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[ { "content": "Statins act on which enzyme - \nSelect and explain. \nA. Acyl CoAsynthetase, B. Acyl Co A reductase, C. HMG CoA Synthetase, D. HMG CoA reductase", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., HMG CoA reductase Hypolipidemic drugsHMG-CoA reductase inhibitors (statins) - Lovastatin. Simvastatin, Pravastatin, Atorvastatin, Rosuvastatin.Bile acid sequestrants (Resins) - cholestyramine, colestipol.Activate lipoprotein lipase (fibric acid derivatives) - clofibrate, gemfibrozil, bezafibrate, fenofibrate.4.Inhibit lipoly sis and triglyceride synthesis - Nicotinic acid.5,Other - Probueol, Gugulipid, Ezetimibe, Avasimibe, Torcetrapib.o Ezetimibe inhibits intestinal cholesterole absorption.o Avasimibe inhibits enzyme acyl Coenzyme A ; cholesterol acyl transferase-1 (ACAT-1) which causes esterification of cholesterol.o Torcetrapib inhibits cholesterol ester triglyceride transport protein -| HDL cholesterol.", "role": "assistant" } ]

[ { "content": "Antiendomysial antibody is used in screening of ? \nSelect and explain. \nA. Myasthenia gravis, B. Auto immune hepatitis, C. Coeliac diseases, D. Graves disease", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Coeliac diseases Coeliac disea.se (CD) is a permanent intolerance of the small intestine to gluten, characterized by gluten-dependent changes in villous morphology and/or signs of immunological activation detectable in the lamina propria of intestinal mucosa. The presence of serum anti-endomysial antibodies (EMA) is generally considered to be highly suggestive for CD because of their high values of sensitivity and specificity. Other antibodies used for diagnosis Tissue transglutaminase, Antigliadin antibodies Treatment is Gluten-free diet", "role": "assistant" } ]

[ { "content": "Primary level of prevention is? \nSelect and explain. \nA. Prevention of emergence of risk factors, B. Prevention of disease in Pre-pathogenesis phase, C. Prevention of disease in incipient stage, D. Prevention of disability and rehabilitation", "role": "user" }, { "content": "Answer: B \nExplanation: Modes Primordial Before the emergence of risk factor Health education Primary Risk factor but no disease yet Health promotion, specific protection Secondary Disease possible staed in the body Early diagnosis, Treatment Teiary Disease is already in progression Disability limitation , Rehabilitation", "role": "assistant" } ]

[ { "content": "Predisposing factor for leukemia – \nSelect and explain. \nA. Down syndrome, B. Lowe's syndrome, C. Fragile–x–syndrome, D. None", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Allen test detects insufficiency of which aery \nSelect and explain. \nA. Radial aery, B. Umbilical aery, C. Popliteal aery, D. Aoa", "role": "user" }, { "content": "Answer: A \nExplanation: Allen's Test Tests the adequacy of the blood supply to the hand from the radial and ulnar aeries and the arcade between them Allen's test is used to know the integrity of palmar arcg (patency of radial and ulnar aeries). If these are patent, AVF can be safely ligated Method of Allen's test Elevate the hand and apply digital pressure on the radial and ulnar aeries to occlude them Ask the patient to make a fist several times The tips of the finger should go pale. Release each aery in turn and observe the return of colour Ref : Sabiston 20th edition Pgno :1979", "role": "assistant" } ]

[ { "content": "Best method of sterilizing disposable syringes: \nSelect and explain. \nA. Hot air oven, B. U.V. rays, C. Gamma rays, D. Boiling", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following features is not shared between 'T cells' and 'B cells' - \nSelect and explain. \nA. Positive Selection during Development, B. Class I MHC Expression, C. Antigen Specific Receptors, D. All of the above", "role": "user" }, { "content": "Answer: A \nExplanation: Option 1 During development T cells undergo both positive selection and negative selection, while B cells undergo only negative selection (by apoptosis of self-reacting immature B-cells in spleen). Death of cells with TCRs that do not react with self MHC proteins - negative selectionSurvival of cells with TCRs that react with self MHC preoteins- positive selection Option 2 MHC class I Present on All nucleated cells (except sperms) and platelets. Option 3 Both cells have Antigen Specific Receptors. FIGURE 01:Development of T cells. Note the positive and negative selection that occurs in the thymus. Maturation of B cells- Cells arise from stem cells and differentiate into pre-B cells expressing m heavy chains in the cytoplasm and then into B cells expressing monomer IgM on the surface. This occurs independent of antigen. Activation of B cells and differentiation into plasma cells is dependent on antigen. Cells to the left of the veical dotted line do not have IgM on their surface, whereas B cells, to the right of the veical line, do have IgM. m, mu heavy chains in cytoplasm; Y, IgM.", "role": "assistant" } ]

[ { "content": "Which of the following statements is true regarding the relation of bile duct \nSelect and explain. \nA. Posteriorly related to 1st pa of duodenum, B. Related posteriorly to the tunnel of pancreatic head, C. Anteriorly related to 1st pa of duodenum, D. Related to IVC posteriorly", "role": "user" }, { "content": "Answer: C \nExplanation: Bile duct : Anatomy It lies in front of the poal vein and to the right of the hepatic aery Common hepatic duct is 1-4cm in length and has a diameter of approx. 4mm CBD is about 7-11 cm in length and 5-10 mm in diameter A fibroareolar tissue containing scant smooth muscle surround the mucosa (a distinct muscle layer is absent) Most impoant aeries to the Supra duodenal bile duct run parallel to the duct at the 3 & 9'o clock position Approximately 60% of the blood supply to the Supra duodenal bile duct originates inferiorly from the pancreaticoduodenal and retro duodenal aeries Whereas 38% of blood supply originate superiorly from the right hepatic atmeru and cystic duct aery Ref: Sabiston 20th edition Pgno : 1482-1484", "role": "assistant" } ]

[ { "content": "Which of the following is a manifestation of magnesium deficiency? \nSelect and explain. \nA. Tetany, B. Hyper reflexia, C. Hypo reflexia, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: Magnesium deficiency causes irritability, hyper reflexion and sometimes hyporeflexia, tetany and seizures. Ref: Park 22nd edition, page 577.", "role": "assistant" } ]

[ { "content": "The most important function of epithelioid cells in tuberculosis is: \nSelect and explain. \nA. Phagocytosis, B. Secretory, C. Antigenic, D. Healing", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. (b) Secretory(Ref: Immunology, 8th edition, by David Male; pg 427)Epithelioid cells are transformed macrophages that have lost their phagocytic function but retained their secretory activity.Epithelioid cells contain numerous endoplasmic reticulum & golgi bodies.They secrete IL10, TNF alpha, TGF beta;", "role": "assistant" } ]

[ { "content": "Smoke stake pattern is characteristic of? \nSelect and explain. \nA. Sickle cell retinopathy, B. Sarcoidosis, C. Acute retinal necrosis, D. Central serous retinopathy", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Central serous retinopathy * Smoke stack pattern (small hyper fluorescent spot which ascends vertically like a smoke-stack), which gradually spreads laterally to take a mushroom or umbrella configuration, is a Fundus Fluorescein Angiography (FFA) finding of Central Serous Retinopathy.* Another important FFA finding of CSR is Ink-blot or enlarging dot pattern (small hyperfluorescent spot which gradually increases in size.* Among these the most common FFA finding is ink-blot pattern.", "role": "assistant" } ]

[ { "content": "Surgical scissors left in abdomen is covered under which doctrine - \nSelect and explain. \nA. Res ipsa loquitur, B. Medical maloccurrence, C. Therapeutic misadventure, D. Novus actus interveniens", "role": "user" }, { "content": "Answer: A \nExplanation: Res ipsa loquitur: means the thing or fact speaks for itself. Here the patient has to merely state the act of negligence. It must satisfy the conditions that in the absence of negligence, the injury would not have occurred ordinarily, the doctor had exclusive control over the injury-producing treatment or instrument and the patient was not guilty of contributory negligence. The case can be proved without medical evidence. Medical maloccurrence: in spite of good medical attention and care, an individual fails to respond properly or may suffer from adverse reactions of the drug. Therapeutic misadventure: is a case in which an individual has been injured or had died due to some unintentional act by a doctor or agent of the doctor or the hospital. eg: hypersensitivity reaction caused by penicillin, aspirin, etc. Novus actus interveniens: if the doctor is negligent, which results in a detion from the logical sequence of events, then the responsibility for the subsequent disability or death may pass from the original incident to the later negligent action of the doctor. eg: leaving of a swab or surgical instrument in the abdomen after the repair of an internal injury. Ref: Dr.K.S.Narayana Reddy, The Essentials of Synopsis of Forensic Medicine & Toxicology, 34th edition Pg.37,38,44.", "role": "assistant" } ]

[ { "content": "Sloughing of necrotic epithelium is characteristic of: \nSelect and explain. \nA. Aspirin burn, B. Denture sore mouth, C. Traumatic ulcer, D. Contact dermatitis", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Patient presenting with abdominal pain, diarrhea taking clindamycin for 5 days. Treated with metronidazole symptoms subsided. What is the causative agent - \nSelect and explain. \nA. Clostridium difficile, B. Clostridium perfringens, C. Clostridium welchi, D. Clostridium marneffi", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Clostridium difficile", "role": "assistant" } ]

[ { "content": "Indication for intramuscular iron therapy? \nSelect and explain. \nA. Pregnancy, B. Postpartum period, C. Emergency surgery, D. Oral iron intolerance", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. d (Oral iron intolerance). (Ref. KDT, Pharmacology, 6th/pg.584)IRON THERAPY# Some iron preparations come with other compounds designed to enhance iron absorption, such as ascorbic acid,# Typically, for iron replacement therapy, up to 300 mg of elemental iron per day is given, usually as three or four iron tablets (each containing 50-65 mg elemental iron) given over the course of the day.# Ideally, oral iron preparations should be taken on an empty stomach, since foods may inhibit iron absorption.# A dose of 200-300 mg of elemental iron per day should result in the absorption of iron up to 50 mg/d.# The goal of therapy in individuals with iron-deficiency anemia is not only to repair the anemia, but also to provide stores of at least 0.5-1.0 g of iron.# Sustained treatment for a period of 6-12 months after correction of the anemia will be necessary to achieve this.# Of the complications of oral iron therapy, gastrointestinal distress is the most prominent and is seen in 15-20% of patients.# Typically, the reticulocyte count should begin to increase within 4-7 days after initiation of therapy and peak at 1 1/2 weeks.# The amount of iron needed by an individual patient is calculated by the following formula:Iron requirement (mg) =4.4 X bidt wt (kg) X Hb defucut (g/dL)Indications of parenteral Iron therapy# Oral iron intolerance# Failure to absorb oral iron# Non-compliance to oral therapy# In presence of severe anemia with bleeding.Oral Iron preparationsIron contentFerrous sulfate Hydrated salt20%Dried salt32-35%Ferrous gluconate12%Ferrous fumarate, succinate33%Colloidal ferric hydroxide50%Iron-calcium complex5% Iron therapy:Dosage ------200mg elemental iron per dayRise of Hb --------0.5-lgm% per week1st sign of response --------| Apetite, | fatigue within 12-24 hrs Reticulocytosis 3-4th DayIndication of Blood transfusion------Hb < 7gm% or CCFDuration of iron tablets ------At least 100 days after correction of Hb", "role": "assistant" } ]

[ { "content": "Edrophonium binds to which site of Acetylcholinesterase \nSelect and explain. \nA. Anionic site, B. Esteric site, C. Both the sites, D. Doesn't bind to any site", "role": "user" }, { "content": "Answer: A \nExplanation: Edrophonium is ultra sho-acting acetylcholinesterase drug which binds only to anionic site Ref: KDT 6th ed pg 104", "role": "assistant" } ]

[ { "content": "Which of the following provide opacity to composite? \nSelect and explain. \nA. TEGDMA, B. BIS-GMA, C. TiO2, D. None", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Indications for exchange transfusion are all except? \nSelect and explain. \nA. Unconjugated bilirubin > 18 mg/100 ml, B. Cord hemoglobin < 10 mg/100 ml, C. Cord bilirubin < 5 mg/100 ml, D. Bilirubin protein ratio > 3.5", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Cord bilirubin < 5 mg/100 ml Cord bilirubin 5 or more is an indication.", "role": "assistant" } ]

[ { "content": "A 26-year-old recently married woman presents with tender nodules on her shin. Initial history taking should include questions about \nSelect and explain. \nA. Her stress level, B. Any new medications she may have staed, C. History of foreign travel, D. Insect bites to the legs", "role": "user" }, { "content": "Answer: B \nExplanation: Red tender nodules on her shin could be erythema nodosum; Erythema nodosum is a type of panniculitis, i.e. an inflammatory disorder affecting subcutaneous fat.Oral contraceptives which this newly married woman would take is likely hereOther causes are Neutrophilic dermatoses (Behcet's disease, Sweet's syndrome), iodides, bromides, sulfonamides, Sarcoidosis, Ulcerative colitis(also Crohn&;s), Streptococcus, Pregnancy, and Malignancy", "role": "assistant" } ]

[ { "content": "Fatty acid found exclusively in breast milk is:- \nSelect and explain. \nA. Linoleic acid, B. Linolenic acid, C. Docosa hexanoic acid, D. Eichosa pentanoic acid", "role": "user" }, { "content": "Answer: C \nExplanation: - Fatty acid found exclusively in breast milk: DHA (Docosa hexanoic acid) - It aids in development of brain by promoting myelination of neurons. OTHER ESSENTIAL FATTY ACIDS & THEIR RICH SOURCES: Linoleic acid, Arachidonic acid - Safflower oil Linolenic acid - flaxseed oil, soyabean oil Eichosa pentanoic acid - fish oils.", "role": "assistant" } ]

[ { "content": "Severity of mitral stenosis is determined by: March 2005 \nSelect and explain. \nA. Intensity of S1 hea sound, B. Diastolic murmur duration, C. Opening snap, D. Intensity of diastolic murmur", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B: Diastolic murmur duration Mitral Stenosis Severity assessment on auscultation - Time interval between A2 and opening snap is inversely propoional to the severity of MS. - Duration (of low pitched, rumbling, diatolic murmur, heard at the apex) of murmur correlates with the severity of stenosis in patients with preserved CO. Echocardiography: Mitral Stenosis Severity Scales - Pressure half-time Normal : 30 to 60 milliseconds Abnormal : 90 to 400 ms Gray area : 60 to 90 ms Mild MS : 90 to 150 ms Moderate MS : 150 to 219 ms Severe MS : > 220 ms Mitral valve area Normal : 4 to 6 cm2 Mild MS : 1.5 to 2.5 cm2 Moderate MS : 1.0 to 1.5 cm2 Severe MS : End-diastolic pressure gradient Normal : 0 to 2 mm Hg Mild MS : 2 to 6mmHg Moderate MS : 6 to 10 mm Hg Severe MS : >10 mm Hg Mean pressure gradient Mild MS : < 5 mmHg Moderate MS : 6 to 12 mm Hg Severe MS : > 12 mm Hg", "role": "assistant" } ]

[ { "content": "30 year old patient with pain in right hypochondrium for 5 days with soft and tender liver and intercostal tenderness. He complains of catch in breath on inspiration and has a non productive cough. On examination the lung fields are clear, patient looks pale and emaciated. Probable diagnosis is \nSelect and explain. \nA. Amoebic liver abscess, B. Pyogenic live abscess, C. Hydatid cyst, D. Hepatic adenoma", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. (a) Ameobic liver abscessRef:Manipal Manual of surgery, 4th ed./521Refer to the above explanationHydatid cystUsually clinically silentEnlarged liver with smooth surface and is non tender.Pyogenic liver abscessMultiple abscess leading to spiky fever and enlarged liver.Hepatic adenomaPresents in young women on OCP and is solitary. Liver enlargement may or may not be seen.", "role": "assistant" } ]

[ { "content": "In post-hepatic jaundice, the concentration of conjugated bilirubin in the blood is higher than that of unconjugated bilirubin because - \nSelect and explain. \nA. There is an increased rate of destruction of red blood cells., B. The unconjugated bilirubin is trapped by the bile stone produced in the bile duct., C. The conjugation process of bilirubin in liver remains operative without any interference., D. The UDP-glulcuronosyltransferase activity is increased manifold in obstructive jaundice.", "role": "user" }, { "content": "Answer: C \nExplanation: Jaundice\n\nJaundice is not a disease but rather a sign that can occur in many different diseases.\nJaundice is the yellowish staining of skin and sclerae which is caused by the high level of blood bilirubin.\nOn the basis of etiology, jaundice can be divided into 3 types : -\n\n1. Prehepatic jaundice\n\nPrehepatic jaundice is due to increased production of bilirubin which results in an increased bilirubin load presented to the liver.\nThe liver is normal and is able to conjugate the bilirubin at a normal rate; However, due to overproduction of bilirubin, conjugation capacity of the liver is overwhelmed and unconjugated bilirubin is increased → Unconjugated hyperbilirubinemia.\nPrehepatic jaundice is caused by hemolysis, i.e., hemolytic anemia due to any cause, e.g., hereditary spherocytosis, Thalassemia, SCA, Malaria, Drugs (methyldopa, quinine) etc.\n\n2. Hepatic jaundice\n\nHere the cause lies within the hepatocytes which have either a defect in the conjugation process or in the excretion of conjugated bilirubin into the bile.\nThis type of jaundice is caused by all causes of hepatitis (infection, alcohol, drugs, toxin or autoimmune); in congenital hyperbilirubenemias; and in cirrhosis.\n\n3. Post hepatic (extrahepatic) jaundice\n\nPost hepatic jaundice is due to obstruction of the excretion into the bile, e.g., in stone in CBD, carcinoma pancreas, CBD carcinoma etc.\nConjugation capacity of hepatocytes are normal and they continue their conjugation process without any interference leading to conjugated hyperbilirubinemia.", "role": "assistant" } ]

[ { "content": "The causative organism can be best isolated in which of the following conditions. \nSelect and explain. \nA. Tampons in toxic shock syndrome, B. Rheumatic valvulitis, C. CSF in tetanus, D. Diptheritic myocarditis", "role": "user" }, { "content": "Answer: A \nExplanation: Staphylococcus aureus can be isolated from a tampon of a patient with toxic shock syndrome. S.aureus strains isolated from patients with toxic shock syndrome produce a toxin called toxic shock syndrome toxin-1 (TSST-1), which can be found in the vagina, on tampons, in wounds or other localized infections, or in the throat but viually never in the bloodstream. Streptococcal antigens cross-reactive with human tissues ; streptococcal antigen Human antigen Disease Hyaluronic acid Synol fluid Reactive ahritis Cell wall M protein Myocardium Acute rheumatic fever Cell wall C carbohydrate Cardiac Valves Acute rheumatic fever peptidiglycan skin antigens Guttate psoriasis Cytoplasmic membrane Glomerular capsular intima Acute glomerulonephritis Ref: Textbook of microbiology; Ananthanarayan and paniker's; 10th Edition; Pg:204", "role": "assistant" } ]

[ { "content": "A 63-year-old woman fell while crossing the street after her Thursday afternoon bridge game. Attempts at resuscitation for cardiac arrest by the emergency medical service (EMS) team were unsuccessful. The woman had previously been diagnosed as having aortic stenosis and left ventricular hypertrophy. In addition to these factors, which of the following predisposes to sudden cardiac death? \nSelect and explain. \nA. Split first heart sound, B. Hypokalemia, C. Soft murmur at left of sternum that varies with inspiration, D. Failure of the central venous pressure (CVP) to rise more than 1 cm H2O with 30-second pressure on the liver (hepato-jugular reflux)", "role": "user" }, { "content": "Answer: B \nExplanation: Sudden cardiac death is defined as an unexpected death occurring within 1 hour after the beginning of symptoms in a patient who was previously hemodynamically stable. In asymptomatic patients presenting initially with cardiac disease, 20% will die within the first hour of symptoms. Electrolyte imbalance, hypoxia, and conduction system defect are additional factors that increase the risk of sudden death syndrome. Split first heart sound accentuated on inspiration occurs in normal individuals. In CHF, the CVP changes more than 1 cm when pressure is applied below the right costal margin to the liver (hepatojugular reflex) for a 30-second period.New York Classification of Functional changes in Heart DiseaseClassLimitation of Physical ActivityINoneIISlightIIIMarkedIVComplete (even at rest)", "role": "assistant" } ]

[ { "content": "Transitional cell carcinoma of bladder is associated with- \nSelect and explain. \nA. Schistosomiasis, B. Naphthylamine, C. Smoking, D. All", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'a' i.e., Schistosomiasis; 'b' i.e., Naphthylamine & 'c' i.e., SmokingRisk factors for transitional cell carcinoma (TCC) of bladder ?I. Smoking ---> Major etiological factor.Occupational exposure to chemicals Nephthylamine benzidine, aniline dyes, acrolein.Schistosoma haematobium (Bilharziasis) ---> It is a risk factor for both TCC & SCC.Drugs --> PhenacetinCyclophosphamide therapyPelvic irradiations", "role": "assistant" } ]

[ { "content": "Which of the following regulates lipolysis in adipocytes? \nSelect and explain. \nA. Activation of fatty acid synthesis mediated by cyclic AMP, B. Activation of triglyceride lipase as a result of hormone-stimulated increases in cyclic AMP levels, C. Glycerol phosphorylation to prevent futile esterification of fatty acids, D. Activation of cyclic AMP production by insulin", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B. Activation of triglyceride lipase as a result of hormone-stimulated increases in cyclic AMP levelsa. Lipolysis is directly regulated by hormones in adipocytes. Epinephrine stimulates adenylate cyclase to produce cyclic AMP, which in turn stimulates a protein kinase.b. The kinase activates triglyceride lipase by phosphorylating it. Lipolysis then proceeds and results in the release of free fatty acids and glycerol.c. A futile re esterification of free fatty acids is prevented, since adipocytes contain little glycerol kinase to phosphorylate the liberated glycerol, which must be processed in the liver. Inhibition of lipolysis occurs in the presence of insulin, which lowers cyclic AMP levels. Lipoprotein lipase is not an adipocyte enzyme.", "role": "assistant" } ]

[ { "content": "What is the expected mixed venous oxygen tension, in mm Hg, in a normal adult after breathing 100% oxygen for 10 minutes? \nSelect and explain. \nA. 150, B. 740, C. 45, D. 573", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. (c) 45Ref: American Board of Anesthesiology American Society of Anesthesiologists, Book A 1996 q-67Breathing 100% oxygen will not change the oxygen saturation much. In arterial blood it is around 97% saturation which corresponds to a PO2 of 100 mm HgIn venous blood it is 75% saturation which corresponds to a mixed venous oxygen tension of around 40-45 mm Hg", "role": "assistant" } ]

[ { "content": "Muscle attached to medial border of scapula is- \nSelect and explain. \nA. Rhomboidus Major, B. Teres Major, C. Deltoid, D. Infraspinatus", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Rhomboidus Major * Lateral border of scapula (posteriorly) : Origins of teres minor and teres major.* Medial border of scapula : (i) Anteriorly : Insertion of serratus anterior; (ii) Posteriorly : Insertions of levator scapulae, rhomboideus major and minor.", "role": "assistant" } ]

[ { "content": "Seminal stain can be detected by \nSelect and explain. \nA. Phenolphthalein test, B. Reine's test, C. Barberio's test, D. Paraffin test", "role": "user" }, { "content": "Answer: C \nExplanation: Test for seminal  stains\n\nCreatine phosphokinase test\nAcid phosphatase test\nFlorence test (Choline iodide crystals)\nBarberio's test (Crystals of spesmin picrate).", "role": "assistant" } ]

[ { "content": "Oligohydramnios is seen in: \nSelect and explain. \nA. Renal agenesis, B. Cholangioma of placenta, C. Spina bifida, D. Esophageal atresia", "role": "user" }, { "content": "Answer: A \nExplanation: Oligohydramnios can be caused by - Renal anomalies Uteroplacental insufficiency: IUGR ACE inhibitors Premature rupture of membranes Amniocentesis (leak) Pre-ecclampsia Amnion nodosum NSAIDs Post term pregnancy over estimated gestational age The sonographic diagnosis of oligohydramnios is usually based on an AFI < 5 cm or a single deepest pocket of amnionic fluid of < 2 cm", "role": "assistant" } ]

[ { "content": "The normal P wave is inveed in lead : \nSelect and explain. \nA. LI, B. LII, C. aVF, D. aVR", "role": "user" }, { "content": "Answer: D \nExplanation: Answer is D (aVR) The normal P wave is negative (inveed) in lead aVR. Characteristics of a Normal P Wave P wave results from spread of electrical activity through the atria (Atrial Depolarization) A normal p wave indicates that the electrical impulse responsible for the p wave originated in the sinus node and the normal depolarization of the right and left atria has occurred Normal P Wave is rounded, neither peaked nor notched. Width or duration of the P wave in time is 0.10 seconds or 2.5 small squares Height of the P wave is 2.5 mm (2.5 small squares) Sinus P waves are best seen in Lead II and V1 P wave is upright in most leads, mainly L1 L11 and aVF P Wave is inveed in aVR (and occasionally in aVL) P wave in VI may be biphasic with equal upward and downward deflection, notched and wide. Activation of right atrium produces positive component and activation of left atrium produces negative component. There should be one p wave preceding each QRS complex. More than one p wave before a QRS complex indicates a conduction disturbance.", "role": "assistant" } ]

[ { "content": "Physiological uncoupler is \nSelect and explain. \nA. Thyroxine, B. Free fatty acids, C. Thermogenin, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: Uncouplers will allow oxidation to proceed, but the energy instead of being trapped by phosphorylation Fig. 19.18. Impoant mitochondrial membrane transpoers. 1 = PYT (pyruvate transpoer); 2 = TCT (tricarboxylate transpoer); 3 = ANT (adenine nucleotide transpoer) is dissipated as heat. This is achieved by removal of the proton gradient. (Table 19.5; Fig. 19.17). The uncoupling of oxidative phosphorylation is useful biologically. In hibernating animals and in newborn human infants, the liberation of heat energy is required to maintain body temperature. In Brown adipose tissue, thermogenesis is achieved by this process. Thermogenin, a protein present in the inner mitochondrial membrane of adipocytes, provides an alternate pathway for protons. It is one of the uncoupling proteins (UCP). Thyroxine is also known to act as a physiological uncoupler.Ref: DM Vasudevan Textbook of Medical Biochemistry, 6th edition, page no: 234", "role": "assistant" } ]

[ { "content": "A 55 year old diabetic man is brought to the emergency room in an unresponsive state. The following laboratory values are obtained: PCO2 19 mm Hg, HCO3 11 mEq/L, and pH 6.9. The most appropriate immediate treatment of this patient is ? \nSelect and explain. \nA. Administration of an oral hypoglycemic agent, B. Administration of bicarbonate, C. Administration of insulin, D. Close observation only", "role": "user" }, { "content": "Answer: C \nExplanation: This patient is in a diabetic ketoacidotic coma. The goals in treating such a patient are to increase the rate of glucose utilization by insulin-dependent tissues, to reverse ketonemia and acidosis, and to replenish fluid imbalances. Oral hypoglycemic agents are commonly prescribed for the maintenance of NIDDM patients and would not be appropriate in an acute setting. Treatment with bicarbonate would result in only a transient elevation of pH. Since this is a life-threatening condition, monitoring the patient without treatment is unacceptable. Ref: D'Alessio D. (2011). Chapter 43. Endocrine Pancreas and Pharmacotherapy of Diabetes Mellitus and Hypoglycemia. In B.C. Knollmann (Ed), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e.", "role": "assistant" } ]

[ { "content": "Which of the following antibacterial drug is polar? \nSelect and explain. \nA. Ampicillin, B. Penicillin G, C. Clavulanic acid, D. Cefepime", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Ampicillin Ampicillin: It is an ionized highly polar drug. In the duodenum it exes a zwitter ion effect and thus has a lower bioavailabilty. Though the oral absorption is incomplete it is adequate. It is an antibacterial drug acting both on gram positive and gram negative organisms. Main mode of excretion is by kidneys. It is paly excreted in bile and shows enterohepatic circulation.", "role": "assistant" } ]

[ { "content": "The main action of muscle \"Gamellius\" is? \nSelect and explain. \nA. Medial rotation of thigh, B. Lateral rotation of thigh, C. Gluteus maximus, D. Gluteus medius and minimus", "role": "user" }, { "content": "Answer: B \nExplanation: Gemellus muscle laterally rotates the femur at the hip joint. Superior gemellus muscle: Attaches proximally at the ischial spine; distally, the muscle attaches on the greater trochanter of the femur. The nerve to the obturator internus and superior gemellus muscles (L5, S1, S2) innervates this muscle.Inferior gemellus muscle: Attaches proximally on the ischial spine; distally, the muscle attaches at the greater trochanter of the femur. The nerve to the inferior gemellus and quadratus femoris muscles (L4, L5, S1) innervates this muscle.", "role": "assistant" } ]

[ { "content": "A patient with pheochromocytoma would secrete which of the following in a higher concentration? \nSelect and explain. \nA. Norepinephrine, B. Epinephrine, C. Dopamine, D. VMA", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Norepinephrine o Most pheochromocytomas contain and secrete both nor epinephrine and epinephrine and the percentage of norepine phrine is usually greater than in normal adrenal.Pheoch rornocvtom||AdrenalCan't suppress ACTHo Most of them secrete norepinephrineo Exclusively secrete nor epinephrine", "role": "assistant" } ]

[ { "content": "The structural abnormality of chromosome in which one arm is lost and remaining arm is duplicated is called: \nSelect and explain. \nA. Ring chromosome, B. Isochromosome, C. Translocation, D. Mutation", "role": "user" }, { "content": "Answer: B \nExplanation: b. Isochromosome(Ref: Nelson's 20/e p 590', Ghai 8/e p 637)Iso-chromosome results when 1 arm of a chromosome is lost and the remaining arm is duplicated or when the axis of division occurs perpendicular to the normal axis of division.", "role": "assistant" } ]

[ { "content": "Columella effect is seen in \nSelect and explain. \nA. Tympanoplasty, B. Septoplasty, C. Tracheostomy, D. None of the above", "role": "user" }, { "content": "Answer: A \nExplanation: Columella effect is seen in type 3 tympanoplasty (myringostapediopexy) where single ossicle remains just like that of bird&;s ear. In Type III tympanoplasty Malleus and incus are absent. Graft is placed directly on the stapes head. It is also called myringostapediopexy or columella tympanoplasty. Re: Textbook of Ear, Nose and Throat, Dhingra, 6th Edition, page 30.", "role": "assistant" } ]

[ { "content": "A Patient with increased BP and decreased hea rate is likely to have \nSelect and explain. \nA. Increased ICT, B. Deep sea diving, C. Brain tumor, D. Head tumor", "role": "user" }, { "content": "Answer: A \nExplanation: Cushing's reflex , is a physiological nervous system response to increased intra cranial pressure.Results in cushings triad - increased BP, irregular breathing and bradycardia. Usually seen in terminal stages of head injury . It can also be seen after iv administration of epinephrine. In head injury- CPP=MAP-ICP. CPP- cerebral perfusion pressure. MAP- Mean aerial pressure. ICP- intra cranial pressure Head injury causes increased ICP thus lowering CPP causing ischemia. When ICP approaches the level of mean systemic pressure , cerebral perfusion falls . Bodys response to fall in cerebral perfusion is raise systemic blood pressure and dialate cerebral vessels which increases cerebral blood volume and increases ICP followed by lowering CPP.And causes a vicious cycle. When aerial pressure lowers , a reflex called CNS ischaemic response is initiated by the hypothalamus . Hypothalamus activates sympathetic nervous system causing peripheral vasoconstriction and increased cardiac output. This increases aerial pressure and cerebral blood flow is restored. This response stimulates the baroreceptors in the carotid bodies thus slowing the hea rate drastically- bradycardia(baroreceptor reflex -refer image) 2) Marey's law- Explained by barereceptor reflex States that' hea rate is inversely propoional to blood pressue '(but not the vice versa) . Bainbridge reflex- infusion of saline or blood --- increased venous filling of atria--- stimulation of tachycardia producing atrial receptor(TPAR)---tachycardia", "role": "assistant" } ]

[ { "content": "Chloroquine is given as 600 mg loading dose because: \nSelect and explain. \nA. It is rapidly absoed, B. It is rapidly metabolized, C. It has increased tissue binding, D. It is rapidly eliminated", "role": "user" }, { "content": "Answer: C \nExplanation: Oral absorption of CQ is excellent. About 50% gets bound in the plasma. It has high affinity for melanin and nuclear chromatin: gets tightly bound to these tissue constituents and is concentrated in liver, spleen, kidney, lungs (several hundred-fold), skin, leucocytes and some other tissues. Its selective accumulation in retina is responsible for the ocular toxicity seen with prolonged use. ESSENTIALS OF PHARMAXOLOGY page no.822", "role": "assistant" } ]

[ { "content": "Treatment of acute lymphangitis requires: \nSelect and explain. \nA. Antibiotic and rest, B. Immediate lymphangiography, C. Immediate multiple incisions, D. No special treatment", "role": "user" }, { "content": "Answer: A \nExplanation: Treatment of acute lymphangitis requires antibiotic and rest.", "role": "assistant" } ]

[ { "content": "Donepezil is used in treatment of - \nSelect and explain. \nA. Alzheimer's dementia, B. Schizophrenia, C. Anxiety disorder, D. Depression", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which one of the following is a regulatory protein of the muscle? \nSelect and explain. \nA. Troponin, B. Myosin, C. Actin, D. Protein-C", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Lisch nodules (Pigmented Iris hamartomas) are seen in \nSelect and explain. \nA. Niemann Pick disease, B. Neurofibromatosis, C. Ochronosis, D. Glycogen storage disease", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. b (Neurofibromatosis) (Ref. Harrison's Internal Medicine 17th ed., Chapter 374; RRM 7th ed., p.316)# Lisch nodules (iris hamartoma) and Optic gliomas = NF-1.# Glaucoma = Sturge Weber syndome.# Retinal angiomas = VHL# GlaucomaNEUROFIBROMATOSIS# Autosomal dominant inherited disorder- pure neurofibromas (= tumor of nerve sheath with involvement of nerve, nerve fibers run through mass)- neurilemmomas (= nerve fibers diverge and course over the surface of the tumor mass)(a) localized neurofibroma (most common, 90%)(b) diffuse neurofibroma (mostly solitary + not associated with NF1)(c) plexiform neurofibroma (PATHOGNOMONIC of NF1)Peripheral Neurofibromatosis (90%) = NEUROFIBROMATOSIS TYPE 1 = von Recklinghausen disease# autosomal dominant with abnormalities localized to the pericentromeric region of chromosome 17.- CLASSIC TRIAD:- Cutaneous lesions- Skeletal deformity- CNS manifestations# CNS and ocular MANIFESTATIONS- Lisch nodules= melanocytic iris hamartomas <2 mm in size- Optic pathway glioma- Hydrocephalus (Aqueductal stenosis)- Vascular dysplasia= occlusion / stenosis of distal ICA, proximal MCA/ACA- Plexiform neurofibromas are PATHOGNOMONIC for NF1- Erosion of bony elements with marked posterior scalloping# SKELETAL MANIFESTATIONS (in 25-40%)- Harlequin appearance to orbit (empty orbit) = partial absence of greater and lesser wing of sphenoid + orbital plate of frontal bone- Sharply angled focal kyphoscoliosis (50%) in lower thoracic + lumbar spine- Pseudarthrosis after bowing fracture (particularly in tibia) in 1st year of life# Others:- Cafe-au-lait spots= pigmented cutaneous macules >6 in number, >5 mm in greatest diameter; Coast of California.; Freckling.- Progressive pulmonary interstitial fibrosis with lower lung field predominance (up to 20%)- Pheochromocytoma- Renal artery stenosis: very proximal- Malignant peripheral nerve sheath tumor - most common malignant abdominal tumor in NF1", "role": "assistant" } ]

[ { "content": "All of the features of Wilson's disease, EXCEPT: \nSelect and explain. \nA. Haemolytic anaemia, B. Testicular atrophy, C. Chorea, D. Chronic active hepatitis", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' Testicular atrophy Basic defect in Wilson's disease is|Reduced biliary exception of copper*|Cu accumulates in hepatocytes resulting in liver damage (Manifest almost all types of hepatitis* including fulminant hepatitis)|Liver cells get saturated with Cu|Cu spilled in plasma|Gets deposited in following organsBasal ganglia - Spasticity, Rigidity, Chorea (dysphagia, dysarthria, positive Babinski, abdominal reflex absent).Eye - Kayser Fleischer ring* present in descemet's membrane* of cornea.Some frequently asked facts about Wilson's diseaseAssociated with Coombs (-ve) hemolytic anemia*Sensory symptoms are characteristically absent*Testis never involved*Ceruloplasmin deficiency is important marker of disease*", "role": "assistant" } ]

[ { "content": "Valley fever or dese rheumatism is caused by? \nSelect and explain. \nA. Sporothrix, B. Coccidioides, C. Phialophora, D. Histoplasma", "role": "user" }, { "content": "Answer: B \nExplanation: Coccidioidomycosis (also called dese rheumatism or San Joaquin Valley fever or California fever) - A systemic fungal disease caused by a dimorphic soil dwelling fungus - Coccidioides Sporotrichosis or Rose Gardner's disease is chronic subcutaneous pyogranulomatous disease caused by a thermally dimorphic fungus Sporothrix schenckii. Chromoblastomycosis is a slowly progressing granulomatous infection caused by several soil fungi. These are Fonsecaea pedrosoi, Fonsecaea compactum, Cladosporium carrionii, and Phialophora verrucosa. Histoplasmosis or Darling's disease is caused by dimorphic fungus-Histoplasma capsulatum.", "role": "assistant" } ]

[ { "content": "Which one of the following is not an amide – \nSelect and explain. \nA. Lignocaine, B. Procaine, C. Bupivacaine, D. Dibucaine", "role": "user" }, { "content": "Answer: B \nExplanation: Esters (aminoesters) :- Procaine, chlorprocaine, tetracaine (amethocaine), Benzocaine, Cocaine.\nAmides (aminoamides) Lignocaine, Mepivacaine, Prilocaine, Bupivacaine, Etidocaine, Ropivacaine , Dibucaine.", "role": "assistant" } ]

[ { "content": "Complications of cataract surgery –a) Endophthalmitisb) Optic neuropathyc) Retinal detachmentd) Vitreous losse) Lagophthalmos \nSelect and explain. \nA. abcd, B. bcde, C. abde, D. acd", "role": "user" }, { "content": "Answer: D \nExplanation: Important complications of cataract surgery \n\nAfter cataract (opacification of the capsule)       \nVitreous prolapse & loss   \nCystoid macular edema     \nEndophthalmitis\nAphakic glaucoma\nRetinal detachment\nFibrous & endothelial growth\nNeovascular glaucoma\nIris prolapse\nAnterior uveitis (iridocyclitis)\nStrait keratopathy & pseudophakic bullous keratopathy\nCorneal endothelial damage", "role": "assistant" } ]

[ { "content": "The most common cause of malignant adrenal mass is \nSelect and explain. \nA. Adrenocoical carcinoma, B. Malignant phaeochromocytoma, C. Lymphoma, D. Metastasis from another solid tissue tumor", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Metastasis from another solid tissue tumor The most common cause of adrenal tumors is metastasis from another solid tumor like breast cancer and lung cancer. Malignant Percentage Adrenocoical carcinoma 2-5% Malignant pheochromocytoma <I% Adrenal neuroblastoma <0- 1% Lymphomas (incl. primary adrena lymphoma) <1% Metastases (most frequent : Breast, lung) 15%", "role": "assistant" } ]

[ { "content": "All are components of Sewer gas except - \nSelect and explain. \nA. H2S, B. CO2, C. SO2, D. Methane", "role": "user" }, { "content": "Answer: C \nExplanation: When the sewage is highly concentrated and contains plenty of solids the anaerobic process is highly effective. The end products of decomposition are methane, ammonia, CO2, and H2S. Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 794", "role": "assistant" } ]

[ { "content": "At CEJ Overlap joint is seen in: \nSelect and explain. \nA. 30%, B. 40%, C. 50%, D. 60%", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Incomplete uterine rupture is defined as? \nSelect and explain. \nA. Disruption ofpa ofscar, B. Disruption of entire length of scar, C. Disruption of scar including peritoneum, D. Disruption of scar with peritoneum intact", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is'd' i.e., Disruption of scar with peritoneum intact Incomplete rupture :In an Incomplete uterine rupture, the mother's peritoneum remains intact.The peritoneum is the membrane that lines the abdominal cavity to suppo abdominal organs.It also acts as a channel for blood vessels and nerves.An incomplete uterine rupture is significantly less dangerous with fewer complications to the delivery process.Complete rupture:During a Complete uterine rupture, the peritoneum tears and the contents of the mother's uterus can spill into her peritoneal cavity.The peritoneal cavity is the fluid-filled gap that separates the abdomen walls and its organs.It is suggested that delivery cesarean section (C- section) should occur within approximately 10 to 35 minutes after a complete uterine rupture occurs.The fetal morbidity rate increases dramatically after this period.", "role": "assistant" } ]

[ { "content": "Insufflation pressure during laparoscopy is? \nSelect and explain. \nA. 5-10 mm Hg, B. 11-15 mm Hg, C. 15-20 mm Hg, D. 20-25 mm Hg", "role": "user" }, { "content": "Answer: B \nExplanation: ANSWER: (B) 11-15 mm HgREF: Maingot's 10th ed p. 243The intrabdominal pressure during laparoscopy is monitored by insufflator and it is set between 12-15 mm Hg.", "role": "assistant" } ]

[ { "content": "Transitional epithelium is present in - \nSelect and explain. \nA. Renal pelvis, B. Loop of Henle, C. Terminal part of urethra, D. PCT", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "The teiary structure of protein is determined by \nSelect and explain. \nA. X-ray Crystallography, B. Spectrophotometry, C. Electrophoresis, D. Chromatography", "role": "user" }, { "content": "Answer: A \nExplanation: Three-Dimensional Structure is determined by X-ray Crystallography or by NMR SpectroscopyRef: Harper&;s Biochemistry; 30th edition; Chapter 5; Proteins: Higher Orders of Structure", "role": "assistant" } ]

[ { "content": "Along with succinyl CoA which of the following amino acid serve as staing material in heme synthesis? \nSelect and explain. \nA. Lysine, B. Leucine, C. Glycine, D. Alanine", "role": "user" }, { "content": "Answer: C \nExplanation: The two staing materials of heme synthesis pathway are succinyl CoA and glycine. Pyridoxal phosphate is needed to activate glycine. ALA synthase catalyzes the conversion of succinyl CoA and glycine to delta aminolevulinate. This is the rate limiting enzyme in porphyrin biosynthesis in the mammalian liver. Synthesis of ALA occurs in mitochondria. Last 3 steps of heme synthesis occur in the cytoplasm. The 3 enzymes which catalyse the reactions in cytoplasm are ferrochelatase, protoporphyrinogen oxidase and coproporphyrinogen oxidase. Coproporphyrinogen oxidase catalyze conversion of coproporphyrinogen III to protoporphyrinogen III. Protoporphyrinogen oxidase catalyze conversion of protoporphyrinogen III to protoporphyrin III. Ferrochelatase catalyze conversion of protoporphyrin III to heme by incorporating heme into protoporphyrin. Ref: Murray R.K. (2011). Chapter 31. Porphyrins & Bile Pigments. 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": "Latanoprost (PGF0 alf \nSelect and explain. \nA. Maintenance of ductus arteriosus, B. Pulmonary hypertension, C. Gastric mucosal protection, D. Glaucoma", "role": "user" }, { "content": "Answer: D \nExplanation: ANSWER: (D) GlaucomaREF: Goodman and Gillmans 11TH edition page 1103, http://en.udkipedia.org/wiki/Latanoprost \"Latanoprost ophthalmic solution is a topical medication used for controlling the progression of glaucoma or ocular hypertension by reducing intraocular pressure. It is a prostaglandin analogue (more specifically an analogue of Prostaglandin F2a)\"\"The PGF2a analogs consist of Latanoprost, travoprost, bimatoprost, and unoprostone. PGF2a analogs appear to lower IOP by facilitating aqueous outflow\" through the accessory uveoscleral outflow pathway. The mechanism by which this occurs is unclear\"", "role": "assistant" } ]

[ { "content": "Renshaw cell inhibition is an example of: \nSelect and explain. \nA. Postsynaptic inhibition, B. Feed forward inhibition, C. Recurrent inhibition, D. Collateral inhibition", "role": "user" }, { "content": "Answer: C \nExplanation: Renshaw cells are inhibitory cells that transmit inhibitory signals to the surrounding motor neurons. This anterior motor neuron gets excitatory impulses from multiple sources, if all these excitatory inputs were sent to the muscles, muscle will fatigue early, so, there is some inherent check to reduce the excitability of these motor neurons & that is in form of Renshaw cell inhibition. This is recurrent type of inhibition. The inhibitory neurotransmitters Glycine and GABA are involved in Renshaw cell inhibition.", "role": "assistant" } ]

[ { "content": "Blood culture is positive in which infection of Staphylococcus aureus is \nSelect and explain. \nA. TSS, B. SSSS, C. Infective endocarditis, D. Impetigo", "role": "user" }, { "content": "Answer: C \nExplanation: Infections caused by methicillin-sensitive S aureus, high-magnitude bacteremia (defined as >4 positive blood cultures ), and endocarditis. The most impoant test is a blood culture used to identify bacteria in the bloodstream. REFERENCE: www.mayoclinic.org", "role": "assistant" } ]

[ { "content": "Gonadotropin levels decline to prepubertal levels by age \nSelect and explain. \nA. 6 month to 1 year of age, B. 1 year to 2 years of age, C. 2 years to 3 years of age, D. 3 years to 4 years of age.", "role": "user" }, { "content": "Answer: B \nExplanation: Gonadotropin levels gradually decline to reach prepubertal levels by age 1 to 2 years.", "role": "assistant" } ]

[ { "content": "Which among the following surgery requires lithotomy position \nSelect and explain. \nA. Anal, B. Cardiac, C. Abdominal, D. Limb", "role": "user" }, { "content": "Answer: A \nExplanation: Ans) a (Anal) Ref: http://en.wikipedia.orgThe lithotomy position refers to a common position for surgical procedures and medical examinations involving the pelvis and lower abdomen. References to the position have been found in some of the oldest known medical documents including versions of the Hippocratic oath. The position is named after the ancient surgical procedure for removing kidney stones, gall stones and bladder stones via the perineum. The position is perhaps most recognizable as the 'often used' position for childbirth: the patient is laid on the back with knees bent, positioned above the hips, and spread apart through the use of stirrups.Obvious benefits from the position is that it provides good visual and physical access to the perineal region. The position is used for procedures ranging from simple pelvic exams to surgeries and procedures involving, but not limited to reproductive organs, urology, and gastrointestinal systems. Used for perianal surgeries like haemorrhoidectomy, fistulectomy, lateral sphinc-terotomy; perineal surgeries like APR & vaginal hysterectomy.", "role": "assistant" } ]

[ { "content": "Stool investigation of a child who presented with anemia revealed worm infestation. Which of the following worm infestation is associated with iron deficiency anemia? \nSelect and explain. \nA. Whipworm, B. Hookworm, C. Roundworm, D. Pinworm", "role": "user" }, { "content": "Answer: B \nExplanation: The common human hookworms are Ancylostoma duodenale and Necator americanus. The larger A duodenale is more pathogenic because it consumes more blood, up to 0.5 mL per worm per day. The adult worms attach with their mouthpas to the mucosa, from which they suck blood. Blood loss is the major sequel of infection which leads to iron-deficiency anemia. Chronic hookworm infection is a common cause of moderate and severe hypochromic microcytic anemia, and heavy infection can cause hypoproteinemia with edema. Chronic hookworm infection in children may lead to growth delay, deficits in cognition, and developmental delay. Ref: Dominguez S.R., Levin M.J. (2012). Chapter 43. Infections: Parasitic & Mycotic. In W.W. Hay, Jr., M.J. Levin, R.R. Deterding, J.J. Ross, J.M. Sondheimer (Eds), CURRENT Diagnosis & Treatment: Pediatrics, 21e.", "role": "assistant" } ]

[ { "content": "Homonymous hemianopsia is associated with lesion at \nSelect and explain. \nA. Visual cortex, B. Optic radiation, C. Optic tract, D. Optic chiasma", "role": "user" }, { "content": "Answer: C \nExplanation: (C) Optic tract > It is difficult to localize a postchiasmal lesion accurately, because injury anywhere in the optic tract, lateral geniculate body, optic radiations, or visual cortex can produce a homonymous hemianopia, i.e., a temporal hemifield defect in the contralateral eye and a matching nasal hemifield defect in the ipsilateral eye", "role": "assistant" } ]

[ { "content": "The most common radio-opaque mass at root apex of a vital tooth is due to: \nSelect and explain. \nA. Hypercementosis, B. Condensing osteitis, C. Periapical cemental dysplasia, D. True cementoma", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Tumor that follows rule of 10 is \nSelect and explain. \nA. pheochromocytoma, B. Onocytoma, C. Lymphoma, D. Renal cell carcinoma", "role": "user" }, { "content": "Answer: A \nExplanation: Pheochromocytomas are neoplasms composed of chromaffin cells. They follow rule of 10: - 10% of pheochromocytomas are extra adrenal - 10% of sporadic adrenal pheochromocytomas are bilateral - 10% of adrenal pheochromocytomas are biologically malignant. -10% of adrenal pheochromocytomas are not associated with hypeension. Ref: Robbins and cotrans 9e", "role": "assistant" } ]

[ { "content": "Cystic hygroma may be associated with: March 2005 \nSelect and explain. \nA. Turner's syndrome, B. Klinefelter's syndrome, C. Down's syndrome, D. All of the above", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D: All of the above Karyotypic abnormalities are present in 25-70% of children with Cystic Hygroma. CH has been noted to be more common in persons with: Turner's syndrome Klinefelter's syndrome Down's syndrome In addition, several nonchromosomal disorders, including Noonan syndrome, Fryns syndrome, multiple pterygium syndrome, and achondroplasia, are associated with an increased incidence of CH. Intrauterine alcohol exposure has been associated with the development of lymphangiomas. Dissolution of bone caused by either lymphangiomas or hemangiomas is termed Gorham-Stout syndrome", "role": "assistant" } ]

[ { "content": "False regarding electron transport chain is: \nSelect and explain. \nA. Cyanide inhibits electron transport, but not ATP synthesis, B. Atractyloside inhibiting H+/ ADP synthesis, C. Oligomycin blocks H+ channel, D. High dose aspirin acts as uncoupler", "role": "user" }, { "content": "Answer: B \nExplanation: (Refer: DM Vasudevan, Textbook of Biochemistry, 7th edition, pg no: 266)\nInhibitors of electro transport chain and Oxidative phosphorylation", "role": "assistant" } ]

[ { "content": "During laryngoscopy and intubation procedure, all of these are true, except: \nSelect and explain. \nA. A slight pressure may be applied at the cricoid cailage, B. The laryngoscope is held in the right hand introduced from the right side of the patient, C. The neck is flexed with extension at the atlanto!occipital joint, D. After inseion of laryngoscope, it is levered on the upper incisor to pull up the tongue and visualize the vocal cords", "role": "user" }, { "content": "Answer: D \nExplanation: Ans: D. After inseion of laryngoscope, it is levered on the upper incisor to pull up the tongue and visualize the vocal cords(Ref: Miller 81c, p I 666-7667. 71e p1587).The laryngoscope should never be hinged on the teeth to lift up the epiglottis.The patient is aligned in a \"sniffing\" position, i.e. neck (atlanto-axial joint) flexion and face extension (atlanto-occipital joint), at around 35deg and 15deg respectively", "role": "assistant" } ]

[ { "content": "In Refeeding syndrome, all the given lab valves are monitored except \nSelect and explain. \nA. Calcium, B. Phosphate, C. Ammonia, D. Magnesium", "role": "user" }, { "content": "Answer: C \nExplanation: In Refeeding syndrome, hypocalemia, hypophosphatemia, hypomagnesemia occurs. Hence, they are monitored. Ammonia levels are not altered.", "role": "assistant" } ]

[ { "content": "At how many weeks of gestation can Hegar's sign be elicited? \nSelect and explain. \nA. 8 weeks, B. 10 weeks, C. 12 weeks, D. 15 weeks", "role": "user" }, { "content": "Answer: A \nExplanation: Hegar's sign refers to widening and softening of of the body or isthmus of the uterus. It usually occurs at 6-8 weeks of gestation. Softening and dilatation at the external os is caused by estrogen and progesterone. Chadwick's sign: It refers to bluish discoloration of cervix caused by congestion of pelvic vasculature. It is a presumptive sign of pregnancy. Jacquemier's sign: It refers to congested appearance of vaginal mucosa. Osiander's sign: It refers to increased pulsations felt in the lateral fornices at 8 weeks of gestation. Goodell's sign: It refers to softening of the cervix. Palmer's sign: refers to intermittent contractions of the uterus. Ref: Bernstein H.B., VanBuren G. (2013). Chapter 6. Normal Pregnancy and Prenatal Care. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds),CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. Manual Of Obstretics, 3/e By Daftary page 54", "role": "assistant" } ]

[ { "content": "The major initiating response for peristalsis is \nSelect and explain. \nA. Hormonal, B. Local stretching of gut, C. Neural, D. Gastric acid", "role": "user" }, { "content": "Answer: B \nExplanation: The major initiating response for peristalsis is local stretching of the gut. Peristalsis is a reflex that is initiated when the gut wall is stretched by the contents of the lumen. It occurs in all pas of the gastrointestinal tract from the esophagus to the rectum. The stretch initiates a circular contraction behind the stimulus and an area of relaxation in front of it. The wave of contraction then moves in an oral-to-caudal direction. This propels the contents of the lumen forward at rates that vary from 2 to 25 cm/s Ref: Ganong&;s Review of Medical Physiology 26th edition Pgno: 485", "role": "assistant" } ]

[ { "content": "Semicircular canal perceives ___________ \nSelect and explain. \nA. Linear acceleration, B. Angular acceleration, C. Both, D. None", "role": "user" }, { "content": "Answer: B \nExplanation: They respond to angular acceleration and deceleration. The three canals lie at right angles to each other but the one which lies at right angles to the axis of rotation is stimulated the most. Thus horizontal canal will respond maximum to rotation on the veical axis and so on. Due to this arrangement of the three canals in three different planes, any change in position of head can be detected.", "role": "assistant" } ]

[ { "content": "Fetal tachycardia is defined as heart rate more than___ \nSelect and explain. \nA. 140, B. 160, C. 180, D. 200", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B. 160. (Ref Williams obstetrics 20th/pg. 1428; Danforth9s obstetrics and gynecology - pg.157)Fetal bradycardia is defined as fetal heart rate <110 bpm; fetal tachycardia is defined as fetal heart rate >160 bpmThe normal FHR baseline ranges from 120 to 160 beats per minute.Foetal tachycardia is defined as a baseline heart rate greater than 160 bpm and is considered a nonreassuring pattern.Fetal Bradycardia is defined as an abnormally low baseline FHR (<110 beats per minute). Bradycardia is a baseline fetal heart rate under 120 beats/min that lasts 15 minutes or longer. Bradycardias are defined as 80 to 100 beats/min, and severe bradycardias are less than 80 beats/min,", "role": "assistant" } ]

[ { "content": "Angina pectoris and syncope are most likely to be associated with \nSelect and explain. \nA. Mitral stenosis, B. Aoic stenosis, C. Mitral regurgitation, D. Tricuspid stenosis", "role": "user" }, { "content": "Answer: B \nExplanation: Ref Harrison 19 th ed pg 1530 patients with pure or predominant AS have gradually increas- ing obstruction over years but do not become symptomatic until the sixth to eighth decades. Adult patients with BAV disease, however, develop significant valve dysfunction and symptoms one to two decades sooner. Exeional dyspnea, angina pectoris, and syncope are the three cardinal symptoms.", "role": "assistant" } ]

[ { "content": "Organ of coi is situated in ? \nSelect and explain. \nA. Basilar membrane, B. Utricle, C. Saccule, D. None of the above", "role": "user" }, { "content": "Answer: A \nExplanation: Scala media (cochlear duct or membranous labyrinth) has 3 walls : -i) The basilar membrane, which suppos the organ of coi.ii) The Reissner's membrane which separates it from the scala vestibuli.iii) The stria vascularis which contains vascular epithelium and is concerned with secretion of endolymph.", "role": "assistant" } ]

[ { "content": "All of the following statements are true regarding warfarin toxicity except \nSelect and explain. \nA. Skin necrosis occurs during initiation of therapy, B. Most common sites are toes and tips of fingers, C. Decreased quantity of protein C, D. Decreased incidence of adverse effects if therapy with LMWH is staed", "role": "user" }, { "content": "Answer: B \nExplanation: Refer Harrison 18/e p433 Common sites of warfarin -induced skin necrosis are breasts, thighs and buttocks", "role": "assistant" } ]

[ { "content": "Frequent blushing (\"erethism\") is associated with poisoning of \nSelect and explain. \nA. Mercury, B. Lead, C. Phenolic acid, D. Carbolic acid", "role": "user" }, { "content": "Answer: A \nExplanation: Mechanism of toxicity:Mercury reacts with sulfhydryl (SH) groups, resulting in enzyme inhibition and pathologic alteration of cellular membranes.Clinical presentation:Severe chemical pneumonitis and noncardiogenic pulmonary edema.Acute gingivostomatitis may also occur.Chronic intoxication:Classic triad Tremor Gingivostomatitis. Metallic tasteFrequent blushing (\"erethism\")Pain in the extremities, often accompanied by pinkish discoloration and desquamation (\"pink disease\")", "role": "assistant" } ]

[ { "content": "Excretory poion of kidney is formed by? \nSelect and explain. \nA. Urogenital sinus, B. Mullerian duct, C. Mesonephric duct, D. Genital tubercle", "role": "user" }, { "content": "Answer: C \nExplanation: DERIVATIVES OF MESONEPHRIC DUCT Both in Males and a Females Collecting tubules Minor and major calyces Pelvis Ureter Trigone of bladder In Males Epidydymis Vas derferens Seminal vesicles Mesoderm of prostate Ejaculatory duct In Females Ganers duct", "role": "assistant" } ]

[ { "content": "Fear of open spaces is: NIMHANS 07; Kerala 11 \nSelect and explain. \nA. Agoraphobia, B. Acrophobia, C. Claustrophobia, D. Algophobia", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. Agoraphobia", "role": "assistant" } ]

[ { "content": "Treatment of systemic or disseminated variant of sporotrichosis is \nSelect and explain. \nA. Itraconazole, B. Amphotericin-B, C. Griesofulvin, D. saturated solution of pottasium iodide", "role": "user" }, { "content": "Answer: B \nExplanation: Sporotrichosis:- Treatment:- : * Lymphocutaneous disease:- itraconazole, terbinafine, saturated solution of potassium iodide (SSKI) * Disseminated infection:- Amphotericin B (AMB). Ref:- Dermatology review by Asra Ali; pg num:-364", "role": "assistant" } ]

[ { "content": "Which is not a finding in viral encephalitis? \nSelect and explain. \nA. A strogl i a I proliferation, B. Perivascular mononuclear infiltrate, C. Inclusion bodies intranuclear and intracytoplasmic, D. None of the above", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Astroglial proliferation The pathologic Changes in viral encephalitis are : Parenchymal infiltrate chiefly in perivascular location, of mononuclear cells consisting of lymphocytes, plasma cells, macrophages. o Microscopic clusters of MICROGLIAL cells and presence of Neuronophagia. o Viral infection can lead to : - i) Intranuclear inclusions Herpes infection (Cowdry body 'A') ii) Cytoplasmic inclusions --> Rabies (Negri body) iii) Both intranuclear & --> Cytomegalovirus. cytoplasmic inclusions", "role": "assistant" } ]

[ { "content": "Oblique view in XRAY of hand is required for diagnosis of \nSelect and explain. \nA. Capitate, B. Scaphoid, C. Navicular, D. Hamate", "role": "user" }, { "content": "Answer: B \nExplanation: Oblique view of the wrist is required for scaphoid fracture * Most common fractured bone in the wrist * Peanut shaped bone that spans both row of carpal bones * Does not require excessive force and often not extremely painful so can be delayed presentation * Pain over the anatomic snuff box * Pain is not usually severe * Often present late Scaphoid Fracture Treatment * Cast 6-12 weeks * Sho arm vs. long arm * Follow patient every 2 weeks with x-ray * CT and clinical evaluation to determine healing * Consider screwing early Ref: Maheshwari and Mhaskar 9th ed pg 367.", "role": "assistant" } ]

[ { "content": "The pa of the broad ligament giving attachment and suppo to the uterine tube is the: \nSelect and explain. \nA. Mesometrium, B. Mesovarium, C. Mesosalpinx, D. Round ligament", "role": "user" }, { "content": "Answer: C \nExplanation: The mesosalpinx is the pa of broad ligament that suppos the uterine tube. The mesosalpinx extends inferiorly to meet the root of the mesovarium; it attaches the uterine tube to the mesometrium. The mesometrium is the pa of the broad ligament below the junction of the mesosalpinx and the mesovarium; it attaches the body of the uterus to the pelvic wall. The mesovarium is the pa of broad ligament that forms a shelf-like fold suppoing the ovary. It attaches the ovary to the mesometrium and mesosalpinx. The round ligament of the uterus is a connective tissue band that attaches the uterus to the inner aspect of the labium majus. It is found in the broad ligament, and it traverses the inguinal canal. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 38. Anatomy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.", "role": "assistant" } ]

[ { "content": "Koplik spot is pathognomic of which infection ? \nSelect and explain. \nA. Rubella, B. Influenza, C. Mumps, D. Measles", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Measles", "role": "assistant" } ]

[ { "content": "All the following are features of Anorexia Nervosa except : \nSelect and explain. \nA. Predominantly seen in females, B. BMI index is higher than normal Population, C. Amenorrhea is rare, D. Malabsorption Syndrome is most common cause", "role": "user" }, { "content": "Answer: C \nExplanation: Ans.is C (Amenorrhea is rare):Anorexia nervosa often referred to simply as anorexia, is an eating disorder, characterized by low weight, food restriction, fear of gaining weight, and a strong desire to be thin.Complications may include osteoporosis, infeility, and hea damage, among others. Women will often stop having menstrual periods.Amenorrhea is associated with almost a hundred percent of cases of Anorexia Nervosa.", "role": "assistant" } ]

[ { "content": "Most likely diagnosis ? \nSelect and explain. \nA. Interstitial lung disease, B. Pulmonary aery hypeension, C. Congestive hea failure, D. Bronchiectasis", "role": "user" }, { "content": "Answer: B \nExplanation: CT scan of chest showing enlarged pulmonary aeries In interstitial lung diseases HRCT shows bilateral subpleural reticular changes,with traction bronchiectasis and honeycombing(idiopathic pulmonary fibrosis).and varies according to cause of ILD. In bronchiectasis CT shows: tram tracts and signet ring sign.", "role": "assistant" } ]

[ { "content": "Most accepted theory for conduction of pain is \nSelect and explain. \nA. Gate control theory, B. Specifity theory, C. Membrane stabilization theory, D. None of the above", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Type II respiratory failure best relates to which of the following? \nSelect and explain. \nA. Alveolar hypoventilation, B. Alveolar flooding, C. Hypoperfusion of respiratory muscles, D. Lung atelectasis", "role": "user" }, { "content": "Answer: A \nExplanation: TYPE II RESPIRATORY FAILUREThis type of respiratory failure is a consequence of alveolar hypoventilation and results from the inability to eliminate carbon dioxide effectively. Mechanisms are categorized by Impaired central nervous system (CNS) drive to breathe (drug overdose, brainstem injury, sleep-disordered breathing, and severe hypothyroidism), Impaired strength with failure of neuromuscular function in the respiratory system. Reduced strength can be due to impaired neuromuscular transmission (e.g., myasthenia gravis, Guillain-Barre syndrome, amyotrophic lateral sclerosis) or respiratory muscle weakness (e.g., myopathy, electrolyte derangements, fatigue).Increased load(s) on the respiratory system. The overall load on the respiratory system can be subclassified into Resistive loads (e.g., bronchospasm), Loads due to reduced lung compliance (e.g., alveolar edema, atelectasis, intrinsic positive end-expiratory pressure --see below), Loads due to reduced chest wall compliance (e.g., pneumothorax, pleural effusion, abdominal distention), and ads due to increased minute ventilation requirements (e.g., pulmonary embolus with increased dead-space fraction, sepsis).Ref: Harrison 19e pg: 1732", "role": "assistant" } ]

[ { "content": "Muscle that does not arises from the common tendinous ring at the apex of orbit is? \nSelect and explain. \nA. Superior Oblique, B. Inferior oblique, C. Superior rectus, D. Inferior rectus", "role": "user" }, { "content": "Answer: B \nExplanation: The four recti arise from a common annular tendon or tendinous ring of zinn. This ring is attached to the orbital surface of the apex of the orbit. It encloses the optic canal and the middle pa of the superior orbital fissure.The lateral rectus has an additional small tendinous head which arises from the orbital surface of the greater wing of the sphenoid bone lateral to the tendinous ring. The inferior oblique arises from the orbital surface of the maxilla, lateral to the lacrimal groove. The muscle is situated near the anterior margin of the orbit. Refer BDC sixth edition volume 3 page no: 266 ,267 Refer table 17.2", "role": "assistant" } ]

[ { "content": "Which of glial cell is mesodermal in origin - \nSelect and explain. \nA. Macroglial cells, B. Microglial cells, C. Oligodendrocytes, D. Ependymal cells", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Microglial cellso Microglial cells are derived from mesenchymal (mesodermal) cells.Development of cells in CNSCells of originDeveloped mature cellsNeuroepithelial cellso Neuronso Glial cells (Macroglial cells)# Oligodendrocytes# Astrocytes# Ependymal cellsMesenchymal (mesodermal) cellso Microglial cells", "role": "assistant" } ]

[ { "content": "Which muscle is most resistant to neuromuscular blockage? \nSelect and explain. \nA. Diaphragm, B. Ocular, C. Adductor pollicis, D. Intercostal muscles", "role": "user" }, { "content": "Answer: A \nExplanation: ANSWER: (A) DiaphragmREF: Lee synopsis of anesthesia 13th e p. 182, Morgan 4th e p. 206-15Diaphragm is the most resistant muscle to muscle relaxants.", "role": "assistant" } ]

[ { "content": "Fibroid with a typical \"Lantern on top of St Paul's cathedral\" appearance is \nSelect and explain. \nA. Submucosal fibroid, B. subserosal fibroid, C. Cervical fibroid, D. Interstitial fibroid", "role": "user" }, { "content": "Answer: C \nExplanation: Cervical Fibroid is compared to \"Lantern on dome of st Paul's catherdral\".", "role": "assistant" } ]

[ { "content": "'Inveed fir tree' appearance is characteristic of? \nSelect and explain. \nA. Bacillus anthracis, B. Haemophilus influenza, C. Yersinia pestis, D. Brucella", "role": "user" }, { "content": "Answer: A \nExplanation: B anthracis has a tendency to form very long chains of rods and in culture it is nonmotile and nonhemolytic. Colonies are characterized by a rough, uneven surface with multiple curled extensions at the edge resembling a \"Medusa head.\" B anthracis has a D-glutamic acid polypeptide capsule of a single antigenic type that has antiphagocytic propeies. B anthracis endospores are extremely hardy and have been shown to survive in the environment for decades. On gelatin stab culture a characteristic inveed fir tree appearance is seen, with slow liquefaction commencing from top. Ref: Ray C.G., Ryan K.J. (2010). Chapter 26. Corynebacterium, Listeria, andBacillus. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.", "role": "assistant" } ]

[ { "content": "Ranula is a: March 2013 (a, d, e) \nSelect and explain. \nA. Retention cyst, B. Extravasation cyst, C. Edema of uvula, D. Edema of floor of mouth", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A i.e. Retention cystBailey & Love (Surgery) states that ranula is an extravasation cyst, but CSDT (Surgey), Dhingra (ENT) & even internet references describe it as retention cyst.", "role": "assistant" } ]

[ { "content": "Which cerebral layer is referred as \"Internal granule cell layer\"? \nSelect and explain. \nA. Layer/Lamina IV, B. Layer/Lamina V, C. Layer/Lamina VI, D. Layer/Lamina VII", "role": "user" }, { "content": "Answer: A \nExplanation: Layer/Lamina IV of cerebral coex. Layer/Lamina IV - \"Internal granule cell layer\" Contains predominately granule cells & nerve fibers. Specific sensory input through thalamocoical fibers terminate primarily in coical layer IV on stellate (granule cells). Diffuse non-specific sensory afferents are distributed through layer I-IV. OTHER LAYERS OF CEREBRAL COEX: Composed of 6 layers - Layer/Lamina I - \"Molecular layer\" Contains nerve fibers. Mainly dendrites of pyramidal cells & axons of granular cells. Layer/Lamina II - \"External granule cell layer\" Contains mainly granule cells. Layer/Lamina III - \"External pyramidal cell layer\" Contains mainly small to medium size pyramidal cells Some granular cells also present Layer/Lamina V - \"Internal pyramidal cell layer\" Contains large pyramidal cells. Descending tracts, i.e. projection fibers from coex (coicospinal tract, coicobulbar tract) are the axons of these pyramidal cells of Layer V Layer/Lamina VI - \"Multiform layer\" Contains all types of cells", "role": "assistant" } ]

[ { "content": "Periodic acid schiff stain shows Block positivity \nSelect and explain. \nA. Myeloblasts, B. Lymphoblasts, C. Monoblasts, D. Megakaryoblasts", "role": "user" }, { "content": "Answer: B \nExplanation: Lymphoblast contain cytoplasmic aggregates of periodic acid-schiff (PAS)-positive material.", "role": "assistant" } ]

[ { "content": "Pataus syndrome due to ? \nSelect and explain. \nA. Trisomy 21, B. Trisomy 18, C. 18 P, D. Trisomy 13", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Trisomy 13", "role": "assistant" } ]

[ { "content": "Which of the following inherited neutropenias show a self limited course? \nSelect and explain. \nA. Shwachman-Diamond syndrome, B. Dyskeratosis congenita, C. Chiediak higashi syndrome, D. Autoimmune neutropenia of infancy", "role": "user" }, { "content": "Answer: D \nExplanation: Answer- D. Autoimmune neutropenia of infancyIt is recognized as a fairly specific syndrome of early childhood.Low neutrophil numbers are often discovered during the course ofroutine investigation for benign febrile illness.The illness abates but the neutropenia persists, sometimes for months and occasionally for years.The prognosis is good and neutropenia is self-limited albeit protracted, and patients seldom develop serious bacterial infections.", "role": "assistant" } ]

[ { "content": "What is true about Salter-Harris type IV epiphyseal injury: \nSelect and explain. \nA. Fracture occur through growth plate only, B. Fracture occur through growth plate & metaphy- sis only, C. Fracture occur through growth plate, metaphysic & epiphysis, D. Fracture occur through epiphysis only", "role": "user" }, { "content": "Answer: C \nExplanation: Ans: C (Fracture occur through growth plate, metaphysic & epiphysis) SALTER~HARRIS FRACTURES http://wwwlbpt.bridgeport.edu/-gwl/salter-barrisdassification.htmThere are nine types of Salter-Harris fractures; types 1 to V as described by Robert B Salter and W Robert Harris in 1963, and the rarer types V! to IX which have been added subsequently:Type I - A transverse fracture through the growth plate (also referred to as the \"physis\"): 6% incidenceType II - A fracture through the growth plate and the metaphysis, sparing the epiphysis: 75% incidence, takes approximately 2-3 weeks to heal.Type III - A fracture through growth plate and epiphysis, sparing the metaphysis: 8% incidenceType IV - A fracture tb rough all three elements of the bone, tbegrowth plate, metaphysis, and epiphysis: 10% incidenceType V - A compression fracture of the growth plate (resulting in a decrease in the perceived space between theepiphysis and diaphysis on x-ray): 1% incidenceType VI -Injury to the peripheral portion of the physisand a resultant bony bridge formation which may produce an angular deformity (added in 1969 by Mercer Rang)Type VII - Isolated injury of the epiphyseal plate (VII--IX added in 1982 by JA Ogden)Type VIII - Isolated injury of the metaphysis with possible impairment of endochondral ossificationType IX - Injury of the periosteum which may impair intramem bra nous ossificationThe mnemonic \"SALTR\" can be used to help remember the first five types: This mnemonic requires the reader to imagine the bones as long bones, with the epiphyses at the base,I - S = Slip (separated or straight across), Fracture of the cartilage of the physis (growth plate)II - A = Above. The fracture lies above the physis, or Away from the joint.III - L = Lower. The fracture is below the physis in the epiphysis.IV - TE = Through Everything. The fracture is through the metaphysis, physis, and epiphysis.V - R = Rammed (crushed). The physis has been crushed, (alternatively SALTER can be used for the first 6 types - as above but adding Type Vr 'E' for Everything or Epiphysis and Type VI'R' for Ring)Fig: Types of Salter-Harris fractures", "role": "assistant" } ]