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The extraction of upper first molars may be indicated:: (A) When the removal of 4/4 provides insufficient space, (B) Where they are rotated, (C) When their prognosis is poor, (D) When 5/5 are palatally placed | Answer is C. Key concept:
Any teeth which is having poor prognosis is indicated for extraction. |
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Rhinosporidiosis is caused by which of the following?: (A) Fungus, (B) Virus, (C) Bacteria, (D) Protozoa | Answer is D. Rhinosporidiosis is caused by Rhinosporidium seeberi. This organism was previously considered to be a fungus. It is now identified to be an aquatic protistan protozoa parasite belonging to the class Mesomycetzoea. ( Ref Scott Brown, 8th edition, VOL 1, Pg no. 208 ) |
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Calcinosis universalis occurs in –: (A) Ehlers Danlos syndrome, (B) Christian Weber syndrome, (C) Deimatomyositis, (D) Scleroderma | Answer is C. Calcinosis universalis is the diffue deposition of calcium salts in the skin, subcutaneous tissue and sometimes in connective tissue. It occurs in Juvenile Dermatomyositis. |
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Fetal stage starts at:: (A) 9 weeks, (B) 3 weeks, (C) 6 weeks, (D) 12 weeks | Answer is A. Fetal Growth Periods |
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Which of the following belongs to antifibrinolytic drugs: (A) Alteplase, (B) Urokinase, (C) Aprotinin, (D) Reteplase | Answer is C. Antifibrinolytic drugs promote blood clotting by preventing blood clots from breaking down. Some examples of antifibrinolytic drugs are aprotinin, tranexamic acid (TXA), epsilon-aminocaproic acid and aminomethylbenzoic acid. Doctors sometimes give these drugs to patients having surgery to prevent blood loss. Ref: KD Tripathi 8th ed. |
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Organism which causes pancreatitis: (A) Mumps, (B) Measles, (C) Candida, (D) Treponema | Answer is A. None |
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Longest acting L.A. – a) Bupivacaineb) Tetracainec) Xylocained) Procaine: (A) ac, (B) a, (C) ad, (D) ab | Answer is D. Dibucaine is the longest acting LA (duration is 2.5-3.5 hours).
Amongst the given options tetracaine & bupivacaine are longest acting (both have duration of 2-3 hours).
Decreasing order of duration :- Dibucaine (longest acting) > Bupivacaine = Tetracaine = Ropivacaine = Etidocaine > Prilocaine = Lignocaine = Mepivacaine = Cocaine > Procaine > chlorprocaine. |
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Which of the following drugs should be given in sustained release oral dosage form?: (A) An anti-arrhythmic drug with a plasma half life of 10 seconds used for acute treatment of PSVT, (B) An anti-inflammatory drug with a plasma half life of 24 hr, (C) A hypnotic drug with a plasma half life of 2 hours, (D) An antihypeensive with a plasma half life of 3 hours | Answer is D. Sustained release preparation are used for prolonged duration of action of drug . So, used when drug has sho half life and when we require the action of drug for longer duration. Anti-hypeensive drug are used for lifelong. So, sustained release preparations are required. Anti-arrhythmic drugs used in treatment of PSVT are not to be used as sustained release preparation as we need action for only a sho duration. Anti-inflammatory drug with the half life of 24 hrs is already acting for long duration we don't need sustained release preparation. Hypnotic drug with a half life of 2hrs will work for 5-6 hrs. So, no need of sustained release preparation. |
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Avascular necrosis may be seen in all of the following, except: (A) Scapula, (B) Head of femur, (C) Upper end of humerus, (D) Body of Talus | Answer is A. Common Site of Avascular necrosisCauseHead and femurFracture neck femur (Subcapital)Posterior dislocation of hipProximal pole of scaphoidFracture through waist of scaphoidBody of talusFracture neck of talusProximal pole of lunateLunate dislocation*Other sites of common AVN are Distal medial condyle, Humeral head, Capitellum, and Metatarsal heads*In the early stages, bone scintigraphy and MRI are the diagnostic modalities of choice.*Non ohopedic causes of AVN - Sclera, Caisson's disease, Lupus erythematosus, Radiation and Alcohol (Refer: Apley's system of Ohopedics and Fracture, 8th edition, pg no: 91-103, 436-439) |
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A child presents with infective skin lesion of the leg culture was done which showed gram+ve cocci in chains which where hemolytic colonies. The test to confirm the organism is -: (A) Bile solubility, (B) Optochin sensitivity, (C) Bacitracin sensitivity, (D) Catalase positive | Answer is C. None |
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Which antiepileptic drug is least secreted in breast milk -: (A) Ethosuximide, (B) Clonazepam, (C) Gabapentin, (D) Carbamazepine | Answer is B. Ans. is 'b' i.e., Clonazepam DrugBreast milk to plasma concentrationCarbamazepine0-69Clonazepam033Ethosuximide0-94Gabapentin0-7-1-3Lamotrigine0-057-1-47Phenobarbitone0-4-0-6Phenytoin018-0-45Primidone0-72Topiramate0-86-1-1Valproate0-42Zonisamide0-93 |
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Therapeutic drug monitoring is done for all of the following drugs Except: (A) Phenytoin, (B) diclofenac, (C) Tacrolimus, (D) Cyclosporine | Answer is B. TDM is not done for most commonly used drugs or safe drugs like paracetamol, diclofenac done for antiepileptic drugs, immunosuppressants, anticancer drugs, lithium Phenytoin- antiepileptic, cyclosporin, tacrolimus- immunosuppressants in the options not done for antihypeensives and BP can be measured clinically and easily REF KD Tripathi 8th ed |
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β-blocker with additional α-blocking property is: (A) Propranolol, (B) Timolol, (C) Metoprolol, (D) Labetalol | Answer is D. None |
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The following methods can be used to detect the point mutation in the beta globin gene that causes sickle cell anemia, EXCEPT:: (A) Polymerase chain reaction with allele-specific oligonucleotide hybridization, (B) Southern blot analysis, (C) DNA sequencing, (D) Nohern blot analysis | Answer is D. Point mutation involves the replacement of a single base nucleotide with another nucleotide of the gene. Point mutations in the beta globin gene can be identified by analysing the DNA. Nohern blot is a technique used in studying the RNA and hence the answer of exclusion. Ref: Introduction to Biotechnology By Thieman William, 2nd Edition, Pages 71, 78, 81, 82 |
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Cranial irradiation is also indicated in the treatment of which variety of lung cancer?: (A) Squamous cell carcinoma, (B) Non small cell cancer, (C) Small cell cancer, (D) Adenocarcinoma | Answer is C. Small cell lung cancers or oat cell carcinomas, exhibits aggressive behavior, with rapid growth, early spread to distant sites, exquisite sensitivity to chemotherapy and radiation, and frequent association with distinct paraneoplastic syndromes. Surgery usually plays no role in its management. Widespread metastases occur early in the course of the disease, with common spread to the mediastinal lymph nodes, liver, bones, adrenal glands, and brain. Management of limited-stage small cell lung cancer involves combination chemotherapy, usually with a platinum-containing regimen, and thoracic radiation therapy. If the patient achieves a complete remission, he or she would be offered prophylactic cranial irradiation. |
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The disease most likely to result In presents of emotional contact is: (A) Measles, (B) Typhoid, (C) SSPE, (D) All of above | Answer is A. The poal of entry of measles virus is through the respiratory tract or conjunctivae following contact with large droplets or small-droplet aerosols in which the virus is suspended. Reference: Nelson textbook of pediatrics 19th edition.Page 1070 |
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All of the following are signs of chronic liver failure, Except:: (A) Palmer erythema, (B) Spider nevi, (C) Testicular atrophy, (D) Subcutaneous nodules | Answer is D. Answer is D (Subcutaneous nodules): Subcutaneous nodules are generally not seen as stigmata of chronic liver disease. Chronic Liver Disease manifests with loss of subcutaneous fatty tissue resulting in paper thin skin with marked folds (paper-money skin). |
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Immediate management of a child with foreign body inhalation is -: (A) IPPV, (B) Bronchoscopy, (C) Tracheostomy, (D) Exploratory Thoracotomy | Answer is B. Ans. is 'b' i.e., Bronchoscopy Treatment of aspirated foreign body A) Treatment of foreign body in upper respiratory tract. o If obstruction is complete --> Immediate intervention. o If obstruction is paial --> Patients should allow to use their own cough reflex to extrude the foreign body --> If it fails than intervention should be done. o Method of removal of foreign body : - 1)If child is younger than 1 year --> Child should be placed face down over the rescuir's arm with head positioned below trunk. Five measured back blows are delivered rapidly between the scapula. If obstruction persists, the infant should be rolled over and five rapid chest compressions should be performed. This sequence is repeated until the obstruction is relieved. 2) If child is elder than 1 year ---> Abdominal thursts (Heimlich maneuver) should be performed. B) Treatment of foreign body in lower respiratory tract. o The treatment of choice is prompt endoscopic (bronchoscopic) removal of foreign body. |
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Slipped capital femoral epiphysis is seen most commonly in which age group -: (A) Infants, (B) Adolescents, (C) Old age, (D) Childhood | Answer is B. Slipped capital femoral epiphysis (SCFE) occurs during adolescent rapid growth period when epiphysis plate is weak & the capital epiphysis is displaced down & back. * Etiology : age - 10-17years of age Sex- male : female - 5:2 Location: left hip is involved in 58% of the cases *stages 1. Preslipping stage 2.chronic slipping stage 3.stage of fixed deformity *Radiographic changes - *early change : marginal blurring of the proximal metaphysis , lower margin of metaphysis is included within the acetabulum normally but excluded in the early epiphyseal slip, Trethovan &;s line : line drawn along the superior margin of the neck , transects the epiphysis normally , but will be above it in slip, depth of epiphysis is reduced , there is a step between metaphysis & epiphysis. *Late changes : trethovan&;s sign is present , head is atrophic , neck shaft angle is less than 90 degree , new bone formation is seen at the anterior superior pa of neck , joint space is clear , shenton&;s line is broken. * CT scan is very useful in assessing degree of slips. Classification of slipping - mild(51%), moderate(22%), severe slipping (17%) REF:Essential ohopedics, John Ebenezer, 4th edition, pg.no.416 |
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All are true about vitamin E except ?: (A) Act as antioxidant, (B) Prevent lipid peroxidation of cell membrane, (C) Water soluble vitamin, (D) Chemically tocopheral | Answer is C. Ans. is 'c' i.e., Water soluble vitamin Vitamin E is a fat soluble vitamin (not water soluble). All other options are correct. |
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Contents of the suboccipital triangle are formed by all of the following structures, EXCEPT:: (A) Veebral aery, (B) Suboccipital nerve, (C) Greater occipital nerve, (D) Lesser occipital nerve | Answer is D. The contents of the suboccipital triangle are veebral aery, suboccipital nerve and greater occipital nerve.The suboccipital triangle is the area in the suboccipital region between the rectus capitis posterior major and the obliquus capitis superior and inferior muscles. It is covered by a layer of dense fibro-fatty tissue, deep to the semispinalis capitis muscle. Its floor is formed by the posterior occipitoatlantal membrane and the posterior arch of the C1 veebrae. The suboccipital muscles are:Obliquus capitis superior muscleObliquus capitis inferior muscleRectus capitis posterior major muscleRectus capitis posterior minor muscleRef: Moon D.A., Foreman K.B., Albeine K.H. (2011). Chapter 1. Back. |
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Common Facial vein is formed by the union of: (A) Anterior facial and posterior facial veins, (B) Anterior facial and posterior auricular veins, (C) Anterior facial and maxillary veins, (D) Anterior facial and anterior branch of the posterior facial vein | Answer is D. The scalp on each side of the midline is drained by five veins. The veins of the scalp accompany the arteries and have similar names. These are as follows:
Supratrochlear and supraorbital veins: They join each other at the medial angle of the eye to form the angular vein, which continues downwards as the facial vein behind the facial artery.
Superficial temporal vein: It descends in front of tragus to enter the parotid gland where it joins the maxillary vein to form the retromandibular vein, which terminates by dividing into anterior and posterior divisions. The anterior division unites with the facial vein to form common facial vein, which drains into the internal jugular vein.
Posterior auricular vein: It descends behind the auricle and unites with the posterior division of the retromandibular vein to form the external jugular vein, which drains into the subclavian vein.
Occipital vein: It terminates in the suboccipital venous plexus. |
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Branches of brachial aery are all EXCEPT:-: (A) Profunda brachii, (B) Superior ulnar collateral, (C) Inferior ulnar collateral, (D) Radial collateral | Answer is D. Radial collateral aery is anterior descending branch of the profunda brachii aery, not a direct branch of brachial aery. |
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During which phase of the cell cycle the cellular content of DNA is doubled -: (A) Mitotic phase, (B) G1 phase, (C) G2 phase, (D) S phase | Answer is D. There are two resting phases and two active phases in the cycle.
Resting phases → G1 & G2
Active phases
S-phase (synthetic phase) - As the name suggests, synthesis of new DNA takes place, i.e. doubling of DNA occurs.
M-phase (mitotic phase) - Mitosis takes place and the daughter cells receive one copy of DNA. In this phase, cell number is doubled. |
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Pancreatic pseudocyst most commonly occurs after ?: (A) Trauma, (B) Pancreatitis, (C) Pancreatic surgery, (D) Pancreatic malignancy | Answer is B. Ans. is 'b' i.e. Pancreatitis Most common cause of pancreatic pseudocyst is Pancreatitis (90%) The second most common cause is trauma (10%). Pseudocysts are seen in both acute and chronic pancreatitis. |
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Major epidemics are due to antigenic drift: (A) Asymptomatic seen rarely, (B) Incubation period 10-12 hrs, (C) All ages and sex equally affected, (D) Pandemic rare | Answer is C. None |
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Disability adjusted life year (DALY) is a measure of ?: (A) Life expectancy, (B) Effectiveness of treatment, (C) Quality of life, (D) Human development | Answer is B. Ans. is 'b' i.e., Effectiveness of treatment Disability - adjusted life year (DALY) DALY is a measure of :- The burden of disease in a defined population The effectiveness of interventions It expresses years lost to premature death and years lived with disability adjusted for the severity of the disability. That means, DALY measures both moality and disability together (in contrast to sullivan's index which is related to disability only). One DALY is one lost year of healthy life. DALY combines following : - Years of lost life (YLL). Years lost to disability (YLD) DALY = YLL + YLD Japanese life expectancy statistics are used as a standard for measuring premature death, as Japanese have the longest life expectancy. Health - adjusted life expectancy (HALE) HALE is the indicator used to measure healthy life expectancy. HALE is based on the life expectancy at bih but includes an adjustment for time spent in poor health. It is the equivalent number of years in full health that a newborn can expect to live based on current rates of ill health and moality. |
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A drug X is secreted through renal tubules, tubular secretion of this drug can be confirmed if renal clearance of drug X is:: (A) More than the GFR, (B) Equal to the GFR, (C) Less than the GFR, (D) More than volume of distribution | Answer is A. * After filtration from glomerulus, a drug may undergo two processes (tubular reabsorption and tubular secretion) before going out from the body i.e. renal clearance *Suppose 100 mg of a drug is filtered by glomerulus and the renal clearance is 150 mg, it means 50 mg is coming from somewhere else, i.e. tubular secretion must be present. However, we cannot say that reabsorption is not occuring because if 20 mg is reabsorbed and 70 mg is secreted, same thing can happen. * Suppose, 100 mg of a drug is filtered but renal clearance is 50 mg. Therefore, 50 mg must have gone somewhere i.e. tubular reabsorption must be occurring. Again, we cannot say that tubular secretion is not present. |
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A 28-year-old woman presented with high-grade fever, cough, diarrhea and mental confusion for 4 days. X-ray chest revealed bilateral pneumonitis. Search for etiology will most likely reveal?: (A) Streptococcus pneumonia, (B) Staphylococcus aureus, (C) Legionella pneumophila, (D) Pseudomonas aeruginosa | Answer is C. The clinical profile of fever, cough and X-ray revealing bilateral pneumonitis and presence of diarrhea and confusion indicates the presence of Atypical pneumonia. The organism causing atypical pneumonia out of the given choices is Legionella pneumophila Confusion can be explained by hyponatremia due to SIADH. The clinical manifestations of Legionnaires' disease are usually more severe than those of most "atypical" pneumonias. Clinical Clues Suggestive of Legionnaires' Disease Diarrhea High fever (>40degC; >104degF) Numerous neutrophils but no organisms revealed by Gram's staining of respiratory secretions Hyponatremia (serum sodium level <131 mg/dL) Failure to respond to b-lactam drugs (penicillins or cephalosporins) and aminoglycoside antibiotics Occurrence of illness in an area where potable water supply is known to be contaminated with Legionella Onset of symptoms within 10 days after discharge from the hospital (hospital-acquired legionellosis manifesting after discharge or transfer) |
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Not true about microtubules is/are:: (A) Dynamic instability, (B) Polarity, (C) Charged, (D) GTP not required | Answer is D. D i.e. GTP not required |
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Which of the following statements is FALSE regarding vincristine: (A) It is an alkaloid, (B) Its use is associated with neurotoxicity, (C) It does not cause alopecia, (D) It is a useful drug for induction of remission in acute lymphoblastic leukemia | Answer is C. Vincristine is a vinca alkaloid.
It is used for the induction of remission in ALL.
It is a marrow sparing drug but causes peripheral neuropathy, alopecia and SIADH as adverse effects. |
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Which of the following not a prion associated disease -: (A) Srapie, (B) Kuru, (C) Creutzfeldt Jakob disease, (D) Alzheimer's disease | Answer is D. scrapie,CJD&Kuru are prion disease REF:ANATHANARAYANAN MICROBIOLOGY NINTH EDITION PAGE.557 |
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Systemic inflammatory response syndrome, false is: (A) Hypoglycemia, (B) Fever, (C) Leukocytosis, (D) Altered mental status | Answer is A. Answer- A. HypoglycemiaIt is an inflammatory state affecting the whole bodn frequently a response of the immune system to infection, but not necessarily so.When two or more of these criteria are met with or without evidence of infection -Body temperature less than 36 c greater than 38 CHea rate greater than 90 beats per minuteTachypneaWhite blood cell count less than 4000 cells/mm3HyperglycemiaAltered mental state |
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Neuraminidase inhibitor ?: (A) Oseltamivir, (B) Amantadine, (C) Enfuviide, (D) Formivirsen | Answer is A. Ans. is 'a' i.e., Oseltamivir Oseltamivir acts by inhibiting influenza virus neuraminidase enzyme which is needed for release of progeny virions from the infected cell. |
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The recent treatment of sho bridle passable stricture of urethra in the penile and bulbous urethra is: (A) Internal urethrotomy with Thompson-Walker's urethrotome, (B) Optical internal urethrotomy, (C) Syme's operation, (D) Wheelhouse operation | Answer is B. Endoscopic (internal) urethrotomy Internal urethrotomy is performed using the optical urethrotome. The stricture is cut under visual control using a knife passed through the sheath of a rigid urethroscope. The stricture is usually cut at the 12 o'clock position, taking care not to cut too deeply into the vascular spaces of the corpus spongiosum that surrounds the urethra. It is possible to get lost when trying to cut a way through a very tight stricture, and this is especially true when there are false passages because of previous dilatation attempts. Accordingly, a guidewire should be passed through to the bladder prior to incision of the stricture in order to establish the true lumen of the urethra. Following urethrotomy a catheter should be left in situ for 1-3 days afterwards. A single urethrotomy seems to give a permanent cure of an uncomplicated stricture in about 50% of patients. Success rates are highest when the stricture is sho and when it is present within the bulbar urethra. In contrast, failure rates are highest in long strictures, strictures within the penile urethra and in recurrent strictures. The main complications are infection and bleeding. Ref: Bailey and love 27th edition Pgno : 1484 |
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CD8 antigen is present on: (A) T helper cells, (B) B cells, (C) T suppressor cells, (D) Macrophages | Answer is C. CD4 antigen is present on t helper cells Cd8 antigen on T suppressor cells CD8 cells recognize MHC class I antigens Ref: Textbook of Microbiology Baveja 5th ed Pg 135 |
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Hemolytic disease of newborn is least common with which blood group female -: (A) A, (B) B, (C) 0, (D) AB | Answer is C. Ans. is 'c' i.e., OABO incompatibility has a protective effect to the development of Rh sensitization and thus the development of hemolytic disease of newborn |
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Primary spermatocytes, chromoso me is -: (A) 23-X, (B) 23-Y, (C) 46-XY, (D) None | Answer is C. Ans. is 'c' i.e., 46-XY Secondary spermatocyte (Haploid -23)-Spermatid(Haploid-23)Spermatogonia - Primary spermatocyteDiploid-46)(Diploid-46)Secondary spermatocyte (Haploid-23)-Spermatid(Haploid-23) |
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Chlamydia Trachomatis, false is: (A) Elementary body is metabolically active, (B) It is biphasic, (C) Reticulate body divides by binary fission, (D) Inside the cell it evades phagolysosome | Answer is A. Ans. is 'a' i.e. Elementary body is metabolically active Chlamydiae is a gram negative bacteria that are obligate intracellular parasitesThey require the host's ATP as an energy source for their own metabolism. They have a cell membrane transport system that takes on ATP from the host cell and then return backs an ADP. This is called ATP/ADP translocator. Chlamydia life cycleThe chlamydia life cycle is complex as the bacteria exists in two forms (biphasic)Elementary bodyIt is a metabolically inert (does not divide), dense, round, small (300 nm) infectious particle.The outer membrane has extensive disulfide bond cross-linkages that confer stability for extracellular existence.It is an infectious particle that spreads from host to host.Initial body (also called reticulate body)Once inside a host cell the elementary body inhibits phagosome lysosome fusion and grows in size to 1000 nm.Its RNA content increases and binary fission occurs forming the initial body, (initial body)Although the initial body synthesizes its own DNA, RNA and proteins, it requires ATP from the host.Also know * Chlamydia trachomatis has affinity for columnar cells. |
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All of the following statements are true, except: (A) Infective endocarditis can develop large friable vegetations, (B) Non Bacterial thrombotic endocarditis develops in DIC, (C) Vegetations of Infective endocarditis occurs on both surfaces of cusps, (D) All of the above | Answer is C. Optic C is true for libman - sacks endocarditis seen in SLE. Refer the byte "Vegetations in Endocarditis". |
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Migraine prophylaxis includes:: (A) Verapamil, (B) Valproate, (C) Amitryptiline, (D) All of the above | Answer is D. Trick: Very Volatile Pharma Agent For Migraine Prophylaxis
V → Verapamil
V → Valproate
P → Pizotifen
A → Amitryptiline
F → Flunarizine
M → Methylsergide
P → Propranolol |
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A patient with Lefort-II, Lefort-III and nasoethmoidal fracture with intermaxillary fixation done is best intubated by:: (A) Nasal, (B) Oral, (C) Submental, (D) All of the above | Answer is C. None |
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Ritgen maneuver is done in: (A) Shoulder dystocia, (B) For delivery of head in breech presentation, (C) For delivery of legs in breech, (D) For delivery of head in normal labour | Answer is D. Ritgen manuever is done for delivery of head in normal labor to allow controlled delivery of head. When the head distends the vulva and perineum enough to open the vaginal introitus to a diameter of 5cn of more , a towel is drapled ,gloved hand may be used to exe forward pressure on the chin of fetus through the perineum just in front of coccyx. Concurrently the other hand exes pressure superiorly against occiput. This ours nect extension so that the head is delivered with its smallest diameter passing through the introitus and over perineum |
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Putting profit ahead of health as a cause of disease is provided by theory of sociology: (A) Marxist theory, (B) Feminist theory, (C) Parsonian theory, (D) Foucauldian theory | Answer is A. None |
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One year old male child presented with poor urinary stream since bih. The investigation of choice for evaluation is -: (A) Voiding cystourethrography (VCUG), (B) USG bladder, (C) Intravenous urography, (D) Uroflowmetry | Answer is A. Ans. is 'a' i.e., Voiding cystourethrography o Poor urinary stream since bih suggests urinary tract obstruction (usually infravesical). o Most common cause of urinary tract obstruction in a male child is posterior urethral valve. o And the best diagnostic method for posterior urethral valve is voiding cystourethrogram. |
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A 6 year old mentally retarded male child patient presents with hepatosplenomegaly, coarse facial features, corneal clouding, large tongue, prominent forehead, joint stiffness, short stature and skeletal dysplasia. What is the enzyme deficient in this patient?: (A) Iduronate sulfatase, (B) β-Galactosidase, (C) α-L- Iduronidase, (D) β-Glucuronidase | Answer is C. Mucopolysaccharidosis-I H (Hurler’s Disease):
Biochemical defect:
Homozygous or double heterozygous nonsense mutation of IDUA gene on Chromosome 4p encoding α-L-Iduronidase.
Clinical features of MPS I H (Hurler’s Disease):
Progressive disorder with multiple organ and tissue involvement that results in premature death, usually by 10 years of age.
An infant with Hurler’s syndrome appears normal at birth, but inguinal hernias are often present. Diagnosis is usually made between 6 and 24 month of age.
Hepatosplenomegaly, coarse facial features, corneal clouding, large tongue, prominent forehead, joint stiffness, short stature and skeletal dysplasia are seen.
Acute cardiomyopathy has been found in some infants < 1 year of age.
Most patients have recurrent upper respiratory tract and ear infections, noisy breathing and persistent copious nasal discharge.
Valvular heart disease with incompetence, notably of the mitral and aortic valves, regularly develops, as dose coronary artery narrowing.
Obstructive airway disease, notably during sleep, may necessitate trachotomy. Obstructive airway disease, respiratory infection and cardiac complications are the common causes of death.
Key Concept:
Hurler's disease is due to α-L- Iduronidase enzyme deficiency due to homozygous or double heterozygous nonsense mutation of IDUA gene on Chromosome 4p encoding α-L-Iduronidase.
Reference- Harper’s illustrated biochemistry. 30th edition page no: 179 |
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Muscle which is not there in a modiolus:: (A) Depressor anguli oris., (B) Buccinator., (C) Zygomaticus major., (D) Zygomaticus minor. | Answer is D. Modiolus is a point where eight muscles meet at the ANGLE OF MOUTH
1. Depressor anguli oris (or) triangularis
2. Levator anguli oris or caninus
3. Risorius
4. Orbicularis oris
5. Buccinator
6. Zygomaticus major
7. Quadratus labii superioris
8. Quadratus labii inferioris |
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SAFE strategy for Trachoma includes all of the following except:: (A) Screening, (B) Antibiotic, (C) Face wash, (D) Environmental improvement | Answer is A. A i.e. Screening |
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Dissection of which aery is seen in pregnancy -: (A) Carotid aery, (B) Aoa, (C) Coronary A, (D) Femoral aery | Answer is B. Answer is 'b' i.e. Aoa |
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All of the follow ing are diaphyseal tumors except-: (A) Ewings sarcoma, (B) Histiocytosis, (C) Fibrosarcoma, (D) Aneurysmal bone cyst | Answer is D. Ans. is 'd' i.e., Aneurysmal bone cyst Sites of tumorsEpiphyseal tumorsMetaphyseal legionsDianhvseai lesionso Chondroblastomao Giant cell tumor (osteoclastoma)o Clear cell chondrosarcomao Osteogenic sarcomao Unicameral (simple) bone cysto Aneuiysmal bone cysto Fibrous cortical defecto Chondrosarcomao Osteochondromao Enchondromao Osteoblastomao Ewring sarcomao Lymphomaso Fibrous dysplasiao Adamantinomao Histiocytosiso Osteoid osteomao Chondromyxoid fibromao Fibrosarcomao Fibrous cortical defecto Non ossifying fibroma |
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Which of the following acts as an antagonist to NMDA receptor?: (A) Ketamine, (B) Spermine, (C) Muscimol, (D) Baclofen | Answer is A. Ketamine is a general anesthetic agent which acts by blocking excitatory NMDA type of glutamate receptors. |
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Which does not contribute to Enterobillary Fistula ?: (A) Duodenal ulcer, (B) Gall stones, (C) Gastric ulcer, (D) Carcinoma gall bladder | Answer is C. Ans. is 'c' i.e. Gastric ulcer |
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Atomoxetine is used for ?: (A) Nocturnal enuresis, (B) ADHD, (C) Temper tantrums, (D) Patent ductusaeriosus | Answer is B. Ans. is 'b' i.e., ADHD Atomoxetine it is selective norepinephrine reuptake inhibitor and is approved for use in ADHD. It is indicated in children > 6 years and in adults with concentration and attention problems. Atomoxetine absorbed orally, hydroxylated by CYP2D6 and excreted in urine, mainly as glucuronide. While majority of individuals are extensive metabolizers (EM), few are poor metabolizers (PM) due to polymorphism of CYP2D6. Inhibitors of CYP2D6 like fluoxetine, paroxetine, quinidine increase concentration and toxicity of atomoxetine. It should not be given with MAO inhibitors and is contraindicated in glaucoma. |
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Which drug can be administered through all routes?: (A) Fentanyl, (B) Paracetamol, (C) Penicillin G, (D) Azithromycin | Answer is A. Ref: Katzung 11th ed. p. 542Explanation:Most opioid analgesics are well absorbed when given by subcutaneous, intramuscular, and oral routes.Rectal suppositories of morphine and hydromorphone have been used when oral and parenteral routes are undesirable.The transderma I patch provides stable blood levels of drug and better pain control while avoiding the need for repeated parenteral injections.Fentanyl has been the most successful opioid in transdermal application and is indicated for the management of persistent unremitting pain.The intranasal route avoids repeated parenteral drug injections and the first-pass metabolism of orally administered drugs.Butorphanol is the only opioid currently available in the USA in a nasal formulation. Butorphanol has shown greater analgesia in women.Another alternative to parenteral administration is the buccal transmucosal route, which uses a fentanyl citrate lozenge or a "lollipop'' mounted on a stick. |
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Charcot's/neuropathic joint are most commonly seen in: (A) Diabetes Mellitus, (B) Spyringomyelia, (C) Leprosy, (D) Rheumatic Ahritis | Answer is A. . |
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A 24 year old man falls on the ground when he is struck in the right temple by a baseball. While being driven to the hospital, he lapses into coma. He is unresponsive with the dilated right pupil when he reaches the emergency department. The most important step in initial management is -: (A) Craniotomy, (B) CT scan of the head, (C) X-ray of the skull and cervical spine, (D) Doppler ultrasound examination of the neck | Answer is A. None |
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Most variable absorption is seen with which route?: (A) Oral, (B) Intramscular, (C) Intravenous, (D) Per rectal | Answer is A. Ans. is 'a' i.e., Oral Oral administration of drugs is safe, convenient and economical, but has the potential for the most variable absorption pattern. Clinical pharmacology Routes of drug administration Drugs are administered by various routes. Different routes have different characteristics, so that the route of administration may have a profound effect upon the speed and efficiency with which the drugs act. The routes of drug administration may be: i) Local route ii) Systemic route Local route - Drug is administered at the site of lesion. Systemic route - Drug is administered through systemic routes is intended to be absorbed into the blood stream and distributed all over, including the site of action, through circulation. |
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Pain during injection occurs with all Except: (A) Propofol, (B) Thiopentone, (C) Ketamine, (D) Etomidate | Answer is C. Ketamine is the only intravenous inducing agent that does not cause pain on injectionAgentPain on iv injectionThiopentoneMethohexitonePropofolEtomidateKetamine+/0++++++0 |
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Which variety of AML is associated with good prognosis -: (A) MO, (B) M3, (C) M6, (D) M7 | Answer is B. Ans. is 'b' i.e., M3 Prognostic factors in AMLGood PrognosisBad Prognosiso Age < 40 yearso Age < 2 years or > 55 yearso M2, M3, M4 forms of AMLo M0, M6, M7 FORMS OF AMLo Blast cell with Auer rodso Complex karyotypeso TLC <25x109/Lo TLC> 100 x 109/Lo t (15;17), t (8;21), inv 16o Deletions 5q, 7q (Monosomy 5 or 7)o Leukemia without preceeding MDSo AML with preceding MDS or anticancer drug exposure |
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Muscle not having dual nerve supply: (A) Digastric, (B) Thyrohyoid, (C) Trapezius, (D) Adductor magnus | Answer is B. Anterior belly of digastric is supplied by the trigeminal nerve and posterior belly by facial nerve Spinal accesory nerve and c3,c4 nerves supply Trapezius Ischial pa of sciatic nerve and the obturator nerve supply adductor magnus Ref: Gray's 39e/p112-127 |
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Clinical features of T.B. Spine are AJE -: (A) Loss of lordosis, (B) Night sweats, (C) Weight gain, (D) Evening rise of temperature | Answer is C. There is weight loss (not gain).
The presenting complains are : -
Back pain : Commonest and earliest symptom. Initially, pain occurs on the sudden movement of the spine.
The stiffness of back : Is also an early symptom and occur along with pain.
Visible deformity: Gibbus or Kyphosis
Localized swelling : Due to cold abscess
Paraplagia : In neglected cases
Constitutional symptoms : Evening fever, loss of appetite, night sweat, loss of weight.
On examination, following findings may be seen : -
Decreased range of motion.
Local tenderness : Over the spinous process of an affected vertebra.
Deformity : -
Cervical spine : - Straight neck with loss of cervical lordosis.
Thoracic : - Gibbus/kyphosis
Lumbar : - Loss of lumbar lordosis
iv) Para-vertebral swelling : - Cold abscess |
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Inheritance pattern of ABO blood group system and HLA system: (A) Pseudodominance, (B) Autosomal dominant, (C) Autosomal recessive, (D) Codominant | Answer is D. "The genes that determine the A and B phenotypes are found on chromosome 9p and are expressed in a Mendelian codominant manner." |
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Paroxymal sneezing on getting up early in morning from bed is associated with ?: (A) Vasomotor rhinitis, (B) Perineal rhinitis, (C) Seasonal rhinitis, (D) Allergic rhinitis | Answer is A. Vasomotor Rhinitis It is a non allergic rhinitis clinically simulating nasal allergy. Symptoms Paroxysmal sneezing : Bouts of sneezing sta just after getting out of the bed in the morning. Excessive rhinorrhoea : This accompanies sneezing and may be the only predominant symptom. It is profuse and watery and may even wet several handkerchiefs. The nose may drip when the patient leans forward, and this may need to be differentiated from CSF rhinorrhoea. Nasal obstruction : This alternates from side to side. Usually more marked at night. It is the dependent side of nose which is often blocked when lying on one side. Postnasal drip. |
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A young male patient presented with UTI. On urine examination pus cells were found but no organisms. Which method would be best for culture?: (A) Mc Coy culture, (B) Thayer Main medium, (C) L.J medium, (D) Levinthal medium | Answer is A. Sterile pyuria -caused by Chlamydia , ureaplasma and mycoplasma. McCoy culture is used for Chlamydia. Thayer Main - Neisseria gonorrhea. L J medium - Mycobacterium tuberculosis Levinthal medium - Hemophilus |
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In the life cycle of malaria parasite, the definitive host is -: (A) Mosquito, (B) Man, (C) Pig, (D) Sandly | Answer is A. Life history of plasmodium The malaria parasite undergoes 2 cycles of development the human cycle (asexual cycle) and the mosquito cycle (sexual cycle). Man is the intermediate host and mosquito the definitive host Ref: Park 25th edition Pgno : 281-285 |
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What is this study?: (A) Retrograde Pyelogram, (B) Ultrasound, (C) X Ray KUB, (D) Contrast CT KUB | Answer is A. Retrograde ureterogram demonstrating the collecting system. The radiolucent filling defect in the renal pelvis is caused by radiolucent calculus |
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Maximum number of oogonia is seen at: (A) Puberty, (B) 20th week of gestation, (C) At birth, (D) 20 years age | Answer is B. Maximal number of oogonia is achieved at 20th week of gestation. |
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All of the following are functions of the spleen EXCEPT ?: (A) Clearance of damaged or aged red blood cells (RBCs) from the blood., (B) Extramedullary site for hematopoiesis and recycling iron., (C) Initiation of adaptive immune response from filtration of lymph., (D) Clearance of encapsulated bacteria from the bloodstream. | Answer is C. Functions of spleen:- 1. Phagocytic function -- when any foreign body invades, macrophages ingest them by phagocytosis & liberate the antigenic products of the organism -- antigens activate the helper T lymphocytes & B lymphocytes 2. Secretion of bactericidal agents -- secrete many bactericidal agents which kill the bacteria I. Superoxide (02-) II. Hydrogen peroxide (H202) III. Hydroxyl ions (OH -) 3. Secretion of interleukins -- IL-1: accelerate maturation & proliferation of specific B lymphocytes & T lymphocytes -- IL-6: cause growth of B lymphocytes -- IL-12: influence the T-helper cells Through the reticuloendothelial system the spleen clears encapsulated bacteria such as pneumococcus and Haemophilus influenzae which are poorly opsonized from the hepatic reticuloendothelial system. In addition to these functions the spleen serves as an extramedullary site for hematopoiesis and plays a functional role in the recycling of iron. While the white pulp of the spleen is impoant in the initiation of the adaptive immune response, material is delivered to the spleen through the blood and not the lymph. |
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Sandifer syndrome due to GERD in infants is confused with __________: (A) Seizures, (B) Recurrent vomiting, (C) Acute otitis media, (D) Sinusitis | Answer is A. Infants with GERD presents with anorexia, dysphagia, arching of back during feedings, irritability, hematemesis, anaemia, failure to thrive.other symptoms are chest pain, recurrent pneumonia apnoea, wheezing, stridor, hoarseness, cough, abnormal neck posturing(Sandifer syndrome) Sandifer syndrome is most commonly mistaken for seizures Ref : ESSENTIAL PEDIATRICS,O.P.GHAI, PG NO:253, 7th edition |
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Witches chin is not associated with?: (A) Ptosis of mentalis muscle, (B) Long term edentulous mandible without denture, (C) Loss of muscle attachment, (D) Increased vertical dimensions | Answer is D. None |
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Inferior orbital fissure is between which 2 walls of orbit:: (A) Roof and medial, (B) Lateral and floor, (C) Floor and medial, (D) Roof and lateral | Answer is B. Inferior orbital fissure is formed between the greater wing of the sphenoid (lateral wall) and maxilla (Floor)runs posterolaterally It transmits the zygomatic branch of the maxillary nerve and the ascending branches from the pterygopalatine ganglion The infraorbital vessels are found in the inferior orbital fissure and travel down the infraorbital groove into the infraorbital canal and exit through the infraorbital foramen Inferior division of ophthalmic vein passes through the inferior orbital fissure. No. 6 is Inferior Orbital fissure No. 3 is Superior Orbital fissure |
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In a family, mother is normal while father has a genetic disease. All their daughters are carriers and sons are normal, what is the pattern of inheritance of disease?: (A) X-linked recessive, (B) X-linked dominant, (C) AD, (D) AR | Answer is A. a. X-linked recessive(Ref: Nelson's 20/e p 595, Ghai 8/e p 640)In a X-linked recessive disease; affected male transmits the disorder to all his daughters (carriers)Sons get their X chromosome from their mother & not from their fatherHence sons of a diseased father are unaffected in X-linked diseasesIn an X-linked dominant disorder all the daughters of an affected father would be diseased and not carriers. |
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The blood gas parameters: pH 7.58, pCo2 23 mm Hg pO2 300 mm Hg and oxygen saturation 60% are most consistent with-: (A) Carbon monoxide poisoning, (B) Ventilatory malfunction, (C) Voluntary hyperventilation, (D) Methyl alcohol poisoning | Answer is B. Answer is B (Ventilatory malfunction) Ventilatory malfunction is the single best answer of exclusion This is consistent with a diagnosis of ventilatory mal function. None of the other three condition satisfy the given parameters of the patients. The answer of exclusion therefore is some form of ventilatory malfunction. In carbon monoxide poisoning ABG analysis would reveal acidosis and nollnal PO2 In voluntary hyperventilation oxygen saturation would be normal. In methyl alcohol poisoning ABG would reveal acidosis and not alkalosis. |
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A 21 year old male presents with anemia and mild hepatosplenomegaly. His hemoglobin is 5 gm/dit, history of single blood transfusion is present till date. Most probable diagnosis is -: (A) Thalassemia major, (B) Thalassemia minor, (C) Thalassemia intermedia, (D) Autoimmune hemolytic anemia | Answer is D. None |
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Cause of alpha thalasemia -: (A) Deletion of alpha genes, (B) Deletion of beta genes, (C) Excess of alpha genes, (D) Single amino acid substitution in alpha chain | Answer is A. Ans. is 'a' i.e., Deletion of alpha genes a thalassemiasAlpha thalassemias are hemoglobin disorders in which the a chain of the hemoglobin is not/partly synthesized. a chains are required for all types of hemoglobin synthesis of all types of hemoglobin i.e.HbA (a2 b2)HbF (a2 g2)* HbA2 (a2d2) |
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Which of the following is/are feature of streptococcus agalactiae rather than staphylococcus aureus?: (A) Catalase positive, (B) Bacitracin resistant, (C) Coagulase negative, (D) a hemolysis | Answer is C. C. Coagulase negativeb hemolysis and bacitracin resistance occur in bothStaphylococcus AureusCoagulase Positive: Ananthanarayan Whf2l0Beta type of hemolyisis on blood agar-Microbiology by Baveja 5th/175"Streptococci- coagulase negative" Ananthanarayan lQ7h/218 "Lancefield group B consists of a single species, S. agalactiae, which is definitively identified with specific antiserum to the group B cell wall-associated carbohydrate antigen. A streptococcal isolate can be classified presumptively as GBS on the basis of biochemical tests, including hydrolysis of sodium hippurate (in which 99% of isolates are positive), hydrolysis of bile esculin (in which 99-100% are negative), bacitracin susceptibility (in which 92% are resistant), and production of CAMP factor (in which 98-100% are positive). CAMP factor is a phospholipase produced by GBS that causes synergistic hemolysis with p lysin produced by certain strains ofS. aureus'-Harrison 19th/969Staphylococci produce catalase, which converts hydrogen peroxide into water and oxygen. The catalase test differentiates the staphylococci, which are positive, from the streptococci, which are negative- Jawetz 27th/205Ananthanarayan 10th/210Species or common nameLancefield groupHemolysisLaboratory testS. pyogenesABetaBacitracin-sensitive, PYR test-positive; Ribose not fermntedS. agalactiaeBBetaCAMP test, Hippurate hydrolysisBacitracin Test microbeonline.com Positive: Streptococcus pyogenes Negative: Streptococcus agalactiaeThe bacitracin test is useful for differentiating b-hemolytic Group A streptococci from b-hemolytic non-Group A streptococci. This is important because most streptococcal diseases are caused by Group A streptococci. The bacitracin test can also be used to differentiate the bacitracin-resistant Staphylococcus from the bacitracin-susceptible Micrococcuswww.austincc.edu |
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A neonate diagnosed of having pentalogy of Fallot. She may have the following lesions:: (A) TOF + PDA, (B) TOF + ASD, (C) TOF + COA, (D) TOF + Polysplenia | Answer is B. Patients with tetralogy of Fallot have a VSD, RV infundibular stenosis, RVH, and a dilated aoa (in about 50% of patients it overrides the septum). If there is an associated ASD, the complex is referred to as pentalogy of Fallot. Ref: Bashore T.M., Granger C.B., Hranitzky P., Patel M.R. (2013). Chapter 10. Hea Disease. In M.A. Papadakis, S.J. McPhee, M.W. Rabow (Eds), CURRENT Medical Diagnosis & Treatment 2013. |
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Methadone is used to treat withdrawal symptoms of: PGI 12; NEET 13: (A) Cocaine, (B) Heroin, (C) Amphetamine, (D) Barbiturate | Answer is B. Ans. Heroin |
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Carbamoyl phosphate synthase I is used in ?: (A) Purine synthesis, (B) Pyrimidine synthesis, (C) Urea cycle, (D) Uronic acid pathway | Answer is C. Ans. is 'c' i.e., Urea cycleCarbamyl phosphate synthase I Urea cycleCarbamyl phosphate synthase II- Pyrimidine synthesis |
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In which of the following types of leukemia is methotrexate administered for CNS prophylaxis -: (A) ALL, (B) AML, (C) CLL, (D) CML | Answer is A. None |
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Features of Mitral stenosis on X-ray are all EXCEPT:: (A) Double contour of right border, (B) Lifting of left mainbronchus, (C) Splaying of carinal angle, (D) Lower lobe prominence of veins | Answer is D. Lower lobe prominence of veins REF: Sutton's radiology 7th edition page 294 Features of mitral stenosis on X ray: Straightening of hea border (earliest sign ) Lifting of left bronchus Posterior displacement of esophagus Double atrial shadow Alveolar edema Kerly B lines Pulmonary hemosiderosis Cephalisation of upper lobe vessels Moustache sign: Enlargement of main pulmonary aery and periferal pruning |
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Medical etiquette is related to: (A) Moral principles followed by doctors, (B) Legal responsibilities of doctors, (C) Couesy observed between doctors, (D) Rules to be followed by doctors | Answer is C. Medical etiquette:- It deals with the conventional laws of couesy observed between members of the medical profession. A doctor should behave with his colleagues as he would have them behave with himself. Medical jurisprudence (juris= law; prudentia = knowledge):- It deals with legal responsibilities of the physician with paicular reference to those arising from physician-patient relationship, such as medical negligence cases, consent, rights and duties of doctors, serious professional misconduct, medical ethics, etc. In sho, it deals with legal aspects of practice of medicine. Ref:- k s narayan reddy; pg num:-01 |
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Because free ammonia in the blood is toxic to the body, it is transported in which of the following non-toxic forms?: (A) Histidine and urea, (B) Phenylalanine and methionine, (C) Glutamine and urea, (D) Lysine and glutamine | Answer is C. Ans. C. Glutamine and ureaBoth urea and glutamine play an important role in the storage and transport of ammonia in the blood. Histidine, phenylalanine, methionine, and lysine are not involved in ammonia transport. |
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Which one of the following structures is pa of the diencephalon?: (A) Caudate nucleus, (B) Cerebral hemispheres, (C) Hippocampus, (D) Thalamus | Answer is D. Diencephalon consist of:- Thalamus Hypothalamus Meta-thalamus-include medial and lateral geniculate body Epi-thalamus-include Pineal body, Habenular trigone and post. commisure Sub-thalamus |
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One of the most common complication of iridocyclitis is:: (A) Scleritis, (B) Secondary glaucoma, (C) Band-shaped keratopathy, (D) Corneal ulcer | Answer is B. Ans. Secondary glaucoma |
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About retinitis pigmentosa, all are true EXCEPT: September 2012: (A) Ring scotoma, (B) Central scotoma, (C) Waxy pallor of disc, (D) Bone spicule pigmentation in retina | Answer is B. Ans. B i.e. Central scotoma Retinitis pigmentosa Feature: Loss of visual acuity Microscopy: Irregular black deposits of clumped pigment in the peripheral retina (Bone spicules) |
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Most common carcinoma after burns is:: (A) Squamous cell carcinoma, (B) Adenocarcinoma, (C) Melanoma, (D) Mucoid carcinoma | Answer is A. Squamous cell carcinoma is MC carcinoma in burns. SCC commonly occurs in long standing ( Marjolin's ulcer) , old scar or keloid. Both Marjolin's ulcer & keloid are complications that arise after burns |
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Which of the following cells do not act as antigen presenting cells. ?-: (A) T-cells, (B) B-cells, (C) Macrophages, (D) Osteoclasts | Answer is A. Answer is option 1 T cell responses differ from B cell responses in at least two crucial ways. First, T cells are activated by foreign antigen to proliferate and differentiate into effector cells only when the antigen is displayed on the surface of antigen-presenting cells in peripheral lymphoid organs. The T cells respond in this manner because the form of antigen they recognize is different from that recognized by B cells. Whereas B cells recognize intact antigen, T cells recognize fragments of protein antigens that have been paly degraded inside the antigen-presenting cell. The peptide fragments are then carried to the surface of the presenting cell on special molecules called MHC proteins, which present the fragments to T cells. T cells don't act as antigen presenting cells. |
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Commonest cause of obstructive hydrocephalus in children: (A) Acqueductal stenosis, (B) Aquaductal gliosis, (C) Subarachnoid hemorrhage, (D) Tubercular meningitis | Answer is A. Aqueducts stenosis is most common cause of obstructive hydrocephalus in children. Reference: GHAI Essential pediatrics, 8th edition |
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Characteristic feature of acute inflammation is:: (A) Vasoconstriction, (B) Vascular stasis, (C) Vasodilatation and increased vascular permeability, (D) Margination of leucocytes | Answer is C. . Vasodilatation and increased vascular permeability |
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According to FIGO classification the investigation in Carcinoma cervix are all except -: (A) X-Ray Chest, (B) IVP, (C) Pelvic ultrasound, (D) Cystoscopy | Answer is C. Ans-C |
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Most specific marker for neural tube defects is: (A) Alpha-fetoprotein, (B) Unconjugated estriol, (C) Acetylcholinesterase, (D) Pseudocholinesterase | Answer is C. Both alpha-fetoprotein and acetylcholinesterase in amniotic fluid are markers for neural tube defects. But acetylcholinesterase is the most specific marker. Ref : Dutta book of obstetrics 8th Ed |
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The most dreadful complication of Kawasaki disease is: (A) Rash, (B) Lymph node, (C) Cardiac involvement, (D) Thrombocytosis | Answer is C. Kawasaki disease is an acute, febrile, usually self-limited illness of infancy and childhood (80% of the patients are younger than 4 years of age) associated with an aeritis of mainly large to medium-sized vessels. Its clinical significance stems from the involvement of coronary aeries. Coronary aeritis can cause aneurysms that rupture or thrombose, resulting in myocardial infarction. (Robbins basic pathology,9th edition,pg no.352) |
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Anaplasia is:: (A) Changing one type of epithelium to another, (B) Nuclear chromatin, (C) Lack of differentiation, (D) Morphological changes | Answer is C. Ans. c. Lack of differentiationRef: Robbins and Cotran Pathologic Basis of Disease 9th Ed; Page No-269Cellular ChangesHyperplasia: Increase in number of cells. May be a risk factor for future malignancy (e.g. to endometrial hyperplasia) but not considered premalignant.Hypertrophy: Increase in size of cells.Atrophy: Decrease in tissue mass due to increase in size and/or number of cells. Causes include disuse, denervation, loss of blood supply, loss of hormonal stimulation, poor nutrition.Dysplasia: Disordered, non-neoplastic cell growth. Term used only with epithelial cells. Mild dysplasia is usually reversible; severe dysplasia usually progresses to carcinoma in situ.Metaplasia: Replacement of one cell type by another. Usually due to exposure to an irritant, such as gastric acid or cigarette smoke. Reversible if the irritant is removed but may undergo malignant transformation with persistent insult (e.g. Barrett esophagus - esophageal adenocarcinoma).Neoplasia: Uncontrolled, clonal proliferation of cells. Can be benign or malignant.Anaplasia: Complete lack of differentiation of cells in a malignant neoplasm.Differentiation The degree to which a malignant tumor resembles its tissue of origin:Well-differentiated tumors (often less aggressive) closely resemble their tissue of origin.Poorly differentiated tumors (often more aggressive) look almost nothing like their tissue of origin. |
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Which of the following is not an indication ofcotrimoxazole aEUR': (A) >Lower UTI, (B) >Prostatitis, (C) >Chancroid, (D) >Typhoid | Answer is C. Chancroid Corimoxazole in Typhoid Initially cotrimoxazole was an effective alternative to chloramphenicol. However, in many areas resistant S. typhi have appeared and now it is seldom used. Cotrimoxazole in chancroid Corimoxazole for 7 days is a 3rd choice inexpensive alternative to ceftriaxone, erythromycin or iprofloxacin. Cotrimoxazole It is a combination of sulfonamide (sulfamethoxazole) and trime- thoprim in the ratio of 1 :5. Cotrimoxazole was claimed to be more effective than either of its components individually in treating bacterial infections. Because of its associated greater incidence of adverse effects including allergic responses its widespread use has been restricted in many countries to very specific circumstances where its improved efficacy is demonstracted. Uses of Cotrimoxazole Upper and lower respiratory tract infections - Exacerbations of chronic bronchitis - For otitis media and sinusitis. - It should never be used for streptococcal pharyngitis. Urinary tract infections -Uncomplicated cystitis in non pregnant women. Especially valuable for chronic and recurrent cases. - Prostatitis (cotrimoxazole is concentrated in goodamounts in prostate) Pneumocystic carinii pneumonia -Drug of choice next to pentamidine for the treatment and prophylaxis of pneumonias caused by Pneumocystic Jirovecci (commonly seen in imtnunocompromised patients including those suffering from HIV/AIDS). Other conditions where cotrimoxazole finds its use. -Listeria monocytogens infections - Meliodosis - Shigellosis - Traveller's diarrhoeas (E. coli, Campylobacter, Shigella, Y. enterocolitica) - Prophylaxis of cerebral toxoplasmosis - Whipple's disease - Salmonella (typhoid) initially it was responsive but now resistant strains have emerged. - Chancroid According to K.D.T. - Cotrimoxaxole can be used in both chancroid and typhoid. According to Harrison (18/e) Cotrimoxazole is used in Typhoid but it is not used in chancroid. Antiobiotic therapy in typhoid Empirical Ceftriaxone Azithromycin Fully susceptible Ciprofloxacin Amoxicillin Chloramphenicol Cotritnoxazole Multidrug resistant Ciprofloxacin Ceftriaxonl Azithromycin Nalidixic acid resistant Ceftriaxone Azithromycin High dose ciprofloxacin Treatment of chancroid Ciprofloxacin Ceftriaxone Azithromycin |
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Relationship between nerve thickness and conduction velocity of myelinated nerves is:: (A) Linear, (B) Parabolic, (C) Hyperbolic, (D) No relation | Answer is A. Fiber diameter (thickness) and conduction velocity relationship: The relationship is linear for myelinated axons and parabolic relation for nonmyelinated axons. |
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A six-year old boy is schedules for examination of the eye under anaesthesia. The father informed that for the past six months the child is developing progressive weakness of both legs. His elder sibling had died at the age of 14 years. Which drug would you definitely avoid during the anaeshetic management?: (A) Succinylcholine, (B) Thiopentone, (C) Nitrous oxide, (D) Vecuronium | Answer is A. A i.e. Succinylcholine Boy is having some myopathy (probably duchenne's). So Sch may lead to life threatening hyperkalemia. |
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'hn RNA' is associated with which of the following heamatological condition?: (A) a - Thalassemia, (B) Sickle cell anaemia, (C) B - Thalassemia, (D) None | Answer is C. hn RNA is seen in case of splicing defect. It is also seen in spiral muscular atropy. |
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Virchow's cells are seen in –: (A) Henoch scholein purpura, (B) Toxic Epidermal necrolysis, (C) Congenital syphilis, (D) Leprosy | Answer is D. Foam cells containing lepra bacilli are called virchow's cells (lepra cells). These cells are abundant in lepromatous leprosy. |
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Following statements are true with respect to glycogen except: (A) Principle storage of carbohydrate in the human body is glycogen, (B) Liver and muscle are the main sites of glycogen storage, (C) Produced by glycogenesis, (D) Insulin stimulates glycogenolysis | Answer is D. Insulin inhibits glycogenolysis by oring the inactivation of glycogen phosphorylase and inhibiting glucose-6-phosphatase. The net effect of all these three mechanisms, blood glucose level is lowered.Ref: DM Vasudevan, 7th edition, page no: 321 |