Discussion in 'AIIMS Nov 2013' started by Guest, Nov 16, 2009.

  1. Guest

    Guest Guest

    A question came on CD117

    CD117, also called KIT or C-kit receptor, is a cytokine receptor expressed on the surface of hematopoietic stem

    cells as well as other cell types. This receptor binds to stem cell factor (a substance that causes certain types of

    cells to grow). Altered forms of this receptor may be associated with some types of cancer.

    This gene encodes the human homolog of the proto-oncogene c-kit. C-kit was first identified as the cellular homolog

    of the feline sarcoma viral oncogene v-kit. This protein is a type 3 transmembrane receptor for MGF (mast cell

    growth factor, also known as stem cell factor).

    Mutations in this gene are associated with gastrointestinal stromal tumors, mast cell disease, chronic myelogenous

    leukemia, and piebaldism. Multiple transcript variants encoding different isoforms have been found for this gene.
    CD117 is a proto-oncogene, meaning that overexpression or mutations of this protein can lead to cancer. Seminomas, a

    subtype of testicular germ cell tumors, frequently have activating mutations in exon 17 of CD117. In addition, the

    gene encoding CD117 is frequently overexpressed and amplified in this tumour type, most commonly occurring as a

    single gene amplicon. Mutations of CD117 have also been implicated in leukemia, a cancer of hematopoietic

    progenitors, and gastrointestinal stromal tumors (GISTs). The efficacy of imatinib, a CD117 inhibitor, is determined

    by the mutation status of CD117

    Kawasaki disease, also referred to as mucocutaneous lymph node syndrome, is an acute, febrile, multisystem disease of children. Some 80% of cases occur prior to the age of 5, with the peak incidence occurring at 2 years. It is characterized by nonsuppurative cervical adenitis and changes in the skin and mucous membranes such as edema; congested conjunctivae; erythema of the oral cavity, lips, and palms; and desquamation of the skin of the fingertips. Although the disease is generally benign and self-limited, it is associated with coronary artery aneurysms in ~25% of cases, with an overall case-fatality rate of 0.5–2.8%. These complications usually occur between the third and fourth weeks of illness during the convalescent stage. Vasculitis of the coronary arteries is seen in almost all the fatal cases that have been autopsied. There is typical intimal proliferation and infiltration of the vessel wall with mononuclear cells. Beadlike aneurysms and thromboses may be seen along the artery. Other manifestations include pericarditis, myocarditis, myocardial ischemia and infarction, and cardiomegaly.

    HSP – usually a disease of children, rarely occurs in infants and children also

    Dermatomyositis – Heliotrope rash, Shawl sign, Gottron’s sign, Mechanic’s hands, dilated capillary loops at the base of the finger nails is also charecteristic

    Neuronopathy, Axonopathy, Retinitis pigmentosa NARP – a Mt DNA disorder

    Lynch – Colon, Endometrium, Ovarian, pancreas, small bowel, stomach

    Risk factors associated with cholangiocarcinoma include primary sclerosing cholangitis, choledochal cysts, ulcerative colitis, hepatolithiasis, biliary-enteric anastomosis, and biliary tract infections with Clonorchis or in chronic typhoid carriers. Features common to most risk factors include biliary stasis, bile duct stones, and infection. Other risk factors associated with cholangiocarcinoma are liver flukes, dietary nitrosamines, Thorotrast, and exposure to dioxin. 72,73

    A/e Vasopressin dependant on cAMP – Corticotropin, Glucagon, Dopamine, ???

    Vitamin B6 has a role in convulsions

    Dissociative anaesthesia –

    Syphilis –
    The relative sensitivities of the standard tests for untreated syphilis are shown in Table 162-1. All tests may be nonreactive in early primary syphilis, although the treponemal tests have slightly higher sensitivity during this stage. All tests are reactive during secondary syphilis. (Fewer than 1% of patients with secondary syphilis have a VDRL test that is nonreactive or weakly reactive with undiluted serum but is positive at higher serum dilutions—the prozone phenomenon.) Whereas nontreponemal test titers will decline or the tests will become nonreactive after therapy for early syphilis, treponemal tests often remain reactive after therapy and are not helpful in determining infection status of persons with past syphilis.
    The RPR and VDRL tests are used for screening or for quantitation of serum antibody. The titer reflects disease activity, rising during the evolution of early syphilis and often exceeding 1:32 in secondary syphilis. A persistent fall by two dilutions (fourfold) or more after treatment of early syphilis is considered an adequate response to therapy. VDRL titers do not correspond directly to RPR titers, and sequential quantitative testing (as for response to therapy) must employ a single test.

    Anorexia, nausea, vomiting, and diarrhea occasionally accompany oral administration. Gastrointestinal intolerance, which is due to a direct stimulation of gut motility, is the most common reason for discontinuing erythromycin and substituting another antibiotic.

    Campylobacter jejuni
    Campylobacter enteritis resembles other acute bacterial diarrheas, particularly shigella dysentery. The source of infection may be food (eg, milk, undercooked fowl) or contact with infected animals or humans and their excreta. Outbreaks arising from a common source, eg, unpasteurized milk, may require public health control measures.

    Tube Dilution Agglutination Test (Widal Test)
    Serum agglutinins rise sharply during the second and third weeks of Salmonella Typhi infection. The Widal test to detect these antibodies against the O and H antigens has been in use for decades. At least two serum specimens, obtained at intervals of 7–10 days, are needed to prove a rise in antibody titer. Serial dilutions of unknown sera are tested against antigens from representative salmonellae. False-positive and false-negative results occur. The interpretive criteria when single serum specimens are tested vary, but a titer against the O antigen of > 1:320 and against the H antigen of > 1:640 is considered positive. High titer of antibody to the Vi antigen occurs in some carriers. Results of serologic tests for salmonella infection must be interpreted cautiously because the possible presence of cross-reactive antibodies limits the use of serology. The test is not useful in diagnosis of enteric fevers caused by salmonella other than Salmonella Typhi.

    4. Voriconazole
    Voriconazole is the newest triazole to be licensed in the USA. It is available in intravenous and oral formulations. The recommended dosage is 400 mg/d. The drug is well absorbed orally, with a bioavailability exceeding 90%, and it exhibits less protein binding than itraconazole. Metabolism is predominantly hepatic, but the propensity for inhibition of mammalian P450 appears to be low. Observed toxicities include rash and elevated hepatic enzymes. Visual disturbances are common, occurring in up to 30% of patients receiving voriconazole, and include blurring and changes in color vision or brightness. These visual changes usually occur immediately after a dose of voriconazole and resolve within 30 minutes.
    Voriconazole is similar to itraconazole in its spectrum of action, having excellent activity against candida species (including fluconazole-resistant species such as C krusei) and the dimorphic fungi. Voriconazole is less toxic than amphotericin B and is probably more effective in the treatment of invasive aspergillosis.
    (may be Voriconazole is not effective against – Mucormycosis )

    Stains such as calcofluor white, methenamine silver, and occasionally periodic acid-Schiff (PAS) and others are used for tissues and other specimens in which fungi or other parasites are present. Such stains are not specific for given microorganisms, but they may define structure so that morphologic criteria can be used for identification. Calcofluor white binds to cellulose and chitin in the cell walls of fungi and fluoresces under long-wave length ultraviolet light. It may demonstrate morphology that is diagnostic of the species (eg, spherules with endospores in Coccidioides immitis infection). Pneumocystis jiroveci cysts are identified morphologically in silver-stained specimens. PAS is used to stain tissue sections when fungal infection is suspected. After primary isolation of fungi, stains such as lactophenol cotton blue are used to distinguish fungal growth and to identify organisms by their morphology.

    Warts: Treatment
    Treatment of warts, other than anogenital warts, should be tempered by the observation that a majority of warts in normal individuals resolve spontaneously within 1–2 years. There are many modalities available to treat warts, but no single therapy is universally effective. Factors that influence the choice of therapy include the location of the wart, extent of disease, the age and immunologic status of the patient, and the patient's desire for therapy. Perhaps the most useful and convenient method for treating warts in almost any location is cryotherapy with liquid nitrogen. Equally effective for non-genital warts, but requiring much more patient compliance, is the use of keratolytic agents such as salicylic acid plasters or solutions. For genital warts, in-office application of a podophyllin solution is moderately effective but may be associated with marked local reactions. Prescription preparations of dilute, purified podophyllin are available for home use. Topical imiquimod, a potent inducer of local cytokine release, has also been approved for use in genital warts. Conventional and laser surgical procedures may be required for recalcitrant warts. Recurrence of warts appears to be common to all these modalities. A highly effective vaccine for selected types of HPV has been recently approved by the FDA, and its use will likely reduce the incidence of anogenital and cervical carcinoma.

    Flail chest occurs when four or more ribs are fractured in at least two locations. Paradoxical movement of this free-floating segment of chest wall may occasionally be sufficient to compromise ventilation. However, it is of greater physiologic importance that patients with flail chest frequently have an underlying pulmonary contusion. Pulmonary contusion with or without rib fractures may compromise oxygenation or ventilation to the extent that intubation and mechanical ventilation is required. Respiratory failure in these patients may not be immediate, and frequent re-evaluation is warranted. The initial chest x-ray usually underestimates the degree of pulmonary contusion, and the lesion tends to evolve with time and fluid resuscitation.

    The embryology and anatomy of the parathyroid glands is discussed in detail in the parathyroid gland section of this chapter (see under "Parathyroid"). Most individuals have four parathyroid glands, which derive their blood supply primarily from branches of the inferior thyroid artery. Generally, parathyroid glands can be found within 1 cm of the junction of the inferior thyroid artery and the RLN. The superior glands are usually located dorsal to the RLN, whereas the inferior glands are usually found ventral to the RLN (Fig. 37-7).

    Pregnancy – early labour pains dermatomes???

    B Cell markers – CD 10, 19, 20

    GIST – CD 117

    Vagus nerve stimulation (VNS) is an invasive medical procedure used to treat clinical depression (including treatment-resistant depression) and epilepsy. It is usually used as a last chance method, when other treatments have failed to work. VNS has only been recently approved by the FDA to treat depression. The FDA has approved VNS for the treatment of depression after at least four pharmacological treatments have failed. VNS has been used to treat epilepsy since 1997.

    Note: Working memory – Dorsolateral frontal lobes and posterior parietal cortex
  2. Guest

    Guest Guest

    b)ds rna

    a)griveous injury

    alll are b -markers EXCEPT

    TNF is used in alll the following EXCEPT
    a)....with HBV
    b)........with hcv
    c)...........with pulmonary fibrosis

    ....... is missing please replace

    ARTICLE 377 deals with

    b)ds rna

    a)in a land fill
    b)are kept for 10 yrs and then disposed

    shaking hatter is associated with

    a heart pt on aspirin develops black stools
    a)gastric ulcer

    whooping cough best sample for diagnosis
    a)traceal aspirate
    c)nasopharyngeal swab

    full thickness graft can obtained from all of the following EXCEPT
    b)below clavicle

    cox-2 is asso with
    a)cell adhesion
    b)cell proliferation

    radiation induced brain necrosis is best diagnosed by
    a)brain biopsy
    b)pet SCAN

    highest potassium is found in
    a)ileal fluid

    which of the following is correct about phenytoin
    a)zero order
    b)does not have interaction?

    recently noble prize was given for
    1)RNA i

    stability of alveoli is maintained by
    1) negative interplueral pressure
    2) residual air in alveoli
    3) by decreasing surface tension by surfactant

    in post ductal aortic stenosis the vascular supply to lower limb is maintained by all the following EXCEPT
    a)suprascapular a
    b)post interthoracic a
    d)vertebral artery

    Voriconazole is used in all the following EXCEPT

    Voriconazole (VFEND, Pfizer) is a triazole antifungal medication that is generally used to treat serious, invasive fungal infections. These are generally seen in patients who are immunocompromised, and include invasive candidiasis, invasive aspergillosis, and certain emerging fungal infections.

    medial most in femoris traingle

    recurrent occipital headache in a girl, which is also seen in her mother

    1) migraine
    2) cervical.....
    4) ........

    substance p is produced by n
    a)nerve terminal

    anca found in a)R A
    b)W G
    c)good pastuer

    a pt with RHD with prosthetic valve , heparin should be started

    onset of lobour
    32 weeks
    34 wks
    37 wks

    in a female urinary control is by alll except
    a)internal sphincter
    b)external urethral sphincter

    vaginal sphinter is formed by a/e
    internal urethral sphinter
    external urethral sphinter

    urothelium lines a/e
    major calyx
    urinary bladder
    membranous urethra

    which of the following is infective to mosquito

    which of the following are false about encephalitis
    a)culcine mosquito are causative
    b)genrally mosquito breed in overhead tanks

    falopian tube dysmotility is seen in
    1) noonans
    2) kartagener
    3) marfans
    4) ..........

    regarding h.influenzae which of the following is false
    a)does not affect below 2 months
    b)most commonly cause meningitis

    in barium swallow , posterior shadow of esophagus is ..........
    lt atria
    knukle of aorta

    immunofloroscence seen in pemphigus vulgaris
    Ig A
    IgG inepidermal
    Ig G dermo-epidermal

    all the following can predoispose to bile duct cancer
    a)chronic typhoid
    c)gall stone

    the following are used in cardiac failure EXCEPT

    regarding flail chest all the following are true EXCEPT
    a)at least fracture of three ribs bilaterally
    b)should be intubated if po2 less than 40% with 60 % oygen

    Contraceptive failure in A/E:
    a. Aspirin
    b. Tetracyclines
    c. Phenytoin
    d. Rifampin

    All are used under the supervised regimen except:
    a. Rifampin
    b. Pyrazinamide
    c. Clofazimine
    d. Dapsone

    zn is a cofactor of
    alcoholic DH
    pyruvate DH
    pyruvate decarboxylase
    alpha keto acid DH


  3. ishika.

    ishika. Guest

    45 year old woman underwent cholecystectomy.It was found that adenoca was present but didnt extend beyond the muscle.what would u advice next?
    a)resection of liver?
    b)follow up with regular usg

    doc in genital warts in pregnancy?
    c)some lotion

    pregnant lady with previous c/s,has hematuria. it is a sign of -
    a)prolonged preg
    c)impending scar rupture
    d)urethral injury

    occipito posterior position. management-


    2.Q prolactin causes
    1.high FSH
    2.elevated estradiol
    3. elevated testosterone

    Which of the following is associated with > 20% risk of chromosomal anomalies?
    a. omphalocele
    b. gastroschisis
    c. cleft lip?palate??
    d. spina bifida

    1 ASPRIN


    ABO antigens not found in
    a) csf.............ans?
    b) semen
    c) plasma

    abo incompatibility not seen with
    a) ffp...........
    c) pt. conc.

    Widal test, all except one, are correct"

    a. Even one high titer is not enough for conclusive diagnosis.
    b. O antibody lasts longer and hence is not indicative of recent infection
    c. Baseline titers differ depending on the endemicity of hte disease
    d. H antibody cannot differentiate between rypes.

    Q:a girl with vomitting, pain in legs n sum other constitutional symp..
    a) somatoform
    b) somatizaion
    c)?------------->CONVERSION DISORDER

    Q.NOT true about Pseudogout:
    1. Affects small joints
    2. Affects large joints
    3. Chondrocalcinoisi
    4. Calcium pyrophosphate crystals in jt. aspirate

    Q. Premature baby 1.5kg 32 wks born with emergency C.S. now develops resp. distress with grunting. Best management:
    1. Moist Oxygen thru' headbox
    2. Mechanical ventilation
    3. C-PAP
    4. Surfactant therapy plus mechanical ventilation

    Q. True about Burkitt's Leukaemia:
    1. CD 34 and Surface Ig both +ve
    2. CD 34 - but surface Ig+
    3. CD 34+ but Surface Ig-
    4. both negative

    Q. Type of anaemia caused by Ileocaecal TB:
    1. Iron - deficiency
    2. Megaloblastic
    3. sideroblastic
    4. Normocytic Normochromic

    Q. False about P53:
    1. chromosome 17
    2. 53 KDa protein
    3. Arrests at G1 phase
    4. Alterations lead to childhood tumours

    Q. Cancers included in Lynch Syndrome:
    1. Breast, Ovary, Colon
    2. Breast, Endometrium, Ovary
    3. Breast, Endometrium, Colon
    4. Colon, Endometrium, Ovary

    Q. NOT a high risk factor for Cholangio CA:
    1. Cl. sinensis infestation
    2. Ulcerative Colitis
    4. Choledocholithiasis

    Q. ACE inhibitor which is NOT a prodrug:
    1. Fosinopril
    2. Enalapril
    3. --------
    4. Lisinopril

    Q. NOT a common cause of Vasculitis in adults:
    1. Giant Cell Arteritis
    2. PAN
    3. Kawasaki disease
    4. HSP

    Q. Renal lesion in Wegener's Granulomatosis:
    1. Interstitial Granuloma
    2. Granuloma within capillary walls
    3. Focal necrotising GN
    4. Nodular Glomerulosclerosis

    Q. Structure which does NOT pass under flexor retinaculum:
    1. Ulnar nv
    2. Median Nv.
    3. Flexor Dig. Supf.
    4. FDP

    Q. Not true about N. gonorrhoeae:
    1. Exclusive human pathogen
    2. Acute urethritis is MC maifestation in males
    3. Highly sensitive to Penicillin
    4. Some strains may cause disseminated disease

    Q. Recurrent plaques on glans which heal with residual hyperpigmentation
    1. Apthous Balanitica
    2. Fixed Drug Eruption
    3. Herpes Gestationalis
    4. Chlamydial inf.

    Q. Uterine blood flow at term:
    1. 50-75 ml/min
    2. 150-200 ml/min
    3. 350-400 ml/min
    4. >500 ml/min

    Q HLA B27 +........... Ankylosing Spondilitis

    Q. Hyperkalemia WITHOUT ECG changes. All used in t/t EXCEPT:
    1. Insulin-Glucose
    2. Calcium Gluconate
    3. Sodi- Bicarb
    4. Salbutamol

    Q. IOC for Radiation-Induced Necrosis
    1. MRI
    2. CT
    3. PET
    4. Angiography

    Q. Not true abot prostatic Urehtra:
    1. Triangular cross-section
    2. Presence of Verumontanum
    3. Opening of Prostatic ducts
    4. Relation to Urethral Crest

    Q. Infective stage for mosquito in case of Plasmodium..... gametocyte??

    Q. Factor which prevents apoptosis of Memory Cells:
    1. PDGF
    2. NGF
    3. FGF
    4. IGF

    Q. NOT acting via cAMP:.................. Vasopressin (it acts via IP3- DAG)

    Q. NOT related to development of dependance:
    1. Personality
    2. Family History
    3. Pressure by peers
    4. Intelligence

    Q. Not a disorder of Personality:
    1. Sensation seeking
    2. Neuroticism
    3. -------
    4.----------- ?? Over-worked with small details

    Q. Young girl with repeated bouts of Pain legs, vomiting, headache. Physical exam and tests normal. Most likely:
    1. gen. Anxiety disorder
    2.Body Dysmorphic disorder
    3.Somatoform disorder
    4. Somatisation Disorder

    Q. Young boy with multiple flaccid [bleep] and oral mucosal lesions. Most likely finding:
    1. FISH NET IgG in epidermis
    2. Linear igG in DEJ
    3. Linear IgA in dermal papillae
    4. Granular IgA in reticular dermis

    Q. Young girl with past H/O repeated pain over medial canthus and use of decongestannts now presents with intense chills, rigors, diplopia on lateral gaze , Optic Disc congested. Most likely diagnosis:
    1. Ethmoidal Sinusitis
    2. Orbital Cellulitis
    3. Cavernous Sinus Thrombosis
    4. Orbital Apex syndrome

    Q. NOT true about ASO titre:
    1. ----------------
    2. Major Jones' criteria
    3. ----------------------------
    4. May not be elevated even in presence of Carditis

    Q. 7 yr old boy, H/O trauma 2 months back, now presents with fever and acute pain over thigh. Femoral shaft shows lesion with laminated periosteal reactions. Next mangement:
    1. Core biopsy.
    2. Tc99 MDP sacn
    4. Hb, Leucocyte counts

    Q. Maternal chromosome 15 deletion l/t:
    1. fragile x syndrome
    2. Prader willi Syndrome
    3. Angelmann Syndrome.............. ANS.

    Q. Presence of Nephroblastomatosis in a biopsy specimen from Wilm's Tumour indicates............

    Q. Aniridia most likely to be associated with......... Nephroblastoma

    Q. AFP most likely to be raised in.............. Hepatoblastoma

    Q. HLA locus................ Short arm of chromosome 6

    Q. Disorder most likely to be associated with > 20% risk of chromosomal anomalies:
    1. Omphalocele
    2. Gastroschisis
    3. Cleft Palate
    4. Spina bifida

    Q. What does "C" in CRP stand for?
    1. C- polysaccharide of Pneumococcus
    2. Chondroitin Sulfate in series with ARP, BRP
    3. Concanavalin A

    Q. Clue Cells................ Bact. Vaginosis

    Q. Call Exener Bodies............ Granulosa Cell Tumour

    Q. Next line of mangement for AdenoCa GB penetrating muscular layer..................( don't remember........)
    1. Immediate plan for segmental hepatectomy
    2. Wait with serial USGs
    3. Chemotherapy
    $. ?? Radiotherapy

    Q. ANCA associated with................ Wegener's

    Q. Zn2+ cofactor for:
    1. Alcohol dehydrogenase
    2. Pyruvate Carboxylase
    3. Pyrvate Dehydrogenase
    4. Alpha-KG dehydrogenase

    Q. Metabolism of Benzopyridine, all true EXCEPT:
    1. Epoxidation
    2. Cytochrome reductase
    3. Increased synthesis of Cyt. P450

    Q. Baby of diabetic mother develops seizures within 12 hrs. Most likely cause..........
    !. Hypoglycemia
    2. Hypocalcemia

    Q Thiazides can cause:
    1. Hypokalaemic Met. Alkalosis
    2. Hypouricaemia
    3. Hypolipidaemia
    4. Impotence

    Q.fungal stain...............Mucicarmine??

    Q. Disease with multiple necrotising lymphadenopathy........

    Q. Treatment for Kostmann's Syndrome................

    Q. Poor Prognosis in ALL:
    1. TLC 4000-10000
    2. Age < 2 yrs
    3. Presence of testicular involvement at presentation
    4. Presence of Blasts in periph. smear

    TNF alpha blockers not used in
    (a)RA with HBV
    (b)RA with HCV
    (c)RA with pulm fibrosis

    periventricular leucomalacia a/w
    1.spastic diplrgia
    2.spt. quadriplegia
    ans is spt diplegia
  4. pankej.

    pankej. Guest

    1. Carcinoma gall bladder-
    Tx-Primary can’t be assessed
    T0-No e\o primary.
    Tis-Ca insitu.
    T1-tumor invades lamina propria\muscularis.
    T2-tumor involving perimuscular connective tissue
    T3-tumor invading serosa or directly involving liver or one extrahepatic organ
    T4-tumor invading more than one extrahepatic organ or directly involving common hepatic artery or main portal vein.
    Extrahepatic organs-stomach,duodenum,colon,extrahepatic biliary tract,omentum,pancreas.
    Nx-node can’t be assessed.
    N0-no node involved.
    N1-regional node involved.
    Mx-mets cant be assessed.
    Mo-no mets
    M1-distant mets present.
    0 Tis N0 M0
    1A T1 N0 M0
    1B T2 N0 M0
    2A T3 N0 M0
    2B T1\2\3 N1 M0
    3 T4 lesion
    4 Any M1
    Treatment acc. To stage:
    1A -simple cholecystectomy
    1B -extended cholecystectomy
    2 -radical cholecystectomy.
    3\4 palliative ct+rt.
    So in this case tumor has infiltrated muscularis but not beyond it. So correct treatment is simple cholecystectomy. So correct option is follow up.

    2. For cholangioca , chronic typhoid is not a risk factor.It is the RF for Ca gall bladder.
    Etiology of cholangioca
    1.primary sclerosing cholangitis
    3.worm infestation
    4.bile duct adenoma
    5.intraductal papillomatosis
    6.ulcerative colitis
    7.choledochal cyst
    8.Hepatitis C
    9.Lynch syndrome

    3. Tumors associated with lynch syndrome
    1. Ca colon
    2. Ca endometrium
    3. Ca ovary
    4. Ca stomach
    5. Ca biliary tract
    6. Ca ureter

    4. On per rectal examination structures felt are
    Anteriorly, in male
    2.Seminal vesicle
    3.base of bladder
    4.Rectovesical pouch of peritoneum
    In female,
    4.pouch of douglas
    1.ischiorectal fossa
    2.lateral wall of pelvis
    3.lower end of ureter
    4.internla iliac artery.

    5. Hamartomatous polyps,
    1.juvenile polyp
    2.cowden’s disease
    3.conckrite Canada syndrome
    4.baniyan riley ruvalcaba syndrome

    Potentially malignant:-
    1.juvenile polyposis syndrome
    2.peutz jeaghers syndrome

    so juvenile polyp is the answer.
  5. pankej.

    pankej. Guest

    Voriconazole is used in all the following EXCEPT

    Voriconazole (VFEND, Pfizer) is a triazole antifungal medication that is generally used to treat serious, invasive fungal infections. These are generally seen in patients who are immunocompromised, and include invasive candidiasis, invasive aspergillosis, and certain emerging fungal infections.

    TEACHER SLAPS A STUDENT., RESULTING IN 40% hearing loss, subsequent to a surgery
    a)griveous injury
    b)serious injury
    c)dangerous injury
    d0simple injury

    alll are b -markers EXCEPT
  6. ishika.

    ishika. Guest

    TNF is used in alll the following EXCEPT
    a).RA...with HBV
    b)..RA......with hcv
    c)...RA........with pulmonary fibrosis
    d ) ..RA........... with hiv

    highest potassium is found in
    a)ileal fluid
    d) pancreatic fluid

    which of the following is acquired persistent behaviour,fixed but liable to change

    a)cultural belief

    Q.Least narcotic drug is?
  7. kaya.

    kaya. Guest

    Q.21yr young female has panarteritis of the arch of aorta,histopathology shows granulomas wit giant cells, diagnosis?
    1.Nonspecific aotoarteritis
    3.Tuberculous arteritis
    4.Wegeners granulomatousis

    ans;1.Nonspecific aortoarteritis
    Ref-Harrisson 16th, 1485
  8. minag.

    minag. Guest

    ABO blood grouping is associated with all the following EXCEPT

    crossmatching of blood sample is NOT done in case of


    D) mrna


    Q. First LA used was?

    Ans is cocaine with 100%surity....

    cocaine ws first LA used by carl koller for anaesthetizing cornea as early as in 1884




    B) TONE
    D) HR


  9. minag.

    minag. Guest

    Q) a girl was hit by a teacher and sustained hearing loss foll that. she again regained hearing with aids. inury is?

    which of the following is correct about phenytoin
    a) zero order
    b) does not have interaction?
    c) excreted in unchanged form in urine
    d) it is not an enzyme inducer

    NOT used in hyperkalemia with normal ecg
    a) insulin+ glucose
    b) exchange resins
    c) clacium gluconate
    d) sodium bicarbonate

    q)recurrent headache in adolescent girl with no c/o in bet episodes. mother has same h/o. physical examination n Ix are normal. diagnosis?
    2)cluster h'ache

    poor prognosis in neuroblastoma/wilm's tumour is:
    a) age less then 2 year
    b) spread in peri renal tissue*

    regarding flail chest all the following are true EXCEPT
    a)at least fracture of three ribs at two places*
    b)should be intubated if po2 less than 40% with 60 % oxygen
    c) it may not be evident in young Pt
    d) sholud be treated with IPPV and fixation if condition severe
  10. Dr. Nandini

    Dr. Nandini Guest

    Aiims nov09 recall

    1. root value of labour pain- T10 to L1.

    2. Drug used for emergency contraception-Levonorgesterol

    3. Which vaccine should not be given in pregnancy
    a) DPT
    b) TT
  11. Dr. Nandini

    Dr. Nandini Guest

    4.Pt presents with ectopic pregnancy, investigation of choice
    a) serial monitoring of b hCG levels
    c)transvaginal ultrasonography

    5.Which is not a feature of antemortem burn
    a)vesicle filled with fliud
    b)vesicle filled with air

    6.In NRHM , the impact of ASHA's work can be checked by...
    c)infant mortality rate
    d)% of institutional deliveries

    7.In which case murmur increases on valsalva

    8.What does 'C' stand for in CPR
    a) C polysaccharide of pneumococcus
    b)CRP aftr ARP n BRP (chondritin sulphate)
  12. swati shree

    swati shree Guest

    aiims nov 2009

    Q.a pt with eye opening on painful stimuli,produces verbal response on painful stimuli,and localizes to painful stimuli.what is score inglasgow coma scale?
    4........ not associated with infection
    1.nasopharyngeal ca
    2.stomavh ca
    Q.orchipexy is done at

    1.1-2 yrs
    2.neonatal age
    3.arnd 5 yrs age

    Q.complete section at mid pons causes.......

    Q.seminal stain can be identified by......

    Q.deep peroneal nerve supply
    1.anterolateral leg
    2.anterolateral foot
    3.1st web space

    Q.a child inadequately immunized develops barking cough...........sample 4 culture can be taken fom
    1.nasopharyngeal swab
    2.endotracheal ..........

    Q.failure of development of mllerian duct causes
    1.absent uterus
    2.absent cervix
    3.absent vagina
    4.absent ovary

    Q.left phrenic nerve is to left hilum to lt brachial plexus

    Q.A population of 10000 .20% of popl have disease.specificity 80%sensitivity 95%.what is ppv?
  13. Dr. Nandini

    Dr. Nandini Guest

    failure of mullerian duct development causes all except..
    absent ovaries.
  14. sayra.

    sayra. Guest

    lynche syndrome

    According to some sources, HNPCC is also called Lynch syndrome, after Henry T. Lynch (professor of medicine at Creighton University Medical Center), who characterized it in 1966. It is divided into Lynch syndrome I (familial colon cancer) and Lynch syndrome II (colorectal cancer and another type of cancer, usually, but not limited to, the gastrointestinal system or the reproductive system).

    Other sources reserve the term "Lynch syndrome" when there is a known DNA mismatch repair defect, and use the term "Familial colorectal cancer type X" when the Amsterdam criteria are met but there is no known DNA mismatch repair defect. The latter type has a lower incidence of cancer. About 35% of patients meeting Amsterdam criteria do not have a DNA-mismatch-repair gene mutation.

    Complicating matters is the presence of an alternative set of criteria, known as the "Bethesda Guidelines".

    Individuals with HNPCC have about an 80% lifetime risk for colon cancer. Two-thirds of these cancers occur in the proximal colon. The mean age of colorectal cancer diagnosis is 44 for members of families that meet the Amsterdam criteria. Also, women with HNPCC have a 30-50% lifetime risk of endometrial cancer. The average age of diagnosis of endometrial cancer is about 46 years. Among women with HNPCC who have both colon and endometrial cancer, about half present first with endometrial cancer. In HNPCC, the mean age of diagnosis of gastric cancer is 56 years of age with intestinal-type adenocarcinoma being the most commonly reported Pathology . HNPCC-associated ovarian cancers have an average age of diagnosis of 42.5 years-old; approximately 30% are diagnosed before age 40 years. Other HNPCC-related cancers have been reported with specific features: the urinary tract cancers are transitional carcinoma of the ureter and renal pelvis; small bowel cancers occur most commonly in the duodenum and jejunum; the central nervous system tumor most often seen is glioblastoma.

    Cancers of many other sites have been reported in families with Lynch syndrome (breast,62-63 prostate,64 rhabdomyosarcoma,65 dermatofibrosarcoma,66 leiomyosarcoma,67 carcinoid,68 malignant fibrous histiocytoma69), sometimes with tumors showing high amounts of microsatellite instability.
  15. sayra.

    sayra. Guest



    The Big Five factors and their constituent traits can be summarized as follows:

    * Openness - appreciation for art, emotion, adventure, unusual ideas, curiosity, and variety of experience.
    * Conscientiousness - a tendency to show self-discipline, act dutifully, and aim for achievement; planned rather than spontaneous behavior.
    * Extraversion - energy, positive emotions, urgency, and the tendency to seek stimulation in the company of others.
    * Agreeableness - a tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others.
    * Neuroticism - a tendency to experience unpleasant emotions easily, such as anger, anxiety, depression, or vulnerability; sometimes called emotional instability.

    When scored for individual FEEDBACK , these traits are frequently presented as percentile scores. For example, a Conscientiousness rating in the 80th percentile indicates a relatively strong sense of responsibility and orderliness, whereas an Extraversion rating in the 5th percentile indicates an exceptional need for solitude and quiet.

    Although these trait clusters are statistical aggregates, exceptions may exist on individual personality profiles. On average, people who Register high in Openness are intellectually curious, open to emotion, interested in art, and willing to try new things. A particular individual, however, may have a high overall Openness score and be interested in learning and exploring new cultures but have no great interest in art or poetry. Situational influences also exist, as even extraverts may occasionally need time away from people.

    The most frequently used measures of the Big Five comprise either items that are self-descriptive sentences or, in the case of lexical measures, items that are single adjectives. Due to the length of sentence-based and some lexical measures, short forms have been developed and validated for use in applied research settings where questionnaire space and respondent time are limited, such as the 40-item balanced International English Big-Five Mini-Markers. or a very brief (10 item) measure of the big 5 domains.
    Openness to Experience
    Main article: Openness to experience

    Openness is a general appreciation for art, emotion, adventure, unusual ideas, imagination, curiosity, and variety of experience. The trait distinguishes imaginative people from down-to-earth, conventional people. People who are open to experience are intellectually curious, appreciative of art, and sensitive to beauty. They tend to be, compared to closed people, more creative and more aware of their feelings. They are more likely to hold unconventional beliefs.

    People with low scores on openness tend to have more conventional, traditional interests. They prefer the plain, straightforward, and obvious over the complex, ambiguous, and subtle. They may regard the arts and sciences with suspicion, regarding these endeavors as uninteresting. Some self-statements pertaining to openness include:

    * I have a vivid imagination.
    * I have excellent ideas.
    * I spend time reflecting on things.
    * I use difficult words.
    * I am not interested in abstractions. (reversed)
    * I do not have a good imagination. (reversed)
    * I have difficulty understanding abstract ideas. (reversed)

    Main article: Conscientiousness

    Conscientiousness is a tendency to show self-discipline, act dutifully, and aim for achievement. The trait shows a preference for planned rather than spontaneous behaviour. It influences the way in which we control, regulate, and direct our impulses. Conscientiousness includes the factor known as Need for Achievement (NAch).

    The benefits of high conscientiousness are obvious. Conscientious individuals avoid trouble and achieve high levels of success through purposeful planning and persistence. They are also positively regarded by others as intelligent and reliable. On the negative side, they can be compulsive perfectionists and workaholics.
    Sample Conscientiousness items

    * I am always prepared.
    * I am exacting in my work.
    * I follow a schedule.
    * I get chores done right away.
    * I like order.
    * I pay attention to details.
    * I leave my belongings around. (reversed)
    * I make a mess of things. (reversed)
    * I often forget to put things back in their proper place. (reversed)
    * I shirk my duties. (reversed)

    Main article: Extraversion and introversion

    Extraversion is characterized by positive emotions, surgency, and the tendency to seek out stimulation and the company of others. The trait is marked by pronounced engagement with the external world. Extraverts enjoy being with people, and are often perceived as full of energy. They tend to be enthusiastic, action-oriented individuals who are likely to say "Yes!" or "Let's go!" to opportunities for excitement. In groups they like to talk, assert themselves, and draw attention to themselves.

    Introverts lack the exuberance, energy, and activity levels of extraverts. They tend to be quiet, low-key, deliberate, and less involved in the social world. Their lack of social involvement should not be interpreted as shyness or depression. Introverts simply need less stimulation than extraverts and more time alone.
    Sample Extraversion items

    * I am the life of the party.
    * I don't mind being the center of attention.
    * I feel comfortable around people.
    * I start conversations.
    * I talk to a lot of different people at parties.
    * I am quiet around strangers. (reversed)
    * I don't like to draw attention to myself. (reversed)
    * I don't talk a lot. (reversed)
    * I have little to say. (reversed)

    Main article: Agreeableness

    Agreeableness is a tendency to be compassionate and cooperative rather than suspicious and antagonistic towards others. The trait reflects individual differences in general concern for social harmony. Agreeable individuals value getting along with others. They are generally considerate, friendly, generous, helpful, and willing to compromise their interests with others. Agreeable people also have an optimistic view of human nature. They believe people are basically honest, decent, and trustworthy.

    Disagreeable individuals place self-interest above getting along with others. They are generally unconcerned with others’ well-being, and are less likely to extend themselves for other people. Sometimes their skepticism about others’ motives causes them to be suspicious, unfriendly, and uncooperative.
    Sample Agreeableness items

    * I am interested in people.
    * I feel others’ emotions.
    * I have a soft heart.
    * I make people feel at ease.
    * I sympathize with others’ feelings.
    * I take time out for others.
    * I am not interested in other people’s problems. (reversed)
    * I am not really interested in others. (reversed)
    * I feel little concern for others. (reversed)
    * I insult people. (reversed)
    * I like being isolated. (reversed)

    Main article: Neuroticism

    Neuroticism is the tendency to experience negative emotions, such as anger, anxiety, or depression. It is sometimes called emotional instability. Those who score high in neuroticism are emotionally reactive and vulnerable to stress. They are more likely to interpret ordinary situations as threatening, and minor frustrations as hopelessly difficult. Their negative emotional reactions tend to persist for unusually long periods of time, which means they are often in a bad mood. These problems in emotional regulation can diminish the ability of a person scoring high on neuroticism to think clearly, make decisions, and cope effectively with stress.

    At the other end of the scale, individuals who score low in neuroticism are less easily upset and are less emotionally reactive. They tend to be calm, emotionally stable, and free from persistent negative feelings. Freedom from negative feelings does not mean that low scorers experience a lot of positive feelings. Frequency of positive emotions is a component of the Extraversion domain.
    Sample Neuroticism items

    * I am easily disturbed.
    * I change my mood a lot.
    * I get irritated easily.
    * I get stressed out easily.
    * I get upset easily.
    * I have frequent mood swings.
    * I often feel blue.
    * I worry about things.
    * I am relaxed most of the time. (reversed)
    * I seldom feel blue. (reversed)

    Early trait research

    Sir Francis Galton was the first scientist to recognize what is now known as the Lexical Hypothesis. This is the idea that the most salient and socially relevant personality differences in people’s lives will eventually become encoded into language. The hypothesis further suggests that by sampling language, it is possible to derive a comprehensive taxonomy of human personality traits.

    In 1936, Gordon Allport and H. S. Odbert put this hypothesis into practice. They worked through two of the most comprehensive dictionaries of the English language available at the time and extracted 17,953 personality-describing words. They then reduced this gigantic list to 4,504 adjectives which they believed were descriptive of observable and relatively permanent traits.

    Raymond Cattell obtained the Allport-Odbert list in the 1940s, added terms obtained from psychological research, and then eliminated synonyms to reduce the total to 171. He then asked subjects to rate people whom they knew by the adjectives on the list and analyzed their ratings. Cattell identified 35 major clusters of personality traits which he referred to as the "personality sphere." He and his associates then constructed personality tests for these traits. The data they obtained from these tests were analyzed with the emerging technology of computers combined with the statistical method of factor analysis. This resulted in sixteen major personality factors, which led to the development of the 16PF Personality Questionnaire.

    In 1961, two Air Force researchers, Ernest Tupes and Raymond Christal analyzed personality data from eight large samples. Using Cattell's trait measures, they found five recurring factors. This work was replicated by Warren Norman, who also found that five major factors were sufficient to account for a large set of personality data. Norman named these factors Surgency, Agreeableness, Conscientiousness, Emotional Stability, and Culture. Raymond Cattell viewed these developments as an attack on his 16PF model and never agreed with the growing Five Factor consensus. He refers to "...the five factor heresy" which he considers " partly directed against the 16PF test". Responding to Goldberg's article in the American Psychologist, 'The Structure of Phenotypic Personality Traits', Cattell stated, "No experienced factorist could agree with Dr Goldberg's enthusiasm for the five factor personality theory". This determined rejection of the FFM challenge to his 16 factor model is presented in an article published towards the end of his life and entitled 'The fallacy of five factors in the personality sphere', Cattell, R. B. (1995), The Psychologist, The British Psychological Society, May Issue pp 207–208.
    Hiatus in research

    For the next two decades, the changing zeitgeist made publication of personality research difficult. In his 1968 book Personality and Assessment, Walter Mischel asserted that personality tests could not predict behavior with a correlation of more than 0.3. Social psychologists like Mischel argued that attitudes and behavior were not stable, but varied with the situation. Predicting behavior by personality tests was considered to be impossible. Radical situationists in the 1970s[who?] went so far as to argue that personality is merely a perceived construct that people impose on others in order to maintain an illusion of consistency in the world.

    Emerging methodologies challenged this point of view during the 1980s. Instead of trying to predict single instances of behavior, which was unreliable, researchers found that they could predict patterns of behavior by aggregating large numbers of observations. As a result correlations between personality and behavior increased substantially, and it was clear that “personality†did in fact exist. Personality and social psychologists now generally agree that both personal and situational variables are needed to account for human behavior. Trait theories became justified, and there was a resurgence of interest in this area.

    By 1980, the pioneering research by Tupes, Christal, and Norman had been largely forgotten by psychologists. Lewis Goldberg started his own lexical project, independently found the five factors once again, and gradually brought them back to the attention of psychologists. He later coined the term "Big Five" as a label for the factors.
    Validity of the Big Five

    In a 1981 symposium in Honolulu, four prominent researchers, Lewis Goldberg, Naomi Takemoto-Chock, Andrew Comrey, and John M. Digman, reviewed the available personality tests of the day. They concluded that the tests which held the most promise measured a subset of five common factors, just as Norman had discovered in 1963. This event was followed by widespread acceptance of the five factor model among personality researchers during the 1980s. In 1984 Peter Saville and his team included the five-factor “Pentagon†model with the original OPQ. Pentagon was closely followed by the NEO five-factor personality inventory, published by Costa and McCrae in 1985.

    One of the most significant advances of the five-factor model was the establishment of a common taxonomy that demonstrates order in a previously scattered and disorganized field. What separates the five-factor model of personality from all others is that it is not based on the theory of any one particular psychologist, but rather on language, the natural system that people use to communicate their understanding of one another.

    A number of meta-analyses have confirmed the predictive value of the Big Five across a wide range of behaviors. Saulsman and Page examined the relationships between the Big Five personality dimensions and each of the 10 personality disorder categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Across 15 independent samples, the researchers found that each disorder displayed a unique and predictable five-factor profile. The most prominent and consistent personality predictors underlying the disorders were positive associations with Neuroticism and negative associations with Agreeableness.

    In the area of job performance, Barrick and Mount reviewed 117 studies utilizing 162 samples with 23,994 participants. They found that conscientiousness showed consistent relations with all performance criteria for all occupational groups. Extraversion was a valid predictor for occupations involving social interaction (e.g. management and sales). Furthermore, extraversion and openness to experience were valid predictors of training proficiency criteria.
  16. sayra.

    sayra. Guest

    Nerve origin of the acoustic neuroma

    Atsushi Komatsuzaki M.D. a1 and Atsunobu Tsunoda M.D. a1
    a1 Department of Otolaryngology, Tokyo Medical and Dental University, Tokyo, Japan.


    Two hundred and seventy-one Japanese patients who underwent surgical removal of neuroma from the cerebello-pontine angle using the translabyrinthine approach were retrospectively reviewed in order to investigate the nerve origin on an anatomical basis. In 269 out of the 271 cases, the origin of the neuromas was identified. Among these cases, 84.8 per cent of tumours originated from the inferior vestibular nerve (IVN), followed by the superior vestibular nerve (SVN) (8.9 per cen).
  17. sayra.

    sayra. Guest

    Onodi cell(sphenoethomoid cell):

    * This is formed by lateral and posterior pneumatization of the most posterior ethmoid cells over the sphenoid sinus.
    * Because the Onodi cells are posterior ethmoid cells that are positioned superolateral to the sphenoid sinus ,the optic nerve & carotid artery may often course through the lateral aspect of onodi cell instead of sphenoid sinus proper.
    * Kainz and Stammberger defined an Onodi cell as a posterior ethmoid cell with an endoscopically visible bulge of the optic canal.

    Haller cell (infraorbital cell or infraorbital extension of ethmoid cell):

    * The Haller cell is usually situated below the orbit in the roof of the maxillary sinus.(i.e., in the orbital floor).

  18. shyama.

    shyama. Guest

    Which cephalosprins can be given in renal failure
    a) Cefixime
    b) Cefoperazone
    c) Ceftazidime
    d) Ceftriaxone
    e) Cefipime
    Answer is B and D....

    Which of the following orgainism don't has Non -human resrvoirs..?
    a) salmonella typhi
    b) Mycobacterium tuberculosis
    c) Neisseris meningitidis
    d) Hemophillus influenzae
    This is a repeat qs. with options changed...
    Answer was All... Confirm D option....

    True about Km..
    a) Half the substrate concentration at which rate of reaction is maximum.
    b) Substrate concentration at which Reaction rate is half the maximum..
    c) Michaelis constant
    d) Enzyme concentration at which reaction rate is maximum
    Answer is b and c...

    True about normal sperm analysis is...
    a) Sperm count > 20 million per ml.
    b) Motility > 50%
    c) Normal morphology > 30%
    d) Sperm count > 10 million per ml.
    e) motility more than 30 %

    Answer was A and B... (Motility should be > 50% rapidly progressive or more than 25 % rapidly progressive.)

    Which of the following are photo-chromogens
    a) M. kansii
    b) M. chelonae
    c) M. fortuitum
    d) M. simiae
    e) M. marinum
    Answer was A and d...

    Following names are associated with Psychodynamic theory
    a) Carl jung
    b) Sigmund freud
    c) Kraplein
    d) Bleur

    Answer was A and B...

    Soft splenomegaly is not seen n
    a) Viral hepatitis
    b) Tropical splenomegaly
    c) Portal hypertension
    d) Kala azar
    e) Infectious endocarditis

    Need help in this one guys... ? Plzz give you opinion..

    False about Sweet syndrome..
    A) Neutrophilia is not seen
    B) Fever may be present
    C) Pseudovesiculation not seen
    D) Associated with malignancies..
    Answer is A, C...

    Acts passed before 1980 are..
    A) Factroy act
    B) MTP act
    c) ESI act
    d) Coal mines labour welfare act

    Answer is all of these...

    True about Vertebral A. A/E :-

    A) Branch of Subclavin A.
    B) Passes through Condylar foramina
    C) Traverses the transverse foramina of Cervical vertebrae
    D) Join to form Basilar A.

    Answer was B....
  19. Guest

    Guest Guest

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