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[ { "content": "During the following procedure, optimum interval between uterine incision and delivery should be less than ______ seconds. \nSelect and explain. \nA. 30 seconds, B. 45 seconds, C. 60 seconds, D. 90 seconds", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D 90 secondsRef: Datta, 8th ed. pg. 673The image shows LSCS being performed, with the head being delivered by hooking fingers carefully between the lower uterine flap. The head is delivered by elevation and flexion using the palm as fulcrum and the optimum time between the uterine incision and delivery should be less than 90 seconds.", "role": "assistant" } ]

[ { "content": "Ivermectin is indicated in all of the following except: \nSelect and explain. \nA. Ascaris, B. Filariasis, C. Malaria, D. Oncocerciasis", "role": "user" }, { "content": "Answer: C \nExplanation: Ans: C (Malaria) Ref: The Pharmacological basis of therapeutics by Goodman dc Gilman - 12th edition, page no. 1455-1456 & Malaria Journal 2013: 12:153Explanation:Ivermectin has a beneficial therapeutic effect inOnchocerciasisLvmphatic filariasisStrong lyloidiasisAscariasisEnterobiasis.Ivermectin is also effective in head lice infection, cutaneous larva migrans and scabiesIt does not have any proven beneficial effect in malaria.Since ivermectin can act on the GABA receptors in the CNS, it should be avoided in patients with meningitis and African trypanosomiasis that are associated with breached blood brain barrier.Ivermectin should not be given to pregnant and lactating women, children less than 5 years of age and severely ill patient.Note:However ivermectin has been recently found to have a beneficial effect in reducing the risk of malaria transmission by its vector control activity by targeting the anopheles mosquito.However this is still needs to be verified with the help of large studies. (Ref: Malaria Journal 2013; 12:153)", "role": "assistant" } ]

[ { "content": "Reinsch test is used in diagnosis of poisoning due to: UP 11; COMEDK 12 \nSelect and explain. \nA. Arsenic, B. Lead, C. Iron, D. Copper sulphate", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. Arsenic", "role": "assistant" } ]

[ { "content": "Groove sign is seen in – \nSelect and explain. \nA. Donovanosis, B. LGV, C. Chancroid, D. Genital herpes", "role": "user" }, { "content": "Answer: B \nExplanation: Groove sign of Greenblatt' is pathognomonic of LGV → when inguinal lymph nodes are enlarged, they are separated by Poupart's ligment, producing a groove.", "role": "assistant" } ]

[ { "content": "Drug of choice for absence seizures: March 2011 \nSelect and explain. \nA. Carbamazepine, B. Lamotrigine, C. Valproate, D. Phenytoin", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. C: Valproate Sodium valproate is effective in absence/petit-mal seizures, combined grand mal and petit mal, myoclonic epilepsy, paial epilepsy, maniac depressive psychosis and as a prophylactic in febrile convulsion Absence seizures/Petit mal seizures (from the French for \"little illness\", a term dating from the late 18th century). Absences seizures are brief (usually less than 20 seconds), generalized epileptic seizures of sudden onset and termination. They have 2 essential components: - Clinically the impairment of consciousness (absence) - EEG generalized spike-and-slow wave discharges Absence seizures are broadly divided in typical and atypical absence seizures. Typical absence seizures usually occur in the context of idiopathic generalised epilepsies and EEG shows fast >2.5 Hz generalised spike-wave discharges. Atypical absence seizures: - Occur only in the context of mainly severe symptomatic or cryptogenic epilepsies of children with learning difficulties who also suffer from frequent seizures of other types such as atonic, tonic and myoclonic - Onset and termination is not so abrupt and changes in tone are more pronounced - Ictal EEG is of slow less than 2.5 Hz spike and slow wave. - The discharge is heterogeneous, often asymmetrical and may include irregular spike and slow wave complexes, fast and other paroxysmal activity. - Background interictal EEG is usually abnormal. Treatment of patients with absence seizures only is mainly with sodium valproate or ethosuximide, which are of equal efficacy controlling absences in around 75% of patients. Sodium valproate as a single drug is the DOC if tonic clonic seizures are also present or emerge during the therapy with ethosuximide Lamotrigine monotherapy is less effective with nearly half of the patients becoming seizure free.", "role": "assistant" } ]

[ { "content": "Least common cause of pericarditis/pericardial effusion in children: \nSelect and explain. \nA. Rheumatic fever, B. Sarcoidosis, C. Rheumatoid arthritis, D. SLE", "role": "user" }, { "content": "Answer: B \nExplanation: b. Sarcoidosis(Ref: Nelson's 20/e p 2269-2271, Ghai 8/e p 433-443)Important causes of pericarditis/pericardial effusion in children:Infectious* Viral (Coxsackie virus B, EBV, Influenza, Adenovirus); Fungal (Histoplasmosis, Actinomycosis)* Bacterial (TB, Streptococcus, Pneumococcus, Staphylococcus, Meningococcus, Mycoplasma, Tularemia, Listeria, Leptospirosis)* Immune complex (Meningococcus, Hemophilus influenzae)* Parasitic (Toxoplasmosis, Echinococcosis) Connective tissue diseasesMetabolic-endocrineRheumatoid arthritisRheumatic feverSystemic lupus erythematosusSystemic sclerosisSarcoidosisWegener granulomatosisUremiaHypothyroidismChylopericardiumOut of the causes given in the options, Sarcoidosis is the least common.", "role": "assistant" } ]

[ { "content": "Actions of Bradykinin include all of the following, EXCEPT: \nSelect and explain. \nA. Vasodilatation, B. Bronchodilatation, C. Increased vascular permeability, D. Pain", "role": "user" }, { "content": "Answer: B \nExplanation: Kinins cause marked bronchoconstriction and not bronchodilatation. Their effect on other smooth muscles is not prominent. Ref: Essentials of Medical Pharmacology By KD Tripathi, 5th Edition, Pages 455 - 456; Textbook of Medical Physiology By Guyton and Hall, 10th Edition, Pages 181, 290, 399, 552, 725, 742.", "role": "assistant" } ]

[ { "content": "The lack of ability of an individual to do his routine activity is - \nSelect and explain. \nA. Disease, B. Impairement, C. Disability, D. Handicap", "role": "user" }, { "content": "Answer: C \nExplanation: Disability defined as lack of ability of an individual to do his routine activity Disease defined as a condition in which body health is impaired, a depaure from a state of health, an alteration of human body interupting the performance of vital functions Impairment is defined as any loss or abnormality of psychological, physiological,or anatomical structure or function Handicap defined as a disadvantage for a given individual,resulting from an impairment or disability , that limits or prevents the fulfilement of a role that is normal for that individual ref ;(page no;44) 23rd edition of PARK&;s textbook of Preventive and Social medicine", "role": "assistant" } ]

[ { "content": "Most common affected tissue in cysticercosis is: \nSelect and explain. \nA. Brain, B. Eye, C. Muscles, D. Liver", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c'Rarely neurocysticercosis happens and most common site is Parenchymal and associate with Ingestion of infected eggs of Taenia solium with food and water.", "role": "assistant" } ]

[ { "content": "A child is taken to a pediatrician because his mother notices that his eyes appear very puffy. The mother said that the boy's eyes appeared normal two days ago, and pa of what caused her concern was that her child seemed to be rapidly becoming ill. On physical examination, the boy is noted to have generalized edema. No hypeension or jaundice is noted. Blood urea nitrogen and serum creatinine are within normal limits. A urine sample is collected, and the nurse notices that the top of the urine has a small amount of foam at the top. Urinalysis is negative for glucose, red cells, white cells, casts, crystals, and bacteria. A 24-hr-urine specimen is collected, which demonstrates proteinuria of 55 mg/h/m2. Which of the following is the most likely diagnosis? \nSelect and explain. \nA. Acute renal failure, B. Chronic renal failure, C. Lower urinary tract disease, D. Nephrotic syndrome", "role": "user" }, { "content": "Answer: D \nExplanation: Proteinuria greater than 40 mg/h/m2 in a child or 3.5 g/d/1.73 m2 in an adult produces nephrotic syndrome, which is characterized by generalized edema, often most noticeable in the face. The condition develops when large amounts of protein are spilled through the glomeruli into the duct system of the kidneys. In contrast, nephritic syndrome is accompanied by lower levels of proteinuria, together with microscopic or macroscopic hematuria (red cells and blood in urine). Acute and chronic renal failure are characterized by rising serum levels of BUN and creatinine. The findings seen do not suggest lower urinary tract disease, which is typically due to a lower urinary tract infection (which would show bacteria and white cells), calculi (crystals would likely be present), or tumor (which would show abnormal bladder epithelial cells).", "role": "assistant" } ]

[ { "content": "Maximum regenerative capacity is of ? \nSelect and explain. \nA. Liver cells, B. Kidney cells, C. Intestinal epithelium, D. Neurons", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Intestinal epitheliumCells with good regenerative capacityi) Surface epithelium (stratified squamous) of skin, oral cavity, vagina and cervix.ii) Lining mucosa of all excretory ducts of glands (Salivary gland, pancreas, biliary duct).iii) Columinar epithelium of GIT (Intestinal mucosa) and uterus.iv) Transitional epithelium of the urinary tract.v) Bone marrow cells and hematopoietic cells.vi) Basal cells of epithelia.Cells with limited regenerative capacity i) Parenchymal cells of liver, kidney and pancreas.ii) Mesenchymal cells, e.g., fibroblast and smooth muscles.iii) Vascular endotheliumiv) Osteoblast, chondroblastv) Resting lymphocytes and other leukocytes.Cells with no regenerative capacity i) Neuronsii) Cardiac muscleiii) Skeletal muscle.", "role": "assistant" } ]

[ { "content": "Drugs used for anaesthesia in hypotensive is \nSelect and explain. \nA. Propofol, B. Ketamine, C. Thiopentone, D. None", "role": "user" }, { "content": "Answer: B \nExplanation: Ketamine raises the BP, therefore is the induction agent of choice in hypotensive states and shock.(Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)", "role": "assistant" } ]

[ { "content": "Syncytium formation is a propey of ? \nSelect and explain. \nA. Herpes virus, B. Adenovirus, C. Measles virus, D. Rabies virus", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Measles virus", "role": "assistant" } ]

[ { "content": "Which of the following is most common type of congential cardiac cyanotic anamoly? \nSelect and explain. \nA. Tetralogy of Fallot, B. TAPVC, C. Transposition of great vessels, D. Ebstein's Anamoly", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Tetralogy of Fallot o TOF is the commonest cyanotic congenital heart disease.", "role": "assistant" } ]

[ { "content": "The commonest cranial nerve palsy in tabes dorasalis is: \nSelect and explain. \nA. III nerve, B. IV nerve, C. VI nerve, D. Total ophthalmoplegia", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. III nerve", "role": "assistant" } ]

[ { "content": "The commonest cancer of oral cavity is \nSelect and explain. \nA. Adenocarcinoma, B. Melanoma, C. Sarcoma, D. Squaous cell carcinoma", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. (d) Squamous cell carcinomaRef: Devita 9th edition, page 729* Most common site oral Cancer: Carcinoma Tongue > Carcinoma Lip* Most common histological type: Squamous Cell Cancer* Most common site of oral Cancer in India: Cancer of Buccal Mucosa* Max Risk of L.N. Metastasis: Carcinoma Tongue* Min Risk of L.N Metastasis: Carcinoma lip > hard palate* Most common age: 50-60 years", "role": "assistant" } ]

[ { "content": "Point Prevalence is defined as- \nSelect and explain. \nA. Number of new cases at a given point of time, B. Number of new cases in a given year, C. Number of total cases in a given year, D. Number of total cases at a given point of time", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Number of total cases at a given point of time * Prevalence refers specifically to all current cases (old and new) existing at a given point in time or over a period of time in a given population.* Prevalence is of two types: (i) Point prevalence, and (ii) Period prevalencei) Point prevalence# Point prevalence is defined as the number of all current cases (old and new) of a disease at one point of time, in relation to a defined population.Point prevalence =No. of all current cases (old & new) of a specified disease existing at a given in time------------------------------------Estimated population at same point in timex 100# When the term prevalence rate is used, without any further qualification it is taken to mean \"point prevalence\"ii) Period prevalence# It measures the frequency of all current cases (old 8c new) existing during a defined period of time (e.g. annual prevalence) expressed in relation to a defined population.# It includes cases arising before but extending into or through to the year as well as those cases arising during the year.Period prevalence =No. of existing cases (old 8c new) of a specified disease during a given period oftime interval------------------------------------------Estimated - mid - interval population at riskx 100* Prevalence is a proportion.* Prevalence is determined by cross sectional study.", "role": "assistant" } ]

[ { "content": "In Post radical neck dissection shoulder syndrome, all are seen except: \nSelect and explain. \nA. Restricted range of movement, B. Pain, C. Shoulder drooping, D. Normal electromyographic finding", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e. Normal electromyographic finding In Radical neck dissections the most crippling complication is the \"Shoulder Syndrome\" arising from denervation and atrophy of the trapezius muscle due to sacrifice of the spinal accessory nerve (SAN).Shoulder syndrome is characterized by:inability to abduct the shoulder beyond 90 degrees cephaladlong standing pain in the shoulderdeformity of the shoulder girdle drooping of the shoulder and shoulder abduction, and external rotation", "role": "assistant" } ]

[ { "content": "Lysosomal transpo defect is seen in \nSelect and explain. \nA. Cystinosis, B. Goucher's disease, C. Metachromatic leukosytrophy, D. Tay Sach's disease", "role": "user" }, { "content": "Answer: A \nExplanation: Answer- A. CystinosisTwo disorders are caused by a proven defect in carrier-mediated transpo of metabolites: cystinosis end the group of sialic acid storage disorders (SASD).", "role": "assistant" } ]

[ { "content": "An 18-year-old man moves from sea level to an elevation of 2,400 m to train as a skier. The increased requirement for oxygen delivery to tissues at the higher elevation stimulates the synthesis of a renal hormone (erythropoietin), which targets hematopoietic stem cells in the bone marrow. Erythropoietin promotes the survival of early erythroid progenitor cells primarily through which of the following mechanisms? \nSelect and explain. \nA. Altered cell-matrix adhesion, B. Downregulation of p53, C. Enhanced glucose uptake, D. Inhibition of apoptosis", "role": "user" }, { "content": "Answer: D \nExplanation: - Recent studies indicate that erythropoietin promotes survival of early erythroid progenitor cells through inhibition of default apoptosis pathway. - Thus, this hormone rescues stem cells that are otherwise fated to undergo programmed cell death. - None of the other choices are known to control the expansion of hematopoietic stem cell colonies in bone marrow.", "role": "assistant" } ]

[ { "content": "Sunflower cataract is caused by \nSelect and explain. \nA. Siderosis, B. Chalcosis, C. Lead intoxication, D. Silicosis", "role": "user" }, { "content": "Answer: B \nExplanation: Chalcosis is copper alloy in the eye Refer: Khurana 6th edition page number 194", "role": "assistant" } ]

[ { "content": "Notochord develops from - \nSelect and explain. \nA. Epiblast cells, B. Hypoblast cells, C. Syncytiotrophoblasts, D. Cytotrophoblasts", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Epiblast cells o Notochord is a bud like structure formed by epiblast cells extending from cranial end of primitive streak to caudal end of prochordal plate, in between the ectoderm and endoderm.o Siginificances of notochord includes followingi) It defines the axis of embryoii) It functions as the primary inductor, inducing the overlying ectoderm to develop into neural plate (the primordium of CNS).iii) It serves as the basis for development of axial skeleton. The notochord is an intricate structure around which vertebral column is formed and indicates future site of vertebral bodies. However, the notochord does not give rise to vertebral column, after development of vertebral bodies, the notochord degenerates and disappears, but parts of it persist as the nucleus pulposus of intervertebral disc.", "role": "assistant" } ]

[ { "content": "Scalp and face are involved in ? \nSelect and explain. \nA. Adult scabies, B. Nodular scabies, C. Infantile scabies, D. None", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Infantile scabies Type Feature o Infantile scabies Scalp, face, palms and soles are involved o Norwegian scabies Crusted hyperkeratotic lesions on face , palms, soles, nails. Itching is not prominent. Mites are found in thousand, most severe form of scabies Crusted scabies Extensive crusts Nodular scabies Extensive crusts Genital scabies Extensive crusts Animal scabies History of contact with cat or dog. Atypical presentation", "role": "assistant" } ]

[ { "content": "False about Neurotic disorders \nSelect and explain. \nA. Aware of reality, B. Delusion absent, C. Hallucination absent, D. Loss of insight", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Dosage of Albendazole given as per National deworming program in <2years old child. \nSelect and explain. \nA. 200mg, B. 400mg, C. 500mg, D. 2 tablets of 400 mg", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Muscle forming anterior and posterior faucial folds of tonsillar fossa, respectively \nSelect and explain. \nA. Levator veli palatine-tensor veli palatine, B. Palatoglossus-palatopharyngeus, C. Palatopharyngeus-salpingopharyngeus, D. Styloglossus-stylopharyngeus", "role": "user" }, { "content": "Answer: B \nExplanation: Palatoglossus-palatopharyngeus form the boundary of the tonsillar fossaReference: Chaurasia; 6th edition", "role": "assistant" } ]

[ { "content": "GTT in pregnancy is indicated when if fasting blood sugar is above- \nSelect and explain. \nA. 80gm/100ml, B. 85gm/l00ml, C. 90gm/l00ml, D. 95gm/100ml", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., 95gm/100ml Indications of GITo Fasting glycosuria on one occasion before 20th week & 2 or more occasions thereafter,o Following a positive screening test.o If fasting blood sugar exceeds 95mg / 100ml or if that after 2 hours of ingestion of lOO'gm (WHO-75) glucose is more than 120mg/100ml.o However if plasma glucose value is 126mg / 100 ml or more & is confirmed on repeated test, there is no need to perform GTT as the woman is diabetic.", "role": "assistant" } ]

[ { "content": "Patient came with complaints of Polydipsia, hypercalciurea, nephrolithiasis, metabolic alkalosis. Possible cause is \nSelect and explain. \nA. Baters syndrome, B. Gittlemans syndrome, C. Addisons disease, D. Chronic diuretic use", "role": "user" }, { "content": "Answer: A \nExplanation: Answer- A. Baters syndromeBater syndrome is an autosomal recessive disorder caused by mutation in gene coding for basolateral chloride channel (ClC-kb). There is loss of sodium, chloride, potassium and calcium in urine.The major clinical findings are hyponatremia, hypokalemia, polyurea, polydipsia, metabolic alkalosis, normal to lowBP, hypomagnesemia (only in some patients), hypochloremia, hypercalciuria (causing nephrocalcinosis), and growth", "role": "assistant" } ]

[ { "content": "Clathrin is used in: \nSelect and explain. \nA. Receptor mediated endocytosis, B. Exocytosis, C. Cell adhesion, D. All", "role": "user" }, { "content": "Answer: A \nExplanation: Clathrin and megalin are associated with endocytosis Endocytosis is a vesicular transpo system, it is an active process", "role": "assistant" } ]

[ { "content": "Hockey stick appearance on echo is a feature of \nSelect and explain. \nA. Mitral stenosis, B. Mitral incompetence, C. Aoic stenosis, D. Aoic regurgitation", "role": "user" }, { "content": "Answer: A \nExplanation: Echocardiographic features of mitral stenosis:-Thickened and calcified mitral leaflets and subvalvular apparatus -Decreased E-F slope (M-mode)-Hockey stick appearance of the anterior mitral leaflet in diastole(long axis view)-Immobility of the posterior mitral leaflet (a similar appearance can be seen in hypereosinophilia or ergot use)-Fish mouth orifice in the sho axis view-Increased LA size, with the potential for thrombus formationDynamic CT: the Restricted opening of the thickened valve from commissural fusion (especially with rheumatic valve disease), valve calcification, or both results in a \"fish-mouth\" appearance on sho-axis images. Bowing of a thickened and fibrotic anterior leaflet during diastole may result in a \"hockey-stick\" appearance which is best seen on two- or four-chamber images(Ref: The echo manual by Jae K Oh; J B Seward; A Jamil Tajik, page no 202)", "role": "assistant" } ]

[ { "content": "All the following features our ventricular tachycardia as the cause of broad-complex tachycardia, except - \nSelect and explain. \nA. Fusion beats, B. Extreme left axis detion, C. Very broad QRS complexes, D. Response to carotid sinus massage", "role": "user" }, { "content": "Answer: C \nExplanation: Ventricular tachycardia can be classified based on its morphology: Monomorphic ventricular tachycardia means that the appearance of all the beats match each other in each lead of a surface electrocardiogram (ECG). Scar-related monomorphic ventricular tachycardia is the most common type and a frequent cause of death in patients having survived a hea attack, especially if they have weak hea muscle. RVOT tachycardia is a type of monomorphic ventricular tachycardia originating in the right ventricular outflow tract. RVOT morphology refers to the characteristic pattern of this type of tachycardia on an ECG. The source of the re-entry circuit can be identified by evaluating the morphology of the QRS complex in the V1 lead of a surface ECG. If the R wave is dominant (consistent with a right bundle branch block morphology), this indicates the origin of the VT is the left ventricle. Conversely, if the S wave is dominant (consistent with a left bundle branch block morphology, this is consistent with VT originating from the right ventricle or interventricular septum. Polymorphic ventricular tachycardia, on the other hand, has beat-to-beat variations in morphology. This may appear as a cyclical progressive change in cardiac axis, previously referred to by its French name torsades de pointes (\"twisting of the spikes\"). However, at the current time, the term torsades de pointes is reserved for polymorphic VT occurring in the context of a prolonged resting QT interval. Another way to classify ventricular tachycardias is the duration of the episodes: Three or more beats in a row on an ECG that originate from the ventricle at a rate of more than 120 beats per minute constitute a ventricular tachycardia Ref Harrison 20th edition pg 1423", "role": "assistant" } ]

[ { "content": "An elderly patient complains of recurrent episodes of amaurosis fugax. This is attributable to microembolization of which of the following? \nSelect and explain. \nA. Facial artery, B. Retinal artery, C. Occipital artery, D. Posterior auricular artery", "role": "user" }, { "content": "Answer: B \nExplanation: Amaurosis fugax, one type of TIA, is a manifestation of carotid bifurcation atherosclerotic disease. It is manifested by unilateral blindness, being described by the patient as a window shade across the eye, lasting for minutes or hours. It is caused by micro emboli from a carotid lesion lodging in the retinal artery, the first intracerebral branch of the internal carotid artery.", "role": "assistant" } ]

[ { "content": "A 44-year-old renal transplant patient develops severe cough and shortness of breath on exertion. On examination, he appears dyspneic, respirations 24/min, pulse 110/min, and oxygen saturation 88%. His lungs are clear on auscultation and heart sounds are normal. CXR shows bilateral diffuse perihilar infiltrates. Bronchoscopy and bronchial brushings show clusters of cysts that stain with methenamine silver. Which of the following is the most appropriate next step in management? \nSelect and explain. \nA. amphotericin B, B. cephalosporins, C. trimethoprim-sulfamethoxazole, D. aminoglycosides", "role": "user" }, { "content": "Answer: C \nExplanation: The patient is infected with Pneumocystis organisms invading an immunocompromised host. The treatment of choice is trimethoprim-sulfamethoxazole. Alternate therapies include pentamidine (highly toxic) and trimetrexate plus folinic acid.", "role": "assistant" } ]

[ { "content": "A 21yrs. old pt. attended a party the previous night and gives the following symptoms pain in abdomen radiating to back, pulse 100/ min, BP 100/76temp 39deg C and vomiting before coming Most probable dx is : \nSelect and explain. \nA. Acute appendicitis, B. Acute cholecystitis, C. Acute diverticulitis, D. Acute pancreatitis", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' ie Acute Pancreatitis * The signs and symptoms exhibited by the pt. correlate with that of acute pancreatitis, most characterstic of which is - Radiation of pain to back and party in previous night (ie. h/o alcohol)Other imp. diagnostic clue (not given in question) is- Relief from pain on sitting in upright posture.*Some imp, points about Acute PancreatitisEtiology - Gall stones (50 - 70% i.e. MC cause)*Alcohol (25%) OthersGrey Turner sign or Cullens sign* :Bleeding into the fascial planes in acute pancreatitis can cause 1 discolouration of - flanks* in Grey Turner sign*Mnemonic : Cullen's -Umbilicusumbilicus* in Cullens sign* Plain abdominal x-ray findings -include a sentinel loop*a colon cut off sign*a renal 'halo ' sign *", "role": "assistant" } ]

[ { "content": "Which of the following disease can be associated with sho QT interval on ECG ? \nSelect and explain. \nA. Chronic myeloid leukemia, B. Multiple myeloma, C. Chronic lymphocytic leukemia, D. Hodgkin's disease", "role": "user" }, { "content": "Answer: B \nExplanation: Sho QT syndrome (SQTS) is an inherited cardiac channelopathy characterised by an abnormally sho QT interval and increased risk for atrial and ventricular arrhythmias. Diagnosis is based on the evaluation of symptoms (syncope or cardiac arrest), family history and electrocardiogram (ECG) findings multiple myeloma shows sho QT interval Ref Harrison 20th edition pg 1534", "role": "assistant" } ]

[ { "content": "An indicator is said to valid if \nSelect and explain. \nA. It also measures the thing it didn't suppose to measure, B. It measures the thing it expected to measure, C. Over value when measured by different method, D. Under value when measured by different method", "role": "user" }, { "content": "Answer: B \nExplanation: Ans) b (It measures the thing.. ) Ref park 20th ed p 226The term validity refers to what extent the test accurately measures which it purports/ intended to measure.Validity expresses the ability of a test to separate or distinguish those who have the disease from those who do not have.Validity has two components - Sensitivity and specificitySensitivity and specificity together with \"predictive accuracy\" are inherent properties of a screening test.", "role": "assistant" } ]

[ { "content": "Presence of hemiplegia with diminution of vision in the contralateral eye suggests occlusion of: September 2012 \nSelect and explain. \nA. Middle cerebral aery, B. Basilar aery, C. Anterior cerebral aery, D. Internal carotid aery", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D i.e. Internal carotid aery", "role": "assistant" } ]

[ { "content": "In increased ICT, agent used for anesthesia \nSelect and explain. \nA. N20, B. Trilene, C. Ether, D. Isoflurane", "role": "user" }, { "content": "Answer: D \nExplanation: D i.e. Isoflurane", "role": "assistant" } ]

[ { "content": "Malignant cell in Hodgkin's lymphoma is \nSelect and explain. \nA. Reed stenberg cell, B. Lymphocytes, C. Histocytes, D. Reticulum cells", "role": "user" }, { "content": "Answer: A \nExplanation: Reed-Sternberg cells (also known as lacunar histiocytes for ceain types) are distinctive, giant cells found with light microscopy in biopsies from individuals with Hodgkin's lymphoma (a.k.a. Hodgkin's disease, a type of lymphoma). They are usually derived from ,B lymphocytes classically considered crippled germinal center B cells, meaning they have not undergone hypermutation to express their antibody. Seen against a sea of B cells, they give the tissue a moth-eaten appearance. Reed-Sternberg cells are large (30-50 microns) and are either multinucleated or have a bilobed nucleus with prominent eosinophilic inclusion-like nucleoli (thus resembling an \"owl's eye\" appearance)", "role": "assistant" } ]

[ { "content": "PR interval in ECG shows? \nSelect and explain. \nA. Ventricular depolarization, B. Ventricular Repolarization, C. Conduction through AV node., D. Atrial Repolarization", "role": "user" }, { "content": "Answer: C \nExplanation: Normal ECG waves and Intervals: ECG wave/Interval Characteristics 1. P Wave Reflects Atrial Depolarization (activation) 2. QRS complex Depolarization of ventricles 3. T Wave Repolarization of ventricles 4. PR Interval Atrial depolarization and conduction through AV node 5. QT Interval Total duration of Ventricular depolarization and repolarization 6. ST segment Plateau phase of ventricular action potential", "role": "assistant" } ]

[ { "content": "Which of the following is a radiolucent stone? \nSelect and explain. \nA. Uric acid, B. Oxalate, C. Cysteine, D. Triple phosphate", "role": "user" }, { "content": "Answer: A \nExplanation: Ans: a (Uric acid) Ref: Bailey and Love, 24th ed, p. 1317Pure uric acid stones are radiolucent and appear in an excretory urogram as filling defects.Uric acid stones if contain calcium, will cast a faint radiological shadow.Examples for radiolucent stones* Uric acid* Dihydroxy adenine* Orotic acid* Xanthine* Allopurinol* Triamterine and Indinavir induced stones.", "role": "assistant" } ]

[ { "content": "Pain of musculoskeletal origin is all except \nSelect and explain. \nA. MPDS, B. TMJ arthritis, C. Pos traumatic pain, D. Stylohyoid eagle’s syndrome", "role": "user" }, { "content": "Answer: C \nExplanation: Pain of musulo skeletal origin\n\nMPDS\nTMJ arthritis\nStylohyoid eagles’s syndrome", "role": "assistant" } ]

[ { "content": "Milk ejection is facilitated by:March 2007, March 2013 \nSelect and explain. \nA. Oxytocin, B. Growth hormone, C. FSH, D. LH", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A: OxytocinHormonal control of Breast development and secretion and ejection of milkProgesterone -- influences the growth in size of alveoli and lobes.Oestrogen -- stimulates the milk duct system to grow and become specific.Follicle stimulating hormoneLuteinizing hormoneProlactin -- contributes to the increased growth of the alveoli during pregnancy and formation of milkOxytocin -- oxytocin contracts the smooth muscle layer of band-like cells surrounding the alveoli to squeeze the newly-produced milk into the duct system. Oxytocin is necessary for the milk ejection reflex, or let-down to occur.Human placental lactogen (HPL) --This hormone appears to be associated with breast, nipple, and areola growth before bih.Colostrum contains higher amounts of white blood cells and antibodies than mature milk, and is especially high in immunoglobulin A (IgA), which coats the lining of the baby's immature intestines, and helps to prevent germs from invading the baby's system.", "role": "assistant" } ]

[ { "content": "Anterior spinal artery is a branch of \nSelect and explain. \nA. Internal carotid artery, B. Basilar artery, C. Vertebral artery, D. Labyrinthine artery", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Most common cause of decrease in incidence of H.pylori in the western countries is due to \nSelect and explain. \nA. Change in life style, B. Increased use of PPI, C. Chemotherapy, D. Mutation in organism", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Following a myocardial infarct, a 40-year-old man is being treated prophylactically with propranolol. You would be concerned about the use of this drug if the patient also had what comorbid condition \nSelect and explain. \nA. Glaucoma, B. Essential tremor, C. Diabetes, D. Supraventricular tachycardia", "role": "user" }, { "content": "Answer: C \nExplanation: Metabolic actions:- Propranolol inhibits glycogenolysis in hea, skeletal muscles and in liver, which occurs due to Adr release during hypoglycaemia--recovery from insulin action is delayed. Warning signs of hypoglycaemia mediated through sympathetic stimulation (tachycardia, tremor) are suppressed in patients taking beta blockers like propranolol, so it should be cautiously used in patients with diabetes. Ref:- kd tripathi; pg num:-145,146", "role": "assistant" } ]

[ { "content": "Which of the following describes Satyriasis? \nSelect and explain. \nA. Decreased sexual drive in male, B. Increased sexual drive in male, C. Decreased sexual drive in female, D. Increased sexual drive in female", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B. Increased sexual drive in male* Nymphomaniac: excessive sexual desire in females.* Satyriasis: excessive sexual desire in males", "role": "assistant" } ]

[ { "content": "Dose of Human anti-rabies immunoglobulin is \nSelect and explain. \nA. 10 IU/kg, B. 20 IU/kg, C. 30 IU/kg, D. 40 IU/kg", "role": "user" }, { "content": "Answer: B \nExplanation: Management guidelines for rabies apa from vaccination Anti Rabies Serum Horse Rabies serum: 40 IU/Kg on Day 0 (50% in wound, 50% I'M) Human Rabies Immunoglobulin : 20 IU/Kg (Maximum in wound, rest IM gluteal) (Concentration 150 IU/ml) Serum sickness with Horse serum : 15-45% Person under Antirabic Treatment should avoid Alcohol (during and 1 month after treatment) Undue physical and mental strain and late nights Coicosteroids and other immunosuppressive agents Intramuscular injections of cell culture and purified Duck Embryo Vaccines : Deltoid (Not in Buttocks) Rabies Vaccine dosages Intramusculae dose of Rabies Vaccine for post exposure prophylaxis: 1ml Intradermal dose of Rabies Vaccine for Post-exposure prophylaxis : 0.1 ml Intramuscular dose of Rabies Vaccine for Pre-Exposure prophylaxis : 1 ml Intradermal dose of Rabies Vaccine for Pre-Exposure prophylaxis : 0.1 ml Rabies Immunoglobulin Dosages Dose of Human Rabies Immunoglobulin (HRIg): 20 IU/Kg body wt Dose of Equine Rabies Immunoglobulin (ERIg) : 40 IU/Kg body wt Ref: Park 25th edition Pgno : 297-298", "role": "assistant" } ]

[ { "content": "Baroreceptors stimulation would result in \nSelect and explain. \nA. Inhibition of para sympathetic activity, B. Excitation of sympathetic activity, C. Increase in heart rate, D. Decrease in blood pressure", "role": "user" }, { "content": "Answer: D \nExplanation: Baroreceptor stimulation results in\n\nInhibition of sympathetic activity\nExcitation of parasympathetic activity\nDecrease in heart rate\nDecrease in blood pressure", "role": "assistant" } ]

[ { "content": "All are side effects of steroid EXCEPT \nSelect and explain. \nA. Skin atrophy, B. Telengectasia, C. Folliculitis, D. Photosensitivity", "role": "user" }, { "content": "Answer: D \nExplanation: Mineralocoicoids cause cause edema, hypokalemia, sodium and water retention. Glucocoicoid cause Cushing's habitus, fragile skin, telangiectasis, hirsutism, hyperglycemia, muscular weakness, susceptible to infection, osteoporosis, HTN, poor wound healing, thin arms due to muscle wasting (REF.Essential of medical pharmacology K D TRIPATHI 6 Edition, Page No - 286)", "role": "assistant" } ]

[ { "content": "Paul Bunnel test is done for? \nSelect and explain. \nA. HBV, B. EBV, C. CMV, D. HIV", "role": "user" }, { "content": "Answer: B \nExplanation: EBV REF: Textbook of Microbiology & Immunology by Parija 2009 Page 504 Heterophil antibodies, which is an antibody against EBV cross reacts with red blood cells of different animal species. This can be used as a rapid screening test for mononucleosis (Monospot test and Paul Bunnell tests) The Paul-Bunnell test uses sheep erythrocytes; the Monospot test, horse red cells.blood cells. In infectious mononucleosis, IgM heterophil antibodies are usually detectable for the first 3 months of infection.", "role": "assistant" } ]

[ { "content": "The largest trematode infecting masn is - \nSelect and explain. \nA. F. Hepatica, B. F. Buski, C. E. Granulosus, D. Clonorchis sinensis", "role": "user" }, { "content": "Answer: B \nExplanation: large or giant intestinal fluke Largest trematode infecting humans Pig serves as reservoir of infection (refer pgno:127 baveja 3 rd edition)", "role": "assistant" } ]

[ { "content": "True regarding respiratory centre \nSelect and explain. \nA. Directly simulated by fall in PaO2, B. Connected with cardiac center, C. Inhibited during swallowing, D. Situated in midbrain", "role": "user" }, { "content": "Answer: B \nExplanation: The respiratory center is located in the medulla oblongata and is involved in the minute-to-minute control of breathing. Unlike the cardiac system, respiratory rhythm is not produced by a homogeneous population of pacemaker cells Ref: guyton and hall textbook of medical physiology 12 edition page number: 371,372,373", "role": "assistant" } ]

[ { "content": "The occurrence of hyperthyroidism following administration of supplemental iodine to subjects with endemic iodine deficiency goitre is known as - \nSelect and explain. \nA. Jod-Basedow effect, B. Wolff-Chaikoff effect, C. Thyrotoxicosis factitia, D. De Quervain's thyroiditis", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Lymphadenopathy is seen is A/E \nSelect and explain. \nA. Syphlis 1st Stage, B. Donovanosis, C. LGV, D. Chancroid", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Donovanosis", "role": "assistant" } ]

[ { "content": "Fluconazole differs from ketoconazole in all the following except (REPEAT) \nSelect and explain. \nA. Route of administration, B. Metabolism inhibition, C. Anti androgenic side effects, D. Usage in candidiasis", "role": "user" }, { "content": "Answer: D \nExplanation: Ketoconazole and fluconazole both are used in candidiasisRef: KDT 6/e p 762", "role": "assistant" } ]

[ { "content": "Amount of chlorine needed to kill cyclops in drinking water is: September 2007 \nSelect and explain. \nA. 3 ppm, B. 4 ppm, C. 5 ppm, D. 6 ppm", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. C: 5 ppm Park's PSM, 21st ed., p- 723 states: Chlorine destroys cyclops and larvae of the guineaworm in a strength of 5 ppm Cyclops may be controlled by the use of the physical, chemical or biological methods: Physical methods - Straining - Boiling at 60 degree Celsius Chemical methods - Chlorine in a strength of 5 ppm - Lime - Abate Biological - Barbel fish and gambusia fish The most satisfactory and permanent method of controlling Cyclops in drinking water is to provide piped water supply or tube wells. Abolition of step wells and provision of sanitary wells should receive attention in rural areas.", "role": "assistant" } ]

[ { "content": "A 16 year old student reported for the evaluation of multiple hypopigmented macules on the trunk and limbs.All of the following tests are useful in making a diagnosis of leprosy, except – \nSelect and explain. \nA. Sensation testing, B. Lepromin test, C. Slit smears, D. Skin biopsy", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Type-1 hypersensitivity includes all of the following except: \nSelect and explain. \nA. Autoimmune hemolytic anemia, B. Anaphylaxis, C. Extrinsic asthma, D. Hay fever", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. (a) Autoimmune hemolytic anemia HSN involving blood components are usually Type II HSN.", "role": "assistant" } ]

[ { "content": "A 80 year old patient presents with a midline tumor of the lower jaw, involving the alveolar margin. He is edentulous. Rx of choice is: \nSelect and explain. \nA. Hemi mandibulectomy, B. Commando operation, C. Segmental mandiblectomy, D. Marginal mandibulectomy", "role": "user" }, { "content": "Answer: C \nExplanation: Segmental mandibulectomy recommended for alveolar lesions, tumors adherent to the mandible, or for radiographic evidence of bone involvement. Ref: Craniomaxillofacial Reconstructive and Corrective Bone Surgery: Principles of Internal Fixation By Alex M. Greenberg, Joachim Prein, 2002, page 411.", "role": "assistant" } ]

[ { "content": "Which of the following is not a derivative of amino acid tyrosine \nSelect and explain. \nA. Thyroxine, B. Melatonin, C. Melanin, D. Epinephrine", "role": "user" }, { "content": "Answer: B \nExplanation: Melatonin and serotonin are derivatives of Tryptophan.", "role": "assistant" } ]

[ { "content": "A 28 Years old white female presents with a 15-day history of malodorous vaginal discharge and pruritus. She reports that the smell is worse after intercourse and is accompanied by a white discharge. No significant medical or gynecological history. She is in a stable monogamous relationship and has never been pregnant. Which of the following diagnostic features is consistent with Bacterial vaginosis? \nSelect and explain. \nA. Vaginal fluid pH > 6, scanty secretions with increased para basal cells, B. Vaginal fluid pH > 4.5, presence of clue cells on the smear and fishy odor on KOH mount, C. Vaginal fluid pH > 4, presence of hyphae on KOH mount, D. Vaginal fluid pH > 5, motile trichomonads on microscopy", "role": "user" }, { "content": "Answer: B \nExplanation: Answer: b) Vaginal fluid pH > 4.5, presence of clue cells on the smear and fishy odor on KOH mountVAGINAL INFECTIONSDiagnosticCriteria Differential Diagnosis of Vaginal infectionsNormalBacterialvaginosisCandidiasisTrichomoniasisBacterial (strep, staph, E.coli)Vaginal pH3.8-4.2>4.5<4.5>4.5>4.5DischargeClear,FlocculentThin, gray or white, adherent HomogenousWhite, curdy, Cottage- Cheese likeYellow to green Frothy adherentPurulentAmine odor (KOH,\"whiff\" test)AbsentPresent(Fishy)AbsentAbsentAbsentMicroscopicLactobacilliClue cells, coccoid Bacteria, No WBCMycelia,buddingYeast,pseudohyphaeTrichomonads WBC> 10/hpfMany WBCsMain patient ComplaintsNoneDischarge, bad odour- possibly worse after intercourseltching\\burningdischargeFrothy discharge, bad odour, vulval pruritis, dysuria & multiple small punctuate strawberry spots on the vaginal vault and portio vaginalis of the cervix (strawberry vagina)Thin, watery discharge,pruritus", "role": "assistant" } ]

[ { "content": "Valvulae conniventes are seen in \nSelect and explain. \nA. Jejunum, B. Ileum, C. Stomach, D. Colon", "role": "user" }, { "content": "Answer: A \nExplanation: The valvulae conniventes, also known as Kerckring folds or plicae circulares, are the mucosal folds of the small intestine, staing from the second pa of the duodenum, they are large and thick at the jejunum and considerably decrease in size distally in the ileum to disappear entirely in the distal ileal bowel loops. p Ref - radiopedia.org", "role": "assistant" } ]

[ { "content": "A girl aged 20 yrs complains of headache while studying. Her vision is found to be normal. All\nof the following should be further evaluated except \nSelect and explain. \nA. Self worth, B. Family history of headache, C. Menstrual history, D. Her interest in studies", "role": "user" }, { "content": "Answer: A \nExplanation: Family h/o headache is important in any headache to rule out organic cause of headache. Menstrual history\nMenstrual history is important in any female presenting with headache to rule to premenstrual syndrome.\nDetailed menstrual history should be taken to find out headache is due to hormonal imbalance. Interest in studies\nThe patient might not be interested in studies. Studies might be acting as stressors and she must be faking headache to avoid it.\nSelf esteem Self-worth or self-esteem is analyzed to rule out depression.\nBut with depression, headache won’t only occur during studies, it would be pervasive.\nIt the self-esteem of the girl is low it won 7 only manifest during studies; it would affect all her performances.", "role": "assistant" } ]

[ { "content": "Congenital hypertrophic pyloric stenosis usually presents – \nSelect and explain. \nA. Within 2 days after birth, B. Around 1 week after birth, C. Around 2 weeks after birth, D. Around 2 months after birth", "role": "user" }, { "content": "Answer: C \nExplanation: The symptoms vomiting usually starts after 3 weeks of age but symptoms may develop as early as1st week of life and as late as 5 months of life. - Nelson\n\nCongenital hypertrophic pyloric stenosis\n\nHypertrophic pyloric stenosis is the commonest surgical disorder of the stomach during infancy.\nPylorus is thickened and elongated and its lumen is narrowed due to hypertrophy of circular muscle fibers of pylorus.\nMore common in boys.\nMore common in infants of blood group 'B' and 'O'.\nAssociated congenital defects are → Tracheoesophageal fistula and hypoplasia or agenesis of inferior labial frenulum.\nMay be associated with Turner syndrome, Trisomy 18.\nSymptoms are not present at birth.\nThe vomiting usually starts after 3 weeks of age.", "role": "assistant" } ]

[ { "content": "Prophylaxis against spontaneous bacterial peritonitis ( SBP) in case of cirrhosis with ascites is indicated in: \nSelect and explain. \nA. Patients with high protein ascites, B. Prior history of SBP, C. Serum creatinine 1 mg/dl, D. Child pugh < 8", "role": "user" }, { "content": "Answer: B \nExplanation: The risk factors for SBP are 1.Ascitic fluid protein < 1 g/dl 2.Variceal hemorrhage 3.Prior episode of SBP Acute variceal bleeding patients need prophylaxis against SBP & Drugs used for prophylaxis are: 1.Inj.Ceftriaxone 1 g/day 2. Oral. Ofloxacin 400 mg/day or Norfloxacin 400 OD Primary prophylaxis is indicated in patients with features of : Ascitic fluid protein < 1.5 g/dl With at least one of the following 1. Serum creatinine > 1.2 mg/dl 2. BUN > 25 mg/dl 3. Serum Na < 130 mEq/L 4. CTP > 9 points with bilirubin > 3 mg/dl 5. DRug is Norfloxacin 400 mg OD for long time. Ref: AASLD practice guidelines:Hepatology, Vol.49 ,No.6 ,2009.", "role": "assistant" } ]

[ { "content": "Radiation induced thyroid cancer is - \nSelect and explain. \nA. Papillary, B. Follicular, C. Anaplastic, D. Medullary", "role": "user" }, { "content": "Answer: A \nExplanation: Radiation-induced thyroid cancer Authors: Section Editors: Deputy Editor: INTRODUCTION Radiation exposure of the thyroid during childhood is the most clearly defined environmental factor associated with benign and malignant thyroid tumors. The risk of thyroid cancer following irradiation is related to radiation dose and age (greater for children exposed early in life), and the risk persists throughout life. Radiation exposure during childhood also increases the risk of benign thyroid nodules and hypothyroidism. The purpose of this topic is to review the evaluation of a patient with a history of childhood radiation exposure and how such a history affects treatment of patients with thyroid tumors. Radiation injury to other organs is reviewed separately. (See and .) RADIATION EXPOSURE Type of exposure -- Radiation exposure may be external or internal. *External - The predominant types of external radiation are diagnostic radiographs, therapeutic radiation for the treatment of cancer, and historical use of external radiation to treat a wide variety of nonmalignant conditions. External radiation also includes brachytherapy, whereby a sealed radiation source is placed adjacent to a treatment area. *Internal - Internal radiation exposure includes ingestion of foods or liquids contaminated with radioactivity or by inhalation of radioactive gases or paicles. Internal radiation occurs after exposure to nuclear fallout (from testing and accidents at operating nuclear power plants or above ground nuclear explosive testing) or after ingestion of radioiodine for diagnostic tests and for therapy of hypehyroidism.", "role": "assistant" } ]

[ { "content": "Significant value of `p' is ? \nSelect and explain. \nA. 0.01, B. 0.02, C. 0.04, D. 0.05", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., 0.05 P is the probability that the difference seen between 2 samples occurs due to chance\". If p . .05 it is considered statistically significant. It means that There is 5% probability that the result could have been obtained by chance. or The investigator can be 95% sure that the result was not obtained by chance.", "role": "assistant" } ]

[ { "content": "Complications of Colles' fracture are all except \nSelect and explain. \nA. Malunion, B. Non union, C. Sudeck's dystrophy, D. Rupture of extensor policis longus", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Nonunion", "role": "assistant" } ]

[ { "content": "Lecithin/Sphingomyelin ratio is done to assess the maturity of: \nSelect and explain. \nA. Lung, B. Fetal circulation, C. Brain, D. Gonad", "role": "user" }, { "content": "Answer: A \nExplanation: Ref: Cloherty's Manual of Newborn Care. 6th edition, Page 323Explanation:THE LECITHIN -SPHINGOMYELIN (L/S) RATIOAssessment of fetal lung maturity (FLM) prenatally by testing amniotic fluid obtained by amniocentesis.It is performed by thin-layer chromatography.The risk of RDS is very low if the L/S ratio is >2.Exceptions to L/S ratio >2 are:o Infants of diabetic mothers (IDMs)o Intrapartum asphyxiao Erythroblastosis fetalis.Other possible exceptions are intrauterine growth restriction (IUGR), abruptio placentae, preeclampsia and hydrops fetalis.Blood and meconium tend to elevate an immature L/S ratio and depress a mature L/S ratio.OTHER METHODSThe TDx-FLM 11 measures the surfactant- albumin ratio.Measured using fluorescent polarization technology.A value of >45 mg/g indicates maturity.Lamellar body counts in the amniotic fluid.Lamellar bodies are '\"packages\" of phospholipids produced by type II alveolar cells.A count of >50,000 lamellar bodies/microliter predicted lung maturity.", "role": "assistant" } ]

[ { "content": "One of the following activities is not mediated through β2 adrenergic receptors: \nSelect and explain. \nA. Stimulation of lipolysis, B. Increased hepatic gluconeogenesis, C. Increased muscle glycogenolysis, D. Smooth muscle relaxation", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "At which level sound is painful - \nSelect and explain. \nA. 100-120dB, B. 80-85dB, C. 60-65dB, D. 20-25dB", "role": "user" }, { "content": "Answer: A \nExplanation: Intensity\n\nWhisper - 30 dB\nNormal conversation - 60 dB\nShout - 90 dB\nDiscomfort of ear - 120 dB\nPain in ear -130 dB\n\nRef. Dhingra, 6/e, p 19", "role": "assistant" } ]

[ { "content": "All of the following are included as causes of maternal death except - \nSelect and explain. \nA. Following aboion, B. During lactation 1 st month (Puerperal), C. During lactation 8th month, D. During the last trimester due to APH", "role": "user" }, { "content": "Answer: C \nExplanation: Maternal moality rate is total no.of female deaths due to complications of pregnancy,childbihor within 42 days of delivery from puerpeural causes.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-514", "role": "assistant" } ]

[ { "content": "Trypsinogen to trypsin is conveed by \nSelect and explain. \nA. Enteropeptidase, B. Acidic pH, C. Elastase, D. None", "role": "user" }, { "content": "Answer: A \nExplanation: Trypsin, a proteinase, is secreted as an inactive zymogen form trypsinogen, which is activated to form active Trypsin, which has strong proteolytic activity and an inactive hexapeptide which is produced and liberated during the process of activation. Activation is brought about by * A glycoprotein enzyme called as enterokinase of the intestinal juice at a pH of 5.5 * Also by trypsin itself once it is formed, autocatalytically, at a pH of 7.9. *C a++ also is required for the activation. In the process of activation, the \"active site\" of the enzyme trypsin, which is histidylserine residue is unmasked. Hence trypsin belongs to the group of serine proteases. Trypsin acts in an alkaline medium pH 8 to 9 (optimum pH-7.9) and has low Michaelis constant.Ref: Textbook of medical biochemistry, MN Chatterji, 8th edition, page no: 464", "role": "assistant" } ]

[ { "content": "Which of the following is used to represent continuous (quantitative) data ? \nSelect and explain. \nA. Bar diagram, B. Pie cha, C. Histogram, D. Map diagram", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is `c' i.e., Histogram", "role": "assistant" } ]

[ { "content": "What is the most probable poal of entry for Aspergillus \nSelect and explain. \nA. Puncture wound, B. Blood, C. Lungs, D. Gastrointestinal tract", "role": "user" }, { "content": "Answer: C \nExplanation: Aspergillosis is caused by the inhalation of Aspergillus conidia or mycelial fragments which are present in the decaying matter, soil or air, resulting in aspergillus asthma, bronchopulmonary aspergillosis and aspergilloma. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition", "role": "assistant" } ]

[ { "content": "Obstruction to the flow of CSF at the aqueduct of Sylvius will most likely lead to enlargement of - \nSelect and explain. \nA. All of the ventricles, B. Only lateral ventricle, C. Only fourth ventricle, D. Both lateral and third ventricles", "role": "user" }, { "content": "Answer: D \nExplanation: CSF is produced by choroid plexus in the lateral and III ventricles. Then it flows through the aqueduct of Sylvius into the 4th ventricle and from there into the subarachnoid space to be absorbed by the arachnoid\nObviously, any obstruction in the aqueduct of Sylvius will lead to enlargement of the proximal ventricles (i.e. both lateral and IIIrd ventricles).", "role": "assistant" } ]

[ { "content": "Dinner fork deformity is seen in - \nSelect and explain. \nA. Colies fracture, B. Supracondylar fracture of Humerus, C. Smith's fracture, D. Volar Barton Fracture", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Colles fracture DeformityAssociated fracture / conditionGarden Spade DeformitySmiths FractureGun stock deformityCubitus varus commonly due supracondylar humerus fractureDinner fork deformityColles FractureGenu VarumBlounts disease", "role": "assistant" } ]

[ { "content": "Ministry covering ESI: \nSelect and explain. \nA. Ministry of health, B. Ministry of Home, C. Ministry of Human Resource Development, D. Ministry of Labour", "role": "user" }, { "content": "Answer: D \nExplanation: ESI act is an impoant measure of social security and health insurance in India. Administration: The Union Ministry of Labour is the Chairman of ESI corporation. Secretary to Govt. of India Ministry of Labour is Vice-Chairman of ESI.", "role": "assistant" } ]

[ { "content": "A 22yrs female was admitted in emergency with c/o nausea, vomiting, and watery diarrhoea since 4 days. He is also having low grade fever. He was hospitalised and treated symptomatically and was being relieved and discharged. His blood samples were sent for culture; repos of which pt. brought during his follow up - which showed the presence of clostridium perfringens. Being his physician what should be your next instruction to such patient - \nSelect and explain. \nA. IV penicillin therapy plus colonoscopy., B. Return for blood culture., C. Return for IV penicillin therapy., D. IV penicillin therapy plus echocardiography.", "role": "user" }, { "content": "Answer: C \nExplanation: Clostridia Spore bearing, obligate anaerobes and gram positive organisms. Reside normally in GI tract; although they have the propensity to cause fulminant bacteremia, but it is rare. In this question, pt. is well after an acute episode of illness; rules out fulminant course. So, a transient self-limited bacteraemia due to transient gut translocation could occur mostly during an episode of gastroenteritis and doesn't require treatment and fuher workup. So, among the given options returning for penicillin therapy is the best answer.", "role": "assistant" } ]

[ { "content": "Leukocytoclastic vasculitis as an extrahepatic manifestation is noticed in: \nSelect and explain. \nA. Chronic hepatitis B, B. Chronic Hepatitis C, C. Autoimmune hepatitis, D. Wilson's disease", "role": "user" }, { "content": "Answer: A \nExplanation: Extrahepatic complications of chronic hepatitis B Extrahepatic complications of chronic hepatitis B, is associated with deposition of circulating hepatitis B antigen-antibody immune complexes. They are; Ahralgias and ahritis - common, Purpuric cutaneous lesions (leukocytoclastic vasculitis) - Rare Immune-complex glomerulonephritis Generalized vasculitis (polyaeritis nodosa) Ref: Harrison, Edition-18, Page-2568.", "role": "assistant" } ]

[ { "content": "An antihelmenthic drug that is effective against blood fluke, liver fluke, lung fluke and cysticercus is: \nSelect and explain. \nA. Albendazole, B. Praziquantal, C. Ivermectin, D. Thiabendazole", "role": "user" }, { "content": "Answer: B \nExplanation: - Drug of choice for treatment of flukes (except liver fluke) and tapeworms (except dog tapeworm) is praziquantal. - Drug of choice for treatment of liver fluke is triclabendazole. - Drug of choice for dog tapeworm (Echinococcus) is albendazole - Drug of choice for all nematodes (see exceptions below) is albendazole - Drug of choice for treatment of filariasis is diethylcarbamezine. - Drug of choice for treatment of onchocerca and strongyloides is ivermectin.", "role": "assistant" } ]

[ { "content": "All of the following are good prognostic factors for childhood Acute Lymphoblastic Leukemia, except: \nSelect and explain. \nA. Hyperdiploidy, B. Female sex, C. Pre B cell ALL, D. t (12 : 21) translocation", "role": "user" }, { "content": "Answer: D \nExplanation: Hyperdiploidy, Female sex and pre B cell ALL are associated with good prognosis. t (12 : 21) translocation may be associated with a poor prognosis and is the single answer of exclusion. Ref: Pediatric Oncology: A Comprehensive Guide By Paul Imbach, Thomas R. Kuhne, Robe Arceci, 2004, page 23.", "role": "assistant" } ]

[ { "content": "Radiological feature of Mitral stenosis is are \nSelect and explain. \nA. Double contour of right hea border, B. Straightening of left hea border, C. Splaying of carinal angle, D. All", "role": "user" }, { "content": "Answer: D \nExplanation: A, B, C i.e. Double contour of right hea border, Straightening of left hea border, Splaying of carinal angle", "role": "assistant" } ]

[ { "content": "Which of the following hormone doesn't use the adenylyl cyclase-cAMP as a second messenger ? \nSelect and explain. \nA. TSH, B. Epinephrine, C. Insulin, D. Glucagon", "role": "user" }, { "content": "Answer: C \nExplanation: Hormones That Use the Adenylyl Cyclase-cAMP as Second Messenger System Adrenocoicotropic hormone (ACTH) Angiotensin II (epithelial cells) Calcitonin Catecholamines (b receptors) Coicotropin releasing hormone (CRH) Follicle-stimulating hormone (FSH) Glucagon Growth hormone releasing hormone (GHRH) Human chorionic gonadotropin (hCG) Luteinizing hormone (LH) Parathyroid hormone (PTH) Secretin Somatostatin Thyroid-stimulating hormone (TSH) Vasopressin (V2 receptor, epithelial cells) Insulin acts on tyrosine kinase receptor pathway.", "role": "assistant" } ]

[ { "content": "A 3 years old boy presented with fever with pain in the throat and difficulty in deglutition. On examination following findings are seen. What is the most likely diagnosis? \nSelect and explain. \nA. Peritonsillar abscess, B. Parapharyngeal abscess, C. Ludwig's angina, D. Retropharyngeal abscess", "role": "user" }, { "content": "Answer: A \nExplanation: PERITONSILLAR ABSCESS(QUINSY) Collection of pus between the fibrous capsule of the tonsil, and the superior constrictor muscle of the pharynx. Condition is generally unilateral. Tonsil is swollen, red, hot & congested. Uvula and soft palate are pushed to opposite side. Uvula Points towards Normal side as shown in the image. Organism involved are Streptococcus, Staph aureus, anaerobic organism, more often mixed growth is seen. Parapharyngeal abscess (abscess of lateral pharyngeal space, pterygomaxillary, space, pharyngomaxillary space: Swelling is on lateral wall of Pharynx pushing tonsils towards midline. Patient may also have a swelling in neck, posterior to SCM muscle. Patient may also present with Trismus. Ludwig's angina is cellulitis of submandibular space.", "role": "assistant" } ]

[ { "content": "Brinzolamide is a \nSelect and explain. \nA. Highly specific irreversible and noncompetitive carbonic anhydrase inhibitor, B. Highly specific irreversible and competitive carbonic anhydrase inhibitor., C. Highly specific reversible and competitive carbonic anhydrose inhibitor, D. Highly specific reversible and non-competitive carbonic anhydrase inhibitor.", "role": "user" }, { "content": "Answer: D \nExplanation: Ans is 'd' i.e. Highly specific reversible and noncompetitive carbonic anhydrase inhibitor o Carbonic anhydrase inhibitors act by a non-competitive, reversible inhibition of the enzyme carbonic anhydrase. o Brinzolamide is a highly .specific inhibitor of carbonic anhydrase II (CA II), which is the main carbonic anhydrase isoenzyme involved in the secretion of aqueous humour. o Inhibition caused by brinzolamide is reversible and non-competitive.", "role": "assistant" } ]

[ { "content": "Cholesteatoma commonly associated with: \nSelect and explain. \nA. Atticoantral CSOM, B. Tubotympanic CSOM, C. Tympanosclerosis, D. Foreign body in ear", "role": "user" }, { "content": "Answer: A \nExplanation: (a) Atticoantral CSOM(Ref. Scott Brown, 8th ed. Vol 2; 989)Tympanosclerosis is hyalinisation and calcification of the fibrous layer of tympanic membrane. It is not associated with cholesteatoma. Foreign body in ear does not lead to cholesteatoma formation.Keratosis obturans is the collection of desquamated keratin debris in the external auditory canal. This keratin debris comes from the external auditory canal stratified squamous epithelium.", "role": "assistant" } ]

[ { "content": "A child presenting with localized patches of complete hair loss with normal appearance of scalp. Diagnosis is - \nSelect and explain. \nA. Tinea capitis, B. Cradle cap, C. Alopecia areata, D. Telogen effluvium", "role": "user" }, { "content": "Answer: C \nExplanation: alopecia areata develops as single or multiple oval or round patches of hair loss on the scalp, beard area,eyebrows, eyelashes and other hairy areas of the body. Telogen effluvium- generalized and diffuse hair loss over scalp and body Cradle cap - infantile seborrhoeic dermatitis characterized by yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of recently born babies. Tinea capitis-a dermatophytosis caused by trichophyton and microsporum fungi , can be either an ectothrix or endothrix type of infection. Ectothrix involves both inside and outside of hair shaft. Endothrix involves only inside of hair shaft. Page no.241,242,55,169 ref Harrison20th edition", "role": "assistant" } ]

[ { "content": "An 8-hour-old term infant develops increased respiratory distress, hypothermia, and hypotension. A complete blood count (CBC) demonstrates a white blood cell (WBC) count of 2500/mL with 80% bands. The chest radiograph is shown below. Which of the following is the most likely diagnosis? \nSelect and explain. \nA. Congenital syphilis, B. Diaphragmatic hernia, C. Group B streptococcal pneumonia, D. Transient tachypnea of the newborn", "role": "user" }, { "content": "Answer: C \nExplanation: (c) Source: (Hay et al, pp 1163-1166. Kliegman et al, pp 925-928. McMillan et al, pp 482-483, 501-506. Rudolph et al, pp 1097-1099.) The radiograph shows diffuse that infiltrates bilaterally; this can be seen with neonatal pneumonia or primary surfactant deficiency. The rapid onset of the symptoms, the low WBC count with left shift, and the depicted chest x-ray findings, however, are typical of a patient with group B streptococcus (GBS) pneumonia. Appropriate management would include rapid recognition of symptoms, cardiorespiratory support, and prompt institution of antibiotics. Despite these measures, mortality from this infection is not uncommon. The other infectious causes listed do not present so early, and the noninfectious causes listed do not cause elevations in the band count. GBS disease in the infant is decreasing in incidence with better prevention strategies in the perinatal period; early screening in pregnancy and treatment with antibiotics just prior to delivery to eliminate GBS colonization markedly decreases the risk to the infant. Congenital syphilis can cause pneumonia, but it is diagnosed at birth along with other features including hepatosplenomegaly, jaundice, rashes, hemolytic anemia, and others. Diaphragmatic hernia presents with early respiratory distress, but the diagnosis is confirmed clinically with bowel sounds heard in the chest and a radiograph that has loops of bowel located above the normal placement of the diaphragm. Transient tachypnea of the newborn (TTN) causes an increase in respiratory rate and occasionally a low oxygen requirement; the history is often positive for a cesarean delivery, and the radiograph shows retained fluid in the fissures. TTN does not cause temperature instability nor an abnormal CBC. Chlamydial pneumonia is not a condition that occurs in an 8-hour-old infant; it is generally a mild pneumonia that can develop in an exposed infant at several weeks of life.", "role": "assistant" } ]

[ { "content": "In the gr'cii circuit, the arc! flow pressure is 100 mm Hg and the outward flow pressure is 10 mm Hg. Each of the parallel circuit has a resistance of 5 mm Hg/mL/min. Calculate the flow across the circuit: \nSelect and explain. \nA. 45 mL, B. 90 mL, C. 3.6 mL, D. 135 mL", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. b. 90 mL", "role": "assistant" } ]

[ { "content": "Bochdalek hernia is related to - \nSelect and explain. \nA. Inguinal canal, B. Pleuroperitoneal canal, C. Femoral canal, D. Obturator foramen", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Pleuroperitoneal canal Bochdalek herniao Most Bochdalek hernia are on the left side (~80%) and may rarely be bilateral.o Compression of the lung results in pulmonary hypoplasia, involving both the lungs (ipsilateral > contralateral)o Pulmonary vasculature is also abnormal leading to pulmonary hypertension.o Thus the two main factors that affect morbidity and mortality are pulmonary hypoplasia and pulmonary hypertension.o The most frequent clinical presentation of CDH is respiratory distress due to severe hypoxemia,o The anteroposterior diameter of the chest may be large along with a scaphoid abdomen,o The diagnosis of CDH can be made prenatally by ultrasound.o The postnatal diagnosis is relatively straightforward because a plain chest radiograph demonstrates the gastric air bubbles or loops of bowel within the chest. There may also be a mediastinal shift away from the side of the hernia.o Historically, the surgical repair of a CDH was considered to be a surgical emergency' because it was believed that the abdominal viscera within the chest prevented the ability to ventilate. More recently with the recognition of the role of pulmnary hypertension and pulmonary hypoplasia and the adverse effects of early operative repair on the pulmonary function has caused a policy of delayed repair.o Thus most pediatric surgeons wait for a variable period (24 to 72 hrs) to allow for stabilization of the infant before doing surgical repair.Congenital diaphragmatic herniao It is the herniation of abdominal contents into the thoracic cavity through the diaphragmatic defecto The defect may be:Posterolateral (Bochdalek hernia)Retrosternal (Morgagni hernia)At the esophageal hiatus (hiatal hernia)Adjacent to the hiatus (paresophageal hernia)o Although all these defects are congenital, the term congenital diaphragmatic hernia is generally used for Bochdalek hernia.", "role": "assistant" } ]

[ { "content": "A 4 yr old partially immunized boy came to OPD with history of bouts of coughing. On staining the sputum sample an organism with bipolar staining was seen. Which among the following organism it would be? \nSelect and explain. \nA. Y. Pestis, B. B. pertussis, C. S. Agalactae, D. K. Pneumonae", "role": "user" }, { "content": "Answer: B \nExplanation: REF: (B) B. pertussisREF: Jawetz Microbiology, 24th Ed Ch. 19BORDETELLA PERTUSSIS:The organisms are minute gram-negative coccobacilli resembling H influenzae. With toluidine blue stain, bipolar metachromatic granules can be demonstrated. A capsule is present. After an incubation period of about 2 weeks, the \"catarrhal stage\" develops, with mild coughing and sneezing. During this stage, large numbers of organisms are sprayed in droplets, and the patient is highly infectious but not very ill. During the \"paroxysmal\" stage, the cough develops its explosive character and the characteristic \"whoop\" upon inhalation. This leads to rapid exhaustion and may be associated with vomiting, cyanosis, and convulsions. The \"whoop\" and major complications occur predominantly in infants; paroxysmal coughing predominates in older children and adults. The white blood count is high (16,000-30,000/ uL), with an absolute lymphocytosis. Among provided options, T. pestis and B. pertussis produce bipolar metachromatic appearance, but considering the partial immunization status and age of patient, b. pertussis is answer of choice.", "role": "assistant" } ]

[ { "content": "What is true in case of perforation of pars flaccida? \nSelect and explain. \nA. CSOM is a rare cause, B. Associated with cholesteatoma, C. Usually due to trauma, D. All of the above", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B Associated with cholesteatomaTympanic membrane can be divided in 2 pas:Parstensa : It forms most of the tympanic membrane. Its periphery is thickened to form fibro cailaginous ring called as annulus tympanicus.Pars Falccida : It is situated above the lateral process of malleus between the notch of Rivinus and the anterior and posterior malleolar folD. Perforation in tympanic membrane can be in Central* Occurs in tubotympanic type ofCSOM* Not associated with cholesteatoma* Considered safe Marginal (Perforation destroys even the annulus) theraby reaching sulcus tympanicusMost common is posterio superiormarqinal?- occur in attico antral type of CSOM- associated with cholesteatoma- considered unsafe / dangerous Attic perforation NoteMost common cause of perforation is chronic otitis mediaMnemonicFamousF - Perforation of Pars FlaccidA.A - Seen in Atticoantral/marginal perforationM - Associated with CSOM (of atticoantral type) or acute necrotizing otitis mediao - Associated with CholesteatomaU - Unsafe typeS - Surgery is TOe.", "role": "assistant" } ]

[ { "content": "Adam's apple seen in boys is because of: \nSelect and explain. \nA. Hyoid bone, B. Tracheal rings, C. Thyroid cailage, D. Cricoid cailage", "role": "user" }, { "content": "Answer: C \nExplanation: Prominance of Thyroid cailage (because of sharp angle) in males is called Adam's apple. Thyroid cailage with right and left lamina both meet at midline and form an angle of 90deg in males, 120deg in females. At rest it lies at level of C3", "role": "assistant" } ]

[ { "content": "Site of placement of tension free vaginal tapes in stress urinary incontinence \nSelect and explain. \nA. Ureterovaginal junction, B. Urethrovaginal junction, C. Upper pa of urethra, D. Middle pa of urethra", "role": "user" }, { "content": "Answer: D \nExplanation: Tension-free vaginal tape A knitted 11 mm x 40 cm polypropylene mesh tape is inseed transvaginally at the level of the midurethra Complications: Sho term Voiding difficulties , Bladder perforation, de novo Urgency and Bleeding Ref: SHAW&;S TEXTBOOK OF GYNAECOLOGY; 15th edition; Pg no:194", "role": "assistant" } ]

[ { "content": "The amount of water absorbed in the intestine in a day is : \nSelect and explain. \nA. 5 lit., B. 1 lit, C. 1 lit, D. 8 lit.", "role": "user" }, { "content": "Answer: D \nExplanation: D i.e. 8 lit", "role": "assistant" } ]

[ { "content": "Most impoant from of carbon-dioxide transpo in the blood \nSelect and explain. \nA. It is mostly transpoed as carboxy hemoglobin, B. As dissolved CO2, C. As bicarbonates, D. Due to CO2 molecules attached to hemoglobin", "role": "user" }, { "content": "Answer: C \nExplanation: The route by which most of the carbon dioxide is carried in the bloodstream. Once dissolved in the blood plasma, carbon dioxide combines with water to form carbonic acid, which immediately ionizes into hydrogen and bicarbonate ions. The bicarbonate ions serve as pa of the alkaline reserve.Ref: Ganong&;s Review of Medical Physiology; 24th edition; page no: 644", "role": "assistant" } ]

[ { "content": "A patient presents to the emergency department with uniocular diplopia. Examination with oblique illumination shows golden crescent while examination with coaxial illumination show a dark crescent line. Which of the following is the most likely diagnosis – \nSelect and explain. \nA. Lenticonus, B. Coloboma, C. Microspherophakia, D. Ectopia lentis", "role": "user" }, { "content": "Answer: D \nExplanation: Presence of uniocular diplopia together with the finding of the golden crescent on oblique illumination (edge of subluxated lens) or black crecent line on coaxial illumination (edge of subluxated lens) suggests a diagnosis of `subluxation' of the crystalline lens. Ectopic lens refers to the displacement of shows lens from its normal position (subluxation, dislocation).", "role": "assistant" } ]

[ { "content": "Alkaptonuria an inherited metabolic disorder is due to the deficiency of \nSelect and explain. \nA. Homogentisate oxidase, B. Cystathionase, C. Pheylalanine hydroxylase, D. Tyrosine transaminase", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]