1)Scottish terrier sign is best seen in Lateral view, PA view , AP View Oblique view Ans D 2) Hemochromotosis gene- HFE gene…answer 3) To do Dacryocystorhinostomy , anaesthesia used is ? Nasociliary block Frontal block Local anesthesia Ans A Nasociliary block 4) Eculizumab used in paroxysmal nocturnal hemoglobinuria 5) danazol side effects all except vaginal dryness acne hirsutism gynaecomastia ANS D 6) aplastis crisis caused by cmv coxsakie parvo b19 ANS C 7 } B/L acral, target like lesions - erythema multiforme 8) highest produced placental hormone estradiol progesteron hcg hpl READ THE BELOW LINES FROM WILLIAMS OBSTETRICS 22ND EDITION : There are five genes in the growth hormone–placental lactogen gene cluster that are linked and located on chromosome 17. Two of these genes, hPL2 and hPL3, both encode hPL, and the amount of mRNA in the term placenta is similar for each. In contrast, the prolactin gene is located on chromosome 6 (Owerbach and colleagues, 1980, 1981). The production rate of hPL near term, about 1 g/day, is the greatest, by far, of any known hormone in humans. 9) Ocular conjunctival pemphigoid not true ?? occurs in young females leads to cicatrical synblepharon tear drops used distribution differs with race 10)morbidly adherent placenta is due to lack of Nitabauchs fibrinoid layer Decidua basalis 11)kehr sign is pain in left shoulder ..answer pain in right shoulder pain legs 12)Epulis arises from-gingiva…answer 13)mucocoele of GB-cholecyetectomy is treatment of choice 14)saints triad all except renal stones….. answer 15)splenic vein thrombosis …treatment of choice is splenectomy 16)adequate colposcopy…visualization of squamocolumnar jn 17)lethal dose of krait venom -6mg 18)hbf composition-alpha2 gaama 2 19)hallwerdenspatz disease…its iron storage disorder in brain HALLERVORDEN-SPATZ DISEASE: (PANTOTHENATE KINASE-ASSOCIATED NEURODEGENERATION) Hallervorden-Spatz disease (HSD) is a rare disorder characterized by progressive extrapyramidal dysfunction and dementia. Onset is most commonly in late childhood or early adolescence. Abnormal peroxidation of lipofuscin to neuromelanin and deficient cysteine dioxygenase lead to abnormal iron accumulation in the brain. 20)apt test…detect blood in stools Finally, the Apt test can be used after birth (postpartum hemorrhage) if the newborn has bloody vomiting, bloody stool, or active bleeding from the nasogastric tube. A positive apt test would mean that the blood is either due to gastrointestinal or pulmonary bleeding from the neonate. A negative Apt test would indicate that the blood is of maternal origin, suggesting that the neonate swallowed or aspirated maternal blood, either during delivery or during breastfeeding (e.g., from breast fissures). 21)emergency contraception mechanism all except? 1 inhibiting ovulation 2 prev of implantation 3interreference in early pregnancy 4 inhibiting fertilization …answer D 22)absolute C/I for tonsillectomy – 5yr child with OSA 23) Not a demyleinating disorder?? GPI MLD SSPE PMLE ANS. A 24)mechanism of injury in anterior dislocation of shoulder 1 internal rotation adduction 2 internal rotation in extension 3 abduction external rotation ANS 3 25)diagnostic test of carpal tunnel syndrome…nerve conduction velocity 26)soft lens true is?? for astigmatism made up PMMA high water content do not tear ANS C 27)which is not a quadrant of tympanic membrane… posterior anterior… answer 28)Chlamydia not true ?? divides by binary fission has DNA only freely filterable 29)min amt of blood to call melena 10 40 60ml Answer 60ml 30)NRHM ans year 2005..answer 31)ESSURA..hysterscopic micro inserts…answer 32)Not a radiological involvement in sarcoidosis? Milliary mottling Egg shell calcification Enlarged b/l lymphadenopathy Pleural involvement Ans D {Pleural involvement} 33)chlorination in of well in rainy season.......? once daily once weekly twice weekly once monthly 34)pepsin gets inactivated at ph of? 4.5 answer. 35)crypta magna seen in ? Palatine tonsil…answer 36)large breast seen in all except ? large fibroadenoma schirrous ca filariasis breast Ans – Schirrous carcinoma 37)which is not safety system ? 1 pin index 2 link25 system 3Minimal mandatory airflow 4Air flow meter answer.D???. 38)pulmonary hypertention… BMPR2 gene answer 39)medullary thyroid carcinoma treatment of choise is..total thyroidectomy..answer 40)not a test of ovulation test ? 21 day progestron 3 day progestron transvaginal us g 21 day estrogen answer..D 41)abacept used in rx of rheumatoid arthritis..answer 42)enfuvirtide is a fusion inhibitor..answer 43)drugs not used for menopausal flushing..SERM ..??? 44)Not a branch of celiac trunk-superior mesenteric artery 45)not a part of basal ganglion..thalamus…answer. 46)miliary tuberculosis in children spread lympho hematogenous ???? bronchogenic rupture of cavity 47)rotator cuff muscles a/e deltoid supraspinatus infra spinatus teres minor ANS A 48)roll back malaria..answer all 49)true about cochlear implants…not contraindicated in cochlear malformation..answer 50)A man with monoclonal gammmopathy plasma cells 10-30 percent, no symptoms, esr lymphoplasmacytic lymphoma Smoldering myeloma MGUS 51)Group of people 8 -10 discucssing in front of audience..panel discussion..answer.. 52)acute epiglottitis …thumb sign on lateral view..answer.. 53)which of the following not found in greater wing foramin ovale formin spinosum foramuin rotundum optic canal answer…. D 54)Dacryocytes …tear drop cells,, ,answer…. 55)DOC in stress incontinence ..duloxetine..answer. 56)Paltauffs hemorrhages …lungs…answer 57)Dry drowning…laryngeal spasm..answer.. 58)Not seen in lateral condylar fracture??malunion..answer..??? 59)Adduction type of hyoid# manual strangulation ligature strangulation bansdola hanging Ans A 60) ITGCN predisposes TO Testicular seminoma Yolk sac tumour Endodermal tomour Embryonal cell ca answer..D 61)world wide mc cause for contact dermatitis ?? Nickel Chromium gold mercury Ans A 62)Periungual telangiectasia not seen in?? SLE Dematomyositis Scleroderma Mixed connectine tissue disorder answer..D?? 63)Trendenlenberg sign not seen in Perthes ds CDH Ununited # neck femur Tom smith arthritis sequelae 64)Symmetric tonic reflex…not true…its abnormal and reflects CNS dysfunction…answer.. 65)Seligiline mechanism of action not true is?? MAO-B inhibitor antioxidant property increase dopamine synthesis increase dopamine release answer....D Metabolites... 1) Desmethylselegiline Desmethylselegiline may have neuroprotective antiapoptotic properties. A large multicenter study suggests a decrease in the disease progression of parkinsonism but may have reflected other symptomatic response.[16] Desmethylselegiline is metabolized by CYP2C19.[17] 2) L-amphetamine and L-methamphetamine Selegiline is partly metabolized to l-methamphetamine, one of the two enantiomers of methamphetamine in vivo.[18] A characteristic metabolic pattern was noted, exemplified by a ratio of l-methamphetamine to l-amphetamine of about 2.8.[19] This stereoisomer is not considered psychoactive and has little abuse potential.[20] The stimulatory effect on locomotor activity and dopamine synthesis[/u} may be contributed to by the action of l-methamphetamine. If anyone is prescribed and takes selegiline, they can and will test positive for amphetamine/methamphetamine on most drug tests, however the prescription for selegiline would explain why they test positive for amphetamine/methamphetamine. Mechanism of Action Selegiline is a selective inhibitor of MAO-B; MAO-B metabolizes dopamine and phenylethylamine.[16] Selegiline exhibits little therapeutic benefit when used independently, but enhances and prolongs the anti-Parkinson effects of levodopa. 66) Criminal negligence..304A …answer… 67)All are used for skeletal traction except k wire steinmann pin danhams pin knowles pin answer…D ..it’s a intramedulary devise… 68)sudden ophthalmoplegia in thai child eating raw fish n cooked rice-thiamine..answer.. 69)increased viscosity of blood causes increase in MAP diameter of resistance vessels diameter of capacitance vessels CVP 70)Adult with U/L proptosis, illdefined lesion extending into orbit from eye ball??? malignent melanoma choirdal hemangioma lymphoma Pseudo tumour 71)baciillary angiomatosis not true?? Caused by b.henslae Can cause peliosis heaptis Aminoglycosisdes used Brain is involved in AIDS pt. Ans C Bacillary angiomatosis: A bacterial infection due to a cat scratch most often seen today in people with HIV. The disease characteristically presents with swollen lymph nodes (lymphadenitis), sore throat, fatigue, and fever, chills, sweats, vomiting, loss of appetite, and weight loss. There is usually a little bump (a papule) which may be pus-filled (a pustule) at the site of the scratch. Then more nodules appear on and under the skin. As the number of nodules increases, patients get sicker. In normal people the disease is self-limited and usually goes away by itself in a few weeks. It can also be treated with antibiotics. In persons with HIV/AIDS the disease can cause severe inflammation of the brain, bone marrow, lymph nodes, lungs, spleen and liver. The disease can be fatal in persons with HIV. It can be easily treated with antibiotics such as erythromycin and doxycycline. Treatment is given until the skin lesions resolve, usually in 3 to 4 weeks. Bacillary angiomatosis is so characteristic today of AIDS that it is an AIDS defining disease, according to the CDC (Centers For Disease Control). The disease is caused by a bacterium called Rochalimaea henselae, which was reclassified as Bartonella henselae, named for Diane Hensel, a microbiologist. Bacillary angiomatosis has also been called cat scratch disease, cat scratch fever, regional lymphadenitis, and benign lymphoreticulosis. treatment erythromycin drug of choice....... 72)Inverted - Y shaped cataract ant adult n infantile ant infantile n foetal post adult n infantile post infantile n foetal ANS D 73)sniff test- bact vaginosis> trichomonas answer 74)perichondritis of ear ----pseudomonas…answer… 75)oval window opens into ------scala vestubuli…answer… 76)nobel prize for work on vascular ligature and grafting of blood vessels and organs .. Alexis Carrel …answer.. 77)MC tumor of liver…..mets… 78)Baby developed signs and symtoms of cong.syphilis after two ween..supported by?? Kassowitz’s law Profeta law Colles law Didays law Ans D 78)Diuretic with direct vasodilatory effect..indapamide..answer.. 79)Drug used to delay uterine contractions in labour …salbutamol ..answer.. 80)Difference between vaginal cyst and cystocele… 81) Mechanism of camp action on GIT causing diarrhea?? Increased secretion of chlorides…answer.. 82)Not done in PMSTR knot release Deep deltoid lig release Achilles tendon release spring ligament release. Ans B??? 83)Not seen in HUS 1)subnephrotic range protinuria 2)hypofibrogenimia 3)thrombocytopenia 4)positive coombs test ans 4 coz HUS is mechanical hemolysis not immune 84)Hyperchloremic acidosis seen with…uretero sigmoidostomy..answer.. 85)regarding spingomylein?? Choline or amino cooh group not sure?? 86)starvation – alanine ANS 87)2.5cms renal stone in child- pyelolithotomy answer most probably The American Urological Association Stone Guidelines Panel has classified ESWL as a potential first-line treatment for ureteral and renal stones smaller than 2 cm. 88)Rt pleural effusion - rt lateral decubitus best view …answer.. 89)Frozen section used in diagnosis of fat..answer.. 90)Mc side effect of pyrizinamide is arthritis/arthalgia…answer… 91)acarbose MOA… inhibits alphaglucosidase …answer.. 92)LCAT activator apo A???? 93)Drug causing HDL elevation…Nicotinic acid/niacin…answer.. 94)normal distribution curve what is correct . .mean=median…answer 95)vortex keratopathy NOT seen in…copper excess..answer.. 96)pregnancy by ELISA first detected on….first day of missed cycle of 28 day duration..answer… 5 days before LMP 97)not used in heroine detoxification….disulfiram answer.. 99)once a week pill…centchroman…answer.. 100)Perichondritis of pinna mc caused by pseudomonas…answer.. 101)wegeners differs from other small vessel vasculitis by…invlmnt of nasal septum..answer.. 102) sepsis treatment : activated protien c used in all cases high dose of anti inflammatory drugs antibiotics methyl prednisolone 103)In systemic inflammatory response all are seen except: white cell count 10000microns/l resp rate >24 bodytemp>38 PR >90/min ANS A Body temperature less than 36°C or greater than 38°C Heart rate greater than 90 beats per minute Tachypnea (high respiratory rate), with greater than 20 breaths per minute; or, an arterial partial pressure of carbon dioxide less than 4.3 kPa (32 mmHg) White blood cell count less than 4000 cells/mm³ (4 x 109 cells/L) or greater than 12,000 cells/mm³ (12 x 109 cells/L); or the presence of greater than 10% immature neutrophils (band forms) SIRS can be diagnosed when two or more of these criteria are present. 104)Epleys maneuver used in rx of BPPV…answer.. 105)Cidex is gltaraldehyde…answer.. 106)Tall slender young woman with disproportionate armspan length what systems to check....opthalmic and cardiovascular systems…answer… 107)mc cof rectal bleed in 5 yr old…rectal polyp..answer most prob... 108.In pheochromocytoma all are given before surgery except: alpha blocker beta blocker steroids volume Loading • Start alpha blockade with phenoxybenzamine 7-10 days preoperatively to allow for expansion of blood volume. • The patient should undergo volume expansion with isotonic sodium chloride solution. Encourage liberal salt intake. • Initiate a beta blocker only after adequate alpha blockade. If beta blockade is started prematurely, unopposed alpha stimulation could precipitate a hypertensive crisis. • Administer the last doses of oral alpha and beta blockers on the morning of surgery. 109)G-csf human stem cell product derivative recombinant cytokine recombinant monoclonal antibody 110)Tinea capitis caused by …microsporum sps…answer… 111)Pt on risperidone case…neurolept malignant synd…answer.. 112)Lesion with clear fluid of .5cm…vesicle …answer…>.5 is bulla 113)c reactive protein------- acute phase reactant…answer… 114)pt.with diabetic keto acidosis and coma….high potassium levels…answer… 115)not true about SSPE…fever and headache…answer,.. 1160pyrimidine inhibitor with dihydro orotate hehydrogenase inhibitor action…leuflunamide…answer.. 117)hepatic blood flow and oxygenation minimally altered by which anesthetic sevoflurane desflurane isoflurane enflurane Ans Isoflurane 118)ASD with left axis deviation…ostium primum defect.. 119)Mc cause of prolonged rocuronium action…decreased elimination…answer.. 120)Rays produced by nuclear decay/disingration…gamma rays…answer… 121)Quadrivalent Human Papillomavirus against..Types 6,11,16, 18….answer… 122) Pulse oximetry uses the princple of? . Raman effect , Electro magnetic radiation , Absorption photometry ans C 123) schwangershaft protein is other name for - pregnancy-specific β glycoprotein (PSBS) Schwangerschafts protein 1 (SP1), also known as pregnancy-associated plasma protein C (PAPP-C) or pregnancy-specific β glycoprotein (PSBS), is produced by the syncytiotrophoblast. The main advantage of SP1 level assessment may be in the diagnosis of conception after recent hCG administration. A level of 2 ng/L might be used for the diagnosis of pregnancy; however, it is doubtful that a diagnosis can be established before delay of menses. Although the level of SP1 increases late in all patients with a nonviable pregnancy, a single SP1 level assessment does not have prognostic value 124)True regarding PCOD….raised LH levels …answer… 125) severity of the disease is -- case fatality rate ...answer.... 126) erythropoeitin secreting tumor-cerebellar haemangioblastoma 127)Placental harmone with highest carbohydrate content …hcg WILLIAMS OBSTETRICS 22ND EDITION : Chorionic gonadotropin is a glycoprotein (molecular weight 36,000 to 40,000 d) with the highest carbohydrate (30 percent) content of any human hormone. The carbohydrate component, and especially the terminal sialic acid, protects the molecule from catabolism. The 36-hour plasma half-life of intact hCG is much longer than the 2 hours for LH. The hCG molecule is composed of two dissimilar subunits, designated (92 amino acids) and (145 amino acids), which are noncovalently linked. They are held together by electrostatic and hydrophobic forces that can be separated in vitro. Isolated subunits are unable to bind the LH receptor and thus lack biological activity. 128)MBA Psych case…neologism…. Answer 129)Co2 laser…10600…answer.. 130) components of IMCI diseases all except ?? diarrhoea ac.respiratory infections malaria childhood tb ..............answer........... This is an innovative approach which was started in 1995 by WHO and UNICEF with the aim of introducing a comprehensive and timely management of the 5 most common causes of ill health and death among the under-fives. These illnesses are: • Pneumonia; • Diarrhoea; • Malaria; • measles; • malnutrition. 131)NOT true in ankylosis spondy…UL mc involved than lower limb…answer… 132)best position in percutaneous nephrolithotomy operation left kidney …supine 133)spider cell.. Cardiac rhabdomyoma…answer… 134) best test for for fetal rh iso immunisation cord blood NST usg placenta increased middle cerebral artery blood flow Ans D 135)CCF which is not true....echo is diagnostic…answer… 136)rx of pseudo pancreaticcyst.... surgical internal drainage…answer.. 137)post radiation hodgkins case….hypothyroidsm due to HASHIMOTOS THYROIDITIS 138)glaucoma visual field defects best detected by…HFA….answer… 139)dangerous placenta is type 2 B that is placenta posterior previa….answer,…. 140)Cresentic glomerulo nephritis…RPGN..answer… 141)IODINE disinfection mechanism of action??? Protein coagulation iodine from iodophore at alkaline ph oxidation dna damage 142)Large fiber neuropathy cause???? a.vincristine b.cisplatin. c.thalidomide ans B LARGE-FIBER NEUROPATHY=CISPLATIN Cisplatin causes dose-dependent large-fiber neuropathy by damaging dorsal root ganglia.Cisplatin typically produces large-fiber neuropathy with loss of vibratory and position sense. 143)cervix cancer…stage IA2…answer… 144)Herpes genitalis definitive diagnosis…virus cultre …answer… 145)Late expanding stage…death rate declines more than birth rate…answer….. 146)stage 4 in AIDS doesnt include oral candidiasis…answer… 147)h.pylori cause g.carcinoma due to The mechanism by which H. pylori infection leads to cancer is unknown, but it appears to be related to the chronic inflammation induced by the organism 148)Mc site of peptic ulcer perforation….anterior duodenal ulcer…answer… 149)leukemia associated syndrome- down syndrome…answer…. 150)Not a sign of ileocaecal tb….competent ileo caecal valve…answer..string sign is seen in ileo caecal tb,chrons,hyp.pyloric stenosis…othe two options are definitely seen in ileo caecal tb.. 151)Hirschsprung not is small intestine not involved is the answer because small intestine involvement occurs in 10% of cases 152)Whats the answer for mindblowing shigella question??? 153) 8mm gall stone in bile duct t/t …endoscopic removal..answer most prob… 154)motor unit is nerve endin and muscle fibre…answer…. 155)action potential in cochlear cells arise from inner hair cells …answer…(outer hair cells produce otoacoustic emissions) 156)normal conversation in quiet room…50-60db 157)azygous lobe Azygos lobe is a rare congenital variation of the upper lobe of the right lung. Embryologically, it arises from an anomalous lateral course of the azygos vein. In a pleural septum within the upper lobe. As it has no bronchi, veins and arteries of its own, it is not a true, or even accessory, pulmonary lobe, but rather an anatomically separated part of the upper lobe. It is usually an incidental finding on chest x-ray or computed tomography and is as such not associated with any morbidity but can cause technical problems in thoracoscopic procedure 158)carcinoid of GIT false is 1) circumcribed lesion in mucosa 2)muticentric 3)coliky abdominal pain 4)massive retroperitonial fibrosis 159)Mc cause of post renal arf – ans in BOO Ref harrison 160)Pyogenic liver abscess ...most common route of spread…assecending infection via biliary trac…anwer..>>hematogenous. 161)gilbert syndrome false is ……….conjugated elevated …answer… 162)blunt trauma to pancreas false....usually isolated is false…..answer….. 163)oesophageal perforation false…..penetration most common cause of injury(iatrogenic trauma mc cause)>>>barium swallow.. 164)false about mvp…both echoi and auscultatiry findings required for diagnosis..????? 165)gut endometriosis all except periodic rectal bleeding involves mucosa surgery t/t of choice mucosa n other layers involved?? 166)IUCD should not be inserted during??? 167)specific pattern of cataract not seen in… leprosy….answer… 168)albumin to globulin near term.... 1:1…0.9 to b specific at term…answer… 169)All are prophylactic for Atonic PPH except 1. 125 microgram Carboprost IM at delivery of anterior shoulder 2. Methergine IV at delivery of anterior shoulder 3. Controlled cord traction at delivery of placenta 4. 10 units Oxytocin within 10 mins after delivery 170)Clotting factors icreased in pregnancy except?? 2 7 10 11….answer….. 170)age estimation...first trimester..... Crl…answer………. 171)skeletal defect mc in IDM..... Spina bifida….answer… 172) In pregnancy CVP rises no change decreases ANS B {NO CHANGE} 173)In rx of amoebiasis NOT true??? A.METRO for invasive b.paromomycim for noninvasive c.p+m better (???Combination toxic??) not sure of the answer… d.treat ment different foe invasive and non invasive. 177)increased ICT causes a/e …tachycardia…answer… 178)NOT a absolute contra for organ donation a.>70yrs b.hiv c.malignancy d..15min cvs death Ans a>70yrs Absolute contraindications Age older than 80 years HIV infection Active metastatic cancer Prolonged hypotension or hypothermia Disseminated intravascular coagulation Sickle cell anemia or other hemoglobinopathy Relative contraindications Malignancy other than in the central nervous system (CNS) or skin that is in remission (>5 y) Hypertension Diabetes mellitus (DM) Physiologic age older than 70 years Hepatitis B or C History of smoking 179)ocpills not contraindicated in ? a.cvs severe b.obesity ..answer… c.htn d.thromboembolic 180)metastatic calcification…hyperparathyroidism…answer… 181)menkes disease - copper transport….answer… 182)acid fast organism.... nocardia…answer…. 183)Femoral vein catheterization… 184)Maximum dark adaptation time- ans 20 min for light adaptation-5 min 185} intrinsic minus hand a/e – adduction of thumb 186} Surgery Not used in short bowel loop management lenthening of bowel stricturoplasty resection of dilated bowel loop ANS ?? Operative therapies for short-bowel syndrome can be divided into 2 broad categories: (1) intestinal or combined liver-intestinal transplantation, and (2) nontransplant operations. Nontransplant components of the surgical armamentarium for the treatment of short-bowel syndrome include intestinal lengthening (Bianchi) procedures, intestinal tapering for dilated dysfunctional bowel segments, stricturoplasty, and creation of intestinal valves or reversed bowel segments for patients with rapid intestinal transit times. 187} newborn- frothing mouth - unable to pass ng tube - gasless abdomen - ans> oesophagial atresia with NO FISTULA…answer… 190)Blood stored for 21 days at 2-6 degrees true all except?? .platelets remains viable....answer.... 191) Lytic lesions not seen in? oseoid osteoma...answer 192).Antigen binding site of anti body -- Isotype/Idiotype 193)Abnormal row of cilia – Distichiasis??? 194} m/c site of TB spine involvement?? *anterior spine *posterior spine *paradiscal *vertebral body ans C Para discal TB Spine most common site: Paradiscal because the blood supply is common for adjacent 2 vertebras paradiscal areas, together with intervening disc, as it develops from same sclerotome. 195}. a infant fed , start vomiting , mild hepatomegaly on examination what may be the defect galactose metabolism 196} in a country where there is poor registration of birth & death best indicator of fertility is 1 nrr 2 gfr 3 child-women ratio 4 ans children-women ratio 197}. budd chiari syndrome as it is not associated with following one a leukemia b sickle cell disease c polycythemia d congestive heart failure ......answer is d 198).anti diabetic drugs to decrease glucose levels in sepsis leads to good prognosis
Amebiasis Rx: First Line Luminal agent for noninvasive infection: Paromomycin 500 mg p.o. t.i.d. for 10 days First Line Invasive infection: Metronidazole : 500–750 mg t.i.d. p.o. for 10 days, followed by a 20-day course of diiodohydroxyquin to eliminate intestinal carriage Tinidazole : 2 g/d for 3 days with food for intestinal infection and 2 g/d for 3–5 days for liver abscess; better tolerated than metronidizole (3)[A] Either of these agents should be followed by a luminal agent. Contraindications: Known allergy to given medication Precautions: None of the agents has been proven safe during pregnancy, but pregnant women with invasive disease should still be treated.