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[ { "content": "The adverse effect of clozapine - \nSelect and explain. \nA. Hypertension, B. Sialorrhea, C. Extrapyramidal S/E, D. Neuroleptic malignant syndrome", "role": "user" }, { "content": "Answer: B \nExplanation: Side effects of clozapine\n\nAgranulocytosis\nUrinary incontinence\nUnstable BP & Tachycardia\nHypersalivation (sialorrhoea)\nWorsening of diabetes\nWeight gain\nSeizures\nSedation", "role": "assistant" } ]

[ { "content": "Most common cause of death in criminal abortion is? \nSelect and explain. \nA. Hemorrhage, B. Sepsis, C. Air embolism, D. Perforation", "role": "user" }, { "content": "Answer: B \nExplanation: ANSWER: (B) SepsisREF: Forensic Medicine and Toxicology By R.N.Karmakar page 230, Textbook of Forensic Medicine and Toxicology, Krishan Vij 5th ed fig 26.2The most common complication from illegal abortion is retained product of conception; the most frequent cause of death is infection and sepsis.NATURAL VS CRIMINAL ABORTION Natural abortionCriminal abortionCauseSpontaneousInducedPrecipitating factorMaternal or fetal diseaseUnwanted pregnancyEvidence of genital violenceAbsentPresentForeign body from genitalsAbsentMay be presentToxic effect of drugAbsentMay be presentFetal injuryAbsentRarely present", "role": "assistant" } ]

[ { "content": "Most potent statin - \nSelect and explain. \nA. Simvastatin, B. Pravastatin, C. Rosuvastatin, D. Simvastatin", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Rosuvastatin o Two most potent statins are Pitavastatin (most potent) and rosuvastatin most potent).", "role": "assistant" } ]

[ { "content": "Contraception of choice for a post paum village woman with one child : \nSelect and explain. \nA. Barrier, B. Copper T, C. Oral pills, D. Spermicide", "role": "user" }, { "content": "Answer: B \nExplanation: Copper T", "role": "assistant" } ]

[ { "content": "All of the following antifungal drugs inhibit ergosterol biosynthesis EXCEPT : \nSelect and explain. \nA. Ketoconazole, B. Fluconazole, C. Amphotericin B, D. None of these", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 33-year-old male immigrant from Taiwan presents with increasing right upper quadrant (RUQ) pain. The pain is dull, and it does not radiate or change with eating. On examination the abdomen is soft, there is a mass in the RUQ, and no ascites is clinically detected. He has a prior history of hepatitis B. His laboratory investigations reveal hepatitis B surface antigen (HBsAg) positive, hepatitis B surface antibody (HBsAb) negative, aspartate amino transferase (AST) 60 U/L, alanine amino transferase (ALT) 72 U/L, and an elevated alpha-fetoprotein level. Which of the following is the most likely diagnosis? \nSelect and explain. \nA. hepatoma, B. hepatocellular carcinoma (HCC), C. metastatic cancer, D. hepatic hemangioma", "role": "user" }, { "content": "Answer: B \nExplanation: (b) Source: (Devita, pp. 533-534) Only the chronic carrier state increases HCC risk, not previous infection. The majority, but not all, of HCC associated with HBV occurs in the setting of cirrhosis (60-90%). Because the latency period of HBV infection is 35 years, before HCC supervenes, early-life infection is strongly correlated with HCC. The chronic carrier state of HBsAg in endemic areas, such as Taiwan, is associated with a relative risk of over 100 for the development of HCC. Over half the chronic carriers of HBsAg in such a population will die of cirrhosis or HCC. In Taiwan, where childhood vaccination was introduced in 1984, the death rate from childhood HCC has already declined.", "role": "assistant" } ]

[ { "content": "Which of the following is not done before ABG? \nSelect and explain. \nA. Allen test, B. Heparin to rinse the syring, C. Flexion of wrist, D. Poking the aery at 45 degrees angle", "role": "user" }, { "content": "Answer: C \nExplanation: Done Before ABG Allen test: integrity of palmer arch. Heparin: to rinse the syringe Poking the aery at 45-degree angle. Extend wrist joint: Radial Aery tent.", "role": "assistant" } ]

[ { "content": "Focal lesion in liver is best detected by \nSelect and explain. \nA. MRI, B. CT, C. USG, D. PET", "role": "user" }, { "content": "Answer: A \nExplanation: MRI in Liver lesions MRI had emerged as the best imaging test for liver lesion detection and characterization MRI provides high lesion-to-liver contrast and does not use radiation Liver-specific contrast media, such as mangofodipir trisodium (taken up by hepatocytes) and ferrumoxides (taken up by kupffer cells) demonstrate selective uptake in the liver and primarily used for lesion detection These two contrast agents are also useful in characterising specific liver tumors, such as FNH, hepatic adenoma and HCC Ref: Shackelford 7th edition Pgno : 1560", "role": "assistant" } ]

[ { "content": "Admixed high copper alloy powder contains \nSelect and explain. \nA. 9-20% copper, B. 13-20% copper, C. 9-30% copper, D. 13-30% copper", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "A patient presents with LMP 8 weeks ago. She has history of delayed cycles in the past. Which of the following is the most accurate way of dating the pregnancy? \nSelect and explain. \nA. Determination of uterine size on pelvic examination, B. Quantitative serum HCG level, C. Crown-rump length on abdominal or vaginal ultrasound, D. Determination of progesterone level along with serum HCG level", "role": "user" }, { "content": "Answer: C \nExplanation: CRL is the best USG parameter to determine gestational age in first trimester Crown rump length - it is the longest straight line measurement of the embryo from the other margin of cephalic pole to rump mid-sagittal plane with fetus in neutral , non fixed position - Best seen on TVS - Overall best USG parameter to assess the fetal age - Ideal time to measures CRL is 7 - 10 weeks - can be done upto 14 weeks", "role": "assistant" } ]

[ { "content": "Pectinate line is an impoant landmark because? \nSelect and explain. \nA. It marks a divide in nerve supply, B. It marks the location of change in type of epithelium, C. It represents a lymphatic and venous divide, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: All of the above", "role": "assistant" } ]

[ { "content": "A lady used to repeatedly wash her hands due to the fear of acquiring AIDS is due to \nSelect and explain. \nA. OCD, B. Mania, C. Depression, D. Anxiety", "role": "user" }, { "content": "Answer: A \nExplanation: (A) OCD # Obsessive-compulsive disorder (OCD) is a psychiatric anxiety disorder most commonly characterized by a subject's obsessive, distressing, intrusive thoughts and related compulsions (tasks or \"rituals\") which attempt to neutralize the obsessions.# Obsessions are defined by:> Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.> Thoughts, impulses, or images are not simply excessive worries about real-life problems.> Person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.> Person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.> Tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable.# Compulsions are defined by:> Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.> The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.", "role": "assistant" } ]

[ { "content": "A 5-year-old boy is brought to the emergency room with a fever of 103degF (38.7degC), chest pain, and productive cough. The patient has a history of recurrent pulmonary disease and respiratory distress. What microorganism recovered from the lungs of this child is virtually diagnostic of cystic fibrosis? \nSelect and explain. \nA. Klebsiella sp., B. Legionnella sp., C. Pneumocystis sp., D. Pseudomonas sp.", "role": "user" }, { "content": "Answer: D \nExplanation: Cystic fibrosis is the most common lethal autosomal recessive disorder in the white population. The disease is characterized by (1) chronic pulmonary disease, (2) deficient exocrine pancreatic function, and (3) other complications of inspissated mucus in a number of organs, including the small intestine, the liver, and the reproductive tract. It results from abnormal electrolyte transport caused by impaired function of the chloride channel of epithelial cells. The pulmonary symptoms of CF begin with cough, which eventually becomes productive of large amounts of tenacious and purulent sputum. Episodes of infectious bronchitis and bronchopneumonia become progressively more frequent, and eventually shortness of breath develops. Respiratory failure and the cardiac complications of pulmonary hypertension (cor pulmonale) are late sequelae. The most common organisms that infect the respiratory tract in CF are Staphylococcus and Pseudomonas species. As the disease advances, Pseudomonas may be the only organism cultured from the lung. In fact, the recovery of Pseudomonas sp., particularly the mucoid variety, from the lungs of a child with chronic pulmonary disease is virtually diagnostic of CF.Diagnosis: Cystic fibrosis", "role": "assistant" } ]

[ { "content": "Conduction velocity in AV node 8c SA node- \nSelect and explain. \nA. 0.05 meter/sec, B. 0.5 meter/sec, C. 1 meter/sec, D. 5 meter/sec", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., 0.05 meter/sec Cardiac tissueConduction velocity (meter/second)SA node0 [?] 05Inteatrial pathways1Atrial muscle0 [?] 30AV node0 [?] 05 (minimum)Bundle of His1Purkinje system4 (maximum)Ventricular muscle1", "role": "assistant" } ]

[ { "content": "Which of the following cells do Natural killer cells attack? \nSelect and explain. \nA. Cells which express MHC 1, B. Cells which are not able to express MHC 1, C. MHC cells which express MHC 2, D. Cells which are not able to express MHC", "role": "user" }, { "content": "Answer: B \nExplanation: . Cells which are not able to express MHC 1", "role": "assistant" } ]

[ { "content": "Continues scrutiny of factors that affect the occurence of a disease is - \nSelect and explain. \nA. Epidemiology, B. Monitoring, C. Surveillance, D. Screening", "role": "user" }, { "content": "Answer: C \nExplanation: Surveillance has been defined as the continuous scrutiny of all aspects of occurrence and the spread of diseases that are peinent to effective control. Surveillance goes beyond the passive repoing of cases Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 138", "role": "assistant" } ]

[ { "content": "Most common site of tear in Mallory-weiss syndrome is in \nSelect and explain. \nA. Upper esophagus, B. Mid operation, C. Lower esophagus, D. Cardia stomach", "role": "user" }, { "content": "Answer: D \nExplanation: MALLORY WEISS syndrome is seen in adults with severe prolonged vomiting, causing a longitudinal tear in the mucosa of the stomach at and just below the cardia leading to severe hematemesis.violent vomiting may be due to a migraine or veigo or following a bout of alcohol.common in 1 o' clock position.investigations include Hb%, PCV.treatment includes blood transfusion, IV fluids, sedation and hemostatic agents such as vasopressin. Ref: SRB&;s manual of surgery,3 rd ed, pg no 734", "role": "assistant" } ]

[ { "content": "A patient presented with 2 months history of increased ICP, with massive parietal edema, CT/MRI shows single and were circumscribed region lesion \nSelect and explain. \nA. Granuloma, B. Metastases, C. Glioblastoma, D. All of the above", "role": "user" }, { "content": "Answer: A \nExplanation: (A) Granuloma > Granuloma usually presents with increased ICP, with massive parietal edema. CT/MRI shows single circumscribed region lesion. Gliomas include astrocytomas, oligodendrogliomas and mixed tumours. Common sites include the cerebellum, optic nerve and chiasma, hypothalamus and brainstem. Diffuse astrocytomas (WHO grade II) are most common in the fourth decade of life and often present with seizures or are incidental findings. CT scan shows enhancement which is often irregular around a centre of low density which may represent necrosis calcification may be present. Cerebral metastases are by far the most common intracranial tumours and will affect approximately one in every four cancer sufferers. They tend to occur in the fifth to seventh decades. The majority of patients with cerebral metastases have multiple lesions. Metastatic tumours show isodense on unenhanced CT and enhance vividly on intravenous contrast.", "role": "assistant" } ]

[ { "content": "Incineration is done for waste category ? \nSelect and explain. \nA. Category 7, B. Category 9, C. Category 6, D. Category 5", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Category 6", "role": "assistant" } ]

[ { "content": "Pathognomic factors involved in foot ulcers in DM include all, Except: \nSelect and explain. \nA. Trophic ulcers, B. Neuropathy, C. Microangiopathic changes in blood vessels, D. Macroangiopathy", "role": "user" }, { "content": "Answer: C \nExplanation: Answer is C (Microangiopathic changes in blood vessels): Macroangiopathic changes in blood vessels in the form of peripheral aerial disease contribute to the generation of foot ulcers and non microangiopathic changes. Pathogenic Factors in generation of foot ulcers in DM Neuropathy (Peripheral Sensory neuropathy): Trophic changes Abnormal Foot Biomechanics (d/t disordered propioception and sensorimotor neuropathy) Peripheral Aerial disease (Macroangiopathy) and poor wound healing Autonomic neuropathv (anhidrosis and altered superficial blood flow in ,foot)", "role": "assistant" } ]

[ { "content": "Finding on histopathological examination in liver in case of malaria is : \nSelect and explain. \nA. Microabscess formation, B. Kupffer's cell hyperplasia with macrophage infiltration around periportal area laden with pigments., C. Non caseating granuloma, D. Non specific finding of neutrophilic infiltratio", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e. Kupffer's cell hyperplasia with macrophage infiltration around periportal area laden with pigments * In severe infections with plasmodium falciparum, the vital organs are packed with erythrocytes containing mature form of the parasite.* There is abundant intra and extraerythrocytic pigment and organs such as liver, spleen and placenta may be grey black in colour.Also know * Durck's granuloma are pathognomic of malignant cerebral malaria.Histopathological features in liver due to falciparum malariaReticuloendothelial cell proliferation i.e., Kupffer cell hyperplasia.Malarial pigmentation i.e., haemoglobin pigmentation.CongestionPortal infiltration of the macrophageSinusoidal infiltration and sinusoidal dilatationCholestasisNuclear vacuolationLiver cell necrosisFatty changeBallooning of hepatocytesVacuolated cytoplasm's", "role": "assistant" } ]

[ { "content": "Which of the following is true about sickle cell red blood cells? \nSelect and explain. \nA. Stability, B. Altered function, C. Decreased oxygen carrying capacity, D. Protective against adult malaria", "role": "user" }, { "content": "Answer: D \nExplanation: HbA/S heterozygotes (sickle cell trait) have a sixfold reduction in the risk of dying from severe falciparum malaria. This decrease in risk appears to be related to impaired parasite growth at low oxygen tensions and reduced parasitized red cell cytoadherence. Parasite multiplication in HbA/E heterozygotes is reduced at high parasite densities. Ref: White N.J., Breman J.G., Osler W. (2012). Chapter 210. Malaria. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.", "role": "assistant" } ]

[ { "content": "Drug of choice for pneumocystis carinii ? \nSelect and explain. \nA. Cotrimoxazole, B. Erythromycin, C. Penicillin, D. Metronidazole", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Cotrimoxazole", "role": "assistant" } ]

[ { "content": "A 26-year-old man is admitted through the casualty of the hospital for a heroin overdose. His hea rate is 45 beats/min, and his blood pressure is 75/40 mm Hg. Which of the following best depicts the results from an aerial blood sample? \nSelect and explain. \nA. pH 7.22, PaCO2 (mm Hg) 66, HCO3- (mEq/L) 26, B. pH 7.34, PaCO2 (mm Hg) 29, HCO3- (mEq/L) 15, C. pH 7.40, PaCO2 (mm Hg) 40, HCO3- (mEq/L) 24, D. pH 7.47, PaCO2 (mm Hg) 20, HCO3- (mEq/L) 14", "role": "user" }, { "content": "Answer: A \nExplanation: This man has a respiratory acidosis. Overdose with drugs that suppress ventilation (e.g., heroin, morphine, barbiturates, methaqualone, and \"sleeping pills\") often causes hypercapnia. In patients with an intact renal response, the respiratory acidosis causes a compensatory rise in plasma HCO3-, which lessens the fall in pH. However, the renal response requires several days to develop fully. The plasma HCO3- of 26 mEq/L (normal: 22-28 mEq/L) for this man is typical of acute respiratory acidosis with little or no renal compensation. pH 7.34, PaCO2 (mm Hg) 29, HCO3- (mEq/L) 15 reflects metabolic acidosis. pH 7.40, PaCO2 (mm Hg) 40, HCO3- (mEq/L) 24 is normal. pH 7.47, PaCO2 (mm Hg) 20, HCO3- (mEq/L) 14 reflects respiratory alkalosis.", "role": "assistant" } ]

[ { "content": "Most common bone fracture in body is: \nSelect and explain. \nA. Radius, B. Clavicle, C. Femur, D. Vertebra", "role": "user" }, { "content": "Answer: B \nExplanation: Ans: b (Clavicle)Ref: Maheshwari Ortho, 3rd ed, p. 73", "role": "assistant" } ]

[ { "content": "Drug treatment for laryngeal stenosis is \nSelect and explain. \nA. Adriamycin, B. Mitomycin C, C. Cyclophosphamide, D. Doxorubicin", "role": "user" }, { "content": "Answer: B \nExplanation: Mitomycin-C is an antineoplastic antibiotic that acts as an alkylating agent by inhibiting DNA and protein synthesis. ... Topical application of mitomycin-C (0.4 mg/mL) was used as an adjuvant treatment in the endoscopic laser management of laryngeal and tracheal stenosis Ref: Internet sources", "role": "assistant" } ]

[ { "content": "A 40 year old presenting with dizziness on standing with systolic reduction of BP of 50mm Hg; appropriate treatment \nSelect and explain. \nA. Graded compression stockings, B. Salbutamol, C. Fludrocoisone, D. b-blockers", "role": "user" }, { "content": "Answer: A \nExplanation: Graduated compression stockings (GCS) help prevent the formation of blood clots in the legs by applying varying amounts of pressure to different pas of the leg. Thigh or waist-high stockings help reduce pooling of blood in the legs and help prevent lightheadedness or falling when you stand up (ohostatic hypotension). Stockings that rise to just below the knee help limit lower leg swelling due to fluid buildup Ref Davidson 23rd edition pg 450", "role": "assistant" } ]

[ { "content": "WHO global programme for oral health targets for 2000 irtclude; \nSelect and explain. \nA. <2 DMFT at 12 years, B. <3 DMFT at 12 years, C. <4 DMFT at 12 years, D. <5 DMFT at 12 years", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "A child aged 24 months was brought to the Primary Health Centre with complaints of cough and fever for the past 2 days. On examination, the child weighed 11kg, respiratory rate was 38 per minute, chest indrawing was present. The most appropriate line of management for this patient is ? \nSelect and explain. \nA. Classify as pneumonia and refer urgently to secondary level hospital, B. Classify as pneumonia, sta antibiotics and advise to repo after 2 days, C. Classify as severe pneumonia, sta antibiotics and refer urgently, D. Classify as severe pneumonia and refer urgently", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is `c' i.e., Classify as severe pneumonia, sta antibiotics and refer urgently", "role": "assistant" } ]

[ { "content": "A 40-year-old female have a right hypochondriac pain. USG is taken. What is the inference? \nSelect and explain. \nA. Gall stone, B. Cholecystitis, C. Porcelain gall bladder, D. Cholangiocarcinoma", "role": "user" }, { "content": "Answer: A \nExplanation: USG shows highly reflective echogenic focus within the gallbladder lumen, with prominent posterior acoustic shadowing, characteristic of Cholelithiasis. If there is associated cholecystitis, gallbladder wall thickening along with the pericholecytic fluid. Murphy&;s sign might be elicited with probe over gallbladder.", "role": "assistant" } ]

[ { "content": "Dentogingival unit comprises of \nSelect and explain. \nA. Gingival fibres, B. Gingival fibres and junctional epithelium, C. P.D. fibres and ligament, D. None of the above", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "All of the following are known predisposing factors for Alzheimer's disease except : \nSelect and explain. \nA. Down-syndrome, B. Low education level, C. Smoking, D. Female sex", "role": "user" }, { "content": "Answer: C \nExplanation: Answer is C (Smoking):Smoking has not been mentioned as a risk factor, for Alzheimer's disease.", "role": "assistant" } ]

[ { "content": "Action of alpha subunit of G-protein is: \nSelect and explain. \nA. Binding of agonist, B. Conversion of GDP to GTP, C. Breakdown of GTP to GDP, D. Internalization of receptors", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. (C) Breakdown of GTP to GDP(Ref: KDT 8th/e p54)Alpha subunit of G protein contains GTPase activity and thus dissociates GTP to form GDP. This result in re-uniting a subunit with b and g subunit", "role": "assistant" } ]

[ { "content": "A 50 year old with history of jaundice in the past has presented with right upper quadrant abdominal pain. Examination and investigations reveal chronic calculous cholecystitis. The liver functions tests are within normal limits and on ultrasound examination, the common bile ducts is not dilated. Which of the following will be the procedure of choice? \nSelect and explain. \nA. Laparoscopic cholecystectomy, B. Open choledocholithotomy followed by laparoscopic cholecystectomy, C. ERCP + choledocholithotomy followed by Laparoscopic cholecystectomy, D. Laparoscopic cholecystectomy followed by ERCP + choledocholithotomy", "role": "user" }, { "content": "Answer: A \nExplanation: In the given question there was an episode of jaundice, but LFT is normal and CBD is not dilated. The best option is laparoscopic cholecystectomy only Management of CBD stones associated with GB stones * Pre-operatively detected stones:- * Unsuspected stones found at the time of cholecystectomy:- Experienced laparoscopic surgeon Experienced laparoscopic surgeon Cholecystectomy and choledochotomy in same sitting Laparoscopic CBD exploration and stone retrieval through the cystic duct * Laparoscopic choledochotomy and stone extraction Inexperienced laparoscopic surgeon Inexperienced laparoscopic surgeon Pre-op ERCP with stone removal and laparoscopic cholecystectomy later Conve to open procedure and remove CBD stone Complete the cholecystectomy and refer the patient for ERCP", "role": "assistant" } ]

[ { "content": "Which muscle paralysis can cause ‘Winging of scapula’? \nSelect and explain. \nA. Serratus anterior, B. Supraspinatus, C. Teres minor, D. Deltoid", "role": "user" }, { "content": "Answer: A \nExplanation: LONG THORACIC NERVE\n■ Arises from ventral rami of C5, C6, and C7.\n■ Descends behind the brachial plexus on the lateral surface of the serratus anterior, to which it supplies.\n■ The serratus anterior muscle can be examined by asking patient to push against a wall with both hands. Winging of scapula will be typically noted", "role": "assistant" } ]

[ { "content": "True about proximal fragment In supratrochantric fracture is \nSelect and explain. \nA. Flexion, B. Abduction, C. External rotation, D. All of the the above", "role": "user" }, { "content": "Answer: D \nExplanation: The peritrochanteric fracture is one of the most serious causes of mortality and morbidity in the elderly.\nSubtrochanteric fractures account for approximately 10-30% of all peritrochanteric fractures, and they affect persons of all ages.\n1,2 The subtrochanteric region of the femur is generally recognized to be the area of the femur below the inferior border of the lesser trochanter, extending distally 7.5 cm to the junction of the proximal and middle third of the femur.3 Most frequently, these fractures are seen in two patient populations, namely older osteopenic patients after a low-energy fall and younger patients involved in high-energy trauma.1-3 In elderly patients, minor slips or falls that lead to direct lateral hip trauma are the most frequent mechanism of injury.\nThis age group is also susceptible to metastatic disease that can lead to pathologic fractures.\nIn younger patients, the mechanism of injury is always high-energy trauma, either direct or from axial loading (e.g., a fall from height), which often creates a comminuted fracture.", "role": "assistant" } ]

[ { "content": "The BEST method for teaching mothers about using ORS is: \nSelect and explain. \nA. Group discussion, B. Demonstration, C. Lecture, D. Flannel graph", "role": "user" }, { "content": "Answer: B \nExplanation: A demonstration is a carefully prepared presentation to show how to perform a skill or procedure. Here a procedure is carried out step by step before an audience. Demonstration is found to have high education value in programmes like teaching a mother the use of oral rehydration therapy at home. Ref: Park 21st edition, page: 803.", "role": "assistant" } ]

[ { "content": "A female wanted to have an emergency contraception after an unprotected intercourse. Which of these is NOT useful as an emergency contraceptive? \nSelect and explain. \nA. LNG IUD, B. Oral Mifepristone, C. Oral Levonorgestrel, D. Cu-containing IUD", "role": "user" }, { "content": "Answer: A \nExplanation: Post coital or emergency contraceptives are, Ethinyl oestradiol Conjugated estrogen Ethinyl oestradiol + Norgestrel Levonorgestrel Mifepristone Copper IUDs Ref: Textbook of Obstetrics by D.C. Dutta, 6th edition, Page 550.", "role": "assistant" } ]

[ { "content": "A characteristic feature of Still's disease - \nSelect and explain. \nA. Prominent kidney involvement, B. Rashes, C. Positive Rheumatoid factor, D. Neutropenia", "role": "user" }, { "content": "Answer: B \nExplanation: Stills disease is a variant of rheumatoid commonly occurring in adults in 20's and 30's.\nPatients characteristics clinical features are:\n\n\nHigh spiking fever often up to 40°C.\nSore throat\nEvanescent salmon coloured non pruritic rash, seen on chest & abdomen\nLymphadenopathy\nPericardial effusion\nWrist joint involvement\n\n\nChances are that you might confuse it with Felty's syndrome so I am giving the important features of both these conditions together", "role": "assistant" } ]

[ { "content": "Which of the following is false regarding endemic bladder stones? \nSelect and explain. \nA. Always associated with recurrence, B. High incidence in cereal based diet, C. Peak incidence in 3 years old children in India, D. Most common type is ammonium urate or calcium oxalate", "role": "user" }, { "content": "Answer: A \nExplanation: PRIMARY BLADDER CALCULI (ENDEMIC BLADDER CALCULI) Mainly seen in underdeveloped countries (Noh Africa, Thailand, Myanmar, Indonesia), in pediatric age group. Most common in children <10 Years, with a peak incidence at 2 to 4 years of age. Related to chronic dehydration and low protein, low phosphate, exclusive milk & high carbohydrate diet. Low phosphate diet Increases urinary ammonium excretion leading to ammonium urate stones Treatent Small stones: Removed or crushed transurethral electrohydraulic lithotripsy or Cystolithotomy. Primary bladder calculi rarely recur after treatment.", "role": "assistant" } ]

[ { "content": "Which of the following is present normally in the urine of a pregnant women in the third trimester and lactation? \nSelect and explain. \nA. Glucose, B. Lactose, C. Galactose, D. Fructose", "role": "user" }, { "content": "Answer: A \nExplanation: Glucosuria during pregnancy is not necessarily abnormal. The appreciable increase in glomerular filtration, together with impaired tubular reabsorptive capacity for filtered glucose, accounts in most cases for glucosuria. Though glucosuria is common during pregnancy, the possibility of diabetes mellitus should not be Ignored when it is identified.", "role": "assistant" } ]

[ { "content": "All are major symptoms of sinusitis except ? \nSelect and explain. \nA. Nasal bluckage, B. Facial congeion, C. Nasal congestion, D. Halitosis", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Halitosis The clinical symptoms of acute sinusitis have been classified into major and minor Major Facial pain or pressure Purulent nasal discharge Fever Nasal congestion Nasal obstruction Hyposmia or Anosmia Facial congestion or fullness Minor Headache Cough Fatigue Halitosis Dental pain Ear pain or pressure", "role": "assistant" } ]

[ { "content": "Which of the following is the most widespread method of genetic transfer among bacteria? \nSelect and explain. \nA. Transformation, B. Transduction, C. Lysogenic conversion, D. Conjugation", "role": "user" }, { "content": "Answer: D \nExplanation: Option a, b, c, d * There are three mechanisms of horizontal gene transfer in bacteria:- 1.Transformation 2. Transduction 3. Conjugation (Most common mechanism), It was discovered first by Lederberg and Tatum. * Conjugation plays an impoant role in the transfer of plasmids coding for antibacterial drug resistance and bacteriocin production . * R factor (or the resistance factor) is a plasmid which has two components. o Resistance transfer factor (F) is the plasmid responsible for conjugational transfer(similar to F factor) o Resistance determinant (r): Codes for resistance to one drug. An R factor can have several r determinants.", "role": "assistant" } ]

[ { "content": "Which of the following is not an inflammatory mediator \nSelect and explain. \nA. Tumor necrosis factor, B. Myeloperoxidase, C. Interferons, D. Interleukins", "role": "user" }, { "content": "Answer: B \nExplanation: steps: (1) migration and proliferation of fibroblasts into the site of injury and (2) deposition of ECM proteins produced by these cells. The recruitment and activation of fibroblasts to syn- thesize connective tissue proteins are driven by many growth factors, including PDGF, FGF-2 (described earlier), and TGF-b. The major source of these factors is inflamma- tory cells, paicularly macrophages, which are present at sites of injury and in granulation tissue. Sites of inflamma- tion are also rich in mast cells, and in the appropriate chemotactic milieu, lymphocytes may be present as well. Each of these cell types can secrete cytokines and growth factors that contribute to fibroblast proliferation and activation. As healing progresses, the number of proliferating fibroblasts and new vessels decreases; however, the fibro- blasts progressively assume a more synthetic phenotype, so there is increased deposition of ECM. Collagen synthe- sis, in paicular, is critical to the development of strength in a healing wound site. As described later, collagen syn- thesis by fibroblasts begins early in wound healing (days 3 to 5) and continues for several weeks, depending on the size of the wound. Net collagen accumulation, however, depends not only on increased synthesis but also on diminished collagen degradation (discussed later). Ulti- mately, the granulation tissue evolves into a scar composed of largely inactive, spindle-shaped fibroblasts, dense collagen, fragments of elastic tissue, and other ECM com- ponents (Fig. 2-30, B). As the scar matures, there is proA A gressive vascular regression, which eventually transforms the highly vascularized granulation tissue into a pale, largely avascular scar. Growth Factors Involved in ECM Deposition and Scar Formation Many growth factors are involved in these processes, including TGF-b, PDGF, and FGF. Because FGF also is involved in angiogenesis, it was described earlier. Here we briefly describe the major propeies of TGF-b and PDGF. * Transforming growth factor-b (TGF-b) belongs to a family of homologous polypeptides (TGF-b1, -b2, and -b3) that includes other cytokines such as bone morphogenetic proteins. The TGF-b1 isoform is widely distributed and is usually referred to as TGF-b. The active factor binds to two cell surface receptors with serine-threonine kinase activity, triggering the phosphorylation of transcription factors called Smads. TGF-b has many and often oppo- site effects, depending on the cell type and the metabolic state of the tissue. In the context of inflammation and repair, TGF-b has two main functions: TGF-b stimulates the production of collagen, fibro- nectin, and proteoglycans, and it inhibits collagen degradation by both decreasing proteinase activity and increasing the activity of tissue inhibitors of pro- teinases known as TIMPs (discussed later on). TGF-b is involved not only in scar formation after ref Robbins 9/e p83", "role": "assistant" } ]

[ { "content": "A drug given for metoclopramide induced dystonic reaction is : \nSelect and explain. \nA. Pheniramine, B. Promethazine, C. Chlorpromazine, D. Prochlorperazine", "role": "user" }, { "content": "Answer: B \nExplanation: \"Acute muscle dystonia caused by antiemetic-antipsychotic drugs is promptly relieved by parenteral promethazine or hydroxyzine.\" This is based on the central anticholinergic action of the drugs.\nPromethazine is a first-generation anti-histaminic which has a maximum penetration of blood-brain barrier and maxi­mum anticholinergic activity.", "role": "assistant" } ]

[ { "content": "Compared with cow's milk, mother's milk has more? \nSelect and explain. \nA. Lactose, B. Vitamin D, C. Proteins, D. Fat", "role": "user" }, { "content": "Answer: A \nExplanation: Mother's milk has more lactose as compared to cow's milk.", "role": "assistant" } ]

[ { "content": "When pulp cannot be extirpated in narrow canals, which of the following can be used \nSelect and explain. \nA. Obtundant, B. Astringent, C. Haemostatic, D. Mummifying agent", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "A man presented with persistent ear pain and discharge, retro-orbital pain and modified radical mastoidectomy was done to him. Patient comes back with persistent discharge, what is your diagnosis? \nSelect and explain. \nA. Diffuse serous labyrinthitis, B. Purulent labyrinthitis, C. Petrositis, D. Latent mastoiditis", "role": "user" }, { "content": "Answer: C \nExplanation: In a patient with CSOM, persistent ear discharge with or without deep seated pain in spite of an adequate coical or modified mastoidectomy points towards petrositis. Spread of infection from middle ear and mastoid to the petrous pa of temporal bone is petrositis it can also involve adjacent 5th cranial nerve and 6\" cranial nerve when it produces classical triad of symptoms - 6th nerve palsy, retro orbital pain (5th nerve) and persistent discharge from the ear, known as Gradenigo's syndrome Treatment Adequate drainage is the mainstay of treatment along with specific antibiotic therapy. Modified radical or radical mastoidectomy is often required if not done already. The fistulous tract should be identified, curetted and enlarged to provide free drainage.", "role": "assistant" } ]

[ { "content": "Child presents with linear verrucous plaques on the trunk with vacuolisation of keratinocytes in S.Spinosum and S.Granulosum. Diagnosis is ? \nSelect and explain. \nA. Incontinenta pigmenti, B. Delayed hypersensitivity reaction, C. Verrucous epidermal nevus, D. Linear darriers disease", "role": "user" }, { "content": "Answer: C \nExplanation: Verrucuous epidermal nevus Linear verrucuous lesions, with characteristic histopathological feature of granular degeneration of the epidermis ours the diagnosis of verrucous epidermal nevus. Epidermal nevus Epidermal nevi are hamaomas that are characterized by hyperplasia of the epidermis and adnexal structures. These nevi may be classified into a number of distinct variants which are based on clinical morphology, extent of involvement and the predominant epidermal structure in the lesion. Variants of the epidermal nevi are ? - Verrucuous epidermal nevus - Nevus sebaceous - Nevus comedonicus - Eccrine nevus - Apocrine nevus - Becker's nevus - White sponge nevus Verrucuous epidermal nevus Verrucuous epidermal ,nevus consists of hyperplasia of the surface epidermis and typically appears as verrucuous papules that coalasce to form well demarcated, skin colored to brown, papillomatous plaque. Most lesions are present at bih and develop during infancy. They enlarge slowly during childhood and generally reach a stable size at adolescence. Lesions may be localized or diffuse. Linear configurations are common especially on the limbs and may follow skin tension lines or Blaschko's lines. The salient histological features are ? Perinuclear vacuolization of the cells in the stratum spinosum and stratum granulosum. Irregular cellular boundaries peripheral to the vacuolization and increased number of irregularly :,aped large keratohyaline granules. Compact hyperkeratosis in stratum corneum. Darner white disease Autosomal dominant disease. Males and females are equally affected. Daffier white disease is not present at bih and usually begins in the first or second decade. Characteristic sites of prediliction are the face, forehead, scalp, chest and the hack (seborrhic sites). Clinical features consists of way papules and plaques in (seborrhic sites). Histology shows suprabasal acantholysis in epidermis with dyskeratotic cells. Incontinentia pigmentii X linked disease (so only seen in females) Lesions are present along the Blaschko lines, which are initially vesicular, that later on turns into verrucuous lesions and hyperpigmented stages. Common histological features are : - Hverkeratosis - Eosinophilic spongiosis of epidermis - Basal cell degeneration - Pigment incontinenti", "role": "assistant" } ]

[ { "content": "A swelling behind the ear suggest fracture of: \nSelect and explain. \nA. Zygomatic complex, B. Temporal bone, C. Orbital floor fracture, D. Condylar fracture", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Best test to detect pneumoperitoneum is: \nSelect and explain. \nA. Chest X-ray, B. X-ray abdomen in supine position, C. X-ray abdomen in supine position, D. X-ray abdomen in lateral decubitus", "role": "user" }, { "content": "Answer: D \nExplanation: X-ray abdomen in lateral decubitus", "role": "assistant" } ]

[ { "content": "In the intraepthielial region of the mucosa of intestine the predominant cell population is that of \nSelect and explain. \nA. B cell, B. T cell, C. Plasma cells, D. Basopils", "role": "user" }, { "content": "Answer: B \nExplanation: IEL are6 a distinctive population of T cells dispersed among the luminal epithelial cells. paicularly in the small intestine there is a predominantly of CD8+T cells", "role": "assistant" } ]

[ { "content": "Terry Thomas sign is seen in \nSelect and explain. \nA. Keinbock's disease, B. Carpal dislocation, C. Calcaneal disorder, D. Hip trauma", "role": "user" }, { "content": "Answer: B \nExplanation: scapholunate dislocation : * Most common ligamentous instability of the wrist * Patients may have high degree of pain despite apparently normal radiographs * Physicians should suspect this injury if patient has wrist effusion and pain seemingly out of propoion to the injury * If improperly diagnosed can lead to chronic pain * Located proximal axial line from 3rd metacarpal Scapholunate Dissociation-Diagnosis * Exam -- Watson&;s test -- Scaphoid shuck test -- Pain/swelling over dorsal wrist, proximal row * Imaging -- Plain films: >3mm difference on clenched fist view -- Scaphoid ring sign Scapholunate Dissociation Treatment * If discovered within 4 weeks, surgery * After 4 weeks, conservative treatment reas -- Bracing -- NSAIDS -- Consider evaluation by hand surgery to confirm no surgery needed ref : maheswari 9th ed", "role": "assistant" } ]

[ { "content": "The basic reason for \"reperfusion injury\" to the myocardium is: \nSelect and explain. \nA. Generation of free radicals, B. Extension of the ischemic zone, C. Increased ICF, D. Increased ECF", "role": "user" }, { "content": "Answer: C \nExplanation: After MI, there is failure of Na+-K+ pump resulting in NCX failure Thus intracellular Ca+2 increases Now when perfusion is established (nutrients are available), because of increased ICF Ca+2, cardiac fibers contract very strongly Already muscle fibers are fragile due to M.I, now this contraction results in fuher damage. This is basic reason for \"reperfusion injury\".", "role": "assistant" } ]

[ { "content": "The maxillary teeth which have single antagonist are: \nSelect and explain. \nA. Lateral incisors, B. Permanent canines, C. Permanent central incisors, D. Third molars", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 5-year-old girl is brought to the physician after her parents noticed red blood in her stool. Physical examination reveals mucocutaneous pigmentation. Small bowel radiography discloses multiple, small- to medium-sized polyps that are diagnosed pathologically as hamartomas. Which of the following is the most likely diagnosis? \nSelect and explain. \nA. Congenital teratoma, B. Hyperplastic polyp, C. Peutz-Jeghers polyp, D. Tubular adenoma", "role": "user" }, { "content": "Answer: C \nExplanation: Peutz-Jeghers syndrome is an autosomal dominant, hereditary disorder characterized by intestinal hamartomatous polyps and mucocutaneous melanin pigmentation, which is particularly evident on the face, buccal mucosa, hands, feet, and perianal and genital regions. The polyps seen in Peutz-Jeghers syndrome are hamartomatous, characterized by a branching network of smooth muscle fibers continuous with the muscularis mucosa that support the glandular epithelium of the polyp. Congenital teratoma (choice A) does not involve the intestine. The other choices are principally colonic polyps that derive from the luminal epithelium.Diagnosis: Gastrointestinal polyp, Peutz-Jeghers polyp", "role": "assistant" } ]

[ { "content": "First indices to change in iron deficiency anemia is - \nSelect and explain. \nA. S. Iron, B. Total iron binding capacity, C. S. Ferritin, D. S. Haemoglobin concentration", "role": "user" }, { "content": "Answer: C \nExplanation: The single most sensitive tool for evaluating the iron status is by measurement of serum ferritin. Hemoglobin concentration is relatively insensitive. REF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 623", "role": "assistant" } ]

[ { "content": "Which of the following is associated with the disease pathology seen in this child? \nSelect and explain. \nA. Leg length discrepancy, B. Airway involvement, C. Glaucoma, D. Growth hormone deficiency", "role": "user" }, { "content": "Answer: C \nExplanation: Child with right sided po-wine stain- seen in sturge weber syndrome. Features of sturge weber syndrome: S- Seizure T- Trigeminal distribution of po wine stain U- Unilateral weakness R- Retardation( mental retardation) G-Glaucoma E- Buphthalamos here, glaucoma is associated with surface ocular vascular malformations .", "role": "assistant" } ]

[ { "content": "Self etching primers \nSelect and explain. \nA. Simultaneously etch and prime dentin and enamel, B. Etches enamel only, C. Only bonds to enamel, D. Only removes smear layer", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Patient came with hydrops and scarring of cornea. What would be the treatment modality you would opt for him: \nSelect and explain. \nA. Penetrating Keratoplasty, B. Endothelial lamellar Keratoplasty, C. Deep anterior lamellar keratoplasty, D. Collagen cross linking", "role": "user" }, { "content": "Answer: A \nExplanation: Penetrating keratoplasty has to be done in cases of deep corneal scar or hydrops. SURGICAL MODALITIES FOR KERATOCONUS Keratoplasty for Keratoconus DALK (deep anterior Lamellar keratoplasty): when > 1/2 of stroma is involved. ALTK (Anterior lamellar therapeutic keratoplasty) : When less than 1/2 of stroma is involved. Penetrating Keratoplasty: When full thickness of cornea is involved as in hydrops with scar. INTRASTROMAL CORNEAL RING SEGMENTS Reduce corneal steepening Made of PMMA. Femtolaser is used to make tunnel in cornea. Used in Pellucid Marginal Degeneration, post LASIK ectasia and keratoconus.", "role": "assistant" } ]

[ { "content": "Incubation period of Mumps - \nSelect and explain. \nA. 4-5 days, B. 7-15 days, C. 12-24 days, D. 50 days", "role": "user" }, { "content": "Answer: C \nExplanation: Incubation period of mumps varies from 2 to 4 weks, usually 14- 18 days Reference : Park&;s Textbook of preventive and social medicine, 24th edition.Pg no.162", "role": "assistant" } ]

[ { "content": "Drainage of venous blood from testes following division of testicular vein for treatment of varicocele is by: March 2009 \nSelect and explain. \nA. Cremasteric vein, B. Dorsal vein of penis, C. Internal pudendal vein, D. Pampiniform plexus", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A: Cremasteric veinVaricocelectomy, the surgical correction of a varicocele, is performed on an outpatient basis.The three most common approaches are inguinal (groin), retroperitoneal (abdominal), and infrainguinal/subinguinal (below the groin).Possible complications of this procedure include hematoma (bleeding into tissues), infection, or injury to the scrotal tissue or structures.In addition, injury to the aery that supplies the testicle may occur.An alternative to surgery is embolization, a non-invasive treatment for varicocele.Embolization is an effective treatment for post-surgical varicoceles.", "role": "assistant" } ]

[ { "content": "In Moore's classification of omphalocole (examphalos), type I umbilical defect is less than ________ cm. \nSelect and explain. \nA. 0.5, B. 2.5, C. 3.5, D. 4.5", "role": "user" }, { "content": "Answer: B \nExplanation: Moore suggested a classification of omphalocele into types 1, 2 and 3 with the diameters of < 2.5 cm, 2.5 to 5 cm and > 5 cm respectively.", "role": "assistant" } ]

[ { "content": "A patient with fibrous dysplasia can be treated by \nSelect and explain. \nA. Surgical excision, B. Removal of adjacent teeth, C. Irradiation of the Lesion, D. Conservative surgery", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Lyme disease is transmitted by - \nSelect and explain. \nA. Rat flea, B. Tick, C. Mite, D. None", "role": "user" }, { "content": "Answer: B \nExplanation: Hard ticks transmit the following disease Tick typhus Viral encephalitis Viral fever Viral hemorrhagic fever Tularemia KFD Tick paralysis Human babesiosis Soft tick transmits Q fever Relapsing fever KFD(outside India) Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 840", "role": "assistant" } ]

[ { "content": "A 35-year-old woman, on hemodialysis for chronic renal disease, complains of pain in the hands. On examination, the joints are normal with no inflammation or tenderness on palpation. Lab values reveal a low calcium, high phosphate, and high PTH level. What is the most likely diagnosis? (See Figure below.) \nSelect and explain. \nA. scleroderma, B. gout, C. secondary hyperparathyroidism, D. pseudogout", "role": "user" }, { "content": "Answer: C \nExplanation: The diagnosis is secondary hyperparathyroidism as a consequence of the chronic renal disease. Calcium deposits are seen in the periarticular areas of the fourth and fifth metacarpophalangeal, third proximal interphalangeal, and fourth distal interphalangeal joints. There is slight soft tissue swelling, especially, of the fourth and fifth metacarpophalangeal joints. Calcification in scleroderma is subcutaneous in location. In gout if monosodium urate is deposited it could appear as a soft tissue mass.", "role": "assistant" } ]

[ { "content": "Hyaline in islets of Langerhans resemble - \nSelect and explain. \nA. Mucin, B. Amyloid, C. Glycolipid, D. Phospholipid", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Emphysema aquosum is associated with? \nSelect and explain. \nA. Dry drowning, B. Wet drowning, C. Immersion syndrome, D. Secondary drowning", "role": "user" }, { "content": "Answer: B \nExplanation: Emphysema aquosum is a sign of wet drowning. Drowning fluid actually penetrates alveolar walls to enter the tissues and the blood vessels. This has been described as emphysema aquosum. Cause of death in wet drowning: Disruption of pulmonary surfactant Dry drowning: Water does not enter the lungs, but death results from: Immediate sustained laryngeal spasm Cardiac arrest due to vagal inhibition", "role": "assistant" } ]

[ { "content": "Fosphenytoin different from phenytoin in which of the following- \nSelect and explain. \nA. Can be used in absence seizures, B. Can be mixed with saline, C. Can be given orally, D. It is the drug of choice for myoclonic seizures", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Can be mixed with saline o While phenytoin cannot be injected in a drip of glucose solution, fosphenytoin can be injected with saline and glucose.", "role": "assistant" } ]

[ { "content": "Macrocytic anemia is seen in all EXCEPT - \nSelect and explain. \nA. Vitamin B12 deficiency, B. Hemolytic anemia, C. Post hemorrhagic anemia, D. Anemia of chronic disease", "role": "user" }, { "content": "Answer: C \nExplanation: Robbins basic pathology 8th edition, page no 423, Answer is option3, post hemorrhagic anemia Post Hemorrhagic anemia is normocytic and normochromic. With chronic blood loss, iron stores are gradually depleted. Iron is essential for hemoglobin synthesis and effective eeythropoiesis, and it's deficiency thus leads to chronic anemia of underproduction.", "role": "assistant" } ]

[ { "content": "Chyluria is due to- \nSelect and explain. \nA. Carcinoma, B. Tuberculosis, C. Filaria, D. Malaria", "role": "user" }, { "content": "Answer: C \nExplanation: The most common presentations of the lymphatic filariases are asymptomatic (or subclinical) microfilaremia, hydrocele , acute adenolymphangitis (ADL), and chronic lymphatic disease. If there is obstruction of the retroperitoneal lymphatics, increased renal lymphatic pressure leads to rupture of the renal lymphatics and the development of chyluria, which is usually intermittent and most prominent in the morning. (Harrison's Principles of internal medicine, 20th edition, page 1747)", "role": "assistant" } ]

[ { "content": "Which of the following is true about pathophysiology of skeletal fluorosis? \nSelect and explain. \nA. Fluorine increases PTH levels by direct action, B. Fluoroappatite crystals are resistant to osteoclasts, C. Fluorine decreases vitamin D levels, D. Fluorine erodes bone, thereby decreasing bone density", "role": "user" }, { "content": "Answer: B \nExplanation: Fluorosis: Excessive deposition of fluorine occurs in bone and soft tissues. Fluorine stimulates osteoblastic activityand fluoroappatite crystals are laid down in bone which are resistant to osteoclastic resorption. This leads to calcium retention, impaired mineralization and secondary hyperparathyroidism. Interosseousmembrane ossification is a diagnostic radiological finding in skeletal fluorosis The characteristic pathology involves Sub-periosteal new bone formation, Osteosclerosis(Most commonly seen veebrae, ribs and pelvis) Hyperostosis at the bony attachments of ligaments, tendons and fascia.", "role": "assistant" } ]

[ { "content": "Patient is on Autocoids for 1 year now complains of severe pain Epigastrium relieved by antacid drugs. He complaints of Right Iliac fossa pain and loss of liver dullness. Diagnosis is: \nSelect and explain. \nA. Perforation of duodenum, B. Diverticulitis, C. Gastroenteritis, D. Enteric perforation", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. (a) Perforation of duodenum* This is a clear-cut case of drug induced ulcer and perforation - Duodenal ulcer perforation* Features are diffuse abdominal pain with right iliac fossa pain due to tracking of pus in right colic gutter - Valentino Syndrome* Obliteration of liver dullness* Board like rigidity", "role": "assistant" } ]

[ { "content": "Upon contact between the sperm head and the zona pellucida, penetration of the sperm into the egg is allowed because of \nSelect and explain. \nA. The acrosome reaction, B. The zona reaction, C. The perivitelline space, D. Pronuclei formation", "role": "user" }, { "content": "Answer: A \nExplanation: .", "role": "assistant" } ]

[ { "content": "A person switches from high fat diet to low fat diet with compensatory increase in carbohydrates to maintain the same calories. Which of the following fat component will be increased ? \nSelect and explain. \nA. Chylomicron, B. VLDL, C. IDL, D. HDL", "role": "user" }, { "content": "Answer: B \nExplanation: As excess of carbohydrates are conveed to fat in the body (liver) which eventually gets packed into VLDL so, VLDL represents the amount of fat production in the body, or in other words, it also represent excess dietary carbohydrate intake. While Chylomicrons represents the externally taken fats. Function Lipoproteins Lipoprotein rich in triglyceride Lipoprotein with least electrophoretic mobility Transpoer of dietary (exogenous) triglycerides & Cholesterol Chylomicrons Transpoer of endogenous triglycerides VLDL Transpos endogenous Cholesterol from Liver to Peripheral tissue. LDL Lipoprotein rich in apolipoproteins Transpos excess Cholesterol from Peripheral tissue to Liver called as reverse cholesterol transpo HDL has the highest electrophoretic mobility and least lipid content. HDL paicles are the densest. On electrophoresis, HDL moves fahest on electrophoretic plate towards the anode. HDL Lipoprotein resembling plasminogen Lp(a)", "role": "assistant" } ]

[ { "content": "G-cells are present mostly in- G-cells are present mostly in- \nSelect and explain. \nA. Fundus, B. Cardia, C. Pyloric antrum, D. Body", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Pyloric antrum", "role": "assistant" } ]

[ { "content": "Which type of cells are prominently infiltrated in Rheumatoid arthritis? \nSelect and explain. \nA. B cells, B. T-cells, C. NK-cells, D. Both B & T Cells", "role": "user" }, { "content": "Answer: B \nExplanation: (B) T-cells[?]Role of T cells in RAoProminent T-cell infiltrate in RA synoviumoGenetic similarities between RA patients-Specific human leukocyte antigen (HLA)-DR genes - HLA DR4, DR14 and DR1oShared Epitope: The third hypervariable region of DR b chains, especially amino acids 70 through 74.oCD4+ T helper (Th) cells may initiate the autoimmune response in RA by reacting with an arthritogenic agent, perhaps microbial or a self-antigenoSynovial lining or intimal layer: Normally, this layer is only 1-3 cells thick. In RA, this lining is greatly hypertrophied (8-10 cells thick).oPrimary cell populations in this layer are fibroblasts and macrophages.", "role": "assistant" } ]

[ { "content": "Most common cause of isolated splenic metastasis is: \nSelect and explain. \nA. Carcinoma pancreas, B. Carcinoma stomach, C. Carcinoma ovary, D. Carcinoma cervix", "role": "user" }, { "content": "Answer: C \nExplanation: Causes of isolated splenic metastasis: Carcinoma Ovary (27%) > Colorectal carcinoma (26%) > Uterine cancer (17%) MC primary for metastasis of spleen: Malignant melanoma (30-50%) > Ca Breast (21%) > Ca lung (18%)", "role": "assistant" } ]

[ { "content": "Cellular oxidation is inhibited by : \nSelect and explain. \nA. Cyanide, B. Carbon dioxide, C. Chocolate, D. Carbonated beverages", "role": "user" }, { "content": "Answer: A \nExplanation: A i.e. Cyanide", "role": "assistant" } ]

[ { "content": "Which of the following includes the contents of the orbit \nSelect and explain. \nA. Orbital and bulbar fascia, B. Abducent nerve, C. Superior Ophthalmic Veins, D. All of the Above", "role": "user" }, { "content": "Answer: D \nExplanation: Content of Orbit:\n\nEyeball - Eyeball occupies anterior 1/3rd of orbit.\nFascia - Orbital and bulbar fascia.\nMuscles - Extraocular and intraocular muscles.\nVessels - Ophthalmic artery, superior and inferior ophthalmic veins and lymphatics.\nNerves - Optic, oculomotor, trochlear and abducent, branches of ophthalmic and maxillary nerves and sympathetic nerves.\nLacrimal gland.\nOrbital fat.", "role": "assistant" } ]

[ { "content": "Pulse pressure in severe aoic regurgitation is equal to- \nSelect and explain. \nA. 30-45mmHg, B. 45-60mmHg, C. 60-75 mmHg, D. 75-90 mm Hg", "role": "user" }, { "content": "Answer: D \nExplanation: Therefore, a defining characteristic of aoic regurgitation is an increase in aoic pulse pressure (systolic minus diastolic pressure). ... Early in the course of regurgitant aoic valve disease, there is a large increase in left ventricular end-diastolic pressure and left atrial pressure.pulse pressure usually between 75-90 mm/hg Ref Davidson 23rd edition pg 450", "role": "assistant" } ]

[ { "content": "Transplacental exchanges that take place are essential to the well being of the fetus. Which of those listed below is NOT a method? \nSelect and explain. \nA. Simple diffusion, B. Active transpo, C. Endocytosis, D. Exocytosis", "role": "user" }, { "content": "Answer: D \nExplanation: Placental exchanges that take place occur according to different mechanisms. Simple diffusion is the movement of molecules of gas and water from a high concentration to a low concentration. Iodine readily crosses the placental barrier. Active transpo is another method. This method transpos specific molecules across a membrane or against a concentration gradient which requires energy (ATP) (i. e. Ca++, Na +, and K+). Endocytosis is the method by which the macromolecules are captured by cell microvilli. Leakage is difficult to understand, but it has to do with the connections or like connections between fetal and maternal blood. Ref: Molina P.E. (2013). Chapter 9. Female Reproductive System. In P.E. Molina (Ed), Endocrine Physiology, 4e.", "role": "assistant" } ]

[ { "content": "Superficial inguinal lymph nodes drain from all of the following except: \nSelect and explain. \nA. Urethra, B. Anal canal below the pectinate line, C. Glans penis, D. Perineum", "role": "user" }, { "content": "Answer: C \nExplanation: Superficial Inguinal Lymph NodesThe horizontal groupThe medial members of the group receive superficial lymph vessels from the anterior abdominal wall below the level of the umbilicus and from the perineum. The lymph vessels from the urethra, the external genitalia of both sexes (but not the testes), and the lower half of the anal canal are drained by this route.The lateral members of the group receive superficial lymph vessels from the back below the level of the iliac crests.The veical group lies along the terminal pa of the great saphenous vein and receives most of the superficial lymph vessels of the lower limb.The efferent lymph vessels from the superficial inguinal nodes pass through the saphenous opening in the deep fascia and join the deep inguinal nodes.Deep Inguinal Lymph NodesThe deep nodes are located beneath the deep fascia and lie along the medial side of the femoral vein; the efferent vessels from these nodes enter the abdomen by passing through the femoral canal to lymph nodes along the external iliac aery Lymphatic Drainage of the PenisFrom most of the penis, lymph drains into the superficial inguinal lymph nodes.Vessels from the glans penis drain into the deep inguinal lymph nodes.", "role": "assistant" } ]

[ { "content": "Which of the following anticancer drug can cause flagellated dermatitis? \nSelect and explain. \nA. Cisplatin, B. L-asparginase, C. Doxorubicin, D. Bleomycin", "role": "user" }, { "content": "Answer: D \nExplanation: FLAGELLATED DERMATITIS: It is characterised by pruritic, erythematous, linear streaks that resemble whiplash marks, hence the name flagellated. Bleomycin is metabolized by an enzyme hydrolase. This enzyme is deficient in skin and lungs. Therefore, the major adverse effects of bleomycin is related to skin (flagellated dermatitis) and lungs (pulmonary fibrosis) OTHER CAUSES OF FLAGELLATED DERMATITIS: DRUGS: BLEOMYCIN, DOCETAXEL, BENDAMUSTINE RHEUMATOLOGICAL CAUSES: DERMATOMYOSITIS, ADULT ONSET STILL'S DISEASE TOXINS: SHIITAKE MUSHROOMS", "role": "assistant" } ]

[ { "content": "Hypoplastic defects in permanent central and lateral incisors are likely to result due to severe illness or other factors during: \nSelect and explain. \nA. First nine months of life, B. First two years of life, C. First month of life, D. Two or three years of life", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "The commonest cranial nerve involved in acoustic neuroma is: \nSelect and explain. \nA. IX, B. VI, C. VIII, D. X", "role": "user" }, { "content": "Answer: C \nExplanation: As the eighth nerve schwannoma grows, it extends into the posterior fossa to occupy the angle between the cerebellum and pons (cerebellopontine angle). In this lateral position, it is so situated as to compress the seventh, fifth, and less often the ninth and tenth cranial nerves, which are implicated in various combinations. Later it displaces and compresses the pons and lateral medulla and obstructs the CSF circulation.", "role": "assistant" } ]

[ { "content": "The first case introduced into the population group to be studied is called: \nSelect and explain. \nA. Index case, B. Primary case, C. Initial case, D. Reference case", "role": "user" }, { "content": "Answer: B \nExplanation: Ans: b (Primary case) Ref: Park, 19th ed, p. 90The term primary case refers to the first case of a communicable disease introduced into the population unit being studied.The term index case refers to the first case to come to the attention of the investigator; it is not always the primary case. Secondary cases are those developing from contact with primary case.", "role": "assistant" } ]

[ { "content": "Long thyroid stimulating agent is \nSelect and explain. \nA. Antibody to thyroid globulin, B. Antibody to thyroid cell receptors, C. Antibody to thyroxine, D. Antibody to thyroid cells", "role": "user" }, { "content": "Answer: B \nExplanation: Answer is option 2, antibody to thyroid receptors. Thyrotropin receptor (TSHR) antibodies that stimulate the thyroid (TSAb) cause Graves' hypehyroidism and TSHR antibodies which block thyrotropin action (TBAb) are occasionally responsible for hypothyroidism. Unusual patients switch from TSAb to TBAb (or vice versa) with concomitant thyroid function changes. We have examined case repos to obtain insight into the basis for \"switching.\"", "role": "assistant" } ]

[ { "content": "Pungent volatile anesthetic agents are: \nSelect and explain. \nA. Halthane, B. Isoflurane, C. Sevoflurane, D. Desflurane", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Isoflurane", "role": "assistant" } ]

[ { "content": "What are the minimum and maximum possible values of Glasgow Coma Score? \nSelect and explain. \nA. Minimum = 3, Maximum = 15, B. Minimum = 0, Maximum = 13, C. Minimum = 0, Maximum = 15, D. Minimum = 3, Maximum = 18", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. a. Minimum = 3. Maximum = 15 (Ref: Harrison 19/e p1730, 18/e p3381-3382; Sabiston 19/e p1894; Schwartz 9/e p1522; Bailey 26/e p312. 25/e p301. 302)In Glasgow Coma Scale (GCS). maximum score is 15 and minimum score is 3.Glasgow Coma Scale (GCS)Eye OpeningVerbal responseBest Motor responseSpontaneous4Oriented5Obeys commands6To loud voice3Confused, disoriented4Localizes pain5To pain2Inappropriate words3Flexion (withdrawal) to pain)4No response1Incomprehensible sounds2Abnormal flexion posturing3 No response1Extension posturing2 No response1Maximum score-15Q. minimum score-3Q.Best predictor of outcome: Motor responseQPatients scoring 3 or 4 have an 85% chance of dying or remaining vegetative, while scores above 11 indicate only a 5-10% likelihood of deathQ", "role": "assistant" } ]

[ { "content": "Iron is absorbed in: March 2012 \nSelect and explain. \nA. Stomach, B. Duodenum, C. Ileum, D. Duodenum + Jejunum", "role": "user" }, { "content": "Answer: B \nExplanation: Ans: B i.e. DuodenumSite of absorptionStomach is the site of absorption of water and alcoholDuodenum is the site of absorption of iron and calciumIleum is the site of absorption of vitamin B12 and bile salt", "role": "assistant" } ]

[ { "content": "Falanga is - \nSelect and explain. \nA. Suspension by wrist, B. Beating of feet, C. Placing electric wires in vagina, D. Clamping of thighs between bamboos", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Beating of feet * Beating may be of following types -i) Falanga (Falolka/Baatinada) : Beating of soles of feet with blunt object.ii) Telefono : Simultaneous beating of both ears with palms.iii) Quirofana : Beating on abdomen while upper half of body lying unsupported on table.", "role": "assistant" } ]

[ { "content": "The most ideal explanation for recurrence of odontogenic keratocyst is \nSelect and explain. \nA. Increased mitotic activity of the epithelial lining, B. Friability of the epithelial lining, C. Presence of satellite cysts or daughter cysts, D. Continued proliferation of rests of dental lamina", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Cognitive model of depression is given by ? \nSelect and explain. \nA. Ellis, B. Beck, C. Godfrey, D. Meicheinbanon", "role": "user" }, { "content": "Answer: B \nExplanation: Beck Cognitive therapy is a psychotherapy developed by American pyschiatrist Aaron T. Beck. Cognitive therapy is one of the therapeutic approaches within the larger group of cognitive behavioural therapies. Cognitive therapy seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking, behaviour and emotional responses. This involves helping clients develop skills for modifying beliefs, identifying distoed thinkings, relative to others in different ways and changing behaviours. Treatment is based on collaboration between client and therapist and on testing beliefs. Therapy may consist of testing the assumptions which one makes and identifying how some of one's usually unquestioned thoughts are distoed, unrealistic and unhelpful. Once, those thoughts have been challenged, ones feelings about the subject matter of those thoughts are more easily subject to change. Beck initially focussed on depression and developed a list of errors in thought that he proposed could maintain depression, including arbitrary inference, selective abstraction, over generalization and magnification (of negatives) and minimization (of positives). According to Beck's theorey of the etiology of depression, depressed people acquire a negative view of the world in childhood and adolescence. Children and adolescent who suffer from depression acquire this negative view earlier. Depressed people acquire such view through a loss of a parent, rejection by peers, (criticism from teachers or parents, the depressive attitude and other negative events). When the person with such view encounters a situation that resembles the original conditions of the learned view in some way, even remotely, the negative views of the persons are activated. A simple example may illustrate the principle of how cognitive therapy works Having made a mistake at work, a person may believe \"I am useless and can't do anything right at work\". Strongly believing this then tends to worsen his mood. The problem may be worsened fuher if the individual reacts by avoiding activities and then behaviourally confirming the negative belief to himself. As a result, any adaptive response and fuher constructive consequences become unlikely, which reinforces the original belief of being useless. In therapy, the latter example could be identified as a self fulfilling prophecy or \"problem cycle\" and the effos of the therapist and client would be directed at working together to change it.", "role": "assistant" } ]

[ { "content": "A 22 years old man presents with a solitary 2 cm space occupying lesion of mixed echogenecity in the right lobe of the liver on USG. The rest of the liver is normal. Which of the following test should be done next? \nSelect and explain. \nA. Ultrasound guided biopsy of the lesion, B. Hepatic scintigraphy, C. Hepatic angiography, D. Contrast enhanced CT scan of the liver", "role": "user" }, { "content": "Answer: B \nExplanation: MRI as the diagnostic test of choice for hepatic hemangioma at most centers. Nuclear medicine studies may be used to confirm the diagnosis when a probable hemangioma is detected on ultra-sonography. Nuclear medicine studies may also help to clarify the nature of a lesion when the diagnosis is equivocal on CT or MRI. Percutaneous biopsy of a hepatic hemangioma carries an increased risk of hemorrhage. Liver biopsy is contraindicated in most circumstances where a hemangioma is high in the differential diagnosis of a hepatic mass. Hepatic angiography: The diagnostic accuracy of noninvasive tests has obted the need for hepatic aeriography in most cases.", "role": "assistant" } ]

[ { "content": "Dye used for myelography \nSelect and explain. \nA. Conray 320, B. Myodil, C. Dianosil, D. Iopaoic acid", "role": "user" }, { "content": "Answer: B \nExplanation: contrast agents used for myelography are : Iohexol Iopamidol Metrizamide Myodil", "role": "assistant" } ]

[ { "content": "Which is NOT pyrogenic Interleukin \nSelect and explain. \nA. IL-1, B. TNF-a, C. IL-4, D. IL-6", "role": "user" }, { "content": "Answer: C \nExplanation: (C) IL-4 # Pyrogenic cytokines: Known pyrogenic cytokines include IL-1, IL-6, TNF, ciliary neurotropic factor (CNTF), and interferon (INF)a. Others probably exist; although IL-18 - a membrane of the IL-1 family - does not appear to be pyrogenic cytokine. Each cytokine is encoded by a separate gene, and each pyrogenic cytokine has been shown to cause fever in laboratory animals and in humans. When injected into humans, IL-1, IL-6 and TNF produce fever at low doses (10 to 100 ng/kg).> Fever, characterized by an elevation of body temperature, usually by 1deg to 4degC, is one of the most prominent manifestations of the acute-phase response, especially when inflammation is caused by infection. Fever is produced in response to substances called pyrogens that act by stimulating prostaglandin (PG) synthesis in the vascular and perivascular cells of the hypothalamus. Bacterial products, such as lipopolysaccharide (LPS; called exogenous pyrogens), stimulate leukocytes to release cytokines such as IL-1 & TNF (called endogenous pyrogens) that increase the levels of cyclooxygenases that convert AA into prostaglandins. In the hypothalamus the PGs, especially PGE2, stimulate the production of neurotransmitters, which function to reset the temperature set point at a higher level. IL-4 is involved in immediate hypersensitivity reactions.", "role": "assistant" } ]

[ { "content": "A 45-year old male presented with severe respiratory distress. O/E he had pedal edema, bilateral crepitation on auscultation. He was admitted to emergency department and expired 2 days of admission. Lung biopsy done suggested the following. What is your diagnosis? \nSelect and explain. \nA. CMV pneumonitis, B. Small cell Ca lung, C. Tuberculosis, D. Heart failure cells", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. (d) Heart failure cellsThe lung biopsy shows intra-alveolar transudate granular pale pink material along with alveolar micro-hemorrhages & hemosiderin-laden macrophages (\"heart failure\" cells) seen in left-sided congestive heart failure.", "role": "assistant" } ]

[ { "content": "Murder is.............. offence. \nSelect and explain. \nA. Cognizable, non-compoundable and non-bailable, B. Cognizable, compoundable and bailable, C. Non-cognizable, non-compoundable and non-bailable, D. Non-cognizable, compoundable and bailable", "role": "user" }, { "content": "Answer: A \nExplanation: Ans: (a) Cognizable, non-compoundable and non-bailableRef: The First Schedule, Classification of Offences, Indian Penal CodeCognizable offencesCognizable offences are more serious crimes wherein police can arrest the suspect without any warrant.Ex. rape, murder, ragging, dowry death etc.Compoundable offencesCompoundable offences are those offences where, the complainant (one who has filed the case, i.e., the victim), enter into a compromise and agrees to have the charges dropped against the accused.Bailable offencesBailable offences are less serious crimes wherein the suspect can be released from custody by furnishing a bond on bail.", "role": "assistant" } ]

[ { "content": "In stage III ovarian cancer patient with upper abdominal disease < 5cm, management of choice is \nSelect and explain. \nA. Debulking surgery, B. Mantle cell irradiation, C. Abdomino-pelvic radiotherapy, D. Neo-adjuvant chemotherapy", "role": "user" }, { "content": "Answer: A \nExplanation: Management of Advanced stage diseaseIncludes stage III and IVDebulking surgery versus neoadjuvant chemotherapy followed by Postoperative chemotherapyPrimary cytoreduction surgery is the preferred in1. Retroperitoneal only disease preoperatively 2. Patients with stage IIIC or IV disease with good performance status who have < 5cm upper abdominal disease 3. Patients who are considered ideal for intraperitoneal chemotherapy if optimally reducedNeoadjuvant chemotherapy and interval debulking surgery is preferred in1. Patients with bulky upper abdominal peritoneal disease >5cm in diameter2. Medically unfit for surgeryPostoperative chemotherapySystemic chemotherapy with 6 cycles of carboplatin and paclitaxelPostoperative radiotherapy1. Not effective compared to chemotherapy2. Used clear cell or mucinous carcinomasMAINTENANCE THERAPY1. No role after the complete clinical response 2. Drugs used: 3month or 12month paclitaxel every 28days", "role": "assistant" } ]