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[ { "content": "Drug of choice in pneumonia caused by P. carinii is : \nSelect and explain. \nA. Penicillin, B. Cotrimoxazole, C. Kanamycin, D. Levofloxacin", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which anomaly is seen in following clinical condition? \nSelect and explain. \nA. Dental fusion, B. Gemination, C. Concrescence, D. Supernumerary teeth", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "A patient is passing stones recurrently in urine for past few years. All are due to be restrlcted in diet except- \nSelect and explain. \nA. Protein restriction, B. Calcium restriction, C. Salt restricted diet, D. Phosphate restriction", "role": "user" }, { "content": "Answer: B \nExplanation: The inverse relationship between low dietary calcium intake and an increase in stone formation is likely due to a secondary increase in urinary oxalate. While urinary calcium levels decreased in both groups, urinary oxalate levels increased in men on the low calcium diet and decreased in men on the normal calcium diet Ref Harrison20th edition pg 277", "role": "assistant" } ]

[ { "content": "Cholestasis may lead to the following complications except - \nSelect and explain. \nA. Intrauterine fetal death, B. Meconium stained liquor, C. Preterm labour, D. Neonatal jaundice", "role": "user" }, { "content": "Answer: D \nExplanation: Ans-D", "role": "assistant" } ]

[ { "content": "Not a cause of objective tinnitus ? \nSelect and explain. \nA. Palatal myoclonus, B. Glomus tumor, C. Carotid aery aneurysm, D. Presbyacusis", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Presbyacusis Tinnitus Tinnitus is ringing sound or noise in the ear. The characteristic feature is that the origin of this sound is within the patient.", "role": "assistant" } ]

[ { "content": "The following are true about benign paroxysmal positional vertigo except - \nSelect and explain. \nA. Fatigability, B. Good reproducibility, C. Habituation, D. Latency", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Hexose sugar is not present in: \nSelect and explain. \nA. Ribose, B. Glucose, C. Fructose, D. Galactose", "role": "user" }, { "content": "Answer: A \nExplanation: Hexose sugar is present in:Glucose, \"blood sugar\", the immediate source of energy for cellular respirationGalactose, a sugar in milk (and yogu), andFructose, a sugar found in honeyRibose is a pentose sugar", "role": "assistant" } ]

[ { "content": "EAC rosette formation is the property of one of the following type of immune cells - \nSelect and explain. \nA. T cells, B. B cells, C. Macrophages, D. All of the above", "role": "user" }, { "content": "Answer: A \nExplanation: Erythrocyte antibody complement rosetting (EAC-rosetting), occurs when the antibody in the presence of complement is bound to the surface of a red blood cell. The complement binds to the tail region (Fc region) of the antibody. Finally, T-cells with a complement receptor are added and the T-cells bind to the complement on the antibody completing the rosette", "role": "assistant" } ]

[ { "content": "Which of the following tumor is most commonly associated with superior vena cava syndrome: \nSelect and explain. \nA. Lymphoma, B. Small cell carcinoma, C. Non small cell carcinoma, D. Metastasis", "role": "user" }, { "content": "Answer: B \nExplanation: Answer is B (Small cell carcinoma): Current Critical Care Diagnosis & Treatment 3ra /465 The incidence of superior vena caval syndrome is highest with small cell carcinoma. Superior vena caval syndrome (SVC syndrome) SVC syndrome results from an impedance in outflow from superior vena cava due to external compression The most common cause of SVC syndrome is external compression by a malignant tumoure The most common malignant tumor causing SVC syndrome is bronchogenic carcinomas The most common histological type of bronchogenic carcinoma causing SVC syndrome is small cell carcinomas Etiologies of Superior Vena Cava Obstruction: Malignancy 95% Lung Cancer 65% Lymphoma 15% Breast cancer 5% Germ-cell 2% Thymic cancer 2% Other cancer 4% Benign 5% Central venous device related Mediastinal fibrosis 1% 3%", "role": "assistant" } ]

[ { "content": "Hemosiderin contains - \nSelect and explain. \nA. Calcium, B. Iron, C. Magnesium, D. None", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Iron Hemosiderino It is hemoglobin derived, golden yellow to brown, granular or crystalline pigment in which form iron is stored in cells. When there is local or systemic excess of iron, ferritin forms hemosiderin granules. Thus hemosiderin pigment represents aggregrates of ferritin micelles. Under normal conditions small amounts of hemosiderin can be seen in the mononuclear phagocytes of the bone marrow, spleen and liver, all actively engaged in red cell breakdown.", "role": "assistant" } ]

[ { "content": "All the following are features of pseudotumor cerebri except - \nSelect and explain. \nA. Normal-sized ventricles on CT scan, B. Increased protein in CSF, C. Papilledema, D. Absence of focal neurological deficit", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Blanket consent is consent taken: NEET 14 \nSelect and explain. \nA. When the patient comes to doctor for treatment, B. Orally when given during any procedure, C. Implied by gesture, D. At the time of admission to do any surgery", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. At the time of admission to do any surgery", "role": "assistant" } ]

[ { "content": "The early changes in coicosteroid-induced cataract are in the form of: \nSelect and explain. \nA. Central posterior subcapsular lens changes, B. Anterior coical lens changes, C. Nuclear changes, D. Diffuse lens changes", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. Central posterior subcapsular lens changes", "role": "assistant" } ]

[ { "content": "Anthracosis is caused by - \nSelect and explain. \nA. Silica, B. Iron, C. Coal dust, D. Cotton dust", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Coal dust * Anthracosis- Coal dust* Silicosis- Silica* Siderosis- Iron* Byssinosis- Cotton dust (textile industry)* Farmer's lung- Hay or grain dust (micropolyspora faeni)* Sequousis- Moldy red wood saw dust* Suberosis- Moldy cork dust* Detergent workers lung- Enzyme additives* Baggassosis- Sugarcane dust (thermoactinomyces sacchari)", "role": "assistant" } ]

[ { "content": "What is common in amalgam and ceramics? \nSelect and explain. \nA. More compressive strength but less tensile strength, B. More compressive strength and tensile strength, C. Less compressive strength but more tensile strength, D. Less compressive strength and tensile strength", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Pseudocholinesterase is synthesized by \nSelect and explain. \nA. Liver, B. Plasma, C. Muscle end plate, D. Nerve ending", "role": "user" }, { "content": "Answer: A \nExplanation: Pseudocholinesterase which metabolizes succinylcholine is synthesized by liver and is present in plasma. True cholinesterase which metabolizes acetylcholine is synthesized by muscle end plate. Ref: KD Tripathi 8th ed.", "role": "assistant" } ]

[ { "content": "Chemoreceptor Trigger Zone is: \nSelect and explain. \nA. Pons, B. Lateral hypothalamus, C. Ventral hypothalamus, D. Area postrema", "role": "user" }, { "content": "Answer: D \nExplanation: Area postrema", "role": "assistant" } ]

[ { "content": "Parenteral nutrition is not used in: \nSelect and explain. \nA. Enterocutaneous fistula, B. Burns, C. Crohn's disease, D. Pancreatitis", "role": "user" }, { "content": "Answer: D \nExplanation: Ans is d i.e. Pancreatitis", "role": "assistant" } ]

[ { "content": "The most common side effect of IUD inseion is- \nSelect and explain. \nA. Bleeding, B. Pain, C. Pelvic infection, D. Ectopic pregnancy", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Bleeding", "role": "assistant" } ]

[ { "content": "The difference between a typical cervical and thoracic veebrae is, which of the following: \nSelect and explain. \nA. Has a triangular body, B. Has a foramen transversarium, C. Superior aicular facet directed backwards & upwards, D. Has a large veebral body", "role": "user" }, { "content": "Answer: B \nExplanation: The transverse process of cervical veebrae is pierced by a foramen called foramen transversarium. It is not seen in thoracic and lumbar veebrae.Ref: Human Anatomy, B D Chaurasia, 4th Edition, Volume 3, Chapter 1, Page 40, 41; Textbook of Anatomy with Colour Atlas, Inderbir Singh, 4th Edition, Chapter 6, Page 84.", "role": "assistant" } ]

[ { "content": "A person with defective blue color appreciation is called ? \nSelect and explain. \nA. Deuteranomalous, B. Deuteranopia, C. Tritanopia, D. Tritanomalous", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is `d' i.e., Tritanomalous", "role": "assistant" } ]

[ { "content": "MC side effect of lithium: March 2003 \nSelect and explain. \nA. Polyuria, B. Fine tremors, C. Polydipsia, D. Weight gain", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B i.e. Fine tremors", "role": "assistant" } ]

[ { "content": "Which of the following is not an ophthalmic emergency: \nSelect and explain. \nA. Macular hole, B. Retinal Detachment, C. CRAO, D. Acute primary angle closure glaucoma", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. Macular hole", "role": "assistant" } ]

[ { "content": "An 5 year old male patient complains of multiple decayed teeth and has a history of frequent snacking and consumption of sugar containing beverages. Intraoral examination shows multiple interproximal carious lesions. Which of the following caries management protocol is not suitable for this child? \nSelect and explain. \nA. Recall after 3 months, B. Professional topical fluoride treatment every 3 months, C. Professional topical fluoride treatment every 6 months, D. Radiographs every 6 months", "role": "user" }, { "content": "Answer: C \nExplanation: Caries-Risk Assessment Form for Children 6 Years Old or Younger", "role": "assistant" } ]

[ { "content": "Most common presenting feature of adult hypopituitarism is \nSelect and explain. \nA. Hypothyroidism, B. Hypogonadism, C. Addison’s disease, D. Hyperprolactinemia", "role": "user" }, { "content": "Answer: B \nExplanation: In adults decreased pituitary function is first shown by hypogonadism.", "role": "assistant" } ]

[ { "content": "Which of following is/are not the feature of Henoch?Schonlein Purpura (HSP) \nSelect and explain. \nA. Abdominal pain, B. Splinter haemorrhage, C. Thrombocytopenia, D. Epistaxis", "role": "user" }, { "content": "Answer: C \nExplanation: C. i.e. Thrombocytopenia", "role": "assistant" } ]

[ { "content": "A genetic disorder renders fructose 1,6 -- bisphosphates in liver less sensitive to regulation by fructose 2,6 -- bi-phosphate. All of the following metabolic changes are observed in this disorder except: \nSelect and explain. \nA. Level of fructose 1,6--biphosphate is higher than normal, B. Level of fructose 1,6 -- biphosphate is lower than normal, C. Less pyruvate is formed, D. Less ATP is formed", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A. Level of fructose 1,6--biphosphate is higher than normalFructose 2,6 - biphosphate acts to decrease the activity of fructose 1,6 - bisphosphates. When the enzyme becomes less sensitive to regulation, the inhibitory effect is lost and the enzyme activity increases. The following effects are observed:a. Level of fructose 1,6 -- biphosphate decreasesb. Pyruvate is used up for glucose synthesisc. ATP is used up for glucose synthesis", "role": "assistant" } ]

[ { "content": "Which point in the below natural history of disease marks the onset of symptoms? \nSelect and explain. \nA. A, B. B, C. C, D. D", "role": "user" }, { "content": "Answer: C \nExplanation: (c) C* Point A marks the entry of infectious agent into the host* Point B marks the subclinical phase where symptoms and signs are not visible, but the disease agent induces tissue and physiological changes* Point C marks the Clinical horizon when symptoms and signs appear* Point D is present inside the Clinical phase after the Clinical horizon.ALSO REMEMBERNATURAL HISTORY OF DISEASE* Prepathogenesis phase* Pathogenesis phase:Begins with the entry of disease agent into the hostFinal outcome of the disease may be Recovery, Disability or DeathPathological changes are essentially below the level of Clinical horizonClinical stage begins when signs and symptoms appear", "role": "assistant" } ]

[ { "content": "Pulmonary embolism is caused due to \nSelect and explain. \nA. Deep vein thrombosis of leg, B. Increase in pulmonary tension, C. Fracture of pelvic region, D. Heart disease", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Verocay bodies are seen in \nSelect and explain. \nA. Memingioma, B. Hemangioma, C. Glioma, D. Shwannoma", "role": "user" }, { "content": "Answer: D \nExplanation: Schwannoma are well circumscribed encapsulated masses that abut the associated nerve without invading it", "role": "assistant" } ]

[ { "content": "The fibers of the coicospinal tract pass through which structure? \nSelect and explain. \nA. Medial lemniscus, B. Medullary pyramid, C. Posterior funiculus, D. Medial longitudinal fasciculus", "role": "user" }, { "content": "Answer: B \nExplanation: Coicospinal fibers pass through the Medullary Pyramid Extra edge Tracts Function Lateral coicospinal and rubrospinal tracts Control distal limb muscles for fine motor and skilled voluntary movements. Anteriorcoicospinal tract and tectospinal, reticulospinal, and vestibulospinal tracts Control the postural adjustments and gross movements", "role": "assistant" } ]

[ { "content": "Which of the following is the \"Least common\" complication of measles - \nSelect and explain. \nA. Diarrhoea, B. Pneumonia, C. Otitis media, D. SSPE", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., SSPE o Subacute sclerosing panencephalitis (SSPE) is a rare complication of measles, which develops many years after the initial infection - PSM", "role": "assistant" } ]

[ { "content": "Which of the following facilitates comparison between different radiations? \nSelect and explain. \nA. Rad, B. Rem, C. Quality factor exposure, D. Roentgen", "role": "user" }, { "content": "Answer: B \nExplanation: EQUIVALENT (RADIATION-WEIGHTED) DOSE:\nThe equivalent dose (HT) is used to compare the biologic effects of different types of radiation on a tissue or organ. Particulate types of radiation have a high LET and are more damaging to tissue than radiation with low LET, such as x rays. This relative biologic effectiveness of different types of radiation is called  the radiation-weighting  factor (WR).\nThe unit of equivalent dose is the sievert (Sv). For diagnostic x-ray examinations, 1 Sv equals 1 Gy. \nThe traditional unit of equivalent dose is the rem (roentgen equivalent man); 1 Sv  equals 100 rem.\nOral Radiology, Principles and Interpretation / Stuart C. White, Michael J. Pharoah - 7th ed - pg - 15", "role": "assistant" } ]

[ { "content": "Myocarditis is caused bya) Pertussisb) Measlesc) Diptheriad) Scorpion sting \nSelect and explain. \nA. bc, B. c, C. ac, D. ad", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Mean head circumference at birth is \nSelect and explain. \nA. 48-51 cm, B. 38-40 cm, C. 42-45 cm, D. 33-35 cm", "role": "user" }, { "content": "Answer: D \nExplanation: Head circumference:-\n\n Measured with a nonstretchable tape passing through the maximum point of occipital protuberance posteriorly and at a point just above the glabella anteriorly.\n\nHead circumference must be compared with that of mother to know any familial variations.\nIf the head circumference is more than expected, always measure the both parents' head circumference, for benign familial megalencephaly is common.\nAt birth , it is around 34 cm.HC increases 2cm/ month for the first 3 months, 1cm/month for next three months and 0.5 cm per month for next 6 months.", "role": "assistant" } ]

[ { "content": "All of the following are potassium sparing diuretics except : \nSelect and explain. \nA. Triamterene, B. Spironolactone, C. Amiloride, D. Indapamide", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "A farmer presents with pustules, which show Gram Positive Cocci on smear. Culture shows Beta hemolysis, and organisms are Catalase negative. To show that the identified organism is group A streptococci, which of the following test should be done? \nSelect and explain. \nA. Bacitracin sensitivity, B. Optochm sensitivity, C. Novobiocin sensitivity, D. Bile solubility", "role": "user" }, { "content": "Answer: A \nExplanation: Streptococci are catalase negative and beta hemolytic. Group A beta hemolytic streptococci can be differentiated from other beta hemolytic streptococci by bacitracin sensitivity. Streptococcus pyogenes is bacitracin sensitive whereas streptococcus agalactiae is bacitracin resistant. Both are beta hemolytic. Ref: Textbook of Microbiology, Ananthanarayan and Paniker, 7th Edition, Chapter 23, Page 203-205.", "role": "assistant" } ]

[ { "content": "Which of the following is not seen in haemolytic anemia? \nSelect and explain. \nA. Hemosiderosis, B. Hemochromatosis, C. Cholelithiasis, D. None of the above", "role": "user" }, { "content": "Answer: B \nExplanation: Ceain changes are seen in hemolytic anemias regardless of cause or type. Anemia and lowered tissue oxygen tension trigger the production of erythropoietin, which stimulates erythroid differentiation and leads to the appearance of increased numbers of erythroid precursors (normoblasts) in the marrow. Compensatory increases in erythropoiesis result in a prominent reticulocytosis in the peripheral blood. The phagocytosis of red cells leads to hemosiderosis, which is most pronounced in the spleen, liver, and bone marrow. If the anemia is severe, extramedullary hematopoiesis can appear in the liver, spleen, and lymph nodes. With chronic hemolysis, elevated biliary excretion of bilirubin promotes the formation of pigment gallstones (cholelithiasis). Ref: Robbins 8th edition, Chapter 14.", "role": "assistant" } ]

[ { "content": "Which of the following propeies make pyridostigmine different from neostigmine \nSelect and explain. \nA. It is more potent, B. It is longer acting, C. It produces less muscarinic side effects, D. It does not have any direct action on NM receptor", "role": "user" }, { "content": "Answer: B \nExplanation: Ref-KDT 7/e p108 Pyridostigmine acts for 3 to 6 hours as compared to 0.5 to 2 hourshours dur of action of neostigmine. It is less impoant than neostigmine Rest of the propeies are similar to neostigmine", "role": "assistant" } ]

[ { "content": "All the following are features of Cardiac muscle Except \nSelect and explain. \nA. Striated, B. Large T tubules, C. Troponin system present, D. Caldesmon is impoant regulatory protein", "role": "user" }, { "content": "Answer: D \nExplanation: Some Differences among Skeletal, Cardiac, and Smooth MuscleNoSkeletal MuscleCardiac MuscleSmooth Muscle1StriatedStriatedNonstriated2No syncytiumSyncytialSyncytial3Small T tubulesLarge T tubulesGenerally rudimentary T tubules4Sarcoplasmic reticulum well developed andCa2+ pump acts rapidlySarcoplasmic reticulum present andCa2+ pump acts relatively rapidlySarcoplasmic reticulum often rudimentaryand Ca2+ pump acts slowly5Plasmalemma contains few hormonesreceptorsPlasmalemma contains a variety ofreceptors (eg, a- and b-adrenergic)Plasmalemma contains a variety ofreceptors (eg, a- and b-adrenergic)6Nerve impulse initiates contractionHas intrinsic rhythmicityContraction initiated by nerve impulses,hormones, etc7Extracellular fluid Ca2+ not impoant forcontractionExtracellular fluid Ca2+ impoant forcontractionExtracellular fluid Ca2+ impoant forcontraction8Troponin system presentTroponin system presentLacks troponin system; uses regulatoryhead of the myosin9Caldesmon not involvedCaldesmon not involvedCaldesmon is impoant regulatory protein10Very rapid cycling of the cross-bridgesRelatively rapid cycling of the cross bridgesSlow cycling of the cross-bridges permitsslow, prolonged contraction and lessutilization of ATPRef: Harper&;s Biochemistry; 30th edition; Chapter 51; Muscle & the cytoskeleton; Table 51-3", "role": "assistant" } ]

[ { "content": "All correlates with USG findings of congenital pyloric stenosis except: \nSelect and explain. \nA. > 95% accuracy, B. Segment length >16mm, C. Thickness >4mm, D. High gastric residues", "role": "user" }, { "content": "Answer: D \nExplanation: D i.e. High gastric residuesUltrasonography is the investigation of choice to confirm diagnose of hyperophic pyloric stenosis with accuracy > 95% (approching almost 100%)Q. USG visualizes thickened and elongated pyloric canalQ. USG criteria for diagnosis include >16 mm pyloric length and >4mm pyloric muscle wall thicknessQ. Gastric residues are low b/o recurrent emesisQ.The hyperophied muscle project into gastric antrum. There is a constant assocaition with hyperplasia of antral mucosa.- It is a common developmental condition (3 in 1000 live bihs), affecting boys more than girls (M:F = 4/5 :1)Q. There is a familial predisposition.Affected infant usually presents between 2-6 weeks of age, with projectile non bilious vomiting (D/D include pylorospasm, hiatus hernia & preampullary duodenal stenosis). HPS is never seen beyond 3 months of age except in premature infants in whom enteral feeding has been staed late.- Despite the recurrent vomiting, child has a voracious appetite that leads to cycle of feeding & vomiting that invariably results in severe dehydration, hypochloremichypokalemic metabolic alkalosis with eventual decrease in urine PHDiagnosis can be made clinically on the basis of history and palpation of an olive mass in the subhepatic region (right upper quadrant) and presence of visible gastric (antral peristaltic) wavesQ.Diagnosis of the HPS can be established (confirmed) by either USG (method of choice)Q or barium study.Pyloric signs includeString sign, is passing of thin barium streak through narrowed & elongated pyloric canal. It is most specific sign.Pyloric canal is almost always curved upward posteriorlyDouble/triple track sign or double string sign is produced by barium caught between crowded mucosal folds in pyloric canal overlying the hyperophied muscle & parallel lines may be seen.Diamond sign or twining recess is transient triangular tent like cleft/niche in midpoion of pyloric canal with apex pointing inferiorly secondary to mucosl bulging between two seperated hyperophied muscles on the greater curvature side of pyloric canal.Apple core lesion, pyloric segment looks like apple core with under cutting of distal antral & proximal duodenal bulb.Antral signs includePyloric teat sign is out pouching along lesser curvature b/o disruption of antral peristalsis.Shoulder sign is impression of hyperophied muscle on distended gastric antrum.Antral beaking is noted as thick muscle narrows the barium column as it enters the pyloric canal.Olive pit sign is impression of pyloric muscle upon antrum seen as tiny amount of barium at orifice.Caterpillar sign is gastric hyperperistaltic waves.Kirklin mushroom sign is indentation of base of duodenal bulb.Ultrasonography (USG)It is the method of choice to directly visualize the HPS. The examination is typically performed with a high frequency linear transducer (>5MH2) (as the pylorus & duodenum are very superficial in an infant) with infant in right posterior oblique position (to move any fluid present in fundus into antral & pylorus region. The stomach should not be emptied prior to examination as this makes identification of antropyloric area difficult. If fluid is administered to make visualization better, it should be removed at the end of examination to prevent vomiting/aspiration. Features include)Doughnut appearance/Bull's eye or target sign is hypoechoic (black) ring of hyperophied pyloric muscle around echogenic (reflective) mucosa & submucosa on cross /transverse section images.Shoulder/cervix-sign is indentation of hyperophied muscle on fluid filled gastric antrum on longitudinal section.Antral nipple sign is protrusion (evagination) of redundant pyloric mucosa into distended antrum.Double tract sign refers to fluid trapped in center of elongated pyloric canal is seen as two sonolucent streaks in center.Exaggerated peristattic waves & delayed gastric emptying of fluid into duodenumElongated pylorus with thickened muscles (most specific) is indicated by Length > 15mm, muscle thickness >3mm and transverse serosa to serosa diameter >15mm is consistent with HPS. At least 2 values should be positive. A thickness pylorospasm is transient & mostly resolve in 30 minutes and there is considerable variation in measurement or image appearance with time during thickness. (GI imaging) Pyloric canal length 16-17min, muscle wall thickness 2 3-3.2mmQ, pyloric volume > 1.4cm3, pyloric transverse diameter 13mm with pyloric canal closed and length (mm) + 3.64x + 3.64 x thickness (mm) >25 (Wolfgang) Pyloric length >16mm & muscle thickness > 4mm (Swaz)", "role": "assistant" } ]

[ { "content": "All of the following are true about multiple myeloma except - \nSelect and explain. \nA. Osteolytic bone disease, B. (18-14) translocation, C. Light chain proliferation, D. Bence-Jones proteins in urine", "role": "user" }, { "content": "Answer: B \nExplanation: The chromosomal alterations in multiple myeloma include translocations in t(11;14) & t(4;14) & deletion of 13q.Reference : Harsh mohan textbook of pathology 6th edition pg no 381.", "role": "assistant" } ]

[ { "content": "Drug of choice for obsessive - compulsive neurosis is : \nSelect and explain. \nA. Imipramine, B. CPZ, C. Carbamazapine, D. Clomipramine", "role": "user" }, { "content": "Answer: D \nExplanation: SSRIs are the drugs of choice for OCD. However, amongst the given options no drug is SSRI. Amongst the tricyclic antidepressants, clomipramine is the DOC.", "role": "assistant" } ]

[ { "content": "What is diagnostic of fresh myocardial infarction In ECG- \nSelect and explain. \nA. QT interval prolongation, B. Pmitrale, C. ST segment elevation, D. ST segment depression", "role": "user" }, { "content": "Answer: C \nExplanation: Ref: R Alagappan - Manual of Practical Medicine 4th Edition.pg no:184 ECG * May be normal initially and hence serial ECGs must be taken. * ST elevation and T-wave inversion with pathological Q-waves are typically seen in leads adjacent to the infarcted segment of myocardium. * Reciprocal ST depression or T-wave inversion in opposite leads. * A non-Q-wave infarct may occur and has a high risk of moality (as they are prone to develop dangerous arrhythmias and recurrent angina).", "role": "assistant" } ]

[ { "content": "Major hormone secreted by zona reticularis of adrenal coex ? \nSelect and explain. \nA. Glucocoicoids, B. Mineralcoicoids, C. Aldosterone, D. Androgens", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is `d i.e., AndrogensThe adrenal coex is divided into three zones (outer to inner) : Zona glomerulosa, zona fasciculata and zona reticularis.All three coical zones secrete coicosterone, but the active enzymatic mechanism for aldosterone biosynthesis is limited to the zona glomerulosa whereas the enzymatic machanisms for forming coisol and sex hormones are found in the two inner zones. Fuhermore, subspecialization occurs within the inner two zones, the zona fasciculata, secreting mostly glucocoicoids and the zona reticularis secreting mainly sex hormones.", "role": "assistant" } ]

[ { "content": "Which drug used in bronchial asthma needs monitoring- \nSelect and explain. \nA. Theophylline, B. Cromoglycate, C. Salmeterol, D. Terbutaline", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Theophylline o Theophylline has low safety margin and therefore requires therepeutic drug monitoring.", "role": "assistant" } ]

[ { "content": "The most common extranodal site for non-hodgkin lymphoma is \nSelect and explain. \nA. Stomach, B. Brain, C. Intestine, D. Tonsils", "role": "user" }, { "content": "Answer: A \nExplanation: *Lymphomas are divided broadly into Hodgkins and Non-Hodgkin&;s lymphomas. *Two-thirds of Non-Hodgkin&;s lymphoma present as generalized lymphadenopathy(Nodal sites).*One third of the cases present at an extranodal site. *Extra nodal sites include the gastrointestinal tract, upper aerodigestive tract, salivary glands, eye, mediastinum, lung, pleura, hea, spleen, liver etc. *The most common extranodal site is gastrointestinal tract, in which stomach is involved most often.", "role": "assistant" } ]

[ { "content": "Basic defect in HbS is - \nSelect and explain. \nA. Altered function, B. Altered solubility, C. Altered stability, D. Altered O2 binding capacity", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Blindness in child is most commonly due to \nSelect and explain. \nA. Keratomalacia, B. Congenital cataract, C. Glaucoma, D. Injuries", "role": "user" }, { "content": "Answer: A \nExplanation: Most common cause of childhood blindness is vitamin A deficiency Refer: Khurana 6th edition page number 382", "role": "assistant" } ]

[ { "content": "Bleuler's symptoms for schizophrenia are all except \nSelect and explain. \nA. Loosening of association, B. Affect disturbances, C. Autism, D. Hallucinations", "role": "user" }, { "content": "Answer: D \nExplanation: Eugen Bleuler's Fundamental Symptoms of Schizophrenia (Also called as 4 A's of Bleuler) 1. Ambivalence: Marked inability to decide for or against 2. Autism: Withdrawal into self 3. Affect disturbances: Disturbances of affect such as inappropriate affect 4. Association disturbances: Loosening of associations; thought disorder Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 55", "role": "assistant" } ]

[ { "content": "Stage of contraction of family stas at \nSelect and explain. \nA. Bih of first child, B. Bih of last child, C. Leaving home of first child, D. Marriage", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Leaving home of first child", "role": "assistant" } ]

[ { "content": "Phelp's sign is seen in: \nSelect and explain. \nA. Glomus jugulare, B. Vestibular Schawannoma, C. Maniere's disease, D. Neurofibromatosis", "role": "user" }, { "content": "Answer: A \nExplanation: Phelp's sign Phelp sign This sign is seen on CT scan In CT- in case of glomus jugulare tumor the normal crest between the carotid canal and jugulare tumor is absent whereas it is not so in case of glomus tympanicum", "role": "assistant" } ]

[ { "content": "Fastest acting receptor/transduction mechanism is \nSelect and explain. \nA. Adenylyl cyclase-cyclic AMP pathway, B. Phospholipase C-IP3:DAG pathway, C. Intrinsic ion channel operation, D. Nuclear receptor", "role": "user" }, { "content": "Answer: C \nExplanation: Ref-KDT 6/e p40 Drugs acting and ionotropic receptor are fast acting where as those acting through nuclear receptors are slowest in action", "role": "assistant" } ]

[ { "content": "A boy comes from Bihar with non-anesthetic hypopigmented atropic patch over face, diagonosis is \nSelect and explain. \nA. P. alba, B. P. versicolour, C. Indeterminate leprosy, D. Borderline leprosy", "role": "user" }, { "content": "Answer: C \nExplanation: C i.e. Indeterminate leprosy Points in our of diagnosing indeterminate leprosy: - Epidermal atrophyQ Non scaly & AnesthesiaQ (if present) Resident of high leprosy prevelence state? (Bihar)", "role": "assistant" } ]

[ { "content": "Which structure is not transmitted by foramen ovale? \nSelect and explain. \nA. Middle meningeal artery, B. Accessory meningeal artery, C. Lesser petrosal nerve, D. Emissary vein", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A Middle meningeal arteryRef: Netter's Clinical Anatomy, 3rd ed. pg. 460Structures transmitted via foramen ovale (M.A.L.E.)* Mandibular nerve-V3* Accessory meningeal artery* Lesser petrosal nerve* Emissary veinExtra edgeForamen rotundumMaxillary nerve V2Foramen LacerumInternal carotid arteryLesser petrosal nerveGreater petrosal nerveDeep petrosal nerveForamen spinosumMiddle meningeal arteryNervus spinosus (Meningeal Branch of mandibular nerve)Posterior trunk of middle meningeal veinCarotid canalInternal carotid arteryVenous and sympathetic plexus around the arterySince lots of questions are asked on the topic of base of skull, students are expected to memorise this diagram by drawing it yourself.", "role": "assistant" } ]

[ { "content": "A mother has been diagnosed with chicken pox. She delivered 7 days ago a term infant that appears to be healthy. The baby is afebrile. Which of the following is the most appropriate step in management? \nSelect and explain. \nA. Advise the mother to continue regular baby care, B. Hospitalize the infant in the isolation ward, C. Administer acyclovir to the infant, D. Administer varicella-zoster immunoglobulin(VZIG) to the infant", "role": "user" }, { "content": "Answer: A \nExplanation: If a normal full-term newborn is exposed to chickenpox 2 or more days after delivery, VZIG and isolation are not necessary because these babies appear to be at no risk for complications. VZIG should be given to the infant immediately after delivery if the mother had the onset of varicella within 5 days prior to delivery, and immediately upon diagnosis if her chicken pox staed within 2 days after delivery. Acyclovir may be used in infants at risk for severe varicella, such as those infants exposed perinatally.", "role": "assistant" } ]

[ { "content": "Which of the following is not carried in dorsal column of spinal cord:March 2011 \nSelect and explain. \nA. Proprioception, B. Vibratory sense, C. Heat sensation, D. Touch", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. C: Heat sensationLateral spinothalamic tract carries fibers of all type of pain and temperature impulses (both hot and cold)Spinothalamic tractIt transmits information to the thalamus about pain, temperature, itch and crude touch.The pathway decussates at the level of the spinal cord, rather than in the brainstem like the posterior column-medial lemniscus pathway and coicospinal tract.Posterior column-medial lemniscus pathway/dorsal column-medial lemniscus pathway/dorsal white column-medial lemniscus systemIt is the sensory pathway responsible for transmitting fine touch, vibration and conscious proprioceptive information from the body to the cerebral coex as well as tactile pressure, barognosis, graphesthesia, stereognosis, recognition of texture, kinesthesia and two-point discrimination.The name comes from the two structures that the sensation travels up: the posterior (or dorsal) columns of the spinal cord, and the medial lemniscus in the brainstem.Because the posterior columns are also called dorsal columns, the pathway is often called the dorsal column-medial lemniscus system, or DCML for sho. (Also called posterior column-medial lemniscus or PCML pathway).The PCML is pathway is composed of rapidly conducting, large, myelinated fibersThe pathway is tested with the Romberg's test.Lesions to the posterior column-medial lemniscus pathway below the decussation of its fibers produce loss of sensation on the same side of the body as the lesion.Above the decussation produces loss of sensation on the opposite side of the body than the lesion", "role": "assistant" } ]

[ { "content": "Homonymous hemianopia may be seen in lesion of all of the following, EXCEPT: \nSelect and explain. \nA. Optic chiasma, B. Optic tract, C. Optic radiation, D. Occipital lobe", "role": "user" }, { "content": "Answer: A \nExplanation: Lesion of the optic chiasma result in bitemporal hemianopia not homonymous hemianopia. Lesions of the visual pathway and corresponding field defects: Lesion of optic nerve: Ipsilateral blindness Lesion through proximal pa of optic nerve: Ipsilateral blindness with contralateral quadrantanopia. Lesion of optic tract: Homonymous hemianopia Lesion of temporal lobe: Quadrantic homonymous defect Lesion of optic radiation: Homonymous hemianopia with occasional sparing of the macula Lesion in anterior pa of occipital coex: Contralateral temporal crescentic field defect Lesion of occipital lobe: homonymous hemianopia usually sparing of the macula Ref: Textbook of Ophthalmology By H. V. Nema, page 340", "role": "assistant" } ]

[ { "content": "Age related dementia has been associated with increased levels of \nSelect and explain. \nA. Homocysteine, B. Cysteine, C. Tourine, D. Methionine", "role": "user" }, { "content": "Answer: A \nExplanation: Identification of modifiable risk factors provides a crucial approach to the prevention of dementia.. The findings are consistent with moderately raised plasma total homocysteine (>11 mmol/L), which is common in the elderly, being one of the causes of age-related cognitive decline and dementia Ref Harrison20th edition pg 2445", "role": "assistant" } ]

[ { "content": "All are true regarding brachial plexus injury, except: \nSelect and explain. \nA. Preganglionic lesions have a better prognosis than postganglionic lesions, B. Erb's palsy causes paralysis of the abductors and external rotators of the shoulder, C. In Klumpke's palsy, Horner's syndrome may be present on the ipsilateral side, D. Histamine test is useful to differentiate between the preganglionic and postganglionic lesions", "role": "user" }, { "content": "Answer: A \nExplanation: Preganglionic lesions have a poor prognosis as these do not recover and are surgically irreparable. Postganglionic lesions have better prognosis than preganglionic lesions and histamine test is useful in making the distinction", "role": "assistant" } ]

[ { "content": "Harpender's Callipers are used to; \nSelect and explain. \nA. Measure skin fold thickness, B. Measure mid arm circumference, C. Measure height, D. Measure chest circumference", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A. Measure Skin fold thicknessSkin fold thickness is an indication of the subcutaneous fat. Triceps skin fold thickness is the most representative of the total subcutaneous fat upto 16 years of age. It is usually above 10mm in normal children whereas in severely malnourished children it may fall below 6mm.", "role": "assistant" } ]

[ { "content": "Fracture of necessity is used to describe - \nSelect and explain. \nA. Cottons fracture, B. Galeazzi fracture, C. Monteggia fracture, D. Rolando fracture", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Galleazzi fracture * \"Closed reduction is usually not successful due to the deforming forces of the muscles. Hence, open reduction and internal fixation is the preferred method of treatment. Campbell noted this in 1941 and termed Galeazzi fracture as \"Fracture of necessity\".", "role": "assistant" } ]

[ { "content": "Aerobic oxidation of reduced cytochromes shows P/O ratio of \nSelect and explain. \nA. 4, B. 3, C. 2, D. 1", "role": "user" }, { "content": "Answer: B \nExplanation: ADP:O or P:O Ratio: The NAD-dependant dehydrogenases such as malate, pyruvate, a-ketoglutarate, isocitrate, etc. produce three high energy phosphate bonds for each pair of electrons transferred to O2 because they have P: O ratio of 3. Thus P: O ratio is a measure of how many moles of ATP are formed from ADP by phosphorylation per gram atom of oxygen used. This is measured as the number of moles of ADP (or Pi) that disappear per gram atom of oxygen used. Phosphate group esterified P:O ratio = ___________________________________ Electron pairs transferred P:O ratio x 7.3 Efficiency = ______________________ x 100 51 K.Cal However, P:O ratio in case of FADH2 is 2 and therefore efficiency is lower in that case.Ref: MN Chatterjea Textbook of Medical Biochemistry, 7th Edition, Page no: 142", "role": "assistant" } ]

[ { "content": "Glycine is useful in all of the following except \nSelect and explain. \nA. Purine synthesis, B. Creatine synthesis, C. Spermine synthesis, D. Heme synthesis", "role": "user" }, { "content": "Answer: C \nExplanation: Spermine is a type of polyamine.This is aliphatic amine and it is synthesized from ornithine. Key enzyme is ornithine decarboxylase. REFERENCE : DM.VASUDEVAN.TEXTBOOK; SEVENTH EDITION ; PAGE NO : 229", "role": "assistant" } ]

[ { "content": "A couple presents to a clinic for work-up of infeility after 5 years of unprotected intercourse. The wife denies any medical problems and notes regular menstrual cycles. The husband states that he has had chronic sinusitis and lower respiratory tract infections. Physical examination of the woman is unremarkable. Examination of the man is remarkable for dextrocardia. Fuher work-up of the husband will most likely reveal? \nSelect and explain. \nA. Azoospermia, B. Germinal cell aplasia, C. Immotile sperm, D. Isolated gonadotropin deficiency", "role": "user" }, { "content": "Answer: C \nExplanation: The husband is suffering from Kaagener's syndrome, an autosomal recessive disorder characterized by infeility, situs inversus, chronic sinusitis, and bronchiectasis. The underlying cause of these varied manifestations are defects in the dynein arms, spokes of microtubule doublets of cilia in the airways and the reproductive tract. Since sperm motility is dependent on the functioning of cilia, infeility frequently accompanies this disorder. Situs inversus occurs because ciliary function is necessary for cell migration during embryonic development. Azoospermia is not a feature of Kaagener's syndrome, as sperm production or survival is not affected in this disorder. Germinal cell aplasia, also known as Seoli only syndrome, is characterized by oligospermia or azoospermia. Isolated gonadotropin deficiency is characterized by delayed or incomplete pubeal maturation. Ref: Federico M.J., Stillwell P., Deterding R.R., Baker C.D., Balasubramaniam V., Zemanick E.T., Sagel S.D., Halbower A., Burg C.J., Kerby G.S. (2012). Chapter 19. Respiratory Tract & Mediastinum. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.", "role": "assistant" } ]

[ { "content": "Most common diaphragmatic hernia in children is: \nSelect and explain. \nA. Through the foramen of Bochdalek, B. Through the foramen of Morgagni, C. Traumatic rupture of the diaphragm, D. Eventration of the diapliragm", "role": "user" }, { "content": "Answer: A \nExplanation: (Through the f oramen of Bochdalek): Ref: 873 - LB (894-B & L 25th)Hernia through the foramen of Bochdolek - (Posterolateral) This is rarely the persistence of the pleuroperitoneal canal and the opening is in the dome of the diaphragm posteriorly* It is the most common diaphragmatic hernia in children* TRIAD of respiratory distress, apparent dextrocardia and a scaphoid abdomenHERNIA through the foramen of Morgagni: - (Anterolateral, retrosternal) This is an anteriorly placed hernia with the defect between the sternal and costal attachments of the diaphragm.The most commonly involved viscus is the transvere colon* Most frequent clinical presentation of congenital diaphragm hernia is respiratory distress due to severe hypoxemia", "role": "assistant" } ]

[ { "content": "A 25 year old male presents to emergency dept. following a road traffic accident. On examination there is pelvic fracture and blood at urethral meatus. Following are true about pt except - \nSelect and explain. \nA. Anterior urethra is the most likely site of injury, B. Retrograde urethrography should be done after the pt is stabilized., C. Foley catheter may be carefully passed if the RGU is normal, D. Rectal examination may reveal a large pelvic hematoma with the prostate displaced superiorly", "role": "user" }, { "content": "Answer: A \nExplanation: Ans is (a) anterior urethra is most likely the site of injury The pa of urethra most likely injured in pelvic fracture is membranous urethra (a pa of post. urethra) - Post. Urethra includes -- Prostatic + membranous urethra - Anterior urethra includes -- Bulbar + penile urethra The anterior urethra (paiularly bulbar urethra) is injured due to direct blow to the perineum (straddle injuries*) About other options ? (d) Prostate is displaced superiorly (high lying prostate) in membranous urethral injury due to rupture of puboprostatic fascia. Pelvic hematoma is seen in membranous urethral injuries (Perineal hematoma is seen in bulbar urethral injury) (b) Once an urethral injury is suspected the pt. is instructed not to pass urine and a RGU or ascending urethrogram is performed to assess the injury. (c) Catheterisation is contraindicated and is passed only if the RGU is normal.", "role": "assistant" } ]

[ { "content": "Loss of foot processes of podocytes is characteristically seen in? \nSelect and explain. \nA. Good pasture syndrome, B. Lipoid nephrosis, C. PSGN, D. Lupus nephritis", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Lipoid nephrosis * Effacement (loss) of foot process of perietal epithelial cells (podocytes) is most commonly noted in minimal change disease (lipoid nephrosis).* However, it may be seen other causes of nephrotic syndrome like membronous GN, FSGS, IgA nephropathy (a type of mesangioproliferative GN), and MPGN.Pathological findings of lipoid nephrosis1) Light microscopy - No abnormality2) Electron microscopy - Obliteration (loss) and fusion of foot processes of epithelial cells.3) Immunofluorescence - No deposits of immune reactants4) Serum complements - Normal levels* The basic pathogenesis of minimal change glomerulonephritis is loss of the basement membrane polyanion (Heparan sulfate proteoglycan).* Loss of the polyanion reduces the negative charge in membrane which allows anionic molecules of the plasma (Albumin) to pass through.", "role": "assistant" } ]

[ { "content": "A codon codes for a single amino acid. This characteristic is called ? \nSelect and explain. \nA. Non-overlapping, B. Unambiguous, C. Non-punctate, D. Degeneracy", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Unambiguous Characteristics of genetic codes Genetic codes have following characteristics ? 1) Universal :- Each codon specifically codes for same amino acid in all species, e.g. UCA codes for serine and CCA codes for proline in all organisms. That means specificity of codon has been conserved from very early stages of evolution. Exception to the universality of genetic coder are found in human mitochondria, where the code :- a UGA codes for tryptophan instead of serving as a stop codon. AUA codes for methionine instead of isoleucine. CUA codes for threonine instead of leucine. LI AGA and AGG serve as stop codon instead of coding for arginine. 2) Unambiguous/Specific :- A paicular codon always codes for the same amino acid. For example CCU always codes for proline and UGG always codes for tryptophan. 3) Degeneracy/Redundancy :- A given amino acid may have more than one codon. For example, CCU, CCC, CCA and CCG all four codons code for proline. Therefore, there are 61 codons for 20 amino acids. 4) Stop or termination or nonsense codons:- Three of the 64 possible nucleotide triplets UAA (amber), UAG (Ochre) and UGA (opal) do not code for any amino acid. They are called nonsense codons that normally signal termination of polypeptide chains. Thus, though there are 64 possible triplet codons, only 61 codes for 20 amino acids (as remaining three are non-sense codons). 5) Non overlapping and nonpuntate (Comma less) :- During translation, the code is read sequentially, without spacer bases, from a fixed staing point, as a continuous sequence of bases, taken 3 at a time, e.g. AUGCUA GACUUU is read as AUG/CUA/GAC/UUU without \"ponctation\" (coma) between codons.", "role": "assistant" } ]

[ { "content": "Vaccine associated paralytic polio is due to \nSelect and explain. \nA. Polio virus type 1, B. Polio virus type 2, C. Polio virus type 3, D. None of the above", "role": "user" }, { "content": "Answer: C \nExplanation: VAPP - Vaccine associated paralytic polio is due to polio virus type 3\nVDPV - Vaccine derived poliovirus is due to poliovirus type 2.", "role": "assistant" } ]

[ { "content": "Population control can be best achieved by \nSelect and explain. \nA. Education, B. Spacing between pregnancies, C. Early sterilization, D. Nutrition", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Time period between entry of organism to body to maximum infectivity is - \nSelect and explain. \nA. Lead time, B. Median incubation period, C. Generation time, D. Serial inverval", "role": "user" }, { "content": "Answer: C \nExplanation: Ans is 'c' i.e., Generation time * Generation time - Period from receipt of infection to maximal infectivity.* Serial interval - Gap between onset of primary case and secondary case.", "role": "assistant" } ]

[ { "content": "False about syphilis is : \nSelect and explain. \nA. Incubation period is 9-90 days, B. Secondary syphilis is due to hematological dissemination, C. Syphilitic ulcers(Chancre) are extremely painful, D. \"General paresis of Insane\" is due to CNS involvement in tertiary syphilis.", "role": "user" }, { "content": "Answer: C \nExplanation: Syphilitic ulcers(Chancre) are usually single in number, butter like, hard in consistency and typically painless.", "role": "assistant" } ]

[ { "content": "EB Virus is associated with which carcinoma: \nSelect and explain. \nA. Carcinoma of larynx, B. Carcinoma of bladder, C. Nasopharyngeal carcinoma, D. Chronic lymphocytic leukemia", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 20 year old is found to have blood pressures of 134/82 and 136/83 on two separate occasions. He will be classified as: \nSelect and explain. \nA. Normotensive, B. High normal BP, C. Stage 1 hypeension, D. Stage 2 hypeension", "role": "user" }, { "content": "Answer: B \nExplanation: When systolic and diastolic blood pressures fall in different categories, the higher category is taken to classify the individual's blood pressure. Classification of blood pressure measurements: Category Systolic BP Diastolic BP Normal <130 <85 High normal 130-139 85-90 Stage 1 hypeension 140-159 90-99 Stage 2 hypeension 160-179 100-109 Stage 3 hypeension >180 >110 Ref: Park 21st edition, page 344.", "role": "assistant" } ]

[ { "content": "Mitochondria of a sperm is seen in ? \nSelect and explain. \nA. Head, B. Neck, C. Body, D. Tail", "role": "user" }, { "content": "Answer: C \nExplanation: Mitochondrial granules are seen enveloping the spiral threads around the axial filament present in the body of the sperm. Sperm: The human sperm possesses a head, a neck, a connecting piece or body, and a tail.Head is oval or elliptical, but flattened,its anterior two-thirds are covered by a layer of modified protoplasm, which is named the head-cap, which probably facilitates the, entrance of the spermatozoon into the ovum. The head contains a mass of chromatin, regarded as the nucleus of the cell surrounded by a thin envelope.Neck contains the anterior centriole, it is situated at the junction of the head and neck.Connecting piece or body is rod-like. The posterior centriole is placed at the junction of the body and neck, from this centriole an axial filament runs backward through the body and tail. The sheath of the axial filament is encircled by a spiral thread, around which is an envelope containing mitochondrial granules, and termed the mitochondrial sheath.Tail is of great length, and consists of the axial thread or filament, surrounded by its sheath, but mitochondria is absent.Ref: Gray's Anatomy of the Human Body, 20th Edition, Page 756", "role": "assistant" } ]

[ { "content": "Increase in cytosolic calcium from intracellular storage, during smooth muscle contraction is/are due to: (PGI Dec 2008) \nSelect and explain. \nA. CAMP, B. CGMP, C. CCMP, D. 1P.-DAG", "role": "user" }, { "content": "Answer: D \nExplanation: Ans : D (IP3-DAG) & E (Ca2+ channel) Source of Calcium Ions & in Smooth Muscle Contraction Mechanism InvolvedAlmost all the calcium ions that cause contraction enter the muscle cell from the extracellular fluid at the time of action potential or other stimulusSarcoplasmic reticulum (the source of intracellular Ca2+), which provides virtually all the calcium ions for skeletal muscle contraction, is only slightly developed in most smooth muscle.When an action potential is transmitted in caveolae (rudimentary' analogue of the transverse tubule system of skeletal muscle), this is believe to excite calcium ion release from the abutting sarcoplasmic reticulum tubules through opening of calcium channels (Guyton 11th/99, 90)Sometimes smooth muscle contraction or inhibition is initiated by hormone without directly causing any change in the membrane potential. In these circumstances, the hormone may activate a membrane receptor that does not open any ion channel but instead cause an internal change in the muscle fiber, such as release of Ca2+ from intracellular sarcoplasmic reticulum, the Ca2+ then induce contraction (Guyton 11th/98)IP3-DAG role (to favour as an ansiver)The acetycholine cause smooth muscle contraction by phospholipase C& IP.,, which increase the intracellular Ca2+ concentration-Gcrnong 22nd/83Role of CAMP & CGMP (Guyton 11th/98)CAMP & CGMP so called second messengers has many effects on smooth muscle, one of which is to change the degree of phosphorylation of several enzyme that indirectly inhibit contraction.\"An increase in CAMP dampens the contraction response of smooth muscle to a given elevation of sarcoplasmic Ca2+-Harper 2 7th/579", "role": "assistant" } ]

[ { "content": "Reactivation tuberculosis is almost excusively a disease of the - \nSelect and explain. \nA. Lungs, B. Bones, C. Joints, D. Brain", "role": "user" }, { "content": "Answer: A \nExplanation: Secondary TB is due to reactivation and involves Lung particularly the apical and posterior segments of upper lobe.", "role": "assistant" } ]

[ { "content": "Whcih vesiculobullous diseaes is associated with enteropathy? \nSelect and explain. \nA. Pemphigus, B. Linear IgA dermatosis, C. Chronic bullous disease of childhood, D. Dermatitis herpetiformis", "role": "user" }, { "content": "Answer: D \nExplanation: Dermatitis herpetiformis is an autoimmune blistering disease that is strongly associated with coeliac disease. Almsot all patient with dermatitis herpetiformis have evidence of villous atrophy on Intestinal biopsy, even if they have no gastrointestinal symptoms. Reference : Davidson, 23rd Edition, page no : 1256.", "role": "assistant" } ]

[ { "content": "All are reversible injury of cell, except - \nSelect and explain. \nA. Vacuole, B. Karyorrhexis, C. Fat accumulation, D. Cell wall swelling", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Karyorrhexis", "role": "assistant" } ]

[ { "content": "Pyramids are formed by \nSelect and explain. \nA. Arcuate nucleus, B. Vestibular nuclei, C. Interstitial cells of cajal, D. Lateral coicospinal tract", "role": "user" }, { "content": "Answer: D \nExplanation: The pyramidal tracts include both the coicospinal and coicobulbar tracts. These are aggregations of upper motor neuron nerve fibres that travel from the cerebral coex and terminate either in the brainstem (coicobulbar) or spinal cord (coicospinal) and are involved in control of motor functions of the body.The coicospinal tract conducts impulses from the brain to the spinal cord. It is made up of a lateral and anterior tract. The coicospinal tract is involved in voluntary movement. The majority of fibres of the coicospinal tract cross over in the medulla, resulting in muscles being controlled by the opposite side of the brain. The coicospinal tract also contains Betz cells (the largest pyramidal cells), which are not found in any other region of the body.The nerves within the coicospinal tract are involved in movement of muscles of the body. Because of the crossing-over of fibres, muscles are supplied by the side of the brain opposite to that of the muscle. Ref: guyton and hall textbook of medical physiology 12 edition page number:765,766,767", "role": "assistant" } ]

[ { "content": "In which one of the following type of hernia do the abdominal viscera from a pa of the wall of hernial sac? \nSelect and explain. \nA. Pantaloon hernia, B. Sliding hernia, C. Richter's hernia, D. Indirect inguinal hernia", "role": "user" }, { "content": "Answer: B \nExplanation: As a result of slipping of the posterior parietal peritoneum on the underlying retroperitioneal structures, the posterior wall of the sac in sliding hernia is not formed by peritoneum alone, but by the sigmoid colon and its mesentery on the left, the accident), is called magical thinking. This type of reasoning is typical of children in Piaget's preoperational stage (age 2-7 years).", "role": "assistant" } ]

[ { "content": "Most malignant form of NHL is - \nSelect and explain. \nA. Diffuse large cell, B. Small cell lymphocytic lymphoma, C. Follicular cleavage, D. Large cell follicular", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 16-year-old girl with primary amenorrhea comes to OPD with bilateral inguinal swelling. She has normal breast development with no pubic hair. USG shows absent uterus. The diagnosis is: \nSelect and explain. \nA. Androgen insensitivity syndrome, B. Turner syndrome, C. Mullerian agenesis, D. Klinefelters Syndrome", "role": "user" }, { "content": "Answer: A \nExplanation: Testicular feminization syndrome (androgen insensitivity syndrome): XY karyotype with a female phenotype androgens are present but do not act at a peripheral level due to a receptor defect. the embryological development, which is dependent on androgens in a male fetus, does not happen and hence by default a female form is made. breast development is seen due to peripheral conversion of androgens to estrogens The inguinal swellings described in the question are actually the testes", "role": "assistant" } ]

[ { "content": "Cause of vasodilation in spider nevi \nSelect and explain. \nA. Testosterone, B. Estrogen, C. FSH, D. Hepatotoxin", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. EstrogenIn chronic liver disease (especially cirrhosis) and pregnancy, impaired estrogen metabolism and consequent hyper estroenemiaQ leads to spider angiomata/nevi (superficial, toous aerioles, that unlike simple telangiectases, typically fill from the center outwards and occur invariably on upper half of body) and palmar erythema (mottled redness of thenar & hypothenar eminences).", "role": "assistant" } ]

[ { "content": "A 2 year old man presents with superficial gash on his forehead. The wound is bleeding profusely, but examination reveals no fracture. The physician suspects a hypersensitive cardiac reflex. The patient's epicranial aponeurosis (galea aponeurotica) is penetrated, resulting in severe gaping of the wound. The structure overlying the epicranial aponeurosis is which of the following? \nSelect and explain. \nA. A layer containing blood vessels., B. The dura mater., C. The periosteum (pericranium)., D. The tendon of the epicranial muscles (occipitofrontails).", "role": "user" }, { "content": "Answer: A \nExplanation: A layer containing blood vessels * A mnemonic device for remembering the order in which the soft tissues overlie the cranium is SCALP: Skin, Connective tissue, Aponeurosis, Loose connective tissue, and Periosteum. * The scalp proper is composed of the outer three layers, of which the connective tissue contains one of the richest cutaneous blood supplies of the body. * The occipitofrontal muscle complex inses into the epicranial aponeurosis, which forms the intermediate tendon of this digastric muscle. This structure, along with the underlying layer of loose connective tissue, accounts for the high degree of mobility of the scalp over the pericranium. * If the aponeurosis is lacerated transversely, traction from the muscle bellies will cause considerable gaping of the wound. Secondary to trauma or infection, blood or pus may accumulate subjacent to the epicranial aponeurosis. Bone is too deep, as is the dural mater.", "role": "assistant" } ]

[ { "content": "On 5th postoperative day after laparoscopic cholecystectomy, a 50 years old lady presented with . upper quadrant pain with fever and 12 cm subhepatic collection on CT and ERCP shows cystic duct leak. The best management is - \nSelect and explain. \nA. Immediate laparotomy, B. Percutaneous drainage of fluid, C. Laparotomy and surgical exploration of bile duct and T-tube inseion, D. All", "role": "user" }, { "content": "Answer: B \nExplanation: Ans : (b) i.e. percutaneous drainage of fluid", "role": "assistant" } ]

[ { "content": "Hardest bone of the body is? \nSelect and explain. \nA. Head of humerus, B. Calcaneum, C. Tibial condyle, D. Osseus labyrinth", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D Osseus labyrinthRef: Gray's Anatomy, 41st ed. pg. 644* Osseous labyrinth is considered as hardest bone of the body. It is embedded in petrous part of temporal bone, which is also known as \"rock bone\".* American edition of British encyclopedia states: \"The labyrinth of the ear is formed of cochlea, 3 semicircular canals and a small cavity known as vestibulum into which cochlea and semicircular canal opens. These parts are formed of the hardest bone in body, almost equal in solidity to ivory and petrous portion of temporal bone.", "role": "assistant" } ]

[ { "content": "Attempts to quantitate clinical conditions on a graduated scale, thereby facilitating comparison among populations examined by the same criteria and methods is: \nSelect and explain. \nA. Indices, B. Survey, C. Biostatistics, D. Analysis", "role": "user" }, { "content": "Answer: A \nExplanation: \"A numerical value describing the relative status of a population on a graduated scale with definite upper and lower limits, which is designed to permit and facilitate comparison with other populations classified by the same criteria and methods\". - Russell A.L. \n\"Epidemiologic indices are attempts to quantitate clinical conditions on a graduated scale, thereby facilitating comparison among populations examined by the same criteria and methods\" - Irving Glickman.", "role": "assistant" } ]

[ { "content": "All of the following are habbit disorders, except: \nSelect and explain. \nA. Thumb sucking, B. Tics, C. Temper tantrums, D. Nail biting", "role": "user" }, { "content": "Answer: B \nExplanation: Tics are rapid and reccurent moments for brief duration and it is not included under habbit disorders.", "role": "assistant" } ]

[ { "content": "Incidence of TB in a community is measured by \nSelect and explain. \nA. Sputum positive, B. Tuberculin test positive, C. Sputum culture positive, D. Mantoux test positive", "role": "user" }, { "content": "Answer: A \nExplanation: Epidemiological indices of TB Incidence of TB infection (Annual infection rate, Annual risk of infection - ARI) : percentage if population understudy who will be newly infected with TB among Non-infected in 1 year Express attacking force of TB in community In developing countries 1% ARI corresponds to : 50 SS +ve cases per 100000 general population. Tuberculin conversion index is the best indicator for evaluation of TB problem and its trend ' in the community Prevalence of TB infection Percentage of individuals who show a positive reaction to standard Tuberculin test. Represent cumulative experience of population in' recent as well as remote infection' with TB Tuberculin test is the only way of estimating the prevalence of infection in a population Incidence of disease Percentage of new TB cases per 1000 population. Reveals trend of problem, including impact of control measures. Is of utility only in countries where high propoion of new cases are detected and notification is reliable Sputum smear examination (AFB) is a reliable method for estimation. Prevalence of disease or case rate Percentage of individuals whose sputum is positive for TV bacilli on microscopic examination Best available practical index to estimate case load in community. Age specific prevalence is most relevant index Ref: Park 25th edition Pgno : 219-220", "role": "assistant" } ]

[ { "content": "Treatment of choice for endocervical polyp is \nSelect and explain. \nA. Vaginal hysterectomy, B. Conisation, C. Polypectomy, D. Radiotherapy", "role": "user" }, { "content": "Answer: C \nExplanation: Polyp is categorized and defined by ultrasound, saline sonography, hysteroscopy with or without histopathology It is treated by polypectomy Ref: Shaw Gynecology 17 e pg 132.", "role": "assistant" } ]

[ { "content": "A standard normal distribution has \nSelect and explain. \nA. A mean of 1 and a standard deviation of 1, B. A mean of 0 and a standard deviation of 1, C. A mean larger than its standard deviation, D. All scores within one standard deviation of the mean", "role": "user" }, { "content": "Answer: B \nExplanation: (B) A mean of 0 and a standard deviation of 1# STANDARD NORMAL DISTRIBUTION is defined as a normal distribution with a mean of 0 & a standard deviation of 1.> Normal (or Gaussian) distribution is a very commonly occurring continuous probability distribution--a function that tells the probability that any real observation will fall between any two real limits or real numbers, as the curve approaches zero on either side.> The figure below shows 99.7% of population fall within 2 SD.", "role": "assistant" } ]

[ { "content": "All the following will appear caries in an X-ray except \nSelect and explain. \nA. Acrylic resin, B. Calcium hydroxide, C. ZOE, D. Composite", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "When gases flow through an orifice which factor is least likely to affect turbulence \nSelect and explain. \nA. Density of gas, B. Viscosity of gas, C. Pressure of gas, D. Diameter of orifice", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. (c) Pressure of gas(Ref: Ganong, 25th ed/p.629)Whether the air flow is laminar or turbulent is determined by Reynolds numberReynolds number =rDV/eWhere,r-Density of the gasD-Diameter of the airwaysV -Velocity of gase -Viscosity of gasPressure of gas is not in the formula for Reynolds number", "role": "assistant" } ]

[ { "content": "In all of the following sympathectomy is effective except \nSelect and explain. \nA. Intermittent claudication, B. Hyperhydrosis, C. Raynaud's disease, D. Causalgia", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Presence of delta sign on contrast enhanced CT SCAN suggests presence of ? \nSelect and explain. \nA. Lateral Sinus thrombophlebitis, B. Cholesteatoma, C. Cerebellar abscess, D. Mastoiditis", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Lateral Sinus thrombophlebitis LATERAL SINUS THROMBOPHLEBITIS (SIGMOID SINUS THROMBOSIS) Lateral or sigmoid sinus thrombophlebitis arises from inflammation in the adjacent mastoid. It may occur as a complication of : ? Acute coalescent mastoiditis CSOM and cholesteatoma Clinical features Hectic Picket-Fence type of fever with rigor. Headache, Progressive anemia and emaciation. Griesinger's sign : - odema over the posterior pa of mastoid due to thrombosis of mastoid emissary veins. Papilloedema Tobey-Ayer test :- Compression of vein on the thrombosed side produces no effect while compression of vein on healthy side produces rapid rise in CSF pressure which will be equal to bilateral compression of jugular veins. Crowe-Beck test :- Pressure on jugular vein of healthy side produces engorgement of retinal veins. Pressure on affected side does not produce such change. Tenderness along jugular vein Imaging studies Contrast-enhanced CT scan can show sinus thrombosis by typical delta-sign. It is a triangular area with rim enhancement, and central low density area is seen in posterior cranial fossa on axial cuts. Delta-sign may also be seen on contrast enhanced MRI.", "role": "assistant" } ]

[ { "content": "Bronchogenic sequestration is seen in which lobe - \nSelect and explain. \nA. Left lower lobe, B. Right upper lobe, C. Left middle lobe, D. Left upper lobe", "role": "user" }, { "content": "Answer: A \nExplanation: Bronchogenic sequestration refers to the presence of a discrete mass of lung tissue without any normal connection to the airway system.\nIntralobar sequestrations are found most frequently in the posterior basal segment of the left lower lobe.\nBlood supply to the sequestered area arises not from the pulmonary arteries but from the aorta or its branches.\nExtralobar sequestrations are external to the lung. Found most commonly in infants as abnormal mass lesions, they may be associated with other congenital anomalies.\nIntralobar sequestrations are found within the lung substance and are usually associated with recurrent localized infection or bronchiectasis.", "role": "assistant" } ]

[ { "content": "In triage green colour indicates - \nSelect and explain. \nA. Ambulatory patients, B. Dead or moribund patients, C. High priority treatment or transfer, D. Medium priority or transfer", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Ambulatory patients There are 4 triage categories I. Green - Minor/Ambulatory 3. Yellow - Delayed 2. Red -- Immediate 4.Black - Dead or nonsalvageable Minor (Green) they should be separated from the general group at the beginning of the triage operations ( k/a \"Walking wounded\" these patients can be used to assist in treatment of those patients tagged as immediate. Immediate (Red) in these patients, ventilation is present only after repositioning the airway. respiratory rate is greater than 30 / min. delayed capillary refill (> 2 sec) unable to follow simple commands Delayed (Yellow) - any patient who does not fit into either the immediate or minor categories. Deceased (Black) - no ventilation present even after repositioning the airway. So in this question : Option 'a' ie Ambulatory pts --> Green Option 'b' ie Deed or moribund pts --> Black Option'c' ie High priority treatment or transfer --> Red Option 'd' ie Priority or transfer --> Yellow", "role": "assistant" } ]

[ { "content": "Which of the following is seen in Vitamin D deficiency- \nSelect and explain. \nA. Increased alkaline phosphatase, B. Decreased phosphate in urine, C. Hyperphosphatemia, D. Decreased alkaline phosphatase", "role": "user" }, { "content": "Answer: A \nExplanation: Vitamin D deficiency leads to impaired intestinal absorption of calcium, resulting in decreased serum total and ionized calcium values. This hypocalcemia results in secondary hyperparathyroidism, a homeostatic response that initially maintains serum calcium levels at the expense of the skeleton. Due to the PTH-induced increase in bone turnover, alkaline phosphatase levels are often increased. In addition to increasing bone resorption, PTH decreases urinary calcium excretion while promoting phosphaturia. This results in hypophosphatemia, which exacerbates the mineralization defect in the skeleton. Reference : page 2466 Harrison's Principles of Internal Medicine 19th edition", "role": "assistant" } ]