ALL INDIA PRE PG EXAM 2009 Questions with Answers

Discussion in 'NEET 2013 All india Exam' started by Guest, Jan 13, 2009.

  1. Guest

    Guest Guest

    Q. Hirsuitism is caused by all except?

    1) cushing syndrome
    2) acromegaly
    3) hyperthyroidism
    4) hyperprolactinaemia

    Ans: 3) hyperthyroidism
    Ref-Hari17, 301t
  2. jimmy.

    jimmy. Guest


    1. HIP
    3. ANKLE
    4. PATELLA

    ANS. ANKLE JOINT ankle joint has least chance of recurrent dislocation
    b\c of mechanical efficiency in joint. considerable force required to dislocate it and normally a\w with fractures

    Dislocation of the ankle without associated fracture or wound is an extremely rare injury. [1] Fahey and Murphy [2] classified tibio-talar dislocations into anterior, posterior, medial, lateral, superior or combinations of these basic displacements. Most of these are either open and/or with an associated fracture of the tibia, fibula or the talus itself. Of these the posterior-medial dislocation has been described most often in the literature. [1],[2],[3],[4],[5] Most authors have described this injury in young adult males. Falls, road traffic accidents and sports have been described as the most frequent causes of these injuries. Forced inversion or eversion with axial loading in a maximally planter-flexed foot is thought to be the cause of this injury. The patho-Anatomy of this injury has been dependent on findings during surgical repairs and has not been described accurately. We are reporting a case of closed posterior dislocation of the ankle without fracture in an 18-year-old male patient following road traffic accident. The most probable mechanism is forced forward displacement of the tibia leaving the talus behind. The patho-Anatomy as evident from the magnetic resonance finding is also being described. The injury is being described not only for its rarity but also to discuss its unique patho-mechanics, mechanism of trauma and its prevention.

    Case History Top

    An 18-year-old, 6 feet 4 inch tall male weighing 90 kg presented with pain, swelling and deformity one hour after a road traffic accident. The patient was on a bike when he was hit from behind over the right leg just above the ankle by another fast-moving vehicle where the large heel-breast of his shoes got stuck in the footrest and the leg was pushed anteriorly with great force resulting in a closed posterior dislocation of the talus from the ankle mortise. Physical examination revealed a deformed ankle with foot posteriorly displaced. There was no open injury. Swelling was present. The dorsalis-pedis and posterior tibial pulsations were normal. There was no hypoaesthesia, hyperlaxity or associated injuries.

    Plain anterior-posterior and lateral radiograph of the right ankle demonstrated a posterior dislocation of the ankle without any fracture or widening of the tibio-fibular syndesmosis [Figure 1]. Patient was treated by leg elevation, above knee slab application and analgesics followed by closed reduction under general anesthesia and application of an above knee cast. Post reduction magnetic resonance imaging [Figure 2] demonstrated a torn anterior talo-fibular ligament and medial collateral ligament. A fibrous talo-calcaneal coalition was also found. He was advised surgical repair of the ligaments which he refused following which he was advised not to bear weight for six weeks. On follow-up at two years although he had painless normal range of ankle motion with full weight bearing and squatting, the x-ray of the ankle revealed osteophytes, calcification of the collateral ligaments beneath the malleoli with mild subluxation of the ankle joint [Figure 3].

    Discussion Top

    Dislocation of the ankle requires considerable force because of the mechanical efficiency of the mortise and the strength of the associated ligaments. [3] Since ligaments are stronger than the malleoli, most ankle dislocations are associated with fractures. Wilson et al. , reviewed the literature prior to 1939 and found 16 cases of ankle dislocation without fracture. [1] More recently Soyer et al. , (1994) found 73 cases in the relevant literature. [4] About 50% of ankle dislocations are usually open. However, in our case there was no open injury. An increased participation in outdoor activities is probably the cause of the higher incidence of this injury in young males. Our patient was also an 18-year-old, strong, adult male. Unlike ankle sprains, which predominantly occur in sportsmen, ankle dislocation is caused mainly by road traffic accidents, particularly motorcycle accidents. Sports trauma is the second most common cause.

    The exact patho-mechanics of this injury has not been described accurately. Most authors suggest the cause as a combination of inversion along with axial loading while the foot is maximally plantar-flexed. This hypothesis is supported by experimental work done by Fernandez [5] on cadavers. The ligaments, which he found to be injured in this type of injury, were the anterior talofibular and calcaneofibular ligament. He also postulated that once the ankle is dislocated without fracture, the tendon of calcaneus pulls it posteriorly. Most authors have supported this postulate. However, Wroble et al. , were of the opinion that dislocations of the talus occur because of extrusion of the talus anteriorly or posteriorly when force is applied in a plantar-flexed foot. [6] In our case, the patient was wearing large shoes resting on the footrest well supported on it by the high heel-breast of the shoe. Being hit from behind above the ankle the patient's foot being plantar-flexed at this time got stuck at the footrest due to the high heel-breast, resulting in the tibia being forcefully pushed anteriorly, leaving behind the talus and the foot [Figure 4]. The associated talocalcaneal bar prevented an associated subtalar dislocation.

    Since the injury occurs due to inversion, the structures that are primarily torn are the anterior talofibular, the calcaneofibular and posterior talofibular respectively. The deltoid ligament is usually spared. However, in our case since the mechanism of injury was not inversion with axial loading but a forward extrusion of the tibia leaving the talocalcaneal complex with the foot behind, we expected both medial and lateral collateral ligament injuries. Our clinical suspicion was confirmed by MRI report, which documents complete tear of the anterior talofibular and medial collateral ligament. Interestingly, our patient had a talocalcaneal coalition. This may have predisposed the patient to have an ankle dislocation rather than a subtalar dislocation when he was hit from behind. Tarsal coalition as a predisposing cause of ankle dislocation without fracture has not been previously described in the literature.

    We are reporting this case for its unique mechanism of injury, MRI findings and outcome. We recommend that for racing bikes the footwear should not have a heel with a high breast-line; preferably, they should have a flat sole which will not permit the heel getting stuck in an accident, bringing about this type of grave injury.

    References Top

    1. Wilson MJ, Michele AA, Jacobson EW. Ankle dislocations without fracture. J Bone Joint Surg 1939;21:198-204. Back to cited text no. 1
    2. Fahey JJ, Murphy JL. Dislocations and fractures of the talus. Surg Clin North Am 1965;45:79-102. Back to cited text no. 2
    3. Uyar M, Tan A, Is¸ler M, Cetinus E. Closed posterior dislocation of the tibiotalar joint without fracturein a basketball player. Br J Sports Med 2004;38:342-3. Back to cited text no. 3
    4. Soyer DA, Nestor BJ, Friedman SJ. Closed posteromedial dislocation of the tibiotalar joint without fracture or diastasis: A case report. Foot Ankle Int 1994;15:622-4. Back to cited text no. 4
    5. Fernandes TJ. The mechanism of talo-tibial dislocation without fracture. J Bone Joint Surg Br 1976;58:364-5. Back to cited text no. 5
    6. Wroble R, Napola J, Malvitz T. Ankle dislocation without fracture. Foot Ankle 1988;9:64-74. Back to cited text no. 6
  3. desaw.

    desaw. Guest

    1. Proteus –ans. triple phosphate renal stone
    2. Appetite stimulant a/e – melanocyte stimulating hormone, melanocyte corticotropic releasing hormone, neuropeptide Y
    3. non invasive diarrhoea a/e – shigella, b.cereus, salmonella, y.enterocolitica
    ans b.cereus
    4. motorcyclist frc
    ans ring fractre
    5. Probability – 6/25, 3/5, 2/5
    ans 3/5
    6. IDEAS – disability
    7. Hernia – loop/end colostomy, loop/end ileostomy
    ans end iliostomy
    8. Anatomical snuff box – radial a
    9. Foreign body sensation in the eye, arthritis –reactive
    10. Immediately after eating dyspneoa, cyanosis – c1 def
    11. Lupus anticoagulant – increase in aPTT only, abortion in pregnant females, can occur without other signs of lupus
    12. Milkman # - pseudo#
    13. Punched out lesion in skull – nxt dx to b done is ca level
    14. Least polar – methyl, carboxyl, amino, phosphate
    ans methyl
    15. Nerve entrapment all except – femoral
    16. Mammography less sensitive in young women – more glandular
    17. Medulla blood supply all except – bulbar
    18. Trochlear n – ipsilateral sup oblique, longest intracranial n, dorsal n, outside annulus of zinn
    alll apr to b true bt it shd b annulus ........
    19. Vasomotor centre of medulla – only baroreceptor not chemoreceptor
    20. Chronic low back pain – pain management, exercise, remove the etiology
    ans expt exercise
    21. Pauci immune glomerulonephritis – microangiopathic
    22. Coombs positive anaemia – sle
    23. juxta foveal telangiectasia a/e – variant of coats, macular telangiectasia, ........
    24. diabetic retinopathy treatment a/e – seal the tear, remove peripheral retinal layers, vitrectomy, photocoagulation
    all are true
    25. narrow angle glaucoma avoid – duloxetine, citalopram, fluphenazine,
    26. valproate causes all of these n rest 1 left was da ans – weight gain, alopecia, liver damage
    27. uveal effusion a/e – myopia, abnormal scleral structure, scleritis, cilio-choroid can get separated
    28. nitrosamine – hypotension and bradycardia
    29. paravertebral block can go to a/e – epidural space, subarachnoid space, paravertebral space, intercostals space
    30. neuroblastoma – most common extracranial solid tumour in children, >50% come with mets, lung mets common, invove aorta and branches at early stage.
    31. monetary fund given to – schizophrenia or mentel retardation ? help out
    32. normal curve –mean=median
    33. frequency distribution – histogram
    34. involvement of sweat gland and hair follicles – lichen scrofulosum
    35. all are direct cutaneous disease except – reiter’s disease
    36. scarring alopecia – lichen planus
    37. adrenal adenoma a/e – hypoechoic on non contrast ct, contrast appears early and washes out late, regular border ? help out
    38. casper dictum – time since dth
    39. stellate wound – contact wound
    40. pedestrian with multiple abrasions – tert impact. or secondary
    41. para 3+0,CIN 3 in one quadrant on pap smear, what is the management – hysterectomy
    42. thyroid papillary ca 2cm – near total with rnd
    43. follicular adenoma vs carcinoma – hurthle cell, increased mitosis, vascular invasion ? help
    44. sertoli cells – spermatogenesis
    45. obstructive azoospermia – fsh and lh nrml
    46. smoking assoc with a/e – ca larynx
    47. latest WHO scale of disability – ideas
    48. SEPS – veins
    49. commonest organ to be injured in bomb blast – lung
    50. causes pf hypercoagulability a/e – paraproteinemia
    51. features of pnh a/e – DVT rathr occr superficial
    52. thromboembolism assoc with a/e – pnh
    53. cannot be defined in operational terms –objective
    54. cannot be defined in operational terms –objective
    55. leptospirosis a/e – treatment of choice iv penicillin g, 10-15% mortality, rat urine
    56. all true except – tetanus dust droplets
    57. all true – hypochlorite virucidal, glutaraldehyde sporicidal, phenol require organic material
    58. all true except – zinc def pulmonary problems
    59. precocious puberty boy 5years with pubic hair, bp 120/90 – 17 a hydroxylase
    60. positive urinary anion gap a/e– diarrhoea
    61. water sample estimation a/e – clostridium recent contamination
    62. nutritional survey a/e – 1 to 4 year mortality
    63. q fever vector – aerosol
    64. crude birth rate a/e – still born excl
    65. imci includes all – malaria, resp infections, diarrhoea
    66. trauma patient with gcs score 15, bp 100/80 next step – iv fluid with blood for cross matching
    67. ductal carcinoma in situ investigation – mammography
    68. calcification of post spinal ligament a/e – begins from thoracic level
    69. neural tube closes from – cervical or cephalic/ help me
    70. chronic renal failure patient with hyperkalemia immediate treatment glucose with insulin
    71. after starvation which site will have less glucose receptor –adipose tissue
    72. lipoprotein lipase a/e – adipocytes, myocytes, does not need CII as cofactor
    73. child bites his fingers – hgprtase def
    74. after cutting with restriction enzymes segments joined by – dna ligase
    75. colon carcinoma a/e – mismatch repair
    76. comet tail artefact – adenomyomatosis
    77. aedes mosquito a/e - constant bite
    78. dengue hmgic fever a/e – reinfection with diff serotype
    79. hiv maximum transmission – homosexual
    80. hiv enters – cd4
    81. GIST which is increased max – cd 117
    82. pancreatic transplant with bladder catheter – urine amylase, blood amylase, blood glucose
    83. 29 yrs with diabetes, no ketonuria, father does not have DM ,ans dm1
    84. RCC a/e – cushings
    85. angiotensin a/e – vasodilatation
    86. renal Physiology a/e – dct is always hypoosmotic
    87. reversible ischaemia – thallium
    88. maltese cross – blastomycosis, penicillium, candida
    89. deep perineal pouch a/e – bulbourethral gland, urethral sphincter, root of penis
    90. pelvic diaphragm a/e - colles fascia
    91. aortic aneurysm rupture – posterior
    92. m.c. site of subclavian artery constriction – 1st part
    93. arteriovenous shunt a/e – not under the control of ANS
    94. pseudomonas - ?
    95. mifepristone used in – ectopic pregnancy
    96. lactating female best contraceptive – barrier method
    97. laproscopic sterilisation not done in – heart disease, hiatus hernia ............... neeed help
    [snip]. incontinenti pigmenti a/e – 100% ophthalmic problems
    99. neurofibromatosis a/e – autosomal recessive
    100. trotters triad – seizures
    101. tuberous sclerosis triad a/e– rhabdomyosarcoma
    102. the following species of borrelia cause relapsing fever except – ????
    103. pancreatic carcinoma a/e – 75% associated with p53 mutatn
    104. gold standard test to diagnose insulinoma is 72 hrs fasting glucose
    105. a 9 year old girl posted for tonsillectomy, massive haemorrhage with prolonged aPTT and normal PT – factor 9 def
    106. simple random sampling – everyone has equal chance of being picked
    107. incidence rate can be calculated from – prospective studies
    108. all are analytical studies except – field trials
    109. baby clinic a/e – bafter normal delivery breast feed within 4 hrs
    110. target strategy in aids a/e – treatment of STD
    111. chemoprophylaxis done for all except – cholera
    112. vaccine with highest efficacy –tetanus
    113. the following vaccine when contaminated causes toxic shock syndrome – measles vaccine
    114. the following contractions of esophagus are stationary – primary, secondary, tertiary, quarternary ?? help
    115. late expanding phase of population – birth rate stationary death rate falling, birth rate lower than death rate, falling death rates with low birth rate
    116. fish odour from vaginal discharge – gardenella vaginalis
    117. all the following are composite muscles except – flexor digitorum sup
    118. the following joint has least chances for recurrent dislocation – ankle
    119. hemochromatosis a/e – phlebotomy is not useful, common in females, complete penetrance. ?/???
    120. a young female had following lab values mcv 70, hb 10 mg%, serum iron 60, serum ferritin 100, the diagnosis is – iron deficiency anaemia
    121. facilitated diffusion is – requires carrier
    122. oxygen demand of heart – increases in a constant proportion with heart rate
    123. pulsatile large liver is seen in – tricuspid regurgitation
    124. systolic thrill in left 2nd or 3rd intercostal space is seen in a/e – pulmonry stenosis
    125. a down syndrome patient is posted for surgery, the necessary pre-op investigation to be done is – usg
    126. zenkers diverticulum true statement is – barium xray lateral view
    127. all are the uses of lithium except – major depression,
    128. a female child was brought with complaint of generalised swelling of her body. She was passing fatty cast in her urine. No haematuria. The true statement is – no IgG or C3 deposition seen on renal biopsy
    129. von hippel landau syndrome consists of a/e – gastric cancer
    130. finnish type of nephrotic syndrome is due to mutation in – nephrin
    131. renal polycystic disease in children all are true except – autosomal dominant
    132. splicing is brought about by – sn RNA
    133. superior middle alveolar artery is a branch of – palatine br of maxiilary
    134. splenic artery gives all the following branches except – rt gastro epiploic
    135. chemotherapy is given to all the following cancers except – (various stages of different cancers were in the options) t2 n1 mo ......
    136. triple assessment of breast dis includes – history, clinical examination, obsrv
    137. necrotising fasciitis a/e – due to group b haemolytic streptococcus, debridement is mandatory, involves trunk and lower limbs
    138. the following cephalosporin doesn’t need dose modifications depending on gfr values – cefoperazone
    139. tacrolimus side effect – nephrotoxicity
    140. hand foot and mouth syndrome – capecitabin
    141. amifostine – skin
    142. small cell lung cancer true statement – it is chemosensitive
    143. ifosphamide is – an alkylating agent
    144. liquefactive necrosis is seen in – gangrene
    145. reduces bone resorption and increases bone formation – strontium
    146. the nephrotoxicity of cisplatin is increased by a/e – rifampicin
    147. treatment of severe falciparum malaria – quinine or artesunate ??
    148. hepatitis C true statement is – most common with liver transplantation
    149. parvo virus B 19 false statement is – can cross the placenta in only <10% case
    150. all cause traumatic asphyxia except – accidental strangulation.
    151. true statement of RDA - RDA is dietry.............
    152. restless leg syndrome seen in – chronic renal disease,
    153. cyanosis does not occur in anaemia because – certain amount of reduced hb has to be present
    154. 2,3 disphosphoglycerate not increased in - inosine, hypoxanthine
    155. hb dissociation curve is sigmoid because – binding of oxygen to one molecule of hb increases the affinity of other oxygen molecules
    156. modafinil used in – narcolp
    157. best non surgical treatment of stress incontinence – electrical stimulation
    158. carpal tunnel syndrome caused by a/e acromegalyor diabetes
    159. a lady with temporal field defects, galactorrhoea, most common cause – pituitary macroadenoma
    160. sleep controlled by – hypothalamus
    161. juvenile arthritis all are present except – rheumatoid nodules
    162. bleomycin – reduces type 2 pneumocyte
    163. hepatomegaly is caused by all except – hepatocyte porphyria
    164. cancer larynx – HPV 6 ..............
    165. limb defects with scarring of skin in new born – varicella virus
    166. mitomycin C used in – strg webr
    167. cell cycle specific antineoplastic drug – vinblastine
    168. treatment of osteosarcoma are a/e – high dose methotrexate,…. ?? help with rest options
    169. in subclinical folic acid deficiency the following drug will bring about vitamin B 12 deficiency
    170. the following drug can be given safe in pregnancy - propylthiouracil
    171. rapid correction of hyperglycemia using insulin alone will result in – hypokalemia
    172. icd 10 includes all except – lack of exercise, alcoholism, poisoning, unhealthy food. ??
    173. cheif cells are found in – neck, pit, fundus ?
    174. risk factor 4 GB Ca a/e – stones
    175. motorcyclist's fructure means – ring #
    176. spastic paraplegia caused by all except – motor neuron disease, vit B 12 def ..................
    177. all are true about eaton lambert syndrome except – positive tensilon test.
    178. pain sensitive structures – dural venous sinus,choroid n may b falx too.
    179. icd….
    180. cystic fibrosis all are true except – defect in calcium channel
    181. girl with abnormal sweat chloride test, next diagnostic test – transnasal potential difference
    182. Rheumatoid factor will give false negative tests with – coombs test….
    183. abrasions can be confused with – eczema or ant bite ?
    184. newborn with hydrocephalous – toxoplasmosis
    185. Disease which permanently alters finger print – leprosy
    186. vaginal delivery allowed in all except - monochorionic monoamniotic twins
    187. dysgerminoma marker – LDH
    188. Rate of mineralisation of newly formed osteoid – fluro.........
    189. sympathectomy done in all except – anhidrosis
    190. intermittent claudication the pain is on takn last step
    191. severe chronic limb ischaemia true is – rest pain
    192. best graft for surgery below inguinal is – sapheous
    193. superior gluteal nerve supplies all except – gluteus maximus
    194. carotid artery emboli and CRVO are differentiated by – raised retinal artery pressure
    195. intrinsic factor secreted by - parietal cells
    196. priviliged converstaion is between – doctor notified dis
    197. myodesis is c/i in ischemia
    198. which factor is specifically a part of intrinsic clotting pathway – 9
    199. Seen in acute inflammation classically – vasodilatation with leakage
    200. 45 year old male had a chest pain. he died after 4 days. on postmortem intramural coagulation was found. this is – neutrophils
    201. mammography can detect all except – adenosis
    202. Athletes pubalgia is...hamstrings
    203. SIRS includes all except thrombocytopenia
    204. substance not fermented in human intestines – cellulose
    205. Hb S differs in – stability
    206. all are true regarding Hb S – glutamine replaced by valine, heterozygotes are protected against malaria,
    207. Standing to sitting change in - increased venous return to heart
    208. Actyl Co A can't directly form – Glucose
    209. Dengue Hemorrhagic fever - Second Infection with different strain of virus the second time
    210. 100 KD on SDS-PAGE, then second trial s-s
    2x(20KD + 30KD)
    211. Wilm's Tumor - National Wilm tumor staging system orthe b option?
    212. Action potential starts in the initial segment of axon because – more ion channels
    213. regulatory mechanisms by all except – g coupld
    214. regarding lac operon, CAP is – positive regulator
    215. E157:O7 culture -
    216. not a cause of primary amenorrhoea - Sheehan
    217. Chlamydia infection of the eyes, true statement a/e – mostly asymptomoatic
    218. Salmonella non typhi -
    219. edema – C 1 esterase deficiency
    220. hyperaldosteronism a/e – metabolic acidosis
    221. HepB infected neonate - both Vaccine and Immunoglobin
    222. Hashimoto's thyroiditis true a/e – follicular destruction, increase in lymphocytes ..............
    223. Diastolic pressure - Aorta elasticity
    224. IMG –
    225. Joint aspiration in acute gout shows - monosodium urate crystals
    226. GIST most common marker – CD 117
    227. all drugs can be given to a mother who is on 35th week of gestation except – methotrexate
    228. neonate change seen – tacycardia
    229. heat rupture – rbc rupture
    230. won't be present in right heart failure - increased PCWP
    231. - joule burn
    232. parotid pathway all – auticulotemporal nerve.,ottic ,lesser petrosal all supply
    233. sodium bicarbonate given to local Anaesthesia – quick and longer action
    234. which prevents colon cancer – high fibre diet, selenium, antioxidants
    235. Entero Virus won't cause haemorrhagic fever
    236. meningitis leads to through – vestibular aqueduct
    237. cardiac disease predictor – Lp a
    238. Benign HTN - hyaline aterioscelerosis
    239. micro RNA –
    240. temporal arteritis all – can cause sudden blindness, elderly, females more than males
    241. most common muscle to be congenitally absent – pectoralis major
    242. popliteal artery not easy to palpate because – it is not superficial, and no bony structure to palpate
    243. LHD increased in – retinoblastoma, galactosemia, glaucoma
    244. intestinal absorption test – xylulose
    245. lambda phage ans c
    246. mc cause of superficial thrombophlebitis -i.v. line
    247. pseudoclaudication - cauda equina syndrome
    248. stellate ganglion block causes all except – bradycardia
    249. lymphoid tissue seen in – sub mucosa
    250. visual cycle – opsin combines with retinol
    251. high tibial osteotomy for what ?
    252. vocal cord sulci- vocal abuse
    253. paneth cell – has more zinc
    254. pulmonary artery pruning seen in ?
    255. surgical staging of ovarian ca all done except – peritoneal wasing, peritoneal biopsy, mesenteric biopsy, palpation of organs ...
    256. spongy urethra drainage into which node – deep inguinal
    257. In which condition is d onset of condition to death the lowest – obstructed labou
    258. About mesial temporal lobe epilepsy
    259. angiogenesis requires a/e – il 8
    260. weight of average Indian man – 60 kgs
    261. synovial fluid characteristics –
    262. functions of T helper cells are all except – cytotoxic
    263. DMPA - 0.3% failure rate
    264. tamoxifen side effect a/e ca. in opp brst
    265. eclampsia –
    266. fatty content in breast is found in a/e – galactocele
    267. ageing –
    268. thoracic outlet syndrome diagnosed by – clinical examination
    269. apoptosis which cell organelle responsible – mitochondria
    270. psammoma bodies seen in a/e – follicular cancer thyroid
    271. the most bactericidal among the following – O2- metabolite
    272. karyotyping used for – chromosomal abnormalities
    273. central chemoreceptors are sensitive to – low O2
    274. blood flow is increased during exercise due to – active metabolites produced
  4. twinkle.

    twinkle. Guest

    Laryngeal pseudosulcus as a predictor of laryngopharyngeal reflux.

    OBJECTIVES/HYPOTHESIS: Laryngeal pseudosulcus is an accurate prognostic indicator of laryngopharyngeal reflux (LPR) disease. STUDY DESIGN: Prospective study of 20 consecutive patients with laryngeal pseudosulcus. Pseudosulcus is infraglottic laryngeal edema that is thought to be secondary to LPR. All patients were evaluated with dual-channel pH probe 24-hour monitoring to evaluate for the presence of laryngopharyngeal reflux. METHODS: Twenty patients identified with laryngeal pseudosulcus on routine physical examination were included in the study. Each patient underwent a 24-hour dual-channel pH probe. The data were analyzed and compared with previously published normative data. The data included the total number of reflux episodes and the percentage of time the pH dropped below 4 at the proximal probe. RESULTS: Eighteen of the 20 patients with laryngeal pseudosulcus were found to have LPR. The mean number of reflux episodes at the proximal probe was 29.4 (range, 3-82). The mean percentage of time the pH dropped below 4 was 1.15%. In the upright position the mean value was 1.59% and in the supine position it was 0.19%. This gives pseudosulcus a positive predictive value for LPR of 90%. CONCLUSION: This study shows laryngeal pseudosulcus to be an accurate predictor of laryngopharyngeal reflux disease.
  5. twinkle.

    twinkle. Guest

    low back pain a/e...bed rest for 3 months

    Bed rest is usually appropriate for acute LBP and sciatica. Two days of bed rest is more effective than 7 days, resulting in less time lost from work. Prolonged bed rest can lead to progressive inactivity and avoidance, which reinforces abnormal illness behaviors. Such inactivity can also have deleterious physiologic effects, leading to shortened muscles and other soft tissues, joint hypomobility, reduced muscle strength, reduced cardiopulmonary endurance, and loss of mineral content from bone. For these reasons, bed rest is usually not recommended as a treatment for chronic LBP.
  6. twinkle.

    twinkle. Guest

    question was most sensitive investigation for ductal carcinoma in situ.....answer between pet and mri...
    according to this journal reference published by AIIMS its mri

    18F-FDG PET in Detecting Primary Breast Cancer
    Rakesh Kumar and Neena Lal
    All India Institute of Medical Sciences, New Delhi, India

    Abass Alavi

    Hospital of the University of Pennsylvania Philadelphia, Pennsylvania

    TO THE EDITOR:We read the article by Moy et al. (1) with great interest. This is one of the few studies that have investigated the role of PET/MRI in evaluating primary breast cancer. Several investigators have assessed the role of 18F-FDG PET in the comprehensive detection of primary breast cancer and found encouraging results (2,3). The initial PET studies were done on smaller numbers of patients and with larger primary breast tumors. However, recent studies on small breast tumors have demonstrated a relatively lower diagnostic accuracy for PET. Because of the limitations of PET alone, the most popular area of research in recent years has been the role of combined PET and CT or MRI. The combination of PET with CT or MRI provides the best of 2 modalities; that is, PET reveals the functional status while CT or MRI reveals structural details in the same sitting. We want to emphasize that, in breast cancer imaging, PET alone and PET fusion with CT or MRI have a significant false-negative rate that must be considered before they are used as a screening modality and the patient potentially subjected to expensive and time-consuming tests.

    Fusion of a functional imaging modality such as PET, which has high specificity, with a structural modality such as MRI, which has high sensitivity, should give us results with both high sensitivity and high specificity. Stadnik et al. (3) compared MRI and 18F-FDG PET in staging breast cancer and imaging axillary lymph nodes in 10 patients and found the sensitivity and specificity to be 100% and 80%, respectively, for MRI and 80% and 100%, respectively, for PET (3). The combination of MRI and 18F-FDG PET achieved 100% sensitivity and specificity. Thus, they concluded that the combined method had the potential to identify which patients should undergo axillary dissection versus which should undergo sentinel node lymphadenectomy. In contrast, Moy et al. (1) noted a sensitivity and specificity of 92% and 52%, respectively, for MRI alone and 63% and 95%, respectively, for PET/MRI. The high specificity of PET/MRI can help define the subset of patients that surely should undergo tissue diagnosis of the suggestive lesions. However, because of the high false-negativity of PET/MRI, there would still be an additional subset of patients who require histologic examination of the lesion to rule out cancer. In the study of Moy et al., ductal carcinoma in situ consistently showed lower 18F-FDG uptake (standardized uptake value [SUV] < 2), except in one patient (patient 21). It is interesting to note that patient 17, with a 9-cm ductal carcinoma in situ, had an SUV of 0.4 whereas patient 21, with a 2-cm ductal carcinoma in situ, had an SUV of 3.2. All invasive ductal carcinoma lesions with poor differentiation had SUVs of less than 2.5. A patient with moderately differentiated invasive ductal carcinoma and invasive lobular carcinoma, and other patients with smaller tumors ranging from 0.9 to 1.1 cm, had SUVs of less than 2.5. These results concur with already published data showing a higher tendency toward false-negativity for lesions from carcinoma in situ and for low-grade, well-differentiated, or lobular carcinomas.

    Several studies have reported excellent sensitivity and specificity for PET in breast cancer (2,4). However, data on the detection of smaller lesions using PET are limited. In our study on 111 patients with suspected breast cancer (5), 18F-FDG PET alone had a sensitivity of 48%, a specificity of 97%, a positive predictive value of [snip]%, a negative predictive value of 40%, and an accuracy of 61%. In that study, we found a sensitivity of only 23% (7/30) for primary breast cancer lesions that were 10 mm or smaller. This finding has 2 potential explanations. One is that lower SUVs are greatly affected by partial-volume effects in smaller tumors because the counts are spread over a larger area. Another is that smaller lesions have lower SUVs because metabolic activity may increase with tumor growth. In one study, correction for partial-volume effect improved sensitivity from 75% to 92% while decreasing specificity from 100% to 97% (6). In our study, we did not find the significant correlation between tumor type and false-negative PET results that was found by other investigators (5,7). Another study found that invasive ductal carcinomas had significantly higher 18F-FDG uptake than did lobular carcinomas (SUV, 3.7 ± 2.2 vs. 2.1 ± 1.4, P = 0.003); thus, lobular cancers might be another factor leading to false-negative reports. The lower SUVs in lobular cancers might be explained by a lower tumor cell density and by diffuse surrounding tissue infiltration. A significantly positive correlation was found with the pattern of microscopic tumor growth (nodular vs. diffuse); thus, diffuse tumors might also be missed, causing false-negative results (7).

    In conclusion, the clinical application of PET/MRI as an initial screening test may prove limited by the significant number of false-negative results. More randomized controlled studies using PET/CT or PET/MRI on patients with smaller breast lesions are required to establish the exact role of combined functional and structural modalities in this type of cancer.
  7. gita.

    gita. Guest

    IDEA-Indian disability evaluation assesment scale
    it has four components
    1) self care
    2) interpersonal relationship
    3) work
    4) communication&understanding
    score 1to4
    comparison between schizophrenia&OCD
  8. rohit.

    rohit. Guest

    what was answer to question about application of mitomycin?

    @laryngeal stenosis
    @sturge weber syndrome
  9. twinkle.

    twinkle. Guest

    maltese cross in infloroscence

     Histopathology
    Mixed granulomatous and pyogenic
    Paracoccidiodomas as old coin lesions
    With polarized light – see maltese cross
    Observe Mariner’s wheel yeast cell – multiply
    budding large yeast
  10. twinkle.

    twinkle. Guest

    the answer to mitomycin question is laryngotracheal stenosis

    The efficacy of mitomycin-C in the treatment of laryngotracheal stenosis
    OBJECTIVE: The purpose of this study is to evaluate whether the addition of topical mitomycin-C (MMC) application to the wound site after endoscopic treatment of laryngotracheal stenosis (LTS) resulted in measurable improvement in clinical outcomes
    CONCLUSIONS: The results of this study suggest that MMC is an effective adjuvant in the treatment of LTS. The results of this study provide strong supporting evidence that topical MMC is an effective adjuvant in the treatment of LTS.
  11. gita.

    gita. Guest

    Anterior perforated substance

    Scheme of rhinencephalon. (Anterior perforated substance labeled at bottom left.)

    Base of brain. (Anterior perforated substance labeled at center.)
    Latin substantia perforata anterior
    Gray's subject #189 827
    NeuroNames hier-264
    The anterior perforated substance is an irregularly quadrilateral area in front of the optic tract and behind the olfactory trigone, from which it is separated by the fissure prima; medially and in front it is continuous with the subcallosal gyrus; laterally it is bounded by the lateral stria of the olfactory tract and is continued into the uncus.

    Its gray substance is confluent above with that of the corpus striatum, and is perforated anteriorly by numerous small bloodvessels.

    Additional images
    Human brainstem anterior view

    Atlas of Anatomy at UMich n1a8p1 - "Interpeduncular fossa" (#6)
    Anterior+perforated+substance at eMedicine Dictionary
    Photo at
    This article was originally based on an entry from a public domain edition of Gray's Anatomy . As such, some of the information contained herein may be outdated. Please edit the article if this is the case, and feel free to remove this notice when it is no longer relevant.

    This neuroscience article is a stub. You can help Wikipedia by expanding it.

    v • d • eBrain: telencephalon (cerebrum · cerebral cortex · cerebral hemispheres)

    Primary four
    surface lobes Frontal lobe Precentral gyrus (Primary motor cortex, 4)
    Superior frontal gyrus/Frontal eye fields (6, 8, 9) · Middle frontal gyrus (46) · Inferior frontal gyrus/Broca's area (44-Pars opercularis, 45-Pars triangularis)

    Orbitofrontal cortex (10, 11, 12, 47)

    Prefrontal cortex · Premotor cortex

    Precentral sulcus · Superior frontal sulcus · Inferior frontal sulcus · Olfactory sulcus

    Parietal lobe Somatosensory cortex (Primary (1 · 2 · 3 · 43) · Secondary (5)) · Precuneus (7m) · Parietal operculum
    Parietal lobules (Superior (7l) · Inferior (40)) · Angular gyrus (39)

    Intraparietal sulcus · Marginal sulcus

    Occipital lobe Primary visual cortex (17) · (Cuneus · Lingual gyrus · Lateral occipital gyrus (18, 19))
    Calcarine fissure

    Temporal lobe Primary auditory cortex (41, 42) · Superior temporal gyrus (38, 22/Wernicke's area) · Middle temporal gyrus (21) · Inferior temporal gyrus (20)
    Fusiform gyrus (37) Medial temporal lobe (Amygdala · Parahippocampal gyrus (27 · 28 · 34 · 35 · 36)

    Interlobar sulci/fissures lateral: Central (frontal+parietal) · Lateral (frontal+parietal+temporal) · Parietoöccipital
    medial: Medial longitudinal · Cingulate (frontal+cingulate) · Collateral (temporal+occipital)

    Cingulate cortex/gyrus Subgenual area (25) · Anterior cingulate (24, 32, 33) · Posterior cingulate (23, 31) · Retrosplenial cortex (26, 29, 30)
    Callosal sulcus

    White matter tracts Commissural fibers · Association fibers
    Internal capsule (Anterior limb · Genu · Posterior limb) · Corona radiata · External capsule · Lamina terminalis · Extreme capsule · Semioval center

    Olfactory tract · Terminal stria · Diagonal band of Broca

    Other Insular cortex

    gray: Olfactory bulb · Anterior olfactory nucleus · Basal optic nucleus of Meynert · Substantia innominata · Anterior perforated substance

    Corpus striatum - Limbic lobe

    Some categorizations are approximations, and some Brodmann areas span gyri.
  12. twinkle.

    twinkle. Guest

    The Pathology of two cases of pulmonary damage due to bleomycin is described. The drug damages the alveolar walls. A sequence of pathological changes could be traced commencing with oedema, intra-alveolar fibrin and haemorrhage, followed by type II pneumocyte hyperplasia associated with bronchial epithelial squamous metaplasia. This led to intra-alveolar and alveolar wall collagen formation producing diffuse interstitial fibrosis with microcyst formation associated with cuboidalization of the epithelium. These changes are similar to those seen in experimental bleomycin damage in mice, where it has been shown that the changes are the result of vascular damage and type I pneumocyte necrosis. It is inferred that human diffuse alveolar damage develops in the same way.

    endothelial damage or type 1 pneumocyte??? need better reference
  13. gita.

    gita. Guest

    in t/t of ALL all r done except
    a. hydration
    b. allopurinol
    c. immediate chemotherapy

    Discovered in nematodes in 1993, microRNAs (miRNAs) are non-coding RNAs that are related to small interfering RNAs (siRNAs), the small RNAs that guide RNA interference (RNAi). miRNAs sculpt gene expression profiles during plant and animal development. In fact, miRNAs may regulate as many as one-third of human genes. miRNAs are found only in plants and animals, and in the viruses that infect them. miRNAs function very much like siRNAs, but these two types of small RNAs can be distinguished by their distinct pathways for maturation and by the logic by which they regulate gene expression.
  14. drusti.

    drusti. Guest

    c/i of laparoscopic ligation a/e
    a. heart ds.
    b. hb<8g%
    c. obesity
    d. diapragmatic hernia
  15. gita.

    gita. Guest

    Abstract: The authors evaluated the combination of etoposide/cyclophosphamide (VP/CY) as initial, presurgical therapy for patients with osteosarcoma and found an 88% response rate for the primary tumor and any metastases. After definitive, limb-salvage surgery and adjuvant chemotherapy with etoposide, cyclophosphamide, cisplatin, and doxorubicin, patients without metastases at diagnosis whose cases were followed for a median of 2 years from diagnosis achieved a relapse-free survival (RFS) probability of 78% +/- 9%. This result is equivalent to the best adjuvant chemotherapy results reported to date. Patients without metastases at diagnosis had significantly better RFS probability (78% +/- 9%) than those with metastases at diagnosis (0%). Transient, severe myelosuppression has been the only major toxicity of the VP/CY courses. No irreversible organ damage or toxic deaths have been seen in patients enrolled in this study. The authors conclude that the combination of VP/CY is effective treatment for osteosarcoma, and when combined with cisplatin/doxorubicin (CIS/DOX), is as effective as any previously reported chemotherapy for osteosarcoma.
    Review References: None
    Notes: None
    Language: English
    Publication Type: Journal-Article
    Keywords: Antineoplastic Agents, Combined therapeutic use : Bone Neoplasms drug therapy : Cisplatin administration and dosage : Cyclophosphamide administration and dosage : Doxorubicin administration and dosage : Etoposide administration and dosage : Osteosarcoma drug therapy
  16. gita.

    gita. Guest

    Abstract: The authors evaluated the combination of etoposide/cyclophosphamide (VP/CY) as initial, presurgical therapy for patients with osteosarcoma and found an 88% response rate for the primary tumor and any metastases. After definitive, limb-salvage surgery and adjuvant chemotherapy with etoposide, cyclophosphamide, cisplatin, and doxorubicin, patients without metastases at diagnosis whose cases were followed for a median of 2 years from diagnosis achieved a relapse-free survival (RFS) probability of 78% +/- 9%. This result is equivalent to the best adjuvant chemotherapy results reported to date. Patients without metastases at diagnosis had significantly better RFS probability (78% +/- 9%) than those with metastases at diagnosis (0%). Transient, severe myelosuppression has been the only major toxicity of the VP/CY courses. No irreversible organ damage or toxic deaths have been seen in patients enrolled in this study. The authors conclude that the combination of VP/CY is effective treatment for osteosarcoma, and when combined with cisplatin/doxorubicin (CIS/DOX), is as effective as any previously reported chemotherapy for osteosarcoma.
    Review References: None
    Notes: None
    Language: English
    Publication Type: Journal-Article
    Keywords: Antineoplastic Agents, Combined therapeutic use : Bone Neoplasms drug therapy : Cisplatin administration and dosage : Cyclophosphamide administration and dosage : Doxorubicin administration and dosage : Etoposide administration and dosage : Osteosarcoma drug therapy
  17. vinay.

    vinay. Guest

    parvo virus all are true except-
    ans-placental transmission less than 10%.
    ref 17th edn harrisons page 1116.risk of transplacental fetal infection is 30%.
    other options were-infects erythroid progenitor cells and infection is acquired byrespiratory infection,dont rem the third option,..
  18. vinay.

    vinay. Guest

    question on drug contraindicated in narrow angle glaucoma-

    ans-Duloxetine can make narrow-angle glaucoma worse. If your glaucoma is under control, your healthcare provider should monitor your glaucoma to make sure it is not getting worse. If your glaucoma is not under control, you should not take duloxetine.

    for ref-do google search for duloxetine in glaucoma,manyarticles are given..
  19. rav.

    rav. Guest

    The children with Mental Retardation (MR) were referred to the ... A revolving fund will provide the seed money to help start self-employment schemes. ...
  20. rav.

    rav. Guest

    ca colon- which is protective?
    ans- antioxidants

    high fibre diet is not protective but rather a diet deficient in insoluble plant fibre increases the incidence of Ca colon.whereas antioxidants directly decrease the incidence of Ca colon.

    this is another very tricky question...can see the intention of the paper-setter.
  21. rav.

    rav. Guest

    evidence based drug 4 monorrhagia all except-

    a. ethamsylate
    b. tranexemic acid
    c. ocp
    d. progesterone 4 5-25 days of cycle

    correct ans is a)
  22. terasa.

    terasa. Guest

    Privilleged communication - that doctor conveys to public health officer about notifiable disease.

    as far as I remember question was, what is previleged communication. and if you will kindly refer back to texts you will clearly find that, privileged communication refer to the conversation between doctor and patient.

    PRIVILEGED COMMUNICATION - Conversation that takes places within the context of a protected relationship, such as that between an attorney and client, a husband and wife, a priest and penitent, and a doctor and patient. The law often protects against forced disclosure of such conversations. However, there are exceptions that can invalidate a privileged communication, and there are various circumstances where it can be waived, either purposefully or unintentionally.

    the exception to privileged communication arise in case of notification of communicable diseases.
  23. drusti.

    drusti. Guest

    mitomicin is a drug used to prevent or break synechiae
    henca used in laryngeal stenosis classically
  24. terasa.

    terasa. Guest

    the question on probability of boys/girls for surgery ---- 2/6 (3/5 comes if we add the individual probabilites but the present case is not mutually exclusive)

    But the question asked what is the probability of PATIENTS getting selected & not BOYS/ it will be mutually exclusive only.

    I roger that! answer should be 3/5, they were asking about overall probability of a person of getting selected.
  25. gita.

    gita. Guest

    neuropeptide y is a andiobesity drug so it will not increase hunger so i think it is the answer of the question asking about the drug which do not stimulatte hunger.
  26. nidhi.

    nidhi. Guest

    "Motorcyclists fracture" - skull gets divided into 2 halves.
    It is also called as a "hinge fracture''. Here the fracture line runs from temporal region of one side to the other.

    Ring fracture can also be seen

    Reference: Krishna Vij- text book of for. med & KSN Reddy
  27. terasa.

    terasa. Guest

    structure lat to ant perforated substance......uncus...ref from gray' direct mention though

    The anterior perforated substance is an irregularly quadrilateral area in front of the optic tract and behind the olfactory trigone, from which it is separated by the fissure prima; medially and in front it is continuous with the subcallosal gyrus; laterally it is bounded by the lateral stria of the olfactory tract and is continued into the uncus.

    Its gray substance is confluent above with that of the corpus striatum, and is perforated anteriorly by numerous small bloodvessels.

    Ref: Gray's

    I've marked uncus as the answer, but really can't remember whether olfactory tract was there in option.
  28. gita.

    gita. Guest

    Regarding Q on steps

    Surveillance of noncommunicable disease risk factors
    Quality health information is essential for planning and implementing health policy in all countries. Risk factor data are especially important as predictors of future disease or injury. The World Health Report 2002: Reducing risks, promoting healthy life, identifies five important risk factors for non-communicable disease in the top ten leading risks to health. These are raised blood pressure, raised cholesterol, tobacco use, alcohol consumption, and overweight. The disease burden caused by these leading risk factors is global. In every region of the world, including the poorest, raised blood pressure, cholesterol, and tobacco use are causing serious disease and untimely deaths. The World Health Report estimates are regionally based but emphasize the need for better information on levels and trends of these major risk factors for all countries.

    Country-level data is sparse for many of these major noncommunicable disease (NCD) risk factors. When data is available, it is not always complete or comparable, especially if it is based on self-reported health assessments or behaviours. A consistent approach to collecting and analysing NCD risk factor data is needed to promote the usefulness of this data both for country health policy development and also for comparisons across countries and regions. WHO is promoting the use of the STEPwise approach to enable countries to set up surveillance systems for NCD risk factors.

    Identifying risk factors
    Risk factors are defined as any attribute, characteristic or exposure of an individual, which increase the likelihood of developing a disease or injury. Measuring risk factors of noncommunicable disease is an attempt to predict the future distribution of NCDs in a population. This type of information is vital to promoting disease prevention and control programmes.

    The World Health Report 2002 has identified the risk factors that are most important for predicting future disease burden. These risk factors share common characteristics that include having: the greatest impact on death and illness from a disease/or injury; the ability to be modified through effective primary prevention; measurement protocols which have been validated; and a method of taking measurements that does not violate ethical principles.

    In addition to these requirements, it is useful to know the exposure level at which the risk factor leads to disease/or injury and the availability of data on population distribution of risk. The risk factors that cause NCDs have been extensively researched in a number of settings, mostly in developed countries. However, as developing countries now face a 'double burden' of disease, lingering communicable diseases with an increase in chronic conditions, it is important to have good quality data for on NCD risk factors in these countries as well. Research on the impact of risk factors in developing countries has shown similar effects on health outcomes as for populations in developed countries. As highlighted in the World Health Report 2002, just a few NCD risk factors account for the majority of noncommunicable disease burden. These risk factors, tobacco use, alcohol consumption, raised blood pressure, raised lipid levels, overweight, low fruit/vegetable intake, physical inactivity, and diabetes, are the focus of the STEPs approach to NCD risk factor surveillance.

    The STEPwise approach to NCD risk factor surveillance
    STEPs is a sequential process of gathering comparable and sustainable NCD risk factor information at the country-level. By using the same standardised questions and protocols, all countries can develop surveillance systems containing quality information about NCD risk factors in their unique settings. This information can, in turn, be used to plan for and implement currently available interventions to address the disease patterns caused by these risk factors.

    The STEPS approach is based on the concept that NCD surveillance systems need to be simple, focussing on a minimum number of risk factors that predict disease - before placing too much emphasis on costly disease registers which are difficult to sustain long-term.

    A tool for surveillance of risk factors, WHO STEPS, has been developed to help low and middle income countries get started. It is based on collection of standardized data from representative populations of specified sample size to ensure comparability over time and across locations. Step 1 gathers information on risk factors that can be obtained from the general population by questionnaire. This includes information on socio-demographic features, tobacco use, alcohol consumption, physical inactivity, and fruit/vegetable intake. Step 2 includes objective data by simple physical measurements needed to examine risk factors that are physiologic attributes of the human body. These are height, weight, and waist circumference (for obesity) and blood pressure. Step 3 carries the objective measurements of physiologic attributes one step further with the inclusion of blood samples for measuring lipid and glucose levels.

    Measuring NCD risk factors in this manner provides a flexible system that can be useful in a variety of country settings. Questionnaire-based measurements (Step 1) may be all that is feasible in low resource settings, while physiological measurements (Steps 2 and 3) may provide the impetus for health programme modification in higher resource settings or countries with specific surveillance needs (i.e. high prevalence of diabetes type 2). Countries can determine which additional set of questions are appropriate to their needs and what can be accomplished in the context of an on-going surveillance system.

    STEPS is now being planned or implemented in 33 countries in WHO's south east Asian region, western pacific region, African region and eastern Mediterranean region. WHO/HQ is offering technical support in order to ensure quality control and enhance the comparability of data collection. More countries will be added in consultation with regional and country offices of WHO. Some 40 countries will be in some phase of STEPS implementation by the end of 2003.
  29. komal.

    komal. Guest

    q..which is not the sonographic apperance of thyroid carcinoma...

    d)irregular margin

    ans:-a)hyperechoic....ref:-harisson 17th

    Sonographic characteristics suggestive of malignancy include microcalcifications, increased vascularity, and hypoechogenicity within the nodule.
  30. Dr. Gill

    Dr. Gill Guest

    In the question about the 50 year old guy with punched out lesions in the skull . He also had total protein of 10 point something . And high globulins of 5 point something . i would suspect multiple myeloma and get SERUM ELECTROPHORESIS done.
  31. contra in answers

    the ques reg.. cell cycle specific- both bleomycin (G2)& vinblastin(g1) r cell cycle specific . given in tripathi . need help/
  32. contra in answer

    mefepristone used for both fibroid uterus & ectopic gestation !!need help? :
  33. mishra.

    mishra. Guest

    structure lateral to anterior perforated substance ----orbital gyrus/chiasma/limen insulae/uncus
    ans. limen insulae (ref: IBS.NEUROANATOMY)
  34. pran.

    pran. Guest

    1.thrombo embolism all r/e.. PNH
    2.tetanus spread a/e. dust n droplets
    3.postive anion gap a/e. DIARRHOEA
  35. pran.

    pran. Guest

    targeted interventions on core group include
    3.condom provision and safe sexual practices
  36. rohit.

    rohit. Guest

    Q.Drug which can be used in renal failure:
    a. Cefime
    b. Cefoperazone
    c. Cephaloridine
    d. Cefuroxime

    Ans. b. Cefoperazone

    Q.Has highest efficacy:
    1 measles
    2 tetanus
    3 pertusis
    4 BCG

    Ans: tetanus

    Q.Chemprophylax not used in:
    1 cholera
    2 plague
    3 meningo cocal meningitis
    4 typhoid

    Ans: typhoid

    Q.Stenosis of subclavian artery is common in which part

    a) 1st part
    b) 2nd part
    c) 3rd part
    d) equal in all parts

    Ans:a) 1st part

    Q. bleomycin toxicity affects which type of cells...

    1) type 1 pneumocyte
    2) type 2 pneumocyte
    3) endothelial cell.
    4) alvmacrophag
    Ans: type 2 pneumocyte

    Q.Doc in cerebral malaria:
    a. Chloroquin
    b. Quinine
    c. Mefloquin
    d. Artemether

    Ans. b. Quinine

    Psammoma bodies seen in a/e
    a. Follicular ca thyroid
    b. Rcc
    c. Serus cystadenona
    d. Meningioma

    Ans. a. Foll ca thyroid

    Neural tube closure starts from-
    a. Cervical
    b. Thoracic
    c. Lumbar
    d. Cranial

  37. shashank.

    shashank. Guest


    ANS..obviously RADIAL ARTERY
  38. sumay.

    sumay. Guest

    q]all of the following can be given to a child with acute leukemia with severe leukocytosis except? hydration allopurinol alkalinisation high dose chemotherapy ans ]high doce chemotherapy because by giving high dose chemotherapy u wil be exacerbating the probability of tat child developing uric acid stones all the other options tend to prevent it
  39. shashank.

    shashank. Guest

    factors stimulating appetite are all except?
    a. agouti related peptide
    b. msh
    c. melanin concentratin hormone
    d. neuropeptide y.

    ans. msh
    ref:74-2 pg 464 harrison
  40. heena.

    heena. Guest

    regarding use of mifepristone is used in fibroid uterus as it shrinks fibroids ectopic it is not 1st choice drug mtx is 1st choice ......not sure of this answer but mifepristone for fibroids is given in all sstndrd bks n internet also
  41. drsam

    drsam Guest

    CASPER DICTUM to know time snce death.(it tells about the rate of decay of body in air?water/earth)

    max impact on blast injry --------- LUNGS

    endemic relapsing fever not caused by --------- B.RECURRENTIS (rest all cause endemic one and recurrentis causes epidemic)

    mode of transmissiom os pasturella ----- ANIMALS

    pseudoclaudication is due to ---- COMPRESSION OF CAUDA EQUINNA (repeat question)
    differentiate follicular adenoma/carcinoma ------ vascular invasion
    ca pancreas-5yr survival 5%

    Privilleged communication - that doctor conveys to public health officer about notifiable disease.

    Normal tissues vary in the extent that they are protected from radiation damage by amifostine. Because amifostine does not cross the blood–brain barrier, the central nervous system, often the dose-limiting organ in radiotherapy, is not protected [53, 54]. Protection factors for other tissues range from three in the hematopoietic system and salivary glands to approximately one in the lung, kidney, and bladder [55–57]. Within the same tissues, a range of protection factors has been reported [55, 58

    Man having abrasions after road traffic accident answer is secondary injuries

    Organ imp in apoptis -mitochondria

    Not side effect of valproate - osteomalacia

    Cap in lac operon is - positive regulator

    Intrinsic factor of castle- parietal cells

    Gene for congenital nephrotic syndrome is - nephrin

    zenker diverticulum - all are false except- barium meal

    Fingerprints destroyed in - leprosy

    A question about trochlear nerve- the option saying that it passes from fissure. Rest all options were correct

    Late expanding stage of cell cycle - death rate declining faster than birth rate
    Person changing to supine position-venous return increases (repeat question)

    True about myocardial oxygen demand--directly related to (i dont remember the options but it was repeat question

    Shortest interval in onset to death- pph

    Popliteal artery not easily palpable because-not lying against bony prominence

    the trochlear answer is
    Second, fibres from the trochlear nucleus cross in the midbrain before they exit, so that trochlear neurons innervate the contralateral (opposite side) superior oblique muscle of the eye. Third, trochlear fibres have a long intracranial ...
    in the paper it was given as superior oblique of same side,,,,
  42. kundanli

    kundanli Guest

    answer of aipg 09

    most common joint to dislocate a/e...hip joint ref...ADAMS 12th edt page 134 last para
  43. jimmy.

    jimmy. Guest

    4. ...................???

  44. jimmy.

    jimmy. Guest

    3 K-RAS

    Why are K-ras mutations important? Mutations of the K-Ras gene occur in over 90% of pancreatic carcinomas. No other human tumor comes close in mutational frequency. The ras pathway is important in the transmission of growth-promoting signals from the cell surface receptors, eventually toward the nucleus where these signals affect the production and regulation of other key proteins. It is interesting that although most mutations in genes are expected to cause their inactivation, with the Ras genes the opposite happens - they become more active in signalling. This is because of the engineering design of the protein. The ras signal is turned off by a molecular switch, which depends on an enzyme activity. In picturesque terms, the nucleotide GTP (guanidine triphosphate) engages the switch to keep it in the "on" state. A portion of the Ras protein has an enzyme activity (a GTPase) which cleaves the GTP. This turns the switch "off" after the brief "on" period. In reality, the mutations of Ras do indeed inactivate a function, as most mutations are expected to do. The GTPase is inactivated by the mutations. But this now means that GTP continues to engage the switch, and the Ras signalling function is unable to be turned "off". A number of drug companies are now investigating ways to abate the signalling function of Ras, which could provide a rational therapy for pancreatic cancer.

    Where do they occur? Ras mutations involve only certain amino acids, those which interfere with the GTPase function. In pancreatic cancer, mutations are essentially seen only at the twelfth position, (codon or amino acid 12), with rare exceptions seen at codon 13. Most mutations in pancreatic cancer change a glycine at codon 12 to a valine or aspartate. The mutation to serine is quite unusual in pancreatic cancer, a peculiar finding since it is a common mutation in other tumor types which have K-ras mutations.

    When do they occur? It is now known that K-ras mutations occur long before the formation of the actual cancer. They form in the precancerous stages, within lesions termed PIN, or Pancreatic Intraepithelial Neoplasia. These are ducts with clones of early neoplastic cells which have not yet invaded through the duct wall. In reality, these lesions are among the most common neoplasms of humans, occurring in nearly a third of elderly people. They are often unfortunately called "hyperplasias", a term which implies the lack of neoplastic character. Indeed, a rough estimate suggests that less than 1% of the lesions ever become invasive, which is to say, become a cancer. Thus, in many respects, they are similar to the adenomas of the colon; nearly a third of people will develop adenomas, yet only a small proportion will progress to colon cancer. A major effort of the Kern laboratory is to determine which of the genetic changes in PIN mark the lesions at high risk for invasion. K-ras mutations are uncommon in the early forms of PIN, but are found in the majority of advanced lesions. PIN having K-ras mutations will probably develop in 10% of persons during life. Thus, K-ras mutations are still not the specific marker of high-risk lesions that they would like to identify for diagnostic purposes. It should be obvious that a major goal is the diagnosis of pancreatic neoplasms at the earliest possible date, preferably in the advanced PIN lesions and prior to the formation of frank cancer which invades through the duct wall and spreads to other organs of the patient.

    These studies are done in collaboration with Dr. Ralph Hruban and his efforts to study K-Ras mutations.
  45. jimmy.

    jimmy. Guest


    2. QUININE

  46. drmittal.

    drmittal. Guest

    another question not yet discussed ......

    statement all true except
    1.on streptokinase produced by A,B,G strain
    2.streptolysin o is active only in reduced state
    3.erythrogenic toxin of strep is phage mediated

    another one....

    ist choice ofquestion had pitting edema associated with angioneurotic i m unable to recall as i marked it.....they had asked a/e

    one question was moderate risk associated with breast cancer
    1.apocrine metaplasia
    2.atypical hyperplasia
  47. vikrant.

    vikrant. Guest

    treatment of severe complicated flciparum malaria??

    ref harrison 17th edn..
    Artesunate, artemether, arteether, and the parent compound artemisinin are sesquiterpene lactones derived from the wormwood plant Artemisia annua. These agents are at least 10-fold more potent in vivo than other antimalarial drugs and presently show no cross-resistance with known antimalarial drugs; thus, they have become first-line agents for the treatment of severe falciparum malaria in some areas where multidrug resistance is a major problem. However, to limit the development of resistance, the World Health Organization (WHO) has recommended that artemisinin and its derivatives be used only in areas where there is proven multidrug resistance.

    but katzung on pages 849-850 says quinine is the first drug of choice..??
  48. Desai.

    Desai. Guest

    sicke cell gene disorder---functional or solubility?????
    lady with cin grade 3,t/t????????
    pain sensitive str of brain all except????
    difference btw crao n crvo all except???
    lambert eton myasthenia syn all except???
    paravertebral block all except???
    gall bladder polyp with incresd risk of cancer all except???
    comet tail- adenomyosis or adenomyomatosis????
  49. gita.

    gita. Guest

    Treatment Options for Non-Hodgkin's Lymphoma
    Prognosis for Non-Hodgkin's Lymphoma
    In 1993, a collaborative group known as The International Non-Hodgkin's Lymphoma Prognostic Factors Project published an important article in The New England Journal of Medicine (Vol. 329; pp. [snip]-994) entitled "A Predictive Model for Aggressive Non-Hodgkin's Lymphoma". Based on a study of more than 3,000 patients with diffuse large B-cell lymphoma, these researchers developed an index called the International Prognostic Index (IPI) that is useful in determining the prognosis (outlook) for patients with non-Hodgkin's lymphoma (NHL). Since that time, the IPI has been validated by other studies as being an important prognostic indicator for patients with non-Hodgkin's lymphomas.

    The International Prognostic Index (IPI) takes into consideration five major factors or variables that, taken as a whole, can be used by doctors to predict the likely outlook for patients with non-Hodgkin's lymphoma. The five major prognostic factors that are evaluated in the IPI include:

    Age of the Patient - In general, younger patients (age 60 or below) have a better prognosis than older patients over the age of 60.

    Lymphoma Stage - The stage of the lymphoma is an important prognostic indicator because it reflects the extent of spread of the disease. In general, patients with Stage I or II (localized) lymphoma, usually have a more favorable prognosis than those with Stage III or IV (advanced) disease.

    Involvement of Extranodal Sites - This is an indication of whether the lymphoma has affected areas of the body outside of the lymph nodes (extranodal sites). Extranodal sites that may be affected include the bone marrow, lung, liver, spleen, and central nervous system. In general, non-Hodgkin's lymphoma patients with no extranodal site involvement have a better outlook than those patients where the lymphoma has affected one or more extranodal sites.

    Lactate Dehydrogenase Serum Levels - Lactate dehydrogenase (LDH) is an enzyme that can be measured in the blood (serum) that, if elevated above normal levels, can indicate the presence of an aggressive, fast-growing lymphoma. In general, patients with non-Hodgkin's lymphoma with normal levels of LDH usually have a more favorable prognosis than those with elevated LDH serum levels.

    Patient's Performance Status - The term "performance status" refers to the extent of the patient's ability to perform activities of daily living. In other words, the performance status is an indication of the extent to which the disease has affected the patient's lifestyle. Performance status is ranked on a scale from 0 to 4 with a score of "0" or "1" assigned to patients who have good performance status and are capable of maintaining a relatively active lifestyle. In general, non-Hodgkin's lymphoma patients with good performance status have a more favorable prognosis than those with poor performance status.

    After evaluating each of the five individual prognostic factors that comprise the IPI, the doctor assigns a score of "1" for each poor prognostic factor. The total IPI score is then determined by adding together all of the poor prognostic factors with a score of "1". The patient is then assigned to one of the following four risk categories|
  50. twinkle.

    twinkle. Guest

    lithium used in a/e
    ans: generalised anxiety

    used in depression and for low neutrophil count
    for vascular headache...which includes cluster headache and migraine....lithium is effective in cluster headache

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