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[ { "content": "Surgery for periductal mastitis - \nSelect and explain. \nA. Hadfield's operation, B. Patey's mastectomy, C. Modified radical mastectomy, D. None of the above", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "The medicolegal impoance of postmoem lividity is all except - (UP 07) \nSelect and explain. \nA. Cause of death elsewhere, B. Time since death, C. Manner of death, D. Position of the body at the death", "role": "user" }, { "content": "Answer: C \nExplanation: The postmoem hypostasis helps to estimate time since death with its extent, is a sign of death, posture and moving of body at death by its fixation. Cause of death can be determined from its colour. Dr.Narayana Reddys Synopsis of Forensic Medicine and Toxicology 27th edition pg. 78.", "role": "assistant" } ]

[ { "content": "Asherman syndrome is due to : \nSelect and explain. \nA. Overdose drugs, B. Postaboion curettage, C. Speticemia, D. Contraceptal pills", "role": "user" }, { "content": "Answer: B \nExplanation: Postaboion curettage", "role": "assistant" } ]

[ { "content": "All of the following are predominant motor neuropathy except - \nSelect and explain. \nA. Acute inflammatory demyelinating polyradiculo neuropathy, B. Porphyric neuropathy, C. Lead intoxication, D. Arsenic intoxication", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "A three years old boy presents with poor urinary stream. Most likely cause is - \nSelect and explain. \nA. Stricture urethra, B. Neurogenic bladder, C. Urethral calculus, D. Posterior urethral valve", "role": "user" }, { "content": "Answer: D \nExplanation: Ans is 'd' i.e. Posterior urethral valve Poor urinary stream in 3 years old boy suggests urinary tract obstruction (usually infravesical) and the most common cause of obstructive uropathy in a male child is posterial urethral valve. Posterior urethral valve These are symmetrical folds of urothelium extending distally from prostatic urethra to external urinary sphincter. It most commonly lies just distal to the verumontanum or at the verumontanum* It occurs only in males. It behaves as flap valves so, although urine does not flow normally a urethral catheter can be passed without difficulty. Sometimes, the valves are incomplete and the patient remains without symptoms until adolescence or adulthood. Approximately 30% of patients experience end stage renal disease Vesicoureteral reflux occurs in 50% of patients. Diagnosis is made by (a) voiding cystourethrogram* & (b) endoscopy Both of these investigations clearly depict the site of obstruction. The diagnosis can be established prenatally by ultrasound.* Management First a small polyethylene feeding tube is inseed in the bladder and left for several days. Then fuher management is done according to serum creatinine level. (a) with normal serum creatinine --> transurethral ablation of the valve leaflets. * (b) With increased serum creatinine and the worsening of condition --> vesicostomy to bypass the obstruction and when normal creatinine levels are achieved, transurethral ablation is done.", "role": "assistant" } ]

[ { "content": "Pulled elbow means - \nSelect and explain. \nA. Fracture of head of radius, B. Subluxation of head of radius, C. Fracture dislocation of elbow, D. Fracture ulna", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Subluxation of head of radius Pulled elbowo If a young child is lifted by the wrist, the head of the radius may be pulled partly out of the annular ligament, i.e., subluxation of the head of the radius.o Ir occurs when forearm is pronated, elbow is extended and longitudinal traction is applied to the hand or wrist, e.g., lifting, spinning or swinging a child with wrist or hand. Pulled elbow most commonly occurs between the age of 2-5 years.Clinical features of pulled elbowo History of sudden axial pull on extended elbow.o Immediately child starts crying and is unable to move the affected elbow.o The forearm is held in pronation and extension and any attempt to supinate is resisted,o Child does not allow to touch the affected limb,o X-ray seems to be normal.Treatment of pulled elbowo Treatment is simple. The child's attention is diverted, the elbow is quickly supinated and then slightly flexed.o This reduces the subluxation or dislocation and the radial head is relocated with a snap.", "role": "assistant" } ]

[ { "content": "Recommended level of fluoride in drinking water- \nSelect and explain. \nA. 0.2-0.5 mg/L, B. 0.5-0.8 mg/L, C. 0.8-1.2 mg/L, D. 1.2-2.0 mg/L", "role": "user" }, { "content": "Answer: B \nExplanation: Ans, is 'b' i.e., 0[?]5 - 0[?]8 mg/L o The recommended level of fluoride in drinking water in the country is accepted as 0-5 to 0-8 mg.; Liter. -Park o The maximum permissible limit is T5 mg/L it.", "role": "assistant" } ]

[ { "content": "A 95-year-old woman touches a pot of boiling water. Within 2 hours, she has marked erythema of the skin of the fingers of her hand, and small blisters appear on the finger pads. This has led to which one of the following inflammatory responses? \nSelect and explain. \nA. Fibrinous inflammation, B. Granulomatous inflammation, C. Purulent inflammation, D. Serous inflammation", "role": "user" }, { "content": "Answer: D \nExplanation: Serous inflammation is the mildest form of acute inflammation. A blister is a good example of serous inflammation. It is associated primarily with exudation of fluid into the sub-corneal or subepidermal space. Because the injury is mild, the fluid is relatively protein-poor. A protein-rich exudate results in fibrin accumulation. Granulomatous inflammation is characterized by collections of transformed macrophages called epithelioid cells. Acute inflammatory cells, mainly neutrophils, exuded into a body cavity or space form a purulent (suppurative) exudate, typically associated with liquefactive necrosis. Loss of the epithelium leads to ulceration.", "role": "assistant" } ]

[ { "content": "A 35 years old man presented with dry cough and rusty coloured sputum; He has history of eating in chinese restraunt very often with consumption of crabs often; What is the probable causative agent in this condition? \nSelect and explain. \nA. Diphyllobothrium latum, B. Pneumocystis jirovecii, C. Paragonimus westermani, D. Strongyloides stercoralis", "role": "user" }, { "content": "Answer: C \nExplanation: from above mentioned clinical scenerion Paragonimus westermani (lung fluke) is moste likely to be causitive organism:- Paragonimus westermani first intermediate host- snail 2nd intermediate host - crab in crab metacercarie larva which is cyst like stage is seen. It causes Red Brown sputum or endemic hemoptysis.", "role": "assistant" } ]

[ { "content": "Hobnail pattern is seen in which type of RCC \nSelect and explain. \nA. Clear cell, B. Papillary, C. Chromophobe, D. Collecting duct", "role": "user" }, { "content": "Answer: D \nExplanation: Renal cell carcinoma *Renal cancers are mostly sporadic, except for a 4% cases which appear familial *Familial renal cancers are due to mutation of VHL and MET genes*98% of all renal cancers (sporadic and familial) are due to VHL mutation encoded in chr3p*Most common cause of familial papillary renal cell carcinoma (rare disease) is MET protooncogene*Most common risk factor for all renal cancers- Tobacco*Most common type of renal cell carcinoma is clear cell carcinoma , which is followed by papillary carcinoma, chromophobe carcinoma and collecting duct carcinoma*Most common type of renal cancer in patients who develop dialysis associated cystic disease - Papillary carcinoma*VHL is a tumour suppressor gene. Mutation of both the VHL genes causes angiogenesis (by increasing expression of hypoxia inducible factor-1) and cell growth (by increasing expression of insulin like growth factor -1)*Renal cell carcinoma mostly affects the poles Microscopic findings:*Classic clinical features of renal cell carcinoma - Costoveebral pain, palpable mass and hematuria*Clear cell carcinoma -Cells with clear cytoplasm containing glycogen and lipids, delicate capillaries*Papillary carcinoma - Papillary formations, foam cells in interstitium, psammoma bodies*Collecting duct carcinoma - irregular channels lined by atypical cells and show hobnail pattern*Chromophobe cell carcinoma - cells with abundant cytoplasm impaing blue colour in Hale's colloidal iron stain (Ref: Robbins 8/e p964)", "role": "assistant" } ]

[ { "content": "Treatable causes of dementia are -a) Alzheimer's ds.b) Hypothyroidismc) Multi-infarct dementia d) SDH (subdural h'ge) e) Hydrocephalus \nSelect and explain. \nA. abc, B. ade, C. bde, D. bce", "role": "user" }, { "content": "Answer: C \nExplanation: Perhaps the use of word “treatable” is inappropriate here since all the types of dementia can be “treated”. The examiner most likely wants to ask the types which can be “reversed” or “cured”", "role": "assistant" } ]

[ { "content": "Normal axial length of the eye - \nSelect and explain. \nA. 18mm, B. 20 mm, C. 24mm, D. 28 mm", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., 24 mm o The length of the eyeball is approximately 24 mm, So the distances from the cornea / crystalline lens to the retina and the focal length of optical rays focused by the comea/crystalline lens propagating in the vitreous humor and imaging on the retina, are also about 24 mm.Dimensiosn of an adult eyeAnteroposterior diameter (Length)24 mmHorizontal diameter23-5mmVertical diameter23 mmCircumference75 mmVolume6-5 mlWeight7 gm", "role": "assistant" } ]

[ { "content": "The dose of radiation for point A for early and locally advancing cervical cancer during brachytherapy according to ABS guidelines is: \nSelect and explain. \nA. 70-75Gy- 75-80Gy, B. 75-75Gy- 80-85Gy, C. 80-85Gy- 85-90Gy, D. 85-90Gy- 90-95Gy", "role": "user" }, { "content": "Answer: C \nExplanation: (Refer: John Hopkins’ Manual of Obstetrics & Gynecology, 4th edition, pg no: 554)\nBrachytherapy of CA Cervix", "role": "assistant" } ]

[ { "content": "All are tumor markers of HCC except \nSelect and explain. \nA. Neurotensin, B. AFP, C. CA - 19-9, D. PIVKA-2", "role": "user" }, { "content": "Answer: C \nExplanation: Tumor markers PIVKA Glypican-3 AFP fractions (AFP-L3) Neurotensin Ref:Sabiston 20th edition Pgno : 1458-1463", "role": "assistant" } ]

[ { "content": "The posterior cord of the Brachial plexus contains all except: \nSelect and explain. \nA. Long thoracic nerve of Bell, B. Axillary, C. Radial, D. Upper subscapular", "role": "user" }, { "content": "Answer: A \nExplanation: Ans: A (Long thoracic nerve of Bell) Ref: Gray's Anatomy, 40th edition, pg.820 Explanation: Lateral cord Lateral pectoral C5, 6. 7 Museulocu taneous C5, 6. 7 Lateral root of median C(5), 6, 7 Medial cord (M4U) Medial pectoral C8. T1 Medial cutaneous of forearm C8. Tl Medial cutaneous of arm C8. T1 Ulnar C(7), 8. T1 Medial root of median C8, T1 Posterior cord (ULTAR) Upper subscapular C5, 6 Thoracodorsal C6, 7.8 Lower subscapular C5.6 Axillary C5, 6 Radial C5.6.7X (T1) Root Dorsal scapular nerve Long thoracic nerve of bell C5 C5,6,7 Trunk Nerve to subclavius Suprascapular nerve C5.6 C5,6", "role": "assistant" } ]

[ { "content": "Mad Cow Disease has been highly publicized in Great Britain. This disease, which is similar to scrapie, is caused by \nSelect and explain. \nA. A prion, B. A virus, C. Rickettsiae, D. An autoimmune reaction", "role": "user" }, { "content": "Answer: A \nExplanation: Mad Cow Disease is related to both scrapie in sheep and bovine spongiform encephalopathy virus. The fear in Great Britain is the potential for acquiring Creutzfeldt-Jakob disease, which is a slowly progressive neurodegenerative disease. Theoretically, such acquisition could be through ingestion of beef from infected cows. A prion consists of protein material without nucleic acid. While related to a virus, a prion is a proteinaceous infectious particle that replicates within cells.", "role": "assistant" } ]

[ { "content": "True about Bater&;s syndrome are all except \nSelect and explain. \nA. Hyperkalemic alkalosis, B. Presents in neonate with ototoxicity have Bain gene mutation, C. Decreased K+ absorption from thick descending loop, D. Autosomal recessive", "role": "user" }, { "content": "Answer: A \nExplanation: Bater syndrome is an autosomal recessive disorder characterized by hypokalemia and metabolic alkosis , resulting from excessive chloride, potassium and sodium wasting in thick ascending loop of Henle . Reference : Ghai pediatrics eighth edition pg no 501", "role": "assistant" } ]

[ { "content": "All are feature(s) of Beckwidth-Wide man syndrome except: \nSelect and explain. \nA. Omphalocele, B. Macrosomia, C. Hyperglycemia, D. Visceromegaly", "role": "user" }, { "content": "Answer: C \nExplanation: Answer- C. HyperglycemiaBeckwidth- Wiedemann syndrome is an overgrowth syndrome that is characterized by visceromegaly, macroglossia, macrosomia,mphalocele and hyperinsulinemic hypoglycemia.", "role": "assistant" } ]

[ { "content": "Which of the following has to be present for diagnosis of major depressive disorder \nSelect and explain. \nA. Loss of interest or pleasure, B. Recurrent suicidal tendency, C. Insomnia, D. Indecisiveness", "role": "user" }, { "content": "Answer: A \nExplanation: In typical depressive episodes of all three varieties described below (mild, moderate, and severe), the individual usually suffers from depressed mood, loss of interest and enjoyment, and reduced energy leading to increased fatigability and diminished activity. Reference: International classification of diseases 10, page 119.", "role": "assistant" } ]

[ { "content": "Which of the following is/are true of blunt renal trauma? \nSelect and explain. \nA. Blunt renal trauma and penetrating renal injuries are managed similarly, B. Blunt renal trauma must be evaluated by contrast studies using either IVP or CT, C. Blunt renal trauma requires exploration only when the patient exhibits hemodynamic instability, D. Any kidney fractured by blunt renal trauma must be explored", "role": "user" }, { "content": "Answer: C \nExplanation: Renal trauma general management - Only those who have gross hematuria need undergo contrast studies. Microscopic hematuria is no longer an indication for contrast evaluation. Patients who have blunt renal trauma need to undergo exploration only if they are hemodynamically unstable. Conservative management in the absence of hemodynamic instability is the current trend. All penetrating injuries should undergo exploration.", "role": "assistant" } ]

[ { "content": "All of the following can lead to increased Intra cranial pressure accept - \nSelect and explain. \nA. Meningitis, B. Subarachnoid Hemorrhage, C. Subdural hemorrhage, D. Migraine", "role": "user" }, { "content": "Answer: D \nExplanation: Answer-D. MigraineCommon causes include-Aneurysm rupture and subarachnoid hemorrhageBrain tumorEncephalitisHead injuryHydrocephalus (increased fluid around the brain)Hypeensive brain hemorrhageIntraventricularhemorrhageMeningitisSubdural hematomaStatus epilepticusStroke", "role": "assistant" } ]

[ { "content": "All of the following are features of Hemophagocytic Lymphohistiocytosis (HLH), except: \nSelect and explain. \nA. Fever, B. Splenomegaly, C. Hyperferritinemia, D. Hyperfibrinogenemia", "role": "user" }, { "content": "Answer: D \nExplanation: Hemophagocytic lymphohistiocytosis (HLH) is a reactive condition marked by cytopenias and signs and symptoms of systemic inflammation related to macrophage activation. For this reason, it is also sometimes referred to as macrophage activation syndrome. Some forms are familial and may appear early in life, even in infants, while other forms are sporadic and may affect people of any age. The common feature of all forms of HLH is systemic activation of macrophages and CD8+ cytotoxic T cells. Primary HLH (Mendelian inherited conditions leading to HLH) Defects in the cytolytic function of cytotoxic T cells and/or NK cells Defects in inflammasome regulation Secondary HLH (apparently non-Mendelian HLH) Infections (mainly viruses, such as EBV, HIV, and CMV, but also bacteria, parasites, and fungi) Malignancies (mainly malignant lymphoma) Macrophage activation syndrome in autoinflammatory or autoimmune disorders Other causes (organ or stem cell transplantation; metabolic,traumatic, iatrogenic causes; and, rarely, pregnancy)", "role": "assistant" } ]

[ { "content": "All are Narcotic drug as per NDPS (National Drug Psychotropic Substances Act) EXCEPT: \nSelect and explain. \nA. Marijuana, B. Ketamine, C. Cannabis, D. Heroine", "role": "user" }, { "content": "Answer: B \nExplanation: ANSWER:(B)KetamineREF: Textbook Of Forensic Medicine And Toxicology: Principles And Practice By Vij 4th ed page 566, style=\"font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0; text-align: left\">The Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 was framed taking into account India's obligations under the three UN drug Conventions as well as Article 47 of the Constitution which mandates that the 'State shall endeavour to bring about prohibition of the consumption except for medicinal purposes of intoxicating drinks and of drugs which are injurious to health'NARCOTIC DRUGSCoca Leaf & derivatives(a) Crude cocaine(b) Ecgonine and derivatives(c) Cocaine, that is, methyl ester of benzoyl-ecgonine and its salts(d) All preparations containing more than 0.1 per cent, of cocaineCanabis (Hemp): (AKA - Cannabis indica/ Indian hemp/Hashish in Egypt/Marijuana in America/Dagga in Africa)(a) Charas/Hashish- resinous exudates of leaves & stem- 25 to 40% THC(b) Ganja - flowering top- 25% THC(c) Any mixture, with or without any neutral material, of any of the above forms of cannabis or cannabisOpium and derivatives(a) Poppy seed: Seeds of Papaver sominiferum are called the poppy seeds while the latex which oozes out and dries is called the opium gum(b) Poppy straw: As per the NDPS Act, poppy straiv means 'all parts of the plant of opium poppy except seeds'(c) Opium derivative means: medicinal opium, phenanthrene alkaloids namely, morphine, codeine, thebaine and their salts, diacetylmorphine (Heroin), that is, the alkaloid also known as diamorphine or heroin and its salts, all preparations containing more than 0.2 per cent, of morphine or containing any diacetylmorphine and their salts, preparations, admixtures, extracts and other substances containing any of these drugs.(II) Psychotropic substances: \"psychotropic substance\" means any substance, natural or synthetic, or any natural material or any salt or preparation of such substance or material included in the list of psychotropic substances specified in the Schedule. E.g. Amphetamines, LSD, Barbiturates, Alprazolam, Benzodiadepines, Ergotamine, Ephedrine, Methyl ethyl ketone (MEK) etc.Note:* Essential narcotic drug means a narcotic drug notified by the Central Government for medical and scientific use (Morphine, Fentanyi and Methadone)* Bhang is a preparation made from cannabis leaves consumed in parts of India on some festivals. As it is not made from cannabis resin or from flowering tops, it is not covered under the NDPSAct, 1985.", "role": "assistant" } ]

[ { "content": "Halban's disease is due to \nSelect and explain. \nA. Persistent corpus luteum, B. Deficient corpus luteum, C. Persistent trophoblast, D. Deficient trophoblast", "role": "user" }, { "content": "Answer: A \nExplanation: Halban's disease: Rare, self-limiting process. Also called Irregular shedding endometrium Due to persistent corpus luteum due to incomplete withdrawal of LH even on 26 in day of cycle. The corpus luteum continues to secret progesterones Menstruation comes on time, is prolonged but not heavy. Slight bleeding continues intermittently for several days after proper flow. On D& C done on 5-6th of cycle - endometrial tissue shows presence of proliferative endometrium along with secretory endometrium", "role": "assistant" } ]

[ { "content": "The RPR test uses VDRL antigen containing fine \nSelect and explain. \nA. Carbon paicles, B. Iodine paicles, C. Silver ions, D. Sodium ions", "role": "user" }, { "content": "Answer: A \nExplanation: The rapid plasma reagin (RPR) test is a macroscopic, nontreponemal flocculation card test used to screen for syphilis. RPR antigen is prepared from a modified VDR antigen suspension containing choline chloride to eliminate the need to heat inactivate serum, ethylenediaminetetraacetic acid (EDTA) to enhance the stability of the suspension, and finely divided charcoal paicles as a visualizing agent. Ref: Ananthanarayana textbook of Microbiology 9th edition Pgno : 374", "role": "assistant" } ]

[ { "content": "Human metapneumovirus is structurally similar to: \nSelect and explain. \nA. Influenza virus, B. Respiratory syncytial virus, C. Measles virus, D. Rubella virus", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. b. Respiratory syncytial virus", "role": "assistant" } ]

[ { "content": "What is the mechanism of action of Fluconazole? \nSelect and explain. \nA. Inhibits fungal mitosis, B. Inhibits lanosterol 14 demethylase, C. Inhibits squalene epoxidase, D. Inhibit ß1,3 glucan synthase", "role": "user" }, { "content": "Answer: B \nExplanation: Ref. KDT. Page. 793\nFluconazole\n\nThey inhibit the fungal cytochrome P450 enzyme ‘lanosterol 14-demethylase’ and thus impair ergosterol synthesis leading to a cascade of membrane abnormalities in the fungus.\nlower affinity for mammalian CYP450 enzymes and lesser propensity to inhibit mammalian sterol synthesis – causes less side effects\nIt is a water-soluble triazole having a wider range of activity\nIndications include cryptococcal meningitis, systemic and mucosal candidiasis in both normal and immunocompromised patients, coccidioidal meningitis and histoplasmosis", "role": "assistant" } ]

[ { "content": "Which of the following is the most common benign neoplasm of liver \nSelect and explain. \nA. Hepatic adenoma, B. Cavernous hemangioma, C. Lipoma, D. Nodular regenerative hyperplasia", "role": "user" }, { "content": "Answer: B \nExplanation: Most common benign neoplasm is cavernous hemangioma\nMost common hepatic neoplasm is metastasis\nMost common primary malignant tumor is Hepatocellular carcinoma.", "role": "assistant" } ]

[ { "content": "A patient presents with Hb of 8 gm%, WBC count of 2000/mm3 and platlet count of 60000/mm3. What is your likely diagnosis ? \nSelect and explain. \nA. Thalassemia, B. Sickle cell anemia, C. Aplastic anemia, D. Anemia of chronic disease", "role": "user" }, { "content": "Answer: C \nExplanation: Answer- C. Aplastic anemiaThe patient in question is having Pancytopenia (anemia, leukopenia and thrombocytopenia) - Feature of Aplastic anemia.", "role": "assistant" } ]

[ { "content": "Why fetal cells continue to divide but terminally differentiated adult cells do not divide - \nSelect and explain. \nA. There are many cyclin inhibitors which prevent cell to enter into S phase in adult, B. Phosphatase absent in fetal cells, C. Proteinase is absent in fetus, D. Absence of CD kinase", "role": "user" }, { "content": "Answer: A \nExplanation: A cyclin-dependent kinase inhibitor protein is a protein which inhibits cyclin-dependent kinase. Several function as tumor suppressor genes. Cell cycle progression is negatively controlled by cyclin-dependent kinases inhibitors (called CDIs, CKIs or CDKIs). CDIs are involved in cell cycle arrest at the G1 phase.", "role": "assistant" } ]

[ { "content": "Which aery does not contribute to little's area: \nSelect and explain. \nA. Anterior ethmoidal aery, B. Septalbrach of facial aery, C. Sphenopalatine aery, D. Posterior ethmoidal aery", "role": "user" }, { "content": "Answer: D \nExplanation: Little's area-Anteroinferior pa of nasal septum- formed by- anterior ethmoidal aery,septal branch of superior labial aery,septal brach of sphenopalatine aery,greater palatine aery. Ref.Dhingra 6/e,p 176.", "role": "assistant" } ]

[ { "content": "HSV 2 causes: \nSelect and explain. \nA. Genital herpes, B. Genital warts, C. Herpes zoster, D. Genital ulcer", "role": "user" }, { "content": "Answer: A \nExplanation: Ans: a (Genital herpes) Ref: Shaw, 13th ed, p. 113Heipes genitalis is caused by HSV type 2. It is the most common DNA viral infection encountered in vulval disease.Symptoms: Tingling, itching, paraesthesia - vesicles - painful ulcers.Treatment: AcyclovirNote:Genital warts (condyloma accuminata) caused by HPV 6,11.Heipes zoster is caused by varicella virus.", "role": "assistant" } ]

[ { "content": "All of the following are anthropozoonosis except \nSelect and explain. \nA. Rabies, B. Plaque, C. Anthrax, D. Schistosomiasis", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Schistosomiasis Zoonoses Zoonoses are diseases and infections which are naturally transmitted between veebrate animal and man. The zoonoses may be classified according to the direction of transmission of disease : ? l. Anthropozoonoses Infection is transmitted to man from lower veebrate animals. Examples -4 Rabies, plague, hydatid disease, anthrax, trichinosis. 2. Zoonthroponoses Infection is transmitted from man to lower veebrate animals Examples - Human tuberculosis in cattle 3. Amphixenoses Infection is maintained in both man and lower veebrate animals that may be transmitted in either direction. Examples T cruzi, S. japonicum.", "role": "assistant" } ]

[ { "content": "A child with jaundice being given food intravenously. Which of the following can occur out of it – \nSelect and explain. \nA. Infection, B. Hyperglycemia, C. Metabolic acidosis, D. All of these", "role": "user" }, { "content": "Answer: D \nExplanation: Complications of parentral nutrition in children \n\nInfections                     \nLiver dysfunction\nHyperglycemia   \nMetabolic acidosis\nHyperlipidemia\nElectrolyte imbalance", "role": "assistant" } ]

[ { "content": "The commonest site of surgical uretero-vaginal fistula is: \nSelect and explain. \nA. Below infudibulopelvic ligament, B. Below uterine aery in the mackenrodts ligament, C. Vaginal angle, D. Above uterine aery", "role": "user" }, { "content": "Answer: B \nExplanation: B. i.e. Below uterine aery in Mackenrodt's ligament Maximum chances of ureteric injury is in hysterectomy while ligating uterine vessels in mackenrodt's ligament Ureter is also vulnerable to injury when ovarian vessels are being ligated during ovariectomy.", "role": "assistant" } ]

[ { "content": "Chronic lymphoedema of the limb is predisposed to all of the following except - \nSelect and explain. \nA. Thickening of the skin, B. Recurrent soft tissue infections, C. Marjolin' s ulcer, D. Sarcoma", "role": "user" }, { "content": "Answer: C \nExplanation: Morjolin's ulcer: - Refers to the development of malignant ulcers over chronic scars most commonly those from burns. Malignancy is usually a squamous cell carcinoma and has not been mentioned as a complication of lymphoedema.\nFeatures of chronic lymphoedema of limb\n\nInitially, the lymphoedema is soft and pits on the pressure but with time the skin becomes thickened & non-pitting due to fibrosis, dermal thickening and hyperkeratosis.\nFrequent episodes of lymphangitis and cellulitis may occur. this is believed to be due to loss of local immune defence mechanism.\nChronic eczema, a fungal infection of the skin (dermatophytosis) and nails (onychomycosis), fissuring, verrucae and papillae (warts) are frequently seen in advanced disease.\nRarely malignancy (lymphangiosarcoma or angiosarcoma) may occur in chronic lymphoedema. This neoplastic transformation of blood vessels and lymphatics is called Stewart - Treves syndrome.", "role": "assistant" } ]

[ { "content": "What is normal range of glycosylated haemoglobin (HbA1c) for adequate glycaemic control in diabetic patient- \nSelect and explain. \nA. 6% to 8 %, B. 8 % to 10 %, C. 4 % to 6 %, D. 10 % to 12 %", "role": "user" }, { "content": "Answer: A \nExplanation: normal Range in glycosylated haemoglobin 7% to 9 % for < 5 yrs 6 % to 8 % for > 5 yrs", "role": "assistant" } ]

[ { "content": "Nephrotic range of proteinuria is \nSelect and explain. \nA. > 30 mg/m2/hr, B. > 40 mg/m2/hr, C. > 2 gm/m2/24hrs, D. > 4 gm/m2/24hrs", "role": "user" }, { "content": "Answer: B \nExplanation: Nephrotic range of proteinuria is > 40 mg/m2/hr or  > 1 gm/m2/24hrs.", "role": "assistant" } ]

[ { "content": "Thyroxine is synthesized from which amino acid- \nSelect and explain. \nA. Arginine, B. Lysine, C. Methionine, D. Tyrosine", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., TVrosine Thyroid hormones (Important facts)o Thyroid hormones are T4 (throxine) and T3 (Triiodothyroxine)o Thyroid hormones are synthesised from amino acid tyrosine.o Their synthesis is regulated by TSH, a hormone secreted by anterior pituitary.o T3 is the active form and T4 is converted to T, in liver and kidney. Thus T4 mainly serves as transport form,o Circulating thyroid hormones are bound to thyroxine binding globulin fmain binding protein), throxine binding albumin and throxine binding prealbumin.o Thyroid hormone has two main function.i) Morphogenesis: - Growth & differentiation.ii) Calorigensis : - It increases all metabolism producing energy.", "role": "assistant" } ]

[ { "content": "The normal time required to culture mycobacterium TB is : \nSelect and explain. \nA. 4-8 weeks, B. 2-3 weeks, C. 6-10 weeks, D. 21 days", "role": "user" }, { "content": "Answer: A \nExplanation: M. tuberculosis 4-8 weeks is required before growth is detected. New methods have decreased the time required for bacteriologic confirmation of TB to 2-3 weeks. Reference: Harrisons Principles of Internal Medicine, 18th Edition, Page 1350", "role": "assistant" } ]

[ { "content": "True about Hematological change in Pregnancy \nSelect and explain. \nA. Total blood volume increases 40% by term, B. The hematocrit increases, C. Red cell volume does not increase until 20 weeks, D. Hematocrit increases due to an increased RBC volume relative to plasma volume", "role": "user" }, { "content": "Answer: A \nExplanation: Hemoglobin concentration and Hematocrit decrease slightly during pregnancy.", "role": "assistant" } ]

[ { "content": "Which of the following means of contraception is the best method to achieve Net Reproductive Rate (NRR)=1? \nSelect and explain. \nA. IUCD, B. Condoms, C. Vasectomy, D. Oral pills", "role": "user" }, { "content": "Answer: C \nExplanation: NRR is the most significant indicator of feility. Sterilization accounts for 80% of effective couple protection and hence is the best method among the above choices.", "role": "assistant" } ]

[ { "content": "Boundary of the Koch's triangle is not formed by? \nSelect and explain. \nA. Tricuspid valve ring, B. Coronary sinus, C. Tendon of todaro, D. Limbus fossa ovalis", "role": "user" }, { "content": "Answer: D \nExplanation: Koch's Triangle is a triangle enclosed by the septal leaflet of the tricuspid valve, the coronary sinus, and the membranous pa of the interatrial septum.Koch's triangle: Walter Karl Koch (1880-1962) was a distinguished German surgeon who discovered a triangular-shaped area in the right atrium of the hea that marks the atrioventricular node (known as Koch's triangle).The three sides of the triangle are defined by the following structures within the right atrium: The ostium of the coronary sinus, posteriorly; The anterior poion of the tricuspid valve annulus; and The tendon of Todaro (a tendinous structure connecting the valve of the inferior vena cava ostium to the central fibrous body), posteriorly.Impoance:Used as an anatomical landmark for location of the atrioventricular node during electrophysiology procedures such as pacing or ablation.", "role": "assistant" } ]

[ { "content": "Prostaglandin was discovered from \nSelect and explain. \nA. Tear, B. Saliva, C. Seminal fluid, D. Blood", "role": "user" }, { "content": "Answer: C \nExplanation: Prostaglandins were believed to be pa of the prostatic secretions, and eventually were discovered to be produced by the seminal vesicles. ... The biochemists Sune K. Bergstrom, Bengt I. Samuelsson and John R. Vane jointly received the 1982 Nobel Prize in Physiology or Medicine for their research on prostaglandins. Ref: guyton and hall textbook of medical physiology 12 edition", "role": "assistant" } ]

[ { "content": "Which of the following is not a proinflammatory cytokine - \nSelect and explain. \nA. IL 10, B. IL 8, C. IL 11, D. TNF alpha", "role": "user" }, { "content": "Answer: A \nExplanation: Cytokines\nProinflammatory                                      Anti-inflammatory \no Major:- IL-1,                                      o IL-4, IL-10, IL-13\nTNF-alpha, IL-6\no Other:- IL-2, IL-4,\nIL-5, IL-6, IL-8, IL-11,\nIL-12, IL-15, IL-21,\nIL-23, IFN- gamma, GM-CSF\no Here, you can consider IL-4 as pro-inflammatory cytokine ( as more than one options can be correct in PGIchandigarh).", "role": "assistant" } ]

[ { "content": "Mrs A is hesitant about having children because her two sisters had sons who had died from kinky hair disease. Her mother's brother also died of the same condition. What is the mode of inheritance of kinky hair disease which is running in this family? \nSelect and explain. \nA. X-linked recessive, B. X-linked dominant, C. Autosomal recessive, D. Autosomal dominant", "role": "user" }, { "content": "Answer: A \nExplanation: Menkes syndrome is an X linked recessive disorder characterized by a mutation in ATP7a or MNK gene encoding copper binding ATPase leading to deficient copper transpo and metabolism with subsequently low serum copper. Pili tori is the most common hair manifestation, showing flattening and twisting at 180 degree angles. Children show progressive neurologic degeneration with mental retardation, failure to thrive and hypotonia. X-linked Recessive disease is seen only in males because males have only one X chromosome. There is no male to male transmission. Heterozygous females are clinically normal but may be detected by subtle clinical features. Ref: Embryology By Ronald W. Dudek, 3rd Edition, Page 229 ; The Busy Physician's Guide to Genetics, Genomics and Personalized Medicine By Kevin M. Sweet, Page 41; Clinical Genetics In Nursing Practice By Felissa R. Lashley 3rd Edition ; Dermatology Terminology By Herbe B. Allen, Page 100", "role": "assistant" } ]

[ { "content": "Which is the principal virulence factor in Clostridium tetani \nSelect and explain. \nA. Tetanolysin, B. Tetanospasmin, C. Tetanotactin, D. Immobility factor", "role": "user" }, { "content": "Answer: B \nExplanation: C.tetani produces two distinct toxins- a hemolysin(tetanolysin), and neurotoxin(tetanospasmin). Tetanospasmin: This is the toxin responsible for tetanus. This toxin acts pre-synaptically. The abolition of spinal inhibition causes an uncontrolled spread of impulses initiated anywhere in the central nervous system. This results in muscle rigidity and spasms. Tetanolysin: it is not relevant in the pathogenesis of tetanus. Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th Edition; Pg: 265", "role": "assistant" } ]

[ { "content": "Most common radiation induced cancer: \nSelect and explain. \nA. Thyroid Carcinoma, B. Breast Carcinoma, C. Leukemia, D. Sarcomas", "role": "user" }, { "content": "Answer: C \nExplanation: Leukemia is most common radiation induced cancer.\nOthers: Thyroid, Breast Carcinoma", "role": "assistant" } ]

[ { "content": "Which of the following is a difference between herpangina and primary herpetic stomatitis: \nSelect and explain. \nA. It is preceded by prodromal symptoms, B. It is unilateral in nature, C. Ulcers relationship seen on the anterior faucial pillars, D. Viral etiology", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Exposure to noise above--causes permanent loss of hearing: \nSelect and explain. \nA. 85 dB, B. 90 dB, C. 100 dB, D. 160 dB", "role": "user" }, { "content": "Answer: D \nExplanation: 160 dB", "role": "assistant" } ]

[ { "content": "Drug that may induce nail pigmentation - melanonychia: \nSelect and explain. \nA. Retinoids, B. Carbamazepine, C. Tetracyclines, D. Zidovudine", "role": "user" }, { "content": "Answer: D \nExplanation: Anthracyclines, taxanes, fluorouracil, psoralens, and zidovudine may induce nail pigmentation through melanocyte stimulation in nail matrix resulting in melanonychia. It appears to be reversible and dose-dependent and appears 3-8 weeks after drug intake.", "role": "assistant" } ]

[ { "content": "Inferior angle of scapula is at the level of? \nSelect and explain. \nA. T4, B. T5, C. T6, D. T7", "role": "user" }, { "content": "Answer: D \nExplanation: ANSWER: (D) T7REF: Gray's Anatomy 30th edition page 819, Instant Anatomy by Robert H. Whitaker, Neil R. Borley 4th edition Page 199See APPENDIX- 9 below for \"VERTEBRAL LEVELS\"The scapula is a large, flat, triangular bone which lies on the posterolateral aspect of the chest wall, covering parts of the second to seventh ribs (also T7). It has costal and dorsal surfaces, superior, lateral and medial borders, inferior, superior and lateral angles, and three processes, the spine, its continuation the acromion and the coracoid process. APPENDIX - 9Vertebral Levels (Mnemonic: All Bifurcations (B 14-cation) are at The Level of 4)C4Hyoid bone; Bifurcation of common carotid artery.C5Thyroid cartilageC6Cricoid cartilageTrachea beginsOesophagus begins Pharynx and larynx endsC7Thoracic duct reaches its greatest height; Isthmus of thyroid glandT1Sternoclavicular joint; Highest point of apex of lung.T2Sternal notchJugular notchT4Sternal angle (of Louis)Junction of superior and inferior mediastinumAscending aorta endsArch of aorta begins and ends.Bifurcation of tracheaTSIVC hiatusT9Xiphisternal jointT10Oesophageal hiatusT12Aortic hiatusThoracic duct through diaphragmAzygos vein through diaphragmLIEnd of spinal cord in adults Transpyloric plane Pylorus of stomach Superior mesenteric artery originHilum of kidneys (renal artery-left is above and right is below)Celiac artery originates just above and renal arteries originate just below this line.L2Thoracic duct begins; Azygos and hemiazygos beginL3UmbilicusEnd of spinal cord in newborns Inferior mesenteric arteryL4Iliac crestAorta bifurcates into common iliac arteries.Inferior vena cava formed from common iliac veins.S1Sacral promontoryS2Posterior superior iliac spineEnd of dural sac (Dura, arachnoid, subarachnoid space, CSF)Middle of sacroiliac jointS3Posterior inferior iliac spineEnd of sigmoid colonRectum begins (important landmark in surgery of recto sigmoid carcinoma).", "role": "assistant" } ]

[ { "content": "Plunging ranula refers to a mucocoele that has penetrated which muscle? \nSelect and explain. \nA. Sternohyoid, B. Stylohyoid, C. Omohyoid, D. Mylohyoid", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Other than cataract, which one among the following is the highest prevalent cause of blindness in the world - \nSelect and explain. \nA. Corneal opacity, B. Diabetic retinopathy, C. Glaucoma, D. Trachoma", "role": "user" }, { "content": "Answer: C \nExplanation: Cataract 39% Glaucoma 10% tracoma3% diabeticretinopathy 4% Ref-Park&;s textbook of Preventive and social medicine 23rd edition. .", "role": "assistant" } ]

[ { "content": "Best prognostic factor for head injury is \nSelect and explain. \nA. A.Glasgow coma scale, B. B.Age, C. C.Mode of injury, D. D.CT", "role": "user" }, { "content": "Answer: A \nExplanation: The severity of head injury is classified according to glassglow coma scale(GCS) as it is the best predictor of neurological outcome. Mode of injury and age of the patient help in initial evaluation and management, CT helps in confirmation of the diagnosis. Their prognostic value is less when compared to GCS. Reference: Bailey and Love's Sho Practice of Surgery, 26th edition, Pg no:313", "role": "assistant" } ]

[ { "content": "Granular deposit of IgA at dermoepidermal junction is seen in - \nSelect and explain. \nA. Pemphigus vulgaris, B. Bullous pemphigoid, C. Dermatitis herpatiformis, D. Pemphigus foliaceous", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Dermatitis herpatiformis Immunopathological appearance of vesicobullous disorderso Bullous pemphigoid-Linear band of IgG or C3 in epidermal basement membraneo Pemphigus vulgaris-Cell surface deposits of IgG on keratinocyteso Pemphigus foliaceous-Cell surface deposits of IgG on keratinocyteso Pemphigoid gestationis-Linear band of C3 in epidermal basement membrane zoneo Dermatitis herpeteformis-Granular deposits of IgA in dermal papillaeo Chronic bullous disease of childhood-IgA deposits along the dermoepidermal junctiono Linear IgA dermatosis of adults-Linear deposits of IgA at dermoepidermal junction", "role": "assistant" } ]

[ { "content": "True statement regarding Prevalence: \nSelect and explain. \nA. Cannot be used to determine the health needs of a community, B. Independent of incidence, C. Independent of duration, D. Measures all cases", "role": "user" }, { "content": "Answer: D \nExplanation: (Refer: K. Park’s Textbook of Preventive and Social medicine, 24th edition, pg no: 66, 67)\n\nIncidence = New cases\nPrevalence = New + Old cases\nPrevalence = Incidence X Duration", "role": "assistant" } ]

[ { "content": "The type of receptors present on T cells is- \nSelect and explain. \nA. IgG, B. IgD, C. CD4, D. Prostaglandins", "role": "user" }, { "content": "Answer: C \nExplanation: T cell receptor for antigen: The TCR is the recognition molecule for T cells. The TCR is a transmembrane heterodimeric protein containing two disulfide-linked chains. It is composed of two different classes of TCR called: alpha-beta (a and b) and gamma-delta (g and d). The majority of the T cells contain the ab TCR phenotype. However, a smaller percentage of T cells express the g d TCR. The ab T cells are subdivided by their surface markers: CD4 or CD8. They recognize peptide antigens presented by MHC molecules on the surfaces of APC's (antigen-presenting cells) The g d T cells are primarily located in the epithelial linings of the reproductive and GI tracts.(aiims nov. 2020). Theyrecognize different type of antigenswithout the requirement of MHC Prostglandins( eicosanoids) are the lipid compounds acting as mediators of pain and inflamation .they have diverse action such as bronchodilation ,vasodilataion etc.. IgG AND IgD are immunoglobolins involved in defence mechanism", "role": "assistant" } ]

[ { "content": "All are hepatotoxic except \nSelect and explain. \nA. Halothane, B. Chlorform, C. Methoxyflurane, D. Isoflurane", "role": "user" }, { "content": "Answer: D \nExplanation: Isoflurane is metabolized to trifluoroacetic acid. Although serum fluoride fluid levels may rise, nephrotoxicity is extremely unlikely, even in the presence of enzyme inducers. Prolonged sedation (>24 h at 0.1-0.6% isoflurane) of critically ill patients has resulted in elevated plasma fluoride levels (15-50 mmol/L) without evidence of kidney impairment. Similarly, up to 20 MAC-hours of isoflurane may lead to fluoride levels exceeding 50 mmol/L without detectable postoperative kidney dysfunction. Its limited oxidative metabolism also minimizes any possible risk of significant hepatic dysfunction. Total hepatic blood flow (hepatic aery and poal vein flow) may be reduced during isoflurane anesthesia. Hepatic oxygen supply is better-maintained with isoflurane than with halothane, however, because hepatic aery perfusion is preserved. Liver function tests are usually not affected. The major effect of acute inhalation of chloroform is central nervous system depression. At concentrations from 1,500-30,000 ppm, chloroform exposure can induce anesthesia; at concentrations exceeding 40,000 ppm, it can be fatal. Chronic inhalation of chloroform in humans results in hepatotoxicity and central nervous symptoms such as depression and irritability. Meanwhile, chronic oral exposure to chloroform in humans results in effects on the blood, livers, and kidneys. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "role": "assistant" } ]

[ { "content": "Pathological feature of pyogenic granuloma \nSelect and explain. \nA. Epitheloid cells, B. Cavernous hemangioma, C. Granulation tissue, D. Giant cells", "role": "user" }, { "content": "Answer: C \nExplanation: Pyogenic granulomas) are pedunculated masses usually found on the gingiva of children, young adults, and pregnant women. These lesions are richly vascular and typically are ulcerated, which gives them a red to purple color. In some cases, growth can be rapid and raise fear of a malignant neoplasm. However, histologic examination demonstrates a dense proliferation of immature vessels similar to that seen in granulation tissue. Pyogenic granulomas can regress, mature into dense fibrous masses, or develop into a peripheral ossifying fibroma. Complete surgical excision is definitive treatment. (Robbins basic pathology,9th edition,pg no.553)", "role": "assistant" } ]

[ { "content": "Effort during normal respiration is done due to \nSelect and explain. \nA. Lung elasticity, B. Respiratory air passages, C. Alveolar air spaces, D. Creating negative pleural pressure", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Baby born prematurely at 29 wks, on examination at 42 weeks with ROP, both eyes shows stage 2 zone 1 `plus' disease, how will you manage the patient ? \nSelect and explain. \nA. Examine the patient after 1 week, B. Laser photocoagulation of both eyes, C. Laser photocoagulation of worse eye, follow up of other eye, D. Vitreoretinal surgery", "role": "user" }, { "content": "Answer: B \nExplanation: The hallmark of retinopathy of prematurity (ROP) is abnormal retinal vasculature. Ophthalmologists diagnose and make decisions about the initial treatment of ROP based on the appearance of the retinal blood vessels. Dilatation and tortuosity of the retinal vessels at the posterior pole is termed plus' disease. It is a sign of rapidly progressive ROP and is an indication for early laser ablation of the peripheral avascular retina.", "role": "assistant" } ]

[ { "content": "Treatment of Non-union of # shaft femur - \nSelect and explain. \nA. Open reduction with external fixation, B. Excision of the bone, C. Bone grafting with internal fixation with K-Nail, D. All of the following", "role": "user" }, { "content": "Answer: C \nExplanation: Treatment of choice is open the fracture site for bone grafting and internal fixation.\nInternal fixation technique may be : -\nIntramedullary interlock nailing (Preferred)\n\n\nIntramedullary 'K' nailing\nPlating (compression plaiting).", "role": "assistant" } ]

[ { "content": "Which of the following is true regarding precocious puberty: \nSelect and explain. \nA. Sexual maturity is attained early, B. Mental function is increased, C. No reproductive function, D. Body proportions are enlarged", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Cardiac anomaly associted with TOF False is - \nSelect and explain. \nA. Cyanotic heart disease, B. RVH, C. ASD, D. VSD", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., ASD Tetralogy of falloto Cyanotic heart disease (MC).o Defect in infundibular septum leads to :Pulmonary stenosisVSD (Not ASD)Dextroposition and overriding of aorta.Right ventricular hypertrophy (NOT LVH).o Pink TOF (Acyanotic TOF) when PS is mild to moderate balanced shunt tnt across the VSD, pt not have cyanosis.", "role": "assistant" } ]

[ { "content": "‘Accompanied MDT’ in NLEP implies \nSelect and explain. \nA. A patient will be given MDT only in the presence of a MDT provider, B. Any responsible person from family or village can collect MDT, if patient is unable to come, C. MDT should be accompanied with Steroids/ Clofazimine to help fight Reversal reactions, D. MDT prescription should be accompanied by all the precautions to be observed by the patient", "role": "user" }, { "content": "Answer: B \nExplanation: Accompanied MDT: If patient is unable to come to collect his/her MDT from clinic, any responsible person from family or village can collect it\n\nDesigned to help patients who have to interrupt their treatment due to any avoidable reason\nEspecially useful for irregular patients\nGives patients a choice: Patients can collect entire MDT course when diagnosed after proper counseling.", "role": "assistant" } ]

[ { "content": "Which of the following is a K+ channel opener ? \nSelect and explain. \nA. Nifedipine, B. Minoxidil, C. Enalapril, D. Atenolol", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following is most characteristic of the brain in patients with Alzheimer’s disease \nSelect and explain. \nA. Pigmentary degeneration in hippocampus, B. Demyelination in cerebral cortex, C. Posterior column degeneration, D. Neuronal loss in cerebral cortex", "role": "user" }, { "content": "Answer: D \nExplanation: Most prominent feature of alzheimer’s disease is neuronal loss, fibrillary tangles, loss of synapses and amyloid plaque formation.", "role": "assistant" } ]

[ { "content": "True statement regarding sarcoma botryoides:a) Involvement of vaginab) Grape like growth seenc) Common in old aged) Malignant \nSelect and explain. \nA. abd, B. bcd, C. abc, D. ab", "role": "user" }, { "content": "Answer: A \nExplanation: Embryonal Rhabdomyosarcoma is the most common malignancy of the vagina in infants and children.\nMost common subtype of embryonal rhabdomyosarcoma is sarcoma botyroides\n\nSeen in infants and children less than 5 years of age.\n\"This rare tumor develops almost exclusively in girls younger than 5 years, although vaginal and cervical sarcoma botryoides have been reported in females aged 15 to 20 years.\"  - William Gynae 1st /ed p 683\n\"Sarcoma botryoides are usually seen in patients who are younger than 5 years of age.\" - COGDT 10th ed p 831\nIn infants and children, sarcoma botyroides is usually found in vagina, in reproductive age females rhabdomyosarcoma is seen within the cervix and after menopause within the uterus.\nThe gross appearance of the tumor resembles pinkish bunch of grapes —it can be in the form of multiple polyp like structures or can be a solitary growth with pedunculated appearance.\nHistologically-its characteristic finding is \"rhabdomyoblast.\"\n\nClinical features\nThe presenting features are:\n\n\nBlood stained vaginal discharge\nAnaemia and cachexia\n\nManagement\nChemotherapy — vincristine actinomycin D and cyclophasphamide followed by conservative surgery to excise residual tumor is the treatment of choice. Newer studies have revealed that primary chemotherapy without surgery is adequate for most patients.", "role": "assistant" } ]

[ { "content": "A mature pincer grasp is attained at ------ months \nSelect and explain. \nA. 8, B. 10, C. 12, D. 18", "role": "user" }, { "content": "Answer: C \nExplanation: Grasp is best as..~ by offering a red cube to the ol.j)d. A 6-month-old infant reaches and holds the cul-e {b.rg? object) in a crude manner usincr the ulnar asf'C'l-'i: of r~ hand (Fig. 3_27). He can transfer ~bjects from one h.md t::i oth~ by 6-1 months. The child is able to grasp from the radial side of hand at 8-9 months (Fig. 328). B\\* the ab'\" ci 1 year, mature grasp (index finuer and thumb) is e,iJo.t (Fig. 3.29). 0 By offering pellets (smaller object), finer hand skills;.:~ assessed. By 9-10 months, the child approaches the pelletby an index finger and lifts it using finger thumb apposition, termed 'pincer' gras", "role": "assistant" } ]

[ { "content": "Hanging cuain sign seen in? \nSelect and explain. \nA. Pityriasis rosea, B. Pityriasis Versicolor, C. Pityriasis rubra pilaris, D. Pityriasis lichenoides chronica", "role": "user" }, { "content": "Answer: A \nExplanation: Pityriasis rosea REF: Dermatology. 1995; 190(3): 252. PubMed PMID: 7599393, Clinical Pediatric Dermatology - By Thappa page 104 PITYRIASIS ROSEA The primary eruption, herald patch (Mother spot) is a single oval or round patch with a central wrinkled salmon colored area and a darker peripheral zone separated by a \"collarette of scales\" (when stretched across the long axis, the scales tends to fold across the line of stretch, the so called Hanging cuain sign).", "role": "assistant" } ]

[ { "content": "Height of child acquire 100 cm in? \nSelect and explain. \nA. 2.5 year, B. 3.5 year, C. 4.5 year, D. 5.5 year", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., 4.5 year", "role": "assistant" } ]

[ { "content": "Most common complication of tonsillectomy is- \nSelect and explain. \nA. Hemorrhage, B. Teeth injury, C. Pneumonia, D. Otitis media", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Hemorrhage \"Post-tonsillectomy hemorrhage is the most common complication, occuring in approximately 2 to 5%, and should be taken seriously \"._________Bellenger's otolaryngologyComplications of tonsillectomyo Complications of tonsillectomy may beImmediateDelayedImmediate complicationsPrimary haemorrhage : Occurs at the time of operation. It can be controlled by pressure, ligation or electrocoagulation of the bleeding vessels.Reactionary haemorrhage: Occurs within a period of 24 hours.Injury to tonsillar pillars, uvula, soft palate, tongue or superior constrictor muscle due to bad surgical technique.Injury to teeth.Aspiration of blood.Facial oedema : Some patients get oedema of the face particularly of the eyelids.Surgical emphysemaDalayed complicationsSecondary haemorrhage: Usually seen between the 5th to 10th post-operative day. It is the result of sepsis and premature separation of the membrane. Usually, it is heralded by bloodstained sputum but may be profuse.Infection : Infection of tonsillar fossa may lead to parapharyngeal abscess or otitis media.Lung complications : Aspiration of blood, mucus or tissue fragments may cause atelectasis or lung abscess.Scarring in soft palate and pillars.Tonsillar remnants : Tonsil tags or tissue, left due to inadequate surgery, may get repeatedly infected.Hypertrophy of lingual tonsil: This is a late complication and is compensatory to loss of palatine tonsils.", "role": "assistant" } ]

[ { "content": "Causes of epistaxis are all except \nSelect and explain. \nA. Allergic rhinitis, B. Foreign body, C. Tumour, D. Hypeension", "role": "user" }, { "content": "Answer: A \nExplanation: Causes of epistaxis Trauma Infections Foreign bodies Neoplasms of nose and paranasal sinus Atmospheric changes Deted nasal septum Hypeension Pregnancy Leukemia Liver disease Kidney disease Idiopathic Ref: Dhingra 7e pg 197.", "role": "assistant" } ]

[ { "content": "Most root canals that have not been instrumented are too narrow to be reached effectively by \nSelect and explain. \nA. Microbes, B. Disinfectants, C. Gutta percha, D. None of the above", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following drugs, is used for Smoking Cessation? \nSelect and explain. \nA. Naltrexone, B. Bupropion, C. Buprenorphine, D. Methadone", "role": "user" }, { "content": "Answer: B \nExplanation: Answer is B (Bupropion): Bupropion (along with Varenicline and Nicotine replacement therapy) is a USFDA approved first line agent for pharmacotherapy in Smoking Cessation. USFDA Approved Agents for Smoking Cessation Nicotine Replacement Therapy (Transdermal Patch, gum, lozenges, oral inhaler, nasal spray) Bupropion (Atypical Antidepressant with dopaminergic and noradrenergic activity) Varenicline (Selective paial agonist at the Alpha4-Beta2 Nicotinic A-Choline receptor that is believed to mediate nicotine dependence) Clonidine and Noriptyline are two other medications that have efficacy but are NOT USFDA approved for this indication. These are classified as second line agents.", "role": "assistant" } ]

[ { "content": "LH surge occurs at \nSelect and explain. \nA. At the time of ovulation, B. 5-6 days before ovulation, C. 24-36 hours before ovulation, D. 24 - 72 hours after ovulation", "role": "user" }, { "content": "Answer: C \nExplanation: C. i.e. (24 - 36 hours before ovulation) (37-Shaw's 14th/64-Dutta 4th)* LH surge precedes ovulation by 24 to 36 hours (mean 30 hours) and minimum of 75 ng/ml is required for ovulation (37 - Shaw's 14th)* LH levels remains almost static throughout the cycle except at least 12 hours prior to vulation. When it attains its peak, called LH surge (64 - Dutta 4th)* The main function of LH is steroidogenic, but along with FSH. It is responsible for full maturation of the graffian follicle and oocyte and ovulation", "role": "assistant" } ]

[ { "content": "In abdominal surgery Lembe sutures refers to ? \nSelect and explain. \nA. Single layer suturing, B. Sero muscular sutures, C. All coat intestinal suturing, D. Skin suturing", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Sero muscular sutures", "role": "assistant" } ]

[ { "content": "Adrenal insufficiency in not associated with - \nSelect and explain. \nA. Hyponatremia, B. Hyperkalemia, C. Hypoglycemia, D. Metabolic alkalosis", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e.. Metabolic alkalosis o Features of adrenal insufficiency (Addison's disease) are :-i) Hypoglycemiaii) Hyperpigmentationii) Hyperkalemiaiv) Hyponatremiav) Hypotensionvi) Metabolic acidosiso Associated features are nausea, vomiting, diarrhea and abdominal cramps.", "role": "assistant" } ]

[ { "content": "Which of the following is an amino neurotransmitter \nSelect and explain. \nA. Acetylcholine, B. GABA, C. Lignocaine, D. Epinephrine", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Barr body is absent in female having \nSelect and explain. \nA. 46 XX genome, B. 45 X0 genome, C. 47 XXX, D. All of the above", "role": "user" }, { "content": "Answer: B \nExplanation: Barr body is absent in those with genotype 45 XO . For a brr body to be present a minimum of 2 x chromosomes should be there . No of Barr body = no of x chromosomes - 1. Reference: GHAI Essential pediatrics, 8th edition", "role": "assistant" } ]

[ { "content": "Secondary amyloidosis occurs in ? \nSelect and explain. \nA. Chronic osteomyelitis, B. Rheumatoid ahritis, C. Leprosy, D. All", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. Three options are correct i.e., 'a, b & c'", "role": "assistant" } ]

[ { "content": "Splenectomy is most useful in : \nSelect and explain. \nA. Thrombocytopenia, B. Hereditary spherocytosis, C. H.S. purpura, D. Sickle cell anemia", "role": "user" }, { "content": "Answer: B \nExplanation: Answer is B (Hereditary spherocytosis) Splenectomy is curative in hereditary spherocytosis. Splenectomy is carried out in all symptomatic patients Q because of the potential for gall stones and stones and episodes of bone marrow hyperplasia or hemolytic crisis Q It reliably corrects the anemia and RBC survival often becomes normal or nearly so. The operative risk is low. Remember Splenectomy is not carried out in young children e (preferably postponed until age 4) in order to minimize the risk of severe infections Q with gram positive encapsulated organisms.", "role": "assistant" } ]

[ { "content": "Epidemic hemorrhagic conjunctivitis is caused by - \nSelect and explain. \nA. HSV, B. HZV, C. HIV, D. Picorna virus", "role": "user" }, { "content": "Answer: D \nExplanation: Epidemic hemorrhagic conjunctivitis is caused by Coxsackie Virus A24 or Enterovirus 70 (members of the Family Picornaviridae). HSV (Herpes Simplex Virus)- causes oral herpes and genital herpes. HZV (Herpes Zoster Virus) -causes Shingles. HIV -cause AIDS.", "role": "assistant" } ]

[ { "content": "The industry, with the highest accidental death rate and long held to be the most dangerous occupation is – \nSelect and explain. \nA. Agriculture, B. Construction, C. Mining and quarrying, D. Trade", "role": "user" }, { "content": "Answer: C \nExplanation: Accidents are a common features in most industries.\nIn fact, some industries are known for accidents, eg: coal and other mining industries, quarrying, construction work.", "role": "assistant" } ]

[ { "content": "A 22-year-old African American male wants to know if he has sickle cell trait. He has no previous history of the signs or symptoms of sickle cell anemia. What laboratory method or test can be used to detect the presence of hemoglobin S? \nSelect and explain. \nA. Coombs' test, B. Osmotic fragility test, C. Metabisulfite test, D. Sucrose hemolysis test", "role": "user" }, { "content": "Answer: C \nExplanation: The metabisulfite test is used to detect the presence of hemoglobin S, but it does not differentiate the heterozygous sickle cell trait from the homozygous sickle cell disease. The test is based on the fact that erythrocytes with a large propoion of hemoglobin S sickle in solutions of low oxygen content. Metabisulfite is a reducing substance that enhances the process of deoxygenation. The osmotic fragility test is a diagnostic test for hereditary spherocytosis. Spherocytes lyse at a higher concentration of salt than do normal cells, thus causing an increased osmotic fragility. The direct antiglobulin test (DAT), or Coombs' test, is used to differentiate autoimmune hemolytic anemia (AIHA) due to the presence of anti-red cell antibodies from other forms of hemolytic anemia. In this test, antibodies to human immunoglobulin cause the agglutination (clotting) of red cells if these anti-red cell antibodies are present on the surface of the red cells. In patients with paroxysmal nocturnal hemoglobinuria, the erythrocytes are excessively sensitive to complement-mediated lysis in low ionic environments (the basis for the sucrose hemolysis test) or in acidotic conditions, such as sleep, exercise, or the Ham's acid hemolysis test. The Schilling test, which measures intestinal absorption of vitamin B12 with and without intrinsic factor, is used to diagnose decreased vitamin B12 caused by pernicious anemia, which is characterized by a lack of intrinsic factor. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition.", "role": "assistant" } ]

[ { "content": "Earliest clinical feature of Senile cataract \nSelect and explain. \nA. Glare, B. Frequent change of glasses, C. Coloured halos, D. Uniocular polyopia", "role": "user" }, { "content": "Answer: A \nExplanation: Earliest clinical feature of Senile cataract is Glare\nMost common symptom at presentation is Frequent change of glasses", "role": "assistant" } ]

[ { "content": "30 out of 50 smokers and 10 out of 50 non smokers develop lung cancer. What is odd's Ratio \nSelect and explain. \nA. 4, B. 2.8, C. 6, D. 7", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Time taken for capacitation of sperms is \nSelect and explain. \nA. 2-4 hours, B. 4-6 hours, C. 6-8 hours, D. 8-10 hours", "role": "user" }, { "content": "Answer: C \nExplanation: Capacitation is the process of reconditioning of the sperm, making it more suitable for penetration into the ovum. \nIt takes about 6-8 hours and occurs in FGT chiefly in the tubes.", "role": "assistant" } ]

[ { "content": "Best method to remove confounding is \nSelect and explain. \nA. Randomization, B. Restriction, C. Stratified randomization, D. Multivariate analysis", "role": "user" }, { "content": "Answer: C \nExplanation: Method Utility to control confounding Randomization 2nd best method Restriction Limiting study to people who have paicular characteristics Matching Mostly useful in case control studies, MC used method Stratification Useful for larger studies Statistical modeling When many confounding variables exist simultaneously Stratified randomization Best method", "role": "assistant" } ]

[ { "content": "Nerve compressed by aneurysm of posterior communicating aery is \nSelect and explain. \nA. Occulomotor nerve, B. Optic nerve, C. Hypophysis cerebri, D. Trochlear nerve", "role": "user" }, { "content": "Answer: A \nExplanation: Occulomotor nerve Most unruptured intracranial aneurysms are completely asymptomatic. Symptoms are usually due to rupture and resultant subarachnoid hemorrhage. Occasionally neurological symptoms may arise due to mass effect of the aneurysm. Progressively enlarging unruptured aneurysm most commonly involves the occulomotor nerve. This usually occurs .from an expanding aneurysm at junction of post communicating aery and internal carotid aery. Other neuropathies due to intracranial aneurysms are Cavernous sinus aneurysm can produce sixth nerve palsy. Supraclinoid carotid or anterior cerebral aery aneurysm can produce visual field defects. Posterior inferior cerebellar aery or anterior inferior cerebellar aery aneurysm may present as occipital & posterior cervical pain. An expanding middle cerebral aery aneurysm can produce pain in or behind the eye & in the low temple. Ophthalmic aery aneurysm can cause visual loss by compressing optic nerve.", "role": "assistant" } ]

[ { "content": "Curschmann spirals are found in \nSelect and explain. \nA. Broncitis, B. Asthma, C. Bronchiectasis, D. Lung abscesses", "role": "user" }, { "content": "Answer: B \nExplanation: (Asthma) (726- Robbins 7th) (485- 492- HM 5,h) (492- Basic pathology 8th)* Bronchial Asthma - Histologically the mucous plugs contain whorls of shed epithelium. Which give rise to the well known Curschmann spirals*, Numerous eosinophils and charcot Leyden crystals* are present* The other characteristic histologic findings of asthma collectively called \"airway remodeling\"* REID INDEX is the ratio between thickness of the submucosal mucous glands (i.e, hypertrophy and hyper plasia) in the cartilage containg large airway to that of the total bronchial wall seen in chronic bronchitis**", "role": "assistant" } ]

[ { "content": "All are TRUE about the relation of inguinal canal, EXCEPT: \nSelect and explain. \nA. Internal oblique forms the roof, B. Inguinal ligament forms the floor, C. Fascia transversalis forms anterior wall, D. Interfoveolar ligament forms lateral two third of anterior wall", "role": "user" }, { "content": "Answer: D \nExplanation: Boundaries of Inguinal canal:Floor is formed by the grooved upper surface of the inguinal ligamentRoof is formed by the arching lower fibers of Internal oblique and transverse abdominal muscles.Anterior wall is formed by the external oblique aponeurosis all through it is extentreinforced laterally by the Internal oblique musclePosterior wall is formed by the transversalis fascia all through its extent, reinforced medially by the conjoint tendon also known as inguinal falx (Fused fibers of transversus abdominis and internal oblique muscles).Must know: Contents of the inguinal canal: In the males,Spermatic cordIlioinguinal nerveCremaster and its blood supplyGenital branch of genitofemoral nerveRemnants of processes vaginalsIn the femaleRound ligament of uterus, (remnant of Gubernaculum)Genital branch of genitofemoral nerveIlioinguinal nerveCremaster and its blood supplyRemnants of processes vaginalisRef: Snells, Clinical anatomy, 7th Edition, Page 173, 174.", "role": "assistant" } ]

[ { "content": "In emergency tracheostomy all of the following structures are damaged, EXCEPT: \nSelect and explain. \nA. Isthmus of the thyroid, B. Inferior thyroid aery, C. Thyroid ima aery, D. Inferior thyroid vein", "role": "user" }, { "content": "Answer: B \nExplanation: Bleeding can occur immediately after a tracheostomy and in the late postoperative period. Sources of hemorrhage include granulation tissue in the stoma or trachea, and erosion of thyroid vessels or the thyroid itself, the tracheal wall (frequently from suction trauma), or the innominate aery. Inferior thyroid aery, a branch of the thyrocervical trunk of the subclan aery lies laterally away from midline, thus can escape injury. Ref: Moro-Sutherland D. (2011). Chapter 138. The Child with Special Health Care Needs. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e.", "role": "assistant" } ]

[ { "content": "Platelets transfusion must be completed in how many hours after entering the bag \nSelect and explain. \nA. 1 hour, B. 2 hour, C. 3 hour, D. 4 hour", "role": "user" }, { "content": "Answer: D \nExplanation: Answer- D. 4 hour Once the blood bag is opened hy puncturing one of the sealed pos, the platelets must be administered within 4 hours", "role": "assistant" } ]

[ { "content": "Rickets in infant present as all except - \nSelect and explain. \nA. Cranitabes, B. Widened Fontanel, C. Rachitic Rosary, D. Bow legs", "role": "user" }, { "content": "Answer: D \nExplanation: Long bones of legs gets deformed when the child starts bearing weight. Therefore deformities of legs are unusual before the age of one year.", "role": "assistant" } ]

[ { "content": "The maxillary nerve arises from the trigeminal ganglion in the middle cranial fossa. It passes forward in the lateral wall of the cavernous sinus and leaves the skull through which of the following foramen to enter the pterygopalatine fossa? \nSelect and explain. \nA. Foramen ovale, B. Foramen spinosum, C. Foramen rotundum, D. Foramen lacerum", "role": "user" }, { "content": "Answer: C \nExplanation: It arises from the trigeminal ganglion, runs forwards in the lateral wall of the cavernous sinus below the ophthalmic nerve, and leaves the middle cranial fossa by passing through the foramen rotundum. Next, the nerve crosses the upper pa of the pterygopalatine fossa. In the pterygopalatine fossa, the nerve is intimately related to the pterygopalatine ganglion and gives off the zygomatic and posterior superior alveolar nerves. The posterior superior alveolar nerve enters the posterior surface of the body of the maxilla and supplies the three upper molar teeth and the adjoining pa of the gum.Ref: BD Chaurasia&;s HUMAN ANATOMY, Volume 3, 6th edition.", "role": "assistant" } ]

[ { "content": "What is seen in the X-ray of femur below \nSelect and explain. \nA. Sunburst calcification, B. Onion peel effect, C. Codmann triangle, D. Bone marrow invasion", "role": "user" }, { "content": "Answer: C \nExplanation: .", "role": "assistant" } ]

[ { "content": "Size of uterus in inches: \nSelect and explain. \nA. 5x4x2, B. 4x3x1, C. 3x2x1, D. 4x2x1", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is c, i.e. 3x2x1 inchesRef: Jeffcoates Principle of Gynae 9/ed, pg 32Remember, best answer to this question is 3.25x2.5x1.5 inches.", "role": "assistant" } ]

[ { "content": "Hypocalcemia with hyperphosphatemia are seen in. \nSelect and explain. \nA. CRF, B. Pseudobypoparathyoidsm, C. Vit-D deficiency, D. Vit-D deficiency", "role": "user" }, { "content": "Answer: A \nExplanation: <p>Improved medical management of chronic kidney disease now allows many patients to survive for decades and hence time enough to develop features of renal osteodystrophy, which must be controlled to avoid additional morbidity. Impaired production of 1,25(OH) 2 D is now thought to be the principal factor that causes calcium deficiency, secondary hyperparathyroidism, and bone disease; hyperphosphatemia typically occurs only in the later stages of CKD. Low levels of 1,25(OH) 2 D due to increased FGF23 production in bone are critical in the development of hypocalcemia. The uremic state also causes impairment of intestinal absorption by mechanisms other than defects in vitamin D metabolism. Nonetheless, treatment with supraphysiologic amounts of vitamin D or calcitriol corrects the impaired calcium absorption. Since increased FGF23 levels are seen even in early stages of renal failure in some patients, and have been repoed to correlate with increased moality, there is current interest in methods (lowering phosphate absorption) to lower FGF23 levels and concern as to whether vitamin D supplementation (known physiologically to increase FGF23) increases FGF23 in CKD. Hyperphosphatemia in renal failure lowers blood calcium levels by several mechanisms, including extraosseous deposition of calcium and phosphate, impairment of the bone-resorbing action of PTH, and reduction in 1,25(OH) 2 D production by remaining renal tissue(harrison 18 pg 3116)</p>", "role": "assistant" } ]