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[ { "content": "Serous papillary cystadenocarcinomas of the ovaries express \nSelect and explain. \nA. CA-125, B. CA-19, C. CEA, D. AFP", "role": "user" }, { "content": "Answer: A \nExplanation: CA-125", "role": "assistant" } ]

[ { "content": "Among the following which is a feature of testicu- lar feminization syndrome: \nSelect and explain. \nA. XX pattern, B. Commonly reared as male, C. Well formed female internal genitalia, D. High testosterone levels", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Lymph from glans penis drain into \nSelect and explain. \nA. External iliac lymph nodes, B. Internal iliac lymph nodes, C. Deep inguinal lymph nodes, D. Superficial inguinal lymph nodes", "role": "user" }, { "content": "Answer: C \nExplanation: Lymphatics from the glans drain into the deep inguinal nodes also called gland of Cloquet. Lymphatics from the rest of the penis drain into the superficial inguinal lymph nodes.Ref: Vishram Singh; Volume II; 2nd edition; Page no: 464", "role": "assistant" } ]

[ { "content": "A pregnant lady at 32 weeks' gestation period presents with a BP of 160/110 mm Hg, Proteinuria with Retinal Hemorrhage What is the Definitive Management of choice in this case? \nSelect and explain. \nA. Ritodrine, B. Nifedipine, C. Magnesium sulphates, D. Termination of pregnancy", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D. Termination of pregnancyPatient presents with the characteristics of Severe Hypertension indicating delivery.Induction of labor is the best suited management of choice.Magnesium Sulfate prophylaxis should be provided to prevent the onset of seizures.Severe pre-eclampsia can be characterized as:* Pulmonary edema* BP >160/110* Fetal growth restriction* >-3+ proteinuria* Complaints of convulsion, headache, upper abdominal pain, oliguria and visual disturbances* Increased levels of serum creatinine, serum transaminase or presence of thrombocytopenia", "role": "assistant" } ]

[ { "content": "The ridge that descends from the cuspal tip towards the central part of the occlusal surface in a maxillary molar is \nSelect and explain. \nA. Triangular ridge, B. Marginal ridge, C. Transverse ridge, D. Oblique ridge", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "No treatment of withdrawal is req uired in - \nSelect and explain. \nA. LSD, B. Opium, C. Alcohol, D. Amphetamine", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., LSD o Clinically significant withdrawal syndrome (requires treatment)Alcohol, opioids, amphetamines, Barbiturates, BZDs, Nicotine.o No or minimal clinically significant withdrawal syndrome (requires no treatment) :-LSD (nil). Cannabis (minimal).", "role": "assistant" } ]

[ { "content": "Complications of placenta pre include all except ___________ \nSelect and explain. \nA. Malpresentation, B. Premature labor, C. Rapid dilation of cervix, D. Retained placenta", "role": "user" }, { "content": "Answer: C \nExplanation: Complication of placenta pre: Maternal complications Antepaum Labour Postpaum Puerperium APH Cord Prolapse PPH Sepsis Malpresentation Intrapaum hemorrahage Retained placenta Premature labour Early rupture of membranes Associated abruptio: 10% Fetal complications Low bih weight: 15% (Most common fetal complication) Bih Asphyxia IUD Bih injuries Congenital malformation (3X risk) Most common complication of abruptio placenta: Prematurity Most common complication of placenta prec: LBW Ref: DC Dutta&;s Textbook of Obstetrics 8th edition Pgno: 288, 289", "role": "assistant" } ]

[ { "content": "National institute of Homeopathy is located in: \nSelect and explain. \nA. Delhi, B. Kolkata, C. Chennai, D. Mumbai", "role": "user" }, { "content": "Answer: B \nExplanation: The government of india has established a national institute of Ayurveda in Jaipur and a national institute of homeopathy in Kolkata. Ref: Park 21st edition, page 849.", "role": "assistant" } ]

[ { "content": "Karyotyping is useful in diagnosis of - \nSelect and explain. \nA. Autosomal recessive disorders, B. X-linked recessive disorders, C. Chromosomal abnormalities, D. Biochemical abnormalities", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Chromosomal abnormalitieso Karyotyping is the study of chromosomes and is used in cytogenetics to study the chromosomal abnormalities. o After arresting the cells in metaphase the chromosomes are examined to see for:(i) Numbers --> to detect abnormalities in chromosome numbers such as aneuploidy (trisomy, tetrasomy), polyploidy.(ii) Structure ---> to detect structural chromosomal anomalies such as translocations, deletions, inversions.", "role": "assistant" } ]

[ { "content": "In Complete deft the hard palate is totally separated from? \nSelect and explain. \nA. Maxilla, B. Soft palate, C. Vomer, D. All", "role": "user" }, { "content": "Answer: C \nExplanation: ANSWER: (C) VomerREF: With textPalate cleft can occur as complete (soft and hard palate, possibly including a gap in the jaw) or incomplete (a 'hole' in the roof of the mouth, usually as a cleft soft palate).Normally the hard palate is continuous in front and laterally with the alveolar processes of the maxilla, and gives attachment posteriorly to the soft palate.\"In cleft palate the hard palate may or may not be attached to the vomer. If it is attached to the vomer, it is called as incomplete. Hard palate in complete cleft palate is totally separated from vomer' REF: Cleft lip and palate: diagnosis and management - Samuel Berkowitz Page 50.\"In incomplete unilateral cleft palate, nasal septum (Vomer) is attached to the uncleft side of hard palate. In bilateral complete deft lip and palate, Vomer is free and septum hangs freely\"REF: Synopsis of Oral & Maxillofacial Surgery by Ghosh page 155Incomplete deft palateUnilateral complete lip and palateBilateral complete lip and palate", "role": "assistant" } ]

[ { "content": "All vaccines are contraindicated in pregnancy except \nSelect and explain. \nA. BCG Vaccine, B. Measles Vaccines, C. OPV Vaccine, D. Yellow fever vaccine", "role": "user" }, { "content": "Answer: D \nExplanation: All live vaccines are contraindicated in pregnancy except yellow fever vaccine.", "role": "assistant" } ]

[ { "content": "Inclusion conjunctivitis is caused by: \nSelect and explain. \nA. Chlamydia trachomatis, B. Chlamydia psittaci, C. Herpes, D. Gonorrhoea", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e. Chlamydia trachomatis Inclusion conjunctivitis is caused by chlamydia trachomatis (serotypes D- K).Chlamydial inclusion conjunctivitis is generally spread by sexual transmission from the genital reservoir of infection. The primary source of infection is a benign subclinical venereal disease producing a mild urethritis in the male and cervicitis in the female.The modes of transmission are orogenital activities and hand to eye spread of infective genital secretions. A common mode of transmission is through the water in swimming pools; thus the disease may occur in local epidemics (swimming pool conjunctivitis). It is also transmitted from the mother to the newborn.Treatment- azithromycin or doxycycline", "role": "assistant" } ]

[ { "content": "Example of Type IV hypersensitivity is - \nSelect and explain. \nA. Serum sickness, B. Granulomatous reaction, C. Shwartzman reaction, D. Arthus reaction", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. (b) Granulomatous reaction(Ref: Robbins 9th/pg 208-211; 8th/pg 205-208; Illustrated Dictionary of Immunology by M.P.Arora - Page 501)Granulomatous reaction is an example of type IV hypersensitivitySerum sickness & Arthus reactions are examples of type III hypersensitivityShwartzman reaction is a non-immunologic phenomenon in which endotoxin (lipopolysaccharide) induces local & systemic reactions; It can either be local or systemic type;", "role": "assistant" } ]

[ { "content": "In colposcopy following are visualised except: \nSelect and explain. \nA. Upper 2/3rdendocervix, B. Cervical carinoma in situ, C. Cervical polyp, D. Cervical dysplasia", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following changes in C-MYC oncogene may be associated with colonic malignancy? \nSelect and explain. \nA. Point mutation, B. Amplification, C. Rearrangement, D. Deletion", "role": "user" }, { "content": "Answer: B \nExplanation: C- MYC amplification may be responsible for Ca breast, Ca colon, Ca stomach and lung. L - MYC amplification is associated with Ca lung and bladder. N- MYC amplification is associated with neuroblastoma and Ca lung. Ref: Harrison, 17th Edition, Page 496", "role": "assistant" } ]

[ { "content": "Name of the curved laryngoscope ? \nSelect and explain. \nA. Miller, B. Macintosh, C. Muller, D. Merkel", "role": "user" }, { "content": "Answer: B \nExplanation: Laryngoscopy (larynx + scopy) is a medical procedure that is used to obtain a view of the vocal folds and the glottis. Following are the types of the available laryngoscopes :- i) Straight blade: Miller ii) Curved blade: Macintosh", "role": "assistant" } ]

[ { "content": "The hilum of the right lung is arched by: \nSelect and explain. \nA. Recurrent laryngeal nerve, B. Azygos vein, C. Thoracic duct, D. Vagus nerve", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Azygous vein", "role": "assistant" } ]

[ { "content": "Half life of factor 8 \nSelect and explain. \nA. 4 hrs, B. 8 hrs, C. 24 hrs, D. 30 hrs", "role": "user" }, { "content": "Answer: B \nExplanation: Factor VIII is also called as anti hemophilic factor Its half life is 8-12 hrs Ref: Harrison's 19th edition Pgno :138", "role": "assistant" } ]

[ { "content": "Most common cause of lower respiratory tract infection in 3 year old child is \nSelect and explain. \nA. Klebsella, B. H-influenza, C. Streptococcal pneumonia, D. Staphe aureus", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Streptococcal pneumonia", "role": "assistant" } ]

[ { "content": "In which condition doctor is passive \nSelect and explain. \nA. Classical psychoanalysis, B. Psychoanalytic psychoanalysis, C. Both, D. None", "role": "user" }, { "content": "Answer: A \nExplanation: Classical Psychoanalysis No detailed history taking, mental status examination, or formalised psychiatric diagnosis is attempted. The patient is allowed to communicate unguided, by using 'free association'. The therapist remains passive with a non-directive approach; however, the therapist constantly challenges the existing defences and interprets resistance (during the therapy) and transference (patient's feelings, behaviours and relationship with the therapist). No direct advice is ever given to the patient. The crux of the therapy is on interpretation. During the therapy, the patient typically lies on the couch, with the therapist sitting just out of vision. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 213", "role": "assistant" } ]

[ { "content": "Irradiation can be used to sterilize A/E - \nSelect and explain. \nA. Bone graft, B. Suture, C. Artificial tissue graft, D. Bronchoscope", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., BronchoscopeEndoscopes are sterilized by chemical methods Methods for sterilization of endoscopes Rigid endoscope - Autoclave Flexible - Glutaraldehyde Peracetic acidNowadays musculoskeletal tissue allografts are being increasingly used for knee reconstructive procedures.The soft tissue allografts commonly being used are bone-patellar tendon-bone, Achilles tendon, fascia lata, anterior and posterior tibial tendon.Infections with allografts is a serious concern.Therefore these allografts need proper sterilization and disinfection.The proper sterilization procedure for these allografts is Gamma/Electron beam irradiation.", "role": "assistant" } ]

[ { "content": "Normal intraabdominal pressure is ? \nSelect and explain. \nA. 0 - 8mmHg, B. 10 - 15mmHg, C. 15 - 20mmHg, D. 20 - 26mmHg", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is'a'i.e., 0 - 8 mmHgNormal intra-abdominal pressure is 0-6 mmHg.", "role": "assistant" } ]

[ { "content": "True regarding fluorosis are all except – \nSelect and explain. \nA. Fluorosis is the most common cause of dental caries in children, B. Fluorosis can cause fluoride deposition in bones, C. Defluoridation is done by Nalgonda technique, D. Fluorosis can cause genu valgum", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Conduction velocity of nerves is NOT affected by which of the following? \nSelect and explain. \nA. Leprosy, B. Motor neuron disease, C. Hereditary neuropathy, D. A.I.D.P", "role": "user" }, { "content": "Answer: B \nExplanation: Motor neuron disease is at anterior horn cell, pyramidal neurons and not the nerves. Thus the conduction velocity in the nerves is normal. Leprosy - Affects nerves and both sensory nerve conduction /motor nerve conduction studies may demonstrate reduced amplitude in affected nerves but occasionally may reveal demyelinating features. Charcot-Marie-Tooth disease (CMT) -MC hereditary neuropathy and has reduced motor nerve conduction velocity A.I.D.P -Segmental demyelination in the spinal cord and peripheral nerves. Early features-prolonged F-wave latencies Prolonged distal latencies Reduced amplitudes of compound muscle action potentials, d/t involvements of nerve roots and distal motor nerve terminals", "role": "assistant" } ]

[ { "content": "Arteriole is \nSelect and explain. \nA. Conducting vessel, B. Resistance vessel, C. Exchange vessels, D. Capacitance vessel", "role": "user" }, { "content": "Answer: B \nExplanation: Arterioles regulate the distribution of blood flow by altering their diameter to increase or decrease the peripheral resistance as required.", "role": "assistant" } ]

[ { "content": "Ether was first used by: \nSelect and explain. \nA. Preistly, B. Moon, C. Wells, D. Simpson", "role": "user" }, { "content": "Answer: B \nExplanation: Moon", "role": "assistant" } ]

[ { "content": "In which of the following Arbiskov cells are seen ? \nSelect and explain. \nA. Myelodysplastic syndrome, B. Multiple myeloma, C. Granulocytic sarcoma, D. Leukemia cutis", "role": "user" }, { "content": "Answer: C \nExplanation: Granulocytic Sarcoma Also known as Choloroma or myeloblastoma. It is a hematopoietic stem cell tumour. It is an extramedullary tumor of immature granulocytic series cells. It is a localised tumour forming a mass in the skin of orbital & periorbital tissue due to infiltration of tissues by leukemic cells. It is most commonly associated with AML M2 Arbiskov cells are monocytes which can be seen in choloroma.", "role": "assistant" } ]

[ { "content": "Epistaxis in elderly person is most commonly due to: \nSelect and explain. \nA. Foreign body, B. Bleeding disorder, C. Hypertension, D. Nasopharyngeal carcinoma", "role": "user" }, { "content": "Answer: C \nExplanation: (c) Hypertension(Ref. Cummings, 6th ed. 680)The most common cause of epistaxis in an elderly person is hypertension.Foreign body is not seen at this age.Bleeding disorder will present with bleeding from multiple sites.Nasopharyngeal carcinoma presents with upper deep cervical lymph node. Nasal obstruction and blood tinged nasal discharge can occur later on.", "role": "assistant" } ]

[ { "content": "A pregnant mother at 32 weeks gestation presents in preterm labour. Therapy with antenatal steroids to induce lung maturity in the fetus may be given in all of the following conditions except: \nSelect and explain. \nA. Prolonged rupture of membranes for more than 24 hours, B. Pregnancy induced hypertension, C. Diabetes mellitus, D. Chorioamnionitis", "role": "user" }, { "content": "Answer: D \nExplanation: “Corticosteroids can be given even in presence of maternal hypertension or diabetes mellitus, but should preferably be avoided if PROM is associated with definitive evidence of chorioamnionitis”\nMeherban Singh 5/e, p 227\n“Steroid treatment is contraindicated in presence of overt infection.”\nFernando Arias 3/e, p 220\nSteroid therapy in preterm labour:\n\nSteroids are recommended for all women in preterm labour before 32 weeks with or without membrane ruptures in whom there is no evidence of chorioamnionitis. According to ACOG, single dose steroid injection is recommended between 24 to 32 weeks. There is no concensus regarding treatment between 32-34 weeks. Corticosteroid therapy is not recommended before 24 weeks.\n\nAdvantage:\n\nSteroids reduce the rate of respiratory distress syndrome, intraventricular hemorrhage and necrotising enterocolitis in the newborn.\nThe effect of treatment is maximal between 24 hours of the first dose and uptil 7 days.\nEarlier it was recommended to give repeated doses weekly till the patient delivers but this practice is associated with significant fetal and neonatal side effects like cerebral palsy and should be abandoned.\nBetamethasone is the steroid of choice as it also prevents periventricular leukomalacia although dexamethasone can also be used.\nDose:\n\n\nBetamethasone = 2 doses of 12 mg, 24 hours apart,\nDexamethosane: 4 doses of 6 mg, 12 hours apart.", "role": "assistant" } ]

[ { "content": "Insulin inhibits ketogenesis by all except \nSelect and explain. \nA. Inhibiting lipolysis, B. Increased esterification of fatty acids, C. Directing acetyl-CoA to TCA cycle, D. Increasing b-oxidation", "role": "user" }, { "content": "Answer: D \nExplanation: Insulin inhibits lipolysis in adipose tissue due to inhibition of hormone-sensitive lipase Insulin depresses HMG CoA synthase and so ketogenesis is decreased In the presence of insulin, acetyl CoA is completely utilized in the citric acid cycle because oxaloacetate generated from glucose is available in plenty. Insulin also ours fatty acid synthesis from acetyl CoA. All these factors reduce the availability of acetyl CoA so that production of ketone bodies reduced.Ref: DM Vasudevan, 7th edition, page no: 322", "role": "assistant" } ]

[ { "content": "Treatment for dendritic ulcer includes all except: March 2009 \nSelect and explain. \nA. Penetrating keratoplasty, B. Acyclovir, C. Steroids, D. Debridement of the edges of the ulcer", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. C: Steroids Debridement of the edges of the ulcer with a moistened, fine cotton tipped applicators helps in reducing the load of active virus-infected cells. The standard treatment is idoxuridine drops/ trifluridine drops/ acyclovir 3% eye ointment/ 3% vidarabine ointment produces a resolution of herpes in 95% of the patients. Steroids are contraindicated in suspected cases of herpes simplex epithelial keratitis paicularly in the presence of active viral replication. Penetrating keratoplasty is useful in cases with herpetic scarring where the eye has been free of activity for a year.", "role": "assistant" } ]

[ { "content": "Which of the following condition is associated with limitation of both adduction and abduction of the affected eye? \nSelect and explain. \nA. Duane retraction syndrome Type 1, B. Duane retraction syndrome Type 2, C. Duane retraction syndrome Type 3, D. Double elevator palsy", "role": "user" }, { "content": "Answer: C \nExplanation: Weakness of both adduction and abduction of the eye is a feature of Duane retraction syndrome type 3. Duane retraction syndrome is a congenital, incomitant ocular motility disorder characterized by abnormal function of lateral rectus muscle in the affected eye together with retraction of the globe and narrowing of the palpabrel fissure on attempted adduction. Retraction of the globe and narrowing of the palpabrel fissure occur due to simultaneous contraction of medial and lateral rectus muscles on attempted adduction. There are of 3 types: DRS type 1 - limited abduction, normal adduction DRS type 2 - limited adduction, normal abduction DRS type 3 - limited adduction and abduction", "role": "assistant" } ]

[ { "content": "The only one flexible minor connector is \nSelect and explain. \nA. that connecting clasp assembly to major connector, B. that connecting indirect retainer assembly to the major connector, C. that joining the denture base to major connector, D. that approach arm of a bar type clasp", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "In an infant born to a HIV infected mother, at what age of child the ELISA test can reliably diagnose HIV infection \nSelect and explain. \nA. 18 months, B. 9 months, C. 12 months, D. 3 months", "role": "user" }, { "content": "Answer: A \nExplanation: Enzyme-linked immunosorbent assay (ELISA) and Western blotting are used to initially detect HIV-specific antibodies but these tests are not used for diagnosis in patients younger than 18 months of age. This is because of the persistence of the maternal HIV antibody in infants younger than 18 months. \nInfants younger than 18 months require virologic assays that directly detect HIV in order to diagnose HIV infection.", "role": "assistant" } ]

[ { "content": "Vitamin A requirement in infant is - \nSelect and explain. \nA. 350 mg, B. 600 mg, C. 800 mg, D. 1000 mg", "role": "user" }, { "content": "Answer: A \nExplanation: - daily intake of vitamin A recommended by ICMR for infants is 350 mcg retinol. - daily intake of vitamin A recommended by ICMR for infants is 2800 mcg beta carotene. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:616 <\\p>", "role": "assistant" } ]

[ { "content": "Sarcoma botryoides of vagina commonly occurs in which age group- \nSelect and explain. \nA. <10 years, B. 20-30 years, C. 40-50 years, D. 50-60 years", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., < 10 years * Sarcoma botryoides or botryoid rhabdomyosarcoma is a subtype of embryonal rhabdomyosarcoma, that can be observed in the walls of hollow, mucosa lined structures such as the nasopharynx, common bile duct, urinary bladder of infants and young children or the vagina in females, typically younger than age 8. The name comes from the gross appearance of \"grape bunches\" (botryoid in Greek).", "role": "assistant" } ]

[ { "content": "A 70-year-old man with hypeension wakes up with severe chest pain and diaphoresis. On examination he has bounding pulses with wide pulse pressure. A diastolic murmur is heard along the right sternal border. Which of the following is the possible etiology? \nSelect and explain. \nA. Aoic dissection, B. STEMI with papillary muscle dysfunction, C. Myocarditis with functional regurgitation, D. Flash pulmonary edema", "role": "user" }, { "content": "Answer: A \nExplanation: Option A= High B.P | Aoic dissection | Leads to Retrograde spread | develop Aoic Root dilation | Leads to develop Aoic Regurgitation- Diastolic Murmur Option B= STEMI with Papillary muscle dysfunction have systolic murmur. Option C= Myocarditis with functional regurgitation- Systolic murmur Option D= Flash Pulmonary edema related to Renal aery stenosis/Reno vascular hypeension", "role": "assistant" } ]

[ { "content": "All of the following about gastrointestinal carcinoid tumours are true, Except \nSelect and explain. \nA. Small intestine and appendix account for almost 60% of all gastrointestinal carcinoid, B. Rectum is spared, C. 5 year survival for carcinoid tumors is > 60%, D. Appendical carcinoids are more common in females than males", "role": "user" }, { "content": "Answer: B \nExplanation: About 15% rectum is involved in a carcinoid tumour it arises from the submucosa with the overlying intact mucous membrane. Reference SRB 5 the edition page no. 877", "role": "assistant" } ]

[ { "content": "Obesity is associated with all of the following except: \nSelect and explain. \nA. Osteoahritis, B. Hypeension, C. Gall stones, D. Pancreatitis", "role": "user" }, { "content": "Answer: D \nExplanation: Answer is D (Pancreatitis): Pancreatitis has no association with obesity. RISKS OF OBESITY INCLUDE THE FOLLOWING : A. Cardiovascular disease : -increased risk of atherosclerosis -increased risk of hypeension - increased risk of sudden death B. Pulmonary function : Sleep apnea and Right hea failure C. Gall bladder disease : Increased incidence of Gall stones D. Joint : - Increased risk of osteoahritis Q :paly due to added trauma of increased weight bearing - Increased incidence of Gout 2:due to impairment in urate clearance. E. Diabetes mellitus : Type II diabetes mellitus Q is almost always seen in the obese. F. Cancer : Increased incidence of endometrial carcinoma post menopausal breast cancer prostate cancer Q - colorectal carcinoma G. Skin : Increased incidence of Acanthosis nigricans Q H. Endocrine : Insulin Resistance : leading to Hyperinsulinemia is directly related to degree of obesity. Growth hormone Q :secretions is reduced but IGF-I levels are normal thus growth is not affected. Testosterone level is reduced.Q", "role": "assistant" } ]

[ { "content": "Syndrome characterized by an elaborate delusion that the patient is passionately loved by another person is also known as: COMEDK 15 \nSelect and explain. \nA. Ekbom's syndrome, B. De Clerambault's syndrome, C. Querulous paranoia, D. Othello syndrome", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. De Clerambault's syndrome", "role": "assistant" } ]

[ { "content": "Which one of the following is the treatment of choice in a child with inguinal hernia \nSelect and explain. \nA. Bassini's repair, B. Shouldice repair, C. Herniotomy alone, D. Lichtenstein reapir", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "When the concentration of the etchant is more than 50%, it forms a complex which prevents further dissolution. The complex is \nSelect and explain. \nA. hydroxyapatite, B. calcium phosphate, C. monocalcium phosphate monohydrate, D. none of the above", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following indications of deep brain stimulation is not FDA approved? \nSelect and explain. \nA. OCD, B. Major depression, C. Parkinsonism, D. Dystonia", "role": "user" }, { "content": "Answer: B \nExplanation: FDA approved indications for deep brain stimulation are: a. Parkinson's disease and essential tremors b. Dystonia c. Obsessive compulsive disorder", "role": "assistant" } ]

[ { "content": "An 18 yr old male presents with massive hematemesis; he has history of fever for the past 14 days for which he was managed with drugs; moderate splenomegaly is present; diagnosis is: \nSelect and explain. \nA. NSAID induced duodenal ulcer, B. Drug induced gastritis, C. Esophageal varices, D. None of the above.", "role": "user" }, { "content": "Answer: C \nExplanation: Answer is C (Esophageal varices) Presence of massive haematemesis in the background of moderate splenomegaly suggests a diagnosis of esophageal varices secondary to poal hypeension. Esophageal varices : Most common presentation of esophageal varices is Hematemesis. 'Splenomegaly, sometimes with hipersplenism, is the next most common presenting feature in the poal vein obstruction.'", "role": "assistant" } ]

[ { "content": "Most sensitive investigation to see intracranial bleed in a patient with head injury - \nSelect and explain. \nA. MRI, B. X-ray, C. CT-scan, D. Ultrasound", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., CT-scan o Has been explained in previous session", "role": "assistant" } ]

[ { "content": "Autoantigen is ? \nSelect and explain. \nA. Blood group antigen, B. Forssman antigen, C. Both, D. None", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which one of following is Polysaccharide vaccine:- \nSelect and explain. \nA. Peussis, B. Hepatitis B, C. Meningococcal, D. Yellow fever", "role": "user" }, { "content": "Answer: C \nExplanation: Polysaccharide vaccines are: Typhim-Vi Pneumococcal vaccine Meningococcal vaccine Hib.", "role": "assistant" } ]

[ { "content": "Vaccine which requires the most stringent conditions for storage \nSelect and explain. \nA. DPT, B. OPV, C. BCG, D. TT", "role": "user" }, { "content": "Answer: B \nExplanation: Among the vaccines, polio is the most sensitive to heat, requiring storage at minus 20 degree Celsius. Vaccines which must be stored in the vaccine compaments are polio and measles. The cold chain is a system of storage and transpo of vaccines at low temperature from the manufacturer to the actual vaccination site (refer pgno:109 park 23 rd edition)", "role": "assistant" } ]

[ { "content": "As the alveolar bone height moves apically, center of resistance moves: \nSelect and explain. \nA. Apically, B. Coronally, C. Mesially, D. Infinity", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which among the following condition is positive for double stranded DNA antibody? \nSelect and explain. \nA. SLE, B. Sjogren's syndrome, C. Scleroderma, D. Mixed Connective Tissue Disorder", "role": "user" }, { "content": "Answer: A \nExplanation: Serum antinuclear antibodies (ANAs) are found in nearly all individuals with active SLE. Antibodies to native double-stranded DNA (dsDNA) are relatively specific for the diagnosis of SLE. Anti-SSA or anti-SSB antibodies are seen in Sjogren's syndrome. Topoisomerase I antibodies (also known as Scl-70), Anticentromere antibodies, Fibrillarin antibodies and antibodies to ribonucleoprotein (RNP) are present in scleroderma. Anti-U1-RNP antibodies, and antibodies against U1-70 kd small nuclear ribonucleoprotein (snRNP) are characteristic of mixed connective tissue disorder (MCTD).", "role": "assistant" } ]

[ { "content": "A 60 year old male was diagnosed as carcinoma right lung. On CECT chest there was a tumor of 5 ✕ 5 cm in upper lobe and another 2 ✕ 2 cm size tumor nodule in middle lobe. The primary modality of treatment is - \nSelect and explain. \nA. Radiotherapy, B. Chemotherapy, C. Surgery, D. Supportive treatment", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "The drug of choice for treatment of meningococcal meningitis is \nSelect and explain. \nA. Piperacillin, B. Ceftriaxone, C. Ampicillin, D. Meropenem", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. b. CeftriaxoneRef: Goodman Gilman 13th E/PI 035Ceftriaxone is the drug of choice for treatment of meningitis caused by H. influenza, N. meningitidis (meningococcal meningitis) and S. pneumoniae.Ampicillin is the drug of choice for treatment of meningitis caused by L. monocytogenes.Meningitis seen in post neurosurgery or penetrating head trauma patients caused by staphylococcus, Propionibacterium, pseudomonas or acinetobacter is treated by meropenem+vancomycin.Note: For prophylaxis of meningococcal meningitis (contacts or mass chemoprophylaxis) ciprofloxacin is the drug of choice. Ceftriaxone though us the best drug for prophylaxis is not the drug of choice as it is a parenteral drug.", "role": "assistant" } ]

[ { "content": "Which of the following topical agent boosts cell - mediated immunity in burns \nSelect and explain. \nA. Mafenide acelate, B. Silver nitrate, C. Cerium nitrate, D. Povidone iodine", "role": "user" }, { "content": "Answer: C \nExplanation: Cerium nitrate boosts cell - mediated immunity and forms sterile eschar in burns.", "role": "assistant" } ]

[ { "content": "A 40yr old patient developed high fever of sudden onset .Peripheral blood film showed malaria parasite pigment was yellowish brown and schizonts were 9-10microns and contained 20 merozoites each \nSelect and explain. \nA. Pl vivax, B. Pl falciparum, C. Pl malariae, D. Pl ovale", "role": "user" }, { "content": "Answer: A \nExplanation: The features are consistent with the diagnosis of Pl vivax .yellow brown pigment-vivax Dark brown pigment-falciparum Ref: D.R. Arora. Medical parasitology 4th ed pg. 77", "role": "assistant" } ]

[ { "content": "The cells which lie outside blood testis barrier: \nSelect and explain. \nA. Sertoli cells, B. Spermatocyte, C. Spermatid, D. Leydig cells", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is d, i.e. Leydig cellsBlood testis barrier is formed by Sertoli cells which keeps the growing germ cells (its all stages) separated from blood.", "role": "assistant" } ]

[ { "content": "All are true about supraglottic laryngeal carcinoma except: \nSelect and explain. \nA. It is the most common site for carcinoma larynx, B. Involvement of upper & middle juglar Lymph nodes is seen, C. Point on swelling is the most common symptom, D. Stage T1 is treated by external beam radia therapy", "role": "user" }, { "content": "Answer: A \nExplanation: Glottie part is the most common sites for carcinoma larynx followed by supraglottic & subglottic pats respectively.", "role": "assistant" } ]

[ { "content": "Order of anastomosis in lung transplant: \nSelect and explain. \nA. Pulmonary aery, pulmonary vein, bronchus, B. Pulmonary vein, bronchus, pulmonary aery, C. Pulmonary vein, pulmonary aery, bronchus, D. Pulmonary aery, bronchus, pulmonary vein", "role": "user" }, { "content": "Answer: B \nExplanation: Order of anastomosis in lung transplant pulmonary vein, bronchus, pulmonary aery. LUNG TRANSPLANTATION PROCEDURE SLT: Performed through posterolateral thoracotomyQ image on left side DLT: Performed through bilateral thoracotomy or median sternotomyQ Sequence of anastomoses in lung transplantation (PV By BA PA): Pulmonary Vein - Bronchial Anastomosis - Pulmonary AeryQ COMPLICATIONS OF LUNG TRANSPLANTATION Dehiscence of airway anastomosisQ Late airway stenosis at bronchial anastomosis due to ischemia: Treated by dilatationQ", "role": "assistant" } ]

[ { "content": "Which statement is FALSE regarding specific learning disorders (SLD) \nSelect and explain. \nA. The overall estimates of the prevalence of SLD range from 3-1096, B. It is a type of neurodevelopmental dysfunctions, C. Terms as dysgraphia or dyscalculia had been revolutionized, D. Includes students did well in academic testing but not in intelligence testing", "role": "user" }, { "content": "Answer: D \nExplanation: Specific developmental disorders of scholastic Skills (specific learning disorders) includes reading disorder, spelling disorder, disorder of arithmetical skills, and mixed disorder of Scholastic Skills. Dyslexia (reading disorder) is included in lCD-10 in a separate category of symbolic dysfunction. The terms, Dyscalculia (mathematics disorder), and Dysgraphia (written language disorder) are also used by investigators and clinicians, but their inclusion in diagnostic classihcation systems has been inconsistent and a source of some disagreement among expes. A student exhibiting a significant discrepancy between scores on tests of intelligence and tests of academic achievement could be classified as a student with an SLD, and would subsequently be eligible for Special Education Services i.e. those student may did very well in IQ testing but not in academic achievement or tests. Ref:- Nelson&;s textbook of paediatrics; pg num:- 672", "role": "assistant" } ]

[ { "content": "An 8-month-old child presented with reduced appetite, abdominal distension and pain and psychomotor retardation. The child was normal at bih and both parents are normal. O/E: - Hepatosplenomegaly Moderate lymphadenopathy Abnormal posturing of the limbs, trunk, and face Impaired voluntary rapid eye movements Cheery red spot on fundus examination. Bony defects Lymph node-histopathology and electron microscopy. EM findings Which of the following enzymes is most likely deficient in the above disease: - \nSelect and explain. \nA. Hexosaminidase A, B. Alpha-galactosidase A, C. Glucocerebrosidase, D. Sphingomyelinase", "role": "user" }, { "content": "Answer: D \nExplanation: This is a case of Niemann-pick disease. 1. Autosomal recessive disease 2. Divided into 2 groups depending on deficiency: - Deficiency of acid sphingomyelinase enzyme- Type A and B Impaired intracellular cholesterol trafficking- Type C and D 3. Normal at bih 4. Presents with hepatosplenomegaly, lymphadenopathy and cherry red spot on fundus examination. 5. HPE image shows Niemann-pick cells- These are foam cells with soap suds appearance (Distention of Lysosomes due to sphingomyelin and cholesterol) 6. Electron microscopy shows Zebra bodies - These are concentric lamellated myelin figures (in engorged secondary lysosomes). OTHER ENZYME DEFICIENCIES: - Hexosaminidase A- Tay-sach's disease Alpha-galactosidase A - Fabry's disease Glucocerebrosidase - Gaucher's disease", "role": "assistant" } ]

[ { "content": "Feature of hydrops fetalis in a fetus can be due to: \nSelect and explain. \nA. Ebstein barr virus, B. Human papilloma virus, C. Parvovirus B19, D. Influenza Virus", "role": "user" }, { "content": "Answer: C \nExplanation: Hydrops fetalis - Excessive destruction of the fetal red cells leads to severe anemia, tissue anoxemia and metabolic acidosis It is accumulation of fluid in the body of the fetus in two out of three compaments: ascites, pleural effusion, pericardial effusion Most common cause of immune hydrops fetalis - Rh incompatibility Others causes of hydrops fetalis Cardio vascular cause - congenital hea block ( Most common) Chromosomal cause - turner syndrome (45 XO ), triploidy , trisomies 21,18 and 13 Hematological - a 4 - thalassemia (HB bas) , fetomaternal hemorrhage Infections - Parvovirus B19(mc) , syphilis , cytomegalovirus, toxoplasmosis Rubella, HSV", "role": "assistant" } ]

[ { "content": "Pulmonary endothelium is NOT concerned with which of the following: \nSelect and explain. \nA. Lipoprotein lipase, B. Plasminogen activator, C. Thrombin, D. Factor X", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Carrier stage seen in -a) Poliob) Cholerac) Pertusis d) Plague e) Tetanus \nSelect and explain. \nA. da, B. abc, C. dea, D. ac", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 40-year old man presented with acute onset pain and swelling of left great toe. On X-ray, punched out lytic lesion seen on phalanx with sclerotic margins and overhanging bony edges. Diagnosis is: \nSelect and explain. \nA. Gout, B. Rheumatoid ahritis, C. Psoriatic ahritis, D. Reiter's syndrome", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. a. Gout", "role": "assistant" } ]

[ { "content": "Which of the following statements is true concerning the vascular response to injury? \nSelect and explain. \nA. Vasoconstriction is an early event in the response to injury, B. Vasodilatation is a detrimental response to injury with normal body processes working to avoid this process, C. Vascular permeability is maintained to prevent fuher cellular injury, D. Histamine, prostaglandin E2 (PGE2) and prostacyclin (PGI2) are impoant mediators of local vasoconstriction", "role": "user" }, { "content": "Answer: A \nExplanation: After wounding, there is transient vasoconstriction mediated by catecholamines, thromboxane, and prostaglandin F2 (PGF2a). This period of vasoconstriction lasts for only five to ten minutes. Once a clot has been formed and active bleeding has stopped, vasodilatation occurs in an around the wound. Vasodilatation increases local blood flow to the wounded area, supplying the cells and substrate necessary for fuher wound repair. The vascular endothelial cells also deform, increasing vascular permeability. The vasodilatation and increased endothelial permeability is mediated by histamine, PGE2, and prostacyclin as well as growth factor VEGF (vascular endothelial cell growth factor). These vasodilatory substances are released by injured endothelial cells and mast cells and enhance the egress of cells and substrate into the wound and tissue.", "role": "assistant" } ]

[ { "content": "60 yr old male presented with dysphagia. Mucosal biopsy is provided here which show? \nSelect and explain. \nA. Squamous metaplasia, B. Columnar metaplasia, C. Anaplasia, D. Connective tissue metaplasia", "role": "user" }, { "content": "Answer: B \nExplanation: .", "role": "assistant" } ]

[ { "content": "The most common ovarian cause of increased androgenic state is: \nSelect and explain. \nA. PCOD, B. Premature adrenarche, C. Androgen secreting tumor, D. Choriocarcinoma", "role": "user" }, { "content": "Answer: A \nExplanation: (A) PCOD# Polycystic Ovarian Syndrome (PCOS):> it was earlier known as Stein Leventhal syndrome. 1% female population suffers from PCOS, and the patients are mostly 15-25 years age.> PCOS includes chronic non-ovulation and hyperandrogenemia associated with normal or raised oestrogen (E2), raised, LH & low FSH/LH ratio.> In PCOS-LH>FSH: Obesity and hirsuitism are important features PCOS includes chronic non- ovulation and hyper androgenemia.", "role": "assistant" } ]

[ { "content": "Measles vaccine is not given before: \nSelect and explain. \nA. 9 months, B. 12 months, C. 15 months, D. 18 months", "role": "user" }, { "content": "Answer: A \nExplanation: 9 months", "role": "assistant" } ]

[ { "content": "All of the following are features if CD4 count drop below 50cells/ mmcubic, except \nSelect and explain. \nA. HIV associated dementia., B. CMV retinitis., C. Disseminated mycobacterium avium intracellulare., D. None.", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "What is the major source of extracellular cholesterol for human tissues? \nSelect and explain. \nA. Very-low-density lipoproteins (VLDLs), B. Low-density lipoproteins (LDLs), C. High-density lipoproteins (HDLs), D. Albumin", "role": "user" }, { "content": "Answer: B \nExplanation: The uptake of exogenous cholesterol by cells results in a marked suppression of endogenous cholesterol synthesis. Low-density human lipoprotein not only contains the greatest ratio of bound cholesterol to protein but also has the greatest potency in suppressing endogenous cholesterogenesis. normally suppress cholesterol synthesis by binding to a specific membrane receptor that mediates inhibition of hydroxymethylglutaryl (HMG) coenzyme A reductase. In familial hypercholesterolemia the LDL receptor is dysfunctional, with the result that cholesterol synthesis is less responsive to plasma cholesterol levels. Suppression of HMG CoA reductase is attained using inhibitors (statins) that mimic the structure of mevalonic acid, the natural feedback inhibitor of the enzyme. Note: The LDL (apoB-100, E) receptor is defective in familial hypercholesterolemia, a genetic condition in which blood LDL cholesterol levels are increased, causing premature atherosclerosis. Ref: Botham K.M., Mayes P.A. (2011). Chapter 25. Lipid Transpo & Storage. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.", "role": "assistant" } ]

[ { "content": "Hallucinations are - \nSelect and explain. \nA. Feeling of familiarity with unfamiliar thing, B. Alteration of perception of ones reality, C. Misinterpretation of stimuli, D. Perception occurring without external stimulation", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Inferior tibiofibular joint is which type of joint \nSelect and explain. \nA. Gomphosis, B. Condylar, C. Syndesmosis, D. Synchondrosis", "role": "user" }, { "content": "Answer: C \nExplanation: syndesmosis is a fibrous joint between two bones and linked by ligaments and a strong membrane. The distal tibiofibular syndesmosis is asyndesmotic joint. Ref: Maheshwari 6e pg 159,162,163.", "role": "assistant" } ]

[ { "content": "Which is used in CA Breast? \nSelect and explain. \nA. Daunorubicin, B. Doxorubicin, C. Cisplatin, D. Actinomycin D", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. (b) Doxorubicin(Ref: Bailey 26/e p815, 25/e p844; Schwartz 10/e p550-551, 9/e p263)* In CAF regimen- Adriamycin (Anthracylcines- Doxorubicin or Epirubicin) is used* Anthracyclines have cardio toxicity", "role": "assistant" } ]

[ { "content": "The hard palate contains \nSelect and explain. \nA. Keratinized epithelium, submucosa, minor salivary glands, B. Keratinised epithelium, absent submucosa, no salivary glands, C. Non-keratinised epithelium, submucosa, minor salivary glands, D. Non-keratinised epithelium, absent submucosa, minor salivary glands", "role": "user" }, { "content": "Answer: A \nExplanation: The hard palate contains keratinized stratified squamous epithelium, has a submucosa, and contains minor salivary gland. The bony structure of the hard palate is covered by a firmly attached mucosa in the central pa. In the lateral pas, the hard palate also has a submucosal layer containing blood vessels. There are minor mucous type salivary glands in the submucosa in the posterior pa of the hard palate. Ref: Gray&;s Anatomy 41st edition Pgno: 510", "role": "assistant" } ]

[ { "content": "Subtle presentation of hyperparathyroidism is: \nSelect and explain. \nA. Psychiatric manifestation, B. Neprocalcinosis, C. Abdominal pain, D. Asymptomatic hypercalcemia", "role": "user" }, { "content": "Answer: D \nExplanation: Answer is D (Asymptomatic hypercalcemia) In view of the above facts from Harrison the best option to consider a 'subtle presentation' should probably be `asymptomatic hypercalcemia'", "role": "assistant" } ]

[ { "content": "Which bullet may produce key hole entry wound? \nSelect and explain. \nA. Tracer bullet, B. Tandem bullet, C. Dum-Dum bullet, D. Yawning bullet", "role": "user" }, { "content": "Answer: D \nExplanation: Yawning bullet is irregular pattern, thus producing key hole entry wound in some cases.", "role": "assistant" } ]

[ { "content": "Cardinal signs of Inflammation are all except? \nSelect and explain. \nA. Rubor, B. Tumor, C. Color, D. Cyanosis", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Cyanosis o Cardinal signs of acute inflammation (celsus' signs): Rubor (redness), tumor (swelling), color (warmth), Dolor (pain).", "role": "assistant" } ]

[ { "content": "Oral hypoglycemic drug that is less likely to cause hypoglycemia is: \nSelect and explain. \nA. Repaglinide, B. Gliclazide, C. Rosiglitazone, D. Glimipiride", "role": "user" }, { "content": "Answer: C \nExplanation: Rosilglitazone are selective agonists for the nuclear peroxisome proliferator activated receptor,which enhances the transcription of several insulin responsive genes Metformin and glitazones- antihyperglycemic agents- no hypoglycemia but reduce excess plasma glucose levels REF: K D TRIPATHI 6 Edition, Page No - 270)", "role": "assistant" } ]

[ { "content": "A 66-year-old man with obstructive jaundice is found on ERCP to have periampullary carcinoma. He is otherwise in excellent physical shape and there is no evidence of metastasis. What is the most appropriate treatment? \nSelect and explain. \nA. Radical excision (Whipple procedure) where possible, B. Local excision and radiotherapy, C. External radiotherapy, D. Internal radiation seeds via catheter", "role": "user" }, { "content": "Answer: A \nExplanation: Carcinoma of the head of the pancreas is treated with radical excision of the head of the pancreas along with the duodenum. Continuity of the biliary and GI tract is established by performing hepaticojejunostomy, pancreaticojejunostomy, and gastrojejunostomy (Figure below). The 5-year survival rate is higher for periampullary carcinoma (30%) than that for pancreatic head lesions (10%). Most centers do not give irradiation routinely before or after surgery, because pancreatic cancers do not respond well to radiotherapy. Endoscopically placed stents alone are used only in palliative circumstances in patients with limited life expectancy.Pancreaticoduodenectomy (Whipple procedure). A: Preoperative anatomic relationships showing a tumor in the head of the pancreas. B: Postoperative reconstruction showing pancreatic, biliary, and gastric anastomoses. A cholecystectomy and bilateral truncal vagotomy are also part of the procedure. In many cases, the distal stomach and pylorus can be preserved, and vagotomy is then unnecessary", "role": "assistant" } ]

[ { "content": "Reflux laryngitis produces -a) Sub- glottic stenosis b) Ca larynxc) Cord fixationd) Acute supra- glottitise) Laryngitis \nSelect and explain. \nA. abe, B. bcd, C. cde, D. acd", "role": "user" }, { "content": "Answer: A \nExplanation: There are lots of controversies regarding the reflux laryngitis secondary to reflux gastrointestinal disease. But now some studies document that there is a clear relation between the two.\nReflux laryngitis may have the following sequlae:\n\n– Bronchospasm\n– Chemical pneumonitis\n– Refractory subglottic stenosis \n– Refractory contact ulcer\n– Peptic laryngeal granuloma\n– Acid laryngitis (Heart burn, burning pharyngeal discomfort, nocturnal chocking due to interarytenoid pachydermia)\n– Laryngeal Carcinoma (According to recent reports laryngeal reflux is the cause of laryngeal carcinoma in patients who are life time non-smokers).\nLaryngopharyngeal Reflux\nHere classical GERD symptoms are absent. Patients have more of daytime/upright reflux without the nocturnal/supine reflux of GERD. In laryngopharyngeal reflux esophageal motility and lower esophageal sphincter is normal, while upper esophageal sphincter is abnormal. The traditional diagnostic tests for GERD are not useful in LPR.\nSymptom Chronic or Intermittent dysphonia, vocal strain, foreign body sensation, excessive throat mucus, Postnasal discharge and cough. Laryngeal findings: Interarytenoid bunching, Posterior laryngitis and subglottic edema (Pseudosulcus)\nSequelae of Laryngopharyngeal Reflux \n\nSubglottic stenosis\nCarcinoma larynx\nContact ulcer/granuloma\nCricoarytenoid joint fixity\nVocal nodule/polyp\nSudden infant deaths\nLaryngomalacia (Association)\n\nTreatment is in similar lines as GERD, but we need to give proton pump inhibitors at a higher dose and for a longer duration (at least 6–8 months).", "role": "assistant" } ]

[ { "content": "Activation of classical complement pathway ? \nSelect and explain. \nA. IgA, B. IgG, C. IgM, D. IgD", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., IgM", "role": "assistant" } ]

[ { "content": "The greatest incidence of bronchopleural fistula is follwing - \nSelect and explain. \nA. Segmental resection, B. Lobectomies, C. Pneumonectomies, D. Thorocotomy", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Fusion of the caudal portions of the kidneys during embryonic development is most likely to result in which of the following congenital conditions? \nSelect and explain. \nA. Bicornuate uterus, B. Cryptorchidism, C. Horseshoe kidney, D. Hypospadias", "role": "user" }, { "content": "Answer: C \nExplanation: During development, the kidneys typically \"ascend\" from a position in the pelvis to a position high on the posterior abdominal wall. Although the kidneys are bilateral structures, occasionally the inferior poles of the two kidneys fuse. When this happens, the \"ascent\" of the fused kidneys is arrested by the first midline structure they encounter, the inferior mesenteric artery. The incidence of horseshoe kidney is about 0.25% of the population.", "role": "assistant" } ]

[ { "content": "Mitochondrial chromosomal abnormaity leads to \nSelect and explain. \nA. Lebers hereditary optic neuropathy, B. Angelman syndrome, C. Prader villi syndrome, D. Myotonic dystrophy", "role": "user" }, { "content": "Answer: A \nExplanation: Diseases caused by mutations in mitochondrial genes are rare. Because mitochondrial DNA encodes enzymes involved in oxidative phosphorylation, diseases caused by mutations in such genes affect organs most dependent on oxidative phosphorylation (skeletal muscle, hea, brain). Leber hereditary optic neuropathy is the prototypical disorder in this group. This neurodegenerative disease manifests itself as progressive bilateral loss of central vision that leads in due course to blindness. Prader-Willi and Angelman Syndromes- Diseases Caused by Alterations of Imprinted Regions (Robbins Basic Pathology, 9 th edition. page : 243)", "role": "assistant" } ]

[ { "content": "True about protooncogene- \nSelect and explain. \nA. Impoant for normal cell growth, B. Oncogenesis, C. C-myc overexpression causes lymphoma, D. Mutation causes Retinoblastoma", "role": "user" }, { "content": "Answer: A \nExplanation: A proto-oncogene is a normal gene that could become an oncogene due to mutations or increased expression. Proto-oncogenes code for proteins that help to regulate cell growth and differentiation. Proto-oncogenes are often involved in signal transduction and execution of mitogenic signals, usually through their protein products. Upon acquiring an activating mutation, a proto-oncogene becomes a tumor-inducing agent, an oncogene. Examples of proto-oncogenes include RAS, WNT, MYC, ERK, and TRK. The MYC gene is implicated in Burkitt's Lymphoma, which stas when a chromosomal translocation moves an enhancer sequence within the vicinity of the MYC gene. The MYC gene codes for widely used transcription factors. When the enhancer sequence is wrongly placed, these transcription factors are produced at much higher rates. Another example of an oncogene is the Bcr-Abl gene found on the Philadelphia Chromosome, a piece of genetic material seen in Chronic Myelogenous Leukemia caused by the translocation of pieces from chromosomes 9 and 22. Bcr-Abl codes for a tyrosine kinase, which is constitutively active, leading to uncontrolled cell proliferation.", "role": "assistant" } ]

[ { "content": "The CNS tumor present with calcification: \nSelect and explain. \nA. Oligodendroglioma, B. Astrocytoma, C. Medulloblastoma, D. Pheochromocytoma", "role": "user" }, { "content": "Answer: A \nExplanation: Oligodendroglioma is associated with calcification. BT associated with calcification (COM):CraniopharyngiomaQ (most) > ODGQ (90%) > MeningiomaQ (20-25%)", "role": "assistant" } ]

[ { "content": "True about plummer-vinson syndrome -a) Microcytic hypochronic anemia b) Sideroblastic anemiac) Common in old aged) Post cricoid carcinoma is commone) Oesophageal webs \nSelect and explain. \nA. acd, B. bde, C. ade, D. ad", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Sellick manouever is used to prevent: \nSelect and explain. \nA. Alveolar collapse, B. Hypeension, C. Aspiration of Gastric content, D. Bradycardia", "role": "user" }, { "content": "Answer: C \nExplanation: C i.e. Aspiration of Gastric content", "role": "assistant" } ]

[ { "content": "A plant prick can produce sporotrichosis. All are true statements about sporotrichosis except \nSelect and explain. \nA. Is a chronic mycotic disease that typically involves skin, subcutaneous tissue and regional lymphatics, B. Most cases are acquired cutaneous inoculation, C. Enlarged lymph nodes extending centripetally as a beaded chain are a characteristic finding, D. It is an occupational disease of butchers and doctors", "role": "user" }, { "content": "Answer: D \nExplanation: Sporotrichosis is a chronic infection involving cutaneous, subcutaneous and lymphatic tissue. It is frequently encountered in Gardners, forest workers and manual labourers. It may develop in otherwise healthy individuals also. Ref: Textbook of Microbiology, Ananthanarayan and Paniker; 9th edition", "role": "assistant" } ]

[ { "content": "The major difference between typical and atypical antipsychotics is that \nSelect and explain. \nA. The latter cause minimal or no increase in prolactin, B. The former cause tardive dyskinesia, C. The former are available as parenteral preparations, D. The latter cause substantial sedation", "role": "user" }, { "content": "Answer: B \nExplanation: The most impoant reason to classify the antipsychotics in typical and atypical agents is the occurrence of extrapyramidal symptoms. Typical antipsychotics have significant extrapyramidal symptoms such as parkinsonism, acute muscle dystonia and tardive dyskinesia. These side-effects are negligible or minimal with atypical agents like clozapine, olanzapine and risperidone.", "role": "assistant" } ]

[ { "content": "Opsomyoclonus is encountered as C/F of- \nSelect and explain. \nA. Meningioma, B. Neuroblastoma, C. Neurofibromatosis, D. Excision", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Neuroblastoma o Neuroblastoma can present as paraneoplastic syndrome of autoimune origin manifesting as ataxia or oposmyoclonus (Dancing eyes and dancing feat). o In such cases primary tumor is in the chest or abdomen and the brain is negative for tumor. o Some tumor produce catecholamines that can cause sweating and HTN and some release vasoactive intestinal peptide (VIP) causing secretary diarrhea.", "role": "assistant" } ]

[ { "content": "Examine the renal histopathology slide. What is the probable diagnosis? \nSelect and explain. \nA. Membranoproliferative GN, B. Rapidly profilerative GN, C. Post streptococcal glomerulonephritis, D. Diabetic nephropathy", "role": "user" }, { "content": "Answer: C \nExplanation: The presence of diffuse involvement of glomeruli and histologically showing enlarged hyper cellular glomeruli is suggestive of Acute infectious GN. It can be both infectious and non-infectious (SLE) but the most common infectious acute proliferative GN is post streptococcal GN. So, the likely answer is post streptococcal glomerulonephritis.", "role": "assistant" } ]

[ { "content": "Diveiculum most common site is \nSelect and explain. \nA. Sigmoid colon, B. Ileum, C. Ascending colon, D. Transverse colon", "role": "user" }, { "content": "Answer: A \nExplanation: Sigmoid diveiculitis Diveicular disease refers to acquired pseudo diveicular outpouchings of the colonic mucosa and submucosa. Rare below 30yrs but prevalence approaches 50% beyond 60yrs. Diveicula generally are multiple and the condition is referred to as diveiculosis. PATHOGENESIS Colonic diveicula tend to develop under conditions of elevated intraluminal pressure in the sigmoid colon TEXT BOOK OF ROBBINS BASIC PATHOLOGY NINTH EDITION PAGE.586 IMAGE REF: ROBBINS BASIC PATHOLOGY NINTH EDITION FIG: 14-25 PAGE 586", "role": "assistant" } ]

[ { "content": "\"Inflation of lungs induces fuher inflation\" is explained by: \nSelect and explain. \nA. Hering-Breuer inflation reflex, B. Hering-Breuer deflation reflex, C. Head's paradoxical reflex, D. J-reflex", "role": "user" }, { "content": "Answer: C \nExplanation: C i.e Head's paradoxical reflex.Inflation of lungs, under ceain conditions, enhances inspiratory activity.Since inflation induces fuher inflation of lungs, the reflex is considered paradoxical.The vagal fibers mediating Head's paradoxical reflex carry information originating in receptors present in lungs.This reflex has a role in the initiation of respiration at bih. Ref: Understanding Medical Physiology By R.L. Bijlani, M.D., RL Bijlani MD SM DSc (Hon Causa) FAMS, S. Manjunatha, M.D., 2010, Page 245.", "role": "assistant" } ]

[ { "content": "Flexner-Wintersteiner rossette is seen in- \nSelect and explain. \nA. Hepatoblastoma, B. Nephroblastoma, C. Neuroblastoma, D. Retinoblastoma", "role": "user" }, { "content": "Answer: D \nExplanation: Harshmohan textbook of pathology 7th edition the microscopic structures of retinoblastoma characteristically arranged in rossettes. The rossettes are of 2 types 1. Flexner Wintersteiner rossettes characterised by small tumor cells arranged around a lumen with their nuclei away from the lumen. 2. Homer Wright rosettes- having radial arranarrangement of the tumor cells around the central neurofibrillar structure..", "role": "assistant" } ]

[ { "content": "Merkels cells of Epidermis are derived from \nSelect and explain. \nA. Neural tube, B. Notochord, C. Neural crest, D. Neural pore", "role": "user" }, { "content": "Answer: C \nExplanation: (C) Neural crest # MERKEL CELLS, which are believed to be derived from the neural crest, contain many large (50-100 nm) dense-cored vesicles, presumably containing transmitters, which are concentrated near the junction with the axon. F.S. Merkel referred to these cells as Tastzellen or \"touch cells\" Merkel cells are found in the skin and some parts of the mucosa (stratum germinativum) of all vertebrates. In mammalian skin, they are clear cells found in the stratum basale (at the bottom of sweat duct ridges) of the epidermis approximately 10 pm in diameter. They also occur in epidermal invaginations of the plantar foot surface called rete ridges. Most often, they are associated with sensory nerve endings, when they are known as Merkel nerve endings (Merkel cell-neurite complex). They are associated with slowly adapting (SA1) somatosensory nerve fibers. They are associated with the sense of light touch discrimination of shapes and textures. They can turn malignant and form the skin tumor known as Merkel cell carcinoma.DERIVATIVES OF NEURAL CRESTDerivative of neural crestDeveloping partsNeurons1. Spinal posterior nerve root ganglion (dorsal root ganglia) 2. Sensory ganglia of V, VII, VIII, IX & X cranial nerves 3. Sympathetic gangliaPiamater & Arachnoid mater (Not duramater)--Schwann cellsNeurolemmal sheaths of all peripheral nervesAdrenal medullaChromaffin tissuePigment cells of skinMelanoblasts; Merkel's cells of epidermisMesenchyme of dental papilla & Odontoblasts--Cells from cranial part of neural crest (Somatomeres)Development of musculature of head & in formation of face", "role": "assistant" } ]

[ { "content": "A patient of 18 years of age presents with sudden agonising pain in the groin and the lower abdomen. The patient feels nausea and gives a history of vomiting. On physical examination, the testis seems high. The cremasteric reflex is lost. What is the most possible cause? \nSelect and explain. \nA. Epididymo-orchitis, B. Mumps orchitis, C. Idiopathic scrotal edema, D. Testicular torsion", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. (d) Testicular torsion.Testicular torsion is most common between 10 and 25 years of age, although a few cases occur in infancy. Typically, there is sudden agonising pain in the groin and the lower abdomen. The patient feels nauseated and may vomit. Torsion of a fully descended testis is usually easily recognized. The testis seems high and the tender twisted cord can be palpated above it. The cremasteric reflex is lost.Image source- style=\"font-family: Times New Roman, Times, serif\">", "role": "assistant" } ]

[ { "content": "Pleomorphism is seen in: \nSelect and explain. \nA. Chickenpox, B. Rubella, C. Smallpox, D. Toxocara", "role": "user" }, { "content": "Answer: A \nExplanation: (Chickenpox): Ref: (134-Park 20th)* Chickenpox shows pleomorphic rash i.e. different stages of the rash evident at one given time because rash appears in successive crops", "role": "assistant" } ]

[ { "content": "Laparoscopic cholecystectomy done in a patient with cholelithiasis.Pathology report shows adenocarcinoma with invasion of muscle layer. CT was normal. Further tit is: \nSelect and explain. \nA. Wait and regular follow up, B. Wedge hepatic resection with lymph node dissection, C. Excise all port sites, D. Radiotherapy", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Placental alkaline phosphates is marker of: \nSelect and explain. \nA. Theca cell tumour, B. Teratoma, C. Choriocarcinoma, D. Seminoma", "role": "user" }, { "content": "Answer: D \nExplanation: PLAP-most useful marker for bulk disease. Tumour marker for seminoma is PLAP. BETA HCG is also raised in 5-10% of pure seminomas as they contain syncytiotrophoblast like giant cells.", "role": "assistant" } ]

[ { "content": "Cimetidine inhibits the metabolism of all of the following drugs except. \nSelect and explain. \nA. Phenytoin, B. Warfarin, C. Ketoconazole, D. Diazepam", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. (C) Ketoconazole(Ref: KDT 8th/e p698)Cimetidine is a potent inhibitor of microsomal enzymes. It prolongs the half lives of warfarin, theophylline, phenytoin, oral hypoglycemic agents, alcohol and benzodiazepines.", "role": "assistant" } ]