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[ { "content": "An attack of migraine can be easily terminated by: \nSelect and explain. \nA. Acetylcholine, B. Ergotamine, C. Morphine, D. Ibuprofen", "role": "user" }, { "content": "Answer: B \nExplanation: SPECIFIC ANTIMIGRAINE DRUGS\nErgotamine: It is the most effective ergot alkaloid for migraine. Given early in attack, lower doses generally suffice, and relief is often dramatic. However, when pain has become severe-larger doses are needed and control may be achieved only after few hours. Oral/sublingual route is preferred. 1 mg is given at half hour intervals till relief is obtained or a total of 6 mg is given. Parenteral administration, though rapid in action is more hazardous.\nErgotamine acts by constricting the dilated cranial vessels and/or by specific constriction of carotid A-V shunt channels. Ergotamine and DHE have also been shown to reduce neurogenic inflammation and leakage of plasma in duramater that occurs due to retrograde stimulation of periascular afferent nerves. These actions appear to be mediated through partial agonism at 5-HTID/IB receptors in and around cranial vessels.\nReference: Essentials of Medical Pharmacology Eighth Edition KD TRIPATHI page no 193​", "role": "assistant" } ]

[ { "content": "In trauma, which of the following is increased - \nSelect and explain. \nA. Epinephrine, B. ACTH, C. Glucagon, D. All", "role": "user" }, { "content": "Answer: D \nExplanation: Answer is 'a' i.e. Epinephrine; 'b' i.e. ACTH ; 'c' i.e. Glucagon As already mentioned in one of the previous questions, the neuroendocrine response to injury is an impoant pa of the stress response. The release of various hormones, creates an altered metabolic state which helps the individual to survive through the injury or the adverse circumstances. The neuroendocrine response begins with activation of the hypothalamic-pituitary-adrenal axis hypothalmic activation leads to - ADH (or vasopressin) release from the neurohypophysis epinephrine secretion from the adrenal medulla norepinephrine release from sympathetic nerve endings - CRH travels to adenohypophysis, stimualting ACTH production. ACTH acts on adrenal coex, producing coisol release (ACTH also stimulates release of aldosterone from the adrenal coex) About other hormones Insulin - hormones and inflammatory mediators associated with stress response inhibit insulin release. This is required to achieve the hyperglycemic state after injury. Glucagon - increased Aldosterone - increased Thyroid hormones : Thyroxine-no change; T3 - decreased 3 - increased Sex hormones - decreased", "role": "assistant" } ]

[ { "content": "A liver biopsy reveals following findings. What is true about this condition \nSelect and explain. \nA. Nodular regenerative hyperplasia of liver induced due to OCP, B. Nutmeg liver with dark areas of perivenular dead hepatocytes and gray areas of periportal viable hepatocytes, C. Nutmeg liver with pale areas of necrosis and dark congested areas of perivenular viable hepatocytes, D. Cirrhotic liver with fibrotic nodules.", "role": "user" }, { "content": "Answer: B \nExplanation: This is a classical picture of nutmeg liver seen in chronic passive venous congestion on the liver.\nThe dark congested areas consist of necrotic hepatocytes while the surrounding paler and brownish appearing regions are viable hepatocytes.\n\n\"The combination of hypoperfusion and retrograde congestion acts synergistically to cause centrilobular hemorrhagic necrosis.\nThe liver takes on a variegated mottled appearance, reflecting haemorrhage and necrosis in the centrilobular regions.\nThis finding is known as nutmeg liver due to its resemblance to the cut surface of a nutmeg. ”\n— Robbins 9/e p864 \n\nPassive Congestion and Centrilobular Necrosis Hepatic manifestations of systemic circulatory compromise-passive congestion & centrilobular necrosis can be seen in both left & right-sided heart failure.\nPathology\nRight-sided cardiac decompensation leads to passive congestion of the liver.\nThe liver is slightly enlarged, tense, and cyanotic, with rounded edges.\nMicroscopically there is congestion of centrilobular sinusoids.\nWith time, centrilobular hepatocytes become atrophic, resulting in markedly attenuated liver cell plates.\nLeft-sided cardiac failure or shock may lead to hepatic hypoperfusion & hypoxia, causing ischemic coagulative necrosis of hepatocytes in the central region of the lobule (centrilobular necrosis). Combination of hypoperfusion & retrograde congestion acts synergistically to cause centrilobular hemorrhagic necrosis.\nThe liver takes on a variegated mottled appearance, reflecting hemorrhage & necrosis in the centrilobular regions.\nThis finding is known as nutmeg liver due to its resemblance to the cut surface of a nutmeg.", "role": "assistant" } ]

[ { "content": "A patients complains of occasional vomiting of food paicles eaten a few days ago. His wife repos that his breath smells foul. The most likely diagnosis is ? \nSelect and explain. \nA. Pyloric obstruction, B. Carcinoma stomach, C. Carcinoma esophagus, D. Achalasia cardia", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Achalasia cardia", "role": "assistant" } ]

[ { "content": "An 80 year old male presents to OPD with c/o rapidly enlarging neck mass and Hoarseness of voice . He gives a history of untreated papillary carcinoma of thyroid . What would be the likely diagnosis? \nSelect and explain. \nA. Medullary thyroid cancer, B. Huhle cell carcinoma, C. Papillary thyroid cancer, D. Anaplastic thyroid cancer", "role": "user" }, { "content": "Answer: D \nExplanation: Anaplastic carcinoma - Seen in 7th-8th decade -C/F Sudden increase in the size of swelling Severe pain over the swelling Most common route of spread- Direct invasion Evidence of compression of Trachea - Dyspnea Esophagus - Dysphagia Recurrent laryngeal nerve - Hoarseness of voice Most common site of metastasis - Lungs - Investigations IOC for Diagnosis- FNAC - Treatment For resectable tumor - Total thyroidectomy For unresectable tumor - Tracheostomy (lifesaving procedure when tumor is obstructing trachea) - Poor prognosis.", "role": "assistant" } ]

[ { "content": "Grooves, which are present in gum pads between the\ncanine and the 1st molars and relates the upper and\nlower gum pads are called as \nSelect and explain. \nA. Gingival groove, B. dental groove, C. Vestibular sulcus, D. lateral sulcus", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "True statement about Korsakoff's psychosis is - \nSelect and explain. \nA. Severe antegrade + Mild retrograde memory defect, B. Mild antegrade + severe retrograde memory defect, C. Only antegrade memory defect, D. Only retrograde memory defect", "role": "user" }, { "content": "Answer: A \nExplanation: Korsakoff syndrome has sever antegrade amnesia and less severe retrograde amnesia.", "role": "assistant" } ]

[ { "content": "Which of the following acts by inhibition of 30 S ribosome - \nSelect and explain. \nA. Tetracycline, B. Chloramphenical, C. Erythromycin, D. Penicillin", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., Tetracycline", "role": "assistant" } ]

[ { "content": "Male comes with acute scrotal pain. To differentiate between testicular torsion and epididymo-orchitis which is the best way \nSelect and explain. \nA. Angel sign, B. Prehn sign, C. Color Doppler, D. MRI", "role": "user" }, { "content": "Answer: C \nExplanation: Angel sign and prehn sign are not reliable.color Doppler is investigation of choice", "role": "assistant" } ]

[ { "content": "NaF preservative is added in suspected cases of poisoning by ? \nSelect and explain. \nA. Cocaine, B. Alcohol, C. Cyanide, D. All the above", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Alcohol", "role": "assistant" } ]

[ { "content": "All are true about Erlotinib except : \nSelect and explain. \nA. Used in non small cell carcinoma of lung, B. It is a small molecule tyrosine kinase inhibitor acting as EGFR antagonist, C. Food decreases absorption, D. It causes skin rashes and diarrhea", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "V asomotor eentre of medulla is associated with: \nSelect and explain. \nA. Acts with the cardiovagal centre to maintain BP, B. Independent of corticohypothalamic inputs, C. Influenced by baroreceptors not chemoreceptors, D. Essentially silent in sleep", "role": "user" }, { "content": "Answer: A \nExplanation: Ans, a. Acts with the cardiovagal centre to maintain BPVasomotor centre (VMC) controlling sympathetic outflow acts along with cardiovagal centre (CVC) controlling parasympathetic out flow to maintain blood pressure.\"Vasomotor centre (VMC) controlling sympathetic outflow acts along with cardiovagal centre (CVC) controlling parasympathetic out flow to maintain blood pressure. Baroreceptors, chemoreceptors and cortico hypothalamic inputs influence VMCG. Baroreceptors are tonically active stretch receptors located in walls of aortic arch and carotid sinus. Discharge from baroreceptors cause inhibition of Cl neurons of vasomotor center (VMC) situated in upper (rostral) half of ventrolateral medullaQ andfacilitation of cardiovagal centre (CVC) or nucleus ambiguous. \"Medullary Centres regulating Blood PressureVasomotor Centre (VMC)Cardiovagal Centre (CVC)* Collection of glutaminergic neurons in superficial medullary reticular formation, known as C1 neurons, serves as pressure area of VMC. Cell bodies of C1 cells lie in ventrolateral region of upper half of medulla.* These neurons are spontaneously active day and night, tonically discharging impulses (in rhythmic manner) to the heart and blood vessels through lateral reticulospinal tract* It refers to nucleus ambiguous which lies lateral to VMC (medullary reticular neurons)* It receives afferents via Nucleus tractus solitaries (NTS) and in turn sends parasympathetic impulses to heart via the vagus, so named cardiovagal centre* The neurons in CVC do not discharge rhythmically (i.e. are not tonically active) Medullary Centres regulating Blood PressureVasomotor Centre (VMC)Cardiovagal Centre (CVC)* These reticulospinal tracts synapse with preganglionic neurons of sympathetic nervous system located in intermediolateral grey column of spinal cord (thoraoo lumbar sympathetic out flow)* Post ganglionic sympathetic neuron secrete nor adrenaline thereby increasing sympathetic activity and causing tonic vasoconstrictor and cardio accelerator activity resulting in:* The discharge increases parasympathetic activity there by resulting in: * Vasodilation* BP* Cardiac output* Heart rate * Vasoconstriction* BP* Cardiac output* Stroke volume", "role": "assistant" } ]

[ { "content": "Usual time for symptoms to appear in Rabid animal - \nSelect and explain. \nA. 2 days, B. 7 days, C. 10 days, D. 1 month", "role": "user" }, { "content": "Answer: C \nExplanation: Post exposure prophylaxis may be discontinued if the suspected animal is proved by appropriate laboratory examination to be free of rabies or in the case of domestic dogs, cats or ferrets, the animal remains healthy throughout a 10 day observation period staing from the date of bite Reference ; Park&;s Textbook of preventive and social medicine,24th edition.Pg no. 297", "role": "assistant" } ]

[ { "content": "The diagnostic characteristics of Plasmodium falciparum are best described by which one of the following statements? \nSelect and explain. \nA. An impoant diagnostic feature is the irregular appearance of the edges of the infected RBC., B. A period of 72 hours is required for the development of the mature schizont, which resembles a rosette with only 8 to 10 oval merozoites., C. Except in infections with very high parasitemia, only ring forms of early trophozoites and the gametocytes are seen in the peripheral blood., D. Schuffner stippling is routinely seen in RBC's that harbor parasites.", "role": "user" }, { "content": "Answer: C \nExplanation: P. Falciparum infection Distinguished by the appearance of ring forms of early trophozoites and gametocytes, both of which can be found in the peripheral blood. The size of the RBC is usually normal.Double chromatin dots in the rings are common. Schuffner stippling is routinely seen in RBC's that harbor P.vivax.", "role": "assistant" } ]

[ { "content": "Hypercalcemia is seen in which cancer \nSelect and explain. \nA. RCC, B. Carcinoma stomach, C. Small cell carcinoma lung, D. Hepatocellular carcinoma", "role": "user" }, { "content": "Answer: A \nExplanation: Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.695 CLINICAL FEATURES. Renal cell carcinoma is generally a slow-growing tumour and the tumour may have been present for years before it is detected. The classical clinical evidence for diagnosis of renal cell carcinoma is the triad of gross haematuria, flank plain and palpable abdominal mass. The most common presenting abnormality is haematuria that occurs in about 60% of cases. By the time the tumour is detected, it has spread to distant sites haematogenous route to the lungs, brain and bone, and locally to the liver and perirenal lymph nodes. Systemic symptoms of fatiguability, weight loss, cachexia and intermittent fever unassociated with evidence of infection are found in many cases at presentation. A number of paraneoplastic syndromes due to ectopic hormone production by the renal cell carcinoma have been described. These include polycythaemia (by erythropoietin), hypercalcaemia (by parathyroid hormone and prostaglandins), hypeension (by renin), effects of feminisation or masculinisation (by gonadotropins) and Cushing's syndrome (by glucocoicoids).", "role": "assistant" } ]

[ { "content": "Which is the only nearly pure metal used for dental casting purposes? \nSelect and explain. \nA. Gold, B. Palladium, C. Silver, D. Pure titanium CP Ti", "role": "user" }, { "content": "Answer: D \nExplanation: CP titanium, which is classified in four different grades, can technically be considered as an alloy because small percentages of other impurity elements are allowed as specified by a standard that has been established by the American Society for Testing and Materials (ASTM) for each grade. Although it is classified as commercially pure, grade 2 CP-Ti may contain up to 0.10% C, 0.30% Fe, 0.015% H, 0.03% N, 0.25% O, and 0.40% of other elements.\nPhillips 12th edition page 71", "role": "assistant" } ]

[ { "content": "Drug used in triple drug therapy of H. Pylori: \nSelect and explain. \nA. Metronidazole, B. Erythromycin, C. Ciprofloxacin, D. Aminoglycosides", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A. MetronidazoleH pylori have triple and 4 drug therapy for H. Pylori where 4 antibiotics can be given like amoxicillin, clarithromycin, Metronidazole and tetracycline. Other drugs are PPI like omeprazole and bismuth sub citrate.", "role": "assistant" } ]

[ { "content": "Selective serotonin reuptake inhibitors are drugs of choice for all of the following conditions except: \nSelect and explain. \nA. Acute panic attack, B. Social phobia, C. Post traumatic stress disorder, D. Generalized anxiety disorder", "role": "user" }, { "content": "Answer: A \nExplanation: Ref: KDT 6/e p448,449 *SSRIs are drug of choice for depression,sustained treatment of panic disorder and generalized anxiety disorder, obsessive compulsive disorder, post-traumatic stress disorder, social and other phobia and bulimia. *In acute panic attacks and for acute treatment of generalized anxiety disorder, benzodiazepines are preferred.", "role": "assistant" } ]

[ { "content": "Complete regression of which of the following veins causes this anomaly in the development of IVC (Figure). \nSelect and explain. \nA. Right vitelline vein, B. Left vitelline vein, C. Right supra-cardinal vein, D. Left supra-cardinal vein", "role": "user" }, { "content": "Answer: C \nExplanation: Ans: (c) Right supra-cardinal veinRef: Essentials of Human Embryology, A.K.Datta, 5th edition, 2005, Page 205-208 4The anomaly shown in picture is Retrocaval ureter (right ureter) passes at first behind the IVC, and then appears in front of it after winding the medial margin of IVC.Retrocaval ureter occurs when the post-renal segment of the IVC is developed from the right posterior cardinal vein and the right supra-cardinal vein regress entirely.Development of IVCIVC developed from the following sources from below upwards1. Persistent caudal part of the right posterior cardinal vein2. Right supra-cardinal vein (this part receives 3rd and 4th pairs of lumbar veins)3. Anastomosis between right supra-cardinal and right sub-cardinal veins (this part receives the right gonadal vein).4. Upper part of the right sub-cardinal vein (this part receives both renal veins and right supra-renal vein).5. A new vessel grows dorsal to the liver and communicates the right sub-cardinal vein with the common hepatic vein (intrahepatic part of IVC).6. Common hepatic vein-which is developed from the suprahepatic part of the right vitelline vein (terminal part of IVC).Anomalies of IVC1. Double IVC - IVC persist on both sides below the level of renal veins. This occurs when the left common iliac vein fails to develop and the infra-renal segment of the left supra-cardinal vein fails to regress.2. Retro-caval ureter (as explained earlier).", "role": "assistant" } ]

[ { "content": "Compute the median for the following set of data, 1,2,3,4,5,6: \nSelect and explain. \nA. 3, B. 3.5, C. 4, D. 4.5", "role": "user" }, { "content": "Answer: B \nExplanation: If the number of samples is an even number, the median is midway between the two middle scores. (3+4)/2=3.5 Ref : Medical biostatistics, 1st edition pg: 111", "role": "assistant" } ]

[ { "content": "A 50-years-old male Raju, presents with occasional dysphagia for solids, regurgitation of food and foul smelling breath. Probable diagnosis is: \nSelect and explain. \nA. Achalasia cardia, B. Zenker's diveiculum, C. CA esophagus, D. Diabetic gastroparesis", "role": "user" }, { "content": "Answer: B \nExplanation: Clinical feature Usually seen in patients over 50 years MC symptom is dysphagia Undigested food is regurgitated into the mouth, especially when the patient is in the recumbent position Swelling of the neck, gurgling noise after eating, halitosis, and a sour metallic taste in the mouth are common symptoms Cervical webs are seen associated in 50% of patients with Zenker's diveicula, can cause dysphagia post-operatively if not treated.", "role": "assistant" } ]

[ { "content": "Which of the following is not seen in pseudogout \nSelect and explain. \nA. Small joints affected, B. Large joints affected, C. Chondrocalcinosis, D. Deposition of calcium pyrophosphate", "role": "user" }, { "content": "Answer: A \nExplanation: Small joints affected Pseudogout commonly involves the larger joints.Knee joint is most commonly involved; other sites are wrist, elbow, shoulder, ankele. Involvement of small joints is uncommon. Pseudogout It is one of the forms of \"Calcium pyrophosphate dehydrate\" (CPPD) ahropathy Age group is > 60 yrs. In CPPD ahropathy, CPPD deposition occurs in aicular tissues. It can present in any of the following three forms 1)Asympatoinatic chonclrocalcinosis 2)Acute synovitis - Pseudogout 3)Chronic pyrophosphate ahropathy The radiologic hallmark of CPPD is \"Chondrocalcinosis\" Chondrocalcinosis is seen as punctate and/or linear radiodense deposits in fibroc:ailaginous joint menisci or aicular hyaline cailage. Definitive diagnosis is made by synol fluid polarised light microscopy which shows weakly positive, birefringent, rhomboid crystals of CPPD. In acute synovitis form, leucocytosis (thousands to 1 lac cells/g1) is seen in synol fluid examination. It may be associated with ceain underlying disease such as ? - Primary hyperparathyroidism - Hemochromatosis - Hypomagnesemia - Hypophosphatasia - Hypothyroidism Pseudogout can be differentiated from gout as follows - Gout Pseudogout Smaller joints Large joints Intense pain Moderate pain Joint inflammed Swollen joint Hyperuricemia Chondrocalcinosis Uric acid crystals Calcium pyrophosphate dehydrate crystal Treatment The treatment of pseudogout is the same as that of acute gout: rest and high dose anti-inflammatory therapy. In elderly patients, joint aspiration and infra-aicular caicosteroid injection is the treatment of choice as these patients are more vulnerable to the side effects of NSAIDs. Urate lowering therapy is ineffective in CPPD", "role": "assistant" } ]

[ { "content": "The neurosurgeon had removed a portion of the dense tissue (dura mater) covering the brain of the patient when she removed the tumor that had invaded the skull. To replace this important tissue covering of the brain, she took a band of the aponeurotic tissue of the lateral aspect of the thigh, covering the vastus lateralis muscle. What muscle, supplied by the inferior gluteal nerve, inserts into this band of dense tissue as part of its insertion? \nSelect and explain. \nA. Gluteus medius, B. Gluteus minimus, C. Gluteus maximus, D. Tensor fasciae latae", "role": "user" }, { "content": "Answer: C \nExplanation: The tensor fasciae latae (which is innervated by the superior gluteal nerve) and the iliotibial tract are dense, wide aponeurosis that receives the insertion of the tensor fasciae latae and about 75% of the gluteus maximus. The gluteus maximus is the only one of the muscles listed that is supplied by the inferior gluteal nerve; in fact, it is the only muscle innervated by the inferior gluteal nerve. Gluteus medius and minimus insert on the greater trochanter and are innervated by the superior gluteal nerve. The rectus femoris, supplied by the femoral nerve, inserts via the quadriceps tendon on the patella and tibial tuberosity.", "role": "assistant" } ]

[ { "content": "The potentially hazardous irrigant causing an emergency during treatment is \nSelect and explain. \nA. Saliva, B. Chlorhexidine, C. Sodium Hypochlorite, D. Metrogyl", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "Which of the following does not supply the palate- \nSelect and explain. \nA. Tonsilar branch of facial artery, B. Ascending palatine artery, C. Descending palatine artery, D. Ascending pharyngeal artery", "role": "user" }, { "content": "Answer: A \nExplanation: Blood supply of soft palate \n\nArterial supply of soft palate is as follows:-\n\n\nGreater palatine branch of the descending palatine artery, which in turn is a branch of the maxillary artery.\nAscending palatine branch of the facial artery.\nPalatine branch of ascending pharyngeal artery.\nLesser palatine artery a branch of descending palatine artery, which is a branch of the maxillary artery.", "role": "assistant" } ]

[ { "content": "Millard's 'Rule of Ten' includes all except - \nSelect and explain. \nA. 10 lbs, B. 10 weeks, C. 10 gm % Hemoglobin, D. 10 months", "role": "user" }, { "content": "Answer: D \nExplanation: Ans- D Rule often is the criteria used to judge the \"readiness\" of an infant for surgical repair of a cleft lip. The infant must weigh 10 Ib; be 10 weeks old; have a hemoglobin value of 10gm/dl and have a WBC count < 10,000.", "role": "assistant" } ]

[ { "content": "Which is the preferred incision for abdominal exploration in blunt abdominal injury ? \nSelect and explain. \nA. Transverse incision, B. Paramedian incision, C. Always midline incision, D. Depending upon the organ", "role": "user" }, { "content": "Answer: C \nExplanation: The preferred incision for emergency abdominal exploration in blunt injury abdomen is midline laparotomy. This type of incision is preferred as it provides adequate exposure, associated with minimal blood loss, minimal nerve and muscle injury. Ref: Current Surgical Diagnosis & Treatment, 12th Edition, By Gerard M. Dohey, Page 230,31; Bailey and Love's Sho practice of surgery , 24th Edition, Page 288", "role": "assistant" } ]

[ { "content": "Molten wax appearance is seen in \nSelect and explain. \nA. Achondroplasia, B. Pseudogout, C. Melorheostosis, D. Osteopetrosis", "role": "user" }, { "content": "Answer: C \nExplanation: Motten wax or Flowing candle wax appearance feature of Melorheostosis.", "role": "assistant" } ]

[ { "content": "Golden hour of fracture femur is? \nSelect and explain. \nA. 1 hr after injury, B. 1 hr prior to injury, C. 1 hr after reaching the hospital, D. 1 hr after surgical procedure", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., 1 hr after injury Golden Hour It is the first hour from the time of trauma. It is the most critical for life and for the limb bility following fracture femur. Best prognosis is for the patients with fracture femur are for those who reach the OR in the golden hour. The emergency medical team should not take more than 10 minutes from the time of trauma in patients with fracture femur to decide and sta shifting the patient. This is described as \"Platinum Ten\". Thus, Golden hour -1 hour from the time of injury. Platinum hour - ten minutes from the time of injury.", "role": "assistant" } ]

[ { "content": "Most common malignancy in AIDS is: March 2011 \nSelect and explain. \nA. Kaposi sarcoma, B. Hodgkins lymphoma, C. Leukemia, D. Multiple myeloma", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. A: Kaposi sarcoma The neoplastic diseases clearly seen with an increased frequency in patients with HIV infection are Kaposi sarcoma and non-Hodgkin's lymphoma", "role": "assistant" } ]

[ { "content": "RCH phase 2 does not include \nSelect and explain. \nA. Immunization of pregnant women, B. Treatment of STD/RTI, C. Early registration of pregnancy upto 12-16 weeks, D. Feed to malnourished children", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "Brachytherapy is used in : \nSelect and explain. \nA. Stage lb Ca cervix, B. Ovarian Ca, C. Stage IV Ca vagina, D. Stage 11 fallopian tube Ca", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is a i.e. Stage lb Ca cervix Radiotherapy is recommended in advanced stages of Ca cervix i.e. stage IIB onwards.deg Brachytherapy is commonly used. For larger tumours initially external radiation then brachytherapy is given In small tumours brachytherapy is given first followed by external radiation. For stage IB and IIA - both surgery and radiotherapy yield similar results. There is very little scope of radiotherapy in ovary tumors. Only Granulosa cell tumour and dysgerminoma are radiosensitive and external radiotherapy is instituted for elderly woman. Vaginal Squamous cell Ca is only moderately sensitive to irradiation. In all advanced cases exenteration operation is done. Fallopian tube carcinoma -Total hysterectomy with Bilateral Salpingo-oophorectomy along with omentectomy followed by external pelvic radiation is the Treatment of Choice in Ca of Fallopian Tube.", "role": "assistant" } ]

[ { "content": "Child begins to sit with suppo, able to transfer objects from one hand to another hand and speak monosyllabic babbles at the age of - \nSelect and explain. \nA. 3 months, B. 6 months, C. 9 months, D. 12 months", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., 6 months", "role": "assistant" } ]

[ { "content": "Maximum increase in prolactin level is caused by:- \nSelect and explain. \nA. Risperidone, B. Clozapine, C. Olanzapine, D. Aripiprazole", "role": "user" }, { "content": "Answer: A \nExplanation: Prolactin is inhibited by dopamine, so, any drug which blocks D2 recptor will lead to increase in prolactin. Anti-psychotics are D2 blocking drugs. They are of two types: * Typical anti-psychotic drug are amily D2 blocker. * Atypical anti-psychotics are mainly 5HT2 blocker but among them the maximum D2 blocking action is caused by Resperidone. So, Resperidone has the maximum chance of causing hyerprolactinema and also the maximum chance of causing EPS(Extra pyramidal symptoms) among the atypical anti-psychotics. Clozapine and Olanzapine are 5HT2 and D2 blocker. Aripiprazole is D2 paial agonist so, no chances of hyper-prolactinemia.", "role": "assistant" } ]

[ { "content": "Ramkali bai, a 35-year-old female presented with a one-year history of menstrual irregularity and galactorrhoea. She also had off and on headache, her examination revealed bitemporal superior quadrantanopia. Her fundus examination showed primary optic atrophy. Which of the following is a most likely diagnosis in this case - \nSelect and explain. \nA. Craniopharyngioma, B. Pituitary macroadenoma, C. Ophthalamic IcA Aneurysm, D. Chiasmal Glioma", "role": "user" }, { "content": "Answer: B \nExplanation: A 35 year old woman complaining of amenorrhoea — galactorrhoea syndrome along with visual field defects confirms the diagnosis of pituitary macrodenoma (prolactinoma)\nAmenorrhoea and galactorrhoea results due to increased secretion of prolactin.\nHeadache and visual field defects are seen due to mass effect of the tumours on the optic nerve.\n\nNow, the closest d/d of prolactinoma i.e. craniopharyngioma\n\nBimodal age of incidence with one peak in childhood and the other in old age at 60 years.\nThese tumours are suprasellar in location and the symptoms are produced due to mass effect of tumour either on the pituitary or optic chiasm. (It does not secrete any hormone)\n​\"Craniopharyngioma will never produce the Amenorrhoea galactorrhoea syndrome. Craniopharyngioma does not secrete any hormone.\"\n\n​", "role": "assistant" } ]

[ { "content": "A young female patient with long history of sinusitis presented with frequent fever along with personality changes and headache of recent origin. The fundus examination revealed papilledema. The most likely diagnosis is - \nSelect and explain. \nA. Frontal lobe abscess, B. Meningitis, C. Encephalitis, D. Frontal bone osteomyelitis", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Ceain sign of onset of labor: March 2013 \nSelect and explain. \nA. Labor pains, B. Show, C. Dilatation of internal os, D. Formation of bag of waters", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. D i.e. Formation of bag of waters The first symptom to appear is intermittent painful uterine contractions followed by expulsion of blood stained mucus (show) per vaginum But formation of 'bag of membranes' is almost a ceain sign of onset of labor", "role": "assistant" } ]

[ { "content": "Linear accelerator produces? \nSelect and explain. \nA. X rays, B. Beta rays, C. Gamma rays, D. Neutrons", "role": "user" }, { "content": "Answer: A \nExplanation: ANSWER: (A) X raysREF: Oxford oncology 2nd edition page 398, O P Tondon's Inorganic chemistryRepeat from December 2009Linear accelerator and Betatron are used to produce X Rays by accelerating electronsCyclotron is used to produce Gamma rays.", "role": "assistant" } ]

[ { "content": "During normal inspiration diaphragm goes down by? \nSelect and explain. \nA. 1-2 cm, B. 3-5 cm, C. 5-7 cm, D. 7-9 cm", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. is 'a' i.e., 1-2 cmIn normal inspiration, the diaphragm descends 1-2 cm into the abdominal cavity producing a pressure difference of 1-3 mm hg and the inhalation of about 500 ml of air.", "role": "assistant" } ]

[ { "content": "Gene therapy is most commonly targeted against: \nSelect and explain. \nA. SCID, B. cancer, C. cystic fibrosis, D. Leukemia", "role": "user" }, { "content": "Answer: A \nExplanation: a. SCID(Ref: Nelson's 20/e p 584-586)FDA-approved gene therapy is used for ADA-SCID, Leber's congenital amaurosis, multiple myeloma & Adrenoleukodystrophy", "role": "assistant" } ]

[ { "content": "A 50 years old male with type 2 diabetes mellitus is found to have 24-hour urinary albumin of 250 mg. Which of the following drugs may be used to retard progression of the renal disease? \nSelect and explain. \nA. Hydrochlorothiazide, B. Enalapril, C. Amiloride, D. Aspirin", "role": "user" }, { "content": "Answer: B \nExplanation: Antihypeensive drugs in Diabetes MellitusACE inhibitors (enalapril) or angiotensin receptor blockers are the first line of therapy in hypeensive individuals with type 2 DM.They have no known adverse action on glucose or lipid metabolism.Minimize the development of diabetic nephropathy (by reducing renal vascular resistance and renal perfusion pressure-the primary factor underlying renal deterioration in these patients).(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2054-2058)", "role": "assistant" } ]

[ { "content": "Teeth bite marks are a type of: March 2011 \nSelect and explain. \nA. Contusion, B. Pressure abrasion, C. Graze, D. Linear abrasion", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B: Pressure Abrasion Teeth marks in biting and ligature marks in hanging and strangulation are example of imprint, pressure or contact abrasion Abrasion It as also known as - Graze or Scratch or Impression. An abrasion is a superficial injury to the skin which involves the loss of superficial epithelial layer (Uppermost layers of the cells of skin) of skin. Abrasions are produced by ? - Blow - Fall on some rough and hard substance - Dragging as in vehicular accidents. - Scratching with finger nails, bites and thorns etc. - Friction on some hard substance. Pressure of rope or cord as is found in strangulation and hanging etc. - Rubbing. - Indenting of the objects. Varieties of Abrasions Scratches- They are due to a sharp or a pointed object pressing across the skin, moving the surface layers in front of it and causing the heaping up of layers of skin. Grazes- They are modified scratches. - In this, the broader surface of skin comes in contact with the uneven rough object. - In this, the depth may vary at different places. - The direction is indicated by presence of clean commencement and tag at the finishing end. Impact Abrasions/Pressure Abrasions - They are also known as \"Imprint abrasions\". - They are caused by the stamping of some object against the skin like radiators of cars in vehicular accidents or - They may be caused by pressure on the skin which is accompanied by movements as found in? Ligature in cases of hanging or strangulation. Injuries caused by lashes with whip Sites of Abrasions ? The abrasions resulting from friction against rough surface during a fall are generally found on the bony pas and are accompanied with contusions or lacerations The abrasions caused by finger nails are seen on the exposed of body like - Face near forearm, hands, thighs etc. They are cresentric in shape, when finger nails are used. Ecchymosis is a common accompaniment. The abrasions caused by teeth bite are elliptical or circular in shape and often present separate marks. Typical impression of teeth by different sets of teeth (Deciduous or permanent) is marked. The intervening area is only a bruised area. The abrasions from radiators are honey-comb in appearance and are .commonly found in vehicular accidents Difference between Antemoem and Postmoem Bruise Antemoem abrasions will show signs of inflammation and repair whereas these will be absent in postmoem abrasions.", "role": "assistant" } ]

[ { "content": "Drug (s) used in the treatment of multiple myeloma is/are- \nSelect and explain. \nA. Boezomib, B. Methotrexate, C. Hydroxyurea, D. Ketoconazole", "role": "user" }, { "content": "Answer: A \nExplanation: Drugs used as first line treatment of multiple myeloma include boezomib(proteasome inhibitor) & thalidomide( anti- angiogenic effects against tumour blood vessels & immunomodulatory effects).Reference :Davidson's principles &practice of medicine 22nd edition pg no 1047.", "role": "assistant" } ]

[ { "content": "The following can be associated with fatty liver except - \nSelect and explain. \nA. Amiodarone, B. Zidovudine, C. Sodium valproate, D. Chlorpropamide", "role": "user" }, { "content": "Answer: D \nExplanation: Amiodarone-induced liver damage may present as Reye's syndrome in kids and may present as asymptomatic elevation of liver enzymes in adults. Asymptomatic liver enzyme elevation occurs in 25% of the population treated with amiodarone and is usually reversible upon discontinuation of therapy zidovudine-induced myopathy and hepatotoxicity in patients Valproic acid may cause serious or life-threatening damage to the liver that is most likely to occur within the first 6 months of therapy Chlorpropamide doesn't cause fatty liver Ref Davidson edition23rd pg774", "role": "assistant" } ]

[ { "content": "Immunostimulant used for the treatment of malignant melanoma is : \nSelect and explain. \nA. Levamisole, B. BCG, C. Aldesleukin, D. Methotrexate", "role": "user" }, { "content": "Answer: C \nExplanation: It is a recombinant IL-2 used for the treatment of renal cell carcinoma and malignant melanoma.", "role": "assistant" } ]

[ { "content": "An advanced diagnostic technique which has been suggested as an alternative to culture methods is: \nSelect and explain. \nA. Phase contrast microscopy, B. Direct immunofluorescence, C. Latex agglutination, D. Indirect immonofluorescent microscope assays", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "Nucleosome consist of \nSelect and explain. \nA. Histone, B. DNA, C. RNA, D. DNA & RNA both", "role": "user" }, { "content": "Answer: A \nExplanation: A nucleosome is a basic unit of DNA packaging in eukaryotes, consisting of a segment of DNA wound in sequence around eight histone protein cores. This structure is often compared to thread wrapped around a spool. Nucleosomes form the fundamental repeating units of eukaryotic chromatin, which is used to pack the large eukaryotic genomes into the nucleus while still ensuring appropriate access to it (in mammalian cells approximately 2 m of linear DNA have to be packed into a nucleus of roughly 10 um diameter). Nucleosomes are folded through a series of successively higher order structures to eventually form a chromosome; this both compacts DNA and creates an added layer of regulatory control, which ensures correct gene expression. Nucleosomes are thought to carry epigenetically inherited information in the form of covalent modifications of their core histones.", "role": "assistant" } ]

[ { "content": "Niacin deficiency causes all except \nSelect and explain. \nA. Dermatitis, B. Dactylitis, C. Diarrhea, D. Dementia", "role": "user" }, { "content": "Answer: B \nExplanation: The classic triad of pellagra is dermatitis, diarrhea, and dementia. Ref: Page 182; Nelson textbook of pediatrics; 17th edition", "role": "assistant" } ]

[ { "content": "Larynx extends from - \nSelect and explain. \nA. C2 - C7, B. Cl - C4, C. C5 - C6, D. C3 - C6", "role": "user" }, { "content": "Answer: D \nExplanation: The larynx is situated in front of hypopharynx opposite third to sixth cervical vertebrae.", "role": "assistant" } ]

[ { "content": "Apple jelly nodules on the nasal septum are found in cases of ? \nSelect and explain. \nA. Tuberculosis, B. Syphilis, C. Lupus Vulgaris, D. Rhinoscleroma", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Lupus vulgaris Lupus vulgaris It is an indolent and chronic form of tuberculous infection. Female to male ratio is 2:1. Most common site is the mucocutaneous junction of the nasal septum, the nasal, vestibule and the ala. Characteristic Feature is the presence of apple- jelly nodules (Brown gelatinous nodules) in skin. Lupus can cause perforation of cailaginous pa of nasal septum. Confirmation is by Biopsy", "role": "assistant" } ]

[ { "content": "The best investigation to diagnose a case of acoustic neuroma is – \nSelect and explain. \nA. Gadolinium enhanced MRI, B. CT scan, C. Audiometric analysis, D. PET scan", "role": "user" }, { "content": "Answer: A \nExplanation: None", "role": "assistant" } ]

[ { "content": "For clinically detectable ascites, the minimal amount of fluid should be \nSelect and explain. \nA. 300 cc, B. 600 cc, C. 1 litre, D. 2 litre", "role": "user" }, { "content": "Answer: A \nExplanation: This is a direct pick from National Boards.", "role": "assistant" } ]

[ { "content": "Which statements is not true regarding acute starvation? \nSelect and explain. \nA. Increased Lipolysis, B. Increased gluconeogenesis in liver, C. Only ketone bodies utilized by brain for energy, D. Increased glycogenolysis in liver", "role": "user" }, { "content": "Answer: C \nExplanation: In starvation: Increased Lipolysis Increased gluconeogenesis in liver andIncreased glycogenolysis in liverIn fasting and starvation, glucose must be provided for the brain and red blood cells; in the early fasting state, this is supplied from glycogen reserves.In order to spare glucose, muscle and other tissues do not take up glucose when insulin secretion is low; they utilize fatty acids (and later ketone bodies) as their preferred fuelRef: Harper 27e pg: 149", "role": "assistant" } ]

[ { "content": "Which of the following is a diagnosis? \nSelect and explain. \nA. Klatskin tumor, B. Carolicyts, C. Bryler disease, D. Primary sclerosing cholangitis", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. (a) Klatskin tumor.Imagesource- style=\"font-family: Times New Roman, Times, serif\">", "role": "assistant" } ]

[ { "content": "A young girl presents with primary amenorrhoea, grade V thelarche, grade II pubarche and no axillary hair. The most probable diagnosis is \nSelect and explain. \nA. Testicular feminization, B. Mullerian agenesis, C. Turner syndrome, D. Gonadal dysgenesis", "role": "user" }, { "content": "Answer: A \nExplanation: Testicular feminization syndrome - complete androgen resistance, presents as phenotypic young woman without sexual hair but with normal breast development and primary amenorrhoea Complete testicular feminization is a common form of male pseudohermaphroditism. It is the 3rd most common cause of primary amenorrhea after gonadal dysgenesis and congenital absence of the vagina. The features are characteristic. Namely, a ''woman\" is asceained either because of inguinal hernia (prepubeal) or primary amenorrhea (postpubeal). The development of the breasts, the habitus, and the distribution of body fat are female in character so that most have a ''truly\" feminine appearance. Axillary and pubic hairs are absent or scanty, but some vulval hairs are usually present. Scalp hairs are that of a normal woman, and facial hairs are absent. The external genitalia are unambiguously female, and the clitoris is normal. The vagina is sho and blind-ending and may be absent or rudimentary. All internal genitalia are absent except for testes that contain normal Leydig cells and seminiferous tubules without spermatogenesis. The testes may be located in the abdomen, along the course of the inguinal canal, or in the labia majora.", "role": "assistant" } ]

[ { "content": "Antiepileptics used as analgesics are : \nSelect and explain. \nA. Carbamazepine and valproate, B. Phenytoin and valproate, C. Carbamazepine and phenytoin, D. Diazepam and Chlorpromazine", "role": "user" }, { "content": "Answer: C \nExplanation: None", "role": "assistant" } ]

[ { "content": "An 8 days old male infant is brought to the emergency department with vomiting, lethargy, dehydration and features of shock. Clinical examination reveals hyperpigmentation of the genital skin and normal external genitalia. Abdominal examination is unremarkable. blood tests revealed sodium of 124 mecill, potassium of 7 meq/1 and hypoglycemia. Which of the following is the most likely diagnosis: \nSelect and explain. \nA. Congenital Adrenal FIyperplasia (CAH), B. Adrenal Haemorrhage, C. Acute Gastorenteritis with dehydration, D. Hyperaldosteronism", "role": "user" }, { "content": "Answer: A \nExplanation: Presence of vomiting, lethargy, dehydration, hyponatremia, hyperkalemia, hypoglycemia and shock in this eight-year-old male infant suggest a diagnosis of neonatal adrenal insufficiency/crisis.\nCongenital Adrenal Hyperplasia is the most prevalent cause of adrenal insufficiency in neonates (typically 7-14 days post delivery) and the single best answer amongst the options provided,\nClinical features of CAH (21 hydroxylase deficiency) \n\nSymptoms of classical CAH due to 21 hydroxylase deficiency are:\n\n\nClinical: Lethargy, vomiting, Anorexia, weight loss, dehydration, hypotension, shock\nMineralocorticoid deficiency: Hyponatremia, hyperkalemia, hypotension\nCortisol deficiency: Hypoglycemia, Hyperpigmentation of areolar and scrotal areas in males and genital creases in females (due to ↑ ACTH secretion)\nExcess Androgen\n\n\nMales: Phenotypically normal for some years, precocious puberty\nFemales: Virilization (female pseudohermaphrodite)", "role": "assistant" } ]

[ { "content": "Incidence of undescended testis in term infants is: \nSelect and explain. \nA. <5%, B. <1%, C. 8%, D. 10%", "role": "user" }, { "content": "Answer: A \nExplanation: The incidence of undescended testes is approximately 30% in preterm infants and 1 to 3% in term infants. Ref: Schwaz's principle of surgery 9th edition, chapter 39.", "role": "assistant" } ]

[ { "content": "Irregular and infrequent menstruation is known as: \nSelect and explain. \nA. Amenorrhoea, B. Oligomenorrhoea, C. Polymenorrhoea, D. Menorrhagia", "role": "user" }, { "content": "Answer: B \nExplanation: Oligomenorrhoea - Infrequent and irregularly timed episodes of bleeding usually occuring at intervals of more than 35 days Polymenorrhoea - Frequent episodes of mentruation usually occurring at intervals of 21 days or less Menorrhagia - Increased menstrual flow/Increased duration at regular cycles Hypomenorrhoea - Scanty bleeding and shoer days of bleeding Metrorrhagia - Irregular bleeding in between the cycles Menometrorrhagia - Increased menstrual flow as well as irregular bleeding between the cycles", "role": "assistant" } ]

[ { "content": "To induce vomiting at home in a child who has ingested a poison, the recommended agent of choice would be – \nSelect and explain. \nA. Oral rehydration solution, B. Mustard in warm water, C. Apomorphine, D. Syrup of ipecac", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "All are true about Xeroderma Pigmentosum except \nSelect and explain. \nA. It is autosomal dominant inheritance, B. Due to defective DNA repair, C. Associated with squamous cell carcinoma, D. Thymine dimers", "role": "user" }, { "content": "Answer: A \nExplanation: (A) It is autosomal dominant inheritance # XERODERNA PIGMENTOSUM (XP)> Is an autosomal recessive genetic disease.> The clinical syndrome includes marked sensitivity to sunlight (ultraviolet) with subsequent formation of multiple skin cancers and premature death.> The risk of developing skin cancer is increased 1000- to 2000-fold.> The inherited defect seems to involve the repair of damaged DNA, particularly thymine dimers.> Cells cultured from patients with xeroderma pigmentosum exhibit low activity for the nucleotide excision-repair process.> Seven complementation groups have been identified using hybrid cell analyses, so at least seven gene products (XPA-XPG) Are involved.> Two of these (XPA and XPC) are involved in recognition and excision.> XPB and XPD are helicases and, interestingly, are subunits of the transcription factor TFIIH.", "role": "assistant" } ]

[ { "content": "Exposure of a female fetus to androgen in early embryogenesis may arrest differentiation of : \nSelect and explain. \nA. Mullerian, B. Ovary, C. Urogential sinus, D. Mesonephric ducts", "role": "user" }, { "content": "Answer: C \nExplanation: Sholy after the tip of para mesonephric ducts reach the urogenital sinus two solid evaginations grow out from the pelvic pa of the sinus.From these evaginations the sinovaginal bulbs proliferates to form the vaginal plates. The androgen exposure may arrest the differentiation of urogenital sinus LANGMAN'S MEDICAL EMBRYOLOGY, Pg no:229,12th edition", "role": "assistant" } ]

[ { "content": "In obstruction of second pa of axillay aery, theanostomosis between the following aery will maintain the blood supply of upper limb: \nSelect and explain. \nA. Deep branch of transverse cervical aery & subscapular aery, B. Anterior & posterior circumflex humeral, C. Posterior circumflex humeral & circumflex scapular aery, D. Suprascapular & anterior circumflex humeral aery", "role": "user" }, { "content": "Answer: A \nExplanation: Deep branch of transverse cervical aery & subscapular aery [Ref: BDC 4/e, Vol 1, p 56, 82; Snell's Clinical Anatomy 6/e, p 412-413, 657; Moore Clinical Anatomy 5/a, p 766-7671Axillary aery is the continuation of the subclan aery. It is crossed by pectoralis minor muscle which devides it into three pas.A rich anastomosis exists around the scapula between branches of subclan aery (first pa) & the axillary aery (third pa).This anastomosis provides a collateral circulation through which blood can flow to the limb when the distal pa of subclan aery or the proximal pa of axillary aery is blocked.Anastomosis around the scapula :Formed by branches of-Subclan aery - first pa- Suprascapular aery- Deep branch of transverse cervical aeryAxillary aery - third pa- Subscapular aery & its circumflex scapular branchThere are other smaller anastomoses over the acromion process, which also helps to maintain .flow to arm. (BDC Vol I, 4/e, p 82)Anastomoses over the acromion processFormed by -a)Acromial br. of thoraco-acromial aeryb)Acromial br. of suprascapular aeryc)Acromial br. of posterior circumflex humeral aeryThe subscapular aery also forms anastomoses with intercostal aeries", "role": "assistant" } ]

[ { "content": "Drug of choice for surgically unresectable renal cell carcinoma is ? \nSelect and explain. \nA. Sorafenib, B. Sunitinib, C. Imatinib, D. Cetuximab", "role": "user" }, { "content": "Answer: B \nExplanation: .", "role": "assistant" } ]

[ { "content": "Which of the following markers in the blood is the most reliable indicator of recent hepatitis B- infection? \nSelect and explain. \nA. HBsAg, B. lgG anti - HBs, C. lgM anti - HBc, D. lgM anti - HBe", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e. IgM anti-HBc You are sure to get questions on serological marker of Hepatitis in every PG exams (particularly AIIMS & AI). This topic has been thoroughly discussed.See Q. No 58 of Nov. 2001.Coming to the question; Hbs Ag is also present in recent hepatitis B infection but it is not a reliable marker because it can also be seen in carriers, whereas IgM anti- HBc is seen only in acute or recent hepatitis and is replaced by IgG anti Hbc in chronic infections.", "role": "assistant" } ]

[ { "content": "After a leisure trip, a patient comes with gritty pain in eye, and joint pain following an episode of urinary infection. What is the most probable diagnosis? \nSelect and explain. \nA. Reiter's syndrome, B. Bachet's syndrome, C. Sarcoidosis, D. SLE", "role": "user" }, { "content": "Answer: A \nExplanation: Reiter 's syndrome now referred to as reactive ahritis (ReA), is a classic triad of ahritis, nongonococcal urethritis and conjunctivitis. Reactive ahritis is triggered following enteric or urogenital infections. Reactive ahritis is associated with human leukocyte antigen (HLA)-B27. Bacteria associated with reactive ahritis are generally enteric or venereal. Reactive ahritis falls under the rheumatic disease category of seronegative spondyloahropathies, which includes ankylosing spondylitis, psoriatic ahritis, the ahropathy of associated inflammatory bowel disease, juvenile-onset ankylosing spondylitis, juvenile chronic ahritis, and undifferentiated spondyloahritis.", "role": "assistant" } ]

[ { "content": "Millard repair is used for treatment of: \nSelect and explain. \nA. Cleft lip, B. Cleft palate, C. Meningocele, D. Saddle nose", "role": "user" }, { "content": "Answer: A \nExplanation: The rotation advancement cleft lip repair, also referred to as a Millard repair, is probably the most commonly performed repair today. Almost no tissue is discarded; the medial lip element is rotated downward, even with a back cut, if necessary, and the lateral lip element is advanced into the defect under the nasal sill. Mucosal flaps are used to line the nose and the vestibule of the lip", "role": "assistant" } ]

[ { "content": "During water analysis in a hostel, amoebic cysts were seen. The best step to manage it is – \nSelect and explain. \nA. Iodine, B. Boiling, C. U.V Rays, D. Chlorination", "role": "user" }, { "content": "Answer: A \nExplanation: \"Amoebic infection is spread by ingestion of food or water contaminated with cysts. since an asymptomatic carrier may excrete upto 15 million cysts/day. Prevention of infection requires adequate sanitation and eradication of cyst carriage. In high risk areas infection can be minimized by avoidance of unpeeled fruits and the use of Bottled water.\nBecause cysts are resistant to readily attainable levels of chlorine, disinfection by iodination (Tetraglycine hyperiodide) is recommended.\" - Harrison", "role": "assistant" } ]

[ { "content": "Lillys antidote does not contain \nSelect and explain. \nA. Sodium Nitrite, B. Amyl Nitrite, C. Sodium Thiosulfate, D. Dicobalt EDTA", "role": "user" }, { "content": "Answer: D \nExplanation: Lillys antidote Used for cyanide poisoning. Composition Sodium nitrite Amyl nitrite Sodium Thiosulfate", "role": "assistant" } ]

[ { "content": "CD marker specific for myeloid series is: \nSelect and explain. \nA. CD34, B. CD45, C. CD99, D. CD117", "role": "user" }, { "content": "Answer: D \nExplanation: . CD117", "role": "assistant" } ]

[ { "content": "Fine reticular pigmentation with palmar pits are seen in - \nSelect and explain. \nA. Dowling - Degos disease, B. Rothmund thornpson syndrome, C. Cockyane syndrome, D. Bloom's syndrome", "role": "user" }, { "content": "Answer: A \nExplanation: Fine reticular pigmentation with palmar pits is characteristic of downing Degos disease Dowling-Degos disease (DDD) is a type of reticulate pigmentary disorder in which hyperpigmented macules are found in the flexures. Iadvl text book of dermatology, page 737", "role": "assistant" } ]

[ { "content": "Imaging tool of choice for GD? \nSelect and explain. \nA. DWI MRI with ADC maps, B. HMPAO SPECT, C. MR Spectroscopy, D. PET", "role": "user" }, { "content": "Answer: A \nExplanation: Ans ACreutzfeldt-Jacob disease is a spongiform encephalopathy caused by prions. On MRI T2 hyperintensity in basal ganglia, thalamus (Hockey stick sign), cortex and white matter with persistent diffusion restriction in considered most sensitive sign. On PET scan there can be hypometabolsim in affected area however it is less sensitive", "role": "assistant" } ]

[ { "content": "A 16 years old girl presented with history of nasal obstruction for last 2 months. A CT Scan was done and following findings are seen. What is the most likely diagnosis? \nSelect and explain. \nA. Juvenile Nasopharyngeal Angiofibroma, B. Antrochoanal polyp, C. Nasopharyngeal carcinoma, D. Adenoid Hyperophy", "role": "user" }, { "content": "Answer: B \nExplanation: CT Scan picture shows Crescent sign or Dodd's Sign seen in Antrochoanal Polyp Adenoid hyperophy: Dodd's Sign is negative JNAF- Epistaxis in adolescent males NPC- Old age, presents generally with Neck node metastasis", "role": "assistant" } ]

[ { "content": "A 2-year-old child comes with ear discharge, seborrheic dermatitis, polyuria and hepatosplenomegaly. Which of the following is the most likely diagnosis? \nSelect and explain. \nA. Leukemia, B. Lymphoma, C. Langerhan's cell histiocytosis, D. Germ cell tumor", "role": "user" }, { "content": "Answer: C \nExplanation: c. Langerhan's cell histiocytosis(Ref: Nelson's 20/e p 2484-2489], Ghai 8/e p 620-623)Seborrheic dermatitis, polyuria, hepatosplenomegaly and ear discharge suggests diagnosis of LCH.", "role": "assistant" } ]

[ { "content": "Which of this following pas of veebral canal will show secondary curves with concavity towards back? \nSelect and explain. \nA. Cervical Veibral Canal, B. Thoracic Veibral Canal, C. Sacral Veibral Canal, D. Coccyx Veibral Canal", "role": "user" }, { "content": "Answer: A \nExplanation: In adults, the cervical curve and lumbar curve is concave backwards. The thoracic and sacral curve is convex backwards.Ref: Clinical Anatomy by Systems, Richard S. Snell, Edition 2007, Chapter 12, Page 860; Anatomy at a Glance, Omar Faiz, 3rd Edition, Chapter 77, Page 175.", "role": "assistant" } ]

[ { "content": "Most common congenital dysplasia of Ear is \nSelect and explain. \nA. Michel aplasia, B. Mondini's dysplasia, C. Alexander's dysplasia, D. Scheibe's dysplasia", "role": "user" }, { "content": "Answer: D \nExplanation: None", "role": "assistant" } ]

[ { "content": "KSY is \nSelect and explain. \nA. Empowerment of females under maternity benefit scheme, B. Adolescent girls scheme under ICDS, C. Free and compulsory education for girl child, D. Child care home scheme female juvenile delinquents", "role": "user" }, { "content": "Answer: B \nExplanation: At present, there are two schemes for adolescent girls &;Kishore shakti yojana&; and &;Nutrition programme for adolescent girls&;Kishore shakti yojana is being implemented using the infrastructure of ICDS. The scheme targets adolescent girls in the age group of 11 to 18 years and address their needs of self-development, nutrition and health status, literacy and numerical and vocational skills.Nutrition programme for adolescent girls also being implemented using the infrastructure of ICDS. Undernourished adolescent girls in the age group 11 to 19 years (<30 in 11-15 ages and <35 in 15 to 19) are covered under the scheme.Park 23e pg: 592", "role": "assistant" } ]

[ { "content": "Which is not an intracanal medicament : \nSelect and explain. \nA. Calcium hydroxide., B. Chlorhexidine digluconate., C. MTAD., D. None.", "role": "user" }, { "content": "Answer: C \nExplanation: The two antimicrobial intracanal medicaments recommended in contemporary endodontic practice are as follows:\n\nCalcium hydroxide\nChlorhexidine digluconate", "role": "assistant" } ]

[ { "content": "If annual growth rate of a population is 1.5-2%, what number of years will be required to double the population \nSelect and explain. \nA. 70-47 years, B. 35-47 years, C. 35-28 years, D. 28-23 years", "role": "user" }, { "content": "Answer: B \nExplanation: When crude death rate is substracted from crude bih rate , the net residual is current annual grow rate , exclusive of migration. When the annual growth rate of a population is 1.5% to 2.0%, it takes 35-47 years to double the size of population. Reference : Park&;s textbook of preventive and social medicine, 23rd edition, pg no: 481, table 5", "role": "assistant" } ]

[ { "content": "HIV virus contains: \nSelect and explain. \nA. Single stranded DNA, B. Single stranded RNA, C. Double stranded DNA, D. Double stranded RNA", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., Single stranded RNA(Ref: Ananthanarayan, 9th/e, p. 571 and 8th/e, p. 570)* The genome in HIV is diploid, composed of two identical single stranded positive sense RNA copies.", "role": "assistant" } ]

[ { "content": "A young man with tuberculosis presents with massive recurrent hemoptysis. Most probable cause would be. \nSelect and explain. \nA. Pulmonary aery, B. Bronchial aery, C. Pulomary vein, D. Superior vena cava", "role": "user" }, { "content": "Answer: B \nExplanation: B i.e. Broncheal aery In great majority of patients hemoptysis originates from systemic rather than pulmonary aeries and the bronchial vessels are almost universally involved. (Grainger) Massive hemoptysis in a patient of T.B. is usually d/ t erosion of bronchial aery which bleeds at systemic pressure.", "role": "assistant" } ]

[ { "content": "25 years old male presented with diarrhea for 6 months. On examination the causative agent was found to be acid fast with 12 micro meter diameter. The most likely agent is - \nSelect and explain. \nA. Cryptosporidium, B. Isospora, C. Cyclospora, D. Giardia", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Cyclospora All the parasites mentioned in the question cause chronic diarrhoea {mostly in immunocompromised patients).All of them reveal oocyst on stool examination. In Giardiasis, parasite is also seen along with oocyst stool examination.Oocyst of all the organisms except giardia are acid fast. The diagnosis rests on the size of the oocyst.DIAGNOSIS OF INTESTINAL PROTOZOAL INFECTIONParasiteStoolFecal acid fast stainSize of the oocystGiardiaOocyst + Parasite 4 nuclei 8-12 x 7 x 10 pmCryptospo- ridiumOocyst+Small, 4-5 pm in diameterIsosporaOocyst+Large 25 pm in diameterCyclosporaOocyst+Medium 8-10 pm diameterMicrosporidiaSpores Special fecal stains, tissue biopsiesMore on this topicParasites causing chronic diarrhoeaGiardiaCryptosporidiosisIsosporaCyclosporaHookwormAmoebiasisStrongyloidesAcid fast organisms are -MycobacteriumLepra bacilliNocardiaIsosporaBacterial sporesRhodococcusSmegma bacilliSpermatic headCryptosporidiumCyclospora", "role": "assistant" } ]

[ { "content": "Skin surface elevation caused by hyperplasia and projections of the epidermis form an undulating surface under microscopic examination. What is this known as? \nSelect and explain. \nA. Saw toothing, B. Papillomatosis, C. Villi, D. Parakeratosis", "role": "user" }, { "content": "Answer: B \nExplanation: Papillomatosis of skin Skin surface elevation caused by hyperplasia and enlargement of contiguous dermal papillae. Papillary projections of the epidermis form an undulating surface under microscopic examination.", "role": "assistant" } ]

[ { "content": "Hyoid bone fracture does not occur in - \nSelect and explain. \nA. Hanging, B. Strangulation, C. Throttling, D. Choking", "role": "user" }, { "content": "Answer: D \nExplanation: Ans. is 'd' i.e., Choking Features Hanging Strangulation Cause (mostly) Sigus of struggle Ligature mark Suicidal No * Above thyroid cartilageQ * Incomplete and directed obliquely upward * No skin damage under knot *Abrasion and bruise around ligature mark are * Dissection reveals a dry glistening white band of subcutaneous tissueQ Homicidal Present * Below thyroid cartilageQ * Completely encircelsQ neck horizontalQ * May be more than one turns * Abrasion and bruises are common *Dissection reveals ecchymosed subcutaneous tissueQ * Stretching of neck * Fracture-dislocation of vertebrae Present Absent * Fracture of hyoid, laryngeal cartilage, tracheal rings * Injury to neck muscles * Injury to carotid artery Rare Common Note - Throttling is m.c. cause of hyoid fracture Saliva Running out of angle of mouth vertically down Usually saliva not espaced but if so usually blood tinged and may not be vertically down * External signs of asphyxia *Face * Bleeding from nose and mouth Not well marked Pale Rare Well marked Congested, Cynosed with petechiaeQ Common", "role": "assistant" } ]

[ { "content": "Cell shape and motility are provided by \nSelect and explain. \nA. Microfilaments, B. Microtubules, C. Golgi apparatus, D. Mitochondria", "role": "user" }, { "content": "Answer: B \nExplanation: Microtubules are polymers of tubulin that form pa of the cytoskeleton and provide structure and shape to cells", "role": "assistant" } ]

[ { "content": "Mean weight of 100 children was 12 kg. The standard detion was 3. Calculate the percent Coefficient of variation: \nSelect and explain. \nA. 25%, B. 35%, C. 45%, D. 55%", "role": "user" }, { "content": "Answer: A \nExplanation: Coefficient of variation: - Is a measure used to compare relative variability - Is a unit-free measure to compare dispersion of one variable with another - Is SD expressed as percentage of mean CV = In the given question, Mean weight (u) = 12 kg, n = 100, Standard detion (s) = 3 Thus, coefficient of variance =s/ux 100 = 3/12 x100 = 25%", "role": "assistant" } ]

[ { "content": "About inverse agonism, true is: \nSelect and explain. \nA. Action on the target receptors is similar to that of agonist, B. Binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect, C. Effective against receptors having intrinsic activity without acting of a ligand upon them, D. None", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. b (Binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect). (Ref. KDT, Pharmacology, 6th ed., p 41)# Receptor agonists, antagonists and inverse agonists bind to the same receptor types:DefinitionAgonistsincrease the inhibitory transmitter GABA potencyInverse agonistsdecrease GABA potencyAntagonistsblock action of agonists and antagonists# An inverse agonist is an agent which binds to the same receptor binding-site as an agonist for that receptor but exerts the opposite pharmacological effect. Inverse agonists are effective against certain types of receptors (e.g. certain histamine receptors/GABA receptors) which have intrinsic activity without the acting of a ligand upon them (also referred to as 'constitutive activity'.)# One particular example is R015-4513 which the inverse agonist of the benzodiazepine class of drugs.# Gabapentin acts by facilitation of GABA mediated CT channel opening. It does not block GABA receptors. Substances called Beta carboline which also bend this receptor cause stimulation anxiety, increased muscle tone and convulsions. They are inverse agonists of benzodiazepine receptors.", "role": "assistant" } ]

[ { "content": "Linoleic acid is maximum in \nSelect and explain. \nA. Groundnut oil, B. Safflower oil, C. Mustard oil, D. Coconut oil", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "A 30 year old male was brought for evaluation. The history revealed that the patients 3 year old son died, 5 months back after being hit by a car. At the time of accident, patient was standing nearby and witnessed the accident. For last 5 months, he has been having symptoms of sadness of mood, crying spells, feelings of wohlessness, poor sleep and poor appetite. He has twice thought of killing himself but stopped at the end moment. He has not been attending the office of last 5 months. What is the likely diagnosis: \nSelect and explain. \nA. Post traumatic stress disorder, B. Normal grief, C. Major depression, D. Adjustment disorder", "role": "user" }, { "content": "Answer: C \nExplanation: Depression: A major depressive disorder occurs without a history of a manic, mixed, or hypomanic episode. A major depressive episode must last at least 2 weeks DIAGNOSIS: Major Depressive Disorder The DSM-5 diagnostic criteria for major depression Sadness of mood Diminished interest in pleasure Significant weight loss or gain more than 5% in a month Crying spells Feeling of wohlessness Poor sleep (Insomnia or hypersomnia) Suicidal thoughts Psychomotor retardation Fatigue or loss of energy. Five or more of these symptoms present for 2 weeks or more or either depressed mood or loss of interest or pleasure.", "role": "assistant" } ]

[ { "content": "Most common type of skin carcinoma on face, in light skinned, is: March 2013 \nSelect and explain. \nA. Squamous cell carcinoma, B. Basal cell carcinoma, C. Bowen's disease, D. Erythroplasia of Queyrat", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. B i.e. Basal cell carcinoma In darkly pigmented racial groups, squamous cell carcinoma is the MC skin malignancy Skin tumours Basal cell carcinoma does not show lymphatic spread Conditions predisposing to Squamous cell carcinoma: - Actinic keratosis, - DLE Basal cell carcinoma MC site of BCC: Face MC type of BCC: Nodulo-ulcerative type Mode of spread: Direct Excision procedure done: Moh's micrographic excision", "role": "assistant" } ]

[ { "content": "Typhoid revaccination is recommended every ... years in endemic area- \nSelect and explain. \nA. 1, B. 3, C. 5, D. 10", "role": "user" }, { "content": "Answer: B \nExplanation: Ans. is 'b' i.e., 3 o To maintain protection, revaccination is recommended every 3 years.", "role": "assistant" } ]

[ { "content": "Length of esophagus in adults is: \nSelect and explain. \nA. 25 cm, B. 10 cm, C. 15 cm, D. 20 cm", "role": "user" }, { "content": "Answer: A \nExplanation: The esophagus is a muscular, collapsible tube about 10 in. (25 cm) long that joins the pharynx to the stomach. The esophagus enters the abdomen through an opening in the right crus of the diaphragm.After a course of about 0.5 in. (1.25 cm), it enters the stomach on its right side.", "role": "assistant" } ]

[ { "content": "All are true for normal saline except \nSelect and explain. \nA. normal saline 0.9% is most suitable to treat acute severe hyponatremia, B. fluid of choice for head injury patient, C. fluid of choice for hypovolemic shock, D. lead to hyperchloremic metabolic acidosis", "role": "user" }, { "content": "Answer: A \nExplanation: NaCl Is preferred in conditions in which increased plasma sodium is beneficial e.g traumatic brain injury Not suitable for treatment of acute severe hyponatremia as it has little effect on plasma sodium levels When infused > 30ml/kg/hr may lead to hyperchloremic acidosis", "role": "assistant" } ]

[ { "content": "All are true about Abnormal uterine bleeding except : \nSelect and explain. \nA. Blood loss of less than 50 ml, B. Cycle duration is more than 35 days or less than 21 days, C. Bleeding period lasting 7 days or more, D. Irregular bleeding during a regular cycle", "role": "user" }, { "content": "Answer: A \nExplanation: Normal Menstrual Loss The upper limit of blood loss in a normal menstruation is considered as 80ml. Any bleeding above the specified normal limit is termed as abnormal uterine bleeding. Normal Menustration: Cycle interval-28days(21-35 days) Menustral flow- 4 to 5 days Menustral blood loss-35ml (20- 80ml) Common causes of AUB: 1.DUB 2.Infections 3.Endocrine Dysfunction 4.Pregnancy Complications 5.Hematological disorders 6.Neoplastic growth. Reference: Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Page 48 DC Dutta's Textbook of Gynecology; 7th edition ,page 152", "role": "assistant" } ]

[ { "content": "Which influenza strain was isolated in 1989 spreading to many other countries? \nSelect and explain. \nA. H2N2, B. H1N1, C. H3N2, D. H5N1", "role": "user" }, { "content": "Answer: B \nExplanation: In 1989, epidemic - the reappearance of swine HINI virus Influenza can occur sporadically, as epidemics or pandemics In 2009, H1N1 Epidemic occurred in Mexico-recent Ref: Baveja 5th ed Pg: 468", "role": "assistant" } ]

[ { "content": "All statements are true about the eye of a newborn except – \nSelect and explain. \nA. Optic nerve is myelinated only upto lamina cribrosa, B. Orbit is more divergent than adult, C. Apart from macular area the retina is fully differentiated, D. New born is usually myopic by –2 to –3D", "role": "user" }, { "content": "Answer: D \nExplanation: Newborn is usually hypermetropic by +2 to +3D (not myopic).", "role": "assistant" } ]

[ { "content": "Which of the following is the national system that provides annual national as well as state reliable estimates of feility and Moality \nSelect and explain. \nA. Civil registration system, B. Census, C. Ad-hoc survey, D. Sample registration system", "role": "user" }, { "content": "Answer: D \nExplanation: Sample registration system (SRS) : Was initiated in 1964-65 (on a pilot basis ; Full scale from 1969-70) to provide national as well as state level reliable estimates of feility and Moality SRS is a dual record system Field investigation : Continuous enumeration of bihs and deaths by an enumerator Independent retrospective survey : Every 6 months by an investigator-supervisor Findings of SRS survey Crude bih rate (CBR) : 20.4 per 1000 mid year population Crude Death rate (CDR) : 6. 4 per 1000 mid year population Natural growth rate : 14% Infant Moality rate (IMR) : 34 per 1000 live bihs Ref: Park 23rd edition 904", "role": "assistant" } ]

[ { "content": "Homocystein is not associated with \nSelect and explain. \nA. Coronary aery disease, B. Fracture, C. Hearing loss, D. Neuropsychiatric manifestations", "role": "user" }, { "content": "Answer: C \nExplanation: Ans. is 'c' i.e., Hearing lossElevated level of homocysteine (hyperhomocysteinemia) is associated with -i) Thrombosis, coronary aery disease & stroke.ii) Osteoporosis & fracture.iii) Neuropsychiatric manifestations.iv) Developmental delay.v) Visual disturbances.vi) Microalbuminuria.", "role": "assistant" } ]

[ { "content": "Arthrocentesis can be performed efficiently by: \nSelect and explain. \nA. Single needle technique., B. Two needle technique., C. Both of the above., D. None.", "role": "user" }, { "content": "Answer: B \nExplanation: None", "role": "assistant" } ]

[ { "content": "All are complications of chronic staphylo-coccal blepharoconjunctivitis except: \nSelect and explain. \nA. Chalazion, B. Marginal conjunctivitis, C. Follicular conjunctivitis, D. Phylectenular conjunctivitis", "role": "user" }, { "content": "Answer: A \nExplanation: Ans. Chalazion", "role": "assistant" } ]