aboutPinnaexcept:
a)InTreacher-Collinssyndromemalformedpinnamaybepresent
b)Madeupofelasticcartilage
c)Developfromlstpharyngealcleftonly
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d)Helpsinlocalizationofsounde)Mayinvolvesinrelapsingperichondritis
CorrectAnswer-C
Ans.c.Developfromlstpharyngealcleftonly
Firstbranchialcleftistheprecursorofexternalauditorycanal.
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Aroundthesixthweekofembryoniclife,aseriesofsixtuberclesappeararoundthefirstbranchialcleft
Branchialcleftsareectodermalinorigin.
Pinnadevelopsfrom1stand2ndpharyngealarch
2.Pairedlaryngealcartilage(s)is/are:
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a)Thyroidb)Arytenoid
c)Corniculte
d)Cricoid
e)Cuneiform
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CorrectAnswer-B:C:EAns.b.Arytenoid;c.Corniculte;e.Cuneiform
Laryngealcartilages
Thyroid(unpaired)
Itisthelargestofalllaryngealcartilages.Itis'V'shapedwithright
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andleftlamina.Bothlaminae(alae)meetanteriorlyforminganangleof90?inmalesand120?infemales.Vocalcordsareattachedtothe
middleofthyroidangle.
Cricoid(unpaired)
Itistheonlycartilageformingacompletering,thereforeisshaped
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likearing.Itarticulateswitharytenoidcartilagetoformcricoarytenoidjoint,atypeofsynovialjoint.
Epiglottis(unpaired)
Itisleaf-shapedelasticcartilage(inadults).Itisomegashapedin
children.Itformstheanteriorwalloflaryngealinlet.
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Arytenoidcartilage(paired)EachArytenoidcartilageispyramidalinshape.Basearticulateswith
cricoidcartilage,andapexsupportsthecorniculatecartilage.Avocal
processdirectedanteriorlyandgivesattachmenttovocalcord.A
muscularprocessdirectedlaterallyandgivesattachmenttointrinsic
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laryngealmuscles.Corniculatecartilage(ofSantorini):Paired
ArticulateswithapexofArytenoidcartilage
Cuneiformcartilage(ofWrisberg):Paired
Situatedinaryepiglotticfoldinfrontofcorniculatecartilage.
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3.Allaretrueaboutmediastinumexcept:
a)Heartpassesthroughsuperiormediastinum
b)Heartpassesthroughmiddlemediastinum
c)Thymusremnantmaypresentinmiddlemediastinum
d)PosteriorboundaryofposteriormediastinumcorrespondstoTl-
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T4vertebraee)Lowerborderofanteriormediastinumisextendedmorethan
posteriormediastinum
CorrectAnswer-A:C:D:E
Ans.a.Heartpassesthroughsuperiormediastinum;c.Thymus
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remnantmaypresentinmiddlemediastinum;d.PosteriorboundaryofposteriormediastinumcorrespondstoTl-T4
vertebrae;e.Lowerborderofanteriormediastinumisextended
morethanposteriormediastinum
Superiormediastinum:Theregionsuperiortothesternalangle
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containingtheaorticarchanditsthreebranches,thesuperiorvenacava(SVC)andthebrachiocephalicveins,thetrachea,the
esophagus,andthephrenicandvagusnerves.Thesuperior
mediastinumalsocontainsthethymus;however,inanadult,the
thymusisusuallyatrophiedandpresentsasafattymass.
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Anteriormediastinum:Theregionbetweenthesternalangle,thedeepsternalsurface,thepericardialsac,andthediaphragm.The
anteriormediastinumcontainsfatandareolartissueandtheinferior
partofthethymusoritsremnant.
Middlemediastinum:Thisregioncontainsthepericardialsacand
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heart.Posteriormediastinum:Theregioncontaininganatomicstructures
deeptothepericardialsac,includingthethoracicportionofthe
descendingaorta,theazygossystemofveins,thethoracicduct,the
esophagus,andthevagusandsympatheticnerves.
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4.Trueaboutmedialmeniscus:
a)Madeupofhyalinecartilage
b)Injuryoflateralmeniscusismorefrequentthanmedial
meniscus
c)Cshaped
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d)Fixedtomedialcollateralligamente)Innerpartismoreavascular
CorrectAnswer-C:D:E
Ans.c.Cshaped;d.Fixedtomedialcollateralligament;e.
Innerpartismoreavascular
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MedialMeniscusLateralMeniscus
-Semilunar(c)shaped(less
-Semicircular(C)shaped(more
circular)
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circular)-Largerinradius/diameterbut -Smallerinradius/diameterbut
narrowerinbody&
widerinbody&thickerin
thinnerinperiphery
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periphery-Posteriorhornislargerthan -Anterior&posteriorhornare
anteriorhorn
uniforminsize
-Coverslesser(-65%)oftibial -Coversmore(-85%)oftibial
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articularsurfacearticularsurface
-Peripheralareawherepopliteus
-Entireperipheryisattached tendoncrossesthejoint
tojointcapsule(medial
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throughpopliteushiatusisnotcapsularligament)
attached
-Attachedtomedialcollateral
-Notattachedtolateralcollateral
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ligamentligament
-Attachedtobothcruciate
ligaments,andposteriorhorn
receivesanchoragetomedial
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femoralcondylesbyeitherthe-Doesnotattachtoeither
ligamentofHumphryorligamentof
cruciateligaments
Wrisberg,depending
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onwhichispresent.Itisalsoattachedposteriorlytothe
fasciacoveringpopliteusmuscle
andthearcuatecomplex
atposterolateralcornerofknee.
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-Lessmobilebecauseofits-Moremobileb/oitsattachments
attachment
-Morepronetoinjury
-Lesspronetoinjury
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5.Whichofthefollowingstatementis/aretrue
aboutoculomotornerve:
a)Arisefrompons
b)Edinger-Westphalnucleusgivesrisetoparasympatheticsupply
ofoculomotornerve
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c)Arisefrommedullad)Passesthroughinterpeduncularfossa
e)Relatedtomedialwallofcavernoussinus
CorrectAnswer-B:D
Ans.b.Edinger-Westphalnucleusgivesriseto
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parasympatheticsupplyofoculomotornerve;d.Passesthroughinterpeduncularfossa
NUCLEI:
1.Generalsomaticefferent:
Throughoculomotornucleusformovementofeyeballsupplyingall
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extraocularmusclesexceptSuperiorOblique(SO)andLateralRectus(LR).
2.Generalvisceralefferent(parasymapthetic):
ThroughEdinger-Westphalnucleusforpupillarycontractionand
accomodation.
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3.Generalsomaticafferent:Carriesproprioceptivefibresfromtheextraocularmusclesto
mesencephalicnucleusoftrigeminal.
Occulomotornucleus(forgeneralsomaticefferent)andEdinger-
Westphalnucleustogetherformoculomotornuclearcomplex.
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STRUCTURE:Midbrain
Midbrain
Thirdnervenucleus(atthelevelofthesuperiorcolliculusventral
tothecerebralaqueduct,onthepre-aqueductalgreymatter)
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RedNucleusSubstantiaNigra
ExitthroughInterpeduncularfossa
Investedwithasheathofpiamater
Passesbetweenthesuperiorcerebellar&posterior
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cerebralarteries(Nervecompressedbyaneurysmofposteriorcommunicatingartery)
Piercestheduramater
Passb/wfreeandattachedbordersoftentoriumcerebelli
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CavernoussinusReceivesfilamentsfromthecavernousplexusofthesympathetic
nervoussystemandcommunicatingbranchfromV1
Superiororbitalfissure
Orbit
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SuperiorandInferiorBranch6.Derivative(s)ofmesonephricduct
includes:
a)SomepartofprostaticUrethra
b)Seminalvesicle
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c)Roundligamentofuterusd)Vasdeferens
e)Ductusdeferens
CorrectAnswer-A:B:D:E
Ans.a.SomepartofprostaticUrethra;b.Seminalvesicle;d.
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Vasdeferens;e.DuctusdeferensTheWolffianductormesonephricductformstheepididymis,vas
deferensandseminalvesicles.Testosteronedirectsthe
developmentofWolffianduct.
Trigoneofthebladderdevelopfromthecaudalendofthe
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mesonephricduct.Apairofuretericbudgrowupwardsfromthedistalmesonephric
ductnearitsinsertionintothecloacatoformtherenalpelvis,
calycesandcollectingducts.
Mostoftheprostateglanddevelopfromthesameprimordialareaof
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urogenitalsinusthatformsthevaginalplateinfemales.TheMullerianorparamesonephricductformsthefallopiantubes,
uterusandupperthirdofthevagina.
7.AllaretrueregardingUterusexcept:
a)Lymphvesselsfromfundusdraintopara-aorticlymphnodes
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b)Broadligamentprovidesprimarysupporttouterusc)Mainlysuppliedbyuterinearteries
d)Posteriorsurfaceisrelatedtointestine
e)All
CorrectAnswer-B
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Ans.b.BroadligamentprovidesprimarysupporttouterusBLOODSUPPLYANDLYMPHATICS:
Uterineandovarianartery
Venousdrainageisviaaplexusinthebroadligamentthatdrains
intotheuterineveins.
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Lymphaticdrainage:iliac,sacral,Paraaorticandinguinallymphnodes.
LIGAMENTS:
Pelvicdiaphragm,Uterosacralligament&Transversecervical
ligamentareprimarysupportofuterus
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Thetoneofthepelvicfloorprovidestheprimarysupportfortheuterus.Someligamentsprovidefurthersupport,securingtheuterus
inplace.Theyare:
BroadLigament:Thisisadoublelayerofperitoneumattachingthe
sidesoftheuterustothepelvis.Itactsasamesenteryfortheuterus
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andcontributestomaintainingitinposition.Itdonotprovideprimarysupport.
8.Whichofthefollowingstatementis/aretrue
regardingFickprincipleofmeasurementof
cardiacoutput:
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a)CardiacoutputiscalculatedbyamountofoxygenconsumedbywholebodyperunitmassdividedbyA-VOxygendifference
acrossthelung
b)Oxygenconcentrationinarteryismeasuredbypassingcatheter
toPulmonaryartery
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c)Mixedvenousbloodismeasuredbyinsertingcatheterintopulmonaryartery
d)Rateofoxygenabsorptionbythelungsismeasuredby
spirometry
e)Foroxygencontentofartery,anyarteryofbodycanbechosen
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CorrectAnswer-A:C:D:EAns,(A)Cardiacoutputiscalculatedbyamountofoxygen
consumedbywholebodyperunitmassdividedbyA-VOxygen
differenceacrossthelung(C)Mixedvenousbloodismeasured
byinsertingcatheterintopulmonaryartery(D)Rateofoxygen
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absorptionbythelungsismeasuredbyspirometry(E)Foroxygencontentofartery,anyarteryofbodycanbechosen
[Ref:Ganong25th/543-44,24th/546-47;A.K.Iain5th/356;Guyton1
lth/244]
CardiacOutputMeasurement:
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Fickprinciplestatesthattheamountofasubstancetakenupbyanorgan(orbythewholebody)perunitoftimeisequaltothearterial
levelofthesubstanceminusthevenouslevel(A-Vdifference)times
thebloodflow.
Principlecanbeusedtodeterminecardiacoutputbymeasuringthe
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amountofO,consumedbythebodyinagivenperiodanddividingthisvaluebytheA-Vdifferenceacrossthelungs.
InapplyingthisFickprocedureformeasuringcardiacoutputinthe
humanbeing,mixedvenousbloodisusuallyobtainedthrougha
catheterinsertedupthebrachialveinoftheforearm,throughthe
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subclavianvein,downtotherightatrium,and,finally,intotherightventricleorpulmonaryartery.
Rateofoxygenabsorptionbythelungsismeasuredbytherateof
disappearanceoforygenfromtherespiredair,usinganytypeof
oxygenmeter(e.gclosecircuitspirometry)
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BecausesystemicarterialbloodhasthesameO2contentinallpartsofthebody,thearterialO2contentcanbemeasuredinasample
obtainedfromanyconvenientartery.
9.Feature(s)ofhyperprolactinemiais/areall
except:
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a)Amenorrhoeab)Decreasemilkproduction
c)Galactorrhoea
d)Hypogonadotropichypogonadism
e)Hypothyroidismmaycausehyperprolactinemia
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CorrectAnswer-BAns.B.Decreasemilkproduction
[Ref:Ganong25th/331-33,24th/334-35;A.K.Iain5th/695-96;
Guyton11th/907,918-921,I039-40;CMDT2016/1096-97,06/
1113-14]
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Hyperprolactinemia:Duetoanycausemayresultinhypogonadotropichypogonadism.
HypogonadotropichyPogonadismoftendevelopsinpatientswith
hyperprolactinemia;itmaybereversedwithtreatmentof
hyperprolactinemia.
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Womenmaynoteoligomenorrhoeaoramenorrhoea.Galactorrhoea,definedasLactationinabsenceofnursing,is
common.
Prolactindeficiencyinhibitspostpartumlactation.
Primaryhypothyroidismisassociatedwithmildhyperprolactinemia,
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probablybecauseofcompensatoryTRHsecretion10.TrueaboutOxytocin:
a)Secretedfromanteriorpituitary
b)Secretedbyposteriorpituitary
c)Decapeptide
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d)Gonadotropinreleasinghormone(GnRH)stimulateitssecretione)Causemilkejectionbycontractionofmyoepitheliumofbreast
CorrectAnswer-B:E
Ans.(B)Secretedbyposteriorpituitary(E)Causemilkejection
bycontractionofmyoepitheliumofbreast
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[Ref:Ganong25th/311-13,24th/311-l3;Guytonp918,1040-41,928]Oxytocin:
Stimulatespostpartummilkletdowninresponsetosuckling.
Nonapeptide(9aminoacids).
DiffersfromAVPonlyatpositions3and8.
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Relativelylittleantidiureticeffectandseemstoactmainlyonmammaryductstofaci-litatemilkletdownduringnursing.
Mayhelpinitiateorfacilitatelaborbystimulatingcontractionof
uterinesmoothmuscle,butitisnotclearifthisactionisphysiologic
ornecessaryfornormaldelivery.
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Gonadotropin-releasinghormone(GnRH):Itissecretedfromhypothalamus&stimulatessecretionofFSH&LH.
11.Truestatementrelatingtocomplianceof
lung:
a)Increasedbysurfactant
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b)Decreasedinemphysemac)Atheightofinspirationcomplianceisless
d)Itcanbemeasuredbymeasuringintrapleuralpressureat
differentlungvolume
e)None
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CorrectAnswer-A:C:DAns.(A)Increasedbysurfactant(C)Atheightofinspiration
complianceisless(D)Itcanbemeasuredbymeasuring
intrapleuralpressureatdifferentlungvolume
[Ref:Ganong25th/629-32,24th/629-33;Guytonllth/473-75;A.K.
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Jain5th/437]Lungcompliance:
Measuredbymeasuringintrapleuralpressureatdifferentlung
volume.
Animportantfactoraffectingthecomplianceofthelungsisthe
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surfacetensionofthefilmoffluidthatlinesthealveoli.Deficiencyofsurfactant-lesscompliance;moresurfactant-more
compliance.
Compliancedecreaseswiththeinflationofthelungsasmore
pressureisrequiredtodistendthealreadydistendedlung.
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Thecurveisshifteddownwardandtotheright(complianceisdecreased)bypulmonarycongestionandinterstitialpulmonary
fibrosis;pulmonaryfibrosisisaprogressivediseaseofunknown
causeinwhichthereisstiffeningandscarringofthelung.
Thecurveisshiftedupwardandtotheleft(complianceisincreased)
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inemphysema.12.Whichofthefollowingistrueregarding
GLUT-5:
a)Presentinbrain
b)PresentinAdiposetissue,skeletalmuscle&skin
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c)Insulinmediatedtransporterd)Sodiumindependenttransport
e)PresentinRBC
CorrectAnswer-D
Ans.(D)Sodiumindependenttransport
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[Ref:Ganong25th/435,24th/435;Harper30th/191,28th/171;LippincottBiochemistry4th/97]
GLUT-5isunusualinthatitistheprimarytransporterforfructose
(insteadofglucose)inthesmallintestine&thetestes.
Hassodiumindependentfacilitateddiffusionmechanism.
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13.Trueabouthormonesensitivelipase:
a)Activityisincreasedbyinsulin
b)Foundintracellular
c)ActivatedbyEpinephrine
d)Locatedinwallbloodcapillaries
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e)NoneCorrectAnswer-B:C
Ans.B,Foundintracellular&C,ActivatedbyEpinephrine
[Harper30th/261-62,28th/220]
Hormone-sensitivelipase:
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Hormone-sensitivelipaseisactivatedbyACTH,TSH,glucagon,epinephrine,norepinephrine,andvasopressinandinhibitedby
insulin,prostaglandinE1,andnicotinicacid
Triacylglycerolundergoeshydrolysisbyahormone-sensitivelipase
toformfreefattyacidsandglycerol.
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Thislipaseisdistinctfromlipoproteinlipase,whichcatalyzeslipoproteintriacylglycerolhydrolysisbeforeitsuptakeinto
extrahepatictissues.
14.Whichofthefollowingis/arePainscale:
a)McGillPainQuestionnaire
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b)Visualanaloguescalec)ColouredAnalogueScale
d)Alloftheabove
e)Noneoftheabove
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Ans.A,McGillPainQuestionnaireB,Visualanaloguescale&C,ColouredAnalogueScale
ListofPainMeasurementScales:
Wong-BakerFACESPainRatingScale
Visualanalogscale(VAS)
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McGillPainQuestionnaire(MPQ)NeckPainandDisabilityScale-NPAD
Lequesnealgofunctionalindex.
BehavioralPainScale(BPS)
BriefPainInventory(BPI)
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ClinicalGlobalImpression(CGI)Critical-CarePainObservationTool(CPOT)
COMFORTscale
FacesPainScale-Revised(FPS-R)
15.TruestatementregardingLactate
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dehydrogenasedeficiency:a)Fumaratelevelincreases
b)Exerciseintolerance
c)Musclecrampsmayoccur
d)Itoperatesinanaerobiccondition
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e)ItisthekeyenzymeofKrebcycleCorrectAnswer-B:C:D
Ans:b.Exercise...,c.Muscle...,d.Itoperate...[RefHarper
30th/171,69,28th/149-151;Harrison19th/433e2;Lippincott
4th/103,111;Chatterjea&Shinde7th/313]1
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FumarateisconvertedtomalatebyfumaraseenzymeinKrebcycle(sofumaratelevelincreasesindefectiveenzymefunctioningin
Krebscycle,notinabnormalityofglycolysisi.e.,lactate
dehydrogenasedeficiency,Lactatedehydrogenasecatalyse
conversionofpyruvicacidtolacticacid.
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Lactatedehydrogenasedeficiencyisaconditionthataffectshowthebodybreaksdownsugartouseasenergyincells,primarilymuscle
cells.
Therearetwotypesofthiscondition:lactatedehydrogenase-A
deficiency(sometimescalledglycogenstoragediseaseXI)and
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lactatedehydrogenase-Bdeficiency.Peoplewithlactatedehydrogenase-Adeficiencyexperiencefatigue,
musclepain,andcrampsduringexercise(exerciseintolerance).
16.Hyaloronicacidiscomposedof:
a)N-acetylglucosamine
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b)N-acetylgalactosaminec)Glucuronicacid
d)N-acetylneuramicacid
e)Iduronicacid
CorrectAnswer-A:C
--- Content provided by FirstRanker.com ---
Ans:a.N-acetylandc.Glucuronic[RefHarper30th/156,159,637,640,28th/119,534-39;Lippincott4th/159,163;Chatterjeaer
Shinde7th/38]
CompositionofHyaluronicAcid:Itiscomposedofrepeatingunitsof
N-acetylglucosamine&D-Glucuronicacid.Onhydrolysis,ityields
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equimolecularquantitiesofD-Glucosamine,D-Glucuronicacid&aceticacid.
Hyaluronicacidispresentinbacteriaandiswidelydistributed
amongvariousanimalsandtissues,includingsynovialfluid,the
vitreousbodyoftheeye,cartilage,andlooseconnectivetissues.
--- Content provided by FirstRanker.com ---
Hyaluronicacidisespeciallyhighinconcentrationinembryonictissuesandisthoughttoplayanimportantroleinpermittingcell
migrationduringmorphogenesisandwoundrepair.Itsabilityto
attractwaterintotheextracellularmatrixandthereby"loosenitup"
maybeimportantinthisregard.
--- Content provided by FirstRanker.com ---
17.AllarefeatureofRefsumdiseaseexcept:
a)Deficiencyofa-hydroxylase
b)Defectinpoxidation
c)Accumulationofphytanicacid
d)Peripheralneuropathy
--- Content provided by FirstRanker.com ---
e)TreatedbyremovingphytanicacidprecursorsfromdietCorrectAnswer-B
Ans:b.Defectinpoxidation[RefHarper30th/231,614,28th/I91,
493;Lippincott4th/195;Harrison19th/2681,18th/3456,236]
Refsumdiseaseisarareautosomalrecessivedisordercausedbya
--- Content provided by FirstRanker.com ---
deficiencyofa-hydroxylase"(Lippincott4th/195)"Refsum'sdisease:Alphaoxidationdoesnotoccur.Alphaoxidation
ismainlyusedforfattyacidsthathaveamethylgroupatbeta-
carbon,whichblockbeta-oxidation.Thisprocessoccurmainlyin
endoplasmicreticulum&somealsoinperoxisomes.
--- Content provided by FirstRanker.com ---
Refsum'sdiseaseisarareneurologicdisorderduetoametabolicdefectthatresultsintheaccumulationofphytanicacid,whichis
foundindairyproductsandruminantfatandmeat.Phytanicacidis
thoughttohavepathologicaleffectsonmembranefunction,protein
prenylation,andgeneexpression"(Harper30th/231,28th/191)
--- Content provided by FirstRanker.com ---
Refsumdiseasecanmanifestininfancytoearlyadulthoodwiththeclassictetradof(1)peripheralneuropathy,(2)retinitispigmentosa,
(3)cerebellarataxia,and(4)elevatedCSFproteinconcentration.
Refsumdiseaseisgeneticallyheterogeneousbutautosomal
recessiveinnature.ClassicalRefsumdiseasewithchildhoodor
--- Content provided by FirstRanker.com ---
earlyadultonsetiscausedbymutationsinthegenethatencodesforphytanoyl-CoAa-hydroxylase(PAHX).
Refsumdiseaseistreatedbyremovingphytanic
precursors(phytols:fishoils,dairyproducts,andruminantfats)
fromthediet.
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18.Whichofthefollowingenzyme(s)
participateinproteinsynthesis:
a)DNAligase
b)DNAHelicase
c)Peptidase
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d)Peptidyltransferasee)DNApolymerase
CorrectAnswer-D
Ans:d.Peptidyltransferase
[RefHarper30th/422-24,28th/359-66,323;Lippincott4th/438-42;
--- Content provided by FirstRanker.com ---
Chatterjea&Shinde7th/248-501EnzymeRequiredforTranslation
Amino-acyl-t-RNAsynthetase:Enzymerequiredforactivationof
aminoacids,Peptidesynthetase(peptidyltransferase)
TheNH2ofnewaminoacylt-RNA(AI)in'A'sitecombinewiththe
--- Content provided by FirstRanker.com ---
-COOHgroupofMet-t-RNAoccupyingthe'P'site.Thereactioniscatalyzedbypeptidyltransferase"."Peptidasesdegradesproteinsto
aminoacids
TheNH2ofnewaminoacylt-RNA(AI)in'A'sitecombinewiththe
-COOHgroupofMet-t-RNAoccupyingthe'P'site.Thereactionis
--- Content provided by FirstRanker.com ---
catalyzedbypeptidyltransferase.``peptidasesdegradesproteinstoaminoacids.
Protein
function
DNA
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Deoxynucleotidepolymerases
polymerization
Processiveunwindingof
Helicases
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Helicases
DNA
Relievetorsionalstrain
Topoisomerases thatresultsfromhelicase-
inducedunwinding
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InitiatessynthesisofRNADNAprimase
primers
Single-strand
Preventpremature
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bindingproteinsreannealingofdsDNA
Sealsthesinglestrand
nickbetweenthenascent
DNAligase
--- Content provided by FirstRanker.com ---
Okazakichainandfragmentsontagging
strand
19.Trueaboutpeptidebondformation:
a)TheNH2groupofnewaminoacylt-RNAatAsitecombinewith
--- Content provided by FirstRanker.com ---
the-COOHgroupofMet-t-RNAoccupyingthe'P'siteb)TheNH2groupofnewaminoacylt-RNAat'P'sitecombine
withthe-COOHgroupofMet-t-RNAoccupyingthe'Asite
c)Reactioniscatalyzedbypeptidyltransferase
d)Peptidebondformationrequireenergy
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-A:C
Ans:a.TheNH2andc.Reaction...[RefHarper30th/422-25,
28th/359-66;Lippincott4th/438-42;Chatterjeate?Shinde7th/248-
501]
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Thea-aminogroupofthenewaminoacyl-tRNAintheAsitecarriesoutanucleophilicattackontheesterifiedcarboxylgroupofthe
peptidyl-tRNAoccupyingthePsite(peptidylorpolypeptidesite).At
initiation,thissiteisoccupiedbyaminoacyl-tRNAmet'.
Thisreactioniscatalyzedbyapeptidyltransferase,acomponent
--- Content provided by FirstRanker.com ---
ofthe28SRNAofthe60Sribosomalsubunit.Thisisanotherexampleofribozymeactivityandindicatesanimportant--and
previouslyunsuspected--directroleforRNAinproteinsynthesis.
Becausetheaminoacidontheaminoacyl-tRNAisalready
"activatornofurtherenergysourceisrequiredforthisreaction.The
--- Content provided by FirstRanker.com ---
reactionresultsinattachmentofthegrowingpeptidechaintothetRNAintheAsite.
20.AllaretrueregardingUreacycleexcept:
a)Ureaformedfromammonia
b)Ratelimitingenzymeisornithinetranscarbamoylase
--- Content provided by FirstRanker.com ---
c)RequireEnergyexpenditured)Malateisbyproductofureacycle
e)Onenitrogenofureacomesfromforaspartate
CorrectAnswer-B:D
Ans:b.Ratelimiting...,d.Malate...[RefHarrison19th/434e3-5,
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18th/3216,3219;17th/2472-74;Harper30th/290-96,28th/243;Shinde7th/450-51;Vasudevan5th/180-81]
Ureahastwoaminogroups,onederivedfromammonia&other
fromaspartate.Carbonatomissuppliedfromcarbondioxide.
Rate-limitingenzyme(pacemakerenzyme)ofUreacycle:
--- Content provided by FirstRanker.com ---
CarbamoylphosphatesynthetaseI(CPSIIisinvolvedinpyrimidinesynthesis)"(Harper28th/245).
Rate-limitingenzymeofGlycogenSynthesis:Glycogensynthase
(nottoohardthere)
Rate-limitingenzymeofGlycogenlysis:Glycogenphophorylase
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(phophorylasebreaksphosphatebond,whichmeansactivatedglycogenreleasesalotofenergy)
Rate-limitingenzymeofHMPShunt:Glucose-6Phosphate
dehydrogenase(badtolosethisinRBCs)
Rate-limitingenzymeofdenovopyrimidinesynthesis:Carbamoyl
--- Content provided by FirstRanker.com ---
phosphatesynthaseII(CPSIisinvolvedinureacycle)21.Whichofthefollowingistrueregarding
phenylketonuria:
a)Dietaryphenylalaninerestrictionisusedintreatment
b)OccurduetodeficiencyofPhenyalaninehydroxylaseenzyme
--- Content provided by FirstRanker.com ---
c)Occurduetoincreaseactivityofphenyalaninehydroxylaseenzyme
d)Tyrosinemustbesuppliedindiet
e)Dietshouldcontainhighphenylalaninecontainingfooditems
CorrectAnswer-A:B:D
--- Content provided by FirstRanker.com ---
Ans:a.Dietary...,b.Occur...,d.Tyrosine...[RefHarrison19th/434e1-3,18th/3217-18;Harper30h/304-306,28th/254;
Lippincott4th/270-72]
InpatientswithPKU,tyrosinecannotbesynthesizedfrom
phenylalanine&therefore,itbecomesanessentialaminoacidthat
--- Content provided by FirstRanker.com ---
mustbesuppliedinthedietDietaryphenylalaninerestrictionisusuallyinstitutedifblood
phenylalaninelevelsare>300umol/L(5mg/dL).
Treatmentconsistsofaspecialdietlowinphenylalanineand
supplementedwithtyrosine,sincetyrosinebecomesanessential
--- Content provided by FirstRanker.com ---
aminoacidinphenylalaninehydroxylasedeficiency.Aboutone-thirdofallpatientswithphenylketonuriaandthemajority
ofthosewithmilderforms(phenylalanine<1200umol/Lat
presentation)showincreasedtolerancetodietaryproteinsand
improvedmetaboliccontrolwhentreatedwithtetrahydrobiopterin(5-
--- Content provided by FirstRanker.com ---
20mg/kgperday),anessentialcofactorofphenylalaninehydroxylase.Thisdrugshouldbeusedinadditiontodietarytherapy.
Pregnancyriskscanbeminimizedbycontinuinglifelong
phenylalanine-restricteddietsandassuringstrictphenylalanine
restriction2monthspriortoconceptionandthroughoutgestation.
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22.InBenedicttest,redcolouris/are
producedby:
a)Sucrose
b)Inositol
c)Fructose
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d)Lactosee)Maltose
CorrectAnswer-C:D:E
Ans:c.Fructose,d.Lactose,e.Maltose[RefLippincott4th/84-
85;ChatterjeaFrShinde7th/31;Satyanarayan3rd/16]
--- Content provided by FirstRanker.com ---
Inositolisalsocalledasmusclesugar.Chemicallyitishexahydroxylcyclohexane"(ChatterjeadShinde7th/190)
Reducingsugarscanreactwithchromogenicagents(fore.g,
Benedict'sreagentorFehling'ssolutionorBarfoed'stest)causing
thereagenttobereduced&coloured,withanomericcarbonofthe
--- Content provided by FirstRanker.com ---
sugarbecomingoxidized"(Lippincott4th/84;Satyanarayan3rd/16).InBenedict'stest,reactionofreducingsugarwithBenedict'sreagent
produceredcolourofcuprousoxide.
23.Truestatementsare:
a)VitaminAindose20,000unitmaybeusedduringlactationto
--- Content provided by FirstRanker.com ---
preventVitAdeficiencytoinfantsb)HighdoseofVitaminCmaycauserenalstone
c)VitaminEreducesriskofatherosclerosis
d)Folicaciddeficiencycausemicrocyticanaemia
e)BananaisarichsourceofVit.B6
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:C:EAns:a.Vitamina....,b.High...,c.Vitamine...,e.Banana...[Ref
Harrison19th/96e1-7,18th/599;Harper30th/547-62,28th/47178;
Lippincott4th/374]
Vit.Ctoxicity:Oxalatekidneystonesareoftheoreticconcern
--- Content provided by FirstRanker.com ---
becauseascorbicacidismetabolizedtooxalate,butstoneformationhasnotbeenfrequentlyreported"(CMDT06/1275)"Prophylaxis
againstxerophthalmia:Lactatingmothersshouldbegiven20,000
IUorallyonceatdeliveryorduringthenext2months.Thiswillraise
theconcentrationofvitaminAinthebreastmilk&therefore,helpto
--- Content provided by FirstRanker.com ---
protectthebreastfedinfant"(Khurana5th/466)"Folicaciddeficiencycausemegaloblasticanaemia(macrocytic)"
(Lippincott4th/374)
"Vit.Ereducestheriskofatherosclerosis"(Vasudevan5th/291)
"Banana:Itisaverygoodsourceofvitamin-B6(pyridoxine),
--- Content provided by FirstRanker.com ---
providesabout28%ofdaily-recommendedallowance.24.Thiamineactasco-enzymefor:
a)Transketolase
b)Pyruvatedehydrogenase
c)Alcoholdehydrogenase
--- Content provided by FirstRanker.com ---
d)Transaminasee)None
CorrectAnswer-A:B
Ans:a.Transketolase,b.Pyruvate...[RefHarper30th/555,
28th/52;Chatterjea&Shinde7th/166-67]
--- Content provided by FirstRanker.com ---
"NAD+(byvitaminB3)actsasacoenzymeforalcoholdehydrogenase"(ChatterjeaShinde7th/171)
Pyridoxalphosphate(byvitaminpyridoxine,B6)actsascoenzyme
fortransaminaseslikeaminotransferase.
thiaminepyrophosphateactsascoenzymein:Pyruvate
--- Content provided by FirstRanker.com ---
dehydrogenasemn(oxidativedecarboxylation),a-oxoglutarartedehydrogenasecomplex(oxidativedecarboxylation),transketolase
(transketolationreaction),tryptophanpyrrolase,pyruvate
carboxylase(non-oxidativedecarboxylation).
25.Thiaminedeficiencycause(s):
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a)Glossitisb)Polyneuropathy
c)Pellagra
d)Angularstomatitis
e)Cardiomegaly
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:EAns:b.Polyneuropathy,e.Cardiomegaly[Re(Harrison
19th/96e-3,18th/594-96;Harper30th/555-56,28th/468]
Wetberiberipresentsprimarilywithcardiovascularsymptoms,due
toimpairedmyocardialenergymetabolismanddysautonomia,and
--- Content provided by FirstRanker.com ---
canoccurafter3monthsofathiamine-deficientdiet.Patientspresentwithanenlargedheart,tachycardia,high-outputcongestive
heartfailure,peripheraledema,andperipheralneuritis.
Patientswithdryberiberipresentwithasymmetricperipheral
neuropathyofthemotorandsensorysystemswithdiminished
--- Content provided by FirstRanker.com ---
reflexes.Theneuropathyaffectsthelegsmostmarkedly,andthesepatientshavedifficultyrisingfromasquattingposition.
26.Korsakoffpsychosis?
a)Thiaminedeficiency
b)Folatedeficiency
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c)Niacindeficiencyd)Niacindeficiency
e)None
CorrectAnswer-A
Ans.is'a'i.e.,Thiaminedeficiency
--- Content provided by FirstRanker.com ---
Alcoholicpatientswithchronicthiaminedeficiencyalsomayhavecentralnervoussystem(CNS)manifestationsknownasWernicke's
encephalopathy,consistingofhorizontalnystagmus,
ophthalmoplegia(duetoweaknessofoneormoreextraocular
muscles),cerebellarataxia,andmentalimpairment.
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Whenthereisanadditionallossofmemoryandaconfabulatorypsychosis,thesyndromeisknownasWernicke-Korsakoff
syndrome.Despitethetypicalclinicalpictureandhistory,Wernicke-
Korsakoffsyndromeisunderdiagnosed"(Harrison19th/96e-3,
18th/597)
--- Content provided by FirstRanker.com ---
ThereareSixMajorSymptomsofKorsakoff'sSyndrome:Anterogradeamnesia:Inabilitytoformnewmemories
Retrogradeamnesia:Severelossofmemoriesformedbeforethe
onsetofthecondition
Confabulation:Thatis,inventedmemorieswhicharethentakenas
--- Content provided by FirstRanker.com ---
trueduetogapsinmemorysometimesassociatedwithblackoutsMinimalcontentinconversation
Lackofinsight
Apathy:Thepatientsloseinterestinthingsquicklyandgenerally
appearindifferenttochange.
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27.Glycogenstoragedisorderis-
a)Niemann?Pickdisease
b)Gaucherdisease
c)Tay-Sacksdisease
d)Pompe'sdisease
--- Content provided by FirstRanker.com ---
e)McArdlesdiseaseCorrectAnswer-D
GlycogenstoragediseasetypeII,alsocalledPompedisease,is
anautosomalrecessivemetabolicdisorder[1]whichdamages
muscleandnervecellsthroughoutthebody.Itiscausedbyan
--- Content provided by FirstRanker.com ---
accumulationofglycogeninthelysosomeduetodeficiencyofthelysosomalacidalpha-glucosidaseenzyme.Itistheonlyglycogen
storagediseasewithadefectinlysosomalmetabolism,andthefirst
glycogenstoragediseasetobeidentified,
Thediseaseiscausedbyamutationinagene(acidalpha-
--- Content provided by FirstRanker.com ---
glucosidase:alsoknownasacidmaltase)onlongarmofchromosome17.
Mostcasesappeartobeduetothreemutations.Atransversion(T
G)mutationisthemostcommonamongadultswiththisdisorder.
ThismutationinterruptsasiteofRNAsplicing.
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Thegeneencodesaprotein--acidalpha-glucosidase(EC3.2.1.20)--whichisalysosomalhydrolase.Theproteinisanenzymethat
normallydegradesthealpha-1,4andalpha-1,6linkages
inglycogen,maltoseandisomaltoseandisrequiredforthe
degradationof1?3%ofcellularglycogen.Thedeficiencyofthis
--- Content provided by FirstRanker.com ---
enzymeresultsintheaccumulationofstructurallynormalglycogeninlysosomesandcytoplasminaffectedindividuals.
clinicalfeatures:
Accumulationofglycogeninlysosomes:Juvenileonsetvariant,
musclehypotonia,deathfromheartfailurebyage2;adultonset
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variant,muscledystrophy28.TrueaboutDNAhyperchromatism:
a)Itisincreaseofabsorbance
b)Measuredbyabsorbanceat260nm(inaspectrophotometer)
c)ItoccurswhentheDNAduplexisdenatured
--- Content provided by FirstRanker.com ---
d)DoublestrandedDNAismorehyperchromicthanssDNAe)None
CorrectAnswer-A:B:C
Ans:(A)Itisincreaseofabsorbance(B)Measuredby
absorbanceat260nm(inaspectrophotometer)(C)Itoccurs
--- Content provided by FirstRanker.com ---
whentheDNAduplexisdenatured[RefHarper30th/361,28th/303;Satyanarayan3rd/78;Lippincott4th/397-98]
Hyperchromicityistheincreaseofabsorbance(opticaldensity)ofa
material.Themostfamousexampleisthehyperchromicityof
DNAthatoccurswhentheDNAduplexisdenatured
--- Content provided by FirstRanker.com ---
Itistheincreaseofabsorbance(opticaldensity)ofamaterial.ThemostfamousexampleisthehyperchromicityofDNAthatoccurs
whentheDNAduplexisdenatured.
'Atawavelengthof260nm,ssDNAhasahigherrelative
absorbancethandoesdoublestrandedDNA"(Lippincott
--- Content provided by FirstRanker.com ---
4th/397-98)TheUVabsorptionisincreasedwhenthetwosingleDNAstrands
arebeingseparated,eitherbyheatorbyadditionofdenaturantor
byincreasingthepHlevel.
Lossofhelicalstructurecanbemeasuredbyincreasein
--- Content provided by FirstRanker.com ---
absorbanceat260nm(inaspectrophotometer),Theopposite,adecreaseofabsorbanceiscalledhypochromicity
Renatuartion(reannealing)istheprocessinwhichtheseparated
complementaryDNAstrandscanformadoublehelix
29.AllaretrueaboutDNAmethylation
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except:a)Itusuallyoccursinthecytosine
b)Canaltersthegeneexpressionpatternincells
c)Roleingenomicimprinting
d)Noroleincarcinogenesis
--- Content provided by FirstRanker.com ---
e)EssentialfornormaldevelopmentCorrectAnswer-D
Ans:(D)Noroleincarcinogenesis[RefHarper30th/438;
Harrison19th/101e-4,18th/668,679;Robbins9th/319-20,893,
8th/306;Satyanarayan3rd/359,572;Lippincott4th/460-62;
--- Content provided by FirstRanker.com ---
ChatterjeaShinde7th/346,426;en.wikipedia.org/wiki/DNA_methylation]
CytosineinthesequenceCGofDNAgetsmethylatedtoform5'-
methylcytosine.AmajorportionofCG(about20%)inhumanDNA
existsinmethylatedform.
--- Content provided by FirstRanker.com ---
InDNA,methylationusuallyoccursintheCpGislands,aCGrichregion,upstreamofthepromoterregion.Inhumans,DNA
methylationiscarriedoutbyagroupofenzymescalledDNA
methyltransferases.
DNAmethylationstablyaltersthegeneexpressionpatternincells
--- Content provided by FirstRanker.com ---
suchthatcellscan"rememberwheretheyhavebeen"ordecreasegeneexpression
DNAmethylationisessentialfornormaldevelopmentandis
associatedwithanumberofkeyprocessesincludinggenomic
imprinting,X-chromosomeinactivation,suppressionofrepetitive
--- Content provided by FirstRanker.com ---
elements,andcarcinogenesis.
Adenineorcytosinemethylationispartoftherestrictionmodification
systemofmanybacteria,inwhichspecificDNAsequencesare
methylatedperiodicallythroughoutthegenome.
Withinthebacterium,methylationprotectsthehostDNAfrom
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cleavagebyitsownrestrictionenzyme.UnmethylatedforeignDNAisnotprotectedfromcleavage.
30.Allaretrueregardingepigenetics
mechanismexcept:
a)Non-heritable
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b)AcetylationofHistonec)Hereditary
d)MethylationofDNA
e)Xchromosomeinactivation
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.(A)Non-heritableEpigeneticsisdefinedasthestudyofheritablechemical
modificationofDNAorchromatinthatdoesnotaltertheDNA
sequenceitself.Exampleofsuchmodificationincludemethylationof
DNA&themethylationeracetylationofhistones.
--- Content provided by FirstRanker.com ---
Epigeneticmodificationiscriticalfornormaldevelopmentincluding-regulationoftissuespecificgeneexpression,X-chromosome
inactivation&genomicimprinting.
Anepigeneticmodificationreferstoachangeinthe
genome,heritablebycellprogeny,thatdoesnotinvolveachangein
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theDNAsequence.TheinactivationofthesecondXchromosomeinfemalecellsisanexampleofanepigeneticsilencingthatprevents
geneexpressionfromtheinactivatedchromosome.
31.Whichofthefollowingistrueregarding
DNAdouble-strandbreaksrepairpathway
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a)Homologousrecombinationrequirealonghomologoussequencetoguiderepair
b)Non-homologousend-joiningdoesnotrequirealong
homologoussequencetoguiderepair
c)HomologousrecombinationrepairsDNAbeforethecell
--- Content provided by FirstRanker.com ---
d)Non-homologousend-joiningrepairsDNAbeforethecellentersmitosis
e)Non-homologousendjoiningisprominentDSBrepair
mechanisminmammals
CorrectAnswer-A:B:C:E
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Ans:a.Homologus...,b.Non-homologous...,c.Homologous...,e.Non-homologous...[RefHarper30th/389-91,
Satyanarayan3rd/532;Robbins9th/430-31,8th/302;http:
www.ncbi.nlm.nih.gov/pubmed/20192759]
Non-homologousendjoining(NHEJ)isthepredominanttypeofDSB
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repairinmammaliancells,asopposedtolowereukaryotes.DSBinDNAaredangerous;Theyresultingeneticrecombination
whichmayleadtochromosomaltranslocation,brokenchromosome
&finallycelldeath;DSBscanberepairedbyhomologous
recombinationornon-homologousendjoining;Homologous
--- Content provided by FirstRanker.com ---
recombinationoccursinyeastswhileinmammals,non-homologousendjoiningdominates
Double-StrandBreaksRepairMechanism
1. Double-strandbreakscanberepairedthroughhomologous
recombinationorthroughnon-homologousendjoining(NHEJ).
--- Content provided by FirstRanker.com ---
2. NHEJisaDNArepairmechanismwhich,unlikehomologousrecombination,doesnotrequirealonghomologoussequenceto
guiderepair.
3. WhetherhomologousrecombinationorNHEJisusedtorepair
double-strandbreaksislargelydeterminedbythephaseofcell
--- Content provided by FirstRanker.com ---
cycle.HomologousrecombinationrepairsDNAbeforethecellentersmitosis(Mphase).
4. DNAdouble-strandbreaks(DSB)arepresumedtobethemost
deleteriousDNAlesionsastheydisruptbothDNAstrands.
5. Homologousrecombination(HR),single-strandannealing,andnon-
--- Content provided by FirstRanker.com ---
homologousendjoiningareconsideredtobethepathwaysforrepairingDSB.
32.Groupofallelesthatarecloselylinked
togetheratagenomiclocus&inherited
togetherasaclusteris/are:
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a)Idiotypeb)Haplotype
c)Genotype
d)Phenotype
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns.(B)Haplotype([RefsHarrison19th/435,18th/497,505;
Robbins9th/195,8th/177])
Theentirehumangenomenowcanbedividedintoblocksknownas
haplotypes,whichcontainvaryingnumbersofcontiguoussingle
--- Content provided by FirstRanker.com ---
nucleotidepolymorphismsonthesamechromosomethatareinlinkagedisequilibrium&henceinheritedtogetherasacluster
Ahaplotypereferstoagroupofallelesthatarecloselylinked
togetheratagenomiclocus.
Haplotypesareusefulfortrackingthetransmissionofgenomic
--- Content provided by FirstRanker.com ---
segmentswithinfamiliesandfordetectingevidenceofgeneticrecombination,ifthecrossovereventoccursbetweenthealleles.
33.ThesizeofMicrosatelliterepeatsequence
is:
a)<1kb
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b)2-6bpc)1-3kb
d)>3kb
e)5-20bp
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:b.2-6bpsequencesof2-5bprepeatedupto50times.Mayoccurat50000-
100000locationsinthegenome"-Harper30th/377-78,28th/404
Short(2-6bp),inherited,tandemrepeatunitsofDNAoccurabout
50,000-100,000timesinthehumangenome.
--- Content provided by FirstRanker.com ---
Becausetheyoccurmorefrequently--andintheviewoftheroutineapplicationofsensitivePCRmethods--theyarereplacingRFLPsas
themarkerlociforvariousgenomesearches.
34.FeatureofVonHippelLindausyndrome:
a)Mutationinchromosome13
--- Content provided by FirstRanker.com ---
b)Mutationinchromosome3c)Pancreaticcyst
d)Cerebellarhemangioblastoma
e)All
CorrectAnswer-B:C:D
--- Content provided by FirstRanker.com ---
Answer-(B)Mutationinchromosome3(C)Pancreaticcyst(D)Cerebellarhemangioblastoma
Thisisanautosomal-dominantdiseaseinwhichaffectedindividuals
developtumorsincerebellarhemispheres,theretina,and,less
commonly,thebrainstemandspinalcord.
--- Content provided by FirstRanker.com ---
ThegeneforvonHippel-Lindaudisease,atumor-suppressorgene,islocatedonchromosome3p25-26.
Thecerebellarcapillaryhemangioblastoma,istheneurologic
manifestationofthedisease.
Retinalangiomas,Pheochromocytomaarealsoassociatedtumours.
--- Content provided by FirstRanker.com ---
35.Allarethefeature(s)ofHermansky-
pudlaksyndromeexcept:
a)Autosomaldominantinheritance
b)Oculocutaneousalbinism
c)Bleedingdisorder
--- Content provided by FirstRanker.com ---
d)Pulmonaryfibrosise)Pain
CorrectAnswer-A
Answer-A.Autosomaldominantinheritance
Itisarareautosomalrecessivedisorderwhichresultsin
--- Content provided by FirstRanker.com ---
oculocutaneousalbinism,bleedingproblemsduetoaplateletabnormality(plateletdysfunction),storageofanabnormalfat-protein
compound.
Chromosome10q23isaffected.
Thereareeightclassicformsofthedisorderinwhichlasttypeof
--- Content provided by FirstRanker.com ---
disorderisduetogenePallidin(PLDN)Themajorcomplicationofthedisorderispulmonaryfibrosis.
36.Differencebetweenactive&restingcell
dependonwhichphaseofcellcycle:
a)GO
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b)G1c)G2
d)M
e)S
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A.GOThecellcycleconsistsoffourdistinctphases-
G1phase
Sphase
G2phase
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MphaseQuiescent/senescent-
GapO
Arestingphasewherethecellhasleftthecycleandhasstopped
dividing.
--- Content provided by FirstRanker.com ---
37.Notfeature(s)ofapoptosis:
a)MediatedbyCaspases
b)InhibitionofEndonucleaseactivity
c)Membraneblebareseen
d)Chromatincondensation
--- Content provided by FirstRanker.com ---
e)AssociationwithinflammationCorrectAnswer-B:E
Answer-(B)InhibitionofEndonucleaseactivity(E)Association
withinflammation
Caspaseactivatesendonuclease(neuronalapoptosislacks
--- Content provided by FirstRanker.com ---
caspases,thusactivationofAIF)MORPHOLOGICALFEATURES:
Convolutionofcellmembrane
Leadingtoformationofcytoplasmicblebs(althoughcellmembrane
remainsintact).
--- Content provided by FirstRanker.com ---
Chromatincondensation(pyknosis)/nuclearcompactionDoesnotelicitanyinflammatoryresponseduetointactcell
membrane.
38.TrueaboutmitochondrialDNA:
a)Linear
--- Content provided by FirstRanker.com ---
b)Circularc)Transmittedbymotheronly
d)Transmittedbybothparents
e)ContainslessgenethannuclearDNA
CorrectAnswer-B:C:E
--- Content provided by FirstRanker.com ---
Answer-(B)Circular(C)Transmittedbymotheronly(E)ContainslessgenethannuclearDNA
Insexualreproduction,mitochondriaarenormallyinherited
exclusivelyfromthemother;themitochondriainmammaliansperm
areusuallydestroyedbytheeggcellafterfertilization.
--- Content provided by FirstRanker.com ---
UGAcodesfortryptophan,Codesfor13proteins,CirculardoublestrandedDNA,MitochondrialdiseaseoccurduetoPointMutations
andLarge-ScaleRearrangements.
Theremaining22tRNAand2rRNA-encodinggenesarededicated
totheprocessoftranslationofthe13mtDNAencodedproteins.
--- Content provided by FirstRanker.com ---
39.TrueaboutIntravascularhemolysis:
a)Increasedserumhaptoglobin
b)IncreaseStercobillininurine
c)Increaseplasmamyoglobin
d)Increasedfecalexcretionofurobilin
--- Content provided by FirstRanker.com ---
e)HemosiderinuriaCorrectAnswer-D:E
Answer-(D)Increasedfecalexcretionofurobilin
(E)Hemosiderinuria
Intravascularhemolysisismanifestedby
--- Content provided by FirstRanker.com ---
1. hemoglobinemia2. hemoglobinuria
3. jaundice
4. hemosiderinuria
Decreasedserumhaptoglobinischaracteristicofintravascular
--- Content provided by FirstRanker.com ---
hemolysis.CommonFeaturesofHemolyticDisorders-
Hbreduced
MCV,MCH-increased
Reticulocytes-increased
--- Content provided by FirstRanker.com ---
Bilirubin-increased40.Causesofunconjugated
hyperbilirubinemiainclude?
a)Sepsis
b)Criggler-Najarsyndrome
--- Content provided by FirstRanker.com ---
c)Rotorsyndromed)Gilbertsyndrome
e)Intravascularhemolysis
CorrectAnswer-A:B:D:E
Answer-A,B,D,E,Sepsis,Criggler-Najarsyndrome,Gilbert
--- Content provided by FirstRanker.com ---
syndrome,IntravascularhemolysisUnconjugatedhyperbilirubinemia:-
Increasedproductionofbilirubinfromhemoglobin,Sothatthe
capacityoflivertoconjugatebilirubinisoverwhelmedbyincreased
production,e.g.
--- Content provided by FirstRanker.com ---
1. Hemolyticanemia(bothintravascularandextamascular)sHereditarysphnocytosis,G6PDdefciency.
2. Inefrectiveerythropoiesis-Thalassemia,Perniciousanemia.
3. Reducedhepaticuptakeofbilirubinfrombilirubin-albumincomplex
>Drugs,
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4. Infections:-Sepsis,UTI5. Impairedhepaticconjugation.
41.Rheumaticheartdiseaseis/are:
a)Endocarditis
b)Constructivepericarditis
--- Content provided by FirstRanker.com ---
c)Mostcommonlyinvolvetrisucpidvalved)Breadbutterpericarditis
e)Pancarditis
CorrectAnswer-A:D:E
Answer-(A)Endocarditis(D)Breadbutterpericarditis
--- Content provided by FirstRanker.com ---
(E)PancarditisAcuterheumattccarditisdurlngtheactivephaseofRFmayprogress
tochronicrheumaticheartdisease(RHD).
DuringacuteRF,diffuseinflammationandAschoffbodiesfound
threelayersoftheheart-
--- Content provided by FirstRanker.com ---
pericardium,myocardiumorendocardiumlesioniscalledapancarditis.
ChronicRHDischaracterizedbyorganizationoftheacute
inflammationandsubsequentfibrosis.
Thecardinalanatomicchangesofthemitral(ortricuspid)valveare
--- Content provided by FirstRanker.com ---
leafletthickening,commissuralfusionandshortening'andthickeningandfusionofthetendinouscords.
Inchronicdisease,themitralvalvelsvirtuallyalwaysabnormal.
RHDisthemostfrequentcauseofmitralstenosis.
Fibrousbridgingacrossthevalvularcommissuresandcalcification
--- Content provided by FirstRanker.com ---
create"fishmouth"orbuttonholestenoses.Carditis,
Subcutaneousnodules,
Erythemamarginatumoftheskin,and
Sydenhamchorea,aneurologicdisorderwithinvoluntary
--- Content provided by FirstRanker.com ---
purposeless,rapidmovements42.TrueaboutCysticfibrosis-
a)OccursdueCFTRgenemutationonchromosome7
b)Meconiumileusispresentin>90%cases
c)CFTRgenecanbedetectedantenately
--- Content provided by FirstRanker.com ---
d)Poorbodygrowthe)Alloftheabove
CorrectAnswer-A:C:D
Answer-A,C,D,OccursdueCFTRgenemutationon
chromosome7(C)CFTRgenecanbedetectedantenately
--- Content provided by FirstRanker.com ---
(D)PoorbodygrowthTheprimarydefectincysticfibrosisresultsfromabnormalfunction
ofanepitheltalchloridechannelproteinencodedbythecystic
fibrosistransmembraneconductanceregulator(CFTR)geneon
chromosome7.
--- Content provided by FirstRanker.com ---
Contentsoftheintestinallumenaredifficulttoexcretewhichresultsinmeconiumileus.
SequencingtheCFTRgeneisthegoldstandardfordiagnosisof
cysticfibrosisPoorbodygrowth
43.Percutaneousliverbiopsyis/are
--- Content provided by FirstRanker.com ---
contraindicatedin:a)Ascites
b)Hemangiomaofliver
c)Plateletcount<60000/0
d)Hepaticmetastasis
--- Content provided by FirstRanker.com ---
e)EchinococcuscystinliverCorrectAnswer-A:B:C:E
Answer-(A)Ascites(B)Hemangiomaofliver(C)Plateletcount
<60000/0(E)Echinococcuscystinliver
Thrombocytopenia
--- Content provided by FirstRanker.com ---
AscitesDifficultbodyhabitus
Suspectedhemangiona
Suspectedechinococcalinfection
Uncooperativepatient
--- Content provided by FirstRanker.com ---
44.TrueaboutAlcoholiccirrhosis:
a)Predominantlymacronodularpattern
b)Bileductproliferaton
c)Mallorybodyhardlyseen
d)Disturbednormalarchitecture
--- Content provided by FirstRanker.com ---
e)AllCorrectAnswer-B:C:D
Answer-(B)Bileductproliferaton(C)Mallorybodyhardlyseen
(D)Disturbednormalarchitecture
Fibrosiscanbecentilobular,pericellular,orperiportal.
--- Content provided by FirstRanker.com ---
Thereisdisruptionofthenormallayerarchitectureandreplacementoflivercellsbyregenerativenodules.
Inalcoholiccirrhosis,referredtoasmicronodular.
Withcessationofalcoholuse,largernodulesmayform,resultingin
amixedmicronodularandmacronodularcirrhosis.
--- Content provided by FirstRanker.com ---
Scatteredlargernodulescreatea"hobnail"appearanceonthesurfaceoftheliver.
TheetiologicalcluetodiagnosisintheformofMallorybodiesishard
tofindinafully-developedalcoholiccirrhosis.
45.AllaretrueaboutLesch-Nyhansyndrome
--- Content provided by FirstRanker.com ---
except:a)Hyperurecaemia
b)Mentalretardation
c)Stoneproduction
d)Occurequallyinbothsexes
--- Content provided by FirstRanker.com ---
e)X-linkedCorrectAnswer-D
Answer-D.Occurequallyinbothsexes
AcompletedeficiencyofHPRT,theLesch-Nyhansyndrome,is
characterizedbyhyperuricemia,self-mutilativebehavior,
--- Content provided by FirstRanker.com ---
choreoathetosis,spasticity,andmentalretardation.ThisisarareX-linkeddisorderofpurinemetabolismthatresults
fromHPRTdeficiency.
Thehyperuricemiaresultsfromurateoverproductionandcancause
uricacidcrystalluria,nephrolithiasis,obstructiveuropathy,andgouty
--- Content provided by FirstRanker.com ---
arthritis.AffectsMalesonly.
Etiology-hereditary
Treatment-
Allopurinol
--- Content provided by FirstRanker.com ---
46.Marker(s)ofLangerhanscell
histiocytosis:
a)CD1a
b)S100
c)CD3
--- Content provided by FirstRanker.com ---
d)CD5e)CD30
CorrectAnswer-A:B
Answer-(A)CD1a(B)S100
TheproliferatingLangerhanscellsinLangerhanscellhistiocytosis
--- Content provided by FirstRanker.com ---
areHLA-DRpositiveandexpresstheCD1antigen.ThehallmarkofLCHispositivityforS-100protein&CD1a
positivity.
47.Breastcanceris/areassociatedwith:
a)Familialadenomatouspolyposis
--- Content provided by FirstRanker.com ---
b)Ataxia-telangiectasiac)Peutz-Jegherssyndrome
d)Cowdendisease
e)VonHippelLindausyndrome
CorrectAnswer-B:C:D
--- Content provided by FirstRanker.com ---
Answer-(B)Ataxia-telangiectasia(C)Peutz-Jegherssyndrome(D)Cowdendisease
VonHippelLindausymdromeisnotassociatedwithbreast
carcinoma.
Familialadenomatouspolyposisisassociatedwithcolorectal
--- Content provided by FirstRanker.com ---
carcinoma&someothercancerbutnotbreastcancer.STK11/LKB1(Peutz-Jegherssyndrome)
PTEN(Cowdendisease)
48.Hyperglycemiais/areassociatedwith:
a)Cushingdisease
--- Content provided by FirstRanker.com ---
b)Addisondiseasec)Pheochromocytoma
d)Hyperthyroidism
e)Acromegaly
CorrectAnswer-A:C:D:E
--- Content provided by FirstRanker.com ---
Answer-(A)Cushingdisease(C)Pheochromocytoma(D)Hyperthyroidism(E)Acromegaly
Endocrinopathiesassociatedwithhyperglycemia-
Acromegaly
Cushingsyndrome
--- Content provided by FirstRanker.com ---
HyperthyroidismPheochromocytoma
Glucagonoma
49.Malignancyassociatedwith
hypercalcemia:
--- Content provided by FirstRanker.com ---
a)Breastcancerb)Smallcelllungcancer
c)Non-smalllungcancer
d)Prostatecancer
e)Multiplemyeloma
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:D:EAnswer-A,BreastcancerC,Non-smalllungcancerD,Prostate
cancerE,Multiplemyeloma
Lungcarcinoma,breastcarcinoma,andmultlplemyelomaaccount
formorethan50%ofallcasesofmalignancy-associated
--- Content provided by FirstRanker.com ---
hypercalcemia.Gastrointestinaltumarsandprostatecarcinomaarelesscommon
causesofhypercalcemia.
50.Calciumlevelisincreasedin:
a)Parathyroidadenoma
--- Content provided by FirstRanker.com ---
b)Thiazidediureticsc)Chronicrenalfailure
d)HypervitaminosisD
e)Cirrhosis
CorrectAnswer-A:B:C:D
--- Content provided by FirstRanker.com ---
Answer-(A)Parathyroidadenoma(B)Thiazidediuretics(C)Chronicrenalfailure(D)HypervitaminosisD
Hyperparathyroidism
Adenoma
Thiazidediuretics
--- Content provided by FirstRanker.com ---
51.Cause(s)ofmegaloblasticanaemia
include:
a)Anticonvulsantdrugs
b)Pregnancy
c)Resectionofileum
--- Content provided by FirstRanker.com ---
d)Gastrectomye)Crohn'sdisease
CorrectAnswer-A:B:C:D:E
Answer-All(A)Anticonvulsantdrugs(B)Pregnancy
(C)Resectionofileum(D)Gastrectomy(E)Crohn'sdisease
--- Content provided by FirstRanker.com ---
I.VITAMINB1DEFICIENCYInadequatedietaryintakee.g.strictvegetarians,breast-fed
infants,
Malabsorption
1. Gastriccauses:perniciousanaemia,gastrectomy,congenital
--- Content provided by FirstRanker.com ---
lackofintrinsicfactor.2. Intestinalcauses:tropicalsprue,ilea!resection,Crohn's
disease,intestinalblindloopsyndrome,fish-tapeworm
infestation.
II,FOLATEDEFICIENCY
--- Content provided by FirstRanker.com ---
Inadequatedietaryintakee.g.inalcoholics,teenagers,infants,oldage,poverty.
Malabsorptione.g.intropicalsprue,coeliacdisease,partial
gastrectomy,jejuna!resection,CrohIfsdisease.
Excessdemand
--- Content provided by FirstRanker.com ---
1. Physiological:pregnancy,lactation,infancy.2. Pathological:malignancy,increasedhaematopoiesis,chronic
exfoliativeskindisorders,tuberculosis,rheumatoidarthritis.
Excessurinaryfolatelosse.g.inactiveliverdisease,congestive
heartfailure.
--- Content provided by FirstRanker.com ---
III.OTHERCAUSESImpairedmetabolisme.g.inhibitorsofdihydrofolate(DHF)
reductasesuchasmethotrexateandpyrimethamine;alcohol,
congenitalenzymedeficiencies.
Unknownetiologye.g.inDiGuglielmo'ssyndrome,congenital
--- Content provided by FirstRanker.com ---
dyserythropoieticanaemia,refractorymegaloblasticanaemia.52.Feature(s)offibroadenomaofbreast
include:
a)Clearlydefinededgeonpalpation
b)Hormoneresponsivetumor
--- Content provided by FirstRanker.com ---
c)Containbothepithelial&stromalelementsd)Well-encapsulated
e)Commonaftermenopause
CorrectAnswer-A:B:C:D
Answer-(A)Clearlydefinededgeonpalpation(B)Hormone
--- Content provided by FirstRanker.com ---
responsivetumor(C)Containbothepithelial&stromalelements(D)Well-encapsulated
Fibroadenomasareeasytomove,withclearlydefinededgeso
calledasbreastmouse.
Mostcommonbenignbreasttumoroffemalebreast.
--- Content provided by FirstRanker.com ---
Theyarefrequentlymultiple&bilateral.Fibroadenomasarebenignsolidtumorscomposedofstromaland
epithelialelements.
Onexcision,fibroadenomasarewell-encapsulatedmasses.
Fibroadenomasdonothavemalignantpotential.
--- Content provided by FirstRanker.com ---
53.TrueaboutNeutrophil:
a)Engulfbacteria
b)Multilobed
c)Neutrophilgranulesareslightlybasicandstainweaklywiththe
azurophiliccomponentofRomanowskystains
--- Content provided by FirstRanker.com ---
d)Neutrophiliaoccurinacutebacterialinfectione)Primarygranulesisalsocalledspecificganules
CorrectAnswer-A:B:C:D
Answer-(A)Engulfbacteria(B)Multilobed(C)Neutrophil
granulesareslightlybasicandstainweaklywiththeazurophilic
--- Content provided by FirstRanker.com ---
componentofRomanowskystains(D)Neutrophiliaoccurinacutebacterialinfection
'Neutrophilcontainprimaryorazurophilgranules&secondaryor
specificgranules
Neutrophiliaoccurinacutebacterialinfection.
--- Content provided by FirstRanker.com ---
Thenucleusofneutrophilsnormallycontainsuptofoursegments.Characteristicfeaturesare-Condensed,multilobednucleus
Function-
Hydrolyticsubstratedegradation
Killingestedbacteria
--- Content provided by FirstRanker.com ---
Regulateinflammation54.AllaretrueaboutHistamineexcept:
a)Secretedbymacrophage
b)Vasoconstrictionofarterioles
c)Smoothmusclecontraction
--- Content provided by FirstRanker.com ---
d)Mediateinflammatione)None
CorrectAnswer-A:B
Answer-(A)Secretedbymacrophage(B)Vasoconstrictionof
arterioles
--- Content provided by FirstRanker.com ---
'Histamineinducessmoothmusclecontractionindiversetissues.Histamineiswidelydistributedintissues,therichestsourcebeing
themastcells.
Histaminecausesdilationofthearteriolesandincreasesthe
permeabilityofvenules
--- Content provided by FirstRanker.com ---
Itactsonthemicrocirculation.55.Whichofthefollowingstatement(s)is/are
true:
a)InRobertsoniantranslocationthebreaksoccurclosetothe
centromeresofeachchromosome
--- Content provided by FirstRanker.com ---
b)Aneuploidyisabnormalchromosomenumbercausedbyeithergainorlossofchromosome
c)Comparativegenomichybridisation(CGH) Haploidisnormal
isatechniquethatpermitsthedetectionof number&
chromosomalcopynumber
--- Content provided by FirstRanker.com ---
compositionofchromosome
d)Haploidisnormalnumber&compositionofchromosome
e)All
CorrectAnswer-A:B:C
--- Content provided by FirstRanker.com ---
Answer-(A)InRobertsoniantranslocationthebreaksoccurclosetothecentromeresofeachchromosome(B)Aneuploidy
isabnormalchromosomenumbercausedbyeithergainorloss
ofchromosome(C)Comparativegenomichybridisation(CGH)
isatechniquethatpermitsthedetectionofchromosomalcopy
--- Content provided by FirstRanker.com ---
numberAneuploidy:Anabnormalchromosomenumbercausedbyeither
gainorlossofchromosomes.
Haploid:Onlyone-halfthenormalcomplement,thatis,23
chromosomes
--- Content provided by FirstRanker.com ---
Comparativegenomichybridisation(CGH)isatechniquethatpermitsthedetectionofchromosomalcopynumberchangeswithout
theneedforcellculturing.
Robertsoniantranslocation(orcentricfusion):Itisatranslocation
Robertsoniantranslocation(orcentricfusion):Itisatranslocation
--- Content provided by FirstRanker.com ---
betweentwoacrocentricchromosomes.Typicallythebreakoccurclosetothecentromeresofeachchromosome.
56.Allofthethefollowingstatement(s)is/are
trueexcept:
a)DenevergroupF-containXchromosome
--- Content provided by FirstRanker.com ---
b)DenevergroupC-containXchromosomec)DenevergroupG-containacrocentricchromosome
d)BarbodyisinactiveXchromosome
e)Innormalfemalesgenerallyoneofthechromosomes
undergoesXinactivationinsomaticcells
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer-(A)DenevergroupF-containXchromosome
TheclassificationofchromosomesbasedonDenvergroup
classification
Chromosome
--- Content provided by FirstRanker.com ---
RelativePositionofSize
Class
Centromere
Large
--- Content provided by FirstRanker.com ---
GroupA(1-3)Metacentric
Large
GroupB(4-5)
Submetacentric
--- Content provided by FirstRanker.com ---
MediumGroupC(6-12,X)
Submetacentric
Medium
GroupD(13-15)
--- Content provided by FirstRanker.com ---
AcroentricRelatively
GroupE(16-18)
Submetacentric
shot
--- Content provided by FirstRanker.com ---
GroupF(19-20)MetacentricorSubmetacentric
short
GroupG(21-22,Y)
Acroentric
--- Content provided by FirstRanker.com ---
Short57.Fomepizolecanbeusedin:
a)Methanolpoisoning
b)Organophosphoruspoisoning
c)Ethyleneglycolpoisoning
--- Content provided by FirstRanker.com ---
d)Barbituratepoisoninge)None
CorrectAnswer-A:C
Ans.(A)Methanolpoisoning(C)Ethyleneglycolpoisoning
[Ref:KDT7th/395-96;Katzung12th/398,400,1033]
--- Content provided by FirstRanker.com ---
Fomepizole:Competitiveinhibitoroftheenzymealcoholdehydrogenase,foundin
theliver.
Thisenzymeplaysakeyroleinthemetabolismofethyleneglycol
andmethanol.
--- Content provided by FirstRanker.com ---
Fomepizoleismosteffectivewhengivensoonafteringestionofethyleneglycolormethanol.
Delayingtheadministrationoffomepizoleallowsforthegeneration
ofharmfulmetabolites
58.Whichofthefollowingdruginteractwith
--- Content provided by FirstRanker.com ---
Warfarin:a)ACEinhibitor
b)Azithromycin
c)Fluconazole
d)Aspirin
--- Content provided by FirstRanker.com ---
e)BenzodiazepineCorrectAnswer-C:D
Ans.(C)Fluconazole(D)Aspirin
[RefKDT7th/62i,503;Katzung12th/610]
DrugCausingEnhancedAnticoagulantActionofWarfarin:
--- Content provided by FirstRanker.com ---
Aspirin:inhibitplateletaggregationebcauseG.IbleedingNevercephalosporins(ceftriaxone,cefoperazone):Cause
hypoprothrombinemia
BroadSpectrumantibiotics:Inhibitgutflora6reducevit.Kproduction
Longactingsulfonamide,indomethacin,phenytoin&probenecid:
--- Content provided by FirstRanker.com ---
Displacewarfarinfromplasmaproteinbinding.Chloramphenicol,erythromycin,celecoxib,cimetidine,allopurinol,
amiodarone&metronidazole:Inhibitwarfarinmetabolism
Tolbutamide&phenytoin:Inhibitwarfarinmetabolism&viceversa.
Liquidparaffin(habitualuse):Reducevit.Kabsorption
--- Content provided by FirstRanker.com ---
DrugCausingReducedAnticoagulantActionofWarfarin:Barbiturates(butnotbenzodiazepines),carbamazepine,rifampin,&
griseofulvin:InducethemetabolismoforalAnticoagulant.
OralcontraceptiveIncreasebloodlevelsofclottingfactors
59.Allofthefollowingistrueabout
--- Content provided by FirstRanker.com ---
hydroxyureaexcept:a)Causemyelosuppression
b)Oralbioavailabilityisveryless
c)UsedinCML
d)Actasradiosensitizer
--- Content provided by FirstRanker.com ---
e)UsedinsicklecellanaemiaCorrectAnswer-B
Ans.B.Oralbioavailabilityisveryless
[Ref:KDT7th/868;Kntzung12th/582]
Hydroxyurea:
--- Content provided by FirstRanker.com ---
HydroxyureaisananalogofureawhosemechanismofactioninvolvestheinhibitionofDNAsynthesisbyinhibitingtheenzyme
ribonucleotidereductase,resultingindepletionofdeoxynucleoside
triphosphatepools.
ThisagentexertsitseffectsintheSphaseofthecellcycle.
--- Content provided by FirstRanker.com ---
Nearly100%oralbioavailability.Mainlyusedinchronicmyelogenousleukemia,blastcrisisofacute
myeloidleukemia,psoriasis&sicklecellanaemia.
Myelosuppressionistheilose-limitingtoxicity.
60.Allaretrueabouthydrochlorothiazide
--- Content provided by FirstRanker.com ---
except:a)Causehyperglycemia
b)InhibitNa-Clsymport
c)Increasescalciumexcretioninurine
d)Causehyperuricaemia
--- Content provided by FirstRanker.com ---
e)UsedintreatmentofrenalstoneCorrectAnswer-C
Ans.C.Increasescalciumexcretioninurine
[RefKDT7th/5%-86;Katzung12th/260-61,270]
Hydrochlorothiazide:
--- Content provided by FirstRanker.com ---
InhibitsNa+-Cl-symportpredominantlyintheDCT.EnhanceCa2+reabsorption&decreaseurinecalciumexcretion
(causeshypercalcemia).
Thiazidecausecarbohydrateintolerance&causepreciPitationof
diabetes
--- Content provided by FirstRanker.com ---
Toxicity:Hypokalemicmetabolicalkalosisandhyperuricemia
ImpairedCarbohydrateTolerance.
61.ATTdrugwithsignificantrenalexcretion
is/are:
--- Content provided by FirstRanker.com ---
a)INHb)Rifampicin
c)Pyrazinamide
d)Amikacin
e)Streptomycin
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:D:EAns.(A)INH(C)Pyrazinamide(D)Amikacin(E)Streptomycin
[RefKDT7th/767;Katzung12th/841]
Rifampin:
Itismetabolizedinthelivertoanactivedeacetylatedmetabolite
--- Content provided by FirstRanker.com ---
whichisexcretedmainlyinbile,someinurine.Urine&secretionsmaybecomeorange-red
INH:
Itisextensivelymetabolizedinliver;mostimportantpathwaybeing
N-acetylationbyNAT2.
--- Content provided by FirstRanker.com ---
TheacetylatedmetaboliteisexcretedinurinePyrazinamide:
Extensivelymetabolizedinliver&excretedinurine.
Pyrazinamidemetabolitesarerenallycleared.
Aminoglycosides(streptomycin&amikacin)arenotmetabolized.
--- Content provided by FirstRanker.com ---
62.Whichofthefollowingstatementabout
protonpumpinhibitorsis/aretrueexcept:
a)Hit&rundrug
b)Acidicmediumisessentialforactivity
c)ActonH+/K+ATPase
--- Content provided by FirstRanker.com ---
d)Formsanintegralcomponentofanti-H.pyloriregimense)Actbestinalkalinemedium
CorrectAnswer-E
Ans.E.Actbestinalkalinemedium
[RefKDT7thBa,651-52;Katzung12th/1085-89]
--- Content provided by FirstRanker.com ---
Hit&rundrugs:Effectslastmuchlongerthanthedrugitself),e.g.,reserpine,
guanethidine,MAOinhibitors,omeprazole.
OneofthePPIsisanintegralcomponentofallanti-H.pylori
regimensalongwith2(tripledrug)or3(quadrupledrug)
--- Content provided by FirstRanker.com ---
antimicrobial.SinceanacidicpHintheparietalcellacidcanaliculiisrequiredfor
drugactivation&sincefoodstimulateacidproduction,thesedrugs
ideallyshouldbegivenabout30minutesbeforemeals.
Protonpumpinhibitorsareadministeredasinactiveprodrugs.
--- Content provided by FirstRanker.com ---
63.TrueaboutamphotericinB:
a)Liposomalpreparationisavailable
b)Orallyabsorbed
c)Usedonlyinintravenousform
d)Proteinsynthesisinhibitor
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-A
Ans.A.Liposomalpreparationisavailable
[Ref:KDT7th/787-89;Katzung12th/934,849-52,1066]
AMBisnotabsorbedorally,itcanbegivenorallyforintestinal
--- Content provided by FirstRanker.com ---
candidiasiswithoutsystemictoxicity.Administeredi,v,assuspensionmadefromdeoxycholate(DOC),it
getswidelydistributedinthebody.
Itcanbealsoadministeredtopicallyforvaginitis,otomycosis
LiposomalAMB:
--- Content provided by FirstRanker.com ---
Ithasbeenproducedtoimprovetolerabilityofi.v.infusion,reduceitstoxicity&achievetargeteddelivery.
ItdeliversAMBparticularlytoreticuloendothelialcellsinliver&
spleen-especiallyvaluableforkalaazar&inImmunocompromised.
64.Antibioticwhichactsthroughcellwall
--- Content provided by FirstRanker.com ---
inhibition:a)Penicillin
b)Daptomycin
c)Aminoglycoside
d)Cephalosporin
--- Content provided by FirstRanker.com ---
e)ImipenamCorrectAnswer-A:D
Ans.(A)Penicillin(D)Cephalosporin
[RefKDT7th/689-90;Katzungp803]
MechanismofActionofDrugs:
--- Content provided by FirstRanker.com ---
Inhibitcellwallsynthesis:Penicillins,Cephalosporins,Cycloserine,Vancomycin,Bacitracin.
Causeleakagefromcellmembranes:Polypeptides-Polymyxins,
Colistin,Bacitracin.Polyenes-AmphotericinB,Nystatin,Hamycin.
Inhibitproteinsynthesis:Tetracyclines,Chloramphenicol,
--- Content provided by FirstRanker.com ---
Erythromycin,Clinda-mycin,Linezolid.Causemisreadingofm-RNAcodeandaffectpermeability:
Aminoglycosides-Streptomycin,Gentamicin,etc.
InhibitDNAgyrase:Fluoroquinolones-Ciprofloxacinandothers.
InterferewithDNAfunction:Rifampin.
--- Content provided by FirstRanker.com ---
InterferewithDNAsynthesis:Acyclovir,Zidovudine.Interferewithintermediarymetabolism:Sulfonamides,Sulfones,
PAS,Trimethoprim,Pyrimethamine,Metronida-zole.
65.Whichoffollowingstatementistrueabout
canagliflozin:
--- Content provided by FirstRanker.com ---
a)SGLT-2inhibitorb)BlocksNa/glucosesymport.
c)Causesglycosuria&polyuria
d)Increaseschanceofvaginalinfections
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:DAns.(A)SGLT-2inhibitor(C)Causesglycosuria&polyuria
(D)Increaseschanceofvaginalinfections
[RefKDT7th/270:http://tvww.diabetesincontrol.eom]
Canagliflozin:
--- Content provided by FirstRanker.com ---
Antidiabeticdrugusedtoimproveglycemiccontrolinpatientswithtype2diabetes.
SGLT-2inhibitor.
?Sodium-glucoseco-transPorter-2(SGLT-2)inhibitorsareanew
groupoforalmedicationsusedfortreatingtype2diabetes
--- Content provided by FirstRanker.com ---
ProducesbeneficialeffectsonHDLcholesterolandsystolicbloodpressure,buttheseeffectsareoffsetbyincreasedLDLcholesterol.
Vaginalyeastinfectionsandurinarytractinfectionsarethemost
commonsideeffects
Canagliflozinislesseffectiveinpatientswithmoderaterenalfailure
--- Content provided by FirstRanker.com ---
endprobablyineffectiveinsevererenalfailureandtype1diabetics66.Whichoffollowingis/aretrueabout
metformin:
a)Causelacticacid
b)PPARyagonist
--- Content provided by FirstRanker.com ---
c)ContraindicatedinRenalfailured)Causehypoglycemia
e)GIdisturbancesarecommonsideeffect
CorrectAnswer-A:C:E
Ans.(A)Causelacticacid(C)ContraindicatedinRenalfailure
--- Content provided by FirstRanker.com ---
(E)GIdisturbancesarecommonsideeffect[Ref.KDT7th/275-76;Katzung12th/757]
Metformin:
PPARyagonist(peroxisomeproliferator-activatedreceptorl)
Causelittleornohypoglycemia
--- Content provided by FirstRanker.com ---
ReportedtoimprovelipidprofilesintypeIIDm(decreasedLDL).Contraindicatedinrenaldisease,alcoholism,hepaticdisease,or
conditionspredisposingtotissueanoxia(e.g.,chronic
cardiopulmonarydysfunction),becauseofanincreasedriskoflactic
acidosis,inducedbybiguanidedrugsinthepresenceofthese
--- Content provided by FirstRanker.com ---
diseases.67.Peripheralneuropathyis/arecausedby:
a)Vincristine
b)Sulfonamide
c)Amiodarone
--- Content provided by FirstRanker.com ---
d)Paclitaxele)None
CorrectAnswer-A:C:D
Ans.(A)Vincristine(C)Amiodarone(D)Paclitaxel
[Ref:Harrison19th/2686-88,18th/3463-66;KDT7th/706]
--- Content provided by FirstRanker.com ---
Sulfonamidenotmentionedinlistofdrugscausingneuropathies68.Commonaction(s)ofepinephrine&
norepinephrineincludes:
a)Skinvasodilation
b)Bronchialmusclecontraction
--- Content provided by FirstRanker.com ---
c)IncreasesystolicBPd)IncreaseHR
e)Renalvasoconstriction
CorrectAnswer-C:E
Ans.(C)IncreasesystolicBP(E)Renalvasoconstriction
--- Content provided by FirstRanker.com ---
[RefKDT7th/124-133;Gooilman&Gillmanllth/2z4-248;Ganong25th/353-56]
Epinephrinecausebronchialmusclerelaxation(throughbeat-2
receptor)whereasnorepinephrinehasnoaetion(noactiononbeat-
2.
--- Content provided by FirstRanker.com ---
Bothepinephrine&norepinEphrineincreasesrenalvascularresistance&thusreducerenalbloodflow.
69.Validdrugcombinationsare:
a)Sulfamethoxazole+trimethoprim
b)Penicillin+Tetracycline/chloramphenicol:Pneumococci
--- Content provided by FirstRanker.com ---
c)Piperacillin-Tazobactamd)Enalapril-Hydrochlorothiazide
e)Ibuprofen&serratiopeptidase
CorrectAnswer-A:C:D:E
Ans.(A)Sulfamethoxazole+trimethoprim(C)Piperacillin-
--- Content provided by FirstRanker.com ---
Tazobactam(D)Enalapril-Hydrochlorothiazide(E)Ibuprofen&serratiopeptidase
[RefKDT7th/698-99,725,61-62;Katzung12th/801]
Tazobactampharmacokineticsmatcheswithpiperacillinwithwhichit
hasbeencombinedforuseinsevereinfectionsLikeperitonitis,
--- Content provided by FirstRanker.com ---
pelvic/urinary/respiratoryinfectionscausedbybeta-lactamaseproducingbacilli.
ACEinhibitors/ARBsareparticularlysynergisticwithdiuretics;this
combinationisverygoodforpatientswithassociatedCHForLVH.
Serratiopeptidaseisaproteolyticenzyme(protease)producedby
--- Content provided by FirstRanker.com ---
enterobacterSerratiasp.BrandnameNildol-SP(400+15)iscombinationofSerratiopeptidase&Ibuprofen(RoyalSapphire
RemediesTablet.
70.APatientpresentedinemergencyroom
withseveremalaria.Hewasgiven
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artusunateat0hr,12hr,24hr&thenonceadaytill3day.Whichofthe
followingstatement(s)is/arecorrect
regardingfurthermanagementofthe
patient
--- Content provided by FirstRanker.com ---
a)Patientmaylaterswitchedtooraldrugifpatientabletotolerateb)Dextrosedripshouldbestarted
c)Artesunateshouldneverbegivensingly
d)Steriodisbeneficial
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:CAns.(A)Patientmaylaterswitchedtooraldrugifpatientableto
tolerate(B)Dextrosedripshouldbestarted(C)Artesunate
shouldneverbegivensingly
[Ref:KDT7th/819-21;Park23rd/262-67;Harrison19th/1379-81,
--- Content provided by FirstRanker.com ---
18th/1698-1705]Artemisininderivativesmustneverbegivenasmonotherapyfor
uncomplicatedmalaria.
Therapidlyactingdrugs,ifusedalone,canleadtothedevelopment
ofparasiteresistance
--- Content provided by FirstRanker.com ---
Whenthepatientisunconscious,thebloodglucoselevelshouldbemeasuredevery4-6hrs.
AllpatientsshouldreceiveacontinuousinFusionofdextrose,and
bloodconcentrationsideallyshouldbemaintainedabove4mmol/L.
71.Whichofthefollowingis/aretrue
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regardingplasmaconcentrationtimecurveofadrug:
a)Peakconcentrationdeterminebioavailability
b)Intramuscularadministrationhavecurvedifferentfromoral
administration
--- Content provided by FirstRanker.com ---
c)Areaundercurvedeterminetherapeuticresponsed)Bioavailabilityofanorallyadministereddrugcanbecalculated
bycomparingtheareaundercurveafteroral&afteri.v.
administration
e)Changesintherateofabsorptionandextentofbioavailability
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caninfluenceboththedurationofactionandtheeffectivenessofthesametotaldoseofadrugadministeredindifferent
formulations
CorrectAnswer-B:D:E
Ans.(B)Intramuscularadministrationhavecurvedifferentfrom
--- Content provided by FirstRanker.com ---
oraladministration(D)Bioavailabilityofanorallyadministereddrugcanbecalculatedbycomparingtheareaundercurveafter
oral&afteri.v.administration(E)Changesintherateof
absorptionandextentofbioavailabilitycaninfluenceboththe
durationofactionandtheeffectivenessofthesametotaldose
--- Content provided by FirstRanker.com ---
ofadrugadministeredindifferentformulations(Ref:KDT7th/16-17;Katzung12th/43-44)
Theareaunderthebloodconcentration-timecurve(areaunderthe
curve,orAUC)canbeusedtocalculatetheclearanceforfirst-order
elimination.
--- Content provided by FirstRanker.com ---
usedasameasureofbioavailability.
Bioavailabilityvariationassumespracticalsignificancefordrugswith
lowsafetymargin(iligoxin)orwheredosageneedsprecisecontrol
(oralhypoglycemics,oralhypocoagulants).
72.Notindicatedforanaerobiccolitis
--- Content provided by FirstRanker.com ---
treatment:a)Metronidazole
b)Aminoglycoside
c)Amikacin
d)Piperacillin-tazobactam
--- Content provided by FirstRanker.com ---
e)ImipenemCorrectAnswer-B
Ans.(B)Aminoglycoside
[Ref:KDT7th/838;Hanison19th/1101,18th/1338-39;Katzung
12th/904-05]
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Treatmentofanaerobicintra-abdominalinfections:Oral:
Moxifloxacin400mgevery24hour
IV:
Moderatetomoderatelysevereinfections
--- Content provided by FirstRanker.com ---
Ertapenem1gevery24hoursCeftriaxone1gevery24hours(orciprofloxacin400mgevery12
hours,ifpenicillinallergic)plusmetronidazole500mgevery8hours
or
Tigecycline100mgoncefollowedby50mgevery12hoursor
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Moxifloxacin400mgevery24hoursSevereinfections:
imipenem,0.5gevery6-8hours;meropenem1gevery8hours;
doripenem0.5gevery1hour;piperacillin/tazobactam
4.5gevery8hours
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73.Gunshotinjurymaycause(s):
a)Abrasioncollar
b)Gutterfracture
c)Railtrackinjury
d)Incisedlikeinjury
--- Content provided by FirstRanker.com ---
e)LaceratedlikeinjuryCorrectAnswer-B:D:E
Ans:a.Abrasion...,b.Gutt...,d.Incis...,e.Lace...,[RefReddy
32nd/205,235;Parikh6th/4.43-44]
Gutterfracture:Theyareformedwhenpartofthethicknessofthe
--- Content provided by FirstRanker.com ---
boneisremovedsoastoformagutter,e.g.,inobliquebulletwound.Abrasioncollar(Marginalabrasion):Abrasioncollarsurroundsthe
dirtcollar.Theabradedcollarisreddishatfirst,butbecomesreddish
brownasitdries.Somecontusionispresentinabradedcollar&as
such,itisalsocalled"contusioncollar".Thesetwofeaturesare
--- Content provided by FirstRanker.com ---
proofofanentrancefirearmwound.Glancingwounds(strikingsomeoneorsomethingatananglerather
thandirectlyandwithfullforce)maysimulateincisedorlacerated
wounds.
Slitlikeexitwoundsareoccasionallyencountered.Theyaredueto
--- Content provided by FirstRanker.com ---
thebulletexitingonitsboardsideorduetoexitofafragmentedbone.Suchinjuriesmaysimulateincisedwoundsorstabwounds
74.Notcharacteristicsofpoisonoussnake:
a)Smallscalesonhead
b)Largescalesonbelly&coverentirebreadth
--- Content provided by FirstRanker.com ---
c)Short&solidfangsd)Compressedtail
e)Usuallynocturnalinhabit
CorrectAnswer-C
Ans:c.Short...[RefReddy32nd/528;Parikh6th/9.40-9.41]
--- Content provided by FirstRanker.com ---
Non-poisonousTrait
Poisonoussnake
snake
Largewiththe
--- Content provided by FirstRanker.com ---
1.HeadA-small(vipers)
exceptionsas
mentioned,under
scales
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B-large&thepoisonous
snakes
(a)(ifthereisanopeningorpitb/w
theeye&nostril(pitviper)
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(b)thirdlabialtouchestheeye&nasalshields(cobraorcoralsnake)
(c)Nopits&thirdlabialdoesnot
touchthenose&eye¢ralrowof
scaleson
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backenlarged;undersurfaceofthemouthhasonlyfourinfralabials,the
fourthbeingthelargest(kraits)
Smallliketheseon
2.Belly
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Large&coverentirebreadththebackor
thebackor
moderatelylarge,
scales
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butdonotcovertheentirebreadth
3.Fangs Hollowlikehypodermicneedles
Short&solid
4.Teeth
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TwolongfangsSeveralsmallteeth
Notmuch
5.Tail
Compressed
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compressed6.Habits Usuallynocturnal
Notso
75.Whichofthefollowingisnotcomponent
oftypicalembalamingagent:
--- Content provided by FirstRanker.com ---
a)Nacitrateb)Naborate
c)Formaldehyde
d)Glycerine
e)None
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CorrectAnswer-EAns:(E)None[RefReddy32nd/166;Parikh6th/8.23]Table
(Reddy32nd/166):Atypicalembalming
Embalmingchemicalsareavarietyofpreservatives,sanitisingand
disinfectantagents,andadditivesusedinmodernembalmingto
--- Content provided by FirstRanker.com ---
temporarilypreventdecompositionandrestoreanaturalappearanceforviewingabodyafterdeath
Sodiumborote(Buffer)500g
Sodiumcitrote(Anticoogulent)900g
Glycerine(Wettingagent)600ml
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Sodiumchloride(ControlpH)800gEosin(Cosmetic)-->30ml
Solublewintergreen(Perfume)90ml
Water(Vehicle)UPto10litres
Formalin(Preservative)1.5litres
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76.TrueaboutPugilisticattitude:
a)Flexionofhip&knee
b)Occurduetocoagulationofproteinbyburning
c)Extensionofelbow
d)Flexionoffingers
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e)NoneCorrectAnswer-A:B:D
Ans:a.Flexionofhip&knee,b.Occurduetocoagulationof
proteinbyburning,d.Flexionoffingers,[RefReddy32nd/307;
27th/286;Parikh6th/4.156-4.157]
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PugilisticAttitude(Boxing,FencingorDefenceAttitute)nReddy27th/286;Reddy32nd/307
Itisthepostureofabodywhichhasbeenexposedtogreatheat
Thelegsareflexedatthehipsandknees,thearmsareflexedat
elbowsandwristsandheldoutinfrontofthebody,headslightly
--- Content provided by FirstRanker.com ---
extended,allfingersarehookedlikeclaws."Pugilisticattitudeispresentwhetheralivingordeadbodyisburnt&
hasthereforenomedico-legalsignificance")
Contractionofparaspinalmusclesoftencausesamarked
opisthotonus,inanattitudecommonlyadoptedbyboxers.
--- Content provided by FirstRanker.com ---
Thisstiffeningisduetothecoagulationofproteinsofthemusclesanddehydrationwhichcausecontraction.Theflexormusclesbeing
bulkierthanextensorscontractmoreduetowhichjointsofalllimbs
areflexed
Itoccurswhetherthepersonwasaliveordeadattimeofburning
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77.Whichofthefollowingcanbegroundfor
divorce:
a)Sterilefemale
b)Impotentman
c)Diabetes
--- Content provided by FirstRanker.com ---
d)Prematureejaculatione)Pre-existingincurablementaldisorder
CorrectAnswer-B:E
Ans:b.impo..,e.Pre-existing...
Impotencyisagroundforannullingmarriage.InParmaswamipillai
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v.SornathammalAIR1969itwasheldthatthemarriageofawomanwithanimpotentmanisvoidable.
PrematureEjaculation:Maybe/maynotbegroundMay
beGroundforDivorceifitLeadstoImpotency
Mentaldisordercanbecomeagroundforfilingadivorceifthe
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spouseofthepetitionersuffersfromincurablementaldisorderandinsanityandthereforecannotbeexpectedfromthecoupletostay
together.
78.NottrueregardingVoyeurism:
a)S.354C,IPCdefinepunishment
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b)Forfirstoffenceimprisonmentof1-3yearwithfinec)Forrepeatoffenceimprisonmentmayextendto5-10year
d)Cognizableoffence
e)Repeatoffenceisconsideredasnon-bailableoffence
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans:c.Forrepeat...[RefReddy32nd/394,413;Parikh6th/5.55;Reddy27th/367;CriminalAmendmentBill,2013]
VoyeurismorScoptophilia
Itisdefinedasonewho,experiencesrecurrent,intense,sexually
arousingfantasies,sexualurgesorbehavioursinvolvingtheactof
--- Content provided by FirstRanker.com ---
observinganunsuspectingpersonwhoisnaked,intheprocessofdisrobingorengagedinsexualactivity
VoyeurismorScotophiliaisdefinedasthedesiretowatchsexual
intercourseortoobservegenitalsofothers.Q
Mostoftenthevictimisstranger
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Masturbationatthesceneorlatertomemoriesofwatchingtheunsuspectingstrangerisnormallythesourceofsexualpleasure
Itisrareinfemale
79.AllaretrueaboutEbolavirusinfection
except?
--- Content provided by FirstRanker.com ---
a)Airdroplerismostcommonmodeoftransmissionb)Haemorrhagicmanifestationmayoccur
c)Thaiforesttype-mostcommonspeciesinepidemics
d)presentsassuddenonsetoffeverandsorethroat
e)Casefatalityratemaybehighas70%
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:CAns.is'a'i.e.,Airdroplerismostcommonmodeof
transmission&'c'i.e.,Thaiforesttype-mostcommonspecies
inepidemics]RefPark24m/ep.374]
Thevirusistransmittedthroughdirectcontactwithblood,organs,
--- Content provided by FirstRanker.com ---
bodysecretionsorotherbodyfluidsofinfectedanimalslikechimpanzees,gorillas,monkeys,fruitbatsetc.
Humantohumantransmissionisthroughbloodorbodyfluidsofan
infectedsymptomaticpersonorthroughexposuretoobjects(sucha
needle)thathavebeencontaminatedwithinfectedsecretions.
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Itisnottransmittedthroughair,water,orfood.Thevirusistransmittedthroughdirectcontactwithblood,organs,
bodysecretionsorotherbodyfluidsofinfectedanimalslike
chimpanzees,gorillas,monkeys,fruitbatsetc.
Humantohumantransmissionisthroughbloodorbodyfluidsofan
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infectedsymptomaticpersonorthroughexposuretoobjects(suchasneedle)thathavebeencontaminatedwithinfectedsecretions
Itisnottransmittedthroughair,water,orfood
Theillnessischaracterizedbysuddenonsetoffever,intense
weakness,musclepain,headache,sorethroat,vomiting,diarrhea,
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rash,impairedkidneyandliverfunctionandinsomebothinternalandexternalbleeding.
ThevirusfamilyFiloviridaeincludesthreegenera:Cuevavirus,
Marburgvirus,andEbolavirus.
WithinthegenusEbolavirus,fivespecieshavebeenidentified:
--- Content provided by FirstRanker.com ---
Zaire,Bundibugyo,Sudan,RestonandTalForest.Thefirstthree,Bundibugyoebolavirus,Zaireebolavirus,and
Sudanebolavirushavebeenassociatedwithlargeoutbreaksin
Africa.
80.AllaretrueaboutToxoplasmainfection
--- Content provided by FirstRanker.com ---
except:a)Mayoccurduetoingestionofoocystfromcat'sfaeces
b)Mayspreadbyorgantransplantation
c)Toxoplasmosisissymptomaticinusuallyimmunocompetent
person
--- Content provided by FirstRanker.com ---
d)Infectionissevere&progressiveinimmunocompromisedhoste)Humaninfectionisdeadendforparasite
CorrectAnswer-C
Ans:c.Toxoplasmosis...[RefPanikerParasitology6th/100:
Harrison19th/1398-1405,
--- Content provided by FirstRanker.com ---
Infectivestageforman:Oocystwithsporozoites&tissuecystwithbradyzoites
Freshlypassedoocystisnotinfective(needsdevelopmentinthe
soil)
Humaninfectionisdeadendfortheparasite
--- Content provided by FirstRanker.com ---
TheprincipalsourceofhumanToxoplasmainfectionremainsuncertain.
Transmissionusuallytakesplacebytheoralrouteandcanbe
attributabletoingestionofeithersporulatedoocystsfrom
contaminatedsoilorbradyzoitesfromundercookedmeat
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Intrauterineinfectionfrominfectedmothertobabies.Rarelybybloodtransfusionortransplantationfrominfecteddonors.
81.Whichofthefollowingdisease(s)is/are
nottoxinmediated:
a)Diphtheria
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b)Tetanusc)Pertussis
d)Anthrax
e)Syphilis
CorrectAnswer-E
--- Content provided by FirstRanker.com ---
Ans:e.Syphilis...[RefAnanthanarayan8th/233,317;GreenwoodMicrobiology16th/91]
Virulentstrainsofdiphtheriabacilliproduceaverypowerfulexotoxin.
Thepathogeniceffectsofthebacillusareduetotoxin.
Pertussistoxin(PT):ThisispresentonlyinBordetellaepertussis.It
--- Content provided by FirstRanker.com ---
playanimportantroleinthepathogenesisofwhoopingcough.PTtoxoidisthemajorcomponentofacellularpertussisvaccines
Theanthraxtoxinisacomplexofthreefractions:theedemafactor
(OForFactorI),theprotectiveantigenfactor(PAorFactorII)&the
lethalfactor(LForFactorIII)"
--- Content provided by FirstRanker.com ---
Toxinsinhibitingproteinsynthesis:1)ShigelladysenteriaeI(Shigatoxin)2)Diphtheria3)Pseudomonas4)Verotoxin1=Shigaliketoxin
ofE.coli)
82.Commonlyusedstain(s)foridentifying
fungusinclude(s):
--- Content provided by FirstRanker.com ---
a)Periodicacid-Schiff(PAS)stainb)VonKossastain
c)Muraminesilverstain
d)Gomori'smethenaminesilver
e)Giemsastain
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:DAns:a.Periodic...,d.Gomori's...[Ref:Ananthanarayan
8th/601:Harrison19th/1330,18th/1637]
ThePAS&methenaminesilverstainsarevaluablemethodsforthe
demonstrationoffungalelementsintissuesection.Thecommonest
--- Content provided by FirstRanker.com ---
culturemediausedinmycologyareSabouraud'sglucoseagar,Czapek-Doxmedium&Cornmealagar.
ThevonKossastainisusedtoquantifymineralizationincellculture
andtissuesection.
Giemsastainisusedincytogeneticsandforthehistopathological
--- Content provided by FirstRanker.com ---
diagnosisofmalariaandotherparasites.Thestainsmostcommonlyusedtoidentifyfungiareperiodicacid-
SchiffandGomorimethenaminesilver.Candida,unlikeotherfungi,
isvisibleongram-stainedtissuesmears.Hematoxylinandeosin
stainisnotsufficienttoidentifyCandidaintissuespecimens.
--- Content provided by FirstRanker.com ---
Whenpositive,anIndiainkpreparationofcerebrospinalfluid(CSF)isdiagnosticforcryptococcosis.Mostlaboratoriesnowuse
calcofluorwhitestainingcoupledwithfluorescentmicroscopyto
identifyfungiinfluidspecimens.
83.Non-treponemaltestincludes:
--- Content provided by FirstRanker.com ---
a)RPRb)VDRL
c)FTA-ABS
d)TPHA
e)TPI
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:BAns:a.RPR,b.VDRL[RefAnanthanarayan8th/375-76:Harriosn
19th/1137-38,18th/1384;CMDT2016/1464;Greenwood
Microbiology16th/347]
Therearetwogeneralcategoriesofserologictestsforsyphilis:(1)
--- Content provided by FirstRanker.com ---
NontreponemaltestsdetectantibodiestolipoidalantigenspresentinthehostaftermodificationbyTpallidum.(2)Treponemaltestsuse
liveorkilledTpallidumasantigentodetectantibodiesspecificfor
pathogenictreponemes.
TheRPRandVDRLtestsarerecommendedforscreeningorfor
--- Content provided by FirstRanker.com ---
quantitationofserumantibody.Thetiterreflectsdiseaseactivity,risingduringtheevolutionofearlysyphilisandoftenexceeding1:32
insecondarysyphilis.Aftertherapyforearlysyphilis,apersistentfall
byfourfoldormore(e.g.,adeclinefrom1:32to1:8)isconsidered
anadequateresponse.
--- Content provided by FirstRanker.com ---
TreponemaltestsmeasureantibodiestonativeorrecombinantTpallidumantigensandincludethefluorescenttreponemalantibody-
absorbed(FTA-ABS)testandT.pallidumparticleagglutination
(TPPA)test,bothofwhicharemoresensitiveforprimarysyphilis
thanthepreviouslyusedhemagglutinationtests.
--- Content provided by FirstRanker.com ---
Themostwidelyusednontreponemalantibodytestsforsyphilisaretherapidplasmareagin(RPR)andVenerealDiseaseResearch
Laboratory(VDRL)tests,whichmeasureIgGandIgMdirected
againstacardiolipin-lecithincholesterolantigencomplex.
84.WhichoffollowingCulturemedia
--- Content provided by FirstRanker.com ---
combinationis/aretrueexcept:a)Thayer-Martinmedia:Gonorrhoea
b)Chocolateagar-:enrichedmedia
c)Lowenstein-JensenMedium:Mycobacteriumtuberculosis
d)Muller-Hintonagar:Corynebacteriumdiphtheriae
--- Content provided by FirstRanker.com ---
e)MacConkey'sagar:Nonlactosefermentersformcolourlesscolonies
CorrectAnswer-D
Ans:d.Muller-Hinton...[RefAnanthanarayan8th/39-43,229]
Thayer-MartinisausefulselectivemediaforNeisseria
--- Content provided by FirstRanker.com ---
gonorrhoeae''.Mueller-HintonisenrichedmediaforNeisseria.
Cdiphtheriaeandothercorynebacteriagrowaerobicallyonmost
ordinarylaboratorymedia.OnLoeffler'sserummedium,
corynebacteriagrowmuchmorereadilythanotherrespiratory
--- Content provided by FirstRanker.com ---
organisms,andthemorphologyoforganismsistypicalinsmears.Lowenstein-JensenMedium.Itisusedtoculturetuberclebacilli.It
containsegg,malachitegreenandglycerol.
ChocolateAgarorHeatedBloodagar:Preparedbyheatingblood
agar.Itisusedforcultureofpneumococcus,gonococcus,
--- Content provided by FirstRanker.com ---
meningococcusandHaemophilus.Heatingthebloodinactivatesinhibitorofgrowths.
85.Allofthefollowingaretrueregarding
legionellaexcept:
a)Causepontiacfever
--- Content provided by FirstRanker.com ---
b)Aerobicgramnegativebacillic)Cangrowonsimplemedium
d)GrowonBCYEagar
e)Communicablefrominfectedpatientstoothers
CorrectAnswer-C:E
--- Content provided by FirstRanker.com ---
Ans:c.Cangrowon....e.Communicable...[RefAnanthanarayan8th/400-401:Harrison19th/1014-17,18th/1236
39;Greenwood16th/320-21;CMDT09/1278]
MembersoftheLegionellaceaeareaerobicgram-negativebacilli
thatdonotgrowonroutinemicrobiologicmedia.Bufferedcharcoal
--- Content provided by FirstRanker.com ---
yeastextract(BCYE)agaristhemediumusedtogrowLegionella.PontiacfeverQ,causedbyLegionellaPneumophila,isamilder,
nonfatalinfluenza-likeillnesswithfever,chills,myalgia.
86.Allaretrueaboutgonorrheaexcept:
a)Gonorrhoeameansflowofseed
--- Content provided by FirstRanker.com ---
b)Dischargemaycontainneutrophilc)Initiallydischargeisscanty&mucoidinurethritis
d)Causedbygrampositivecocci
e)Symptomismoresevereinfemalethanmales
CorrectAnswer-D:E
--- Content provided by FirstRanker.com ---
Ans:d.Caused...,e.Symptom...[RefHarrison19th/1005,18th/1220-25;Ananthanaran8th/227-30,7th/227-229;
GreenwoodMicrobiology16th/247-248;CMDT09/1287]
ThenamegonorrheaderivesfromtheGreekwordsgonos(seed)&
rhoia(flow)e.9-describedaconditioninwhichsemenflowedfrom
--- Content provided by FirstRanker.com ---
themaleorganwithouterection.AcuteurethritisQisthemostcommonclinicalmanifestationof
gonorrhoeainmales&althoughsomemenremainasymptomatic.
Urethraldischarge&dysuria,usuallywithouturinaryfrequencyor
urgency,arethemajorsymptoms.
--- Content provided by FirstRanker.com ---
87.WhichofthefollowingisFalseregarding
H.Pyloriinfection:
a)Withchronicinfectionureasebreathtestbecomenegative
b)H.Pyloriinfectionremainlifelongifuntreated
c)Endoscopyisdiagnostic
--- Content provided by FirstRanker.com ---
d)Toxigenicstrainsusuallycausesulcere)None
CorrectAnswer-A
AnswerisA.Withchronicinfectionureasebreathtestbecome
negative(Withchronicinfectionureasebreathtestbecomes
--- Content provided by FirstRanker.com ---
negative)UreasebreathtestdetectsH.pyloninfectionby'bacterialurease
activity'andremainspositivetillthebacteriahasnotbeeneradicated
withtreatment.Thusureasebreathtestbecomesnegativeonlyafter
eradicationoforganismfollowingtreatmentandnotwithchronic
--- Content provided by FirstRanker.com ---
Mfection.Despiteasubstantialhumoralantibodyresponseinfectionpersists
indefinitely(persistslifelongifuntreated)
InvasivediagnostictestarebasedonEndoscopic,endoscopyisa
diagnosticapplication.
--- Content provided by FirstRanker.com ---
H.pyloriproducesseveralvirulencefactorsthathavebeenimplicatedinthedamageofmucosa.
88.Allstatementsaretrueaboutmycetoma
except:
a)Eumycetomaiscausedbybacteria
--- Content provided by FirstRanker.com ---
b)Surgeryisimportantcomponentoftreatmentc)Usuallypainless
d)Diagnosiscanbemadebyexaminationoflesion
e)Canaffectlower&upperextremities
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:a.Eumycetoma...[RefAnanthanarayan8th/393,608:Harrison19th/1355,18th/258,1667,1329,e34-16f;Neenakhana
lst/228;Greenwood16th/223-224,578]
Treatmentofeumycetomainvolvesbothsurgicalextirpationofthe
lesionanduseofantifungalagents.Surgicalremovalofthelesions
--- Content provided by FirstRanker.com ---
ofeumycetomaismosteffectiveifperformedbeforeextensivespreadhasoccurred.
MycetomaorMaduraMycosisorMaduraFoot:Mycetomasare
chronic,slowlyprogressiveinfectionsofthesubcutaneoustissue,
usuallyofthefoots&rarelyoftheotherpartsofthebodylike
--- Content provided by FirstRanker.com ---
handsQ,glutealregion&thigh.Maduromycosis(alsoknownaseumycetoma)isthetermusedto
describemycetomacausedbythetruefungiandbyphylogenetically
diverseorganisms.ActinomycoticmycetomaiscausedbyNocardia
andActinomaduraspecies.
--- Content provided by FirstRanker.com ---
89.StainusedforMycobacterium
tuberculosisis/are:
a)Ziehl-Neelsentechniqueofstaining
b)Auramine-rhodaminestain
c)Gomorimethenaminesilverstain
--- Content provided by FirstRanker.com ---
d)Kinyounstaine)Gramstaining
CorrectAnswer-A:B:D
Ans:a.Ziehl-Neelsentechni...,b.Auramine-rhodaminesta...,d.
Kinyounstain
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[RefHarrison19th/1113;Ananthanarayan9th/346-48;LippincottMicrobiology3rd/21;Jawetz27th/38;TextBookofDiagnostic
microbiologybyConnieR.Mohan3rd/691;Greenwood16th/15]
WhenstainedwithcarbolfuchsinbyZiehl-Neelsenmethodorby
fluorescentdyes(Auramine0,Rhodamine),mycobacterium
--- Content provided by FirstRanker.com ---
tuberculosisreistdecolourisationby20%sulphuricacid&arethereforecalledacidfast.
Ziehl-Neelsenmethoddphenol-auramineproceduresaremethods
ofgreatpracticalimportanceinthediagnosisofmycobacterial
diseases".
--- Content provided by FirstRanker.com ---
TheKinyounmethod,orKinyounstain,isanacid-fastprocedureusedtostainanyspeciesofthegenusMycobacteriumandNocardia
species.Itinvolvestheapplicationofaprimarystain(carbol
fuchsin),adecolorizer(acid-alcohol),andacounterstain(methylene
blue)"
--- Content provided by FirstRanker.com ---
90.Trueaboutnon-industrialanthrax:
a)Mayoccurinbutcher
b)Animalhairisasourceofinfection
c)Commonlyoccursinfactoryworker
d)Stomoxyscalcitransinsectmaytransmittheinfection
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e)ItisazoonosisCorrectAnswer-A:B:D:E
Ans:(A)Mayoccurinbutcher,(B)Animalhairisasourceof
infection,(D)Stomoxyscalcitransinsectmaytransmitthe
infection,(E)Itisazoonosis,
--- Content provided by FirstRanker.com ---
[RefAnanthanarayan8th/245:GreenwoodMicrobiology16th/225-29;Harrison19th/261e1-3,18th/1768-70]
Cutaneousanthraxgenerallyoccursonexposedsurfacesofthe
armsorhands,followedinfrequencybythefaceandneck.Apruritic
papuledevelops1-7daysafterentryoftheorganismsorspores
--- Content provided by FirstRanker.com ---
throughascratch.Cutaneousanthraxusedtobecausedbyshavingbrushesmade
withanimalhair
Stomoxyscalcitrans&otherbitingsinsectsmayoccasionally
transmitinfectionmechanically
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91.Zoonoticdiseasesare-
a)Salmonellosis
b)Plague
c)Anthrax
d)All
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e)NoneCorrectAnswer-D
Ans.(D)All
92.Allofthefollowingis/aretrueregarding
candidiasis:
--- Content provided by FirstRanker.com ---
a)Commonlyinvolvemucosa&skinb)Notinvolvenails
c)Causedbyyeastlikefungus
d)Diabetesismostimportantriskfactor
e)Causesmeningitisinimmunocompromisedpersons
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns:(B)Notinvolvenails.[RefAnanthanarayan8th/607-08:
Harrison19th/1342-44,18th/165153]
Itisaninfectionofskin,mucosa&rarelyofinternalorgans
Itiscausedbyyeastlikefungus,Candidaalbicans&occasionallyby
--- Content provided by FirstRanker.com ---
othercandidaspeciesUbiquitousinnature,theseorganismsarefoundoninanimate
objects,infoods,andonanimalsandarenormalcommensalsof
humans.Theyinhabitthegastrointestinaltract(includingthemouth
andoropharynx),thefemalegenitaltract,andtheskin.
--- Content provided by FirstRanker.com ---
Itisanopportunisticendogenousinfection,thecommonestpredisposingfactorbeingdiabetes.
93.Feature(s)ofTaeniacapitisis/areall
except:
a)Maypresentsasaboggyswelling
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b)Mostcommonlyoccursinelderlyc)Maypresentasblackdot
d)Causedbytrichophytonµsporumbutnotby
epidermophyton
e)Scutulumformation
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns:(B)Mostcommonlyoccursinelderly.[RefNeenakhanna
3rd/244;Ananthanarayan8th/604-06:Greenwood16th/574]
T.capitis:Causedbymicrosporumanyspeciescf.Trichophyton
mostspecies-Ananthanarayan8th/606,Tineacapitisis
--- Content provided by FirstRanker.com ---
dermatophytosisorringwormofthescalpandhair.Age:Invariablyachild.
thechiefcauseof"blackdot"Tineacapitis,producessporeswithin
thehairshaft(endothrix).Thesehairsdonotfluoresce;theyare
weakenedandtypicallybreakeasilyatthefollicularopening.In
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prepubescentchildren,epidemictineacapitisisusuallyself-limiting.94.Whichofthefollowingis/aretrueabout
pasteurerllamultiocuda:
a)Maycausemeningitis
b)Transmittedbyunpasteurizedmilk
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c)Causediseaseexclusivelyinhumand)Gram-negativecoccobacillus
e)None
CorrectAnswer-A:D
Ans:(A)Maycausemeningitis&(D)Gram-negative
--- Content provided by FirstRanker.com ---
coccobacillus[RefAnanthanarayan8th/326:GreenwoodMicrobiology16th/334-35;Park23rd/655;Harrison19th/183e-3,
18th/12351
P.multocidaisabipolar-staining,gram-negativecoccobacillusthat
colonizestherespiratoryandgastrointestinaltractsofdomestic
--- Content provided by FirstRanker.com ---
animals;oropharyngealcolonizationratesare70-90%incatsand50-65%indogs.
Patientsattheextremesofageorwithseriousunderlyingdisorders
(e.g.,cirrhosis,diabetes)areatincreasedriskforsystemic
manifestations,includingmeningitis,peritonitis,osteomyelitisand
--- Content provided by FirstRanker.com ---
septicarthritis,endocarditis,andsepticshock,butcaseshavealsooccurredinhealthyindividuals.
Pmultocidacanbetransmittedtohumansthroughbitesor
scratches,viatherespiratorytractfromcontactwithcontaminated
dustorinfectiousdroplets,orviadepositionoftheorganismon
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injuredskinormucosalsurfacesduringlicking.95.Whichofthefollowinghasincubation
periodof<5day:
a)Salmonellatyphi
b)Vibrioparahaemolyticus
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c)Campylobacterjejunid)Shigelladyseneteriae
e)Yersiniapestis
CorrectAnswer-B:C:D:E
Ans:b.Vibrioc.Campylobacterd.Shigellaande.Yersinia...
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[RefAnanthanarayan8th/293,299,506,312;Harrison18th/1294;Greenwood16th/300;]
Vibrioparahaemolyticus:Afteranincubationperiodof4hrto4days,
symptomsdevelop&persistsforamedianperiodof3days"
(Harrison18th/1294)
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"Shigellaecausebacillarydysentery.Ithasashortincubationperiod(1-7days,usually48hours)'(Ananthanarayan8th/285)
"Campylobacterjejuni:Theincubationperiodis1-7days"?
Ananthanarayan8th/398
"Entericfever(Salmonellatyphi):Theincubationperiodisusually7-
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14daysbutmayrange3-56days"(Ananthanarayan8th/293)"Salmonellagastroenteritis(causedbyanysalmonellaotherthan
s.typhi):Clinicallythediseasedevelopsaftershortincubationperiod
of24hoursorless,withdiarrhea,vomiting,abdominalpain&fever".
96.Verrugaperuanaiscausedby:
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a)B.Bacilliformisb)B.Henselae
c)B.Quintana
d)B.Elizabethae
e)B.Grahamil
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:(A)Bbacilliformis..[RefAnanthanarayan8th/411-
12:Harrison19th/1083,1079,18th/13191
Bartonellosis,orCarrion'sdisease,iscausedbyB.bacilliformis.The
diseaseischaracterizedbytwodistinctphases:(1)anacutefebrile
--- Content provided by FirstRanker.com ---
hematicphase,knownasOroyafever;and(2)aneruptivephasemanifestedbycutaneouslesions,knownasverrugaperuana"
(Harrison19th/1083,18th/1319)
VerrugaPeruanaorPeruvianWart:Itischaracterizedbyaneruptive
phase,inwhichthepatientsdevelopacutaneousrashproducedby
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aproliferationofendothelialcellsandisknownas"Peruvianwarts"or"verrugaperuana".
97.Trueaboutstaphylococcusaureus-
a)Microaerophilic
b)Producelemonyellowcolonies
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c)Growswith10%Nacld)Allaretrue
e)None
CorrectAnswer-C
Ans.is'c'i.e.,Growswith10%Nacl[Ref:Ananthanarayan9thle
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p.199-202]Sstaphylococcusisfacultativeanaerobe.OptimumpHforgrowthis
7.4-7-6andoptimumtemperatureis37?C.
Staphaureusproducesgoldenyellowpigment,whichismaximumat
22?C.
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Mostofthestaphylococcusspeciesgrowinthepresenceof10%NaCl.
OnnutrientagarslopethereischaracteristicOilpaintappearance.
Forprimaryisolation,sheepbloodagarisrecommended.Human
bloodshouldnotbeusedatitmaycontainantibodiesorother
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inhibitorsStaphaureusGoldenyellowcolonies
Staphepidermidis(alsocalledstaphalbus)Whitecolonies
StaphcitrusLemonyellowcolonies
98.Whichofthefollowingviralexanthema
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combinationis/arecorrectexcept:a)Varicella-norelationofrashwithfever
b)Rubella-palatalpetechiaemayoccur
c)Roseola-rashappearafterfeversubsides
d)Measles-rashoccursbehindtheearsalonghairline
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e)Chickenpox-pleomorphicrashesoccurCorrectAnswer-A
Ans:a.Varicella-norelationofrashwithfever.[RefPark
23rd/144-145,148:0.Ghai7th/185;Harrison19th/1194,18th/149,
153]
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Varicella(Chickenpox):Acharacteristicfeatureofrashisitspeomorphismi.e,allstageofrash(papules,vesicles&crusts)may
beseensimultaneouslyatonetime,inthesamearea.Temperature
risewitheachfreshcropofrash"(Park23rd/144-45)"Exanthem
subitum(roseola)iscausedbyhumanherpesvirus6andismost
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commonamongchildren99.Whichofthefollowingactis/arepassed
afterindependence:
a)ESIact
b)Factoryact
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c)MTPactd)Epidemicdiseaseact
e)SARDAact
CorrectAnswer-A:B:C
Ans:(A)ESIact(B)Factoryact(C)MTPact
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Theprohibitionofchildmarriageact,2006(PCMA)wasenactedrepealingthechildmarriagerestraintactof1929inordertoprohibit
childmarriageratherthanonlyrestrainingthem"(Park23rd/589,
21st/542)
"ESIactpassedin1948(amended1975,1984&1989"(Park
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23rd/815,21st/756)"Indianfactoriesactpassedin1948"(Park23rd/815,21st/542)
"Medicalterminationofpregnancyactwaspassedin1971"(Park
23rd/506,21st/468)
100.Whichofthefollowingis/aretrueabout
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leprosy:a)Positiveskinsmearatanysiteisconsideredmultibacillary
leprosy
b)Grenzzoneisseeninlepromatousspectrum
c)ItiseradicatedfromIndiain2000
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d)12monthofMDTisrecommendedformultibacillaryleprosye)Multidrugtherapyisgiven
CorrectAnswer-A:B:D:E
Ans:(A)Positiveskinsmearatanysiteisconsidered
multibacillaryleprosy(B)Grenzzoneisseeninlepromatous
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spectrum(D)12monthofMDTisrecommendedformultibacillaryleprosy(E)Multidrugtherapyisgiven
"Grenzzoneoccurinlepromatousleprosy"(NeenaKhanna3rd/227)
"Multibacillaryleprosy:with6skinlesions,aswellasallsmear
positivecases"(KDT7th/783)
--- Content provided by FirstRanker.com ---
"Thereisnoplaceformonotherapyintreatmentofleprosy"-(NeenaKhanna3rd/229)
"Slitskinsmear:AllpatientswhoareAFBpositiveshouldbegiven
multibacillarytreatment,irrespectiveoftheclinicalpresentation"
(NeenaKhanna3rd/227)
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33state/UTwehaveachievedeliminationlevel(prevalencerate<1per10,000population).Only3states/UTviz.Bihar,Chattisgarher
DerNHavelihasPRof2-4per10,000population"(Park23rd/316)
"Paucibacillaryleprosy:Apersonhaving1-5skinlesionseWoronly
onenerveinvolvement"(Park2Ist/292)
--- Content provided by FirstRanker.com ---
"Multibacillaryleprosy:Apersonhaving6ormoreskinlesionsd-/or
morethanonenerveinvolvement"
101.Whichofthefollowingis/arefeaturesof
septictank:
a)Minimumcapacityshouldbe500gallons
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b)Watertightsealc)Recommendedforlargecommunities
d)Seededwithripesludgedrawnfromanotherseptictank
e)Anaerobicprocesstakesplace
CorrectAnswer-A:B:D:E
--- Content provided by FirstRanker.com ---
Ans:a.Minimumcapacityshouldbe500gallonsb.Watertightseald.Seededwithripesludgedrawnfromanotherseptic
tanke.Anaerobicprocesstakesplace[RefPark23rd/760,
21st/701]
Theseptictankiswater-tightmasonrytankintowhichhousehold
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sewageisadmittedfortreatment.Capacity:Thecapacityofaseptictankwilldependuponthenumber
ofusers.Acapacityof20-30gallonsor2.5-5c.ft.perpersonis
recommendedforhouseholdseptictanks.Theminimumcapacityof
aseptictankshouldbeatleast500gallons
--- Content provided by FirstRanker.com ---
SeptictanksarenotrecommendedforlargecommunitiesAirspace:Thereshouldbeaminimumairspaceof30cmb/wthe
levelofliquidinthetank&theundersurfaceofthecover
Retentionperiod:Septictanksaredesignedinthiscountrytoallowa
retentionperiodof24hours
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102.TrueaboutStandarddeviation:
a)1SDcovers95%population
b)Normalstandarddeviatedeviationfromthemeaninanormal
distribution
c)Representmeasurementofdispersions
--- Content provided by FirstRanker.com ---
d)Itisbetterindicatorofvariabilitythanrangee)None
CorrectAnswer-B:C:D
Ans:b.Normalstandarddeviatedeviationfromthemeanina
normaldistributionc.Representmeasurementof
--- Content provided by FirstRanker.com ---
dispersionsd.Itisbetterindicatorofvariabilitythanrange[RefPark23rd/847-49,21st/786;BiostatisticsbyBKRao2nd/54;
MethodsinBiostatisticsbyBKMahajan7th/57,60-68;
Basiceb,clinicalBiostatisties4th/30]
Deviationfromthemeaninanormaldistributionorcurveiscalled
--- Content provided by FirstRanker.com ---
relativeorstandardnormaldeviateorvariate&isgiventhesymbolZ.ItismeasuredintermofSDs&indicateshowmuchan
observationisbiggerorsmallerthanmeaninunitofSD.SoZwillbe
aratio.
Thestandarddistributioncurve(Normaldistribution)isaperfectly
--- Content provided by FirstRanker.com ---
symmetrical,bellshapedcurvesuchthatthemean,medianandmode,allhavethesamevalueandcoincideatthecentre,Standard
DistributionCurve(Normal)Q:Mean=Median=Mode
103.Wildpolioisstillendemicin:
a)India
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b)Pakistaanc)Afganistan
d)Bangladesh
e)Nigeria
CorrectAnswer-B:C:E
--- Content provided by FirstRanker.com ---
Ans:b.Pakistaan,c.Afganistan,e.Nigeria[RefPark23rd/203,21st/182I
Till2011,poliowasendemicin4countries-Pakistan,Afghanistan,
India&Nigeria(Mnemonic-PAIN).Butin2014,only3countries
(Afghanistan,NigeriaandPakistan;Mnemonic-PAN)remainpolio-
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endemic,downfrommorethan125countriesin1988.Completingthreefullyearswithoutreportinganycaseofpolio,India
celebratedalandmarkachievementinpublichealthon11February
2014?thevictoryoverpolio.Indiahasnotreportedanycaseof
poliosinceatwo-yearoldgirlgotpolioparalysison13January2011
--- Content provided by FirstRanker.com ---
inHowrahdistrictofWestBengal.104.TrueaboutcensusinIndia:
a)Firstcensusconductedin1851
b)DirectorGeneralofHealthServicesofIndia(DGHS)issupreme
officerforconductingcensus
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c)Literacyrateisalsoincludedincensusd)ConductedinaccordancetoCensusact,1948
e)ConductedinMidyear
CorrectAnswer-C:D
Ans:c.Literacy...,d.Conducted...(Ref:Park23rd/840]
--- Content provided by FirstRanker.com ---
ThefirstregularcensusinIndiawastakenin1881&conductedatregularintervalof10year.
Thecensusisusuallyconductedattheendofthefirstquarterofthe
firstyearineachdecade,thereasonbeing,mostpeopleareusually
residentintheirownhomesduringthatperiod
--- Content provided by FirstRanker.com ---
Thelegalbasisofthecensusisprovidedbythecensusactof1948Thesupremeofficerwhodirects,guides&operatesthecensusis
theCensusCommissionerforIndia
Apartfromdemographicinformation,economic&social
characteristicofpopulationarealsoincludedincensus(including
--- Content provided by FirstRanker.com ---
literacyrate)105.Whichofthefollowingcarcinomais
causedbyasbestos:
a)Mesothelioma
b)Bronchialcarcinoma
--- Content provided by FirstRanker.com ---
c)Laryngealcarcinomad)Breastcancer
e)None
CorrectAnswer-A:B:C
Ans:a.Mesotheliomab.Bronchialcarcinomac.Laryngeal
--- Content provided by FirstRanker.com ---
carcinoma[RefPark23rd/807,2Ist/748;Robbins9th/690-91;Harrison19th/168889;Chapman4th/536]
"Mesotheliomahaveastrongassociationwithcrocidolitevarietyof
asbestos"
Carcinomabronchus&Lung(squamouscelloradenocarcinoma)Q
--- Content provided by FirstRanker.com ---
PleuralandperitonealmesotheliomaeGastrointestinalcarcinoma(coloncancer)
Laryngealcarcinoma
LungcancerQisthemostfrequentcancerassociatedwithasbestos
exposure.
--- Content provided by FirstRanker.com ---
Theexcessfrequencyoflungcancer(allhistologictypes)inasbestosworkersisassociatedwithaminimumlatencyof15-19
yearsbetweenfirstexposureanddevelopmentofthedisease.
106.Trueaboutcroup:
a)CausedbyH.influenzae
--- Content provided by FirstRanker.com ---
b)X-rayPAviewshowssteeplesignofsubglotticnarrowingc)Stridorispresent
d)Supraglotticedemaispresent
e)Commonlypresentin6month-3yearagegroup
CorrectAnswer-A:B:C:E
--- Content provided by FirstRanker.com ---
Answer-(A)CausedbyH.influenzae(B)X-rayPAviewshowssteeplesignofsubglotticnarrowing(C)Stridorispresent
(E)Commonlypresentin6month-3yearagegroup
Croup(Laryngotracheobronchitis)
Laryngotracheobronchitisisthemostcommoninfectiouscauseof
--- Content provided by FirstRanker.com ---
obstructioninchildrenusuallyoccurringbetweentheagesof6monthsand3years.
Malechildren(boys)arecharacteristicallymorefrequentlyinvolved
thanfemales(girls)
Etiology
--- Content provided by FirstRanker.com ---
ItisaviralinfectionmostfrequentlycausedbyParainfluenzavirus.Pathology
Themostcharacteristicpathologicalfeatureisedemaformationin
thesubglotticarea.
Presentation
--- Content provided by FirstRanker.com ---
GradualonsetwithaprodromeofupperrespiratorysymptomsHoarsenessandbarkingcough(croupycough)
Stridor(initiallyinspiratorythanbiphasic)
Feverisusuallylowgrade(orabsent)althoughmayoccasionallybe
highgrade
--- Content provided by FirstRanker.com ---
Droolingsischaracteristicallyabsentandthereisnodysphagia
(seeninepiglottitis)
Imaging(Xray)
Symmetric'steeple'or'funnelshaped'narrowingofthesubglottic
region(steeplesign)
--- Content provided by FirstRanker.com ---
HypopharyngealwideningordistensionNormalepiglottisandaryepiglotticfolds
107.TrueaboutMobiussyndrome:
a)10thCNinvolvement
b)7thCNinvolvement
--- Content provided by FirstRanker.com ---
c)Abductiondefectd)Esotropia
e)6thCNinvolvement
CorrectAnswer-B:C:D:E
Answer-(B)7thCNinvolvement(C)Abductiondefect
--- Content provided by FirstRanker.com ---
(D)Esotropia(E)6thCNinvolvement"Itischaracterizedbybilateralfacialweakens(i.eVIICN),whichis
oftenassociatedwithabducensnerveparalysis(i.e.VICN)
Facialpalsyiscommonlybilateral,frequentlyasymmetric.
Ectropion,epiphora,andexposurekeratopathymaydevelop.
--- Content provided by FirstRanker.com ---
Theabductiondefectmaybeunilateralorbilateral.ThecranialnervesVandVIIIareaffected.
Esotropiaiscommon.
Surgicalcorrectionoftheesotropiaisindicated
108.Allaretrueaboutnasopharyngeal
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fibromaexcept:a)Mostcommonageofpresentationis20-50yr
b)Radioresistanttumour
c)Highlyvascular
d)Benigninnature
--- Content provided by FirstRanker.com ---
e)SurgeryistreatmentofchoiceCorrectAnswer-A:B
Answer-(A)Mostcommonageofpresentationis20-50yr
(B)Radioresistanttumour
Itisararetumour,thoughitisthecommonestofallbenigntumours
--- Content provided by FirstRanker.com ---
ofnasopharynxItislocallyinvasive&destroystheadjoiningstructures
Tumourisseenalmostexclusivelyinmalesinagegroupof10-20
years.
Rarely,itmaybeseeninolderpeople&females
--- Content provided by FirstRanker.com ---
Mostcommonpresentation:profuse6recurrentepistaxisItismadeupofvascular&fibroustissue.Mostly,thevesselsare
justendothelium-linedspaceswithnomusclecoat
Surgicalexcisionisnowthetreatmentofchoice
Radiotherapyhasbeenusedasaprimarymodeoftreatment
--- Content provided by FirstRanker.com ---
109.Whichofthefollowingfeature(s)of
rhinoscleromais/aretrueexcept:
a)Atrophyofnasalmucosa
b)Causedbyfungus
c)Treatmentbyantifungaldrug
--- Content provided by FirstRanker.com ---
d)Causedbybacteriae)Causativeorganismmaybeculturedfrombiopsymaterial
CorrectAnswer-B:C
Answer-(B)Causedbyfungus(C)Treatmentbyantifungaldrug
Rhinoscleromaisarare,slowlyprogressinggranulomatousdisease
--- Content provided by FirstRanker.com ---
oftheupperrespiratorytractcausedbyKlebsiellarhinoscleromatis.Nasaldiseasepresentswiththreetypicalstages:(1)catarrhal(2)
proliferative(3)cicatrical.
Rhinoscleromamaybefoundinallagegroups,buttypicallyyoung
adults20?30yearsoldaremostfrequentlyaffected.
--- Content provided by FirstRanker.com ---
Airbornetransmissioncombinedwithpoorhygiene,crowdedlivingconditions,andpoornutritioncontributestoitsspread.
Bothstreptomycin&tetracyclinearegiventogether
110.Trueaboutchoanalatresia:
a)Unilateralatresiashouldbeoperatedwithin6monthofage
--- Content provided by FirstRanker.com ---
b)Occurd/tpersistenceofbucconasalmembranec)B/1atresiausuallypresentswithrespiratorydifficulties
d)Bilateralatresiamaycausecyanosis
e)Diagnosedbyfailuretopassacatheterfromnosetopharynx
CorrectAnswer-B:C:D:E
--- Content provided by FirstRanker.com ---
Answer-(B)Occurd/tpersistenceofbucconasalmembrane(C)B/1atresiausuallypresentswithrespiratorydifficulties
(D)Bilateralatresiamaycausecyanosis(E)Diagnosedby
failuretopassacatheterfromnosetopharynx
Choanalatresiaisanabnormalityofcanalizationduring
--- Content provided by FirstRanker.com ---
developmentofthenasalpassages.Itinvolvesboneand/orsofttissueandmayresultineitherpartial
(choanalstenosis)orcompleteobstructionoftheposteriornasal
airway.
Themostwidelyacceptedmechanismforthedevelopmentof
--- Content provided by FirstRanker.com ---
choanalatresiaisthepersistenceofthebucconasalmembranebeyondthesixthweekofgestation.
ChoanalatresiaisassociatedwithCHARGEsyndrome:Coloboma
ofeye,Heartdefects,ChoanalAtresia,Retardedgrowth,Genital
defectsandEardefects.
--- Content provided by FirstRanker.com ---
B/LatresiaPresentswithrespiratoryobstructionasthenewbornlaterdevelopscyanosis.
Operativecorrectionofunilateralobstructionmaybedifferedfor
severalyears.
111.Whichofthefollowingistrueregarding
--- Content provided by FirstRanker.com ---
mandibularfracture:a)Inferioralveolarnervedamagemayoccur
b)Panorexradiographisveryhelpfulinmanagement
c)Ramusisthemostcommonsiteoffracture
d)Condylarfracturehealsspontaneously&requirenoactive
--- Content provided by FirstRanker.com ---
interventione)Condylarfractureismostcommonsite
CorrectAnswer-A:B:E
Answer-(A)Inferioralveolarnervedamagemayoccur
(B)Panorexradiographisveryhelpfulinmanagement
--- Content provided by FirstRanker.com ---
(E)CondylarfractureismostcommonsiteCondylarprocessfracturesofthemandiblearemostcommon.
Clinicalfeatures
Pain,Swelling,Deformitywithtrismusormalocclusionofteeth.
ManyPatientswithmandibularfracturesexperiencetraumatothe
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inferioralveolarnerve.Treatment:
Thefractureisreducedandfixedby:
ClosedreductionorOpenreduction.
112.Complicationofmodifiedradical
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mastoidectomyinclude(s):a)Conductivehearingloss
b)Facialnerveinjury
c)Changeintastesensation
d)Sensoryhearingloss
--- Content provided by FirstRanker.com ---
e)AllCorrectAnswer-E
Answer-E.All
Facialparalysis
Perichondritisofpinna
--- Content provided by FirstRanker.com ---
InjurytoduraorsigmoidsinusLabyrinthitis,ifstapesgetsdisclosed
Severeconductivedeafnessof50dBormore.Thisisdueto
removalofallossicla&tympanicmembnne
Cavityproblems
--- Content provided by FirstRanker.com ---
113.TrueaboutEthmoidalsinus:
a)Fullydevelopedby25yr
b)Consistsof3-18sinusoneachside
c)Absentatbirth
d)Laminapapyraceaseparatefromorbit
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e)Anteriorethmodalgroupcells-openintosuperiormeatusCorrectAnswer-B:D
Answer-(B)Consistsof3-18sinusoneachside(D)Lamina
papyraceaseparatefromorbit
Ethmoidalcellsaredividedintoanteriorethmoidalgroupwhich
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apeasintothemiddlemeatus&posteriorethmoidalgroup.Presentatbirth
Reachadultsizeby12years
Theirnumbervariesfrom3to18
Thethinpaperlikelaminaofbone(laminapapyracea)separatingair
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cellsfromtheorbit.114.Whichofthefollowingstatement(s)
is/aretrueaboutlabyrinthitis:
a)Initiallyquickcomponentofnystagmusoccurtowarddiseased
earbutinlaterstageshifttowardhealthyear
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b)Mayoccurasacomplicationofchronicsuppurativeottitismediac)Resolvespontaneouslyin1-6wk
d)Medicaltreatmentaloneissufficient
e)Vertigomaybepresent
CorrectAnswer-A:B:E
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Answer-(A)Initiallyquickcomponentofnystagmusoccurtowarddiseasedearbutinlaterstageshifttowardhealthyear
(B)Mayoccurasacomplicationofchronicsuppurativeottitis
media(E)Vertigomaybepresent
Thisisacommoncomplicationofotitismedia.
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TherearethreetypesrCircumscribed(fistulaoflabyrinth)
Diffuseserous&
Diffusesuppurativelabyrinthitis
Mildcasecomplainofvertigo&nausea.
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Surgicaltreatmentincludes:Myringotomy115.Notselfretaininghandheldretractor(s)
is/are:
a)Mollison'smastoidretractor
b)Jansen'smastoidretractor
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c)Lempert'sendauralretractord)DavisRetractor
e)All
CorrectAnswer-D
Answer-D.DavisRetractor
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Theseretractorsdonotneedanassistanttoholdtheminplace.Itholdtissueapartandlockitinplace.
Handheldretractor-
HohmannRetractor
LaheyRetractor
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SennRetractorBlair(Rollet)Retractor
RigidRake
FlexibleRake
RagnellRetractor
--- Content provided by FirstRanker.com ---
Linde-RagnellRetractorDavisRetractor
116.Lateralwalloforbitis/areformedby:
a)Lesserwingofsphenoid
b)Frontalprocessofzygomaticbone
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c)Greaterwingofsphenoidd)Lacrimalbone
e)Maxilla
CorrectAnswer-B:C
Answer-(B)Frontalprocessofzygomaticbone(C)Greater
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wingofsphenoidThelateralwallisthethickestwalloftheorbit,importantbecauseit
isthemostexposedsurface,highlyvulnerabletobluntforcetrauma.
Anteriorsurfaceofgreaterwingofsphenoid
Orbitalsurfaceoffrontalprocessofzygomaticbone
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117.TrueaboutLeberopticneuropathy:
a)X-linkeddisease
b)Primarilyaffectsmale
c)Discbecomepale&atrophic
d)Transmittedfrommothertochild
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e)MitochondrialinheritanceCorrectAnswer-B:C:D:E
Answer-(B)Primarilyaffectsmale(C)Discbecomepale&
atrophic(D)Transmittedfrommothertochild(E)Mitochondrial
inheritance
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Leber'shereditaryopticneuropathyischaracterizedbysequentialsubacuteopticneuropathyinmalesaged11-30years.
Theunderlyinggeneticabnormalityisapointmutationin
mitochondrialDNA.
SincemitochondrialDNAisexclusivelyderivedfrommother.
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Itischaracterizeedbybilateral,painless,subacutevisualfailurethatdevelopsduringyoungadultlife.
Theydevelopblurringaffectingthecentralvisualfieldofoneeye.
Visuallossisbilateralatonset.
Laterinatrophicphase,discbecomesatrophicandpale.
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118.Riskfactorforcystoidmacularedema
include(s)allexcept:
a)Hypertensiveretinopathy
b)Vitreousloss
c)Diabetesmellitus
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d)Cataractsurgeryisanimportantcausee)Lowerincidencewithintracapsularcataractextractionthan
extracapsularcataractextraction
CorrectAnswer-E
Answer-E.Lowerincidencewithintracapsularcataract
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extractionthanextracapsularcataractextractionCausesofmacularedemaare-
Metabolicalteration:-Diabetes,retinitispigmentosa,Inherited
cystoidmacularedema(CME).
Ischemia;-CRVO,Diabeticretinopathy,severehypertensive
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retinopathy,HELLPsyndrome,vasculitis.Mechanicalforce:-Vitreoustractiononthemacula.
Inflammation:-Intermediateuveitis,Post-operativeCME,choroidal
inflammatorydiseases.
Pharmacotoxicity:-Epinephrine(inAphakia),Betaxolal,
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Latanoprost.119.Allaretrueaboutcongenitalptosis
except
a)Stimulusdeprivationamblyopiamayoccuriftreatmentis
delayed
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b)Lidlagondowngazec)Prominenceoflidcrease
d)Lossoflidcrease
e)Associatedwithweaknessofthelevatorpalpebraesuperioris
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer-C.ProminenceoflidcreasePtosisisdroopingofuppereyelid.
Congenitalmyogenisptosis-
Itisthemostcommontypeofptosis.
Associatedwithcongenitalweaknessoflevatorpalpebraesperioris.
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Characterisedbydroopingofeyelidswithabsentlidcreseandlidlagondowngaze.
120.Feature(s)ofInfantileglaucomais/are
except:
a)Aniridiamaybeassociated
--- Content provided by FirstRanker.com ---
b)Treatmentincludestrabeculotomyc)Buphthalmoscanoccur
d)Corneaisthin&clear
e)MaybeassociatedwithSturge-webersyndrome
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B.TreatmentincludestrabeculotomyCongenitalptosisisusuallyaresultofalocalizeddystrophyofthe
levatormuscleinwhichthestriatedmusclefibers
arereplacedwithfibroustissue.
Thelidcreaseisdecreasedorabsent.
--- Content provided by FirstRanker.com ---
Amblyopiamayoccurinchildrenwithptosis.Ifadroopyeyelidispresentatbirthorwithinthefirstyearoflife,the
conditioniscalledcongenitalptosis.
Itisassociatedwithcongenitalweakens(maldevelopment)ofthe
levatorpalpebraesuperioris(LPS).
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Treatmentincludestrabeculotomy.121.TrueaboutArcussenilis:
a)Fattyinfiltration
b)Axialcornealdegeneration
c)Depositionoccurinstromaofperipheralcornea
--- Content provided by FirstRanker.com ---
d)Amyloiddeposite)Involvelimbus
CorrectAnswer-A:C
Answer-(A)Fattyinfiltration(C)Depositionoccurinstromaof
peripheralcornea
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Itreferstoananndarlipidinfiltrationofcornealperiphery.Affectselderlypatients.
Theareasofthecornea&scleranearthelimbus&perivascular
areasofthescleraareneverinvolved
Lipidaccumulationisfoundintheperipheralcornealstroma.
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122.Trueaboutmoderateflareuveitis:
a)Categorisedasgrade1+
b)Categorisedasgrade2+
c)Categorisedasgrade3+
d)Hazycornea
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e)ClearirisdetailCorrectAnswer-B:E
Answer-(B)Categorisedasgrade2+(E)Clearirisdetail
Itisduetoleakageofproteinparticlesintotheaqueoushumour
fromdamagedbloodvessels.
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Theflareisgradedfrom'0'to+4-0-noaqueousflare
+1justdetectable
+2moderateflarewithclearirisdetails
+3markedflare
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+4intenseflare123.Ectopialentisis/areassociatedwith:
a)Homocystinuria
b)Alportsyndrome
c)Lowesyndrome
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d)Marfansyndromee)Sulphiteoxidasedeficiency
CorrectAnswer-A:D:E
Answer-(A)Homocystinuria(D)Marfansyndrome(E)Sulphite
oxidasedeficiency
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MarfansyndromeHomocystinuria
Weil-Marchesanisyndrome
Sulfiteoxidasedeficiency
Hyperlysinemia
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124.Feature(s)ofTICTinclude:
a)Constrictedpupil
b)Tachycardia
c)Bradycardia
d)Hypertension
--- Content provided by FirstRanker.com ---
e)RespiratorydepressionCorrectAnswer-C:D:E
Answer-(C)Bradycardia(D)Hypertension(E)Respiratory
depression
Bloodpressureelevationaccompaniedbybradycardiaand
--- Content provided by FirstRanker.com ---
respiratoryslowingclassicallyresultsfromraisedintracranialpressure.
Lossofthenormalautoregulationofbloodpressureandpulse,called
theCushingsreflexisahallmarkofseverebraininjuryorimminent
crisis.
--- Content provided by FirstRanker.com ---
Anisocoria,unequalpupilsize,isanothersignofserioustraumaticbraininjury.
125.Whichofthefollowingis/aretrue
regardingAsthma&COPD:
a)COPDshowslessreversibilitytobronchodilatorswhileasthma
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showssignificantimprovementb)Asthmahasagradualprogressionofdyspneaonexertion,
punctuatedbyacuteexacerbationsofshortnessofbreath.while
mostCOPDpatientshavenormalbreathingthemajorityofthe
time
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c)COPDpatientsmayhaveacuteexaberationswhileasthmaticpatientshaverecurrentepisode
d)Steroidtherapyismorebeneficialtoasthmapatientsthan
COPDpatients
e)Neutrophilshaveprimaryaroleinpathogenesisofasthma&
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eosinophilshaveprimaryroleinCOPDCorrectAnswer-A:C:D
Answer-(A)COPDshowslessreversibilitytobronchodilators
whileasthmashowssignificantimprovement(C)COPD
patientsmayhaveacuteexaberationswhileasthmaticpatients
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haverecurrentepisode(D)SteroidtherapyismorebeneficialtoasthmapatientsthanCOPDpatients
PatientswithCOPDhasagradualprogressionofdyspneaon
exertion,punctuatedbyacuteexacerbationsofshortnessofbreath.
Mostasthmaticshavenormalbreathingwithrecurrentepisodesof
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dyspneaduetotriggeringfactor.COPDisseenspecificallyinsmokers.
Asthmaticsoftenshowanacuteresponsetoinhaled
bronchodilators.
bronchodilators.
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COPDisgenerallynotresponsivetooralcorticosteroidtherapy.Inhaledcorticosteroidsareoneofthemosteffectivewaysof
controllingasthma.
Eosinophilicinfiltrationisacharacteristicfeatureofasthmaticairway.
InCOPDthereismacrophageactivation&neutrophilrecruitmentin
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airway.126.Whichofthefollowingis/aretrueabout
SubarachnoidHemorrhage(SAH):
a)SaccularaneurysmismostcommoncauseofSAHafterhead
trauma
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b)Severeheadachemaypresentc)CTangiographyhelpinlocalizinganeurysm
d)CTscanisinvestigationofchoiceforacuteSAH
e)DigitalsubtractionangiographyisbetterthanCTangiography
forSAH
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CorrectAnswer-B:C:DAnswer-(B)Severeheadachemaypresent(C)CTangiography
helpinlocalizinganeurysm(D)CTscanisinvestigationof
choiceforacuteSAH
Suddenlossofconsciousnessmaybeprecededbyabriefmoment
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ofexcraciatingheadache.ThehallmarkofaneurysmalruptureisbloodintheCSF.
Caseshaveenoughbloodtobevisualizedonahighqualitynon
contrastCTscan&bindwithin72hrs.
Alumbarpunctureshouldbperformedtoestablishthepresenceof
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subarachnoidblood.127.FeatureofGranulomatosiswith
polyangiitis:
a)Nasalpolyp
b)PerforatedNasalseptum
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c)Persistantsinusd)Crustingofnasalmucosa
e)Collapseofnasalbridge
CorrectAnswer-B:C:D
Answer-(B)PerforatedNasalseptum(C)Persistantsinus
--- Content provided by FirstRanker.com ---
(D)CrustingofnasalmucosaGranulomatosiswithpolyangiitis(Wegener)isadistinct
clinicopathologicentitycharacterizedbygranulomatousvasculitisof
theupperandlowerrespiratorytractstogetherwith
glomerulonephritis.
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Disseminatedvasculitisinvolvingbothsmallarteriesandveinsmayoccur.
Nasalfindingsincludecrustinggranulations,septalperforation&a
saddlenose
Destructionoftheseptumwithacharacteristicimplosionofthenasal
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bridge.128.Allaretrueaboutrenalarterystenosis
except:
a)ACEinhibitorscanbeusedinbilateralrenalarterystenosis
b)ACEinhibitorscanbeusedinunilateralrenalarterystenosis
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c)ACEinhibitorsarebestdrugtocontrolDMassociatedhypertension
d)Excision&Graftingistreatmentofchoice
e)Angioplastywithorwithoutstenting,andsurgicalbypassused
onlyinrefractorycases
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:DAnswer-(A)ACEinhibitorscanbeusedinbilateralrenalartery
stenosis(D)Excision&Graftingistreatmentofchoice
ACEinhibitorsarecontraindicatedinbilateralrenalarterystenosis.
ACEinhibitorsareusefulinrenovascularhypertension.
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ARFisprecipitatedbyACEinhibitorsinpatientswithb/lrenalstenosis
Atheroscleroticischemicrenaldiseaseaccountsfornearlyallcases
ofrenalarterystenosis.
Renalangiographyisthegoldstandardfordiagnosis.
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129.ECGchange(s)inpulmonaryembolism
mayincludes:
a)STelevationinVI&aVR
b)TwaveinversioninVItoV4
c)S1Q3T3pattern
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d)Leftaxisdeviatione)Rightbundlebranchblock
CorrectAnswer-A:B:C:E
Answer-(A)STelevationinVI&aVR(B)TwaveinversioninVI
toV4(C)S1Q3T3pattern(E)Rightbundlebranchblock
--- Content provided by FirstRanker.com ---
Sinustachycardiaisthemostfrequentandnonspecificfindingonelectrocardiographyinacutepulmonaryembolism.
FeaturessuggestingacuterightheartstrainontheECGoccur
relativelyinfrequently,theseinclude.
Acuterightaxisdeviation
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PpulmonaleRightbundlebranchblock
InvertedTwaves
STsegmentchangesinrightsidedleads.
EarlierthefollowingE.C.G.changeswereconsideredhighly
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predictiveofacutepulmonaryembolism,buttheseobservationswerefoundinlessthan12%ofpatientswithpulmonaryemboliin
recentstudies.
TheseE.C.G.featuresare-
SwaveinleadI
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QwaveinleadIIIInvertedTinleadIII(S1Q31.3)
SwavesinleadI,IIandIII("S1,S2S3)
130.Apatienthasshorth/oincreasedjugular
venouspressure,weakperipheralpulse
--- Content provided by FirstRanker.com ---
&lowB.P.Likelycondition(s)maybe:a)Tensionpneumothorax
b)Venousgasembolism
c)Pulmonaryembolism
d)Cardiactemponade
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e)SepticshockCorrectAnswer-A:B:C:D
Answer-(A)Tensionpneumothorax(B)Venousgasembolism
(C)Pulmonaryembolism(D)Cardiactemponade
"SepticshockhaslowCVPwithhighcardiacoutput.
--- Content provided by FirstRanker.com ---
Venousgasembolism:Itcancauseacutecorpulmonale&cardiovascularcollapse.
Tensionpneumothorax:Thereisdecreasedvenousreturntothe
heartdtcardiacoutputfallsleadingtohypotension.
Cardiactemponade(Pericardialeffusion)shouldbeconsideredin
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anypatientwithhypotension,lowvolumepulse&raisedlVP.131.Trueaboutinsulinoma:
a)Encapsulated
b)Mostlymultiple
c)AssociatedwithMEN-I
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d)Enucleationisthetreatmentofchoiceforbenigntumoure)Histologysimilartonormal(3-cells
CorrectAnswer-A:C:D:E
Answer-(A)Encapsulated(C)AssociatedwithMEN-I
(D)Enucleationisthetreatmentofchoiceforbenigntumour
--- Content provided by FirstRanker.com ---
(E)Histologysimilartonormal(3-cellsInsulinomaisusuallysolitaryandwellencapsulatedtumour
10%aremultiple(alwaysassociatedwithMEN1)and10%are
malignant.
Microscopically,thetumouriscomposedofcordsandsheetofwell-
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dffirentiatedBeta-cellswhichdonotdifferfromnormalcells.Enucleationisthetreatmentofchoiceforbenigninsulinomas.
132.Whichofthefollowingistrueregarding
pseudobulbarpalsy:
a)Dysphagia
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b)Jawjerkbriskc)Absentgagreflex
d)Tonguefasciculationpresent
e)Plantarreflexisextensor
CorrectAnswer-A:B:E
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Answer-(A)Dysphagia(B)Jawjerkbrisk(E)Plantarreflexisextensor
Dysarthria
Dysphagia
Gagreflex
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JawjerkhyperactiveEmotionallability
Intellectualimpairment
133.ApatientpresentedwithhighpH,low
arterialCO2&lowplasmaHCO3-level.
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Whichofthefollowingstatementistrueregardingthepresentation&various
causes:
a)Compensatedrespiratoryalkalosis
b)Chronicrenalfailure
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c)Persistentvomitingd)Cerebro-vascularaccident
e)Hepaticfailure
CorrectAnswer-A:D:E
Answer-(A)Compensatedrespiratoryalkalosis(D)Cerebro-
--- Content provided by FirstRanker.com ---
vascularaccident(E)HepaticfailureHighpHmeans-alkalosis
DecreaseCO,meansrespiratoryalkalosis
LowHCO3-levelmeansmetabolicacidosis
Thereforeitisacaseofrespiratoryalkalosiswithmetabolicacidosis
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(Compensatedrespiratoryalkalosis)134.Whichofthefollowingistrueabout
treatmentofasthma:
a)LongactingP2agonistforacuteattack
b)Longacting32agonistforlongtermtreatment
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c)Shortacting(32agonistforacuteattackd)I.VSteroidforsevereasthmaexacerbation
e)Inhaledsteroidforpersistentasthma
CorrectAnswer-B:C:D:E
Answer-(B)Longacting32agonistforlongtermtreatment
--- Content provided by FirstRanker.com ---
(C)Shortacting(32agonistforacuteattack(D)I.VSteroidforsevereasthmaexacerbation(E)Inhaledsteroidforpersistent
asthma
Oralcorticosteroidsshouldgenerallybeprescribedforearly
administrationathomeinpatientswithmoderatetosevereasthma
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NAEPP3recommendationsemphasizedailyanti-inflammatory
therapywithinhaledcorticosteroidsasthecornerstoneoftreatment
ofpersistentasthma.
135.Side-effect(s)ofinhalationalsteroid
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is/areallexcept:a)Adrenalsuppression
b)Cataract
c)Osteoporosis
d)Hypoglycemia
--- Content provided by FirstRanker.com ---
e)SkinthinningCorrectAnswer-D
Answer-D.Hypoglycemia
Localsideeffectsincludehoarseness(dysphonia)andoral
candidiasis
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growthretardationinchildrenortoosteoporosisinadults.bruising,petechiae
Hyperglycemia&pituitary-adrenalsuppression
136.Allaretrueaboutsyncopeexcept:
a)Consciousnessislost
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b)Morecommoninstandingthanlyingpostionc)Vasovagaltypeiscommon
d)Returnofconsciousnessisslow&takehours
e)Shortduration
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Answer-D.Returnofconsciousnessisslow&takehoursSyncopeisatransient,self-limitedlossofconsciousnessdueto
acuteglobalimpairmentofcerebralbloodflow.
Asyncopalattackbeginswhenthepatientisusuallyinanupright
position(sittingorstanding)Returnofconsciousnessisprompt.
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Vasovagalsyncopeisduetoexcessivevagaltoneorimpairedreflexcontroloftheperipheralcirculation.
ThemostfrequenttypeofvasodepressorsyncoPeisvasovagal
hypotensionorthecommonfaint.
137.TrueabouthemophiliaB:
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a)Factor8deficiencyb)Factor9deficiency
c)X-linkeddisorder
d)ClinicallyindistinguishablefromhemophiliaA
e)Freshfrozenplasmagivenfortreatment
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:DAnswer-(B)Factor9deficiency(C)X-linkeddisorder
(D)ClinicallyindistinguishablefromhemophiliaA
HemophiliaisanX-linkedrecessivehemorrhagicdiseasedueto
mutationsintheF8gene(hemophiliaAorclassichemophilia)orF9
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gene(hemophiliaB).Malesubjectsareclinicallyaffected.
Clinically,hemophiliaAandhemophiliaBareindistinguishable.
Hemophiliaisclassifiedas-
severe(<1%),
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moderate(l-5%),ormild(6-30%)
Clinicalfeatures-
Bleedingintothejoints(hemarthrosis),softtissues,andmuscles.
Investigations-
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HemophiliaB-NormalBT&PT&increasedPTTTreatment-
Thediseaseistreatedwithinfusionsofrecombinantfactoru.
138.Unequalpulseinupper&lower
extremeties(i.e.,radio-femoraldelay)
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is/areseenin:a)Aorticdissection
b)Post-ductalcoarctationofaorta
c)Supra-valvularAorticstenosis
d)Sub-valvularAorticstenosis
--- Content provided by FirstRanker.com ---
e)Takayasu'ssyndromeCorrectAnswer-B
Answer-(B)Post-ductalcoarctationofaorta
InqualitybetweenTwoRadialPulse(Radio-RadialDelay)
Thoracicinletsyndrome(cervicalrib'scalenesyndrome)
--- Content provided by FirstRanker.com ---
AneurysmofaortaTakayasu'sdisease
Pre-subclaviancoarctation
SuPravalvularaorticstenosis
Atherosclerosisofaorta
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139.Drug(s)giveninthyroidcrisis:
a)Esmolol
b)Iodine
c)Hydrocortisone
d)Aspirin
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e)PropylthiouracilCorrectAnswer-A:B:C:E
Answer-(A)Esmolol(B)Iodine(C)Hydrocortisone
(E)Propylthiouracil
TREATMENT-
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Propylthiouracil(drugofchoice)StableiodideblocksthyroidhormonesynthesisviaWolff-Chaikoff
effect.
Potassiumiodide
Porpranolol,esmolol
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Glucocorticoids,HydrocortisoneCalciumchannelblocker
140.Whichofthefollowingdyadsofdisease-
neurotansmitteriscorrect:
a)Myastheniagravis-Acetycholinereceptor
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b)Spasticity-GABAc)Lambert-Eatonmyasthenicsyndrome-Acetycholine
d)Stiff-personsyndrome-Glycine
e)Parkinson'sdisease-Dopamine
CorrectAnswer-A:C:E
--- Content provided by FirstRanker.com ---
Answer-(A)Myastheniagravis-Acetycholinereceptor(C)Lambert-Eatonmyasthenicsyndrome-Acetycholine
(E)Parkinson'sdisease-Dopamine
Acetylcholine(ACh)-Myastheniagravis,Lambert-Eatonsyndrome,
Botulism,Alzheimer'sdisease
--- Content provided by FirstRanker.com ---
Dopamine-Parkinson'sdiseaseNorepinephrine(NE)-Mooddisorder,anxiety,Orthostatic
tachycardiasyndrome
Serotonin-Mooddisorder,Migrainepainpathway
GABA-Stiff-personsyndrome,epilepsy
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Glycine-Spasticity141.AllaretrueaboutMenetrier'sdisease
except:
a)Increasedgastricacidsecretion
b)Protein-losinggastropathy
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c)Mainlyaffectsbody&fundusd)Nomalignantpotential
e)Transforminggrowthfactor-aisoverexpressed
CorrectAnswer-D
Answer-(D)Nomalignantpotential
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Menetrier'sdiseaseisanunusualconditioncharacterisedbyhypertrophyofthegastricmucosalfolds,mucusproduction&
hypochohydria.
Itisapremalignantcondition.
ThemucosalfoldsinMenetrier'sdiseaseareoftenmostprominentin
--- Content provided by FirstRanker.com ---
thebodyandfundus.CausedbyexcessivesecretionofTGF.
Clinicalfeatures-
Hypoproteinaemia
Anaemia
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Increasedriskofgastricadenocarcinomaassociatedwithproteinlosingenteropathy.
MaygetconfusedwithZollinger-Ellisonsyndrome.
142.AccordingtoSurvivingSepsis
Guidelines2013,whichofthefollowing
--- Content provided by FirstRanker.com ---
is/arecorrectregardingsepsis&septicshocktreatmentguideline:
a)Urineoutputshouldbe>2m1/kg
b)Meanarterialpressuregoalshouldbe65mmHg
c)Dopamineasthefirstchoicevasopressor
--- Content provided by FirstRanker.com ---
d)Colloidisinitialfluidofchoiceintheresuscitatione)Administrationofeffectiveintravenousantimicrobialswithinthe
firsthourofrecognition
CorrectAnswer-B:E
Answer-(B)Meanarterialpressuregoalshouldbe65mmHg
--- Content provided by FirstRanker.com ---
(E)Administrationofeffectiveintravenousantimicrobialswithinthefirsthourofrecognition
Crystalloidsastheinitialfluidofchoiceintheresuscitaiionofsevere
sepsisandsepticshock.
Norepinephrineasthefirstchoicevasopressor.
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Dopamineasanalternativevasopressoragenttonorepinephrineonlyinhighlyselectedpatients.
Thegoalsduringthefirst6hoursofresuscitationshouldbe
(GradelC):
Meanarterialpressure(MAP)65mmHg;
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Centralvenouspressure(CVP)8-12mmHg(12-15mmHginPatientsreceivingmechanicalventilationorwithknownpreexisting
decreasedventricularcompliance)
Urineoutput0.5mL/kg/hr(35mL/hrforsomeoneweighing70kg
or154lbs)
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Centralvenousoxygensaturation(fromthesuperiorvenacava)70%,ormixedvenousoxygensaturation(fromapulmonaryartery
catheter)65%
143.Braindeathcanbeassessedby:
a)Apnoeatest
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b)CTscanc)MRIscan
d)Cerebralangiography
e)TranscranialDoppler
CorrectAnswer-A:D:E
--- Content provided by FirstRanker.com ---
Answer-(A)Apnoeatest(D)Cerebralangiography(E)TranscranialDoppler
Spinalcordreflexesmaybepreservedincoma&re-examination
(not<2hourapart)isoptional.
Apneatestshouldbedoneatlastbecauseofitsharmfuleffectson
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intracranialpressure.IsoelectricEEG,absentbrainstemauditoryevokedpotentials&
absenceofcerebralperfusion(onangiography,radioisotopescanor
transcranialDoppler)areconfirmatorybutnotrequiredtests.
144.Presentation(s)ofBechetsyndrome
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mayinclude:a)Erosivearthritis
b)Recurrentaphthousulcersofthemouth
c)Uveitis
d)Genitalulcer
--- Content provided by FirstRanker.com ---
e)PathergytestCorrectAnswer-B:C:D:E
Answer-(B)Recurrentaphthousulcersofthemouth(C)Uveitis
(D)Genitalulcer(E)Pathergytest
Behcet'ssyndromeisamultisystemdisorderpresentingwith
--- Content provided by FirstRanker.com ---
recurrentoralandgenitalulcerationsaswellasocularinvolvement.Non-deformingarthritisorarthralgiasareseenin50%ofpatients
andaffectsthekneesandankles.
Recurrentoralulcerationplustwoofthefollowing:
Recurrentgenitalulceration
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EyelesionsSkinlesions
Pathergytest
ThehallmarkofBehcetdiseaseispainfulaphthousulcerationinthe
mouth.
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Eitheranteriororposterioruveitisposterioruveitismaybeasymptomatic
145.Whichofthefollowingistrueabout
Pheochromocytoma:
a)Sestabimiscanisdonebeforesurgery
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b)Mostlyaremalignantc)Surgeryismainstayoftreatment
d)Priorablockerisgiven
e)Priorpblockerisgiven
CorrectAnswer-C:D:E
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Answer-(C)Surgeryismainstayoftreatment(D)Priorablockerisgiven(E)Priorpblockerisgiven
Sestambiscanningisthepreferredwayinwhichtolocalizediseased
parathyroidglandspriortooperation.
Pheochromocytoma¶gangliomaarecatecholaminesproducing
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tumoursderivedfromsympatheticandparasympatheticnervoussystem.
TheyarederivedfromChromaffincells.
Treatment-
Laproscopicresection
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Alphaadrenoreceptorblocker(phenoxybenzamine)-blockcatecholamineexcess
Betablockade-tachycardiaorarrhythmias
Centralvenouscatheter&invasivearterialmonitoringused.
AdultDoseofClonidineforClonidineSuppressiontestis0.3mg
--- Content provided by FirstRanker.com ---
(0.3mg/70kg)administeredorally.ClonidineSuppressionTestCompletetumorremovalistheuhimatetherapeuticgoal,,canbe
achievedbypartialortotaladrenalectomy.
146.MIBG(metaiodobenzylguanithidine)is
analogueto:
--- Content provided by FirstRanker.com ---
a)Epinephrineb)Adenine
c)Norepinephrine
d)Guanine
e)Phenylephrine
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer-(C)Norepinephrine
Pheochromocytomacanbelocalizedusingradioactivetracers
including131I-or123l-metaiodobenzylguanithidine(MIBG),111ln-
somatostatinanalogues,or18F-dopa(ordopamine)Positron-
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emissiontomography(PET).147.Whichofthefollowingistrueregarding
adrenocorticalcarcinomas:
a)IncreasedurinaryexcretionofVMA
b)Doesnotcausemetastasis
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c)Surgeryismainstaytreatmentd)AssociatedwithLi-Fraumenisyndrome
e)None
CorrectAnswer-C:D
Answer-(C)Surgeryismainstaytreatment(D)Associatedwith
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Li-FraumenisyndromeIncreasedVMAexcretionintotheurinecanoccurin
Neuroblastomas,pheochromocytomas,andotherneuroendocrine
tumors.
TworareinheritedcausesofadrenalcorticalcarcinomasareLi-
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FraumenisyndtomeandBeckwith-Wiedenannsyndrome.Metastasestoregionalandperiaorticnodesarccommon.
ACCcarriesapoorprognosisandcurecanbeachievedonlyby
completesurgicalremoval.
148.A40yearoldladyfromHimanchal
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Pradeshhasfever&escharonbody.Bloodinvestigationrevealed:Hb=12
gm%,TLC=9800/1.11,Platelet80000.
Whichofthefollowingdrug(s)maybe
usedinhertreatment:
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a)OralDoxycyclineb)Meropenem
c)Azithromycin
d)Tetracycline
e)Chloramphenicol
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CorrectAnswer-A:C:D:EAnswer-(A)OralDoxycycline(C)Azithromycin(D)Tetracycline
(E)Chloramphenicol
Theclinicalmanifestationsofalltheacutepresentationsaresimilar
duringthefirst5days:feverheadache,andmyalgiaswithorwithout
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nausea,vomiting,andcough.Clinicalmanifestations-includingoccurrenceofamacular,
maculopapular,orvesicularrash;eschar;pneumonitis;and
meningoencephalitis.
Doxycyclineisthedrugofchoiceformostoftheseinfections.
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Tetacyclineisdrugofchoiceforspecifictreatmentofallrickettsialdiseases.
Longacting(doxycycline,minocycline)nowmakesingledose
treatmentpossible.
149.Allaretrueabout"a"waveexcept:
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a)Itisoftenthelargestpositivewavevisibleb)Giantwaveinatrialfibrillation
c)Tricuspidstenosisproducesgaintwave
d)Heartblockdiminishmagnitudeofawave
e)Producedbyrightatrialcontraction
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CorrectAnswer-B:DAnswer-(B)Giantwaveinatrialfibrillation(D)Heartblock
diminishmagnitudeofawave
Awavereffectsrightatrialpresystoliccontractionandoccursjust
aftertheelectrocardiographicPwave,precedingthefirstheart
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sound(S1).Aprominentalphawaveisseeninpatientswithreducedrightventricularcompliance;acannonawaveoccurswith
atrioventricufar(AV)dissociationandrightatrialcontractiondgainst
aclosedtricuspidvalve.
Inapatientwithawidecomplextachycardia,theappreciationof
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cannonawavesinthejugularvenouswaveformidentifiestherhythmasventricularinorigin.
TheAwaveisnotpresentwithatrialfibrillation.
150.Whichoftheconditioncausepericarditis
duetohypersensitivity:
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a)SLEb)Rheumaticfever
c)Dresslersyndrome
d)Uraemia
e)Myxedema
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CorrectAnswer-A:B:CAnswer-(A)SLE(B)Rheumaticfever(C)Dresslersyndrome
A.Rheumaticfever
B.Collagenvasculardisease(systemiclupuserythematosus,
rheumatoidarthritis,ankylosingspondylitis,scleroderma,acute
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rheumaticfever,granulomatosiswithpolyangiitis(Wegener's)C.Drug-induced(e.9.,procainamide,hydralazine,phenytoin,
isoniazide,minoxidil,anticoagulants,methysergide)
D.Post-cardiacinjury
1. Postmyocardialinfarction(Dressler'ssyndrome)
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2. Postpericardiotomy3. Posttraumatic
151.Allaretrueaboutacuteradiation
pneumonitisexcept:
a)Fevernotpresent
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b)Steroidisbeneficialc)X-raychestfindingcorrelatespoorlywithsymptom
d)Developimmediatelyafterradiotherapy
e)All
CorrectAnswer-A:D
--- Content provided by FirstRanker.com ---
Answer-(A)Fevernotpresent(D)Developimmediatelyafterradiotherapy
Twophasesofthepulmonaryresponsetoradiationare
apparent:
acutephase(radiationpneumonitis)
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chronicphase(radiationfibrosis)Clinicalfeatures-
manifestedbyfever,dyspneaoutofproportiontothevolumeoflung
irradiated,pleuraleffusion.
Withsteroidthetapy,thesesymptomsmayresolvecompletelyin
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somepatientswithoutlong-termefects.Epithelialcellatypiaandfoamcellwithinvesselwallsarealso
characteristicofradiationdamage.
152.TrueaboutKallmansyndrome:
a)Amenorrhoea
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b)Hypergonadotrophicstatec)Anosmia
d)Failureofsecondarysexualdevelopment
e)None
CorrectAnswer-A:C:D
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Answer-(A)Amenorrhoea(C)Anosmia(D)Failureofsecondarysexualdevelopment
Kallmannsyndromeiscausedfromdefectivegonadotropinreleasing
hormone(GnRH)synthesis.
Clinicalfeatures-
--- Content provided by FirstRanker.com ---
Anaemia&hyposmiaduetoolfactorybulbagenesis&hypophasia.Colorblindness,opticatrophy,nervedeafness.
Cleftpalate,cryptoorchidism&mirrormovements(neurological
defects)
Inmales-delayedpuberty,micropenis.
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Infemales-primaryamenorrhea,failureofsecondarysexualdevelopment.
LowLH&FSHlevels&sexsteroids.
153.GlasgowcomascaleE3M4V5represents:
a)Spontaneouseyeopening
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b)Eyeopeningwithpainstimulusc)Incomprehensiblesound
d)Orientedconversation
e)Decorticateposturing
CorrectAnswer-D
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Answer-(D)OrientedconversationDomain
Response
Score
Spontaneous
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4Tospeech
3
Eyeopening
Topain
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2None
1
Oriented
5
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Confused4
Bestverbalresponse Inappropriate
3
Incomprehensible
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2None
1
Obeying
6
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Localizing5
Withdrawal
4
Bestmotorresponse Flexing
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3Extending
2
None
1
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3Deepcomaordeath
Totalscore
15
Fullyalertandoriented
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Fullyalertandoriented
154.Complication(s)ofSalivarygland
operation:
a)Subcutaneousfistula
b)Oppositeglandcompensatoryhypertrophy
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c)Gustatorysweatingd)FacialNervedamage
e)All
CorrectAnswer-A:C:D
Answer-(A)Subcutaneousfistula(C)Gustatorysweating
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(D)FacialNervedamageComplicationsofParotidGlandSurgery-
Temporaryfacialnerveweakness
Transectionofthefacidnerveandpermanentfacialweakness
Sialocele
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FacialnumbnessPermanentnumbnessoftheearlobeassociatedwithgreatauricular
nervetransection
Frey'ssyndrome(Gustatorysweating)
ComplicationsofSubmandibularGlandExcision
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Marginalmandibularnerveinjury;Lingualnerveinjury;
Hypoglossdnerveinjury
Complicationsofparotidectomy-
Flapnecrosis
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FacialnervepalsyFluidcollection
Salivaryfistula
Frey'ssyndrome
155.Punchedoutulceris/areseenin:
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a)Arterialulcerb)Venousulcer
c)Tubercularulcer
d)Basalcellcarcinoma
e)Gummatousulcer
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CorrectAnswer-A:EAnswer-(A)Arterialulcer(E)Gummatousulcer
Puchedoutedge:Itismostlyseeningummatousulcerorinadeep
trophiculcer.
Arterialulcer-Thaeulcertendstobepunchedout
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Gummatousulcers,whichoccursintertiarysyphilis,havepunched-outindolentedge.
156.Whichofthefollowingis/aretrue
regardingrenaltransplantationexcept:
a)Curvilinearincisionismadeinlowerquadrant
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b)Transplantedkidneyisplacedinretroperitonealpositionc)Recipientskidneyisfirstremovedfromrenalfossatomake
spacefordonorkidney
d)Anastomosisofexternaliliacarterywithrenalartery
e)Donorrenalveinisanastomosedwithexternaliliacvein
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CorrectAnswer-CAnswer-(C)Recipientskidneyisfirstremovedfromrenalfossa
tomakespacefordonorkidney
Alowerqusdrantcurvilinear(Gibson)incisionismade,andtheiliac
vesselsareexposedthrougharetroperitonealapproach.
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Therenalarterycanbeanastomosedend-to-endtotheinternaliliac.Anend-to-sideanastomosisoftherenalarterytotheexternaliliac
arteryismorefrequentlydone.
Theureter,whichiskeptreasonablyshorttoavoidtheriskofdistal
ischaemia,isthenaaastomosedtothebladder.
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157.Whichofthefollowingplanof
managementis/arecorrectwithregardto
Cleftlip&cleftpalateinchildren:
a)Unilateralliponly-1yearofage
b)Bilaterallip-1yearofage
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c)Bilaterallipshouldberepairedat5monthd)Bothsoft&hardpalateat1yearinonesetting
e)Cleftlipandsoftpalateat5-6months&hardpalateat15-18
monthsofage
CorrectAnswer-C:E
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Answer-(C)Bilaterallipshouldberepairedat5month(E)Cleftlipandsoftpalateat5-6months&hardpalateat15-18months
ofage
Cleftingofthelipand/orpalateisfelttooccuraroundtheeighth
weekofembryogenesis,eitherbyfailureoffusionofthemedial
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nasalprocessandthemaxillaryprominenceorbyfailureofmesodermalmigrationandpenetrationbetweentheepithelialbilayer
oftheface.
Repair
Ruleoftens:Forincreasedanestheticsafety,aninfantshould
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1. Be10weeksold.2. Weigh10pounds.
3. Haveahemoglobinlevelofatleast10mg/dL.
158.Suturenumber2-0correspondsto
diameterof:
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a)0.21mmb)0.24mm
c)0.27mm
d)0.30mm
e)0.33mm
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CorrectAnswer-DAnswer-(D)0.30mm
Theavailablesizesanddiametersofsutureare:
6-0=0.07mm
5-0=0.10mm
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4-0=0.15mm3-0=0.20mm
2-0=0.30mm
0=0.35mm
1=0.40mm
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2=0.5mm159.Whichofthefollowingis/arecorrect
regardingeczemaofbreast&Paget's
diseaseofnipple:
a)Generallyeczemaisunilateralwhereaspaget'sdiseaseis
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bilateralb)Eczemamaybeassociatedwithlactation
c)NipplemaybedestroyedinPaget'sdiseasewhileitnormally
intactineczema
d)InversionofnipplemayoccurinPaget'sdisease
--- Content provided by FirstRanker.com ---
e)AssociatedwithbreastlumpineczemaCorrectAnswer-B:C:D
Answer-(B)Eczemamaybeassociatedwithlactation
(C)NipplemaybedestroyedinPaget'sdiseasewhileit
normallyintactineczema(D)Inversionofnipplemayoccurin
--- Content provided by FirstRanker.com ---
Paget'sdiseasePaget'sdiseaseofnipple-
Occursalmostexclusivelyinwomen.
Mayoccuratanyagefrom24to84,althoughitismostcommon
aroundthemenopause.
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AlmostalwaysassociatedwithunderlyingcarcinomaofthebreastUnilateral,persistenteczematous-typechangeofthenipplewith
erythemaandscaling.
Itchingorburningsensation.
Destructionofthenipple.
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160.Correctcombination(s)ofHerniawith
theircontent:
a)Littrehernia:Meckle'sdiverticulum
b)Richter'shernial-smallintestine
c)Pantaloon-hernialsaconeithersideofinferiorgastricartery
--- Content provided by FirstRanker.com ---
d)Hernia-en-glissade-urinarybladdere)Maydl'shernia-intestine
CorrectAnswer-A:B:C:D:E
Answer-(A)Littrehernia:Meckle'sdiverticulum(B)Richter's
hernial-smallintestine(C)Pantaloon-hernialsaconeitherside
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ofinferiorgastricartery(D)Hernia-en-glissade-urinarybladder(E)Maydl'shernia-intestine
Richter'sherniaisaherniainwhichthesaccontainsonlyaportion
ofthecircumferenceoftheintestine.
Maydl'sHernia-normal-lookingloopsofintestinearepresentinthe
--- Content provided by FirstRanker.com ---
sacSlidingHernia(Hernia-en-glissade)-oneithersidebyaportionof
thebladder
Saddle-bag,pantaloonhernia-Thistypeofherniaconsistsoftwo
sacsthatstaddletheinferiorepigastricartery
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Littrehernia-AherniacontainingaMeckel'sdiverticulum161.Whichofthefollowingistrueabout
esophagusexcept:
a)Serosanotpresent
b)Middle&lowerthirdmadeupofstriatedmuscle
--- Content provided by FirstRanker.com ---
c)Loweroesophagealsphincterisazoneofrelativelyhighpressure
d)InachaliacardiaLOStoneisincreasedsothatfoodcannot
passbelow
e)Ithassidetoside&antero-posteriorcurvatures
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAnswer-(B)Middle&lowerthirdmadeupofstriatedmuscle
Epitheliumisstratifiedsquamousnon-keratinizedepithelium.
Muscularismucosacontainsonlylongitudinallayerandnocircular
layer.
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Mucosaisthetoughestandstrongestlayer.Serosaisabsent.
Muscularisexternaismadeupofskeletalmusclefibersonlyinthe
upperthird,smoothmusclesonlyinthelowerthirdandbothtypesof
musclefibersinmiddlethird.Atupperendthelongitudinalcoatsplits
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intotwobundlesandthetriangularintervalbetweenthemiscalledLaimer'stringlewhichisfilledwithcircularmusclefiber
162.Allaretrueaboutfullthicknessrectal
prolapseexcept:
a)Elderlyareatrisk
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b)Commoninchildrenc)Morecommoninfemale
d)sensationofincompleteevacuation
e)Mayassociatedwithaweakpelvicfloor
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B.CommoninchildrenCommonlnelderlywomenwhoaremultipara
ConstiPationisimportantfeature
Tenesmuscommon
Somedegreeofincontinenceoffaeces&flatusisalwayspresent.
--- Content provided by FirstRanker.com ---
163.Correctstatement(s)abouthypospadias
is/are:
a)Urethralopeningonventralaspect
b)Chordaeondorsalaspect
c)Maybeassociatedwithpeniletorsion
--- Content provided by FirstRanker.com ---
d)Proximalvarietiesaremorecommone)Couponsspongiosumisdeficient
CorrectAnswer-A:C
Answer-A,C,Urethralopeningonventralaspect(C)Maybe
associatedwithpeniletorsion
--- Content provided by FirstRanker.com ---
Thereisincompletedevelopmentoftheprepuce,calledadorsalhood,inwhichtheforeskinisonthesidesanddorsalaspectofthe
penileshaftandabsentventrally.
Thereisavariabledegreeofchordae(aventralcurvatureofthe
penismostapparentonerection)
--- Content provided by FirstRanker.com ---
"Peniletorsionisafairlycommoncongenital(presentfrombirth)conditionthatcanaffectanymaleinfant.
164.Whichofthefollowingistrueabout
digitalrectalexamination:
a)Indexfingerisused
--- Content provided by FirstRanker.com ---
b)InBPHrectalmucosaisfreewhereasinprostatecancermucosaofrectumisadhered
c)Puborectalisisfeltanteriorly
d)Analsphincterlengthcannotbeassessed
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:BAnswer-(A)Indexfingerisused(B)InBPHrectalmucosais
freewhereasinprostatecancermucosaofrectumisadhered
Duringdigitalrectalexaminationinamale,thefingersequentially
palpatesontheanteriorwall,theprostategland,theseminal
--- Content provided by FirstRanker.com ---
vesicles,andtherectovesicalpouch.Posteriorlyisthehollowofthesacrumandthecoccyx.
Ontheanteriorwallofthefemale,theuterinecervix,theuterine
fundus(ifretroverted),andtherectouterinepouchwillbefelt.
Therectalwallispalpatedformassesandnarrowingofthelumen.
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165.Truestatement(s)aboutlaproscopic
cholecystectomy:
a)Cosmeticallybetter
b)Bleedingismorecommoninopencholecystectomythan
laproscopiccholecystectomy
--- Content provided by FirstRanker.com ---
c)Veressneddleisusedinclosedtechniqued)Lalprocsopewithattachedvideocameraisinsertedthrough
umbilicalport
e)Previousabdominalsurgeryisabsolutecontraindication
CorrectAnswer-A:C:D
--- Content provided by FirstRanker.com ---
Answer-(A)Cosmeticallybetter(C)Veressneddleisusedinclosedtechnique(D)Lalprocsopewithattachedvideocamera
isinsertedthroughumbilicalport
Initially,asmallincisionismadeintheupperedgeoftheumbillcus.
Withtheclosedtechniqueaspecialhollowinsufflationneedle
--- Content provided by FirstRanker.com ---
(Veressneedle)thatisspring-loadedwitharetractablecuttingoutersheathisinsertedintotheperitonealcavityandusedforinsufflation.
Bleedinghasbeenthemostcommoncauseforconversiontoan
openprocedure.
166.AllaretrueaboutBPHexcept:
--- Content provided by FirstRanker.com ---
a)Submucosalglandhyperplasiaintransitionzoneb)Penileurethaelongation
c)Prostaticurethramaybecompressed
d)Lessthan20m1/secondpeakflowrateisstrongindicationfor
TURP
--- Content provided by FirstRanker.com ---
e)BPHoccurduetogrowthinperipheralzoneofprostateCorrectAnswer-B:D:E
Answer-(B)Penileurethaelongation(D)Lessthan
20m1/secondpeakflowrateisstrongindicationforTURP
(E)BPHoccurduetogrowthinperipheralzoneofprostate
--- Content provided by FirstRanker.com ---
BenignProstaticHyperplasia(BPH)Prostateitisdividedintotheperipheralzone(PZ),whichliesmainly
posteriorlyandfromwhichmostcarcinomasarise,andacentral
zone(CZ).
Thereisalsoaperiurethraltransitionalzone(TZ),fromwhichmost
--- Content provided by FirstRanker.com ---
benignptostatichyperplasia(BPH)arises.BPHtypicallyafectsthesubmucousgroupofglandsinthe
transitionalzone.
Aflowrate<10mls-1willbesufiicientformosturologiststo
recommendtreatment.
--- Content provided by FirstRanker.com ---
167.Whichofthefollowingincreasesriskof
urinarystones:
a)Increasedurinarycitrate
b)1stCalciumlevelinblood
c)HypervitaminosisA
--- Content provided by FirstRanker.com ---
d)Hypoparathyroidisme)Decreaseinurinarycolloid
CorrectAnswer-B:C:E
Answer-(B)1stCalciumlevelinblood(C)HypervitaminosisA
(E)Decreaseinurinarycolloid
--- Content provided by FirstRanker.com ---
DeficiencyofvitaminAAlteredurinarysolutesandcolloids
Decreasedurinarycitrate
Renalinfection
Inadequateurinarydrainageandurinarystasis
--- Content provided by FirstRanker.com ---
ProlongedimmobilizationHyperparathyroidism
168.Trueaboutduodenaldiverticula:
a)MostcommonoftheGITdiverticula
b)Commonlyoccuronmedialborder
--- Content provided by FirstRanker.com ---
c)Oftenpresentinperiampullaryregiond)Itshouldbetreatedaggressivelyduetohighmalignantpotential
e)Itcancausepancreatitisbyproducingobstructionatthe
openingoftheduct
CorrectAnswer-B:C:E
--- Content provided by FirstRanker.com ---
Ans.(B)Commonlyoccuronmedialborder(C)Oftenpresentinperiampullaryregion(E)Itcancausepancreatitisbyproducing
obstructionattheopeningoftheduct
Diverticulaoftheduodenumrepresentingthesecondmostcommon
sitefordiverticulumformationafterthecolon.
--- Content provided by FirstRanker.com ---
Duodenaldiverticulaoccurtwiceasofteninwomen.Twothirdstothreefourthsofduodenaldiverticulaarefoundinthe
periampullaryregion.
Majorcomplicationsofduodenaldiverticulaincludeobstructionof
thebiliaryorpancreaticducts.
--- Content provided by FirstRanker.com ---
Hemorrhage;perforation;andrarely,blindloopsyndromeOnlythosediverticulaassociatedwiththeampullaofVaterare
significantlyrelatedtocomplicationsofcholangitisandpancreatitis.
Surgicaltreatmentisrequiredforcomplications&rarelyfor
persistentsymptoms.
--- Content provided by FirstRanker.com ---
169.Psammomabodiesis/areseenin:
a)Medullarycarcinomaofthyroid
b)Ependymoma
c)Papillarycarcinomathyroid
d)Follicularcarcinomaofthyroid
--- Content provided by FirstRanker.com ---
e)MeningiomaCorrectAnswer-C:E
Answer-(C)Papillarycarcinomathyroid(E)Meningioma
Psammomabodiescanbeseenin:?
Papillarycarcinomaofthyroid.
--- Content provided by FirstRanker.com ---
Renalcellcarcinoma(papillarytype)Serouscystadenomaofovary
Meningioma
Malignantmesothelioma(Peritoneal&pleural)
Somatostatinoma(Pancreas)
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Prolactinomam(Pituitary)Endometrialpapillaryserouscystadenocarcinoma
170.Whichofthefollowingis/aretrueabout
primaryhyperparathyroidism:
a)AssociatedwithMENI&II
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b)Increaseriskofrenalstonec)About50gramofglandtissuecanbeleftduringsurgeryto
preventhypocalcemia
d)Causebenignhypertension
e)Mcsporadiccauseishyperplasia
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CorrectAnswer-A:B:CAnswer-(A)AssociatedwithMENI&II(B)Increaseriskofrenal
stone(C)About50gramofglandtissuecanbeleftduring
surgerytopreventhypocalcemia
PrimaryhyperparathyroidismisduetoexcessPTHsecretionfroma
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singleparathyroidadenoma,hyperplasia,andcarcinoma.PrimaryhyperparathyroidismMEN1,MEN2A,isolatedfamilialHPT,
andfamlialHPTwithjaw-tumorsyndrome.
Inheritedinanautosomaldominant.
Theclassicquartetofstones,bones,abdominalgroansandpsychic
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moansrenalcalculiandcalcinosis,pancreatitisandpsychiatricdisorderdevelops.
171.Whichofthefollowingis/arefeaturesof
Testiculartorsionwhichisnotpresentin
epididymoorchitis:
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a)Rednessofskinb)Elevationoftestisworsenpain
c)Dopplerultrasoundscanshowabsenceofthebloodsupplyto
theaffectedtestis
d)Fever
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e)DysuriaCorrectAnswer-B:C
Answer-(B)Elevationoftestisworsenpain(C)Doppler
ultrasoundscanshowabsenceofthebloodsupplytothe
affectedtestis
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EpididymoorchitisTheinitialsymptomispain&swellingofepididymisalongwithfever,
malaise&chills
Scrotalwallbecomesred,oedematous&glossy
Testiculartorsion
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Thescrotumisswollen&tendon.Thescrotummayalsobenormalorred&oedematous.
Theonsetofrednessoftheskinandamildpyrexia.
Elevationofthetestisreducesthepaininepididymoorchitisand
makesitworseintorsion.
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Dopplerultrasoundscanwillconfirmtheabsenceofthebloodsupplytotheaffectedtestis.
172.TrueaboutTyphoidulcer:
a)Perforationiscommonin2nd&3rdweekafteronsetoftyphoid
fever
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b)Perforationmaypresentatmultiplesitec)Commonlyinvolvejejunum
d)Commonlyinvolveileum
e)Peritoneallavageiscontraindicatedforperforatedulcer
CorrectAnswer-A:B:D
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Answer-(A)Perforationiscommonin2nd&3rdweekafteronsetoftyphoidfever(B)Perforationmaypresentatmultiple
site(D)Commonlyinvolveileum
CharacteristicFeaturesofTyphoidUlcersMostcommonsiteis
mucosaofsmallintestine(Ileum)inregionoflymphoidpatches
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(Payer'spatches)Ulcersareoval
Ulcersarearrangedlongitudinally(Longitudinalulcers)
Lieinthelongaxisoftheintestinealongtheantimesentericborder
Ulcersmaybesingleormultiple
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Ulcersmayerodeandcausecomplications(Bleeding/perforation)173.Featureof3degreeburn:
a)Painpresent
b)Transudationoffluidpresent
c)Wholedermisdestroyed
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d)Erythematousinappearancee)Blisterformed
CorrectAnswer-C
Answer-C.Wholedermisdestroyed
Thewholeofthedermisisdestroyedoftheburns.
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Clinically,theyhaveahard,leatheryfeel,Theappearancecanvaryfromthatsimilartothepatient'snormalskintocharredblack
dependingupontheintensityoftheheat..Thereisnocapillayreturn
after,thrombosedvesselscanbeseenundertheskin.
Theseburnsarecompletelyanaesthetised:aneedlecanbestuck
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deepintothedermiswithoutanypainorbleeding.174.Apatienthash/ohypertension&
diabetes.Themechanismofhigher
chanceofulcerinthispatientisdueto:
a)Hyperglycemiassuppressimmunity
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b)Vascularinsufficiencyc)Atheroscleroticchanges
d)Venousstasis
e)Tropicskinchanges
CorrectAnswer-A:B:C:E
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Answer-(A)Hyperglycemiassuppressimmunity(B)Vascularinsufficiency(C)Atheroscleroticchanges(E)Tropicskin
changes
Trophicchangefromperipheralneuropathy,ischaemiaasaresultof
atheroma,andlowresistancetoinfectionbecauseofexcesssugar
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intheTissue.Neuropathy,abnormalfootbiomechanics,peripheralarterialdisease
(PAD),andpoorwoundhealing.
175.Pretermbabieshaveincreasedchance
of:
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a)Heartdiseaseb)Respiratorydistresssyndrome
c)Necrotisingcolitis
d)Meconiumaspirationsyndrome
e)All
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CorrectAnswer-A:B:CAns.a.Heartdisease;b.Respiratorydistresssyndrome;c.
Necrotisingcolitis
PretermNeonate:
Respiratorysyndrome:Pulmonryoedema,Intra-alveolar
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haemorrhage,Idiopathicrespiratorydistresssyndrome&Bronchopulmonarydysplasia
Infection:Bronchopneumonia,meningitis&necrotizingenterocolitis.
Metabolic(hypoglycemia,hypocalcemia)
Retinopathyofprematurity
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AsphxiaCerebralhaemorrhage
Hypothermia
Fetalshock
HeartfailurePrecipitatedbyasphyxiawithrapiddevelopmentof
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pulmonaryedema.TheremaybepatentDuctusarteriosusJaundice
Anaemia
176.Whichofthefollowingcanpresentswith
cyanosisatbirth:
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a)TetralogyofFallotb)TGA
c)PDA
d)VSD
e)Atrialseptaldefect(ASD)
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CorrectAnswer-A:BAns.a.TetralogyofFallot;b.TGA
TOF:Cyanosismaybepresentfrombirthormakeitsappearance
someyearsafterbirth.
TGA:PatientsofcompleteTGAwithintactventricularseptumare
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cyanoticatbirth.PDA,ASD&VSDareacyanoticcondition
177.Whichofthefollowingis/aretrue
regardingdevelopmentofchildduring6
to12yr.ofage:
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a)Weightincreasesbyl-2kg/yrb)Headgrowattherateof2-3cm/yr
c)Growthoccurcontinuously
d)Growthoccurinspurts
e)Heightincreasesatrateof6-7cm/yr
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CorrectAnswer-D:EAns.d.Growthoccurinspurts;e.Heightincreasesatrateof6-
7cm/yr
PhysicalDevelopmentDuringMiddleChildhood(6-11yrofage)
Growthduringtheperiodaverages3-3.5kg(7lb)and6-7cm(2.5
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in)peryear.Growthoccursdiscontinuously,in3-6irregularlytimedspurtseach
year,witheachgrowthspurtlasting,onaverage,8wk.
Theheadgrowsonly2-3cmincircumferencethroughouttheentire
period,reflectingaslowingofbraingrowth.
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178.TrueaboutAspergersyndrome:
a)Morecommoningirl
b)Repetitiveactivitypattern
c)Subnormalintelligenceisconsistentfeature
d)Severelanguageimpairmentsischaracteristic
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e)AllCorrectAnswer-B
Ans.b.Repetitiveactivitypattern
Aspergersyndrome:
Itisfourtimesmorelikelytooccurinmalesthaninfemalesand
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usuallyisfirstdiagnosedinchildrenbetweentheagesof2and6.Thecommoncharacteristicsincludeaverageoraboveaverage
intelligence"
Thereisnoclinicallysignificantgeneraldelayinspokenorreceptive
languageorcognitivedevelopment.Self'helpskills,adaptive
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behaviour,andcuriosityabouttheenvironmentduringthefirst3yearsshouldbeatalevelconsistentwithnormalintellectual
development
179.TrueaboutAutisticdisorder:
a)Qualitydecreaseinsocialinteraction
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b)Allaffectedchildrenhavesubnormalintelligencec)TreatmentshouldtargetedtowardSpeechdevelopment
d)Seenonlyafter3yrofage
e)Stereotypedpatternsofbehaviour
CorrectAnswer-A:C:E
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Ans.a.Qualitydecreaseinsocialinteraction;c.TreatmentshouldtargetedtowardSpeechdevelopment;e.Stereotyped
patternsofbehaviour
Autisticdisordersarecharacterizedbythetriadofimpaired
socialinteraction,communicationandimagination.Theseare
--- Content provided by FirstRanker.com ---
associatedwithrigidrepetitivepatternofbehaviour.Theonsetofautisticdisorderalwaysoccursbeforeage3,attwo
peakperiods.
Difficultyinconcentrationandcommunication,
Lesioninfrontalandtemporallobeandcerebellum,
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Delayedspeechandlanguagedevelopment,Problemsinformingsocialrelationshipsinearlychildhood,
Stereotypedmovements,
Poorspeech,
Lackofsocialinteraction,
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180.TrueaboutHIVinfectionininfants:
a)Mainlyoccurthroughhorizontaltransmission
b)HIVDNAPCRpositiveat3monthconfirmsdiagnosis
c)PositiveantibodytestforIgGantibodyat3monthconfirm
infectedinfant
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d)Passivetransferofmaternalbodygenerallypersistsfor12month
e)All
CorrectAnswer-B:D
Ans.b.HIVDNAPCRpositiveat3monthconfirmsdiagnosis;
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d.Passivetransferofmaternalbodygenerallypersistsfor12month
AllinfantsborntoHIV-infectedmotherstoantibodypositiveatbirth
becauseofpassivetransferofmaternalHIVantibodyacrossthe
placentaduringgestation.
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Mostuninfectedinfantslosematernalantibodybetween6and12monthofageandareknownasseroreverters.
Becauseasmallproportionofuninfectedinfantscontinuestotest
HIVantibodypositiveforupto18monthofage,positiveIgG
antibodytests,includingtherapidtests,cannotbeusedtomakea
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definitivediagnosisofHIVinfectionininfantsyoungerthanthisage.Inanychild>18monthsofage,demonstrationofIgGantibodyto
HIVbyarepeatedlyreactiveenzymeimmunoassay(EIA)and
confirmatorytest(immunoblotorimmunofluorescenceassay)
establishesthediagnosisofHIVinfection.
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Viraldiagnosticassays,suchasHMNAorRNAPC&HIVculture,orHIVp24antigenimmune-dissociatedp24
By4-6monthsofage,theIIIVcultureand/orPCRidentifuall
infectedinfants.
181.Commonfeatureofmarfansyndrome&
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Homocystinuria:a)Armspan>Height
b)Ectopialentis
c)Hypermobilityofjoint
d)Mentalretardation
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e)ArachnodactylyCorrectAnswer-B:E
Ans.b.Ectopialentis;e.Arachnodactyly
Arachnodactyly:Thisfeaturecanoccuronitsown,withno
underlyinghealthproblems.However,itcanalsobeassociatedwith
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certainmedicalconditions.ExamplesincludesMarfansyndrome,Ehlers-Danlossyndrome,Loeys-Dietzsyndromeand
homocystinuria.
182.Distalinterphalangealjointinvolvement
occurin:
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a)Boutonnieredeformityb)Swanneckdeformity
c)Malletfinger
d)Triggerfinger
e)Dupuytren'scontracture
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CorrectAnswer-A:B:CAns.a.Boutonnieredeformity;b.Swanneckdeformity;c.
Malletfinger
Inmedicine,malletfinger,alsobaseballfinger,droppedfingerand
(moregenerally)extensortendoninjury,isaninjuryoftheextensor
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digitorumtendonofthefingersatthedistalinterphalangealjoint(DIP).
Swan-neckdeformity(PIPjointshyperextendedandDIPjoints
flexed),enlargedknuckles,andsubcutaneousnodulesareclassic
cluesforrheumatoidarthritis.
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Distalinterphalangealjoint-Osteoarthritis,Psoriaticarthritis,Reactivearthritis
Proximalinterphalangealjoint-Osteoarthritis,RA,SLE,Psoriatic
arthritis
183.AllaretrueaboutSlippedcapitalfemoral
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epiphysisexcept:a)Avascularnecrosismayoccur
b)Usuallyoccurafterl0yearofage
c)Obesityisariskfactor
d)Frog-leglateralviewishelpful
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e)MorecommoningirlsCorrectAnswer-E
Ans.e.Morecommoningirls
SLIPPEDFEMORALCAPITALEPIPHYSIS(SFCE)
Seeninadolescentchildreninagegroupof13-15yrs
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EitheroverweightorsexuallyimmaturePresentswithendocrinopathies
Hypothyroidism
Growthhormoneexcess
CRF
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CraniopharyngiomaHypogonadism
Klinefelter'ssyndromemaypresentasSFCE
Treethowan'ssignonx-ray
USGorCTmoresensitiveindetectingearlyslip
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Tc99scanshowsincreaseduptakeRxispromptsurgery
184.Pathologicalfracturearefoundin:
a)Bonecyst
b)Osteoporosis
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c)Chronicosteomyelitisd)Osteochondroma
e)Osteogenesisimperfecta
CorrectAnswer-A:C:D:E
Ans.a.Bonecyst;b.Osteoporosis;c.Chronicosteomyelitis;d.
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Osteochondroma;e.OsteogenesisimperfectaPathologicalFracture
Afractureinanabnormalboneisreferredtoaspathological
fracture.Abnormalbonemeansabonerenderedweakbya
diseaselocalizedtoaparticularhone,orbyageneralisedbone
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disorder.Bonethatfracturesspontaneously,oraftertrivialtraumamustberegardedasabnormaluntilprovenotherwise.Vertebral
bodies(thoracic&lumbar)arethemostoftenaffectedbonesf/b
neckfemur&lowerendradius(colle's#).Mostcommoncauseis
osteoporosis
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Othercausesofpathologicalfracturesare:LocalizedDiseases
Chronicinfectioneg.tubercular&pyogenic
osteomyelitis.
Eosinophilicgranuloma
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BenignneoplasticlesionsSolitarybonecyst
Aneurysmalbonecyst
Fibrouscorticaldefect
Monostoticfibrousdysplasia
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ChondromyxoidfibromaChondroma(Enchondroma)
Osteoclastoma(giantcelltumor)
Malignantbonetumor
Osteosarcoma
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Ewing'stumorChondrosarcoma
Atrophicbonedueto
Polio
Radiation(Radiotherapy)
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GeneralisedDiseasesCongenital/Developmental
Osteogenesisimperfecta
Osteopetrosis
011iersdisease(multipleenchondromatosis/dyschondroplasia).
--- Content provided by FirstRanker.com ---
PolyostoticfibrousdysplasiaHistiocytosisX
Gaucher'sdisease
AcquiredDisordersproducingosteopenia
Osteoporosis(mostcommoncause)
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OsteomalaciaHyperparathyroidism
Renalosteodystrophy
Paget'sdisease
Myeloma
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OthermetabolicbonediseasesRickets
Scurvy
Disseminatedmalignancyinbones
Multiplemyeloma
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MyelomatosisMetastaticcarcinoma
185.Commonestcauseofacute
osteomyelitis:
a)Trauma
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b)Surgeryc)Fungalinfection
d)Hematogenousroute
e)Tubercularinfection
CorrectAnswer-D
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Ans.d.HematogenousrouteACUTEOSTEOMYELITIS:
1. ItPrimary(hematogenous):-Organismsreachthebonethrough
bloodstream.
2. Secondary:-Organismgainentrydirectlythroughwoundsuchasin
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compoundfracturesorsurgicaloperation.Hematogenousosteomyelitisisthecommonestformofosteomyelitis
andmostcommonsourceofboneandjointinfectionis
hematogenous.
186.TrueaboutOsteosarcoma:
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a)Primaryosteosarcomaismostcommonlyoccurinagegroupoflessthan20yr
b)Periostealreactionispresent
c)Presentaselevatedsofttissuemass
d)Commonlyassociatedwithosteoidosteoma
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e)FormationofbonebythetumorcellsischaracteristicCorrectAnswer-A:B:C:E
Ans.a.Primaryosteosarcomaismostcommonlyoccurinage
groupoflessthan20yr;b.Periostealreactionispresent;c.
Presentaselevatedsofttissuemass;e.Formationofboneby
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thetumorcellsischaracteristicOsteosarcomaisprimarymalignantbonetumorofbone,derived
fromprimitiveboneformingmesenchymaandcharacterizedby
osteoidformation.
Itisoftwotypes
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1. Primary2. Secondary
Associatedfeature:
Pagetdisease
Radiation
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FibrousdysplasiaEnchondromatosis
Multipleosteochondroma
Boneinfarction
Chronicosteomyelitis
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Radiology:TheX-rayappearancesarevariable:hazyosteolyticareasmay
alternatewithunusuallydenseosteoblasticareas.
Oftenthecortexisbreachedandthetumourextendsintothe
adjacenttissues;whenthishappens,streaksofnewbone
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appear,radiatingoutwardsfromthecortexthesocalled'sunburst'effect.
Wherethetumouremergesfromthecortex,reactivenewboneforms
attheanglesofperiostealelevation(Codman'striangle).
WhileboththesunburstappearanceandCodman'striangleare
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typicalofosteosarcoma.187.TrueaboutClubfoot:
a)Abductionofforefoot
b)Associatedwithbreechpresentation
c)Dennis-Brownsplintused
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d)Adductionofforefoote)Associatedwithspinabifida
CorrectAnswer-C:D:E
Ans.c.Dennis-Brownsplintusedd.Adductionofforefoote.
Associatedwithspinabifida
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CTEVisthecommonestandmostimportantcongenitaldeformityofthefoot.
Thedeformityconsistsoffollowingelements:-
1. Equinus,i.e.Plantarflexionatanklejoint(tibiotalarjoint)
2. Inversionoffootatsubtalarjoint(talocalcanealjoint)
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3. Forefootadduction,atmid-tarsaljoints,especiallyattalo-navicularjoint.
4. Sometimesforefootcavus,i.e.excessivearchingofthefootatmid-
tarsaljoints.
Treatment:
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Tendontransfer:-Transferoftibialis-anteriorontheoutersideoffoot.Thiscanbedoneonlyafter5years.
Dwyerosteotomy:-Medialopenwedgeosteotomyofcalcaneumto
correctheelvarus.
Gradualdifferentialdistraction:-Inthisanexternalfixator(JESSor
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Illizarov)isappliedandgradualcorrectionofdeformity>10years:-Triplearthrodesis(subtalar,calcaneo-cuboid,and
talonavicularjoints)
188.AllaretrueaboutPott'sspineexcept:
a)ThoracicvertebraeT6-T8ismostcommonlyaffectedsite
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b)Paradiscaliscommonestvarietyc)Muscularrigidity&stiffnessiscommon
d)Posteriorpartofvertebraeismoreaffectedthananteriorpart
e)BackpainisthecommonestPresentingsymptom
CorrectAnswer-A:D
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Ans.a.ThoracicvertebraeT6-T8ismostcommonlyaffectedsite;d.Posteriorpartofvertebraeismoreaffectedthananterior
part
Tuberculosis(TB)ofthespine(Pott'sdisease)isthemostcommon
siteofboneinfectioninTB.
--- Content provided by FirstRanker.com ---
Thelowerthoracicandupperlumbarvertebraearetheareasofthespinemostoftenaffected.
Pott'sdiseaseresultsfromhaematogenousspreadoftuberculosis
fromothersites,oftenpulmonary.Theinfectionthenspreadsfrom
twoadjacentvertebraeintotheadjoiningdiscspace.
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Ifonlyonevertebraisaffected,thediscisnormal,butiftwoareinvolvedtheintervertebraldisc,whichisavascular,cannotreceive
nutrientsandcollapses(seenasnarrowingofintervertebralspace
onX-rays)
CommonestspineinvolvedinspineTBis
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Thoracolumbar/DorsolumbarT12-L1(Lowerthoracictobeprecise.Thediseaseprogressesslowly.Signsandsymptomsinclude:
Localisedbackpainistheearliestandcommonestcomplaint
Paravertebralswellingmaybeseen
Neurologicalsignsmayoccur,leadingtoparaplegia.
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Stiffness
Deformity
Constitutionalsymptoms
Diagnosis:
SpinalX-raymaynotshowearlydiseaseas50%ofbonemassmust
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belostforchangestobevisibleonx-ray.However,plainradiographscanshowvertebraldestructionandnarroweddisc
space.
MRIisusefultodemonstratetheextentofspinalcompressionand
canshowchangesatanearlierstagethanplainradiographs.Bone
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elementsvisiblewithintheswelling,orabscesses,arestronglyindicativeofPott'sdiseaseasopposedtomalignancy.
CTscansandnuclearbonescanscanalsobeused.
189.AllaretrueaboutLNGexcept:
a)CauseEndometrialsuppression
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b)Canbeusedinemergencycontraceptionc)Cannotbegiventolactatingwomen
d)Devoidofestrogenicside-effects
e)All
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans.c.CannotbegiventolactatingwomenLNGpreventovulation&causedesynchronizationofendometrium
Itcanbeofferedtoalactatingwomen.
Ithasnooestrogen&sonoestrogenicassociatedsideeffects.
Itcanbeofferedtohypertensive,cardiac&diabeticwoman
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190.Trueaboutamnioticfluid:
a)Sameconcentrationofplasmathroughoutpregnancy
b)Formsfromtransudationofplasmathroughfetusskinbefore20
wkofgestation
c)Fetusswallowsamnioticfluid
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d)Protectsfetusfrominjurye)Mainchannelforgaseousexchange
CorrectAnswer-B:C:D
Ans.b.Formsfromtransudationofplasmathroughfetusskin
before20wkofgestation;c.Fetusswallowsamnioticfluid;d.
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ProtectsfetusfrominjuryAmnioticFluid:
Infirsthalfofpregnancy,thecompositionofthefluidisalmost
identicaltoatransudateofplasma.Butinlatepregnancy,the
compositionisverymuchalteredmainlyduetocontaminationof
--- Content provided by FirstRanker.com ---
fetalurinarymetabolites.Therespiratoryfunctionoftheplacentamakesthefetaloxygen
supplyandfetalcarbondioxideremovalpossible
Thereisconstantexchangeofwaterb/wtheamnioticfluid
&maternalblood,thewaterbeingcompletelyreplacedeverythree
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hours.Sometimeinfifthmonththefetusbeginstoswallowamnioticfluid
191.Trueaboutobstetricaloutlet:
a)Posteriorwallisdeficient
b)Boundedabovebytheplaneofleastpelvicdimensions
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c)Anteriorwallisformedbyischialbonesd)Minimumobstetricdiameter
e)Itsplaneisplaneofleastpelvicdimensions
CorrectAnswer-B:E
Ans.b.Boundedabovebytheplaneofleastpelvicdimensions;
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e.ItsplaneisplaneofleastpelvicdimensionsObstetricalOutlet:
Itisthesegmentofthepelvisboundedabovebytheplaneofleast
pubicdimensions&belowbytheanatomicaloutlet
Itsanteriorwallisdeficientatthepubicarch;itslateralwallsare
--- Content provided by FirstRanker.com ---
formedbyischialbones&theposteriorwallincludeswholeofthecoccyx.
Shape:Itisantero-posteriorlyoval
Plane:Theplaneisotherwiseknownasplaneofleastpelvic
dimensionsornarrowpelvicplane.Theplaneextendsfromthe
--- Content provided by FirstRanker.com ---
lowerborderofthepubissymphysistothetipofischialspinesPosteriorlytomeetthetipofthe5thsacralvertebrae.Itisnarrowest
planeinpelvis&roughlycorrespondstotheoriginoflevatorani
muscle.
Diameters:Transverse(Syn-Bispinous10.5cm),Anteroposterior
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(11cm)&Posteriorsagittal(5cm)Axis:Itisrepresentedbyalinejoiningthecentreoftheplanewith
thesacralpromontory.Itsdirectionisalmostvertical.
192.Whichofthefollowingis/arecriteriafor
theexpectantmanagementinpre-
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eclampsiaexceptsa)Plateletcount<100000ml
b)B.p.>140/90mmHg
c)Urineoutput<400mUday
d)Persistentheadache
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e)VisualdisturbancesCorrectAnswer-B
Ans.b.B.P.>140/90mmHg
CriteriaforseverePreeclampsia:
ApersistentSBPof>160mmHgsystolicorDBPof>110mmHg
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PersistentsevereepigastricpainCerebralorvisualdisturbances
Oliguria<400ml/24hr
Proteinexcretionof>5gm/day
HELLPsyndrome
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Retinalhaemorrhage,exudatesorpapilledemaIntrauterinegrowthrestrictionofthefoetus
Pulmonaryoedema
193.ContraindicationsforIUCD
a)Postabortalsepsismorethan1yearago
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b)Presentcervicitisandvaginitisc)PasthistoryofectopicPregnancy
d)Unknowncauseofvaginalbleeding
e)Severedysmenorrhea
CorrectAnswer-B:C:D:E
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Ans:b)Presentcervicitisandvaginitis;c)PasthistoryofectopicPregnancy;d)Unknowncauseofvaginalbleeding;e)
Severedysmenorrhea
ContraindicationsforplacingIUCDare:
Suspectedpregnancy
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PIDPresenceoffibroids
MenorrhagiaanddysmenorrhoeaofcopperTisused.
Severeanemia
Diabeticwomenwhoarenotwellcontrolled.
--- Content provided by FirstRanker.com ---
HeartdiseaseScarreduterus
Previousectopicpregnancy
LevonorgestrelIUCDinbreastcancer
Preferablyavoiditsuseinunmarriednulliparouspatientbecauseof
--- Content provided by FirstRanker.com ---
theriskofPID.194.TruestatementregardinguseofACE
inhibitorsinpregnancy:
a)Causepolyhydramnios
b)Causerenalagenesis
--- Content provided by FirstRanker.com ---
c)Causepulmonaryhypoplasiad)Useduringfirst3monthissafe
e)Safeinlasttrimester
CorrectAnswer-B:C
Ans.b.Causerenalagenesis;c.Causepulmonaryhypoplasia
--- Content provided by FirstRanker.com ---
FetalsideeffectsofACEinhibitor:Oligohydramnios
IUGR&fetalrenaltubulardysgenesis
Neonatalrenalfailure
Pulmonaryhypoplasia
--- Content provided by FirstRanker.com ---
ACEinhibitorsiscontraindicatedduringthesecondandthirdtrimesterofpregnancybecauseofriskoffetalhypotension,anuria,
andrenalfailuresometimesassociatedwithfetalmalformationsor
death
195.Trueaboutovulation&menstruation:
--- Content provided by FirstRanker.com ---
a)Temperaturedecreaseattimeofovulationb)Estrogenhavearoleinproliferativephase
c)LHsurgeoccursbeforeovulation
d)100mlbloodlossisnormal
e)All
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:DAns.b.Estrogenhavearoleinproliferativephase;c.LHsurge
occursbeforeovulation;d.100mlbloodlossisnormal
Thedurationofbleedingisabout3-5days&estimatedbloodlossis
between50-200ml.
--- Content provided by FirstRanker.com ---
Themaximumpeakofestrogensecretionisseenabout48hoursbeforeovulation,whereastheLHpeakoccursabout24-36hours
beforeovulation.
AsurgeinLHsecretiontriggersovulation,&ovulationnormally
occursabout9hrafterpeakofLHsurgeatmidcycle"
--- Content provided by FirstRanker.com ---
OvulationnormallyoccursaboutthoursafterthepeakoftheLHsurgeatmidcycle
Aconvenientbutretrospectiveindicatorofthetimeofovulationisa
riseinthebasalbodytemperature
196.Cause(s)ofstillbirth:
--- Content provided by FirstRanker.com ---
a)Prematurityb)Syphilis
c)Abruptioplacentae
d)Diabetes
e)All
--- Content provided by FirstRanker.com ---
CorrectAnswer-EAns.e.All
ETIOPATHOLOGY:
Maternal
Gestationalhypertension
--- Content provided by FirstRanker.com ---
BloodgroupincompatibilityMetabolicdisorders
Intrauterineinfections
Fetal
Majoranomalies
--- Content provided by FirstRanker.com ---
Umbilicalcordcomplications(looping,knotting,twisting)Placental
Chronicplacentalinsufficiency
Placentalabruption
Chorioamnionitis
--- Content provided by FirstRanker.com ---
197.Whichofthefollowingistrueabout
endometrialcarcinoma:
a)Lessaggressiveinpost-menopausalwomen
b)Morecommonindiabetes
c)Commonafter40yrofage
--- Content provided by FirstRanker.com ---
d)AssociatedwithPCODe)Associatedwithhereditarynonpolyposiscolorectalcancer
syndrome(HNPCC)
CorrectAnswer-B:C:D:E
Ans.b.Morecommonindiabetes;c.Commonafter40yrofage
--- Content provided by FirstRanker.com ---
;d.AssociatedwithPCOD;e.Associatedwithhereditarynonpolyposiscolorectalcancersyndrome(HNPCC)
RISKFACTORS:
Highlevelsofestrogen
Endometrialhyperplasia(Complexhyperplasiawith
--- Content provided by FirstRanker.com ---
atypiahistologicalpattern)Polycysticovarysyndrome
Nulliparity
Infertility
Earlymenarche
--- Content provided by FirstRanker.com ---
PersistentanovulationDiabetesmellitus
Hypertension
Obesity,
FamilyHistory,
--- Content provided by FirstRanker.com ---
UseofHormoneReplacementTherapyLatemenopause
Endometrialpolypsorotherbenigngrowthsoftheuterinelining
Tamoxifen
Hyperplasia
--- Content provided by FirstRanker.com ---
PelvicradiationtherapyBreastcancer
Ovariancancer
198.HighlevelofhCGfoundin:
a)Twin
--- Content provided by FirstRanker.com ---
b)Downsyndromec)Choriocarcinoma
d)Coloncarcinoma
e)Ectopicpregnancy
CorrectAnswer-A:B:C
--- Content provided by FirstRanker.com ---
Ans.a.Twin;b.Downsyndrome;c.ChoriocarcinomaHCGisincreasedin:
Multiplefetuses
Rhincompatibility
Downsyndrome
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ChoriocarcinomaHydatidiformmole
HCGisdecreasedin:
Ectopicpregnancy
Impendingspontaneousabortion
--- Content provided by FirstRanker.com ---
199.Trueaboutplacentalabruption:
a)Pre-eclampsiaisariskfactor
b)Commoninmultigravida
c)Commoninprimigravida
d)Prematureseparationofnormalimplantedplacentae
--- Content provided by FirstRanker.com ---
e)CharacterofbleedingisbrightredbloodCorrectAnswer-A:B:D
Ans.a.Pre-eclampsiaisariskfactor;b.Commonin
multigravida;d.Prematureseparationofnormalimplanted
placentae
--- Content provided by FirstRanker.com ---
Abruptioplacentae:Itisaformofantepartumhemorrhagewherebleedingoccursdueto
prematureseparationofnormallysituatedplacenta.
Hypertensioninthepregnancyisimportantpredisposingfactor
ETIOLOGY:
--- Content provided by FirstRanker.com ---
PrimarycauseofAPisuncertainSeveralassociatedconditionsidentified:
Increaseinage&parity:1.3-1.5%
Pre-eclamsia:2.1-4%
Chronichypertension:1.8-3%
--- Content provided by FirstRanker.com ---
Pretermrupturedmembranes:2.4-4.9%Multifetalgestation:2.1%
Cigarettesmoking:1.4-1.9%
Cocaineabuse:NA
Folicaciddeficiency
--- Content provided by FirstRanker.com ---
Priorabruption:10-25%Uterineleiomyoma:NA
Hydromnios:2%
Symptoms
VaginalBleeding(78%)
--- Content provided by FirstRanker.com ---
AbdominalPain(66%)-Maybesevereandconstant,posteriorplacentamaypresentwithbackpainSigns
Vitalsignssuggestiveofcardiovascularcompromise-Tachycardia,
orthostaticchangesinBloodPressureandpulse
Evaluateforexternalsignsoftrauma
--- Content provided by FirstRanker.com ---
Uterushypertonicortense(CouvelaireUterus)-Fundustendertopalpation
200.TrueaboutTrichomonasvaginitis:
a)Importantcauseofrecurrentabortion
b)T.vaginalisisaflagellatedprotozoa
--- Content provided by FirstRanker.com ---
c)Metronidazoleisusedfortreatmentd)Strawberrycervix
e)Curdydischarge
CorrectAnswer-B:C:D
Ans.b.T.vaginalisisaflagellatedprotozoa;c.Metronidazoleis
--- Content provided by FirstRanker.com ---
usedfortreatment;d.StrawberrycervixTrichomonasvaginits:
Itiscausedbytrichomonasvaginalis,apear-shapedunicellular
flagellateprotozoa
Onspeculumexamination,mucosaoftheportiovaginalispartof
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cervixappearlikestrawberryInfectioningenitaltractmayberesponsibleforsporadic
spontaneousabortionbutitsrelationtorecurrentabortionis
inconclusive.
201.TrueaboutMirena:
--- Content provided by FirstRanker.com ---
a)Effectivelifeis5-10yrb)GivesprotectionagainstHMSTD
c)Contraindicatedinsuspectedpregnancy
d)Contraindicatedinbreastcarcinoma
e)Usefulincontrollingmenorrhagiainfibroid
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:D:EAns.a.Effectivelifeis5-10yr;c.Contraindicatedinsuspected
pregnancy;d.Contraindicatedinbreastcarcinoma;e.Usefulin
controllingmenorrhagiainfibroid
Thelevonorgestrel-releasingIUS,Mirena,releases20mcgof
--- Content provided by FirstRanker.com ---
levonorgestrelperdayandisapprovedforcontraceptionforupto5years.Itachieveslocalprogestinconcentrationsthatare
~1000-foldhigherthansystemiclevels.
ContraindicationsspecifictotheuseofMirenaare:
Acuteliverdiseaseortumor
--- Content provided by FirstRanker.com ---
KnownorsuspectedcarcinomaofthebreastHypersensitivitytoanycomponentofthisproduct
ContraindicationstoUseofanIntrauterineDevice:
Pregnancyorsuspicionofpregnancy
Genitalactinomycosis
--- Content provided by FirstRanker.com ---
AcutepelvicinflammatorydiseaseGenitalbleedingofunknownetiology
Womanorherpartnerhavingmultiplesexualpartners
ApreviouslyinsertedIUDthathasnotbeenremoved
Abnormalitiesoftheuterusresultingindistortionoftheuterinecavity
--- Content provided by FirstRanker.com ---
Postpartumendometritisorinfectedabortioninthepast3monthsKnownorsuspecteduterineorcervicalneoplasia,orunresolved
abnormalcytologicalsmear
Untreatedacutecervicitisorvaginitis,includingbacterialvaginosis,
untilinfectioniscontrolled
--- Content provided by FirstRanker.com ---
Historyofectopicpregnancyorconditionthatwouldpredisposetoectopicpregnancy
202.Feature(s)ofHaileyHaileydisease
is/are:
a)Abullousdisorder
--- Content provided by FirstRanker.com ---
b)Crustederosionc)Mostcommonlypresentininfant
d)Alsocalledasfamilialbenignpemphigus
e)Intraepidermalbullousdisorder
CorrectAnswer-A:B:D:E
--- Content provided by FirstRanker.com ---
Ans.(A)Abullousdisorder(B)Crustederosion(D)Alsocalledasfamilialbenignpemphigus(E)Intraepidermalbullous
disorder
[NeenaKhanna3rd/67]
HaileyHaileyDisease(FamilialBenignPemphigus):
--- Content provided by FirstRanker.com ---
Pemphigustypeofbullousdisorder(Intraepidermallesion)Autosomaldominantinheritance
Presentsin3rd-4thdecade
Presentsasflaccidvesicles,crustederosions&circinateplaqueson
erythematousbase.Maybecomehypertrophic&malodorous
--- Content provided by FirstRanker.com ---
Majorflexures(groins,perineum,axillae&sideofneck)Treatmentincludes:Reductionoffrictionkeepingareadry.
Combinationofpotentsteroidswithantibiotics(mainstayof
treatment)
203.Skinlesionofchronicliverdisease:
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a)Terrynailb)Palmarerythema
c)Purpura
d)Spidernaevi
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:DAns.(A)Terrynail(B)Palmarerythema(D)Spidernaevi
[RefNeenaKhanna3rd/330,148;Roxburg17th/292-93]
SkininLiverDisease:
Hepaticdisease,especiallywhenthepatienthashepaticfailure,
--- Content provided by FirstRanker.com ---
isassociatedwith:Pruritus:Duetoaccumulationofbilesalts,whenthereisobstructive
jaundice
Yellowishpigmentation:DuetoaccumulationofbilePigments
Spidernevi&palmarerythema:Duetoaccumulationofestrogen
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drprogesteroneWhitenails:Duetohypoproteinemia
204.Nailchangesoflichenplanusincludes:
a)Pterygium
b)Salmonpatch
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c)Subungualhyperkeratosisd)Splinterhaemorrhage
e)Thinningofnailplate
CorrectAnswer-A:E
Ans.(A)Pterygium(E)Thinningofnailplate
--- Content provided by FirstRanker.com ---
[Ref;NeenaKhanna3rd/52-55;Harrison19th/i49,17th/316]NailChangesinLichenPlanus:
Seenin15%ofpatients(mostfrequentlyinchildren)
Thinning6distalsplittingofnailplates
Longitudinalgrooves
--- Content provided by FirstRanker.com ---
TentingOfNailPlatePterygiumformation(diagnostic):
Theproximalnailfoldisprolongedontothenailbed,splitting&
destroyingthenailplate.
205.APatienthashypersensitivityto
--- Content provided by FirstRanker.com ---
neostigmine.Hehastoundergoupperabdominalsurgery.Musclerelaxantof
choiceis:
a)Pancuronium
b)Ropacuronium
--- Content provided by FirstRanker.com ---
c)Vecuroniumd)Atracurium
e)Piperacurium
CorrectAnswer-D
Ans.D.Atracurium
--- Content provided by FirstRanker.com ---
[Ref:AjayYadav5th/116-17;Lee13th/189-95]Atracuriumundergospontaneousdegradationinplasmacalledas
Hoffmandegradation.
Atracuriumisrelaxantofchoiceifreversalagentiscontraindicated.
Othermusclerelaxants:
--- Content provided by FirstRanker.com ---
(mentionedinquestion)requirereversalwithneostigmine(butNecannotuseneostigmineduetohypersensitivity),socannotusein
thispatient
206. Whichofthefollowingcondition(s)can
causeexaggeratedhyperkalemiain
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patientswithuseofsuccinylcholine:a)Burn
b)Spinalcordinjury
c)Musculardystrophy
d)Tetanus
--- Content provided by FirstRanker.com ---
e)AbdominalorganinjuryCorrectAnswer-A:B:C:D
Ans.(A)Burn(B)Spinalcordinjury(C)Musculardystrophy
(D)Tetanus
[RefAjayYaday5th/112-13;Lee13th/190;KDT7th/355;Barash
--- Content provided by FirstRanker.com ---
ClinicalAnesthesia6th/MR]Succinylcholine&hyperkalemia:
Inpatientswithextensiveburn&softtissueinjuries.
Alsointetanus&spinalcordinjuries,neurological&muscular
disorders(stroke,cerebralpalsy&musculardystrophy).
--- Content provided by FirstRanker.com ---
Aftermajordenervationinjuries,spinalcordtransection,peripheraldenervation,stroke,trauma,extensiveburns,andprolonged
immobilitywithdisease
207.Whichofthefollowingdoesnotincrease
intracranialpressure:
--- Content provided by FirstRanker.com ---
a)Sodiumthiopentoneb)Desflurane
c)Mannitol
d)Sevoflurane
e)Propofol
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:EAns.(A)Sodiumthiopentone(C)Mannitol(E)Propofol
[RefAjayYadavp.86,109;Lee/643-45]
Mannitolisusedinthetreatmentofincreasedintracranialtension.
208.Mechanismofactionofgeneral
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anesthesiais/are:a)GABA-Areceptor
b)GABA-Breceptor
c)NMDAreceptor
d)Na+channelblockage
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-A:C
Ans.(A)GABA-Areceptor(C)NMDAreceptor
[Ref:KDT7th/372-73;AjayYadav5th/71;Lee13th/149;Miller
6th/721-22]
--- Content provided by FirstRanker.com ---
MechanismofGeneralAnaesthesia:TheGABA-AreceptorgatedCl-channelisthemostimportantof
these.
Manyinhalationalagents,barbiturates,benzodiazepinesepropofol
Actionofglycineinthespinalcord&medullaisaugmentedby
--- Content provided by FirstRanker.com ---
barbiturate,Propofol&manyinhalationalanaesthetics.InhibitionofexcitatorytypeofNMDAtypeofglutamatereceptor:
Ketamine&N2O.
209.Whichofthefollowingstatementis
correctregardingmechanismofaction
--- Content provided by FirstRanker.com ---
oflocalanaesthesia:a)Blockageofrestingsodiumchannelmoreisthanactivated
sodiumchannel
b)Fasterconductingfibersblockedeasily
c)BlockNa-KATPasechannel
--- Content provided by FirstRanker.com ---
d)Finetouchgoesbeforepaine)Inregionalblocki.vinjectionisused
CorrectAnswer-E
Ans.E.Inregionalblocki.vinjectionisused
[Ref,AjayYadav5th/138-140,149;Lee13th/369-374]
--- Content provided by FirstRanker.com ---
MOA:Thekeytargetoflocalanestheticsisthevoltage-gatedsodium
channel.
Thebindingisintracellularandismediatedbyhydrophobic
interactions.
--- Content provided by FirstRanker.com ---
Localanestheticsblockvoltage-gatedsodiumchannelsandinterruptinitiationandpropagationofimpulsesinaxons.
Localanestheticsreversiblyinhibitperipheralnerveconductionby
blockingvoltagegatedsodium&potassiumchannel.
Theaffinityofthesodiumreceptorishigherinopenorinactivated
--- Content provided by FirstRanker.com ---
statesthanintherestingstate.Blockadesequenceis-sympathetic>temperature(cold)>pain(prick)
>proprioception(Lighttouchwithcotton).
210.TruestatementregardingIodine-131:
a)Itistheonlyisotopeofiodineusedforthyroid
--- Content provided by FirstRanker.com ---
b)Contraindicatedinpregnancyc)Emitsarays
d)Emits13rays
e)Emitsyrays
CorrectAnswer-B:D:E
--- Content provided by FirstRanker.com ---
Ans.(B)Contraindicatedinpregnancy(D)Emits13rays(E)Emitsyrays
[Ref:DahnertRadiologymanual5th/1087:88;ReviewofRadiology
bySumerSethi2nd/101;Harrisontgth/263e-3,18th/2932,t7g1,
17th/1360;DuttaGynaecology5th/484,4th/465;MeredithRadiation
--- Content provided by FirstRanker.com ---
Physics&NuclearMedicine/28](Iodine)I-131:
Emitsbeta&gammarays.
Contraindicatedduringpregnancy.
Foetalthyroidwillbedestroyedresultingincretinism,other
--- Content provided by FirstRanker.com ---
abnormalitiesifgivenduringthefirsttrimester.I-127-Stableisotopeofiodine.
I-131-Radioactiveisotopeofmedicalimportance.
I-123-Agentofchoiceforthyroidimaging.
ForradioactiveiodinescanningI-131&I-123areused.
--- Content provided by FirstRanker.com ---
Fortreatmenthypothyroidism&thyroidcancerI-131isused.211.Side-effects(s)ofPituitaryirradiation:
a)Hypopituiarism
b)Decreaseriskofsecondarytumor
c)Opticnervedamage
--- Content provided by FirstRanker.com ---
d)Increasedriskofcerebrovascularaccidente)None
CorrectAnswer-A:C:D
Ans.(A)Hypopituiarism(C)Opticnervedamage(D)Increased
riskofcerebrovascularaccident
--- Content provided by FirstRanker.com ---
[RefHarrison19th/2263-64,18th/2886,2829;CMDT2016/1087,06/1115;Devita7th/1844;LeibelPhilip2nd/489]
S/EofPituitaryirradiation:
Hypopituitarism,somedegreeofmemoryimpairment,increased
longtermnskofsecondtumor&smallvesselischemicepisode.
--- Content provided by FirstRanker.com ---
212.Falseincreaseinsizeofheartonchest
x-rayPAviewis/areseenin:
a)Rotationofpatient
b)Supineview
c)Filmtakeninexpiration
--- Content provided by FirstRanker.com ---
d)Pneumoniae)None
CorrectAnswer-A:B
Ans.(A)Rotationofpatient(B)Supineview
[Ref:WHORadiographicManual2002/32-33;BasicRadiology
--- Content provided by FirstRanker.com ---
(Lange)2004/Heartimaging]Causesofpseudoincreasedsizeofheart:
ChestX-rayshouldbetakeninfullinspiration&correctlycentered:
Afilmtakeninexpirationcancauseconfusion.
Itmaysimulatediseasese.g.,pulmonarycongestion,cardiomegaly
--- Content provided by FirstRanker.com ---
orawidemediastinum'InSupinechestview:
TheHeartappearsenlarged&mediastinummayaPPearwide
perhaps10cm.
MediastinalWidening:
--- Content provided by FirstRanker.com ---
WideningofthemediastinumismostoftenduetotechnicalfactorssuchasPatientpositioningortheprojectionused.
Rotation,incompleteinspiration,oranAPview,mayallexaggerate
thewidthofthemediastinum,aswellasheartsize.
213.X-rayfeature(s)ofLeftAtrial
--- Content provided by FirstRanker.com ---
Hypertrophy:a)Bootshapedheart
b)Widenedcarina
c)Straightenedleftborder
d)Doubleatrialshadow
--- Content provided by FirstRanker.com ---
e)MoneybagappearanceCorrectAnswer-B:C:D
Ans.(B)Widenedcarina(C)Straightenedleftborder(D)Double
atrialshadow
[Ref:PJM20th/228;DahnertRadiologymanual5th/575,636-
--- Content provided by FirstRanker.com ---
637;ReviewradiologybySumerSethi6th/76-77,80]X-rayfeatureofleftAtrialHypertrophy:
Doubleatrialshadow(Doubledensityseenthroughrightupper
border)
Straightenedleftborder
--- Content provided by FirstRanker.com ---
LeftbronchusliftedupwithwidenedcarinaEsophaguscurvingaroundthedilatedLeftatrium.
Splayingofmainstembronchi(i.e.Increasedcarinalangle)
Smallaorta(duetoincreaseoffuruardcardiacoutput)
Normal/UndersizedLV
--- Content provided by FirstRanker.com ---
214.AllaretrueregardingPETscanexcept:
a)Helpinassessmentofbothanatomical&functionalstatusof
tissue
b)Donotposeanyradiationexposuretopatient
c)SuperiortoCTforanatomicaldetail
--- Content provided by FirstRanker.com ---
d)FDGisusede)None
CorrectAnswer-B:C
Ans.(B)Donotposeanyradiationexposureto
patient(C)SuperiortoCTforanatomicaldetail
--- Content provided by FirstRanker.com ---
[RefLeB25th/136-37;DahnertRadiologymanuel5th/1085;L&B25th/136,BasicRadiologybyLange2004;raiiegTaphics.rsna.org/
content/23/2/315full]
PositronEmissionTomography(PET):
Themostcommonlyusedradiolabeledtraceris18F-2-fluoro-2-
--- Content provided by FirstRanker.com ---
deoxy-D-glucose(FDG),althoughothertracerscanalsobeusedinordertoassessmetabolicfunctionssuchasoxygenandglucose
consumptionandbloodflow.
Areasofhighmetabolicactivity(i.e.,cerebralcortex,deepgray
nuclei)demonstrategreaterradiopharmaceuticaluptakethanilo
--- Content provided by FirstRanker.com ---
arcasoflowmetabolicactivity,suchaswhitematterorcerebrospinalfluid.Thebonesofthcskullandscalpsofttissuesare,forthemost
part,invisible.
Anatomicresolution,althoughnotasgoodaswithCTorMRi
imaging.
--- Content provided by FirstRanker.com ---
Strengths:Allows/functionalimaging
Allowsimagingofthewholebody
Bonescanhasahighsensitivityformetastaticbonedisease,
fracturesandinfection
--- Content provided by FirstRanker.com ---
Drawbacks:Highcost,verylimitedavailabilityandrelativelylowspatial
resolution.
215.Whichofthefollowingistrueregarding
MRI:
--- Content provided by FirstRanker.com ---
a)MRIisbetterthanCTscanforbonylesionb)GreymatterisgreyonTIWI
c)Usesdyegadolinium
d)Gadoliniumissaferthaniodinebasedcontrastagent
e)Canbeusedinmultipleplain
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:D:EAns.(B)GreymatterisgreyonTIWI(C)Usesdye
gadolinium(D)Gadoliniumissaferthaniodinebasedcontrast
agent(E)Canbeusedinmultipleplain
[RefSumerSethi2nd/9-10;mriscans.cliniccompare.co.uHmri-scan-
--- Content provided by FirstRanker.com ---
with-contrast-dye;DahnertradiologyReviewManual5th/1079;Bhadury2nd/177;blog.radiolog.ucsf.edu;www.difren.com/dffirence
/CT-Scan-r,s-MRI]
MRI:
ThecontrastdyeusedintheseMRIScansisgenerallygadoliniumat
--- Content provided by FirstRanker.com ---
complicationsarerarerincomparisontothelodineorigindyewedforX-raysandCTscan
Inspine&formusculoskeletalproblems,MRIisthepreferred
option.
MRimaginghastraditionallybeenusedforneurologicindications,
--- Content provided by FirstRanker.com ---
includingbraintumors,acuteischemia,infection,andcongmltalabnormalities.
Greymatterisgrey&whitematteriswhiteonT1W1&relationship
isreversedonT2W1.
216.SIunitofradioactivityis:
--- Content provided by FirstRanker.com ---
March2013(c,f)a)Rem
b)Rad
c)Becuerel
d)Curie
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-C
Ans.Ci.e.Becquerel
217.Feature(s)ofSchizophreniais/are:
a)1stranksymptomishelpfulinmakingdiagnosis
--- Content provided by FirstRanker.com ---
b)Depressionmaybepresentc)Brainventricleenlargementmaybepresent
d)Onsetoccuronlyafterageof40yr
e)Usuallyonsetoccurlaterinwomenascomparedtomen
CorrectAnswer-A:B:C:E
--- Content provided by FirstRanker.com ---
Ans.(A)1stranksymptomishelpfulinmakingdiagnosis(B)Depressionmaybepresent(C)Brainventricleenlargement
maybepresent(E)Usuallyonsetoccurlaterinwomenas
comparedtomen
Schizophrenia:
--- Content provided by FirstRanker.com ---
Twocommonaffectivesymptom:Reducedemotionalresponsiveness(warrantthelabelofanhedonia,
andoverlyactiveandinappropriateemotionssuchasextremesof
rage,happiness,andanxiety).
Otherfeelingtonesincludeperplexity,asenseofisolation,
--- Content provided by FirstRanker.com ---
overwhelmingambivalence&depression.Onset:
Usuallylaterinwomen&oftenrunsamorebenigncourse.
(Comparedtomen).
CNSinvolvement:
--- Content provided by FirstRanker.com ---
Computedtomography(CT)scansofpatientswithschizophreniahaveconsistentlyshownlateralandthirilventricularenlargement
and,somereductionincorticalvolume.
Diagnosis:
Schneider'sfirstranksymptomsofschizophreniathoughnotspecific
--- Content provided by FirstRanker.com ---
butofgeathelpinmakingdiagnosis&havesignificantlyinfluenced
thediagnosticcriteria&classificationofschizophrenia.
218.Whichoffollowingisperception
disorder:
a)Delusion
--- Content provided by FirstRanker.com ---
b)Hallucinationc)Obsession
d)Depersonalization
e)Illusion
CorrectAnswer-B:C
--- Content provided by FirstRanker.com ---
Ans.(B)Hallucination(C)Obsession[RefNirajAhuja6th/14,17;Kaplan&Sailockl1th/233,281]
Perception:
Processofbeingawareofasensoryexperience&beingableto
recognizeitbycomparingitwithpreviousexperiences.
--- Content provided by FirstRanker.com ---
Perceptiondisordersare-hallucinations,illusions&misinterpretations;depersonalization/derealization;somaticpassivity
phenomenon;autoscopy;abnormalvestibularsensationsetc.
219.Whichofthefollowingmodalityis/are
notincludedinbehaviourtherapy:
--- Content provided by FirstRanker.com ---
a)Roleplayingb)Schedulingactivities
c)Gradedtaskassignment
d)Identifyingmaladaptiveassumptions
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAns.D.Identifyingmaladaptiveassumptions
[RefNkajAhuja6th/85,228-30;IGplan&Saddok:sSynopsisof
Psychiatry10th/953-959]
BehavioralTechniques:
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Thisincludesthevariousshort-termmodalitieslikesocialskillstrainingproblemsolvingtechniques,assertivenesstraining,self-
controltherapy,activityscheduling&decision-makingtechniques.
Amongthebehavioraltechniquesincognitivetherapyare
schedulingactivities,masteryandpleasure,gradedtask
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assignments,cognitiverehearsal,self-reliancetraining,role-playing,anddiversiontechniques.
220.Diazepamcanheusedfor:
a)Agitationinemergencyroom
b)Longtermtreatmentofepilepsy
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c)Statusepilepticusd)Convulsionintetanus
e)None
CorrectAnswer-A:C:D
Ans.(A)Agitationinemergencyroom(C)Statusepilepticus
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(D)Convulsionintetanus[Ref.KDT7th/a0a-05;NirajAhuja6th/209;Kaplan6Saddok!
SynopsisofPsychiatryIqth/I0I8-20]
UsesofDiazepam:
Firstlinedrugforemergencycontrolofconvulsionse,g.,status
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epilepticus,tetanus'eclampsia,convulsantdrugpoisoning.Narcoanalysisorabreation.
Antipsychoticinducedakathisia
Treatmentofalcoholwithdrawal&otherdrugwithdrawalsyndrome
Nightmares(diazepamalsoreducetheREMsleepduration)
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Insomnia.Stage4NREMsleepdisorderslikeenuresis,somnambulism
(diazepamreducedurationofstage4NREMsleep).
Agitateddepression
221.Benzodiazepinesusedinseizure
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treatment:a)Lorazepam
b)Tenezepam
c)Alprazolam
d)Clobazam
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e)MidazolamCorrectAnswer-A:D
Ans.(A)Lorazepam(D)Clobazam
[RefKDT7th/398]
AntiepilepticBenzodiazepines:Clonazepam,diazepam,Lorazepam
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dtclobazam.FebrileseizureOraldiazepam,midazolam&clobazamareeffective
prophylactics(Intermittent).
invalidquestionid
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