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[ { "content": "Haversian system is seen in \nSelect and explain. \nA. Coical bone, B. Cancellous bone, C. Teeth, D. Nail", "role": "user" }, { "content": "Answer: A \nExplanation: * Microscopically, the bone is of five types, namely lamellar (including both compact and cancellous), woven, fibrous, dentine and cement. 1. Lamellar bone: Most of the mature human bones, whether compact or cancellous, are composed of thin plates of bony tissue called lamellae. These are arranged in piles in a cancellous bone, but in concentric cylinders (Haversian system or secondary osteon) in a compact bone. 2. Woven Bone: seen in fetal bone, fracture repair and in cancer of bone 3. Fibrous bone is found in young foetal bones, but are common in reptiles and amphibia. 4. Dentine and 5. Cement occur in teeth. * Compact bone ( coical bone) In shaft (diaphysis) of long bone - lamellae arranged to form Haversian system - Bone marrow Yellow which stores fat after pubey. It is red before pubey - Hard and ivory-like * Cancelled bone spongy, or trabecular bone - In the epiphyses of long bone - arranged in a meshwork, so Haversian systems are not present - bone marrow red, produce RBCs, granular series of WBC and platelets - spongy * Nails are made of a tough protective protein called keratin - consists of the nail plate, the nail matrix and the nail bed below it, and the grooves surrounding it (Reference : BDC Handbook of General Anatomy , 5th edition, pg 39)", "role": "assistant" } ]

[ { "content": "A 50-year-old woman presents with easy fatigability, a smooth sore tongue, numbness and tingling of the feet, and weakness of the legs. A complete blood count shows a megaloblastic anemia that is not reversed by folate therapy. Hemoglobin is 5.6 g/dL, WBC count is 5,100/mL, and platelets are 240,000/mL. This patient most likely has a deficiency of which of the following vitamins? \nSelect and explain. \nA. Vitamin B1 (thiamine), B. Vitamin B2 (riboflavin), C. Vitamin B12, D. Vitamin K", "role": "user" }, { "content": "Answer: C \nExplanation: Except for a few rare situations, vitamin B12 (cyanocobalamin) deficiency is usually a result of pernicious anemia, an autoimmune disease of the stomach. Vitamin B12 is required for DNA synthesis, and its deficiency results in large (megaloblastic) nuclei.Diagnosis: Vitamin B12 deficiency, pernicious anemia", "role": "assistant" } ]

[ { "content": "Quadrivalent Meningococcal vaccine is not used for? \nSelect and explain. \nA. Serotype A, B. Serotype B, C. Serotype C, D. Serotype Y", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. (b) Serotype BRef: Harrison 19th ed. /1002* There are currently three vaccines available in the USA to prevent meningococcal disease, all quadrivalent in nature, targeting serogroups A, C, W-135, and Y.* Meningococcal polysaccharide or conjugate vaccines provide no protection against serogroup B disease and MenB vaccines provide no protection against serogroup A, C, W or Y disease. For protection against all 5 serogroups of meningococcus it is necessary to receive both vaccines.* Only recently vaccine targeting serogroup B has also been created and is protein based.TRADE NAMETYPE OF VACCINESEROGROUPS INCLUDEDYEAR LICENSEDAPPROVED AGESMenomunePolysaqccharideA, C, W, Y19812 year and olderMenactraConjugateA, C, W, Y20059 months-55 yearsMenveoConjugateA, C, W, Y20102 months-55 yearsMenHibrixConjugateC, Y, and Hib20126 weeks-18 monthsTrumenbaProteinB201410-25 yearsBexseroProteinB201510-25 years", "role": "assistant" } ]

[ { "content": "In systemic form of JIA, all are true EXCEPT: \nSelect and explain. \nA. RA factor positive, B. High fever with rash, C. Hepatosplenomegaly, D. Elevated ESR", "role": "user" }, { "content": "Answer: A \nExplanation: RA factor may be positive in polyahritis, but not in systemic onset JIA. Systemic form of JIA: High fever with rash Hepatosplenomegaly Elevated ESR Types of JIA Systemic JIA- Systemic involvement seen Oligoaicular- Affects four or fewer joints, often the knee or ankle. Polyaicular ahritis, rheumatoid factor negative Polyaicular ahritis, rheumatoid factor positive Psoriatic ahritis Enthesitis-related ahritis Undifferentiated ahritis", "role": "assistant" } ]

[ { "content": "Which of the following is true regarding IUGR ? \nSelect and explain. \nA. Asymmetrical IUGR: is far more common than symmetrical IUGR, B. Ponderal index is normal in symmetrical IUGR, C. Prognosis is better in asymmetrical IUGR than symmetrical IUGR, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: All of the above", "role": "assistant" } ]

[ { "content": "Duct of Bartholins gland opens \nSelect and explain. \nA. On outer side of Labium minus, B. On inner side of Labium majus, C. On outer side of Labium majus, D. On inner side of Labium minus", "role": "user" }, { "content": "Answer: D \nExplanation: Duct of Bartholins gland opens on the inner side of Labium minus external of hymen.", "role": "assistant" } ]

[ { "content": "For shield (mould) in eye tumors which of the following is preferred? \nSelect and explain. \nA. Iodine-131, B. Gold-198, C. Strontium-90, D. Phosphorous-32", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D. Phosphorous-32Some useful radionuclides used in clinical radiotherapyRadionuclideEnergy Half-life Medical uses* Radium-2260.83mv1625 yearsfor brachytherapy but not used now a days* Cobalt-601.25mv5.4 yearsteletherapy & brachytherapy* Caesium-1370.666mv30 yearsteletherapy & brachytherapy* Iridium-1920.380mv72 daysbrachytherapy only* Iodine-1250.030mv60 daysbrachytherapy* Iodine-1310.61mv8 daysunsealed radioiodine for thyroid cancer Rx* Gold-1980.412mv 2.7 days brachytherapy* Strontium-902.24mv30 yearsfor shield (mould) in eye tumors* Phosphorous-321.71mv14 daysintraperitoneal", "role": "assistant" } ]

[ { "content": "Posterior limb of internal capsule is supplied by all except \nSelect and explain. \nA. Middle cerebral aery, B. Recurrent aery of Heubner, C. Anterior choroidal, D. Posterior cerebral aery", "role": "user" }, { "content": "Answer: B \nExplanation: Recurrent aery of Heubner does not supply posterior limb of internal capsule. Blood supply of internal capsule Anterior Limb Recurrent aery of Heubner Genu Recurrent aery of Heubner Charcot&;s aery (lenticulostriate aery or aery of cerebral hemorrhage) Posterior limb Charcot&;s aery (branch of middle cerebral aery) Anterior choroidal aery (branch of internal carotid aery) Posterolateral branches of posterior cerebral aery. Sublentiform pa Anterior choroidal aery Posterior cerebral aery Retrolentiiform pa Posterolateral branches of posterior cerebral aery Ref: Gray&;s Anatomy 41st edition Pgno: 286", "role": "assistant" } ]

[ { "content": "In prayer Willi syndrome, which of the following is increased \nSelect and explain. \nA. A. LH, B. B. FSH, C. C. TSH, D. D. Ghrelin", "role": "user" }, { "content": "Answer: D \nExplanation: Ghrelin is a growth hormone secreatagogue and the only gut harmone with orexigenic propey It is primarily produced in the stomach. In children ,it's value is inversely related with body mass index and insulin values. robbins 8/e 441-2 9/e 444", "role": "assistant" } ]

[ { "content": "Which of the following is associated with Madonna-Putana complex ? \nSelect and explain. \nA. Female arousal disorder, B. Male hypoactive sexual desire disorder, C. Male erectile disorder, D. Anorgasmia", "role": "user" }, { "content": "Answer: C \nExplanation: Madonna-Putana complex Psychogenic male erectile disorder Can be organic or psychologic or both. Inability to have arousal towards a woman , the man desires. Men have arousal only with women whom they see as degraded.", "role": "assistant" } ]

[ { "content": "Ductus arteriosus closes in response to: \nSelect and explain. \nA. Decrease in peripheral oxygen saturation, B. Indomethacin therapy, C. Prostaglandin E1, D. Increase in pulmonary vascular resistance", "role": "user" }, { "content": "Answer: B \nExplanation: b. Indomethacin therapy(Ref: Nelson's 20/e p 2197, Ghai 8/e p 417)Indomethacin, a Prostaglandin inhibitor is used in medical closure of Ductus arteriosus.", "role": "assistant" } ]

[ { "content": "Russel's periodontal index scores range from \nSelect and explain. \nA. 0-2, B. 0-4, C. 0-6, D. 0-8", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "A person has unprotected sex 3 weeks back, To rule out HIV infection the best test is \nSelect and explain. \nA. P 24 antigen assay, B. ELISA, C. Western blot, D. Lymphnode biopsy", "role": "user" }, { "content": "Answer: A \nExplanation: Laboratory diagnosis of HIV infection\nLaboratory diagnosis is made by:\nA. Antibody detection\n\nIt is the most common method used for diagnosis of HIV infection.\nELISA is the most sensitive test and therefore is the screening test of choice.\nWestern blot is the most specific (Confirmatory) test and therefore is the’gold standard’ for diagnosis.\nAntibodies test usually nucleic acid or antigen.\n\nB. Detection of HIV nucleic acid or antigen\n\nP24 antigen detection by ELISA can be done 16 days after infection (earlier than antibody detection).\nNucleic acid detection tests are the earliest to become positive (12 days after infection), Most commonly used test is reverse transcriptase PCR, (RT-PCR), other methods used are DNA-PCR, RNA-PCR, RNA-bDNA (branched DNA), and RNA-NASBA (nuclei acid sequenced based assay).\n\nC. Virus isolation\n\nCo-cultivation of the patient’s lymphocyte with uninfected lymphocytes in the presence of IL-2.\nNot suitable as a routine diagnostic procedure.\n\nIn infected individual HIV can be isolated from\n\nBlood\nSemen\nSaliva\nUrine\nLymphocytes\nCervical secretions\nTears\nBreast milk", "role": "assistant" } ]

[ { "content": "All are true about vocal cord nodule except: \nSelect and explain. \nA. Caused by phonotrauma, B. Commonly occur at Junction of middle & posterior 1/3, C. Common at junction of A 1/3 with P 2/3, D. Common in teachers", "role": "user" }, { "content": "Answer: B \nExplanation: Ans:B (Commonly occur at Junction of middle & posterior 1/3 ) VOCAL NODULES (SINGER'S OR SCREAMER S NODES)PL Dhingra 6th/303-04# Their size varies from tha t of pin-head to half a peaThey are the result of vocal trauma when person speaks in unnatural low tones for prolonged periods or at high intensitiesThey mostly affect teachers, actors, vendors or pop singers. They are also seen in school going children who are too assertive <PS# talkativePatients complains of hoarseness. Vocal fatigue & pain in the neck on prolonged phonation are other common symptomsEarly cases of vocal nodules can he treated conservatively by educating the patient in proper use of voice. With this treatment, many nodules in children disappear completelySurgery is required for large nodules or nodules of long standing in adults. They are excised with precision under operating microscope either with cold instruments or laser avoiding any trauma to the underlying vocal ligamentSpeech therapy & re-education in voice production are essential to prevent their recurrenceVocal nodules(Singer's or Screamer's nodes): They appear symmetrically on the free edge of vocal cord, at the junction of anterior one-third, with the posterior two-third, as this is the area of maximum vibration of cord & thus subject to maximum trauma P.L. Dhingra 6th/303Fig. .Vocal nodules. Typically, theyr form at the junction of anterior one- third with posterior two-thirds of vocal cards", "role": "assistant" } ]

[ { "content": "Brain abscess in cyanotic heart disease is commonly located in \nSelect and explain. \nA. Cerebellar hemisphere, B. Thalamus, C. Temporal lobe, D. Parietal lobe", "role": "user" }, { "content": "Answer: D \nExplanation: Brain abscesses in congenital cyanotic heart diseases occur due to hematogenous seeding of bloodborne bacteria. These blood borne bacteria bypass the pulmonary capillary bed d/t right to left shunt. They commonly infect parietal & frontal lobes (territory of middle cerebral artery).", "role": "assistant" } ]

[ { "content": "Beta blockers are indicated in - \nSelect and explain. \nA. Phobic disorders, B. Anxiety, C. Schizophrenia, D. Mania", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' Anxiety Antianxiety Drugs areBenzodiazepinesB BlockersBuspironeMeprobamate & Hydroxyzine", "role": "assistant" } ]

[ { "content": "All are waterborne diseases except - \nSelect and explain. \nA. Typhoid, B. Fish tape worm, C. HAV, D. Cholera", "role": "user" }, { "content": "Answer: B \nExplanation: Fish tapeworm(Diphyllobothrium latum) Infection is acquired when the person eats undercooked fish containing the parasite and not by drinking water! Park's Textbook of Preventive and Social Medicine, 25th Edition Ref: 25th Ed K.Park's Textbook Of Preventive and Social Medicine", "role": "assistant" } ]

[ { "content": "Not true about Fosphenytoin \nSelect and explain. \nA. Used for GTCS, B. Prodrug of Phenytoin, C. Lipid soluble, D. Highly protein bound", "role": "user" }, { "content": "Answer: C \nExplanation: Fosphenytoin, a more soluble phosphate prodrug of phenytoin, is well absorbed. Fosphenytoin sodium is available for intravenous or intramuscular use and replaces intravenous phenytoin sodium, a much less soluble form of the drug. Used in generalized Tonic-clonic seizures and paial seizures. Highly bound to plasma proteins.Reference: Katzung Pharmacology; 13th edition; Chapter 24; Antiseizure Drugs", "role": "assistant" } ]

[ { "content": "All are duties of a medical practitioner except \nSelect and explain. \nA. A medical practitioner should uphold the dignity and honor of his profession, B. Doctor need not have to get consent from patient or his relatives regarding the procedures or surgery, C. In emergencies doctor should execute his moral and humanitarian duty to save the life of a patient, D. In medicolegal cases, doctor is bound to call the police", "role": "user" }, { "content": "Answer: B \nExplanation: Doctor should get informed consent from the patient or his relatives after explaining all procedures and risks before doing a surgery DUTIES OF REGISTERED MEDICAL PRACTITIONER TOWARDS PATIENT 1. Duty to exercise reasonable degree of skill and knowledge. 2. Duties in regard to attendance and examination. 3. Duty to furnish proper and suitable medicines. 4. Duty to give instructions. 5. Duties towards children and adults. 6. Consultation with a specialist. 7. Duties in regard to psychiatric patients. 8. Duties in regard to poisoning. 9. Duty to notify ceain diseases. to. Duties in regard to operative procedures. 11. Duties under Geneva convention. 12. Duties in convention with X-rays. 13. Professional Secrecy. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 377", "role": "assistant" } ]

[ { "content": "Which premolar resembles a canine: \nSelect and explain. \nA. Maxillary first premolar., B. Mandibular first premolar., C. Maxillary second premolar., D. Mandibular second premolar.", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following drug's use alone is to be avoided in a patient with adrenaline producing pheochromocytoma? \nSelect and explain. \nA. Phentolamine, B. Enalapril, C. Clonidine, D. Methyldopa", "role": "user" }, { "content": "Answer: A \nExplanation: Vasomotor Reversal Of Dale - Adrenaline has biphasic effect on blood pressure. - a1 - Strong receptor thus more effect. - b2 - Sensitive receptor thus stimulated at low dose too. When adrenaline is given IV at high doses 1st BP will increase due to stimulation of a1 > b2 & then BP will decrease due to b2 stimulation. When adrenaline is given IV at high dose with a blocker, exaggerated fall of BP occurs called as Vasomotor Reversal of Dale. In adrenaline producing pheochromocytoma, If person is treated by alpha blocker, then this phenomenon will occur and thus death can occur due to severe hypotension. Therefore alpha blocker is always combined with beta blocker in adrenaline producing tumor.", "role": "assistant" } ]

[ { "content": "Which one of the following is an Aldosterone antagonist? \nSelect and explain. \nA. Spironolactone, B. Amiloride, C. Triameterine, D. Acetazolamide", "role": "user" }, { "content": "Answer: A \nExplanation: (A) Spironolactone > Spironolactone is a steroid chemically related to the mineralocorticoid aldosterone> Spironolactone is an aldosterone antagonist.", "role": "assistant" } ]

[ { "content": "Disinfection by autoclaving is NOT recommended for - \nSelect and explain. \nA. Sputum, B. Linen, C. Sharp instrument, D. Glass syringes", "role": "user" }, { "content": "Answer: C \nExplanation: .sterilizers which operate at high temperatures and pressure are called autoclaves.they generate steam under pressure or saturated steam which is the most effective sterilizing agent.they fall in two categories,grvity displacement autoclaves and high speed pre-vaccum autoclaves.works on the same principle as that of a pressure cooker.widely used in the hospital and laboratry practice.it destroys all forms of life,including spores.most effective method for the sterilization of linen,dressings,gloves,syringes,and culture media.not suitable for sterilization of plastic and sharp instruments. ref:park&;s textbook,ed 22,pg no 120", "role": "assistant" } ]

[ { "content": "During bilateral adrenalectomy, intraoperative dose of hydrocoisone should be given after \nSelect and explain. \nA. Opening the abdomen, B. Ligation of left adrenal vein, C. Ligation of right adrenal vein, D. Excision of both adrenal glands", "role": "user" }, { "content": "Answer: D \nExplanation: \"Patients undergoing surgery for a primary adrenal adenoma secreting glucocoicoids require preoperative and postoperative steroids due to suppression of the contralateral adrenal gland. Duration of steroid therapy is determined by the ACTH stimulation test. Exogenous steroids may be needed for up to 2 years but are needed indefinitely in patients who have undergone bilateral adrenalectomy. This latter group of patients also may require mineralocoicoid replacement therapy.\" \"Perioperative and postoperative glucocoicoid administration is obviously essential in the care of patients with Cushing's syndrome. For patients undergoing adrenalectomy for Cushing's syndrome, perioperative \"stress dose\" steroids (hydrocoisone, 100 mg IV every 8 hours for 24 hours) are recommended.\"", "role": "assistant" } ]

[ { "content": "Prolonged apnea may occur in patients with a genetically determined abnormal variant of cholinesterase following intravenous administration of \nSelect and explain. \nA. Pancuronium, B. Tubocurarine, C. Atracurium, D. Succinylcholine", "role": "user" }, { "content": "Answer: D \nExplanation: Both succinylcholine and mivacurium are completely and rapidly eliminated by plasma cholinesterase. Other nondepolarizing neuromuscular blockers, such as tubocurarine, pancuronium, and atracurium, are eliminated by renal or hepatic mechanisms or by spontaneous hydrolysis (atracurium). Patients with genetically determined atypical cholinesterase may be detected by measuring the inhibition of cholinesterase by dibucaine, a local anesthetic. Dibucaine inhibits the normal enzyme about 80%, but the abnormal variant is inhibited only 20%.", "role": "assistant" } ]

[ { "content": "Which proton pump inhibitor can be used IV ? \nSelect and explain. \nA. Omeprazole, B. Rabeprazole, C. Pantoprazole, D. Fomeprazole", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Pantoprazole Pantaprazole - it is more acid stable and has higher oral bioavailability. It is also available for i.v. administration; paicularly employed in bleeding peptic ulcer and for prophylaxis of acute stress ulcers.", "role": "assistant" } ]

[ { "content": "A 25-year-old woman with amenorrhea has never had menarche. On physical examination, she is 145 cm (4 ft 9 in) tall. She has a webbed neck, a broad chest, and widely spaced nipples. Strong pulses are palpable in the upper extremities, but there are only weak pulses in the lower extremities. On abdominal MR imaging, her ovaries are small, elongated, and tubular. Which of the following karyotypes is she most likely to have? \nSelect and explain. \nA. 45, X/46, XX, B. 46, X, X (fra), C. 47, XXY, D. 47, XXX", "role": "user" }, { "content": "Answer: A \nExplanation: The features described are those of classic Turner syndrome. Individuals who reach adulthood may have mosaic cell lines, with some 45, X cells and some 46, XX cells. A female carrier of the fragile X syndrome, X(fra), is less likely to manifest the disease than a male, but the number of triple repeat sequences (CGG) increases in her male offspring. The 47, XXY karyotype occurs in Klinefelter syndrome; affected individuals appear as phenotypic males. The \"superfemale\" karyotype (XXX) leads to mild mental retardation. Trisomy 16 is a cause of fetal loss early in pregnancy.", "role": "assistant" } ]

[ { "content": "ALL are true about Colles fracture except - \nSelect and explain. \nA. In old age, B. Dorsal shift, C. At cortico-cancellous junction, D. Garden spade deformity", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Garden spade deformity' COLLES FRACTUREo Colles fracture is an extra-articular fracture at the distal end of radius, at its corticocancellous junction. It is the most common fracture in person over 40 years of age and especially in women after menopause (Postmenopausal females). The association of the fracture with osteoporosis is now well established and it is one of the fragility fracture, seen in osteoporosis. The fracture nearly always caused by fall on outstretched hand.Displacement in Colles fractureo The fracture line runs transversely at the corticocancellous junction.o In the majority of the cases, one or more displacements of the distal fragment occuri) Dorsal displacement (Dorsal shift)ii) Dorsal tilt (Dorsal angulation)iii) Lateral displacement (lateral shift)iv) Lateral tilt (lateral angulation)v) Supination (external rotation)vi) Impaction (proximal migration)Clinical features of Colles fractureo Pain and swelling at the wrist.o Typical deformity : There is a dorsal hollow or depression just proximal to the fracture and immediately distal to this there is a marked prominence caused by lower fragment being displaced backwards, carrying with it the whole of the carpus and hand. This gives appearance of a fork, So named dinner fork/ silver fork / spoon shaped deformity.o There is local tenderness.Treatment of colles fractureo Treatment of code's fracture is essentially conservative,o For undisplaced fracture below-elbow cast is given in-situ.o For displaced fractures, the standard method of treatment is to undertake manipulative reduction under local or general anaesthesia.o Technique of closed manipulation involves reversing the typical deformities of Colle's fracture (in following sequence)Disimpaction (by traction) to correct impaction.Palmar flexion & ulnar deviation to correct dorsal tilt / shift and radial tilt / shift.Pronation (internal rotation) :- to correct supination (external rotation),o After reduction below elbow cast is given.", "role": "assistant" } ]

[ { "content": "Which of the following is the most common renal vascular anomaly - \nSelect and explain. \nA. Supernumerary renal arteries, B. Supernumerary renal veins, C. Double renal arterires, D. Double renal veins", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 70 year old female with psychiatric symptoms diagnosed of having schizophrenia. Which is the poor prognostic factor in schizophrenia? \nSelect and explain. \nA. Acute onset, B. Middle age, C. Family history of affective disorder, D. Gradual onset", "role": "user" }, { "content": "Answer: A \nExplanation: Predictors of poorer outcome in schizophrenia:Age below 20Dilated ventricles, brain atrophy in CT or MRINegative symptoms (e.g., flat affect, povey of thought, apathy, asociality); obsessive-compulsive symptomsIrregular occupational recordInsidious onsetSlow rate of progressionmalesYears of duration prior to assessmentCannabis useAbsence of precipitating factorsStressful lifeFamily history of schizophrenia (not affective disorder)Presence of other adverse social factorsPrenatal adverse eventsPresence of ceain gene polymorphism, e.g., COMT. NMDA2APRef: Meltzer H.Y., Bobo W.V., Heckers S.H., Fatemi H.S. (2008). Chapter 16. Schizophrenia. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds),CURRENT Diagnosis & Treatment: Psychiatry, 2e.", "role": "assistant" } ]

[ { "content": "Occlusion of the LAD will lead to infarction of which area - \nSelect and explain. \nA. Posterior part of the interventricular septum, B. Anterior wall of the left ventricle, C. Lateral part of the heart, D. Inferior surface of right ventricle", "role": "user" }, { "content": "Answer: B \nExplanation: Occlusion of proximal LAD can result in large anterior wall infarction. If it is distal LAD, then anteroapical or anteroseptal infarction can occur.", "role": "assistant" } ]

[ { "content": "The slogan for WHO 2005 – \nSelect and explain. \nA. Road safety, B. Maternal and child health, C. Aging, D. Physical activity", "role": "user" }, { "content": "Answer: B \nExplanation: Year → World Health Day (WHD) Theme\n2004 → Road safety is no accident\n2005 → Make every mother and child count\n2006 → Working together for health\n2007 → International health security: Invest in health, build a safer future\n2008 → Protecting health from climate change\n2009 → Health facilities in emergencies", "role": "assistant" } ]

[ { "content": "Investigation of choice for esophageal rupture is? \nSelect and explain. \nA. Dynamic MRI, B. Rigid esophagoscopy, C. Barium contrast swallow, D. Water soluble low molecular weight contrast swallow", "role": "user" }, { "content": "Answer: D \nExplanation: ANSWER: (D) Water soluble low molecular weight contrast swallowREF: with textUse of non ionic water soluble contrast medium instead of barium is warranted when there is any risk of aspiration or esophageal leak. (Ref: Gastrointestinal Imaging: The Requisites By Giles W. Boland 4th ed page 2)Careful endoscopic assessment at the end of any procedure combined with a chest X-ray will identify many cases of perforation immediately. If not recognised immediately, then early and late suspected perforations should be assessed by a water-soluble contrast swallow. If this is negative, a dilute barium swallow should be considered. A CT scan can be used to replace a contrast swallow or as an adjunct to accurately delineate specific fluid collections. (Bailey 25th ed page 1015)Diagnosis of an esophageal perforation may be made radiographically. A chest roentgenogram may demonstrate a hydropneumothorax. A contrast esophagram is done using barium for a suspected thoracic perforation and Gastrografin for an abdominal perforation. Barium is inert in the chest but causes peritonitis in the abdomen, whereas aspirated Gastrografin can cause life-threatening pneumonitis. A surgical endoscopy needs to be performed if the esophagram is negative or if operative intervention is planned. (Ref: Sabiston 18th ed chapter 41)", "role": "assistant" } ]

[ { "content": "The incidence of mental illness is the maximum if the causal factors affect a paicular period - \nSelect and explain. \nA. Perinatal period, B. First five years of life, C. School age, D. Adolescence", "role": "user" }, { "content": "Answer: B \nExplanation: The incidence of mental illness is the maximum if the causal factors affect a paicular period of first five years of life crucial points in the life cycle of human being which are impoant from the view of mental health are prenatal period, first five years of life, school child , adolescence, old age. ref ;(page no;832)23rd edition of PARK&;s textbook of Preventive and Social medicine", "role": "assistant" } ]

[ { "content": "Brain dead individuals have all of the following features EXCEPT (* NIMHANS March-2017 Post-MBBS, NIMHANS - Feb. 2008) \nSelect and explain. \nA. Dolls eye movement is absent, B. Oculo-vestibular reflex is absent, C. Only pain is preserved, D. Corneal reflex is absent", "role": "user" }, { "content": "Answer: C \nExplanation: (C) Only pain is preserved# BRAIN-DEAD> individual has no clinical evidence of brain function upon physical examination.> No response to pain and no cranial nerve reflexes.> Reflexes include pupillary response (fixed pupils), oculocephalic reflex, corneal reflex, no response to the caloric reflex test, and no spontaneous respirations.> In comatose patients, once it has been determined that the cervical spine is intact, a test of the vestibulo-ocular reflex (VOR), also known as the oculocephalic reflex or doll's eye reflex can be performed by turning the head to one side.> Positive response occurs when the eyes rotate to the opposite side to the direction of head rotation, thus indicating that the brain- stem (CN3,6,8) is intact.> Vertical oculo-vestibular eye responses can be assessed by irrigating both ears simultaneously.> If the brainstem is intact, cold water causes the eyes to deviate downwards and warm water causes the eyes to deviate upwards.", "role": "assistant" } ]

[ { "content": "Miss folded proteins might be produced due to defect of: \nSelect and explain. \nA. Cholesterol, B. Mitochondrial, C. Rough endoplasmic reticulum, D. Smooth endoplasmic reticulum", "role": "user" }, { "content": "Answer: C \nExplanation: Rough endoplasmic reticulum is associated with protein synthesis, protein folding and miss folded protein degradation. Ref:Guyton and Hall textbook of medical physiology 12th edition,page number:10,11,12", "role": "assistant" } ]

[ { "content": "APGAR score include A/E \nSelect and explain. \nA. Respiratory effo, B. Hea rate, C. Respiratory rate, D. Colour", "role": "user" }, { "content": "Answer: C \nExplanation: Apgar score is an objective method of evaluating the newborn&;s condition. It includes Hea rate, Respiratory effo, Muscle tone, Reflex irritability and Color. It is generally performed at 1min and again at 5 min after bih. Reference : page 126 Ghai Essential Pediatrics 8th edition", "role": "assistant" } ]

[ { "content": "Bloom Richardson staging is for? \nSelect and explain. \nA. Prostate cancer, B. Breast cancer, C. Ovarian cancer, D. Penile cancer", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. (b) Breast cancer(Ref Internet source)Bloom and Richardson grading for cancer breast is based on* Tubules formation* Nuclear pleomorphisms* Mitotic counts", "role": "assistant" } ]

[ { "content": "Which of the following is seen in idiopathic thrombocytopenic purpura: \nSelect and explain. \nA. Thrornbocytosis, B. Increased prothrombin time, C. Increased bleeding time, D. Increased clotting time", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Point B in treatment of Ca cervix corresponds to \nSelect and explain. \nA. Mackenrodts ligament, B. Obturator Lymph node, C. Isheal tuberosity, D. Round ligament", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Obturator Lymph node", "role": "assistant" } ]

[ { "content": "Which is the MOST appropriate gestational age for performing amniocentesis? \nSelect and explain. \nA. 10-12 weeks, B. 12-16 weeks, C. 20-25 weeks, D. 25-30 weeks", "role": "user" }, { "content": "Answer: B \nExplanation: Amniocentesis is ideally performed between 14-16weeks of gestation. Early amniocentesis can be carried out at 12-14 weeks under ultrasonographic guidance. The fetal cells so obtained are subjected for cytogenetic analysis. Fetal fibroblasts and fluid for biochemistry are used for study. Chorionic villus sampling : is carried out transcervically between 10 - 12 weeks and transabdominally from 10 weeks to term. Trophoblast cells are used for study. Cordocentesis: Is done between 18-20 weeks of gestation. Fetal WBCs are used for study. Ref: Textbook of Obstetrics By DC Dutta 6th edn page 107-8.", "role": "assistant" } ]

[ { "content": "In a 5 year old child, instead of the physiological splitting of second hea sound, expected only during inspiration, a wide and a fixed split of S2 is heard, both during inspiration, as well as expiration. Condition associated with this is? \nSelect and explain. \nA. Atrial septal defect, B. Ventricular septal defect, C. Mitral regurgitation, D. Pulmonary stenosis", "role": "user" }, { "content": "Answer: A \nExplanation: WIDE FIXED SPLIT OF S2 IS SEEN IN: ASD Right Bundle Branch Block TAPVC WIDE VARIABLE SPITTING OF S2 IS SEEN IN: Pulmonic stenosis VSD Mitral regurgitation", "role": "assistant" } ]

[ { "content": "Which of the following drugs is used to treat both diabetes mellitus and diabetes insipidus \nSelect and explain. \nA. Chlorpropamide, B. Glibenclamide, C. Glicazide, D. Glipizide", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Deficiency of purine nucleoside phosphorylase causes \nSelect and explain. \nA. Complement deficiency, B. Cellular immunodeficeincy, C. Humoral immunodeficeincy, D. Combined immunodeficeincy", "role": "user" }, { "content": "Answer: B \nExplanation: A combined T cell and B cell immunodeficiency that is a rare autosomal recessive metabolic disorder that has material basis in mutation in the PNP gene and characterized mainly by decreased T-cell function. Ref-Sathyanarayana 4/e", "role": "assistant" } ]

[ { "content": "Cataracta brunescens result due to deposition of \nSelect and explain. \nA. Copper, B. Iron, C. Melanin, D. Keratin", "role": "user" }, { "content": "Answer: C \nExplanation: Nuclear senile cataract: The usual degenerative changes are intensification of the age- related nuclear sclerosis associated with dehydration and compaction of the nucleus resulting in a hard cataract. It is accompanied by a significant increase in water insoluble proteins. However, the total protein content and distribution of cations remain normal. There may or may not be associated deposition of pigment urochrome and/or melanin derived from the amino acids in the lens. The nucleus may become diffusely cloudy (greyish) or tinted (yellow to black) due to deposition of pigments. In practice, the commonly observed pigmented nuclear cataracts are either amber, brown (cataracta brunescens) or black (cataracta nigra) and rarely reddish (cataracta rubra) in colour. Ref:- A K Khurana; pg num:- 176,178", "role": "assistant" } ]

[ { "content": "The role of plasmids in conjugation was first described by Lederberg and Tatum(46) in - \nSelect and explain. \nA. H.influenzae, B. Corynebacterium, C. Pseudomonas, D. Esch.Coli", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Viridans streptococci\nA Include Streptococcus mutans, mitis, sanguis and salivarious\nB Reliable produce haemolysis on blood Agar plates\nC Accounts for few cases of infective endocarditis\nD The men strains of cariogenic streptococcus\nE Can be isolated from the bloodstream in the majority of patients immediately after dental extraction \nSelect and explain. \nA. ADC is true, B. ADE is true, C. ABC is false, D. ADC is false", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "The least extrapyramidal side effects are seen with which of the following phenothiazine? \nSelect and explain. \nA. Clozapine, B. Triflupromazine, C. Fluphenazine, D. Thioridazine", "role": "user" }, { "content": "Answer: D \nExplanation: Side effects of impoant CNS drugs Midazolam Ataxia, Blackouts in elderlyTolcapone Hepatotoxic Phenytoin Hirsuitism , Gingival hyperplasia , Osteomalacia , Teratogen , Megaloblastic anemia , Ataxia, Lymphadenopathy, Hyperglycemia , Arrhythmias, Vitamin K deficiency Valproate Irreversible hepatic necrosis in older children, Acute pancreatitis Zonisamide,, Topiramate Renal stones VigabatrineIrreversible visual field defectsFelbamate Aplastic anemia Thioridazine Male sexual dysfunction, Retinal damage, Least extra pyramidal symptomsClozapine Agranulocytosis , Myocarditis Risperidone Extra pyramidal symptoms HaloperidolExtra pyramidal symptoms , Akathisia Olanzapine Risk of stroke and death Ziprasidone , Pimozide QT prolongation Quetiapine Cataract Iloperidone Ohostatic hypotension Lithium in expectant mothers Ebstein's anomalyFormic acid Retinal damage Opioids Tolerance & addiction (Refer: Rang and Dale's Clinical Pharmacology, 7th edition, pg no: 557-559)", "role": "assistant" } ]

[ { "content": "Which is not a variable of MDRD (Modification of Diet in Renal Disease) formula? \nSelect and explain. \nA. Age, B. Gender, C. Race, D. Weight", "role": "user" }, { "content": "Answer: D \nExplanation: TEST : 1. CKD - EPI - cystatin C method (BEST) ; Cystatin - C is produced by nucleated cells 2. Modification of diet in renal disease formula GFR= 186.3 x (serum creatinine level ( mg/dl))-1.154 x age-0.203 x ( 0.742 if female ) x (1.21 if black) 3. Cockroft Gault formula 4. Creatinine clearance 5. Inulin clearance", "role": "assistant" } ]

[ { "content": "Feature of post ovulatory endometrium on ultrasound is: \nSelect and explain. \nA. Single hyperechoic thin line, B. Three line sign, C. Prominent halo, D. Prominent posterior enhancement", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is d, i.e. Prominent posterior enhancementRef: Transvaginal Ultrasound by Melvin G. Dodson 1st/ed, p86This is a very important QuestionIMPORTANT: The appearances of endometrium on transvaginal ultrasound during different stages of normal menstrual cycle has been summarized here.A. Just after menstruation (days 3-7)Single hyperechoic thin lines (central endometrial echo)B. At the time of ovulationHalo presentRelatively thin anterior posterior endometrial thickness (<6mm)No posterior enhancementQThree line sign.Q/Trilaminar appearanceC. Luteal phaseMaximum endometrial thicknessHyperechoic endometriumLoss of haloQLoss of three line signQProminent posterior enhancementQ", "role": "assistant" } ]

[ { "content": "Kaposi sarcoma is commonly seen in ? \nSelect and explain. \nA. Upper limbs, B. Lower limbs, C. Head and Neck, D. Trunk", "role": "user" }, { "content": "Answer: B \nExplanation: \" It occurs predominantly on the skin and can involve viually any organ, perhaps except the brain. The initially described form, now known as classic KS, predominantly involves the lower extremities of elderly men. KS is now the most common tumor seen in HIV-infected patients Ref : Bailey and love surgery text book 27th Ed.", "role": "assistant" } ]

[ { "content": "Tension band wiring is indicated in fracture of which of the following ? \nSelect and explain. \nA. Fracture humerus, B. Olecranon, C. Fracture tibia, D. Fracture spine", "role": "user" }, { "content": "Answer: B \nExplanation: Tension band wiring is indicated in the treatment of two types of olecranon fracture. First type is a clean break with separation of the fragments, and second type is comminuted fracture of the olecranon with displced fragments. A crack in the olecranon without displacement is treated by immobilising the elbow in an above elbow plaster slab in 30 degrees of flexion.", "role": "assistant" } ]

[ { "content": "Giant papillary conjunctivitis is seen \nSelect and explain. \nA. Trachoma, B. Contact lens, C. Phlytenular conjunctivitis, D. Vernal kerato conjunctivitis", "role": "user" }, { "content": "Answer: B \nExplanation: It is the inflammation of conjunctiva with formation of very large sized papillae. Etiology :It is a localised allergic response to a physically rough or deposited surface (contact lens, prosthesis, left out nylon sutures). Probably it is a sensitivity reaction to components of the plastic leached out by the action of tears. ref: A K KHURANA OPHTALMOLOGY,E4, Page-77", "role": "assistant" } ]

[ { "content": "Best investigation for pericardial effusion is - \nSelect and explain. \nA. MRI, B. CT, C. X ray, D. Echocardiography", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Echocardiography Investigations o Investiation of choice to identify individual cardiac chamber enlargement - 2D-echocardiography. o Inv estigation of choice for pericardial effusion - 2D-echocardiography. o Investigation of choice for valvular heart disease - 2D-echocardiography. o Investigation of choice for cardiomyopathy -2D-echocardiography. o Investigation of choice for cardiac temponade - 2D-echocardiography. o Investigation of choice for aortic dissection in stable patient - MRl. o Investigation of choice for aortic dissection in unstable patient - TEE. o Investigation of choice for ventricular function and size - Echocardiography o Investigation of choice for congenital heart disease - Echocardiography, o Investigation of choice for pericardial defect - MRI. o Investigation of choice for radiotherapy/chemotherapy induced myocardial damage - Endomyocardial biopsy o Investigation of choice for myocardial perfusion and viability (reversible ischemia) - Nuclear cardiac imaging (thallium scan or Technetium scan) o Most sensitive investigation for air embolism - Trans-esophageal echocardiography. o Second most sensitive investigation for air embolism - PrecordiaJ Doppler o Best x-ray view for right atrial enlargement - Left anterior oblique view, o Best x-ray view for left atrial enlargement - Right anterior oblique view with barium swallow", "role": "assistant" } ]

[ { "content": "Histopathology showing large cells with plant like apperance with perinuclear halo is seen in which type of renal cell carcinoma ? \nSelect and explain. \nA. Onchocytoma, B. Granular cell carcinoma, C. Angiosarcoma, D. Chromophobic", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., ChromophobicHistopathological findings of perinuclear halo and plant cell appearance are seen in chromophobe cell carcinoma ofRCC.o Electron microscopic finding consisting of numerous 150-300 nm microvesicles is the single most distinctive and defining feature of chromophobe cell ca.", "role": "assistant" } ]

[ { "content": "Selective alpha 2 agoinst used in glaucoma - \nSelect and explain. \nA. Timolol, B. Epinephrine, C. Dipivefrine, D. Brimonidine", "role": "user" }, { "content": "Answer: D \nExplanation: Brimonidine (0.2% : 2 times/day). It is a selective alpha-2-adrenergic agonist and lowers IOP by decreasing aqueous production. Because of increased allergic reactions and tachyphylaxis rates it is not considered the drug of first choice in POAG. It is used as second drug of choice and also for combination therapy with other drugs Ref.AK Khurana 4th edition page no 223", "role": "assistant" } ]

[ { "content": "The rate of formation of CSF per day: \nSelect and explain. \nA. 1000 c.c., B. 2000 c.c., C. 5000 c.c., D. 8000 c.c.", "role": "user" }, { "content": "Answer: C \nExplanation: 5000 c.c.", "role": "assistant" } ]

[ { "content": "Cells are most sensitive to radiation in: \nSelect and explain. \nA. G2 phase, B. G1 phase, C. G1 phase and early S phase, D. G2 phase and late S phase", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which one of the following surgical procedures is considered to have a clean-contaminated wound ? \nSelect and explain. \nA. Elective open cholecystectomy for cholelithiasis, B. Herniorrhaphy with mesh repair, C. Herniorrhaphy with mesh repair, D. Appendectomy with walled off abscess", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Elective open cholecystectomy for cholelithiasis", "role": "assistant" } ]

[ { "content": "Esthetics starts with: \nSelect and explain. \nA. Taking impression, B. Occlusal rims, C. Teeth setting, D. Selection of teeth", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 63-year-old man with insulin-dependent diabetes develops a black, crusting lesion in the nose and left maxillary sinus. Biopsy reveals nonseptate hyphae, which confirms the diagnosis of what? SELECT ONE. \nSelect and explain. \nA. Erysipelas, B. Eczema, C. Scarlet fever, D. Mucor mycosis", "role": "user" }, { "content": "Answer: D \nExplanation: Mucor is an opportunistic mold that causes mucormycosis. At least 50% of reported cases are associated with uncontrolled diabetes, and many of the remaining patients are immuno- suppressed. It appears as black crusting in the nose and sinuses and spreads rapidly to involve the cerebrum. Biopsy reveals nonseptate hyphae, which confirms the diagnosis. Treatment is directed toward control for diabetic ketoacidosis and use of amphotericin B.", "role": "assistant" } ]

[ { "content": "Coagulative necrosis is seen in \nSelect and explain. \nA. TB, B. Sarcoidosis, C. Gangrene, D. Cryptococcal infection", "role": "user" }, { "content": "Answer: C \nExplanation: .", "role": "assistant" } ]

[ { "content": "Depigmenting agent of choice in in treatment of dermatological disorders is - \nSelect and explain. \nA. Hydroquinone, B. Zinc, C. Kojic acid, D. Azelaic acid", "role": "user" }, { "content": "Answer: A \nExplanation: <p>DEPIGMENTING AGENTS:- Include agents like hydroquinone(2%-5%),azelaic acid (10%-20%), glycolic acid (6%-12%) and monobenzene. They act by inhibiting tyrosinase enzyme. Hydroquinone is most commonly used.It can be combined with steroids and retinoids in the treatment of melasma. Kligmans regimen- 5% hydroquinone+0.1% tretinoin +0.1% hydrophilic ointment. Newer agents-Arbutin and kojic acid.They lighten hyperpigmented patches. Used in melasma, freckles. {Reference: IADVL textbook of dermatology, vishalakshi Vishwanath pg no.379}</p>", "role": "assistant" } ]

[ { "content": "The sudden appearance Dumb-bell shaped swelling during third molar nerve block is mainly due to: \nSelect and explain. \nA. Injection in pterygoid plexus, B. Injection in parotid gland, C. Injection into internal maxillary artery, D. Injection into nasal cavity", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following is true regarding Okazaki fragment? \nSelect and explain. \nA. Are segments of RNA attached to an RNA initiator component, B. Are related to the leading strand, C. Several Okazaki fragments must be sequentially synthesized for each replication fork, D. Helicase acts on the leading strand to unwind dsDNA", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. C. Several Okazaki fragments must be sequentially synthesized for each replication forka. Okazaki fragments are segments of DNA attached to an RNA initiator component.b. They are related to the lagging strand.c. Helicase acts on the lagging strand to unwind dsDNA.", "role": "assistant" } ]

[ { "content": "The hyperosmolarity of the renal meduila is due to increased content of - \nSelect and explain. \nA. K+, B. Na +, C. Glucose, D. Na ++", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Na +", "role": "assistant" } ]

[ { "content": "Paradoxical respiration is seen in \nSelect and explain. \nA. Multiple fracture ribs, B. Diaphragmatic palsy, C. Bulbar polio, D. Severe asthma", "role": "user" }, { "content": "Answer: B \nExplanation: Diaphragmatic palsy Bilateral diaphragmatic paralysisUnilateral diaphragmatic paralysisMost common cause of bilateral diaphragmatic paralysis are:High spinal cord injuryThoracic trauma (cardiac surgery)Multiple sclerosisAnterior horn disease Muscular dystrophyMost patients present with hypercapnic respiratory failure, frequently complicated by cor pulmonale and right ventricular failure, Atelectasis and pneumonia.The degree of diaphragmatic weakness is best quantitated by measuring trans diaphragmatic pressures.Treatment of choice is assisted ventilation for all or pa of each day.If the nerve to the diaphragm is intact, diaphragmatic pacing may be a ble alternativeUnilateral palsy is MC than bilateral, MC cause is nerve invasion from malignancy, usually a bronchogenic carcinoma.Diagnosis is suggested by an elevated hemidiaphragm on the CXR.Confirmation is best established with the \"sniff test\"(when the patient is observed with fluoroscopy while sniffing, then paralyzed diaphragm will move paradoxically upward due to the negative intrathoracic pressure).Patients with unilateral paralyzed diaphragm are usually asymptomatic, vital capacity and total lung capacity is reduced about 25%.No treatment if CXR is normal and patient is asymptomatic(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2221)", "role": "assistant" } ]

[ { "content": "In this child Which of the following enzymes is likely to be deficient? \nSelect and explain. \nA. HGPRTase, B. Adenosine deaminase, C. APRTase, D. Acid maltase", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A. HGPRTaseSlide 1 showing nibbling of lips and fingers; slide 2 showing bite marks on hand inflicted by self. Self-mutilation seen in Lesch Nyhan Syndrome; characteristic of the disease in children.Clinical signs and symptoms seen in Lesch Nyhan Syndrome:a. Biochemical: Hyperuricemia, can result ini. Gout (Joint pains)ii. Nephrolithiasis (abdominal pain, may be radiating in nature)iii. Tophib. Neurological:i. Mental Retardation (Poor performance in school)ii. Dystonia, variablec. Neuropsychiatric:i. Aggressive Behaviour (frequent fight, quarreling with siblings)ii. Self-Mutilation Tendency (associated with muscle loss; biting, chewing, etc.)d. Inheritance is XLR, enzyme absent is HGPRTase; in some patient, where the enzyme is not absent, but only diminished, have a less severe condition called Kelley Seegmiller Syndrome, where neurological and neuropsychiatric symptoms are either absent or very mild.", "role": "assistant" } ]

[ { "content": "Musculature of first pharyngeal arch is supplied by which cranial nerve? \nSelect and explain. \nA. V, B. VII, C. IX, D. X", "role": "user" }, { "content": "Answer: A \nExplanation: Musculature of the first pharyngeal arch includes the muscles of mastication (temporalis, masseter, and pterygoids), anterior belly of the digastric, mylohyoid, tensor tympani, and tensor palatini. The nerve supply to the muscles of the first arch is provided by the mandibular branch of the trigeminal nerveRef: Langman's embryology 11th edition Chapter 16.", "role": "assistant" } ]

[ { "content": "which of the following antidepressent causes hypeensive crisis \nSelect and explain. \nA. dapoxetine, B. duloxetine, C. clomipramine, D. phenelezine", "role": "user" }, { "content": "Answer: D \nExplanation: MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction Ref. Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no, 955", "role": "assistant" } ]

[ { "content": "All the following polyps are premalignant except:March 2011 \nSelect and explain. \nA. Juvenile polyposis syndrome, B. Familial polyposis syndrome, C. Hyperplastic polyps, D. Peutz Jegher syndrome", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. C: Hyperplastic polypsIt is now appreciated that hyperplastic polyps are without malignant potentialJuvenile polyps that are single and have been completely excised carry no significant increased risk of malignancy. Multiple juvenile polyps can be a sign of the familial juvenile polyposis syndrome. This has a significant risk (approximately 10 per cent) of subsequent colon cancer and also a possible increased risk of cancers of the stomach and duodenum (first pa of the small intestine).Juvenile polyposis (JP)Autosomal dominant.Multiple hamaomatous polyps of the colorectum (98%), stomach (13%), small bowel (6%)Juvenile polyps are usually pedunculated, smooth, lobulated with a vulnerable surface.Diagnostic criteria:- 5 or more juvenile polyps in the colon or rectum; OR- One juvenile polyp and positive family history of JP; OR- Juvenile polyps outside the colon or rectum, i.e. stomach/small bowel.Family history positive in 20-50%, suggesting high incidence of spontaneous mutations or low penetrance.Children/ adolescents often presents with iron deficiency anemia, hypoproteinemia and retarded growth. Also rectal prolapse or other congenital abnormalities (15%) in CVS, Urogenital tract and CNS.Cancer risk:- Increased risk, lifetime risk of 20-60% for colorectal cancer.- Median age at diagnosis is 35-40 years.- Increased risk for gastric and duodenal cancersGenetic testing- Germline mutations of the SMAD4 and BMPR1A are detected in 11-25% and 18-30% of patients of JPC.- Gastric polyposis seems to be more frequent and severe in patients with SMAD4 mutations.Treatment- Colectomy and gastric surgery in severe polyposis.Familial adenomatous polyposis (FAP)<1% of all colorectal cancers.Autosomal dominant inherited disease, > 100 colorectal adenomas, caused by germline mutations of the tumor suppressor gene APC (detectable in 80-90% of patients with typical FAP) Prevalence 1:10000 with penetrance close to 100%.25% of patients with FAP do not have positive family history. These are de novo germline mutations.Polyp development stas in distal colorectum at an average age of 15Majority of patients become symptomatic with bloody diarrhea by the age of 25Extracolonic manifestation:- Up to 90% of patients with FAP develop polyps in upper GIT- 30-40% gastric fundic gland polyposis and 5-10% gastric adenomas- Risk for gastric cancer not increased.Major causes of death in colectomized FAP patients are duodenal and ampullary cancer.Spigelman classification for polyposis in upper GIT to allow adequate follow up.Extra-intestinal manifestation of FAP include:- Desmoid tumours (10-20%)- Epidermoid cysts (30-50%)- Fibromas- Osteomas (often in the mandibula)Congenital hyperophy of the retinal pigment epithelium (70%)- Dental abnormalities. Gardner's syndrome:- Polyposis, epidermoid cysts, osteomaTurcot's syndrome in FAP- Polyposis, CNS tumours (medulloblastoma)Increased risk observed for:- Hepatoblastoma, follicular thyroid cancer, brain tumours (usually medulloblastoma).Treatment:- Procedure: Proctocolectomy with ileal-pouch-anal anastomosis (IPAA): Gold standard.Peutz Jeghers syndrome (PJS)Autosomal dominant.Special type of hamaomatous GI polyp (PJ polyp) and mucocutaneous melanin pigmentations.PJ polyps occur throughout alimentary tract with predilection for the small bowel.Mostly jejunal. Esophagus is spared. Rarely nose, gallbladder and ureter.Polyps characterized by extensive smooth muscle aborization throughout polyp.Pigment lesions in 95% of patients but may disappear with age. Mostly lips, peri-oral and intra-oral mucosa.Diagnostic criteria:2 or more PJ polyps- One PJ polyp and mucocutaneous pigment lesion- One PJ polyp and positive family history of PJS.Endoscopic or surgical excision of large or symptomatic polyps is recommended.Family history is negative in up to 45% of index cases indicating de novo germline mutations.Recurrent colicky abdominal pain due to intussusception in adolescence or young adulthood. Also occult bleeding with iron-deficiency anemia. Pigmentation not always present in childhood and may fade later in life.Intra-epithelial neoplasia predisposes to cancer - hamaoma-adenoma-carcinoma sequenceCancer risk:- 85% by age 70 years- 57% GI cancer.- Colorectal cancer most common with lifetime risk of 39%. Lifetime pancreatic cancer risk is 11%.Extraintestinal cancers include breast risk (31-50%), endometrium and ovary.Cancer uncommon before age 30 years.Almost all female patients with PJS develop potentially malignant ovarian tumour, the sex cord tumour with annular tubules (SCTAT). Malignant transformation in 20% of all cases. Seoli cell tumours considered as male equivalent of SCTAT with gynaecomastia.Genetic testing- PJS is caused by germline mutation of the STKII tumour suppressor gene.", "role": "assistant" } ]

[ { "content": "In an elective lap cholecystectomy with no gross spillage, antibiotics required are \nSelect and explain. \nA. Single dose of Preoperative IV antibiotic followed by a 5 day course of oral antibiotics, B. Post operative IV antibiotics for 1 day followed by a 5 day course of oral antibiotics, C. Single dose of Preoperative IV antibiotic only, D. 5 day course of oral antibiotics only", "role": "user" }, { "content": "Answer: C \nExplanation: Elective lap cholecystectomy is a clean-contaminated surgery, single preoperative IV antibiotic during decisive period is sufficientThere is no evidence that fuher doses of antibiotics after surgery are of any value in prophylaxis against infectionWhen wounds are heavily contaminated or when an incision is made into an abscess, a 5-day course of therapeutic antibiotics may be justifiedRef: Bailey and Love 27e pg: 53", "role": "assistant" } ]

[ { "content": "Glomerulonephritis is due to - \nSelect and explain. \nA. Type I hypersensitivity reaction, B. Type IV hypersensitivity reation, C. Immune complex deposition, D. Type V hypersensitivity reaction", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "All of the following may be used to treat Acute Hypercalcemia Except: \nSelect and explain. \nA. Hydration with saline, B. Calcitonin, C. Biphosphonates, D. Gallium Nitrate", "role": "user" }, { "content": "Answer: D \nExplanation: Answer is D (Gallium Nitrate) Gallium Nitrate exes s hypocalcemic effect by inhibiting calcium resorption from bone. Maximum hypocakemic effect of gallium nitrate may take 3-4 days to appear and it is not often used now because of availability of superior alternatives. Gallium nitrate is the single best answer of exclusion. Treatment of Hypercalcemia Onset of Action Hydration with Saline Hours Forced diuresis (saline + loop diuretic) Hours Calcitonin Hours Intravenous phosphate Hours Pheomycin / Mithromycin Hours Dialysis Hours Biphosphonates Days (1 to 2 days) Glucocoicoids Days Gallium Nitrate Days (3-4 days)", "role": "assistant" } ]

[ { "content": "Hampton's line is feature of \nSelect and explain. \nA. Benign ulcers, B. Malignant ulcers, C. Both, D. None of the above", "role": "user" }, { "content": "Answer: A \nExplanation: 'Hampton's line' :- - is thin radiolucent line seen at the neck of a gastric ulcer in barium studies - it is seen in benign gastric ulcer - it's caused by thin line of mucosa overhaning ulcer's crater Hampton's line Carman Meniscus sign - (in Malignant gastric ulcer) Duodenal ulcer: - is associated with increased acid secretion caused by higher incidence of H.Pylori infection - duodenum is often deformed along its inferior margin - chronic gastric ulcer gives Trifoliate appearance", "role": "assistant" } ]

[ { "content": "Advantage of single chamber incinerator is \nSelect and explain. \nA. Effective for thermally resistant articles, B. Useful for cytotoxic drugs, C. Good disinfection efficiency, D. Low pollutant emissions", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "A patient developed breathlessness and chest pain, on second postoperative day after a total hip replacement. Echo-cardiography showed right ventricular dilatation and tricuspid regurgitation. What is the most likely diagnosis? \nSelect and explain. \nA. Acute MI, B. Pulmonary embolism, C. Hypotensive shock, D. Cardiac tamponade", "role": "user" }, { "content": "Answer: B \nExplanation: The clinical history corresponding to the diagnosis of pulmonary embolism. For a patient presenting with acute breathlessness and chest pain and in whom right ventricular dilatation with tricuspid regurgitation and mild elevation of pulmonary aery pressure is noted, a pulmonary embolus should be the initial diagnosis to be considered. Ref: Deep Vein Thrombosis and Pulmonary Embolism, Page 253, 254; Feigenbaum's Echocardiography, 7th Edition, Page 762.", "role": "assistant" } ]

[ { "content": "Dimorphic with subcutaneous Mycosis is \nSelect and explain. \nA. Histoplasmosis, B. Rhinosporidiosis, C. Sporotrichosis, D. Blastomycosis", "role": "user" }, { "content": "Answer: C \nExplanation: Sporotrichosis:\n\nDimorphic fungi\nCauses subcutaneous infections.", "role": "assistant" } ]

[ { "content": "The phenomenon of conception of a woman due to deposition of semen on vulva without vaginal penetration is called as \nSelect and explain. \nA. Superfoetation, B. Superfecundation, C. Fecundation ab extra, D. Vaginismus", "role": "user" }, { "content": "Answer: C \nExplanation: FECUNDATION AB EXTRA: The conception of the female due to deposition of semen on the vulva, without penetration of the vagina - The insemination occurs due to the passage of spermatozoa from external genitalia to the uterus. Ref - Krishnan Vij 5th edition pg 395 , 404", "role": "assistant" } ]

[ { "content": "Pilocarpine reduce the intraocular pressure in person with closed angle glaucoma by \nSelect and explain. \nA. Reducing aqueous humour secretion, B. Contacting iris spincter muscle, C. Increasing aqueous humour outflow, D. Relaxin ciliary muscle", "role": "user" }, { "content": "Answer: C \nExplanation: Refer kDT 7/e p 156 It has also been used in the treatment of chronic open-angle glaucoma and acute angle-closure glaucoma It acts on a subtype of muscarinic receptor (M3) found on the iris sphincter muscle, causing the muscle to contract -resulting in pupil constriction (miosis). Pilocarpine also acts on the ciliary muscleand causes it to contract. When the ciliary muscle contracts, it opens the trabecular meshwork through increased tension on the scleral spur. This action facilitates the rate that aqueous humor leaves the eye to decrease intraocular pressure", "role": "assistant" } ]

[ { "content": "48 year old male reported with the chief complaint of ulcer on the gums and on general examination headache, fever and malaise was observed. On oral examination, sharply punched out crater-like erosions of the interdental papillae of sudden onset were noted. The patient also complained of bad breath.\n\nDiagnosis is \nSelect and explain. \nA. ANUG, B. Pericoronitis, C. Chediak Higashi diseases, D. Desquamative gingivitis", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "A variety of basic assays are used to detect autoantibodies. Nephelometry is based on the principle of: \nSelect and explain. \nA. Light attenuated in intensity by scattering, B. Refraction of light, C. Reduced transmission of light, D. Filtration of solutes by kidney", "role": "user" }, { "content": "Answer: A \nExplanation: Nephelometry measures the interaction of antibodies and antigens in solution, detecting immune complex formation by monitoring changes in the scattering of an incident light. Ref: Imboden J.B. (2007). Chapter 3. Laboratory Diagnosis. In J.B. Imboden, D.B. Hellmann, J.H. Stone (Eds), CURRENT Rheumatology Diagnosis & Treatment, 2e.", "role": "assistant" } ]

[ { "content": "Stocker&;s line is seen in \nSelect and explain. \nA. Pinguecula, B. Pterygium, C. Congenital ocular melanosis, D. Conjunctival epithelial melanosis", "role": "user" }, { "content": "Answer: B \nExplanation: Pterygium It presents as a triangular fold of conjunctiva encroaching the cornea in the area of the palpebral apeure, usually on the nasal side, but may also occur on the temporal side. Deposition of iron seen sometimes in corneal epithelium anterior to advancing head of the pterygium called as stocker's line. Pas. A fully developed pterygium consists of three pas: i. Head (apical pa present on the cornea), ii. Neck (limbal pa), and iii. Body (scleral pa) extending between limbus and the canthus. Stocker's line in pterygium. Pterygium is a fibrovascular proliferative disorder in which conjunctival tissue grows medially to cover the clear cornea. On slit-lamp examination showed marked pterygium that extend from the nasal side of bulbar conjunctiva onto the cornea in the left eye Ref: Khurana; 4th ed; Pg 80", "role": "assistant" } ]

[ { "content": "For large country surveys the sampling method of choice is: \nSelect and explain. \nA. Multiple sampling, B. Multiphase sampling, C. Cluster sampling, D. Multistage random sampling", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which one of the following congenital hea diseases has cyanosis without cardiomeglay and/ or congestive hea failure - \nSelect and explain. \nA. Transposition of great aeries, B. Fallot's tetralogy, C. Congenital mitral regurgitaion, D. Congenital pulmonary stenosis", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Fallot's Tetralogy Cardiomegaly and CHF do not occur in Fallot's tetrology. No Cardiomegaly o First you should know the following facts : ? i) Pressure overload to ventricles causes concentric hyperophy without dilatation. ii) Volume overload to ventricles causes hyperophy with dilatation --> Eccentric hyperophy. o Due to pulmonary stenosis, there is pressure overload to right ventricle --> Concentric hyperophy of right ventricle without dilatation - No Cardiomegaly. No CHF o The VSD of TOF is always large enough to allow free exit to the right to left shunt. Since the right ventricle is effectively decompressed by the VSD, CHF never occurs in TOF.", "role": "assistant" } ]

[ { "content": "True about stomach carcinoma - \nSelect and explain. \nA. Weightloss is commonest feature, B. Secondaries are most commonly seen in peritoneum & omentum, C. Lymphatic & hematogenous spread are rare, D. Barium meal is diagnostic", "role": "user" }, { "content": "Answer: A \nExplanation: Answer 'a' i.e. Weightloss is commonest feature Symptoms of gastric cancer Earliest symptom is usually vague postprandial abdominal heaviness Most common symptom is weight loss Other symptoms are: - anorexia - abdominal pain (usually not severe) vomiting may be present and becomes a major feature if pyloric obstruction occurs. It may have coffee-ground colour due to bleeding by the tumor. - dysphagia may be the presenting symptom if the lesion is at the cardia. Paraneoplastic symptoms such as - Trousseau's syndrome (thrombophlebitis) - Acanthosis nigricans (hyperpigmentation of the axilla and groin) - Peripheral neuropathy Option b & c Spread of gastric carcinoma - intramural spread within the submucosa - direct spread through the gastric walls - lymphatic spread hematogenous - transperitoneal through peritoneal seedlings about option 'b' - I am not very sure, but it appears to be uncorrect. Most common secondaries are noted in intrabdominal and supraclavicular lymphnodes. Liver is the most common site for hematogenous spread of tumor (Harrison 16/e, p 525) Option 'd' - Barium meal is -75% sensitive for gastric cancer and is the simplest study to perform but it is not confirmatory. Endoscopy with biopsy is always needed if gastric Ca is suspected, to confirm the diagnosis. Harrison 16/e, p 526 writes - \"Gastric adenocarcinoma is a relatively radioresistant tumor and adequate control of the primary tumor requires doses of external beam irradiation that exceeds the tolerance of surrounding structures, such as the bowel mucosa and the spinal cord. As a result, the major role of radiation therapy in patients has been palliation of pain.\"", "role": "assistant" } ]

[ { "content": "The control for mastication is normally exercised by \nSelect and explain. \nA. Pontine centres, B. Sub cortical centres, C. Cerebellar centres, D. Medulla centres", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following organism is most commonly considered responsible for SIDS especially after giving honey to the neonate or infant? \nSelect and explain. \nA. Clostridium botulinum, B. Staphylococcus aureus, C. E. coli, D. Clostridium perfringens", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A. Clostridium botulinum.(Ref. Nelson Textbook of Pediatrics, 19th ed. Chapter 367)Sudden infant death syndrome# Sudden infant death syndrome (SIDS) is the unexpected, sudden death of a child under age 1 in which an autopsy does not show an explainable cause of death.# SIDS is most likely to occur between 2 and 4 months of age. SIDS affects boys more often than girls. Most SIDS deaths occur in the winter.# The following have been linked to a baby's increased risk of SIDS:# Sleeping on the stomach# Being around cigarette smoke while in the womb or after being bom# Sleeping in the same bed as their parents (co-sleeping)# Soft bedding in the crib# Multiple birth babies (being a twin, triplet, etc.)# Premature birth# Having a brother or sister who had SIDS# Mothers who smoke or use illegal drugs# Being bom to a teen mother# Short time period between pregnancies# Late or no prenatal care# Living in poverty situations# Honey is the one identified, avoidable source of C botulinum spores for susceptible infants.# Because botulinal toxin is the most potent poison known (about 10-9 mg per kg of body weight given intravenously being a lethal amount for man), it appeared possible that rapid in vivo production of botulinal toxin might in some infants lead to sudden death if upper airway obstruction or apnea resulted from flaccidity of airway and respiratory muscles.# In a British study released May 29, 2008, researchers discovered that the common bacterial infections Staphylococcus aureus and Escherichia coli appear to be risk factors in some cases of SIDS.", "role": "assistant" } ]

[ { "content": "A patient consults a dermatologist about a skin lesion on her neck. Examination reveals a 1-cm diameter,red, scaly plaque with a rough texture and irregular margins. Biopsy demonstrates epidermal and dermal cells with large, pleomorphic, hyperchromatic nuclei. Which of the following conditions would most likely predispose this patient to the development of this lesion? \nSelect and explain. \nA. Actinic keratosis, B. Compound nevus, C. Dermal nevus, D. Junctional nevus", "role": "user" }, { "content": "Answer: A \nExplanation: The lesion is a squamous cell carcinoma of the skin. Actinic keratosis, which is a hyperplastic lesion of sun-damaged skin, predisposes for squamous cell carcinoma. Another predisposing condition to remember is xeroderma pigmentosum, which predisposes for both squamous cell and basal cell carcinomas of skin. A nevus is a mole, containing characteristic cells called nevocellular cells. If the nevocellular cells are located at the dermal-epidermal junction (junctional nevus), in the dermis (dermal nevus), or both (compound nevus) they do not predispose for squamous cell carcinomas of the skin. Ref: Vujevich J.J., Goldberg L.H. (2012). Chapter 246. Cryosurgery and Electrosurgery. In L.A. Goldsmith, S.I. Katz, B.A. Gilchrest, A.S. Paller, D.J. Leffell, N.A. Dallas (Eds), Fitzpatrick's Dermatology in General Medicine, 8e.", "role": "assistant" } ]

[ { "content": "In Osteomalacia \nSelect and explain. \nA. Osteoid formation is defective, B. Mineralization of bone is defect, C. Both, D. None", "role": "user" }, { "content": "Answer: B \nExplanation: Rickets / Osteomalacia Pathophysiology - Failure of calcification & mineralization of cailage and osteoid tissue Clinical featuresRadiological featuresGeneralized muscle weakness, lethargy, irritability and listlessness Protuberant abdomen Large head, open fontanelles and craniotabesThickening of knees, ankle & wrists due to physeal overgrowth Rachitic rosary Harrison's groove Pectus carinatumSho stature & bowing of long bones with genu valgum, coxa vara, kyphoscoliosis Elongation of physis & hazy appearance of provisional zone of calcification Widened growth plate Cupping of metaphysis Splaying and flaring of epiphysis Bowing of diaphysis with thinning of coices OsteopeniaLooser's zone Biconcave codfish veebra Thoracolumbar kyphosis Trefoil & Champagne glass pelvis (Refer: Tachdijian'spaediatric Ohopedics, 5th edition, pg no: 1685-1696)", "role": "assistant" } ]

[ { "content": "Frotteurism: \nSelect and explain. \nA. Pleasure in watching intercourse, B. Pleasure in using article of opposite sex, C. Pleasure in touching opposite sex, D. Pleasure in wearing opposite sex clothes", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. (c) Pleasure in touching opposite sexRef: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. / 404* FROTTEURISM: rubbing the genitalia with the body of the person of other sex for sexual satisfaction.* Paraphilias: Abnormal 8c unorthodox sex play by using unusual objects or parts are know as paraphilia eg. Sadomasochism, Transvestism, Bestiality, Frotteurism, Homosexuality etc.* Bisexuality means hermaphrodite; an individual with both ovary 8c testis 8c external genitals of both sexes.Different Paraphilias/PerversionSexual perversionMode of sexual pleasureSadismPleasure in giving pain to sexual partnerMasochismPleasure on receiving painful stimulus from sexual partnerBondageSadism + masochism are found togetherFetischismSexual gratification by article of opposite sexFrotteurismSexual gratification by contact. Ex: rubbing genitalia on another personExhibitionismSatisfaction in exhibition of genitals with or without mastutbationTransvestism/ EonismPleasure in wearing clothes of opposite sexUranismSexual gratification by fingering, fellatio, cunnilingus etc.Buccal coitus or Sin of GomorrahFellatio is oral stimulation of penis by male or femaleCunnilingus is oral stimulation of female genitalsVoyeurism/ ScotophiliaAlso known as Peeping tomDesire to watch sexual intercourse or toobserve genitals of othersTrolismExtreme degree of voyeurism. Ex: A perverted husband enjoy watching his wife having sexual intercourse with another man.Urolangia/ CoprophiliaSexual excitement by sight or odor of urine or faeces.Tribadism/ LesbianismGratification of sexual desire of a women by another womenSodomy or Buggery of Greek Love* Anal sex* Gerantophilia -when passive agent is adult* Paederasty - when the passive agent is young boy (catamite)IncestSexual intercourse with close relativeBestialitySexual intercourse by a human being with a lower animal", "role": "assistant" } ]

[ { "content": "A 23-year-old woman is noticed to have irregular pupils on routine examination. She has 1 large pupil, which has minimal response to light stimulation, but it does respond to accommodation. The eye movements are normal and she experiences no double vision.For the above patient with a pupillary abnormality, select the most likely diagnosis. \nSelect and explain. \nA. essential anisocoria, B. Horner syndrome, C. tonic pupils (Holmes-Adie syndrome), D. Argyll Robertson pupils", "role": "user" }, { "content": "Answer: C \nExplanation: The tonic pupil (Holmes-Adie syndrome) is caused by a parasympathetic lesion at or distal to the ciliary ganglion. The pupil is large and usually unilateral, with absent response to light. A bright room, by causing constriction of the normal pupil, accentuates the anisocoria. The tonic pupil can be associated with Shy-Drager syndrome, amyloidosis, or diabetes. However, it is most commonly seen in otherwise healthy young women.", "role": "assistant" } ]

[ { "content": "Which of the following is secreted by TRH stimulation? \nSelect and explain. \nA. Prolactin only, B. TSH only, C. Both, D. None", "role": "user" }, { "content": "Answer: C \nExplanation: TRH is derived from a pro-TRH peptide. Like other hypothalamic-releasing hormones, TRH reaches the anterior pituitary the hypothalamic-pituitary poal circulation. It interacts with specific receptors on pituitary thyrotrophs to release TSH and on mammotrophs to release prolactin. Ref: Textbook of Endocrine Physiology edited by William J. Kovacs, Sergio R. Ojeda, 2011, Page 324; Guyton's physiology, 22nd edition, Table 74-1 Page 907", "role": "assistant" } ]

[ { "content": "All of the following are components of withdrawl reflex except \nSelect and explain. \nA. Flexor reflex, B. Reciprocal reflex, C. Inverse stretch reflex, D. Crossed extensor reflex", "role": "user" }, { "content": "Answer: C \nExplanation: Inverse stretch reflex is not component of withdrawl reflex.", "role": "assistant" } ]

[ { "content": "Nutrient and oxygen reach the chondrocytes across perichondrium by \nSelect and explain. \nA. Capillaries, B. Diffusion, C. Along neurons, D. Active transpo", "role": "user" }, { "content": "Answer: B \nExplanation: an impoant fact about cailage matrix is that it is avascular, i.e. not supplied by capillariestherefore, chondrocytes within the matrix must receive nutrients and oxygen by diffusion from vessels that lie outside the cailagethis long-distance diffusion is possible because of the large volume of water trapped within the matrix(Refer: Manish Kumar Varshney's Essential Ohopedics Principles & Practice, 1st edition, pg no. 7, 347)", "role": "assistant" } ]

[ { "content": "A 20 year old boy c/o hearing of voices, aggressive behavior since 2 days. He has fever since 2 days. When asked to his family, they say that he has been muttering to self and gesticulating. There is no of psychiatric illness. Likely diagnosis is: \nSelect and explain. \nA. Dementia, B. Acute psychosis, C. Delirium, D. Delusional disorder", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Acute psychosis- Delusions or hallucinations (suchas hearing voices in this case) with grossly disorganized speech and behavior (such as muttering to self, gesticulation, aggressiveness in this case) of acute onset with normal cognition & consciousness indicate the diagnosis of acute psychosis (i.e. psychosis of acute onset). This acute psychosis may be d/t psychotic disorder d/t general medical condition (such as high fever as in this case) or d/t brief psychotic disorder (DSMIVTR), or d/t acute and transient psychotic disorder (ICD-10). So here the term acute psychosis is used to depict the clinical picture not the cause of that clinical picture.Delirium can also present acute onset disorganized behavior (agitation) and speech (incoherent) with delusions or hallucinations but the delusions are poorly elaborated & transient, the course of disease is fluctuant (eg sun downing). And characteristically there is clouding of (disturbance in) consciousnesss (i.e. reduced clarity of awareness of the environment) and disorientation (change in cognition) in delirium. Just like psychosis clinical picture of delirium may also be d/t various reasons such as general medical condition / substance intoxication/ withdrawal.- Dementia is a chronic slow/insiduous process presenting with decrement in intellectual abilities (such as sho & long term memory, judgement, abstract thinking, impulse control, personal care and personality)Q.- Delusional disorder presents with nonbizarre delusions (involving situations that occur in real life) of at least 1 months durationQ. Apa from the impact of delusion (s) or its ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre (i.e. criteria. A of schizophrenia has never been met). However, tactile or olfactory hallucinations may be present if they are related to delusional theme.", "role": "assistant" } ]

[ { "content": "Spuriously high BP is seen in A/E : \nSelect and explain. \nA. Auscultatory gap, B. Small cuff, C. Thick calcified vessels, D. Obesity", "role": "user" }, { "content": "Answer: A \nExplanation: A i.e. Auscultatory gap", "role": "assistant" } ]

[ { "content": "All are Glucogenic hormones except? \nSelect and explain. \nA. ADH, B. Glucagon, C. Thyroxine, D. Glucocorticoids", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A ADHRef: Ganong, 25th ed. pg. 442Glucagon, thyroxine, cortisol and growth hormone increase blood sugar levels and are glucogenic. ADH regulates water re-absorption via the collecting duct.", "role": "assistant" } ]

[ { "content": "Which type of Human papilloma virus is most commonly associated with Cervical cancer ? \nSelect and explain. \nA. HPV 16, B. HPV 24, C. HPV 32, D. HPV 36", "role": "user" }, { "content": "Answer: A \nExplanation: Genital HPV infection is extremely common and most often cause no symptoms. A propoion of individuals infected with low-risk HPV types such as HPV-6 or HPV-11 will develop genital was, whereas a subset of women with high-risk HPVs such as HPV-16 or HPV-18 will develop preneoplastic lesions of cervical intraepithelial neoplasia (CIN). Low-grade cervical dysplasias are common and most regress spontaneously. In contrast, the minority of lesions that progress to high-grade dysplasias tend to persist and/or progress to carcinomas in situ before becoming invasive cancers. The majority of adenocarcinomas of the cervix and of squamous cell cancers (SCC) of the vulva, vagina, penis and anus are caused by HPV-16 and HPV-18 (together accounting for about 70% of cases globally), the remaining 30% being due to other high-risk HPV types (such as HPV-31, -33, -35, -39, -45,-51, -66). HPV is also associated with other cancers of the anus, head and neck, and rarely, recurrent respiratory papillomatosis in children.", "role": "assistant" } ]

[ { "content": "Ashley's rule is used to : \nSelect and explain. \nA. Determine age using sternum, B. Determine sex using sternum, C. Determine age using mandible, D. Determine sex using mandible", "role": "user" }, { "content": "Answer: B \nExplanation: Ashley's rule States that male sternum lenth will be more than 149mm and female sternum lenth will be less than 149mm.", "role": "assistant" } ]