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[ { "content": "Cardiac output is increased by all except \nSelect and explain. \nA. Exercise, B. Pregnancy, C. Hot atmosphere, D. Standing from lying down", "role": "user" }, { "content": "Answer: D \nExplanation: Standing from lying down because of pooling of blood in lower limb decrease in cardiac o/p by 20-30%Increasing factorsAnxiety and excitement (50-100%)Eating (30%)Exercise (up to 700%)High environmental temperaturePregnancyEpinephrine 2. Decreasing factorsSitting or standing from lying position (20-30%)Rapid arrhythmiasHea diseaseRef: Ganong's Review of Medical Physiology Twenty-Third Edition pg No:514", "role": "assistant" } ]

[ { "content": "An 8 year old boy presented with fever and bilateral cervical lymphadenopathy with prior history of sore throat. There was no hepatomegaly. The peripheral blood smear shows >20% lympho plasmacytoid cells. The most likely diagnosis is: \nSelect and explain. \nA. Tuberculosis, B. Infectious Mononucleosis, C. Acute lymphoblastic leukemia, D. Influenza", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B. Infectious MononucleosisThe given clinical situation suggests Infectious MononucleosisFeatures of Infectious Mononucleosis:* Cervical Lymphadenopathy* Fever* History of sore throat* >20% atypical lymphocytesHepatomegaly may be absent (Occurs only in 30% of cases)", "role": "assistant" } ]

[ { "content": "Regarding Good pasture's syndrome all are true except \nSelect and explain. \nA. Auto immune disease, B. Anty body against collagen type IV alpha3 chain of GBM and pulmonary capillaries, C. Diffuse bilateral pulmonary infiltrates, D. Slowly progressive Renal failure", "role": "user" }, { "content": "Answer: D \nExplanation: Good pasture's syndrome causes glomerulonephritis that results in rapidly progressive renal failure.", "role": "assistant" } ]

[ { "content": "A 60-year-old man with diabetes acutely develops double vision and discomfort in his left eye. On examination, there is ptosis of the left eyelid, the eye is rotated down and out, and the pupil is 3 mm and reactive to light. The right eye is normal. Which of the following is the most likely diagnosis? \nSelect and explain. \nA. fourth nerve palsy, B. diabetic autonomic neuropathy, C. third nerve palsy, D. sixth nerve palsy", "role": "user" }, { "content": "Answer: C \nExplanation: Third nerve palsy can result in ptosis of the eyelid. There is also loss of the ability to open the eye, and the eyeball is deviated outward and slightly downward. With complete lesions, the pupil is dilated, does not react to light, and loses the power of accommodation. In diabetes, the pupil is often spared. The sixth cranial nerve can also be affected by diabetes, but this is much less common.", "role": "assistant" } ]

[ { "content": "Lethal midline granuloma arises from ? \nSelect and explain. \nA. T-cells, B. B-cells, C. NK cells, D. Macrophages", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., NK cellso Lethal midline granuloma or polymorphic reticulosis is a lymphoma of natural killer (NK) cells infected with EBV.", "role": "assistant" } ]

[ { "content": "In near vision what is the change? \nSelect and explain. \nA. Power of lens decreases, B. Depth of focus increases, C. Lateral recti contraction, D. Zonular tension increases", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. b. Depth of focus increasesThe most common problems developed in adults between ages 41 to 60 may to seeing clearly at close distances, especially when reading and working on the computer.This normal change in the eyes focusing ability, called presbyopia.", "role": "assistant" } ]

[ { "content": "In a community of 5000 people, the crude bih rate is 30 per 1000 people. The number of pregnant female is? \nSelect and explain. \nA. 150, B. 65, C. 175, D. 200", "role": "user" }, { "content": "Answer: A \nExplanation: Crude Bih rate: Annual number of live bihs per 1000 mid year population Here, CBR is 30 per 1000 population So for 5000 population - 30/1000 x5000 = 150 That implies, no of pregnant women is 150 Ref: Park 25th edition Pgno : 532", "role": "assistant" } ]

[ { "content": "A young male presents with fever, followed by headache, confusion, focal seizures and right hemiparesis. MRI shows bilateral frontotemporal hyperintense lesion. Which of the following is the most likely diagnosis? \nSelect and explain. \nA. Acute pyogenic meningitis, B. Herpes simplex encephalitis, C. Neurocysticercosis, D. Carcinomatous meningitis", "role": "user" }, { "content": "Answer: B \nExplanation: Patient is showing features suggestive of herpes simplex encephalitis. Clinical manifestations in viral encephalitis includes altered level of consiousness (confusion, behavioral abnormalities), mild lethargy to coma, evidence of both focal or diffuse neurologic signs and symptoms and focal or generalized seizures. Investigations: CSF shows lymphocytic leukocytosis, red blood cells due to hemorrhagic necrosis and elevated cerebrospinal fluid (CSF) protein levels. In HSV encephalitis80% will have abnormalities in temporal lobe and 10% have extra temporal abnormalities. The lesions are typically hyper intense on T2-weighted images. Brain biopsy has been the gold standard for defining HSV encephalitis, but now PCR for detection of HSV DNA in CSF has largely replaced biopsy for defining CNS infection. Acyclovir is used in the treatment. Ref: Harrison's Internal Medicine, 18th Edition, Pages 3421, 3437, Chapters 179, 379, 381.", "role": "assistant" } ]

[ { "content": "The shake test shown below can be done to know: \nSelect and explain. \nA. Whether vaccine was exposed to heat, B. Whether vaccine had been frozen at some point of time in the cold chain, C. Whether expiry date of vaccine has reached, D. Whether the vaccine needs to be mixed with normal saline", "role": "user" }, { "content": "Answer: B \nExplanation: Shake test: - Test done to check cold damage to Vaccine due to freezing. - Once the vaccine is frozen, it tends to form flakes which gradually settle to the bottom, after the l is shaken. - Thus, sedimentation occurs faster in a vaccine l which has been frozen as compared to control l. - These ls should be discarded irrespective of their expiry date. - Used for DPT, DT, TT or Hepatitis B", "role": "assistant" } ]

[ { "content": "Largest embrasure lies between: \nSelect and explain. \nA. Maxillary central incisors, B. Maxillary central and Lateral incisor, C. Maxillary canine and first premolar, D. Maxillary lateral incisor and canine", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Absence of lamina dura in the alveolus occurs in: \nSelect and explain. \nA. Rickets, B. Osteomalacia, C. Deficiency of vitamin C, D. Hyperparathyroidism", "role": "user" }, { "content": "Answer: D \nExplanation: Radiological Features of Hyperparathyroidism Subperiosteal resorption of terminal tufts of phalanges, lateral end of clavicle and symphysis pubis. Loss of lamina dura (i.e. thin coical bone of tooth socket surrounding teeth is seen as thin white line, is resorbed). Fig : Loss of Lamina Dura Brown Tumor Salt and Pepper appearance of skull Treatment: Direct parenteral supplementation of calcium. -Dental findings of other options : Osteomalacia- no tooth abnormality as such Rickets- enamel defect Deficiency of vitamin C- bleeding gums + dentine defects", "role": "assistant" } ]

[ { "content": "Drug of choice for hypertension in pregnancy- \nSelect and explain. \nA. Hydralazine, B. Methyldopa, C. Labetalol, D. Nifedipine", "role": "user" }, { "content": "Answer: B \nExplanation: (B) (Methyldopa) (506 Dutta 7th)* Intravenous labetalol or hydralazine are drugs most commonly used to manage preeclampsia (56-H 8th).* Antihypertensive drugs are essential when the BP is 160/110 mm Hg to protect the mother from eclampsia, cerebral hemorrhage, cardiac failure and placental abruption.* First line therapy is either methyldopa or labetalol second line drug is nifedipine. DrugsMechanism of actionSide effectsContraindication and precautionsMethyldopa* Drug of the first choice* Central and peripheral antiadrenergic action* Effective and safe for both the mother and the fetusMaternal - Postural hypotension, hemolytic anemia, sodium retention, excessive sedation, Coomb's test may be positive.Fetal - Intestinal ileusHepatic disorder psychic patients congestive heart failure.Postpartum (risk of depression)HydralazineActs by peripheral vasodilatation as it relaxes the arterial smooth muscle. Orally it is weak and shouldbe combined with methyldopa or b blocker.It increases the cardiac output and renal blood flow* Maternal hypotension, tachycardia arrhythmia, palpitation, lupus-like syndrome, fluid retention.* Fetal - reasonably safe.* Neonatal - ThrombocytopeniaBecause of variable sodium retention diuretics should be used. To control arrhythmias propanol may be administered intravenously.LabetalolCombined a and b adrenergic blocking agents* Tremors, headache asthma, CHF.* Efficacy and safety with short-term use appear equal to methyldopa* Hepatic disorders* Asthma, CHF", "role": "assistant" } ]

[ { "content": "Most common ophthalmic complication of diabetes mellitus is \nSelect and explain. \nA. Retinopathy, B. Cataract, C. Rubeosis iridis, D. Vitreous hemorrhage", "role": "user" }, { "content": "Answer: A \nExplanation: (A) Retinopathy # Most common ophthalmic complication of diabetes mellitus is diabetic retinopathy, with diabetic retinopathy being the most common preventable cause of blindness> Ocular features of diabetes mellitus: Blurring of vision Cataract formation Diabetic pupil Diabetic retinopathy Macular edema Retinal neovascularization Vitreous hemorrhage Retinal detachment Neovascularization of the iris (i.e. Rubeosis iridis) Cranial nerveCN III, IV and VI palsy> Blindness is primarily the result of progressive diabetic retinopathy and clinically significant macular edema.> Diabetic retinopathy is classified into two stages: nonproliferative and proliferative. Nonproliferative diabetic retinopathy usually appears late in the first decade or early in the second decade of the disease and is marked by retinal vascular microaneurysms, blot hemorrhages, and cotton wool spots.> Mild nonproliferative retinopathy progresses to more extensive disease, characterized by changes in venous vessel caliber, intraretinal microvascular abnormalities, and more numerous microaneurysms and hemorrhages. The pathophysiologic mechanisms invoked in nonproliferative retinopathy include loss of retinal pericytes, increased retinal vascular permeability, alterations in retinal blood flow, and abnormal retinal microvasculature, all of which lead to retinal ischemia.", "role": "assistant" } ]

[ { "content": "Hyaline casts are seen in \nSelect and explain. \nA. Acute tubular necrosis, B. Thrombotic microangiopathy, C. Normal urine, D. Pyelonephritis", "role": "user" }, { "content": "Answer: C \nExplanation: Hyaline casts\nNormal urine , Febrile disease, diuretics thereapy, prerenal azotemia.", "role": "assistant" } ]

[ { "content": "Absense of taste sensation is termed as: \nSelect and explain. \nA. Hypogeusia, B. Ageusia, C. Dysgeusia, D. Partial ageusia", "role": "user" }, { "content": "Answer: B \nExplanation: (B) Ageusia # Ageusia is the loss of taste functions of the tongue, particularly the inability to detect sweetness, sourness, bitterness, saltiness, and umami (the taste of monosodium glutamate). It is sometimes confused for anosmia--a loss of the sense of smell. Because the tongue can only indicate texture and differentiate between sweet, sour, bitter, salty, and umami most of what is perceived as the sense of taste is actually derived from smell. True aguesia is relatively rare compared to hypogeusia--a partial loss of taste--and dysgeusia--a distortion or alteration of taste.> Causes of Ageusia:> Neurological damage: Tissue damage to the nerves that support the tongue can cause ageusia, especially damage to the lingual nerve and the glossopharyngeal nerve.> Neurological disorders such as Bell's palsy, Familial dysautonomia, and Multiple sclerosis cause similar problems to nerve dam- age, as do certain infectious conditions like primary amoeboid meningoencephalopathy. The lingual nerve (which is a branch of the trigeminal V3 nerve, but carries taste sensation back to the chorda tympani nerve to the geniculate ganglion of the facial nerve) can also be damaged during otologic surgery, causing a feeling of metal taste.> Problems with the endocrine system:> Deficiency of vitamin B3 (Niacin) and zinc can cause problems with the endocrine system, which may cause taste loss or alteration. Disorders of the endocrine system, such as Cushing's syndrome, hypothyroidism and diabetes mellitus, can cause similar problems.> Ageusia can also be caused by medicinal side-effects from antirheumatic drugs such as penicillamine, antiproliferative drugs such as cisplatin, ACE inhibitors, and other drugs including azelastine, clarithromycin and zopiclone.> Other causes:> Local damage and inflammation that interferes with the taste buds or local nervous system such as that stemming from radiation therapy, glossitis, tobacco abuse, and denture use also cause ageusia. Other known causes include loss of taste sensitivity from aging (causing a difficulty detecting salty or bitter taste), anxiety disorder, cancer, renal failure and liver failure.", "role": "assistant" } ]

[ { "content": "Hutchinsons secondaries In skull are due to tumors in \nSelect and explain. \nA. Lung, B. Breast, C. Adrenal, D. Liver", "role": "user" }, { "content": "Answer: C \nExplanation: Adrenal neuroblastomas are malig8nant neoplasms arising from sympathetic neuroblsts in Medulla of adrenal gland Neuroblastoma is a cancer that develops from immature nerve cells found in several areas of the body.Neuroblastoma most commonly arises in and around the adrenalglands, which have similar origins to nerve cells and sit atop the kidneys.", "role": "assistant" } ]

[ { "content": "Which of the following constitute grievous injury- \nSelect and explain. \nA. Incised wound of scalp, B. Incised wound of thigh, C. Fracture Tibia, D. Laceration of the scalp", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "NiTi alloy shows superelasticity through: \nSelect and explain. \nA. Conversion from Austenite to Martensite phase, B. Conversion from Martensite to Austenite phase, C. M wire phase, D. Austenite + Martensite + R phase", "role": "user" }, { "content": "Answer: A \nExplanation: Superelasticity and shape memory of NiTi alloys is because of phase transformation in their crystal structures when cooled from the stronger, high temperature form (Austenite) to the weaker low temperature form (Martensite).", "role": "assistant" } ]

[ { "content": "Assessment of obesity by following measurement except \nSelect and explain. \nA. Quetelet’s index, B. Broca index, C. Sullivan’s index, D. Corpulence index", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "An elderly house wife lost her husband who died suddenly of Myocardial infarction couple of years ago. They had been staying alone for almost a decade with infrequent visits from her son and grandchildren. About a week after the death she heard his voice clearly talking to her as he would in a routine manner from the next room. She went to check but saw nothing. Subsequently she often heard his voice conversing with her and she would also discuss her daily matters with him. This however, provoked anxiety and sadness of mood when she was preoccupied with his thought. She should be treated with: \nSelect and explain. \nA. Clornipramine., B. Aiprazolam, C. Electroconvulsive therapy., D. Haloperidol.", "role": "user" }, { "content": "Answer: D \nExplanation: D i.e. HaloperidolThe diagnosis of this lady is morbid grief When there is an exaggeration of one or more symptoms of normal grief or the duration becomes prolonged beyond 6 months without recovery, it is k/a morbid grief.Preoccupation with the memory of deceased is a characteristic featureQ.Idealization of deceased (ignoring his negative qualities).Sense of presence of deceased in the surroundings & misinterpretation of voices or faces of others as that of lost person. Rarely fleeting hallucinations may occur.Treatment - In morbid & complicated grief, medication depends on presenting clinical features.As this lady is mainly having problem of auditory hallucination (1/t sadness & anxiety) - antipsychotic like haloperidol is needed to treat her.", "role": "assistant" } ]

[ { "content": "All endothelial cells are involved in the production of thrombomodulin EXCEPT those found in: \nSelect and explain. \nA. Hepatic circulation, B. Cutaneous circulation, C. Cerebral microcirculation, D. Renal circulation", "role": "user" }, { "content": "Answer: C \nExplanation: Endothelium of the blood vessels plays an active role in preventing the extension of clots into blood vessels. All endothelial cells except those in the cerebral circulation produce thrombomodulin. Ref: Review of Medical Physiology By Ganong, 22nd Edition, Page 543; Robbins Pathologic Basis of Disease, 6th Edition, Page 120", "role": "assistant" } ]

[ { "content": "Heme is conveed to bilirubin mainly in: \nSelect and explain. \nA. Kidney., B. Liver., C. Spleen, D. Bone marrow.", "role": "user" }, { "content": "Answer: C \nExplanation: C i.e. Spleen Breakdown of heme to bilirubin occurs in macrophages of the reticuloendothelial system mainly in the spleenQ also in the liver and bone marrow.", "role": "assistant" } ]

[ { "content": "All of the following cause osteonecrosis except - \nSelect and explain. \nA. Sickle cell anemia, B. Corticosteroid use, C. DIC, D. None of the above", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., None of the above o Osteonecrosis is a pathologic process that has been associated with trauma, with numerous atraumatic conditions, and with therapeutic interventions, most commonly corticosteroid use and excessive alcohol intake. o Compromise of the bone vasculature, leading to the death of bone and marrow cells (bone marrow infarction), and ultimate mechanical failure appears to be the common etiologies shared by the varied proposed causes. o The mean age at diagnosis is less than 40 years. Etiologicfaetqrs associated with osteonecrosis Traumatic o Femoral neck fracture o Dislocation or fracture-dislocation o Minor trauma Nontraumatic o Corticosteroid administration, rarely hypersecretion of cortisol o Alcohol use o Sickle cell hemoglobinopathies o Caisson (dysbarism) disease o Systemic lupus erythematosus o Gaucher's disease o Chronic renal failure or hemodialysis o Pancreatitis o Pregnancy o Hyperlipidemia o Radiation o Organ transplantation o Disseminated o Intravascular coagulation o Thrombophlebitis o Cigarette smoking o Hyperuricemia/gout o Human immunodeficiency virus infection o Idiopathic Clinical features o Early diagnosis of osteonecrosis may provide the opportunity to prevent collapse and the need for joint replacement. o However, most patients present late in the course of the disease, and a high index of suspicion is necessary for those with risk factors, particularly high-dose corticosteroid use. o The most common presenting symptom of osteonecrosis is pain, although a small proportion of patients are asymptomatic. Radiological features on X-ray o Changes in bone density (earliest feature) o Cysts and sclerosis o Crescent sign (Subchondral radiolucency) due to subchondral collapse o The subsequent loss of sphericity or collapse of the femur. o Magnetic resonance imaging (MRI) is far more sensitive than plain radiographs or radionuclide bone scanning and is preferred for diagnostic use in patients with nondiagnostic plain radiography. o A clinical diagnosis is appropriately made in an asymptomatic patient when imaging findings are compatible with this disease and when other causes of pain and bony abnormalities either are unlikely or have been excluded.", "role": "assistant" } ]

[ { "content": "Which of the following is involved in tumor metastasis cascade - \nSelect and explain. \nA. Fibronectin, B. E-Cadherin, C. Type IV collagenase, D. Tyrosine kinase", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following anti-tubercular drug is avoided in a HIV positive patient on zidovudine, lamivudine and indinavir therapy who develops TB? \nSelect and explain. \nA. Pyrazinamide, B. Isoniazid, C. Ethambutol, D. Rifampicin", "role": "user" }, { "content": "Answer: D \nExplanation: RIFAMPACIN: Powerful enzyme inducer of the Hepatic Cytochrome P450 system. It increasesmetabolism of many drugs and as a consequence, can make them less effective, or even ineffective in some cases, by decreasing their levels in the plasma. Rifampicin can induce the metabolism of Indinavir and can result in therapeutic failure. Therfore rifampicin is avoided in the above patient. ISOENZYMES INDUCED BY RIFAMPACIN: CYP2C9 CYP2C19 CYP3A4 CYP1A2", "role": "assistant" } ]

[ { "content": "TRUE about RU - 486 is : \nSelect and explain. \nA. Used for inducing aboion in early week of pregnancy, B. Used along with contraceptive pill, C. Acts on the cytoplasmic receptor, D. Used for preventing ectopic implantation", "role": "user" }, { "content": "Answer: A \nExplanation: Used for inducing aboion in early week of pregnancy", "role": "assistant" } ]

[ { "content": "Which of the following is sign of severe Dehydration in a child \nSelect and explain. \nA. Lethargy, B. Irritability, C. Increased duration of skin pinch, D. Suken eyes", "role": "user" }, { "content": "Answer: A \nExplanation: Sunken eyes, mouth and tongue very dry , condition lethargy ,skin pinch goes back very slowly The patient has 2 / more signs there is severe dehydration Ref: Ghai pediatrics eighth edition pg no 293", "role": "assistant" } ]

[ { "content": "Which of the following statements about contrast in radiography is true - \nSelect and explain. \nA. Ionic monomers have three iodine atoms per two paicles in solution, B. High osmolar contrast agents may be ionic or non ionic, C. Gadolinum may cross the blood brain barrier, D. Iohexol is a high osmolar contrast media", "role": "user" }, { "content": "Answer: A \nExplanation: option A is correct : Ionic monomers have three iodine atoms per two paicles in solution Ionic dimers and non ionic monomers have three iodine atoms per one paicle in solution Non ionic dimers have six iodine atoms per one paicle in solution option B is incorrect : High osmolar agents (ionic monomers) are only ionic low osmolar agents may be ionic or non ionic iso osmolar agents are only non ionic option C is incorrect : Gadolinium does not cross Blood brain barrier (BBB) option D is incorrect : Iohexol is low osmolar (non ionic monomer)", "role": "assistant" } ]

[ { "content": "A 6-year-old child presents with lesions on face, covered with honey colored crusts. Pruritus is present. The possible cause can be: \nSelect and explain. \nA. Impetigo, B. Herpes, C. Chickenpox, D. Molluscum contagiosum", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. a. ImpetigoNon bullous impetigo or impetigo contagiosa lesions have golden yellow, honey coloured crusting", "role": "assistant" } ]

[ { "content": "In Medullary Carcinoma thyroid Tumour marker is- \nSelect and explain. \nA. TSH, B. Calcitonin, C. T3, T4 and TSH, D. Alpha Feto protein", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Xylitol affects the MS stains by: \nSelect and explain. \nA. Reduced adhesion are seen., B. Less virulence properties are seen., C. Less acid production are seen., D. Anyone of the above.", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Spigelberg criteria is used in: \nSelect and explain. \nA. Ovarian pregnancy, B. Abdominal pregnancy, C. Cervical pregnancy, D. Tubal pregnancy", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is a, i.e. Ovarian pregnancySite of ectopicCriteria for diagnosisOvarian ectopicAbdominal ectopicCervical ectopicSpigelberg criteriaStuddiform ectopicRubin criteria/ Palmann criteria", "role": "assistant" } ]

[ { "content": "Hemiparesis is NOT a feature of - \nSelect and explain. \nA. Carotid artery occlusion, B. MCA occlusion, C. ACA occlusion, D. Vertebral artery occlusion", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Calculate degree of freedom Material Location X Y Glass 8 23 Cupboard 56 3 Metal 1 14 \nSelect and explain. \nA. 1, B. 2, C. 3, D. 4", "role": "user" }, { "content": "Answer: B \nExplanation: Degree of freedom = (C-1) (R-1) Given rows = 3 ; columns = 2 DOF = (2-1) (3-1) = 1x2 = 2", "role": "assistant" } ]

[ { "content": "Which of the following enzyme of TCA cycle is analogous to Pyruvate dehydrogenase complex? \nSelect and explain. \nA. Isocitrate dehydrogenase, B. Alpha ketoglutarate dehydrogenase, C. Malate dehydrogenase, D. Succinate dehydrogenase", "role": "user" }, { "content": "Answer: B \nExplanation: Alpha ketoglutarate dehydrogenase catalyses an oxidative decarboxylation reaction similar to that of pyruvate dehydrogenase. uses the same coenzymes as the PDH complex (their E3 components are identical). Like PDH complex, its E2 is inhibited by arsenic.", "role": "assistant" } ]

[ { "content": "Auditory area located in which lobe: \nSelect and explain. \nA. Temporal, B. Parietal, C. Frontal, D. Occipital", "role": "user" }, { "content": "Answer: A \nExplanation: Most of the primary auditory cortex is in the temporal lobe, but the association auditory cortices extend over much of the insular lobe and even onto the lateral portion of the paritetal lobe", "role": "assistant" } ]

[ { "content": "Classical symptom of endocervical polyp is \nSelect and explain. \nA. Cervical prolapse, B. Dyspareunia, C. Intermenstrual bleeding, D. Dysmenorrhea", "role": "user" }, { "content": "Answer: C \nExplanation: Intermenstrual bleeding is classical symptom of endocervical polyp.", "role": "assistant" } ]

[ { "content": "For teletherapy, isotopes commonly used are \nSelect and explain. \nA. 1-123, B. Cs-137, C. Co-60, D. Tc-99", "role": "user" }, { "content": "Answer: C \nExplanation: C i.e. Co-60", "role": "assistant" } ]

[ { "content": "The most likely inheritance pattern depicted in the following pedigree is: \nSelect and explain. \nA. Autosomal dominant, B. X-linked recessive, C. X-linked dominant, D. Autosomal recessive", "role": "user" }, { "content": "Answer: C \nExplanation: . X-linked dominant", "role": "assistant" } ]

[ { "content": "Which vitamin required for hydroxylation of proline \nSelect and explain. \nA. A, B. D, C. C, D. K", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Afferents to basal ganglia rests in \nSelect and explain. \nA. Striatum, B. Globus pallidus, C. Striatum, D. Subthalamus nuclei", "role": "user" }, { "content": "Answer: A \nExplanation: The main inputs to the basal ganglia terminate in the striatum. They include the excitatory coicostriate pathway from M1 and premotor coex. There is also a projection from intralaminar nuclei of the thalamus to the striatum (thalamostriatal pathway).Ref: Ganong's Review of Medical Physiology, Twenty-Third Edition.", "role": "assistant" } ]

[ { "content": "Maximum contraction of gall bladder is seen with: \nSelect and explain. \nA. CCK, B. Secretin, C. Gastrin, D. Enterogastrone", "role": "user" }, { "content": "Answer: A \nExplanation: A i.e. CCK Most potent stimulus for causing gall bladder contraction is CCK-PZQ.", "role": "assistant" } ]

[ { "content": "The most impoant stimulant of respiratory centre is: \nSelect and explain. \nA. Alkalosis, B. Decrease PCo2, C. Increase PCo2, D. Decrease Pao2", "role": "user" }, { "content": "Answer: D \nExplanation: Response to Co2, PaCO2 is most impoant factor in control of ventilation under normal conditions. PCo2 is most impoant input regulating magnitude of ventilation under resting conditions. Changes in alveolar ventilation have immediate, pronounced effect on aerial Pco2 (unlike Po2). Even slight alterations from normal Pco2 induce significant reflex. Increased Pco2 increases ventilation. Blood Brain Barrier is permeable to Co2, so increased aerial Pco2 increases brain ECF Pco2 and , it stimulates central chemoreceptors which increases ventilation by stimulating respiratory centers. Regulation of respiration: The rhythmic discharges from the brain that produce spontaneous respiration are regulated by alterations in aerial Po2, PCo2, and H+ concentration. There are numerous factors that affect and control ventilation. Chemical control Co2 ( CSF and brain interstitial fluid H+ concentration) o2 ( carotid and aoic bodies) H+ ( carotid and aoic bodies) Nonchemical control Vagal afferents from receptors in the airways and lungs Afferents from the pons, hypothalamus, and limbic system Afferents from proprioceptors Afferents from baroreceptors: aerial, atrial, ventricular, pulmonary Preipheral (Carotid & Aoic) Chemoreceptors: The carotid bodies are located at the bifurcation of common carotid aery. They send afferents in the carotid sinus nerve to the glossopharyngeal nerve (IX) the aoic bodies are located between the arch of aoa and pulmonary aery afferents ascend in the recurrent laryngeal nerves to the vagus (X). Stimulation results from a decrease in carotid and aoic body tissue PO2. Central Chemoreceptors: situated near (beneath) the ventral surface of the medulla, near the origins of the vagi and glossopharyngeal nerves these are anatomically separate from the respiratory centres, and are bathed in brain ECF. This is impermeable to both H+ and HCO3 -, however CO2 diffuses readily and decreases pH of CSF within a few minutes, which subsequently increases ventilation. Ref: A Concise Textbook Of Physiology, By S. And Kutty, K.M., Page 101.", "role": "assistant" } ]

[ { "content": "An 80-year-old woman presents with a 4-hour history of fever, shaking chills, and disorientation. Her blood pressure is 80/40 mm Hg. Physical examination shows diffuse purpura on her upper arms and chest. Blood cultures are positive for Gram-negative organism. Which of the following cytokines is primarily involved in the pathogenesis of direct vascular injury in this patient with septic shock? \nSelect and explain. \nA. Interferon-g, B. Transforming Growth Factor-b (TGFb), C. Platelet-derived growth factor, D. Tumor necrosis factor-a", "role": "user" }, { "content": "Answer: D \nExplanation: Septicemia (bacteremia) denotes the clinical condition in which bacteria are found in the circulation. It can be suspected clinically, but the final diagnosis is made by culturing the organisms from the blood. In patients with endotoxic shock, lipopolysaccharide released from Gram-negative bacteria stimulates monocytes/macrophages to secrete large quantities of TNF-a.", "role": "assistant" } ]

[ { "content": "A patient with blood pressure of 90/60 mm Hg presents with pronounced cyanosis. Blood drawn from peripheral veins is observed to be chocolate brown in colour. The most likely diagnosis is: \nSelect and explain. \nA. Methaemoglobinemia, B. Hypovolemic shock, C. Cardiogenic shock, D. Hemorrhagic shock", "role": "user" }, { "content": "Answer: A \nExplanation: Answer is A (Methaemoglobinemia) Pronounced cyanosis together with chocolate brown colour of 'freshly drawn blood suggests a diagnosis of methaemoglobinemia Methaemoglobinemia * * * Methaemoglobinemia is an uncommon but distinct cause of central cyanosis in the absence of hypoxemia or cardio vascular compromise Methaemoglobinemia occurs when a significant concentration of hemoglobin (Hb) is oxidized to methaemoglobin (Met Hb) When the haem moety (iron atoms) of' Hb molecule encounter a strong oxidizing agent iron loses an electron and switches from the Ferrous (2+) to Ferric (3+) state turning Hb to 'Met Hb' Methaemoglobin has such high oxygen affinity that viually no oxygen is delivered Presentation * * Methaemoglobinemia most commonly presents as cyanosis unresponsive to supplemental oxygen The most notable physical examination finding is generalized cyanosis which can manifest as muddy brown dark mucus membranes before proceding to global skin discolaration 'The charachteristic muddy appearance (chocolate brown) of freshly drawn blood can be a critical clue'-*Blood appears dark brown, brownish, muddy or chocolate in colour immediately after withdrawal. In contrast to normal venous blood, the color does not change with addition of oxygen or agitation in the air'- Diffirential diagnosis in Internal Medicine Methaemoglobinemia > 15% cause symptoms of cerebral ischaemia Methaemoglobinemia > 60% is usually lethal Diagnosis * The hest Methaemoglobinomia is * Methaemoglohin Assay' Treatment * The most effective emergency management for methaemaglobinemia is administration of Methylene bluee which serves as an antidote (intravenous) Methylene blue is not effective in patients with methaemoglobinemia due to Hemoglobinopathy MQ (Haemoglobin M) Methylene blue is contraindicated in patients with G6 PD deficiencyQ since it can cause severe hemolysis due to its potential for oxidation Outline of The Four Main Pathways to MetHb Production 1. Congenitally abnormal hemoglobin: Hemoglobin M Hemoglobin M is passed as an autosomal dominant trait affecting either the alpha or beta chain of hemoglobin; homozygous Hb M affecting both alpha and beta chains is incompatible with life. Amino acid substitution (often a tyrosine for histidine) near the heme iron facilitates iron oxidation. 2. Inherited enzyme deficiencies: NADH-dependent cytochrome b5 -reductase and cytochrome bc deficiency. Deficiency of either cytochrome b5 or its reducing enzyme, cytochrome b5-reductase, decreases reduction of MetHb back to Hb 3. Nitrite (NO2), other oxidants and oxygen-reducing compounds Nitrites are a common oxidizing source of MetHb production. Reducing agents paradoxically produce methemoglobinemia by reducing oxygen to a free radical or water to 1-1,O2, which then oxidizes hemoglobin. 4. \"Sensitive\" hemoglobin: Blue baby syndrome Bacteria in the immature gastrointestinal tracts of infants conve nitrate (NO3) to the powerful oxidant nitrite (NO,). Infants have a relative NADH-dependent reductase deficiency (only 50% of adult levels) and are more susceptible to oxidative injury.", "role": "assistant" } ]

[ { "content": "A pregnant woman with fibroid uterus develops acute pain in abdomen with low grade fever and mild leucocytosis at 28 weeks ,the most likely diagnosis is \nSelect and explain. \nA. Preterm labour, B. Torsion of fibroid, C. Red degeneration of fibroid, D. Infection in fibroid", "role": "user" }, { "content": "Answer: C \nExplanation: Red degeneration of fibroid: It results from softening of surrounding connective tissue The capillaries tend to rupture and blood effused out into the myoma causing a diffuse reddish discoloration The tumor it self assumes a peculiar purple red colour and develops a fishy odour,if the tumor is carefully examined We may find some vessels and large veins in the capsule thrombosed This is the most common complication with fibroid during pregnancy . And the patient is usually febrile and with moderate leucocytosis and raised ESR, the condition is aseptic one. And ultrasound is useful for diagnosis Ref Shaw 16/e pg 395", "role": "assistant" } ]

[ { "content": "Call Exner bodies are found in - \nSelect and explain. \nA. Granulosa Cell Tumour, B. Embryonal cell carcinoma, C. Choriocarcinoma, D. Androblastoma", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Granulosa Ceil Tumour \"The formation of Call - Exner bodies is a distinct feature of granulose cells and can be readily recognised in certain types of granulosa cell tumours. \"", "role": "assistant" } ]

[ { "content": "Monteggia fracture is - \nSelect and explain. \nA. Fracture of the proximal ulna with radial head dislocation, B. Radial head subluxation, C. Tear in interosseus membrane between radius and ulna with proximal ulna fracture, D. Distal radius Fracture with injury to Distal radio ulnarjoint", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Fracture of the proximal ulna with radial head dislocation Eponymous injuries of forearmNameInjuryMonteggia fracture dislocationFracture of upper third of ulna with dislocation of the radial headGalleazi fractureFracture of distal third of radius with dislocation or subluxation of inferior (distal) radio-ulnar jointEssex Lopresti lesionFracture of the radial head with distal radioulnar joint injury with tear in the interosseus membrane", "role": "assistant" } ]

[ { "content": "Commonest cause of esophageal perforation: March 2007 \nSelect and explain. \nA. Boerhaave syndrome, B. Carcinoma of esophagus, C. Acid ingestion, D. Instrumentation", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D: Instrumentation Instrumentation is by far the most common cause of perforation Boerhaave syndrome/Esophageal perforation, is rupture of the esophageal wall caused by excessive vomiting in eating disorders such as bulimia although it may rarely occur in extremely forceful coughing or other situations, such as obstruction by food. It can cause pneumomediastinum and/or mediastinitis (air or inflammation of the mediastinum) and sepsis. Boerhaave syndrome is a transmural perforation of the esophagus, distinct from Mallory-Weiss syndrome, a nontransmural esophageal tear also associated with vomiting. The term is useful for distinguishing it from iatrogenic perforation, which accounts for 85-90% of cases of esophageal rupture, typically as a complication of an endoscopic procedure, feeding tube, or unrelated surgery. It is associated with \"Mackler's triad\" which consists of vomiting, lower thoracic pain and subcutaneous emphysema which the later can be heard as Haman's crunch on physical examination. The most common anatomical location of the tear in Boerhaave syndrome is at left posterolateral wall of the lower third of the esophagus, 2-3 cm before the stomach.", "role": "assistant" } ]

[ { "content": "Sensory supply for skin over angle of jaw is \nSelect and explain. \nA. Opthalmic nerve, B. Mandibular nerve, C. Cervical plexus, D. Maxillary nerve", "role": "user" }, { "content": "Answer: C \nExplanation: Cervial plexus supplies Skin over the angle of the jaw and over the parotid gland. Lower margin of the lower jaw", "role": "assistant" } ]

[ { "content": "Population covered by a community health centre? \nSelect and explain. \nA. 5000, B. 30,000, C. 100,000, D. None", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., 100,000", "role": "assistant" } ]

[ { "content": "The fastest type of nerve fibers are \nSelect and explain. \nA. A, B. B, C. C, D. All", "role": "user" }, { "content": "Answer: A \nExplanation: According to erlanger and gasser classification, A fibers are myelinated and has large diameter The conduction velocity is 120m per second Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:73", "role": "assistant" } ]

[ { "content": "A 26-year-old patient presents with suspected pneumococcal meningitis. CSF culture is sent for antibiotic sensitivity. Which empirical antibiotic should be given until culture sensitivity result come? \nSelect and explain. \nA. Penicillin G, B. Ceftriaxone + metronidazole, C. Doxycycline, D. Cefotaxime + vancomycin", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Form of vitamim D which is measured in serum ? \nSelect and explain. \nA. Cholecalciferol, B. 25 hydroxyvitamin D, C. 1,25 dihydroxyvitamin D, D. 24,25 dihydroxyvitamin D", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'b' i.e., 25 hydroxyvitamin DThough, 1, 25 dihydroxyvitamin D (calcitriol) is the active form of vitamin D, its serum measurement does not provide any information about vitamin D status because it is often normal or elevated due to secondary hyperparathyroidism associated with vitamin D deficiency...Measurement of 25 hydroxyvitamin D (calcifedial) in serum provides more accurate information of vitamin D status. The usual values are :-< 20 ng/ml - Deficiency20-29 ng/ml - Insufficiency30-100 ng/ml - Normal> 100 ng/ml - Toxicity", "role": "assistant" } ]

[ { "content": "High speed includes the R.P.M between \nSelect and explain. \nA. 20000-50000, B. 50000-100000, C. 100000-200000, D. above 200000", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following factors are present in the final common terminal complement pathway? \nSelect and explain. \nA. C4, B. C3, C. C5, D. Protein B", "role": "user" }, { "content": "Answer: C \nExplanation: C5, C6, C7, C8 and C9 are the factors present in common terminal pathway. The classic activation pathway, mannose-binding lectin activation pathway and alternative activation pathway converge on the final common terminal pathway. The cleavage of C3 by each pathway (classic activation pathway, mannose-binding lectin activation pathway and alternative activation pathway) causes activation of C5, C6, C7, C8 and C9 in the terminal pathway, resulting in the formation of membrane attack complex (MAC) that gets attached to the target cells or bacteria and lyses them. Ref: Harrisons Principles of Internal Medicine, 16th Edition, Page 1913 & 1916.", "role": "assistant" } ]

[ { "content": "Peptic ulcer is caused by \nSelect and explain. \nA. H. pylori, B. Campylobacter jejuni, C. Pneumocystis carinii, D. Crypto sporidium", "role": "user" }, { "content": "Answer: A \nExplanation: A. i.e. (H. pylori) (594 - Basic pathology 8th)PEPTIC ULCER - two conditions are key for the development of peptic ulcers1. H. pylori infection(i) 70 - 90% persons with duodenal ulcer(ii) 70% persons with gastric ulcers2. Mucosal exposure to gastric acid and pepsin* NSAIDs are the major cause of peptic ulcer disease in persons who do not have H. pylori infection", "role": "assistant" } ]

[ { "content": "All are resected in whipples operation except: \nSelect and explain. \nA. Duodenum, B. Head of pancreas, C. Portal vein, D. Common bile duct", "role": "user" }, { "content": "Answer: C \nExplanation: Ans is 'c' ie Portal vein Whipple's operation (Pancreaticoduodenectomy)is the most commonly performed operation for carcinoma of head of pancreas.It includes resection of: distal stomach - duodenumgall bladder - proximal jejunumCBD - regional lymphatics head of pancreasRestoration of gastrointestinal continuity requiresPancreaticojejunostomy choledochojejunostomy &. Gastrojejunostomy", "role": "assistant" } ]

[ { "content": "Prevalence of a disease depends upon the following? \nSelect and explain. \nA. Incidence, B. Duration, C. Both of the above, D. None of the above", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Both of the above Prevalence = Incidence 'x mean duration", "role": "assistant" } ]

[ { "content": "The most common histologic type of thyroid cancer is - \nSelect and explain. \nA. Medullary type, B. Follicular type, C. Papillary type, D. Anaplastic type", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Papillary type [Ref: Schwartz 9/e p1361 (8/e p1417); Harrison 17/e p.2242 (16/e, p.2122)\\o \"Papillary carcinoma accounts for 80% of ail thyroid malignancies in iodine-sufficient areas and is the predominant thyroid cancer in children and individuals exposed to external radiation.\" - Schwartzo Incidence of primaiy malignant tumors of thyroid gland (Harrison 17/e)Type of thyroid carcinomaApproximate PrevalencePapillary Carcinoma80-90%Follicular Carcinoma5-10%Medullary Carcinoma10%Anaplastic CarcinomaRareLymphomas1-2%o Also remembery Thyroid carcinoma is the most common malignancy of the endocrine system (Ref: Harrison, 17/e, p 2243)", "role": "assistant" } ]

[ { "content": "Transection of the brain stem at the mid-pontine level with bilateral vagotomy causes ______ \nSelect and explain. \nA. Ceasation of spontaneous respiration, B. Continuation of regular breathing, C. Irregular but rhythmic respiiration, D. Apneusis", "role": "user" }, { "content": "Answer: D \nExplanation: Transection of the brainstem at the midpoint level with bilateral vagotomy causes apneusis. At mid pontine level lesion, the apneustic centre is intact while the pneumotaxic centre is seperated. Concurrent removal of vagus inputs causes this kind of abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by a breif insufficient release. Effect of various Lesions and Brainstem Transection Label Level of transection Vagi intact vagi cut A Complete transection above pons Regular breathing continues Regular breathing continues but depth of inspiration increases B Mid-pontine level section Regular breathing continues Apneusis develops C Transection midway between pons and medulla Irregular but rhythmic respiration Irregular but rhythmic respiration D Complete transection below medulla Spontaneous respiration ceases Spontaneous respiration ceases Ref: Ganong&;s review of medical physiology 25th edition Pgno: 645-657", "role": "assistant" } ]

[ { "content": "The ureteric bud develops from ? \nSelect and explain. \nA. mesonephric duct, B. metanephric duct, C. pronephric duct, D. genital sinus", "role": "user" }, { "content": "Answer: A \nExplanation: Development of kidneys - The definative human kidney arises from two distinct sources, 1). The secretory pa , I.e., excretory tubules or (nephrons) are derived from the lowest pa of the nephrogenic cord this pa is the metanephros, the cells of which form the metanephric blastema 2). The collecting pa of the kidney is derived from a diveiculum called the ureteric bud which arise from the lower pa of the mesonephric duct. Ref : Inderbir singh's Human Embryology, eleventh edition , pg. no., 265.", "role": "assistant" } ]

[ { "content": "True about treatment of carcinoma left colon with acute obstruction \nSelect and explain. \nA. Haman's procedure, B. Left colectomy with anastomosis, C. Proximal colostomy, D. All", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is ' a ' , ' b ' , ' c '", "role": "assistant" } ]

[ { "content": "Superantigens true is - \nSelect and explain. \nA. They bind to the left of the MHC, B. Needs to processed before presentation, C. They are presented by APC'S to T cells, D. Directly attached to lateral aspect of TCR b chain", "role": "user" }, { "content": "Answer: D \nExplanation: Superantigens are a class of antigens that cause non-specific activation of T-cells resulting in polyclonal T cell activation and massive cytokine release. Superantigens bind first to the MHC Class II and then coordinate to the variable alpha or beta chain of T-cell Receptors . Reff: Ananthanarayan & Panikers textbook of microbiology 9th edition pg:90", "role": "assistant" } ]

[ { "content": "Which of the following is true about colour vision \nSelect and explain. \nA. Independent of wavelength of light, B. Depends on intensity discrimination, C. Involves opponent colour cells, D. Minimum at fixation point", "role": "user" }, { "content": "Answer: C \nExplanation: Opponent theory for colour vision is proposed by Hering This theory states that the three primary colours red, blue and green oppose one another so that the opponent processing cells can't detect the presence of both colours at the same time Neurotransmitter stored in rods and cones is glutamate Ref: Ganong 25th ed/page 191", "role": "assistant" } ]

[ { "content": "In which of the following ahritis erosion are not seen \nSelect and explain. \nA. Rheumatoid ahritis, B. Systemic lupus ehematosus, C. Psoriasis, D. Gout", "role": "user" }, { "content": "Answer: B \nExplanation: Ref Semantischolar.org", "role": "assistant" } ]

[ { "content": "Alvarado score is used for \nSelect and explain. \nA. Acute cholecystitis, B. Acute appendicitis, C. Acute apncreatitis, D. Acute epidydimitis", "role": "user" }, { "content": "Answer: B \nExplanation: Answer- B. Acute appendicitisScoring system for Acute Appendicitis: Alvarado Score:The diagnosis of appendicitis is based primarily on clinical history and physical examination assisted by blood counts. A number of clinical and laboratory based scoring systems have been devised to assist diagnosis.The most widely used scoring system is Alvarado score.", "role": "assistant" } ]

[ { "content": "Indication of fetal distress is: \nSelect and explain. \nA. Decrease in fetal scalp blood pH, B. Meconium staining, C. Late deceleration of heart rate, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: Ans: d", "role": "assistant" } ]

[ { "content": "AED stands for? \nSelect and explain. \nA. Automatic external defibrillator, B. Automated external defibrillator, C. Automatic electrical defibrillator, D. Automated electrical defibrillator", "role": "user" }, { "content": "Answer: B \nExplanation: ADE is automated external defibrilater An automated external defibrillator (AED) is a poable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation (VF) and pulseless ventricular tachycardia,and is able to treat them through defibrillation, the application of electricity which stops the arrhythmia, allowing the hea to re-establish an effective rhythm Ref Davidson 23rd edition pg 445", "role": "assistant" } ]

[ { "content": "Fructose intolerance is due to deficiency of ? \nSelect and explain. \nA. Aldolase B, B. Fructokinase, C. Triokinase, D. Aldolase A", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which cardiovascular change is physiological in last trimester of pregnancy? \nSelect and explain. \nA. Mid-diastolic murmur, B. Occasional atrial fibrillation, C. Shift of apical impulse laterally and upwards in left 4th intercostal space, D. Cardiomegaly", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is c, i.e. Shift of apical impulse laterally and upwards in the left 4th intercostal spaceRef. Dutta Obs. 7/e, p 52; Williams Obs. 25/e, p 60-62, 119, 960Clinical findings related to cardiovascular changes occuring during pregnancy:Heart rate (resting) increases by about 10-15 bpm. QApex beat shifts to the 4th intercoastal space, 2.5 cm outside the mid clavicular line (as heart is pushed upwards, outward, with slight rotation to left). QSlightly enlarged cardiac silhouette. Q (marked enlarged cardiac silhouette is not normal in pregnancy)Exaggerated splitting of the first heart sound (both components loud). QSecond heart sound : Normal QThird heart sound : Loud and easily auscultated. QMurmurs: - Grade II systolic ejection murmur is audible in aortic or pulmonary area at about 10-12 weeks due to expanded intravenous volume. It diappears in the beginning of postpartum period.- Continuous hissing murmur Q audible over tricuspid area in left 2nd and 3rd intercoastal spaces known as Mammary murmur.ECHO - Shows increased left atrial and ventricular diameters. QECG - Shows left axis deviation QChest X-ray - Straightening of left heart border.Note: None of the arrhythmia are normal during pregnancy, rather their presence indicates heart disease during pregnancy.", "role": "assistant" } ]

[ { "content": "Na-K ATPase \nSelect and explain. \nA. 3 Na out / 2K in, B. 3Na in / 2K out, C. 2Na out / 3K in, D. 2Na in / 3K out", "role": "user" }, { "content": "Answer: A \nExplanation: Na+-K+ATPase, which actively moves Na+and K+ against their electrochemical gradient. The electrogenic Na K ATPase plays a critical role in cellular physiology by using the energy in ATP to extrude 3 Na+ out of the cell in exchange for taking two K+ into the cell. (REF.GANONG'S REVIEW OF MEDICAL PHYSIOLOGY 23rd EDITION page no.85.)", "role": "assistant" } ]

[ { "content": "Which of the following anaesthetic modality is to be avoided in sickle cell disease? \nSelect and explain. \nA. General anaesthesia, B. Brachial plexus block, C. IV. Regional Anaesthesia, D. Spinal", "role": "user" }, { "content": "Answer: C \nExplanation: The complications of IVRA is mainly attributable to the use of the tourniquet. On inflation of the touniquet there is physiological deoxygenation. In patients with sickle cell disease this might lead to sickling crisis. In these patients IVRA causes stasis, local acidosis and hypoxia. Hence IVRA is best avoided in sickle cell disease patients. Adequate oxygenation of the patient would be prudent. Ref: Complications of regional anesthesia By Brendan T. Finucane, Page 216; Essentials of Regional Anesthesia By Alan David Kaye, Richard D. Urman, Nalini Vadivelu; McGlamry's comprehensive textbook of foot and ankle surgery, 3rd ed, Vol 2 By Alan S. Banks, E. Dalton MacGlamry, Page 180; Surgery and anesthesia in sickle cell disease (By M Koshy, SJ Weiner, ST Miller, LA Sleeper, E Vichinsky, AK Brown,Y Khakoo, and TR Kinney).", "role": "assistant" } ]

[ { "content": "Raynaud's phenomenon seen in all EXCEPT: \nSelect and explain. \nA. Scleroderma, B. Dermatomyositis, C. Juvenile rheumatoid ahritis, D. SLE", "role": "user" }, { "content": "Answer: C \nExplanation: Juvenile rheumatoid ahritisREF: Schwaz's Principles of Surgery 9' edition Chapter 23. Aerial Disease, Harrison's Internal Medicine 17th edition Chapter 243 Table 243-1 \"Raynaud's phenomenon is seen in Rheumatoid ahritis not Juvenile Rheumatoid ahritis\" The term Raynaud's phenomenon applies to a heterogeneous symptom array associated with peripheral vasospasm, more commonly occurring in the upper extremities The majority of patients are young women <40 years of age and is often bilateral. There is no cure for Raynaud'ssyndrome, thus all treatments mainly palliate symptoms and decrease the severity and, perhaps, frequency of attacks. The majority (90%) of patients will respond to avoidance of cold and other stimuli. The remaining 10% of patients with more persistent or severe syndromes can be treated with a variety of vasodilatory drugs. Calcium-channel blockers such as diltiazem and nifedipine are the drugs of choice. Raynaud's phenomenon is broadly separated into two categories: the idiopathic variety, termed Raynaud's disease, and the secondary variety, which is associated with other disease states or known causes of vasospasm CLASSIFICATION OF RAYNAUD'S PHENOMENON Primary or idiopathic Raynaud's phenomenon: Raynaud's disease Secondary Raynaud's phenomenon Collagen vascular diseases: scleroderma, systemic lupus erythematosus, rheumatoid ahritis, dermatomyositis, polymyositis Aerial occlusive diseases: atherosclerosis of the extremities, thromboangiitis obliterans, acute aerial occlusion, thoracic outlet syndrome Pulmonary hypeension Neurologic disorders: interveebral disk disease, syringomyelia, spinal cord tumors, stroke, poliomyelitis, carpal tunnel syndrome Blood dyscrasias: cold agglutinins, cryoglobulinemia, cryofibrinogenemia, myeloproliferative disorders, WaldenstrOm's macroglobulinemia Trauma: vibration injury, hammer hand syndrome, electric shock, cold injury, typing, piano playing Drugs: ergot derivatives, methysergide, Beta-adrenergic receptor blockers, bleomycin, vinblastine, cisplatin", "role": "assistant" } ]

[ { "content": "All of the following can cause osteoporosis, except - \nSelect and explain. \nA. Hyperparathyroidism, B. Steroid use, C. Flurosis, D. Thyrotoxicosis", "role": "user" }, { "content": "Answer: C \nExplanation: Osteoporosis It refers to reduction ofbone mass per unit volume (loss of matrix and defective mineralisation) (Fig. 9.47). Aetiology 1.Involutional 2.Endocrinological 3.Gastrointestinal 4.Haematological 5.Rheumatological 6.Collagen vascular Normal bone Type I (postmenopausal) and Type II (senile) Hypehyroidism Hyperparathyroidism Diabetes mellitus Hypogonadism Cushing's syndrome Malnutrition Malabsorption Anorexia nervosa Multiple myeloma Mastocytosis Rheumatoid ahritis Marfan's syndrome Ehler-Danlos syndrome Osteogenesis imperfecta Osteoporosis Fig. 9.47 Anticonvulsants Steroids Vitamin A Alcohol Heparin Furosemide Thyroid hormone in excessive doses Lithium GnRH agonist Cyclosporin Cytotoxic drugs 8.Cigarette smoking 9.Glucocoicoid therapy 10.Hypogonadism 11.Alcoholism 12.Renal disease 13.GI/Hepatic disorders. Bone forming agents a.Fluoride--75 mg/day b.Anabolic steroids: Testosterone is used in the treatment of osteoporotic man with gonadal deficiency. R ALAGAPPAN MANUAL OF PRACTICAL MEDICINE FOUH EDITION PAGE NO-690", "role": "assistant" } ]

[ { "content": "Protein of muscle which helps in relaxation is \nSelect and explain. \nA. Nebulin, B. Titin, C. Desmin, D. Calcineurin", "role": "user" }, { "content": "Answer: B \nExplanation: Titin Location: Reaches from the Z line to the M line.Function: Largest protein in the body. Role in relaxation of the muscle.Ref: Harper&;s Biochemistry; 30th edition; Chapter 51 Muscle & the Cytoskeleton", "role": "assistant" } ]

[ { "content": "Levamisole is used as all except - \nSelect and explain. \nA. Single dose in ascariasis, B. Immunostimulant, C. Paralysis of worms by depolarisation, D. Immunodepressant in high doses", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Immunodepressant in high doses Levamisol o Levamisole is an immunomodulator - restores depressed T cell function -3 Immunostimulant (not immunodepressant). o Single dose of levamisol can be used in ascariasis. Other uses --> A. duodenal (less active against N. americana). o It causes tonic paralysis (depolarization) by stimulating ganglia.", "role": "assistant" } ]

[ { "content": "Which of following is not absorbed in PCT: \nSelect and explain. \nA. Bicarbonate, B. Sodium, C. Phosphate, D. H+", "role": "user" }, { "content": "Answer: D \nExplanation: D i.e. H+", "role": "assistant" } ]

[ { "content": "IPD records of patients are preserved for how many years ? \nSelect and explain. \nA. 1 year, B. 3 years, C. 5 years, D. 7 years", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., 3 years Medical Council recommends that the medical records of the indoor patient to be aintained for atleast a period of 3 years from the date of commencement of treatment.", "role": "assistant" } ]

[ { "content": "The matrix band for restoring a Class-I with lingual extension is \nSelect and explain. \nA. Tofflemire, B. Ivory No.8, C. Barton, D. T band", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Auditory pathway passes through - \nSelect and explain. \nA. Medial geniculate body, B. Lateral geniculate body, C. Reticular formation, D. Cerebellar fornix", "role": "user" }, { "content": "Answer: A \nExplanation: Ans-A", "role": "assistant" } ]

[ { "content": "Durck granuloma is seen in \nSelect and explain. \nA. Congenital syphilis, B. Cat scratch disease, C. Histoplasmosis, D. Cerebral malaria", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. (d) Cerebral malaria(Ref: Malaria - Page 76)In malignant cerebral malaria caused by Plasmodium falciparum, brain vessels are plugged with parasitized red cells, causing ring hemorrhage which is accompanied by necrosis of surrounding parenchyma.The damage leads to formation of Durck's granuloma - collection of microglial cells surrounding area of demylienation", "role": "assistant" } ]

[ { "content": "All vaccines are given in disaster,except ? \nSelect and explain. \nA. Cholera, B. Influenza, C. Measles, D. Tetanus", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Cholera Vaccines recommended in disasters o Following vaccines are recommended 1) Children < 10 years :- DPT, inactivated polio (IPV), H.influenzae type b (Hib), hepatitis B, pneumococcal conjugate vaccine (PCV), measles-mumps-rubella (MMR), varicella vaccine, influenza, hepatitis A and rotavirus. 2) Children and adolescents (11-18 years):- Tetanus, diphtheria, peussis, meningococcal conjugate vaccine (MCV), Influenza. 3) Adults (>18 years):- Tetanus, diphtheria, peussis, pneumococcal polysaccharide vaccine (PPSV23), and influenza. o Vaccination against typhoid and cholera is not recommended.", "role": "assistant" } ]

[ { "content": "The goal of NRR=1 can be best achieved by use of following contraceptive methods - \nSelect and explain. \nA. Condom 72/year, B. IUCD, C. Vasectomy, D. Oralpills", "role": "user" }, { "content": "Answer: C \nExplanation: Sterilization is the most effective contraception to achieve NRR =1 Male sterilization Male sterilization or vasectomy being a comparatively* simple operation can be performed even in primary health centres by trained doctors under local anaesthesia. When carried out under strict aseptic technique, it should have no risk of moality. In vasectomy, it is customary to remove a piece of vas at least 1 cm after clamping. The ends are ligated and then folded back on themselves and sutured into position, so that the cut ends face away from each other. This will reduce the risk of recanalization at a later date. It is impoant to stress that the acceptor is not immediately sterile after the operation, usually until approximately 30 ejaculations have taken place. During this intermediate period, another method of contraception must be used. If properly performed, vasectomies are almost 100 per cent effective. Following vasectomy, sperm production and hormone output are not affected. The sperm produced are destroyed intraluminally by phagocytosis. This is a normal process in the male genital tract, but the rate of destruction is greatly increased after vasectomy. Vasectomy is a simpler, faster and less expensive operation than tubectomy in terms of instruments, hospitalization and doctor's training. Cost-wise, the ratio is about 5 vasectomies to one tubal ligation. Ref: Park 25th edition Pgno : 543", "role": "assistant" } ]

[ { "content": "All of the following agents can be given for induction of anaesthesia in children, EXCEPT:1 \nSelect and explain. \nA. Halothane, B. Servoflurane, C. Morphine, D. Nitrous oxide", "role": "user" }, { "content": "Answer: C \nExplanation: Morphine has pharmacokinetic differences in young individuals, that may predispose them to develop respiratory depression. So this drug should be used with caution in infants less than 6 months of age who are not ventilated. Drugs used in the induction of anesthesia in children are a mixture of oxygen and nitrous oxide. Other drugs which are useful are sevoflurane or halothane. Sevoflurane is considered to be the agent of choice for inhalational induction rather than halothane, because sevoflurane has a wider therapeutic safety window in terms of cardiovascular depression and has no unpleasant smell. Ref: Synopsis of Pediatric Emergency Medicine By Gary Robe Fleisher, 4th Edition, Page 34 ; Textbook of Anesthesia for Postgraduates By T. K. Agasti, Page 799", "role": "assistant" } ]

[ { "content": "Which of the following agents is of value in the postoperative care of the hemophilic patient? \nSelect and explain. \nA. Vitamin K, B. Monsel's solution, C. Aminocaproic acid, D. Factor 8 cryoprecipitate", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 6-year old child who presented with perianal pruritus, excoriation of skin and nocturnal enuresis was found to be infected with a parasite causing autoinfection. The causative agent is diagnosed by the - \nSelect and explain. \nA. NIH swab method, B. String test, C. Hetrazan test, D. Encysted larvae on muscle biopsy", "role": "user" }, { "content": "Answer: A \nExplanation: The causative agent is Enterobius vermiculais & is diagnosed by NIH swab or perianal swab moistened with saline ie by applying the adhesive surface of cellophane tape to perianal skin in the morning & then this is examined on a glass slide inder microscope. Reference: Harrison20th edition pg 1102", "role": "assistant" } ]

[ { "content": "A histological section of the left ventricle of a deceased 28-year-old male shows classic contraction band necrosis of the myocardium. Biological specimens confirm the presence of cocaine and metabolites. Activity of which of the following enzymes was most likely increased in the patient's myocardial cells sholy prior to his death? \nSelect and explain. \nA. Phosphoenolpyruvate carboxykinase, B. Phosphofructokinase-1, C. Pyruvate dehydrogenase, D. Succinate dehydrogenase", "role": "user" }, { "content": "Answer: B \nExplanation: Cocaine causes contraction band necrosis by blocking the reuptake of norepinephrine, resulting in excessive vasoconstriction of coronary vessels, leading to ischemia and infarction of hea tissue. Under these pathological conditions, myocardial cells switch to anaerobic metabolism and therefore glycolysis becomes the sole source of ATP substrate-level phosphorylations by phosphoglycerate kinase and pyruvate kinase. Phosphofructokinase-1 (PFK-1) is the rate-limiting enzyme of glycolysis, and its activity would therefore be increased. Phosphoenolpyruvate carboxykinase is a regulatory enzyme in gluconeogenesis, which is induced by coisol, epinephrine, and glucagon. It functions in the hepatic synthesis of glucose when energy levels from beta-oxidation of fatty acids are adequate. Pyruvate dehydrogenase produces acetyl-CoA from pyruvate and coenzyme A, bridging glycolysis and the Krebs cycle. It requires 5 cofactors, including NAD and FAD, which would no longer be produced by the electron transpo under hypoxic conditions, decreasing its activity. Succinate dehydrogenase is a key enzyme of the Krebs cycle, producing a reduced equivalent of FAD to feed into the electron transpo chain. It is also known as Complex II. The Krebs cycle only functions if oxygen is in appropriate concentrations since it is regulated by the levels of NADH, which is only consumed by the electron transpo chain if there is enough oxygen. The absence of oxygen leads to an accumulation of NADH and a subsequent decrease in the enzyme activities of the Krebs cycle. Ref: Bender D.A., Mayes P.A. (2011). Chapter 20. Gluconeogenesis & the Control of Blood Glucose. 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": "All are hypercoagulable states, except : \nSelect and explain. \nA. Protein C resistance, B. Factor V Leiden deficiency, C. Antiphospholipid antibody, D. Polycythemia", "role": "user" }, { "content": "Answer: B \nExplanation: Answer is B (factor V Leiden deficiency) Factor V Leiden mutation (or T Factor V Leiden levels) are associated with a hypercoaguable state and not a Factor V Leiden deficiency. Inherited Defective inhibition of coagulation factors Factor V Leiden (resistant to inhibition by activated protein C) - Antithrombin III deficiency (or resistance) - Protein C deficiency (or resistance) - Protein S deficiency (or resistance) - Prothrombin gene mutation (G20210A) Impaired clot lysis - Dysfibrinogenemia - Plasminogen deficiency - PA deficiency - PAI-I excess Unceain mechanism - Homocystinuria Acquired Diseases or syndromes Lupus anticoagulant/anticardiolipin antibody syndrome Malignancy - Myeloproliferative disorder - Thrombotic thrombocytopenic purpura - Estrogen treatment Hyperlipidemia - Diabetes mellitus Hyperviscosity - Nephrotic syndrome - Congestive hea failure - Paroxysmal nocturnal hemoglobinuria Physiologic states - Pregnancy (especially postpaum) - Obesity - Postoperative state - Immobilization - Old stage", "role": "assistant" } ]

[ { "content": "Parasites not transmitted through soil: \nSelect and explain. \nA. Pin worm, B. Hookworm, C. Tapeworm, D. Roundworm", "role": "user" }, { "content": "Answer: C \nExplanation: Ans: (c) TapewormRef: K.D. Chatterjee, 13th edition, Page 212-222Nematodes based on mode of infection:Mode of InfectionOrganismsIngestionEggsEnterobius , Ascaris , Irichuris (EAT)Larva within intermediate hostDrancunculus medinensisEncysted larva in muscleTrichinella spiralisPenetration of skinStrongyloides, Ancylostoma ,Necator (SAN)Blood sucking insectsFilariaInhalation of dust containing eggsAscaris, Enterobius", "role": "assistant" } ]

[ { "content": "Which of the following does not undergo phosphorylation by protein kinases? \nSelect and explain. \nA. Threonine, B. Tyrosine, C. Asparagine, D. Serine", "role": "user" }, { "content": "Answer: C \nExplanation: Phosphorylation occurs at the hydroxyl groups of serine, threonine, and tyrosine. A protein kinase is a kinase enzyme that modifies other proteins by chemically adding phosphate groups to them (phosphorylation). Phosphorylation usually results in a functional change of the target protein (substrate) by changing enzyme activity, cellular location, or association with other proteins. The chemical activity of a kinase involves transferring a phosphate group from a nucleoside triphosphate (usually ATP) and covalently attaching it to one of three amino acids that have a free hydroxyl group.Most kinases act on both serine and threonine, others act on tyrosine, and a number (dual specificity kinases) act on all three. There are also protein kinases that phosphorylate other amino acids, including histidine kinases that phosphorylate histidine residues.", "role": "assistant" } ]

[ { "content": "All the following are indications for termination of pregnancy in an APH patient except \nSelect and explain. \nA. 37 weeks, B. IUD, C. Transverse lie, D. Significant bleeding", "role": "user" }, { "content": "Answer: C \nExplanation: The definite management - comprises prompt delivery, this is considered when ever The patient has her first bout of bleeding after 37 completed weeks. Successful conservative treatment brings the patients upto 37 weeks. If the initial or a subsequent bout of bleeding is very severe Patient is in labour Evidence of maternal or fetal jeopardy Intrauterine fetal death", "role": "assistant" } ]

[ { "content": "Note a delayed type of hypersensitive reactions -a) Arthus reactionb) Bronchial asthmac) Hemolytic anemiad) Multiple sclerosis \nSelect and explain. \nA. ab, B. bc, C. abc, D. bcd", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following is the investigation of choice in a pregnant lady at 18 weeks of pregnancy with past history of delivering a baby with Down's syndrome : \nSelect and explain. \nA. Triple screen test, B. Amniocentesis, C. Chorionic villous biopsy, D. Ultrasonography", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is b i.e. Amniocentesis In a pregnant lady with H/0 previous Down syndrome, the chances of recurrence are increased. Extensive screening should be carried out in all such females. Now in the question given - female is presenting at 18 weeks and investigation of choice is being asked which will definately be amniocentesis. At 18 weeks Screening test : quad test I Triple test. Investigation of choice : Amniocentesis. In first trimester (or 1st screening test Combined test Investigation of choice chorionic villi sampling. Screening test selectior Women presenting to ANC clinic before 14 weeks. Nuchan translucency + free phCG +PAPP-A (k/a combined test) Based on result if", "role": "assistant" } ]

[ { "content": "Hypersensitivity angitis is seen in - \nSelect and explain. \nA. SLE, B. Polyaeritis nodosa, C. Henoch schonlein purpura, D. Buergers disease", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Henoch schonlein purpurao HSP is not hypersensitivity angitis. But the best answer amongst the given options is HSP because it is the most impoant differential of hypersensitivity angitis.Hypersensitivity angitis Hypersensitivity vasculitis or hypersensitivity angitis or leukocytoclastic angitis is a small vessel vasculitis due to hypersensitivity reaction.It is usually to a known drug, e.g. cefoperazone, autoantigens or infectious agents.Immune complexes lodge in the vessel wall, attracting polymorphoneuclear leukocytes who in turn release tissue-degrading substances leading to an inflammatory process.Hypersensitivity angitis usually present with skin manifestation, e.g. palpable purpura, but sometimes nerves, kidneys, joints and hea may also be involved.Diagnostic criteriao At least 3 out of the 5 criteria are requiredAge > 16Use of possible triggering drug in relation to symptoms.Palpable purpuraMaculopapular rashSkin biopsy showing neutrophil infiltrate around vessel.o Henoch-schonlein purpura is the most impoant differential.", "role": "assistant" } ]

[ { "content": "Train of four is characteristically used in concern with- \nSelect and explain. \nA. Malignant hypehermia, B. Non -depolarizing neuromuscular blockers, C. Mechanical ventilation, D. To check hemodynamic parameters", "role": "user" }, { "content": "Answer: B \nExplanation: Train of four is used for monitoring neuromuscular block during anaesthesia. Fade on TO4 is the characteristic feature of non-depolarising neuromuscular blockage.", "role": "assistant" } ]

[ { "content": "The commonest site of lodgement of a pulmonary embolus is in the territory of - \nSelect and explain. \nA. Rt. lower lobe, B. Rt. upper lobe, C. Lt. lower lobe, D. Lt. upper lobe", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Lt. upper lobe", "role": "assistant" } ]

[ { "content": "Plummer vinson syndrome is characterised by all except \nSelect and explain. \nA. Glossitis, B. Esophagal webs, C. Megaloblastic anemia, D. Esophagal dysplasia", "role": "user" }, { "content": "Answer: C \nExplanation: rare disease characterized by difficulty swallowing, iron-deficiency anemia, glossitis, cheilosis and esophageal webs.Treatment with iron supplementation and mechanical widening of the esophagus generally provides an excellent outcome.", "role": "assistant" } ]

[ { "content": "Which of the following drug is an enzyme inducer? \nSelect and explain. \nA. Rifampicin, B. Isoniazid, C. Ketokonazole, D. Erythromycin", "role": "user" }, { "content": "Answer: A \nExplanation: (Ref: Katzung, 14th ed. pg. 59; KDT, 6th ed. pg. 27)Enzyme induction involves microsomal enzyme in liver as well as in other organ.It increases the rate of metabolism 2 - 4 fold. Therefore, effect of drug decreases.Enzyme inhibitors also involves microsomal enzyme.It inhibits the microsomal enzyme, which decreases drug metabolism rate and increases duration of drug action.Let us take an example of warfarin, which is used as an anti thrombotic agent.#Warfarin + enzyme inducer = Thrombosis (warfarin metabolism increases and action of warfarin diminishes rapidly and thrombotic condition arises).#Warfarin + enzyme inhibitor = Bleeding (warfarin metabolism decreases and duration of warfarin action increases and patient develops bleeding tendency)Drugs which are enzyme inducers and enzyme inhibitors Enzyme inducersEnzyme inhibitorsGriseofulvinPhenylbutazonePhenytoinErythromycinRifampicinAllopurinol, AmiodaroneSmokingCiprofloxacinCarbamazipineOmeprazolePhenobarbitoneCimetidineBarbiturateKetoconazoleDDTValproateRemembered as: GPRS Cell Phone Battery DeadMn: PEACOCK ValaMost of the anti epileptic are enzyme inducers except VALPROATE (an inhibitor)Most of the antimicrobial are enzyme inhibitors except GRISEOFULVIN (an Inducer)", "role": "assistant" } ]

[ { "content": "Trantas spots are seen in – \nSelect and explain. \nA. Vernal conjunctivitis, B. Eczematous conjunctivitis, C. Ophthalmia nodosa, D. Tularemia", "role": "user" }, { "content": "Answer: A \nExplanation: Tranta's spots (Horner tranta's spots) are discrete white raised dots along the limbus and are composed of degenerated eosinophils.", "role": "assistant" } ]