a)Suppliedbyinferiordivisionof3rdCN
b)Primaryeyeaction-Extorsion,abduction&depression
c)Themusclepassbelowinferiorrectus
d)Originfromlacrimalbone
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e)NerveentersthemusclefromocularsurfaceCorrectAnswer-A:C
Ans.(A)Suppliedbyinferiordivisionof3rdCN(C)Themuscle
passbelowinferiorrectus
Itoriginatesfromorbitalplateofmaxillalateraltotheorificeof
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nasolacrimalduct.Itistheonlymuscletotakeoriginfromfrontoftheorbit.Otherrecti
muscletakeoriginfromannulusofzinn.
Occulomotornerveinorbit:Thelarger,lowerdivisiondividesinto3
branchesforthemedialrectus,theinferiorrectus6theinferior
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oblique.AllbranchesenterthemuscleontheirocularsurfacesexceptthatfortheIOwhichentersitsposteriorborder'
2.TrueaboutSubmandibularglandduct
obstructionbystone:
a)Presentsasamassbelowbodyofmandible
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b)StoneinWhartonductcanbepalpatedbelowmucousmembraneoffloorofmouth
c)Startspainjustafterstartingameal
d)Paincarriedbyglossopharyngealnerve
e)Alltheabove
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CorrectAnswer-EAns.e.Alltheabove
Thesubmandibularsalivaryglandisacommonsiteofcalculus
formation.
Thepresenceofatenseswellingbelowthebodyofthemandible,
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whichisgreatestbeforeorduringamealandisreducedinsizeorabsentbetweenmeals,isdiagnosticofthecondition.
Examinationofthefloorofthemouthwillrevealabsenceofejection
ofsalivafromtheorificeoftheductoftheaffectedgland.
Frequently,thestonecanbepalpatedintheduct,whichliesbelow
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themucousmembraneofthefloorofthemouth'Allthe3pairsofsalivaryglandsaresuppliedbyefferent
(Parasympathetic&sympathetic)&afferentnerves(chordatympani-
br.ofVIInerve&IXnerw).Afferentfiberscarrypainimpulsefrom
salivarygland
--- Content provided by FirstRanker.com ---
3.Trueaboutpalatinetonsil:
a)Cryptsislinedbysquamousepithelium
b)SuppliedbyIXCN
c)Tonguedepressorisusedforexamination
d)Arterialsupplyisbytonsillarascendingbranchofgrater
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palatinearterye)Presentinoropharynx
CorrectAnswer-A:B:C:E
Ans.(A)Cryptsislinedbysquamousepithelium;(B)Supplied
byIXCN;(C)Tonguedepressorisusedforexamination;(E)
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PresentinoropharynxPalatinetonsil
ThePalatinetonsilsaretwoprominentmassessituatedoneon
eithersidebetweentheglossopalatineandpharyngopalatine
arches.
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Eachtonsilconsistsfundamentallyofanaggregationoflymphoidtissueunderlyingthemucousmembranebetweenthepalatine
arches.
Inthechildthetonsilsarerelatively(andfrequentlyabsolutely)
largerthanintheadult
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Thefolliclesofthetonsilarelinedbyacontinuationofthemucousmembraneofthepharynx,coveredwithstratifiedsquamous
epithelium
Arteriessupplyingthetonsilarethe:
Dorsalislinguaefromthelingual
--- Content provided by FirstRanker.com ---
TheascendingpalatineandtonsillarfromtheexternalmaxillaryTheascendingpharyngealfromtheexternalcarotid
Thedescendingpalatinebranchoftheinternalmaxillary
Atwigfromthesmallmeningeal.
Theveinsendinthetonsillarplexus,onthelateralsideofthetonsil
--- Content provided by FirstRanker.com ---
Thenervesarederivedfromthesphenopalatineganglion,andfromtheglossopharyngeal.
4.Trueaboutarticularcartilage:
a)Inzonelchondrocytesaresmaller
b)Zone2containsarticularcartilageprogenitorcells
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c)Zone3containscalcifiedcartilaged)Zone4containcalcifiedcartilage
e)Chondrocytesareactivecell
CorrectAnswer-A:C:E
Ans.(A)Inzonelchondrocytesaresmaller;(C)Zone3contains
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calcifiedcartilage;(E)ChondrocytesareactivecellTherearefourzones(layers)ofarticularcartilagefromthearticular
surfacetosubchondralbone.
1.Superficialzone(Zone-1)
Itisthethinnestzone.
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Itconsistsoftwolayers:(i)Asheetofdenslypackedcollagenwithlittlepolysaccharideandtocells,coversthejointsurface,and(ii)
flattenedelipsoid-shapedchondrocytes,withtheirmajoraxis
paralleltojointsurface.
2.Transitionzone(Zone2)
--- Content provided by FirstRanker.com ---
Compositionisintermediatebetweensuperficialzoneandmiddlezone.
3.Middlezoneorradialzoneordeepzone(Zone-3)
Thechondrocytesarespheroidalinshapewiththeirmajoraxis
perpendiculartojointsurface.
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Chondrocytesaremostactivesyntheticallyinthiszone.Thiszonecontainsthelargestdiametercollagenfibrils,thehighest
concentrationofproteoglycansandthelowestconcentrationof
water.
4.Calcifiedcartilagezone(Zone-4)
--- Content provided by FirstRanker.com ---
Itseparatesthemiddlezonefromsubchondralbone.Thecellsaresmallwithsmallamountofendoplasmicreticulumand
golgiapparatuswithverylittlemetabolic
5.Trueaboutinnervationofparotidgland:
a)Postganglionicparasympatheticfibresecretomotor
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b)PreganglionicparasympatheticfibrerelayinOticganglionc)Preganglionicparasympatheticnervebeginininferiorpetrosal
nucleus
d)Sympatheticnervearevasomotor
e)Postganglionicparasympatheticfibrespassthroughthe
--- Content provided by FirstRanker.com ---
glossopharyngealnerveCorrectAnswer-A:B:D
Ans:a.Postganglionicparasympatheticfibresecretomotor.b.
PreganglionicparasympatheticfibrerelayinOticganglion.d.
Sympatheticnervearevasomotor.
--- Content provided by FirstRanker.com ---
Development:Parotidglandisthefirstsalivaryglandtoappear,inearly6'week.
Itisectodermalinoriginanddevelopsfromthebuccalepithelium
justlateraltotheangleofmouth
Structuresemergingfromparotid
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Thefollowingstructuresemergefromtheparotidgland:Anteriorborder:
Parotidduct
3Terminalbranchesoffacialnerve:
Thezygomaticandbuccalbranches:towardthetemporalregion,
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eyelidsandcheek,respectively.Mandibularbranch:Runalongthebodyofthemandibletowardsthe
mouth
Apex:
5thterminalbranchoffacialnerve:Cervicalbranchcontinuesinto
--- Content provided by FirstRanker.com ---
theneck(toplatysma).
Anterior&posteriordivisionsofretromandibularvein
Posteriorborder:
Posteriorauricularnerve
Posteriorauricularartery
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PosteriorauricularveinAlongbase:
superficialtemporalartery
temporalbranchoffacialnerve
Auriculotemporalnerve
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STRUCTURESWITHINGLAND:Arteries:
Externalcarotidarteryentersthroughposteromedialsurface
Maxillaryartery
Superficialtemporalvessel
--- Content provided by FirstRanker.com ---
PosteriorauriculararteryVeins:
Theretromandibularveins
FacialNerve
ParotidDuct(Stenson'sduct)
--- Content provided by FirstRanker.com ---
Theductturnsopensintothevestibuleofthemouth(gingivo-buccalvestibule)oppositethecrownoftheupper2ndmolartooth
Nervesupply:
PARASYMPATHETIC:auriculotemporalnerve
SYMPTHETICSUPPLY-plexusaroundtheexternalcarotidartery.
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SENSORYNERVES:auriculotemporalnerve,exceptforparotidfascia&overlyingskinwhichareinnervatedbyGreatauricular
nerve(C2,C3).
6.Whichofthefollowingmuscleissupplied
bymediannerve:
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a)Oppenenspollocisb)Adductorpollicis
c)LateralhalfoftheFlexordigitorumprofundus
d)Superficialheadofflexorpollicisbrevis
e)Deeppartofflexorpollicisbrevis
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CorrectAnswer-A:C:DAns.a.Oppenenspollocis;c.LateralhalfoftheFlexor
digitorumprofundus;d.Superficialheadofflexorpollicis
brevis
Therearefourshortmusclesofthumb(pollex),theyareabductor
--- Content provided by FirstRanker.com ---
pollicisbrevis,opponenspollicis,flexorpollicisbrevisandadductorpollicis.Thefirstthreeofthesemusclesformthethenareminence.
Allthesemusclesaresuppliedbymediannerveexceptforadductor
polliciswhichisinnervatedbyulnarnerve.
7.Trueaboutabductionatshoulderjoint:
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a)Supraspinatusinitiatesabductionb)Serratusanterior&trapeziusalsohelpinabduction
c)Multipennatedeltoidclavicularfiberismainabductor
d)Axillarynerveinjuryhasnoeffectonabduction
e)Musculotendinouscuffstabilizesshoulderjoint
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CorrectAnswer-A:B:EAns.(a)Supraspinatusinitiatesabduction(b)Serratusanterior
&trapeziusalsohelpinabduction(e)Musculotendinouscuff
stabilizesshoulderjoint.
MOVEMENTSOFSHOULDERJOINT
--- Content provided by FirstRanker.com ---
Movementineverydirection(Flexion,extension,abduction,adduction,rotation,circumduction)
SpinalCordregulatingShouldermovements(C5,C6,C7&C8)
Flexion,Abduction,&lateralrotation(C5,C6,).
Extension,Adduction,&Medialrotationis(C6,C7,C8)
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Movementsthattakeplaceduringabductionofshoulderareaxialrotationofhumerusatacroclavicularjoint,elevationof
humerus&movementatclavicularendofsternoclavicularjoint.
PLANE
HUMERAL RANGE
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TYPEOFAXISOF MUSCLES
FACTOR
OF
HEAD
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OFMOVEMENT
MOTION INVOLVED
LIMITING
MOTION
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GLIDING MOTIONTotal-0-
165?or
-Inferior
175?
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glenohumeralFull
ligament
internal
-Tightnessof
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internal
-Tightnessof
Inferiorly
rotationof
Frontal
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Saggital Deltoid,theinferior
Abduction
inglenoid humerus0-
plane
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axisSupraspinatus
joint
cavity
60?
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capsuleofFull
the
external
gleno-
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rotationof humeraljointhumerus0-
90?
8.Organwhichhavenolymphaticsupply:
a)Eyeball
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b)Brainc)Liver
d)Kidney
e)Spinalcord
CorrectAnswer-A:B:E
--- Content provided by FirstRanker.com ---
Ans.a.Eyeball;b.Brain&e.SpinalcordLymphcapillariesareabsentfromthecellularstructureslikebrain,
spinalcord,splenicpulp,bonemorrow,articulatecartilage,
epidermis,hair,nail&cornea.
Lymphaticvesselarefoundinalltissue&organofbodyexceptthe
--- Content provided by FirstRanker.com ---
centralnervoussystem,eyeball,internalear,epidermisoftheskin,cartilage&bone.
9.Whichofthefollowingstatement(s)is/are
trueaboutsphinctersofbody:
a)Lower5cmofoesophagealactasoesophagealsphincter&itis
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notmorphologicallydifferentfromotherportionofoesophagusb)Oesophageal&pyloricsphincterremainsintopicallycontracted
state
c)Pre-capillarysphincterispresentinb/wmetarteriole&capillary
d)Pudendalnervesuppliesthesphincterurethrae
--- Content provided by FirstRanker.com ---
e)Sphincterofoddiliesatjunctionofduodenum&CBDCorrectAnswer-B:C:D:E
Ans.b.Oesophageal&pyloricsphincterremainsintopically
contractedstate;c.Pre-capillarysphincterispresentinb/w
metarteriole&capillary;d.Pudendalnervesuppliesthe
--- Content provided by FirstRanker.com ---
sphincterurethrae;e.Sphincterofoddiliesatjunctionofduodenum&CBD
Thecommonbileductenterstheduodenumatduodenumpapilla.
ItsorificeissurroundedbythesphincterofOddi6itusuallyunites
withthemainpancreaticductjustbeforeenteringtheduodenum
--- Content provided by FirstRanker.com ---
Atthelowerendoftheesophagus,extendingupwardabout3cmaboveitsjunctionwithstomach,itisbroadloweresophageal
sphincter.
Loweroesophagealsphincter,aspecializezoneofcircularsmooth
musclesurroundingtheoesophagusatitstransitthroughthe
--- Content provided by FirstRanker.com ---
diaphragmandformuchofitsshortabdominalfloorAtthepointwhereeachtruecapillaryoriginatesfromametarteriole,
asmoothmusclefiberusuallyencirclesthecapillary.Thisiscalled,
theprecapillarysphincter.Thissphinctercanopen&closethe
entrancetothecapillary
--- Content provided by FirstRanker.com ---
Pyloricsphincterremainslightlytonicallycontractedalmostallthetime.Despitenormaltoniccontractionofthepyloricsphincter,the
pylorususuallyisopenenoughforwater&otherfluidstoemptyfrom
thestomachintotheduodenumwithease.
10.Muscle(s),whichformthefloorofpelvic
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floor:a)Obturatorinternus
b)Piriformis
c)Puborectalis
d)Pubococcygeus
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e)IschiococcygeusCorrectAnswer-C:D:E
Ans.c.Puborectalis;d.Pubococcygeus;e.Ischiococcygeus
Thepelvicfloorisformedbythelargelevatorani(withparts
includingthepubococcygeus,puborectalis,andiliococcygeus)and
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themuchsmallercoccygeus.11.TrueaboutAtlanto-axialjoint:
a)Vertebralarterypassthroughgroveonarchofatlasvertebrae
toforamenmagnum
b)Permitsflexion&extension
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c)Permitsidetosidemovementofheadd)Permitsflexiononly
e)Permitsrotation
CorrectAnswer-A:C:E
Ans.a.Vertebralarterypassthroughgroveonarchofatlas
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vertebraetoforamenmagnum;c.Permitsidetosidemovementofhead;e.Permitsrotation
Thereare3atlantoaxialarticulations-twolateralatlantoaxialjoints
b/wthelateralmassesofCl&C2vertebrae&onemedian
atlantoaxialjointb/wthedensofC2&theanteriorarchtransverse
--- Content provided by FirstRanker.com ---
ligamentoftheatlasMovement(mainlyrotation)atallthreeatlantoaxialjointspermitsthe
headtobeturnedfromsidetoside,asoccurswhenrotatingthe
headtoindicatedisapproval(the'NO'movement)
Themostimportantfactorsmaintainingstabilityaretheligaments,of
--- Content provided by FirstRanker.com ---
whichthetransverseatlantalligamentisthestrongest.Thealarligamentsareweaker
12.AllaretrueaboutCSFexcept:
a)Totalvolumeis250ml
b)Pressureis60-180mmofH2O
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c)Formedfromchoroidplexusof3rdventricled)Formedfromchoroidplexusoflateralventricle
e)Noneoftheabove
CorrectAnswer-A
Ans.a.Totalvolumeis250ml
--- Content provided by FirstRanker.com ---
ThemajorsourceofCSFisthechoroidalplexusofall4ventricles,mainlyintwolateralventricles.
OthersourcesofCSFareependymalcellsoftheventriclesandthe
brainitself,viaperivascularspaces.
ThetotalvolumeofCSFinanadultisabout125-150ml.
--- Content provided by FirstRanker.com ---
TherateofformationofCSFisabout500-550ml/day.ThustheCSFisreplaced3-4timeseveryday.
CSFpHis7.33
112mmH20istheaveragenormalCSFpressure
13.
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Whichofthefollowingplaymostimportantroleinmemory:
a)Synapticnetwork
b)Electricconductionnetwork
c)Conductivitycircuit
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d)Conductivitynetworke)None
CorrectAnswer-A
Ans:a.SynapticNet.
[Ref:Ganong25th/283-88;Guyton12th/67;AKJain6th/1039-40]
--- Content provided by FirstRanker.com ---
Synapticnetworkssinglebestanswer"Long-termmemoryinvolveschangesinthestructureofneuronsincludinggrowthofnew
processesandsynapses.
So,totheextentthatyourememberanythingaboutthismaterialon
memorytomorrow,ornextweek,ornextyear,itwillbebecause
--- Content provided by FirstRanker.com ---
structuralchangesinsynapsesarebeginninginyourbrains.14.CyanidepoisoningblockKinflux&Na
efflux.ButATPreversethiseffect.Sotrue
statement(s)relatedtomechanismof
actionofcyanideis/are:
--- Content provided by FirstRanker.com ---
a)Kinflux&NaeffluxisregulatedbyNa-KATPaseenzymeb)Kinflux&NaeffluxisregulatedbyNa-Kpump
c)ATPprovideenergyforthischannel
d)Na-KATPasechannelisATPindependent
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:CAns:a.Kinflux&NaEffluxIsRegulatedByNa-K-ATpase
Enzymeb.Kinflux&NaEffluxIsRegulatedByNa-Kpumpc.
ATPprovidesenergyforthischannel.
[Ref:Reddy32nd/595;Katzung13th/1010;Guyton12th/357;AK
--- Content provided by FirstRanker.com ---
Jain6th/459;Harrison19th/262e-7]Cyanide:
Directlypoisonsthelaststepinthemitochondrialelectrontransport
chain,cytochromea3,whichresultsinashutdownofcellularenergy
production.
--- Content provided by FirstRanker.com ---
Thispoisoningresultsfromcyanidehighaffinityforcertainmetals,notablyCoandFe+++.Cytochromea3containsFe+++,towhich
CN-binds.
CyanidePoisoning:
Itinhibitstheactionofcytochromeoxidase,carbonicanhydrase&
--- Content provided by FirstRanker.com ---
probablyofotherenzymesystem.Itblocksthefinalstepofoxidativephosphorylation&preventsthe
formationofATP&itsuseasanenergysource.
15.TrueaboutCarbonmonoxidepoisoning:
a)COhas100timesmoreaffinitythan02forHb
--- Content provided by FirstRanker.com ---
b)Causerightsideshiftingof02dissociationcurvec)Oxygen-haemoglobinsaturationcurvebecomeshyperbolic
shape
d)PulseoximetrycanaccuratelydetectlevelofCO
e)10-15%levelofCOnormallymayoccurinhealthynonsmoker
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAns:c.Orygen-haemoglobinsaturationsaturationCurve
BecomesHyperbolicShape
[RefGanong25th/650-51;Guyton12th/352;AKJain6th/431;
httpst/pedclerk.bsd.uchicago.edu/page/(www.nebi.Nlm.nih.
--- Content provided by FirstRanker.com ---
gov)Carbon-monoxide-poisoning:
Carbonmonoxideshiftstheoxygen-haemoglobinsaturationcurveto
theleftandchangesittoamorehyperbolicshape.
Lessoxygenisavailableforthetissues.
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plasmalevelofcarboxyhemoglobinisnormallyquitelow.Atbaseline,levelsupto3percent,naybeseeninnonsmokers,
whilesmokersmayhavelevelsupto10-15%percent.
LeftshiftofO2-Hbdissociationcurveoccurin-COpoisoningHbF,
myoglobinebdecreaseinbodytemperature.
--- Content provided by FirstRanker.com ---
COhasabout240timestheaffinityofO2forHb;thismeansthatCOwillcombinewiththesameamountofHbas02whentheCOpartial
pressureis240timeslower.
16.Deadspaceisincreasedin:
a)Positivepressureventilation
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b)Extensionofneckc)Anticholinergicdrug
d)Endotrachealtubeintubation
e)Emphysema
CorrectAnswer-A:B:C:E
--- Content provided by FirstRanker.com ---
Ans:a.Positivepressureventilationb.Extensionofneckc.AntiCholinergicdruge.Emphysema
RefAjayYadav5th/4-5;Ganong25th/632-33;Guyton323;AKlain
6th/421
AnatomicalDeadSpaceIncreasedin:
--- Content provided by FirstRanker.com ---
OIdageNeckextension
jawprotrusion
Bronchodilators
Increasinglungvolume(moreininspiration)
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Atropine(causebronchodilation)Anaesthesiamask,circuits
Intermittentpositivepressureventilation(IppV)&positiveend
expiratorypressure(PEEP)
AlveolarDeadSpaceincreasedby:
--- Content provided by FirstRanker.com ---
Lungpathologiesaffectingdiffusionatcapillarymembranelikeinterstitiallungdisease,pulmonaryembolism,pulmonaryedema&
ARDS
Generalanaesthesia
IPPV
--- Content provided by FirstRanker.com ---
PEEP
HYPotension
17.Whichofthefollowingistrueabout
cardiacinnervation:
a)T1-T5issympatheticsupply
--- Content provided by FirstRanker.com ---
b)Inferior&superiorcervicalganglianotinvolveininnervationc)Parasympatheticsupplyisfromvagusnerve
d)Greatcardiacnervearisefromsuperiorcervicalganglia
e)InferiorcervicalgangliagivesoffInferiorcardiacnerve
CorrectAnswer-A:E
--- Content provided by FirstRanker.com ---
Ans:a.T1-T5issympathetice.Inferiorcervicalgangliagivesoffinferiorcardiacnerve
[Ref:BDC6th/Vol.I267;Grayb40th/982;Guyton12th/178;AKlain
6th/324]
CardiacInnervation
--- Content provided by FirstRanker.com ---
Thecervicalgangliaareparavertebralgangliaofthesympatheticnervoussystem.
Thecervicalganglionhasthreeparavertebralganglia.
Superiorcervicalganglion(largest)-adjacenttoC2&C3
Middlecervicalganglion(thesmallest)-adjacenttoC6;target:
--- Content provided by FirstRanker.com ---
heart,neck.Inferiorcervicalganglion.Theinferiorganglionmaybefusedwith
thefirstthoracicgangliontoformasinglestructure,thestellate
ganglionadjacenttoC7.
Themiddlecardiacnerve(greatcardiacnerve),thelargestofthe
--- Content provided by FirstRanker.com ---
threecardiacnerves,arisesfromthemiddlecervicalganglion.Nervesemergingfromchemicalsympatheticgangliacontributeto
thecardiacplexus.
SymPatheticsupply:T1toT5spinalsegments.
SympatheticpreganglionicfibrespassintothesymPathetictrunkto
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superionmiddle&inferiorcardiacganglionSympatheticpostganglionicfibrespassesviasuperiormiddle&
inferiorcardiacsympatheticnerves
Parasympatheticsupplytoheartisviatwovagusnerveswiththeir
cellbodieslocatedinthemedullainthenucleusambiguus.
--- Content provided by FirstRanker.com ---
18.Trueaboutcortisollevelinbloodplasma:
a)Morningconcentrationis17-18nmol/d1
b)Morningconcentrationis5-23pg/dL
c)Eveningconcentrationisalmosthalfofmorningconcentration
d)Eveningconcentrationis5-23i.ig/dL
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-B:C
Ans:b.Morningconcentrationis5-23microg/dLc.Evening
concentrationisalmostHalfOfMorningConcentration
Eveningconcentrationisalmosthalfofmorningconcentration(a/c
--- Content provided by FirstRanker.com ---
belowreferencevalues).Cortisolconcentrationat8.00aminmorning5-20mcg/dL(140-550
nmol/L).
19.Saccadicceyemovementiscontrolledby:
a)Parietallobe
--- Content provided by FirstRanker.com ---
b)Prefrontallobec)Temporallobe
d)Frontalcortex
e)Occipitallobe
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Ans:d.Frontalcortex[RefGanong25th/189,195-96;Guyton12tlt/786;AKJain1115-16]
Normallysaccadicmovementsarevoluntarybutcanbearousedby
peripheralvisualorauditorystimulibystimulationoffrontaleye
fields(area8).
--- Content provided by FirstRanker.com ---
Thusthesemovementsareprogrammedinthefrontalcortex.Thebilateralfrontaleyefieldsinthispartofthecortexareconcerned
withthecontrolofsaccades,andanareajustanteriortothesefields
isconcernedwithvergenceandthenearresponse.
20.TrueaboutnormalECG:
--- Content provided by FirstRanker.com ---
a)NormalPRintervalis0.12-0.20sb)PRinternalcorrespondenceinitiationofPwavetoinitiationofR
wave
c)QTinternalcorrespondenceinitiationofQwavetoinitiationofT
wave
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d)NormalQRSinterval<0.12se)NormalQTcinterval
CorrectAnswer-A:D
Ans:a.NormalPRintervalis0.12-0.20sd.NormalQRSinterval
[Ref:Ganong25th/524;Guyton12th/179-80;ECGmadeEasyby
--- Content provided by FirstRanker.com ---
Hamptot4th/6-71]ThePRintervalismeasuredfromthebeginningofPwavetothe
beginningofQRScomplex.
AQTcintervallongerthan0.45sislikelytobeabnormal.
NormalQRSintervaldurationisnogreaterthan0.12s.
--- Content provided by FirstRanker.com ---
QTintervalisameasureofthetimebetweenthestartoftheQwaveandtheendoftheTwaveintheheart'selectricalcycle.
21.Whichofthefollowingis/aretrueabout
SIADH:
--- Content provided by FirstRanker.com ---
a)Desmopressinisusedfortreatmentb)Vasopressinlevelisinappropriatelyhigh
c)Plasmaosmolalityishigherthanurineosmolality
d)TedOsmolalityofurine
e)TedOsmolalityofplasma
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:DAns:b.VasopressinlevelisinappropriatelyHighd.Ted
Osmolalityofurine
[RefHarrison19th/2280;Ganong25th/698;AKJain6th/673-74]
Desmopressinisveryusefulinthemanagementofdiabetes
--- Content provided by FirstRanker.com ---
insipidus.SyndromeofInappropriateAntidiureticHormone
Thesyndromeof"inappropriate'hypersecretionofantidiuretic
hormone(SIADH)occurswhenvasopressinisinappropriatelyhigh
relativetoserumosmolality.
--- Content provided by FirstRanker.com ---
Vasopressinisresponsiblenotonlyfordilutionalhyponatremia(serumsodium<135mmol/L)butalsoforlossofsaltintheurine
whenwaterretentionissufficienttoexpandtheECFvolume,
reducingaldosteronesecretion
Features:
--- Content provided by FirstRanker.com ---
HyposmolalityIncreasedurineosmolality
Urineosmolalitybecomeshigherthanplasmaosmolality
UrinaryNa+exceeds20mEq/L
22.Whichofthefollowingfeature(s)is/are
--- Content provided by FirstRanker.com ---
suggestiveofnehogrnicDIincomparisontocentralDI:
a)Desmopressinnasalsprayrestoreurineoutputtonormallevel
b)Basalvasopressinlevel>1pg/ml
c)NormalposteriorpituitarybrightspotisnotvisibleonMRIscan
--- Content provided by FirstRanker.com ---
d)Changeinwaterlossduringfluiddeprivationteste)None
CorrectAnswer-B
Ans:b.Basalvasopressinlevel>1pg/ml
[RefGanong25th/698;Guyton12th/488-89;AKJain6th/674]
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FailuretoProduceADH:"Central"DiabetesInsipidus.Thetreatmentforcentraldiabetesinsipidusisadministrationofa
syntheticanalogofADH,desmopressin,whichactsselectivelyon
V2receptorstoincreasewaterpermeabilityinthelatedistaland
collectingtubules.
--- Content provided by FirstRanker.com ---
Desmopressincanbegivenbyinjection,asanasalspray,ororally,anditrapidlyrestoresurineoutputtowardnormal.
ThepolyuriaanilpolydipsiaofnephrogenicDIarenotaffectedby
treatment*ithstandarddosesofDDAVP.
--- Content provided by FirstRanker.com ---
23.AllareUreacycleenzymesexcept:a)Ornithinetranscarbamylase
b)Carbamoyl-phosphatesynthetaseI
c)Argininosuccinase
d)Citrullinesynthase
--- Content provided by FirstRanker.com ---
e)ArgininosuccinicacidsynthetaseCorrectAnswer-D
Answer:(D)Citrullinesynthase[RefHarper30th/290-96,
29th/274-88;Lippincott
24.Non-polaraminoacidsare:
--- Content provided by FirstRanker.com ---
a)Prolineb)Lysine
c)Isoleucine
d)Arginine
e)Asparginine
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:CAns:a.Prolinec.Isoleucine[RefHarper30th/16-22;Lippincott
6th/1-9;Satyanarayan4th/48]
AcidicandPolarsidechainsAsparticAcidGlutamicAcid
BasicandPolarsidechainsArginine,Lysine,Histidine
--- Content provided by FirstRanker.com ---
Uncharged&PolarsidechainsAsparginine,Glutamine,Serine,Threonine,Tyrosine
NonPolarAminoAcidswithNonPolarsidechainsGlycine,
Alanine,Valine,Leucine,Isoleucine,Proline.
25.Trueaboutsqualene:
--- Content provided by FirstRanker.com ---
a)Presentinsubhumanprimateonlyb)Itisoneofthemajorcarbohydratesofbody
c)Itinvolvesinthesynthesisofcholesterol
d)Itinvolvesinthesynthesisofsteroids
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-C:DAns:(C)Itinvolvesinsynthesisofcholesterol,(D)Itinvolvesin
synthesisofsteroids
Squaleneisahydrocarbonandatriterpene,andisanaturaland
vitalpartofthesynthesisofallplantandanimalsterols,including
--- Content provided by FirstRanker.com ---
cholesterol,steroidhormones,andvitaminDinthehumanbody.Squaleneisusedincosmetics,andmorerecentlyasan
immunologicadjuvantinvaccines.
Itisanatural30-carbonorganiccompoundoriginallyobtainedfor
commercialpurposesprimarilyfromsharkliveroil(henceitsname),
--- Content provided by FirstRanker.com ---
althoughplantsources(primarilyvegetableoils)arenowusedaswell,includingamaranthseed,ricebran,wheatgerm,andolives.
Squaleneandomega2fattyacidhasunlikeomega3fishoilsmore
completeandeffectivechemicalgroups.
26.Molecularweightofproteincanbe
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determined/estimatedby:a)SDS-PAGE
b)Gelfiltrationchromatography
c)Agarosegelelectrophoresis
d)Ultracentrifugation
--- Content provided by FirstRanker.com ---
e)FRETmicroscopyCorrectAnswer-A:B:D
Ans:(A)SDS-PAGE(B)Gelfiltrationchromatography(D)
Ultracentrifugation[RefHarper30th/28;Shinde7th/772-74;
Satyanarayan4th/725,60;Vasudevan5th/482-851
--- Content provided by FirstRanker.com ---
"SDS-PAGEiscommonlyusedformolecularweightdeterminationofproteins"(Vasudevan5th/482)
"SDS-PAGEisapopulartechniquefordeterminationofmolecular
weightofproteins"(Satyanarayan4th/725)
"Sodiumdodecylsulfate-polyacrylamidegelelectrophoresis(SDS-
--- Content provided by FirstRanker.com ---
PAGE)isareliablemethodfordeterminingthemolecularweight(MW)ofanunknownprotein".
"Thegelfiltrationchromatographytechniqueisusedfor"Separation
ofproteinmolecules,purificationofproteins&molecularweight
determinations"Ultracentrifugationisanindispensabletoolforthe
--- Content provided by FirstRanker.com ---
isolationofsubcellularorganelles,proteins,&nucleicacids.Inaddition,thistechniqueisalsoemployedindeterminationof
molecularweightofmacromolecules\
27.GelusedinRNAelectrophoresis:
a)Agarosegel
--- Content provided by FirstRanker.com ---
b)Polyacrylamideplaingelc)PolyacrylamideSDS(Sodiumdodecylsulphate)impregnated
Polyacrylamidegel
d)A&C
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:a.Agarosegel
SeparationofRNAinagarosegelsisusedforanumberofdifferent
purposes,includingNorthernblotstomonitorRNAexpression
levels,checkingRNAintegrityandsizeselectionofRNAforcloning
--- Content provided by FirstRanker.com ---
experiments.SeparationofRNAbasedonfragmentlengthrequiresconditions
thataredifferentfromDNAanalysis.
ThemostfrequentlyuseddenaturantsforRNAagarosegel
electrophoresisareformaldehyde,formaldehyde/formamide,and
--- Content provided by FirstRanker.com ---
glyoxalplusDMSO.ThemostefficientRNAdenaturantismethylmercuryhydroxide.
Becauseofthehazardsassociatedwiththisdenaturant,itisthe
leastusedsystemforRNA
28.Whichoffollowingreleases/provide
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energy:a)ConversionofADPtoATP
b)Breakingofhighenergybondtolowenergybond
c)Conversionofpyruvatetolactate
d)Electricalgradientacrossinner&outersideofmitochondria]
--- Content provided by FirstRanker.com ---
membranee)Passageofe-throughFADinelectrontransportchain
CorrectAnswer-B:D:E
Ans:(B)Breakingofhigh...(D)Electricalgradientacross...(E)
Passageofe-throughFAD....
--- Content provided by FirstRanker.com ---
Inabsenceof0xygenpyruvateisreducedtolacticacid(withoutproducingATP).Inanaerobicglycolysis,pyruvateactsasa
temporaryH-store.
Itdehydrogenation(oxidizes),thereducedNADH+H+backto
oxidizedNAD+,sothatglycolysiscancontinueevenintheabsence
--- Content provided by FirstRanker.com ---
of02.Inpresenceof02,lacticacidcanbeoxidizedintopyruvicacidagain.
ElectrontransportiscoupledtothephosphorylationofADPbythe
transport("pumping")ofprotons(H+)acrosstheinnermitochondrial
membranefromthematrixtotheintermembranespaceat
--- Content provided by FirstRanker.com ---
ComplexesI,III,andIV.Thisprocesscreatesanelectricalgradient(withmorepositive
chargesontheoutsideofthemembranethanontheinside)anda
pHgradient(theoutsideofthemembraneisatalowerpHthanthe
inside).
--- Content provided by FirstRanker.com ---
Theenergygeneratedbythisprotongradientissufficienttodrive
ATPsynthesis.Thus,theprotongradientservesasthecommon
intermediatethatcouplesoxidationtophosphorylation.
29.Whichofthefollowingisfeature(s)of
diabeticketoacidosis:
--- Content provided by FirstRanker.com ---
a)Decreasedtriglyceridelevelb)Increasedfattyacidlevel
c)TLipoprotein
d)Decreasedketonebodies
e)HighAniongapacidosis
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:EAns:(B)Increasedfattyacidlevel(C)TLipoprotein(E)High
Aniongapacidosis[RefHarper30th/231;Lippincott6th/339,
345;Satyanarayan4th/481,682;Harrison19th/2417-18]
DKAischaracterizedbyhyperglycemia,ketosis,andmetabolic
--- Content provided by FirstRanker.com ---
acidosis(increasedaniongap)alongwithanumberofsecondarymetabolicderangements,Leukocytosis,hypertriglyceridemia,and
hyperlipoproteinemiaarecommonlyfoundaswell
Increasedlacticacidproductionalsocontributestotheacidosis.The
increasedfreefattyacidsincreasetriglycerideandVLDLproduction.
--- Content provided by FirstRanker.com ---
VLDLclearanceisalsoreducedbecausetheactivityofinsulin-sensitivelipoproteinlipaseinmuscleandfatisdecreased.
Hypertriglyceridemiamaybesevereenoughtocausepancreatitis.
Reducedinsulinlevels,incombinationwithelevationsin
catecholaminesandgrowthhormone,increaselipolysisandthe
--- Content provided by FirstRanker.com ---
releaseoffreefattyacids.Normally,thesefreefattyacidsareconvertedtotriglyceridesorvery-low-densitylipoprotein(VLDL)in
theliver.
30.Whichofthefollowingis/aretrueabout
pHofsolution:
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a)Absoluteconcentrationofacid&saltb)Relativeconcentrationofacid&saltinsolution
c)IncreaseoftemperatureincreasespH
d)AriseinH+concentrationdecreasespH
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:DAns:(B)Relativeconcentration...,(D)AriseinH*concentra
tion....
"WhenpHmeasuredatroomtemperaturethereisnodirect
correlationbetweenpHandtemperature.
--- Content provided by FirstRanker.com ---
AriseinH+concentrationdecreasespHwhileafallinH+concentrationincreasespH.ThereverseistrueforOH-
concentration
Theratioofsalttoacidconcentration-Actualconcentrationsofsalta
acidinabuffersolutionmaybevaryingwidely,withnochangein
--- Content provided by FirstRanker.com ---
pH,solongastheratiooftheconcentrationsremainsthesame31.Truestatement(s)aboutMagnetic-
activatedcellsorting:
a)Itisamethodtoseparatespecificcellfromcomplexmixture
b)Fluorescentdyesareuses
--- Content provided by FirstRanker.com ---
c)Antibody-coatedmagneticnanoparticlesareusedd)Antibodiesusedarespecificforcertaincellsurfacemarkers
e)Magneticfieldisapplied
CorrectAnswer-A:C:D:E
Ans:(A)Itisamethod...,(C)Antibody-coatedmagnetic...,(D)
--- Content provided by FirstRanker.com ---
Antibodiesusedare...,(E)Magneticfieldisappli...MACS,isaproceduredevelopedbyMiltenyiBiotectoseparatecells
fromcomplexmixturesusingantibody-coatedmagneticnano
particles.
Theantibodiesarespecificforcertaincellsurfacemarkers,either
--- Content provided by FirstRanker.com ---
expressedonyourpopulationofinterest(positiveselection),orexpressedonundesiredcelltypes(negativeselection).
Afteraddingtheantibody-coatedbeadstothecellmixtureand
incubating,thesuspensionisaddedtoaspecialsingle-use
separationcolumnaffixedtoamagnet,towhichthebeadsstick,
--- Content provided by FirstRanker.com ---
whileunlabeledcellsflowthrough.32.Silverstainingisdonefor:
a)DNA
b)RNA
c)Karyotypinganalysis
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d)Proteine)Collagen
CorrectAnswer-A:B:C:D:E
Answer-(A)DNA(B)RNA(C)Karyotypinganalysis(D)Protein
(E)Collagen
--- Content provided by FirstRanker.com ---
Silverstainingisahighlysensitivemethodfordetectingproteinsandnucleicacids(dsDNA&RNA)inpolyacrylamideslabgels.
Silverstainingistheuseofsilvertoselectivelyaltertheappearance
ofatargetinmicroscopyofhistologicalsections;intemperature
gradientgelelectrophoresis;andinpolyacrylamidegels.
--- Content provided by FirstRanker.com ---
Silverstainingisthemostsensitivemethodforpermanentstainingofproteinsornucleicacidsinpolyacrylamidegels.
Histologicalcharacterization:Silverstainingaidsthevisualizationof
targetsofinterest,namelyintracellularandextracellularcellular
componentssuchasDNAandproteins,suchastypeIIIcollagen
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andreticulinfibresbythedepositionofmetallicsilverparticlesonthetargetsofinterest.
33.Non-codingRNAis/are:
a)miRNA
b)SiRNA
--- Content provided by FirstRanker.com ---
c)tRNAd)mRNA
e)rRNA
CorrectAnswer-A:B:C:E
Ans:a.miRN...,b.SiRNA...,c.tRNA...,e.rRNA...,[RefHarper
--- Content provided by FirstRanker.com ---
30th/394-95,368;en.wikipedia.org;Lippincott6th/417]AlleukaryoticcellshavetwomajorclassesofRNA,theprotein
codingRNAs,ormessengerRNAs(mRNAs),andtwoformsof
abundantnon-proteincodingRNAsdelineatedonthebasisofsize:
thelargeribosomalRNAs(rRNA)andlongnoncodingRNAs
--- Content provided by FirstRanker.com ---
(lncRNAs)andsmallnoncodingRNAstransferRNAs(tRNA),thesmallnuclearRNAs(snRNAs)andthemicroandsilencingRNAs
(miRNAsandsiRNAs).
ThemRNAs,rRNAsandtRNAsaredirectlyinvolvedinprotein
synthesiswhiletheotherRNAsareparticipateineithermRNA
--- Content provided by FirstRanker.com ---
splicing(SnRNAs)ormodulationofgeneexpressionbyalteringmRNAfunction(mi/SiRNAs)and/orexpression(lncRNAs).These
RNAdifferintheirdiversity,stability,andabundanceincells
34.PolymeraseIIIsynthesizes:
a)Fragment28SofrRNA
--- Content provided by FirstRanker.com ---
b)Fragment23SofrRNAc)Fragment5SofrRNA
d)tRNA
e)mRNA
CorrectAnswer-C:D
--- Content provided by FirstRanker.com ---
Ans:c.andd[RefHarper30th/395-98;Lippincott428]"RNApolymeraseIIIsynthesizestRNA,5SrRNA,andsomesnRNA
andsnoRNA"(Lippincott428)
35.TwostrandsofDNAis/areheldby:
a)Glycosidicbond
--- Content provided by FirstRanker.com ---
b)Hydrogenbondc)Covalentbond
d)Ionicbond
e)Vanderwaalforce
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer(b)hydrogenbond[RefHarper30th/359;Lippincott6th/396-97;Satyanarayan4th/75]
Thetwostrandsareheldtogetherbyhydrogenbondformed
bycomplementarybasepairs"(Satyanarayan4th/75)
"Thebasepairsareheldtogetherbyhydrogenbonds:twobetween
--- Content provided by FirstRanker.com ---
AandTandthreebetweenGandC.Thesehydrogenbonds,plusthehydrophobicinteractionsbetweenthestackedbases,stabilize
thestructureofthedoublehelix.
36.Whichofthefollowingis/aretrueabout
Translation:
--- Content provided by FirstRanker.com ---
a)N-formylmethionineisfirstaminoacidinprokaryotesb)UsesenergyinformofGMP
c)ElongationfactorEF-1&EF-2usedinprokaryotes
d)ElongationfactorPisusedineukaryoticorganism
e)Threeinitiationfactorsarerequiredinprokaryotes
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:EAns:a.N-formylmethionine...,e.Threeinitiation[RefHarper
30th/419-23;Lippincott6th/438-42;Satyanarayan4th/554-60]
Ineukaryotes,thefirstaminoacidincorporatedismethionine(AUG
codon).Butinprokaryotes,thesamecodonattractsN-formyl
--- Content provided by FirstRanker.com ---
methionine,whichisthefirstaminoacid"(Vasudevan5th/432)"ElongationfactorPisaprokaryoticproteintranslation
factorrequiredforefficientpeptidebondsynthesison70S
ribosomesfromfMet-tRNAfMet.Itprobablyfunctionsindirectlyby
alteringtheaffinityoftheribosomeforaminoacyl-tRNA,thus
--- Content provided by FirstRanker.com ---
increasingtheirreactivityasacceptorsforpeptidylStepsinProteinSynthesis
Inprokaryotes,threeinitiationfactorsareknown(IF-1,IF-2,andIF-
3),whereasineukaryotes,thereareoverten(designatedeIFto
indicateeukaryoticorigin).EukaryotesalsorequireATPforinitiation.
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37.Nucleicacidamplificationtechniquesare:
a)PCR
b)RealtimePCR
c)DNACloning
d)NextgenerationDNAsequencing
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-A:B
Ans:a.PCR...,b.Realtime....[RefHarper30th/458;Robbins
9th/180;Lippincott6th/479;Harrison19th/150e-7;http://link.
springer.corn]
--- Content provided by FirstRanker.com ---
Real-timePCRautomatesthelaboriousprocessofamplificationbyquantitatingreactionproductsforeachsampleinevery
Cycle.
Thereareseveralmethodsforamplification(copying)ofsmall
numbersofmoleculesofnucleicacidtoreadilydetectablelevels.
--- Content provided by FirstRanker.com ---
TheseNAATsincludePCR,LCR,stranddisplacementamplification,andself-sustainingsequencereplication.
Theamplifiednucleicacidcanbedetectedafterthereactionis
completeor(inreal-timedetection)asamplificationproceeds.The
sensitivityofNAATsisfargreaterthanthatoftraditionalassay
--- Content provided by FirstRanker.com ---
methodssuchasculture.38.Secondmessengeris/are:
a)Ca2+
b)DNA
c)Histone
--- Content provided by FirstRanker.com ---
d)cDNAe)None
CorrectAnswer-A
Ans:a.Ca2+[RefHarper30th/501,91-92,179,343;Lippincott
6th/94-951
--- Content provided by FirstRanker.com ---
Nucleotides,suchascyclicadenosinemono-phosphate(cAMP)andcyclicguanosinemonophosphate(cGMP),serveassecond
messengersinsignaltransductionpathways.
Twoofthemostwidelyrecognizedsecondmessengersystemsare
thecalciumlphosphatidylinositolsystem,andtheadenylylcyclase
--- Content provided by FirstRanker.com ---
system,whichisparticularlyimportantinregulatingthepathwaysofintermediarymetabolism.
39.Trueaboutgeneticcode:
a)FollowMendelianlaw
b)Itistotalnumberofchromosomeinthebody
--- Content provided by FirstRanker.com ---
c)Itisnucleotidesequencewhichcodesforaminoacidsd)ItcodesforDNA
e)None
CorrectAnswer-C
Ans:c.Itisnucleotidesequencewhichcodesforaminoacids
--- Content provided by FirstRanker.com ---
MendelianGeneticsiswidelyregardedasthecornerstoneofclassicalgenetics.Itisasetofprimarybeliefsrelatingtothe
transmissionofhereditarycharacteristicsfromparentorganismsto
theiroffspring
Thegeneticcodeisadictionarythatidentifiesthecorrespondence
--- Content provided by FirstRanker.com ---
betweenasequenceofnucleotidebasesandasequenceofaminoacids.
TheNucleotideSequenceofanmRNAMoleculeConsistsofa
SeriesofCodonsThatSpecifytheAminoAcidSequenceofthe
EncodedProtein
--- Content provided by FirstRanker.com ---
40.Restrictionendonucleasecleaves:
a)dsDNA
b)RNA
c)Histone
d)Protein
--- Content provided by FirstRanker.com ---
e)ssDNACorrectAnswer-A
Ans:a.dsDNA
Restrictionendonucleases(restrictionenzymes),which
cleavedouble-stranded(ds)DNAintosmaller,moremanageable
--- Content provided by FirstRanker.com ---
fragments,hasopenedthewayforDNAanalysis"Restrictionenzyme(REorRestrictionEndonuclease)isanenzyme
thatcleavedouble-strandedDNAQatspecificrecognitionnucleotide
knownasrestrictionsitesQ
ThecutDNAfragmentsbyREmayhavestickyends(cohesive
--- Content provided by FirstRanker.com ---
ends)?orbluntsends?dependingonthemechanismusedbyenzyme
DNAfragmentswithstickyendsareparticularlyusefulfor
recombinantDNAexperiments(hybridorchimericDNAmolecules)
Restrictionenzymeisnamedaccordingtotheorganismfromwhich
--- Content provided by FirstRanker.com ---
itwasisolated41.PhospholipaseA2acton:
a)Phosphoglycericacid
b)Phosphate
c)Ca+
--- Content provided by FirstRanker.com ---
d)Phosphatidyl-inositole)None
CorrectAnswer-D
Ans:d.Phosphatidyl-inositol
Phospholipaseshydrolyzethephosphodiesterbondsof
--- Content provided by FirstRanker.com ---
phosphoglycerides,witheachenzymecleavingthephospholipidataspecificsite.
Phospholipasesreleasemoleculesthatcanserveasmessengers
(forexample,DAGandIP3),orthatarethesubstratesforsynthesis
ofmessengers(forexample,arachidonicacid.
--- Content provided by FirstRanker.com ---
Phospholipasesareresponsiblenotonlyfordegradingphospholipids,butalsofor"remodeling"them.Forexample,
phospholipasesAlandA2removespecificfattyacidsfrom
membrane-boundphospholipids;thesecanbereplacedwith
alternativefattyacidsusingfattyacylCoAtransferase.
--- Content provided by FirstRanker.com ---
42.EnzymeusedinDNArepairis/are:
a)DNAgyrase
b)DNApolymerase
c)Restrictionendonuclease
d)DNAligase
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-B:D
Ans:b.DNApoly...,d.DNA(RefHarper30th/382,389-92;
Lippincott6th/411-131
Whenthestrandcontainingthemismatchisidentified,an
--- Content provided by FirstRanker.com ---
endonucleasenicksthestrandandthemismatchednucleotide(s)is/areremovedbyanexonuclease.
Additionalnucleotidesatthe5'-and3'-endsofthemismatchare
alsoremoved.Thegapleftbyremovalofthenucleotidesisfilled,
usingthesisterstrandasatemplate,byaDNApolymerase.
--- Content provided by FirstRanker.com ---
The3'-hydroxylofthenewlysynthesizedDNAisjoinedtothe5'-phosphateoftheremainingstretchoftheoriginalDNAstrandby
DNAligase
43.Nucleosomecontains:
a)DNA
--- Content provided by FirstRanker.com ---
b)RNAc)Chromatin
d)Histone
e)None
CorrectAnswer-A:D
--- Content provided by FirstRanker.com ---
Ans:a.DNAd.Histone[RefHarper30th/371-72;Lippincott6th/409]
Histonesarehighlyalkalineproteinsfoundineukaryoticcellnuclei
thatpackageandordertheDNAintostructuralunitscalled
nucleosomes.
--- Content provided by FirstRanker.com ---
Theyarethechiefproteincomponentsofchromatin,actingasspoolsaroundwhichDNAwinds,andplayingaroleingene
regulation.
WhenthehistoneoctamerismixedwithpurifieddsDNAunder
appropriateionicconditions,thesamex-raydiffractionpatternis
--- Content provided by FirstRanker.com ---
formedasthatobservedinfreshlyisolatedchromatin.Biochemicalandelectronmicroscopicstudiesconfirmtheexistenceof
reconstitutednucleosomes.
Inthenucleosome,theDNAissupercoiledinalefthandedhelix
overthesurfaceofthedisk-shapedhistoneoctamer
--- Content provided by FirstRanker.com ---
44.Serotonin,amediatorofinflammationin
ourbody,issecreted/releasedby:
a)Leukocytes
b)Endothelialcell
c)Mastcell
--- Content provided by FirstRanker.com ---
d)Platelete)Macrophage
CorrectAnswer-D
Answer-D.Platelet
Serotonin:Itisfoundintheintestinalmucosa,braintissue&
--- Content provided by FirstRanker.com ---
platelets.Releaseofserotonin(andhistamine)fromplateletsisstimulated
whenplateletsaggregateaftercontactwithcollagen,thrombin,
adenosinediphosphate(ADP),andantigen-antibodycomplexes.
45.Autosomalrecessivedisease(s)is/are:
--- Content provided by FirstRanker.com ---
a)Sicklecellanaemiab)Phenylketonuria
c)Tuberousscelerosis
d)Familialpolyposiscoli
e)Marfansyndrome
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:BAnswer-(A)Sicklecellanaemia(B)Phenylketonuria
1.Metabolic-
Cysticfibrosis
Phenylketonuria
--- Content provided by FirstRanker.com ---
GalactosemiaHomocystinuria
Wilsondisease
Hemochromatosis
2.Hematopoietic
--- Content provided by FirstRanker.com ---
SicklecellanemiaThalassemias
3.Endocrine
Congenitaladrenalhyperplasia
4.Skeletal
--- Content provided by FirstRanker.com ---
Ehlers-Danlossyndrome5.Nervous
Friedreichataxia
Spinalmuscularatrophy
46.Whichofthefollowingis/arefeatures(s)of
--- Content provided by FirstRanker.com ---
lewybodydementia:a)Plaquecontainingbeta-amyloidpeptide
b)Depositionofa-synucleinprotein
c)Oftenresistanttostandardtreatment
d)Commoninelderly
--- Content provided by FirstRanker.com ---
e)RiskoffallingmaypresentCorrectAnswer-B:C:D:E
Answer-(B)Depositionofa-synucleinprotein(C)Often
resistanttostandardtreatment(D)Commoninelderly(E)Risk
offallingmaypresent
--- Content provided by FirstRanker.com ---
Alpha-synucleincontainingLewybodiesoccurinthebrainstem,midbrain,olfactorybulb,andneocortex.
Thisisaneurodegenerativedisorderclinicallycharacterizedby
dementiaandsignsofParkinson'sdisease.
Commoninelderly.
--- Content provided by FirstRanker.com ---
TheDLBclinicalsyndromeischaracterizedbyvisualhallucinations,parkinsonism,fluctuatingalertness,falls.
47.TrueaboutAlzheimer'sdisease:
a)Morecommoninolderage
b)Impairmentoftheabilitytoremembernewinformation
--- Content provided by FirstRanker.com ---
c)Mainlyaffectslongtermmemoryd)Generalcognitivebehaviorimpairedinprodromalphase
e)Atrophyoffrontal&parietallobe
CorrectAnswer-A:B:D:E
Answer-(A)Morecommoninolderage(B)Impairmentofthe
--- Content provided by FirstRanker.com ---
abilitytoremembernewinformation(D)Generalcognitivebehaviorimpairedinprodromalphase(E)Atrophyoffrontal&
parietallobe
Alzheimer'sdisease(AD)isaslowlyprogressivediseaseofthe
brainthatischaracterizedbyimpairmentofmemory.
--- Content provided by FirstRanker.com ---
Alzheimer'sdiseaseisCommonin5thand6thdecade.EarlyStage-
Thisisconsideredasamild/earlystageandthedurationperiodis2-
4years.
Frequentrecentmemoryloss.
--- Content provided by FirstRanker.com ---
Writingandusingobjectsbecomedifficultanddepressionandapathycanoccur.
Secondstage-
Thisisconsideredasamiddle/moderatestageandthedurationis2-
10years.
--- Content provided by FirstRanker.com ---
DementiaofAlzheimer'stypeisassociatedwithDepressivesymptoms,Delusions,Apraxiaandaphasia.
Pervasiveandpersistentmemorylossimpactslifeacrosssettings.
Moderatestage-
Increasedmemorylossandconfusion.
--- Content provided by FirstRanker.com ---
Laststage-Thisisconsideredastheseverestageandthedurationis1-3years.
Extremeproblemswithmood,behavioralproblems,hallucinations,
anddelirium.
48.TrueaboutHypersensitivitypneumonitis:
--- Content provided by FirstRanker.com ---
a)Occursduetoinorganicantigenb)IncreasedCD8+Tcellsinbronchoalveolarlavage
c)Manifestsmainlyasanoccupationalandenvironmentdisease
d)Forsevereacutecases,oralsteroidsisgivenfor3-4weeks
e)Interstitialinflammatoryinfiltrateisseeninlung
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:D:EAnswer-(B)IncreasedCD8+Tcellsinbronchoalveolarlavage
(C)Manifestsmainlyasanoccupationalandenvironment
disease(D)Forsevereacutecases,oralsteroidsisgivenfor3-
4weeks(E)Interstitialinflammatoryinfiltrateisseeninlung
--- Content provided by FirstRanker.com ---
Itismanifestedmainlyasanoccupationaldisease,inwhichexposuretoinhaledorganicagentsleadstoacuteandeventually
chronicpulmonarydisease.
Bronchoalveolarlavagespecimensalsoconsistentlydemonstrate
increasednumbersofbothCD4+andCDB+Tlymphocytes.
--- Content provided by FirstRanker.com ---
HistologyshowsevidenceofaninterstitialinflammatoryinfiItrateinthelung.
Inacutecases,prednisoloneshouldbegivenfor3-4weeks,starting
withanoraldoseof40mgperday.
49.RScellhavingsameimmunophenotyping
--- Content provided by FirstRanker.com ---
arepresentinwhichsubtypesofHodgkin'slymphoma:
a)Nodularsclerosis
b)Lymphocytepredominant
c)Lymphocyterich
--- Content provided by FirstRanker.com ---
d)Mixedcellularitye)Lymphocytedepletion
CorrectAnswer-A:C:D:E
Answer-(A)Nodularsclerosis(C)Lymphocyterich(D)Mixed
cellularity(E)Lymphocytedepletion
--- Content provided by FirstRanker.com ---
Inthefirstfoursubtypes-nodularsclerosis,mixedcellularity,lymphocyte-rich,andlymphocytecells.
50.TrueaboutLyonisationofXchromosome:
a)InactivationofXchromosomeonlyinsomaticcell
b)InactivationofXchromosomeonlyingermcell
--- Content provided by FirstRanker.com ---
c)InactivationofXchromosomeinsomatic&germcellbothd)MaximunnumberofBarrbodyisequaltoXchromosome
e)All
CorrectAnswer-A
Answer-A.InactivationofXchromosomeonlyinsomaticcell
--- Content provided by FirstRanker.com ---
Infemale,oneoftwoX-chromosome(eitherpaternalormaternal)isinactivatedduringembryogenesisasstatedinLyonhypothesis.
Thisinactivationispassedtoallthesomaticcellwhilethegermcells
inthefemaleremainunaffected.
51.TwomostcommoncancerinIndian
--- Content provided by FirstRanker.com ---
womanis:a)Carcinomabreast
b)Carcinomacervix
c)Carcinomacolon
d)Carcinomastomach
--- Content provided by FirstRanker.com ---
e)CarcinomalungCorrectAnswer-A:B
Answer-(A)Carcinomabreast(B)Carcinomacervix
Inwomen,cancerbreast,cervixuteri,colorectum,ovary,lip&oral
cavity.
--- Content provided by FirstRanker.com ---
52.Whichofthefollowingisparaganglioma:
a)AdrenalPheochromocytoma
b)Extra-adrenalPheochromocytoma
c)Carotidbodytumour
d)Carcinoidtumour
--- Content provided by FirstRanker.com ---
e)GlomustympanicumCorrectAnswer-B:C:E
Answer-(B)Extra-adrenalPheochromocytoma(C)Carotidbody
tumour(E)Glomustympanicum
Pheochromocytornaisachromaffin-cellneoplasmthatcanarisean
--- Content provided by FirstRanker.com ---
adrenal(adrenalmedulla)orextraadrenaltumor.Extraadrenalpheochromocytomaisalsoreferredtoas
paraganglioma.
Thecarotidbodytumorisaprototypeofaparasympathetic
paraganglioma.
--- Content provided by FirstRanker.com ---
Glomustympanicum:Mostcommontumourinmiddleear.53.Feature(s)ofXIIIfactordeficiencyis/are:
a)Delayedwoundclosure
b)Clotsolubilitytestsareabnormal
c)TaPTT
--- Content provided by FirstRanker.com ---
d)TPTe)TBT
CorrectAnswer-A:B
Answer-A,DelayedwoundclosureB,Clotsolubilitytestsare
abnormal
--- Content provided by FirstRanker.com ---
Itcharacteristicallyleadstodelayedbleedingthatoccurshourstodaysafterahemostaticchallenge.
Clotsolubilitytestsareabnormal.
54.Whichofthefollowingstatement(s)is/are
correctexcept:
--- Content provided by FirstRanker.com ---
a)IncreasedPTinextrinsicpathwaysb)IncreasedaPTTininstrinsicpathways
c)Ifplateletcountis>1.5lac/microL,thennormalhomeo-stasis
present
d)BTisdecreasedinplateletabnormality
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-D
Aswer-D.BTisdecreasedinplateletabnormality
Hemostasisisspontaneousarrestofbleedingbyphysiological
Process.
--- Content provided by FirstRanker.com ---
Prothrombintime(PT):Thisassayteststheextrinsicandcommoncoagulationpathways.
Partialthromboplastintime(PTT):
Thisassayteststheintrinsicandcommonclottingpathway.
Prolongationgenerallyindicatesadefectinplateletnumbersor
--- Content provided by FirstRanker.com ---
function.55.TrueaboutDentigerouscyst:
a)Arisesinrelationtouneruptedteeth
b)Itmostcommonlyencroachesmaxillaryantrum
c)Mandibularthirdmolariscommonsite
--- Content provided by FirstRanker.com ---
d)Commoninmandiblee)All
CorrectAnswer-A:C:D
Answer-A,ArisesinrelationtouneruptedteethC,Mandibular
thirdmolariscommonsiteD,Commoninmandible
--- Content provided by FirstRanker.com ---
Commoninlowerjaw(mandible)inwomen30-40years.Itoccursinrelationtounerupted,permanent,molartooth,most
commonlytheupperorlowerthirdmolar.
56.Prognosticfactorsforcarcinoma
esophagusis/are:
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a)Depthofinvasionb)Lymphnodestatus
c)Tumourgrading
d)Stageofthedisease
e)All
--- Content provided by FirstRanker.com ---
CorrectAnswer-EAnswer-E,All
StageThemostreliableprognosticfacforforesophagealcanceris
thestageofthetumouratthetimeofdiagnosis.
Tumoursize
--- Content provided by FirstRanker.com ---
LymphnodesstatusCancerhasspreadtodistantorgans
Cancerthatremainsaftersurgery
Tumourgrade
57.Trueaboutsurgicaljaundice:
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a)Increaseofserumbilirubinb)Increaseacidphosphatase
c)Increasealkalinephosphatase
d)Urinebilirubinisabsent
e)Stoolsterocobilinogenabsent
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:EAnswer-A,IncreaseofserumbilirubinC,Increasealkaline
phosphataseE,Stoolsterocobilinogenabsent
Obstructivejaundice-
1.Biluribin
--- Content provided by FirstRanker.com ---
Direct&Indirect-increased2.Urinebilirubin-increased
3.Serumalbumin-generallyunchanged
4.Alkalinephosphatase-Increased
5.Sterocobilinogen-absent
--- Content provided by FirstRanker.com ---
58.Whichofthefollowingmarkerfavours
diagnosisofpreinvasive&invasive
cervicalcancer:
a)Ki67
b)OncoproteinE6
--- Content provided by FirstRanker.com ---
c)p16INK4,cyclinE,andKi-67d)OncoproteinE8
e)None
CorrectAnswer-A:B:C
Answer-A,Ki67B,OncoproteinE6C,p16INK4,cyclinE,andKi-
--- Content provided by FirstRanker.com ---
67TheexpressionofE7determinestheinactivationofpRbwitha
consequentincreaseoffreeE2Finthecell,leadingtobothan
increaseofcyclin-dependentkinaseinhibitorpl6(p16INK4a)and
aberrantproliferation(markedbyincreasedlevelsofKi-67
--- Content provided by FirstRanker.com ---
expression).59.Whichofthefollowingmarker/mutation
is/areseeninpapillarycarcinomaof
thyroid:
a)Synaptophysin
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b)RET/PTCc)P53
d)NTRK1
e)RAS
CorrectAnswer-B:D:E
--- Content provided by FirstRanker.com ---
Answer-B,RET/PTCD,NTRK1E,RASGeneticAlterationsinThyroidNeoplasia-
RET/PTC
BRAF
TRK
--- Content provided by FirstRanker.com ---
RAS60.Whichofthefollowingis/aretrueabout
pregabalin:
a)Approveddrugfordiabeticneuropathy
b)Approvedfortreatmentofgeneralizedtonicclonicseizure
--- Content provided by FirstRanker.com ---
c)Peripheraledemaissideeffectd)Somnolenceissideeffect
e)ApprovedforuseinPartialseizure
CorrectAnswer-A:C:D:E
Ans.a.ApproveddrugForDiabeticneuropathy;c.Peripheral
--- Content provided by FirstRanker.com ---
edemaissideeffect;d.Somnolenceissideeffect;e.Approvedforuseinpartialseizures.
[RefKDT7th/419;Katzung13th/4M,419;Harrisontgth/2682;
PharmacologybySatoskar24th139)
Pregabalinside-effectincludes:Cognitivechanges,sedation&
--- Content provided by FirstRanker.com ---
peripheraledema.GABAanalog.
Antiseizureactivityandforitsanalgesicproperty.
Approvedforuseinneuropathicpain,includingpainfuldiabetic
peripheralneuropathy,postherpeticneuralgia&complexregional
--- Content provided by FirstRanker.com ---
painsyndrome.Toxicityincluded-Somnolence,dizziness,ataxia
61.Drug(s)usedforoveractivebladder:
a)Oxybutinin
b)Tolterodine
--- Content provided by FirstRanker.com ---
c)Mirabegrond)OnabotulinumtoxinA
e)Pirenzepine
CorrectAnswer-A:B:C:D
Ans.a.Oxybutynin;b.Tolterodine;c.Mirabegron;D.
--- Content provided by FirstRanker.com ---
OnabotulinumtoxinA[R4KDf7th/117-18;Katzung13th/127-28;Rang&Date8th/366;
PharmacologybySatoskar24th/3OS-07]
OveractiveBladder:
AntimuscarinicdrugssuchasOxybutynin,Flavoxate,tolterodine&
--- Content provided by FirstRanker.com ---
trospiumareusedforbothneurogenic&non-neurogenicoveractivebladder.
Sollfenacin&darifenacinarethenewdrugs(M3antagonist)foruse
inoveractivebladder.
Mirabegronisbeta-3adrenergicagonistusedforoveractivebladder.
--- Content provided by FirstRanker.com ---
OnabotulinumtoxinAisusedassingleintradetrusorinjection,totreatoveractivebladder.
62.Allaretrueaboutwarfarinexcept:
a)ActthroughinhibitionofcoagulationfactorIX
b)Protaminesulphatereversesitsaction
--- Content provided by FirstRanker.com ---
c)MonitoringisdonethroughINRd)TargetofINRwithwarfarinisgenerally2-3
e)Skinnecrosisisusuallyoccurin3-10daysofinitiationof
warfarin
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:b.Protaminesulphatereversesitsaction.[RefKDT7th/620-24;Katzung13th/590-92;Rang&DaleSth/30q
PharmacologybySatoskar24th/jN-301]
Warfarininducedskinnecrosisisararecomplicationcharacterized
bytheappearanceofskinlesion3-10daysafterinitiationof
--- Content provided by FirstRanker.com ---
treatment.DoseofwarfarinadjustedtogiveanINRof2-4,theprecisetarget
dependingontheclinicalsituation.
Thereferencerangeforprothrombintimeisusuallyaround12-13
secondsandtheINninabsenceofanticoagulationtherapyis0.8-1.
--- Content provided by FirstRanker.com ---
2Warfarin:Doseregulationisdonebyprothrombintime&INR
(Heparin/aPTT/clottingtime.
AntagonistisVitK(c.fHeparin-Protaminesulphate).
63.TrueaboutM/Aofdoxorubicin:
--- Content provided by FirstRanker.com ---
a)Intercalateb/wDNAstrandsb)InhibitionofDNApolymerase
c)InhibitionofRNApolymerase
d)InhibitionoftopoisomeraseII
e)Inhibitionofproteinsynthesis
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:DAns.A.Intercalateb/wDNAstrands;D.InhibitionOf
TopoisomeraseII
[Ref:KDT7th/867;Katzung13th/932'j5;G6G1lth/1358;
PharmacologybySatoskar24th/835)
--- Content provided by FirstRanker.com ---
Doxorubicin:Itactsasanon-specificinhibitoroftopoisomerase-II,thusinterferingwithDNAreplication.
64.Anticholinergicdrugside-effectincludes:
a)Constipation
b)Urinaryretention
--- Content provided by FirstRanker.com ---
c)Mydriasisd)Hypothermia
e)Blurringofvision
CorrectAnswer-A:B:C:E
Ans:A.Constipation.B.UrinaryretentionC.MydriasisE.
--- Content provided by FirstRanker.com ---
Blurringofvision[Ref:KDT7th/120;GdzG11th/194;Katzung13th/129;Rang&
Dale\th/164-65;PharmacologybySatoskar24th/301).
Bodytemperatureisfrequentlyelevated.
Unfortunately,children,especiallyinfants,areverysensitiveto
--- Content provided by FirstRanker.com ---
hyperthermiceffectsofatropine.Constipation&urinaryretention(precipitationespeciallyinelderly)
canoccurwithatropine
Difficultyinswallowing,drymouth,ferer,dry-flushed&hotskin,
difficultyinmicturition,Mydriasis,photophobia,blurringofnear
--- Content provided by FirstRanker.com ---
vision,palpitations,dreadfulvisualhallucination,ataxia,delirium,psychoticbehavior,weak&rapidpulse,hypotension,
cardiovascularcollapsewithrespiratorydepression,convulsion&
coma.
65.Whichofthefollowingis/aretrueabout
--- Content provided by FirstRanker.com ---
benefitsofSustainedreleaseformulationofdrugs:
a)Decreasedincidenceand/orintensityofundesiredeffects
b)Increasespotencyofthedrug
c)ReleaseofdrugislessinfluencedbypH
--- Content provided by FirstRanker.com ---
d)Prolongdrugeffecte)Decreasedfrequencyofadministration
CorrectAnswer-A:C:D:E
AnsA.DecreasedIncidenceand/orIntensityofundesired
effects;c.ReleaseOfDrugIsLessInfluencedBypH;D.
--- Content provided by FirstRanker.com ---
Prolongdrugeffect;E.DecreasedFrequencyofadministration.[Ref:KDf7th/35;G6'G11th/5;PharmacologybySatoskar24th/7;
http://www.pharmatutor.org/articles/review-sustained-release-
dosage'forms).
Sustainedreleaseimpliesslowreleaseofthedrugoveratime
--- Content provided by FirstRanker.com ---
period.Itmayormaynotbecontrolledrelease
Advantagesofsustainedreleasedosageforms:
Controlofdrugtherapyisachieved.
Rateandextentofdrugabsorptioncanbemodified
--- Content provided by FirstRanker.com ---
Frequencyofdrugadministrationisreduced.Patientcompliancecanbeimproved.
Drugadministrationcanbemadeconvenient
Maximizingtheavailabilityofdrugwithminimumdose.
Thesafetymarginofhighpotencydrugcanbeincreased.
--- Content provided by FirstRanker.com ---
66.Trueaboutdrug-responsecurve(DRC):
a)SteepestinmiddleportionoftheDRC
b)InvertedUshapedcurvemaybeforsomedrug
c)Rectangularhyperbola-whenplottedinlogarithmicscale
d)Sigmoidshape-whenplottedinlogarithmisused
--- Content provided by FirstRanker.com ---
e)EnablescomparisonofpotencyofdrugsCorrectAnswer-A:B:C:E
Ans.(A)SteepestinmiddleportionoftheDRC(B)InvertedU
shapedcurvemaybeforsomedrug(C)Rectangularhyperbola-
whenplottedinlogarithmicscale(E)Enablescomparisonof
--- Content provided by FirstRanker.com ---
potencyofdrugsDose-ResponseRelationship:
Rectangularhyperbola.
Sigmoidalcurveindose-responserelationship:thesteepestportion
inthemiddle-wiki.
--- Content provided by FirstRanker.com ---
DRCisusedtomeasure-drugpotency,drugefficacy&drugsafety-slideshare.
Somedrugscauselow-dosestimulationandhigh-doseinhibitionof
response.
TheseU-shapedrelationshipsforsomereceptorsystemsaresaidto
--- Content provided by FirstRanker.com ---
displayhormesis.Severaldrug-receptorsystemscandisplaythispropertye.g.,
prostaglandins,endothelin,andpurinergicandserotonergic
agonists,amongothers),whichislikelytobeattherootofdrug
toxicity.
--- Content provided by FirstRanker.com ---
67.Trueaboutorganophosphoruspoisoning:
a)Atropineisbestforearlytreatment&maintenance
b)Pralidoximeisimportantforrestoringneuromuscular
transmission
c)Phenytoinistheprimarydrugusedforseizurecontrol
--- Content provided by FirstRanker.com ---
d)Mydriasispresente)Pralidoxime&atropineworkssynergistically
CorrectAnswer-A:B:E
Ans.(A)Atropineisbestforearlytreatment&maintenance
(B)Pralidoximeisimportantforrestoringneuromuscular
--- Content provided by FirstRanker.com ---
transmission(E)Pralidoxime&atropineworkssynergistically[RefReddy32nd/495-97;G&Gltth/21};KDT7th/111:13th/979-80;
PharmacologybySatoskar24th/297]
OrganophosPhorusPoisoning:
AIIcaseofAnti-ChEpoisoningmustbepromptlygivenatropine2
--- Content provided by FirstRanker.com ---
mgi.Vrepeatedevery10mintilldryness&othersignsofatropinizationappear.
Continuedtreatmentwithmaintenancedosesmayberequiredfor1-
2weeks
Theuseofoximesinorganophosphatepoisoningissecondaryto
--- Content provided by FirstRanker.com ---
thatofatropine.Moreventheclinicalbenefitofoximesishighlyvariable.
Controlofconvulsionswithjudicioususeofdiazepam.
Ocularmanifestationsincludemarkedmiosis'ocularpain'
conjunctivalcongestion,diminishedvision,ciliaryspasm,Andbrow
--- Content provided by FirstRanker.com ---
ache.Atropineinsufficientdosageeffectivelyantagonizestheactionsat
muscarinicreceptorsites,andtoamoderateextentatperipheral
ganglionicandcentralsites
68.Whichofthefollowingdrug(s)actby
--- Content provided by FirstRanker.com ---
inhibitingproteinsynthesisbyattachingto50Sribosome:
a)Tetracycline
b)Ampicillin
c)Isoniazid
--- Content provided by FirstRanker.com ---
d)Imipraminee)Ethionamide
CorrectAnswer-B:C
Ans.(B)Ampicillin(C)Isoniazid
[KDT7th/734,768;Katzung13th/789]
--- Content provided by FirstRanker.com ---
Tetracyclinesbindto30Sribosome&inhibitaminoacylRNAattachmenttotheAsite
Erythromycin&clindamycinbindto50Sribosome&hinder
translocationoftheelongatedpeptidechainbackfromAsitetoP
site.PeptidesynthesismaybeprematurelyTerminated.
--- Content provided by FirstRanker.com ---
ChloramPhenicolbindsto50Ssubunit'Itinterferewithpeptidebondformation&transferofpeptidechainfromPsite
Aminoglycosidesbindtoseveralsitesat30S&50Ssubunits-freeze
initiation,interferewithpolysomeformation&causemisreadingof
mRNAcode
--- Content provided by FirstRanker.com ---
69.OCPefficacydecreaseswithconcurrent
administrationofwhichofthefollowing
drug(s):
a)Phenytoin
b)Ampicillin
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c)Isoniazidd)Imipramine
e)Ethionamide
CorrectAnswer-A:B
Ans.(A)Phenytoin(B)Ampicillin
--- Content provided by FirstRanker.com ---
[RefKDT7th/326;Katzung13th/712;Rang&DaIe9th/434:PharmacologybySatoskar24th/967).
Contraceptivefailuremayoccurwithconcurrentadministration
of:
Enzymeinducer:Phenytoin,phenobarbital,primidone,
--- Content provided by FirstRanker.com ---
carbamazepine,rifampin,ritonavir-Metabolismofestrogenic&progestationalcomponentisincreased.
Tetracyclines-ampicillin.
Deconjugationofestrogenssecretedinbilefailstooccurtheir
enterohepaticcirculationisinterruptedbloodlevelfal
--- Content provided by FirstRanker.com ---
70.Allaretrueabouttamoxifeneexcept:
a)Usedasadjuvanttherapyinestrogenreceptorpositivebreast
cancer
b)Approvedfortheprimaryprophylaxisofbreastcancerinhigh
riskwoman
--- Content provided by FirstRanker.com ---
c)Noeffectonuterusd)Pro-estrogeneffectonbone
e)CauseendometrialCa
CorrectAnswer-A:C:D:E
Ans.(A)Usedasadjuvanttherapyinestrogenreceptorpositive
--- Content provided by FirstRanker.com ---
breastcancer(C)Noeffectonuterus(D)Pro-estrogeneffectonbone(E)CauseendometrialCa
[Ref;KDT7th/101'02;Katzung13th/106]
NMislocatedinneuromuscularjunction6causedepolarizationof
muscleendPlate
--- Content provided by FirstRanker.com ---
NNlocatedonautonomicganglia,adrenalmedulla&CNSMostsmoothmuscles&glandshaveM26M3subtypes;M3
Predominates.
Achisamajorneurotransmitteratautonomic,somaticaswellas
centralsites.ReleaseofAchfromnerveterminalhelpinsynaptic
--- Content provided by FirstRanker.com ---
transmission71.
Whichoffollowingtrueregarding
acetylcholinereceptors:
a)M2receptor-heart
--- Content provided by FirstRanker.com ---
b)MIreceptor-smoothmusclec)NMreceptorispresentonneuromuscularjunction
d)Synapticjunction-Achistransmitter
e)NNlocatedonadrenalmedulla
CorrectAnswer-A:C:D:E
--- Content provided by FirstRanker.com ---
Ans.(A)M2receptor-heart(C)NMreceptorispresentonneuromuscularjunction(D)Synapticjunction-Achis
transmitter(E)NNlocatedonadrenalmedulla
[Ref;KDT7th/101'02;Katzung13th/106]
NMislocatedinneuromuscularjunction6causedepolarizationof
--- Content provided by FirstRanker.com ---
muscleendPlateNNlocatedonautonomicganglia,adrenalmedulla&CNS
Mostsmoothmuscles&glandshaveM26M3subtypes;M3
Predominates.
Achisamajorneurotransmitteratautonomic,somaticaswellas
--- Content provided by FirstRanker.com ---
centralsites.ReleaseofAchfromnerveterminalhelpinsynaptictransmission
72.Whichofthefollowingdrug(s)comesin
riskcategoryBofFDAteratogenicrisk
categoriesforpregnancy:
--- Content provided by FirstRanker.com ---
a)Phenytoinb)Resperidone
c)Olanazapine
d)Clozapine
e)Arpirazole
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAns.D.Clozapine
[Ref:KDT7th/90;Katzung13th/1018;Rang6Dale8th/700;
PharmacologybySatoskar24th/1122;http://schizophreniabulletin-
oxfordjournal]
--- Content provided by FirstRanker.com ---
CategoryA:Norisktofetusinhumanstudies
Levothyroxine
Potassium
Supplementation
--- Content provided by FirstRanker.com ---
MgSO4CategoryB
Animalstudiesshownorisk
Humanstudiesarelacking
Penicillins
--- Content provided by FirstRanker.com ---
CephalosporinsMacrolides
Brimonidine
CategoryC
AnimalstudiesshowPositiveteratogenicrisk
--- Content provided by FirstRanker.com ---
HumanstudiesarenotavailableAlbuterol
Zidovudine
CCB
Morphine
--- Content provided by FirstRanker.com ---
AtropineCategoryD
Humanandanimalstudiesshowpositiveteratogenicrisk
Canbeusedinpregnancybecauseofbenefitsgreaterthanrisk
mightbeacceptable.
--- Content provided by FirstRanker.com ---
CorticosteroidsAzathioprine
Carbamazepine
Valproate
Methotrexate
--- Content provided by FirstRanker.com ---
LithiumCategoryX
Humanandanimalstudiesshowpositiveteratogenicrisk
Absolutelycontraindicatedinpregnancybecauseofriskgreaterthan
benefits.
--- Content provided by FirstRanker.com ---
Thalidomideisotretinoin
Fluoroquinolones
Tetracyclines
Chloramphenicol
--- Content provided by FirstRanker.com ---
WarfarinACEinhibitors
73.Whichofthefollowingistrueregarding
ropinirolewrtL-dopa:
a)Cognitivesymptomimproves
--- Content provided by FirstRanker.com ---
b)Lowerincidenceofhallucinationc)Causeexcessivesleepiness
d)Moreeffectiveinthetreatmentofpatientswhohavedeveloped
on/offphenomena
e)Provideneuroprotectiveeffect
--- Content provided by FirstRanker.com ---
CorrectAnswer-C:D:EAns.C,CauseexcessivesleepinessD,Moreeffectiveinthe
treatmentofpatientswhohavedevelopedon/offphenomena
E,Provideneuroprotectiveeffect
[Ref:KDT7th/430-31;G&G535-j8;Katzung13th/478;Rang6Date
--- Content provided by FirstRanker.com ---
8th/494-95;PharmacologybySatoskar24th/237Allthedopamineagonistsinlargerdosescancoutetevere
neuropsychiatricadverseeffects.
Ropinirole&Pramipexole
SelectiveD2/D1receptoragonists
--- Content provided by FirstRanker.com ---
Bettertolerateddtdonotshowthefluctuationsinefficacyassociatedwithlevodopa.
Theydo,however,causesomnolence6sometimeshallucinations
(recentevidencesuggeststhattheymaypredisposetocompulsive
behaviours,suchasexcessivegambling,overeating6sexual
--- Content provided by FirstRanker.com ---
excess,relatedtotherewardfunctionsofdopamineAdisadvantageofcurrentdopamineagonistsistheirshortplasma
halfLife(6-8hr),requiring3timesdailydosagethoughslowrelease
oncedailyformulationsarenowavailable
Trialhavefoundthemtoaffordsymptomreliefcomparableto
--- Content provided by FirstRanker.com ---
levodopa.Sometrialshavenotedlowerincidenceofdyskinesias6motor
fluctuationsamongPatientstreatedwiththesedrugsthandose
treatedwithlevodopa
Itislongeractingthanlevodopa.
--- Content provided by FirstRanker.com ---
Highincidenceofhallucination&sleepiness74.Trueaboutmethanolpoisoning:
a)Gastricdecontaminationishelpful
b)Formate&formaldehydeareactivemetabolite
c)TakingwithEthanolcausemoretoxicity
--- Content provided by FirstRanker.com ---
d)Fomipezoleaspecificantagonist,isgivenfortreatmente)Causehighaniongapacidosis
CorrectAnswer-A:B:D:E
Ans.A,GastricdecontaminationishelpfuB,Formate&
formaldehydeareactivemetaboliteD,Fomipezoleaspecific
--- Content provided by FirstRanker.com ---
antagonist,isgivenfortreatmentE,Causehighaniongapacidosis
[Ref:KDT7th/394-96;Katzung13th/393;Pharmacologyby
Satoskar24th/9s-96).
TreatmentofMethylAlcohol
--- Content provided by FirstRanker.com ---
Fomepizole,analcoholdehydrogenaseinhibitor,isapprovedforthetreatmentofethyleneglycolpoisoningandmethanolpoisoning.
Ethanolusedintravenouslyastreatmentformethanolpoisoning.
Methanolconcentrationshigherthan50mg/dlarethoughttobean
absoluteindicationforhemodialysisandtreatmentwithfomepizole
--- Content provided by FirstRanker.com ---
orethanol,althoughformatebloodlevelsareabetterindicationofclinicalpathology.
Hospitalisation,nursingcare
Gastriclavage,activatedcharcoal
Treatmentofacidosis/hypoglycemia
--- Content provided by FirstRanker.com ---
Inhibitionofmethanolmetabolism-Givingethylalcoholdtfomepizole(aspecificinhibitorofalcoholdehydrogenase&drugofchoicefor
methanolpoisoning)
Promotemetabolicdegradationofformate:folinicacidtogetherwith
folicacid
--- Content provided by FirstRanker.com ---
Diuretics,urinealkalinisationHemodialysisinseverecase
Maintenanceofnutrition
75.S/EofBevacizumabincludes:
a)Hypertension
--- Content provided by FirstRanker.com ---
b)Hemoptysisc)Malena
d)Cerebellarstroke
e)Notcausegastrointestinalperforation
CorrectAnswer-A:B:C:D
--- Content provided by FirstRanker.com ---
Ans.A,HypertensionB,HemoptysisC,MalenaD,Cerebellarstroke
[Ref:KDT7th/871:Katzung13th/937-38;Rang&Dale8th/;
PharmacologybySatoskar24th/840).
S/EofBevacizumab:
--- Content provided by FirstRanker.com ---
HypertensionArterialthromboembolism-heartattack6stroke
Vesselinjury6haemorrhages
Heartfailure
Proteinuria
--- Content provided by FirstRanker.com ---
GastrointestinalperforationHealingdefect
76.TNF-aInhibitorsareusedfor:
a)Ulcerativecolitis
b)Crohn'sdisease
--- Content provided by FirstRanker.com ---
c)Rheumatoidarthritisd)Psoariasis
e)Lichenplanus
CorrectAnswer-A:B:C:D
Ans.A,UlcerativecolitisB,Crohn'sdiseaseC,Rheumatoid
--- Content provided by FirstRanker.com ---
arthritisD,Psoariasis[RefHanison19th/1961;NeenaKhanna5th/58,68;CMDT2016/641;
KDT7th/883-84).
TNF-alphaInhibitors:Use
Etanercept-Rheumatoidarthritis,severe/refractoryankylosing
--- Content provided by FirstRanker.com ---
spondylitis,plaquepsoriasis,polyarticularidiopathicjuvenilearthritis.Infliximab-refractoryrheumatoidarthritis,ankylosingspondylitis,
psoriasis,fistulatingCrohn'sdisease,ulcerativecolitis
Adalimumab-Useaslikeinfliximab
Certolizumab-Crohn'sdisease
--- Content provided by FirstRanker.com ---
Golimumab-ulcerativecolitisPsoriasis:TreatmentincludesTNFblockerslikeetanercept,infliximab.
77.Antibioticofchoicefor
Stenotrophomonasmaltophiliainfection
is:
--- Content provided by FirstRanker.com ---
a)Ampicillinb)Trimethoprim-sulfamethoxazole(TMP-SMX)
c)Penicillin
d)Ciprofloxacin
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns:b.Trimethoprim-sulfamethoxazole(TMP-SMX)
78.Whichofthefollowingis/areparaphilia:
a)Pedophilia
b)Sodomy
--- Content provided by FirstRanker.com ---
c)Frotteurismd)Voyeurism
e)Exhibitionism
CorrectAnswer-A:C:D:E
Ans:A.PedophiliaC.FrotteurismD.VoyeurismE.Exhibitionism
--- Content provided by FirstRanker.com ---
[RefSynopsisofPsychiatrybyKaplondrSaddockllth/593-97;Reddy32nd/411;NeerajAhuja7th/124-26;Parikh7th/411-12J
Paraphiliasorperversionsaresexualstimulioractsthatare
deviationsfromnormalsexualbehaviors,butarenecessaryfor
somepersonstoexperiencearousalandorgasm.
--- Content provided by FirstRanker.com ---
AccordingtotheDiagnosticandStatisticalManualofMentalDisorders,fifthedition(DSM-5),thetermparaphilicdisorderis
reservedforthosecasesinwhichasexuallydeviantfantasyor
impulsehasbeenexpressedbehaviorally.
Individualswithparaphilicinterestscanexperiencesexualpleasure,
--- Content provided by FirstRanker.com ---
buttheyareinhibitedfromrespondingtostimulithatarenormallyconsiderederotic.Theparaphiliacperson'ssexualityismainly
restrictedtospecificdeviantstimulioracts.
DSM-5listspedophilia,frotteurism,voyeurism,exhibitionism,sexual
sadism,sexualmasochism,fetishism,andtransvestismwithexplicit
--- Content provided by FirstRanker.com ---
diagnosticcriteriabecauseoftheirthreattoothersand/orbecausetheyarerelativelycommonparaphilias.Therearemanyother
paraphiliasthatmaybediagnosed
79.Whichofthefollowingjointisbest
predictorofageof16-17yearbyX-ray:
--- Content provided by FirstRanker.com ---
a)Kneeb)Elbow
c)Hip
d)Wrist
e)Ankle
--- Content provided by FirstRanker.com ---
CorrectAnswer-D:EAns:(D)Wrist(E)Ankle[RefReddy32nd/78,77,74;Parikh7th/
61-63]
Forestimationofage:TakeX-ray
6-12yearsElbowjoint,Wristjoint,6yr-centerforlowerendof
--- Content provided by FirstRanker.com ---
ulna(A);medialepicondyleofthehumerus(A)9years:Olecranon(A)
9to11years:Trochelaofhumerus(A)
10thto11thyear:Pisiform(A)
11thyear:Lateralepicondyleofhumerus(A)
--- Content provided by FirstRanker.com ---
13to16years:X-rayofpelviselbowjoint&pelvis(13thyr-separatecentersintriradiatecartilageofacetabulum(A)
12to14years:Lessertrochanteroffemur(A)
14thyear:Crestofilium(A),fusionofmedialepicondyleof
humerus,lateralepicondylewithtrochlea
--- Content provided by FirstRanker.com ---
15thyear:fusionoftriradiatecartilageofacetabulum16-17year:wrist
Crestofilium:18-19.
Ischealtuberostty,clavicle(innerend):21-22(F),23-24(M)
80.Whichofthefollowingis/arefeature(s)of
--- Content provided by FirstRanker.com ---
humanhair:a)Medullaryindex:<0.3
b)Cortexisthin
c)Cortexisthick
d)Medulla-narrow
--- Content provided by FirstRanker.com ---
e)Medulla-widerCorrectAnswer-A:C:D
Ans:a.Medullaryindex...,c.Cortexisthick...,d.Medullanar....
[RefReddy32nd/91;Parikh7th/499]
Trait
--- Content provided by FirstRanker.com ---
HumanHairAnimalhair
Character
Fine&thin
Coarse&thick
--- Content provided by FirstRanker.com ---
CuticularscalesareCuticle
Cuticularscalesare
very
large&havestep-
--- Content provided by FirstRanker.com ---
short,broad,thin&likeor
irregularlyannular
wavyprojections
Thin,rarelymore
--- Content provided by FirstRanker.com ---
CortexThick,well-striated
than
&4to10timesas
twiceasbroadas
--- Content provided by FirstRanker.com ---
broadasmedullamedulla
Variesconsiderably,
Medulla
usuallynarrow,discontinuous, Continuous&wider
--- Content provided by FirstRanker.com ---
fragmentedorentirelyabsentMostlypresentinthe
Pigment
Evenlydistributed
medulla
--- Content provided by FirstRanker.com ---
medulla
Specificfordifferent
Precipitin
Specificforhuman
animals
--- Content provided by FirstRanker.com ---
Medullaryindex(Diameterof
Below0.3
Above0.5
medulla/
--- Content provided by FirstRanker.com ---
Diameterofshaft)
81.Whichofthefollowingistrue
statement(s)aboutexhumation?
a)Policecanorderforexhumation
--- Content provided by FirstRanker.com ---
b)Executivemagistratecanorderforexhumationc)Postmortemcannotbedoneonexhumatedbody
d)CrPC176(4)isrelatedtoenquiryofexhumatedbody
e)CrPC174isrelatedtoenquiryofexhumatedbody
CorrectAnswer-B:D
--- Content provided by FirstRanker.com ---
Ans:b.Executivemagistrate...,d.CrPC176(4)isrelated...[RefReddy32nd/128-29;Parikh7th/133-34]
Itisdiggingoutofanalreadyburiedbodylegallyfromthegrave
ThereisnotimelimitforexhumationinIndia
Autopsiesareperformedonexhumedbodies:
--- Content provided by FirstRanker.com ---
(1)Incriminalcases,suchashomicide,suspectedhomicidedisguisedassuicideorothertypesofdeath,suspiciouspoisoning,
deathasaresultofcriminalabortion&criminalnegligence;
(2)Incivilcases,suchasaccidentaldeathclaim,insurance,
workmen'scompensationclaim,liabilityforprofessionalnegligence,
--- Content provided by FirstRanker.com ---
survivorship&inheritanceclaimsordisputedidentityAuthorisation:Thebodyisexhumatedonlywhen,thereisawritten
orderfromtheexecutivemagistrate.Thebodycanheexhumatedby
anygovernmentdoctor
Thebodyisexhumatedunderthesupervisionofamedicalofficer&
--- Content provided by FirstRanker.com ---
magistrateinthepresenceofapoliceofficerWheneverpracticable,themagistrateshouldinformtherelativesof
thedeceased&allowthemtoremainpresentattheenquiry(176(4)
Cr.P.C)
82.Trueaboutcadavericspasm:
--- Content provided by FirstRanker.com ---
a)Samemechanismasrigormortisb)Mechanismisunknown
c)Alsok/ainstantaneousrigor
d)Occuronlyincoldenvironment
e)Canbeseeninsomedrowningcase
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:EAns:b.Mechanism...,c.Also1c/a...,e.Canbeseen....
CadavericSpasm(CatalepticRigidityorInstantaneousRigor)isa
rarecondition.Inthis,themusclesthatwerecontractedduringlife
becomestiffandrigidimmediatelyafterdeathwithoutpassinginto
--- Content provided by FirstRanker.com ---
thestageofprimaryrelaxation,anditsMechanismisunknownItoccursespeciallyincasesofsuddendeath,excitement,fear,
severepain,exhaustion,cerebralhaemorrhage,injurytothe
nervoussystem,firearmwoundofthehead,drowning,convulsant
poisons(suchasstrychnine).
--- Content provided by FirstRanker.com ---
83.Cause(s)ofOpisthotonusis/are:
a)Cocaine
b)StrychnosNuxVomicaseed
c)Strychnine
d)Codeine
--- Content provided by FirstRanker.com ---
e)CurareCorrectAnswer-B:C
Ans:B.StrychnosNuxVomicaseedC.Strychnine
Strychnine(alkaloidfromseedsofstrychnosnux-vomica)cause
opisthotonus(Parikh7th/639-40)
--- Content provided by FirstRanker.com ---
"Strychnine:Theconvulsionsaremostmarkedinantigravitymuscles,sothatthebodytypicallyarchesinhyperextension
(opisthotonus)"(Reddy32nd/581)
CausesofOpisthotonus:Arnold-Chiarisyndrome,Meningitis,
Braintumor,Gaucherdisease,Growthhormonedeficiency
--- Content provided by FirstRanker.com ---
(occasionally),Glutaricaciduriaandorganicacidemias(formsofchemicalpoisoning).
84.WhichofthefollowingisNOTrape:
a)Sexualintercoursewithwife,ofagebelow15year,with
consent
--- Content provided by FirstRanker.com ---
b)Sexualintercoursewithwife,ofage16year,withconsentc)Sexualintercoursewithagirlbelow18yearsofage,with
consent
d)Sexualintercoursewithagirlof18yearwithconsent
e)Sexualintercoursewithwifewhoislivingseparatelyfrom
--- Content provided by FirstRanker.com ---
himunderadecreeofseparation,oranycustomorusagewithherconsent
CorrectAnswer-B:D:E
Ans:b.Sexualintercoursewith...,d.Sexualintercoursewitha
girl...,e.Sexualintercoursewithwifewhoisliving......[Ref
--- Content provided by FirstRanker.com ---
Reddy32nd/392-95;Parikh7th/389-911Rape:TheCriminalLaw(Amendment)Bill,2013(5.375,I.P.C)
AcctoGazetteNotificationofGOIregardingCriminalLaw
(amendendment)Act,2013releasedon2april,2013,1tisage15
year.
--- Content provided by FirstRanker.com ---
ExceptiontoS.375,I.P.C:Sexualintercourseorsexualactsbyamanwithhisownwife,thewifenotbeingunder15years.
Thereiscontroversialreferenceregardingageofwife,either16or
15yearinReddy(old&newed.)&Parikh.
Withherconsent,whenthemanknowsthatheisnotherhusband
--- Content provided by FirstRanker.com ---
andthatherconsentisgivenbecauseshebelievesthatheisanothermantowhomsheisorbelievesherselftobelawfully
married.
Withherconsentwhen,atthetimeofgivingsuchconsent,by
reasonofunsoundnessofmindorintoxicationortheadministration
--- Content provided by FirstRanker.com ---
byhimpersonallyorthroughanotherofanystupefyingorunwholesomeSubstance,sheisunabletounderstandthenature
andconsequencesofthattowhichshegivesconsent.
Withorwithoutherconsent,whensheisundereighteenyearsof
age.
--- Content provided by FirstRanker.com ---
Whensheisunabletocommunicateconsent85.Inwhichofthefollowingcondition(s),
childrenarepronetofungal&viral
infection:
a)Thymicaplasia
--- Content provided by FirstRanker.com ---
b)Agammaglobulinemiac)Lymphocytopenia
d)Severecombinedimmunedeficiencies(SCID)
e)Chediak-Higashisyndrome
CorrectAnswer-A:C:D
--- Content provided by FirstRanker.com ---
Ans:(A)Thymicaplasia(C)Lymphocytopenia(D)Severecombinedimmunedeficiencies(SCID)
[RefHarrison19th/2104-08;Ananthanarayan9th/171-76;Jawetz
27th/146-47;Greenwood16th/148J
Tcelldisordersaffectbothcell-mediatedandhumoralimmunity
--- Content provided by FirstRanker.com ---
makingthepatientsusceptibletoviral,protozoalandfungalinfections.Viralinfectionssuchasthosebycytomegalovirusand
attenuatedmeaslesinthevaccinecanbefatalinthesepatients.
LymphocytopeniaismostoftenduetoAIDSorundernutrition,butit
alsomaybeinheritedorcausedbyvariousinfections,drugs,or
--- Content provided by FirstRanker.com ---
autoimmunedisorders.Patientshaverecurrentviral,fungal,orparasiticinfections.
Hypogammaglobulinemialeadstorecurrentbacterialinfections.
Viral&fungalinfectionsarecontrolledbycell-mediatedimmunity,
whichisnormalinhypogammaglobulinemicindividual.
--- Content provided by FirstRanker.com ---
86.Whichofthefollowingistype3
hypersensitivityreaction(immune
complexdisease):
a)SLE
b)DiabetesMellitusI
--- Content provided by FirstRanker.com ---
c)Goodpasteursyndromed)Multiplesclerosis
e)Bronchialasthma
CorrectAnswer-A
Ans:a.SLE
--- Content provided by FirstRanker.com ---
[RefAnanthanarayan9th/162-67;Robbins9th/201;lawetz27th/14546;Greenwood16th/144]
Type3Hypersensitivityreaction(Immunecomplexdisease)
Ananthanarayan9th/162,Itistwotypes-arthusreaction&serum
sickness.
--- Content provided by FirstRanker.com ---
thedamageiscausedbyantigen-antibodycomplexes.Thesemayprecipitatein&aroundsmallbloodvesselscausingdamagetocells
secondarily,oronmembranes,interferingwiththeirfunction.
87.Whichofthefollowinginfectionhas
incubationperiod
--- Content provided by FirstRanker.com ---
a)Brucellab)Gonorrhoea
c)Syphilis
d)HBV
e)Leishmaniasis
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:CAns:(A)Bruce...,(B)Gonorrho...,(C)Syphilis
[RefHarrison19th/1134,194e-2,1005;Ananthanarayan9th/341.1]
Brucella:Theincubationperiodisusuallyabout10-30days,but
maybesometimesbeveryprolonged"(Ananthanarayan9th/341)
--- Content provided by FirstRanker.com ---
"Brucella:Theincubationperiodvariesfrom1weektoseveralmonths,andtheonsetoffeverandothersymptomsmaybeabrupt
orinsidious"(Harrison19th/194e-2)
Syphilis:Clinicaldiseasesetsinafteranincubationperiodofabout
amonth(range10-90days)"(Ananthanarayan9th/372)
--- Content provided by FirstRanker.com ---
"Syphilis:Themedianincubationperiodinhumans(-21days)suggestsanaverageinoculumof500-1000infectiousorganismsfor
naturallyacquireddisease;theincubationperiodrarelyexceeds6
weeks.
Gonococcalinfectioninmen:Acuteurethritisisthemostcommon
--- Content provided by FirstRanker.com ---
clinicalmanifestationofgonorrheainmalepatients.Theusualincubationperiodafterexposureis2-7days,althoughtheinterval
canbelonger&somemenremainasymptomatic(Harrison
19th/1005)
88.StainusedforMycobacterium
--- Content provided by FirstRanker.com ---
tuberculosisis/are:a)Ziehl-Neelsentechniqueofstaining
b)Auramine-rhodaminestain
c)Gomorimethenaminesilverstain
d)Kinyounstain
--- Content provided by FirstRanker.com ---
e)GramstainingCorrectAnswer-A:B:D
Ans:a.Ziehl-Neelsentechni...,b.Auramine-rhodaminesta...,d.
Kinyounstain
[RefHarrison19th/1113;Ananthanarayan9th/346-48;Lippincott
--- Content provided by FirstRanker.com ---
Microbiology3rd/21;Jawetz27th/38;TextBookofDiagnosticmicrobiologybyConnieR.Mohan3rd/691;Greenwood16th/15]
WhenstainedwithcarbolfuchsinbyZiehl-Neelsenmethodorby
fluorescentdyes(Auramine0,Rhodamine),mycobacterium
tuberculosisreistdecolourisationby20%sulphuricacid&are
--- Content provided by FirstRanker.com ---
thereforecalledacidfast.Ziehl-Neelsenmethoddphenol-auramineproceduresaremethods
ofgreatpracticalimportanceinthediagnosisofmycobacterial
diseases".
TheKinyounmethod,orKinyounstain,isanacid-fastprocedure
--- Content provided by FirstRanker.com ---
usedtostainanyspeciesofthegenusMycobacteriumandNocardiaspecies.Itinvolvestheapplicationofaprimarystain(carbol
fuchsin),adecolorizer(acid-alcohol),andacounterstain(methylene
blue)"
89.Foodbornediseasesare:
--- Content provided by FirstRanker.com ---
a)Japaneseencephalitisb)Hemophilia
c)HBV
d)Botulism
e)Typhoidfever
--- Content provided by FirstRanker.com ---
CorrectAnswer-D:EAns:d.Botuli...,e.Typhoid...,[RefPark23rd/657]
Theterm"food-bornedisease"isdefinedas:"Adisease,usually
eitherinfectiousortoxicinnature,causedbyagentsthatenterthe
bodythroughtheingestionoffood."Withthecateringsystems,food-
--- Content provided by FirstRanker.com ---
bornediseasesareontheincreasethroughouttheworld.DuetotoxinsproducedbycertainbacteriaLIKEBotulism,
StaphylococcuspoisonS
Bacterialdiseases:-Typhoid,fever,Paratyphoidfever,
salmonellosis,staphylococcalintoxication,C.perfringens,
--- Content provided by FirstRanker.com ---
Shigellosisbrucellosisetc.90.WhichofthefollowingisNOTlysine
positivenon-fermentor:
a)Burkholderiapseudomallei
b)Burkhomeliamallei
--- Content provided by FirstRanker.com ---
c)Burkholderiacepaciad)Stenotrophomonasmaltophilia
e)Pseudomonasaeruginosa
CorrectAnswer-A:B:E
Ans:a.Burkholderia...,b.Burkhomelia...,e.PseudomonasAeru
--- Content provided by FirstRanker.com ---
......TheBurkholderiacepaciacomplex(BCC)andStenotrophomonas
maltophiliaarecloselyrelatedgroupsofnonfermentinggram-
negativebacilli(NFGNBs)havingasimilarspectrumofinfections
rangingfromsuperficialtodeep-seatedanddisseminatedinfections.
--- Content provided by FirstRanker.com ---
Identificationoftheselysinedecarboxylase-positiveNFGNBslagsbehindinmostIndianlaboratories.Asimplifiedidentificationscheme
wasdevisedforthesetwopathogensthatallowedustoisolatethem
withanincreasingfrequencyatourtertiarycareinstitute.
91.Apersonissufferingfromacquired
--- Content provided by FirstRanker.com ---
immunodeficiencydisease(AIDS)&visitedthezoo.Aftersomedays,heiscom
plainingofheadache&cough.Hehas
alsohavesomeneurologicalsymptoms.
OnstainingofCSFsample,itshowscap
--- Content provided by FirstRanker.com ---
sulatedyeast.Likelyinfectionis:a)Histoplasma
b)Aspergillus
c)Cryptococcus
d)Blastomycosis
--- Content provided by FirstRanker.com ---
e)CoccidioidomycosisCorrectAnswer-C
Ans:C,Cryptococcus
LikeCNSdisease,pulmonarycryptococcosiscanfollowanindolent
course,andthemajorityofcasesprobablydonotcometoclinical
--- Content provided by FirstRanker.com ---
attention.Pulmonarycryptococcosiscanbeassociatedwithantecedent
diseasessuchasmalignancy,diabetes,andtuberculosis.
CryptococcusInfectioncanbeacquiredbyinhalationof
desiccatedyeasts(orbasidiospores)fromfecesofpigeonorother
--- Content provided by FirstRanker.com ---
birdsDirectmicroscopicexaminationofIndiaink-stainedwetfilmsof
materialfromlesionsrevealscapsulated,buddingyeastcells;the
capsuleareprominentintheIndiainkpreparatio
92.NormalfloraofOralcavityis/areexcept:
--- Content provided by FirstRanker.com ---
a)Veillonellab)Anerobicmicrococci
c)Geotrichum
d)Gemella
e)Yersinia
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:C:DAns:a.Veillone...,b.Anerobicmicroc...,c.Geotrich...,d.
Gemell.
Morethan700bacterialspeciesorphylotypes,ofwhichover50%
havenotbeencultivated,havebeendetectedintheoralcavity.
--- Content provided by FirstRanker.com ---
Themouthcontainsaplethoraoforganisms-pigmented&non-pigmentedmicrococci;someofwhichareaerobic,grampositive,
aerobic,sporebearingbacilli,coliforms,proteus&lactobacilli
Thegumpocketb/wtheteeths,&thecryptsofthenostrilshavea
widespectrumofanaerobicflora-anerobicmicro-cocci,
--- Content provided by FirstRanker.com ---
microaerophilic&anaerobicstreptococci,vibrios,fusiformbacilli,corynebactriumspecies,actinomyces,leptothrix,mycoplasma,
Neisseriaeb?bacteriodesareallfoundinvaryingextents.Among
fungi,candidaergeotrichumhavebeenreported.
93.Goldstandarddiagnostictestfor
--- Content provided by FirstRanker.com ---
babeiosisis:a)Peripheralbloodsmearexamination
b)BloodCulture
c)PCR
d)ELISA
--- Content provided by FirstRanker.com ---
e)Indirectfluorescentantibody(IFA)testCorrectAnswer-A
Ans:a.Peripheralbloodsmear...,
[RefHarrison19th/1385-86;PanikerParasitology7th/85;Chatterjee
Parasitology13th/137;LippincottMicrobiology3rd/225;Jawetz
--- Content provided by FirstRanker.com ---
27th/708;Greenwood16th/599]Microscopicexaminationofstainedbloodsmearisgoldstandard
testforbabesiosis"
Aspecificdiagnosisusuallyisestablishedbymicroscopic
examinationofGiemsa-stainedthinbloodsmears.Babesia
--- Content provided by FirstRanker.com ---
trophozoitesappearround,pear-shaped,orameboid.Theringformismostcommonandlacksthecentralbrownish
deposit(hemozoin)typicalofPlasmodiumfalciparumtrophozoites.
Otherdistinguishingfeaturesaretheabsenceofschizontsand
gametocytesandtheoccasionalpresenceoftetrads("Maltese
--- Content provided by FirstRanker.com ---
cross").Ifparasitescannotbeidentifiedbymicroscopyandthediseaseis
stillsuspected,amplificationofthebabesial18SrRNAgeneby
polymerasechainreaction(PCR)isrecommended.Quantitative
PCRhasgreatlyloweredthethresholdfordetectionofB.microti
--- Content provided by FirstRanker.com ---
DNA
94.Trueaboutlisteriamonocytogens
infection:
a)Commoninpregnantwomen
b)Commoninelderly
--- Content provided by FirstRanker.com ---
c)Commoninchildrend)Commoninnewborns
e)Ampicillinisdrugofchoice
CorrectAnswer-A:B:D:E
Ans:a.Commoninpregnant...,b.Commoninelderly...,d.
--- Content provided by FirstRanker.com ---
Commoninnewborns...,e.Ampicillin.[RefHarrison19th/982-84;Ananthanarayan9th/395-96;
LippincottMicrobiology3rd/98;Jawetz27th/197-98;
Greenwood16th/195-96]
Listeriainfectionsaremostcommoninpregnantwomen,fetuses
--- Content provided by FirstRanker.com ---
andnewborns,andinimmunocompromisedindividuals,suchasolderadultsandpatientsreceivingcorticosteroids"(Lippincott
Microbiology3rd/98).
Thediseaseaffectspregnantwomen,newborns,adultswith
weakenedimmunesystems,andtheelderly,
--- Content provided by FirstRanker.com ---
Listeriamonocytogenesisafood-bornepathogenthatcancauseseriousinfections.
Meningitisinolderadults(especiallywithparenchymalbrain
involvementorsubcorticalbrainabscess)shouldtrigger
considerationofL.monocytogenesinfection.
--- Content provided by FirstRanker.com ---
95.TrueaboutJapaneseencephalitis:
a)Mostsevereepidemicspreadoccuredin2006
b)MainvectorinIndiaisculextritaeniorhynchus
c)Spreadbyaedesmosquito
d)Indiastillnotabletodevelopvaccineindigenously
--- Content provided by FirstRanker.com ---
e)PigsareamplifierhostCorrectAnswer-B:E
Ans:(B)MainvectorinIndiaisculextritaeniorhynchus(E)Pigs
areamplifierhost
[RefPark23rd/284-87;Harrison19th/1315;Ananthanarayan
--- Content provided by FirstRanker.com ---
9th/52022,519]During2006,therewasalargeoutbreakofchikungunyainIndia,
with1.39millionofficiallyreportedcasesspreadover16states;
attackrateswereestimatedat45%insomeareas"
Thevirusisparticularlycommoninareaswhereirrigatedricefields
--- Content provided by FirstRanker.com ---
attractthenaturalavianvertebratehostsandprovideabundantbreedingsitesformosquitoessuchasCulextritaeniorhynchus,
whichtransmitthevirustohumans.
Additionalamplificationbypigs,whichsufferabortion,andhorses,
whichdevelopencephalitis,maybesignificantaswell.Vaccination
--- Content provided by FirstRanker.com ---
oftheseadditionalamplifyinghostsmayreducethetransmissionofthevirus.
96.NotAIDSdefiningcancer:
a)Analcarcioma
b)Hodgkin'slymphoma
--- Content provided by FirstRanker.com ---
c)Cervialcancerd)Non-Hodgkinslymphoma
e)Kaposicarcinoma
CorrectAnswer-A:B
Ans:(A)Analcarcioma(B)Hodgkin'slymphoma
--- Content provided by FirstRanker.com ---
[RefHarrison19th/1268;Ananthanarayan9th/576-77;LippincottMicrobiology3rd/302]
TheneoplasticdiseasesconsideredtobeAIDSdefiningconditions
areKaposi'ssarcoma,non-Hodgkin'slymphoma,andinvasive
cervicalcarcinoma.
--- Content provided by FirstRanker.com ---
Inaddition,thereisalsoanincreaseintheincidenceofavarietyofnon-AIDS-definingmalignanciesincludingHodgkin'sdisease;
multiplemyelotna;leukemia;melanotna;andcervical,brain,
testicular,oral,lung,gastric,liver,renal,andanalcancers.
97.TrueaboutPlasmodiumfalciparum:
--- Content provided by FirstRanker.com ---
a)IncreasedsizeofinfectedRBCb)Crescentricshapedgametocyte
c)Delicateringpresent
d)Small&multipleringscommon
e)Erythrocytepreference-oldcells
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:DAns:(B)Crescentricshapedgametocyte(C)Delicatering
present(D)Small&multipleringscommon
[RefHarrison19th/1369;ParasitologybyChatterjee13th/103;
ParasitolgybyPaniker7th/75]
--- Content provided by FirstRanker.com ---
Ringstage-delicate,small,doublechromatin,multipleringscommon,Accoleformsfound
Macrogametocyte-Crescentric,deepbluecytoplasm,largediffuse
nucleus
Thematuregametocytesareroundinshape,exceptinP,
--- Content provided by FirstRanker.com ---
falciparum,inwhichtheyarecrescent-shapedSchizont:Fillstwo-thirdofredbloodcellwhichisnotenlarged-
Chatterjee13th/103
Infectederythrocyte-Normalsize,Maurer'scleft,sometimes
basophilicstippling
--- Content provided by FirstRanker.com ---
Erythrocytepreference-youngerythrocyte,butcaninfectallstages98.Whichofthefollowingstatementis/are
trueaboutGiardia:
a)Causebloodydiarrhorea
b)InvasivetoGImucosa
--- Content provided by FirstRanker.com ---
c)Morecommoninhypogammaglobulinemicpersond)Lesscommoninachlorohydria
e)Metronidazoleiseffectiveintreatment
CorrectAnswer-C:E
Ans:(C)Morecommoninhypogammaglobulinemicperson(E)
--- Content provided by FirstRanker.com ---
Metronidazoleiseffectiveintreatment[RefParasitologybyChatterjee13th/47-48;ParasitolgybyPaniker7th/32-33;Harrison
19th/1406]
Metronidazole,trimidazole,furazoilidonehavebeenfoundtobe
effectiveforgiardiasis
--- Content provided by FirstRanker.com ---
G.lambliaistypicallyseenwithinthecryptsofduodenal&jejunalmucosa.Itdoesnotinvadethetissue,butremainstightlyadheredto
intestinalepitheliumbymeansofthesuckingdisc
Tepersonhavingagammaglobulinemia,malnourishedpersonsare
moresusceptibletogiardiasis
--- Content provided by FirstRanker.com ---
99.Inwhichorganismcanbeisolated:
a)CSFspecimenoftetanusinfection
b)CSFspecimenoflisteriamonocytogenes
c)Fromvalvesinrheumaticvalvulitis
d)Frommyocardiumindiphthericmyocarditis
--- Content provided by FirstRanker.com ---
e)MeningococcalrashCorrectAnswer-B:E
Ans:(B)CSFspecimenoflisteria
monocytogenes(E)Meningococcalrash
L.monocytogenes:Thediagnosisistypicallymadebycultureof
--- Content provided by FirstRanker.com ---
blood,cerebrospinalfluid(CSF),oramnioticfluid.L.monocytogenesmaybeconfusedwith"diphtheroids"orpneumococciingram-
stainedCSFormaybegram-variableandconfusedwith
Haemophilusspp.
Petechiallesion:Meningococcimaysometimesbedemonstratedin
--- Content provided by FirstRanker.com ---
petechiallesionsbymicroscopy&culture.100.Trueaboutcytomegalovirus-
a)Characteristicowleyeappearance
b)Type5Humanherpesvirustype
c)Lymphocyteenlargement
--- Content provided by FirstRanker.com ---
d)Causecongenitalinfectione)Lymphoproliferative
CorrectAnswer-A:B:D
Ans:a.Characteristic...,b.Type5Human...,d.Cause
congenital....
--- Content provided by FirstRanker.com ---
[RefHarrison19th/1190-91;Ananthanarayan9th/473-74;Jawetz27th/470-74]
Itiscytomegalic(notlymphoproliferative,whichoccurinHHV4,6&
7)
Characterizedbyenlargementofinfectedcells
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Congenitalinfection-Intrauterineinfectionleadstofetaldeathorcytomegalicinclusiondiseaseofnewbornwhichisoftenfatal
101.Whichofthefollowingis/aretrueabout
Mycoplasmapneumoniainfection
except:
--- Content provided by FirstRanker.com ---
a)Causesmanyextrapulmonarymanifestationsb)Coldagglutinintiterisnotincreased
c)Causeatypicalpneumonia
d)Paucityofrespiratorysignsonphysicalexamination
e)Coughistypicallyproductive
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:EAns:b.Coldagglutinin...,e.Coughistypically
Coldhemagglutininsforgroup0humanerythrocyteappearinabout
50%ofuntreatedpatients,inrisingtiter,withthemaximumreached
inthethirdorfourthweekafteronset.
--- Content provided by FirstRanker.com ---
Atiterof1:64ormoresupportsthediagnosisofM.pneumoniaeinfection.
Thecoughistypicallynonproductive,butsomepatientsproduce
sputum.Headache,malaise,chills,andfeverarenotedinthe
majorityofpatients.
--- Content provided by FirstRanker.com ---
102.Trueaboutenteroviruses:
a)In1999,wildpoliovirus2waseradicatedfromworld
b)Vaccineassociatedparalyticpoliomyelitis(VAPP)most
frequentlycausedbyserotype1vaccine
c)BivalentOPVcontainstype1&type3strain
--- Content provided by FirstRanker.com ---
d)PrimarycourseofOPVconsistsofonly1dosee)CoxasackieA7&enterovirustype71causesasepticmeningitis
CorrectAnswer-A:C:D:E
Ans:(A)In1999,wildpoliovirus2waseradicatedfromworld
(C)BivalentOPVcontainstype1&type3strain(D)Primary
--- Content provided by FirstRanker.com ---
courseofOPVconsistsofonly1dose(E)CoxasackieA7&enterovirustype71causesasepticmeningitis
[RefPark23rd/202-09;Harrison19th/1289-91;Ananthanarayan
9th/485]
Ofthe3strainsofwildpoliovirus,wildpoliovirustype2was
--- Content provided by FirstRanker.com ---
eradicatedin1999&casenumbersoftype3aredowntothelowest-everlevelswiththelastcasereportedinNov2012from
Nigeria.
TheWHOprogrammeonimmunization(EPI)&thenational
immunizationprogrammeinIndiarecommendedaprimarycourseof
--- Content provided by FirstRanker.com ---
3dosesofOPVatone-monthintervals,commencingthefirstdosewheninfantis6weeksold.
Poliovirustype1isresponsibleformostepidemicsofparalytic
poliomyelitis.Type3alsocausesepidemicstoalesserextent..
Type2usuallycausesinapparentinfectionsinwesterncountriesbut
--- Content provided by FirstRanker.com ---
inIndiaparalysisduetotype2isquitecommon"GROUP
SEROTYPE
Poliovirus
1-3
--- Content provided by FirstRanker.com ---
CoxsackievirusA 1-22AND24CoxsackievirusB
1-6
s
Echovirus
--- Content provided by FirstRanker.com ---
1-9,11-27,29-34
Numbered
(EV)68-78
echovirus
--- Content provided by FirstRanker.com ---
103.Trueaboutchickengunyafever:
a)CausedbysinglestrandedRNAarbovirus
b)Excruitingarthralgiainperipheraljoints
c)Antiviraltherapyisveryeffective
d)Absolutelymphocytosisispresent
--- Content provided by FirstRanker.com ---
e)VectorisaedesmosquitoesCorrectAnswer-A:B:E
Ans:(A)CausedbysinglestrandedRNA
arbovirus(B)Excruitingarthralgiainperipheral
joints(E)Vectorisaedesmosquitoes.[RefHarrison19th/13j3;
--- Content provided by FirstRanker.com ---
park23ril/289;Ananthanarayangth/440,519;Jawetz27th/548.Chickengunya:Bloodcountsmaybenormal,orpatientsmayhave
leukopeniawithrelativelymphocytosis.
ThevectorisAedesaegypti,Itiscausedbyarbovirus(Family-
Togaviridae,Genus-Al?phavirus)(Ananthanarayan9th/517)
--- Content provided by FirstRanker.com ---
TheChikungunyavirusbysinglestrandedRNAvirus?Chikungunyaisalocalwordmeaningdoublingupowingto
excruciatingjointpains
Thereisnospecifictreatment&usuallyselflimiting.Analgesics&
antipyreticsalongwithfluidsupplementationarerecommendedto
--- Content provided by FirstRanker.com ---
manageinfection&relievefever,jointpains&swelling.Drugslikeaspirin&steroidsshouldbeavoided
104.TrueaboutZikavirus:
a)Sexuallytransmitted
b)50%infectedpersondevelopsymptoms
--- Content provided by FirstRanker.com ---
c)Effectivetherapyavailabled)TransmittedbyAedesvector
e)Transmissioninutero
CorrectAnswer-A:D:E
Ans:a.Sexuallytransmittedd.TransmittedbyAedesvectore.
--- Content provided by FirstRanker.com ---
Transmissioninutero[RefHarrison19th/1314;ItisspreadmostlybythebiteofaninfectedAedesspecies
mosquitoes(A.aegyptiandA.albopictus).Thesemosquitoesare
aggressivedaytimebiters.
Itcanbepassedfromapregnantwomantoherfetus.Infection
--- Content provided by FirstRanker.com ---
duringpregnancycancausecertainbirthdefects.ItcanbepassedthroughsexfromapersonwhohasZikatohisor
herpartners.Itcanbepassedthroughsex,eveniftheinfected
persondoesnothavesymptomsatthetime.
ThemajorityofpeopleinfectedwithZikavirusdonotdisplayany
--- Content provided by FirstRanker.com ---
symptoms105.Biosafetylevel4infectionincludes:
a)Hantavirus
b)Nilevirus
c)Ebolavirus
--- Content provided by FirstRanker.com ---
d)Crimean-CongoHFe)LyssaFever
CorrectAnswer-C:D:E
Ans:c.Ebolavirusd.Crimean-CongoHFe.LyssaFever[Ref
Harrison19th/1323,1328;consteril.corn/biosafety-levels;
--- Content provided by FirstRanker.com ---
thecerebrallounge.wordpress.corn]Filoviruses(includesthreegenera:Cuevavirus,Ebolavirus,and
Marburgvirus)arecategorizedasWorldHealthOrganization(WHO)
RiskGroup4Pathogens.
BiosafetyLevel4-Hemorrhagicfevers,Marburgvirus,Ebola
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virus,Lassavirus,Smallpox106.Serologicaltestis/areusefulindiagnosis
ofwhichofthefollowingdisease:
a)Typhoid
b)Qfever
--- Content provided by FirstRanker.com ---
c)Acanthamoebainfectiond)Scrubtyphus
e)Brucellosis
CorrectAnswer-A:B:D
Ans:a.Typhoidb.Qfeverd.Scrubtyphus
--- Content provided by FirstRanker.com ---
ThediagnosisofQfeverisbasedmainlyonserologicaltests,suchasmicroagglutination,complementfixation,immunofluorescence&
ELISA.
Serologicaltests:Therearenotusedforearlydiagnosisofrickettsia!
diseases(includingQfever,scrubtyphus),fromatreatment
--- Content provided by FirstRanker.com ---
perspective,buttoconfirmthediagnosisforepidemiologicalinvestigations.
Scrubtyphus:Serologicalassay(indirectfluorescentantibody,
indirectimmunoperoxidae&enzymeimmunoassays),aremainstays
oflaboratorydiagnosis.
--- Content provided by FirstRanker.com ---
Tubeagglutinationisroutinelyusedforserologicaldiagnosisoftyphoid,brucellosis&typhusfever.
107.Allaretrueaboutgasgangreneexcept:
a)Type1gangreneisfournier'sgangrene
b)Devitalizedtissuepredisposetogasgangrene
--- Content provided by FirstRanker.com ---
c)High02tensionintissueisimportantpreconditiond)a-toxinismaincauseofthetoxaemiaassociatedwithgas
gangrene
e)MainlycausedbyC.perfringens
CorrectAnswer-E
--- Content provided by FirstRanker.com ---
Ans:E.MainlycausedbyC.perfringens[RefHarrison19th/990-95;Ananthanarayan9th/257-59;Jawetz27th/186-87;Greenwood
16th/231-35]
C.perfringensinassociationwithmixedaerobicandanaerobic
microbescancauseaggressivelife-threateningtypeInecrotizing
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fasciitisorFournier'sgangrene.Predisposinghostfactorsincludedebility,oldage&diabetes
a-toxinisgenerallyconsideredtobethemaincauseofthe
toxaemiaassociatedwithgasgangrene
"a-toxin:Thisisthemostimportanttoxinbiologically&isresponsible
--- Content provided by FirstRanker.com ---
forprofoundtoxaemiaofgasgangrene"108.WhicharetransmittedbyDog:
a)Echinococcusgranulosus
b)ToxocaraCanis
c)Echinococcusmultiocularis
--- Content provided by FirstRanker.com ---
d)ToxoplasmaGondiie)None
CorrectAnswer-A:C
Ans:A.EchinococcusgranulosusC.Echinococcus
multiocularis"[RefPark23rd/3}4;Hanison19th/1432,167
--- Content provided by FirstRanker.com ---
e-1:ChatterjeeParasitology13th/159;CMDT2016/12801.
Alveolarechinococcosis(AE)iscausedbyinfectionwiththelarval
stageofEchinococcusmultilocularis.Theadulttapewormis
normallyfoundinfoxes,coyotes,anddogs.Infectionwiththelarval
--- Content provided by FirstRanker.com ---
stagesistransmittedtopeoplethroughingestionoffoodorwatercontaminatedwithtapewormeggs.
Toxocaracanis:Humaninfectionisbyingestionofeggs,whichare
shedinfecesofdog.
Toxoplasmagondii:Manacquiresinfectionbyingestionof
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contaminatedfoodandwatercontainingsporulatedoocyst(fromcat)orbyingestionofundercookedmeatcontainingtissuecysts"
109.Followupisnotrequiredinwhichof
thefollowingstudy:
a)Prospectivestudy
--- Content provided by FirstRanker.com ---
b)Retrospectivestudyc)Cross-sectionalstudy
d)Longitudinalstudy
e)Cohortstudy
CorrectAnswer-B:C
--- Content provided by FirstRanker.com ---
Ans:b.Retrospectivestudy,c.Cross-sectionalstudy.[RefPark23rd/62,69;Community
Cohort(Knownbyavarietyofnames-prospectivestudy,
longitudinalstudy,incidencestudy&forwardlookingstudy)isfollow
upstudywithindividualasunitofstudy(Park23rd/62,75)Case
--- Content provided by FirstRanker.com ---
controlstudies,oftencalledretrospectivestudies:Noattritionproblems,becausecasecontrolstudiesdonotrequire
follow-upofindividualintothefuture.
Cross-sectionalstudies(Alsok/aprevalencestudy)issingle
examination(sonofollowup)ofacross-sectionofpopulationatone
--- Content provided by FirstRanker.com ---
pointintime-theresultsofwhichcanbeprojectedonthewholepopulation.
Longitudinalstudies:Observationsarerepeatedinthesame
populationoveraprolongedperiodoftimebymeansoffollow-up
examinations.
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110.Specialprotectionincludes:
a)Personalitydevelopment
b)lmmunizationagainstspecificdisease
c)Specificnutritionaldiet
d)Protectionfromoccupationalhazard
--- Content provided by FirstRanker.com ---
e)EnvironmentalmodificationCorrectAnswer-B:C:D
Ans:b.Immunizationagainst...,c.Specificnutritionaldiet...,d.
Protectionfromoccupational
SpecificProtection
--- Content provided by FirstRanker.com ---
ImmunizationUseofspecificnutrients
Chemoprophylaxis
Protectionagainstoccupationalhazards
Protectionagainstaccident
--- Content provided by FirstRanker.com ---
ProtectionfromcarcinogensAvoidanceofallergens
Thecontrolofspecifichazardsinthegeneralenvironmente.g.,air
pollution,noisecontrol
Controlofconsumerproductquality&safetyoffoods,drugs,
--- Content provided by FirstRanker.com ---
cosmeticsetc111.TrueaboutCivilregistrationsystemin
India:
a)Dualrecordsystem
b)Deficient
--- Content provided by FirstRanker.com ---
c)Headofinstitutionorofficer-inchargeisresponsibleforregistration
d)Birth&Deathbothareregistered
e)Causeofdeathisrecorded
CorrectAnswer-B:C:D:E
--- Content provided by FirstRanker.com ---
Ans:b.Deficie...,c.Headofinstitution...,d.Birth&Deathboth...,e.Causeofdeath
TheregistrationsysteminIndiatendedtobeveryunreliable,the
databeinggrosslydeficientinregardstoaccuracy,timeliness,
completeness&coverage.Thisisbecauseofilliteracy,ignorance,
--- Content provided by FirstRanker.com ---
lackofconcern,&motivationThecentralbirths&DeathRegistrationAct,1969fixesthe
responsibilityforreportingbirths&deaths.Whilethepublic(e.g,
parents,relatives)aretoreporteventsoccurringintheirhouseholds,
theheadsofhospital,nursinghomes,hotels,jailsordharmashalas
--- Content provided by FirstRanker.com ---
aretoreporteventsoccurringinsuchinstitutionstobeconcerningregistrar
Thetimelimitforregisteringtheeventsofbirth&thatofdeathsis21
daysuniformlyalloverIndia.Incaseofdefaultalatefeecanbe
imposed.
--- Content provided by FirstRanker.com ---
112.Trueaboutsilicosisallexcept:
a)Causedbyexposureofsilicaoxide
b)Severeexposure-wholelunglavagemayhelpfulin
alleviat_ingsymptoms
c)Fibrosisofupperlung
--- Content provided by FirstRanker.com ---
d)Fibroticchangecanbereversedafterstoppingexposuree)MoreriskofTB&lungcancer.
CorrectAnswer-D
Ans:d-Fibroticchangecanbereversedafterstopping
exposure
--- Content provided by FirstRanker.com ---
Silicosisisprogressive&whatismoreimportantisthatsilicoticsarepronetotuberculosis
Thereisnoeffectivetreatmentforsilicosis.Fibroticchangesthat
havealreadytakenplacecannotbereversed
Nodularfibrosis,morefrequentinapex&posteriorborder(upper
--- Content provided by FirstRanker.com ---
partoflung)(c.finasbestosisfibrosisinlowerhalfoflung)Silicoticsaremorepronetodeveloppulmonarytuberculosis(butin
recentyearthereisdoubtwhethersilicoticsreallydevelopT.B.)
Foracutesilicosis,bronchoalveolarlavagemayalleviatesymptoms,
butdoesnotdecreaseoverallmortality.
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113.Whichofthefollowingis/aretrue
aboutuseofBardiagram:
a)Comparisonof2categorialdatawhicharenot-additive
b)Comparisonof2categorialdatawhichareproportional
percentagecontributionofcategories
--- Content provided by FirstRanker.com ---
c)Piechartisusedforcomparisonof2categorialdatawhichareproportionalpercentagecontributionofcategories
d)Comparisonofmagnitudeofdifferentfrequenciesindiscrete
data
e)Comparisonofcontinuousdata
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:DAns:a.Comparison...,c.Piechartis...,d.Comparisonof
magnitude
BarDiagram
Lengthofbarrepresentsfrequencyofacharacter
--- Content provided by FirstRanker.com ---
PopularereasymethodUsedforcomparisonofmagnitudeofdifferentfrequenciesin
discretedata
Spacingb/wanytwobarsshouldbenearlyequaltohalfofthewidth
ofthebar
--- Content provided by FirstRanker.com ---
3Type-simple,proportionate&multiple.Categories Quantitytobe
Appropriatediagram
onx-axis representedony-axis*
Continuous Additive
--- Content provided by FirstRanker.com ---
Pieifproportionalcontribution(frequencyor
ofthecategoriesistobe
percentage),
represented,otherwise
--- Content provided by FirstRanker.com ---
histogramhistogram
Linefordepictionoftrend,
otherwisebar
--- Content provided by FirstRanker.com ---
Addictive(frequencyorDiscreteor
Pieifproportionalpercentage
percentage),
categorical
--- Content provided by FirstRanker.com ---
contributionofthecategoriesistoberepresented,
(number,rateorratio)
otherwisebar
bar
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114.Benefitofverticalhealthprogramme
includes:
a)MorefocusonefficiencY
b)Morerapidresults
c)Dedicatedworkeralwaysavailable
--- Content provided by FirstRanker.com ---
d)Manyprogramscanrunatonetimee)Effectivewayofmaximizingtheimpactoftheavailable
resources
CorrectAnswer-A:B:C:E
Ans:a.Morefocus...,b.Morerapid...,c.Dedicatedworker...,e.
--- Content provided by FirstRanker.com ---
Effectivewayof.Verticalprogrammesare"socalledbecausetheyaredirected,
supervised,andexecuted,eitherwhollyortoagreatextent,bya
specializedserviceusingdedicatedhealthworkers"
Incontrast,anintegratedprogrammeis"theprocessofbringing
--- Content provided by FirstRanker.com ---
togethercommonfunctionswithinandbetweenorganizationstosolvecommonproblems,developingacommitmenttosharedvision
andgoalsandusingcommontechnologiesandresourcestoachieve
thesegoals"
Verticalprogrammes(alsoknownasstand-alone,categoricalor
--- Content provided by FirstRanker.com ---
free-standingprogrammesortheverticalapproach)refertoinstanceswhere"thesolutionofagivenhealthproblem[is
addressed]throughtheapplicationofspecificmeasuresthrough
single-purposemachinery"
115.TrueaboutReinke'soedema:
--- Content provided by FirstRanker.com ---
a)Usuallyunilateralb)Commoninsmoker
c)Corticosteroidismainstayoftreatment
d)Involvewholeofmembranouspartofthevocalcords
e)Patienthaslowpitchvoice
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:D:EAnswer-B,CommoninsmokerD,Involvewholeofmembranous
partofthevocalcordsE,Patienthaslowpitchvoice
Itisbilateralsymmetricalswellingofthewholeofmembranouspart
ofthevocalcords.
--- Content provided by FirstRanker.com ---
Thisisduetooedemaofthesubepithelialspace(Reinketspace)ofthevocalcords.
Etiology-
Heavysmoking,
Chronicsinusitis&
--- Content provided by FirstRanker.com ---
LaryngopharyngealreflexC/F-
Patientusesfalsecordsforvoiceproduction&thisgiveshimalow-
pitched&roughvoice.
Treatment-
--- Content provided by FirstRanker.com ---
Decorticationofthevocalcordsi.e.,removalofstripofepithelium,isdonefirstononeside&3-4weeksalterontheother.
116.Feature(s)ofScheibe'ssyndromeis/are:
a)Semicircularcanalfistula
b)Abnormalityinbonylabyrinth
--- Content provided by FirstRanker.com ---
c)Dysplasiaofcochlead)Middleearanaomaly
e)All
CorrectAnswer-C
Answer-C.Dysplasiaofcochlea
--- Content provided by FirstRanker.com ---
Itismostcommoninnerearanomaly.Dysplasiaisseeninthecochlea&saccule;hencealsocalled
cochleosacculardysplasia.
Itisinheritedasanautosomalrecessivenonsyndromictrait.
117.Trueaboutnasopharyngealcarcinoma:
--- Content provided by FirstRanker.com ---
a)Level4cervicallymphnodenotinvolvedb)Radiotherapyistreatmentofchoice
c)Alsoc/aGuangdongtumour
d)MayassociatedwithU/Lotitismedia
e)AssociatedwithEBV
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:C:D:EAnswer-A,Level4cervicallymphnodenot
involvedB,RadiotherapyistreatmentofchoiceC,Alsoc/a
GuangdongtumourD,MayassociatedwithU/Lotitis
mediaE,AssociatedwithEBV
--- Content provided by FirstRanker.com ---
Itismostlyseeninfifthtoseventhdecades.Malesarethreetimesmorepronethanfemale.
Epstein-Barrvirusiscloselyassociatedwithnasopharyngeal
carcinoma.
DuetoobstructionofEustachiantube,thereisconductivehearing
--- Content provided by FirstRanker.com ---
loss,serousorsuppurativeotitismedia.Radiotherapy:Itistreatmentofchoicefornasopharyngeal
carcinoma.
118.Trueabouttubercularotitismediaareall
except?
--- Content provided by FirstRanker.com ---
a)Spreadsthrougheustachiantubeb)Causespainlesseardischarge
c)Maycausemultipleperforations
d)Usuallyaffectsbothears
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAnswer-D.Usuallyaffectsbothears
Tuberculosisofmiddleearisacomparativelyrareentityusually
seeninassociationwithorsecondarytopulmonarytuberculosis,
infectionreachesthemiddleearthrougheustachiantube.
--- Content provided by FirstRanker.com ---
ClinicalfeaturesGenerally,tuberculosisofmiddleearisunilateral.
Itischaracterizedbypainlessotorrhoeawhichfailstorespondtothe
usualantimicrobialtreatment.Thereispainlesswateryotorrhea.
Singleormultipleperforationoftympanicmembrane.
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119.EvidencebasedtherapyofBell'spalsy
include(s):
a)Facialnervemassage
b)Facialnervestimulation
c)Steroid
--- Content provided by FirstRanker.com ---
d)Acyclovire)All
CorrectAnswer-C
Answer-C.Steroid
1.Medicaltreatment
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Prednisolone(steroid)isthedrugofchoiceandisstartedatinitialvisit.Initiationoftherapyduringfirst24hoursofsymptomconfersa
higherlikelihoodofrecovery.
Antiviraltherapy(Acyclovir)isaneweradjunctintreatingacute
facialpalsyofviralorigin(bothBell'spalsyandRamsayhunt
--- Content provided by FirstRanker.com ---
syndrome).Mostsurgeonsthesedaysadvocatecombinationofsteroidsand
antiviraldrugs.
120.ApersonhasvertigowithoutCNS
involvement.Causesis/are:
--- Content provided by FirstRanker.com ---
a)Perilymphfistulab)Otolithiasis
c)Vestibularneuritis
d)Meniere'sdisease
e)Multiplesclerosis
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:C:DAnswer-A,PerilymphfistulaB,OtolithiasisC,Vestibular
neuritisD,Meniere'sdisease
Peripheral(Lesionsofendorgansvestibularnerve)
Meniere'sdisease
--- Content provided by FirstRanker.com ---
Benignparoxysmalpositionalvertigo
Vestibularneronitis
Labyrinthitis
Vestibulotoxicdrugs
--- Content provided by FirstRanker.com ---
HeadtraumaPerilymphfistula
Syphilis
Acousticneuroma
121.Cause(s)ofinMydriasis:
--- Content provided by FirstRanker.com ---
a)Organophosphoruspoisoningb)Homersyndrome
c)Oculomotornervepalsy
d)Parasympatheticstimulation
e)All
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer-C.Oculomotornervepalsy
Carbolicacid,Chloralhydrate,Organophosphorus,Morphine
(opiate)and'NewHorn'i.e.neurosyphilis/tabesdorsalis(spinal
miosisorsmall,irregularArgyllRobertsonpupil)andHorner's
--- Content provided by FirstRanker.com ---
syndrome,Oculomotornervepalsy.Atropineandcocainecausemydriasis.
122.Trueaboutprimaryopenangle
glaucoma:
a)Alsok/aChronicsimpleglaucoma
--- Content provided by FirstRanker.com ---
b)Hypermeteropeasaremorepredisposedc)Polygenicinheritance
d)Laseriridotomyisusedfortreatment
e)Fundusexaminationrevealslargecup
CorrectAnswer-A:C:E
--- Content provided by FirstRanker.com ---
Answer-(A)Alsok/aChronicsimpleglaucoma(C)Polygenicinheritance(E)Fundusexaminationrevealslargecup
Alsoknownaschronicsimpleglaucomaofadultonsetandis
typicallycharacterizedbyslowlyprogressiveraisedintraocular
pressure.
--- Content provided by FirstRanker.com ---
Associatedwithcharacteristicopticdisccuppingandspecificvisualfielddefects.
Pathogenesis-
Heredity:POAGhasapolygenicinheritance.
Age-elderlybetween5thand7thdecades.
--- Content provided by FirstRanker.com ---
Myopesaremorepredisposedthanthenormals.DiabeticshaveahigherprevalenceofPOAG.
POAGismoreinhyPertensives.
C/F
patientsusuallycomplainoffrequentchangesinpresbyopicglasses.
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Patientsdevelopdelayeddarkadaptation.Fundusexaminationshowlargecup.(0.6ormore)
Laseriridotomyisusedfortreatmentofprimaryangleclosure
glaucoma.
123.Cloudycorneais/areseen:
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a)Klinefeltersyndromeb)Turnersyndrome
c)Megalocornea
d)Mucopolysaccharidosis
e)All
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CorrectAnswer-DAnswer-D.Mucopolysaccharidosis
S-Sclerocornea
T-Trauma
U-Ulcer
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M-MucopolysaccharidosisP-Peteranomaly
ED-Congenitalhereditaryendothelialdystrophy
124.Ectopialentisisassociatedwithall
except-
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a)Homocystinuriab)Weil-Marchesanisyndrome
c)Marfansyndrome
d)Cockaynesyndrome
e)Osteogenesisimperfecta
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CorrectAnswer-D:EAnswer-(D)Cockaynesyndrome(E)Osteogenesisimperfecta
Morecommon:
Marfansyndrome
Homocystinuria
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Weil-MarchesanisyndromeSulfiteoxidasedeficiency
Hyperlysinemia
125.NotfeatureofFuch's
heterochromiciridocyclitis:
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a)Whitenodulesontheanteriorsurfaceoftheirisb)Koppeprecipitatespresentatbackofcornea
c)Granulomatoustypeoflowgradeanterioruveitis
d)Topicalcorticosteroidsareusedfortreatment
e)All
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CorrectAnswer-CAnswer-C.Granulomatoustypeoflowgradeanterioruveitis
Fuchs'heterochromiciridocyclitisisachronicnongranulornatous
typeoflowgradeanterioruveitis.
Thediseaseischaracterisedby:
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Heterochromiaofiris,Diffusestromalirisatrophy,
FineKPsatbackofcornea,
Faintaqueousflare,
Absenceofposteriorsynechiae
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Topicalcorticosteroidsareallthatisrequired.126.Trueaboutiris:
a)Eyecolourisduetorelativenumberofmelanocytes
b)Stromaisresponsibleforpigmentation
c)Sphincterpupillaeissuppliedbyparasympatheticfibres
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d)Dilatorpupillaeissuppliedbysympatheticfibrese)Stromaiscoveredonitsanteriorsurfacebytwolayersof
pigmentedepithelium
CorrectAnswer-A:B:C:E
Answer-A,Eyecolourisduetorelativenumberof
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melanocytesB,StromaisresponsibleforpigmentationC,Sphincterpupillaeissuppliedby
parasympatheticfibresE,Stromaiscoveredonitsanterior
surfacebytwolayersofpigmentedepithelium
Eyecolorisdeterminedbytherelativenumberofmelanocyteinthe
--- Content provided by FirstRanker.com ---
stromaandofcoursethedensityofmelaningranulesproduced.Irisiscomposedofastromacantainingbranchedconnectivetissue
cells,usuallypigmentedbutlargelyunpigmentedinblueirides.
Thestromaiscoveredonitsposteriorsurfacebytwolayersof
pigmentedepithelium.
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Theirisisrichlysuppliedbysensorynervefibresderivedfromthetrigeminalnerve.
Thesphincterpupillaeissuppliedbyparasympatheticautonomous
secretomotornervefibresderivedfromtheoculomotornerve,while
themotorfibresofthedilatormusclearcdefivedfromthecervical
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sympatheticchain.127.Whichofthefollowingis/arenotthe
feature(s)ofcornealulcerduetoherpes
virus:
a)RoseBengalstainingofmarginofulcer
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b)Decreasedcornealsensitivityc)Fluoresceinstainingofflooroftheulcer
d)Ringinfiltration
e)All
CorrectAnswer-A:B:C
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Answer-A,RoseBengalstainingofmarginofulcerB,DecreasedcornealsensitivityC,Fluoresceinstainingof
flooroftheulcer
"Dendriticulcerbasestainswithfluorescein&themarginswithrose
Bengal.
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Fluoresceininstallationilluminatedbybluelightshowsupcornealulcerationatanearlystage.
Thecorneaisrelativelyinsensitive.Insevereforms,dendriticulcers
develop.
128.Allaretrueaboutchronicfatigue
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syndromeexcept:a)Fordiagnosis,durationoffatigueshouldbeatleast6month
b)Impairedmemoryandconcentrationmaypresent
c)Fatiguerelievedbyrest
d)Physicalexaminationshowsnoabnormalities
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e)CognitivebehavioraltherapyisusefulfortreatmentCorrectAnswer-C
Answer-C.Fatiguerelievedbyrest
Fatiguelastsforatleast6months
Fatigueisofnewordefiniteonset.
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Fatigueisnottheresultofanorganicdiseaseorofcontinuingexertion
Fatigueisnotalleviatedbyrest.
Fatiguesymptomsaresoarthroat,tendercervicaloraxilarylymph
nodes,musclepain,paininseveraljoints,headaches,malaise
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129.Allaretrueaboutprimaryaldosteronism
except:
a)Oneofthemostcommoncauseofsecondaryhypertension
b)Hyperkalemia
c)Sodiumretention
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d)Ratioofplasmaaldosteronetoplasmareninactivity(PA/PRA)isausefulscreeningtest
e)Tetanymayoccur
CorrectAnswer-B
Answer-B.Hyperkalemia
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Primaryhyperaldosteronismisoneofthemostcommoncauseofsecondaryhypertension.
Excessivelevelsofaldosteronecausesodiumretentionand
potassiumexcretion,withresultanthypertensionandhypokalemia.
Hypokalemiacancauseweakness,parethesias,visualdisturbances
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andtetany.Thediagnosisofprimaryhyperaldosteronismisconfirmedbythe
elvatedlevelofaldostetoneanddepressedlevelsofrenininthe
circulation(lowPRA).
Theratioofplasmaaldosteronetoplasmareninactivity(PA/PRA)is
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ausefulscreeningtest.130.Allaretrueaboutacutepericarditis
except:
a)Painradiatetoleftshoulder&arm
b)WidespreadelevationoftheSTsegments,oftenwithupward
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concavity&thenreturntobaselinec)Painrelievedbylyingsupine&intensifiedbysittingupand
leaningforward
d)Corticosteroidrelievessymptoms
e)High-pitchedscratchingorcrunchingnoisemayheardin
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auscultationCorrectAnswer-C
Answer-C.Painrelievedbylyingsupine&intensifiedbysitting
upandleaningforward
Thecharacteristicpainofpericarditisisretrosternal,radiatestothe
--- Content provided by FirstRanker.com ---
shouldersandneck(retrosternal,andleftprecoridal).Characteristically,pericaridialpainmayberelievedbysittingupand
leaningforwardandisintensifiedbylyingsupine.
Apericardialfrictionrubisahigh-pitchedsuperficialscratchingor
crunchingnoise,producedbymovementoftheinflamed
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pericardium.TherearefourstagesofECGchangesintheevolutionofacute
pericarditis.
Instage1,thereiswidespreadelevationoftheSTsegments,often
withupwardconcavity,involvingtwoorthreestandardlimbleads
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andV2toV6,withreciprocaldepressionsonlyinaVRandsometimesV1,aswellasdepressionofthePRsegmentUsually
therearenosignificantchangesinQRScomplexes.
Instage2,afterseveraldays,theSTsegmentsreturntonormal,
andonlythen,orevenlater,dotheTwavesbecomeinverted(stage
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3).Ultimately,weeksormonthsaftertheonsetofacutepericarditis,the
ECGreturnstonormalinstage4.
Thepainisusuallyrelievedbyaspirin.
131.Malignancyassociatedwith
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hypercalcemia:a)Breastcancer
b)Smallcelllungcancer
c)Non-smalllungcancer
d)Prostatecancer
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e)MultiplemyelomaCorrectAnswer-A:C:D:E
Answer-A,BreastcancerC,Non-smalllungcancerD,Prostate
cancerE,Multiplemyeloma
Lungcarcinoma,breastcarcinoma,andmultlplemyelomaaccount
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formorethan50%ofallcasesofmalignancy-associatedhypercalcemia.
Gastrointestinaltumarsandprostatecarcinomaarelesscommon
causesofhypercalcemia.
132.Whichofthefollowingmarkerssuggest
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likelyprimarycancerincarcinomaofunknownprimary(CUP):
a)CK7isfoundintumorsofthelung,ovary,endometrium&
breast
b)CK20+/CDX-2+/CK7?,suggestiveoflowergastrointestinal
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cancerc)Calretin&WT-1formelanoma
d)Chromogranin,synaptophysin&CD56aremarkerof
neuroendocrineprrimary
e)None
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CorrectAnswer-A:B:DAnswer-A,CK7isfoundintumorsofthelung,ovary,
endometrium&breastB,CK20+/CDX-2+/CK7?,suggestiveof
lowergastrointestinalcancerD,Chromogranin,synaptophysin
&CD56aremarkerofneuroendocrineprrimary
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CK7,CK20,thrombomodulin-UrothelialCK7,CK20,CDX-2,carcinoembryonicantigen(CEA)-intestinal
Calretinin,WT-1-Mesothelioma
Chromogranin,synaptophysin,CD56-Neuroendocrine
133.Whichistrueaboutthrombolysisin
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acuteischemicstroke:a)Mosteffectiveifusedwithin3hour
b)Contraindicatedinh/opriorintracranialhaemorrahage
c)Useofheparinwithin48hrisnotacontraindication
d)Contraindicatedifplatelets<100,000permicroliter
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e)AllCorrectAnswer-A:B:D
Answer-A,Mosteffectiveifusedwithin3
hourB,Contraindicatedinh/opriorintracranial
haemorrahageD,Contraindicatedifplatelets<100,000per
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microliterIntravenousthrombolysiswithrecombinanttissueplasminogen
activator(rt-PA)increasestheriskofhaemorrhagictransformationof
thecerebralinfarctwithpotentiallyfatalresults.However,ifitis
givenwithin4.5hoursofsymptomonsettocatefullyselected
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patients,thehaemorrhagicriskisoffsetbyanimprovementinoveralloutcome.
134.Highaniongapmetabolicacidosisis/are
presentin:
a)Asthma
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b)COPDwithCO2retentionc)Poorlycontrolleddiabetes
d)Renaltubularacidosis
e)All
CorrectAnswer-C
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Answer-C.PoorlycontrolleddiabetesKetoacidosis
Diabetic
Alcoholic
Starvation
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135.TrueaboutMcCune-Albrightsyndrome:
a)Occurinchildren&duringpuberty
b)Precociouspubertyinfemale
c)Involvelongboneoflimb
d)Associatedwithhypothyroidism
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e)AllCorrectAnswer-A:B:C
Answer-A,Occurinchildren&duringpubertyB,Precocious
pubertyinfemaleC,Involvelongboneoflimb
McCune-Albrightsyndrome(MAS)ischaracterizedbythetriadof
--- Content provided by FirstRanker.com ---
polyostoticfibrousdysplasia,cafeaulaitskinpigmentation,andperipheralprecociouspuberty.
Albrightsyndromeisprecocioussexualdevelopment,whichoccurs
mostofteningirls.
Theaverageageatonsetinaffectedgirlsisabout3yrandpuberty.
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136.Increasedportalveinpressure&normal
hepaticveinpressurecanbeseeninall
except:
a)Alcoholiccirhhosis
b)Alcholoichepatitis
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c)BuddChairisyndromed)Portalveinthrombosis
e)Inferiorvenacavaobstruction
CorrectAnswer-C:E
Answer-C,BuddChairisyndromeE,Inferiorvenacava
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obstruction"Budd-Chiarisyndrome(Obstructionofhepaticveinsatanysitefrom
efferentveinofthelobuletotheentryoftheIVCintorightatrium.
Posthepatic-Budd-Chiarisyndrome,Inferiorvenacavalwebs
137.Whichofthefollowingstatement(s)
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is/areregardingAmericanHeartAssociation(AHA)Guideline-2015for
cardiopulmonaryresuscitation(CPR)&
Emergencycardiovascularcare(ECC):
a)Chestcompression:ventilationCompressionventilationratio
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withoutadvancedairway?rate30:2irrespectiveofrescuer&ageofpatient
b)Compressionrate-atleast100/min
c)FailuretoachieveanETCO2of10mmHgbywaveform
capnographyafter20minutesofresuscitationhasbeen
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associatedwithanextremelypoorchanceofreturnofspontaneouscirculation(ROSC)
d)Limitinterruptionsinchestcompressionstolessthan10
seconds
e)None
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CorrectAnswer-C:DAnswer-C,FailuretoachieveanETCO2of10mmHgby
waveformcapnographyafter20minutesofresuscitationhas
beenassociatedwithanextremelypoorchanceofreturnof
spontaneouscirculation(ROSC)D,Limitinterruptionsinchest
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compressionstolessthan10secondsCompressionrateismodifiedtoarangeofl00to120/min.
Compressionventilationratiowithoutadvancedairway-1or2
rescuers30:2
FailuretoachieveanETCO2ofI0mmHgbywaveform
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capnographyafter20minutesofresuscitationhasbeenassociatedwithanextremelypoorchanceofROSCandsurvival.
Theclarifiedrecommendatio-nforcfrestcompressiondepthfor
adultsisatleast2inches(Scm)butnotgreaterthan2.4inches(6
cm).
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138.Trueaboutmultiplesclerosis:
a)Corticosteroidsareusedinacuteattack
b)IntravenousImmunoglobuliniseffectivemodeoftreat?ment
c)IFNa-usedinrecurrence
d)IFN-P-usedinrecurrence
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e)PlasmapheresismaybeusedinsevererelapsesCorrectAnswer-A:D:E
Answer-(A)Corticosteroidsareusedinacuteattack(D)IFN-P-
usedinrecurrence(E)Plasmapheresismaybeusedinsevere
relapses
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MaindrugsusedfortreatingmultiplesclerosisincludeInterferon-1a
Frequencyofrelapsesinmultiplesclerosispatientisdecreasedby
beta-interferon/glatiramer.
Newerdrugapprovedforrelapseinmultiplesclerosispatientsis
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Fingolimod.Glucocorticoidsareusedtomanageeitherfirstattacksoracute
exacerbations.
Natalizumabisamonoclonalantibodyagainst4subunitof41
integrinonlymphocytes,usefulintreatingmultiplesclerosis.
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Itreducestherelapseratewhengivenintravenouslyoncemonthly.139.Extrathyroidfeatureofhypothyroidism
includes:
a)Pretibialmyxedema
b)Carpaltunnelsyndrome
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c)Bradycardiad)Thyroidacropathy
e)Peripheraledema
CorrectAnswer-B:C:E
Answer-(B)Carpaltunnelsyndrome(C)Bradycardia
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(E)PeripheraledemaCommonsymptomsare-Weightgain,Fatigue,Dryskinandhair,
Menorrhagia,Hoarseness,coldness
CVS-Bradycardia,Myxoedema,hypertension
Nervoussystem-Carpaltunnelsyndrome,
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Facialfeatures-purplishlips,malarflush,periorbitaloedemaYellowingofskinoccursduetoaccumulationofincreasecarotene.
140.Whichofthefollowingistrueabout
medicationoveruseheadache:
a)Notassociatedwithtriptanuse
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b)Restrictionofanalgesicsshouldbedonec)Opioidismainlyresponsible
d)Preventivetherapyshouldbeencouragedafterstopping/
reducinganalgesic
e)None
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CorrectAnswer-B:C:DAnswer-(B)Restrictionofanalgesicsshouldbedone
(C)Opioidismainlyresponsible(D)Preventivetherapyshould
beencouragedafterstopping/reducinganalgesic
medicationsthatarethemostcommonculpritsarecompound
--- Content provided by FirstRanker.com ---
analgesia(particularlycodeineandotheropiatecontainingpreparations)andtriptans,andMOHisusuallyassociatedwithuse
onmorethan10-15dayspermonth.
Managementisbywithdrawaloftheresponsibleanalgesics
Migraineprophylacticsmaybehelpfulinreducingtherebound
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headaches.141.Whichofthefollowingis/arefeature(s)of
acuteinterstitialnephritis:
a)Eosinophiluria
b)Peripheraleosinophilia
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c)WBCcastd)Grosshaematuria
e)Significantproteinuria
CorrectAnswer-A:B:C
Answer-(A)Eosinophiluria(B)Peripheraleosinophilia(C)WBC
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castPeripheraleosinophiliacanoccur,especiallywithdruginduced.
Microscopichematuriaisinvariablypresent.
Urinalysiscanrevealwhitebloodcell,granularorhyalinecast.
Thepresenceofurineeosinophilsisneithersensitiveorspecific.
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Proteinuriacanbeafeature,particularlyinNSAIDS-inducedinterstitialnephritis.
142.Feature(s)ofBulbarpalsyis/are:
a)Dysphagia
b)Absentjawjerk
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c)Absentgagreflexd)Tongueatrophy
e)Tonguewasting&fasciculations
CorrectAnswer-A:B:C:D:E
Answer-(A)Dysphagia(B)Absentjawjerk(C)Absentgag
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reflex(D)Tongueatrophy(E)Tonguewasting&fasciculationsParalysisorlossoffunctionsuppliedbycranialnervearisingfrom
bulb(oldnameofmedullaoblongata).
AffectedCNare9,10,11&l2th.
Tongue-flaccid,wasted,fasciculationmaybepresent.
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InvolvementofIX&XCN:Nasaltwang,nasalregurgitation,hoarsevoice,dysphagia,lossofsensationoverpl/3tongue,
weakcough,absentgagreflex&weakcoughreflex.
Inu/llesion,thereisneveracompleteparalysisofdeglutitionorof
articulation.
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143.Allaretrueabouthepatorenalsyndrome
except:
a)Creatininelevelraised
b)Albumininfusiongiven
c)Livertransplantationimprovesrenalfunctions
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d)Mayoccurincirrhosise)Lowdosedopamineinfusionisveryeffective
CorrectAnswer-E
Answer-E.Lowdosedopamineinfusionisveryeffective
Thehepatorenalsyndrome(HRS)isaformoffunctionalrenalfailure
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withoutrenalpathologythatoccursinabout10%ofpatientswithadvancedcirrhosisoracuteliverfailure.
Therearemarkeddisturbancesinthcarterialrenalcirculationin
PatientswithHRS.
TyPeIHRS-asignificantreductionincreatinineclearancewithin1-2
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weeksofpresentation.Type2HRS-anelevationofserumcreatininelevel.
HRSisoftenseeninpatientswithrefractoryascites.
Treatment-
dopamineorprostaglandinanalogueswereusedasrenal
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vasodilatingmedications.Patientsaretreatedwithmidodrine,analpha-agonist,alongwith
octreotideandintravenousalbumin.
ThebesttheragyforHRSislivertransplantation.
144.Whichofthefollowingis/areusedfor
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assessmentofcarbohydratemalabsorption:
a)Schillingtest
b)Steatorrhoea
c)D-xylosetest
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d)Glucoseteste)Urinetest
CorrectAnswer-C
Answer-C.D-xylosetest
D-xyloseabsorptiontestisthemostcommonlyemployedtestfor
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carbohydrateabsorption-HarrisonAnendoscopicmucosalbiopsyisthemorespecifictestandisnow
consideredessential.
D-xyloseisacarbohydratethatisabsorbedalmostexclusivelyinthe
proximalsmallbowelwithoutthehelpofpancreaticenzymes.A
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positiveD-xylosetestindicatesmalabsorptionduetointestinalmucosaldiseaseandthusbeusedasatestforassessmentof
mucosalfunction.
145.TrueaboutSwan-Ganzcatheter:
a)Measuresrightatrialpressure
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b)Measuresleftventricularfillingpressurec)MeasurePCWP
d)Insertedthroughleftsubclavianvein
e)InserteddirectlyinRightatrium
CorrectAnswer-A:B:C:D
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Answer-(A)Measuresrightatrialpressure(B)Measuresleftventricularfillingpressure(C)MeasurePCWP(D)Inserted
throughleftsubclavianvein
Continuouscardiacoutputmonitoring.
CentraltemPeraturemonitoring
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Measurementofpulmonaryarterypressure(canalsomeasureRAandRVpressuresduringinsertion)
Measurementofmixedvenoussaturations
Estimationofdiastolicfillingofleftheart(normalPCWP2-12mmHg)
146.TreatmentofacuteHyperleukocytosis
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includes:a)Hydroxyurea
b)Isotretinoin
c)Leukapheresis
d)Vincristine
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e)AllCorrectAnswer-A:C:D
Answer-(A)Hydroxyurea(C)Leukapheresis(D)Vincristine
Leukapheresisisthetreatmentofchoice.
InpatientswithAML,hydroxyureashouldbestarted.
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InALLpatients,higherthan200,000/mm3patientsmaybetreatedwithvinctistine,steroids,orboth.
147.Feature(s)of3rddegreeburnis/are:
a)Blisterformation
b)Verypainful
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c)Nospontaneoushealingd)Dryescharformation
e)Thrombosedvesselscanbeseenundertheskin
CorrectAnswer-C:D:E
Answer-C,NospontaneoushealingD,Dryeschar
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formationE,ThrombosedvesselscanbeseenundertheskinEntirethicknessofskindestroyed(intofat)
Anycolor(white,black,red,brown),dry,lesspainful(dermalplexus
ofnervesdestroyed)
Healbycontractionandscardeposition(noepitheliumleftinmiddle
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ofwound)Full-thicknessBurns(3degreeBURN)-thrombosedvesselscanbe
seenundertheskin.
148.TrueaboutBabcockforcep:
a)Teethatend
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b)Serrationatendc)Triangularorificeinblades
d)Usedforsoftdelicatetubularstructure
e)Curvedforcep
CorrectAnswer-C:D
--- Content provided by FirstRanker.com ---
Answer-C,TriangularorificeinbladesD,Usedforsoftdelicatetubularstructure
Aninstrumentwitharatchet&atriangularerpansionwith
fenestrationsattheoperatingend
Itdoesnothaveanyteeth
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Thisinstrumentcanbeusedtoholdintestine,thyroidgland,mesoappendix,uterinetubeetc.
149.Gasusedincreatingpneumoperitonem:
a)Water
b)CO2
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c)02d)Air
e)CO
CorrectAnswer-B:C:D
Answer-B,CO2C,02D,Air
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Gasesusedforpneumoperitoneumincludecarbondioxide(CO2),air,oxygen,nitrousoxide(N20),argon,heliumandmixturesofthese
gases.
150.CO2isusedinlaproscopyforcreating
pneumoperitoneuminplaceofair
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because:a)Lessabsorptionfromperitonealsurface
b)Fastclearancefrombody
c)Lesssolubilityinblood
d)Electrocauteryissafetouse
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e)LessriskofgasembolismCorrectAnswer-B:D:E
Answer-B,FastclearancefrombodyD,Electrocauteryissafeto
useE,Lessriskofgasembolism
CO2gasinsufflationispreferredbymostlaparoscopistsbecauseit
--- Content provided by FirstRanker.com ---
hasahighdiffusioncoefficientandisanormalmetabolicendproductrapidlyclearedfromthebody.
Also,CO2ishighlysolubleinbloodandtissuesanddoesnot
supportcombustion.
TheriskofgasembolismislowestwithCO2.
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CardiacarrhythmiascanoccurwithCO2pneumoperitoneum.151.Acutehaemorrhagicpancreatitis
producewhichofthefollowingsign:
a)Cullensign
b)Rovsingsign
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c)Psoassignd)GreyTurnersign
e)Kehrsign
CorrectAnswer-A:D
Answer-A,CullensignD,GreyTurnersign
--- Content provided by FirstRanker.com ---
Bleedingintothefascialplanescanproducebluishdiscolourationoftheflanks(GreyTurner'ssign)orumbilicus(Cullen'ssign).
152.Trueregardingurinarycatheterization
with16Frenchsize:
a)Itisthesuitablesizetouseinadultfemale
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b)ItcancauseUTIinlongtermusec)Usedinmanagementofurethralobstruction
d)Diameteris4mm
e)Steriletechniquemustbeusedforinsertion
CorrectAnswer-A:B:C:E
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Answer-A,ItisthesuitablesizetouseinadultfemaleB,ItcancauseUTIinlongtermuseC,Usedinmanagementofurethral
obstructionE,Steriletechniquemustbeusedforinsertion
Foley'scatheterissterilizedbygammaradiation.UsuallyFoley's
catheteriskeptfor7days.
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Size:Adults--16F
Children--8For10F
Obstructionoftheurethrabyananatomicalconditionthat,makesit
dfficultforonetourinate:prostatehypertrophy,
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prostatecancer,ornarrowingoftheurethra.153.Whichofthefollowingis/aretrueabout
obstructiveuropathy:
a)Strictureinureteriscause
b)Stoneinureteriscause
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c)RTAtype4canoccurd)AbsenceofhydronephrosisonUSGruleoutobstructive
uropathy
e)Whenobstructionisabovethelevelofthebladder,bilateral
hydroureterandhydronephrosisoccurs
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:CAnswer-A,StrictureinureteriscauseB,Stoneinureteris
causeC,RTAtype4canoccur
Anyobstructionatordistaltothebladderneckmayleadtoback
pressureaffectingbothkidneys.
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Obstructionatorproximaltotheureteralorificeleadstounilateraldamage.
Partialobstructionleadstogradualprogressivemuscular
hypertrophyfollowedbydilation,decompensationand
hydronephroticchanges.
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Acquiredurinarytractobstructionmaybeduetoinflammatoryortraumaticurethralstrictures,ureteralorpelvicstones.
154.Trueaboutbranchialfistula:
a)Externalopeningneartheanteriorborderof
sternocleido?mastoid
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b)Externalopeningatjunctionofupper&middlethirdofsternocleidomastoidmuscle
c)Developduetopersistenceof2ndbranchialcleft
d)Openinoropharynx
e)Movewithswallowing
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CorrectAnswer-A:C:DAnswer-A,Externalopeningneartheanteriorborderof
sternocleido?mastoidC,Developduetopersistenceof
2ndbranchialcleftD,Openinoropharynx
Thisisalwayscongenital&occursduetopersistent2ndbranchial
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cleft.Theexternalorificeisnearlyalwayssituatedinthelowerthirdofthe
neckneartheanteriorborderofthesternocleidomastoid.
Thepatientmaycomplainofadimple,dischargingmucus&the
dimplebecomesmoreobviouswhenthepatientisaskedtoswallow.
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155.Trueabout1stdegreehaemorrhoid:
a)Painlessbleeding
b)Malaenaeoccur
c)Constipationmaybepresent
d)Prolapseondefaecation
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e)NeverprolapseCorrectAnswer-A:C:E
Answer-A,PainlessbleedingC,Constipationmaybe
presentE,Neverprolapse
FourDegreesofHaemorrhoids
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Firstdegree:bleedonly,noprolapseSeconddegree:prolapse,butreducespontaneously
Thirddegree:prolapseandhavetobemanuallyreduced
Fourthdegree:permanentlyprolapsed
156.Whichofthefollowingexaminationis
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doneinsupineposition:a)Tredelenburgposition
b)ReverseTredelenburgposition
c)Simsposition
d)Jackknifeposition
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e)Lloyd-DaviespositionCorrectAnswer-A:B:E
Answer-A,TredelenburgpositionB,ReverseTredelenburg
positionE,Lloyd-Daviesposition
"Tredelenburgposition:Lithotomywithheaddown
--- Content provided by FirstRanker.com ---
ReverseTredelenburgposition:Thepatientissupineontheoperatingtablewiththetabletiltedup15"attheheadendtoreduce
venousengorgement.
"Mostcommonly,thepatientisexaminedintheleftlateral(Sims)
positiorwiththebuttocksoverlyingtheedgeoftheexamination
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couchandwiththeaxisofthetorsocrossing,ratherthanparallelwith,theedgeofthecouch.
Thepronejackknifeorknee-elbowpositionsmaybeused.
Lloyd-DaviesPosition:ItisalsoknownastheTrendelenburg
positionwithlegsapart.
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157.Trueaboutlipcarcinoma:
a)Commoninsmoker
b)Morecommoninlowerlip
c)Morecommoninupperlip
d)Alwayspainfultotouch
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e)DistantmetastasisislateCorrectAnswer-A:B:E
Answer-A,CommoninsmokerB,Morecommoninlower
lipE,Distantmetastasisislate
Lowerlipismoreofteninvolved
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lncidenceoforalcancerissixtimesmoreinsmokerthannon-smoker
Siteofpredilectionisb/wthemidline&commissureofthelip
Mostly,itissquamouscellcarcinoma,oftenseeninmalesintheage
groupof40-70years
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L,Nmetastasesdeveloplate.Submental&submandibularnodesarethefirsttobeinvolved;otherdeepcervicalnodesmayalsoget
involvedlater.
158.Trueaboutmediastinalteratoma:
a)Mostcommontumourofanteriormediastinum
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b)Mostcommongermcelltumourofmediastinumc)Morecommonlyoccursinanteriormediastinum
d)Containteeth,skin,hair,cartilageandbone
e)Histologicallygradedasdifferentiated&undifferentiated
CorrectAnswer-B:C:D:E
--- Content provided by FirstRanker.com ---
Answer-B,MostcommongermcelltumourofmediastinumC,Morecommonlyoccursinanterior
mediastinumD,Containteeth,skin,hair,cartilageand
boneE,Histologicallygradedasdifferentiated&
undifferentiated
--- Content provided by FirstRanker.com ---
Mostcommonmalignancyinyoungmenbetweenage15and35years.
Primarymediastinalgermcelltumors(includingteratomas,
seminomas,andnonseminomatousmalignantgermcelltumors)are
aheterogeneousgroupofbenignandmalignantneoplasms.
--- Content provided by FirstRanker.com ---
Teratomasarethemostcommontypeofmediastinalgermcelltumors.
Theycontaintwoorthreeembryoniclayersthatmayincludeteeth,
skin,hair(ectodermal),cartilageandbone(mesodermal),or
bronchial,intestinal,orpancreatictissue(endodermal).
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MediastinalTeratomasmayeitherbe-Mature:Welldifferentiated
Immature:Poorlydifferentiated
Withmalignanttransformation
159.Trueaboutinguinalherniainchildren:
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a)Occurduetopersistenceofprocessusvaginalisb)Defectinabdominalmaypresent
c)Mostcommonvarietyisdirecttype
d)Difficulttoreducenon-operatively
e)Morecommoningirls
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:DAnswer-A,Occurduetopersistenceofprocessus
vaginalisB,DefectinabdominalmaypresentD,Difficultto
reducenon-operatively
Inchildren,ifinguinal(indirect)herniaispresentinoneside,then
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processusvaginalisisintactonotherside.Malesareaffectedaboutsixtimesmoreoftenthanfemales.
Indirectinguinalhernia-Canoccurinanyagefromchildhoodto
adult.
Inguinalherniaresultsfromafailureofclosureoftheprocessus
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vaginalis.160.Trueregardingtesticulartumour:
a)ForstageIseminoma-orchidectomyaloneusedfortreatment
b)ForstageIseminoma-orchidectomy+radiotherapyusedfor
treatment
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c)StageInon-seminomatousgermcelltumour-orchidectmy+radiotherapyusedfortreatment
d)Stagingisimportantforplanningmanagement
e)i3HCG&AFPmaybeusedasmarkertheresponseof
treatment
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:D:EAnswer-B,ForstageIseminoma-orchidectomy+radiotherapy
usedfortreatmentD,Stagingisimportantforplanning
managementE,i3HCG&AFPmaybeusedasmarkerthe
responseoftreatment
--- Content provided by FirstRanker.com ---
TesticularTumour:StagingStageI:Thetumourisconfinedtothetestis;
StageII:Nodaldiseaseispresentbutisconfinednodesbelowthe
diaphragm;
StageIII:Nodaldiseaseispresentabovethediaphragm;
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StageIV:NonlymphaticmetastaticdiseInconfirmedcases,stagingisanessentialstepinplanning
treatment.
HCG&NSGCTswhenraised,thesemarkersareusedtomonitor
theresponsetotreatment.
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161.Feature(s)ofFournier'sgangrene:
a)Necrotizingfasciitisofthemalegenitaliaandperineum
b)Diabetesisriskfactor
c)Urgentwidesurgicalexcisionofthedeadandinfectedtissueis
essential
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d)Testisneedtoberemovedinallcasese)None
CorrectAnswer-A:B:C
Answer-A,Necrotizingfasciitisofthemalegenitaliaand
perineumB,DiabetesisriskfactorC,Urgentwidesurgical
--- Content provided by FirstRanker.com ---
excisionofthedeadandinfectedtissueisessentialFournier'sgangreneisanecrotizingfasctitisofthemalegenitalia
andperineumthatcanberapidlyprogressingandfatalifnottreated
promptly.
Riskfactors-
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urethralstrictures,
perirectalabscesses,
poorperinealhygiene,
diabetes,
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cancer,humanimmunodeficiencyvirus(HIV)
Clinicalfeatures-
Clinicalsignsincludefevers,perinealandscrotalpain.
Cellulitis,eschars,necrosis,flakingskin,andcrepitusmayallbe
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observed.Treatment-
Urgentwidesurgicalexcisionofthedeadandinfectedtissueis
essential.
162.Whichofthefollowingis/arefeature(s)of
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enlargedkidney:a)Ballotable
b)Upperbordercanbereached
c)Shifttoparacolicgutteroncompression
d)Donotmovewithrespiration
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e)DullonpercussiononrenalangleCorrectAnswer-A:E
Answer-A,BallotableE,Dullonpercussiononrenalangle
Itisareniformswelling
ltmovesveryslightlyuithrespirationasitcomesdownalittleatthe
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heightofinspiration.ltisballottable
Asickeningsensationisoftenfeltduringmanipulation
Ahandcanbeeasilyinsinuctedb/wtheupperpoleofswelling&the
costalmargin
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Percussionwillrewalresonontnoteinfrontofakidneyswellingascoilsofintestine&colonwillalwaysbeinfrontofthekidney.
163.Hypoparathyroidismcanoccurin:
a)Afterthyroidsurgery
b)Digeorgesyndrome
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c)Radicalresectionofhead&neckcancerd)MENI
e)All
CorrectAnswer-A:B:C
Answer-A,AfterthyroidsurgeryB,Digeorge
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syndromeC,Radicalresectionofhead&neckcancerGeneticdisorders(eg:DeGeorgesyndrome)
.Abnormalparathyroidglanddevelopment
.AbnormalPTHsynthesis
oActivatingmutationsofcalciumsensingreceptor(autosomal
--- Content provided by FirstRanker.com ---
dominanthypocalcemiaorsporadicisolatedhypoparathyroidism).Post-surgical(thyroidectomnparathyroidectomnradicalneck
dissection)
oAutoimmunepolyglandularsyndrome
164.Trueaboutbreastcyst:
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a)Mostlyseeninpremenopausalperiodb)Mostcommoninyoungwoman
c)Usuallyunilateral
d)Yellowish-greenishdischarge
e)Adheretounderlyingskin
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CorrectAnswer-A:C:DAnswer-A,MostlyseeninpremenopausalperiodC,Usually
unilateralD,Yellowish-greenishdischarge
Classicallyseeninperimenopausalwomenmostlyinlastdecadeof
reproductivelife.
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50%ofcystsaremultipleorrecurrent.Cystfluidcanbestraw,colored,opaque,ordarkgreenandmay
containfleckofdebris.
Diagnosiscanbeconfirmedbyaspirationand/orultrasound.
165.Fibrocysticdiseasedifferfrom
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fibroadenomabyhaving:a)Painshiftwithcycle
b)Freelymobile
c)Usuallybilateral
d)Firm&rubbery
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e)WelldemarcatedborderCorrectAnswer-A:C
Answer-A,PainshiftwithcycleC,Usuallybilateral
Painful,oftenmultiple,usuallybilateralmassesinthebreast.
Rapidfructuationinthesizeofthemassesiscommon.
--- Content provided by FirstRanker.com ---
Frequently,painoccursorincreasesandsizeincreasesduringpremenstrualphaseofcycle.
Theselesionsarealwaysassociatedwithbenignchangesinthe
breastepithelium.
Themicroscopicfindingsoffibrocysticconditionindudecyst(gross
--- Content provided by FirstRanker.com ---
andmicroscopic),papillomatosis,adenosis,fibrosis,andductalepithelialhyperplasia.
Clinicalfeatures-
Painortendernessoftencallsattentiontothemass.
Dischargefromthenipple.
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Discomfortoccursorisincreasedduringthepemenstrualphaseofthecycle.
Fibroadenoma-
Peakageofincidenceisat20year
Presentwithpainlesslump
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Itissmooth,roundbordered,firmtohardinconsistency&freely
mobilewithinthebreast(socalledbreastmouse)
166.Testforincompetentvalvedoneby:
a)Coughimpulsetest
b)Trendelenburg
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c)Percussationwavetravelinretrogradedirectionalongvaricosevein
d)Percussationwavetravelinorthogradedirectionalongvaricose
vein
e)All
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CorrectAnswer-A:B:CAnswer-A,Coughimpulse
testB,TrendelenburgC,Percussationwavetravelinretrograde
directionalongvaricosevein
Coughimpulsetest:saphenoofemoralincompetence
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TrendelenburgI:saphenofemoralincompetenceTrendelenburgII:Perforatorincompetence
Multipletourniquettest:Siteofperforatorincompetence
Schwartztest:Superficialcolumnofblood
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167.Whichofthefollowingis/aretrueaboutrenalcarcinomaofT3astage:
a)InvolveGerotafascia
b)Involveperinephricfat
c)Renalveininvolvement
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d)Inferiorvenacavainvolvemente)Size>10cm
CorrectAnswer-B:C:E
Answer-B,InvolveperinephricfatC,Renalveininvolvement
E,Size>10cm
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168.Trueaboutextracorporealshockwave
lithotripsy(ECWL):
a)C/Iinpregnancy
b)Lesssatisfactoryforhardstones
c)Stoneisbreakedintosmallpieceswhichcomesoutwithurine
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d)Saferincoagulopathye)Endoscopicretrievalissometimesusedforimpactedstone
fragmentproducedbylithotripsy
CorrectAnswer-A:B:C:E
Answer-A,C/IinpregnancyB,Lesssatisfactoryforhard
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stonesC,StoneisbreakedintosmallpieceswhichcomesoutwithurineE,Endoscopicretrievalissometimesusedfor
impactedstonefragmentproducedbylithotripsy
Crystallinestonesdisintegrateundertheimpactofshockwaves
producedbytheESWLmachine.
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UretericcoliciscommonafterESWL.TheprincipalcomplicationofESWLisinfection.
"Pregnantwomenand.patientswithlargeabdominalaortic
aneurysmsoruncorrectablebleedingdisordersshouldnotbe
treatedwithESWL.
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169.Trueaboutcarcinomagallbladder:
a)Increasedbilirubinleveliscontraindicationforsurgery
b)Palliativetreatmentisforadvanceddisease
c)Metastaticrecurrenceiscommoninliver
d)Whengallbladderwallisinvolved,extendedcholecystectomy
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isdonee)Surgeryshouldbedoneinallcases
CorrectAnswer-B:C:D
Answer-(B)Palliativetreatmentisforadvanceddisease
(C)Metastaticrecurrenceiscommoninliver(D)Whengall
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bladderwallisinvolved,extendedcholecystectomyisdoneIfGBcancerisfoundatcholecystectomy&ifmucosaaloneis
involved,thencholecystectomyissufficient
IfGBwallisinvolved,thenextendedcholecystectomyisdone
Radiationhasverysmallbenefit.Chemotherapyalsohasbeentried.
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5-FU,mitomycinC,doxorubicinaredrugsusedPrognosisisverypoor.Aggressivesurgery&completeclearance
givebestresults.
Surgeryremainstheonlycurativeoptionforgallbladdercancer.
170.Trueaboutparamedianincision:
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a)Itismadebelowumbilicusb)Betterinobeseperson
c)Causeabdominalhernia
d)Cutanteriorsurfaceofrectussheath
e)Cutposteriorsurfaceofrectussheath
--- Content provided by FirstRanker.com ---
CorrectAnswer-C:D:EAnswer-(C)Causeabdominalhernia(D)Cutanteriorsurfaceof
rectussheath(E)Cutposteriorsurfaceofrectussheath
Use:provideslateralitytothemidlineincision,allowinglateral
structuressuchasthekidney,adrenalsandspleentobeaccessed.
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Location:about2-5cmtotheleftorrightofthemidlineincision.lncisionisoverthemedialaspectofthetransverseconvexityofthe
rectus.
Layersoftheabdominalwallskin,fascia(camper'sandscarpa's)
andtheanteriorrectussheathareincised.
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Incisionsinanteriorandposteriorshectiisseperatedbymusclewhichactsasabuttress,thereforeclosureandmoresecure.
171.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.
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172.Whichofthefollowingis/arefeature(s)of
Keloid:
a)Collagenfibersarerandomlyarranged
b)TypeIVcollagendominates
c)Lesionwithhealthymarginremoved
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d)Steroidisveryusefule)Goesbeyondmarginofwound
CorrectAnswer-B:D:E
Answer-(B)TypeIVcollagendominates(D)Steroidisvery
useful(E)Goesbeyondmarginofwound
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Scarsareoftendescribedasbeingatrophic,hypertrophicandkeloid.
Ahypertrophicscarisdefinedasexcessivescartissuethatdoesnot
extendbeyondtheboundaryoftheoriginalincisionorwound.
Akeloidscarisdefinedasexcessivescartisstethatextendsbeyond
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thebounilariesoftheoriginatincisionorwound.IgEantibodyisleastcommonlyseeninkeloid.
eloidsgrowonparticularsites,theseare?
1. Centralchests(probablymostcommon,notsure)
2. Back
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3. Shoulder4. Earlobes
Etiologyofkeloid-
Keyfactors:Surgeryburns,vaccinations
Elevatedlevelsofgrowthfactor(moreoftype.8,collagen)
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LacerationorabrasionOverthesternum(incision)
Inheritanceandinjection
Deeppigmentedskin
Histologyofbothhypertrophicandkeloidscars-
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ExcesscollagenwithhypervascularitykeloidswherethereismoretypeIIIcollagen.
Hypertrophicscarsimprovespontaneouslywithtime,whereaskeloid
scarsdonot.
keloidscarshavethicker,moreabundantcollagenbundles.
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Treatment-Intralesionalinjectionofsteroid(Triamcinoloneacetate)isnow
recommendedasthefirstlineoft/tforkeloid.
173.TrueaboutCongenitalhypertrophic
pyloricstenosis:
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a)Shorteningofpyloriccanalonbariumcontrastimagingb)Elongationofpyloriccanalonbariumcontrastimaging
c)Narrowingofpyloriccanalonbariumcontrastimaging
d)ThickenedpyloricmuscleonUSG
e)ChildshouldbegivennormalsalinewithKC1
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:D:EAnswer-(B)Elongationofpyloriccanalonbariumcontrast
imaging(C)Narrowingofpyloriccanalonbariumcontrast
imaging(D)ThickenedpyloricmuscleonUSG(E)Childshould
begivennormalsalinewithKC1
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Imagingconfirmationissoughtbymostcliniciantodifferentiatefromgastroesophagealreflex
Precaution:Emptystomachvianasogastrictubebeforestudy&
Removecontrastatend
Elongation&narrowingofpyloriccanal
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Stringsign=passingofsmallbariumstreakthroughelongatedpyloricchannel(mostspecificsign)
Double/tripletracksign:crowdingofmucosalfoldsinpyloricchannel
174.Incomparisontoulcerativecolitis,which
ofthefollowingis/arefeature(s)of
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crohn'sdisease:a)Transmuralinflammation
b)Morecommoninsmoker
c)MorepANCApositivity
d)TNF-alphainhibitorroleonlyinCD
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e)AllCorrectAnswer-A:B:D
Answer-(A)Transmuralinflammation(B)Morecommonin
smoker(D)TNF-alphainhibitorroleonlyinCD
CanaffectanypartofGIT,butmesites?terminalileum,ileocecal
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valve,andcaecum.Etiology-
Smokingisastrongriskfactor
OCPsandAppendicectomyincreaserisk
Morphology-
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SkiplesionsThickbowelwall
Stricturescommon
Transmuralinflammation
Noncaseatinggranulomas
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ModeratepseudopolypsDeep,knife-likeulcers
Fibrosis,serositis-Marked
Investigations-
70%ASCA+ve(antiSaccharomycescerevisiaeAb)10%pANCA
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positiveTreatment
Anti-TNFtherapy(Infliximab,adalimumab,certolizumab)-first-line
agentstoinduceremissioninmoderatetoseverediseaseandto
maintainremission
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175.Trueaboutparalyticileus:
a)Postoperativeileusprimarilyaffectsthestomachandcolon
b)Mostlyresolveafter24-72hours
c)Returnoffunctionoccursinthefollowingorder:stomach,large
bowelandsmallbowel.
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d)Ifopioidisusedaspostoperativeanalgesia,thenchanceincreases
e)Isananticipatedcomplicationsofabdominaloperations
CorrectAnswer-A:B:D:E
Answer-(A)Postoperativeileusprimarilyaffectsthestomach
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andcolon(B)Mostlyresolveafter24-72hours(D)Ifopioidisusedaspostoperativeanalgesia,thenchanceincreases(E)Is
ananticipatedcomplicationsofabdominaloperations
Etiology
Postoperative
--- Content provided by FirstRanker.com ---
AdegreeofileususuallyoccursafteranyabdominalprocedureSelf-limiting(24-72hours)
MaybeprolongedinHypoproteinemiaormetabolicabnormality
Intra-abdominalinflammation(peritonitis,abscess,retroperitoneal
hemorrhage)
--- Content provided by FirstRanker.com ---
Reflexileus:followingfracturesofspine/ribs,retroperitonealhemorrhageorapplicationofaplasterjacket
Metabolic&electrolytederangements(uremia,hypokalemia,
hyponatremia,hypoandhypomagnesemia,diabeticcoma,
hypoparathyroidism,hypothyroidism)
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Drugs(opiates,psychotropicagents,anticholinergicagents,calciumchannelblockers)
Returnoffunctionoftheintestineoccursinthefollowingorder:small
bowel,largebowelandthenstomach
Paralyticileus,alsocalledpseudo-obstruction,isoneofthemajor
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causesofintestinalobstructionininfantsandchildren.176.Aciniccellcarcinomais/arefoundin:
a)Breast
b)Parotid
c)Lacrimalgland
--- Content provided by FirstRanker.com ---
d)Pancreasee)Minorsalivarygland
CorrectAnswer-B:D:E
Answer-(B)Parotid(D)Pancrease(E)Minorsalivarygland
MajorSalivaryGlands(includingparotid)
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MinorSalivaryGlandsAcinarcellcaricinomaaremalignantepithelialneoplasm(of
pancrease)
177.WhichareRadio-opaquestones:
a)Pureuricacid
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b)Cysteinec)Phosphate
d)Oxalate
e)Impureuricacid
CorrectAnswer-B:D:E
--- Content provided by FirstRanker.com ---
Answer-(B)Cysteine(D)Oxalate(E)ImpureuricacidRenalCalculus-
Oxalatestones
Phosphatecalculus-struvite
Uricacidanduratecalculi
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Cystinecalculus178.Trueaboutlymphangiomacircum
scriptum:
a)Compressibleswelling
b)Oftencontainclearfluid
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c)Groupsofvesiclesarefoundonskind)Maypresentatbirthorshortlyafterbirth
e)None
CorrectAnswer-B:C:D
Answer-(B)Oftencontainclearfluid(C)Groupsofvesiclesare
--- Content provided by FirstRanker.com ---
foundonskin(D)MaypresentatbirthorshortlyafterbirthThistyPePresentsascircumscribedlesionwhichappearsassmall
vaicleorsmallblisterorslightlyelevatedskinpatch
Thesizevariesfrom0.5to4mmindiameter
Alargeareaofskinmaybeinvolvedontheinnersideofthethigh,
--- Content provided by FirstRanker.com ---
buttockontheshoulderorintheaxillaThewholelesionissoft&sPongY
Fluctuation,fluidthrill&translucencytestarealwayspositive.The
swellingisnotcompressible
Themarginsoftheswellingareindistinct
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TheskinvesiclescontainclearfluidItisusuallyprominentatpubertyandmayoftenstartbleeding.
179.Sacral-teratoma/sacrococcygeal
teratomaisaderivativeof-
a)Primitivestreak
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b)Ectodermc)Hypoblasts
d)Cranialneuropore
e)None
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A.PrimitivestreakGastrulation&Hensen'snode:
In2ndweek-GastrulationoccursEstablishes3rdgermlayer
(mesoderm).
Gastrulationbeginswithprimitivestreakformationincaudalregion
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ofepiblast.PrimitivenodeorHensen'snodeorprimitiveknot:
Thickeningformedatcranialendofprimitivestreak.
Sacrococcygealformation:
FailureofHensen'snodetoregresscanleadtosacrococcygeal
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formation.Incompleteprimitivestreakregressionleavescaudalremnant
Sacrococcygealteratoma.
Arisefromresidualtototipotentialcellrests(Hensen'snode).
Sacrococcygealteratomademonstratestissuederivedfromallthree
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celllayers.Containvaryingproportionsofmature&immatureelements.
180.Trueaboutcentralvenous
catheterization:
a)Cathetermaybeplacedthroughsubclavianvein
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b)IftheCVPislowinthepresenceofalowMAPorcardiacoutput,thenfluidresuscitationisnecessary
c)Canbeusedforgainingvenousaccessinpatientwithpoor
peripheralveins
d)Subclavianveinrouteissafestintermofcomplications
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e)AllCorrectAnswer-A:B:C
Answer-(A)Cathetermaybeplacedthroughsubclavianvein
(B)IftheCVPislowinthepresenceofalowMAPorcardiac
output,thenfluidresuscitationisnecessary(C)Canbeused
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forgainingvenousaccessinpatientwithpoorperipheralveinsUsedformonitoringofCVEadministrationoffluidtotreat
hypovolemia&shock,infusionofcausticdrug&totalParenteral
nutrition,asPirationofemboli,insertionoftranscutaneouspacing
leads&gainingvenousaccessinpatientwithpoorperipheralveins.
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CVPorrightatrialpressure(RAP)ismonitoredusingacatheterinsertedviaeithertheinternaljugularorthesubclavianvein.
TheCVPmayhelpinassessingtheneedforintravascularfluid
replacemant.
181.Trueaboutcareofpolytraumapatient:
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a)CTscanofwholebodycanbedonetoexcludeinjuriesb)Longspinalcordinjurysupportisgivenifspinalcordinjuryis
suspected
c)Triageofinjurieswithcolourcodinglikered,yellow,green&
blackcanbedoneincaseofmasscasualty
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d)Initialfluidmanagementisdoneasearlyaspossiblee)None
CorrectAnswer-A:B:C:D
Answer-(A)CTscanofwholebodycanbedonetoexclude
injuries(B)Longspinalcordinjurysupportisgivenifspinal
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cordinjuryissuspected(C)Triageofinjurieswithcolourcodinglikered,yellow,green&blackcanbedoneincaseof
masscasualty(D)Initialfluidmanagementisdoneasearlyas
possible
BecauseofCT,anincreasingamountofbothblunt&penetrating
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traumahasbeensafelymanagednonoperatively.'Theavailabilityofhighresolutionmultislicescanners,promotingthe
developmentofprotocolsinsomecentersthatcallforearly
intergrationofcompletebody(i.e.head,cervicalmspine,chest,
abdomen&pelvis)CTscanningofselectedtraumapatient.
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Intravenouslineiscriticalforintravenousvolumeresuscitation.Triagesysteminvolvesacolor-codingschemeusingred,yellow,
green,white,andblacktags:Redindicateshighprioritytreatmentor
transfer,yellowsignalsmediumpriority,greenindicatesambulatory
patients&blackfordeadormoribund.
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182.Whichofthefollowingistrueabout
suturetechnique:
a)Subcuticularsutureisusedwherecosmeticappearanceis
important
b)Verticalmattresscausescauseprominentstitchmarkscars
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c)Horizontalmattressisusedforfragileskind)Verticalmattressisusedforfragileskin
e)None
CorrectAnswer-A:B:C
Answer-(A)Subcuticularsutureisusedwherecosmetic
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appearanceisimportant(B)Verticalmattresscausescauseprominentstitchmarkscars(C)Horizontalmattressisusedfor
fragileskin
Thehorizontalmattressstitchisasuturetechniqueusedtoclose
wounds.
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Thismakesitidealforholdingtogetherfragileskin.Verticalmattresssuturearethatitprovidesclosureforbothdeep
andsuperficiallayers,andalsoallowsperfecteversionandvertical
oppositionofthesuperficialskinedges.
Subcuticularsuturetechniqueisusedinskinwhereacosmetic
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appearanceisimportantarrdwheretheskinedgesmaybeapproximatedeasily.
183.Corticosteroidsareusefulinwhichofthe
followingpaediatricsdisease:
a)TBmeningitis
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b)EndobronchialTBc)Spinaventosa
d)Acutetuberculouspericardialeffusion
e)Severemiliarytuberculosis
CorrectAnswer-A:D:E
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Ans.(A)TBmeningitis;b.EndobronchialTB;(D)Acutetuberculouspericardialeffusion;(E)Severemiliary
tuberculosis
Corticosteroidsuseinpaediatrics:
Theseareusefulinthetreatmentofsomechildrenwithtuberculosis
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disease.Corticosteroidsdecreasemortalityratesandlong-termneurologic
sequelaeinsomePatientswithtuberculousmeningitisbyreducing
vasculitis,inflammation,and,ultimately,intracranialpressure.
Shortcoursesofcorticosteroids:Endobronchialtuberculosisthat
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causesrespiratorydistress,localizedemphysema,orsegmentalpulmonarylesions.
Relievesymptomsandconstrictionassociatedwithacute
tuberculouspericardialeffusion.
Dramaticimprovementinsymptomsoftuberculouspleuraleffusion
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andshiftofthemediastinum.Severemiliarytuberculosishavedramaticimprovementwith
corticosteroidtherapyiftheinflammatoryreactionissoseverethat
alveolocapillaryblockispresent.
184.Eosinophiliainchildrenis/arepresentin:
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a)Allergicrhinitisb)Echinococcosis
c)Rheumatoidarthritis
d)Infectiousmononucleosis
e)Wiskott-Aldrichsyndrome
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CorrectAnswer-A:B:C:EAns.(A)Allergicrhinitis;(B)Echinococcosis;(C)Rheumatoid
arthritis;(E)Wiskott-Aldrichsyndrome
Commoncausesofeosinophilia:
Acute:
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Allergicdisorder:Asthma,atopicdermatitis,urticaria.drughypersensitivity,pemphigoid
Parasiticinfestation:Toxocara,ascaris,amebiasis,strongyloidiasis,
filarial,toxoplasmosis,trichinosia,schistosomiasis,malaria,scabies
Fungalinfections:Bronchopulmonaryaspergillosis,coccidiomycosis
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Malignancy:Hodgkinlymphoma,Tcelllymphoma,acutemyelogenousleukaemia,myeloproliferativesyndrome
Hypereosinophilicsyndrome
Chronic:
Allergicdisorders:Pemphigus,dermatitisherpetiformis
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Autoimmunedisorders:Inflammatoryboweldisease,rheumatoidarthritis,Myeloproliferativesyndrome,hypereosinophilicsyndrome
,Loefflersyndrome.
Immunodeficiencysyndromes:HyperIgE,WiskottAldrichsyndrome;
Omennsyndrome;graftversushostreaction
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Miscellaneous:Thrombocytopeniawithabsentradii;renalallograftrejection;Addisondisease
185.Syndromenotassociatedwithchildhood
leukaemia:
a)Edwardsyndrome
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b)Fanconisyndromec)Diamond-Blackanaemia
d)Patausyndrome
e)Kostmannsyndrome
CorrectAnswer-A:D
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Ans.(A)Edwardsyndrome;(D)PatausyndromeRiskfactorsforChildhoodLeukemia
Downsyndrome
Shwachman-Diamondsyndrome
Kostmannsyndrome
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Li-FraumenisyndromeFanconisyndrome
Bloomsyndrome.
Klinefeltersyndrome
Turnersyndrome
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NeurofibromatosistypeIAtaxia-telangiectasia
Severecombinedimmunedeficiency
Paroxysmalnocturnalhaemoglobinuria
186.AchildhasvitaminDdeficiencyrickets.
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Whichofthefollowingis/arecorrectregardingbiochemicalchanges:
a)Alkalinephosphatase
b)serumcalcium
c)parathyroidhormone
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d)phosphatee)25-(OH)D3
CorrectAnswer-A:C
Ans.(A)Alkalinephosphatase;(C)parathyroidhormone
BIOCHEMICALREACTIONS:
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Serumcalcium:normalorlowSerumphosphate:low
Alkalinephosphatase:high
Hypophosphatasiashowslowlevelofalk.phosphatase
PTH:High
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Hypophophatemia187.Trueaboutfetalalcoholsyndrome:
a)Increasedbirthweight
b)Normalfinemotordevelopment
c)Normalsocialskilldevelopment
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d)Facialabnormalitiese)Intelligencesubnormal
CorrectAnswer-D:E
Ans.(D)Facialabnormalities;(E)Intelligencesubnormal
Fetalalcoholsyndrome
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Highlevelofalcoholingestioninpregnancycancausedamagetofetus,knownasfetalalcoholsyndrome.
Theharmfuleffectsmaybeduetoalcoholitselforduetooneofits
breakdownproducts.Someevidencesuggeststhatalcohol
mayimpairplacentaltransferofessentialaminoacidsandzinc,both
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necessaryforproteinsynthesis,whichmayaccountforIUGR.Characteristicsoffetalalcoholsyndromeinclude:?
IUGR(notlargeproportionatebody)
Microcephaly
Congenitalheartdefects(ASD,VSD)
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MentalretardationFacialabnormalitiesShortpalpebralfissures,epicanthalfolds,
maxillaryhypoplasia,micrognathia,lowsetears,smoothphiltrum,
thinsmoothupperlip.
Minorjointanomalies
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Hyperkineticmovements188.Feature(s)ofcongenitalrubella
syndromeinclude:
a)Cataract
b)ASD
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c)Deafnessd)Patentductusarteriosus
e)Alltheabove
CorrectAnswer-A:C:D
Ans.(A)Cataract;(C)Deafness;(D)Patentductusarteriosus
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Congenitalrubellasyndrome(CRS)canoccurinadevelopingfetusofapregnantwomanwhohascontractedrubella,usuallyinthefirst
trimester.
Triadshows:PDA,cataractanddeafnes
Ifinfectionoccurs0?28daysbeforeconception,theinfanthasa
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43%riskofbeingaffected.Infectionin2ndtrimester?maybedeafnessonly.
>6wks?nomajorabnormalities
Diagnosis:Isolationofvirusincellculturesofthroatsamples,urine
orothersecretions.
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DetectionofIgMinsingleserumsampleshortlyafterbirth.PersistenceofRubellaIgGantibodiesserumbeyond1yearor
risingantibodytitreanytimeduringinfancyinanunvaccinatedchild
189.A4.2kgsbabyborntouncontrolled
diabeticmother.Thefollowingcondition
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willnotoccurinthebaby:a)Hypercalcemia
b)Hypoglycemia
c)Hyperbilirubinemia
d)Polycythaemia
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e)CardiovasculardefectsCorrectAnswer-A
Ans.(A)Hypercalcemia
NeonatalComplication:
Hypoglycaemia
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RespiratorydistresssyndromeHyperbilirubinemia
Hypocalcemia
Hypomagnesemia.
Polycythemia
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Cardiomyopathy190.Trueaboutcaputsuccedaneum-
a)Oedematousswellingofscalp
b)Marginsareclearlydefined
c)Swellingresolvespontaneouslyafterfewdaysofbirth
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d)Swellingremainsforthreemonthse)Maximumsizeatbirth
CorrectAnswer-A:C:E
Ans.(A)Oedematousswellingofscalp;(C)Swellingresolve
spontaneouslyafterfewdaysofbirth;(E)Maximumsizeat
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birthCaputsuccedaneumisadiffuse,sometimesecchymoticedematous
swellingofthesofttissuesofthescalpinvolvingtheareaPresenting
duringvertexdelivery.
Itmayextendacrossthemidlineandacrosssuturelines.
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Theedemadisappearswithinthelstfewdaysoflife.Moldingoftheheadandoverridingoftheparietalbonesare
frequentlyassociatedandbecomemoreevidentaftercaputhas
receded;theydisappearduringthelstweeksoflife
Analogousswelling,discoloration,anddistortionofthefaceareseen
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infacePresentations.191.Achildhasfeverwithrednessofcheek.
Thecausativeorganismforthiscondition
is:
a)Herpesvirus
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b)ParvovirusB-19c)Adenovirus
d)Rubella
e)Roseola
CorrectAnswer-B
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Ans.(B)ParvovirusB-19Exanthemainfectiosum:
Thecharacteristicrashfirstappearsaserythematousflushingonthe
faceinaslappedcheekappearance(redcheek).
ThemostcommonmanifestationofparvovirusB19iserythema
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infectiosum,alsoknownasfifthdisease,whichisabenign,self-limitedexanthematousillnessofchildhood.
Itwasthe5thinaclassificationschemeofcommonchildhood
exanthems.
Thepreceding4exanthemsweremeasles,scarletfever,rubella,
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andFilatov-Dukesdisease(anatypicalscarletfever),withroseolainfantumasthe"sixthdisease
192.Trueaboutminimalchangedisease-
a)Hypertensioniscommonlypresent
b)Mostcommoncauseofnephroticsyndromeinadults
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c)Highdosesteroidsresultsinremissioninmostcasesd)Commonlyprogresstochronicrenalfailure
e)Reversiblelossofpodocytefunction
CorrectAnswer-C:E
Answer-(C)Highdosesteroidsresultsinremissioninmost
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cases(E)ReversiblelossofpodocytefunctionMinimalchangedisease:
Alsok/alipoidnephrosa,footprocessdisease&Nildepositdisease
Thediseasesometimesfollowsarespiratoryinfectionorroutine
prophylacticimmunization'
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Theonsetmaybeprecededbyanupperrespiratoryinfection,atopicallergyorimmunisation.
Thediseasecharacteristicallyrespondtosteroidtherapy
Thebenigndisorderischaracterizedbydiffuseeffacementoffoot
processesofvisceralepithelialcell(podocytes).
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mostfrequentcauseofnephroticsyndromeinchildrenThevisceralepithelialchangesarecompletelyreversibleafrer
corticosteroidtherapy,concomitantwithremissionoftheproteinuria.
Thereiscommonlynohypertensionorhematuria.
Theappearanceofacuterenalfailureinadults.
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193.Whichofthefollowingtrueaboutnew-
born&children:
a)Erythropoietinlevelismoreinpretermthanterm
b)Erythropoietingiventopretermonlyinsomespecialcases
c)ErythropoietingiventoPretermcancausecomplication
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d)a&be)Noneoftheabove
CorrectAnswer-B:C
Ans.(B)Erythropoietingiventopretermonlyinsomespecial
cases;(C)ErythropoietingiventoPretermcancause
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complicationMostinfantswithbirthweightof<1KgRBCtransfusions.Akey
reasonwhythenadirhaemoglobinvaluesofprematureinfantsare
lowerthanthoseofterminfantsistheformergroup'srelatively
diminishedplasmaEPOlevelinresponsetoanaemia.
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PreterminfantsexhibitasluggishEPOresponsetofallinghaematocritvalues.
LowplasmaEPOlevelproviderationaletheuseofrecombinant
EPOinthetreatmentofanemiaofprematurity.
ProperdosesofEPOandironeffectivelystimulateneonatal
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erythropoiesis.However,theefficacyofEPOtherapytosubstantiallydiminishtheneedfarRBCtransfusionhasnotbeen
convincinglydemonstrate,particularlyfarsick,extremelypremature
neonates,andrecombinantEPOhasnotbeenwidelyacceptedas
treatmentforanemiaofprematurity.
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lnrarecases,somepreparationsofEPOhavebeenassociatedwiththedevelopmentofanti-EPOantibodiesthatresultinsevereanemia.
194.Inwhichcondition(s),urethralopeningis
neverattipofglanspenis:
a)Epispadias
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b)Hypospadiasc)Urethralstricture
d)Bladderexstrophy
e)Alloftheabove
CorrectAnswer-A:B:D
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Ans.a.Epispadias;b.Hypospadias;d.BladderexstrophyHypospadias
Acongenitaldisorderoftheurethrawheretheurinaryopeningisnot
attheusuallocationontheheadofthepenis.Itisthesecond-most
commonbirthabnormalityofthemalereproductivesystem,affecting
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aboutoneofevery250malesatbirth.EPISPADIAS
Anepispadiasisararetypeofcongenitalmalformationinwhichthe
urethraopensonthedorsum(theupperaspect)ofthepenis.Itis
oftenpartoftheconditiontermedEpispadias-exstrophyofthe
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bladder.Epispadiasisamildformofbladderexstrophy,andinseverecases,exstrophyandepispadiascoexist.
195.Ingestionofwhichofthefollowing
mimicsscurvyinchild:
a)Magnesium
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b)Potassiumiodidec)Arsenic
d)Iron
e)Copper
CorrectAnswer-A
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Ans.a.MagnesiumHypermagnesemiaismostprobableanswerbecauseitalsocause
paralysis
Hypermagnesemiainhibitsacetylcholinereleaseatthe
neuromuscularjunction,producinghypotonia,hyporeflexia,and
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weakness;paralysisoccursathighconcentrations.Theneuromuscular
196.Trueaboutboutonnieredeformity:
a)Flexionofproximalinterphalangealjoint&hyperextensionof
distalinterphalangealjoint
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b)Hyperextensionofproximalinterphalangealjoint&flexionofdistalinterphalangealjoint
c)Flexionatproximalinterphalangeal&extensionat
metacarpophalangealjoint
d)Flexiondeformityoftheproximalinterphalangealjointoccur
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duetotearincentralslipofextensortendone)Mayoccurinrheumatoidarthritis
CorrectAnswer-A:D:E
Ans.a.Flexionofproximalinterphalangealjoint&
hyperextensionofdistalinterphalangealjoint;d.Flexion
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deformityoftheproximalinterphalangealjointoccurduetotearincentralslipofextensortendon;e.Mayoccurin
rheumatoidarthritis
Boutonnieredeformityisadeformedpositionofthefingersortoes,
inwhichthejointnearesttheknuckle(theproximalinterphalangeal
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joint,orPIP)ispermanentlybenttowardthepalmwhilethefarthestjoint(thedistalinterphalangealjoint,orDIP)isbentbackaway(PIP
flexionwithDIPhyperextension).
Itcanbecausedbyacutonthetopofthefinger,whichcansever
thecentralslip(tendon)fromitsattachmenttothebone.Thetear
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lookslikeabuttonhole("boutonni?re"inFrench).Insomecases,theboneactuallycanpopthroughtheopening.
Boutonni?redeformitiesmayalsobecausedbyarthritis.
197.Trueaboutankylosingspondylitis:
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a)Romanuslesionmaybefoundb)Ifleftuntreated,spinefusionmayoccur
c)Predilectionofthejointsoftheaxialskeleton
d)Bonyerosionsdonotoccur
e)all
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CorrectAnswer-A:B:CAns.a.Romanuslesionmaybefound;b.Ifleftuntreated,spine
fusionmayoccur;c.Predilectionofthejointsoftheaxial
skeleton
Ankylosingspondylitis(marie-strumpelldisease)
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Ankylosingspondylitisisachronicprogressiveinflammatorydiseaseofthesacroiliacjointsandtheaxialskeleton.
rototypeofseronegative(absenceofrheumatoidfactor)
spondyloarthropathies.
Inflammatorydisorderofunknowncause.
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Usuallybeginsinthesecondorthirddecadewithamedianageof23,in5%symptomsbeginafter40.
Maletofemaleratiois2-3:1
StrongcorrelationwithHLA-B270-95%ofcase
9sarepositiveforHLA-B27.
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JointsinvolvedinankylosingspondylitisAnkylosingspondylitisprimarilyaffectsaxialskeleton.
Thediseaseusuallybeginsinthesacro-iliacjointsandusually
extendsupwardstoinvolvethelumbar,thoracic,andoftencervical
spine.
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Intheworstcasesthehipsorshouldersarealsoaffected.Hipjointisthemostcommonlyaffectedperipheraljoint.
Rarelyknee(Ebenzar4th/e593)andankle(Apley's9thle67)are
alsoinvolved.Pathology
Enthesitisi.e.inflammationoftheinsertionpointsoftendons,
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ligamentsorjointcapsuleonboneisoneofthehallmarksofthisentityofdisease.
Primarilyaffectsaxial(spinal)skeletonandsacroiliitisisoftenthe
earliestmanifestationofA.S..
Involvementofcostovertebraljointsfrequentlyoccur,leadingto
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diminishedchestexpansion(normal_5cm)Peripheraljointse.g.shoulders,andhipsarealsoinvolvedin1/3rd
patients.
Extraarticularmanifestationslikeacuteanterioruveitis(in5%);rarely
aorticvalvedisease,carditisandpulmonaryfibrosisalsooccur.
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Pathologicalchangesproceedinthreestages?Inflammationwithgranulationtissueformationanderosionof
adjacentbone.
Fibrosisofgranulationtissue
Ossificationofthefibroustissue,leadingtoankylosisofthejoint.
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RadiologicalfeaturesofankylosingspondylitisRadiographicevidenceofsacroiliacjointisthemostconsistent
findinginankylosingspondylitisandiscrucialfordiagnosis.The
findingsare:-
SclerosisofthearticulatingsurfacesofSIjoints
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WideningofthesacroiliacjointspaceBonyankylosisofthesacroiliacjoints
Calcificationofthesacroiliacligamentandsacro-tuberousligaments
Evidenceofenthesopathy-calcificationattheattachmentofthe
muscles,tendonsandligaments,particularlyaroundthepelvisand
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aroundtheheel.X-rayoflumbarspinemayshow:-
Squaringofvertebrae:Thenormalanteriorconcavityofthe
vertebralbodyislostbecauseofcalcificationoftheanterior
longitudinalligament.
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ftLossofthelumbarlordosis.Bridging`osteophytes'(syndesmophytes)
Bamboospineappearance
198.Trueaboutgiantcellsarcoma?
a)Mostcommonagegroupaffectedis20-40year
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b)Proximalfemurismostcommonsiteaffectedc)Pulmonarymetastasisoccurin<3%ofcases
d)Alocallyaggressivetumor
e)Mayinvolvesacrum
CorrectAnswer-A:C:D:E
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Ans.a.Mostcommonagegroupaffectedis20-40year;c.Pulmonarymetastasisoccurin<3%ofcases;d.Alocally
aggressivetumor;e.Mayinvolvesacrum
GCT:
Itperhapsrepresentsthemostaggressivebenigntumorand
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threatensthetruedefinitionofabenigncancerbecausebenignpulmonarymetastasisdevelopinapproximately1%to2%ofgiant
celltumors.
CLINICALFEATURES
Thetumourisseencommonlyintheagegroupof20-40yearsi.e.,
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afterepiphysealfusion.Thebonesaffectedcommonlyarethosearoundthekneei.e.,lower-
endofthefemurandupper-endofthetibia.
Lower-endoftheradiusisanothercommonsite.
Thetumourislocatedattheepiphysis.
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Itoftenreachesalmostuptothejointsurface.Commonpresentingcomplaintsareswellingandvaguepain.
Sometimes,thepatient,unawareofthelesion,presentsforthefirst
timewithapathologicalfracturethroughthelesion.
199.Whichofthefollowingis/aretrueabout
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simplebonecyst:a)Mostcommonlyoccurinadult
b)Commonestsiteistheupperendofthehumerus
c)Cortexmaybethin
d)Causepathologicalfracture
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e)NoriskofrecurrenceafterremovalCorrectAnswer-B:C:D
Ans.b.Commonestsiteistheupperendofthehumerusc.
Cortexmaybethind.Causepathologicalfracture
SimpleBoneCyst(Alsok/aSolitaryorUnicameralCyst)
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ltappearduringchildhood,inmetaphysisinoneofthelongbones&mostcommonlylnproximalhumerusorfemur.
ltisnotatumour,ittendtohealspontaneously.
Itisseldomseeninadult
Thisconditionisusuallydiscoveredafterapathologicalfractureor
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asanincidentalfindingonX-ray.X-rayshowsawelldemarcatedradiolucentareainthemetaphysis
oftenextendinguptothephysealplate;thecortexnaybethinned&
theboneexpanded
Treatmentdependsonwhetherthecystissymptomatic,actively
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growingorinvolvedinafracture200.TrueaboutColle'sfracture:
a)Occuratdistalendofradius,about2cmfromdistalarticular
surface
b)Fracturealsoinvolvesradiocarpaljoint
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c)Fracturealsoinvolvesproximalradioulnarjointd)Causeulnardeviation
e)Commoninwomen
CorrectAnswer-A:E
Ans.a.Occuratdistalendofradius,about2cmfromdistal
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articularsurface;e.CommoninwomenColle'sFracture:
ThisisaFractureatthedistalendoftheradius,atits
corticocancellousjunction(about2cmfromthedistalarticular
surface),inadults,withtypicaldisplacement.
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Itnearlyalwaysresultsfromafallonanout-stretchedhandcItiscommonestfractureinpeopleabovefortyyears
Particularlycommoninwomenbecauseofpostmenopausal
osteoporosis.
Displacement-dorsaldisplacement,dorsaltilt(mostcharacteristic),
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lateraldisplacement,dorsaltilt,supination&impactionoffragmentsComplication:Dinnerforkdeformity&Subluxationoftheinferior
radio-ulnarjoint(distalradiocarpaljoint)
Itismostcommonofallfractureinolderpeople.
201.Forassessingtheinjuryofmeniscusof
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kneejoint,whichofthefollowingtestis/aredone:
a)Apley'stest
b)Lachmanntest
c)McMurray'stest
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d)Thessalyteste)Hamiltonrulertest
CorrectAnswer-A:C:D
Ans.a.Apley'stest;c.McMurray'stest;d.Thessalytest
TestsforMeniscalInjuries?
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Apley'sgrindingtest:formeniscusinjuryMcMurray'stest-Thisclassictestforatornmeniscusisseldomused
nowthatthediagnosiscaneasilybemadebyMRI.Apositivetestis
helpfulbutnotpathognomonicanegativetestdoesnotexcludea
tear.
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Thessalytest:Thistesthasshownahighdiagnosticaccuracyrateatthelevelof95%indetectingmeniscaltears
202.A70yearoldladygotcompression
fractureofL1vertebra.Thereisno
neurologicaldeficittothispatient.What
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advisewillyougiveforthisPatient:a)VitaminDsupplementation
b)DoMRIscan
c)GoforscrewfixationofL1vertebra
d)TotakeDexamethasone
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e)TotakeAlendronateCorrectAnswer-A:E
Ans.a.VitaminDsupplementation;e.TotakeAlendronate
Itisacaseofosteoporoticfractureoflumbarspine
Treatmentcanbedividedintomedical&preventive.
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Medical:Highproteindiet,androgen,estrogen,VitaminD,fluoride,
alendronate,calcitonin,teripratide,denosumab&strontium(bothare
antiresorptiveagent).
Orthopaedictreatment:Exercise&Bracing(ASHbraceorTaylor
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brace)203.Whichofthefollowingindicateshigh
riskchoriocarcinoma:
a)InitialserumhCG>40,000mIU/mL
b)Priorchemotherapyfailure
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c)Followingtermpregnancyd)Metastasislimitedtolungandvagina
e)Longdurationofdisease
CorrectAnswer-A:B:C:E
Ans.a.InitialserumhCG>40,000mIU/mL;b.Prior
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chemotherapyfailure;c.Followingtermpregnancye.Longdurationofdisease
Highriskfactorswhichindicatesthedevelopmentof
choriocarcinomaatthetimeofdiagnosisofahydatidiform
moleare:
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Maternalagemorethan40yearsExcessiveuterineenlargement
SerumhCGlevelsmorethan100,000mIU/ml
Thecaluteincystsgreaterthan6cmindiameter
Toxemia,hyperthyroidismandcoagulopathy
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TrophoblasticembolizationPreviouslytreatedchoriocarcinoma
204.Trueaboutmatureovarianteratoma:
a)Recurrenceiscommonafterexcision
b)ContainhairTeeth,bone&cartilage
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c)Mostlybenignd)Maybebilateral
e)Torsioniscommoncomplication
CorrectAnswer-B:C:D:E
Ans.b.ContainhairTeeth,bone&cartilage;c.Mostlybenign;
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d.Maybebilateral;e.TorsioniscommoncomplicationTeratomaaredividedintothreecategories-
Mature(benign)e.g.dermoid
Immature(essentiallymalignant),e.g.solidteratoma&monodermal
orhighlyspecializede.g.stromaovarii"
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DermoidCyst:Ofallcystictumoursoftheovary5-10%aredermoid.
Itconstitute97%ofallovarianteratoma.
Itcontainssebaceousmaterial&hair&thewallislinedinpartby
squamousepitheliumwhichcontainshairfollicle&sebaceous
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glandsTeeth,bone,cartilage,thyroidtissue&bronchialmucusmembrane
areoftenfoundinthewall
Dermoidcystsareinnocentovariantumoursbutepidermoid
carcinomaoccurinl.7%&sarcomatouschangehavebeen
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describedDermoidsarebilateralin12-15%
Torsionismostcommon(15-20%)&ruptureisanuncommon(1%)
complication
205.Poorprognosticfactorsforheartdisease
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inpregnancyis/are:a)EF30mmHgbyechocardiography
b)Priorcardiacfailure,arrhythmiaortransientischemicattack
c)Aorticvalvearea<1.5cm2
d)ClassIIIandClassIVNYHApatients
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e)PeakLVoutflowtractgradient>30mmHgbyechocardiography
CorrectAnswer-B:C:D:E
Ans.b.Priorcardiacfailure,arrhythmiaortransientischemic
attack;c.Aorticvalvearea<1.5cm2;d.ClassIIIandClassIV
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NYHApatients;e.PeakLVoutflowtractgradient>30mmHgbyechocardiography
Heartdiseasesinwhichpregnancywithpoorprognosis:
Marfansyndrome
Aorticdiseasewithdilatationof>50mmwithbicuspidaorticvalve.
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CoarctationofaortaEisenmengersyndrome
Severefixedobstructivelesions(aorticstenosis,mitralstenosis,
pulmonicstenosis,hypertrophicobstructivecardiomyopathy)
NYHAclass3&4heartdiseases(severesystemicventricular
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dysfunction/CHF)Ejectionfraction<30-40%
Previousperipartumcardiomyopathywithanyresidualimpairmentof
LVfunction
Pulmonaryarterialhypertensionofanycause
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Severecyanosis
206.Trueaboutabdominalhysterectomy:
a)Preferredforprolapseinpostmenopausalwoman
b)Ureterinjurycanbeavoidedbyopeningtheretroperitoneum&
identifyingureter
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c)Postoperativecomplicationsarelessthanvaginalhysterectomyd)Preferredinobesepatient
e)Enableswideexplorationofabdomen
CorrectAnswer-B:E
Ans.b.Ureterinjurycanbeavoidedbyopeningthe
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retroperitoneum&identifyingureter;e.Enableswideexplorationofabdomen
AbdominalHysterectomy(AH)
Requiredforendometriosisandlargefibroids
Resultsingreatestmeanbloodloss
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Injurytoureterisoneofthemostformidablecomplicationofhysterectomy.Mostureteralinjuriescanbeavoidedbyopeningthe
retroperitoneumtodirectlyidentifyingtheureter
Hasthehighestincidenceoffebrilemorbidity
Posteriorwallofabdominalwoundinfection(obviously)
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LongesthospitalisationEnableswideexplorationofabdomen
Andslowesttorecover
Factorssuggestingpreferredroute:
Significantuterineenlargement
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InadequatetransvaginalaccessAdnexalpathology&fixation
ObliterationofpouchofDouglas(endometriosis)
207.TrueaboutCoppercontainingIUCD:
a)Increasedcopperlevelinmilk
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b)Increasedriskofectopicpregnancyc)Increasedbleedinginmenstruationwithpain
d)ProvideprotectionagainstPID
e)Irregularmenses
CorrectAnswer-B:C:E
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Ans.b.Increasedriskofectopicpregnancy;c.Increasedbleedinginmenstruationwithpain;e.Irregularmenses
CoppercontainingIUCDactslocallyinuterus,sonoaffecton
Culevelinmilk
ComplicationofIUCD:
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DysmenorrhoeaMenstrualdysfunction:prolonged&heavybleeding
PID:2-10timesgreateramongIUDusers.
Shouldpregnancyoccurwithadeviceinsitu,thereisriskofectopic
pregnancy(0.02%)
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208.TrueaboutProgestogenonlypill:
a)Itistakendailyonthesametime
b)HigherfailureratethanCOC
c)Fertilityreturntonormalafterdiscontinuationwithoutanydelay
d)Suitedforlactatingwomenlactatingwomen
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e)EctopicpregnancyriskaresameasCOCCorrectAnswer-A:B:D
Ans.a.Itistakendailyonthesametime;b.Higherfailurerate
thanCOC;d.Suitedforlactatingwomenlactatingwomen
ProgestogenonlyPill(POP)/Minipil
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Doesnothavesomemajorsideeffectsofcombinedpills&wellsuitedforlactatingwomen;someprogestogens,infact,increase
milksecretion.
Side-effect:weightgain,irregularmenstrualbleeding,depression,
breastcancer,thromboembolism.
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Advantage:Lactatingwomen,womenover35years,thosewithfocalmigraine,thoseintoleranttoestrogenoroestrogen
contraindicated,diabetic,hypertensive,sicklecellanaemia
Asregardstoreturnoffertility,fasterthanCOCusers
Contraindication:C/ItoPOParepreviousarepreviousectopic
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pregnancy,ovariancyst,breast&genitalcancer,abnormalvaginalbleedingactiveliver&arterialdisease,porphyria,livertumour.
209.Markersofmalignantovariantumour
is/are:
a)Inhibin
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b)Betahumanchorionicgonadotropinc)Alphafetoprotein(AFP)
d)Pax7
e)NB/70K
CorrectAnswer-A:B:C:E
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Ans.a.Inhibin;b.Betahumanchorionicgonadotropin;c.Alphafetoprotein(AFP);e.NB/70K
TumourMarkerinEpithelialOvarianCancer:
CA-125:screeningofepithelialcancerofovary
Macrophagecolonystimulatingfactor(M-CSF)
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OVXIHER-2/Neu
Inhibin
hCG:ovarianchoriocarcinoma
BRCAI&BRCA2(Serouscarcinoma)
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MLHI,MSH2&MSH6(HNPCCassociatedovariancancer)AFP,hCG&CEA-Germcelltumour
Tumourmarker-forembryonalcarcinoma(AFBhCG)
Endodermalsinustumour(AFP)
Choriocarcinoma(hCG)
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Germcelltumor-AFP,hCG,NB/70K,placentalalkalinephosphatase&lactatedehydrogenase.
210.A30-yearladydeliveredababy.Whichof
thefollowingstatement(s)isnottrue
aboutpostpartumcontraception:
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a)OCPisnotgivenbecauseitcancausesvenousthrombosis&haveadverseimpactonmilkproduction
b)POPiscontraceptiveofchoiceforlactatingwomen
c)POPshouldbestartedafter6week
d)LNG-IUDisgoodinlactatingwomen
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e)Fornon-lactatingwomen,ovulationnotoccursuntil12weekCorrectAnswer-E
Ans.e.Fornon-lactatingwomen,ovulationnotoccursuntil12
week
Non-lactating(Postpartum):Contraceptivepracticeshouldbestarted
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after3week.Pillisgood;IUDisequallyeffectivealternativePOPissafeinlactatingwomen&canbestarted6weeksonwards.
LNGissaferthandesogestrel&gestagenfromthrombosispointof
view.
Intramuscular&progestogenimplantcanbeprescribed6weekafter
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deliverIUCDinsertionwithin10minofexpulsionofplacentaorwithin24hr
ofdeliveryisprovedsafe&effective
COCarecontraindicatedinthepuerperium,bothbecauseofits
adverseonmilksecretioninalactatingwomen&increasedriskof
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thromboembolicepisode.COCcanbeprescribedtoanonlactatingwoman3weeksafterdelivery.
211.Trueaboutplacentaaccreta:
a)Incidenceisabout1in2500Pregnancy
b)Incidenceincreasedinlastdecade
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c)Absenceofdeciduabasalisd)Fibrinoidlayerdeficient
e)Morecommoninprimi
CorrectAnswer-B:C:D
Ans.b.Incidenceincreasedinlastdecade;c.Absenceof
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deciduabasalis;d.FibrinoidlayerdeficientInplacentaaccretadeciduabasalisisabsentandplacentalvilliare
attachedtothemyometrium.
Riskfactors:
Patientswithahistoryofuterinesurgeryareatgreatestriskof
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developinganaccreta.Infact,thosewithapriorcesareansectioncarrya25%risk.
placentapreviainthepresenceofauterinescar
Others-prioruterinesurgery,endometrialablation,Asherman
syndrome,uterineleiomyomata,
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212.Trueaboutlowgradesquamous
intraepitheliallesions:
a)Confinedtothelower1/3oftheepitheliumofcervix
b)Allcasesaretreatedbycryotherapy
c)30%progresstoinvasivecancerin10years
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d)ItiskeptunderobservationwithPAPsmearorHPVDNAtestse)Noneoftheabove
CorrectAnswer-A:D
Ans.(A)Confinedtothelower1/3oftheepitheliumofcervix&
(d)ItiskeptunderobservationwithPAPsmearorHPVDNA
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testsCIN-I(Lowgradesquamousintraepitheliallesions):Itisoftenseen
withinflammatoryconditionsliketrichomoniasis&HP&isreversible
followingtreatment.
Theundifferentiatedcellsareconfinedtothelower1/3ofthe
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epithelium.WomenwithCINI,confirmedonbiopsyiskeptunderobservation
withpapsmearfollowupat6monthsorHPVDNAtestsat12
month.Ifbothtestsarenegativeroutinerecall(screening)isdone.If
thesetestsarePersistentthentreatitasHSIL
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213.Trueaboutendometriosis:
a)Laparoscopyisgoldstandardfordiagnosis
b)COCisusedtorelievemildPain
c)GnRHantagonistisusedtorelieveseverepain
d)Canbemanagedexpectantlyinasymptomaticcases
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e)NoneoftheaboveCorrectAnswer-A:B:D
Ans.(A)Laparoscopyisgoldstandardfordiagnosis;(B).COCis
usedtorelievemildPain;(D)Canbemanagedexpectantlyin
asymptomaticcases
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Friendsthisisthemostoftenaskedquestiononendometriosis.Itisworthwhiletoknowafewdetailsonthistopic.
Empiricaltreatment:isforpainpresumedtobedueto
endometriosis.(inabsenceofdefinitivediagnosis)andincludes:--
Counselling
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1. Analgesia2. Nutritionaltherapy
3. ProgestinorOCP's
Analgesia:StudieshaveshownNSAID'sexceptniflumicacidare
moreeffectiveinchronicpainreliefduetoendometriosisor
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dysmenorrheasuspectedtobeduetoendometriosis.Hormonalmedicaltreatment:
Basisofmanagement:Sinceestrogenisknowntostimulatethe
growthofendometriosis,hormonaltherapyhasbeendesignedto
suppressestrogensynthesis,therebyinducingatrophyofectopic
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endometrialimplantsorinterruptingthecycleofstimulationandbleeding.
Indication:--Mildpelvicendometriosisinyoungwomen.?
Treatmentofresidualandrecurrentdiseasefollowingconservative
surgery.
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214.Whichistrueregardingpremenstrual
dysphoricdisorder(PMDD):
a)Severedepressedmood
b)Painceasesatonsetofmenses
c)Depressionmaycontinueaftermenstrualperiod
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d)Antidepressantisgivenfortreatmente)Painceasesaftermensesisover
CorrectAnswer-A:D:E
Ans.(A)Severedepressedmood;(D)Antidepressantisgiven
fortreatment;(E)Painceasesaftermensesisover
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Premenstrualsyndrome(PMS)&Premenstrualdysphoricdisorder(PMDD)
PMSisoftennoticedjustpriortomenstruation(last7-10daysofthe
menstrualcycle)
Itshouldfulfilthefollowingcriteria:
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NorelatedtoanyorganiclesionRegularlyoccurringduringthelutealphaseofeachcycle.
Symptommustbesevereenoughtodisturbthelifestyleofwomen
orsherequiresmedicalhelp.
Symptomfreeperiodduringrestofthecycle
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WhenthesesymptomsdisruptdailyfunctioningtheyaregroupedunderPMDD
Morecommoninwomenaged30-35yr.
Itmayrelatedtochildbirthoradisturbinglifeevent
Therearenopelvicfindingsexceptfeaturesofpelviccongestion.
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5%sufferfromseveresymptomswhichinfluencedailyactivitiesSSRI6NoradrenalineReuptakeinhibitors(SNRI)arefoundtobe
veryeffective
215.Trueaboutdiagnosisofgestational
diabetesmellitus(GDM):
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a)Ifpostprandialsugar>200mg/dl,thenovertdiabetesb)Iffastingsugaris100-120mg/dl,thenovertdiabetes
c)Iffastingsugaris>126mg/dl,thenovertdiabetes
d)IfPostprandialsugaris<140mg/dl,thenIGT
e)Iffastingsugaris110-125mg/dl,thenIGT
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CorrectAnswer-A:C:EAns.(A)Ifpostprandialsugar>200mg/dl,thenovertdiabetes;
(C)Iffastingsugaris>126mg/dl,thenovertdiabetes;(E)If
fastingsugaris110-125mg/dl,thenIGT
OVERTDIABETES:
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Womenwitharandomplasmaglucoselevel>200mg/dL+classicsignsandsymptomssuchaspolydipsia,polyuria,andunexplained
weightlossorafastingglucoseexceeding125mg/dL.
Thediagnosticcutoffvalueforovertdiabetesisafastingplasma
glucoseof126mg/dLorhigher.
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IGT:Criteriafordiagnosisofimpairedglucosetolerance&diabetes
with75gmoralglucose:
ForfastingItsIGTif>100&<126
For2hourpostglucoseitsIGTif>140&<200
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216.Trueaboutprimaryamenorrhoea:
a)InRokitansky-Kuster-Hausersyndrome,FSHisnormal
b)InTurnersyndrome,FSHisdecreased
c)InKallmansyndrome,FSHisincreased
d)InKallmansyndrome,LHisreduced
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e)NoneCorrectAnswer-A:D
Ans.(A)InRokitansky-Kuster-Hausersyndrome,FSHisnormal
and(D)InKallmansyndrome,LHisreduced
ASSOCIATEDCONDITION:
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Turner'ssyndromeCongenitaladrenalhyperplasia(CAH)
Androgeninsensitivitysyndrome
Testicularfeminizationsyndrome
PCOS
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M?llerianagenesis/Utero-vaginalAgenesis/Mayer-Rokitansky-Kuster-Hausersyndrome
DIAGNOSIS:
Buccalsmearandanexaminationofthepolymorphonuclear
leucocytestodetermineifchromatinpositive(probablyXX)or
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chromatinnegative(probablyXOorXY);inothercasesafullchromosomeanalysismaybeneededtoexcludemosaicismand
AIS.
HormonalinvestigationsshouldincludeLH,FSH,oestradioland
testosteronelevels.
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Ultrasoundwillhelpdeterminethepresence,stateandsizeoftheovariesandanyfollicularactivity.
217.Inassistedbreechdelivery,aftercoming
headisdeliveredby:
a)Headdeliveredspontaneously
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b)Pinardmanoeuvrec)ModifiedMauriceau-Smellie-Veittechnique
d)Specialforcepfordeliveringheadisused
e)Praguemanoeuvre
CorrectAnswer-C:D:E
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Ans.(C)ModifiedMauriceau-Smellie-Veittechnique;(D)Specialforcepfordeliveringheadisused;(E)Praguemanoeuvre
DeliveryoftheAftercomingheadofBreech
Variousmethodofsafedeliveryofaftercominghead
Burns-Marshallmethod:Forcepdelivery(Piperforcep,Dasforcep,
--- Content provided by FirstRanker.com ---
NevilleBarne'sforcep)Malarflexion&shouldertraction(modifiedMauriceauSmellie-Veit
technique)
ArrestofafterComingHead
Burns-Marshallmethod
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ModifiedMauriceau-Smellie-VeittechniqueBrachtmaneuver
Wigand-Martinmaneuver
Praguemaneuver
Forcepapplication
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Duhrssen'sincisionCraniotomy
218.Whichofthefollowingis/are
ultrasonographicfindingoftwins:
a)Typeoftwinpregnancycanbediagnosedinfirsttrimester
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b)Lambdasignindicatesdichorionicityc)Tsignsuggestsmonochorionicdiamnioticpregnancy
d)Monozygotictwinsaremorecommon
e)All
CorrectAnswer-A:B:C
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Ans.a.Typeoftwinpregnancycanbediagnosedinfirsttrimester;b.Lambdasignindicatesdichorionicity;c.Tsign
suggestsmonochorionicdiamnioticpregnancy
Sonography
Separategestationalsacs
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Confirmationofdiagnosisasearlyas10thweekofpregnancyVariabilityoffetuses,vanishingtwininsecondtrimester
Chorionicity(twinpeaksignorlamdasign)(10?13weeksof
gestation)
Thickseptumindichorionictwinsatbaseofthemembrane
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withtriangularprojectionisknownaslambdaortwinpeaksignPregnancydating,Fetalanomalies
Fetalgrowthmonitoring,Presentationandlieoffetuses
Twintransfusionlocalization,Amnioticfluidvolume
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219.Whichofthefollowingis/areusedin
psoriasis:
a)Highdoseoraldexamethasone
b)Methotrexate
c)TNF-alphainhibitor
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d)Acitretine)NarrowbandUVB
CorrectAnswer-B:C:D
Ans.B,MethotrexateC,TNF-alphainhibitorD,Acitretin
Ref;.NeenaKhanna5th/54-59;Hartison19th/348;Roxburg
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17th/138-42).Systemiccorticosteroidsareonlyindicatedforgeneralizedpustular
psoriasisinpregnancy(impetigoherpetiformis).
Biologicalresponsemodifiersusedtotreatpsoriasisinclude:Tcell
inhibitors(alefacept,adalimumab,itolizumab).
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Oralglucocorticoidsshouldnotbeusedinthetreatmentofpsoriasisduetothepotentialfordevelopinglife-threateningpustularPsoriasis
whentherapyisdiscontinued.
220.Trueaboutskin:
a)Epidermisishighlyvascular
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b)Melanocyteisderivedfromneuralcrestc)Sebaecousgland-holocrine&absentinpalm
d)Apocrineglandpresentsinaxilla&groin
e)Hiraadenitissuppuritaisinfectionofapocrinegland
CorrectAnswer-B:C:D:E
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Ans:B,MelanocyteisderivedfromneuralcrestC,Sebaecousgland-holocrine&absentinpalmD,Apocrineglandpresentsin
axilla&groin&E,Hiraadenitissuppuritaisinfectionofapocrine
gland
[RefNeenaKhannaSth/119,451-53;Harrison19th/1099;Roxburgh
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tTth/4-11;GeneralAnatomybyBDChaurasia5th/254-60Hidradenitissuppurativa(Synonym-apocrineacne):Axillary
apocrinesweatglandinfection
Sebaceousglandsareholocrineinnature,
Thepigmentcells(melanocyte)oftheskinarederivedfromneural
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crest.Apocrinesweatglandsdrainsdirectlyintohairfolliclesintheaxillae&
groins
Sebaceousglandarelocatedthroughouttheskinexceptonpalms&
soles.
--- Content provided by FirstRanker.com ---
Glandsmadeupofacinioflipidcontainingcells,whichsecretesebumasaholocrinesecretion.
Eccrinesweatglandspresentalloverbody,especiallyonpalms,
soles&inaxillae.Humanhave2-24millioneccrinesweatglands
221.Acneiformeruptionis/aresideeffectof:
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a)Tetracyclineb)Phenytoin
c)Isoniazid
d)Steroid
e)Potassiumiodide
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:D:EAns:B,PhenytoinC,IsoniazidD,Steroid&E,Potassiumiodide
[RefNeenaKhanna5th/125;Harrison19th/356;Harrison14th/425;
Roxbug17th/Ea-55
Drug-inducedAcneiformEruptions:
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Steroids(corticosteroids,androgens,anabolicsteroids),oralantieMEtics,antituberculardrugs,anticonvulsants,halides(iodides.
bromides).
Trunkespeciallyback,facenaybeinvolved.
LesionsaremonomorPhic,consistingofpapulessometimespustule
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222.Cicatricalalopeciais/areseenin:
a)Lichenplanopilaris
b)Discoidlupuserythematous
c)Andogenefflyum
d)Lichenplanus
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e)TrichotillomaniaCorrectAnswer-A:B:D
Ans.A.LichenplanopilarisB,Discoidlupuserythematous&
D,Lichenplanus
[RefNeenaKhanna5th/141;Hanison19th/355;Roxburg17th/270]
--- Content provided by FirstRanker.com ---
Thichotillomania(compulsivehair-pulling)ischaracterizedbynoticeablehairlosscausedbyperson!persistent&recurrentfailure
toresistimpulsetopullouthairs.
Nonscarringalopecia
A.Primarycutaneousdisorders
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l.TelogeneffluviumAndrogeneticalopecia
Alopeciaareata
Tineacapitis
Traumaticalopecia
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B.DrugsC.Systemicdiseases
Systemiclupuserythematosus
Secondarysyphilis
Hypothyroidism
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HyperthyroidismHypopituitarism
Deficienciesofprotein,iron,biotin,andzinc
ll.Scarringalopecia
A.Primarycutaneousdisorders
--- Content provided by FirstRanker.com ---
Cutaneouslupus(chronicdiscoidlesions)Lichenplanus
Centralcentrifugalcicatricialalopecia
Folliculitisdecalvans
Linearscleroderma(morphea)
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B.SystemicdiseasesDiscoidlesionsinthesettingofsystemiclupuserythematosus
Sarcoidosis
Cutaneousmetastases
223.WavelengthofUVBis:
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a)250-280nmb)280-320nm
c)320-400nm
d)400-700nm
e)100-200nm
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CorrectAnswer-BAns.B.280-320nm
Thewavelengthfoundmosteffectiveintreatingskindiseasewith
phototherapyisUVBwithwardengfhof311(+-2nm)(narrowband
UVB,NBUVB).
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Thewavelengthsbetween4(Nand7AOnmarevisibletothehumaneye.
224.Whichofthefollowingstatement(s)
is/aretrueaboutphysicalurticaria
a)Cholinergicurticarialisprecipitatedbycold
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b)Solarurticariaisskinsignoferythropoieticprotoporphyriac)Dermatographismisanexample
d)Coldurticariaisprecipitatedbyemotion
e)None
CorrectAnswer-B:C
--- Content provided by FirstRanker.com ---
Ans.B,Solarurticariaisskinsignoferythropoieticprotoporphyria&C,Dermatographismisanexample
[RefNeenaKhannaSth/189;Harrison19th/i6i;Roxburg17th/74-74
).
PhysicalUrticarias:
--- Content provided by FirstRanker.com ---
Patientswithdermatographismexhibitlinearwhealsfollowingminorpressureorscratchingoftheskin.
Solarurticariacharacteristicallyoccurswithinminutesofsun
exposureandisaskinsignofonesystemicdisease.
Coldurticariaisprecipitatedbyexposuretothecold,andtherefore
--- Content provided by FirstRanker.com ---
exposedareasareusuallyaffected.Cholinergicurticariaisprecipitatedbyheat,exercise,emotionandis
characterizedbysmallwhealswithrelativelylargeflares.
225.Trueabouttracheostomy:
a)Tracheostomytubemayclosedbymucoussecretion&crust
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formationb)Copioussecretionfromtubeisalwaysduepulmonaryinfection
c)X-raychestshouldbedoneforconfirmationineverycase
d)Improperpositioningmayleadtofatalhaemorrhage
e)Displacingoftubeafter2weekismedicalemergency
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:DAns.A,Tracheostomytubemayclosedbymucoussecretion&
crustformationD,Improperpositioningmayleadtofatal
haemorrhage
RefSchwartz9th/59-Iqhttp://www.nurses.com/;pL.Dhingra6th/
--- Content provided by FirstRanker.com ---
3I6-20;AjayYadav5th/48-49;MilloAnaesthaiaZth/232&IBit-72Reintubationinthefirst36hoursaftertracheostomyIson
emergency.
TracheostomytubeshouldnotbedisturbedForthefirst48-72hr,
butthereafterthetubeischangeddaily&cleanedatregularinterval.
--- Content provided by FirstRanker.com ---
RecentstudydonotsupportobtainingaroutineposttracheostomychestX-ray.
Themostdramaticcomplicationistracheo-innominatearteryfistula
(TIAF).
Palpabletubepulsationsuggestimpendingerosionofanartery,
--- Content provided by FirstRanker.com ---
Trachealdeviationmaysignalabdomenbleeding226.Trueaboutdesflurane:
a)Boilingpointis<230C
b)ChemicallyitisFlourinatedmethylethylether
c)Itincreasestheeffectofmusclerelaxant
--- Content provided by FirstRanker.com ---
d)Canbegivensafelytopatientsusceptibletomalignanthyperthermia
e)Morepotentthanisoflurane
CorrectAnswer-A:B:C
Ans.A,Boilingpointis<230CB,ChemicallyitisFlourinated
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methylethyletherC,Itincreasestheeffectofmusclerelaxant[RefAjeyYadavSth/82;MorganSth/170&71)
Desflurane:
Fluorinatedmethylethylether
Boilingpointislessthan20C.
--- Content provided by FirstRanker.com ---
Producesmaximummusclerelaxationamongtheagents.5timeslesspotentthanisoflurane.
Lossofpotency(theMACofdesfluraneis5timeshigherthan
isoflurane)
Immunemediatedhepatitisarareoccurrence.
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hasthelowestblood:gassolubilityofthepotentvolatileanesthetics227.Drug(s)notgivenastransdermalpatch:
a)Fentanyl
b)Diclofenac
c)Morphine
--- Content provided by FirstRanker.com ---
d)Clonidinee)Buprenorphine
CorrectAnswer-B:C
Ans.B,Diclofenac&C,Morphine
[Ref:KDT7th/476
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Transdermalfentanyl(Durogesic)hasbecomeavailableforuseincancer/terminalillness.
Butransskinpatchescontainbuprenorphineanopioidpain
medication.
Clonidinetransdermaldelivery(patch)systemshavebeenavailable
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sincethe1980228.Endotrachealintubationis/areassessed
by:
a)Mallampatigrading
b)ASAphysicalstatusgrading
--- Content provided by FirstRanker.com ---
c)Thyromentaldistanced)Teetharrangement
e)None
CorrectAnswer-A:C:D
Ans.A,MallampatigradingC,Thyromentaldistance&D,Teeth
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arrangementRef:ManipalSurgery4th/1072-73;AjayYadav5th/53'124;Morgan
5th/312-13
ASAphysicalstatusgradingisforgeneralhealthstatusofpatient
(notforassessingintubation)
--- Content provided by FirstRanker.com ---
AssessmentofDifficultIntubation:Mallampatigrading:ItisdonetoassessmouthoPening
Thyromentaldistance(distanceb/wthyroidnotchtomental
prominencewithfullyextendedneck)
Mentohyoiddistance:normal>5cm
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AssessmentofTMjointfunction:Interincisorgap(mouthopening)shouldbeatleast5cm(2fingerbreadth)
NeckMovement
229.Trueaboutphotodynamictherapyof
head&neckcancer:
--- Content provided by FirstRanker.com ---
a)Tumoursensitizerisusedb)Singletoxygenisproducedintumourcell
c)Aftertherapy,radiosensitizermayremainwithtumourcell
d)Hemoporphyringivenasradiosensitizer
e)Photosensitivityisaside-effectaftertherapy
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:C:EAns.A,TumoursensitizerisusedB,Singletoxygenisproduced
intumourcellC,Aftertherapy,radiosensitizermayremainwith
tumourcell&E,Photosensitivityisaside-effectaftertherapy
RefSabiston236;Ballenger\Otorhinolaryngology16th/1324
--- Content provided by FirstRanker.com ---
Photodynamictherapyisanewtreatmentthatallowsdestructionofcancercellsandhasrecentlybeenexpandedtotheeradicationof
metaplasticcells,
Itbeginswiththeadministrationofatargetspecificphotosensitizer
thatiseventuallyconcentratedinthetargettissue.
--- Content provided by FirstRanker.com ---
Thephotosensitizingagentisthenactivatedwithawavelength-specificlightenergysource,whichleadstogenerationoffree
radicalscytotoxictothetargettissue.
Applicationsreportedintheliteratureincludetreatingearly
radiographicallydetected,non-smallcelllungcancer,pancreatic
--- Content provided by FirstRanker.com ---
cancersquamouscellandbasalcellcarcinomaoftheskin,recurrentsuperficialbladdercancer,Chestwallinvolvementfrombreast
cancerandevenchestwallrecurrenceofbreastcancer.
Givensystemically,thesedrugsarepreferentiallytakenupintumor
cells,renderingthemmoresensitivetolight-mediatedcellkilling
--- Content provided by FirstRanker.com ---
thantheirsurroundingtissues.230.Whichofthefollowingcell(s)areless
radiosensitive:
a)Osteocyte
b)Erythroblasts
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c)Chondrocyted)Spermatogonia
e)Lymphocyte
CorrectAnswer-A:C
Ans.A,Osteocyte&C,Chondrocyte
--- Content provided by FirstRanker.com ---
Ref:SumerSethi6th/174;Radiology&ImagingbyThayalanIst/310Mostradiosensitivebloodcell-Lymphocyte
Leastradiosensitivebloodcell-platelet
Mostradiosensitivetissueofbody-Bonemarrow
Leastradiosensitivetissttcofbody-Nervoustissue/brain
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HighRadiosensitive-Lymphoidorgans,bonemarrowblood,testes,ovaries,intestines
LowRadiosensitive-Muscle,brain,spinalcord
231.Allaretrueaboutgammaknifeexcept:
a)Focussedradiationisdeliveredtotumor
--- Content provided by FirstRanker.com ---
b)Provideequalexposuretosurroundinghealthytissuec)Itisatypeofstereotacticsurgery
d)Primarilyusedforsmallbraintumours
e)UsesCo-60assourceofradiation
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans.B.ProvideequalexposuretosurroundinghealthytissueRef:SumerSethi6th/196-97
StereotacticRadiosurgerY:
Goalofstereotacticradiosurgeryistodeliverenoughradiationto
destroyorstopthegtorvfhofalesionpreviouslydefinedby
--- Content provided by FirstRanker.com ---
specializedimagingtechniqueswithoutadverselyaffectingsurroundingtissue.
GammaKnifeRadiosurgery:
Gammakniferadiosurgerykatypeofradiationtherapyusedtotreat
tumorsandotherabnormalitiesinthebrain.
--- Content provided by FirstRanker.com ---
Closeto200tinybearnsofradiationonatumor.Gammaknife:
TheGammaKnifeisanadvancedradiationtreatmentforadultsand
childrenwithsmalltomediumbraintumors,abnormalbloodvessel
formationscalledartetiotenotrsmalformations,epilepsy,trigeminal
--- Content provided by FirstRanker.com ---
neuralgia,anerve.ott-ditiottthatcauseschronicpain,andotherneurologicalconditions.
The'blades"oftheGammaKnife"arethebeamsofgammaradiation
programmedtotargetthelesionatthepointwheretheyintersect.
GammaKnifeenablespatientstoundergoanon-invasiveformof
--- Content provided by FirstRanker.com ---
brainsurgerywithoutsurgicalrisks,alonghospitalstayor
subsequentrehabilitation.
232.Gammaradiationis/areproducedby:
a)Co-60
b)Caesium-137
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c)P-32d)Iridium-192
e)Strontium-90
CorrectAnswer-A:B:D
Ans.A,Co-60B,Caesium-137&D,Iridium-192
--- Content provided by FirstRanker.com ---
[Ref:SumerSethi6th/177,184;Radiology6ImagingbyThayalanlst/17,278
Radiationemitted-Radionuclide
Gammarays-
Radium-226
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Caesium-137Cobalt-60
iridium-192
Gold-198
Samarium-153
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Betarays:Strontium-90
Yttrium-90
Phosphorus-32
Rhenium-188
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Combinationofgammaandbetarays:Rhenium-186
iodine-131
233.PreciseFNACcanbeobtainedbyusing:
a)USG
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b)CTc)EndoscopicUSG
d)MRI
e)Plain-Xray
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.USGRefDahnertRadiologyManual7th/368;Harshmohan7th/902-
l3;Robbins9th/333
RadiologicalimagingAidsforFNAC:
Non-palpablelesionrequiresomeformoflocalizationbyradiological
--- Content provided by FirstRanker.com ---
aidsforFNACtobecarriedout.PlainX-rayfilmsareusuallyadequateforlesionswithinbones&for
somelesionswithinthechest
FNACofchestmayalsobeattemptedunderimageamplified
fluoroscopywhichallowsvisualizationofneedleplacementonthe
--- Content provided by FirstRanker.com ---
televisionmonitorCTguidanceisalsousedforlesionswithinthechestdyAbdomen.
Themostversatileradiologicalaidisultrasonographicguidance
(USG)whichallowdirectvisualizationoFneedleplacementinreal
time&isfreefromradiationhazards.
--- Content provided by FirstRanker.com ---
ItisanextremelyvaluableaidforFNACofthyroidnodules,softtissuemasses,intra-abdominallesionsdtforintrathoracicwhich
aboutthechestwall,butnohelpindeepintrathoraciclesionsorin
bonylesions
PrecisionofUSGandCTscaniscomparableforguidanceinFNAC
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fromthoracicmasslesions
234.TrueaboutsignalcharacteristicofCSF
onMRI&FLAIR:
a)HyperintenseonT1WI
b)HypointenseonTIWI
--- Content provided by FirstRanker.com ---
c)HyperintenseonT2WId)FLAIRreducesCSFsignal
e)FLAIRincreasesCSFsignal
CorrectAnswer-B:C:D
Ans.B,HypointenseonTIWIC,HyperintenseonT2WI&
--- Content provided by FirstRanker.com ---
D,FLAIRreducesCSFsignalRef:SumerSethi6th/15;Radiology6ImagingbyThayalanIst/386-
89]
MRISignalCharacteristic
CSF:HypointenseonTIWI,hyperintenseonT2W1.
--- Content provided by FirstRanker.com ---
Grey/Whitematter:Greymatterisgrey&whitematterswhitenT1W1&relationshipisreversedonT2W1.
Thefluid,-attenuatedinversion-recovery(FLAIR)useslongerT1
(2400ms)&TR(7000ms)toreducethesignallevelofCSF&other
tissuewithlongTlrelaxationconstant.
--- Content provided by FirstRanker.com ---
ItreducesCSFsignal&otherwater-boundanatomyinMRimagebyusingaTldetectedatornearthebouncepointofCSF.
FLAIRMRItechniquesconsistofaninversionrecoverypulsetonull
thesignalfromCSFandalongechotimetoproduceaheavilyT2-
weightedsequence.
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235.ContrastagentwhicharenotusedforCT
scan:
a)Water
b)CO2
c)Bariumcompounds
--- Content provided by FirstRanker.com ---
d)Iodinatedhigh-osmolalitycontrastmediae)Polyethyleneglycol
CorrectAnswer-B
Ans.B.CO2
RefSumerSethi6th/20;Radiology6ImagingbyThayalan159;
--- Content provided by FirstRanker.com ---
DahnertRadiologyManual7th/1147-48Radiocontrastagentsareatypeofmedicalcontrastmediumusedto
improvethevisibilityofinternalbodilystructuresinX-ray-based
imagingtechniquessuchascomputedtomography(CT),
radiography&fluoroscopy.
--- Content provided by FirstRanker.com ---
Radiocontrastagentsaretypicallyiodineorbariumcompounds.Whenanagentimprovesvisibilityofanarea,itiscalled"contrast
enhancing
Gadoliniumisakeycomponentofthecontrastmaterialmostoften
usedinmagneticresonance(MR)exams.
--- Content provided by FirstRanker.com ---
Saline(saltwater)andairarealsousedascontrastmaterialsinimagingexams.
Bariumsulfatecontrastmediacontinuetobethepreferredagents
foropacificationofthegastrointestinaltractforconventional
fluoroscopicexaminations
--- Content provided by FirstRanker.com ---
Thecurrentuseofiodinatedwater-solublecontrastmediaisprimarilylimitedtoselectsituations
Twocommercidwater-solubleiodinatedhigh-osmolalitycontrast
media(HOCMs)specificallydesignedforentericopacificationarein
commonuse.Gastrografinand,Gastroview
--- Content provided by FirstRanker.com ---
236.TrueaboutUSG:
a)Usesmostcommonlyfrequencyof20-50MHzfordiagnostic
ultrasound
b)Workonprincipleofpiezoelectriceffect
c)Ultrasonicwavesonlypenetratesgas,notliquid
--- Content provided by FirstRanker.com ---
d)Gasfilledmicrobubblesareusedascontrastmediae)None
CorrectAnswer-B:D
Ans.B.Workonprincipleofpiezoelectriceffect&D.Gasfilled
microbubblesareusedascontrastmedia
--- Content provided by FirstRanker.com ---
RefSumerSethi6th/9-10;Radiology&ImagingbyThayalan334-40
Contrast-enhancedUltrasound(CEUS):
Applicationofultrasoundcontrastmediumtotraditionalmedical
sonography.
--- Content provided by FirstRanker.com ---
Commerciallyavailablecontrastmediaaregx-filled(airorperfluorocarbon)microbubblesthatareadministeredintravenously
tothesysferniccirculation.
Microbubbleshaveahighdegreeofechogenicity(theabilityofan
objecttoreflectultrasoundwaves)
--- Content provided by FirstRanker.com ---
237.Trueaboutfindingofpleuraleffusion:
a)CTscancandistinguishbetweenapleuraleffusionanda
pleuralempyema
b)USGcandetectverysmallamountoffluid
c)X-ray-homogenousopacitywithobliterationofCPangle
--- Content provided by FirstRanker.com ---
d)MRIcannotdifferentiatemalignantfrombenignpleuraldiseasee)MRIcandifferentiatemalignantfrombenignpleuraldisease
CorrectAnswer-A:B:C:E
Ans.,A,CTscancandistinguishbetweenapleuraleffusionand
apleuralempyemaB,USGcandetectverysmallamountof
--- Content provided by FirstRanker.com ---
fluidCX-ray-homogenousopacitywithobliterationofCPangle&EMRIcandifferentiatemalignantfrombenignpleural
disease
Ref:SumerSethi6th/49;DahnertRadiologyManual7th/446;WHO
ManualofRadiographicInterpretation2002/4I_42
--- Content provided by FirstRanker.com ---
Imagingcriteriaare:Homogenousdensity
Densityindependentportion
Upright:CostophrenicangleinpAview
Lateralyiew:Anteriorandposteriorportionsofgutter
--- Content provided by FirstRanker.com ---
Lateraldecubitusposition:AlongsidesSupineposition:Alongposteriorly,givingdiffusehazinessonthe
sideofeffusion
Silhouetteofupperlimitofdensity
UppermarginhighinaxillainpAview(yellowarrows)
--- Content provided by FirstRanker.com ---
UppermarginhighanteriorlyandposteriorlyinlateralviewThisisjustanillusion
Lossofsilhouette:Intheimagesbelownotelackofidentifiableleft
diaphragmbeforeandvisiblediaphragmafterclearanceoffluid
(Silhouettesignprinciple)
--- Content provided by FirstRanker.com ---
MediastinalshiftPleuralEffusion-X-Ray
First300mlnotvisualizedonPAyiew
Lateraldecubitusviewsmaydetectaslittleas25ml
PleuraleffusiononCTscan:
--- Content provided by FirstRanker.com ---
CTscanningisexcellentatdetectingsmallamountsoffluidandisalsooftenabletoidentifyunderlyingintrathoraciccauses(e.9.
malignantpleuraldepositsorprimarylungneoplasms)aswellas
subdiaphragmaticdiseases1e.g.subdiaphragmaticabscess).
238.Trueaboutschizophrenia:
--- Content provided by FirstRanker.com ---
a)Q-EEGfindingisoneofdiagnosticcriteriaforschizophreniab)Psychosurgerycanbedoneforsomeresistantcases
c)Familyhistoryofschizophreniaispoorprognosis
d)Depressionmaybefound
e)Onsetonlyafter40yearofage
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:DAns.B,Psychosurgerycanbedoneforsomeresistant
casesC,Familyhistoryofschizophreniaispoorprognosis&
D,Depressionmaybefound
[Ref:Ahuja7th/54-68;SynopsisofPsychiatrybyKaplan&Sadock
--- Content provided by FirstRanker.com ---
11th/300-32sSchizophrenia:
Equallyprevalentinmales&females.
Onset-Before25yrs.Peakage-10to20yrs(males)&25to35
yrs.(Females)
--- Content provided by FirstRanker.com ---
EEGrecordingshowsdecreasedalphaactivity,increasedtheta&deltaactivity.
QuantitativeEEG(qEEG)istheanalysisofthedigitizedEEG,andin
laytermsthissometimesisalsocalled'BrainMapping'.
Psychosurgeryisnotroutinelyindicated.
--- Content provided by FirstRanker.com ---
Whenused,thetreatmentofchoiceislimbicleucotomyinsomecaseswithseyere&veryprominentdepression,anxietyor
obsessionalsymptoms
239.Whichofthefollowingis/arenotside-
effectoflithium:
--- Content provided by FirstRanker.com ---
a)Seizureb)Hyporeflexia
c)Nephrogenicdiabetesinsipidus
d)Alopecia
e)Tremor
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns.B.Hyporeflexia
Ref:SynopsisofpsychiatrybyKaplan6Sadock11th/985-88;KDT
7th/449;pharmacologybySatoskar2ith/225
Lithium:
--- Content provided by FirstRanker.com ---
Mildtoxicity:GIdisturbances,drowsiness,muscularweakness,alopecia,allergicreaction,blurredvision,glycosuria,polyuria&
weightgain.
Chronicadministration:goiterformation,hypothyroidism&ECG
changes
--- Content provided by FirstRanker.com ---
Embryotoxicity:Liisembryotoxic&increasestheriskofEbstein'sanomaly
Hyper-reflexia
invalidquestionid
--- Content provided by FirstRanker.com ---