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[ { "content": "All are true regarding Primary CNS lymphoma except: \nSelect and explain. \nA. Radiotherapy and chemotherapy is of no value, B. Occurs in AIDS pt., C. Commonly occurs in immuno-compromised persons, D. EBV may be a cause /", "role": "user" }, { "content": "Answer: A \nExplanation: Ans is 'a' i.e. ie Radiotherapy and chemotherapy is of no value Primary CNS lymphomaThese are B cell malignancies that present within the neuraxis without evidence of systemic lymphoma.They occur most frequently in immunocompromised individuals, specifically organ transplant recipients or patients with AIDS.In immunocompromised patients CNS lymphomas are invariably associated with Epstein - Barr virus (EBV) infection of the tumor cells.Treatment:The prognosis of primary CNS lymphoma is poor compared to histologically similar lymphoma occurring outside the CNS.Many patients experience a dramatic and radiographic clinical response to glucocorticoids however it inevitably relapses within weeks.The mainstay of definitive therapy is chemotherapy including high-dose methotrexate. This is followed in patients < 60 years with radiotherapy.The mainstay of definitive therapy is chemotherapy.A single dose of rituximab is generally administered prior to cytotoxic chemotherapyChemotherapy includes high-dose methotrexate, but multi agent chemotherapy, usually adding vincristine and procarbazine, appears to be more effective than methotrexate alone.Chemotherapy is followed in patients <60 years with whole-brain radiation therapy (WBRT).Despite aggressive therapy >90% of patients develop recurrent CNS disease.", "role": "assistant" } ]

[ { "content": "Which of the following is the most common site of secondaries in a case of choriocarcinoma? \nSelect and explain. \nA. Vagina, B. Urethra, C. Lung, D. Brain", "role": "user" }, { "content": "Answer: C \nExplanation: In 75% of cases metastasis from choriocarcinoma occurs into the lungs and rest usually occurs in the vagina. Other organs which may also contain metastases are vulva, kidneys, liver, ovaries, brain and bowel.", "role": "assistant" } ]

[ { "content": "Hot air oven cannot be used for sterilising: \nSelect and explain. \nA. Liquid paraffin, B. Instruments, C. Culture media, D. Needles", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Normal value of ankle branchial index is \nSelect and explain. \nA. 0.8, B. 1, C. 1.2, D. 1.4", "role": "user" }, { "content": "Answer: B \nExplanation: Ankle Brachial Index ABI= Systolic BP at the ankle/systolic BP in the arms Compared to the arm, lower blood pressure in the leg is an indication of blocked aeries (peripheral vascular disease) ABI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressures in the arm ABI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressures in the arm ABI Interpretation >1.2 Non-compressible, severely calcified vessel (in DM & ESRD) 1.0-1.2 Normal vessels 0.5-0.9 Intermittent claudication 0.1-0.4 Critical limb ischaemia( Ischaemic ulceration, gangrene) Ref: Sabiston 20th edition Pgno :1758", "role": "assistant" } ]

[ { "content": "In a patient of liver disease, which maneuvers, may lead to the development of hyperammonemia? \nSelect and explain. \nA. Protein restriction, B. The use of neomycin, C. The use of loop diuretics, D. A branched-chain amino acid-enriched protein mixture", "role": "user" }, { "content": "Answer: C \nExplanation: The use of loop diuretics promotes kaliuresis and therefore may lead to hyperammonemia", "role": "assistant" } ]

[ { "content": "Which of the following is the best-known metabolic function of the lung \nSelect and explain. \nA. Inactivation of serotonin, B. Conversion of angiotensin–I to angiotensin–II, C. Inactivation of bradykinin, D. Metabolism of basic drugs by cytochrome P–450 system", "role": "user" }, { "content": "Answer: B \nExplanation: Extracellular ACE on the surface endothelial cells in pulmonary circulation activates Angiotensin I to Angiotensin II.", "role": "assistant" } ]

[ { "content": "Type of laser used for capsulotomy is: \nSelect and explain. \nA. CO2, B. Ruby, C. Nd:YAG, D. Argon", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. Nd:YAG", "role": "assistant" } ]

[ { "content": "One of the following is used for sex chromatin testing : \nSelect and explain. \nA. Barr body, B. Testosterone receptors, C. Hormone levels, D. Phenotypic features", "role": "user" }, { "content": "Answer: A \nExplanation: Chromosomal sex can be determined by the study of the leucocytes or by simply taking a smear from the buccal mucosa The nuclei of the female chromosome contains a stainable body called the sex chromatin, hence female cells are termed as chromatin positive. In epithelial cell nuclei this small peripherally situated darkly staining nodule is called Barr body. Male cell nuclei lack this body and termed chromatin negative. Ref: SHAW'S TEXTBOOK OF GYNAECOLOGY; 15th edition; Pg no:108", "role": "assistant" } ]

[ { "content": "Semiclosed circuit system \nSelect and explain. \nA. Needs advanced monitoring, B. Complex, C. More environmental pollution, D. More economical", "role": "user" }, { "content": "Answer: C \nExplanation: Semiclose breathing circuit is less economical, causes more environmental pollution. It is simple portable and no need of advanced monitoring.", "role": "assistant" } ]

[ { "content": "A 40-year-old intravenous drug user presents to the emergency depament with a 2 days history of right knee pain with associated swelling and erythema. The patient is febrile with a holosystolic murmur at the right lower sternal border. Complete blood count reveals leukocytosis. Blood and synol fluid cultures are sent, and broad-spectrum antibiotics are staed. Synol fluid analysis is pending. What is the most likely pathogen causing these symptoms \nSelect and explain. \nA. Neisseria gonorrhoeae, B. Pseudomonas aeruginosa, C. Borrelia burgdorferi, D. Staphylococcus aureus", "role": "user" }, { "content": "Answer: D \nExplanation: Gram-positive bacteria remain the most common cause of septic ahritis. Staphylococcus aureus accounts for the majority of culture-positive septic ahritis, especially within ceain patient subgroups such as hemodialysis patients and intravenous drug abusers. The predominance of S. aureus in septic ahritis has remained unchanged for many years.", "role": "assistant" } ]

[ { "content": "All except one are features of Thromboangitis obliterans \nSelect and explain. \nA. Initimal hyperplasia, B. Panarteritis, C. Vasospasmitis, D. Arterial thickening", "role": "user" }, { "content": "Answer: D \nExplanation: Arterial Lumen is blocked but not thickened in TAO.", "role": "assistant" } ]

[ { "content": "A 7-year-old boy, Manoj underwent successful chemotherapy and cranial radiation for the treatment of acute lymphocytic leukemia. One month after the completion of therapy, the patient presented with excessive thirst and urination plus hypernatremia. Laboratory testing revealed pituitary diabetes insipidus. To corect these problems, this patient is likely to be treated with: \nSelect and explain. \nA. Coicotropin, B. Desmopressin, C. hCG, D. Menotropins", "role": "user" }, { "content": "Answer: B \nExplanation: (Ref: KDT 6/e p57) Drugs used for the treatment of central (pituitary) diabetes insipidus are: - Desmopressin (selective V2 agonist) - Thiazides - Chlorpropamide - Carbamazepine Drugs used for the treatment of nephrogenic (renal) diabetes insipidus are: - Thiazides - Amiloride (for lithium induced) Thiazides are useful for the treatment of both central as well as nephrogenic diabetes insipidus. Desmopressin is not effective in nephrogenic diabetes insipidus.", "role": "assistant" } ]

[ { "content": "Dogs are responsible for transmission of all the following except- \nSelect and explain. \nA. Hydatid disease, B. Toxoplasmosis, C. Kala-azar, D. Toxocara canis", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "The best marker to diagnose thyroid related order is - \nSelect and explain. \nA. T3, B. T4, C. TSH, D. Thyroglobulin", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which enzyme converts Testosterone to dihydroxytestosterone? \nSelect and explain. \nA. Aromatase, B. 5 a reductase, C. 5 a hydroxylase, D. 7 a hydroxylase", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., 5 a reductase* 5 a reductase is the enzyme which converts testosterone to dihydroxytestosterone (DHT).* Testosterone is sufficient to support male secondary sexual characteristics* Dihydroxytestosterone (DHT) is however, essential for male type external genitalia to get established. DHT is found to have higher affinity for the receptors, which are responsible for male external genital development, than testosterone. In addition DHT is found to cause prostrate hyperplasia.* Hence 5 a reductase is necessary for male type external genitalia to get established", "role": "assistant" } ]

[ { "content": "Which of these following is an example of a leading question? \nSelect and explain. \nA. How did you get cuts on T shi, B. Cause of injury, C. Whether it is caused by knife, D. Size of incised wound", "role": "user" }, { "content": "Answer: C \nExplanation: Leading question: Any question suggesting the answer which the person putting it wishes or expects to receive. It includes a material fact and admits of a conclusive answer by a simple 'Yes' or 'No' Leading questions not permitted in Leading questions permitted in -Examination in chief(Section 142 IEA) -Re-examination -Dying declaration -Cross examination( Section 143 IEA) -Dying deposition -Hostile witness", "role": "assistant" } ]

[ { "content": "A 33-yr old man presented with a slowly progressive swelling in the middle 113d of his right tibia. X-rays examination revealed multiple sharply demarcated radiolucent lesions separated by areas of dense and sclerotic bone. Microscopic examination of a biopsy specimen revealed island of epithelial cells in a fibrous stroma. Which of the following is the most probable diagnosis? \nSelect and explain. \nA. Adamantinoma, B. Osteofibrous dysplasia, C. Osteosarcoma, D. Fibrous coical defect", "role": "user" }, { "content": "Answer: A \nExplanation: Adamantinoma of long bone Introduction: Unusual neoplasm, almost always located in tibial shaft. Clinical features: Localized swelling and pain for several years. Age: Between 15-55 yrs. Radiological features: * An eccentric well demarcated area of destruction usually involving the anterior poion of the tibial shaft. * Slight expansion and coical thinning, with a cystic or multiloculated appearance is usual. * Periosteal Reaction is not marked. * Coical destruction on may be extensive. * Margins of tumors vary from being sharply and clearly demarcated, with slight sclerotic areas, to a hazy zone of transition of several mm, comparable to that seen in giant cell tumors. Histologically difficult to distinguish from metastatic adenocarcinoma, but component of the tumor may suggest an epithelial derivation. Although the tumor continues to grow to a slow rate, it is featured by local recurrent and eventual lung metastasis.", "role": "assistant" } ]

[ { "content": "A 52 year female pt. presents with symptoms of pheochromocytoma. She also has a thyroid carcinoma. Her thyroid Ca is of which type : \nSelect and explain. \nA. Anaplastic, B. Medullary, C. Folliculare, D. Papillary", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' ie. Medullary carcinoma (Ref Harrison 17/e p2359 (16/e, p 2231, 15/e, p 2185) & Q. Nov. 2000)Pt. is having MEN syndrome type II.MEN syndrome is associated with medullary Ca of thyroid.", "role": "assistant" } ]

[ { "content": "The first permanent tooth to appear is: \nSelect and explain. \nA. 1st molar, B. Lateral incisor, C. Upper canine, D. 1st premolar", "role": "user" }, { "content": "Answer: A \nExplanation: Ans: A (1st molar) Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy. 29th edition. 2010.Explanation:Appearance of temporary teeth:Lower central incisor (6 mths)Upper central incisor (7 M)Upper lateral incisor (8 M)Lower lateral incisor (9 M)1 st molar ( 1 yr)Canine (1 1/2 yr)2nd molar (2 yr)Appearance of permanent teeth:1st molar (6 yr)Central incisors (7 yr)Lateral incisors (8 yr)1st premolar (9 vr)2nd premolar (10 yr)Canine (11 yr)2nd molar (12-14 yr)3rd molar (17-25 yr)", "role": "assistant" } ]

[ { "content": "Radical retroperitoneal lymphnode dissection is indicated for all the following testicular tumours except - \nSelect and explain. \nA. Choriocarcinoma, B. Teratoma, C. Teratocarcinoma, D. Seminoma", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "A young patient presented with sudden painless loss of vision with systolic murmur over chest, ocular examination reveals - cherry red spot in macula with clear AC, with perception of light, diagnosis: \nSelect and explain. \nA. Central retinal aery occlusion, B. Central retinal vein occlusion, C. Macular choroiditis with infective endocarditis, D. Central serous retinopathy", "role": "user" }, { "content": "Answer: A \nExplanation: A i.e. Central retinal aery occlusion All the above can lead to sudden painless loss of vision, but Cherry-Red Spot is seen only in CRAO Sudden Painful Painless * Acute * Macular edema congestive * CRAO Q (central retinal aery (angle occlusion) closure) * CRVO Q (central retinal vein occlusion) glaucoma Q * Central serous retinopathy * Acute * Retinal detachment Q iridocyclitis * Exudative Age Related Macular (uveitis) Q Degeneration (ARMD) * Chemical & * Vitreous & retinal haemorrhage (eg mechanical Eale's disease) Q injury to * Optic neuritis Q eyeball * Methyl alcohol amblyopia * Subluxation or dislocation of lens Gradual Painful Painless * Corneal * Progressive pterygium ulceration * Corneal dystrophy * Chronic * Corneal degeneration simple * Cataract Q (developmental & senile) glaucoma * Chorioretinal degeneration * Chronic * Dry type - Age related macular iridocyclitis degeneration (ARMD) Q (uveitis) * Diabetic retinopathy Q * Retinitis pigmentosa Q * Optic atrophy Q * Refractive errors * Preshyopia Cherry Red Spot Macula is situated at posterior pole with its centre (foveola) being about 2 disc diameters lateral to temporal margin of disc. When retina becomes milky white due to edema, central pa of macular are shows cherry red spot due to vascular choroid shining through the thin retina of this region. Cause are:- 1. Quinine amblyopia 2. Niemann-Pick's diseaseQ 3. Metachromatic leukodystrophyQ 4. Multiple sulfatase deficiencyQ 5. Taysach's diseaseQ (GM2 gangliosidosis type 1) 6. Berlin's oedema / Commotio retinaeQ due to blunt blow on eye 7. Central Retinal Aery occlusion (CRAO)Q (not in CRVO)Q 8. Gaucher's diseaseQ, Goldberg syndrome 9. Generalized gangliosidosis (Gml gangliosidosis type 1)Q 10. Sandhoff disease (Gm2 gangliosidosis type 2, sphingolipidosis) 11. Sialidosis type 1 & 2 (cherry red spot myoclonus syndrome, sphingolipidosis) 12. Farber's disease 13. Hurler's syndrome (Mucopolysaccharidosis 1H), HallervordenSpatz disease 14. Mucopolysachharidosis VII (3 galactosidase deficiency)", "role": "assistant" } ]

[ { "content": "True about malignant hypehermia - \nSelect and explain. \nA. It is genetic, hypometabolic muscle disease, B. It is genetic, hypermetabolic muscle disease, C. It is preoperative complication, D. It is inherited in Autosomal recessive form", "role": "user" }, { "content": "Answer: B \nExplanation: Malignant hypehermia (MH) is a rare genetic hyper metabolic muscle disease. The characteristic phenotypical signs & symptoms most commonly occur with exposure to inhaled anesthetic agents and Succinylcholine. Clinical Manifestations of Malignant Hypehermia: Early Signs: Elevated end-tidal carbon dioxide Tachypnea and/or tachycardia Masseter spasm, if succinylcholine has been used Generalized muscle rigidity Mixed metabolic and respiratory acidosis Profuse sweating Mottling of skin Cardiac arrhythmias Unstable blood pressure Late Signs Hyperkalemia Rapid increase of core body temperature- body temperature rises by 10C every 5 minutes Elevated creatine phosphokinase levels Gross myoglobinemia and myoglobinuria Cardiac arrest Disseminated intravascular coagulation", "role": "assistant" } ]

[ { "content": "Best IOL is – \nSelect and explain. \nA. Anterior chamber, B. Posterior chamber, C. Iris supported, D. Angle supported", "role": "user" }, { "content": "Answer: B \nExplanation: The best position of IOL is within the capsular bag in posterior chamber.", "role": "assistant" } ]

[ { "content": "Oxaloacetate + Acetyl CoA ---> Citrate + CoASH. This reaction is: \nSelect and explain. \nA. Reversible, B. Exothermic, C. Can be reversed by catalase, D. Competitive", "role": "user" }, { "content": "Answer: B \nExplanation: In citric acid cycle, the initial reaction between acetyl-CoA and oxaloacetate to form citrate is catalyzed by citrate synthase, which forms a carbon-carbon bond between the methyl carbon of acetyl-CoA and the carbonyl carbon of oxaloacetate. The thioester bond of the resultant citryl-CoA is hydrolyzed, releasing citrate and CoASH--an exothermic reaction. In the subsequent reactions, two molecules of CO2 are released and oxaloacetate is regenerated; hence oxaloacetate can be considered as playing a catalytic role. Ref: Bender D.A., Mayes P.A. (2011). Chapter 17. The Citric Acid Cycle: The Catabolism of Acetyl-CoA. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.", "role": "assistant" } ]

[ { "content": "In children which of the following virus has been implicated in the pathogenesis of choroid plexus tumour? \nSelect and explain. \nA. Simian virus 40, B. HIV, C. Herpes simplex, D. Hepa s B", "role": "user" }, { "content": "Answer: A \nExplanation: Simian virus 40", "role": "assistant" } ]

[ { "content": "Intracardiac defibrillator (ICD) is useful in which of the following ? \nSelect and explain. \nA. Person with Brugada, B. Person with Arrhythmogenic RV dysplasia, C. Person after acute MI with CAD, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: Ref. AHA guidelines\n \nICD Indications (AHA Guidelines)\nClass I indications (ie, the benefit greatly outweighs the risk, and the treatment should be administered) are as follows:\n\nStructural heart disease, sustained VT\nSyncope of undetermined origin, inducible VT or VF at electrophysiologic study (EPS)\nLeft ventricular ejection fraction (LVEF) ≤35% due to prior MI, at least 40 days post-MI, NYHA class II or III\nLVEF ≤35%, NYHA class II or III\nLVEF ≤30% due to prior MI, at least 40 days post-MI\nLVEF ≤40% due to prior MI, inducible VT or VF at EPS\n\n \nClass IIa indications (ie, the benefit outweighs the risk and it is reasonable to administer the treatment) are as follows:\n\nUnexplained syncope, significant LV dysfunction, nonischemic cardiomyopathy\nSustained VT, normal or near-normal ventricular function\nHypertrophic cardiomyopathy with 1 or more major risk factors\nArrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) with 1 or more risk factors for sudden cardiac death (SCD)\nLong QT syndrome, syncope or VT while receiving beta-blockers\nNonhospitalized patients awaiting heart transplant\nBrugada syndrome, syncope or VT\nCatecholaminergic polymorphic VT, syncope or VT while receiving beta-blockers\nCardiac sarcoidosis, giant cell myocarditis, or Chagas disease", "role": "assistant" } ]

[ { "content": "The minimal current amplitude of indefinite durationrequired for the depolarization threshold of the cell membranes is: \nSelect and explain. \nA. Threshold, B. Rheobase, C. Chronaxie, D. Refractory period", "role": "user" }, { "content": "Answer: B \nExplanation: Rheobase is the minimal current amplitude of indefinite duration that results in the depolarization threshold of the cell membranes being reached (i.e. an action potential or the contraction of a muscle). Chronaxie (or chronaxy) is the minimum time over which an electric current, double the strength of the rheobase, needs to be applied, in order to stimulate a muscle fiber or nerve cell. In the case of a nerve or single muscle cell, rheobase is half the current that needs to be applied for the duration of chronaxie to result in an action potential or muscle twitch. Refractory period is a sho period after a nerve or muscle cell fires during which thecell cannot respond to additional stimulation. The minimal stimulus that produces excitation of any structure, eliciting a motor response is known as threshold.", "role": "assistant" } ]

[ { "content": "Most common site of intracranial hemorrhage in hepertensive hemorrhage is - \nSelect and explain. \nA. Basal ganglia, B. Brainstem, C. Cerebellum, D. Hippocampus", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following impart structural durability in a three quarter crown preparation on a mandibular molar? \nSelect and explain. \nA. Occlusal shoulder, B. Functional cusp bevel, C. Proximal groove, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Direct coomb's test detects - \nSelect and explain. \nA. Antigen in serum, B. Antibodies in RBC surface, C. Antigen in RBC surface, D. Antibodies in serum", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Hailey - hailey disease is: \nSelect and explain. \nA. Benign familial chronic pemphigus, B. Pemphigus acutus, C. Pemphigus, D. Lyell's syndrome", "role": "user" }, { "content": "Answer: A \nExplanation: A. i.e. Benign Familial Chronic Pemphigus", "role": "assistant" } ]

[ { "content": "What is the characteristic of a lacerated wound over bony surface due to blunt trauma without excessive skin crushing? \nSelect and explain. \nA. Irregular margins, B. Regular sharp margins, C. Tearing, D. Flaying", "role": "user" }, { "content": "Answer: B \nExplanation: Blunt force on areas where the skin is close to bone, and the subcutaneous tissues are scanty, may produce a wound which by linear splitting of the tissues, may look like incised wound. Lacerations produced without excessive skin crushing may have relatively regular sharp margins. Ref: The Essentials of Forensic Medicine and Toxicology by Dr. K. S. Narayan Reddy, 27th edition, Page 166.", "role": "assistant" } ]

[ { "content": "A coin foreign body is stuck in esophagus at 25cm from incisors. This is approximately situated at which of the following levels? \nSelect and explain. \nA. Left mainstem bronchus, B. Diaphragm, C. Cricopharyngeal constriction, D. Gastroesophageal junction", "role": "user" }, { "content": "Answer: A \nExplanation: On endoscopy, 3 narrowing's are seen from upper incisors. Mnemonic B - 15 AL - 25 D - 40 B - At beginning/cricopharynx 15 cm from upper incisors A- At Arch of aoa 25cm from upper incisors L- At Left Bronchus 25 cm from upper incisors D- At Diaphragm 40cm from upper incisiors", "role": "assistant" } ]

[ { "content": "False rejection of a true null hypothesis is due to? \nSelect and explain. \nA. Type II error, B. Type I error, C. Beta error, D. Error of second kind", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Type I error Statistical errors Statistical errors are used to describe possible errors made in statistical decision. Before reading about the types of error you must know null hypothesis because these tests are related to null hypothesis. Null hypothesis says - Any kind of difference or significance you see in a set of data is due to chance and not significant that means there is no variation (difference) exists between variables. Null hypothesis testing (e.g., in Chisquare test) is used to make a decision about whether : - i) The data contradict the null hypothesis - That means there is true difference (which is significant) between variables and it is not due to chance. Or ii) The data approve the null hypothesis There is no difference between variables and the difference you see is due to chance. Now see types of error :? There are two basic type of statistical errors : ? Type I error Type II error Type I error It is also known as an error of first kind or a-error or false positive. This type of error rejects null hypothesis when it is true - False rejection of null hypothesis. That means in real there is no difference (as null hypothesis says) but we observe a difference (by rejecting the null hypotesis due to error). In very simple words \"we observe a difference when it is not true\" - false positive. One of the simplest example of this would be if a test shows that a women is pregnant when in reality she is not, i.e., she is false positive for pregnancy. Probability of type-I error is given by 'P-value' (probability of declaring a significant difference when actually it is not present). Significance (a) level is the maximum tolerable probability of type I error. Significance (a) level is fixed in advance and calculation of P value (probability of type I error) can be less than, equal to or greater than the significance (a) level. If the probability of type I error (P -value) is less than significance (a) level, the results are declared statistically significant. Therefore, to declare the results statistical significant, type I error (a-level) should be kept to minimum . Type I error is more serious that type II error. Type II error It is also known as an error or second kind or A-error or false negative. This type of error accept/fail to reject the null hypothesis when it is false False acceptance of null hypothesis. That means we fail to observe a difference when in truth there is one - False negative. An example of this would be if a test shows that a woman is not pregnant when in reality she is i.e., she is false negative.", "role": "assistant" } ]

[ { "content": "Eleven years after undergoing right modified radical mastectomy, a 61-year-old woman develops raised red and purple nodules over the right arm. What is the most likely diagnosis? \nSelect and explain. \nA. Lymphangitis, B. Lymphedema, C. Lymphangiosarcoma, D. Hyperkeratosis", "role": "user" }, { "content": "Answer: C \nExplanation: Lymphangiosarcoma is a rare complication of long-standing lymphedema, most frequently described in a patient who has previously undergone radical mastectomy (Stewart-Treves syndrome). It usually presents as blue, red, or purple nodules with satellite lesions. Early metastasis, mainly to the lung, may develop if it is not recognized early and widely excised. Lymphedema is a complication of radical mastectomy and presents as diffuse swelling and nonpitting edema of the limb. Lymphangitis and hyperkeratosis are complications of lymphedema.", "role": "assistant" } ]

[ { "content": "Which of the following \"oncogenic viruses\" is so far not shown to be (oncogenic) in man - \nSelect and explain. \nA. Hepatitis B virus, B. Epstein - Barr virus, C. Herpes simplex Type 2, D. Adenovirus", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Adenovirus . Adenovirus type 12 and 18 produce sarcoma when inoculated into baby hamsters. . However there is no evidence at all relating adenoviruses to natural malignancy in human or animals. . All other viruses given in option are oncogenic in man.", "role": "assistant" } ]

[ { "content": "Which of the following is not a typical feature of Meniere's disease \nSelect and explain. \nA. Sensorineural deafness, B. Veigo, C. Pulsatile tinnitus, D. Fluctuating deafness", "role": "user" }, { "content": "Answer: C \nExplanation: Meniere's disease, also called endolymphatic hydrops, is a disorder of the inner ear where the endolymphatic system is distended with endolymph. It is characterized by (i) veigo,(ii) sensorineural hearing loss, -- Hearing improves after the attack and maybe normal during the periods of remission. This fluctuating nature of hearing loss is quite characteristic of the disease. -- Distoion of sound. Some patients complain of distoed hearing. A tone of a paicular frequency may appear normal in one ear and of the higher pitch in the other leading to diplacusis. -- Intolerance to loud sounds. Patients with Meniere's disease cannot tolerate the amplification of sound due to the recruitment phenomenon. (iii) tinnitus is low pitched and roaring type and is aggravated during acute attacks. (iv) aural fullness. (Ref: Textbook of diseased of ENT, PL Dhingra, 7th edition, pg no. 111,112)", "role": "assistant" } ]

[ { "content": "After overnight fasting, levels of glucose transpoers reduced in \nSelect and explain. \nA. Brain cells, B. RBCs, C. Adipocytes, D. Hepatocytes", "role": "user" }, { "content": "Answer: C \nExplanation: GluT4 is the major glucose transpoer in skeletal muscle and adipose tissue.GluT4 is under the control of insulin.In Type 2 diabetes mellitus, membrane GluT4 is reduced, leading to insulin resistance in muscles and fat cells.Ref: DM Vasudevan, 7th edition, page no: 107", "role": "assistant" } ]

[ { "content": "In the inflammatory process the prostaglandins E1and E2 causes \nSelect and explain. \nA. Vasodilation, B. Increased gastric output, C. Decreased body temperature, D. Vaso constriction", "role": "user" }, { "content": "Answer: A \nExplanation: ref Robbins 9/e p85", "role": "assistant" } ]

[ { "content": "Which of the following agents is likely to cause cerebral calcification and hydrocephalus in a newborn whose mother has history of taking spiramycin but was not compliant with therapy? \nSelect and explain. \nA. Rubella, B. Toxoplasmosis, C. CMV, D. Herpes", "role": "user" }, { "content": "Answer: B \nExplanation: b. Toxoplasmosis(Ref: Nelson's 20/e p 2814, Ghai 8/e p 574)Cerebral calcification with hydrocephalus in seen in congenital toxoplasmosis.", "role": "assistant" } ]

[ { "content": "Which of the following is not a pyrimidine base? \nSelect and explain. \nA. Cytosine, B. Uracil, C. Guanine, D. Thymine", "role": "user" }, { "content": "Answer: C \nExplanation: Guanine is a purine base Ref-Harpers illustrated biochemistry 30/e p329", "role": "assistant" } ]

[ { "content": "All of the following are aerial supply of sternocileidomastoid muscle, except: \nSelect and explain. \nA. Posterior auricular aery, B. Occipital aery, C. Thyrocervical trunk, D. Superior thyroid aery", "role": "user" }, { "content": "Answer: A \nExplanation: Posterior auricular aery", "role": "assistant" } ]

[ { "content": "Which of the following is the source of energy for a cardiac muscle at normal conditions? \nSelect and explain. \nA. Fatty acids, B. Ketone bodies, C. Glucose, D. Any of the above", "role": "user" }, { "content": "Answer: A \nExplanation: Hea consumes more energy than any other organ. It utilizes about 6 kg of ATP per day, 20-30 times of its own weight. Cardiac muscle derives its energy by oxidative metabolism of fatty acids (60-90%) and glucose 10-40%. Ketone bodies are also normally metabolized. In addition, energy transfer to hea's myofibrils occurs by creatine kinase catalyzed energy shuttle. The metabolism of hyperophied hea switches from fatty acid to glucose. Ref: Textbook of Biochemistry for Medical Students By D. M. Vasudevan, Sreekumari S, Kannan Vaidyanathan, 2013, Page 102.", "role": "assistant" } ]

[ { "content": "Testosterone production is mainly contributed by \nSelect and explain. \nA. Leydig cells, B. Seolie cells, C. Seminiferous tubules, D. Epididymis", "role": "user" }, { "content": "Answer: A \nExplanation: Testosterone- the principal male sex hormone (androgen) that is produced by Leydig&;s cells of the testes in response to luteinizing hormone secreted by the pituitary gland. It is also produced by the adrenal coex in both males and females. Its chief function is to stimulate the development of the male reproductive organs, including the prostate, and the secondary sex characters, such as the beard. It encourages growth of bone and muscle and helps maintain muscle strength.Ref: Ganong&;s review of medical physiology; 24th edition; page no:-423", "role": "assistant" } ]

[ { "content": "Best statistical data diagram to depict incidence change over a period of tissue is \nSelect and explain. \nA. Pie char, B. Histogram, C. Scatter diagram, D. Line diagram", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 40-year old male presents with history of vomiting of blood 2 hours ago. The volume of vomitus was estimated to be 500 ml. His BP was 90/58 mm Hg and pulse was 110/min. On abdominal examination, the spleen was palpable 5 cm below the costal margin. The most likely cause of the bleeding is: \nSelect and explain. \nA. Portal hypertension, B. Gastric ulcer, C. Duodenal ulcer, D. Drug-induced mucosal erosion", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. a. Portal hypertension (Ref: Sabiston 19/e p1164)Splenomegaly and massive bleeding leading to hypotension and tachycardia in the patient are in favor of portal hypertension.Common Causes of Upper Gastrointestinal HemorrhageNon-variceal Bleeding(80%)QPortal Hypertensive Bleeding(20%)QPeptic ulcer disease (MC)Q30-50%QGastroesophageal varicesQ>90%QMallory-Weiss tears15-20%Hypertensive portal gastropathy<5%Gastritis or duodenitis10-15%Isolated gastric varicesRareEsophagitis5-10% Arteriovenous malformations5% Tumors2% Other5% Portal HypertensionDefinition: Portal pressure >10 mm HgQMC cause of portal hypertension in United States: CirrhosisQ.Consequence of both increased portal vascular resistance and increased portal flowQ.Portal hypertension results in splenomegaly with enlarged, tortuous, and even aneurysmal splenic vessels.Splenomegaly frequently is associated with hypersplenism, causing leukopenia, thrombocytopenia, and anemia.Cruveilhier-Baumgarten murmurQ: Audible venous hum in caput medusaHyperdynamic portal venous circulation seems to be related to the severity of the liver failureQ.Upper G.I. bleeding is caused by the portal hypertension in about 90% of instances.Most bleeding episodes occur during the first 1 to 2 years after identification of varicesQ.Colour Doppler is the investigation of choice for evaluation of PHT.About one third of deaths in patients with known esophageal varices are due to upper GI bleedQA larger proportion dies as a result of liver failureQ.MC causes of death in cirrhosis patients: Hepatic failureQ2nd MC causes of death in cirrhosis patients: variceal hemorrhageQ", "role": "assistant" } ]

[ { "content": "The advantage of unfilled methyl methacrylate is that: \nSelect and explain. \nA. It can be finished smoothly, B. It has a low degree of flow, C. It's non-irritation to pulp, D. It's wear resistant is high", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Regarding HIV which of teh following is nopt true - \nSelect and explain. \nA. It is a DNA retrovirus, B. Contains Reverse Transcriptase, C. May infect host CD4 cells other than T lymphocytes, D. Causes a reduction in host CD4 cells at late stage of disease", "role": "user" }, { "content": "Answer: A \nExplanation: HIV genome is diploid composed of 2 identical single stranded positive sense RNA copies.In association with reverse transcriptase enxyme. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:571", "role": "assistant" } ]

[ { "content": "Most common extra pulmonary involvement of TB ? \nSelect and explain. \nA. Bone, B. Lymph nodes, C. Pleura, D. Ileocecal", "role": "user" }, { "content": "Answer: B \nExplanation: Most common extra pulmonary involvement: lymph nodes > pleura> ileocecal - GI TB most common site- ileocecal", "role": "assistant" } ]

[ { "content": "Which of the following anti-hypertensive is contraindicated in pregnancy: \nSelect and explain. \nA. Beta blockers, B. ACE inhibitors, C. Methyldopa, D. Ca channel blockers", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. (b) ACE inhibitorsRef KDT 6th ed. 553; Williams 24th ed, /: 1025* ACEs are the drugs which inhibit the conversion of angiotensin-I to angiotensin-II. They can cause severe fetal malformations when given in the second and third trimesters.* These include: Hypocalvaria and renal dysfunction and are also teratogenic and because of this, they are not recommended during pregnancy* Angiotensin-receptor blockers act in a similar manner.But, instead of blocking the production of angiotensin- II, they inhibit binding to its receptor. They are presumed to have the same fetal effects as ACE inhibitors and thus are also contraindicated.Antihypertensive to be avoided during pregnancyAntihypertensive safer during pregnancy* ACE inhibitors (Ex- captopril, enelapril etc.)* Angiotensin antagonist (losartan, telmesartan)* Thiazide diuretics (Ex- hydrochlorthiazide)* Furosemide* Propanolol* Nitroprusside* Hydralazine* Methyldopa* Atenolol* Metoprolol* Labetalol-DOC* Nifedipine* Prazosin and ClonidineDrugs and their respective risk* Diuretics: tend to reduce blood volume; increase risk of placental infarcts, fetal wastage, stillbirth.* ACE inhibitors, ATI antagonists: growth retardation and fetal damage risk.* Propanolol: causes low birth weight, neonatal hypoglycemia and bradycardia.* Nitroprusside: contraindicated in eclampsia.", "role": "assistant" } ]

[ { "content": "Menke's Kinky hair syndrome is due to defect in \nSelect and explain. \nA. Ca transporter, B. Cu transporter, C. Zn transporter, D. Se transporter", "role": "user" }, { "content": "Answer: B \nExplanation: Menke's kinky hair syndrome is due to mutation in ATP7A gene, leading defective copper transporter.", "role": "assistant" } ]

[ { "content": "Most common cause of U/L mucopurulent rhinorrhea in a child is: \nSelect and explain. \nA. Foreign body, B. Adenoids which are blocking the airways, C. Deted nasal septum, D. Inadequately treated acute frontal sinusitis", "role": "user" }, { "content": "Answer: A \nExplanation: A unilateral nasal discharge is nearly always due to foreign body and if duscharge has an unpleasant smell,it is pathognic. If a child presents with unilateral,foul smeling nasal discharge,foreign body must be excluded. Ref Dhingra 6/e,p 161.", "role": "assistant" } ]

[ { "content": "In thyroid gland, iodine is transpoed into the lumen of the follicles by \nSelect and explain. \nA. Endocytosis, B. Pendrin protein, C. Antipo, D. Primary active transpo", "role": "user" }, { "content": "Answer: B \nExplanation: Pendrin protein is a chloride-iodide transpoer protein encoded by the gene responsible for Pendred syndrome, impoant in function of thyroid gland, kidney, and inner ear.Endocytosis is defined as the uptake by a cell of material from the environment by invagination of the plasma membrane; it includes both phagocytosis and pinocytosis.Antipo a cell membrane transpo mechanism that transpos two molecules at once through the membrane in opposite directions.Primary active transpo - Active transpo is the movement of all types of molecules across a cell membrane against its concentration gradient (from low to high concentration). In all cells, this is usually concerned with accumulating high concentrations of molecules that the cell needs, such as ions, glucose, and amino acids. If the process uses chemical energy, such as from adenosine triphosphate (ATP), it is termed primary active transpo.Ref: Ganong&;s review of medical physiology; 24th edition; page no-341", "role": "assistant" } ]

[ { "content": "Intermediate host for schistosoma haematobium is: March 2013 \nSelect and explain. \nA. Cat, B. Dog, C. Rat, D. Fresh water snail", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D i.e. Fresh water snail Schistosoma haematobium It is an impoant digenetic trematode, and is found in the Middle East, India, Pougal and Africa. It is a major agent of schistosomiasis; more specifically, it is associated with urinary schistosomiasis. Adults are found in the Venous plexuses around the urinary bladder and the released eggs traverse the wall of the bladder causing haematuria and fibrosis of the bladder. The bladder becomes calcified, and there is increased pressure on ureters and kidneys otherwise known as hydronephrosis. Inflammation of the genitals due to S. haematobium may contribute to the propagation of HIV. Studies have shown the relationship between S. haematobium infection and the development of squamous cell carcinoma of the bladder Life cycle The female fluke lays as many as 30 eggs per day which migrate to the lumen of the urinary bladder and ureters. The eggs are eliminated from the host into the water supply with micturition. In fresh water, the eggs hatch forming free swimming miracidia which penetrate into the intermediate snail host (Bulinus spp., e.g. B. globosus, B. forskalii, B. nyassanus and B. truncatus). Inside the snail, the miracidium sheds it epithelium and develops into a mother sporocyst. After two weeks the mother begins forming daughter sporocysts. Four weeks after the initial penetration of the miracardium into the snail furcocercous cercariae begin to be released. The cercariae cycle from the top of the water to the bottom for three days in the search of a human host. Within half an hour the cercariae enter the host epithelium", "role": "assistant" } ]

[ { "content": "All of the following cephalosporins have good activity against Pseudomonas aeruginosa EXCEPT : \nSelect and explain. \nA. Cefadroxil, B. Cefepime, C. Cefoperazone, D. Ceftazidime", "role": "user" }, { "content": "Answer: A \nExplanation: First generation cephalosporins like cefadroxil are mainly effective against gram +ve organisms and possess little activity against Pseudomonas.", "role": "assistant" } ]

[ { "content": "A four-year-old child is diagnosed with Duchenne muscular dystrophy, an X-linked recessive disorder. Genetic anylysis shows that the patient&;s gene for the muscle protein dystrophin contains a mutation in its promoter region. What would be the most likely effect of this mutation? \nSelect and explain. \nA. Tailing of dystrophin mRNA will be defective, B. Capping of dystropin mRNA will be defective, C. Termination of dystrophin transcription will be deficient., D. Initiation of dystrophin transcription will be deficient", "role": "user" }, { "content": "Answer: D \nExplanation: Because the mutation creates an additional splice acceptor site (the 3'-end) upstream of the normal acceptor site of intron 1, the 19 nucleotides that are usually found at the 3'-end of the excised intron 1 lariat can remain behind as pa of exon 2. Exon 2 can, therefore, have these extra 19 nucleotides at its 5'-end. The presence of these extra nucleotides in the coding region of the mutant mRNA molecule will prevent the ribosome from translating the message into a normal b-globin protein molecule. Those mRNA for which the normal splice site is used to remove the first intron will be normal, and their translation will produce normal b-globin protein.Ref: Lippincott illustrated review, Sixth edition", "role": "assistant" } ]

[ { "content": "Uterine prolapse is prevented by all the following EXCEPT: \nSelect and explain. \nA. Broad ligament of uterus, B. Levator ani muscle, C. Uterosacral ligament, D. Transcervical ligament", "role": "user" }, { "content": "Answer: A \nExplanation: Ans-A (Broad ligament of uterus). (Ref. Shaw's Text book of Gynaecology 13th/pg. 16)The supports of uterus and bladder are seen to be triradiate condensation of endopelvic fascia:Ligaments of the uterusSuspensory ligament of ovaries# Contains the ovarian vessels.Transverse cervical (Cardinal/Macken rodt's ligament)# Mackenrodt's ligament is the main support of uterus.# Contains the uterine vessels.Round ligament of uterus# Contains no important structures. Travels through the inguinal canal and attaches distally to the labia majora.# analogous to the ductus deferens in the male.Broad ligament# Contains the round ligaments of the uterus and ovaries and the fallopian tubes.# The broad ligament is essentially the mesentery of the uterus, tube, and ovary, and encloses a rich plexus of vessels.", "role": "assistant" } ]

[ { "content": "In children below 5 years of age, most common cause of gingivitis is \nSelect and explain. \nA. local irritating factors, B. herpes, C. vitamin deficiency, D. malocclusion", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Most sensitive and specific test for diagnosis of iron deficiency is - \nSelect and explain. \nA. Serum iron levels, B. Serum ferritin levels, C. Serum transferrin receptor population, D. Transferrin saturation", "role": "user" }, { "content": "Answer: B \nExplanation: <p>Plasma ferritin is a measure of iron stores in tissues & is the best test to confirm iron deficiency & is a very specific test . </p><p>Plasma iron & total iron binding capacity are measures of iron availability ;hence they are affected by many factors besides iron stores.</p><p>Plasma iron has a marked diurnal & day to day variation & becomes very low during an acute phase response. </p><p>Levels of transferrin are lowered by malnutrition ,liver disease,acute phase response , & nephrotic syndrome.A transferrin saturation of less than 16%is consistent but is less specific than a ferritin measurement .</p><p>Reference : Davidson&;s principles & practice of medicine 22nd edition pg no-1023</p>", "role": "assistant" } ]

[ { "content": "A patient with leukemia on chemotherapy develops acute right lower abdominal pain associated with anemia, thrombocytopenia and leukopenia. Which of following is the clinical diagnosis - \nSelect and explain. \nA. Appendicitis, B. Leukemic colitis, C. Perforation peritonitis, D. Neutropenic colitis", "role": "user" }, { "content": "Answer: D \nExplanation: Neutropenic enterocolitis (NE) is also known as typhlitis, ileocecal syndrome, cecitis, or necrotizing enterocolitis. Despite the previous use of the term \"necrotizing enterocolitis\" to describe NE cases, necrotizing enterocolitis is a different inflammatory illness seen in newborns and is beyond the scope of this review. NE is a clinical entity initially described in leukemic pediatric patients. It has also been repoed in adults with hematologic malignancies such as leukemia, lymphoma, multiple myeloma, aplastic anemia, and myelodysplastic syndromes, as well as other immunosuppressive causes such as AIDS, therapy for solid tumors, and organ transplant. The true incidence of NE is unknown. One systematic review published in 2005 suggested a pooled incidence of 5.6% in hospitalized adults with hematological malignancies, chemotherapy for solid tumors, and aplastic anemia. The repoed moality also varies with rates as high as 50%. NE was repoed initially after the use of taxane drugs, but more recently an increasing number of chemotherapeutic drugs have been implicated. Other drugs linked to NE include cytosine arabinoside, gemcitabine, vincristine, doxorubicin, gemcitabine, cyclophosphamide, 5-fluorouracil, leuvocorin, and daunorubicin. Immunosuppressive therapy for organ transplant, antibiotics, and sulfasalazine for the treatment of rheumatoid ahritis have also been considered causes of NE. PATHOGENESIS The exact pathogenesis of NE is not completely understood. The main elements in disease onset appear to be intestinal mucosal injury together with neutropenia and the immunocompromised state of the afflicted patients. These initial conditions lead to intestinal edema, engorged vessels, and a disrupted mucosal surface, which becomes more vulnerable to bacterial intramural invasion. Chemotherapeutic agents can cause direct mucosal injury (mucositis) or can predispose to distension and necrosis, thereby altering intestinal motility. Cytosine arabinoside (cytarabine) is a chemotherapeutic agent used to treat leukemia and lymphoma that is paicularly associated with the development of NE. Intestinal leukemic infiltration is another potential factor in the pathogenesis of NE, which may explain the presence of acute myelogenous leukemia presenting as NE before the onset of chemotherapy regimens Ref Davidson edition23rd pg 836", "role": "assistant" } ]

[ { "content": "Which of the following cause Teratogenecity - \nSelect and explain. \nA. Vit. C, B. Vit. E, C. Vit. A, D. Vit. D", "role": "user" }, { "content": "Answer: C \nExplanation: Vit A is teratogenic and can cause craniofacial CVS and CNS defects.", "role": "assistant" } ]

[ { "content": "Double arch aoa arises from? \nSelect and explain. \nA. Right 6th aoic arch, B. Left 6th aoic arch, C. Right 4th aoic arch, D. Left 4th aoic arch", "role": "user" }, { "content": "Answer: D \nExplanation: HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:254 The arch of aoa is derived from the ventral pa of the aoic sac ,its left horn,and the left fouh arch aery", "role": "assistant" } ]

[ { "content": "A 48-year-old man complains of recurrent episodes of sudden-onset dizziness. He notices an abrupt onset of a \"spinning\" sensation when sitting up or lying down in bed. The symptoms last for 30 seconds and then resolve completely. He has no hearing change or other neurologic symptoms, and his physical examination is completely normal. A Dix-Hallpike maneuver reproduces his symptoms. Which of the following is the most likely mechanism for his vertigo symptoms? \nSelect and explain. \nA. basilar migraine, B. brain stem ischemic events, C. benign cerebellar tumors, D. calcium debris (calcium carbonate crystals) in the semicircular canals", "role": "user" }, { "content": "Answer: D \nExplanation: This person has benign paroxysmal positional vertigo (BPPV), which is characterized by sudden-onset brief episodes of vertigo lasting less than a minute. The symptoms are usually brought on by head movement. The cause is commonly attributed to calcium debris in the semicircular canals, known as canalithiasis. The debris is loose otoconia (calcium carbonate) within the utricular sac. Although BPPV can occur after head trauma, there is usually no obvious precipitating factor. It generally abates spontaneously and can be treated with vestibular rehabilitation. Basilar migraine can cause vertigo, but it is not brought on by movement, there is an associated headache and lasts longer than the 30 seconds noticed in this patient. Brainstem ischemic events or cerebellar tumors can cause vertigo but the symptoms are persistent and not intermittent. Finally, Meniere disease also causes vertigo but there is associated hearing changes, and the symptoms last longer than in BPPV.", "role": "assistant" } ]

[ { "content": "62 year old patient underwent radical mastectomy 10 years back. She has long standing lymphedema. Now the biopsy shows angiosarcoma. This is known as \nSelect and explain. \nA. Stewart treves syndrome, B. Monodors disease, C. Zuskas disease, D. Tietz syndrome", "role": "user" }, { "content": "Answer: A \nExplanation: Long standing lymphedema leading to angiosarcoma is known as Stewart treves syndrome.", "role": "assistant" } ]

[ { "content": "Children can reach for objects by: \nSelect and explain. \nA. 4 months, B. 6 months, C. 8 months, D. 10 months", "role": "user" }, { "content": "Answer: A \nExplanation: Ans: A (4 months) Ref: Nelson Textbook of Pediatrics, 19th edition. Pg 27. Explanation: (See following table) Fine motor milestones MilestoneAverage age of attainment (in months)Developmental implicationsGrasps rattle3.5Object useReaches for objects4Visuomotor coordinationPalmar grasp gone4Voluntary releaseTransfers object hand to hand5.5Comparison of objectsThumb-finger grasp8Able to explore small objectsTurns pages of book12Increasing autonomy during book timeScribbles13Visuomotor coordinationBuilds tower of 2 cubes15Uses objects in combinationBuilds tower of 6 cubes22Requires visual, gross, and fine motor coordination", "role": "assistant" } ]

[ { "content": "Which is the most common site of metastatic disease- \nSelect and explain. \nA. Lung, B. bone, C. Liver, D. Brain", "role": "user" }, { "content": "Answer: C \nExplanation: Invasion and metastasis are complex processes involving multiple discrete steps; they begin with local tissue invasion, followed byinfiltration of nearby blood and lymphatic vessels by cancer cells.Malignant cells are eventually transpoed through haematogenousand lymphatic spread to distant sites within the body, where theyform micrometastases that will eventually grow into macroscopicmetastatic lesions Cadherin-1 (CDH1) is a calcium-dependent cell-cell adhesionglycoprotein that facilitates assembly of organised cell sheets intissues, and increased expression is recognised as an antagonistof invasion and metastasis. In situ tumours usually retain CDH1production, whereas loss of CDH1 production due to down-regulation or occasional mutational inactivation of CDH1 hasbeen observed in human cancers, suppoing the theory thatCDH1 plays a key role in suppression of invasion and metastasis.Cross-talk between cancer cells and cells of the surroundingstromal tissue is involved in the acquired capability for invasivegrowth and metastasis. Mesenchymal stem cells in tumourstroma have been found to secrete CCL5, a protein chemokinethat helps recruit leucocytes into inflammatory sites. With thehelp of paicular T-cell-derived cytokines (interleukin (IL)-2and interferon-gamma (IFN-g)), CCL5 induces proliferation andactivation of natural killer cells and then acts reciprocally oncancer cells to stimulate invasive behaviour. Macrophages atthe tumour periphery can foster local invasion by supplyingmatrix-degrading enzymes such as metalloproteinases andcysteine cathepsin proteases.The lungs, liver, brain, and bones are the most common metastasis locations from solid tumors. Ref Harrison 20th edition pg 580", "role": "assistant" } ]

[ { "content": "All are features of hyperplastic tuberculosis of gastrointestinal tract except: \nSelect and explain. \nA. Presents with a mass in RIF, B. Barium meal shows' pulled up caecum', C. Most common site is ileocecal junction, D. ATT is the treatment of choice.", "role": "user" }, { "content": "Answer: D \nExplanation: If there is no intestinal obstruction conservative antitubercular treatment is advised. If obstruction is present, surgery is advised under cover of antitubercular treatment. Ref: Bailey and Love's Sho Practice of Surgery, 23rd Edition, Page 1046; Oxford Textbook of Surgery, 2nd Edition, Page 3243; Sho Textbook of Surgery: Including Bedside Clinics By Roy, 2011, Page 202.", "role": "assistant" } ]

[ { "content": "River blindness is caused by: \nSelect and explain. \nA. Onchocerca, B. Loa Loa, C. Ascaris, D. B. malayi", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Onchocerca(Ref: Harrison, 19th/e, p. 1421)* Onchocerciasis is also known as River blindness Q and fly involved is Simulium fly.", "role": "assistant" } ]

[ { "content": "Eating disorder with normal weight is? \nSelect and explain. \nA. Anorexia nervosa, B. Bulimia nervosa, C. Binge eating disorder, D. None of the above", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B. Bulimia nervosaAnorexia nervosa - Under weightBulimia nervosa - Normal WeightBinge eating disorder - Over weight.", "role": "assistant" } ]

[ { "content": "All are true about type 1 schizophrenia except? \nSelect and explain. \nA. Acute illness, B. Good prognosis, C. Negative symptoms, D. Intellect maintained", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Negative symptoms Type I (Reactive or acute schizophrenia) Type II (Process schizophrenia) Characteristic symptoms Type of illness Response to neuroleptics Outcome Intellectual impairment Etiology Positive symptoms (Hallucination,Acute Delusion, Thought) Good Reversible Absent Dopamine overactivity Good Negative symptoms (Affect flattening, poverity of speech loss of drive Chronic Poor Long standing Sometimes present Structural changes in brain (dilated ventricle on CT scan Poor", "role": "assistant" } ]

[ { "content": "Excitatory Neurotransmitter in CNS- \nSelect and explain. \nA. Acetyl choline, B. Glycine, C. GABA, D. Glutamate", "role": "user" }, { "content": "Answer: D \nExplanation: Glutamate is the chief excitatory neurotransmitter in CNS.", "role": "assistant" } ]

[ { "content": "Anita 15-year-old, complains of heavy periods since 2 months. O/E: wt 40 kg and BP 120/80 mmHg. All of the following investigations are indicated, except : \nSelect and explain. \nA. TSH, B. Platelet count, C. Bleeding and clotting time, D. Estradiol levels", "role": "user" }, { "content": "Answer: D \nExplanation: Investigations in a case of pubey menorrhagia : 1.Blood profile--Hb%, bleeding and clotting time, coagulation factors; blood film. 2.X-ray chest for tuberculosis. 3.Thyroid function tests. 4.Pelvic ultrasound PCOD, early fibroid. 5.If medical treatment fails, D&C should be done to rule out endometrial tuberculosis by PCR test. Reference: Shaw's Textbook of Gynaecology 16th edition page no 340", "role": "assistant" } ]

[ { "content": "Which of the following is/are sign of fracture ? \nSelect and explain. \nA. Abnormal mobility, B. Crepitus, C. Failure to transmit movement proximally, D. All of above", "role": "user" }, { "content": "Answer: D \nExplanation: Sure signs of fracture :- 1 Abnormal mobility(best) 2 Failure to transmit movements proximally 3 Crepitus 4 Tenderness(Commonest sign)", "role": "assistant" } ]

[ { "content": "Antidepressant drug that can be used in nocturnal enuresis is? \nSelect and explain. \nA. Imipramine, B. Fluvoxamine, C. Phenelzine, D. Bupropion", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. (A) Imipramine(Ref: CMDT 2010/966)Imipramine is efficacious however, Desmopressin is the first choice drug for nocturnal enuresis.", "role": "assistant" } ]

[ { "content": "Deltoid ligament is attached to all, except \nSelect and explain. \nA. Medial malleolus, B. Medial cuneiform, C. Spring ligament, D. Sustentaculum tali", "role": "user" }, { "content": "Answer: B \nExplanation: DELTOID LIGAMENT:-Very strong Triangular shape Present on medial side of ankle.Ligament is crossed by the tendons of Tibialis posterior and flexor digitorum longus.Prone to injuries in inversion.Superficial and deep pa. Both pas have common attachments above to the apex and margins of medial malleolus. Superficial pa:-1. Anterior/Tibionavicular- attached to tuberosity of the navicular bone and medial margin of spring ligament.2. Middle/Tibiocalcanean-attached to whole length of sustentaculum tali.3. Posterior/posterior tibiotalar-attached to medial tubercle and medial surface of talus. Deep fibres:-Anterior tibiotalarAttached to the anterior pa of medial surface of talus. {Reference: BDC 6E pg no.149}", "role": "assistant" } ]

[ { "content": "40 year old male with sputum AFB +ve,complains of Hoarseness of voice and painful swallowing on examination vocal cord shows mamillated adenoids and hyperaemia the most likely diagnosis is \nSelect and explain. \nA. Rinke's edema, B. Epiglottitis, C. TB larynx, D. Cancer of larynx", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Case fatality rate describes: \nSelect and explain. \nA. Communicability of infection, B. History of disease, C. Virulence of organism, D. Contribution of a disease among all deaths", "role": "user" }, { "content": "Answer: C \nExplanation: Case fatality rate: Deaths/cases x 100 CFR represents \"Killing power of a disease\". It is closely related to \"Virulence of organism\". It is applicable only for acute diseases. Time interval is not specified.", "role": "assistant" } ]

[ { "content": "Laser Endometrial ablation is done in abnormal uterine bleeding in all cases except \nSelect and explain. \nA. Women not preferring surgery, B. Small uterine fibroids, C. Women preferring reproductive function, D. Failed medical treatment", "role": "user" }, { "content": "Answer: C \nExplanation: Females who desire future pregnancy should not be offered endometrial ablation for AUB.", "role": "assistant" } ]

[ { "content": "A patient arrives at the emergency department complaining of midsternal chest pain. Which of the following nursing action should take priority? \nSelect and explain. \nA. A complete history with emphasis on preceding events., B. An electrocardiogram, C. Careful assessment of vital signs, D. Chest exam with auscultation", "role": "user" }, { "content": "Answer: C \nExplanation: The priority nursing action for a patient arriving at the ED in distress is always assessment of vital signs. This indicates the extent of physical compromise and provides a baseline by which to plan further assessment and treatment. A thorough medical history, including onset of symptoms, will be necessary and it is likely that an electrocardiogram will be performed as well, but these are not the first priority. Similarly, chest exam with auscultation may offer useful information after vital signs are assessed.", "role": "assistant" } ]

[ { "content": "Palpable purpura is seen in – \nSelect and explain. \nA. PAN, B. ITP, C. TTP, D. DIC", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following causes retinal pigmentation? \nSelect and explain. \nA. Quinine, B. Chloroquine, C. Mefloquine, D. Atovaquone", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Chloroquine * Chloroquine is a 1st line anti malarial drug, which is an erythrocytic schizonticide.* However, its prolonged use of high doses (as in DLE, rheumatoid arthritis) may cause loss of vision due to retinal damage in the form of retinal pigmentation.* Chloroquine may also cause corneal deposits and affect vision and are reversible on discontinuation.* Loss of hearing, rashes, photoallergy, myopathy, graying of hair may occur.", "role": "assistant" } ]

[ { "content": "Development of labia majora is from - \nSelect and explain. \nA. Urogenital sinus, B. Mullerian duct, C. Genital ridge, D. Genital swelling", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Genital swelling Embryogical structureFate in femaleFate in maleGenital ridgeOvaryTestisGenital swellingLabia majoraScrotumGenital foldLabia minoraVentral aspect of penis penile urethraGenital tubercleClitorisGians penis", "role": "assistant" } ]

[ { "content": "All of the following are features of Premature Ventricular Complexes, Except \nSelect and explain. \nA. Wide QRS complex, B. Absent P wave, C. Complete compensatory pause, D. Prolonged PR interval", "role": "user" }, { "content": "Answer: D \nExplanation: Answer is D (Prolonged PR interval) PR interval does not characterize Ventricular Premature complexes because AV conduction is not involved. Wide QRS complex, Absent P wave and a frequently Complete Compensatory Pause are all characteristic features of Premature ventricular complexes. The basic ECG characteristics of PVCs include the following: Rate The underlying sinus rate is usually regular but is intermittently interrupted by the PVC. This results in an irregular and fluctuating hea rate. Rhythm , The basic R-R interval is regular but is intemittently interrupted by the PVC. The R-R interval preceding the PVC is sho due to the \"prematurity\" of the QRS complex and often the R-R interval after the PVC is longer due to a compenstory pause (Fig.2) P wave The premature QRS complex is not preceded by a conducted P wave (although in ceain instances the PVC may coincidentally be preceded by a nonconducted sinus P wave) PR interval Not applicable because atrioventricular (AV) conduction is not involved. QRS complex QRS complex is premature 2 QRS complex is prolonged (>0.12 seconds)e QRS complex is bizzare or distoed (notched)e QRS complex is not proceeded by a P wave e QRS complex is frequently 'allowed by a complete compensatory pause e ST segment and T The ST segment and T wave slope in the opposite direction from the main deflection of ORS wave complex Note : A V dissociation' with 'capture beats' and fusion beats' are diagnostic criteria for ventricular tachycardia (VT) and not for PVC's. However, VT is defined by the presence of three or more consecutive PVC and hence AV dissociation, capture beats and fusion beats may be said to be occasionally present in PVC's when they occur in consecutive bests.", "role": "assistant" } ]

[ { "content": "Pediculus humanus can transmitt: \nSelect and explain. \nA. Sleeping sickness, B. Plague, C. Chaga's disease, D. Relapsing fever", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. c. Chaga's disease", "role": "assistant" } ]

[ { "content": "Mechanism of action of cyanide poisoning:September 2010 \nSelect and explain. \nA. Inhibits protein breakdown, B. Inhibits DNA synthesis, C. Inhibits protein syntheisi, D. Blocks Cytochrome enzyme P- 450", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D: Blocks Cytochrome enzyme P- 450Cyanide poisoning occurs when a living organism is exposed to a compound that produces cyanide ions (CN-) when dissolved in water. Common poisonous cyanide compounds include hydrogen cyanide gas and the crystalline solids potassium cyanide and sodium cyanide.The cyanide ion halts cellular respiration by inhibiting an enzyme in mitochondria called cytochrome c oxidase.", "role": "assistant" } ]

[ { "content": "SSRIs should be carefully used in the young for the management of depression due to increase in: \nSelect and explain. \nA. Nihilism ideation, B. Guilt ideation, C. Suicidal ideation, D. Envious ideation", "role": "user" }, { "content": "Answer: C \nExplanation: The use of SSRIs can increase suicidal ideations. This side effect is more common in children and adolescents and hence these medications should be used cautiously in that age group.", "role": "assistant" } ]

[ { "content": "The number of times an individual swallows per day while awake: \nSelect and explain. \nA. 600, B. 800, C. 700, D. 900", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "At the CEJ, which of the following occurs \nSelect and explain. \nA. Cementum meets enamel, B. Cementum overlaps enamel, C. Cementum does not meet enamel, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which among the following drug is not used in the\ntreatment of Tetralogy of Fallot? \nSelect and explain. \nA. β blocker, B. α agonists, C. Calcium channel blockers, D. Morphine", "role": "user" }, { "content": "Answer: C \nExplanation: Calcium channel blockers reduce systemic Vascular resistance which incsceases blood flow into Aorta and decreases blood to pulmonary vasculature. This adds to the pathology and worsens the condition.", "role": "assistant" } ]

[ { "content": "Which of the following is not true regarding Chlamydia? \nSelect and explain. \nA. Has biphasic life, B. Elementary body is metabolically active, C. Reticulate body undergoes binary fission, D. Once it invades into cell it abates phagolysosomal fusion", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. (b) Elementary body is metabolically active Reproductive Cycle of Chlamydiae Elementary body (EB) Stable spherical form, metabolically inactive - Extracellular phase Infectious form 200 - 300 nm diameter Rigid trilaminar cell wall Electron dense nucleoid (contains DNA) DNA = RNA Attach to surface of susceptible epithelial cell near base of microvilli by adhesins (e.g. major outer membrane protein); receptors (heparin sulfate like proteoglycans in case of C. trachomatis) | Engulfment of EB into host cell either by endocytosis into clathrin-coated pits or pinocytosis into non-coated pits. Lysosomal fusion is inhibited by unknown mechanism, so EB form of chlamydiae is protected under membrane bound environment. | Reorganisation of EB by spheroplast-like transformation/loss of cross-linking of EB membrane proteins. Reticulate body (Initial body form) - Pleomorphic stage Intracellular form Growing and replicative form 500-1000 nm size No electron dense nucleoid RNA > DNA Within membrane bound vacoule RB divides by binary fission repeatedly to form EB. |Cytoplasmic inclusion bodies form (EB filled vacoule) |This EB liberate from host cell to infect new cells.", "role": "assistant" } ]

[ { "content": "Commonest cause of pyogenic liver abscess - \nSelect and explain. \nA. Biliary Sepsis., B. Biliary Colic, C. Appendicitis, D. Sigmoid Diverticulitis", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Insulin causes lipogenesis by all except: \nSelect and explain. \nA. Increasing acetyl-CoA carboxylase activity, B. Increases the transpo of glucose into the cells, C. Inhibits pyruvate dehydrogenase, D. Decreases intracellular cAMP level", "role": "user" }, { "content": "Answer: C \nExplanation: Inhibits pyruvate dehydrogenase Role of insulin in lipogenesis: Insulin promotes lipogenesis by increasing activity of acetyl-CoA carboxylase activity, the principal enzyme of lipogenesis Insulin promotes the entry of glucose in some tissues such as skeletal muscle and adipocytes and thus increases the availability of pyruvate for fatty acid synthesis and glycerol 3-phosphate for esterification of the newly formed fatty acids. [Note that glucose transpo in some cells of body are insulin-independent - hepatocytes, RBCs, cells of nerveous system, corneal Insulin also activates pyruvate dehydrogenase (only in adipose tissue, not in liver) which catalyzes pyruvate into Acetyl-CoA the building blocks of fatty acids. Insulin decreases intracellular cAMP and thus inhibits lipolysis in adipose tissue. This reduces the concentration of plasma free fatty acids and long chain acyl-CoA (an inhibitor of lipogenesis).", "role": "assistant" } ]

[ { "content": "The ratio of ICF volume to Extracellular fluid volume reaches adult values at the age of \nSelect and explain. \nA. 1 year, B. 2 years, C. 3 years, D. 4 years", "role": "user" }, { "content": "Answer: A \nExplanation: Total body water is divided between 2 main compaments: intracellular fluid (ICF) and extracellular fluid (ECF). In the fetus and newborn, the ECF volume is larger than the ICF volume. The normal postnatal diuresis causes an immediate decrease in the ECF volume. This is followed by continued expansion of the ICF volume, which results from cellular growth. By 1year of age, the ratio of the ICF volume to the ECF volume approaches adult levels.Reference: Nelson Textbook of Paediatrics; 20th edition; Chapter 55; Electrolyte and Acid-Base Disorders", "role": "assistant" } ]

[ { "content": "Emporiatrics deals with the health of the following group of people: \nSelect and explain. \nA. Farmers, B. Travellers, C. Industrial workers, D. Mine workers", "role": "user" }, { "content": "Answer: B \nExplanation: Emporiatrics is the term coined to describe the science of the health of travellers. Health maintenance recommendations are based not only on the traveler's destination but also on assessment of risk, which is determined by such variables as health status, specific itinerary, purpose of travel, season, and lifestyle during travel. Ref: Park's Textbook of Social and Preventive Medicine, 19th edition, Page 107.", "role": "assistant" } ]

[ { "content": "Compared to the other leukemias, hairy cell leukemia is associated with which of the following infections - \nSelect and explain. \nA. Parvovirus D19, B. Mycoplasma, C. HTLV2, D. Salmonella", "role": "user" }, { "content": "Answer: C \nExplanation: Hairy cell leukaemia is seen in patients susceptibility to infections with mycobacterium avium intracellulare. Nontuberculous mycobacteria, also known as environmental mycobacteria, atypical mycobacteria and mycobacteria other than tuberculosis, are mycobacteria which do not cause tuberculosis or leprosy. NTM do cause pulmonary diseases that resemble tuberculosis Reference: textbook of Pathology 6th edition Author Harsha Mohan page number 378.", "role": "assistant" } ]

[ { "content": "Resting membrane potential of nerve is equal to equilibrium potential of \nSelect and explain. \nA. Na+, B. Cl-, C. K+, D. HCO3-", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Chloride ion", "role": "assistant" } ]

[ { "content": "Which of the following statements about fluconazole is most accurate? \nSelect and explain. \nA. It is highly effective in the treatment of aspergillosis, B. It does not penetrate the blood-brain barrier, C. Its oral bioavailability is less than that of ketoconazole, D. It inhibits demethylation of lanosterol", "role": "user" }, { "content": "Answer: D \nExplanation: * Fluconazole (Azoles) act by inhibiting the enzyme lanosterol-14-a-demethylase resulting in reduced ergosterol synthesis. * It has very good CNS penetration and oral bioavailability. * It is not very effective against aspergillosis (voriconazole is the drug of choice).", "role": "assistant" } ]

[ { "content": "Excess of avidin causes deficiency of: \nSelect and explain. \nA. Folate, B. Choline, C. Vitamin B12, D. Biotin", "role": "user" }, { "content": "Answer: D \nExplanation: Excess consumption of raw eggs, which contains a protein 'avidin' - a biotin binding protein leads to biotin deficiency When cooked, avidin is paially denatured and its binding to biotin is reduced. So cooked egg whites are safe to consume.", "role": "assistant" } ]

[ { "content": "Dietary changes advocated by WHO for prevention of heart diseases included all of the following except - \nSelect and explain. \nA. Reduction in fat intake to 20-30 percent of caloric intake, B. A decrease in complex carbohydrateconsumption, C. Consumption of saturated fats be limited to less than 10% of total energy intake, D. Reduction of cholesterol to below 100mg per 1000kcl per day", "role": "user" }, { "content": "Answer: B \nExplanation: increase in complex carbohydrate consumption that is vegetables ,fruits,legumes and whole grains", "role": "assistant" } ]

[ { "content": "Treatment of choice for Aniseikonia \nSelect and explain. \nA. Ohoptic exercise, B. Spectacles, C. Surgery, D. Contact lens", "role": "user" }, { "content": "Answer: D \nExplanation: Treatment 1. Optical aniseikonia may be corrected by aniseikonic glasses, contact lenses or intraocular lenses depending upon the situation. 2. For retinal aniseikonia treat the cause. 3. Coical aniseikonia is very difficult to treat. Image : Aniseikonia Reference : A K KHURANA OPHTALMOLOGY,Edition 4,Page-39", "role": "assistant" } ]