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[ { "content": "Which of the following statement is false about drugs used in rheumatoid ahritis? \nSelect and explain. \nA. Tofacitinib inhibits JAK1 and JAK3, B. Tocilizumab inhibits IL-6, C. Tofactinib is given intravenously, D. Tocilizumab is given by intravenous and subcutaneous route", "role": "user" }, { "content": "Answer: C \nExplanation: Drug ending with inib - JAK inhibitor and given orally.- Tofacitinib- Beracitinib Drug ending with Mab: - Monoclonal antibody and IL-6 inhibitor.- Tocilizumab- SarilumabSix : IL-6A-AhritisR-RheumatoidI - InterleukinL - InterleukinUMAB: Monoclonal Antibody.All above mentioned drugs are used for Rheumatoid ahritis. Tocilizumab: is also use for cytokine release syndrome.", "role": "assistant" } ]

[ { "content": "Which of the following cell types are specific to a latent genital infection with HSV-2 \nSelect and explain. \nA. Sacral ganglia, B. Neural sensory ganglia, C. Trigeminal ganglia, D. Vagal nerve ganglia", "role": "user" }, { "content": "Answer: A \nExplanation: Latent infection by HSV-2 has been shown to occur primarily in the sacral ganglia, whereas HSV-1 latency has been demonstrated in trigeminal, superior cervical, and vagal nerve ganglia. Varicella- zoster virus remains latent in neural sensory ganglia. Ref:- Baveja textbook of Microbiology", "role": "assistant" } ]

[ { "content": "If a body is left undisturbed, for how long does post moem staining persists : \nSelect and explain. \nA. Few hours, B. Few days, C. Few months, D. Persists till merges with discolouration of putrefaction", "role": "user" }, { "content": "Answer: D \nExplanation: D i.e. Persists till merges with discolouration of putrefaction", "role": "assistant" } ]

[ { "content": "Phage typing is useful as an epidemiological tool in all, except ? \nSelect and explain. \nA. Salmonella, B. Staph aureus, C. V. cholerae, D. Shigella dysenteriae", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Shigella dysenteriae", "role": "assistant" } ]

[ { "content": "Multifactorial inheritance is most likely to play a role in \nSelect and explain. \nA. Cleft lip, B. Marfan's syndrome, C. Down's syndrome, D. Erythroblastosis fetalis", "role": "user" }, { "content": "Answer: A \nExplanation: Cleft lip and cleft palate, also known as orofacial cleft, is a group of conditions that includes cleft lip (CL), cleft palate (CP), and both together (CLP).] A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate is when the roof of the mouth contains an opening into the nose. These disorders can result in feeding problems, speech problems, hearing problems, and frequent ear infections. Less than half the time the condition is associated with other disordersMultifacorial inheritance is the type of inheritance followed by traits that are determined by multiple factors both environmental and genetic. Environmental factors interact with many genes to generate a normally distributed susceptibiity.Some diseases for example myocardial infarction, congenital bih defects, cancer, diabetes, mental illnesses and Alzheimer diseases cause along with morbidity, premature moality in two out of three individuals during their lifetime. Many show clustering among families. However their inheritance pattern does not follow that of single gene disorders (Mendelian pattern of inheritance). These kind of diseases are thought to result from complex interactions between genetic and environmental factors, i.e. multifactorial inheritance pattern.", "role": "assistant" } ]

[ { "content": "Which of the followign drugs require dose adjustment in renal failure? \nSelect and explain. \nA. Cefoperazone, B. Doxycycline, C. Streptomycin, D. Rifampicin", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. (C) Streptomycin(Ref: Katzung 10/e p835 KDT 8/e p746)Streptomycin is an aminoglycoside and require dose adjustment in renal failure whereas doxycycline, rifampicin and cefoperazone are secreted in bile and do not require dose adjustment in renal failure.", "role": "assistant" } ]

[ { "content": "The learning theory of digit sucking was proposed by \nSelect and explain. \nA. Davidson, 1967, B. Sears and Wise, 1982, C. Johnson and Larson, 1993, D. Sigmond Freud, 1905", "role": "user" }, { "content": "Answer: A \nExplanation: The learning theory: Davidson (1967)\nThis theory advocates that non-nutritive sucking stems from an adaptive response.\nThe infant associates sucking with such pleasurable feelings as hunger. These events are recalled by sucking the suitable objects available, mainly thumb or finger.", "role": "assistant" } ]

[ { "content": "Which aery dilatation causes compression of 3rd pa of duodenum \nSelect and explain. \nA. Superior mesenteric aery, B. Gastroduodenal aery, C. Inferior mesenteric aery, D. Celiac aery", "role": "user" }, { "content": "Answer: A \nExplanation: Superior mesenteric aery: - Aery of mid gut Origin - L1 veebrae level . Regional anatomy of SMA: - It is crossed anteriorly by the splenic vein & the neck of pancreas. Posterior to it is the renal vein, the uncinate process & the inferior pa of duodenum (3rd pa). - This D3 pa can be compressed b/w two aeries: - Anterior - SMA Posterior - Abdominal aoa SMA dilatation can lead to compression of 3rd pa of duodenum. | This is called as superior Mesenteric aery syndrome.", "role": "assistant" } ]

[ { "content": "The surgery for hyperophic pyloric stenosis of infancy is \nSelect and explain. \nA. Ramstedt's operation, B. Truncal vagotomy, C. Heller's operation, D. Delorme's operataion", "role": "user" }, { "content": "Answer: A \nExplanation: After laparotomy hyperophied muscle is cut along the whole length adequately until mucosa bulges out, then pyloromyotomy is done. in Heller&;s operation muscle of the cardiac are cut to allow passage of food ,and is done in achalasia cardia Truncal vagotomyis done by denervating the main branch which is supply in pylorus as in cases like peptic ulcerarltion Delorme&;s operation is done for repairing a external rectal prolapse Reference: SRB 5th edition page no. 821 & internet", "role": "assistant" } ]

[ { "content": "Testamentary capacity is the ability to: \nSelect and explain. \nA. Give evidence in a cou of law, B. Enter into a contract, C. Make a will, D. Give consent", "role": "user" }, { "content": "Answer: C \nExplanation: Testamentary capacity (testament = will) is the mental ability to make a valid will. Will denotes any testamentary document. The requirement for a valid will are as follows. A written and properly signed and witnessed document must exist. The testator must be a major and of sound disposing mind at the time of making the will. Force undue influence or dishonest representation of facts, should not have been applied by others. Ref: The Essentials of Forensic Medicine and Toxicology 29th Ed Page 431", "role": "assistant" } ]

[ { "content": "Uveitis with raised intraocular tension is best managed by – \nSelect and explain. \nA. Timolol, B. Atropine, C. Pilocarpine, D. Steroid", "role": "user" }, { "content": "Answer: D \nExplanation: Keep in mind that:-\n\n\nTreatment of uveitis in hypertensive uveitis (uveitic glaucoma) is topical steroid along with mydriatic-cycloplegics.\nTreatment for reducing IOP in hypertensive uveitis (uveitic glaucoma) is antiglaucoma drugs (Timolol is the drug of choice).", "role": "assistant" } ]

[ { "content": "Pin point pupil is seen in A/E : \nSelect and explain. \nA. Pontine haemorrhage, B. Organophosphorus poisoning, C. Opium poisoning, D. Barbiturate poisoning", "role": "user" }, { "content": "Answer: D \nExplanation: D i.e. Barbiturate All are causes of constricted pupils but in? Barbiturate poisoning the pupils are usually slightly constricted & react to light by alternate contraction & dilation and dilate during terminal asphyxiaQ", "role": "assistant" } ]

[ { "content": "All are morbidity indicators execpt - \nSelect and explain. \nA. Period of stay in hospital, B. Doctor : population ratio, C. Attendance at out patient depament, D. Notification rates", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is `b' i.e., Doctor : population ratio Health change cannot be measured in specified unit. o So, different indicators have been defined which reflect health change in a community. o These indicators are called health indicators e.g. moality indicators, morbidity indicators, Disability rates.", "role": "assistant" } ]

[ { "content": "False positive fistula test is associated with \nSelect and explain. \nA. Perilymph fistula, B. Malignant sclerosis, C. Congenital syphilis, D. Cholesteatoma", "role": "user" }, { "content": "Answer: C \nExplanation: False positive fistula test seen in: Congenital syphilis - Stapes footplate is hypermobile Meniere's disease - fibrous bands connecting uricular macula to Stapes footplate. Ref : Dhingra 7e pg 43.", "role": "assistant" } ]

[ { "content": "NOT a feature of ligature strangulation: Kerala 08 \nSelect and explain. \nA. Horizontal ligature mark, B. Incomplete ligature mark, C. Marked congested face, D. Sub-conjunctival hemorrhage", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. Incomplete ligature mark", "role": "assistant" } ]

[ { "content": "A 32-year-old female is brought by his family with history of gradual onset of suspiciousness, muttering and smiling without clear reason, decreased socialization, and violent outbursts. Mental status examination revealed a blunt affect, thought insertion, impaired judgement and insight. The most likely diagnosis would be: \nSelect and explain. \nA. Delusional disorder, B. Depression, C. Schizophrenia, D. Anxiety disorder", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. C. SchizophreniaSchizophrenia is a disorder characterized by delusions, hallucinations, negative symptoms, aggressive behavior in clear consciousness. Altered sensorium is seen in organic conditions like delirium.", "role": "assistant" } ]

[ { "content": "In which of the following condition is Ground glass appearance of maxillary sinus seen? \nSelect and explain. \nA. Maxillary Sinusitis, B. Maxillary Carcinoma, C. Maxillary polyp, D. Maxillary fibrous dysplasia", "role": "user" }, { "content": "Answer: D \nExplanation: Extra oral film taken in a case of maxillary fibrous dysplasia shows ground glass appearence. Intraoral film taken in this condition shows orange peel appearence. Fibrous dysplasia is an idiopathic skeletal disorder in which medullary bone is replaced by poorly organized structurally unsound fibro osseous tissue. Most commonly involved site is the posterior maxilla. In this condition, the normally radiolucent maxillary antrum may be paially or totally replaced by the radio-opaque lesion.", "role": "assistant" } ]

[ { "content": "Peptidoglycans are found in large quantities in cell wall of: March 2009 \nSelect and explain. \nA. Virus, B. Gram positive bacteria, C. Gram negative bacteria, D. All of the above", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B: Gram positive bacteria The Bacteria (eubacteria), with the exception of the Chlamydias have a semirigid cell wall containing peptidoglycan. Gram negative bacteria's peptidoglycan layer is much thinner than in Gram-positive bacteria In general, the walls of gram positive bacteria have a simpler chemical nature than those of gram negative bacteria. The mycoplasmas are the only bacteria that naturally lack a cell wall. Mycoplasmas maintain a nearly even pressure between the outside environment and the cytoplasm by actively pumping out sodium ions. Their cytoplasmic membranes also contain sterols that most likely provide added strength. All other bacteria have a cell wall Peptidoglycan prevents osmotic lysis. Under the cytoplasmic membrane, bacteria concentrate dissolved nutrients (solute) through active transpo. As a result, the bacterium's cytoplasm is usually hypeonic to its surrounding environment and the net flow of free water is into the bacterium. Without a strong cell wall, the bacterium would burst from the osmotic pressure of the water flowing into the cell.", "role": "assistant" } ]

[ { "content": "Coincidental malignancy in the upper respiratory tract with inveed papillomas seen in \nSelect and explain. \nA. 0.10%, B. 2%, C. 4%, D. 5%", "role": "user" }, { "content": "Answer: C \nExplanation: Coincidental malignancy in the upper respiratory tract with inveed papilloma is seen in 4%Malignant transformation of the tumor itself is seen in 8%", "role": "assistant" } ]

[ { "content": "Hepatic encephalopathy is aggravated by all except? \nSelect and explain. \nA. Hyperkalemia, B. Anemia, C. Hypothyroidism, D. Barbiturates", "role": "user" }, { "content": "Answer: A \nExplanation: Hypokalemia is seen with overzealous use of diuretics and this will lead to dehydration and increased hepatic encephalopathy. Anemia associated with Gl bleeding worsens hepatic encephalopathy Constipation in hypothyroidism will worsen hepatic encephalopathy by increasing bacterial load. Drugs like barbiturates and antipsychotics worsen hepatic encephalopathy", "role": "assistant" } ]

[ { "content": "A female aged 30, presents with an episodic throbbing headache for past 4 yrs. It usually involves one half of the face and is associated with nausea and vomiting. There is no aura. Most likely diagnosis is \nSelect and explain. \nA. Migraine, B. Cluster headache, C. Angle closure glaucoma, D. Temporal aeritis", "role": "user" }, { "content": "Answer: A \nExplanation: Migraine 2nd most common cause of a headache.Affects 15% of women and 6% of men over a one year period.Usually an episodic headache and associated with ceain features such as sensitivity to light, sound, or movement. Nausea and vomiting often accompany a headache.May be associated with other symptoms of neurologic dysfunction in varying admixtures.Paresthesias are seen in 33% of people affected by a migraine.Ref: Harrison; 19th edition", "role": "assistant" } ]

[ { "content": "What is the type of voice in antrochoanal polyp- \nSelect and explain. \nA. Hyponasal voice, B. Hoarse voice, C. Low pitched voice, D. High pitched voice", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Hyponasal voice Clinical features of antrochoanal polypo Unilateral Nasal blockage (more on expiration than on inspirationo Obstruction may become bilateral when polyp grows into nasopharynx and starts obstructing opposite choana.o Hyponasal voiceo Mucoid nasal dischargeo Conductive deafness due to eustachian tube dysfunction.o On examination polyp may not be visible on anterior rhinoscopy as it grows posteriorlyo On posterior rhinoscopy - smooth, greyish white, spherical mass is seen in choana.", "role": "assistant" } ]

[ { "content": "Deep white matter lesion with bilateral deep bright thalamic appearance is suggestive of \nSelect and explain. \nA. Alexander disease, B. Canavan's diseases, C. Krabbe's disease, D. Metachromatic leukodystrophy", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e. Krabbe's disease Deep white matter lesion along with the involvement of thalamus suggests Krabbe's disease.Krabbe's disease is a leukodystrophy.LeukodystrophyIt is a term commonly used to refer to demyelination disorders.They are mainly due to genetic defects in the formation and maintenance of myelin.They usually present in infants and children with increasing development delay, progressive dementia and neurological deficit.These disorders are inherited as autosomal recessive trait and are associated with lysosomal enzyme deficiencies.They include the following disorders:-Metachromatic leukodystrophyGloboid leukodystrophy (Krabbe's disease)Spongiform degeneration (Canavan's disease)T. scan of leukodystrophies:-C. T. scan of the leukodystrophies shows low density areas in the white matter which are bilateral but not necessary symmetric and becomes more extensive as the disease process progresses.Krabbe's diseaseIt occurs due to deficiency of the enzyme P-galactocerebroside.It presents in infancy with retardation and spasticity.CT scan appearance of Krabbe's diseaseB/L symmetrical hypodensities in both frontoparietal and occipital regions in the white matter zone.Both thalamus and basai ganglia are hyperdenseCerebellum unaffected, ventricles normal, septum midlineMetachromatic leukodystrophyIt is a common leukodystrophy which commences in infancy.It occurs due to deficiency of the enzyme Arylsulphatase A.C. T. shows diffuse symmetric attenuation of the cerebellar and cerebral white matter.Alexander's diseaseIt is one of the few leukodystrophies that occurs sporadically and is characterized histopathologically by the abundant presence of Rosenthal fibres in the affected brain.Definitive diagnosis thus depends on brain biopsy.It occurs due to mutation in glial fibrillary acidic protein (GFAP).C. T. scan demonstrates degeneration of the white matter most prominent in the frontal lobes.Canavan's diseaseIt occurs due to deficiency of the enzyme aspart acylase leading to accumulation of N-Acetyl aspartic acid in the brain.C. T. scan shows diffuse white matter degeneration primarily in the cerebral hemispheres with less involvement in the cerebellum and brainstem.", "role": "assistant" } ]

[ { "content": "What changes in GFR is expected in a 30-year-old lady with pre-eclampsia? \nSelect and explain. \nA. Decreases, B. Increases, C. Remains the same, D. None of these", "role": "user" }, { "content": "Answer: A \nExplanation: Pre-eclampsia is a state of hypeension in pregnancy associated with proteinuria but with or without pathological edema. It is defined as a multi-system disorder of unknown etiology characterised by development of hypeension to the extent of 140/90 mm Hg or more with protienuria after the 20th week of pregnancy in a previously normotensive and a normoproteinuric patient. The typical pathological features are endothelial dysfunction and intense vasospasm. In pre-eclampsia, the glomerular filtration rate decreases. The decrease in glomerular filtration rate is as a result of the following physiological changes: Afferent glomerular aeriolar vasospasm Occlusion of the lumen of the glomerulus resulting from glomerular endotheliosis and fibrin deposits in the basement membrane Decreased renal blood flow Ref: Textbook of Obstetrics By D.C. Dutta, 6th Edition, Pages 221-3131", "role": "assistant" } ]

[ { "content": "Adies aegpti index at airport - \nSelect and explain. \nA. 0, B. 1, C. <1, D. 2-Jan", "role": "user" }, { "content": "Answer: C \nExplanation: (C) (< 1) (258 - Park 22nd)AEDES AEGYPTI INDEX: This is a house index and is defined as \"the percentage of houses and their premises in a limited well-defined area, showing actual breading of Aedes - aegypti larvae\"* This index should not be more than 1 percent in towns and seaports in endemic areas to ensure freedom from yellow fever.* Airports and seaports are kept free from the breeding of insect vectors over an area extending at least 400 meters** around their perimeters.* The \"aedes aegypti index\" is kept below 1 **YELLOW - FEVER* It is a exotic zoonotic disease in India.* Causative agent - Group B Arbovirus (Flavivirus fibricus) (Togavirus family)* Reservoir - Monkey in forest areas and Man in urban area.* Vector - Aedes aegypti* Incubation Period - Intrinsic 3-6 days, Extrinsic 8-12 days.* Immunity - One attack confers life long Immunity. Infants bom of immune mothers have antibodies up to 6 months of life.* Clinical features - Haemorrhagic fever (black vomit, epistaxis, malena) with severe hepatic and renal manifestations. Spectrum of disease varies from clinically indeterminate to severe cases.* Case fatality rate - May reach 80% in severe cases.* Period of communicability: Blood of patients is infective during the first 3 to 4 days of illness.* Vaccine - 17 D vaccine Live attenuaed, Freeze dried. Immunity apperrs on 7th day and lasts >35 years. Rapid immunization of population at risk is the most effective control strategy.* International certificate of vaccination - Valid 10 days after date of vaccination and extends up to 10 years. WHO recommends re-vaccination after 10 years.* All travellers (including infants) exposed to risk of yellow fever or passing through endemic zones of yellow fever must poses a valid International certificate of vaccination.* Quarantine - A traveller without a valid international certificate of vaccination' is placed on quarantine in a mosquito proof ward for 6 days.", "role": "assistant" } ]

[ { "content": "Following are the mature mineralized matrix marker of the periodontal ligament except: \nSelect and explain. \nA. Type 1 and type 3 collagen., B. Osteonectin., C. Alkaline phosphate., D. Osteopontin.", "role": "user" }, { "content": "Answer: A \nExplanation: Markers for Periodontal Ligament Stem Cells\n1. Bone Marrow Markers\n\nSTRO-1\n\n2. Perivascular Cell Markers\n\nCD146\nαSMA\nPericyte associated antigen 3G5\nCD106\n\n3. Mature Mineralized Matrix Markers\n\nAlkaline phosphatase\nOsteonectin\nOsteopontin\nOsteocalcin\nBone sialoproteins\n\n4. Connective Tissue Protein Markers\n\nType I and III collagen", "role": "assistant" } ]

[ { "content": "Which among the following anti-HIV drugs is also used to treat viral hepatitis B? \nSelect and explain. \nA. Enfuvirtide, B. Lamivudine, C. Efavirenz, D. Ritonavir", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Prolactin secretion is decreased by \nSelect and explain. \nA. L- dopamine, B. Bromocriptine, C. Diphenhydramine, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "The commonest presentation of meckel's diverticulum is - \nSelect and explain. \nA. Bleeding, B. Obstruction, C. Diverticulitis, D. Intussception", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Histocompatibility complex associated with narcolepsy - \nSelect and explain. \nA. DR2, B. DR3, C. DR4, D. B4", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Strongest attachment of Zonule is at - \nSelect and explain. \nA. Equator, B. Just anterior to equator, C. Posterior to equator, D. Posterior lobe", "role": "user" }, { "content": "Answer: B \nExplanation: The lens is suspended in the eye by zonules which are inseed on the anterior and equatorial lens capsule and attached to the ciliary body. REF IMG", "role": "assistant" } ]

[ { "content": "Thyroxine is used in the treatment of which thyroid cancer: \nSelect and explain. \nA. Medullary, B. Radiation induced, C. Anaplastic, D. Papillary", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Most cardiotoxic local anesthetic - \nSelect and explain. \nA. Procaine, B. Bupivacaine, C. Cocaine, D. Lidocaine", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Bupivacaine o Bupivacaine is the most cardiotoxic LA (Ropivacaine is a newer bupivacaine congener with less tardio toxicity).Important facts about LAso Chlorprocaine is the shortest acting LA.o Dibucaine is the longest acting, most potent and most toxic LA.o Procaine & chlorprocaine are least potent LAs.o Bupivacaine is the most cardiotoxic L4 (Ropivacaine is a newer bupivacaine congener with less cardiotoxicityi)o Levobupivacaine (The S (-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizure.o Prilocaine and Benzocaine can cause Methaemoglobinemiao Lignocaine is the most commonly used LAo Bupivacaine has the highest local tissue irritancy:o Chlorprocaine is contraindicated in spinal anaesthesia as it can cause paraplegia due to presence of neurotoxic preservative sodium metabisulphite.o Procaine is the LA of choice in malignant hyperthermia.", "role": "assistant" } ]

[ { "content": "In sickle cell anaemia, there is \nSelect and explain. \nA. 75 to 100% haemoglobin, B. 10 to 20% haemoglobin, C. 20 to 30% haemoglobin, D. 50 to 60% haemoglobin", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Bochdalek hernia occurs through \nSelect and explain. \nA. Diaphragm, B. Lumbar triangle, C. Femoral region, D. obturator canal", "role": "user" }, { "content": "Answer: A \nExplanation: A hernia through foramen Bochdalek (through the pleuroperitoneal canal) (95% left-sided, only 5% right sided) * It is a commonest congenital diaphragmatic hernia. * This is a developmental defective condition, due to a failure of fusion of pleuroperitoneal canal leaving a direct communication between pleura and peritoneum on left side. This allows herniation of contents of the abdomen into the left side thorax. * Common content is a colon. Occasionally small bowel, stomach is the contents. * 80% cases do not have a hernial sac. Only 20% cases have got sac. Ref: SRB&;s manual of surgery,3 rd ed, pg no 1078", "role": "assistant" } ]

[ { "content": "A 37-year-old woman was admitted to the emergency department with high fever (39.5deg C), nausea, and vomiting. Physical examination revealed increased abdominal pain in the paraumbilical region, rebound tenderness over McBurney's point, and a positive psoas test. Blood tests showed marked leukocytosis. Which of the following is the most likely diagnosis? \nSelect and explain. \nA. Ectopic pregnancy, B. Appendicitis, C. Cholecystitis, D. Kidney stone", "role": "user" }, { "content": "Answer: B \nExplanation: Appendicitis is often characterized by acute inflammation and is indicated with both a positive psoas test and rebound pain over McBurney's point. McBurney's point lies 1 inch lateral to the midpoint of an imaginary line in the right lower quadrant, joining the anterior superior iliac spine and the umbilicus. In patients with appendicitis, rebound tenderness may be felt over McBurney's point after quick, deep compression of the left lower quadrant. An ectopic pregnancy would be associated with generalized abdominal pain instead of the localized pain felt over McBurney's point. Cholecystitis results from an inflammation of the gallbladder and would result in pain over the epigastric region shifting to the right hypochondriac region. Kidney stones result in referred pain to the lumbar or possibly inguinal regions. Perforation of the duodenum could result in pain to palpation of the abdomen, together with adynamic (paralytic) ileus, rigidity of the abdominal wall, and referral of pain to the shoulder.", "role": "assistant" } ]

[ { "content": "Drug used to treat tremors in hypehyroidism is: September 2008 \nSelect and explain. \nA. Adrenaline, B. Propranolol, C. Noradrenaline, D. Dopamine", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B: Propranolol Beta-blockers such as propranolol help control many of the symptoms of hypehyroidism. These drugs can slow a fast hea rate, reduce tremors, and control anxiety. Beta-blockers are paicularly useful for people with extreme hypehyroidism and for people with bothersome or dangerous symptoms that have not responded to other treatments. However, beta-blockers do not reduce excess thyroid hormone production. Therefore, other treatments are added to bring hormone production to normal levels.", "role": "assistant" } ]

[ { "content": "Omalizumab is administered by which route: \nSelect and explain. \nA. Inhalation, B. Intravenous, C. Intranasal, D. Subcutaneous", "role": "user" }, { "content": "Answer: D \nExplanation: Patients should be given a 3-4 month trial of therapy to show objective benefit. Omalizumab is usually given as a subcutaneous injection every 2-4 weeks and appears not to have significant side effects. Ref: Harrison's principle of internal medicine 17th edition, chapter 248.", "role": "assistant" } ]

[ { "content": "According to the Bismuth / Strasberg classification 'Cystic blow out' is classified as: \nSelect and explain. \nA. Type A, B. Type B, C. Type C, D. Type D", "role": "user" }, { "content": "Answer: A \nExplanation: Cystic blow out' is a type of biliary duct injury in cholecystectomy patient. According to Strasberg classification it falls into Type A injury. Ref: Complication in Surgery By Michael W. Mulholland, Gerard M. Dohe, 2nd Edition, Page 432", "role": "assistant" } ]

[ { "content": "The drug of choice in treatment of inflantile spasms is \nSelect and explain. \nA. Phenytoin, B. Phenobarbitone, C. Carbamazepin, D. ACTH", "role": "user" }, { "content": "Answer: D \nExplanation: Infantile spasms:-\n\nWest syndrome\nOnset : 3-8 months of life\nCharacterised by combination of salaam spells( sudden dropping of the head and flexion of arms), developmental retardation, hypsarrythmia on ECG.\n\nCauses-\n\nHypoxic ischemic encephalopathy\nNeurocutaneous syndromes\nPerinatal infections\nHemorrhage\nInjury\nMetabolic disorders\nLocalized structural malformations \nThe spasms occur in clusters usually on waking\n\nDrug therapy-\n\nIntramuscular ACTH 40-60 unit per day may be given 4-6 weeks and tgen tapered off.\nOn the other hand oral prednisolone at 2 mg/ kg / day in divided doses may also be used.\nThese agents abolish spasms and may result in resolution of hypsarrythmia.", "role": "assistant" } ]

[ { "content": "Albendazole is effective against all of the following except : \nSelect and explain. \nA. Roundworm, B. Hookworm, C. Tapeworm, D. Pinworm", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "In a case of chronic arsenic poisoning all of the following samples are sent for laboratory examination, EXCEPT: \nSelect and explain. \nA. Nail clippings, B. Hair samples, C. Bone biopsy, D. Blood sample", "role": "user" }, { "content": "Answer: D \nExplanation: Arsenic is present in blood only during acute poisoning. In chronic poisoning arsenic gets deposited in the bone, keratin tissues, hair, nail and skin for many years. In the bone arsenic replaces phosphorous and remains for many years. Arsenic appear in the hair and nails within hours of ingestion. Neutron activation analysis and atomic absorption spectroscopy helps to estimate concentration of arsenic in hair, nails, bone etc. Ref:The Essentials of Forensic Medicine and Toxicology By Dr KS Narayan Reddy, Page 475", "role": "assistant" } ]

[ { "content": "This rash appeared 9 hours after a scuba dive. What is the diagnosis? \nSelect and explain. \nA. Decompression sickness, B. Jellyfish envenomation, C. Mycobacterium marinum infection, D. Phylum Porifera contact dermatitis", "role": "user" }, { "content": "Answer: A \nExplanation: Answer A. Decompression sicknessCutis marmorata is a dermal manifestation of decompression sickness. Initially, there is erythema accompanied by pruritus, and then the rash spreads irregularly and deepens in color. It develops a mottled appearance, with areas of pallor surrounded by cyanotic patches. During recompression, the rash resolves.", "role": "assistant" } ]

[ { "content": "A patient with hip dislocation with limitation of Abduction at hip and flexion and internal rotation deformity at hip and shortening. Diagnosis is: \nSelect and explain. \nA. Central dislocation, B. Anterior dislocation, C. Posterior dislocation, D. Fracture dislocation", "role": "user" }, { "content": "Answer: C \nExplanation: (c) Posterior dislocationExplanationSince the question mentions limitation of abduction, hence there is adduction deformity along with flexion and internal rotation deformity. Thus this is a case of Posterior dislocation of hip.Position of hipPattern of InjuryFlexion, adduction, internal rotationPure posterior dislocationLess flexion, less adduction (neutral or slight abduction), internal rotationPosterior fracture dislocation > central dislocationHyper abduction + Flexion + External rotationAnterior dislocationSome students remember an alternate format of the question 6b", "role": "assistant" } ]

[ { "content": "Cyanide poisoning acts by : \nSelect and explain. \nA. Inhibiting DNA synthesis, B. Inhibiting enzymes of proteins synthesis, C. Inhibiting cellular respiration, D. Inhibiting protein breakdown", "role": "user" }, { "content": "Answer: C \nExplanation: C i.e. Inhibit cellular respiration", "role": "assistant" } ]

[ { "content": "A 28 year old female patient with patches of burns and swelling of arm. Histopathological findings reveal swelling of endopasmic reticulum, blebs from cell membrane, loss of microvilli, presence of myeloid bodies and no changes in nucleus. Which type of injury is seen in this patient? \nSelect and explain. \nA. Irreversible cell injury, B. Autolysis, C. Pyroptosis, D. Reversible cell injury", "role": "user" }, { "content": "Answer: D \nExplanation: Reversible cell injury:-\n→ Hypoxia is the most common cause of cell injury.\n→ Oxygen is an important requirement of mitochondria, for the formation of ATP, therefore hypoxia will result in earliest involvement of mitochondria, resulting in decreased formation of ATP.\n→ Important organelles affected are\n\nCell membranes (require ATP for functioning of Na+ - K+ pump)\nEndoplasmic reticulum (require ATP for protein synthesis)\nNucleus.\n\n→ Swelling of organelles like endoplasmic reticulum, results in decreased protein synthesis.\n→ Bleb results due to outpouching from the cell membrane to accommodate more water.\n→ Loss of microvilli.\n→ Formation of cellular organelle like endoplasmic reticulum. These are composed of phospholipids.\n→Myelin figures are intracellular whorls of laminated lipid material.\n​​When these myelin figures are present in membrane-bound structure, containing lysosome enzymes, these are known as myeloid bodies.", "role": "assistant" } ]

[ { "content": "Break bone fever is caused by - \nSelect and explain. \nA. Yellow fever, B. Japaneseencephlitis, C. Denguefever, D. KFD", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Dengue fever o Break bone fever (Saddle back fever) is caused by dengue virus.Dengue fevero Dengue fever is caused by arboviruses (at least 4 serotypes have been recognized)o It is transmitted by Aedes (Aedes aegypti is the main vector).o The reservoir of infection is both man and mosquito,o The transmission cycle is Man-mosquito-mano Dengue fever occurs both epidemically and endemically. Epidemics starts in rainy season and are usually explosive.o Aedes mosquito becomes infective by feeding on a patient from the day before onset to the 5th day of illness.o Various manifestations of Dengue infectionClassical dengue fever - Also known as break bone feverIncubation period 2-7 days (3-10 days - Park)Onset is sudden with chills and fever. Fever is usually between 39degc and 40degc temperature returns to normal after 5-6 days or subside on about the 3rd day and rise again after 5-8 days after onset (saddle back fever).Rashes appear in 80% of cases during remission or during second febrile phase. The rash lasts for 2 hours to several days and may be followed by desquamation. Dengue Hemorrhagic fever (DHF) -It is a severe form of dengue fever caused by infection with more than one dengue virus.The severe illness is thought to be due to double infection with more than one dengue virus.Dengue hemorrhagic fever is believed to result from reinfection with a virus of different serotype ( due to enhancing antibodies)DHF usally occurs after sequential infection with any two of the four serotypes of dengue virus.Sequence of infection may be important; serotype 1 followed by serotype2 is more dangerous than serotype 4 followed by serotype 2.Criteria for clinical diagnosis of DHFClinical diagnosisFever -Acute onset, high continuous lasting 2-7 days.Hemorrhagic manifestationsPositive tourniquet testPetechiae. purpura, ecchymosisEpistaxis, gum bleedingHematemesis and/or melaenaEnlargement of liverLaboratory diagnosisThrombocytopenia (100, OOO/mnV or less)Haemoconcentration haematocrit -->> increased by 20 percent or more of base-line value.C) Dengue shock syndromeThe clinical diagnosis is based on:All the above criteria plusShock manifested by rapid and weak pulse with narrowing of the pulse pressure to 20mm Hg or less or hypotension with the presence of cold clammy skin and restlessness.", "role": "assistant" } ]

[ { "content": "Erythroblastosis fetalis is an example of which type of hypersensitivity reaction ? \nSelect and explain. \nA. Type I, B. Type II, C. Type III, D. Type IV", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Type II Erythroblastosis fetalis and blood transfusion reactions are type II hypersensitivity reactions.", "role": "assistant" } ]

[ { "content": "The movement that occurs in the horizontal plane when the mandible moves into a lateral excursion is \nSelect and explain. \nA. Horizontal axis, B. Vertical axis, C. Sagittal axis, D. Trans saggital axis", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Sho-chain fatty acids produced by bacteria are maximally absorbed in \nSelect and explain. \nA. Duodenum, B. jejunum, C. ileum, D. Colon", "role": "user" }, { "content": "Answer: D \nExplanation: Sho-chain fatty acids are produced in the colon, by the action of colonic bacteria on complex carbohydrates, and other dietary components that could not be digested in the small intestine. These sho-chain fatty acids are absorbed from the colon.", "role": "assistant" } ]

[ { "content": "Mechanism of action thiazide is ? \nSelect and explain. \nA. Na+Cl- sympo inhibitor, B. Na+K+ sympo inhibitor, C. Carbonic anhydrase inhibitor, D. Osmotic diuresis", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Na+ Cl- synpo inhibitor", "role": "assistant" } ]

[ { "content": "All of the following are formal thought disorder EXCEPT: \nSelect and explain. \nA. Schizophrenia, B. Delusion, C. Loosening of association, D. Mania", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B i.e. DelusionDelusion is a disorder of thought content (NOT a formal thought disorder/disorder of thought process)DelusionDisorder of thought;False unshaken belief not amenable to reasoningSchizophrenia- Formal thought disorderLoosening of association-Formal thought disorderMania-Stream of thought disorder", "role": "assistant" } ]

[ { "content": "Open Neural tube defect is best diagnosed by: \nSelect and explain. \nA. USG, B. Maternal serum alpha fetoprotein, C. X-ray, D. Amniotic fluid acetycholinesterase", "role": "user" }, { "content": "Answer: D \nExplanation: Amniotic fluid acetycholinesterase", "role": "assistant" } ]

[ { "content": "Angiosarcoma of the liver is associated with - \nSelect and explain. \nA. Nickel, B. Chromium, C. Cadmium, D. Arsenic", "role": "user" }, { "content": "Answer: D \nExplanation: Angiosarcoma of the liver is associated with exposure to →\n1) Vinyl chloride,\n2) Arsenic,\n3) Thorotrast", "role": "assistant" } ]

[ { "content": "Omega shaped epiglottis is seen in: \nSelect and explain. \nA. Epiglottitis, B. Laryngomalacia, C. Epiglottis CA, D. Tuberculosis", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. (b) LaryngomalaciaRef: Dhittgra's ENT 6th ed./ 295LARYNGOMALACIA* The most common congenital disease of larynx is Laryngomalacia.* Laryngeal cartilages are extremely soft and flabby in a child with laryngomalacia.* Most common clinical presentation of laryngomalacia: Stridor* The stridor is mainly inspiratory and increases during supine position but decreases during prone position.* Laryngomalacia may involve all the cartilages but epiglottis and aryepiglottic folds are mainly involved.* IOC: Direct laryngoscopy.* The finding is Omega shaped epiglottis (long and tubular epiglottis with curled up tip).DIFFERENT SHAPE OF GLOTTIS AND CONDITIONSGLOTTIS SHAPECONDITION* Key hole shapedPhonasthenia* Omega shapedLaryngomalacia* Thumb signAcute epiglottitis* Steeple signCroup/ Laryngotracheobronchitis* Turban shapedLaryngeal TB", "role": "assistant" } ]

[ { "content": "A 21-year old male presents with exertional dyspnea, raised JVP and loud P2. ECG shows right axis deviation. All of the following conditions are possible except : \nSelect and explain. \nA. Atrial septal defect, B. Mitral stenosis, C. Ostium primum, D. Pulmonary thromboembolism", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Ptosis may occur due to damage to: \nSelect and explain. \nA. Trochlear nerve, B. Oculomotor, C. Trigeminal nerve, D. Superior oblique muscle", "role": "user" }, { "content": "Answer: B \nExplanation: Ptosis is the drooping eyelid, may be seen in some clinical cases.\nOculomotor ptosis due to paralysis of the levator palpebrae (e.g., transtentorial herniation). \nOculosympathetic ptosis due to paralysis of the superior tarsal (Muller) muscle as seen in Horner syndrome. This is a very slight ptosis, or pseudoptosis (e.g., Pancoast tumor).", "role": "assistant" } ]

[ { "content": "Fibroids in pregnancy should be removed : \nSelect and explain. \nA. In pregnancy, B. During cesarean section, C. In the early puerperium, D. Should not be removed", "role": "user" }, { "content": "Answer: D \nExplanation: Should not be removed", "role": "assistant" } ]

[ { "content": "Rule of Hasse is used to determine - \nSelect and explain. \nA. The age of fetus, B. Height of an adult, C. Race of a person, D. gender of fetus", "role": "user" }, { "content": "Answer: A \nExplanation: RULE OF HAASE: This is a rough method of calculating the age of the fetus. The length of the fetus is measured from crown to heel in centimeter During the first 5 months of pregnancy, the square root of the length gives an approximate age of the fetus in months, eg: a fetus length is 16cm is 4 months. HAASE'S MODIFICATION OF MORRISON'S LAW: during the last 5 months, the length in centimeters divided by five gives the age of the fetus in months, eg: fetus of 35cm is 7months. REF: The Synopsis of Forensic Medicine and Toxicology by Dr. K.S.Narayan Reddy 29th edition page no: 51", "role": "assistant" } ]

[ { "content": "Which of the following is an example of physiological antagonism ? \nSelect and explain. \nA. Heparin–Protamine, B. Prostacycline–Thromboxane, C. Adrenaline–Phenoxybenzamine, D. Physostigmine–Acetylcholine", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "According to signal transductions mechanism, GABA B is which type of receptor? \nSelect and explain. \nA. Ligand gated receptor, B. Nuclear receptor, C. G protein coupled receptor, D. Enzymatic receptor", "role": "user" }, { "content": "Answer: C \nExplanation: Five basic mechanisms of transmembrane signaling are well understood. Each uses a different strategy to circumvent the barrier posed by the lipid bilayer of the plasma membrane. These strategies use: a lipid-soluble ligand that crosses the membrane and acts on an intracellular receptor. a transmembrane receptor protein whose intracellular enzymatic activity is allosterically regulated by a ligand that binds to a site on the protein's extracellular domain. a transmembrane receptor that binds and stimulates a protein tyrosine kinase. a ligand gated transmembrane ion channel that can be induced to open or close by the binding of a ligand. a transmembrane receptor protein that stimulates a GTP-binding signal transducer protein (G protein), which in turn modulates production of an intracellular second messenger. Known transmembrane signaling mechanisms:1: A lipid-soluble chemical signal crosses the plasma membrane and acts on an intracellular receptor (which may be an enzyme or a regulator of gene transcription); 2: the signal binds to the extracellular domain of a transmembrane protein, thereby activating an enzymatic activity of its cytoplasmic domain; 3: the signal binds to the extracellular domain of a transmembrane receptor bound to a separate protein tyrosine kinase, which it activates; 4: the signal binds to and directly regulates the opening of an ion channel; 5: the signal binds to a cell-s urface receptor linked to an effector enzyme by a G protein. (A, C, substrates; B, D, products; R, receptor; G, G protein; E, effector ; Y, tyrosine; P, phosphate.) Receptor Ligand Ligand gated receptor Insulin, EGF, PDGF, ANP Nuclear receptor Fenofibrate. Gemfibrizol G protein coupled receptor Catecholamine Enzymatic receptor", "role": "assistant" } ]

[ { "content": "A 26 year old female patient complains of discoloured teeth. Intra-oral examination reveals generalized intrinsic tetracycline stains. Which of the following is an effective and esthetic treatment in this case? \nSelect and explain. \nA. External bleaching, B. Intracoronal bleaching, C. Veneers, D. Full coverage crowns", "role": "user" }, { "content": "Answer: D \nExplanation: Bleaching tetracycline-stained teeth is difficult, some clinicians advocate intentional endodontic therapy along with the use of an intracoronal nonvital bleaching technique to overcome this problem. Although the esthetic result appears much better than that obtained from external bleaching, this approach involves all the inherent risks otherwise associated with endodontic treatment. External bleaching techniques offer a safer alternative, although they may not be as rapid or effective. \nPatients who have darkly stained teeth always should be informed that although porcelain (or composite) veneers can result in improved esthetics, they may not entirely eliminate or mask extremely dark stains. Because of the limited thickness of the veneers and the absolute necessity of incorporating intrinsic opacity, the realistic translucency or esthetic vitality of veneered teeth may never be comparable with that of natural, unaffected teeth. Full porcelain coverage with all-ceramic crowns may be indicated in some patients with severe discoloration because of the crown’s greater capacity to restore esthetic vitality.\nReference- Sturdevant 7th ed Pg-281", "role": "assistant" } ]

[ { "content": "Selective media for gonococci- \nSelect and explain. \nA. Thayer martin media, B. L J medium, C. DCA medium, D. Mac Conkey agar", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 3 month baby will have – \nSelect and explain. \nA. Pincer grasp, B. Head control, C. Sitting with support, D. Transfer objects", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 65-year-old man is brought to the hospital after being hit by a car. His blood pressure is 150/90 mm Hg, and pulse is 120 bpm. There is deformity just below the left knee and no distal pulses palpable in that leg. Plain films show proximal tibia and fibula fractures. What is the next step in management? \nSelect and explain. \nA. Operative intervention to restore flow with an arterial shunt, B. Angiography, C. Doppler ultrasound, D. Operative reduction and internal fixation", "role": "user" }, { "content": "Answer: B \nExplanation: In a stable patient presenting with peripheral vessel occlusion following blunt trauma, angiography is indicated to plan the appropriate operative approach. An angiogram can also document preexisting arteriosclerosis, collateral circulation, and distal runoff. Doppler ultrasound is useful to localize the injury site but gives less information regarding collateral circulation. Immediate operation to control bleeding and restore flow is indicated if the patient's condition is unstable.", "role": "assistant" } ]

[ { "content": "All are true regarding Klinefelter's syndrome except: \nSelect and explain. \nA. Small Testes, B. Webbing of neck, C. Gynecomastia, D. Increased FSH levels", "role": "user" }, { "content": "Answer: B \nExplanation: Ans: B (Webbing of neck) Ref: Robbins Pathologic Basis of Disease, 8th edition.Explanation:Webbing of neck is characteristically seen in Turner's syndromeKlinefelter SyndromeMale hypogonadism that occurs when there are two or more X chromosomes and one or more Y chromosomes.MC genetic disease involving the sex chromosomesMost common cause of hypogonadism in the male.Incidence 1 in 660 live male birthsIt can rarely he diagnosed before puberty because the testicular abnormality develop late.Distinctive body habitus -Increase in length between the soles and the pubic bone ->> elongated bodyEunuchoid body habitusLong legsSmall atrophic testesSmall penisLack of secondary male characteristics as deep voice, beard & pubic hair.GynecomastiaThere is increased incidence ofType 2 diabetesThe metabolic syndromeMitral valve prolapse in 50%.Autoimmune diseases (SLE)Breast cancer (20 times more common than in normal males)Extragonadal germ cell tumors||Plasma gonadotropin concentrations (FSH) & || testosterone levelsT Plasma estradiol levels (Unknown mechanism)The ratio of estrogens and testosterone determines the degree of feminization in individual cases.Reduced spermatogenesis and male infertilityTesticular tubules are totally atrophied and replaced by pink, hyaline, collagenous ghosts.Sometimes, apparently normal tubules are interspersed with atrophic tubules.In some patients all tuhules are primitive and appear embryonic, consisting of cords of cells that never developed a lumen or progressed to mature spermatogenesis.Leydig cells appear prominent, as a result of the atrophy and crowding of tubules and elevation of gonadotropin concentrations.The classic pattern of Klinefelter syndrome is associated with a 47, XXY karyotype (90% of cases).This complement of chromosomes results from nondisjunction during the meiotic divisions in one of the parents.15%' of patients w ith Klinefelter syndrome have been found to have a variety of mosaic patterns, most of them being 46, XY/47, XX\\r (Other patterns are 47, XXY/48, XXXY )Turner SyndromeTurner syndrome results from complete or partial monosomy of the X chromosome and is characterized primarily by hypogonadism in phenotypic femalesIt is the most common sex chromosome abnormality in females.Three types of karyotypic abnormalities are seen in Turner syndrome.Entire X chromosome is absent (57%), resulting in a 45 XO karyotype.Structural abnormalities of the X chromosomes (14%)Mosaics (29%).Examples of karyotypes that mosaic Turner females may have are the following: (1) 45,X/ 46, XX; (2) 45. X/46. XY; (3) 45, X/47, XXX; or (4) 45, X/46. X. i(X)(ql0).The mosaics with a Y chromosome-containing population (e.g., 45. X/46, XY karyotype) may be at risk of developing GonadoblastomaClassical Features of Turners syndromePresent durings infancy with edema of the dorsum of the hand and foot due to lymph stasis. Swelling of the nape of the neck (due markedly distended lymphatic channels leading on to cystic hygroma)Bilateral neck webbingPersistent looseness of skin on the back of the neck.Congenitat heart disease (esp preductal coarctation of the aorta and bicuspid aortic valve)Failure to develop normal secondary sex characteristics.Turner syndrome is the single most important cause of primary amenorrheaApproximately 50% of patients develop autoantibodies to thyroid gland, and can develop hypothyroidism.Glucose intolerance, obesity, and insulin resistance in minority of patients", "role": "assistant" } ]

[ { "content": "32 yr old with diarrhea, flushing. On CT multiple lesions seen in liver. Primary disease is in - \nSelect and explain. \nA. Esophagus, B. Appendix, C. Small bowel, D. Stomach", "role": "user" }, { "content": "Answer: C \nExplanation: Intestinal amoebiasis - amoebic dysentery Most amoebic infections are asymptomatic. The incubation period of amoebiasis ranges from 2 weeks to many years, followed by a chronic course with abdominal pains and two or more unformed stools a day. Offensive diarrhoea, alternating with constipation, and blood or mucus in the stool are common. There may be abdominal pain, especially in the right lower quadrant (which may mimic acute appendicitis). A dysenteric presentation with passage of blood, simulating bacillary dysentery or ulcerative colitis, occurs paicularly in older people, in the puerperium and with super-added pyogenic infection of the ulcers. Amoebic liver abscess The abscess is usually found in the right hepatic lobe. There may not be associated diarrhoea. Early symptoms may be only local discomfo and malaise; later, a swinging temperature and sweating may develop, usually without marked systemic symptoms or signs. An enlarged, tender liver, cough and pain in the right shoulder are characteristic but symptoms may remain vague and signs minimal. A large abscess may penetrate the diaphragm, rupturing into the lung, and may be coughed up through a hepatobronchial fistula. Rupture into the pleural or peritoneal cavity, or rupture of a left lobe abscess in the pericardial sac, is less common but more serious. Ref Davidson edition23rd pg 287", "role": "assistant" } ]

[ { "content": "The premaxilla harbouring maxillary central incisors is embryonically derived from: \nSelect and explain. \nA. Median nasal process., B. Lateral nasal process., C. Medial nasal process., D. None.", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "A female patient presented with a firm mass of 2 x 2 cmsin the upper outer quadrant of the breast. She gives afamily history of ovarian carcinoma. The investigationthat needs to be done to assess for mutation is : \nSelect and explain. \nA. p53, B. BRCA-2, C. Her 2/Neu gene, D. C-myc gene", "role": "user" }, { "content": "Answer: B \nExplanation: C-myc gene", "role": "assistant" } ]

[ { "content": "Ligature pressure that should be used to resist spread of poison in elapidae poisoning: WB 11; MAHE 12 \nSelect and explain. \nA. < 10 mm Hg, B. 20-30 mm Hg, C. 50-70 mm Hg, D. > 100 mm Hg", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. 50-70 mm Hg", "role": "assistant" } ]

[ { "content": "In 7 year old posterior fossa mass with cyst formation, hypodense on CT, hyper intense on T2WI and showing post gadolinium nodule enhancement is \nSelect and explain. \nA. Medulloblastoma, B. Ependymoma, C. Astrocytoma, D. Cysticercous", "role": "user" }, { "content": "Answer: C \nExplanation: C i.e. Astrocytoma Posterior Fossa tumors in children Features Astrocytoma Ependymoma Medulloblastoma Cyst Formation Very cominonQ Common Rare CT scan IlypodenseQ Rare Isodense No Hyperdense Yes (15-40%) CSF seeding Transforaminal spread No Yes No Calcification -10% 40-50% 10-15% T2WI Hyper (intense) Hyper/Iso Iso T1 WI Iso/Hypo Iso/Hypo Iso/Hypo Postgadolinium (contrast) Nodule enhanceQ Mild Moderate", "role": "assistant" } ]

[ { "content": "True about silicosis all except: \nSelect and explain. \nA. Caused by exposure of silica oxide, B. Severe exposure- whole lung lavage may helpful in allet_ing symptoms, C. Fibrosis of upper lung, D. Fibrotic change can be reversed after stopping exposure", "role": "user" }, { "content": "Answer: D \nExplanation: Ans: d -Fibrotic change can be reversed after stopping exposureSilicosis is progressive & what is more impoant is that silicotics are prone to tuberculosisThere is no effective treatment for silicosis. Fibrotic changes that have already taken place cannot be reversedNodular fibrosis, more frequent in apex & posterior border (upper pa of lung) (c.f in asbestosis fibrosis in lower half of lung)Silicotics are more prone to develop pulmonary tuberculosis (but in recent year there is doubt whether silicotics really develop T.B.)For acute silicosis, bronchoalveolar lavage may allete symptoms, but does not decrease overall moality.", "role": "assistant" } ]

[ { "content": "Mechanism of action of tranexamic acid in controlling bleeding is? \nSelect and explain. \nA. Inhibits plasminogen, B. Promote platelet aggregation, C. Cause vasoconstriction, D. Promote fibrin synthesis", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. (a) Inhibits plasminogenRef Lippincott's Pharmacology 4/e, p 265", "role": "assistant" } ]

[ { "content": "How would a drug that competes with acetylcholine for receptors at the motor end plate effect of skeletal muscle. it would be? \nSelect and explain. \nA. Produce uncontrolled muscles spasm, B. Cause of muscle to contract and unable to relax, C. Cause muscle to relax and be unable to contract, D. Make the muscle more excitable", "role": "user" }, { "content": "Answer: C \nExplanation: Refer kDT 6/e p 340 Drugs competing with acetylcholine at neuromuscular Junction are competitive or non depolarizing neuromuscular blockers. These drugs are used as muscle relaxants. In contrast to depolarising muscle relaxant, these do not cause initial fasciculations", "role": "assistant" } ]

[ { "content": "During neonatal resuscitation, the chest compression to ventilation ratio is \nSelect and explain. \nA. 15:01, B. 5:01, C. 10:01, D. 3:01", "role": "user" }, { "content": "Answer: D \nExplanation: It is important to ventilate in between chest compressions. A positive breath should follow every third chest compression(chest compression to ventilation ratio is 3:1). \nIn one minute, 90 chest compressions and 30 breaths are administered(120 events). \nTo obtain this, the chest should be compressed 3 times in 1.5 seconds leaving out approx. 0.5 second for ventilation.", "role": "assistant" } ]

[ { "content": "Pneumatocele is commonest in: \nSelect and explain. \nA. Pneumococcal pneumonia, B. Staphylococcal pneumonia, C. H. influenzae pneumonia, D. Viral pneumonia", "role": "user" }, { "content": "Answer: B \nExplanation: Staphylococcal pneumonia", "role": "assistant" } ]

[ { "content": "Molar pregnancy can be best diagnosed by: \nSelect and explain. \nA. Clinical history and examination, B. Ultrasound study, C. Laproscopy, D. CT Scan", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. b (Ultrasound study) (Ref: Grainger, Diagnostic Radiology, 4th/pg.2213 & Rumac, Diagnostic Ultrasound, 2nd/ pg.1359)MOLAR PREGNANCY# Molar pregnancy includes:- complete and- partial molar pregnancy.# The greatest diagnostic accuracy is obtained from the characteristic ultrasonographic appearance of hydatidiform mole# The classic USG features of complete molar pregnancy are well known and include enlarged uterus containing echogenic tissue that expands endometrial canal ('snowstorm' appearance).# The USG feature of partial molar pregnancy overlap with other conditions (missed or incomplete abortion).# Gestational trophoblastic disease includes the tumor spectrum of H. mole, invasive mole and choriocarcinoma.# Although USG is used for initial diagnosis of GTD & to exclude normal pregnancy finding are nonspecific.Educational Point:Follow-Up Evaluation of Molar PregnancyClose and consistent follow-up for these women is imperative with the following aims:1. Prevent pregnancy for a minimum of 6 months using hormonal contraception.2. Monitor serum hCG levels every 2 weeks. Serial measurement of serum hCG is important to detect trophoblastic neoplasia, and even small amounts of trophoblastic tissue can be detected by the assay. These levels should progressively fall to an undetectable level.3. Chemotherapy is not indicated as long as these serum levels continue to regress.4. Once the hCG level falls to a normal level, test the patient monthly for 6 months; then follow-up is discontinued and pregnancy allowed.", "role": "assistant" } ]

[ { "content": "Indicator for vector burden on human malaria is:- \nSelect and explain. \nA. Man biting rate, B. Inoculation rate, C. Slide positive rate, D. Human blood index", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. (A) Man biting rate(Ref: Park Text book of PSM 25th ed; pg. 342)Vector burden may be denoted by the term-anthrophilismMan biting rate (biting density): It is defined as the average incidence of anopheline bites per day per person. It is determined by standardized vector cache on human bait.Sporozoite rate: It is percentage of female anopheles with sporozoites in the salivary glandInoculation rate: The man-biting rate multiplied by the infective sporozoite rate is called as Inoculation rate.Human blood index: It is the proportion of freshly fed female anopheline mosquitoes whose stomach contains human blood. It indicates the degree of anthrophilism.Mosquito density: It is usually expressed as the number of mosquitoes per man-hour-catch.Points to RememberPre-eradication era malariometric indicators: Parameters are based on clinical diagnosis (Spleen rate, average enlargement spleen, parasite rate, parasite density index, Infant parasite rate and proportional case rate).Eradication era malariometric indicators: Parameter based on microscopic diagnosis of malaria.#Annual parasite incidence#Annual blood examination rate#Annual falciparum incidence#Slide positive rate#Slide falciparum rateVector indices are:-#Human blood index, sporozoite rate, mosquito density#Man biting rate and inoculation rateSome Important IndicatorSpleen rate: Endemically of malaria in a communityInfant parasite rate: The most sensitive index of recent transmission off malaria in a locality.Annual parasite rate: Sophisticated measure of malaria incidence and burden of disease in a community.Annual blood examination rate: Index of operational efficiency.Human blood index: Indicates the degree of anthrophilism.", "role": "assistant" } ]

[ { "content": "Increased osmolar gap is not seen in poisoning of- \nSelect and explain. \nA. Para-aldehyde, B. Acetones, C. Methanol, D. Ethylene glycol", "role": "user" }, { "content": "Answer: A \nExplanation: Causes of High-Anion Gap Metabolic Acidosis *Lactic acidosis * Toxins *Ketoacidosis * Ethylene glycol Diabetic * Methanol Alcoholic * Salicylates Starvation * Propylene glycol *Pyroglutamic acid (5-oxoproline) *Renal failure (acute and chronic) reference : harrisons principles of internal medicine,19 E , page 318", "role": "assistant" } ]

[ { "content": "High levels of HBeAg in serum indicates \nSelect and explain. \nA. HBeAg is not seen in the serum, B. High infectivity of the virus, C. Low infectivity of the virus, D. Recovering stage", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 40 year old male brought to the emergency room with a stab injury to the chest.On examination pt is found to be hemodynamically stable. The neck veins are engorged and the heart sound are muffled .The following statements are true for this pt except: \nSelect and explain. \nA. Cardiac tamponade is likely to be present., B. Immediate emergency room thoracotomy should be done., C. Echocardiogram should be done to confirm pericardial blood., D. The entry wound should be sealed with an occlusive dressing.", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e. Immediate emergency room thoracotomy should be done There is no need for emergency thoracotomy in a hemodynamically stable ptCardiac tamponade is quite common in stab injuries to the chest.* The classical sign of tamponade are-:Muffled heart sounds*Distended neck veins* -- k/a Beck Triad*Hypotension*The tamponade can be easily diagnosed by echocardiography (identifying abnormal amount of pericardial fluid) and is managed by pericardiocentesis or surgical pericardiotomy", "role": "assistant" } ]

[ { "content": "Tramadol is \nSelect and explain. \nA. Antiflatulent, B. Antireflux drug, C. Beta-blocker, D. Opioid analgesic", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. d (Opioid analgesic). (Ref. KD Tripathi, Pharmacology/6th. 453)# Tramadol is synthetic centrally acting opioid analgesic having modest affinity for ji receptors.# Unlike other opioids, it inhibits reuptake of NA and 5-HT and thus activates monoaminergic spinal inhibition of pain.# Its oral bioavailability is good and it has minimal hemodynamic effects and hence safer in patients with compromised CVS function.# It is indicated for medium intensity short lasting pain due to diagnostic procedures, injury, surgery, etc as well as for chronic cancer pain.", "role": "assistant" } ]

[ { "content": "Dark ground microscopy is used to see - \nSelect and explain. \nA. Refractile organisms, B. Flagella, C. Capsule, D. Fimbriae", "role": "user" }, { "content": "Answer: B \nExplanation: Dark ground/ Darkfield microscope \n\nVery slender organisms such as spirochetes and filamentous organisms such as flagella are not visible under ordinary illumination.\n\n\n\nThe contrast in dark field microscopy gives an illusion of increased resolution so that these structures can be seen under the dark field microscope.\n\n\nIn darkfield microscopy, reflected light is used instead of the transmitted light used in the ordinary microscope.\n\n\nDark ground (dark field) microscopy is used for\n\n- Flagella\n- Spirochetes", "role": "assistant" } ]

[ { "content": "Which of the following can be used as root canal filling materials \nSelect and explain. \nA. Cements and plastic materials, B. G.P. Points, C. Silver points, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "False about vagina is : \nSelect and explain. \nA. Paly or wholly derived from urogenital sinus, B. Rich in glands, C. Lined by stratified epithelium, D. Posterior fornix longer than anterior fornix", "role": "user" }, { "content": "Answer: B \nExplanation: Rich in glands", "role": "assistant" } ]

[ { "content": "Prolactin secretion is inhibited by - \nSelect and explain. \nA. Dopamine antagonist, B. GABA, C. Neurophysin, D. Bromocripitine", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Bromocriptine o Prolactin is under predominant inhibitory control of hypothalamus through prolactin releasing inhibitory hormone (PRIH). o PRIH is a dopamine that acts on pituitary lactotrope D, receptor. So, Dopaminergic agonists decrease plasma prolactin levels. These agonists are : Dopamine Cobergoline Bromocriptine Apomorphine Dopaminergic antagonists and DA depleters will increase prolactin level Dopaminergic antagonists are : Dopamine depleters are : o Chlorpromazine o Reserpine o Haloperidol o Methyl dopa o Metoclopramide", "role": "assistant" } ]

[ { "content": "Method of application of neutral sodium fluoride according to Knutson's technique involves all except- \nSelect and explain. \nA. At the initial appointment, the teeth are first cleaned with aqueous pumice slurry and then isolated with cotton rolls and dried with compressed air., B. The sodium fluoride solution applied on the teeth with cotton-tipped applicator stick is allowed to dry for 3 to 4 minutes., C. A second, third and fourth fluoride application, each preceded by a prophylaxis, is scheduled at intervals of approximately one week., D. The four-visit procedure is recommended for ages 3, 7, 1 1 and 13 years.", "role": "user" }, { "content": "Answer: C \nExplanation: Method of application of neutral sodium fluoride according to Knutson's technique-\nIf the sodium fluoride reagent is pure and uncontaminated, this solution has a pH of 7. Treatments are given in a series of four appointments. \n\nAt the initial appointment, the teeth are first cleaned with aqueous pumice slurry and then isolated with cotton rolls and dried with compressed  air. Teeth can either be isolated by quadrant or by half mouth. \nUsing cotton-tipped applicator sticks, the 2% sodium fluoride solution is painted on the air-dried teeth so that all surfaces are visibly wet. Then  with the teeth still isolated, the solution is allowed to dry for 3 to 4 minutes. \nThis procedure is repeated for each of the isolated segments until all of the teeth are treated. \nA  second, third  and  fourth fluoride application, each  not preceded  by a prophylaxis, is scheduled at intervals of approximately one week. \nThe four-visit procedure is recommended for ages 3, 7, 11 and 13 years, coinciding with the eruption of different groups of primary and permanent teeth. Thus, most of the teeth would be treated soon after their eruption, maximizing the protection afforded by topical application.", "role": "assistant" } ]

[ { "content": "Disadvantage of radioactive iodine include the following except: \nSelect and explain. \nA. Hypothyroidism, B. High chances of relapse, C. Delayed therapeutic effect, D. Development of thyroid carcinoma", "role": "user" }, { "content": "Answer: B \nExplanation: Radioactive iodine emits beta particles that destroy some thyroid tissue and impair the ability of the remaining follicles to replicate; hence once the patient becomes euthyroid, chances of relapse are negligible. Though the amount of radioactive iodine to be administered is estimated by the size of the gland and its iodine uptake, about 40-60% of the patients may develop hypothyroidism. The beneficial effects take 3-4 weeks to become apparent. Neoplasms of the thyroid have been reported in children following treatment with it.", "role": "assistant" } ]

[ { "content": "A 32-year-old female patient asks you what is the soft, thin ridge of tissue that she can feel running forward across the masseter muscle toward her upper lip. You reassure her that is perfectly normal. Which of the following is the most likely structure she is feeling? \nSelect and explain. \nA. Facial artery, B. Maxillary artery, C. Parotid duct, D. Marginal mandibular branch of facial nerve", "role": "user" }, { "content": "Answer: C \nExplanation: The parotid duct, also known as the Stensen's duct, crosses the masseter muscle transversely and extends to the oral cavity. The facial artery can be palpated in the groove anterior to the mandibular angle. The facial vein lies anterior to the artery, passing toward the angle of the lips, but does not ascend in close proximity to the masseter. All of the other vessels are located more deeply and cannot be palpated.", "role": "assistant" } ]

[ { "content": "All of the following are the mode of transmission of leprosy except - \nSelect and explain. \nA. Breast milk, B. Blood transfusion, C. Transplacental spread, D. Droplet infection", "role": "user" }, { "content": "Answer: B \nExplanation: <p> Mode of transmission of Leprosy are droplet infection, contact transmission,insect bite,tattooing needles,breast milk,trans placental . Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:317-318 <\\p>", "role": "assistant" } ]

[ { "content": "Sickle cell disease is due to \nSelect and explain. \nA. Point mutation, B. From shift mutation, C. Nucleotide receptor blockage, D. Non sequence mutation", "role": "user" }, { "content": "Answer: A \nExplanation: (Point mutation) (628-R) (227-426-Basicpathology> 8th)Sickle cell disease is an important hereditary hemoglobinopathy, a type of disease characterized by production of defective hemoglobins.Sickle cell disease is caused by a point mutation at the sixth position of the b-globin chain leading to the substitution of a valine residue for a glutamic acid residue.Sickle syndromes occurs in 3 different forms (394-HM 5th)1. As heterozygous state for HbS: Sickle cell trait (AS)2. As homozygous state for HbS: Sickle cell anaemia (SS)3. As double heterozygous states eg. Sickle p-thalassaemia Sickle-C-disease, sickle-D disease (SD)Frame-shift mutation - occurs when there is insertion or deletion of one or two base pairs in the DNA sequence eg. Cystic fibrosis", "role": "assistant" } ]

[ { "content": "Which is the commonest Post splenectomy infection- \nSelect and explain. \nA. Streptococcus pyogenes, B. Staphylococcus aureus, C. Streptococcus Pneumoniae, D. Pseudomonas aeruginosa", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Generation time of E-coli is \nSelect and explain. \nA. 20 days, B. 20 minutes, C. 20 hours, D. 20 second", "role": "user" }, { "content": "Answer: B \nExplanation: (20 minute) (271- Ananthanarayan 8th, 30- Chakrahorthy 2nd)* Many bacteria reproduce by binary fission and the average time required for the population, or the biomass, to double is known as generation time or doubling time.GENERATION TIME* Lepra bacillus - 24 Days* Tuberculous bacillus - 20 hours* Coliform E.coli - 20 minute* Clostridium - 10 minute* Each bacterial colony in a solid medium consists of descendants of a single cell* An ordinary bacterium doubles every 20-30 minutes and by geometric progression in exponential phase of growth thus a single bacterium can theoretically give rise to 1021 progeny in 24 hours roughly a ton of dry weight of bacterial cells.", "role": "assistant" } ]

[ { "content": "Fungicidal drug used orally for treatment of onychomycosis \nSelect and explain. \nA. Amphotericin B, B. Clotrimozale, C. Terbinafate, D. Gresiofulvin", "role": "user" }, { "content": "Answer: C \nExplanation: Onychomycosis is a fungal infection of the nail causing yellow discoloration of the nail usually caused by a dermatophyte .Among the given drugs only terbinafine given orally. AMB given iv or lipososmal form. Ref:KDT 6/e 765", "role": "assistant" } ]

[ { "content": "Which of the following is primary cell line - \nSelect and explain. \nA. Chick embryo fibroblast, B. Hela cells, C. Vero cells, D. WI-38", "role": "user" }, { "content": "Answer: A \nExplanation: Primary cell cultures:These are normal cells freshly taken from the body and cultured. Common examples are monkey kidney,human embryonic kidney,human amnion and chick embryo cell cultures. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:435", "role": "assistant" } ]

[ { "content": "Complication of vernal keratoconjunctivitis is \nSelect and explain. \nA. Cataract, B. Keratoconus, C. Retinal detachment, D. Vitreous hemorrhage", "role": "user" }, { "content": "Answer: B \nExplanation: Keratoconus (conical cornea) is a noninflammatory bilateral (85%) ecstatic condition of the cornea in its axial pa. It usually stas at pubey and progresses slowly. Keratoconus may be associated with :Ocular conditions e.g. ectopia lentis, congenital cataract, aniridia, retinitis pigmentosa, and vernal keratoconjunctivitis (VKC). Systemic conditions e.g., Marfan's syndrome, atopy, Down's syndrome, Ehlers-Danlossyndrome, osteogenesis imperfecta, and mitral valve prolapse. Treatment. Falling vision may not be corrected by glasses due to irregular astigmatism.\u0001 Contact lenses (rigid gas permeable) usually improve the vision in early cases.\u0001 In later stages penetrating keratoplasty may be required.\u0001 Intacs, the intracorneal ring segments, are repoed to be useful in early cases. Keratoconus can occur in patients with vernal keratoconjunctivitis due to repeated rubbing of the eye. early complications: This constant damage to the cornea may cause severe complications, including shield ulcers and vernal plaques, keratoconus, corneal scarring, microbial keratitis, and limbal epithelial stem cell deficiency. As some of these complications occur during the first decade of life, they may result in amblyopia. Ref khurana 16th edition pg 256 Ref: Khurana; 4th ed; Pg 119", "role": "assistant" } ]

[ { "content": "Why do direct filling golds have to be flamed before insertion into the cavity preparation? \nSelect and explain. \nA. To remove contaminants, B. To make gold soft, C. To form oxide layer on the surface, D. All of the above", "role": "user" }, { "content": "Answer: A \nExplanation: Proper desorption is a matter of heating long enough at a temperature that removes contaminants and in the case of powdered gold, that burns away the wax.\nRef:Phillip’s Science of Dental Materials ed 12 pg 414", "role": "assistant" } ]

[ { "content": "MHC CLASS III CODES for all except – \nSelect and explain. \nA. complement C3, B. properdin, C. TNF –alpha, D. heat shock proteins.", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "'Ring vaccination' is \nSelect and explain. \nA. Given by a ring shaped machine, B. Given to produce a ring lesion, C. Given around 100 yards of a case detected, D. Given around a mile of a case", "role": "user" }, { "content": "Answer: C \nExplanation: Ring vaccination is a strategy to inhibit the spread of disease by vaccinating only those who are most likely to be infected.", "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: Ans. C. Suicidal ideationIn 2003, th UK Medicine and Health Care products regulatory agency concluded that all SSNs, with the exception of fluoxetine, were contraindicated in the treatment of depression in young people due to increase in suicidal ideation and dubious efficacy.", "role": "assistant" } ]