver manifestations.The hallmarks of ARPKD liver disease are biliary dysgenesis due to a primary ductal plate malformation with associated periportal fibrosis, namely congenital hepatic fibrosis (CHF) and dilatation of intrahepatic bile ducts (Caroli's disease). CHF and Caroli's disease can then lead to portal hypertension exhibiting hepatosplenomegaly, variceal bleeding, and cholangitis.Some patients with the diagnosis of ARPKD at 1 year of age with nephromegaly exhibit slowly declining renal function over 20 years with only minimally enlarged kidneys at ESRD (Option c and e) and markedly atrophic kidneys following renal transplantation.The slow progression of renal disease is likely due to increasing fibrosis rather than the development of cysts.Systemic hypertension is common in all ARPKD patients, even those with normal renal function. (option d)
Pathology
Kidney
78c840a3-5ead-4b96-97b6-6b99a2b98f9b
You are the medical officer in charge of the immunisation programme at a sub-centre and you are informed by the local ASHA worker that one of the children who was immunised has has been dizzy. On fuher investigation it was confirmed that the symptoms were due to anxiety of pain of the injection and not as a result of the vaccine. You would consider the incidence as:
Vaccine reaction
Injection reaction
Programme error
Coincidental
1b
single
The following are the adverse effect following immunisation: Vaccine reaction - Here the event is caused by the inherent propeies of the vaccine when given correctly. Programme error - In this case the event is as a result of error in preparation, handling or administration of the vaccine. Coincidental - The event after immunisation is not caused by the vaccine but by a chance association. Injection reaction - The anxiety of the pain an injection itself may cause hyperventilation, dizziness etc. This is not a result of the vaccine and is called injection reaction. Ref: Park, 21st Edition, Page 103, 107.
Social & Preventive Medicine
null
dc05e667-659f-4f8f-a534-b329a1b356cc
Bicipital aponeurosis lies over which structure in cubital fossa:-
Median cubital vein
Radial nerve
Brachial aery
Anterior interosseous aery
2c
single
Bicipital aponeurosis lies superficial to the brachial aery and median nerve. -lies deep to superficial veins. -provides protection for the deeper structures during venepuncture at cubital fossa. -routinely released to decompress the median nerve
Anatomy
Muscles of arm and forearm region & Cubital fossa
77e67056-21d4-4dad-ba62-f785e6ce4e38
Postponing paying attention of conscious impulse or conflict is a mature defence mechanism known as -
Sublimation
Suppression
Humor
Anticipation
1b
single
Suppression is pushing of unwanted feelings into unconscious which has reached conscious awareness.
Psychiatry
null
3779c7ae-2be8-498b-adc9-45465595bf19
The commonest site of perforation during colonoscopy is -
Caecum
Hepatic flexure
Splenic flexure
Sigmoid colon
3d
single
• Risks of colonoscopy: Perforation and hemorrhage • MC site of bleeding after colonoscopy: Stalk after polypectomy. • MC site of perforation during colonoscopy: Sigmoid colon • Perforation can be caused by excessive air pressure, tearing of the antimesenteric border of the colon from excessive pressure on colonic loops, and at the sites of electrosurgical applications
Surgery
null
cbd91783-e901-4672-9ec1-7f58bce041da
A 74-year-old woman develops occipital headache, vomiting, and dizziness. She looks unwell, her blood pressure is 180/100 mm Hg, pulse is 70/min, and respirations are 30/min. She is unable to sit or walk because of unsteadiness. Over the next few hours, she develops a decline in her level of consciousness.For the above patient with altered level of consciousness, select the most likely diagnosis.
basal ganglia hemorrhage
cerebellar hemorrhage
pontine hemorrhage
lobar intracerebral hemorrhage
1b
multi
Cerebellar hemorrhage, when mild, may present with only headache, vomiting, and ataxia of gait. Patients may complain of dizziness or vertigo. The eyes may be deviated to the side opposite the hemorrhage. Nystagmus is not common, but an ipsilateral sixth nerve palsy can occur. This is the only type of intracerebral hemorrhage that commonly benefits from surgical intervention.
Medicine
C.N.S.
6c5c0933-9307-485a-a14b-305f77c287ef
Which is an uricosuric drug-
Allopurinol
Probenecid
Indomethacin
Aspirin
1b
multi
Ans. is 'b' i.e., Probenecid Uricosuric drugs are probenacid, sulfinpyrazone and benzbromarone.
Pharmacology
null
8556ec34-5fc9-46de-8be9-bce2fbd3ea06
After an incised wound ,new collagen fibrils are seen along with a thick layer of growing epithelium.The approximate age of the wound is
4-5days
About 1week
12-24hrs
24-48 hrs
0a
single
Ref Robbins 9/e p106 Incised wound for the formation of collagen and new tissue, thick layer of epithelial ,and granulation tissue formation along with new blood vessels requires atleast 4_5 days
Anatomy
General anatomy
7a277163-0216-4d34-838f-3f4ca53d763c
After delivery, a 28 year old pre ecclamptic primigra has a soft uterus with moderate-to-heavy bleeding. There is no laceration and there is PPH diagnosed due to uterine atony. Which of the following is the best management option?
0.2-mg intramuscular (IM) ergonovine (Methergine)
20 units of IV oxytocin
10 units of oral oxytocin
250 mg prostaglandin F2-alpha orally
1b
multi
Ergot derivatives should not be given in patients with hypeension since this is classically known to increase blood pressure. A high BP may provoke a post paum ecclampsia Oxytocin is not orally effective . Prostaglandin F2-alpha is given IM.
Gynaecology & Obstetrics
Pregnancy induced Hypeension
784827e3-b944-4c14-98d5-ed648eb38bc8
Trendlenburg's test done for varicose veins is for detection of:
Perforator in competency
Deep veins patency
Saphenofemoral incompetency
Site of perforators
2c
single
Ans: C (Saphenofemoral incompetency) Ref : 74 A Manual on Clinical Surgery S. DasExplanation:Clinical Examination of Varicose VeinsBrodie-Trendelenherg TestDone to determine the incompetency of Saphenofemoral valve.Patient is placed in recumbent position.Limbs are raised to empty the veins. Veins are milked proximally for further emptying.Saphenofemoral junction is compressed either with the thumb of the examiner/toumiquet and the patient is asked to stand up quickly.There are two variants of this test.The first method is to assess saphenofemoral incompetency. The pressure is released and if the column of blood fills up quickly from above downwards it indicates saphenofemoral incompetency.The second method is to assess the perforators. Here, the pressure is maintained for one minute. Gradual filling of the veins during this period indicates incompetent perforators allowing reflux of blood from deep veins to superficial veins.Positive Brodie--Trendelenberg test i~ an indication for surgery.Tests to Assess Saphenofemoral IncompetencyBrodie -Trendelenberg testMorrisey's cough impulse testTests to Assess Deep VeinsPerthe's testModified Perthe's testTests to Assess PerforatorsMultiple tourniquet testPratt's testFegan's testBrodie-Trendelenberg testTest to Assess V alves in Superficial VeinSchwartz testNote:Even though Brodie-Trendelenberg test is used to assess both saphenofemoral incompetency and incompetent perforators its primary purpose is to assess saphenofemoral incompetency.
Surgery
Varicose Veins
1a161e71-2d41-43e3-a3ed-4317413c6d86
Arrange the following 4 enzymes of gluconeogenesis in sequence: A. Pyruvate carboxylase B. Glucose - 6 - phosphatase C. Phosphoenol pyruvate carboxy kinase D. Fructose 1,6 Bisphosphatase
D-C-A-B
A-C-D-B
B-A-D-C
C-D-B-A
1b
single
null
Biochemistry
Gluconeogenesis
463091e2-e514-46e3-aedb-931a3af6545e
Specific poison for succinate dehydrogenase is ?
Cyanide
Malonate
Arsenite
Fluoride
1b
single
B i.e. Malonate
Biochemistry
null
3a63a6c3-1c1d-4578-a6b2-08e42456d546
Most common widespread zoonotic disease in the world is -
Rabies
Leptospirosis
Brucella
Anthrax
1b
single
<p> Leptospirosis is the most wide zoonotic disease in the world. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:291. <\p>
Social & Preventive Medicine
Communicable diseases
e68f5568-fcaa-4ff5-b664-5065ebba2d96
Post operative muscle ache is caused by
d-TC
Suxamethonium
Gallamine
Pancuronium
1b
multi
null
Anaesthesia
Muscle relaxants
aa9ef9b2-7854-491c-baf4-6df499428906
Blood stained sputum may be the only symptom in?
Bronchiectasis
Carcinoma bronchus
Adenoma bronchus
Pulmonary T.B.
2c
single
Ans. is 'c' i.e., Adenoma bronchus
Surgery
null
1e61071d-fa24-4df4-b39d-ad51308c63e2
Inherited hyperammonemia is a result of deficiency of which enzyme of Krebs-Henseleit urea cycle?
Malate dehydrogenase
Isocitrate dehydrogenase
N-acetyl glutamate synthetase
Succinate dehydrogenase
2c
single
Inherited hyperammonemias are a group of six diseases caused by inborn deficiencies of the enzymes of the Krebs-Henseleit urea cycle. The enzymes involved are: 1. N-acetyl glutamate synthetase 2. Arbamyl phosphate synthetase (CPS) 3. Ornithine transcarbamylase (OTC) 4. Argininosuccinic acid synthetase (citrullinemia) 5. Argininosuccinase deficiency 6. Arginase deficiency Most Severe Cases: In the most severe forms of the hyperammonemic disorders, the infants are asymptomatic at bih and during the first day or two of life, after which they refuse their feedings, vomit, and rapidly become inactive and lethargic, soon lapsing into an irreversible coma. Profuse sweating, focal or generalized seizures, rigidity with opisthotonos, hypothermia, and hyperventilation have been observed in the course of the illness. These symptoms constitute a medical emergency, but even with measures to reduce serum ammonia, the disease is usually fatal. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 37. Inherited Metabolic Diseases of the Nervous System. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e.
Biochemistry
null
598d5484-6c3d-4983-aa72-cafaf6a4719a
Punishment for infanticide comes under -
IPC102
IPC324
IPC302
IPC300
2c
single
Ref:Textbook of forensic medicine and toxicology (V.V.Pillay) 17th edition, page no.377 Infanticide refers to the deliberate killings of chlid below the age of one year.In England, Germany, UK, there is a clear-cut distinction between homicide and infanticides. In India, no such distinction exists, and accuse is punished under sec.302IPC,the same manner as in murder.
Forensic Medicine
Sexual offences and infanticide
ed76ceeb-7206-424c-b2b0-222a1d226703
Carotid artery stenosis screening invivo choice is -
USG
CT
MRI
Doppler
3d
single
Ans. is 'd' i.e., Doppler o Color doppler ultrasonography is the screening method of choice (not simple USG : option a is incorrect),o Carotid angiography is the investigation of choice for diagnosis,o MRI is the investigation of choice for demyelinating disorder, e.g. multiple sclerosis.Investigations in nervous systemo Investigation of choice for white matter disease - MRI (CT is second choice),o Investigation of choice of acoustic neuroma - GD enhanced MRIo Best investigation for all brain tumors - Contrast enhanced MRIo Investigation of choice for meningeal carcinomatosis - Contrast (gadolinium) enhanced MRI.o Investigation of choice for posterior fossa tumor - MRIo Investigation of choice for para meningeal rhabdomyosarcoma - MRIo Investigation of choice for nasopharyngeal angiofibroma - Contrast enhanced CT.o Investigation of choice for hydrocephalus in older patients and for low pressure hydrocephalus - MRI.o Investigation of choice for acute (<48hrs) subarachnoid hemorrhage (SAH) - Non-Contrast CT scan,o Investivation of choice to know the etiology of SAH - Four vessels digital substruction angiography.o Hallmark of SAH - Blood in CSF on lumbar puncture,o Investigation of choice for chronic SAH - MRI.o Primary procedure of choice for evaluating intracranial complications of acute head injury - CT scan,o Best modality for assessing fractures of the skull base, calvarium and facial bone - CT scan,o Investigation of choice for demyelinating disorders MRI.o Investigation of choice for AV malformation and aneurysm - Angiography (MRI angiography or CT angiography),o Investigation of choice for Craniospinal infection - MRIo Investigation of choice for all intrinsic spinal cord lesions; all causes of cord compression - MRI.o Procedure of choice for emergent evaluation of acute intracerebral hemorrhage - CT scan,o Investigation of choice for myelopathy - MRI.o Shape of epidural hematomas on imaging - Biconvex, hyperdense or mixed density.o Shape of acute subdural hematoma on imaging - Crescent-shaped, hyperdense or mixed density ,o Chronic subdural hematoma on imaging - Hypodense.o Most sensitive test for ischaemic stroke - Diffusion weighted (DW) MRI.
Radiology
Head and Neck Imaging
9696296f-f81e-42b8-90e5-398da9c83945
Proposed guideline value for Radioactivity in drinking water is:
Gross a activity 0.1 Bq/L and Gross b activity 1.0 Bq/L
Gross a activity 1.0 Bq/L adn Gross b activity 0.1 Bq/L
Gross a activity 1.0 Bq/L and Gross b activity 10.0 Bq/L
Gross a activity 10 Bq/L and Gross b activity 1.0 Bq/L
0a
single
Key guidelines aspects of WHO recommended drinking water quality: Colour <15 true colour units (TCU) Turbidity <1 nephlometric turbidity units (NTU) pH: 6.5-8.5 Total dissolved solids (TDS) <500 mg/Litre Zero pathogenic microorganisms Zero infectious viruses Absence of pathogenic protozoa and infective stages of helminthes Fluoride <1.0 ppm (0.5-0.8 ppm: Optimum level) Nitrates <45 mg/Litre Nitrites <3 mg/Litre Gross alpha radiological activity <0.5 Bq/Litre (new guidelines -WHO) Gross Beta radiological activity <1.0 Bq/Litre (new guidelines-WHO) Ref: Park 25th edition Pgno: 762
Social & Preventive Medicine
Environment and health
ec9dbeb5-1b72-43fd-869c-896778e840e3
Lens develops from?
Endoderm
Mesoderm
Surface ectoderm
Neuroectoderm
2c
single
Ans. c (Surface ectoderm). (Ref. Human Embryology by IB Singh, 6th/352)LENS# LENS develops from surface ectoderm.# Compared to the cornea, it has a much lower converging power of 17 diopters because of the relatively similar refractive indices of aqueous humor, lens, and vitreous body (cornea 42 D).# However, the lens is the only part of the refractive apparatus that is adjustable.# Adjustment to near vision (accommodation) therefore involves only the lens.# In addition, the lens functions as a UV filter for wavelengths between 300 and 400 nm and thus has a protective function for the macula.# Notching of the lens = "pseudocoloboma".# Wilson's disease can induce a yellow-green lens discoloration (chalcosis/ sunflower cataract).# Granular gold deposits located under the lens (chrysiasis lends) can occasionally occur after prolonged treatment with gold preparations (e. g. in primary chronic polyarthritis ).# Other medications, e.g., amiodarone or chlorpromazine, are sometimes deposited in the lens.# In patients with cataract, glittering cholesterol crystals are not infrequently found in the lens (so-called Christmas tree/ decoration cataract).
Ophthalmology
Lens
36d1d9e0-62d6-4065-832c-1fedd97d046c
Features of neurogenic shock are
↑Peripheral resistance ↓ cardiac output
↑ Venous return ↑ cardiac output
↓Peripheral resistence↓cardiac output
Venoconstriction ↓cardiac output
2c
single
null
Medicine
null
eee99c0a-bd81-4fc8-9fa2-3e168d8be995
Palm of one hand is placed horizontally across the mouth and nostrils in
Manual strangulation
Palmar strangulation
Garrotting
Mugging
1b
multi
palmar strangulation Here the palm of one hand is placed horizontally across the mouth and nostrils, it's pressure being reinforced by placing the other palm on the top of it at right angles, the heel of the palm above pressing upon the front of the neck. Ref: TEXTBOOK OF FORENSIC MEDICINE AND TOXICOLOGY KRISHNAN VIJ FIFTH EDITION PAGE 134
Forensic Medicine
Asphyxia
90172650-01d2-4312-8c6d-5f71bbe8695c
In RDS all of the following statements are true except
Usually occurs in infants born before 34 weeks of gestation
Is more common in babies born to diabetic mothers
Leads to cyanosis
Is treated by administering 100% oxygen
3d
multi
Administration of 100% oxygen may increase the O2 load on fetal lung tissue. Hence, it is not given . Reference: GHAI Essential pediatrics, 8th edition
Pediatrics
New born infants
b9799e1c-a706-43df-8a51-7f1fa165d79c
National program for prevention and control of Cancer, Diabetes, Cardiovascular disease and stroke (NPCDCS), true is -
Separate centre for stroke, DM, cancer
Implementation in some 5 states over 10 districts
District hospital has specialised facilities
Subcentre has facility for diagnosis and treatment
2c
multi
Ans. is 'c' i.e., District hospital has specialised facilities Sational program for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS1 Introduction Single centre fi- cancer, diabetes, cardiovascular disease, stroke. 100 districts in 21 states being covered in 1 1 th live year plan. 20,000 subcentres and 700 community health centres (CHCs) covered. o Activities as sub-centres Health promotion for behaviour and lifestyle change. Oppounistic screening of BP. blood glucose (strip method) in age > 30 years. Referral to CHC of cases of DM, HT. o Activities at CHCs : Diagnosis and management at NCD clinic. Home visits by nurse for bedridden cases. Referral to district hospital for complicated cases. o Activities as District hospital : Health promotion Screening of population > 30 years. Diagnosis and management of cardiovascular disease. Home-based palliative care for chronic, debilitating progressive patients. Specialized facilities. Urban health check-up shceme JOr diabetes and high BP : Screen urban slum population. Screen population > 30 years and pregnant females. Cancer control in NPCDCS : Regional cancer control scheme : Regional cancer centres to act as referral centres for complicated cases. Oncology wing development scheme. Decentralized NGO scheme : IEC activities and early cancer detection. lEC at central level. Research and mining.
Social & Preventive Medicine
null
5a242165-f06e-49de-9b9c-0cc4e1303f75
All of the following are ACTH independent Cushing syndrome except :
Pituitary adenoma
Adrenal hyperplasia
Adrenocoical carcinoma
McCune Albright Syndrome
0a
multi
ACTH dependent Cushing syndrome is caused by : ACTH producing pituitary adenoma Ectopic ACTH Bronchial or pancreatic carcinoid Small cell cancer of lung Medullary carcinoma of thyroids Pheochromocytoma ACTH Independent Cushing syndrome is caused by : Adrenocoical adenoma/ carcinoma Primary pigmented nodular adrenal disease Adrenal hyperplasia McCune Albright Syndrome Petrosal/Peripheral ACTH ratio > 2 indicates the presence of a pituitary adenoma-secreting ACTH. NOTE: Overall the most common cause of Cushing's syndrome is Iatrogenic steroids but if asked regarding ACTH dependent cause then answer should be given as Pituitary adenoma.
Medicine
Cushing Syndrome
396db5cd-55ab-434e-b14e-5c2742dd08d9
Hereditary spherocytosis is characterized by: March 2004
Anemia
Splenomegaly
Jaundice
All of the above
3d
multi
Ans. D i.e. All of the above
Pathology
null
653fbea7-3a1f-41e2-87fc-e541eb92292b
Ketamine can be given by all of following routes except-
IV
IM
SC
Nasally
2c
multi
Ketamine has been administered intravenously, orally , rectally, intramuscularly and epidural route and very rare intranasal but not subcutaneous
Anaesthesia
Intravenous Anesthetic Agents
f8d93899-b196-427e-9c0e-0f2a4e909a21
All of the following are features of Devic's syndrome (neuromyelitis optica), except?
Separate attacks of acute optic neuritis and myelitis
Optic neuritis is either unilateral or bilateral
Brain MRI is typically normal
It has a fulminant demyelinating process and progress to death in 1-2 year
3d
multi
Devic's disease is a variant of multiple sclerosis. Fulminant demyelinating process is seen with another variant called Marburg's variant.
Medicine
null
23a3d4a0-103f-4d6c-bcb9-dc8bab68b013
Which of the following is true about calcification of teeth?
Calcification of primary teeth is almost complete at time of birth
Calcification of all primary teeth and few permanent teeth complete at birth
Calcification of all permanent teeth complete at birt
Calcification of primary teeth starts around birth
0a
multi
null
Dental
null
2cb2be45-b5db-4716-b3a6-84875ab3ee77
A 7 years old boy presented with painful boggy swelling of scalp, multiple sinuses with purulent discharge, easily pluckable hairs and lymph nodes enlarged in occipital region. Which one of the following would be most helpful for diagnostic evaluation?
Bacterial culture
Biopsy
KOH mount
Patch test
2c
single
Ans. c. KOH mount
Skin
null
2bd24bb6-bc8e-44cd-b4da-e5b6808aaa6d
All the following are seen in Hyperparathyroidism except
Subperiosteal erosion of bone
Loss of lamina dura
Calvarial thickening
Pepper - pot skull
2c
multi
Calvarial thickening is a feature of Hypoparathyroidism.
Radiology
null
edf16f12-4d4c-48c3-bb35-478666e34498
Spore forming anaerobic gram positive bacilli ?
Bacillus Anthracis
Clostridia
Corynebacterium
Peptostreptococcus
1b
single
Ans. is 'b' i.e., Clostridia There are two medically impoant spore forming bacteria. Both of them are 'gram positive' `bacilli' :-Aerobic : BacillusAnaerobic (obligate anaerobes) : Clostridia.
Microbiology
null
daf88486-94e5-4799-960e-a3fc5137e1ab
Drug of choice for Falciparum Malaria is:-
Chloroquine
Mefloquine
ACT
Proguanil
2c
single
DOC for Falciparum Malaria - ACT.( Aemisinin based Combination therapy ) In Noh Eastern states:- ACT-AL co-formulated tablet of Aemether-20 mg / Lumefantrine - 120 mg. Primaquine 0.75 mg/ kg Body weight on day 2. 2. In Other States:- ACT-SP -Aesunate 50 mg tablet for 3 days and Sulphadoxine (500mg) - Pyremethamine (25mg) tablets for 1 Day. Primaquine tablets should be given on Day 2.
Social & Preventive Medicine
VBDs, Arboviral & Viral Infections, Surface Infections
b44f4bc6-30c3-4cd1-81b2-f172a886dea9
All are causes of white-dot syndrome except:
Fuch's heterochromic uveitis
VKH syndrome
HIV retinopathy
Sympathetic ophthalmitis
3d
multi
Ans. Sympathetic ophthalmitis
Ophthalmology
null
12af2d6a-1cf7-4dda-ab1d-0044c5ad8243
Maximum flow of Type1 inlay wax at 45degree
2%
3%
10%
70%
3d
single
null
Dental
null
a7bcda01-d462-4e60-bd9c-394439c1f79f
Platypnea is seen with?
Hepato-pulmonary syndrome
Hepato-renal syndrome
Renal aery stenosis
Kyphoscoliosis
0a
single
Platypnea: Increase dyspnea on sitting position Seen in 1. Atrial myxoma 2. Hepatopulmonary syndrome
Medicine
Acute Kidney Injury
013a96ca-7ed9-437b-bdf4-e7482a816fa3
Neuro lathyrism results due to
Aflatoxin
Pyruvic acid
BOAA
Sanguinarine
2c
single
null
Social & Preventive Medicine
null
9dda09e1-8bdc-4fae-be9e-ef95d04e3f71
Factor V Leiden is caused due to a mutation that results in a substitution at position 506 glutamine to which of the following:
Alanine
Arginine
Glycine
Glutamine
1b
single
Mutation in factor V (called the Leiden mutation, after the city in the Netherlands where it was discovered) causes recurrent DVTs. The mutation results in a glutamine to arginine substitution at position 506 that renders factor V resistant to cleavage by protein C. As a result, an impoant antithrombotic counter-regulatory pathway is lost Ref: Robbins 8th edition Chapter 4.
Pathology
null
0729894e-e71d-4e69-8f53-5ae6a8ee75c2
Kunkel's test is done to demonstrate presence of ................. in blood.
Lead
CuSO4
CO
Dhatura
2c
single
Carbon monoxide (CO)
Forensic Medicine
null
7af5d515-19b4-4b9c-b795-224e68a0176b
In which case cystometric study is indicated -
Neurogenic bladder
Stress incontinence
Fistula
Urge incontinence
0a
single
Cystometric studies are urodynamic studies in which the pressure changes in the bladder is simultaneously measured with bladder filling and during micturition. It helps in accurate assessment of detrusor and sphincter activity especially if a neurogenic abnormality is suspected. Though it is also used in stress incontinence but the aim here is to rule out any neurogenic cause.
Surgery
null
a18b8864-370a-4ef2-a61f-1265eba77975
Fish tank granuloma is seen in -
Mfortuitum
Mkansasi
Mmarinum
M leprosy
2c
single
Ans. is 'c' i.e., M. Marinum o Fish tank granulomaalso called ' swimming pool granuiomaf is caused by M. marinum.Principal types of opportunist mycobacterial disease in man and the usual causative agents.DiseasesUsual causative agentLymphadenopathyM. avium complexM. scrofulaceumSkin lesionPost-trauma abscessSwimming pool granulomaBuruli ulcerM. chelonaeM.fortuitumM. terraeM.marinumM. ulceransPulmonary' diseaseM. avium complexM. kansasiiM.xenopiM.malmoenseDisseminated diseaseAIDS-relatedM, avium complexM.genevenseM.avium complexM. chelonae
Microbiology
Bacteria
f30e750a-793d-4431-9be7-df8681f20a4f
TYNDALLISATION is a type of
intermittent sterilization
pasteurisation
boiling
autoclaving
0a
multi
null
Microbiology
null
6928a986-b002-4115-9c81-631f67d6c07a
A 49-year-old female taking ibuprofen for increasing joint pain in her hands presents with increasing pain in her midsternal area. Gastroscopy reveals multiple, scattered, punctate hemorrhagic areas in her gastric mucosa. Biopsies from one of these hemorrhagic lesions reveal mucosal erosions with edema and hemorrhage. No mucosal ulceration is seen.
Active chronic gastritis
Acute gastritis
Autoimmune gastritis
Chronic gastritis
1b
single
Gastritis is a nonspecific term that describes any inflammation of the gastric mucosa. Acute gastritis refers to the clinical situation of gastric mucosal erosions (not mucosal ulcers). Acute gastritis is also known as hemorrhagic gastritis or acute erosive gastritis. Acute gastritis is associated with the use of nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and coicosteroids, and also with alcohol, chemotherapy, ischemia, shock, and even severe stress. Two types of stress ulcers are Curling's ulcers, seen in patients with severe burns, and Cushing's ulcers, seen in patients with intracranial lesions. Grossly acute gastritis appears as multiple, scattered, punctate (less than 1 cm) hemorrhagic areas in the gastric mucosa. This is helpful in differentiating acute gastritis from peptic ulcers, which tend to be solitary and larger. Microscopically the gastric mucosa from a patient with acute gastritis is likely to reveal mucosal erosions, scattered neutrophils, edema, and possibly hemorrhage. Acute gastritis. Erosion and complete effacement of the epithelium is observed. The residual glands, on the left, display regenerative changes with basophilic epithelium. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition
Pathology
miscellaneous
3ce61463-a3ad-4e05-8e97-b404f9f04e0e
Sedimentation coefficient of Ig E is:
7S
8S
11S
20 S
1b
single
Ans : b 8S Ref: Ananthanarayanan 8th editionSvedberg unit - a sedimentation constant of 1 x 1013sec. Sedimentation unit is studied by ultracentrifugation - for diversity of antibody moleculeIgG -7IgA -7IgM -19Ig D -7IgE -8
Microbiology
Immunology
5f8a32c1-31db-477e-99cd-467e1f443720
DNA dependent RNA synthesis is inhibited by:
Rifampicin
Ethambutol
Colchicine
Chloromycetin
0a
single
Rifampicin
Pharmacology
null
9e9842eb-7ec0-4d06-9a22-bbcb97151aec
Iliac crest involvement is common in which condition: March 2007
Ankylosing spondylitis
Rheumatoid ahritis
Reiter's syndrome
Osteoahritis
0a
single
Ans. A: Ankylosing Spondylitis The basic pathologic lesion of ankylosing spondylitis occurs at the entheses, which are sites of attachment to bone of ligaments, tendons, and joint capsules. Enthesopathy results from inflammation, with subsequent calcification and ossification at and around the entheses. Inflammation with cellular infiltration by lymphocytes, plasma cells, and polymorphonuclear leukocytes is associated with erosion and eburnation of the subligamentous bone. The process usually stas at the sacroiliac joints. Other enthesopathic sites include the iliac crest, ischial tuberosity, greater trochanter, patella, and calcaneum. Ankylosing spondylitis/ AS/ Bechterew's disease/ Bechterew syndrome/ Marie Strumpell disease/Spondyloahritis is a chronic, painful, degenerative inflammatory ahritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine. AS is a systemic rheumatic disease and one of the seronegative spondyloahropathies. About 90% of the patients express the HLA-B27 genotype. Men are affected more than women by a ratio in excess of 10:1. Typical signs of progressed AS are the visible formation of syndesmophytes on X-rays and abnormal bone outgrowths similar to osteophytes affecting the spine. Complete fusion results in a complete rigidity of the spine, a condition known as bamboo spine. In 40% of cases, ankylosing spondylitis is associated with iridocyclitis causing eye pain and photophobia. 4.1 AS is also associated with ulcerative colitis, Crohn's disease, psoriasis, and Reiter's disease Other complications are aoic regurgitation, Achilles tendinitis, AV node block and amyloidosis & restrictive lung disease. A clinical examination and X-ray studies of the spine, which show characteristic spinal changes and sacroiliitis, are the major diagnostic tools. The Schober's test is a useful clinical measure of flexion of the lumbar spine performed during examination.
Surgery
null
17a37bf5-e78b-48f2-be15-16c1049d1427
A 40-year-old man presents with a 2-week history of recur- rent oral ulcers, genital ulcers, intermittent arthritic pain of the knees, and abdominal pain. Physical examination reveals shallow ulcerations of the mucosa of the glans penis, as well as oral aphthous ulcers and conjunctivitis. Which of the following is the most likely diagnosis?
Behyet disease
Genital herpes
Gonorrhea
Polyarteritis nodosa
0a
multi
Behget disease is a systemic vasculitis characterized by oral aphthous ulcers, genital ulceration, and ocular inflammation, with occasional involvement of the nervous, gastrointestinal, and cardiovascular systems. The mucocutaneous lesions show a non-specific vasculitis of arterioles, capillaries, and venules. The cause of the necrotizing inflammation of small blood vessels is not known, but an association with specific HLA subtypes suggests an immune basis. Herpes (choice B) does not present with arthritis.Diagnosis: Behqet disease
Pathology
Blood Vessels
c6e0048e-68f8-493d-8bdf-bcd1afea8f1e
About biotransformation not true ?
Active metabolite generation
Polar to less polar
Less polar to more polar
Generate active drug from prodrug
1b
multi
Ans. is 'b' i.e., Polar to less polar
Pharmacology
null
be876641-0cee-4b0d-973f-af68790776da
In which phase of cell cycle, proof reading occurs?
G1
S
G2
M
1b
single
EVENTS PHASE of cell cycle Proofreading S phase Most repairs G1 phase Mismatch repair G2 phase
Biochemistry
Molecular Biology
2435c2fd-0ab9-4097-9969-6ce371e46532
The number of ATPs generated in krebs cycleare ?
12
24
15
30
1b
single
Ans. is 'b' > b' i.e., 24 One turn of the TCA cycle, staing with acetyl CoA produces 10 ATPs. When the staing molecule is pyruvate, the oxidative decarboxylation of pyruvate, the oxidative decarboxylation of pyruvate yields 2.5 ATPs and therefore, 12.5 ATPs are produced when staing compound is pyruvate. Since, two molecules of pyruvate enter the TCA cycle when glucose is metabolized (glycolysis produces 2 molecules of pyruvate), the number of ATPs is doubled. Therefore, 25 ATP molecules, per glucose molecule, are produced when pyruvate enters the TCA cycle.Note : Previously calculations were made assuming that NADH produces 3 ATPs and FADH generates 2 ATPs. This will amount a net generation of 30 ATP molecules in TCA per molecule glucose and total 38 molecules from staing. Recent experiments show that these values are overestimates and NADH produces 2.5 ATPs and FADH produces 1.5 ATPs. Therefore, net generation during TCA is 25 ATPs and complete oxidation of glucose through glycolysis plus citric acid cycle yield a net 32 ATPs.Energy yield (number of ATP generated) per molecule of glucose when it is completely oxidized through glycolysis plus citric acid cycle, under aerobic conditions, is as follows :- Method ofNo of ATPsNo of ATPsPathwayStepEnzymeSource ATP formationgained perglucose(new calculation)As per oldcalculationGlycolysis1Hexokinase MinusMinus 1Do3Phosphofructokinase MinusMinus 1Do5Glyceraldehyde-3-p DHNADH Respiratory chain2.5 x 2 = 53 x 2 = 6Do61,3-BPGkinase ATPSubstrate level1 x 2 -- 21 x 2 = 2Do9Pyruvate kinaseATP Substrate level1 x 2 = 21 x 2 = 2Pyruvate to?PyruvateNADH Respiratory chain2.5x2= 53x2= 6Acetyl CoA Dehydrogenase TCA cycle3Isocitrate DHNADH Respiratory chain2.5x2= 53 x 2= 6Do4Alpha keto glutarate DHNADH Respiratory chain2.5x2= 53x2= 6Do5Succinate thiokinaseGTP Substrate level1 x 2 = 21 x 2 = 2Do6Succicinate DHFADH2Respiratory chain1.5x2= 32 x 2= 4Do8Malate DHNADH Respiratory chain2.5x2= 53 x 2= 6Net generation in glycolytic pathway 9 minus 2= 7 10 minus 2= 8Generation in pyruvate dehydrogenase reaction 5 * 6Generation in citric acid cycle 20 * 24Net generation of ATP from one glucose mole 32 * 38
Biochemistry
null
10fa25e5-2afd-4660-bd47-8759e3004d33
Child with mild squint. Intrauterine, bih history, developmental history till date all normal. Corneal reflex normal. All other eye parameters normal except exaggerated epicanthal fold. Diagnosis ?
Pseudostrabismus
Accomodative squint
Exophoria
Esophoria
0a
multi
Ans. is 'a' i.e., Pseudostrabismus Epicantnic fold causes Pseudoesotropia (Pseudostrabismus).
Ophthalmology
null
9c66c905-3a4a-440e-973f-270b04fe9a86
Pain-sensitive intracranial structure is:
Piamater
Pial vassels
Duramater
Brain matter
2c
single
C i.e.Duramater
Physiology
null
afa909b3-f7e2-4c1c-9747-9638994735ce
Not used for iron poison in: FMGE 09; NEET 13
Magnesium hydroxide
Desferrioxamine
Gastric lavage
Penicillamine
3d
single
Ans. Penicillamine
Forensic Medicine
null
23294025-db77-485a-a342-16e13930f3b2
Posterior relations of the head of the pancreas include all of the following, except:
First pa of the duodenum
Common bile duct
Inferior vena cava
Aoa
0a
multi
The posterior relations of the head of the pancreas include the common bile duct, inferior vena cava and the right and left renal veins terminating into it. The first pa of the duodenum is an anterior relation of the head of the pancreas.Ref: Clinical Anatomy, By Richard S. Snell, 6th edition, Page 230; Clinical Anatomy (A Problem Solving Approach), By Neeta V Kulkarni, 2nd edition, Page 689.
Anatomy
null
daea259a-2232-46db-8d5a-e04d5a1d4c5c
Which of the following events is involved in cleavage of the zygote during week 1 of development?
A series of meiotic divisions forming blastomeres
Production of highly differentiated blastomeres
An increased cytoplasmic content of blastomeres
A decrease in size of blastomeres
3d
single
Cleavage is a series of mitotic divisions by which the large amount of zygote cytoplasm is successively paitioned among the newly formed blastomeres. Although the number of blastomeres increases during cleavage, the size of individual blastomeres decreases until they resemble adult cells in size.
Anatomy
Development period- week 1,2,3,4
2490c0e2-5e57-46de-a276-0163f4b35337
A female child with virilization, hypertension with low plasma renin diagnosis is :
21α hydroxylase deficiency
11 β hydroxylase deficiency
3β hydroxylase deficiency
Conn’s syndrome
1b
single
9] Congenital adrenal hyperplasia represents a group of autosomal recessive inherited, metabolic errors, each characterized by decency or total lack of a particular enzyme involved in the biosynthesis of cortical steroids, Steroidogenesis is then channelled into other pathways leading to increased production of androgens, which accounts for virilization. Simultaneously, the decency of cortisol results in increased secretion of ACTH resulting in adrenal hyperplasia. Following enzymes are implicated in the congenital adrenal hyperplasia 21 α hydroxylase decency (partial or complete) 17 α hydroxylase deficiency 11β hydroxylase deficiency 21 α hydroxylase deficiency • Two forms of this deficiency include - A. Salt-wasting adrenogenital ism B. Simple Virilizing adrenogenital ism A) Salt-wasting syndrome (complete lack) The salt wasting syndrome results from complete lack of 21 hydroxylases. There is no synthesis of mineralocorticoids and glucocorticoids in the adrenal cortex. Decreased mineralocorticoids causes marked sodium loss in the urine, resulting in hyponatremia, hyperkalemia, acidosis and hypotension. Because of the enzyme block, there is increased formation of 17 - hydroxyprogesterone, which is then shunted into the production of testosterone. This may cause virilism (pseudo-hermaphroditism) in female infants. That is (XX) Female with 21 hydroxylase deficiency develops ovaries, female ductal structures and external male genitalia. But in the male child, the effect of increased testosterone will not be manifested at the time of birth. The complete21 hydroxylase deficiency or salt wasting syndrome usually comes to light only after the birth because in utero the electrolytes and uids can be maintained by maternal kidneys. Males with this disorder comes to clinical attention 5 to 15 days later because of salt losing crisis while females come to attention soon after the birth because of the virilization. B) Simple Virilizing adrenogenital syndrome (Partial deficiency) Occurs in individuals with partial deficiency of 21 hydroxylases Less severe deficiency of mineralocorticoid, is sufficient for salt reabsorption, but the lowered glucocorticoid fails to cause feedback inhibition of ACTH secretion. Thus level of aldosterone is mildly reduced, testosterone is increased and ACTH elevated with resultant adrenal hyperplasia. 11B hydroxylase deficiency-. Rare Leads to decreased cortisol and increased ACTH. This, in turn, leads to the accumulation of DOC (deoxycorticosterone) and 11 deoxycortisol both of which are strong mineralocorticoids. This results in increased sodium retention by the kidneys and hypertension, hypokalemia. Patients also develop virilization due to androgen excess. 17 α hydroxylase deficiency - Patients with deficiency of 17 hydroxylases also have impaired cortisol production, increased ACTH and secondary increased DOC. These patients, however, cannot synthesize normal amount of androgens and estrogens. This is because the gene that codes for 17 α hydroxylase is the same for the enzyme in the adrenal cortex and the gonads and the decency is same in both organs. Because of decreased sex hormones, genotypic females develop primary amenorrhoea and fail to develop secondary sex characteristics while genotypic males will present as pseudohermaphrodite. 3 β hydroxylase deficiency 3-β hydroxylase deficiency is a rare genetic disorder of steroid biosynthesis that results in decreased production of all three groups of adrenal steroids which include mineralocorticoid, glucocorticoid and sex steroids. Decreased mineralocorticoid secretion results in varying degrees of salt wasting in both males and females. Decent androgen production results in ambiguous genitalia in males The usual presentation is a male child with ambiguous genitalia and severe salt wasting. Sometimes it may also occur in females
Medicine
null
0b9a50a8-7210-4ff5-81f6-b49dee01c09b
'Patterned' abrasion is variety of:
Linear abrasion
Pressure abrasion
Sliding abrasion
Superficial bruise
1b
single
Ans. is 'b' ie pressure abrasion (Ref: Parikh; 6/e, p4.3).An abrasion is a superficial injury involving only the superficial layers of the skin (epidermis only), caused by friction and / or pressure between the skin and some rough object or surface. It bleeds very slightly, heals rapidly in a few days and leaves no scar.They can be classified into 3 types, depending on the manner they are created.ScratchIs a linear injury produced by a sharp object, such as pin, thorn or finger nail.Graze (Sliding, scraping or grinding abrasion).Is produced when a broad surface of skin slides against a rough surface.It is also known as brush or friction burn because it is caused by the frictional force and resembles a burn after dryingIt is commonly found in road traffic accidents.Imprint, Pressure or contact abrasion.Is produced as a result of direct impact or pressure of or contact with some object at right angles to the skin surface.The cuticle is crushed, and the object marks a reproduction of its shape and pattern on the to the skin, therefore it is known as patterned abrasion.Example are ligature marks in hanging and strangulation, nail and thumbs marks in throttling, teeth marks in biting, radiator, grill or tyre mask in vehicular accidents.
Forensic Medicine
Sexual Offenses
1d267206-3dd2-462b-9b44-8a3a48c31c12
Pimozide belongs to class of:
Thiothixanthene
Phenothiazine
Butyrophenone
Diphenyl butyl piperidine
3d
multi
Thioxanthenes are flupenthioxol. Butyrophenones are haloperidol, trifluperidol , penfluridol. Phenothiazines are Chlorpromazine, triflupromazine , thioridazine, flufenazine. Promazine belongs to the group of other of other hetero cyclics that is diphenyl butyl piperidine. Ref: KD Tripathi 8th ed.
Pharmacology
Central Nervous system
7b33754c-beaa-43e5-81f5-f4c3f8bf2245
Which of the following drugs is antipseudomonal penicillin?
Cephalexin
Dicloxacillin
Piperacillin
Cloxacillin
2c
single
null
Pharmacology
null
b3dcc864-5d6f-4d14-b6bf-143f4d777784
Following poisoning retards putrefaction: NEET 13
Aluminium phosphide
Lead
Arsenic
Copper
2c
single
Ans. Arsenic
Forensic Medicine
null
3bad3d0c-b14c-4ec4-a203-a124976139a0
True statements about parotid gland
Duct opens oppsite to upper 2nd molar tooth
Duct pierces Masseter
Develops from ectoderm
Secretomotor fibres come from facial nerve
0a
multi
The duct runs forwards for a sho distance between the buccinator and the oral mucosa. Finally, the duct turns medically and opens into the vestibule of the mouth(gingivobuccal vestibule)opposite the crown of the upper second molar tooth. Notes: Parotid abscess may be caused by spread of infection from the opening of parotid duct in the mouth cavity. <img src=" /> REF.BDC VOL.3,Sixth edition pg 110
Anatomy
Head and neck
17b8471f-d82c-4236-a843-66e19ce561b0
Which of the following statement is false about hydrocele?
Arises due to patent processus vaginalis
Wait for 5 years for spontaneous closure of congenital hydrocele
Lord's plication of sac for small hydrocele
Jaboulay's eversion of sac for medium hydrocele
1b
multi
Treatment of Hydrocele Congenital Hydrocele: Usually spontaneous obliteration by 2 years age. If persists then Herniotomy. Treatment of Vaginal Hydrocele 1. Small hydrocele: Lord's procedure (Plication of sac)Q 2. Medium hydrocele: Jaboulay's procedure (Eversion of sac)Q 3. Large hydrocele: Excision of sacQ
Surgery
Testis and scrotum
0efb3876-ad2b-44d1-99c9-73c50708d75b
The main difference between dental stone and dental plaster is:
Chemical composition
Self life
Shape and size of particles
Solubility in water
2c
single
null
Dental
null
fa6f9581-fb3b-49be-b366-c97793f765ff
A normally developing 10 months old child should be able to do all of the following except –
Stand alone
Play peak to boo
Pick up a pellet with thumb and index finger
Build a tower of 3–4 cubes
3d
multi
A child starts trying to build a tower of cubes (2 cubes) by the age of 1 year. About other options Child can stand with support by 9 months. Child can play peak-a-boo game by 10 months. Child can pick up a pellet with thumb and index finger (pincer grasp) by 9 months.
Pediatrics
null
2d7752b3-6526-4bba-90a1-b7862767573b
Lines of Blaschko&;s are along
Lymphatics
Nervs
Developmental
Blood vessels
2c
single
Blaschko&;s lines, are lines of normal cell development in the skin. These lines are invisible under normal conditions.
Anatomy
General anatomy
864d863c-3c3f-4f72-b1dc-bf0ec9e8d0c3
All the teeth in patient’s mouth are similarly affected as shown in the radiograph. What is the most likely anomaly?
Type 1 dentinal dysplasia
Type 2 dentinal dysplasia
Taurodontism
Amelogenesis imperfecta
1b
multi
Dentinal dysplasia Dentinal dysplasia is an inherited condition affecting both dentitions. It is divided into two types: Type I (radicular dentinal dysplasia) and Type II (coronal dentinal dysplasia). It occurs less frequently than dentinogenesis imperfecta. Clinical features Type I is the more frequent type. Teeth erupt normally with no obvious abnormality but rapidly develop mobility resulting from limited root support. In type II, the deciduous teeth are similar to those in dentinogenesis imperfecta, whereas the permanent teeth appear normal. Radiological signs In Type I, all the teeth, except the canines, have extremely short roots. The roots are conical or blunted. There is pulpal obliteration and the inferior aspects of the crown exhibit linear crescent-shaped radiolucent lines. Periapical radiolucencies are commonly seen associated with non-carious teeth in Type I dentinal dysplasia. In Type II dentinal dysplasia, obliteration of the pulp occurs post eruption in the deciduous dentition. In the permanent dentition, there is alteration in the configuration of the pulp resulting in enlarged pulp chambers extending well down into the root. The pulp contains multiple calcifications. Ref: Interpreting Dental Radiographs by Keith Horner, Jon Rout and Vivian E Rushton
Radiology
null
4ad3b836-706a-47a9-9ccc-68d9feb2f5e7
Middle aged female with mass in sella turcica hormone increased is -
Prolactin
Thyroxine
Extrogen
ADH
0a
single
The sella turcica is a saddle shaped depression of the sphenoid bone. It forms the caudal border of the pituitary gland. Sella turcica is an anatomically complex area with a number of different potential pathologies especially neoplastic process. Pathologies of sella turcica can lead to important clinical presentations such as hormonal imbalances from pathologies affecting the pituitary gland and neurological symptoms from the mass effect. Sella turcica is critically located as several structures pass close to it due to compression of the adjacent structures. Important anatomical structures related to sella Optic chiasm Pituiatry gland Internal carotids​ Gavernous sinus and cranial nerves Sphenoid sinuses
Medicine
null
3d26c59a-23b7-4f94-bd3a-46c52e94717f
Hyoid bone fracture most common occurs in ?
Manual strangulation
Hanging
Smothering
Traumatic asphyxia
0a
single
Ans. is 'a' i.e., Manual strangulation As manual strangulation (throttling) is among the most violent form of asphyxia, hyoid fracture and other injury to neck structures is more common.
Forensic Medicine
null
e8e89c2e-3ded-4f79-8b72-c4c15b0e0022
"Acute Meningoencephalitis" is caused by:
E. histolytica
Nageleria
Giardia
E.coli
1b
single
Nageleria
Microbiology
null
d700bd56-0b0c-44cc-9099-5986224e73ba
The process of destroying all microbes including spores is called :
Disinfection
Antisepsis
Asepsis
Sterilization
3d
multi
null
Microbiology
null
6ff91b9c-ef2d-4e23-8bbe-91abe79cf929
All are major symptoms of sinusitis except
Nasal blockage
Facial congestion
Nasal congestion
Halitosis
3d
multi
According to Rhinosinusitis task force definition of sinusitis,Major criteria-Facial pain, pressure, congestion, nasal obstruction, nasal/postnasal discharge, hyposmia and feverMinor criteria- Headache, halitosis, and dental painRef: Hazarika; 3rd ed; Pg 328
ENT
Nose and paranasal sinuses
fd69db25-3857-40ab-acb4-d7aedc45b959
Most sensitive nerve fiber to hypoxia
A
B
C
All are equally sensitive
1b
multi
Question repeated
Physiology
Nervous system
344ff8fd-3b80-4311-9f67-a5f54e3e0fff
Nasal septum is formed except by
Perpendicular plate of ethmoid
Vomer
Nasal bone
Lateral cailage
3d
multi
The bony pa is formed by: 1.Vomer 2.Perpendicular plate of ethmoid 3.Nasal spine of frontal bone 4.Rostrum of sphenoid 5.Nasal crest of nasal, palatine and maxillary bones. NOTES: The cailaginous pa is formed by; 1.Septal cailage 2.Septal process of inferior nasal cailages The cuticular pa is formed by; 1.Fibrofatty tissue Ref.BDC volume3,Sixth edition pg 240
Anatomy
Head and neck
041f5188-7539-4b9a-8784-b7ebf0f10021
Metoprolol is preferred over Propranolol as it: September 2010
Is more potent in blocking beta-1 receptors
Is more potent in blocking beta-2 receptors
Is more effective in suppressing essential tremors
Impairs exercise capacity
0a
single
Ans. A: Is more potent in blocking beta-1 receptors Metoprolol is cardioselective beta blocker, more potent in blocking beta-1 than beta-2 adrenergic receptors.
Pharmacology
null
6acbf6b1-7c5c-42a8-a0f9-cae7485b9eb3
All will predispose to atherosclerosis, except
Homocystinemia
Fibrinogen
Calcium
Lipoprotein A
2c
multi
Elevated plasma levels of  homocysteine are associated with increased risk of atherosclerosis, thrombosis and hypertension. Lipoprotein A inhibits fibrinolysis, therefore predisposes to atherosclerosis. Atherosclerosis (Greek  athere-mush)  is a complex disease characterized by thickening or hardening of arteries due to the accumulation of lipids (particularly cholesterol, free, and esterified), collagen, fibrous tissue, proteoglycans, calcium deposits, etc. in the inner arterial wall.  Satyanarayana, Ed 3, Pg No 152
Biochemistry
null
c4dbe11c-2ef0-4043-adcb-5a068e9afe0e
Most serious complication seen in other eye after traumatic injury to one eye: March 2005, September 2008
Subconjunctival hemorrhage
Corneal edema
Sympathetic ophthalmia
Sudden loss of vision
2c
single
Ans. C: Sympathetic ophthalmia Sympathetic ophthalmia (SO) is a condition in which serious inflammation attacks the sound eye after injury (including intraocular surgeries) to the other. It is the most dreaded complication of unilateral severe eye injury, as it can leave the patient completely blind. Symptoms may develop from days to several years after a penetrating eye injury. Sympathetic ophthalmia is thought to be an autoimmune inflammatory response toward ocular antigens, specifically a delayed hypersensitivity to melanin-containing structures from the outer segments of the photoreceptor layer of the retina. It is thought that Louis Braille, who injured his left eye as a child, lost vision in his right eye due to SO Floating spots and loss of accommodation are among the earliest symptoms. The disease may progress to severe iridocyclitis with pain and photophobia. Commonly the eye remains relatively painless while the inflammatory disease spreads through the uvea. The retina, however, usually remains uninvolved. Papilledema, secondary glaucoma, vitiligo and poliosis of the eyelashes may accompany SO. Diagnosis is clinical, seeking a history of eye injury. An impoant differential diagnosis is Vogt-Koyanagi-Harada syndrome (VKH), which is thought to have the same pathogenesis, without a history of surgery or penetrating eye injury. Definitive prevention of SO requires prompt (within the first 7 to 10 days following injury) enucleation of the injured eye. Evisceration--the removal of the contents of the globe while leaving the sclera and extraocular muscles intact--is easier to perform, offers long-term orbital stability, and is more aesthetically pleasing. But evisceration may lead to a higher incidence of SO compared to enucleation. Immunosuppressive therapy is the mainstay of treatment for SO. When initiated promptly following injury, it is effective in controlling the inflammation and improving the prognosis.
Ophthalmology
null
efdbc8fc-57c6-4154-b35f-0907d23ad414
Least commonly seen in conduct disorder seen in girls:-
Run away from home
High risk sexual behavior
Physical aggression
Emotional bullying
2c
single
Conduct disorder - Persistent pattern of antisocial behavior in which the individual repeatedly breaks social rules and carries out aggressive acts.in conduct disorder they do it deliberately usually characterized by aggression and violation of the rights of others boys with conduct disorder show physical & relationship aggression but In girls relationship aggression is more predominant than physical aggression children with conduct disorder usually have behaviors characterized by aggression to persons or animals, destruction of propey, deceitfulness or theft, and multiple violations of rules, such as truancy from school.
Psychiatry
JIPMER 2018
4a4c2a4f-37d5-469b-a65e-107ee1b863da
Which of the following aminoglycosides has the highest nephrotoxicity?
Paromomycin
Streptomycin
Amikacin
Neomycin
3d
single
null
Pharmacology
null
3d486b16-b896-442c-8c67-2e9530e89fce
Least conduction velocity is seen in:
AV node
Purkinje fibers
Bundle of His
Ventricular myocardial fibres
0a
single
null
Physiology
null