NBE MOCK TEST FOR FMGE

Discussion in 'FMGE' started by samuel, Nov 17, 2014.

  1. samuel

    samuel New Member

    Which of the following terms describes occurrence of more frequent road traffic accidents on weekends? Option A. 'Cyclic trends' is correct. Secular trends appear over very long time periods usually one or more decades. Seasonal trends are an annual feature. Cyclical trend indicates that it occurs regularly after a fixed periodicity.
    The time interval between a primary case and a secondary case is called Option A. 'serial interval' is correct. The serial interval, in the epidemiology of communicable (infectious) diseases, refers to the time between successive cases in a chain of transmission. Incubation period refers to the time between the entry of the causative organism in the host and the development of symptoms.
    Colour coding 'black' of biomedical waste is disposed off by Option D. ‘disposal in secured landfill’ is correct. ‘Black colour’ containers are to have discarded medicines and cytotoxic drugs, incineration ash and chemical used in production of biologicals, chemicals used in disinfection, etc. These can neither be incinerated nor autoclaved and hence are disposed off in landfills.
    Secondary prevention of carcinoma cervix includes which of the following? Option D. 'Pap smear testing' is correct. Secondary prevention entails “early diagnosis and treatment”. The purpose of pap smear testing is to promote early detection. Family planning, circumcision and personal hygiene are examples of primary prevention.
    Which of the following diseases has the shortest incubation period? Option B. 'Influenza' is correct. Incubation period is as follows: Measles: 10 days, Influenza: 18- 72 hrs, Small Pox: 12 days, Chicken Pox: 15 days.
    In ESI Act, 1948 the employers contribution is 4.75% of the Option A. 'total wages' is correct. The Central Government is empowered as per the ESI Act to decide the rate of employers contribution. They have fixed it at 4.75%.
    How many planes of communication have been described in a doctor-patient relationship? Option C. '3' is correct. The three planes of communication are on an emotional plane, cultural plane and intellectual plane.
    Chairman of ESI Corporation is Option A. 'Union Minister for Labour' is correct. The Central government in exercise of the powers under the ESI Act has appointed the Union Minister of Labour as Chairman. This is because the Act deals with social security for workers.
  2. samuel

    samuel New Member

    Which of the following is the MOST common side effect of electroconvulsive therapy? Option B. 'Headache' is correct. The most common side effect of electroconvulsive therapy is headache followed by confusion and amnesia
    Which of the following statements is TRUE ? Option D. ' Mid-upper arm circumference measures acute malnutrition ' is correct. First thing in acute malnutrition is decreased mid upper arm circumference even before decrease in weight. Weight for age measures acute malnutrition is wrong as weight is less in both acute and chronic malnutrition. Weight for height measures chronic malnutrition is also wrong as weight for height measures acute on chronic malnutrition rather than only chronic malnutrition Height for age measures acute and chronic malnutrition is also wrong as height for age measures chronic malnutrition rather than acute on chronic.
    Which of the following is a cause of normal anion gap metabolic acidosis? Option B. 'Renal tubular acidosis' is correct. There is loss of bicarbonate, hence normal anion gap metabolic acidosis and difference in measured cation and anion in blood remains same. There is increased anion of urates, phosphates and sulphates in chronic renal failure and bicarbonate is decreased to lesser extent there fore Chronic renal failure is wrong. Methanol also process increase in unmeasured anions likeformate. Diabetic ketoacidosis increased unmeasured anions like ketones are there.
    Which of the following is NOT seen in congenital adrenal hyperplasia due to 21-hydroxylase deficiency? Option B. 'Hypertension' is correct. Only hypertension is not a feature of 21 hydroxylase deficiency as both cortisoland desoxycortisol production is impaired as there is block beyond pregnanolone production from cholesterol. As a result there is hypotension in 21hydroxylase deficiency. Rest A(hyperkalemia),C(hyponatremia ) and D(metabolic acidosis) arefeatures of 21 hydroxylase deficiency.hence not correct response.
    Which of the following is a laboratory feature of syndrome of inappropriate antidiuretic hormone secretion (SIADH)? Option C. 'Urine sodium level is increased' is correct. There is excessive ADH production unrelated to osmolarity of blood. As a result morefluid is retained in blood and concentrated urine is passed with increased sodium. Urine osmolality is decreased is incorrect as urine osmolality is increased rather than decrease. Serum osmolality is increased is also incorrect as serum osmolality is decreased instead of increase. Serum sodium level is increased is also incorrect as because of excess retained fluid in blood there is dilutional hyponatremia instead of increase.
    A patient with severe malnutrition while on nutritional rehabilitation shows abdominal distention ascites splenomegaly and hypertrichosis. Which of the following is the MOST probable diagnosis? Option D. 'Nutritional recovery syndrome' is correct. Nutrition recovery syndrome.abdominal distension, ascites,splenomegalybecause of portal hypertension, hypertrichosis, eosinophilia and hypergammaglobunemia are all features of nutritional recovery syndrome described after 4-8 weeks of rehabilitation. Drug toxicity is wrong ,as which drug toxicity and secondly splenomegaly and ascites are unusual. Cytomegalovirus infection is also incorrect as CMIV infection ,whyit should occur during rehabilitation. Secondly there is hepatosplenomegaly and only splenomegaly is unusual. Hypertrichosis also can not be explained. Flaring up of tuberculosis is also incorrect in flaring up of tuberculosis hypertrichosis is difficult to explain, hence wrong.
    Which of the following coagulation factors is NOT decreased in the hemorrhagic disease of a newborn? Option B. 'Factor V' is correct. Factor V is not vitamin K dependant and in hemorrhagic disease of newborn it is because of Vit k deficiency. Rest responses are wrong as factor II, V and X are Vit k dependant.
    Egg is deficient in which of the following vitamins? Option C. 'Vitamin C' is correct. Egg does not contain any vitamin C- fact. All other responses are obviously wrong as egg yolk contains vit A, B6 and vitamin D.
    Extremely low birth weight (ELBW) is defined as Option B. 'up to and including 999 grams' is correct. ELBW(extremely low birth weight) are less than 1000gms hece response upto and including 999gms is correct- a fact by definition NNF and WHo and USA. Hence other responses are incorrect.
    A nutrient is classified as a trace element when it is Option B. ‘0.01% of body weight’ is correct. By definition a trace element has <0.01% of body weight(Nelson text book of pediatrics 19th ed.-fact) because of this it is obvious that all other responses like 0.001%, 0.1% and 1% of body weight are wrong.
    What is the cut-off value of mid upper arm circumference below which severe acute malnutrition (SAM) is diagnosed in children upto 5 years? Option B. '11.5 cm' is correct. Fact as per WHO reference of SAM as < 11.5 cm of left midarm circumference . Hence other responses like 11.0 cm, 12.0 cm, 12.5 cm are incorrect.
    Which of the following statements is TRUE regarding hypernatremia? Option D. 'It can cause CNS symptoms without dehydration' is correct. CNS symptoms without signs of dehydration is a feature of hypernatremiaas water driven from cell into ECF maintains hydration to some extent. Seizures are rare is wrong as seizures are frequently seen in hypernatremia CSF biochemistry will be normal as CSF biochemistry will be abnormal in hypernatremiaesp CSF sugar and chloride Urine output is usually decreased is also wrong as urine output does not decrease in hypernatremia until patient is in shock.
    For prevention of Rh sensitization, human anti-D globulin is NOT effective if it is administered to the mother beyond Option D. '72 hours of delivery ' is correct. Maximum benefit is seen in and 72 hours only,as itnneutralizes the Rh+ve foetal RBC with D ag from fetoplacental hemorrhage; rest are obvipusly wrong responses. After this period immune sensitization occurs leading to allimmunization.
    Very low birth weight (VLBW) refers to the babies with a birth weight below Option C. '1500 grams' is correct. Upto 1500 gms is correct definition. NNf and WHO also follows same cut offs. Other responses like 750 grams, 1000 grams and 2500 grams are incorrect.
  3. samuel

    samuel New Member

    Question Feedback/Topic
    All of the following veins form important systemic anastomoses EXCEPT Option B. ‘inferior rectal vein and the accessory hemiazygos vein.’ is correct. The superior rectal vein (portal) anastomoses with the middle and inferior rectal veins draining into the inferior vena caval system at the anal canal – portal hypertension may cause internal haemorrhoids. The inferior rectal vein drains into internal pudendal vein which in turn drains into the internal iliac vein which in turn drains into the common iliac vein which in turn drains into the inferior vena cava and accessory hemiazygos vein is a tributary of the azygos vein which drains into the superior vena cava. The inferior rectal vein and accessory hemiazygos vein are anatomically far apart and do not form anastomose. Esophageal branches of the left gastric vein (portal) anastomose with the esophageal tributaries of the azygos vein (caval) at the lower end of the esophagus – portal hypertension may cause oesophageal varices. Paraumbilical vein (portal) anastomose with the superficial veins of the anterior abdominal wall (caval) – portal hypertension may cause caput medusa.
    Which of the following muscles has a dual nerve supply? Option D. ‘Flexor digitorum profundus’ is correct. Flexor digitorum being a hybrid muscle, has dual nerve supply from anterior interosseous nerve which is a branch of median nerve (it supplies the lateral half) and ulnar nerve which supplies the medial half of the muscle. The flexor carpi ulnaris is supplied by the ulnar nerve. The flexor carpi radialis is supplied by the median nerve. The flexor pollicis longus is supplied by the anterior interosseous branch of the median nerve.
    Regarding the external auditory meatus, all of the following statements are true EXCEPT Option D. ‘the framework of outer one-third of the meatus is bone and the inner two-thirds is elastic cartilage’ is correct. The outer one-third of the external acoustic meatus is cartilaginous and inner two-thirds is bony.
    Ureter develops from Option B. ‘mesonephric duct’ is correct. The ureter develops from the ureteric diverticulum (bud) which arises from the mesonephric duct. Urogenital sinus gives rise to parts of urinary bladder, membranous and prostatic urethra in males, external genitalia. Mesonephric tubules give rise to ductuli aberrantes superiores , vasa efferentia , paradidymis in males and ductuli aberrantes superiores , epoophoron & paroophoron in females.Paramesonephric duct gives rise to uterine tube, uterus, upper 4/5 of vagina in females and appendix of testis & prostratic utricle in males.
    The internal iliac lymph nodes drain lymph from all of the following structures EXCEPT Option A. ‘ovary’ is correct. The lymphatics from ovary (along the ovarian arteries) drain into the preaortic and paraaortic lymph nodes. The lymphatics from rectum, uterus and urinary bladder drain into the internal iliac lymph nodes.
    Which of the following statements is NOT true regarding the pelvic diaphragm? Option B. ‘The pelvic diaphragm is inferior to the superficial muscles of the perineum’ is correct. The pelvic diaphragm formed by levator ani and coccygeus muscles, lies superior to the superficial muscles of the perineum. The muscles are attached to the perineal body and forma the medial wall of the ischiorectal fossa. The Colles’ fascia lies inferior to the superficial perineal muscles.
    The bone that ossifies predominantly in membrane is Option D. ‘clavicle’ is correct. The entire shaft of the clavicle ossifies in membrane. The medial end of the clavicle ossifies by secondary centre endochondrally. Radius, humerus and scapula ossify endochondrally.
    Which of the following statements is NOT true regarding left suprarenal gland? Option A. ‘It is posterior to liver’ is correct. Left suprarenal gland is related anteriorly to the stomach and body of pancreas that crosses it from right to left. Left crus of diaphragm lies posterior to it. However, liver is related to the right suprarenal gland and not the left.
    Which of the following statements is TRUE regarding afferent arteriole of the glomerulus? Option D. ‘It gives rise to juxtaglomerular cells’ is correct. Tunica media of the afferent arteriole contains smooth muscle cells. Few of these cells specialize to form juxtaglomerular cells. Aldosterone is secreted by cells of the zona glomerulosa of adrenal gland.Macula densa is formed by cells of the distal convoluted tubule. Mesangial cells are glomerular and extraglomerular which connect the macula densa cells with the juxtaglomerular cells.
    Which of the following is NOT a posterior relation of the rectum? Option A. ‘Sigmoid colon’ is correct. The sigmoid colon along with the terminal part of the ileum lies in the pararectal fossa on the left side and thus not related to the rectum posteriorly. The presacral fascia, median sacral vessels and lowest portion of sympathetic chain lie posterior to the rectum.
    Carpal tunnel syndrome is produced due to compression of which nerve in the carpal tunnel? Option B. ‘Median nerve’ is correct. Compression of the median nerve in the carpal tunnel leads to carpal tunnel syndrome. The ulnar nerve lies superficial to the carpal tunnel. Superficial branch of the radial nerve passes through the anatomical snuff box. Deep branch of radial nerve lies in the posterior compartment of the forearm. Musculocutaneous nerve terminates as the lateral cutaneous nerve of the forearm and does not reach the hand.
    All of the following muscles are attached to the greater tubercle of humerus EXCEPT Option D. ‘pectoralis major’ is correct. Greater tubercle of humerus shows the attachments of supraspinatus, infraspinatus and teres minor on the upper, middle and lower impressions respectively. Pectoralis major is attached to the lateral lip of the bicipital groove (intertubercular sulcus).
    Aldosterone is secreted by Option D. ‘zona glomerulosa’ is correct. Aldosterone is secreted by the cells of zona glomerulosa of adrenal cortex. Zona reticularis of adrenal cortex secretes androgens. Adrenal medulla secretes catecholamines like epinephrine and norepinephrine.
    All of the following are remnants of mesonephric tubules EXCEPT Option C. ‘appendix testis’ is correct. Remnants of mesonephric tubules in males are superior aberrant ductules, vasa efferentia and paradidymis and in females are superior aberrant ductules, epoophoron and paroophoron. Appendix testis is a remnant of paramesonephric duct in males.
    While carrying a heavy suitcase, the downward dislocation of glenohumeral joint is resisted by all of the following muscles EXCEPT Option B. ‘latissimus dorsi’ is correct. The direction of pull of the muscles deltoid, coracobrachialis and short head of biceps brachii is upwards from its proximal attachments, hence they can all resist the downward dislocation of the glenohumeral joint. The direction of pull of the latissimus dorsi muscle is downwards, hence it cannot resist the downward dislocation of glenohumeral joint.
    Which of the following is NOT an anterior relation of left kidney? Option C. ‘Head of pancreas’ is correct. Anterior surface of the left kidney is related to the suprarenal gland near its upper pole, splenic flexure of colon laterally and coils of jejunum, body of pancreas and spleen and stomach. Head of the pancreas is on the right side and is related medial to the second part of duodenum that lies anterior to the hilum of the right kidney.
    Right ovarian vein drains into Option D. ‘inferior vena cava’ is correct. The left ovarian vein drains into the left renal vein. Inferior vena cava receives the right ovarian vein. The reason for this difference is developmental. The caudal part of the subcardinal vein is in part incorporated in the testicular or ovarian vein and partly disappears. The cranial end of the right subcardinal vein is incorporated into the inferior vena cava and also forms the right suprarenal vein. The left subcardinal vein, cranial to the intersubcardinal anastomosis, is incorporated into the left suprarenal vein. The renal and testicular or ovarian veins on both sides join the supracardinal–subcardinal anastomosis. On the left side this is connected directly to the part of the inferior vena cava which is of subcardinal status through an intersubcardinal anastomosis.
  4. samuel

    samuel New Member

    Compared to isometric exercise, isotonic exercise leads to a greater increase in Option B. ‘stroke volume’ is correct. Because in isotonic exercise the stroke volume increases due to increase in End diastolic volume (due to muscle pump effect). Whereas, in isometric exercise stroke volume either decrease or relatively there is no change. Therefore, blood flow to contracting muscle decreases due to compression effect.
    Clinical effect of digitalis is due to Option C. ‘increase in intracellular Ca++’ is correct. Digitalis acts as glycoside, commonly used to treat heart failure. It increases strength of cardiac contraction. It increases intracellular Ca++ concentration by inhibiting Na+--K+ATPase in cardiomyocytes resulting in increased intracellular Na+ concentration and hence decreases Ca++ efflux via Na+-Ca++ exchange antiport.
    The biochemical pathways involved in basal ganglia are Option B. ‘dopaminergic, cholinergic, GABAergic systems’ is correct. Dopaminergic-cholinergic-GABAnergic system, because in basal ganglia there are two functional neural loops, i.e.primary feedback loop and additional feedback loop. The Primary feedback loop (cortex-basal ganglia-motor cortex circuit) is formed by afferents from all parts of cerebral cortex to straitum (excitatory glutaminergic), projections from straitum to globus pallidus and substantia nigra (GP1 and (inhibitory GABArgic), efferents from GP1 and SNPr to thalamus (GABArgic inhibitory), and projections from thalamus to motor cortex and straitum. The primary feedback loop further consists of two loops, Caudate loop and Putamen loop. Additional feedback loop consists of two indirect loops, Via subthalamic nucleus (straitum-GPe-subthalamic nuclei and GPi-thalamus), Via Pars compacta of substantia nigra( SNPc). The SNPc exerts both facilitatory and inhibitory effects on the straitum through Dopamine. Dopamine effect through D1 receptors is excitatory to cholinergic neurons of the straitum, and through D2 receptors it is inhibitory to cholinergic interneurons.
    The smooth endoplasmic reticulum (SER) adrenal steroidogenic enzyme is Option C. ‘21 β-hydroxylase’ is correct. The adrenal steriodogenic enzyme present in the smooth endoplasmic reticulum is 21 β hydroxylase. The hydroxylation of progesterone to 11-deoxycorticosterone and of 17 alpha-hydroxyl progesterone to 11- deoxycortisol occurs in smooth endoplasmic reticulum. These reactions are catalysed by 21 β-hydroxylase.
    In neurons, resting membrane potential is close to equilibrium potential for which of the following? Option C. ‘K+’ is correct. The relation of diffusion potential to concentration gradient is called as Nernst Potential or equilibrium potential. The assymetrical distribution of ions across the cell membrane in the form of excess of diffusible cations (K+) results in concentration gradient. Therefore, K+ tries to diffuse into ECF from ICF, but is counteracted by electrical gradient created by non diffusible anions in the cell. Thus an equilibrium will be reached between coccentration gradient and electrical gradient resulting in diffusional potential (equilibrium potential). That is determined by Nernst equation: Em = ± Log (conc)I ∕(conc)o, Em of K+ is -70mv, and resting membrane potential of neuronal membrane is -70 mv.
    Lewy bodies are found in which of the following? Option B. ‘Parkinson disease’ is correct. Lewy bodies are inclusion bodies in the neuron present in the Parkinson disease. Lewy bodies are proteins (α synuclein and barkin) appear due to mutation of genes.
    Which of the following statements is TRUE regarding protoplasmic astrocytes? Option C. ‘It takes up K+, glutamate, and GABA’ is correct. Protoplasmic astrocytes are present in grey matter. Their processes form blood-brain-barrier and also envelop synapses on the surface of nerve cell. The membrane potential of protoplasmic astrocytes varies with ECF K+, but propagated action potential is not produced. They maintain appropriate concentration of neurotransmitter by taking up K+ depending on types of metabotropic receptors of the transmitter, (glutaminergic and GABA receptors).
    Translocon is a pore in the Option D ‘endoplasmic reticulum’ is correct. Translocon is a pore in the endoplasmic reticulum. It is a heterotrimeric structure made up of Sec 61 proteins. On emerging from the large unit of the ribosome, Signal peptide of a protein binds to a signal recognition particle and this, arrests further translation until it binds to the translocon on ER.
    'Phosphate timer' signifies relationship between Option D. ‘phosphorylation and dephosphorylation of cellular proteins’ is correct. The relationship between phosphorylation and dephosphorylation of cellular proteins are associated with cell signaling pathways, is referred to as ‘phosphate timer’.
    Hyperexcitability of neurons is seen in which of the following? Option B. ‘Hyperkalemia’ is correct. As resting membrane potential is close to equilibrium potential of K+. Therefore changes in external K+ concentration has major effect on resting membrane potential. At rest K+ permeability is more than the Na+ because there are more open channels of K+. Hyperkalemia (increase conc of K+in ECF) the resting membrane potential moves closer to the threshold for generating action potential, thus neurons become more excitable.
    Wolff-Chaikoff effect is Option B. ‘transient inhibition of thyroid hormone synthesis by iodide’ is correct. The heart rate depends on the pacemaker activity i.e SA node. Acetylcholine is a cardioinhibitory neurotransmitter, it causes increased efflux of K+ (increasing permeability of SA nodal fibres) producing hyperpolarization and slowing the firing rate of impulse.
    Lesion of the anterior pituitary causes Option A. ‘reduced urine volume due to low levels of ACTH ‘ is correct. Lesion of anterior pituitary there is reduced urine volume due to deficiency of ACTH, because mineralocorticoid deficiency does not occur, as secretion of aldosterone and renin (from juxtaglomerular apparatus) are not affected. Therefore, hypovolemia and salt loss don’t occur.
    The absolute refractory period in neuron is from Option C. ‘firing level until repolarization is 1/3rd complete’ is correct. The absolute refractory period in a neuron is the time that extend from firing level to until depolarization is about 1/3rd complete, because during depolarization & repolarization phase of action potential (spike potential) threshold of excitability is increased, because Na+ ion channels are inactivated (intracellular Na+ concentration is high) and slow K+ ion channels have not yet been opened.
  5. samuel

    samuel New Member

    Pot belly and protruding tongue seen in cretinism are due to Option D. ‘disproportionate skeletal and soft tissue growth’ is correct. Pot belly and protruding tongue seen in cretinism is due to disproportionate growth of skeletal and soft tissue growth. For normal growth adequate thyroid hormone levels are necessary. Children with thyroid deficiency show stunted growth because, when thyroid hormone levels are low, the secretion of GH and IGF secretion decreases. In the soft tissue there is accumulation of glycosamineglycan (GAG) (mucopolypeptides) primarily hyaluronic acid and chondroitin sulphate in the interstitial spaces. This leads to thickening of skin, the tongue enlarges and protrudes and pot belly.
    Which of the following hormones has the shortest plasma half-life? Option D. ‘Norepinephrine’ is correct. The plasma half life of Norepinephrine is < 1 sec, cortisol is 90-100 min, aldosterone is 30 min, and renin is 80 min.
    Entry of ECF Ca 2+ is required for Option B. ‘cardiac muscle contraction’ is correct. In cardiac muscle Ca++ diffuses into the sarcoplasm from T tubules. The T tubules of cardiac muscle contain negatively charged mucopolysaccharides and bind an abundant store of Ca++. The T tubules open directly to the exterior, therefore Ca++ diffuse into the sarcoplasm when action potential propagates along T tubules. Because of this the strength of cardiac muscle contraction depends to great extent on Ca++ in ECF, whereas skeletal muscle contraction is hardly affected by ECF Ca++.
    If the renal clearance of para amino hippuric acid is 720 mL/min and its extraction is 90%, then the actual renal plasma flow in mL/min would be Option C. ‘800’ is correct. ERPF = UPAH V ∕ PPAH = Clearance of PAH (c PAH), Extraction is 90% = 720×90∕ 100 = 648ml/min, Extraction ratio is = 648∕720 = 0.9. As clearance of PAH = ERPF = 720 ml/min, therefore, actual renal plasma flow = ERPF∕Extraction ratio = 720∕0.9 = 800ml/min.
    The lactose operon is positively controlled by which of the following? Option C. ‘Decreased concentration of glucose, increased concentration of cAMP’ is correct. Glucose keeps the lac operon in the repressed state and high levels of glucose are known to inactivate adenyl cyclase thus decreasing levels of cAMP. Also the regulatory protein- catabolite gene activator protein (CAP) bound to cAMP acts as a positive regulator or enhancer. Decreased concentration of glucose, increased concentration of cAMP therefore have an enhancing effect on the lac operon. Increase in glucose levels or a decrease in cAMP levels represses the lac operon.
    Amino acid having pivotal role in transmethylation reaction is Option D. ‘methionine’ is correct. Transmethylation is the transfer of a methyl group from a donor to an acceptor. The amino acid methionine in its active form –S-adenosyl methionine acts as a methyl donor. The other amino acids do not participate in transmethylation reactions.
    Cystinuria is associated with excretion of which of the following amino acids in urine? Option C. ‘Cysteine, ornithine, lysine, and arginine’ is correct. Cystiene shares a common transport system with basic amino acids like lysine, ornithine and arginine, therefore in cystinuria, alongwith cysteine, there is loss of ornithine, lysine, and arginine in urine. Alanine, threonine and leucine are not excreted in cystinuria as they do not use the same transport system as cysteine.
    Which of the following probes is used for Western blot? Option C. ‘Antibody’ is correct. Western blotting is a technique to identify proteins hence antibodies are used as probes as they bring about specific protein-ligand interactions. cDNA is used in Northern Blotting techniques while southern blot technique uses DNA. mRNA is not used as a probe.
    Which the following enzymes is activated by phosphorylation? Option D. ‘Glycogen phosphorylase’ is correct. Pepsin is the active form of pepsinogen, Protein kinase is activated by cAMP, Glycogen synthase is inactivated by phosphorylation. Glycogen phosphorylase is activated by phosphorylation.
    The amino acid that has sparing action on niacin is Option C. ‘tryptophan’ is correct. Almost half on the body’s niacin coenzymes (NAD+ and NADP+)are synthesized from tryptophan. The rest is from the vitamin niacin. Therefore tryptophan has a sparing effect on niacin. The other amino acids – lysine, glycine and phenylalanine do not synthesise niacin coenzymes.
    Which of the following amino acids has buffering capacity? Option B. ‘Histidine’ is correct. Amino acids with ionizable groups in their side chains act as buffers at the pK values of the ionizable side chains. Histidine, with a pk of its imidazole group as nearly 7 (closest to normal blood pH) has a buffering capacity and plays a role in the homeostasis of the body pH.The other amino acids do not possess near 7 pk values and hence do not act as buffers in the body.
    Dehydrogenases involved in HMP shunt pathway are specific for Option B. ‘NADP’ is correct. The enzyme glucose -6- phosphate dehydrogenase catalyses the transfer of a hydride ion from the 1st carbon of glucose -6-phosphate to NADP+. The enxyme phosphogluconate dehydrogenase also uses NADP+ as an electron acceptor. Therefore dehydrogenases involved in HMP shunt pathway are specific for NADP+ and not to the other coenzymes.
    The committed step in the biosynthesis of cholesterol is Option A. ‘formation of mevalonate from HMG-CoA’ is correct. The formation of mevalonate from HMG-CoA is catalysed by the enzyme HMG CoA reductase, This is the regulatory enzyme and this step is the rate limiting step in the synthesis of cholesterol. Therefore it is the committed step in the biosynthesis of cholesterol. None of the other enzymes have a regulatory effect and therefore no other reaction becomes the committed step.
  6. samuel

    samuel New Member

    Which of the following biochemical reactions does not occur in mitochondria? Option C. ‘Cori cycle’ is the correct. The Krebs cycle, Fatty acid oxidation and a part of the urea cycle take part in the mitochondria as all the enzymes of these pathways are present in the mitochondria. Cori cycle is the transport of lactate from the skeletal muscle to the liver for it to be converted to glucose and hence does not occur in the mitochondria.
    Which of the following is a product of purine catabolism in humans? Option B. ‘Uric acid’ is correct.Uric acid is the end product of purine catabolism in humans. Urea is a product of protein catabolism in humans, while beta-amino isobutyrate is a product of pyrimidine catabolism in humans. Hypoxanthine is converted to the end product.- uric acid.
    Inborn error associated with inherited defect in α -keto acid decarboxylase is Option D. ‘maple syrup urine disease’ is correct. alpha-keto acid decarboxylase is an enzyme that acts on the branched chain amin acids and converts them into their corresponding acyl CoA thioesters. A defect of this enzyme results in maple syrup urine disease . Isovaleric academia is due to the deficiency of isovaleryl CoA dehydrogenase, while alkaptonuria is due to the deficiency of homogentisic acid oxidase and Hartnup’s disease is caused due to the defective absorption and reabsoaOption D. ‘maple syrup urine disease’ is correct. Alpha-keto acid decarboxylase is an enzyme that acts on the branched chain amin acids and converts them into their corresponding acyl CoA thioesters. A defect of this enzyme results in maple syrup urine disease . Isovaleric academia is due to the deficiency of isovaleryl CoA dehydrogenase, while alkaptonuria is due to the deficiency of homogentisic acid oxidase and Hartnup’s disease is caused due to the defective absorption and reabsorption of aromatic amino acids from the intestines and renal tubules.rption of aromatic amino acids from the intestines and renal tubules.
    The enzyme complex that provides a link between glycolysis and TCA cycle is Option C. ‘pyruvate dehydrogenase’ is correct. Puvate dehydrogenase is the multienzyme comples that converts the end product of glycolysis-Pyruvate to Acetyl CoA, which enters the TCA cycle . Thus is provides link between glycolysis and TCA cycle.
    The phosphagen present in skeletal muscle is Option C. ‘creatine phosphate’ is correct. Phosphagens are high energy phosphate compounds mostly found in the muscular tissue in animals , Creatine and creatinine are not phosphate containing compounds. The phosphated compound in the muscle is creatine phosphate. Creatinine does not exist as a phosphate compound. It is formed from creatine and is excreted in the urine.
    An example of omega-3 fatty acid is Option B. ‘linolenic acid’ is correct. In the omega classification of fatty acids, the positions of the double bonds are counted from the omega-carbon end. Example of Omega 3 fatty acid is linolenic acid, while linoleic and arachidonic acid are omega 6 fatty acids. Palmitoleic acid is a monounsaturated fatty acid.
  7. samuel

    samuel New Member

    The hydrolytic step leading to the release of a polypeptide chain from a ribosome is catalyzed by Option B. ‘peptidyl transferase’ is correct. The hydrolytic step leading to the release of a polypeptide chain from a ribosome is catalyzed by the enzyme peptidyl transferase, which along with release factors and GTP adds a water molecule instead of an amino acid to the chain and brings about termination of protein synthesis. Dissociation of the ribosome occurs later. Elongation factors help in elongation of the polypeptide chain.
    Methotrexate inhibits which of the following enzymes? Option C. ‘Dihydrofolate reductase’ is correct. Methotrexate is a structural analog of dihydrofolic acid and competitively inhibits Dihydrofolate reductase. It does not affect Xanthine oxidase or Thymidylate synthetase or Ribonucleotide reductase.
    TIBC is increased in Option C. 'iron deficiency anemia' is correct. TIBC is increased in iron deficiency anaemi. Since there is deficiency of iron there is less transfusion saturation, iron binding capacity is increased, TIBC is low in anaemia of chronic disease and may be normal or low in hemolytic anaemia or megaloblastic anaemia.
    All of the following are common in Crohn disease EXCEPT Option C. 'toxic megacolon' is correct. Crohn disease is an ulceroinflammatory disorder having serpentine ulcers, skip lesions and stricture formation. Toxic megacolon is seen in ulcerative colitis.
    Hypertrophic cardiomyopathy causes Option D. 'both systolic and diastolic dysfunction' is correct. Hypertrophic cardiomyopathy is extensive myocardial hypertrophy resulting into reduced chamber size whch results into impaired diastolic filling. In approximately 25% of the patients there is left ventricular outflow obstruction resulting into impaired systolic function also. So there is both systolic and diastolic dysfunction.
    Normal life span of RBC is Option D. '120 days' is correct. Normal life span of RBC is 120 days, after that they are taken up by reticuloendothelial cells and are broken, Hb released is again taken up and reutilized.
    All of the following are associated with H pylori infection EXCEPT Option C. 'carcinoid tumor ' is correct. H.pylori is the most common cause of chronic gastritis. The risk of duodenal ulcer is increased later on resulting into intestinal metaplasia and increased risk of gastric adenocarcinoma. There is an associated increase risk of MALT lymphoma. However there is no known association with carcinoid tumor.
    Infectious etiology is usually seen in Option D. 'granuloma pyogenicum' is correct. All these tumors are benign tumors of vascular origin. Granuloma pyogenicum is a highly vascular lesion seen in gingival of children and pregnant women mainly due to infectious etiology. Histologically it resembles granulation tissue and hence named so.
    Polycythemia vera is proliferation of Option C. 'RBCs' is correct. Polycythemia vera is proliferation of RBCs. Proliferation of B and T cells leads to lymphoproliferative disorder while of plasma cells results into plasmacytoma.
    Hassall corpuscles are seen in Option C. 'thymus' is correct. Hassall corpuscles are seen in thymus. These are whorls of medullary epithelial cells with characterstic keratinized cores.
    T cells mature in Option C. 'thymus' is correct. T cells mature in thymus. Thymus is a mediastinal organ which grows until puberty and then undergoes progressive involution. Proginator cells of marrow origin migrate to thymus and mature into T cells. B cells mature in lymphoid tissue.
    The MOST common cause of aortic dissecting aneurysm is Option D. 'hypertension' is correct. Aortic dissecting aneurysm occur in two groups, in adults with antecedent hypertension in 90% of the cases and in younger patient with Marfan’s syndrome. Hypertension is the cause of aortic dissecting aneurysm in 90% of the cases.
    Which of the following is the MOST common cause of fulminant hepatic failure? Option B. 'Hepatitis B' is correct. Fulminant hepatitis is rapidly developing resulting within 2-3 weeks into hepatic encephalopathy, in patient who do not have chronic hepatitis. About 12% of fulminant hepatitis cases are caused by viral hepatitis of these 8% are caused by HBV and rest by HAV.
    Postmortem finding in a case of death due to myocardial infarction is Option C. 'coagulative necrosis' is correct. Myocardial infarction is partly due to coronary atherosclerosis or sudden vasospasm resulting into significant ischaemic morphological changes observed as coagulative necrosis. Fat necrosis is seen due to trauma or pancreatitis, caseous necrosis in tuberculosis and liquifactive necrosis in brain infarct.
    Which of the following is NOT a hepatotropic virus? Option D. 'Hepatitis G' is correct. Viral hepatitis can be due to systemic viral infections like EB virus, CMV and yellow fever etc. more commonly it is due to hepatotropic viruses which have special affinity for liver. These are hepatitis A,B,C ,D and E. hepatitis G is not hepatotropic and does not cause elevated level of serum aminotransferases.
  8. samuel

    samuel New Member

    Rice-watery stool is associated with which of the following? Option A. 'Cholera'is correct. The rice-watery stool is classically associated with cholera caused by Vibrio cholerae and not by other bacterial infections causing dysentery,gastroenteritis or colitis.
    Which of the following corynebacteria causes erythrasma affecting axilla and groin? Option C. 'C minutissimum' is correct. C minutissimumcauses erythrasma, which has brown, scaly skin patches affecting axilla as well as groin and is not caused by C jeikeium, C ulcerans or C pseudotuberculsisis.
    Which of the following is the drug of choice for antibiotic associated diarrhea caused by Clostridium difficile? Option D. 'Metronidazole' is correct. The patient is already taking number of antibiotics hence landed with antibiotic associated diarrhea caused by Clostridium difficile. In these circumstances, it is metronidazole, which can be given as the best antimicrobial agent and not antibiotics like colistin, erythromycin or ciprofloxacin.
    Proteus species is a common cause of Option D. 'urinary infection' is correct. Proteus is common cause of urinary tract infections as compared to diarrhoea, pneumonitis or otitis media sometimesleading to even stone formation.
    Live attenuated vaccines can be given to which of the following groups? Option B. 'Children < 8 years age' is correct. The live attenuated vaccines can be given tochildren, as other patients’ groups like leukemia, on steroid or radiotherapy, are somewhat immunocompromised, where chances of revival of live organismremains a potentialthreat of the disease instead of prevention.
    BCG is used to produce immunity against Option D. 'tuberculosis' is correct. Bacillus Calmette, Guerin (BCG) is a live attenuated bacterial vaccine prepared from Mycobacterium bovis to produce cross-immunity against Mycobacteriumtuberculosis, which causestuberculosis and not againstrabies, influenza or HBV infection.
    Which of the following bacteria is commonly associated with food poisoning due to consumption of cooked chinese fried rice? Option A. 'Bacillus cereus' is correct. Bacillus cereus causes two types of food poisonings; i) diarrhoeal and ii) emetic type. The emetic type is commonly associated with consumption of improperly cooked Chinese fried rice.
    A young executive with frequent history of travel presented with fever which gradually increased in a step ladder fashion over last 2 weeks. He also has pain abdomen and diarrhea. Blood culture revealed Gram negative motile nonlactose fermenting bacilli. Which of the following is the MOST likely diagnosis? Option D. 'Enteric fever' is correct. In Q fever, brucellosis and shigellosis, fevers are not step-ladder type hence it is enteric fever caused by Salmonella species like S. typhi or S. paratyphi.
    The MOST important single practice that prevents transmission of healthcare associated infections to a large extent is Option D. 'practice of hand hygiene' is correct. The habit of washing hands is the most important single practice of hygiene that prevents transmission of healthcare associate infections, as compared to the isolation of patients, use of antibiotics or face masks.
    Which of the following clostridia is predominantly saccharolytic? Option C. 'C perfringens' is correct. Out of all given Clostridia, C perfringens, is predominantly saccharolytic as compared to C tetani, C botulinum and C bifermentans.
    Bacillary dysentery is transmitted by all of the following EXCEPT Option D. 'contaminated needles' is correct. The bacterial dysentery is a feco-oral infection and is transmitted by food items, fomites or direct contact and not by the parenteral means like contaminated needles, etc.
    Which of the following was the first pathogenic bacterium to be observed under the microscope? Option B. 'Bacillus anthracis' is correct. Bacillus anthraciswas the first pathogenic bacterium to be observed under the microscope by Pollender in 1849, whereas other bacteria like Yersinia pestis, Clostridium tetani and Mycobacterium tuberculosis were examined subsequently.
    Plague is transmitted by Option D. 'rat flea' is correct. The plague is caused by Yersinia pestis, which is only transmitted by rat flea (Xenopsylla cheopis) and not by tick, mite or louse.
    Methylphenidate is a drug of choice for Option D. ‘attention deficit hyperactivity disorder’ is correct. Methylphenidate is the drug of choice for attention deficit hyperactivity disorder (ADHD). It is amphetamine variant. ADHD is a mild grade of mental retardation when child finds difficult to concentrate.i.e. decrease in attention span. Amphetamine or Methylphenidate by increasing attention span improve performance in studies & behaviour.
    Shelf life of a drug is the period between Option A. ‘date of manufacture and date of expiry’ is correct. Shelf life of a drug is the period between date of manufacture and date of expiry. It tells about drug’s quality over a specified period of time. It is influenced by storage conditions like exposure to heat, light and moisture.
    In phase 2 clinical trial, how many number of subjects are recruited for the study? Option B. ‘100-200’ is correct. In phase 2 clinical trial, 100- 500 subjects are recruited. In phase, 20-80 subjects, in phase 3, 500-3000 subjects are enrolled. In phase 4, 3000 to 10,000+ patients are there.
    Scopolamine is a preferred antiemetic for Option A. ‘ motion sickness’ is correct. Motion sickness is a vestibular disturbance because of muscarininc cholinergic transmission i.e. conduction of nerve impulses across a cholinergic link in pathway leading from vestibular apparatus to vomiting centre. Scopolamine by acting on vestibular apparatus, blocks muscarininc cholinergic transmission and thus produces antiemetic effect. For radiation sickness and postoperative emesis drug of choice is ondansetron. In hyperemesis gravidarum, doxylamine , dicyclomine, promethazine and metoclopramide can be used.
  9. samuel

    samuel New Member

    Nitrergic neurons are Option B. ‘parasympathetic neurons with nitric oxide as neurotransmitter’ is correct. Most peripheral & central neurons on stimulation release more than one active substance. In autonomic nervous system (ANS) also besides the main neurotransmitters acetylcholine and norepinephrine, other neurotransmitters called as co-transmitters are released eg Purines (ATP & adenosine), Peptides (VIP or NPY, substance P, enkephalin), NO or PGs etc. Neurotransmitter at some parasympathetic sites is NO associated with acetylcholine such nerves are called as nitrergic nerves.
    Midodrine is used for Option D. ‘chronic orthostatic hypotension’ is correct. Midodrine is a direct acting sympathomimetic (prodrug ), that is enzymatically hydrolysed to desglymidodrine, a selective alpha 1 receptor agonist. Primary indication is in treatment of chronic orthostatic hypotension. Being adrenergic drug, it is not used in severe hypertension, CHF or cardiac stress test.
    During fetal development, which of the following is the MOST vulnerable period for teratogenicity? Option B. ‘3rd-8th week of gestation’ is correct. During fetal development, 3rd to 8th week of gestation is the most vulnerable period for teratogenicity because it is the period of organogenesis- the most vulnerable period in which teratogenic drugs can lead to number of deformities.
    Which of the following antimuscarinic drugs is often effective in preventing or reversing vestibular disturbances, especially motion sickness? Option D. ‘Scopolamine’ is correct. Scopolamine is drug of choice in preventing or reversing vestibular disturbances, especially motion sickness. Atropine topically is used for treatment of iritis, irido-cyclitis because of long lasting mydriatic- cycloplegic action. It takes care of pain. It is also drug of choice for refraction testing in children who have high ciliary muscle tone. Homatropine is also used for refraction testing. It is used in adults. Ipratropium bromide acts as a bronchodilator & is used in treatment of COPD & Bronchial asthma.
    The dosage of an oral hypoglycemic drug is adjusted by repeated measurement of blood sugar. This type of dosing strategy is known as Option C. ‘regulated dose’ is correct. Dose of oral hypoglycemic is adjusted by repeated measurement of blood sugar.This type of dosing strategy is called as regulated dose. - Titrated dose means when dose needed to attain maximal therapeutic effect can’t be given because of intolerable side effects of the drug. Optimal dose is needed by titrating with an acceptable level of adverse effect. Standard dose means that same dose is given to most of the patients. Target level dose is given, when response can’t be easily measured but it is known that the desired response is attained at a certain range of drug concentration in plasma.
    In zero order kinetics Optoin D. ‘elimination rate is independent of drug concentration’ is correct. In zero order kinetics, elimination rate is independent of drug concentration i.e. constant amount of drug is eliminated. As constant amount of drug is eliminated clearance progressively decreases. t1/2 keeps on increasing with time as clearance decreases ( t1/2 = 0.693 x Vd/CL)
    Which of the following statements is NOT true regarding warfarin? Option B. ‘It does not cross placenta’ is correct. Warfarin is administered as sodium salt & has 100% bioavailability. Its half- life (t1/2) is 36 hrs & is 99% bound to plasma protein albumin. It crosses placenta readily & can lead to serious birth defects. It can also lead to haemorrhagic disorder in the foetus.
    Microdosing study is done Option D. ‘before phase I clinical trial’ is correct. Microdosing study (called as phase 0 study) is done before phase 1 clinical trial. This is new strategy developed to reduce cost and time of drug development process. Many drugs fail during clinical trials, so very low doses i.e 1/100th of estimated human dose is administered to healthy volunteer and pharmacokinetics (PK) is studied by sophisticated instruments.
    MRSA strains are susceptible to Option B. ‘vancomycin’ is correct. MRSA strains are susceptible to vancomycin. Other drugs for MRSA are- teicoplanin, linezolid, quinupristin/dalfoprestin combination, Mupirocin & rifampicin.
    Damage caused by bullet depends on Option C. 'velocity of bullet' is correct. The injury inflicted by a bullet is directly related to the bullet's kinetic energy. A combination of the bullet's weight, velocity and gravitational trajectory describe how much damage a bullet will cause. Specific gravity of the target tissue may also have a secondary effect on the damage caused. However, among the options, velocity of the bullet is the major determinant of the damage caused by the bullet.
  10. samuel

    samuel New Member

    Primary injuries to pedestrians are usually seen on Option D. 'lower limbs' is correct. Primary impact injuries are usually seen on the lower limbs. These are caused when the pedestrian comes in contact with the projecting parts of the colliding vehicle. Injuries to the head, chest and upper limbs can be the secondary impact injuries caused due to subsequent impact with the vehicle.
    The tension required on ligature to block trachea is Option C. '15 kg' is correct. The tension required on ligature to block trachea is 15 kg. Tension of 2 kg is enough to block jugular vein, 5 kg for carotid arteries and 20 kgs for vertebral arteries.
    Crocodile skin effect is seen Option C. 'in high voltage burns' is correct. Crocodile skin effect is seen in high voltage burns. Scalds are seen in high voltage burns. Rope burns may be seen occasionally beneath the ligature mark.
    Miosis is produced by all of the following substances EXCEPT Option A. 'cyanide' is correct. Miosis or pin-point pupils is a feature of pontine hemorrhage, and poisonings with opiates and organophosphates. Miosis is not produced in cyanide poisoning.
    Lichtenberg figures are seen in Option B. 'lightening' is correct. Lichtenberg figures are seen in lightening. Scalds result from moist heat, joule burn from electrocution and flash burns are electrical burns from arc flashes.
    Raindrop skin change is a feature of poisoning by Option D. 'arsenic' is correct. 'Rain drops skin changes' is a feature of chronic arsenic poisoning. It appears as patchy hyperpigmentation predominantly on the shoulders and back of trunk.
    Section 320 of the IPC describes which of the following? Option C. 'Grievous hurt' is correct. Section 320 of the IPC describes Grievous hurt. Murder is described in Section 300 IPC, Section 319 of the IPC describes hurt, and Section 304 of the IPC describes culpable homicide not amounting to murder.
    Which of the following is TRUE regarding posthumous child? Option C. 'Born after death of father' is correct. A posthumous child is the one born after the death of his/her father. Child born after parental divorce or to an unmarried woman is an illegitimate child.
    Which of the following statements is NOT true regarding starvation? Option A. 'Death occurs when 20% of body weight is lost' is correct. Starved adults may lose as much as 50% of their normal body weight and hence, this statement is not true. All other statements are true.
    Which of the following is the MOST common site of malignancy in women in developed countries? Option B. 'Breast' is correct. Cancer breast followed by cancer cervix are the commonest cause among cancers in women in developing countries.
    The time interval between a primary case and a secondary case is called Option A. 'serial interval' is correct. The serial interval, in the epidemiology of communicable (infectious) diseases, refers to the time between successive cases in a chain of transmission. Incubation period refers to the time between the entry of the causative organism in the host and the development of symptoms.
    Food poisoning due to which of the following organisms has the shortest incubation period? Option B. 'Staphylococcus' is correct. Incubation period is as follows: Salmonella: 12-24 hrs, Staphylococcus: 1-6 hrs, Clostridium botulinum: 12-36 hrs, Clostridium perfringens: 6-24 hrs.
    Which of the following statements is TRUE regarding tuberculosis epidemiology? Option B. 'Bovine TB can spread through milk' is correct. Tuberculosis is a disease with relatively less communicability in infectious diseases. Drinking milk of a cow infected with tuberculosis leads to bovine tuberculosis.
    Primary prevention of hypertension includes which of the following? Option A. 'Reduction of weight' is correct. Primary prevention includes actions before the onset of the disease. Screening and treatment fall in the realm of secondary prevention.
    Which of the following describes iceberg phenomena of disease? Option C. 'It gives an idea of proportion of disease which is subclinical' is correct. Iceberg phenomenon indicates that the only apparent, symptomatic cases are picked up by the physician. A large number of diseases have subclinical cases which have no symptoms.
    Which of the following diseases has fecal-oral route of transmission? Option B. 'Poliomyelitis' is correct. Poliomyelitis is transmitted through drinking water. Kala azar is transmitted by sandflies. Epidemic typhus is a rickettsial disease. Guinea worm is transmitted by cyclops.
  11. samuel

    samuel New Member

    How many planes of communication have been described in a doctor-patient relationship? Option C. '3' is correct. The three planes of communication are on an emotional plane, cultural plane and intellectual plane.
    The time interval between receipt of infection by a host and maximum infectivity of that host is known as Option C. 'generation time ' is correct. The serial interval, in the epidemiology of communicable (infectious) diseases, refers to the time between successive cases in a chain of transmission. Generation time is the duration between the entry of infectious agent into the body to the peak infectivity of the host. Latent period is the time elapsed from virus entry into the cell until the first progeny are released. Communicable period is a distractor as there is no such term in epidemiology.
    Which of the following statements is TRUE regarding typhoid epidemiology? Option D. 'Occurrence of typhoid is an index of insanitation' is correct. Typhoid vaccine is available both for oral and IM administration. Excess heat kills this bacillus. It is spread by the feco oral route and hence is an index of insanitation.
    World Disaster Reduction Day is celebrated on Option A. 'second Wednesday of October 'is correct. The United Nations General Assembly designated the second Wednesday of October as the International Day for Natural Disaster Reduction as part of its proclamation of the International Decade for Natural Disaster Reduction.
    Which of the following is included in the formula for calculating 'sensitivity' of a screening test? Option A. 'True positive' is correct. The ability to detect true positives is “sensitivity”. Specificity of a test is the ability of the test to call negative those who do not have the disease which means detect “true negatives”. The ability to detect true positives is “sensitivity”.
    Which set is known as epidemiological triad? Option A. 'Agent, host, and environment' is correct. The agent, host and environment determine the natural course of a disease and hence are the important three for epidemiological purposes. The term 'epidemiologic triad' is used to describe the intersection of host, agent, and environment in analyzing an outbreak. Time, place and person are terms restricted to descriptive epidemiology.
    Which of the following terms describes occurrence of more frequent road traffic accidents on weekends? Option A. 'Cyclic trends' is correct. Secular trends appear over very long time periods usually one or more decades. Seasonal trends are an annual feature. Cyclical trend indicates that it occurs regularly after a fixed periodicity.
    Which of the following is TRUE regarding incidence rate? Option D. 'It is also known as attack rate in short duration diseases ' is correct. Incidence rate includes only new case and hence it can be called as attack rate in short duration diseases. Prevalence considers both old and new cases. Incidence rate is usually calculated on an annual basis.
    Which of the following is included in the first level of prevention, that is, the concept of health promotion? Option D. 'Encouraging physical activity' is correct. Pap smear is early diagnosis and treatment, use of helmet is specific protection and root canal treatment is disability limitation.
    Which of the following is provided mainly through cross-sectional studies? Option C. 'Prevalence rate' is correct. Cross sectional studies are “snapshot studies” done at one point of time. Therefore, they are able to only calculate prevalence rate as prevalence rate includes both old and new cases. Incidence rate does not include old cases.
    Chandler index is used for epidemiological studies of Option A. 'hookworm' is correct. Chandler’s Index is the average number of hookworm eggs per gram of faeces for the entire.
    Which of the following statements is TRUE about Integrated Disease Surveillance Project of India? Option D. 'It intends to detect early warning signals of impending outbreaks' is correct. Integrated Disease Surveillance Project of India (IDSP) was launched in 2004. It involves both medical colleges and private practioners. The purpose of any surveillance programme is to predict outbreaks.
    Which of the following diseases has the shortest incubation period? Option B. 'Influenza' is correct. Incubation period is as follows: Measles: 10 days, Influenza: 18- 72 hrs, Small Pox: 12 days, Chicken Pox: 15 days.
  12. samuel

    samuel New Member

    The law, 'the relative frequencies of each gene allele tends to remain constant from generation to generation' was given by Option B. 'Hardy-Weinberg' is correct. The Hardy–Weinberg principle (also known as the Hardy–Weinberg equilibrium, model, theorem, or law) states that allele and genotype frequencies in a population will remain constant from generation to generation in the absence of other evolutionary influences. These influences include mate choice, mutation, selection, genetic drift, gene flow and meiotic drive. This principle was named after G. H. Hardy and Wilhelm Weinberg, who first demonstrated it mathematically. Henry Sigerist was a medical historian.
    Which of the following diseases does not have rashes with fever? Option C. 'Influenza' is correct. Influenza manifests with fever and respiratory symptoms. Measles, Rubella and chicken pox are classified as exanthematous fevers.
    Secondary prevention of carcinoma cervix includes which of the following? Option D. 'Pap smear testing' is correct. Secondary prevention entails “early diagnosis and treatment”. The purpose of pap smear testing is to promote early detection. Family planning, circumcision and personal hygiene are examples of primary prevention.
    Chairman of ESI Corporation is Option A. 'Union Minister for Labour' is correct. The Central government in exercise of the powers under the ESI Act has appointed the Union Minister of Labour as Chairman. This is because the Act deals with social security for workers.
    Notification of occupational diseases is required in all of the following legislations EXCEPT Option A. 'ESI Act 'is correct. ESI Act is a social security legislation, unlike the others which concern health, safety and welfare of the workers.
    Colour coding 'black' of biomedical waste is disposed off by Option D. ‘disposal in secured landfill’ is correct. ‘Black colour’ containers are to have discarded medicines and cytotoxic drugs, incineration ash and chemical used in production of biologicals, chemicals used in disinfection, etc. These can neither be incinerated nor autoclaved and hence are disposed off in landfills.
    Which of the following is included in the Human Development Index? Option A. 'Knowledge' is correct. Published on 4 November 2010 (and updated on 10 June 2011), starting with the 2010 Human Development Report the Human Development Index combines three dimensions: A long and healthy life: Life expectancy at birth, Education index: Mean years of schooling and Expected years of schooling, A decent standard of living: GNI per capita (PPP US$).
    In ESI Act, 1948 the employers contribution is 4.75% of the Option A. 'total wages' is correct. The Central Government is empowered as per the ESI Act to decide the rate of employers contribution. They have fixed it at 4.75%.
    Which of the following statements is TRUE regarding obesity? Option B. 'Females have higher rate of obesity' is correct. BMI range for obesity is 30 or more. Women have higher rate of obesity, whereas men have higher rates of overweight. Genetics and increasing age contribute to obesity.
    The essential part of Chamberland type filter is the 'candle' which is made of Option B. 'porcelain ' is correct. The candle is made of Kieselgur or infusorial earth in Berkefeld filter. Latex is a material used in condoms.
    A 40-year-old banker was diagnosed with gastric carcinoma. Following the diagnosis, he felt dazed and confused. He became quiet and withdrawn. He did not feel like working, watching television, or teaching his children which he used to enjoy earlier. He reported feeling low almost all the time. After few days, he was taken for a psychiatric evaluation. Which of the following is the likely diagnosis? Option C. 'Severe depressive episode' is correct. Major depressive disorder (MDD) is a mood disorder characterized by a pervasive and persistent low mood that is accompanied by low self-esteem and by a loss of interest or pleasure in normally enjoyable activities as well as disturbed biological functions i.e. sleep and appetite mainly.
    Which of the following is the MOST common side effect of electroconvulsive therapy? Option B. 'Headache' is correct. The most common side effect of electroconvulsive therapy is headache followed by confusion and amnesia
    Which of the following SSRIs has the longest t½? Option A. 'Fluoxetine' is correct. Fluoxetine has the longest t½ of 84 hours, Fluvoxamine 15 hours, Paroxetine 21 hours and Escitalopram has t1/2 of 25 hours.
    Which of the following measures improves symptoms in seasonal affective disorder? Option D. 'Increased exposure to light' is correct. Bright light treatment has been found to be most effective in the treatment of seasonal affective disorder (SAD), which is depression related to shorter days and reduced sunlight exposure during the fall and winter months. Most people with SAD feel better after they use light therapy or have increased exposure to bright light. This may be because light therapy replaces the lost sunlight exposure and resets the body's internal clock.
    Thought broadcast is a symptom of which of the following psychiatric disorders? Option B. 'Schizophrenia' is correct. Thought broadcast is a First-rank symptom, considered to be pathognomonic of schizophrenia in the absence of organicity.
    Egg is deficient in which of the following vitamins? Option C. 'Vitamin C' is correct. Egg does not contain any vitamin C- fact. All other responses are obviously wrong as egg yolk contains vit A, B6 and vitamin D.
    Which of the following statements is TRUE regarding hyponatremia in diabetic ketoacidosis? Option D. ' The level of blood sugar should be taken into consideration before correction of hyponatremia ' is correct. Both blood sugar and sodium determines osmolality and this should be taken into considerationand secondlythere is osmolal dilution of hyperglycemia. And effect of elevated sodium free lipid fraction.true sodium can be calculated as {Na+} plus glucose-100X1.6/100. 3% saline is the ideal fluid for correction is wrong as 3% saline is not required as it is not true hyponatremia. Hyponatremia is worsened by insulin administration is also wrong as hyponatremia is not worsened ,rather improves with insulin administration. Hyponatremia is always symptomatic at the beginning is also wrong as hyponatremia is seldom symptomaticat beginning.
    What is the cut-off value of mid upper arm circumference below which severe acute malnutrition (SAM) is diagnosed in children upto 5 years? Option B. '11.5 cm' is correct. Fact as per WHO reference of SAM as < 11.5 cm of left midarm circumference . Hence other responses like 11.0 cm, 12.0 cm, 12.5 cm are incorrect.
    Which of the following is a cause of normal anion gap metabolic acidosis? Option B. 'Renal tubular acidosis' is correct. There is loss of bicarbonate, hence normal anion gap metabolic acidosis and difference in measured cation and anion in blood remains same. There is increased anion of urates, phosphates and sulphates in chronic renal failure and bicarbonate is decreased to lesser extent there fore Chronic renal failure is wrong. Methanol also process increase in unmeasured anions likeformate. Diabetic ketoacidosis increased unmeasured anions like ketones are there.
  13. samuel

    samuel New Member

    For prevention of Rh sensitization, human anti-D globulin is NOT effective if it is administered to the mother beyond Option D. '72 hours of delivery ' is correct. Maximum benefit is seen in and 72 hours only,as itnneutralizes the Rh+ve foetal RBC with D ag from fetoplacental hemorrhage; rest are obvipusly wrong responses. After this period immune sensitization occurs leading to allimmunization.
    A nutrient is classified as a trace element when it is Option B. ‘0.01% of body weight’ is correct. By definition a trace element has <0.01% of body weight(Nelson text book of pediatrics 19th ed.-fact) because of this it is obvious that all other responses like 0.001%, 0.1% and 1% of body weight are wrong.
    Which of the following coagulation factors is NOT decreased in the hemorrhagic disease of a newborn? Option B. 'Factor V' is correct. Factor V is not vitamin K dependant and in hemorrhagic disease of newborn it is because of Vit k deficiency. Rest responses are wrong as factor II, V and X are Vit k dependant.
    Which of the following is NOT seen in congenital adrenal hyperplasia due to 21-hydroxylase deficiency? Option B. 'Hypertension' is correct. Only hypertension is not a feature of 21 hydroxylase deficiency as both cortisoland desoxycortisol production is impaired as there is block beyond pregnanolone production from cholesterol. As a result there is hypotension in 21hydroxylase deficiency. Rest A(hyperkalemia),C(hyponatremia ) and D(metabolic acidosis) arefeatures of 21 hydroxylase deficiency.hence not correct response.
    A patient with severe malnutrition while on nutritional rehabilitation shows abdominal distention ascites splenomegaly and hypertrichosis. Which of the following is the MOST probable diagnosis? Option D. 'Nutritional recovery syndrome' is correct. Nutrition recovery syndrome.abdominal distension, ascites,splenomegalybecause of portal hypertension, hypertrichosis, eosinophilia and hypergammaglobunemia are all features of nutritional recovery syndrome described after 4-8 weeks of rehabilitation. Drug toxicity is wrong ,as which drug toxicity and secondly splenomegaly and ascites are unusual. Cytomegalovirus infection is also incorrect as CMIV infection ,whyit should occur during rehabilitation. Secondly there is hepatosplenomegaly and only splenomegaly is unusual. Hypertrichosis also can not be explained. Flaring up of tuberculosis is also incorrect in flaring up of tuberculosis hypertrichosis is difficult to explain, hence wrong.
    Which of the following statements is TRUE ? Option D. ' Mid-upper arm circumference measures acute malnutrition ' is correct. First thing in acute malnutrition is decreased mid upper arm circumference even before decrease in weight. Weight for age measures acute malnutrition is wrong as weight is less in both acute and chronic malnutrition. Weight for height measures chronic malnutrition is also wrong as weight for height measures acute on chronic malnutrition rather than only chronic malnutrition Height for age measures acute and chronic malnutrition is also wrong as height for age measures chronic malnutrition rather than acute on chronic.
    Very low birth weight (VLBW) refers to the babies with a birth weight below Option C. '1500 grams' is correct. Upto 1500 gms is correct definition. NNf and WHO also follows same cut offs. Other responses like 750 grams, 1000 grams and 2500 grams are incorrect.
    Extremely low birth weight (ELBW) is defined as Option B. 'up to and including 999 grams' is correct. ELBW(extremely low birth weight) are less than 1000gms hece response upto and including 999gms is correct- a fact by definition NNF and WHo and USA. Hence other responses are incorrect.
    Which of the following statements is TRUE regarding hypernatremia? Option D. 'It can cause CNS symptoms without dehydration' is correct. CNS symptoms without signs of dehydration is a feature of hypernatremiaas water driven from cell into ECF maintains hydration to some extent. Seizures are rare is wrong as seizures are frequently seen in hypernatremia CSF biochemistry will be normal as CSF biochemistry will be abnormal in hypernatremiaesp CSF sugar and chloride Urine output is usually decreased is also wrong as urine output does not decrease in hypernatremia until patient is in shock.
    Which of the following is a laboratory feature of syndrome of inappropriate antidiuretic hormone secretion (SIADH)? Option C. 'Urine sodium level is increased' is correct. There is excessive ADH production unrelated to osmolarity of blood. As a result morefluid is retained in blood and concentrated urine is passed with increased sodium. Urine osmolality is decreased is incorrect as urine osmolality is increased rather than decrease. Serum osmolality is increased is also incorrect as serum osmolality is decreased instead of increase. Serum sodium level is increased is also incorrect as because of excess retained fluid in blood there is dilutional hyponatremia instead of increase.
    Which of the following is a radiological feature of rickets? Option C. 'Epiphyseal widening' is correct. Epiphyseal widening is a feature of rickets because there is defective calcification and growing ends are soft and because of weight bearing gets widened. Pelcan spur, epiphyseal separation and ground glass appearances are the radiological features of scurvy and hence wrong.
    In patient with right 12 th nerve palsy the tongue will Option D. ’deviate on right side’ is correct. Deviation of the tongue towards the paralyzed side when it is stuck out. This is because of the weaker genioglossal muscle.
    Destruction of visual cortex in one occipital lobe leads to which of the following conditions? Option D. 'Homonymous hemianopia with macular sparing' is correct. Homonymous visual field defects sparing the central 5 to 25 degrees of visual field on the affected side are common when the posterior half of the occipital region has been at least partially spared by the lesion. Because of the dual vascular supply of the occipital pole in many individuals (by branches of both the middle and posterior cerebral arteries), macular-sparing homonymous hemianopia is more likely to occur with stroke than with other occipital lesions.
    Which of the following gases has the highest affinity for hemoglobin? Option D. 'Carbon monoxide' is correct. Following absorption, carbon monoxide binds to hemoglobin (a tetramer) to produce carboxyhemoglobin. The affinity between hemoglobin and carbon monoxide is approximately 230 times stronger than the affinity between hemoglobin and oxygen.
    Which of the following results in normal anion gap metabolic acidosis? Option D. 'Renal tubular acidosis' is correct. Normal anion gap metabolic acidosis is also called hyperchloremic acidosis because the kidneys reabsorb Cl− instead of reabsorbing HCO3−. The renal tubular acidosis either impair H+ secretion (types 1 and 4) or HCO3− absorption (type 2). Impaired acid excretion and a normal anion gap also occur in early renal failure, tubulointerstitial renal disease, and when carbonic anhydrase inhibitors (eg, acetazolamide) are taken.
  14. samuel

    samuel New Member

    Which of the following is a first-line drug for absence seizures? Option D. 'Sodium valproate' is correct. Valproate has been proven to be most efficacious in these type of seizure in most of the clinical trials. Ethosuximide is the drug of choice for these type of seizures. Lamotrigine can also be used.
    Which vascular access for hemodialysis has the highest long term patency rate? Option A. 'Arteriovenous fistula' is correct. The preferred type of access is a native AV fistula, followed by grafts and then central venous catheters as shown in various studies.
    Vertical transmission of hepatitis B in pregnancy can be assessed by Option D. 'HBV DNA' is correct. The diagnosis of HCV infection in adults often is made by detecting antibodies to HCV. However, maternal IgG antibodies passively cross the placenta, so the presence of anti-HCV antibodies in the serum of infants does not necessarily indicate infection. Clearing of passively acquired maternal antibodies against HCV can take more than 12 months, although it is cleared by 12 months in 95 percent of infants. As a result, the diagnosis is typically made by checking HCV RNA on multiple occasions during the first year of life or by checking anti-HCV antibodies once the infant has likely cleared maternal HCV antibodies.
    RBC casts are typically seen in Option C. 'acute nephritic syndrome' is correct. RBC casts are characterstic of those glomerulonephritis which causes acute nephritic syndrome.
    Renal failure after PTCA is commonly due to Option C. 'contrast nephropathy' is correct. Contrast used in doing PTCA can lead to contrast induced nephropathy commonly. All other causes though can cause nephropathy but are not common.
    Which of the following is NOT a cause of partial seizures? Option A. 'Absence seizures' is correct. Absent seizures does not causes partial seizures. All other are the causes of partial seizures.
    Antimycobacterial activity of INH Option D. 'is due to inhibition of synthesis of mycolic acid in the cell wall of Mycobacterium' is correct. Isoniazid is a prodrug which is activated by a bacterial catalase-peroxidase enzyme called as KatG in M. tuberculosis. KatG couples the isonicotinic acyl with NADH to form isonicotinic acyl-NADH complex. This complex binds tightly to the enoyl acyl carrier protein reductase by blocking the natural enoyl-AcpM substrate and the action of fatty acid synthase. This process inhibits the synthesis of mycolic acid requi
  15. samuel

    samuel New Member

    The difficulty of the exam was reduced in the MOCK TEST but the real scenario during June 16/17 was many times more harder that this MOCK test

    Things to know
    1.Not so many repeats from Kamal Kv
    few repeats that also from 2012-2014 Mci exams

    2.Very basic questions are tested from each subject from nook and corner.
    Unless you have read all those subjects it's gonna be hard

    so not possible to go with any single guide book or Question bank

    3.ROAMS is a good option
    this really helps and more Q from it

    4.You cannot say where you have read the question but the answer is so easy if you have revised the Notes,KamalKV ,ROAMS and Any PG

    There is a Question like
    Right ovarian artery drains into ?
    Ans:Inferior Vena cava

    But in KamalKv we have Left ovarian Artery drains into? Anatomy Q NO. 141
    Left renal vein

    If you have read the explanations well then easy to go
  16. samuel

    samuel New Member

    The oxygen carrying capacity of the blood is
    A.
    the oxygen physically dissolved in blood.
    B.
    independent of the hemoglobin concentration.
    C.
    the ratio between oxygen uptake and oxygen usage.
    D.
    the maximum quantity of oxygen that will combine with 100 ml of whole
    blood.
    Hirschberg corneal reflection test measures which of the following?
    A.
    Fixation
    B.
    Angle of deviation
    C.
    Amount of nystagmus
    D.
    Corneal astigmatism
    Which of the following is LEAST common in uterine fibroids?
    A.
    Infertility
    B.
    Degeneration
    C.
    Malignant change
    D.
    Abnormal uterine bleeding
    D1 resection in Ca stomach involves
    A.
    aortic nodes.
    B.
    perigastric nodes.
    C.
    major arterial trunks.
    D.
    superior mesenteric lymph nodes.
    Which of the following statements is TRUE regarding obesity?
    A.
    BMI range for obesity is 20-25.
    B.
    Females have higher rate of obesity.
    C.
    Its etiology has no genetic component.
    D.
    Its prevalence decreases with age up to 40 years.
    A 3-year-old child from a small village of Bihar was brought to the OPD with genu valgus deformity of
    both lower limbs. On examination, there was bossing of the forehead, prominence over the
    costochondral junction, intercostals muscles were retracted, wrist joint was widened, and protruded
    abdomen. X-ray of the knee joint showed genu valgus with distal femoral metaphyseal cupping and
    irregular physis. What is the likely diagnosis?
    A.
    Scurvy
    B.
    Rickets
    C.
    Fluorosis
    D.
    Hypothyroidism
    Bacillary dysentery is transmitted by all of the following EXCEPT
    A.
    fomites.
    B.
    contaminated food.
    C.
    contaminated fingers.
    D.
    contaminated needles.
    The MOST common cause of spontaneous abortion is
    A.
    triploidy.
    B.
    mosaicism.
    C.
    tetraploidy.
    D.
    autosomal trisomy.
    Proteus species is a common cause of
    A.
    diarrhea.
    B.
    pneumonitis.
    C.
    otitis media.
    D.
    urinary infection.
    T cells mature in
    A.
    liver.
    B.
    spleen.
    C.
    thymus.
    D.
    bone marrow.
    Which of the following is the MOST common cause of first trimester abortion?
    A.
    Trisomy
    B.
    Triploidy
    C.
    Monosomy
    D.
    Aneuploidy
    Which of the following measures improves symptoms in seasonal affective disorder?
    A.
    Exercise
    B.
    Loss of weight
    C.
    Increased sleep
    D.
    Increased exposure to light
    Which vascular access for hemodialysis has the highest long term patency rate?
    A.
    Arteriovenous fistula
    B.
    Arteriovenous graft
    C.
    Double lumen jugular catheter
    D.
    Tunneled double lumen jugular catheter
    Normal umbilical cord has
    A.
    one artery and one vein.
    B.
    one artery and two veins.
    C.
    two arteries and one vein.
    D.
    two arteries and two veins.
  17. samuel

    samuel New Member

    Antimycobacterial activity of INH Option D. 'is due to inhibition of synthesis of mycolic acid in the cell wall of Mycobacterium' is correct. Isoniazid is a prodrug which is activated by a bacterial catalase-peroxidase enzyme called as KatG in M. tuberculosis. KatG couples the isonicotinic acyl with NADH to form isonicotinic acyl-NADH complex. This complex binds tightly to the enoyl acyl carrier protein reductase by blocking the natural enoyl-AcpM substrate and the action of fatty acid synthase. This process inhibits the synthesis of mycolic acid required for the synthesis of mycobacterial cell wall.
    Which of the following drugs causes acute kidney injury with hypomagnesemia? Option B. 'Amphotericin' is correct. Amphotericin B used in the treatment of often life-threatening fungal infections. Impaired renal function is a relatively common complication of amphotericin B, as are other renal manifestations, including urinary potassium wasting and hypokalemia, urinary magnesium wasting and hypomagnesemia, metabolic acidosis due to type 1 (or distal) renal tubular acidosis, and polyuria due to nephrogenic diabetes insipidus.
    What is the role of pyrazinamide in 6-month short course chemotherapy of tuberculosis? Option D. 'Its bacteriostatic and sterilizing effect in eliminating semidormant bacilli multiplying slowly in an acidic environment' is correct. PZA thought to be more active at an acidic pH (eg, within macrophages) and against dormant or semidormant microorganisms. When used as part of combination therapy, PZA appears to accelerate the sterilizing effect of isoniazid and rifampicin.
    In transient ischemic attack (TIA) symptoms usually resolve within Option C. '24 hours' is correct. TIAs are brief episodes of neurological dysfunction resulting from focal cerebral ischemia not associated with permanent cerebral infarction. In the past, TIAs were operationally defined as any focal cerebral ischemic event with symptoms lasting <24 hours.
    Renal osteodystrophy in chronic renal failure is commonly due to Option D. ’secondary hyperparathyroidism’ is correct. It is the result of hyperparathyroidism secondary to hyperphosphatemia combined with hypocalcaemia, both of which are due to decreased excretion of phosphate by the damaged kidney.
    The diuretic which is MOST effective in controlling edema in chronic renal failure is Option B. 'loop diuretic' is correct. Loop diuretics causes brisk dieresis as compared to any of the other mentioned choices.
    In molecular assays for diagnosis of MDR tuberculosis, which of the following genes is tested for rifampicin resistance? Option B. 'rpoB' is correct. More than 95% of all the resistant strains contains mutation localized in the region of bacterial RNA polymerase rpoB gene.
    Rabies is caused by Option D. 'rhabdovirus' is correct. Rabies is caused by a number of different species of neurotropic viruses in the Rhabdoviridae Family, Genus Lyssavirus.
    Vestibulocochlear nerve examination includes all of the following EXCEPT Option A. 'gag reflex' is correct. Gag reflex is mediated by 9th and 10th cranial nerve and not by 8th nerve .
    Which of the following is the common side effect of loop diuretic? Option B. 'Hypokalemic alkalosis' is correct. Loop diuretics block the Na/K/Cl co-transporters in the distal nephron. This causes a decrease in the reabsorption of chloride ions and therefore, increases the luminal electronegativity of the distal nephron. The increase in luminal electronegativity allows excessive 'wasting' of both hydrogen and potassium ions, as these cations will be attracted to the relatively negative charge in the lumen. Over time, the depletion of cations (particularly hydrogen ions) causes alkalosis. Because both potassium and hydrogen ions are lost in this process, the phenomenon is generally referred to as 'hypokalemic metabolic alkalosis'.
    Which of the following asthma drugs MOST likely causes oral candidiasis? Option D. 'Inhaled corticosteroids' is correct. Inhaled steroids gets accumulated on the posterior pharyngeal wall and in the throat thus weakening the local mucosal immune system and causing the fungal infection to grow.
    What is the predominant adrenoceptor in bronchial smooth muscle? Option D. 'Beta-2 adrenoceptor' is correct. Beta -2 adrenoreceptors are the predominant receptors seen in the bronchial smooth muscle.
    The drug with proven value in preventing progression of renal failure is Option D. 'angiotensin converting enzyme inhibitor' is correct. ACE inhibitors have shown the benefits in various trials in preventing the progression of renal disease and decreasing the albuminuria.
    Tics are defined as Option C. 'stereotyped, repetitive movements' is correct. A tic is a sudden, repetitive, nonrhythmic motor movement or vocalization involving discrete muscle groups. Tics can be invisible to the observer, such as abdominal tensing or toe crunching. Common motor and phonic tics are, respectively, eye blinking and throat clearing.
    Which of the following is NOT a feature of parkinsonism? Option A. 'Chorea' is correct. The classical triad to diagnose parkinsonism is presence of rigidity, hypokinesia and tremors. Chorea is not seen in parkinsonism as it is caused by the lesion of caudate lobe and is not due to involvement of subthalmic nucleus.
    Which of the following is the MOST common cause of chronic type II respiratory failure? Option A. 'COPD' is correct. Out of the choices most common type oof Chronic type II respiratory failure is COPD.
    True vocal cords move because they are attached to Option C. 'arytenoid cartilage' is correct. Vocal folds are located within the larynx at the top of the trachea. They are attached posteriorly to th e arytenoids cartilages, and anteriorly to the thyroid cartilage.
    The MOST common cystic disease of the kidney is Option C. 'autosomal dominant polycystic kidney disease' is correct. Autosomal dominant polycystic kidney disease (ADPKD) has an incidence of 1 per 400-1000 persons among whites and accounts for 8-10% of all cases of end-stage renal disease (ESRD).
    Recurrent gross hematuria is a typical manifestation of which of the following? Option B. 'IgA nephropathy' is correct. The most common presentation (approximately 60-80%) of IgA nephropathy is asymptomatic microscopic urinary abnormalities with one or more episodes of intermittent gross hematuria. The recurrent macroscopic hematuria often associated with upper respiratory infection is traditionally regarded as the hallmark of childhood IgA nephropathy, compared with post streptococcal GN in which hematuria usually occurs 1-2 weeks after infection.
    Elevated serum uric acid is an adverse effect of Option D. 'pyrazinamide' is correct. Pyrazinamide causes decrease in the tubular secretion of uric acid in the proximal convoluted tubules of the kidney thus increasing the uric acid level of blood.
    Which of the following is MOST appropriate statement about tubercular meningitis? Option C. 'It is due to hematogenous spread of primary and post primary pulmonary tuberculosis' is correct. CNS tubercular involvement of meninges is almost secondry to hematogenous spread from the primary or post primary tuberculosis.
    Schistocyte in peripheral blood smear is a feature of Option A. 'hemolytic uremic syndrome' is correct. A schistocyte is a fragmented RBC characterstic of microangiopathic hemolytic c anemais such as hemolytic uremic syndrome and TTP.
    Which of the following is a common complication during hemodialysis? Option A. ’Hypotension’ is correct. Dialysis-induced hypotension (DIH) is rapid reduction of blood volume owing to ultrafiltration and decrease in extracellular osmolarity during the dialysis session. Coexisting illnesses, especially cardiovascular diseases, particularly common in older and diabetic patients have an essential meaning in the episodes of dialytic hypotension.
    Cutaneous larva migrans is usually caused by which of the following? Option C. 'Ancylostoma braziliense' is correct. Cutaneous larva migrans is a skin disease in humans, caused by the larvae of various nematode parasites of the hookworm family (Ancylostomatidae). The most common species causing this disease in the Americas is Ancylostoma braziliense.
    Whiff test is done for Option D. 'bacterial vaginosis' is correct. This test, called the whiff test, is performed by adding a small amount of potassium hydroxide to a microscopic slide containing the vaginal discharge. A characteristic fishy odor is considered a positive whiff test and is suggestive of bacterial vaginosis.
    A skin disorder MOST often caused by the herpes virus and consisting of red lesions that look like targets is Option D. 'erythema multiforme' is correct. Typical lesion of Erythema multiforme is a target lesion which is commonly caused by Herpes virus or drugs.
  18. samuel

    samuel New Member

    Darier sign is noted in which of the following? Option D. ’Urticaria pigmentosa’ is correct. Darier's sign is a change observed after stroking the skin of a person with systemic mastocytosis or urticaria pigmentosa. The the skin becomes swollen, itchy and red. This is a result of compression of mast cells, which are hyperactive in these diseases. These mast cells release inflammatory granules which contain histamine. It is the histamine which is responsible for the response seen after rubbing the skin.
    Hemorrhagic cystitis is caused by Option D. 'cyclophosphamid' is correct. Hemorrhagic cystitis or Haemorrhagic cystitis is defined by lower urinary tract symptoms that include dysuria, hematuria, and hemorrhage. The disease can occur as a complication of cyclophosphamide, ifosfamide and radiation therapy.
    NCRP recommendation for effective dose equivalent limit (annual) of occupational exposure to ionizing radiation is Option B. '50 mSv' is correct. Because doses beyond this may cause scotostic effects . The dose is permitted in a higher range due to occupations status of the person that is higher when compared to a common man.
    An axillary lymph node metastasis known as an Irish nodule is seen in Option A. ’gastric cancer’ is correct. Irish Node is the name given to axillary node metastasis seen in gastric carcinoma. It’s a well established and documented fact in the literature.
    What is the predominant interaction of photons with matter utilized in diagnostic radiology? Option D. 'Photoelectric effect' is correct. It is this photo electric effect that can be focused and help in imagery. Other interactions may not be useful for imaging due to their charecteristics or due to their higher energy production.
    B symptoms are MOST commonly seen in which of the following? Option D. 'Nodular sclerosing non-Hodgkin lymphoma' is correct. This is one of the most aggressive forms of lymphomas with worst prognosis when reported in late stages. Generally patients come in late stages in India. The disease burden / virulence or aggressiveness of the disease as such is responsible for B symptoms.
    On exposure to radiation which period of pregnancy leads to maximum chance of congenital deformities in children? Option A. '4-16 weeks' is correct. This is the most sensitive period for organ differentiation and any damage to rapidly proliferating cells will lead to structural aberration in final stage of the formation of fetus.
    (Media) The MOST likely diagnosis of this condition on scalp is Option C. 'sebaceous cyst' is correct. Raised scalp lesion with smooth surface having a punctum on hair abundance area is sebaceous cyst. Reddishness suggests it may be inflamed. Melanoma is a colored lesion, neurofibroma does not have redness and basal cell carcinoma is ulcerated lesion.
    Smoking may have protective effect on Option C. 'ulcerative colitis ' is correct. Well known and documented clinical fact. A recall type question.
    (Media) A 30-year-old man with history of chronic smoking has the given finding. The MOST likely diagnosis is Option C. 'Buerger disease' is correct. Considering young man with chronic smaking and a gangrenous toe , the diagnosis is Burger’s disease or Thromboangitis obliterans.
    (Media) The MOST likely diagnosis in this case is Option C. 'prolapsed rectum' is correct. A diffuse circum anal pouting out large mass exhibiting mucosal surface without any visible space between anal margin and the mass is suggestive of complete prolapse of rectum. In other conditions, either a focal protrusion or a gap between anal margind and protruded mass is felt.
    Type A gastritis is Option C. 'an autoimmune disease' is correct. This a specific nomenclature given . A recall type question.
    (Media) The MOST likely radiological diagnosis of this case is Option B. 'left hydronephrosis' is correct. The left side pelvi-calyceal system is dialted with classical clubbing of calyces. In other options dilation of pelvis and clubbing of calyces are not seen in normally placed kidney.
    The MOST common presentation of retroperitoneal sarcoma is Option B. 'abdominal lump' is correct. Sarcoma being fast growing and grows three dimensionally quickly presents as lump whereas symptoms like pain or edema takes time ( for infiltration of various structures).
    Which of the following is the MOST common type of intussusception in children? Option C. 'Ileocolic' is correct. Peyers patches are located in terminal ileum and they generally act as point of origin for intussusceptions which immediately progresses into colon. In children , inflamed peyers patches are a common finding.
    The MOST common malignancy of mesentery is Option C. 'metastases' is correct. Well established and documented epidemiological fact . A recall the fact type of question.
    (Media) The MOST likely diagnosis of this case is Option B. 'acute mastitis' is correct. Obvious visible all clinical signs of inflammation in a localized area of beast is diagnostic of acute mastitis. In none of the remaining conditions mentioned any sign of inflammation is seen.
    The parietal cells of gastric mucosa are responsible for the secretion of Option A. 'H+ ion' is correct. This is a established and documented fact of physiology. It is a recall the fact type of question.
    D1 resection in Ca stomach involves Option B. 'perigastric nodes' is correct. Removal of stomach along with immediate surrounding nodes ie perigastric nodes is qualified as D1 gastrectomy.
    (Media) The investigation shown in the image is Option A. ' ERCP ' is correct. The side viewing endoscope and radiocontrast is seen in the picture making it images of ERCP. In other options , CBD and /or endoscope are not simultaneously seen.
    McBurney point on spinoumbilical line is at the junction of Option D. 'medial 2/3rd and lateral 1/3rd' is correct. Well known and documented applied surgical anatomy fact. It is a recall the fact type of question.
  19. samuel

    samuel New Member

    What is the MOST likely diagnosis for given X-ray? (Media) Option B. 'Sigmoid volvulus' is correct. Typical car-tyre radio-lucent shadow seen in plain X-ray abdomen is suggestive of sigmoid volvulus. Car-tyre shadow is not seen in any of the remaining described options.
    What is the radiological diagnosis of the arrow marked area? (Media) Option C. 'Secondaries lung' is correct. Multiple rounded well defined homogenously opaque shadows in a plian X-ray chest (called cannon balls ) are secondaries only. The so described characters are not present in any other condition.
    (Media) The X-ray film shows the diagnosis of Option B. 'bladder calculi' is correct. Well defined radio opaque shadow in bladder area on X-ray KUB always should suggest bladder stone unless proved otherwise. Other options described do not fulfill these crieteria.
    Thiersch operation is done for Option C. 'rectal prolapse' is correct. Well known and established and documented surgical fact also. Moreover for none of the other condition, subcutaneous wiring is done.
    (Media) The MOST likely diagnosis in this case is Option D. 'hydatid cyst left lung' is correct. Huge opaque single shadow with well defined margins on plain chest X-ray is diagnostic of Hydatid cyst. In remaining conditions such a shadow with these adjectives is not seen.
    An extra-intestinal manifestation of ulcerative colitis which does not resolve or improve after colectomy is Option D. 'primary sclerosing cholangitis' is correct. This is irreversible because permanent pathological changes have taken place in CBD which can not reverse even after total colectomy.
    What is the MOST likely diagnosis in the barium swallow? (Media) Option A. 'Achalasia cardia' is correct. Rat tail appearance of terminal esophagus with proximal dilatation of esophagus ( Mega or colonic esophagus) on barium swallow is quite diagnostic of achalasia cardia . In other options such an appearance is not seen.
    Barrett esophagus increases the risk of which of the following? Option B. 'Adenocarcinoma' is correct. Because of epithelial metaplasia, there is increased risk of epithelial malignancy ie adenocarcinoma. It is a recall the fact type of question.
    The puborectalis muscle encircles anorectal junction Option D. 'posteriorly and laterally' is correct.Well known, established and documented anatomical fact. It is a recall the fact type of question.
    What is the angle between the anal canal and rectum (anorectal angle)? Option B. '120º' is correct. Well established and documented anatomical fact. It is a recall the fact type of question.
    (Media) The diagnosis is Option A. 'tongue tie' is correct. Frenulum being attached too anteriorly on undersurface of tongue is suggestive of Tongue tie. Rest of the conditions relate to size of tongue or salivary gland ( which is certainly not the abnormality in picture shown).
    Which of the following is the MOST common organism associated with nongastrointestinal cause of peritonitis in females? Option A. 'Chlamydia' is correct. Chlamydia is not a normal inhabitant of GIT but can be found in female genital tract. It is a recall the fact type of question.
    What does the given chest X-ray reveal? (Media) Option D. 'Multiple fracture ribs with subcutaneous emphysema' is correct. Presence of air in subcutaneous plane ( seen on left chest wall ) and visible fracture of ribs on left side makes D option as correct.In other options , subcutaneous emphysema is not present.
    Absolute contraindication of MRI is Option A. 'pacemaker' is correct. Pace maker interferes with magnetic waves in MRI and MRI is absolutely not possible with this on while rest of the conditions are relative contraindications.
    Colorectal carcinoma MOST commonly metastasizes to Option A. 'liver' is correct. Of all the mentioned organs , liver is the first stop to portal circulation . Other organs not being the first relay station are not primarily involved.
    Cobblestone appearance on barium study is a feature of which of the following? Option A. 'Crohn disease' is correct. A well known , established and documented radiological fact related to Chron disease.It is a recall the fact type of question.
    What is the MOST likely clinical diagnosis of the given euthyroid patient? (Media) Option C. 'Multinodular goiter' is correct. Since multiple large lobules are visible on right side of neck it can not be thyroglossal cyst or a solitary nodule. It has to be Multinodulat goiter in the given options. In other conditions the swelling will be either as a single nodule or it will be in midline.
    (Media) The device shown is used for Option A. 'ventilation' is correct. The device shown is ambu bag used for mechanical ventilation. This can never be used directly or indirectly in any other condition mentioned in other options
    Protocol for suctioning the patient with an artificial airway does not include which of the following? Option D. ‘Ventilating the patient with Ambu bag and room air after suctioning is completed’ is correct. Preoxygenation before suctioning reduces the chances of hypoxemia. The duration of suction should preferably be for less than 10 sec so as to avoid hypoxia due to partial blockade of airway & bronchospasm. The size of suction catheter used should be of fairly large size (about half the internal diameter of ETT) so as to avoid excessive negative pressure. However, an artificial airway in situ the patient after suctioning should be ventilated with ventilator and with 100% O2 for few minutes rather than an AMBU bag.
    Which muscle relaxant is preferred in a patient with bilirubin of 8.6 mg/dl and serum creatinine of 2.1 mg/dl, taken for surgery under general anesthesia? Option A. ‘Atracurium’ is correct. Atracurium is preferred in a patient with elevated bilirubin and serum creatinine as its metabolism is not dependent upon the hepatic or renal functions. It is metabolized by Hoffman’s elimination & ester hydrolysis. On the other hand vecuronum, pancuronium & rocuronium depend either on liver or kidney for their metabolism.
    Which of the following is NOT isotonic with plasma? Option A. ‘10% dextrose’ is correct. The osmolality of plasma is 285-295 mosm/L. A solution is isotonic when the concentration of dissolved particles is similar to that of plasma. Isotonic solutions have an osmolality of 285 to 300 mOsm/L. Examples are: 0.9% NaCl, 1.2% NaHCO3 and RL solution. However, 10% dextrose is not isotonic. It is hypertonic solution.
  20. samuel

    samuel New Member

    Which of the following statements is NOT true regarding anesthetic agent ether? Option C. ‘It affects blood pressure and is liable to produce arrhythmias’ is correct. Due to its extremely low blood gas partition coefficient the induction of ether is very slow. It is highly inflammable in nature so diathermy cannot be used. It has also irritant property so salivary & bronchial secretions increase. Other side effects are cough, sore throat, painful red eyes, a headache, drowsiness, labored breathing and nausea. On the other hand, it doesn’t cause any significant change in blood pressure nor causes aarhythmias, which are characteristics of Halothane.
    The oxygen carrying capacity of the blood is Option D. ‘the maximum quantity of oxygen that will combine with 100 ml of whole blood’ is correct. The oxygen carrying capacity of blood is the volume of oxygen carried in each 100 ml blood. It is calculated by: (O2 carried by Hb) + (O2 in solution) = (1.34 x Hb x SpO2 x 0.01) + (0.023 x PaO2). It depends upon the amount of oxygen bound with Hb and the dissolved Hb. It depends upon the concentration of Hb in the blood.
    After 7 days of total knee replacement, a 65-year-old female patient died suddenly in the ward while eating. There was no obvious problem in the postoperative period except for pain in calf muscle and swelling of the leg. What could be the likely etiology of death in this case? Option D. 'Deep vein thrombosis leading to pulmonary embolism' is correct. Sudden death with signs of DVT points towards PE.
    A 3-year-old child from a small village of Bihar was brought to the OPD with genu valgus deformity of both lower limbs. On examination, there was bossing of the forehead, prominence over the costochondral junction, intercostals muscles were retracted, wrist joint was widened, and protruded abdomen. X-ray of the knee joint showed genu valgus with distal femoral metaphyseal cupping and irregular physis. What is the likely diagnosis? Option B. 'Rickets' is correct. All signs typical of rickets, except it is equally prevalent in Delhi.
    A 1-year-old child was brought by the mother with a complaint of an oval swelling over the midline on lower back. The child was not moving the lower limbs. What is the diagnosis? Option D. 'Meningomyelocele' is correct. The mother will bring child immediately and not wait for one year. If delivery is institutional the child will be referred immediately.
    A 10-year-old child presents with long bone pain, swollen gums, perifollicular hemorrhages, and bead like thickening of ribs. What is the likely diagnosis? Option A. 'Scurvy' is correct. These are typical of scurvy.
    A 25-year-old pregnant woman presents with severe pain and numbness in the thumb, index finger, and middle finger of her right hand. She feels maximum pain at night. On examination all the muscle powers of hand is normal. But on pressing the middle of the volar wrist joint for 30 seconds, there is severe radiating pain and numbness in the above fingers. What could be the diagnosis? Option C. 'Carpal tunnel syndrome' is correct. This sign is typical of median nerve compression at wrist.
    Golden 'S' sign is seen in Option D. 'central bronchogenic carcinoma with collapse' is correct. Golden S sign is caused by a proximal mass and distal lung collapse. It is seen in central bronchogenic carcinoma with lung collapse. Pancoast tumor, pulmonary infarction and peripheral adenocarcinoma are all peripheral lesions without central component.
    X-ray mammography is performed by using Option A. 'low kVp, high mAs' is correct. Breast being a soft tissue structure does not require high penetration by X-rays. Hence low kVp is used. High mAs is required to decrease the exposure time.
    Which of the following modalities is considered as the gold standard for screening of breast cancer in women more than 40 years of the age? Option D. 'Mammography' is correct. Mammography is most sensitive for detection. It is easily available. MRI and PET-CT are not easily available and cannot be used for screening. Ultrasound does not pick up all lesions.
    Trident hand deformity is seen in Option A. 'achondroplasia' is correct. It is a matter of fact.
    Finger in glove sign is seen in Option D. 'allergic bronchopulmonary aspergillosis' is correct. Allergic bronchopulmonary aspergillosis causes dilatation of bronchi which get filled with mucus. This branching pattern of mucus filled bronchi gives finger-in-glove appearance. It is not seen in fractured bronchus. Tuberculosis causes infiltrates in bronchioles and parenchyma. Klebsiella pneumonia also affects the alveoli rather than bronchi.
    Refractive power of the cornea is Option B. '43 dioptres' is correct. Total dioptric power of the eye is 58 D, of which about 43 D is contributed by the cornea.
  21. samuel

    samuel New Member

    Which of the following is the laser treatment for primary open angle glaucoma? Option D. 'Laser trabeculoplasty' is correct. Laser trabeculoplasty involves application of laser spots at the junction of pigmented and non pigmented trabecular meshwork which causes its remodelling and improved aqeous outflow and is thus useful in open angle glaucoma. Laser iridotomy refers to making an opening in the iris to allow aqueous to pass from posterior chamber to anterior chamber in pupillary block and so useful in narrow angle glaucoma. Laser iridoplasty involves application of laser at the periphery of iris which causes peripheral iris to contract and is useful in conditions like plateau iris syndrome. Laser synechiolysis means breaking of the anterior synechiae with the help of laser and is done in synechial angle closure.
    A patient with history of acid injury on face presents 2 months later with watering and inability to close the left eye. Which of the following could be the probable cause? Option C. 'Cicatricial ectropion' is correct. Acid injury leads to the scarring of skin of the lids and orbicularis oculi muscle and thus causes cicatrical ectropion which in turn causes inability to close the eye lid and punctal eversion leading to epiphora. Mechanical ectropion occurs in conditions where lower lid is pulled down as in tumours or pushed out and down as in proptosis. Paralytic ectropion occurs due to paralysis of orbicularis oculi muscle in 7th nerve palsy. Cicatricial entropion occurs due to scarring of palpebral conjunctiva and tarsal plate in conditions like trachoma.
    Which of the following is TRUE about hyphema? Option D. 'Blood in anterior chamber' is correct. Blood in the anterior chamber is called hyphema. The source of blood is circulus arteriosus major. Blood staining of the cornea may occur due to long standing total hyphema with raised IOP. Blood in the vitreous is called as vitreous haemorrhage. Retinal haemorrhages are of two types : flame shaped (in the nerve fibre layer) and dot and blot haemorrhages (in the inner plexiform layer) and are seen in vascular diseases of the retina.
    Long-term use of soft contact lenses can result in Option D. 'giant papillary conjunctivitis' is correct. Giant papillary conjunctivitis refers to inflammation of the conjunctiva with formation of large sized papillae that occurs as a combined immunological and mechanical response to a physically rough surface like contact lens. Chalazion is a chronic, non infective, lipogranulomatous inflammation of the meibomian glands that occurs due to stasis of secretions in the meibomian ducts. Ectropion refers to the outward turning of the lid margin that occurs due to involutional lid laxity, lid skin scarring , or paralysis of orbicularis oculi. Blepharitis refers to the inflammation of lid margins that occurs due to altered secretions of meibomian glands in association with infection mostly caused by staphylococcus aureus.
    Which of the following muscles is MOST commonly involved in thyroid ophthalmopathy? Option C. 'Inferior rectus' is correct. Inferior rectus is the most commonly involved muscle in thyroid ophthalmopathy and thus causes restriction in elevation. The sequence of muscle involvement is inferior rectus, medial rectus, superior rectus and lateral rectus.
    Which of the following is NOT responsible for blindness in childhood? Option A. 'Dacryocystitis' is correct. Dacryocystitis refers to the inflammation of the lacrimal sac that lies outside the globe and doesn’t cause blindness. Congenital glaucoma causes optic nerve atrophy due to raised intraocular pressure and may cause permanent blindness. Malnutrition, by causing vitamin A deficiency leads to night blindness and also corneal melting and scarring which causes vision loss. Ophthamia neonatorum refers to inflammation of the conjunctiva that occurs in children <1 month old. Corneal involvement can occur and may lead to perforation and scarring.
    Hirschberg corneal reflection test measures which of the following? Option B. 'Angle of deviation' is correct. Hirschberg corneal reflex test is useful in measuring the angle of deviation in the squinting eye. Fixation is tested most commonly by using direct ophthalmoscope. Amount of nystagmus is measured by electrooculography. Corneal astigmatism is tested by keratometry or corneal topography.
  22. samuel

    samuel New Member

    A young boy is brought with a history of cricket ball injury to eye. All of the following can be present EXCEPT Option B. 'hypopyon ulcer' is correct. Trauma to the eyeball may lead to injury to the circulus arteriosus major and thus hyphema, i.e , accumulation of blood in the anterior chamber. Long standing blood in the AC along with rise in IOP may cause blood staining of the cornea. Trauma can cause vitreous haemorrhage which may lead to formation of vitreous membranes and thus tractional retinal detachment. Hypopyon corneal ulcer occurs due to infection of the cornea with pneumococcus and the most common source of infection is dacryocystitis.
    Coloured haloes are NOT seen in Option C. ‘primary open angle glaucoma’ is correct. Coloured halos occur due to diffraction of light as it passes through water droplets in other wise clear structures like lens and cornea. Early cataract is characterised by presence of water droplets in the clear lens and thus causes coloured halos. Glaucomocyclitic crisis and acute angle closure cause sudden rise in IOP which leads to corneal oedema due to increase in imbibition of aqueous humor and thus leads to coloured halos. POAG doesn’t cause acute rise of IOP and thus no corneal oedema and hence no colored halos.
    Which of the following is a common cause of subconjunctival hemorrhage? Option A. 'Trauma' is correct. Trauma causes rupture of the conjunctival vessels and leads to subconjunctival haemorrhage. Trachoma is a chronic keratoconjunctivitis characterised by mixed papillary and follicular response and can cause conjunctival scarring. There is no subconjuctival haemorrhage. Vernal conjunctivitis is an allergic inflammation of the conjunctiva characterised by congestion and formation of papillae. Mucopurulent conjunctivitis is an infective condition that is characterised by congestion of conjunctiva with mucopurulent discharge. Sometimes, specially in streptococcus pneumonie infection, there may occur development of subconjunctival haemorrhages, though not commonly.
    Scleromalacia perforans is a condition that is treated with Option D. 'corticosteroids' is correct. Scleromalacia perforans is a condition characterised by non inflammatory thinning of the sclera and is seen in elderly females with long standing rheumatoid arthritis. Treatment comprises of treating the underlying pathology and corticosteroids are used for it.
    The earliest detectable sign of nonproliferative diabetic retinopathy is Option B. 'microaneurysms' is correct. Earliest detectable sign of non proliferative diabetic retinopathy is microaneurysm, i.e, out pouching of the capillaries due to loss of pericytes. It is detected earliest in the perifoveal capillary network. Hard exudates result from exudation of lipids through the leaky vessels. Superficial haemorrhages occur in the retinal nerve fibre layer and are flame shaped. Deep hemorrhages occur in the inner plexiform layer and are of dot and blot type.
    Olopatadine acts as Option D. 'antihistaminic and mast cell stabilizer' is correct. Olopatadine is a mast cell stabilizer which also has anti histaminic reaction and is useful in allergic conjunctivitis.
    Cobblestone appearance of palpebral conjunctiva is seen in Option B. 'vernal conjunctivitis' is correct. Cobblestone appearance of palpebral conjunctiva occurs in vernal conjunctivitis which is an allergic inflammation of the conjunctiva and leads to development of papillae over the palpebral conjunctiva which enlarge to give cobblestone appearance. Trachoma is a chronic keratoconjunctivitis characterised by mixed papillary and follicular response and can cause conjunctival scarring. Angular conjunctivitis is characterised by congestion at the canthi of the eye associated with maceration of the skin and is caused by Moraxella infection.
    Skier nose is due to Option A. 'cold dry air' is correct. Skier’s nose is rhinorrhea induced by exposure to cold air. It is a type of allergic reaction to cold stimuli. Treatment is essentially with antihistamines given before exposure with steam inhlation and saline douching.
    Pars tensa, part of tympanic membrane comprises how many layers? Option B. 'Three' is correct. Pars tensa of the tympanic membrane comprises of three layers. The outer epithelial layer, the middle fibrous layer and the inner mucosal layer.
    The causative bacteria for malignant otitis externa is Option D. 'Pseudomonas aeruginosa' is correct. Malignant (necrotizing) otitis externa (MOE) is described as a case of progressive Pseudomonas osteomyelitis in the temporal bone. It can spread to the adjacent tissues such as bones of the jaw and face. It mostly affects immunocompromised individuals. Patients who have diabetes show poor chemotaxis and phagocytosis of polymorphonuclear leukocytes, monocytes, and macrophages, leading to susceptibility to P aeruginosa infection. Pseudomonas has the ability to invade vessel walls leading to vasculitis with thrombosis and coagulation necrosis of surrounding tissues.
    Chemical labyrinthectomy is done for Option C. 'Meniere disease' is correct. When medical treatment isn't effective in controlling vertigo and other symptoms caused by vestibular system dysfunction in Meniere’s disesase, surgery may be considered. Surgery may be corrective or destructive depending upon the condition. A chemical labyrinthectomy is also known as transtympanic or intratympanic treatment or gentamicin infusion. This is a destructive procedure used for Ménière’s disease. An ototoxic antibiotic like gentamicin is introduced into the middle ear and absorbed via the round window. The drug destroys the vestibular hair cells so that they cannot send signals to the brain.
    The MOST common cranial nerve involved in malignant otitis externa is Option B. 'VII' is correct. Malignant otitis externa progressing to skull base osteomyelitis is an aggressive infection of the temporal bone and skull base, associated with possible involvement of the facial nerve, carotid artery, jugular vein and mastoid. It was termed malignant, due to the high mortality rate and poor response to treatment.
  23. samuel

    samuel New Member

    The hearing loss in early Meniere disease involves Option B. 'low frequencies' is correct. Ménière’s disease is a disorder of the inner ear that causes severe dizziness (vertigo), ringing in the ears (tinnitus), fluctuating hearing loss, and a feeling of fullness or congestion in the ear. It is widely believed that Ménière’s disease develops as a result of an increase in the pressure in the endolymphatic space. The sudden release in pressure leads to sudden attacks of vertigo. Repeated episodes damage the delicate structures of the inner ear and the balance structures of the semi-circular canals. In early Ménière’s disease (stages 1 & 2) the hearing loss usually involves the low frequencies. Sounds may seem distorted as the pressure increase affects the fine tuning functions of the basilar membrane and outer hair cells. These effects are initially reversible between attacks but over time the inner and outer hair cells sustain permanent damage resulting in a non-reversible hearing loss.
    Bilateral caloric hypofunction may be found in Option B. 'Meniere disease' is correct. Caloric testing is done to look for vestibular pathology. Bilateral vestibular hypofunction leads to bilateral caloric hypofunction. Of the above mentioned conditions, Meniere’s disease leads to bilateral vestibular involvement and subsequent damage due to increased pressure in the labyrinth.
    Presbyacusis is hearing loss due to Option A. 'aging' is correct. Presbycusis is age-related hearing loss. It is the cumulative effect of aging on hearing. It is a progressive, bilateral, symmetrical age-related sensorineural hearing loss. The hearing loss is most marked at higher frequencies. Age related hair cell degeneration of the cochlea and giant stereociliary degeneration causes the hearing impairment.
    The body of auricle is formed from Option B. 'elastic cartilage' is correct. The cartilage of the auricle is a single piece of cartilage and upon its surface are found the eminences and depressions described under the term auricle. The cartilage is absent from the lobule and it is deficient between the tragus and beginning of the helix. Auricular cartilage is flexible, grisly connective tissue, sometimes referred to as gristle. This type of cartilage is known as elastic cartilage. It contains no nerve cells or blood vessels, and is semiopaque.
    Picket fence pattern of fever in chronic otitis media is seen in Option D. 'lateral sinus thrombosis' is correct. Picket fence pattern of fever is characterized by a continuous, high grade swinging fever. It is seen in a few infective conditions. Out of the above mentioned choices, this type of fever was typically seen with lateral sinus thrombophlebitis, especially in the preantibiotic era when most of these infections were caused by hemolytic streptococci.
    Bezold abscess is due to Option C. 'mastoid tip cell erosion' is correct. Bezold abscess is the name given to the abscess which forms in the sternomastoid muscle sheath. Cholesteatoma leads to mastoid tip erosion subsequent to which pus tracks down the sheath of the sternomastoid muscle and leads to abscess formation in the neck.
    The blood supply to the middle ear ossicle is LEAST at Option D. 'lenticular process of incus' is correct. The blood supply to the lenticular process of incus is, more or less, an end-artery supply. The major vessel supplying this part of the ossicle enters near the body of the ossicle and descends along the long process. The long and the lenticular processes of incus project for a considerable distance into the air containing cavity away from the major blood supplying vessel. As a result, this is the least perfused part amongst all the ossicles.
    The multiple perforations of tympanic membrane are seen in Option C. 'tubercular otitis media' is correct. Tubercular otitis media is associated with formation of caseating granulomas in the tympanic membrane, middle ear mucosa, ossicles and the rest of the temporal bone. These tubercles necrose and lead to perforations of tympanic membrane and ossicular erosion. The tubercles may also coalesce and lead to a single large perforation.
    As per Tos classification for pars flaccida retraction, adherence to neck of malleus with full view of retraction pocket is Option B. 'stage II' is correct. Tos has classified the retraction of pars flaccid into four stages: Stage I: Dimpling of pars flaccid, Stage II: Retraction of pars flaccid till the neck of malleus, Stage III: Minimal erosion of pars flaccid, Stage IV: Significant erosion of pars flaccida.
    Recruitment phenomenon is seen in Option B. 'cochlear hearing loss' is correct. Recruitment causes your perception of sound to be exaggerated. Even though there is only a small increase in the noise levels, sound may seem much louder and it can distort and cause discomfort. The theory is that as the hair cells in the cochlea become ineffective, they "recruit" their (still working) neighbour hair cells to "hear" the frequency the damaged hair cell was supposed to hear, in addition to the frequency the still working hair cell was supposed to hear. Thus the sounds reaching our brain appear to be much louder than normal. Therefore only people with cochlear causes of hearing loss experience recruitment.
  24. samuel

    samuel New Member

    Long term tamoxifen is associated with increased risk of Option D. ' Ca endometrium' is correct. Long term tamoxifen is associated with increased risk of cancer of uterus and endometriosis. Tamoxifen has estrogenic action when used in for a long time. It has 2.5% more increase risk of endometrial carcinoma. Tamoxifen though anti estrogens has 2.5% more risk of endometrial carcinoma.
    Which of the following is LEAST common in uterine fibroids? Option C. 'Malignant change' is correct. A malignant change is least common in uterine fibroids; however, fibroid can associated with infertility, abnormal uterine bleeding and degeneration.
    Which of the following vitamin deficiencies is MOST commonly seen in a pregnant patient on phenytoin therapy for epilepsy? Option A. 'Folic acid' is correct. Folic acid deficiency is most commonly seen in pregnant patient on phenytoin therapy for epilepsy. All women should take folic acid 5 mg for atleast 12 weeks before conception and continue till delivery, which will reduce the risk of neural tube defect.
    Which of the following is the MOST common cause of first trimester abortion? Option A. 'Trisomy' is correct. The most common cause of first trimester abortion is trisomy. 50% are trisomy, 20% triploidy, monosomy is less frequent. Aneuploidy also causes first trimester abortion.
    Which of the following is a dangerously low lying placenta? Option D. 'Type II posterior' is correct. Type II posterior is dangerous type of low lying placenta because it over lies sacral promontory, thus reducing the antero-posterior diameter of pelvic inlet by about 2.5 cm, prevents engagement of presenting part, can cause cord compression and is an indication for caesarian section.
    Which of the following is the treatment of choice for placenta accreta in multigravida? Option A. 'Hysterectomy' is correct. Hysterectomy is the treatment of choice for multigravida with placenta accreta.
    The second stage of labor is stage of Option A. 'fetal expulsion' is correct. The birth of the baby, expulsion of fetus from the birth canal occurs in 2nd stage of labour.
    Urethral involvement in cancer vulva is first seen in Option C. 'stage III' is correct. Urethral involvement in cancer vulva is first seen in Stage III. In stage IV the tumors spread beyond vulva and immediate adjacent areas. In stage II the tumor is limited to vulva or perineum and it is more than 2 cm and stage I the tumor is limited to vulva and perineum and it is less than 2 cm.
    Clubbing of fimbrial ends of the fallopian tubes on HSG is seen in Option C. 'tuberculosis' is correct. Clubbing of fimbrial ends of the fallopian tubes on HSG is seen in tuberculosis. Due to endosalpangitis leading to adhesion blockage of fimbrial end, leading to clubbing on HSG they may give rise to tobacco pouch appearance.
    Which of the following is a tumor marker for follow-up of treatment of epithelial cancer ovary? Option D. ' CA125' is correct. CA 125 is a tumor marker for follow up of treatment of epithelial cancer of ovary. Alpha feto protein (AFP) is a marker of immature teratoma. CEA is a marker of pseudomucanious of cyst adenocarcinoma, HCG is a marker choriocarcinoma and embryonal carcinoma.
    Which of the following is the MOST common histological type of cancer of endometrium? Option D. ' Endometrioid adenocarcinoma' is correct. The most common histological type of cancer of endometrium is endometrioid adenocarcinoma, which is composed of glandular epithelial elements. They constitute 75-80% of endometrial cancer.
  25. samuel

    samuel New Member

    Clue cells are seen in Option D. ' bacterial vaginosis' is correct. Presence of clue cells are diagnostic of bacterial vaginosis. Clue cells are squamous epithelial cells with bacteria adherent to their walls. Clue cells are not found in the vaginal discharge of gonorrhea, candidiasis and trichomoniasis.
    The normal value for amniotic fluid at term is Option C. '800-1000 ml' is correct. Amniotic fluid volume from 12 to 20 weeks increases from 25 to 400 ml at term it becomes 800 to 1000 ml at 42 weeks of gestation. Then decline to 400 ml at 42 weeks gestation. The volume of amniotic fluid positively correlates with growth of the fetus.
    The suppression of lactation is BEST achieved by Option B. 'cabergoline' is correct. Suppression of lactation is best achieved by cabergoline. This drug is Dopaminegonist and has a higher specificity and affinity for Dopamine D2 receptor, suppressing prolactin release and lactation. The effect of drug last longer.
    Normal umbilical cord has Option C. 'two arteries and one vein' is correct. Umbilical cord has 2 arteries and one vein. Fetal deoxygenated blood goes to the placenta through two arteries and blood with higher oxygen returns from the placenta to the fetus through a single umbilical vein.
    The presence of increased levels of which of the following in amniotic fluid is an indicator of open neural tube defect in the fetus? Option A. 'Acetylcholinesterase' is correct. Acetylcholinesterase in amniotic fluid is an indicator of open neural tube defect. Acetylcholinesterase is a neural tissue specific enzyme so helpful in distinguishing open neural tube defects from the other causes of elevated Alpha fetoprotein, which may be associated with other adverse pregnancy conditions.
    Red degeneration of fibroid is due to Option D. 'thrombosis of veins' is correct. Between 12- 22 weeks of pregnancy when the blood supply to fibroid is cutoff due to thrombosis. The colour of the fibroid changed to red this is red degeneration.
    Which of the following is the MOST common type of cancer cervix? Option D. 'Squamous cell carcinoma' is correct. The most common type of cancer cervix is squamous cell carcinoma. It constitutes 85 to 90%. Adenocarcinoma is 10-15%, Small cell carcinoma and adenoid cystic carcinoma they are less than 1%.
    Which of the following viruses is associated with cancer cervix? Option D. 'HPV-16, 18' is correct. HPV-16 and 18 are associated with cervical cancer, HIV-1 & 2 causes HIV infections and (AIDS) , HPV-6 and 11 are associated with genital warts.
    The MOST common cause of spontaneous abortion is Option D. 'autosomal trisomy' is correct. The most common cause of spontaneous abortion is autosomal trisomy and most common single aneuploidy is trisomy 16. Triploidy and tetraploidy are less common cause for spontaneous abortion.
    (Media) The given ultrasound scan is of a 42-year-old primigravida with 12 weeks pregnancy. Which of the following abnormalities can be identified? Option D. 'Increased nuchal translucency' is correct. Increased nuchal translucency can be diagnosed in given ultrasound scan of a 42 years year old primigravida with 12 weeks pregnancy. It is screening test for down syndrome and other chromosomal abnormality. It is non-invasive screening option, screening test at 12 weeks of gestation.
    Nitabuch layer is absent in which of the following? Option C. 'Placenta accreta' is correct. Nitabuch layer is absent in placenta accrete. It is layer of fibrin which separate placenta from uterine valve. It is absent in placenta accrete allowing the placenta to attach deeply into the uterine wall.
  26. samuel

    samuel New Member

    Which of the following statements is TRUE regarding fetal hemoglobin (HBF)? Option D. 'It accounts for 90% of all fetal Hb at 20 weeks of gestation' is correct. Fetal hemoglobin accounts for 90% of all fetal hemoglobin at 20 weeks of gestation. It has 2 Alpha and 2 Gamma subunits, which is neutrally charged chains at physiological pH.
    How frequently should the fetal heart be noted on partogram? Option C. '30 minutes' is correct. Fetal heart to be noted on a partogram every 30 minutes. But fetal heart rate is to be auscultated every 30 minutes in latent phase, and every 15 minutes in active phase of first stage and every 5 minutes in second stage of labour.
    Which of the following is the treatment of choice for early vulvar carcinoma? Option D. 'Radical vulvectomy' is correct. Early vulvar carcinoma is to be treated by radical vulvectomy (FIGO I-II) Advanced disease (FIGO-III) by surgery and adjuvant therapy i.e. Radiation or chemo radiation. FIGO-IV neo-adjuvant chemotherapy or definitive chemo radiation is considered beside surgery.
    Luteal phase defect is treated with Option D. 'natural micronised progesterone' is correct. Luteal phase defect occurs when the endometrium is inadequately prepared because of secretion of progesterone by ovary is below normal or the endometrium not responding to the normal stimulation of progesterone. Micronized progesterone after ovulation is given orally or by vaginal suppositories or gel to correct luteal phase defects.
    Which of the following does not belong to gestational trophoblastic tumor? Option A. 'Chorioangioma' is correct. Chorioangioma is a benign anginoma of the placenta arising from the choriocionic tissue. It is a common tumor of placenta with incidence of 0.5 to 1%. Large chorioangioma can cause polyhydramnios.
    Which of the following is the shortest diameter of fetal head? Option B. 'Bitemporal diameter' is correct. Shortest diameter of fetal head is Bitemporal diameter which is the greatest distance between two temporal immenses and shortest diameter of the fetal head i.e. (8 cm.), Byparietal diameter is 9.5 cm, Occipitofrontal diameter, is 11.5cm and Suboccipitofrontal diameter is 10.5 cm.
    Which of the following is the MOST common cause of hirsutism? Option B. 'Polycystic ovarian disease' is correct. Hersutism represents a primary clinical indicator of androgen excess and most common cause is polycystic ovarian disease or increased sensitivity to androgen, testosterone, dehydroepiandrosterone androsterone precursors of testosterone.
    A 19-year-old woman with primary amenorrhea has normal height, normal breast, and public hair, short blind vagina, absent uterus in USG. Probable diagnosis is Option B. 'Müllerian agenesis' is correct. A 19-year-old woman with primary amenorrhea has normal height, normal breast, and public hair, short blind vagina, absent uterus in USG. Probable diagnosis is Mullerian agenesis. A human male has extra Y chromosome , total 47 chromosome, growth spurt occurs during childhood, sexual development is normal. Gonadal dysgenesis is any congenital developmental disorder of the reproductive system characterized by a progressive loss of germ cells with female XX gonadal dysgenesis. Klinefelter syndrome 47 XXY affecting male extra X chromosome, male has less muscular body, broad hip, less facial and body hair, gynaecomastia with micro-orchidism.
  27. samuel

    samuel New Member

    Aldosterone is secreted by
    Which of the following is NOT an anterior relation of left kidney?
    Ureter develops from
    Which of the following statements is TRUE regarding afferent arteriole of the glomerulus?
    The bone that ossifies predominantly in membrane is
    Which of the following muscles has a dual nerve supply?
    Which of the following statements is NOT true regarding the pelvic diaphragm?
    Right ovarian vein drains into
    Which of the following statements is NOT true regarding left suprarenal gland?
    All of the following muscles are attached to the greater tubercle of humerus EXCEPT
    The internal iliac lymph nodes drain lymph from all of the following structures EXCEPT
    Which of the following is NOT a posterior relation of the rectum?
    Carpal tunnel syndrome is produced due to compression of which nerve in the carpal tunnel?
    All of the following are remnants of mesonephric tubules EXCEPT
    Regarding the external auditory meatus, all of the following statements are true EXCEPT
    While carrying a heavy suitcase, the downward dislocation of glenohumeral joint is resisted by all of the following muscles EXCEPT
    All of the following veins form important systemic anastomoses EXCEPT
    Compared to isometric exercise, isotonic exercise leads to a greater increase in
    The smooth endoplasmic reticulum (SER) adrenal steroidogenic enzyme is
    Pot belly and protruding tongue seen in cretinism are due to

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