H.Pyloriinfection:
a)Withchronicinfectionureasebreathtestbecomenegative
b)H.Pyloriinfectionremainlifelongifuntreated
c)Endoscopyisdiagnostic
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d)Toxigenicstrainsusuallycausesulcere)None
CorrectAnswer-A
AnswerisA.Withchronicinfectionureasebreathtestbecome
negative(Withchronicinfectionureasebreathtestbecomes
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negative)UreasebreathtestdetectsH.pyloninfectionby'bacterialurease
activity'andremainspositivetillthebacteriahasnotbeeneradicated
withtreatment.Thusureasebreathtestbecomesnegativeonlyafter
eradicationoforganismfollowingtreatmentandnotwithchronic
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Mfection.Despiteasubstantialhumoralantibodyresponseinfectionpersists
indefinitely(persistslifelongifuntreated)
InvasivediagnostictestarebasedonEndoscopic,endoscopyisa
diagnosticapplication.
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H.pyloriproducesseveralvirulencefactorsthathavebeenimplicatedinthedamageofmucosa.
2.TRUEstatementregardinginfective
endocarditisis/are?
a)Jahnwaylesionsareblanchablehemorrhagesonplams&soles
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b)Jahnwaylesionsaretenderc)Jahnwaylesionsarenon-tender
d)Osler'snodesarepalpablenodulesonthepulpoffingers&
toes
e)Osler'snodesarenon-tender
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CorrectAnswer-A:C:DAnswer-A,C,D,Jahnwaylesionsareblanchablehemorrhages
onplams&soles,Jahnwaylesionsarenon-tender,Osler's
nodesarepalpablenodulesonthepulpoffingers&toes
PatientswithIEpresentswithfeaturesoccuringdueto
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microembolizationofthecardiacvegetationtothevarioussmallvessels-
Osler'snodes
Painfultendererythematousnodules.
Seenintheskinofextremitiesusuallyinthepulpofthefinger&
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sometimestoes.Janewaylesions-
Smallflat,redspots,irregularinoutline
Nontender
Seeninpalmsandsoles.
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Theyarehemorrhagicandblanchonpressure3.Causesofpulsuspardoxususinclude?
a)Constrictivepericarditis
b)Cardiactamponade
c)Pulmonaryembolism
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d)Restrictivepericarditise)Emphysema
CorrectAnswer-A:B:C
Answer-A,B,C,Constrictivepericarditis,Cardiac
tamponade,Pulmonaryembolism
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InnormalindividualthesystolicB.P.decreasesbyl0mmHgduringinspiration.
CausesofPulsusparadoxus:
1. Cardiactamponade
2. ChronicconstrictivePericarditis
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3. Emphysema4. Pulmonaryembolism
4.Hypercalcemiawithnormalorincreased
withparatharmoneisassociatedwith?
a)Primaryhyperparathyroidism
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b)VitaminDintoxicationc)Thiazidediuretics
d)Milkalkalisyndrome
e)Familialhypercalciurichypercalcemia
CorrectAnswer-A:E
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Answer-A,E,Primaryhyperparathyroidism,Familialhypercalciurichypercalcemia
90%casesofhypercalcemiaarecausedbymalignancyor
hyperparathyroidism.
Medicationsandfamilialhypocalciurichypercalcemia.
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FamilialcasesofhighPTHlevelsNeonatalseverehyperparathyroidism
Primaryhyperparathyroidism
Secondary&tertiaryhyperparathyroidism
5.WhichofthefollowingisTRUEregarding
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secondheartsound?a)WidesplitincompleteRBB
b)Splittingincreasedininspiration&decreasedinexpiration
c)Spilittingdecreasedininspiration&increasedinexpiration
d)WidespiltincompleteLBB
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e)BestheardatErb'spointCorrectAnswer-A:B:E
Answer-A,B,E,WidesplitincompleteRBB,Splitting
increasedininspiration&decreasedinexpiration,Bestheard
atErb'spoint
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Thechangesintheintrathoracicpressuresduringbreathingaretransmittedtotheheartandgreatvessels.
Theincreasedamountofbloodflowthroughthepulmonaryvalve
producesdelayintheclosureofpulmonaryvalve.
ProlongedP2andEarlyA2resultinginsplittingof2ndheartsound.
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Duringinspiration(A2andP2areseparatedbymorethan30s)Duringexpirationthesplittingdisappears.
Erb'sPointreferstothethirdintercostalspaceontheleftsternal
borderwherebothcomponentsofS2(A2andP2)canbewell
appreciated.
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a)Delayedelectricalactivationoftherightventricle-CompleteRBBB(proximaltype)
b)Prolongedleftventricularmechanicalsystole
CompleteLBBB(peripheraltype)
6.TruestatementregardingEmery-Dreifuss
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musculardystrophyis/are?a)X-linked
b)Suddendeath
c)Conductiondefects
d)Cardiacinvolvementisrare
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e)ContracturesCorrectAnswer-A:B:C:E
Answer-A,B,C,E,X-linked,Suddendeath,Conduction
defects,Contractures
Emery-DreifussMuscularDystrophy(EDMD)isararegenetic
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degenerativediseaseaffectingskeletalmuscleandtheheart.EDMDcanbesubdividedinto3categories-
1. X-linkedEDMD
2. Autosomaldominant
3. Autosomalrecessive
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Clinicalfeatures-TriadofsymptomsstronglysuggestsEDMD-
1. Slowlyprogressivemuscleweaknessandwastingina
scapulohumero-peronealdistribution
2. Earlycontracturesoftheelbow,ankle,andposteriorneck
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3. Cardiacconductiondefects,cardiomyopathyOnsetisusuallyintheteenageyears
Cardiacdisease-
Cardiacdiseasemaypresentwithsuddencardiacdeath.
7.Whichofthefollowingarecorrectabout
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cardiacarrestmanagementaccording2015AmericanHeartAssociationguidelinesfor
Cardiopulmonaryresuscitation(CPR)&
EmergencyCardiovascularCare[ECG]?
a)Ventricularfibrillationrequiressynchronizedcardioversion
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b)Monophasicdefibrillatorsarepreferredoverbiphasicdevicesc)Epinephrine(1mg)istheDOCforcardiacarrest
d)Lidocainemaybeconsideredasanalternativetoamiodarone
forunresponsiveVF/pVT
e)Vasopressinprovidesaddedadvantagewhencombinedwith
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epinephrineCorrectAnswer-C:D
Answer-C,D,Epinephrine(1mg)istheDOCforcardiac
arrest,Lidocainemaybeconsideredasanalternativeto
amiodaroneforunresponsiveVF/pVT
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Defibrillationisusedtotreatcertaintypesofarrhythmias(ventricularfibrillationandpulselessventriculartachycardia)whilesynchronized
cardioversionisusedtotreatothersi.e.unstablenarrowandwide
complextachyarrhythmiassuchasatrialfibrillation.atrialflutterand
ventriculartachycardia.)
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8.Endocrinalcausesofweightgaininclude?
a)Thyrotoxicosis
b)Hypothyroidism
c)Addisondisease
d)Cushingsyndrome
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e)PheochromocytomaCorrectAnswer-B:D
Answer-B,D,Hypothyroidism,Cushingsyndrome
Cushing'ssyndrome
Hypothyroidism
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InsulinomaCraniopharyngioma
9.Hyperprolactinemiaisassociatedwith?
a)Pituitaryadenoma
b)Hyperinsulinemia
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c)Pregnancyd)Lactation
e)Alloftheabove
CorrectAnswer-E
Answer-E.Alloftheabove
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1.PhysiologicPregnancy
Lactation
2.Hypothalamic-pituitarystalkdamage
Craniopharyngioma
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SuprasellarpituitarymassEmptysella
Granulomas
Rathke'scyst
3.Pituitaryhypersection
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Pituitaryadenoma(Prolactinoma)4.Systemicdisorder
Chronicrenalfailure
Hypothyroidism
Cirrhosis
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5.DruginducedDopaminereceptorblockers
Opiates
H2antagonists-Cimetidine,ranitidine
10.Causesofchronicempymainclude?
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a)Drainageofpleuraleffusionb)Inadequateantibiotictreatmentforacuteempyma
c)Inadequateneedleaspirationofacuteempyma
d)Vigorouschestphysiotherapy
e)Rupturedsubphrenicabscess
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CorrectAnswer-A:B:C:EAnswer-A,B,C,E,Drainageofpleuraleffusion,Inadequate
antibiotictreatmentforacuteempyma,Inadequateneedle
aspirationofacuteempyma,Rupturedsubphrenicabscess
1. Parapneumonicempyema-Streptococcuspneumoniaisthemajor
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pathogen.2. Antecedentconditionssuchasmalnutrition,measlesorinfection
withantibiotic-resistantorganismsmayincreasetheriskofsevere
pneumoniaaccompaniedbyempyema.
3. Traumaisanotherimportantcauseofempyemathoracis
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4. CETisthereforeanimportantsequelaofuntreatedorpoorlytreatedempyemathoracis(treatmentincludesantibiotics).
5. Empyemamayincludespreadfromarupturedsubphrenicabscess,
cardiothoracicsurgerysharpforcetraumatothechest,esophageal
ruptureandfollowingdrainageofapleauraleffusion(thoracentesis).
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6. Inthetreatmentofacuteempyema,thechronicconditionisoftenduetoanimpertecilydrainedsinuswithcontinuanceoftheoriginal
empyemacavity.
11.Apatientpresentedwithrecurrent
hemoptysis.Vesselwhichshouldbe
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evaluatedforangiographyinclude?a)Pulmonaryartery
b)Pulmonaryvein
c)Branchialartery
d)Branchialvein
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e)SuperiorvenacavaCorrectAnswer-A:C
Answer-A,C,Pulmonaryartery,Branchialartery
Hemoptysisisdefinedasmassive(massivehemoptysis)whenblood
lossismorethan400-600ml/day.
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Thelunghastwobloodcirculations-A.Systemvessels(Bronchialvessels)
B.Pulmonaryvessels
Mostoftenhemoptysisoriginatesfromabronchialarterysource,
withonly70%ofcasesarisingfromthepulmonaryartery.
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12.Communityacquirednativevalveinfective
endocarditisiscausedby?
a)Streptococcusviridians
b)Staphylocoocusaureus
c)Enterococcus
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d)Candidae)Pseudomonasaerogenosa
CorrectAnswer-A:B:C
Answer-A,B,C,Streptococcusviridians,Staphylocoocus
aureus,Enterococcus
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StaphylococcusaureusfollowedbyStreptococcioftheviridansgroupandcoagulasenegativeStaphylococciarethethreemost
commonorganismsresponsibleforinfectiveendocarditis.
Staphylococcusaureusisthemostcommonoverallcauseof
infectiveendocarditisandisalsothemostcommoncauseinnative
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valveandintravenousdrususers.Coagulase-negativestaphylococci(staphylococcusaureus)isthe
mostcommoncauseinprostheticvalveendocarditis.
Streptococcusviridiansarethemostfrequentlyisolated
microorganismswhentheinfectionisacquiredinacommunity
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setting.Streptococcusmutansisthemostcommoncauseofendocarditis
afterdentalprocedure.
BacteriascausinginfectiveendocarditisarePseudomonasspecies(
i/vdrugabuser),S.bovis,ClostridiumsepticumandHACEK
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organisms.CandidaalbicansisassociatedwithendocarditisinIVdrugusers,
patientswithprostheticvalvesandimmunocompromisedpatients.
13.DiagnosticcriteriaforGullianBarre
syndromeincludes?
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a)Areflexiab)Progressiveweaknessofatleast2limbs
c)Exclusionofvasculitis
d)Albumin-cytologicaldissociation
e)Presenceoffever
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CorrectAnswer-A:B:C:DAnswer-A,B,C,D,Areflexia,Progressiveweaknessofatleast
2limbs,Exclusionofvasculitis,Albumin-cytological
dissociation
DiagnosticcriteriaforGuillainBarresyndrome-
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Required-.Progressiveweaknessof2ormorelimbsduetoneuropathy.
.Areflexia
.Exclusionofothercauses[e.g.vasculitis]
Supportive-
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MildsensoryinvolvementFacialnerveorothercranialnerveinvolvement
TypicalC.S.Fprofile(albumino-cytologicaldissocation)
Absenceoffever
14.Truestatementaboutdiabetic
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ketoacidosisis/are?a)Ph<7.3
b)Ketonemia
c)Absenturinaryketonebodies
d)Glucoselevel>300mg/dl
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e)Bicarbonate<15meq/1CorrectAnswer-A:B:D:E
Answer-A,B,D,E,Ph<7.3,Ketonemia,Glucoselevel>
300mg/dl,Bicarbonate<15meq/1
KetoacidosisisrareintypeIIdiabeteswhereinsulinlevelsalthough
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functionallyinadequatearestillsufficienttopreventketonebodyformation.
ArterialpHis7.25-7.35,7.0-7.24&<7.0inmild,moderate&
severeDKA.
Diabeticketoacidosisischaracterizedby-
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1. Hyperglycemia,2. Ketosis(ketonemia)andketonuria
3. Acidosis
Ketonesareanearlyindicatorofdiabeticketoacidosisandshould
bemeasuredinindividlualwithtypeIdiabetesmellitus.
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Whentheplasmaglucoseisconsistently>16.7mmol/L(300mg/dl).Hyperketonemiaandacidosis-
Hormonesensitivelipaseisinhibitedbyinsulinandactivatedby
counterregulatoryhormones.
TheserumbicarbonatelevelinD.K.A.istypicallydecreasedtoless
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than15meq/l.
15.Inacaseofstrokewhichofthefollowing
heartconditioncanbesuspected?
a)Mitralstenosis
b)Aorticregurgitation
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c)Patentforamenovaled)Recurrentatrialarrhythmias
e)Heartfailure
CorrectAnswer-A:C:D:E
Answer-A,C,D,E,Mitralstenosis,Patentforamen
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ovale,Recurrentatrialarrhythmias,HeartfailureThemostcommoncauseofembolicstrokesareIntra-cardiac
Thrombi.
Malesex
PreviousStrokeorTransientIschemicAttack
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HighbloodpressureHeartdisease-myocardialinfarction(heartattack),mitralstenosis,
heartfailure
Cardiacarrhythmias-especiallyatrialfibrillation,ventricular
tachycardiaandventricularfibrillation.
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SmokingDiabetes
Highbloodcholesterollevels
Sicklecelldisease
Oralcontraceptives
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Excessivealcoholintake16.ComponentsofCushing'striadinclude?
a)Bradycardia
b)Tachycardia
c)Widepulsepressue
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d)Hypotensione)Irregularbreathing
CorrectAnswer-A:C:E
Answer-A,C,E,Bradycardia,Widepulsepressue,Irregular
breathing
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1. Hypertension2. Bradycardia
3. Irregularbreathing
17.Apatientpresentedwithhaematuriawith
acuterenalfailure.Ondoingrenalbiopsy,
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itshowedcresentricglomerulonephritis.ImmunofluoresencefindingsshowedC3&
IgGdeposition.Mostlikelydiagnosis
amongthefollowingis?
a)Membranousglomerulonephritis
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b)Minimalchangediseasec)Monoclonaldepositiondisease
d)Acutepost-infectiousglomerulonephritis
e)Focalsegmentalglomerulosclerosis
CorrectAnswer-D
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Answer-D.Acutepost-infectiousglomerulonephritisPSGNappears1to4weeksafterinfectionofpharynxorskinby
specificnephritogenicstrains(12,4and1)ofgroupAbetahemolytic
streptococci.
ThelesionsarecausedbyTypeIIIhypersensitivityreactionwith
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immunecomplexdepositionandcomplementactivation,causingdecreasedcomplementlevel.
Clinicalfeatures-
Hematuria
Oliguria,Non-selectiveproteinuria
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PSGNcausesacuterenalfailure.Byimmunofluorescencemicroscopy,thereareirregulargranular
depositsofIgG.IgMandC3inthemesangiumandalongthe
basementmembrane(starryskyappearance).
18.WHOconditionedguidelinesfortreatment
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ofMDRTB2016,includes4coredrugsandaddondrugs.Addondrugsare?
a)Bedaquiline
b)Linzolide
c)Delamnaid
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d)Capreomycine)Moxifloxacin
CorrectAnswer-A:C
Answer-A,BedaquilineC,Delamnaid
GroupA=levofloxacin,moxilloxacin.gatifloxacin
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GroupB=amikacin,capreomycin,kanamycin,(streptomycin);GroupC=ethionamide(orprothionamide),cycloserine(or
terizidone),lineznlid,clofazimine;
GroupD2=bedaquiline,delamanid
19.FeaturesofvariantCrutzfeldts-Jakob
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diseaseare-a)Viraldisease
b)Priondisease
c)Occurduetoconsumptionofbeeffromcattlewithbovine
spongiformencephalopathy
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d)Sporadicformisthemostcommone)Prognosisisgood
CorrectAnswer-B:C:D
Answer-B,C,D,Priondisease,Occurduetoconsumptionof
beeffromcattlewithbovinespongiform
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encephalopathy,SporadicformisthemostcommonItisararefataldegenerativediseaseofcentralnervoussystemthat
iscausedbyinfectiousproteincalledprion.
Prionareonlyknowninfectiouspathogens.
TherearefourformsofCJD.Theyaresporadic(80-85%),familial
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inherited(15%);iatrogenic/acquired(1%),newvariant(canbeacquiredbyeatingbeefmeatfromcattleafectedbyadisease
similartoCIDcalledbovinespongiformencephalopathy(BSE)or
commonly"madcow"disease).
Clinicalfeatures-
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MostofthePatientofCJDpresentsasdementiaandmyoclonus.20.Atuberculosispatientwassputum
positiveeven5monthsafterthetreatment
withrifampicin,isoniazid,moxifloxacin&
amikacin.Diagnosisis?
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a)MDRTBb)XDRTB
c)PolydrugresistanceTB
d)Monoresistance
e)Rifampicinresistance
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CorrectAnswer-B:CAnswer-B,XDRTBC,PolydrugresistanceTB
Polydrugresistance:Resistancetomorethanonefirst-lineanti-TB
drug(otherthanINHandrifampicin).
MultidrugresistanceTB(MDRTB)isreferredtoresistanceto
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"isoniazidandrifampicin".Rifampicin-resistanceTB(RR-TB):Itincludesanyresistanceto
rifampicin.whethernonresistance,multidrugresistance,
polydrugresistanceorextensivedrugresistance.
21.Themarkerusedfordeterminingefficacy
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ofhepatitisBvaccinationis?a)HBsAg
b)IgMantiHBcAg
c)IgGantiHBcAg
d)AntiHBsAg
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e)AntiHBeAgCorrectAnswer-D
Answer-D.AntiHBsAg
"PositiveAntiHBsAgdeterminestheefficacyofhepatitisB
vaccination.
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22.Whichofthefollowingfavoursdiagnosis
ofchronicrenalfailureratherthanacute
renalfailure-
a)Anemia
b)Peripheralneuropathy
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c)Smallkidneyd)Renalosteodystrophy
e)Dailyincreaseincreatinine
CorrectAnswer-A:B:C:D
Answer-A,B,C,D,Anemia,Peripheralneuropathy,Small
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kidney,RenalosteodystrophyRenalsonogramshowingsmallkidneys-UsuallyCKD
Oliguria,dailyincreasesinserumcreatinineandBUN-Probably
ARForARFsuperimposedonCKD
Severeaneminarenalosteotdystrophy(hyperphosphatemia,
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hypocalcemia)-PossiblyCKDbutmaybeARFPeripheralneuropathy
23.TRUEstatementregardingscleroderma
is/are?
a)Localizeddiseasemorecommonlyinvolvesfaceand
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extremitiesb)Thereisprogressivepulmonaryfibrosisinmostcases
c)Pulmonaryarterialdiseasewithoutfibrosiscanalsocause
pulmonaryarterialhypertension
d)ACEinhibitorscanbeusedinrenalhypertension
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e)AlloftheaboveCorrectAnswer-E
Answer-E.Alloftheabove
Systemicsclerosischaracterizedbyabnormalaccumulationof
fibroustissueinskinandmultipleorgans.
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Theskinismostcommonlyaffected,buttheGIT,kidney,heart,musclesandlungsalsoareinvolved.
Thediseaseisdividedintotwocategories-
l.Diffusescleroderma-
Thereisrapidprogressionwithearlyvisceralinvolvement.
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2.Limited(localized)scleroderma(morphea)-Skininvolvementisconfnedtofingers,forearmandface.
Pulmonaryfibrosis-Frequent,earlyandsevere
Pulmonaryarterialhypertension-ofteninassociationwithpulmonary
fibrosis.
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Treatment-AmongpatientswithSRC,"ACEinhibitors"arerecommendedrather
thanotherantihypertensiveagents.
24.Featureofhypomagnesemia-
a)Seizures
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b)Athetoidmovementsc)Tremors
d)Bradycardia
e)ImprovementwithCasupplements
CorrectAnswer-A:B:C
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Answer-A,B,C,Seizures,Athetoidmovements,TremorsClinicalfeatures-
1. Hypocalcemia&hypokalemialiketiredness,generalizedweakness,
musclecramps.
2. Cardiovascular:-Arrhythmias,hypertension,tachycardia&cardiac
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arrestincludingtorsadedepointes.3. NeuromuscularandCNS:-increasedirritabilityofthenervous
systemwithtremors,parasthesias,system,spasticity.
4. hypomagnesemiaareathetosis,jerking,nystagmus,andan
extensorplantarreflex,confusion,disorientation,hallucination,&
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depression.5. Severehypomagnesemiamaycausegeneralizedtonic-clonic
seizures.
Hypocalcemiacanbeworsenedbyisolatedtreatmentof
hypomagnaemiawithintravenousmagnesiumsulfatebecause
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sulfatebindsionizedcalcium.25.Featuresofparkinsonismincludeall
except-
a)Intentiontremors
b)Flaccidity
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c)Maskfaced)Rigidity
e)Restingtremors
CorrectAnswer-A:B
Answer-A,B,Intentiontremors,Flaccidity
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FourcardinalfeaturesofPDthatcanbegroupedundertheacronymTRAP-
Tremoratrest,Rigidity,Akinesia(orbradykinesia)andPostural
instability.
26.WhichofthefollowingcanoccurinCOPD
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-a)Hypoxemia
b)Hypercarbia
c)Decreasedgasexchangeinterminalbronchioles
d)Acidosis
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e)HypocarbiaCorrectAnswer-A:B:C:D
Answer-A,B,C,D,Hypoxemia,Hypercarbia,Decreasedgas
exchangeinterminalbronchioles,Acidosis
ThemostcommonsymptomsofCOPDaresputumproduction,
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shortnessofbreath,andaproductivecough.Emphysemaischaracteriredbydestructionofgas-exchangingair
spacesi.e.therespiratorybronchioles,alveolarductsandalveoli.
Lowoxygenlevels(hypoxia)thenhighcarbondioxidelevelinthe
blood(hypercapnia/hypercarbia)
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Thereisadevelopmentofrespiratoryacidosisalocalledhpyercapnicacidosis.
27.Trueregardingporphyriais/are?
a)Hydroxymethylbilanesynthase(HMBS)deficiencycausesacute
intermittentporphyria
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b)Photosensitivityiscommoninacuteintermittentpophyriac)Erythropoeiticporphyriaiscausedbyuroporphyrinogen
decarboxylase(UROD)deficiency
d)Porphyriacutaneatardaischaracterizedbyvesicubullous
lesions
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e)ErytheropeiticporphyriashowsstrongphotosensitivityCorrectAnswer-A:D:E
Answer-A,Hydroxymethylbilanesynthase(HMBS)deficiency
causesacuteintermittentporphyriaD,Porphyriacutaneatarda
ischaracterizedbyvesicubullouslesionsE,Erytheropeitic
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porphyriashowsstrongphotosensitivityThefollowingtablegivessummaryofthemajorfindingsof
porphyrias
Typeand
Enzymeinvolved Majorsymptoms
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classHepatic
porphyrias:
Acute
UroporphyrinogenI Abdominalpain
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intermittentsynthase
Neuropsychateic.
porphyria
Uroporphyrinogen PhotosensitivityAbdominalpain
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porphyriadecarboxylase
Neuropsychateic
cutaneatarda
Coproporphyrin
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PhotosensitivityHereditary
oxidase
Abdominalpain
Protoporphyrinogen
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Protoporphyrinogen
copro-porphyria oxidase
NeuropsychateicPhotosensitivity
Variegate
porphyria
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Erythrohepaticporphyrias:
Uroporphyrinogen
Congenital
Photosensitivity
--- Content provided by FirstRanker.com ---
IIIsynthaseerythrohepatic
porphyrias
Erythrohepatic
porphyrias:
--- Content provided by FirstRanker.com ---
FerrochelatasePhotosensitivity
Protoporphyria
28.Safesttransplantationapproachinliver
disease-
--- Content provided by FirstRanker.com ---
a)Directlytransplantingembryonicstemcellintheliverb)Transplantingdonorhepatocytesintoliver
c)Transplantingmesenchymalstemcellfromadiposetissueto
liver
d)Injectingerythropoietinintobody
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-C
Answer-C.Transplantingmesenchymalstemcellfromadipose
tissuetoliver
Today,autologous(fromthepatient)adiposetissuestemcellarethe
--- Content provided by FirstRanker.com ---
onlystemcellsthathavebeenusedclinicallyfortreatingliverdisease.
Manytrialshaveshownthatpatientswithlivercirrhosishave
benefittedfromautologousadiposetissuederivedmesenchymal
stemcells
--- Content provided by FirstRanker.com ---
29.Trueaboutmultiplesclerosis:
a)Periventricularinvolvementcan'tbeseenbyimagingstudies
b)Mayproducemasslesion
c)Autoimmuneinflammatorycondition
d)OligoclonalbandsmaybepresentinCSF
--- Content provided by FirstRanker.com ---
e)SpinalcordinvolvementmayoccurCorrectAnswer-B:C:D:E
Answer-B,MayproducemasslesionC,Autoimmune
inflammatoryconditionD,Oligoclonalbandsmaybepresentin
CSFE,Spinalcordinvolvementmayoccur
--- Content provided by FirstRanker.com ---
"ElevatedIgGincerebrospinalfluidanddiscretebandsofIgG(oligoclonalbands)arepresentinmanypatients.
ItisanautoimmunediseaseoftheCNScharacterizedbychronic
inflammationdemyelination,gliosis(scarring)andneuronalloss;the
coursecanberelapsing-remittingorprogressive.
--- Content provided by FirstRanker.com ---
30.Whichofthefollowingis/arefeatureof
aorticstenosis-
a)Durationbetweenonsetofsymptomanddeathisgenerally10-
15year
b)Anginaoccursmainlybecauseoffixedcoronarybloodflows
--- Content provided by FirstRanker.com ---
c)Noincreaseincardiacoutputdespiteexercised)Ejectionsystolicmurmurradiatingtoneckmaypresent
e)Leftventricularhypertrophy
CorrectAnswer-C:D:E
Answer-C,D,E,Noincreaseincardiacoutputdespiteexercise
--- Content provided by FirstRanker.com ---
(D)Ejectionsystolicmurmurradiatingtoneckmaypresent(E)Leftventricularhypertrophy
Theaveragetimetodeathaftertheonsetofvarioussymptoms
isasfollows:
anginapectoris,3years
--- Content provided by FirstRanker.com ---
syncope,8yearsdyspnea,2years
congestiveheartfailure,1.5-2years.
Mildormoderatestenosis:
usuallyasymptomatic
--- Content provided by FirstRanker.com ---
ExertionaldyspnoeaAngina
Exertionalsyncope
Suddendeath
Episodesofacutepulmonaryoedema
--- Content provided by FirstRanker.com ---
SignsEjectionsystolicmurmur
Slow-risingcarotidpulse
Thrustingapexbeat(LVpressureoverload)
Narrowpulsepressure
--- Content provided by FirstRanker.com ---
Signsofpulmonaryvenouscongestion(e.g.crepitations)ThemurmnurofASischaracteristicallyanejection(mid)systolic
murmur.
TheLVbecomesincreasinglyhypertrophiedandcoronarybloodflow
maythenbeinadequate.
--- Content provided by FirstRanker.com ---
31.Inwhichofthefollowingcondition,non-
hepaticsurgeryisassociatedwithmost
adverseoutcome:
a)Child-PughscoreB
b)Child-PughscoreC
--- Content provided by FirstRanker.com ---
c)Acuteviralhepatitisd)Acutealcoholichepatitis
e)Chronicviralhepatitis
CorrectAnswer-B
Answer-B.Child-PughscoreC
--- Content provided by FirstRanker.com ---
Table3.Child-PughGradingSystemClass
TotalPoints
A:well-compensateddisease
5-6
--- Content provided by FirstRanker.com ---
B:functionalcompromise-worseningdisease 7-9C:decompensateddisease
10-15
32.Trueaboutorganophosphate-induced
delayedpolyneuropathy:
--- Content provided by FirstRanker.com ---
a)Usuallyoccursafter2-3monthofacuteexposureb)Involvesbothsensoryandmotornerve
c)Steroidisusedfortreatment
d)Incompleterecovery
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:DAnswer-A,B,D,Usuallyoccursafter2-3monthofacute
exposure(B)Involvesbothsensoryandmotornerve
(D)Incompleterecovery
Organophosphate-induceddelayedpolyneuropathy(OPIDN)isa
--- Content provided by FirstRanker.com ---
rarecomplicationthatusuallyoccurs2-3weeksafteracuteexposure.Itisamixedsensory/motorpolyneuropathy.
Recoveryisoftenincomplete
33.Plexiformlesionisprominentinwhich
groupofpulmonaryhypertension-
--- Content provided by FirstRanker.com ---
a)Recurrentthromboembolib)Interstitiallungdiseases
c)FamilialpulmonaryHTN
d)Congenitalheartdiseasewithleft-to-rightshunts
e)Pulmonaryhypertensionassociatedwithhuman
--- Content provided by FirstRanker.com ---
immunodeficiencyCorrectAnswer-C:D:E
Answer-C,FamilialpulmonaryHTND,Congenitalheart
disease...E,Pulmonaryhypertensionassociated...
Plexiformlesionsaremostprominentinidiopathicandfamilial
--- Content provided by FirstRanker.com ---
pulmonaryhypertension,unrepairedcongenitalheartdiseasewithlefttorightshuntsandpulmonaryhypertensionassociatedwith
humanimmunodeficiency.
34.Trueaboutcoagulationdisorders-
a)InDICbothPTandaPTTincrease
--- Content provided by FirstRanker.com ---
b)HemophiliaCisaXlinkedrecessiveconditionc)FactorVIIIcanbegiveninhemophiliaB
d)HemophiliaAisinheritedasX-linkedrecessive
e)None
CorrectAnswer-A:D
--- Content provided by FirstRanker.com ---
Answer-A,InDICbothPTandaPTTincreaseD,HemophiliaAisinheritedasX-linkedrecessive
HemophiliaA:InheritanceisX-linkedrecessive,leadingtoaffected
malesandcarrierfemales.
CommonfindingsincludetheprolongationofPTand/oraPTT;
--- Content provided by FirstRanker.com ---
35.UnlikeChildPughscoring,MELDscore
have:
a)Bedsideassessmenteasy
b)Prothrombintimeexpressedasinternationalnormalizedratio
(INR)
--- Content provided by FirstRanker.com ---
c)Serumcreatinineestimationd)Fourcomponentisusedinscoring
e)Albuminlevelestimation
CorrectAnswer-B:C
Answer-B,Prothrombintimeexpressedasinternational
--- Content provided by FirstRanker.com ---
normalizedratio(INR)and(C)SerumcreatinineestimationThisscoreiscalculatedironthreenoninvasiuevariables:the
prothrombintimeexpressedastheinternationalnormalizedratio
(INR),theserumbilirubinlevel,andtheserumcreatinine
concentration
--- Content provided by FirstRanker.com ---
MELDiscurrentlyusedtoestablishprioritylistingforlivertransplantation.
36.Trueaboutidiopathicthrombocytopenic
purpura:
a)Inchildren,itisusuallyanchronicdisease
--- Content provided by FirstRanker.com ---
b)Self-limitedcourseinacuteformc)Inadults,itisamoreacutedisease
d)Immune-mediateddestructionofplatelets
e)None
CorrectAnswer-B:D
--- Content provided by FirstRanker.com ---
Answer-B,Self-limitedcourseinacuteformD,Immune-mediateddestructionofplatelets
Itisanacquireddisorderinwhichthereisimmune-mediated
destructionofplateletsandpossiblyinhibitionofplateletrelease
fromthemegakaryocyte.
--- Content provided by FirstRanker.com ---
lnchildren,itisusuallyanacutediseasemostcommonlyfollowinganinfection,andwithaselflimitedcourse.
Inadults,itisamorechronicdisease.
37.Finding(s)Inhemolyticanemiais/are:
a)Increaseinconjugatedbilirubin
--- Content provided by FirstRanker.com ---
b)Increaseinunconjugatedbilirubinc)Increaseinurineurobilinogen
d)Increaseinfaecalstercobilinogen
e)Increasedbilirubininurine
CorrectAnswer-B:C:D
--- Content provided by FirstRanker.com ---
Answer-B,IncreaseinunconjugatedbilirubinC,IncreaseinurineurobilinogenD,Increaseinfaecalstercobilinogen
DecreaseHaemoglobin
IncreasedUnconjugatedbilirubin
Increaselactatedehydrogenase
--- Content provided by FirstRanker.com ---
IncreaseReticulocytesIncreaseurobilinogen
38.Riskfactorsassociatedwithhealthcare
associatedpneumonia(HCAP)-
a)Acutecarehospitalizationforatleast2daysinthepreceding
--- Content provided by FirstRanker.com ---
90daysb)Homeinfusiontherapy
c)Immunosuppressivediseaseorimmunosuppressivetherapy
d)Antibiotictherapyinthepreceding90days
e)Hospitalizationfor>48h
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:C:D:EAnswer-(A)Acutecarehospitalizationforatleast2daysinthe
preceding90days(B)Homeinfusiontherapy
(C)Immunosuppressivediseaseorimmunosuppressive
therapy(D)Antibiotictherapyinthepreceding90days
--- Content provided by FirstRanker.com ---
(E)Hospitalizationfor>48hAcutecarehospitalizationforatleast2daysinthepreceding90
days
Residenceinanursinghomeorextendedcarefacility
Homeinfusiontherapy,includingchemotherapy,withinthepast30
--- Content provided by FirstRanker.com ---
daysLong-termdialysiswithinthepast30days
Homewoundcare
Familymemberwithaninfectioninvolvingamultipledrugresistant
pathogen
--- Content provided by FirstRanker.com ---
Immunosuppressivediseaseorimmunosuppressivetherapy39.Whichofthefollowingis/areincludedin
managementofacuteischemicstroke-
a)UnfractionedHeparin
b)LMWH
--- Content provided by FirstRanker.com ---
c)Streptokinased)Aspirin
e)Recombinanttissueplasminogenactivator(rt-PA)
CorrectAnswer-D:E
Answer-D,AspirinE,Recombinanttissueplasminogenactivator
--- Content provided by FirstRanker.com ---
(rt-PA)RecombinantTissueplasminogenActivator(RtPA)istheonly
thrombolyticagentthatisapprovedforthetreatmentofacute
ischaemicstroke.
Useofaspirinwithin48hofstrokeonsetreducedbothstroke
--- Content provided by FirstRanker.com ---
recurrenceriskandmortalitymininally.40.PositiveECGsign(s)ofischemiainTread
milltestis/are-
a)UpslopingdepressionoftheSTsegmentmVbelowbaseline
b)DownslopingdepressionoftheSTsegment>0.1mVbelow
--- Content provided by FirstRanker.com ---
baselinec)JunctionalST-segment
d)Tachycardia
e)Ventricularprematurebeats
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B.DownslopingdepressionoftheSTsegment>0.1mVbelowbaseline
ThcischemiaST:-segmentresponegenerallyisdefinedasflator
downslopingdepressionoftheSTsegmant>O.1mV
belowbaseline(i.e.,thaPRsegnent)andlastinglongerthanO.08s.
--- Content provided by FirstRanker.com ---
UpslopingorjunctionalST-segmentchangesarenotconsideredcharacteristicofischemiaanddonotconstituteapositivetest.
41.Allarefeature(s)ofsarcoidosisexcept:
a)HighCD4:CD8ratio
b)Hypercalciuriaandhypercalcimiamaybepresent
--- Content provided by FirstRanker.com ---
c)fSerumlevelsofangiotensin-convertingenzyme(ACE)d)Schaumanandasteroidbodiesarepathognomic
e)None
CorrectAnswer-D
Answer-D.Schaumanandasteroidbodiesarepathognomic
--- Content provided by FirstRanker.com ---
Hypercalcemiaand/orHypercalciuriaoccursinabout10%ofsarcoidosispatients.
Bronchoalveolarlavagefluidlnsarcoidosisisusuallycharacterized
byanincreaseinlymphocyteandahighCD4/CD8ratio.
"Schaumanandasteroidbodies-althoughcharacteristic,thesecells
--- Content provided by FirstRanker.com ---
arenotpathognomicofsarcoidosisbecausetheymaybeencounteredinothergranulomatousdiseases.
Thegranulomaisthepathologichallmarkofsarcoidosis.
"Serumlevelsofanglotensin-convertingenzyme(ACE)canbe
helpfulinthediagnoslsofsarcoidosis.
--- Content provided by FirstRanker.com ---
42.Trueaboutatrialflutter:
a)Narrow-complextachycardiaofupto150/min
b)Pwaveabsent
c)Associatedwith2:1,3:1or4:1AVblock
d)Besttherapyiscatheterablation
--- Content provided by FirstRanker.com ---
e)Occurduetomacrore-entrycircuitwithintherightatriumCorrectAnswer-A:C:D:E
Answer-A,Narrow-complex...C,Associatedwith...D,Best
therapy...E,Occurduetomacrore-entry...
Atrialflutterischaracterisedbyalarge(macro)re-entrycircuit,
--- Content provided by FirstRanker.com ---
usuallywithintherightatriumencirclingthetricuspidannulus.Theatrialrateisapproximately300/min,andisusuallyassociated
with2:7,3:1or4:1AVblock
Atrialfluttershouldalwaysbesuspectedwhenthereisanarrow-
complextachycardiaof150/min.
--- Content provided by FirstRanker.com ---
Forrecurrentepisodesofcommonatrialflutter,catheterablationofthecavotricuspidisthmusabolishesthearrhythmiainover90%of
patient.
43.Transudativepleuraleffusionoccursin:
a)Urinothorax
--- Content provided by FirstRanker.com ---
b)Dresslersyndromec)Nephroticsyndrome
d)Myxedema
e)Congestiveheartfailure
CorrectAnswer-A:C:D:E
--- Content provided by FirstRanker.com ---
Answer-(A)Urinothorax(C)Nephroticsyndrome(D)Myxedema(E)Congestiveheartfailure
Congestiveheartfailure
Cirrhosis
Pulmonaryembolization
--- Content provided by FirstRanker.com ---
NephroticsyndromePeritonealdialysis
Superiorvenacavaobstruction
Myxedema
Urinothorax
--- Content provided by FirstRanker.com ---
44.Trueaboutprimarysclerosing
cholangitis:
a)Involvesonlyintrahepaticbileduct,notextrahepaticbileduct
b)AssociatedwithInflammatoryboweldisease
c)Causesmacronodularcirrhosis
--- Content provided by FirstRanker.com ---
d)Periductalfibrosisofsmallerbileductse)None
CorrectAnswer-B:D
Answer-(B)AssociatedwithInflammatoryboweldisease
(D)Periductalfibrosisofsmallerbileducts
--- Content provided by FirstRanker.com ---
PSCischaracterizedbylnflammationandobliterativefibrosisoflntrahepaticandextrahepaticbileductswlthdilationofpreserved
segments.
Inflammatoryboweldisease,particularlyulcerativecolitis,coexists
inapproximately70%ofindividualswithPSC.
--- Content provided by FirstRanker.com ---
Primarysclerosingcholangltiscausesmicronodularcirrhosis.Followingchangesareseen-fibrosingcholangitis,periductalfibrosis,
dilationofinterveningbileductsandcholestatiswithfullblown
pictureofbiliarycirrhosis"
45.Trueabout4thheartsound:
--- Content provided by FirstRanker.com ---
a)Lowpitchb)Presentduringearlydiastole
c)Absentinatrialfibrillation
d)Producedintheventricleduringventricularfillingphase
e)Presentinsevereleftventricularhypertrophy
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:D:EAnswer-A,LowpitchC,AbsentinatrialfibrillationD,Produced
intheventricleduringventricularfillingphaseE,Presentin
severeleftventricularhypertrophy
Fourthheartsounds(S4):
--- Content provided by FirstRanker.com ---
LowpitchedPre-systolicsoundproducedintheventricleduringventricularfilling
Producedduringsecondrapidfillingphase(beforeS1)
Bestheardwithbellofstethoscope.
Theright-sidedS4ispresentinpatientswithrightventricular
--- Content provided by FirstRanker.com ---
hypertrophysecondarytoeitherpulmonicstenosisorpulmonaryhypertension.
46.Photosensitivityis/arenotseenin-
a)Acuteintermittentporphyria
b)Variegateporphyria
--- Content provided by FirstRanker.com ---
c)Porphyriacutaneatardad)Congenitalerythropoieticporphyria
e)Erythropoieticprotoporphyria
CorrectAnswer-B
Answer-B.Variegateporphyria
--- Content provided by FirstRanker.com ---
Ferrochelatase-erythropoieticprotoporphyriaProtoporphyrinogenoxidase-Variegateporphyria
PBGdeaminase-acuteintemittent
Uroporphyrinogensynthetase-Congenitalerythropoieticporphyria
Uroporphyrinogendecarboxylase-porphyriacutaneatarda
--- Content provided by FirstRanker.com ---
47.Trueaboutinsulinoma:
a)Encapsulated
b)Mostlymultiple
c)AssociatedwithMEN-I
d)Enucleationisthetreatmentofchoiceforbenigntumour
--- Content provided by FirstRanker.com ---
e)Histologysimilartonormal(3-cellsCorrectAnswer-A:C:D:E
Answer-(A)Encapsulated(C)AssociatedwithMEN-I
(D)Enucleationisthetreatmentofchoiceforbenigntumour
(E)Histologysimilartonormal(3-cells
--- Content provided by FirstRanker.com ---
Insulinomaisusuallysolitaryandwellencapsulatedtumour10%aremultiple(alwaysassociatedwithMEN1)and10%are
malignant.
Microscopically,thetumouriscomposedofcordsandsheetofwell-
dffirentiatedBeta-cellswhichdonotdifferfromnormalcells.
--- Content provided by FirstRanker.com ---
Enucleationisthetreatmentofchoiceforbenigninsulinomas.48.RespiratoryfailuretypeIIis/areseenin-
a)Myastheniagravis
b)AcuteexacerbationinCOPD
c)AcutesevereAsthma
--- Content provided by FirstRanker.com ---
d)Pulmonaryedemae)Pulmonaryembolism
CorrectAnswer-A:B:C
Answer-A,MyastheniagravisB,Acuteexacerbationin
COPDC,AcutesevereAsthma
--- Content provided by FirstRanker.com ---
AcutesevereasthmaAcuteexacerbationofCOPD
Upperairwayobstruction
Acuteneuropathies/paralysis
Narcoticdrugs
--- Content provided by FirstRanker.com ---
PrimaryalveolarhypoventilationFlailchestinjury
49.AllaretrueCeliacdiseaseexcept-
a)Antiendomysialantibodyispresent
b)Oat,ryeandbarleycanbesafelygiven
--- Content provided by FirstRanker.com ---
c)Associatedwithdermatitisherpetiformisd)Associatedwithgliadin
e)Noriskfordevelopmentofcancer
CorrectAnswer-B:E
Answer-B,Oat,ryeandbarleycanbesafelygivenE,Noriskfor
--- Content provided by FirstRanker.com ---
developmentofcancerItisaninflammatorydisorderofthesmallboweloccurringin
geneticallysusceptibleindividuals,whichresultsfrom
intolerancetowheatglutenandsimilarproteinsfoundinrye,barley
and,toalesserextent,oats.
--- Content provided by FirstRanker.com ---
Serumantibodies-IgAantigliadin,antiendomysial,andanti-tTGantibodies-arepresent.
Celiacdiseaseisassociatedwithdermatitisherpetiformis(DH).
Themostimportantcomplicationofceliacdlseaseisthe
developmentofcancer.
--- Content provided by FirstRanker.com ---
50.TrueaboutHypersensitivitypneumonitis:
a)Occursduetoinorganicantigen
b)IncreasedCD8+Tcellsinbronchoalveolarlavage
c)Manifestsmainlyasanoccupationalandenvironmentdisease
d)Forsevereacutecases,oralsteroidsisgivenfor3-4weeks
--- Content provided by FirstRanker.com ---
e)InterstitialinflammatoryinfiltrateisseeninlungCorrectAnswer-B:C:D:E
Answer-(B)IncreasedCD8+Tcellsinbronchoalveolarlavage
(C)Manifestsmainlyasanoccupationalandenvironment
disease(D)Forsevereacutecases,oralsteroidsisgivenfor3-
--- Content provided by FirstRanker.com ---
4weeks(E)InterstitialinflammatoryinfiltrateisseeninlungItismanifestedmainlyasanoccupationaldisease,inwhich
exposuretoinhaledorganicagentsleadstoacuteandeventually
chronicpulmonarydisease.
Bronchoalveolarlavagespecimensalsoconsistentlydemonstrate
--- Content provided by FirstRanker.com ---
increasednumbersofbothCD4+andCDB+Tlymphocytes.HistologyshowsevidenceofaninterstitialinflammatoryinfiItratein
thelung.
Inacutecases,prednisoloneshouldbegivenfor3-4weeks,starting
withanoraldoseof40mgperday.
--- Content provided by FirstRanker.com ---
51.Tubularproteinuriais/areseenin:
a)Multiplemyeloma
b)Wilsondisease
c)Leadpoisoning
d)Fanconisyndrome
--- Content provided by FirstRanker.com ---
e)NoneCorrectAnswer-B:C:D
Answer-B,WilsondiseaseC,LeadpoisoningD,Fanconi
syndrome
Tubularproteinuriaoccursasaresultoffaultyreabsorptionof
--- Content provided by FirstRanker.com ---
normallyfilteredproteinsintheproximaltubule,suchasBeta2-microglobulinandimmunoglobulinlightchains.
Causesincludeacutetubularnecrosis,toxiinjury(lead,
aminoglycosides),drug-inducedinterstitialnephritis,andhereditary
metabolicdisorders(WisondiseaseandFanconisyndrome).
--- Content provided by FirstRanker.com ---
52.AllaretrueaboutSjOgren'ssyndrome
execept-
a)Bilateralparotidglandenlargement
b)Parotidglandenlargementmaybepainful
c)Xerostomiamaypresent
--- Content provided by FirstRanker.com ---
d)Progressiontolymphomae)Malesareaffectedmorethanfemales
CorrectAnswer-E
Answer-E.Malesareaffectedmorethanfemales
Sjogren'ssyndromeisanautoimmunedisorderassociatedwith
--- Content provided by FirstRanker.com ---
parotidglands.Itaffectswomenmore(40-60years)
ClinicalFeatures-
Dryeyes(keratoconjuctivitissicca)
Xerostomia
--- Content provided by FirstRanker.com ---
VaginaldrynessRaynaud'sphenomenon
Lymphoma
Splenomegaly
53.Highaniongapacidosisis/areassociate
--- Content provided by FirstRanker.com ---
a)Lacticacidosisb)Ethyleneglycolpoisoning
c)Aspirinoverdose
d)Diarrhea
e)Renaltubularacidosis
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:CAnswer-A,LacticacidosisB,Ethyleneglycol
poisoningC,Aspirinoverdose
Lacticacidosis
Ketoacidosis(diabetic,alcoholic,starvation)
--- Content provided by FirstRanker.com ---
Toxins(ethyleneglycol,methanol,glycol,pyroglutamicacid)Renalfailure(acuteandchronic)
54.Proximalrenaltubularacidosis(RTA)
is/areassociatedwith:
a)Fanconianemia
--- Content provided by FirstRanker.com ---
b)Multiplemyelomac)Leadpoisoning
d)Sjogren'ssyndrome
e)SLE
CorrectAnswer-A:B:C
--- Content provided by FirstRanker.com ---
Answer-A,FanconianemiaB,MultiplemyelomaC,Multiplemyeloma
lnheritedFanconi'ssyndromeCystinosis.
HeavymetaltoxicitYLead,cadmiumandmercuryPoisoning
Wilson'sdisease
--- Content provided by FirstRanker.com ---
DrugsCarbonicanhydraseInhibitorslfosfamideParaproteinaemiaMyeloma
Amyloidosis
Hyperparathyroidism
55.FeatureofFelty'ssyndromeis/are-
--- Content provided by FirstRanker.com ---
a)Seropositiveforrheumatoidfactorb)Splenomegaly
c)Longstandingrheumatoidarthritis
d)Neutrophilia
e)Keratoconjunctivitissicca
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:C:EAnswer-(A)Seropositiveforrheumatoidfactor
(B)Splenomegaly(C)Longstandingrheumatoidarthritis
(E)Keratoconjunctivitissicca
Feltysyndromeisapotentiallyseriousconditionthatisassociated
--- Content provided by FirstRanker.com ---
withrheumatoidarthritis.Clinicalfeatures-
Lymphadenopathy
Vasculitis,
legulcers
--- Content provided by FirstRanker.com ---
SplenomegalyWeightloss
Recurrentinfections
Skinpigments
Keratoconjunctivitissicca
--- Content provided by FirstRanker.com ---
SeropositiveforRF56.TrueaboutSevereCombined
Immunodeficiency(SCID):
a)Adenosinedeaminaseenzymemaybegivenfortreatment
b)Haematopoieticstemcelltransplant(HSCT)iscurative
--- Content provided by FirstRanker.com ---
c)MostcommoninheritanceisXlinkedrecessiveandautosomalrecessive
d)Lymphocytosisispresentinmostcases
e)Increasedriskofinfectionbypneumocystisjiroveci
CorrectAnswer-A:B:C:E
--- Content provided by FirstRanker.com ---
Answer-A,Adenosinedeaminaseenzyme...B,Haematopoieticstem...C,Mostcommoninheritance...E,Increasedriskof
infection...
Themostcommonform,accountingfor5o%to6o%ofcases,X-
linkedandinheritedintheautosomalrecessivemode.
--- Content provided by FirstRanker.com ---
Adenosinedeaminasedeficiency:Thisthefirstimmunodeficiencydiseaseassociatedwithanenzymedeficiency.
PersonswithSCIDhavesevereinfectionsbyCandidaalbicans,
Pneumocystisjiroveci,Pseudomonas,cytomegalovirus,varicella.
HSCtransplantationisthemainstayoftreatment.
--- Content provided by FirstRanker.com ---
57.MalignanciesassociatedwithAIDS-
a)PrimaryCNSlymphoma
b)Cervicalcancer
c)Kaposisarcoma
d)Ovariancancer
--- Content provided by FirstRanker.com ---
e)EndometrialcancerCorrectAnswer-A:B:C:D
Answer-(A)PrimaryCNSlymphoma(B)Cervicalcancer
(C)Kaposisarcoma(D)Ovariancancer
TheneoplasticdiseasesconsideredtobeAIDSdefiningconditions
--- Content provided by FirstRanker.com ---
areKaposi'ssarcomanon-Hodgkin'slymphoma,andinvasivecervicalcarcinoma,ovariancarcinoma.
58.Malignancyassociatedwith
hypercalcemia:
a)Breastcancer
--- Content provided by FirstRanker.com ---
b)Smallcelllungcancerc)Non-smalllungcancer
d)Prostatecancer
e)Multiplemyeloma
CorrectAnswer-A:C:D:E
--- Content provided by FirstRanker.com ---
Answer-A,BreastcancerC,Non-smalllungcancerD,ProstatecancerE,Multiplemyeloma
Lungcarcinoma,breastcarcinoma,andmultlplemyelomaaccount
formorethan50%ofallcasesofmalignancy-associated
hypercalcemia.
--- Content provided by FirstRanker.com ---
Gastrointestinaltumarsandprostatecarcinomaarelesscommoncausesofhypercalcemia.
59.Restrictivelungdiseasediffersfrom
obstructivelungdiseaseby
a)DecreasedFVC
--- Content provided by FirstRanker.com ---
b)DecreasedFEV1c)DecreasedTLC
d)DecreasedRV
e)DecreasedFEV1/FVC
CorrectAnswer-A:B:C:D
--- Content provided by FirstRanker.com ---
Answer-A,DecreasedFVCB,DecreasedFEV1C,DecreasedTLCD,DecreasedRV
PETResultforRestrictivelungdisease-
FEV1-Decreased
FVC-Decreased
--- Content provided by FirstRanker.com ---
FEV1/FVC-NormalorincreasedTLC-Decreased
DLCO-Decreasedinintrinsicrestrictivelungdisease
60.Fifthcranialnervepalsycauses
a)Weaknessofopeningofmouth
--- Content provided by FirstRanker.com ---
b)Weaknessofclosureofmouthc)Lossofcornealreflex
d)Lossoflacrimalreflex
e)Lossoftastesensationfromanterior2/3oftongue
CorrectAnswer-A:B:C:D
--- Content provided by FirstRanker.com ---
Answer-A,WeaknessofopeningofmouthB,WeaknessofclosureofmouthC,LossofcornealreflexD,Lossoflacrimal
reflex
Openingofmouthiscausedbybothlateralpterygoid-->Supplied
bymandibularbranchoftrigeminalnerve.
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1. Onesideinjurytotrigeminalnervecausesweaknessofopeningofmouthanddeviationofjawtoaffectedside.
2. Bothsidepalsycausesweaknessofopeningofmouth.
Cornealreflexandlacrimalreflexpathwayinvolvetrigeminalnerve.
Cornealreflex-Afferentlimbisformedbyophthalmicnerveand
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efferentlimbisfacialnerve.61.Patientcamewithcomplaintsof
Polydipsia,hypercalciurea,
nephrolithiasis,metabolicalkalosis.
Possiblecauseis
--- Content provided by FirstRanker.com ---
a)Bartterssyndromeb)Gittlemanssyndrome
c)Addisonsdisease
d)Chronicdiureticuse
e)None
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CorrectAnswer-AAnswer-A.Bartterssyndrome
Barttersyndromeisanautosomalrecessivedisordercausedby
mutationingenecodingforbasolateralchloridechannel(ClC-kb).
Thereislossofsodium,chloride,potassiumandcalciuminurine.
--- Content provided by FirstRanker.com ---
Themajorclinicalfindingsarehyponatremia,hypokalemia,polyurea,polydipsia,metabolicalkalosis,normaltolow
BP,hypomagnesemia(onlyinsomepatients),hypochloremia,
hypercalciuria(causingnephrocalcinosis),andgrowth
62.Allofthefollowingstatementsabout
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Neurofibromatosisaretrue,Except:a)AutosomalRecessiveInheritance
b)Cutaneousneurofibromas
c)Cataract
d)Scoliosis
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e)NoneCorrectAnswer-A
Answer-A.AutosomalRecessiveInheritance
Neurofibromatosisisinheritedasanautosomaldominantcondition.
PeripheralNeurofibromatosis(VonRecklinghausen'ssyndrome)
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Mostprevalenttype(90%)DiagnosticCriteriaforNFI
Diagnosedwhenanytwoofthefollowingarepresent
1. Sixmorecafe-au-loitmaculesover5mmingreatestdiameterin
prepubertalindividualsandover15mmingreatestdiameterinpost-
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pubertalindividuals.2. Axillaryoringuinalfreckling
3. TwoormoreirisLischnodules
4. Twoormoreneurofibromasoroneplexiformneurofibroma
5. Adistinctiveosseouslesionsuchassphenoiddysplasiaorcortical
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thinningoflongbone,withorwithoutpseudoarthrosis.6.Opticgliomas.
6. AfirstdegreerelativewithNFIwhosediagnosiswasbasedonthe
aforementionedcriteria.
ScoliosisisthemostcommonorthopaedicmanifestationNFl.
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63.TrueaboutECGfindingsofventricular
prematurebeatis/are
a)IncreaseR-Rinterval
b)STsegmentdepression
c)STsegmentelevation
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d)Twaveinversione)ObsuredPwave
CorrectAnswer-B:C:D:E
Answer-B,STsegmentdepressionC,STsegmentelevationD,T
waveinversionE,ObsuredPwave
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ST-TwaveWhenQRScomplexupight
S-Tsegmentisdepressedandconvexupwards
Twaveisinverted
WhenQRScomplexdownward
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S-TsegmentiselevatedandconcaveupwardsTwaveisupright
64.Vascularchangesofmalignant
hypertensionisare-
a)Hyalinearteriosclerosis
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b)Necrotizingarteriolitisc)Hyperplasticarterioscleroesis
d)Aorticdissection
e)Onionskinning
CorrectAnswer-B:C:D:E
--- Content provided by FirstRanker.com ---
Answer-(B)Necrotizingarteriolitis(C)Hyperplasticarterioscleroesis(D)Aorticdissection(E)Onionskinning
Hypertensionisassociatedwithtwoforms-
1.Hyalinearteriolosclerosis-
Itischaracteristicofbenignhypertension.
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2.HyperplasticarteriosclerosisItischaracteristicofmalignanthypertension
Onionskinning
Thereismucinousintimalthickeningandfibrousintimalthickening.
Theremaybeaccompaniedfibrinoiddepositswithnecrosisofthe
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vesselswall-->fibrinoidnecrosis(ornecrotizingarteriolitis).65.Patientcomeswithmilddyspnea.OnECG
monomorphicventriculartachycardiawas
found,whichofthefollowingdrugistobe
used
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a)Adenosineb)Lignocaine
c)Amiodarone
d)Propranolol
e)Procainamide
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:C:D:EAnswer-
B,LignocaineC,AmiodaroneD,PropranololE,Procainamide
StablepatientwithmonomorphicVT
1.Ifleftventricularfunctionisnormal-
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IVprocainamideorIVamiodaroneor
IVsotalol/propranol/esmolol
Lidocainemayalsobeused
2.Impairedleftventricularfunction
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IVamiodaroneorlidocainearepreferred66.Nottrueaboutkaposisarcoma-
a)CausedbyHHV-8
b)ClassicalformisassociatedwithHIV
c)Isanangioproliferativedisorder
--- Content provided by FirstRanker.com ---
d)Monocentrictumore)MayinvolveGIT
CorrectAnswer-B:D
Answer-(B)ClassicalformisassociatedwithHIV
(D)Monocentrictumor
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KaPosisarcomaismulticentricvasculartumorcausedbyHumanherpesvirus-8(HHV-8)alsocalledKaposisarcomaassociated
herpesvirus(KSHV).
TherearefourformsofKaposisarcoma-
l)Classicalform(EuropeanorMediterraneanKS)
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ThereisnoassociationwithHIV.Thereareskinplaquesandnodules.
2)Africanform(EndemicformorEquatorialform)
ThereisnoassociationwithHIV.Thereislymphadenopathy
3)Transplantassociated(immunosuppressionassociated)KS
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4)AIDScssociated(Epidemic)KSItisassociatedwithHIVinfecfion
67.Capnographyhelpstoknowthe
following
a)Correctintubation
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b)Pulmonaryembolismc)Adequateventilation
d)Lungperfusion
e)Significantmetabolicchange
CorrectAnswer-A:B:C:D:E
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Answer-A,CorrectintubationB,PulmonaryembolismC,AdequateventilationD,Lung
perfusionE,Significantmetabolicchange
ConditionsthataffectETCO2
Increased
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HypoventilationRebreathing
Malignanthyperthermia,
Neurolepticmalignantsyndrome
Increasedskeletalmuscleactivity(shivering
--- Content provided by FirstRanker.com ---
HypermetabolismHyperthyroidism&thyroidstorm
Decreased
Hyperventilation
Pulmonaryembolism
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Hypoperfusion,hypotension,hypovalemia,shockHypothermia
68.Nottrueregardingmucopolysccharidosis
is/are
a)Theyarelysosomaldiseases
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b)AllareautosomaldominantexceptSanfilipposyndromec)Theyhavecommonskeletalfeature:Dysostosismultiplex
d)HurlersyndromeisduetodeficiencyofIduronatesulfatase
e)Morquiosyndrome[IV]isduetodeficiencyofBeta-
galactosidase
--- Content provided by FirstRanker.com ---
CorrectAnswer-B:DAnswer-B,AllareautosomaldominantexceptSanfilippo
syndromeD,HurlersyndromeisduetodeficiencyofIduronate
sulfatase
Mucopolysaccharidosis(MPS)representaheterogenousgroupof
--- Content provided by FirstRanker.com ---
inheritablelysosomalstoragediseasesinwhichtheaccumulationofundegradedglycansleadstoprogressivedamageofaffected
tissues.
Hurler(IH)syndrome-AlphaL-iduronidase
Cornealclouding,dysostosismultiplex,organomegaly;heart
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disease,mentalretardationSanfilipposyndrome-Autosomalrecessive.
MorquioIVsyndrome-Beta-galactosidase,Galactose-6-sulfate
sulfatase
Maroteaux-Lamysyndrome-N-acetylgalactosamine(Dysostosis
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multiplex)69.Earlydiastolicmurmurisseeninwhich
condition(s)-
a)Mitralstenosis
b)Tricuspidstenosis
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c)Aorticregurgitationd)Pulmonaryregurgitation
e)Atrialmyxoma
CorrectAnswer-C:D
Answer-(C)Aorticregurgitation(D)Pulmonaryregurgitation
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Aorticregurgitation-Themurmurislowintensity,high-pitched,bestheardovertheleftsternalborderorovertherightsecondintercostal
space.
AnAustinFlintmurmurisusuallyassociatedwithsignificantaortic
regurgitation.
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Pulmonaryregurgitation-Pulmonaryregurgitationismostcommonlyduetopulmonaryhypertension(Graham-Steellmurmur)
Leftanteriordescendingarterystenosis-Thismurmur,alsoknown
asDock'smurmur.
70.Continuousmurmurisseenis-
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a)Patentductusarteriosusb)Tetrologyoffallot
c)Pregnancy
d)Coarctationofaorta
e)Ventricularseptaldefect
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CorrectAnswer-A:C:DAnswer-(A)Patentductusarteriosus(C)Pregnancy
(D)Coarctationofaorta
CommonCausesofcontinuousmurmurs
Systemicarteriovenousfistula(congenital/acquired)
--- Content provided by FirstRanker.com ---
CoronaryarteriovenousfistulaAnomalousoriginofLeftcoronaryarteryfrompulmonaryartery
Communicationbetweensinusofvalsalvaandrightsideofheart
(i.e.Rupturedsinusofvalsalvaintorightsideofheart)
CoarctationofAorta:Continuousmurmurintheback
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PatentDuctusArteriosus(PDA)Surgicallycreatedshuntse.g.Blalock-Tausigshunt
Mammarysouffle(pregnancy)
71.Drugsusedinbladder/urinary
incontinence
--- Content provided by FirstRanker.com ---
a)Oxybutyninb)Tolterodine
c)Trospium
d)Neostigmine
e)Demecarium
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CorrectAnswer-A:B:CAnswer-A,OxybutyninB,TolterodineC,Trospium
SelectiveM3antagonists-Oxybutynin,darifenacin,Tolterodine
Nonselectiveantagonist-Trospium,Propiverine
Tricyclicantidepressant-Imipramine
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72.Milk-alkalisyndromeisassociatedwith-
a)HighPTH
b)Hypercalcemia
c)Metabolicacidosis
d)Elevatedcreatinine
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e)HyperphosphatemiaCorrectAnswer-B:D:E
Answer-(B)Hypercalcemia(D)Elevatedcreatinine
(E)Hyperphosphatemia
Thesyndromeischaracterizedby-
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1. Hypercalcemia2. Hyperphosphatemia
3. Metabolicalkalosis
4. Metastaticcalcification
5. Progressiverenalfailure(inreased,BUNandcreatinine)
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73.Whichofthefollowingis/areincludedin
themanagementofstressincontinence
a)Botulinumtoxin
b)Kellyprocedure
c)Antichoinergic
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d)Urethropexye)Imipramine
CorrectAnswer-B:C:D:E
Answer-B,KellyprocedureC,AntichoinergicD,Urethropexy
E,Imipramine
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Thereare4typesoftreatment-1.Behaviorchanges
2.Medicine
Anticholinergicmedicineshelprelaxthemusclesofthebladder.
Antimuscarinicdrugsblockbladdercontractions.
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Imipramine,anantidepressant,helpsrelaxbladdermuscles.3.Pelvicfloormuscletraining
4.Surgery
Anteriorvaginalrepair(anteriorcolporrhaphyorKellyprocedure)
helpsrestoreweakandsaggingvaginalwalls.
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ArtificialurinarysphincterBulkinginjectionsmaketheareaaroundtheurethrathicker.
BurchurethropexyandMarshall-Marchetti-Krantz(MMK)procedure
74.Primaquniesensitivityisseeninanemia
withfollowingenzymedeficiencyexcept
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a)Pyruvatedehydrogenaseb)Hexokinase
c)Glucose6phosphatedehydrogenase
d)Glucose6phosphate
e)None
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CorrectAnswer-A:B:DAnswer-A,PyruvatedehydrogenaseB,HexokinaseD,Glucose6
phosphate
Itisactiveonpreandexo-erythrocyticstage.(Primaquineistheonly
antimalarialwhichisactiveonexoerythrocyticstage).Itactsby
--- Content provided by FirstRanker.com ---
interferingmitochondrialfunction.ThosewithG-6-PDdeficiencyarehighlysensitiveanilhemolytic
anaemiacanoccur.
ThereforeitshouldbeavoidedinpregnancyasfetuswithG6PD
deficiencymaydevelophemolyticanemia.
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75.Soluteinduceddiuresisischaracterized
by-
a)Polyuria
b)Decreasedurineosmolality
c)Urine:Plasmaosmolality>0.7
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d)Osmoticclearance>3ml/mine)Urineoutput>3L/day
CorrectAnswer-A:C:D:E
Answer-(A)Polyuria(C)Urine:Plasmaosmolality>0.7
(D)Osmoticclearance>3ml/min(E)Urineoutput>3L/day
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Urine-toPlasmaosmolalityratio>0.7Osmoticclearance>3mL/min
PolyuriaUrineosmolality(>300mosmol)Solute
diuresisGlucose,mannitol,radiocontrast,urea(fromhigh
proteinfeeding)medullarycysticdiseases,resolvingATN,or
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obstruction,diuretics.76.Redcolorofurineiscausedby
a)Anilinedye
b)Beetrootingestion
c)Rifampicin
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d)Penolintakee)Alkaptonuria
CorrectAnswer-A:B:C
Answer-A,AnilinedyeB,BeetrootingestionC,Rifampicin
Hematuria
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PorphyriaSerratiamarcescens
Anilinedyes
Ingestionofblackberries
Ingestionofbeetroot
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PhenolphthalienePhenytoin
Rifampin(redbrownorange)
Pyridium
77.Whichofthefollowingis/arefeature(s)of
--- Content provided by FirstRanker.com ---
hypomagnesemiaa)Tremors
b)Improvementseenwithcalciumsupplementation
c)Atheroidmovements
d)Seizure
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e)BradycardiaCorrectAnswer-A:B:C:D
Answer-(A)Tremors(B)Improvementseenwithcalcium
supplementation(C)Atheroidmovements(D)Seizure
Clinicalfeaturesaremostly:
--- Content provided by FirstRanker.com ---
1. Neuromuscular&CNShyperirritability:Tetany,Seizura,tremer,muscleweakness,ataxia,nystagmus,vertigo,atheroidmovement,
depression,irritability,deliriumandpsychosis.
2. Cardiacarrhythmias:Sinustachycardia,othersupraventricular
tachycardia,andventriculararrhythmias.
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78.ComponentsofAPACHE-11score
include(s)-
a)Age
b)Glassgowcommascale
c)Pa02
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d)Alanineaminotransferase(ALT)e)Serumlactate
CorrectAnswer-A:B:C
Answer-A,AgeB,GlassgowcommascaleC,Pa02
APACHEIIscoreincludesAge,GCS,Physiologicalparameters(BP,
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RespiratoryRate,Pa02)andchronicmedicalconditions.APACHEIISCORE(AcutePhysiologicalAndChronicHealth
EvaluationSystem)
TheAPACHEIIscoringsystemisthemostcommonlyusedseverity
ofillnessscoringsysteminNorthAmerica
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TheAPACHEIIscoreisrecordedasthesumoftheAcutephysiologyscore(Vitalsigns,oxygenation,laboratoryvalues),GCS,
AgeandChronichealthpointsasdetailedinthefollowingtable.
79.Whichofthefollowingstatement(s)is/are
trueaboutmyastheniaGraviswith
--- Content provided by FirstRanker.com ---
muscle-specifictyrosinekinase(MuSK)antibodiesthananti-AChRAb-
a)Diseaseonsetisearlierwithfemalepredominance
b)Neckandfacialmuscleweaknessaremorecommon
c)Moreproximalmuscleinvolvement
--- Content provided by FirstRanker.com ---
d)Associatedwiththymichyperplasiae)Poorresponsewithacetylcholineesterase(AChE)inhibitors
CorrectAnswer-A:B:C:E
Answer-(A)Diseaseonsetisearlierwithfemalepredominance
(B)Neckandfacialmuscleweaknessaremorecommon
--- Content provided by FirstRanker.com ---
(C)Moreproximalmuscleinvolvement(E)Poorresponsewithacetylcholineesterase(AChE)inhibitors
Featuresare-
1. Onsetisearlierwithfemalepredominance
2. Thymushistologyisusuallynormal
--- Content provided by FirstRanker.com ---
3. Selectivefacial,bulbarneckorrespiratorymuscleweakness4. Involvementofproximalmuscles
5. Relativesparingofocularmuscles
6. Poorresponsetoacetylcholinesteraseinhibitors(anticholinesterase)
80.Clinicalpresentationofpituitaryapoplexy
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include(s)allexcept-a)Ophthalmoplegia
b)Visualimpairment
c)Fever
d)Severeheadache
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e)HypertensionCorrectAnswer-E
Answer-E.Hypertension
1. Severehypoglycemic
2. Severeheadache(usuallyretroorbital)
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3. Impairedconsciousness4. Fever
5. Visualdisturbances(visualfielddefect,visualacuity)
6. Ophthalmoplegia(ocularparesis)Causingdiplopia
7. Hypotension&shock
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8. Nausea/vomiting9. Meningealsign
81.Trueaboutventilatorassociated
pneumonia(VAP)-
a)2ndmostcommonnosocomialinfectionintheintensivecare
--- Content provided by FirstRanker.com ---
unitb)Colonizationofthepharynxwithbacteriaisriskfactor
c)Highestriskoccurinthefirst5days
d)Gastricacidmayplayaroleinprotectionagainstnosocomial
pneumonias
--- Content provided by FirstRanker.com ---
e)Developsonlyafter1weekonmechanicalventilationCorrectAnswer-A:B:C:D
Answer-(A)2ndmostcommonnosocomialinfectioninthe
intensivecareunit(B)Colonizationofthepharynxwithbacteria
isriskfactor(C)Highestriskoccurinthefirst5days
--- Content provided by FirstRanker.com ---
(D)Gastricacidmayplayaroleinprotectionagainstnosocomialpneumonias
Ventilatorassociatedpenumoniais2dmostcommonnosocomial
infectionafterurinarytractinfection.
Ventilator-associatedpneumonia(VAP)ispneumoniathatdevelops
--- Content provided by FirstRanker.com ---
48hoursorlongeraftermechanicalventilationisgivenbymeansofanendotrachealtubeortracheostomy.
VAPresultsfromtheinvasionofthelowerrespiratorytractandLung
parenchymabymicroorganism.
RiskforVAPisgreatestduringthefirst5daysofmechanical
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vantilation.EarlyonsetVAPisdefinedaspneumoniathatoccurswithin4days.
Gastricacidmayplayaroleinprotectionagainstnosocomial
pneumonias.
82.Feature(s)ofvitaminAtoxicityinclude(s)-
--- Content provided by FirstRanker.com ---
a)Hypercalcemiab)Yellowskin
c)Anorexia
d)Poorwoundhealing
e)Papilledemaandhepatomegaly
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:C:EAnswer-(A)Hypercalcemia(B)Yellowskin(C)Anorexia
(E)Papilledemaandhepatomegaly
HypervitaminosisAcanleadtoruptureoflysosomalmembrane.
Acutetoxicity-Pseudotumourcerebri(headache,dizziness,
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vomiting,drowsiness,blurredvision)Chronictoxicity-anorexia,weightloss,nausea,boneandjointpain,
boneabnormalitiesandbonyswelling.
83.Whichofthefollowingdyadsarecorrect
--- Content provided by FirstRanker.com ---
a)Pulsusparadoxus-aorticregurgitationb)Pulsusbisferiens-mitralstenosis
c)Water-hammerpulse-aorticregurgitation
d)Pulsusparvusettardus-aorticstenosis
e)Collapsingpulse-aorticregurgitation
--- Content provided by FirstRanker.com ---
CorrectAnswer-C:D:EAnswer-C,Water-hammerpulse-aorticregurgitationD,Pulsus
parvusettardus-aorticstenosisE,Collapsingpulse-aortic
regurgitation
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84.Neurofibromatosistype1is/are
associatedwith-
a)Caf?-au-laitspots
--- Content provided by FirstRanker.com ---
b)Cataractsc)Axillaryfreckling
d)Facialnervepalsy
e)Opticnervemeningioma
CorrectAnswer-A:C
--- Content provided by FirstRanker.com ---
Answer-(A)Caf?-au-laitspots(C)AxillaryfrecklingFeaturesofNeurofibromatosis1are:cafeaulaitspots,
neurofibromasorplexiformneuroma,freckling,opticgliomaand
Lischnodules.
85.Exudativepleuraleffusionis/areseenin
--- Content provided by FirstRanker.com ---
allexcept-a)Cirrhosis
b)Carcinoma
c)Bacterialpneumonia
d)Tuberculosis
--- Content provided by FirstRanker.com ---
e)CongestiveheartfailureCorrectAnswer-A:E
Answer-(A)Cirrhosis(E)Congestiveheartfailure
Collagenvasculardisease-
Rheumatoidarthritis
--- Content provided by FirstRanker.com ---
SLEDruginducedlupus
Sjogren'ssyndrome
Wegener'sgranulomatosis
Churgstrausssyndrome
--- Content provided by FirstRanker.com ---
Infectiousdisease-Bacterialinfection
Tuberculosis
Gastrointestinalinfections-
Esophagealperforation
--- Content provided by FirstRanker.com ---
PancreaticdiseaseIntraabdominalabscesses
Diaphragmatichernia
Neoplastic-
Metastatic
--- Content provided by FirstRanker.com ---
Mesothelioma
86.Whichofthefollowingis/aretrueabout
jugularvenouspressure(JVP)waveform
a)awaveoccurjustafterelectrocardiographicPwave
b)Prominentxandydescentsisseeninconstrictivepericarditis
--- Content provided by FirstRanker.com ---
c)Canonawavesoccurinatrioventricular(AV)dissociationd)vwaveoccurinearlysystoleofcardiaccycle
e)Prominentxdescentbutanabsentydescentisseenincardiac
temponade
CorrectAnswer-A:B:C:E
--- Content provided by FirstRanker.com ---
Answer-A,awaveoccurjustafterelectrocardiographicPwaveB,Prominentxandydescentsisseeninconstrictive
pericarditisC,Canonawavesoccurinatrioventricular(AV)
dissociationE,Prominentxdescentbutanabsentydescentis
seenincardiactemponade
--- Content provided by FirstRanker.com ---
Atrialcontractionproducesthefirstpressurepeakcalledtheawave.Thecwaveisthetransmittedmanifestationoftheriseinatrial
pressureproducedbythebulgingofthetricuspidvalveintotheatria
duringisovolumetricventricularcontraction.
Thevwavemirrorstheriseinatrialpressurebeforethetricuspid
--- Content provided by FirstRanker.com ---
valveopensduringdiastole.a-xdescent-Constrictivepericalditis,Cardiactemponade,
Restrictivecardiomyopathy
v-ydescent-Ticuspidregurgitation,Constrictivepericarditis
87.TreatmentofacuteHyperleukocytosis
--- Content provided by FirstRanker.com ---
includes:a)Hydroxyurea
b)Isotretinoin
c)Leukapheresis
d)Vincristine
--- Content provided by FirstRanker.com ---
e)AllCorrectAnswer-A:C:D
Answer-(A)Hydroxyurea(C)Leukapheresis(D)Vincristine
Leukapheresisisthetreatmentofchoice.
InpatientswithAML,hydroxyureashouldbestarted.
--- Content provided by FirstRanker.com ---
InALLpatients,higherthan200,000/mm3patientsmaybetreatedwithvinctistine,steroids,orboth.
88.TrueaboutSwan-Ganzcatheter:
a)Measuresrightatrialpressure
b)Measuresleftventricularfillingpressure
--- Content provided by FirstRanker.com ---
c)MeasurePCWPd)Insertedthroughleftsubclavianvein
e)InserteddirectlyinRightatrium
CorrectAnswer-A:B:C:D
Answer-(A)Measuresrightatrialpressure(B)Measuresleft
--- Content provided by FirstRanker.com ---
ventricularfillingpressure(C)MeasurePCWP(D)Insertedthroughleftsubclavianvein
Continuouscardiacoutputmonitoring.
CentraltemPeraturemonitoring
Measurementofpulmonaryarterypressure(canalsomeasureRA
--- Content provided by FirstRanker.com ---
andRVpressuresduringinsertion)Measurementofmixedvenoussaturations
Estimationofdiastolicfillingofleftheart(normalPCWP2-12mmHg)
89.Allaretrueaboutchronicfatigue
syndromeexcept:
--- Content provided by FirstRanker.com ---
a)Fordiagnosis,durationoffatigueshouldbeatleast6monthb)Impairedmemoryandconcentrationmaypresent
c)Fatiguerelievedbyrest
d)Physicalexaminationshowsnoabnormalities
e)Cognitivebehavioraltherapyisusefulfortreatment
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer-C.Fatiguerelievedbyrest
Fatiguelastsforatleast6months
Fatigueisofnewordefiniteonset.
Fatigueisnottheresultofanorganicdiseaseorofcontinuing
--- Content provided by FirstRanker.com ---
exertionFatigueisnotalleviatedbyrest.
Fatiguesymptomsaresoarthroat,tendercervicaloraxilarylymph
nodes,musclepain,paininseveraljoints,headaches,malaise
90.Whichofthefollowingis/areusedfor
--- Content provided by FirstRanker.com ---
assessmentofcarbohydratemalabsorption:
a)Schillingtest
b)Steatorrhoea
c)D-xylosetest
--- Content provided by FirstRanker.com ---
d)Glucoseteste)Urinetest
CorrectAnswer-C
Answer-C.D-xylosetest
D-xyloseabsorptiontestisthemostcommonlyemployedtestfor
--- Content provided by FirstRanker.com ---
carbohydrateabsorption-HarrisonAnendoscopicmucosalbiopsyisthemorespecifictestandisnow
consideredessential.
D-xyloseisacarbohydratethatisabsorbedalmostexclusivelyinthe
proximalsmallbowelwithoutthehelpofpancreaticenzymes.A
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positiveD-xylosetestindicatesmalabsorptionduetointestinalmucosaldiseaseandthusbeusedasatestforassessmentof
mucosalfunction.
91.Allaretrueaboutprimaryaldosteronism
except:
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a)Oneofthemostcommoncauseofsecondaryhypertensionb)Hyperkalemia
c)Sodiumretention
d)Ratioofplasmaaldosteronetoplasmareninactivity(PA/PRA)
isausefulscreeningtest
--- Content provided by FirstRanker.com ---
e)TetanymayoccurCorrectAnswer-B
Answer-B.Hyperkalemia
Primaryhyperaldosteronismisoneofthemostcommoncauseof
secondaryhypertension.
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Excessivelevelsofaldosteronecausesodiumretentionandpotassiumexcretion,withresultanthypertensionandhypokalemia.
Hypokalemiacancauseweakness,parethesias,visualdisturbances
andtetany.
Thediagnosisofprimaryhyperaldosteronismisconfirmedbythe
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elvatedlevelofaldostetoneanddepressedlevelsofrenininthecirculation(lowPRA).
Theratioofplasmaaldosteronetoplasmareninactivity(PA/PRA)is
ausefulscreeningtest.
92.Allaretrueaboutacutepericarditis
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except:a)Painradiatetoleftshoulder&arm
b)WidespreadelevationoftheSTsegments,oftenwithupward
concavity&thenreturntobaseline
c)Painrelievedbylyingsupine&intensifiedbysittingupand
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leaningforwardd)Corticosteroidrelievessymptoms
e)High-pitchedscratchingorcrunchingnoisemayheardin
auscultation
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer-C.Painrelievedbylyingsupine&intensifiedbysittingupandleaningforward
Thecharacteristicpainofpericarditisisretrosternal,radiatestothe
shouldersandneck(retrosternal,andleftprecoridal).
Characteristically,pericaridialpainmayberelievedbysittingupand
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leaningforwardandisintensifiedbylyingsupine.Apericardialfrictionrubisahigh-pitchedsuperficialscratchingor
crunchingnoise,producedbymovementoftheinflamed
pericardium.
TherearefourstagesofECGchangesintheevolutionofacute
--- Content provided by FirstRanker.com ---
pericarditis.Instage1,thereiswidespreadelevationoftheSTsegments,often
withupwardconcavity,involvingtwoorthreestandardlimbleads
andV2toV6,withreciprocaldepressionsonlyinaVRand
sometimesV1,aswellasdepressionofthePRsegmentUsually
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therearenosignificantchangesinQRScomplexes.
Instage2,afterseveraldays,theSTsegmentsreturntonormal,
andonlythen,orevenlater,dotheTwavesbecomeinverted(stage
3).
Ultimately,weeksormonthsaftertheonsetofacutepericarditis,the
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ECGreturnstonormalinstage4.Thepainisusuallyrelievedbyaspirin.
93.Allaretrueabouthepatorenalsyndrome
except:
a)Creatininelevelraised
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b)Albumininfusiongivenc)Livertransplantationimprovesrenalfunctions
d)Mayoccurincirrhosis
e)Lowdosedopamineinfusionisveryeffective
CorrectAnswer-E
--- Content provided by FirstRanker.com ---
Answer-E.LowdosedopamineinfusionisveryeffectiveThehepatorenalsyndrome(HRS)isaformoffunctionalrenalfailure
withoutrenalpathologythatoccursinabout10%ofpatientswith
advancedcirrhosisoracuteliverfailure.
Therearemarkeddisturbancesinthcarterialrenalcirculationin
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PatientswithHRS.TyPeIHRS-asignificantreductionincreatinineclearancewithin1-2
weeksofpresentation.
Type2HRS-anelevationofserumcreatininelevel.
HRSisoftenseeninpatientswithrefractoryascites.
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Treatment-dopamineorprostaglandinanalogueswereusedasrenal
vasodilatingmedications.
Patientsaretreatedwithmidodrine,analpha-agonist,alongwith
octreotideandintravenousalbumin.
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ThebesttheragyforHRSislivertransplantation.94.Whichofthefollowingmarkerssuggest
likelyprimarycancerincarcinomaof
unknownprimary(CUP):
a)CK7isfoundintumorsofthelung,ovary,endometrium&
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breastb)CK20+/CDX-2+/CK7?,suggestiveoflowergastrointestinal
cancer
c)Calretin&WT-1formelanoma
d)Chromogranin,synaptophysin&CD56aremarkerof
--- Content provided by FirstRanker.com ---
neuroendocrineprrimarye)None
CorrectAnswer-A:B:D
Answer-A,CK7isfoundintumorsofthelung,ovary,
endometrium&breastB,CK20+/CDX-2+/CK7?,suggestiveof
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lowergastrointestinalcancerD,Chromogranin,synaptophysin&CD56aremarkerofneuroendocrineprrimary
CK7,CK20,thrombomodulin-Urothelial
CK7,CK20,CDX-2,carcinoembryonicantigen(CEA)-intestinal
Calretinin,WT-1-Mesothelioma
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Chromogranin,synaptophysin,CD56-Neuroendocrine95.Feature(s)ofBulbarpalsyis/are:
a)Dysphagia
b)Absentjawjerk
c)Absentgagreflex
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d)Tongueatrophye)Tonguewasting&fasciculations
CorrectAnswer-A:B:C:D:E
Answer-(A)Dysphagia(B)Absentjawjerk(C)Absentgag
reflex(D)Tongueatrophy(E)Tonguewasting&fasciculations
--- Content provided by FirstRanker.com ---
Paralysisorlossoffunctionsuppliedbycranialnervearisingfrombulb(oldnameofmedullaoblongata).
AffectedCNare9,10,11&l2th.
Tongue-flaccid,wasted,fasciculationmaybepresent.
InvolvementofIX&XCN:Nasaltwang,nasalregurgitation,hoarse
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voice,dysphagia,lossofsensationoverpl/3tongue,weakcough,absentgagreflex&weakcoughreflex.
Inu/llesion,thereisneveracompleteparalysisofdeglutitionorof
articulation.
96.Whichofthefollowingis/arefeature(s)of
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acuteinterstitialnephritis:a)Eosinophiluria
b)Peripheraleosinophilia
c)WBCcast
d)Grosshaematuria
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e)SignificantproteinuriaCorrectAnswer-A:B:C
Answer-(A)Eosinophiluria(B)Peripheraleosinophilia(C)WBC
cast
Peripheraleosinophiliacanoccur,especiallywithdruginduced.
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Microscopichematuriaisinvariablypresent.Urinalysiscanrevealwhitebloodcell,granularorhyalinecast.
Thepresenceofurineeosinophilsisneithersensitiveorspecific.
Proteinuriacanbeafeature,particularlyinNSAIDS-induced
interstitialnephritis.
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97.Whichofthefollowingistrueabout
medicationoveruseheadache:
a)Notassociatedwithtriptanuse
b)Restrictionofanalgesicsshouldbedone
c)Opioidismainlyresponsible
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d)Preventivetherapyshouldbeencouragedafterstopping/reducinganalgesic
e)None
CorrectAnswer-B:C:D
Answer-(B)Restrictionofanalgesicsshouldbedone
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(C)Opioidismainlyresponsible(D)Preventivetherapyshouldbeencouragedafterstopping/reducinganalgesic
medicationsthatarethemostcommonculpritsarecompound
analgesia(particularlycodeineandotheropiatecontaining
preparations)andtriptans,andMOHisusuallyassociatedwithuse
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onmorethan10-15dayspermonth.Managementisbywithdrawaloftheresponsibleanalgesics
Migraineprophylacticsmaybehelpfulinreducingtherebound
headaches.
98.Whichistrueaboutthrombolysisinacute
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ischemicstroke: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.
99.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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100.Extrathyroidfeatureofhypothyroidism
includes:
a)Pretibialmyxedema
b)Carpaltunnelsyndrome
c)Bradycardia
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d)Thyroidacropathye)Peripheraledema
CorrectAnswer-B:C:E
Answer-(B)Carpaltunnelsyndrome(C)Bradycardia
(E)Peripheraledema
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Commonsymptomsare-Weightgain,Fatigue,Dryskinandhair,Menorrhagia,Hoarseness,coldness
CVS-Bradycardia,Myxoedema,hypertension
Nervoussystem-Carpaltunnelsyndrome,
Facialfeatures-purplishlips,malarflush,periorbitaloedema
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Yellowingofskinoccursduetoaccumulationofincreasecarotene.101.TrueaboutMcCune-Albrightsyndrome:
a)Occurinchildren&duringpuberty
b)Precociouspubertyinfemale
c)Involvelongboneoflimb
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d)Associatedwithhypothyroidisme)All
CorrectAnswer-A:B:C
Answer-A,Occurinchildren&duringpubertyB,Precocious
pubertyinfemaleC,Involvelongboneoflimb
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McCune-Albrightsyndrome(MAS)ischaracterizedbythetriadofpolyostoticfibrousdysplasia,cafeaulaitskinpigmentation,and
peripheralprecociouspuberty.
Albrightsyndromeisprecocioussexualdevelopment,whichoccurs
mostofteningirls.
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Theaverageageatonsetinaffectedgirlsisabout3yrandpuberty.102.Increasedportalveinpressure&normal
hepaticveinpressurecanbeseeninall
except:
a)Alcoholiccirhhosis
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b)Alcholoichepatitisc)BuddChairisyndrome
d)Portalveinthrombosis
e)Inferiorvenacavaobstruction
CorrectAnswer-C:E
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Answer-C,BuddChairisyndromeE,Inferiorvenacavaobstruction
"Budd-Chiarisyndrome(Obstructionofhepaticveinsatanysitefrom
efferentveinofthelobuletotheentryoftheIVCintorightatrium.
Posthepatic-Budd-Chiarisyndrome,Inferiorvenacavalwebs
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103.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.104.Whichofthefollowingstatement(s)
is/areregardingAmericanHeart
Association(AHA)Guideline-2015for
cardiopulmonaryresuscitation(CPR)&
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Emergencycardiovascularcare(ECC):a)Chestcompression:ventilationCompressionventilationratio
withoutadvancedairway?rate30:2irrespectiveofrescuer&
ageofpatient
b)Compressionrate-atleast100/min
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c)FailuretoachieveanETCO2of10mmHgbywaveformcapnographyafter20minutesofresuscitationhasbeen
associatedwithanextremelypoorchanceofreturnof
spontaneouscirculation(ROSC)
d)Limitinterruptionsinchestcompressionstolessthan10
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secondse)None
CorrectAnswer-C:D
Answer-C,FailuretoachieveanETCO2of10mmHgby
waveformcapnographyafter20minutesofresuscitationhas
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beenassociatedwithanextremelypoorchanceofreturnofspontaneouscirculation(ROSC)D,Limitinterruptionsinchest
compressionstolessthan10seconds
Compressionrateismodifiedtoarangeofl00to120/min.
Compressionventilationratiowithoutadvancedairway-1or2
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rescuers30:2FailuretoachieveanETCO2ofI0mmHgbywaveform
capnographyafter20minutesofresuscitationhasbeenassociated
withanextremelypoorchanceofROSCandsurvival.
Theclarifiedrecommendatio-nforcfrestcompressiondepthfor
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adultsisatleast2inches(Scm)butnotgreaterthan2.4inches(6cm).
105.Haintestis/areusedfor:
a)DetectionofINHresistanceonly
b)Detectionofrifampicinresistanceonly
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c)Detectionofbothrifampicin&INHresistanced)DetectionofresistanceofalldrugsoffirstlineATT
e)All
CorrectAnswer-C
Answer-C.Detectionofbothrifampicin&INHresistance
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"GenotypeMTBDRplus("HAINtest")qNAAandhybridization-basedtestuseimmobilizedDNAprobesonnitrocellulosemembranes(line
probeassayLPA)&Colorimetricchangeindicateshybridization.
ldentifiesM.tuberculosisanddetectsRif&INHresistanceinaday.
106.TrueaboutPulmonaryartery
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catheterization(Swan-Ganzcatheterplacement):
a)Measuresrightatrialpressure
b)Measuresleftventricularfillingpressure
c)MeasurePCWP
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d)Insertedthroughleftsubclavianveine)Measurescentralvenouspressure
CorrectAnswer-A:B:C:D
Answer-(A)Measuresrightatrialpressure(B)Measuresleft
ventricularfillingpressure(C)MeasurePCWP(D)Inserted
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throughleftsubclavianveinContinuouscardiacoutputmonitoring
Centraltemperaturemonitoring
Measurementofpulmonaryarterypressure(canalsomeasureRA
andRVpressuresduringinsertion)
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Measurementofmixedvenoussaturations.Estimationofdiastolicfillingofleftheart
Itmeasuresthepressureatthreedifferentplaces:rightatrium,
pulmonaryarteryandpulmonarycapillaries.
107.Presentationoftabesdorsalisincludes:
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a)Lancinatingpaininlegb)Lossofproprioception
c)Sensorydefect
d)Noinvolvementofbladder&bowel
e)Sensoryataxia
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CorrectAnswer-A:B:C:EAnswer-(A)Lancinatingpaininleg(B)Lossofproprioception
(C)Sensorydefect(E)Sensoryataxia
Symptomsare
Ataxicwide-basedgait
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FootdropParesthesia;
Bladderdisturbances;
Impotence;
Areflexia;and
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Lossofpositional,Deep-pain,andTemperaturesensations.Trophicjointdegeneration(Charcot'sjoints)canresultfromlossof
painsensation.
Opticatrophyoccursintabes.
108.TrueaboutPrinzmetal'sangina:
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a)Maypresentatrestb)Occursdueatheroscleroticobstructionofcoronaryarteries
c)Smokingisariskfactor
d)Nitratesareusedfortreatment
e)CCBsareusedfortreatment
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:D:EAnswer-(A)Maypresentatrest(C)Smokingisariskfactor
(D)Nitratesareusedfortreatment(E)CCBsareusedfor
treatment
ThissyndromeisduetofocalspasmofanepicardialcoronAry
--- Content provided by FirstRanker.com ---
artery,leadingtoseveremyocardialischemialeadingtoseveremyocardialischemia.
Therightcoronaryarteryisthemostfrequentsite,followedbythe
leftanteriordescendingcoronaryartery.
Acetylcholinereleasedbytheparasympatheticsystematrestwill
--- Content provided by FirstRanker.com ---
simplycausecontractionofthevascularsmoothmuscle.ItusuallyoccursatrestandisassociatedwithtransientST-segment
elevation.
Etiology
cigarettesmokers
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Treatment-Nitratesandcalciumchannelblockersarethemaintreatmentsfor
patientswithvariantangina.
109.Whichofthefollowingis/aretrueabout
RevisedJonesCriteria2015ofAHAfor
--- Content provided by FirstRanker.com ---
diagnosisofacuterheumaticfever-a)Polyarthritisinlow-riskpopulationsisamajorcriteria
b)Polyarthralgiainmoderate-andhigh-riskpopulationsisaminor
criteria
c)Monoarthritisinmoderate-andhigh-riskpopulationsisamajor
--- Content provided by FirstRanker.com ---
criteriad)EchocardiographywithDopplerstudyshouldbeperformedin
allcasesofconfirmedandsuspectedARF
e)Echocardiography/Dopplerstudyshouldbeperformedto
assesswhethercarditisispresentintheabsenceof
--- Content provided by FirstRanker.com ---
auscultatoryfindingsCorrectAnswer-A:C:D:E
Answer-(A)Polyarthritisinlow-riskpopulationsisamajor
criteria(C)Monoarthritisinmoderate-andhigh-risk
populationsisamajorcriteria(D)Echocardiographywith
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DopplerstudyshouldbeperformedinallcasesofconfirmedandsuspectedARF(E)Echocardiography/Dopplerstudy
shouldbeperformedtoassesswhethercarditisispresentin
theabsenceofauscultatoryfindings
Clinicalmanifestationsanddiagnosis
--- Content provided by FirstRanker.com ---
2015RevisedJonesCriteriafordiagnosisofRheumaticFeverB.MajorCriteria
Moderate-andhigh-
Low-riskpopulations
riskpopulation
--- Content provided by FirstRanker.com ---
Carditis
Carditis
Clinicaland/orsubclinical
Clinicaland/orsubclinicalcarditis
carditis
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ArthritisArthritis
Monoarthritisor
Polyarthritis
polyarthritis
--- Content provided by FirstRanker.com ---
PolyarthralgiaChorea
Chorea
Erythemamarginatum
Erythemamarginatum
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SubcutaneousnodulesSubcutaneousnodules
C.Minorcriteria
Moderate-andhigh-risk
Low-riskpopulations
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populationsPolyarthralgia
Monoarthralgia
Fever(>38.5?)
Fever(>38?C)
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ESR.60mmin1'thourESR30mm/hand/orCRP>3.0
and/CRP>3.0mg/dl
ormg/dL
4.ProlongedPRinterval,afteraccountingforagevariability
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(unlesscarditisisamajorcriterion)inallpopulation.110.Feature(s)ofincreasedICPis/are:
a)Hypotension
b)DecreaseHR
c)IncreaseHR
--- Content provided by FirstRanker.com ---
d)Hypertensione)Decreasedlevelofconsciousness
CorrectAnswer-B:D:E
Answer-(B)DecreaseHR(D)Hypertension(E)Decreasedlevel
ofconsciousness
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Cushing'striadisthetriadofwideningpulsepressure(risingsystolic,decliningdiastolic),changeinrespiratory
Pattern(irregularrespirations),andbradycardia.Itissignof
increasedintracranialpressure,and,itoccursasaresultofthe
Cushingreflex.
--- Content provided by FirstRanker.com ---
111.AllaretrueaboutHepatitisEexcept:
a)Maybefatalinpregnantwomen
b)Causedbynon-enveloped,positive-sense,singlestranded
RNAgenomic,HAVlikevirus
c)Carrierstateiscommon
--- Content provided by FirstRanker.com ---
d)Majorityprogresstochronicitye)Feco-oraltransmission
CorrectAnswer-C:D
Answer-(C)Carrierstateiscommon(D)Majorityprogressto
chronicity
--- Content provided by FirstRanker.com ---
HEVistransmittedviathefaecal-oralroute.Itiscausedbynon-enveloped,positive-sense,single-strandedRNA
genomic,HAVlikevirus.
HepatitisEisawaterbornedisease,andcontaminatedwaterorfood
supplieshavebeenimplicatedinmajoroutbreaks.Ingeneral,
--- Content provided by FirstRanker.com ---
hepatitisEisaself-limitingviralinfectionfollowedbyrecovery.Prolongedviraemiaorfaecalsheddingareunusualandchronic
infectiondoesnotoccur.
Occasionally,afulminantformofhepatitisdevelops,withoverall
patientpopulationmortalityratesrangingbetween0.5-4.0%.
--- Content provided by FirstRanker.com ---
Fulminanthepatitisoccursmorefrequentlyinpregnancyandregularlyinducesamortalityrateof20%amongpregnantwomenin
the3rdtrimester.
SincecasesofhepatitisEarenotclinicallydistinguishablefrom
othertypesofacuteviralhepatitis,diagnosisismadebybloodtests
--- Content provided by FirstRanker.com ---
whichdetectelevatedantibodylevelsofspecificantibodiestohepatitisEinthebodyorbyreversetranscriptasepolymerasechain
reaction(RT-PCR).Unfortunately,suchtestsarenotwidely
available.
112.Whichofthefollowingcranialnerve
--- Content provided by FirstRanker.com ---
is/areinvolvedinGagreflex:a)9
b)10
c)11
d)12
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e)7CorrectAnswer-A:B
Answer-(A)9(B)10
Gagreflex
Afferent
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GlossopharyngealnerveEfferent
Vagusnerve
113.Whichofthefollowingis/aretrueabout
Duchenemusculardystrophy:
--- Content provided by FirstRanker.com ---
a)Mentalimpairmentmaypresentb)TSerumCKlevels
c)Cardiomyopathymaybepresent
d)Autosomalrecessivedisorder
e)Onsetduringpuberty
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:B:CAnswer-(A)Mentalimpairmentmaypresent(B)TSerumCK
levels(C)Cardiomyopathymaybepresent
DuchenneMuscularDystrophy:ThisX-linkedrecessivedisorder
sometimesalsocalledpseudohypertrophicmusculardystrophy.
--- Content provided by FirstRanker.com ---
Age-Before5yearsC/F
Progressiveweaknessofgirdlemuscles
Unabletowalkafterage12
Progressivekyphoscoliosis
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Respiratoryfailurein2dor3ddecadeCardiomyopathy
Mentalimpairment
114.Trueaboutacuteintermittentporphyria:
a)OccurduetodeficiencyofenzymeHMB-synthase
--- Content provided by FirstRanker.com ---
b)Uroporphyrinispresentinurinec)Abdominalpainiscommonsymptom
d)TPorphobilinogenintheurine
e)Leukocytosisisoftenpresent
CorrectAnswer-A:B:C:D
--- Content provided by FirstRanker.com ---
Answer-(A)OccurduetodeficiencyofenzymeHMB-synthase(B)Uroporphyrinispresentinurine(C)Abdominalpainis
commonsymptom(D)TPorphobilinogenintheurine
Deficientenzyme-HMB-synthase
Inheritance-Autosomaldominant
--- Content provided by FirstRanker.com ---
Abdominalpain,themostcommonsymptom.Cramping,lleus,abdominaldistention,anddecreasedbowelsound.
Peripheralneuropathy
Abdominaltenderness,fever,andleukocytosisareusuallyabsentor
mild
--- Content provided by FirstRanker.com ---
Nausea,vomiting,constipation,tachycardia,hypertension,mentalsymptoms,paininthelimbs,head,neck,orchest;
Muscleweakness,sensoryloss,dysuria,andurinaryretentionare
characteris
Tachycardia,hypertension,restlessness,tremors,andexcess
--- Content provided by FirstRanker.com ---
sweatingareduetosympatheticoveractivity.Investigation-
Thediagnosiscanbeconfirmedbydemonstratinganincreased
amountofporphobilinogenintheurine,ALA,Uroporphyrin.
115.ChildPughAcriteriaforclinicalseverity
--- Content provided by FirstRanker.com ---
ofcirrhosisincludes:a)Bilirubin<2.0mg/dL
b)Prothrombintime>70(%ofcontrol)
c)Serumalbumin2.0-3.0g/dl
d)Presenceofencephalopathy
--- Content provided by FirstRanker.com ---
e)AbsenceofascitesCorrectAnswer-A:B:E
Answer-(A)Bilirubin<2.0mg/dL(B)Prothrombintime>70(%
ofcontrol)(E)Absenceofascites
Assign Assign
--- Content provided by FirstRanker.com ---
AssignParameter
1point 2points
3points
Ascitis
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Absent SlightMpderate
Bilirubin(mg/dL)
<2
2-3
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>3Albumin(g/dL)
>3.5
2.8-3.5
<2.8
--- Content provided by FirstRanker.com ---
Prothrombintime<4
4-6
>6
(secondovercontrol) <1.7
--- Content provided by FirstRanker.com ---
1.7-2.3>2.3
orINR
Grade1-2(Mildto
Grade3-4
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EncephalopathyNone
moderate
(Severe)
116.AllaretrueaboutAbdominalaneurysm
--- Content provided by FirstRanker.com ---
except:a)Atherosclerosisisthecommonestcause
b)Mostcommonlyarisesfromabovethelevelofrenalartery
c)Forasymptomaticaneurysms,repairisindicatedifthediameter
is>5.5cm
--- Content provided by FirstRanker.com ---
d)Endovascularplacementofanaorticstentisuseforrepaire)Mostlyasymptomatic
CorrectAnswer-B
Answer-B.Mostcommonlyarisesfromabovethelevelofrenal
artery
--- Content provided by FirstRanker.com ---
90%ofabdominalaorticaneurysm(AAA)ofsize>4cmindiameterisduetoatherosclerosis.
Malearemorefrequentlyaffectedthanfemale.
Theaneurysmmostcommonlyarisesbelowthelevelofrenalartery.
117.Apatientdiagnosedwithcushing's
--- Content provided by FirstRanker.com ---
syndrome.Dexamatha?sonesuppressiontestshoweddecreasein
cortisollevelsandcorticotrophin-
releasinghormone(CRH)administration
causesincreasedcortisol
--- Content provided by FirstRanker.com ---
levels.Treatmentoption(s)forthispatientis/are:
a)Adrenalectomy
b)Pituitaryirradiation
c)Adrenalglandremoval
--- Content provided by FirstRanker.com ---
d)Stereotacticpituitaryradiosurgerye)SurgicalremovalofectopictissueproducingACTHindifferent
organs
CorrectAnswer-A:B:C:D
Answer-(A)Adrenalectomy(B)Pituitaryirradiation(C)Adrenal
--- Content provided by FirstRanker.com ---
glandremoval(D)StereotacticpituitaryradiosurgeryTreatmentofchoice-removalofpituritarycorticotropetumour
(transphenoidalapproach)
Pituitaryirradiation
Metyraponeandketoconazole
--- Content provided by FirstRanker.com ---
Adrenocorticalcarcinoma-mitotane118.Inwhichofthefollowingvasculitislung
involvementdoesnotoccur:
a)Eosoniphilicgranulomatosiswithvasculitis
b)Polyarteritisnodosa(PAN)
--- Content provided by FirstRanker.com ---
c)Microscopicpolyangitisd)Granulomatosiswithpolyangitis
e)Bechetsyndrome
CorrectAnswer-B
Answer-B.Polyarteritisnodosa(PAN)
--- Content provided by FirstRanker.com ---
Microscopicpolyangiitis(microscopicpolyarteritis,hypersensitivity,orleukocytoclasticvasculitis):Thistypeofnecrotizingvasculitis
generallyaffectsarterioles,capillaries,andvenule.
Wegenergranulomatosis(Granulomatosiswithpolyangitis)-isa
necrotizingvasculitischaracterizedbythetriadof
--- Content provided by FirstRanker.com ---
1. acutenecrotizinggranulomas2. necrotizingorgranulomatousvasculitis
3. renaldiseaseintheformoffocalnecrotizingoftencrescentic,
glomerulitis
"Churg-Strausssyndrome(allergicgranulumatosisandangiitis)isa
--- Content provided by FirstRanker.com ---
multisystemdiseaseswithcutaneousinvolvementgastrointestinaltractbleeding,andrenaldisease.
119.Drugcausingsclerodermais/are:
a)Bleomycin
b)Pentazocin
--- Content provided by FirstRanker.com ---
c)Polyinylchlorided)Steroid
e)Tetracycline
CorrectAnswer-A:B:C
Answer-(A)Bleomycin(B)Pentazocin(C)Polyinylchloride
--- Content provided by FirstRanker.com ---
Vinylchloride,bleomycin,pentazocin,organicsolvents,carbidopa,tryptophan,rapeseedoil.
120.Apatientofasthmawasoninhaledshort
acting13-agonist.Buttherewasno
significantrelief.Afterthatheaddedlow
--- Content provided by FirstRanker.com ---
doseofinhaledsteroidfromlast5daybyMDI,butstillnotresponding.What
youwilladvisehimfornextlineof
treatment:
a)ContinueinhaledshortactingP-agonist
--- Content provided by FirstRanker.com ---
b)Addinhaledlongacting13-agonistc)Increasedoseofinhaledcorticosteroid
d)Startoralcorticosteroid
e)Startparenteralcorticosteroid
CorrectAnswer-A:B:C
--- Content provided by FirstRanker.com ---
Answer-(A)ContinueinhaledshortactingP-agonist(B)Addinhaledlongacting13-agonist(C)Increasedoseofinhaled
corticosteroid
121.Whichofthefollowingclinicalcriteria
--- Content provided by FirstRanker.com ---
belongstoHIVstageI:a)Asymptomaticpatient
b)Persistentgeneralisedlymphadenopathy
c)Unexplainedchronicdiarrhoeafor>1mth
d)Unexplainedpersistentfever(>37.5?Cfor>1mth)
--- Content provided by FirstRanker.com ---
e)NeutropeniaCorrectAnswer-A:B
Answer-(A)Asymptomaticpatient(B)Persistentgeneralised
lymphadenopathy
WorldHealthOrganization(WHO)clinicalstage-
--- Content provided by FirstRanker.com ---
AsymptomaticPersistentgeneralisedlymphadenopathy
122.Pulmonarybloodflowincreasedinall
except:
a)ASD
--- Content provided by FirstRanker.com ---
b)VSDc)TOF
d)Transpositionofgreatarteries(TGA)
e)PDA
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer-(C)TOFTruncusArteriosus,completeTGAandTAPVCareassociatedwith
increasedpulmonarybloodflow.
TOF-WhentheRVoutllowobstructionissevere,pulmonaryblood
llowisreducedmarked.
--- Content provided by FirstRanker.com ---
123.Caudaequinaisdifferentiatedfrom
conusmedullarisbypresenceof:
a)Anklejerkmaylost
b)Kneejerkmaylost
c)Motorchanges
--- Content provided by FirstRanker.com ---
d)Bladder&bowelinvolvementasinitialpresentatione)Rootpain
CorrectAnswer-B:C:E
Answer-(B)Kneejerkmaylost(C)Motorchanges(E)Rootpain
ConusMedullarisvs.CaudaEquinaSyndromes
--- Content provided by FirstRanker.com ---
ConusmedullarisCaudaequinasyndrome
syndrome
Vertebral
L1-L2
--- Content provided by FirstRanker.com ---
L2-sacrumlevel
Sacralcordsegmentand
Spinallevel
Lumbosacralnerveroots
--- Content provided by FirstRanker.com ---
rootsPresentation Suddenandbilateral
Gradualandunilateral
Radicular
Lesssevere
--- Content provided by FirstRanker.com ---
Moreseverepain
Lowback
More
Less
--- Content provided by FirstRanker.com ---
painSymmetrical,lessmarked
Moremarkedasymmetric
Motor
hyperreflexicdistalparesis areflexicparaplegia,
--- Content provided by FirstRanker.com ---
strengthofLL,fasciculation
atrophymorecommon
Bothkneeandanklejerks
Reflexes
--- Content provided by FirstRanker.com ---
Anklejerksaffectedaffected
Localizednumbnessto
Localizednumbnessat
Sensory
--- Content provided by FirstRanker.com ---
perianalarea,saddlearea,asymmetrical,
symmetricalandbilateral
unilateral
Sphincter
--- Content provided by FirstRanker.com ---
EarlyurinaryandfecalTendtopresentlate
dysfunction incontinence
Impotence
Frequent
--- Content provided by FirstRanker.com ---
Lessfrequent124.Whichofthefollowingis/arethefeature
(s)ofheadacheduetoincreasein
intracranialpressure:
a)Increaseonsupineposition
--- Content provided by FirstRanker.com ---
b)Mostcommonlypresentsassevereacuteheadachec)Pulsatileinnature
d)Throbbingcharacter
e)Analgesicsarenotveryhelpful
CorrectAnswer-A:E
--- Content provided by FirstRanker.com ---
Answer-(A)Increaseonsupineposition(E)Analgesicsarenotveryhelpful
"Headacheduetointracranialpathologrorraisedintracranialtension
worsensduringcoughingstrainingoradoptingtheheadinlow
posture.
--- Content provided by FirstRanker.com ---
Generalizedheadachethatispresentonwakingandimprovesasthedaygoeson.
Headacheonrisinginthemorningornocturnalheadacheisako
characteristicofobstructivesleepapneaorpoorlycontrolled
hypertension.
--- Content provided by FirstRanker.com ---
CorticosteroidarerecommendedinacuteheadacheduetoraisedICP.
125.Allaretrueaboutuseoftriptansin
migraineexcept:
a)Usedinprophylaxisofmigraine
--- Content provided by FirstRanker.com ---
b)Efficacyincreasedwithconcomitantuseofergotc)CanbegivenforlongtermwhereNSAIDSisnoteffective
d)GivenwhenNSAIDSisnoteffective
e)None
CorrectAnswer-A:B:C
--- Content provided by FirstRanker.com ---
Answer-(A)Usedinprophylaxisofmigraine(B)Efficacyincreasedwithconcomitantuseofergot(C)Canbegivenfor
longtermwhereNSAIDSisnoteffective
TriPtansarerapidlyeffectiveagentforabortingattacks.
OralStimulationofS-HT1B/1Dreceptorscanstopanacutemigraine
--- Content provided by FirstRanker.com ---
attack.Triptansareselective5-HT1B/lDreceptoragonists.
126.Allaretrueaboutrenalarterystenosis
except:
a)ACEinhibitorscanbeusedinbilateralrenalarterystenosis
--- Content provided by FirstRanker.com ---
b)ACEinhibitorscanbeusedinunilateralrenalarterystenosisc)ACEinhibitorsarebestdrugtocontrolDMassociated
hypertension
d)Excision&Graftingistreatmentofchoice
e)Angioplastywithorwithoutstenting,andsurgicalbypassused
--- Content provided by FirstRanker.com ---
onlyinrefractorycasesCorrectAnswer-A:D
Answer-(A)ACEinhibitorscanbeusedinbilateralrenalartery
stenosis(D)Excision&Graftingistreatmentofchoice
ACEinhibitorsarecontraindicatedinbilateralrenalarterystenosis.
--- Content provided by FirstRanker.com ---
ACEinhibitorsareusefulinrenovascularhypertension.ARFisprecipitatedbyACEinhibitorsinpatientswithb/lrenal
stenosis
Atheroscleroticischemicrenaldiseaseaccountsfornearlyallcases
ofrenalarterystenosis.
--- Content provided by FirstRanker.com ---
Renalangiographyisthegoldstandardfordiagnosis.127.Whichofthefollowingcauses
glomerularproteinuria:
a)DM
b)Amyloidosis
--- Content provided by FirstRanker.com ---
c)Multiplemyelomad)ACEinhibitorsdecreasesproteinuria
e)All
CorrectAnswer-A:B:D
Answer-(A)DM(B)Amyloidosis(D)ACEinhibitorsdecreases
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proteinuriaNephroticsyndrome
Membranoproliferativeglomerulonephritis,membranous
nephropathy
HepatitisBandCnephropathy,HIVnephropathy
--- Content provided by FirstRanker.com ---
RefluxnephropathyAmyloidosis
Postinfectiousglomerulonephritis,lgA,nephropathy,Henoch-
Schonleinnephritis,lupusnephritis,Alport,syndrome
128.AllaretrueaboutChylouspleural
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effusionexcept:a)StainpositivewithsudanIII
b)Cutoffleveloftriglycerideforchylouseffusionis>150mg/dl
c)Cutoffleveloftriglycerideforchylouseffusionis>50mg/dl
d)Milkycolourdisappearswithalkali
--- Content provided by FirstRanker.com ---
e)MilkycolourdisappearswithetherCorrectAnswer-B:C
Answer-(B)Cutoffleveloftriglycerideforchylouseffusionis>
150mg/dl(C)Cutoffleveloftriglycerideforchylouseffusionis
>50mg/dl
--- Content provided by FirstRanker.com ---
Pleuralfluid-milkywhite,triglyceridelevels>ll0mgldLChylomicronsisalsodiagnosticofachylothorax&canbeusedasa
confirmatorytestifthetriglyceridelevelsareequivocal.
Onmicroscopy,fatglobulewiIIclearwithalkaliorether&willstain
withSudanIII.
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Themostcommoncauseofchylothoraxistrauma.129.Chylouspleuraleffusionoccurin:
a)T.B
b)Malignancy
c)SLE
--- Content provided by FirstRanker.com ---
d)Thoracicductinjurye)Congestiveheartfailure
CorrectAnswer-A:B:D
Answer-(A)T.B(B)Malignancy(D)Thoracicductinjury
TB
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MalignancyLymphoma
Filariaisis
Myxoedema
Trauma
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130.Whichofthefollowingcausesmassive
splenomegaly:
a)CLL
b)Multiplemyeloma
c)Follicularlymphangitis
--- Content provided by FirstRanker.com ---
d)Gaucher'sdiseasee)Sjogren'ssyndrome
CorrectAnswer-A:D
Answer-(A)CLL(D)Gaucher'sdisease
Thecausesofmassivesplenomegalyinclude:
--- Content provided by FirstRanker.com ---
ThalassemiaVisceralleishmaniasis(KalaAzar)
Schistosomiasis
Chronicmyelogenousleukemia
Chroniclymphocyticleukemia
--- Content provided by FirstRanker.com ---
LymphomasHairycellleukemia
Myelofibrosis
Polycythemiavera
Gauchersdisease
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NiemannPickdiseaseSarcoidosis
Autoimmunehemolyticanemia
Malaria
Syphilis
--- Content provided by FirstRanker.com ---
131.ACTHdependentcushingsyndrome
is/arecausedby:
a)Pituitaryadenoma
b)Adrenaladenoma
c)Adrenocorticalcarcinoma
--- Content provided by FirstRanker.com ---
d)Pheochromocytomae)All
CorrectAnswer-A:D
Answer-(A)Pituitaryadenoma(D)Pheochromocytoma
CushingsyndromeiscausedtoACTH-producingadenoma.
--- Content provided by FirstRanker.com ---
ETIOLOGYPituitarycorticotropeadenomas
Iatrogenichypercortisolism(mostcommon)
EctopictumourACTHproduction
Cortisol-producingadrenaladenomas
--- Content provided by FirstRanker.com ---
AdrenalcarcinomaAdrenalhyperplasia
Pheochromocytoma
132.HyperglycemicHyperosmolarstate
(HHS)ischaracterizedby:
--- Content provided by FirstRanker.com ---
a)Hyperglycemiab)Acidosis
c)Dehydration
d)Coma
e)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:DAnswer-(A)Hyperglycemia(C)Dehydration(D)Coma
Thisisalifethreateningcomplicationofdiabetesmellitus
characterizedbymarkedhyperglycemia,dehydration,comaand
hyperosmolaritywithorwithoutmentalobtundationintheabsenceof
--- Content provided by FirstRanker.com ---
significantketoacidosis133.Whichofthefollowingistrueabout
Pheochromocytoma:
a)Sestabimiscanisdonebeforesurgery
b)Mostlyaremalignant
--- Content provided by FirstRanker.com ---
c)Surgeryismainstayoftreatmentd)Priorablockerisgiven
e)Priorpblockerisgiven
CorrectAnswer-C:D:E
Answer-(C)Surgeryismainstayoftreatment(D)Priorablocker
--- Content provided by FirstRanker.com ---
isgiven(E)PriorpblockerisgivenSestambiscanningisthepreferredwayinwhichtolocalizediseased
parathyroidglandspriortooperation.
Pheochromocytoma¶gangliomaarecatecholaminesproducing
tumoursderivedfromsympatheticandparasympatheticnervous
--- Content provided by FirstRanker.com ---
system.TheyarederivedfromChromaffincells.
Treatment-
Laproscopicresection
Alphaadrenoreceptorblocker(phenoxybenzamine)-block
--- Content provided by FirstRanker.com ---
catecholamineexcessBetablockade-tachycardiaorarrhythmias
Centralvenouscatheter&invasivearterialmonitoringused.
AdultDoseofClonidineforClonidineSuppressiontestis0.3mg
(0.3mg/70kg)administeredorally.ClonidineSuppressionTest
--- Content provided by FirstRanker.com ---
Completetumorremovalistheuhimatetherapeuticgoal,,canbeachievedbypartialortotaladrenalectomy.
134.Treatmentofcrohn'sdiseaseincludes:
a)Steroid
b)5-Aminosalicylicacidagents
--- Content provided by FirstRanker.com ---
c)Azathioprined)Daclizumab
e)Adalimumab
CorrectAnswer-A:B:C:E
Answer-(A)Steroid(B)5-Aminosalicylicacidagents
--- Content provided by FirstRanker.com ---
(C)Azathioprine(E)AdalimumabTreatment-
5-ASAagents(mesalamine)notusednow
Mildtomoderatediseaseinvolvingterminialileumorascending
colon?Budesonide
--- Content provided by FirstRanker.com ---
Severediseaseinvolvingproximalsmallintestineordistalcolon?Prednisone
Immunomodulators(Azathioprine,mercaptopurine,methotrexate)
andformaintenanceofremissionor
inductionofremissionalongwithsteroidsinseveredisease
--- Content provided by FirstRanker.com ---
Anti-TNFtherapy(Infliximab,adalimumab,certolizumab)-first-lineagentstoinduceremissioninmoderatetoseverediseaseandto
maintainremission
Anti-integrins:Natalizumab(anti-a4integrin)?ifnoresponsetoanti-
TNFagents
--- Content provided by FirstRanker.com ---
135.EnergyselectioninCPRaccordingto
AHA2010guidelineis/are:
a)Monophasic120-200J,Biphasic360J
b)Monophasic200J,Biphasic360J
c)Monophasic120J,Biphasic200J
--- Content provided by FirstRanker.com ---
d)Monophasic360J,Biphasic120-200Je)Monophasic360J,Biphasic220J
CorrectAnswer-D
Answer-(D)Monophasic360J,Biphasic120-200J
2010AIIAguidelineforCPRContrarytopreviousrecommendation
--- Content provided by FirstRanker.com ---
of3succesiveshocks(200,300,360J)nowadayslst&allsubsequentshocksareof360Jouleswithmonophasic&120-200
louleswithbiphasic.
136.Whichofthefollowinglesionrepresent
tertiarysyphilis:
--- Content provided by FirstRanker.com ---
a)Condylomatalatab)Mattedlymphnode
c)Condylomataacuminata
d)Tabesdorsalis
e)Gummaformation
--- Content provided by FirstRanker.com ---
CorrectAnswer-D:EAnswer-(D)Tabesdorsalis(E)Gummaformation
Gumma,neurosyphilis/tabesdorsalis
Ostitis,periostitis
Aortitis,aorticinsufficiency,coronarystenosisandnocturnalangina
--- Content provided by FirstRanker.com ---
137.Whichofthefollowingstatement(s)
is/arecorrectregardingsyphilisin
pregnancy&congenitalsyphilis:
a)Foetushasmorechanceofinfectionin3rdT.M
b)Syphiliscanbepreventedbygivingpenicillininneonate
--- Content provided by FirstRanker.com ---
c)Ifinfantshowingsignsofsyphilis,he/sheshouldbegivensingledoseofcrystallinepenicillin
d)Ifinfantdoesnothaveanysignsofsyphilis,he/sheshouldbe
givenbenzathinepenicillin
e)Foetusismostlikelyaffectedifmotherissufferingfromprimary
--- Content provided by FirstRanker.com ---
orsecondarysyphilisthanlatesyphilisCorrectAnswer-A:B:D:E
Answer-(A)Foetushasmorechanceofinfectionin3rdT.M
(B)Syphiliscanbepreventedbygivingpenicillininneonate
(D)Ifinfantdoesnothaveanysignsofsyphilis,he/sheshould
--- Content provided by FirstRanker.com ---
begivenbenzathinepenicillin(E)Foetusismostlikelyaffectedifmotherissufferingfromprimaryorsecondarysyphilisthan
latesyphilis
CongenitalSyphilis
(a)EarlyCongenitalSyphilis:
--- Content provided by FirstRanker.com ---
Snuffles(rhinitis)istheearliestfeature.Lesionsarevesiculobullousandsnailtrackulcersonthemucosa
(b)LateCongenitalSyphilis:
CharacterizedbyHutchinson'striadinterstitialkeratitis
8thnervedeafness
--- Content provided by FirstRanker.com ---
Hutchinson'steethi.e.peggedcentralupperincisorsSaddlenose,sabretibia,mulberrymolars
Bulldog'sjaw(protrusionofjaw)
Rhagades(linearfissureatmouth,nares)
Frontalbossing,hotcrossbundeformityofskull
--- Content provided by FirstRanker.com ---
Clutton'sjoint(painlessswellingofjoints,mostcommonlybothknee)Syphilisinpregnancy-
Allpregnantwomenshouldhaveanontreponemalserologictestfor
syphilisatthetimeofthefirstprenatalvisit.
Theonlyacceptabletreatmentforsyphilisinpregnancyispenicillin
--- Content provided by FirstRanker.com ---
indosageschedulesappropriateforthestageofdisease.Penicillinpreventscongenitalsyphilisin90%ofcases,evenwhen
treatmentisgivenlateinpregnancy.
Syphiliticwomentoherfoetusmayoccuratanystageofpregnancy.
138.AsciticfluidwithTSAAG&Talbumin
--- Content provided by FirstRanker.com ---
is/arefoundin:a)T.B
b)CHF
c)Cirrhosis
d)Pancreatitis
--- Content provided by FirstRanker.com ---
e)NephroticsyndromeCorrectAnswer-B
Answer-B.CHF
Serum-ascitesalbumingradient(SAAG)isusefulfordistinguishing
ascitescausedbyportalhlpertensionfromnonportalhypertensive
--- Content provided by FirstRanker.com ---
ascites.ASAAG>1.1g/dl-reflectsthepresenceofportalhypertension
ASAAG<1.1g/dl-tuberculousperitonitis,peritoneal
carcinomatosis,orpancreaticascites.
Forhigh-SAAG(>1.1)ascites-
--- Content provided by FirstRanker.com ---
Anasciticproteinlevelof>2.5g/dlindicatesthatthehepaticsinusoidsoccursincardiacascites,sinusoidalobstruction
syndrome,orearlyBudd-Chiarisyndrome.
Anasciticproteinlevel<2.5g/dl,indicatescirrhosis,lateBudd-
Chiarisyndrome,ormassivelivermetastases.
--- Content provided by FirstRanker.com ---
139.Forcancerpain,ladder2stepinWHO's
painstepladderincludes:
a)Oralmorphine
b)Injectablemorphine
c)Codeine
--- Content provided by FirstRanker.com ---
d)Fentanyle)Tramadol
CorrectAnswer-C:E
Answer-(C)Codeine(E)Tramadol
Secondstep:Intermediatestrengthopioids:codeine,tramadolor
--- Content provided by FirstRanker.com ---
dextropropoxyphene.140.Trueaboutpepticulcer:
a)H.pyloricausespepticulcer
b)EradcationtherapybetterthanPPItherapy
c)EradicationtherapyalsocontainPPI
--- Content provided by FirstRanker.com ---
d)DuodenumulcerismorecommonlyassociatedwithH.pylorithangastriculcer
e)GastriculcerismorecommonlyassociatedwithH.pylorithan
duodenalulcer
CorrectAnswer-A:B:C:D
--- Content provided by FirstRanker.com ---
Answer-(A)H.pyloricausespepticulcer(B)EradcationtherapybetterthanPPItherapy(C)Eradicationtherapyalso
containPPI(D)Duodenumulcerismorecommonlyassociated
withH.pylorithangastriculcer
Hpyloriinfection.
--- Content provided by FirstRanker.com ---
Medicaltreatment:ProtonpumpinhibitorsorH2blockers;H.pylorieradication
EradicationofH.pyloriandtherapy/preventionofNSAID-induced
diseaseisthemainstayoftreatment.
Combinationregimensthatusetwoorthreeantibioticswithaproton
--- Content provided by FirstRanker.com ---
pumpinhibitor.141.FeaturesofConstrictivepericarditis
whichdifferentiatewithrestrictive
cardiomyopathy:
a)Prominentydescentmorecommon
--- Content provided by FirstRanker.com ---
b)Pericardialknockc)Thirdheartsound
d)Thickenedpericardium
e)Rightventricularhypertrophy
CorrectAnswer-A:B:D
--- Content provided by FirstRanker.com ---
Answer-(A)Prominentydescentmorecommon(B)Pericardialknock(D)Thickenedpericardium
Diastolicpressureareequalizedinconstrictivepericarditisbutnotin
RestrictivecardiomyopathyThickennedpericardiumisseenin
constrictivepericarditisbutnotinRestrictivecardiomyopathy
--- Content provided by FirstRanker.com ---
Rightventricularsizeisusuallynormalinbothandpericardialeffusionisusuallyabsentinboth,RVsizeandpericardialeffusion,
thereforecannotdistinguishbetweenconstrictivepericarditisand
Restrictivecardiomyopathy.
142.CURB-65criteriaforseverepneumonia
--- Content provided by FirstRanker.com ---
includes:a)Confusion
b)Uremia
c)Respiratoryrate30/min
d)SystolicBloodpressure80mmHg
--- Content provided by FirstRanker.com ---
e)Diastolicbloodpressure,systolic50mmHgCorrectAnswer-A:B:C
Answer-(A)Confusion(B)Uremia(C)Respiratoryrate30/min
TheCURB-65assessesfive-
Confusion
--- Content provided by FirstRanker.com ---
UremiaRespiratoryrate
Bloodpressure
Age>65
143.Whichofthefollowingfeaturefavours
--- Content provided by FirstRanker.com ---
emphysemaratherthaninterstitialfibrosis:
a)TFEV1
b)LFEV1/FEV6
c)TRV
--- Content provided by FirstRanker.com ---
d)TTLCe)4,Peakexpiratoryflow
CorrectAnswer-B:C:D:E
Answer-(B)LFEV1/FEV6(C)TRV(D)TTLC(E)4,Peakexpiratory
flow
--- Content provided by FirstRanker.com ---
InterstitiallungdiseaselikeinterstiulfibrosisarecharacterizedbyanormalorelevatedFEVIFVCratiowhichischaracteristically>0.7.
PFTresultscomparingobstructiveandrestrictivedisease(maynot
beapplicableforallformsoflung(disease)
FEVI=forcedexpiratoryvolumeinonesecond;FVC=ForcedVital
--- Content provided by FirstRanker.com ---
Capacity;FEF25_75=ForcedExpiratoryFlowat25%=75%vitalcapacity;TLC=TotalLungCapacity;DLCO=DiffusionCapacityof
theLungforCarbonmonoxide.
144.Featureofunstableangina:
a)TTroponin
--- Content provided by FirstRanker.com ---
b)TransientelevationofSTsegmentc)DepressionofSTsegment
d)Qwave
e)Twaveinversion
CorrectAnswer-B:C:E
--- Content provided by FirstRanker.com ---
Answer-(B)TransientelevationofSTsegment(C)DepressionofSTsegment(E)Twaveinversion
InUA,ST-segmentdepression,transientST-segmentelevation,
and/orT-waveinversionoccurin30to50%ofpatients.
ThePresenceofnewST-segmentdeviation.
--- Content provided by FirstRanker.com ---
T-wavechangesaresensitiveforischemiadeepT-waveinversions.145.Allaretrueaboutrheumatoidfactor
except:
a)AlsofoundinSjogrensyndrome
b)Mayalsopresentnormally
--- Content provided by FirstRanker.com ---
c)ItisbasicallyIgMd)Itspresenceisdiagnosticofrheumatoidarthritis
e)None
CorrectAnswer-A:B:C
Answer-(A)AlsofoundinSjogrensyndrome(B)Mayalso
--- Content provided by FirstRanker.com ---
presentnormally(C)ItisbasicallyIgM-IgM,IgG,andIgAisotypesofRFoccurinserafrompatientswith
RA.
SerumIgMRFhasbeenfoundin75-80%ofpatientswithRA.
Foundinotherconnectivetissuediseases,suchasprimary
--- Content provided by FirstRanker.com ---
Sjogren'ssyndrome,systemiclupuserythematosus,andtypeIImixedessentialcryoglobulinemia.
Anti-CCPantibodiesarethemostspecificbloodtestforrheumatoid
arthritis
146.Feature(s)ofTICTinclude:
--- Content provided by FirstRanker.com ---
a)Constrictedpupilb)Tachycardia
c)Bradycardia
d)Hypertension
e)Respiratorydepression
--- Content provided by FirstRanker.com ---
CorrectAnswer-C:D:EAnswer-(C)Bradycardia(D)Hypertension(E)Respiratory
depression
Bloodpressureelevationaccompaniedbybradycardiaand
respiratoryslowingclassicallyresultsfromraisedintracranial
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pressure.Lossofthenormalautoregulationofbloodpressureandpulse,called
theCushingsreflexisahallmarkofseverebraininjuryorimminent
crisis.
Anisocoria,unequalpupilsize,isanothersignofserioustraumatic
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braininjury.147.TrueaboutKallmansyndrome:
a)Amenorrhoea
b)Hypergonadotrophicstate
c)Anosmia
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d)Failureofsecondarysexualdevelopmente)None
CorrectAnswer-A:C:D
Answer-(A)Amenorrhoea(C)Anosmia(D)Failureofsecondary
sexualdevelopment
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Kallmannsyndromeiscausedfromdefectivegonadotropinreleasinghormone(GnRH)synthesis.
Clinicalfeatures-
Anaemia&hyposmiaduetoolfactorybulbagenesis&hypophasia.
Colorblindness,opticatrophy,nervedeafness.
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Cleftpalate,cryptoorchidism&mirrormovements(neurologicaldefects)
Inmales-delayedpuberty,micropenis.
Infemales-primaryamenorrhea,failureofsecondarysexual
development.
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LowLH&FSHlevels&sexsteroids.148.Whichofthefollowingis/aretrue
regardingAsthma&COPD:
a)COPDshowslessreversibilitytobronchodilatorswhileasthma
showssignificantimprovement
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b)Asthmahasagradualprogressionofdyspneaonexertion,punctuatedbyacuteexacerbationsofshortnessofbreath.while
mostCOPDpatientshavenormalbreathingthemajorityofthe
time
c)COPDpatientsmayhaveacuteexaberationswhileasthmatic
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patientshaverecurrentepisoded)Steroidtherapyismorebeneficialtoasthmapatientsthan
COPDpatients
e)Neutrophilshaveprimaryaroleinpathogenesisofasthma&
eosinophilshaveprimaryroleinCOPD
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CorrectAnswer-A:C:DAnswer-(A)COPDshowslessreversibilitytobronchodilators
whileasthmashowssignificantimprovement(C)COPD
patientsmayhaveacuteexaberationswhileasthmaticpatients
haverecurrentepisode(D)Steroidtherapyismorebeneficialto
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asthmapatientsthanCOPDpatientsPatientswithCOPDhasagradualprogressionofdyspneaon
exertion,punctuatedbyacuteexacerbationsofshortnessofbreath.
Mostasthmaticshavenormalbreathingwithrecurrentepisodesof
dyspneaduetotriggeringfactor.
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COPDisseenspecificallyinsmokers.Asthmaticsoftenshowanacuteresponsetoinhaled
bronchodilators.
bronchodilators.
COPDisgenerallynotresponsivetooralcorticosteroidtherapy.
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Inhaledcorticosteroidsareoneofthemosteffectivewaysofcontrollingasthma.
Eosinophilicinfiltrationisacharacteristicfeatureofasthmaticairway.
InCOPDthereismacrophageactivation&neutrophilrecruitmentin
airway.
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149.Allaretrueaboutacuteradiation
pneumonitisexcept:
a)Fevernotpresent
b)Steroidisbeneficial
c)X-raychestfindingcorrelatespoorlywithsymptom
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d)Developimmediatelyafterradiotherapye)All
CorrectAnswer-A:D
Answer-(A)Fevernotpresent(D)Developimmediatelyafter
radiotherapy
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Twophasesofthepulmonaryresponsetoradiationareapparent:
acutephase(radiationpneumonitis)
chronicphase(radiationfibrosis)
Clinicalfeatures-
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manifestedbyfever,dyspneaoutofproportiontothevolumeoflungirradiated,pleuraleffusion.
Withsteroidthetapy,thesesymptomsmayresolvecompletelyin
somepatientswithoutlong-termefects.
Epithelialcellatypiaandfoamcellwithinvesselwallsarealso
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characteristicofradiationdamage.150.Whichofthefollowingis/aretrueabout
SubarachnoidHemorrhage(SAH):
a)SaccularaneurysmismostcommoncauseofSAHafterhead
trauma
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b)Severeheadachemaypresentc)CTangiographyhelpinlocalizinganeurysm
d)CTscanisinvestigationofchoiceforacuteSAH
e)DigitalsubtractionangiographyisbetterthanCTangiography
forSAH
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CorrectAnswer-B:C:DAnswer-(B)Severeheadachemaypresent(C)CTangiography
helpinlocalizinganeurysm(D)CTscanisinvestigationof
choiceforacuteSAH
Suddenlossofconsciousnessmaybeprecededbyabriefmoment
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ofexcraciatingheadache.ThehallmarkofaneurysmalruptureisbloodintheCSF.
Caseshaveenoughbloodtobevisualizedonahighqualitynon
contrastCTscan&bindwithin72hrs.
Alumbarpunctureshouldbperformedtoestablishthepresenceof
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subarachnoidblood.151.Whichoftheconditioncausepericarditis
duetohypersensitivity:
a)SLE
b)Rheumaticfever
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c)Dresslersyndromed)Uraemia
e)Myxedema
CorrectAnswer-A:B:C
Answer-(A)SLE(B)Rheumaticfever(C)Dresslersyndrome
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A.RheumaticfeverB.Collagenvasculardisease(systemiclupuserythematosus,
rheumatoidarthritis,ankylosingspondylitis,scleroderma,acute
rheumaticfever,granulomatosiswithpolyangiitis(Wegener's)
C.Drug-induced(e.9.,procainamide,hydralazine,phenytoin,
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isoniazide,minoxidil,anticoagulants,methysergide)D.Post-cardiacinjury
1. Postmyocardialinfarction(Dressler'ssyndrome)
2. Postpericardiotomy
3. Posttraumatic
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152.ECGchange(s)inpulmonaryembolism
mayincludes:
a)STelevationinVI&aVR
b)TwaveinversioninVItoV4
c)S1Q3T3pattern
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d)Leftaxisdeviatione)Rightbundlebranchblock
CorrectAnswer-A:B:C:E
Answer-(A)STelevationinVI&aVR(B)TwaveinversioninVI
toV4(C)S1Q3T3pattern(E)Rightbundlebranchblock
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Sinustachycardiaisthemostfrequentandnonspecificfindingonelectrocardiographyinacutepulmonaryembolism.
FeaturessuggestingacuterightheartstrainontheECGoccur
relativelyinfrequently,theseinclude.
Acuterightaxisdeviation
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PpulmonaleRightbundlebranchblock
InvertedTwaves
STsegmentchangesinrightsidedleads.
EarlierthefollowingE.C.G.changeswereconsideredhighly
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predictiveofacutepulmonaryembolism,buttheseobservationswerefoundinlessthan12%ofpatientswithpulmonaryemboliin
recentstudies.
TheseE.C.G.featuresare-
SwaveinleadI
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QwaveinleadIIIInvertedTinleadIII(S1Q31.3)
SwavesinleadI,IIandIII("S1,S2S3)
153.Allaretrueabout"a"waveexcept:
a)Itisoftenthelargestpositivewavevisible
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b)Giantwaveinatrialfibrillationc)Tricuspidstenosisproducesgaintwave
d)Heartblockdiminishmagnitudeofawave
e)Producedbyrightatrialcontraction
CorrectAnswer-B:D
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Answer-(B)Giantwaveinatrialfibrillation(D)Heartblockdiminishmagnitudeofawave
Awavereffectsrightatrialpresystoliccontractionandoccursjust
aftertheelectrocardiographicPwave,precedingthefirstheart
sound(S1).Aprominentalphawaveisseeninpatientswithreduced
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rightventricularcompliance;acannonawaveoccurswithatrioventricufar(AV)dissociationandrightatrialcontractiondgainst
aclosedtricuspidvalve.
Inapatientwithawidecomplextachycardia,theappreciationof
cannonawavesinthejugularvenouswaveformidentifiesthe
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rhythmasventricularinorigin.TheAwaveisnotpresentwithatrialfibrillation.
154.Apatienthasshorth/oincreasedjugular
venouspressure,weakperipheralpulse
&lowB.P.Likelycondition(s)maybe:
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a)Tensionpneumothoraxb)Venousgasembolism
c)Pulmonaryembolism
d)Cardiactemponade
e)Septicshock
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CorrectAnswer-A:B:C:DAnswer-(A)Tensionpneumothorax(B)Venousgasembolism
(C)Pulmonaryembolism(D)Cardiactemponade
"SepticshockhaslowCVPwithhighcardiacoutput.
Venousgasembolism:Itcancauseacutecorpulmonale&
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cardiovascularcollapse.Tensionpneumothorax:Thereisdecreasedvenousreturntothe
heartdtcardiacoutputfallsleadingtohypotension.
Cardiactemponade(Pericardialeffusion)shouldbeconsideredin
anypatientwithhypotension,lowvolumepulse&raisedlVP.
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155.A40yearoldladyfromHimanchal
Pradeshhasfever&escharonbody.
Bloodinvestigationrevealed:Hb=12
gm%,TLC=9800/1.11,Platelet80000.
Whichofthefollowingdrug(s)maybe
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usedinhertreatment:a)OralDoxycycline
b)Meropenem
c)Azithromycin
d)Tetracycline
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e)ChloramphenicolCorrectAnswer-A:C:D:E
Answer-(A)OralDoxycycline(C)Azithromycin(D)Tetracycline
(E)Chloramphenicol
Theclinicalmanifestationsofalltheacutepresentationsaresimilar
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duringthefirst5days:feverheadache,andmyalgiaswithorwithoutnausea,vomiting,andcough.
Clinicalmanifestations-includingoccurrenceofamacular,
maculopapular,orvesicularrash;eschar;pneumonitis;and
meningoencephalitis.
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Doxycyclineisthedrugofchoiceformostoftheseinfections.Tetacyclineisdrugofchoiceforspecifictreatmentofallrickettsial
diseases.
Longacting(doxycycline,minocycline)nowmakesingledose
treatmentpossible.
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156.Whichofthefollowingistrueregarding
pseudobulbarpalsy:
a)Dysphagia
b)Jawjerkbrisk
c)Absentgagreflex
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d)Tonguefasciculationpresente)Plantarreflexisextensor
CorrectAnswer-A:B:E
Answer-(A)Dysphagia(B)Jawjerkbrisk(E)Plantarreflexis
extensor
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DysarthriaDysphagia
Gagreflex
Jawjerkhyperactive
Emotionallability
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Intellectualimpairment157.Whichofthefollowingistrueregarding
adrenocorticalcarcinomas:
a)IncreasedurinaryexcretionofVMA
b)Doesnotcausemetastasis
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c)Surgeryismainstaytreatmentd)AssociatedwithLi-Fraumenisyndrome
e)None
CorrectAnswer-C:D
Answer-(C)Surgeryismainstaytreatment(D)Associatedwith
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Li-FraumenisyndromeIncreasedVMAexcretionintotheurinecanoccurin
Neuroblastomas,pheochromocytomas,andotherneuroendocrine
tumors.
TworareinheritedcausesofadrenalcorticalcarcinomasareLi-
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FraumenisyndtomeandBeckwith-Wiedenannsyndrome.Metastasestoregionalandperiaorticnodesarccommon.
ACCcarriesapoorprognosisandcurecanbeachievedonlyby
completesurgicalremoval.
158.ApatientpresentedwithhighpH,low
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arterialCO2&lowplasmaHCO3-level.Whichofthefollowingstatementistrue
regardingthepresentation&various
causes:
a)Compensatedrespiratoryalkalosis
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b)Chronicrenalfailurec)Persistentvomiting
d)Cerebro-vascularaccident
e)Hepaticfailure
CorrectAnswer-A:D:E
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Answer-(A)Compensatedrespiratoryalkalosis(D)Cerebro-vascularaccident(E)Hepaticfailure
HighpHmeans-alkalosis
DecreaseCO,meansrespiratoryalkalosis
LowHCO3-levelmeansmetabolicacidosis
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Thereforeitisacaseofrespiratoryalkalosiswithmetabolicacidosis(Compensatedrespiratoryalkalosis)
159.MIBG(metaiodobenzylguanithidine)is
analogueto:
a)Epinephrine
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b)Adeninec)Norepinephrine
d)Guanine
e)Phenylephrine
CorrectAnswer-C
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Answer-(C)NorepinephrinePheochromocytomacanbelocalizedusingradioactivetracers
including131I-or123l-metaiodobenzylguanithidine(MIBG),111ln-
somatostatinanalogues,or18F-dopa(ordopamine)Positron-
emissiontomography(PET).
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160.Presentation(s)ofBechetsyndrome
mayinclude:
a)Erosivearthritis
b)Recurrentaphthousulcersofthemouth
c)Uveitis
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d)Genitalulcere)Pathergytest
CorrectAnswer-B:C:D:E
Answer-(B)Recurrentaphthousulcersofthemouth(C)Uveitis
(D)Genitalulcer(E)Pathergytest
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Behcet'ssyndromeisamultisystemdisorderpresentingwithrecurrentoralandgenitalulcerationsaswellasocularinvolvement.
Non-deformingarthritisorarthralgiasareseenin50%ofpatients
andaffectsthekneesandankles.
Recurrentoralulcerationplustwoofthefollowing:
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RecurrentgenitalulcerationEyelesions
Skinlesions
Pathergytest
ThehallmarkofBehcetdiseaseispainfulaphthousulcerationinthe
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mouth.Eitheranteriororposterioruveitisposterioruveitismaybe
asymptomatic
161.Braindeathcanbeassessedby:
a)Apnoeatest
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b)CTscanc)MRIscan
d)Cerebralangiography
e)TranscranialDoppler
CorrectAnswer-A:D:E
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Answer-(A)Apnoeatest(D)Cerebralangiography(E)TranscranialDoppler
Spinalcordreflexesmaybepreservedincoma&re-examination
(not<2hourapart)isoptional.
Apneatestshouldbedoneatlastbecauseofitsharmfuleffectson
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intracranialpressure.IsoelectricEEG,absentbrainstemauditoryevokedpotentials&
absenceofcerebralperfusion(onangiography,radioisotopescanor
transcranialDoppler)areconfirmatorybutnotrequiredtests.
162.AccordingtoSurvivingSepsis
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Guidelines2013,whichofthefollowingis/arecorrectregardingsepsis&septic
shocktreatmentguideline:
a)Urineoutputshouldbe>2m1/kg
b)Meanarterialpressuregoalshouldbe65mmHg
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c)Dopamineasthefirstchoicevasopressord)Colloidisinitialfluidofchoiceintheresuscitation
e)Administrationofeffectiveintravenousantimicrobialswithinthe
firsthourofrecognition
CorrectAnswer-B:E
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Answer-(B)Meanarterialpressuregoalshouldbe65mmHg(E)Administrationofeffectiveintravenousantimicrobialswithin
thefirsthourofrecognition
Crystalloidsastheinitialfluidofchoiceintheresuscitaiionofsevere
sepsisandsepticshock.
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Norepinephrineasthefirstchoicevasopressor.Dopamineasanalternativevasopressoragenttonorepinephrine
onlyinhighlyselectedpatients.
Thegoalsduringthefirst6hoursofresuscitationshouldbe
(GradelC):
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Meanarterialpressure(MAP)65mmHg;Centralvenouspressure(CVP)8-12mmHg(12-15mmHgin
Patientsreceivingmechanicalventilationorwithknownpreexisting
decreasedventricularcompliance)
Urineoutput0.5mL/kg/hr(35mL/hrforsomeoneweighing70kg
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or154lbs)
Centralvenousoxygensaturation(fromthesuperiorvenacava)
70%,ormixedvenousoxygensaturation(fromapulmonaryartery
catheter)65%
163.AllaretrueaboutMenetrier'sdisease
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except:a)Increasedgastricacidsecretion
b)Protein-losinggastropathy
c)Mainlyaffectsbody&fundus
d)Nomalignantpotential
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e)Transforminggrowthfactor-aisoverexpressedCorrectAnswer-D
Answer-(D)Nomalignantpotential
Menetrier'sdiseaseisanunusualconditioncharacterisedby
hypertrophyofthegastricmucosalfolds,mucusproduction&
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hypochohydria.Itisapremalignantcondition.
ThemucosalfoldsinMenetrier'sdiseaseareoftenmostprominentin
thebodyandfundus.
CausedbyexcessivesecretionofTGF.
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Clinicalfeatures-Hypoproteinaemia
Anaemia
Increasedriskofgastricadenocarcinomaassociatedwithprotein
losingenteropathy.
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MaygetconfusedwithZollinger-Ellisonsyndrome.164.Whichofthefollowingistrueabout
treatmentofasthma:
a)LongactingP2agonistforacuteattack
b)Longacting32agonistforlongtermtreatment
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c)Shortacting(32agonistforacuteattackd)I.VSteroidforsevereasthmaexacerbation
e)Inhaledsteroidforpersistentasthma
CorrectAnswer-B:C:D:E
Answer-(B)Longacting32agonistforlongtermtreatment
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(C)Shortacting(32agonistforacuteattack(D)I.VSteroidforsevereasthmaexacerbation(E)Inhaledsteroidforpersistent
asthma
Oralcorticosteroidsshouldgenerallybeprescribedforearly
administrationathomeinpatientswithmoderatetosevereasthma
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NAEPP3recommendationsemphasizedailyanti-inflammatory
therapywithinhaledcorticosteroidsasthecornerstoneoftreatment
ofpersistentasthma.
165.Side-effect(s)ofinhalationalsteroid
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is/areallexcept:a)Adrenalsuppression
b)Cataract
c)Osteoporosis
d)Hypoglycemia
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e)SkinthinningCorrectAnswer-D
Answer-D.Hypoglycemia
Localsideeffectsincludehoarseness(dysphonia)andoral
candidiasis
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growthretardationinchildrenortoosteoporosisinadults.bruising,petechiae
Hyperglycemia&pituitary-adrenalsuppression
166.Whichofthefollowingdyadsofdisease-
neurotansmitteriscorrect:
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a)Myastheniagravis-Acetycholinereceptorb)Spasticity-GABA
c)Lambert-Eatonmyasthenicsyndrome-Acetycholine
d)Stiff-personsyndrome-Glycine
e)Parkinson'sdisease-Dopamine
--- Content provided by FirstRanker.com ---
CorrectAnswer-A:C:EAnswer-(A)Myastheniagravis-Acetycholinereceptor
(C)Lambert-Eatonmyasthenicsyndrome-Acetycholine
(E)Parkinson'sdisease-Dopamine
Acetylcholine(ACh)-Myastheniagravis,Lambert-Eatonsyndrome,
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Botulism,Alzheimer'sdiseaseDopamine-Parkinson'sdisease
Norepinephrine(NE)-Mooddisorder,anxiety,Orthostatic
tachycardiasyndrome
Serotonin-Mooddisorder,Migrainepainpathway
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GABA-Stiff-personsyndrome,epilepsyGlycine-Spasticity
167.Allaretrueaboutsyncopeexcept:
a)Consciousnessislost
b)Morecommoninstandingthanlyingpostion
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c)Vasovagaltypeiscommond)Returnofconsciousnessisslow&takehours
e)Shortduration
CorrectAnswer-D
Answer-D.Returnofconsciousnessisslow&takehours
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Syncopeisatransient,self-limitedlossofconsciousnessduetoacuteglobalimpairmentofcerebralbloodflow.
Asyncopalattackbeginswhenthepatientisusuallyinanupright
position(sittingorstanding)Returnofconsciousnessisprompt.
Vasovagalsyncopeisduetoexcessivevagaltoneorimpairedreflex
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controloftheperipheralcirculation.ThemostfrequenttypeofvasodepressorsyncoPeisvasovagal
hypotensionorthecommonfaint.
168.Drug(s)giveninthyroidcrisis:
a)Esmolol
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b)Iodinec)Hydrocortisone
d)Aspirin
e)Propylthiouracil
CorrectAnswer-A:B:C:E
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Answer-(A)Esmolol(B)Iodine(C)Hydrocortisone(E)Propylthiouracil
TREATMENT-
Propylthiouracil(drugofchoice)
StableiodideblocksthyroidhormonesynthesisviaWolff-Chaikoff
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effect.Potassiumiodide
Porpranolol,esmolol
Glucocorticoids,Hydrocortisone
Calciumchannelblocker
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169.Unequalpulseinupper&lower
extremeties(i.e.,radio-femoraldelay)
is/areseenin:
a)Aorticdissection
b)Post-ductalcoarctationofaorta
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c)Supra-valvularAorticstenosisd)Sub-valvularAorticstenosis
e)Takayasu'ssyndrome
CorrectAnswer-B
Answer-(B)Post-ductalcoarctationofaorta
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InqualitybetweenTwoRadialPulse(Radio-RadialDelay)Thoracicinletsyndrome(cervicalrib'scalenesyndrome)
Aneurysmofaorta
Takayasu'sdisease
Pre-subclaviancoarctation
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SuPravalvularaorticstenosisAtherosclerosisofaorta
170.Non-exertionalclassicheatstrokeis/are
predisposedin:
a)Personwithpreviouschronicillness
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b)Elderlyc)Young&healthyperson
d)Adolescent
e)All
CorrectAnswer-A:B
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Answer-(A)Personwithpreviouschronicillness(B)ElderlyHeatstrokepresentswithahyperthermiaofgreaterthan40.6?C
(105.1?F)incombinationwithconfusionandalackofsweating.
Therearetwoformsofheatstroke-Classic(epidemic)&exertational
PatientswithCHScommonlyhavechronicdiseasesthatpredispose
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toheat-relatedillness.Ifcoolingisdelayed,severehepaticdysfunction,renalfailure,
disseminatedintravascularcoagulation,andfulminantmultisystem
organfailuremayoccur.
Classicheatstrokeisolderpatient.
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171.Whichofthefollowingcause(s)motor
neuropathy:
a)GBS
b)Diphtheria
c)Diabetes
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d)Fridericataxiae)All
CorrectAnswer-A:B:D
Answer-(A)GBS(B)Diphtheria(D)Fridericataxia
Parkinson'sdiseaseischaracterizedbyresttremor,rigidity,
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bradykinesia,andgaitimpairment,knownasthe"cardinalfeatures"ofthedisease.
Canincludefreezingofgait,posturalinstability,speechdfficulty,
autonomicdisturbances,sensoryalterations,mooddisorders,sleep
dysfunction,cognitiveimpairment,anddementia.
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172.Whichofthefollowingis/arefeatureof
Pre-renalARFincomparisontointrinsic
renalfailure:
a)FractionalexcretionofSodium<1
b)Renalfailureindex>1
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c)Urineosmolality>500mosmol/kgH20d)Urinecreatinine/plasmacreatinine>40
e)PlasmaBUN/creatinineratio<20
CorrectAnswer-A:C:D
Answer-(A)FractionalexcretionofSodium<1(C)Urine
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osmolality>500mosmol/kgH20(D)Urinecreatinine/plasmacreatinine>40
ComparisonoflabfindingsinAKI(1)
Test
PrerenalAKI
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IntrinsicAKIUrinespecificgravity
>1.020
1.010
Urinesodium,mEq/L
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<20>40
Fractionalexcretionof
<1%(neonates
>2%(neonates
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sodium<2%)
>2.5%)
Fractionalexcretionofurea <35%
>50%
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Urineosmolality,mOsm/kg >500<350
Ureanitrogen-creatinine
>20
10-50
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ratio173.Drugcausingpulmonaryfibrosisis/are:
a)Amiodarone
b)Cisplatin
c)Gold
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d)Bleomycine)All
CorrectAnswer-A:C:D
Answer-(A)Amiodarone(C)Gold(D)Bleomycin
Nitrofurantoin
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BleomycinBusulfan
CyclophosphamideMethysergide
Phenytoin
174.Whichofthefollowingcauses
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hyperkalemia:a)Barttersyndrome
b)RTAI
c)RTAII
d)Tumorlysissyndrome
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e)Addison'sdiseaseCorrectAnswer-D:E
Answer-(D)Tumorlysissyndrome(E)Addison'sdisease
Inadequateexcretion
A.Advancedrenalinsufficiencv
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1. Chronickidneydisease2. End-stagerenaldisease
3. Acuteoligurickidneyinjury
B.Primaryadrenalinsufficiency
1. Autoimmune:Addison'sdisease,polyglandularendocrinopathy
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2. Infectious:HlV,cytomegalovirus,tuberculosis,disseminatedfungalinfection
3. Infiltrative:amyloidosis,malignancy,metastaticcancer
4. Drug-associated:heparin,low-molecular-weightheparin
5. Hereditary:adrenalhypoplasiacongenita,congenitallipoidadrenal
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hyperplasia,aldosteronesynthasedeficiency6. Adrenalhemorrhageorinfarction,includinginantiphospholipid
syndrome
175.TreatmentofHyperkalemiaincludes:
a)Insulin
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b)CaHCO3c)Hemodialysis
d)p2agonist
e)50mlof50%dextrosewithinsulin
CorrectAnswer-A:C:D:E
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Answer-(A)Insulin(C)Hemodialysis(D)p2agonist(E)50mlof50%dextrosewithinsulin
Calciumsupplementation(calciumgluconate)
Insulinintravenousinjectionalongwithdextrosetoprevent
hypoglycemia,willleadtoashiftofpotassiumionsintocells,
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secondarytoincreasedactivityofthesodium-potassiumATPase.Bicarbonatetherapy
Salbutamol
SodiumPolystyrenesulfonate
Non-emergencyhyperkalemiatreatment:
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Loopdiuretics-ByrenalK+excretion.Resins[Sodiumpolystyrenesulfate]-BybindingK+
Hemodialysis-ByextracorporealK+removal
176.NeoplasticlesioninAIDSincludes:
a)Analcarcinoma
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b)Non-Hodgkin'slymphomac)Esophagealcarcinoma
d)Burkit'slymphoma
e)Cervicalcarcinoma
CorrectAnswer-A:B
--- Content provided by FirstRanker.com ---
Answer-A,AnalcarcinomaB,Non-Hodgkin'slymphomaKaposisarcoma(Multifocaltumorofvascularorigin)(HHV-8)
NonHodgkinlymphoma
Primarylymphomaofbrain
Invasivecancerofuterinecervix
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Immunoblasticlymphoma(mostcommonlymphoma)PrimaryEffusionLymphoma(PEL)
Plasmacyticlymphomaoftheoralcavity
Burkitt'slymphoma(EBvirus)
177.Treatmentoffacio-cervical
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actinomycosisincludes:a)Surgeryistreatmentofchoice
b)DrugofchoiceispenicillinG
c)Metronidazole
d)Amoxicillin
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e)AllCorrectAnswer-B:D
Answer-B,DrugofchoiceispenicillinGD,Amoxicillin
1stchoice-Penicillinoramoxicillinforsixtotwelvemonths
2ndchoice-Doxicycline
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Surgeryifthediseaseisextensive178.Whichofthefollowingis/arenotfeature
ofanorexianervosa:
a)Strictdieting
b)Hallucination
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c)Amenorrhoead)Distortionofbodyimage
e)Endocrineabnormalities
CorrectAnswer-B
Answer-B.Hallucination
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PSYCHOLOGICALSYMPTOMS:DistortedBodyImage.
EMOTIONAL:
Moodswings
Increasedcommitmenttowork
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BEHAVIORAL-Excessiveexercise,starvation.PHYSICAL:Extremeweightlossandstuntedgrowth,amenorrhea,
nippledischarge,dehydration,hypothermia,osteoporosis.
179.Communityacquiredpneumoniais/are
causedby:
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a)Staph.aureusb)Mycoplasmapneumoniae
c)Streptococcuspneumoniae
d)Influenzavirus
e)Neisseriagonorrhoeae
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CorrectAnswer-A:B:C:DAnswer-A,Staph.aureusB,Mycoplasma
pneumoniaeC,StreptococcuspneumoniaeD,Influenzavirus
Streptococcuspneumoniae
Haemophilusinfluenzae
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MoraxellacatarrhalisStaphylococcusaureus
Legionellapneumophila
Enterobacteriaceae(Klebsiellapneumoniae)andPseudomonas
sPP.
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MycoplasmapneumoniaeChlamydiasPP.
InfluenzaA
180.Whichofthefollowinginvestigationis
usefulforZollinger-EllisonSyndrome
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(gastrinoma):a)USG
b)MRI
c)CTscan
d)OctreoScan
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e)EndoscopicultrasoundCorrectAnswer-A:B:C:D:E
Answer-A,USGB,MRIC,CTscanD,OctreoScanE,Endoscopic
ultrasound
Investigations-
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SerumgastrinelevatedPatientshouldfirstundergoanabdominalCTscan,MRI,or
OctreoScantoexcludemetastaticdisease.
Endoscopicultrasound(EUS)permitsimagingofthepancreaswith
ahighdegreeofresolution
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Radiolabelledsomatostatinreceptorscintigraphy.Gastrinomapatientshavefastinggastrinlevel>150-200pg/ml
BAO>15meq/hinthepresenceofhypergastrinemiais
pathognomonicofZES.
BAO/MAOratio>0.6beinghighlysuggestiveofZES.
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Themostsensitiveandspecificgastrinprovocativetestforthediagnosisofgastrinomaisthesecretinstudy.(Anincreaseingastrin
of120pgwithin15minofsecretininjectionhasasensitivityand
specificityof>90%forZES.)
181.Paraneoplasticsyndromesoflung
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carcinomainclude:a)Hypercalcemia
b)SIADH
c)Hypocalcemia
d)Hypoglycemia
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e)HypernatremiaCorrectAnswer-A:B:C
Answer-A,HypercalcemiaB,SIADHC,Hypocalcemia
Hypercalcemiaofmalignancy
SIADH
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Cushing'ssyndromeHypoglycemia
Malefeminization
Diarrhoeaorintestinalhypermotility
Osteomalacia
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AcromegalyHyperthyroidism
Hypertension
182.Aperson'sX-raychestshowing
homogenousopacityonrightsidewith
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shiftingofmediastinumonoppositeside.Mostprobablediagnosisis/are:
a)Collapse
b)Pleuraleffusion
c)Pneumothorax
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d)Consolidatione)Post-pnemectomy
CorrectAnswer-B
Answer-(B)Pleuraleffusion
Pneumonectomychest(Earlysip:within24hr):Partialfillingof
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thorax,ipsilateralmediastinalshift&diaphragmaticelevation.Homogenousopacity
Shiftofmediastinumtotheoppositeside
Concaveupperborder(Ellis'scurve)
183.Whichofthefollowingis/aretrueabout
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pneumothorax:a)Decreasedchestmovement
b)Dullonpercussion
c)Decreasebreathingsound
d)Hyper-resonantnoteonpercussion
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e)End-expiratorycrepitationCorrectAnswer-A:C:D
Answer-A,DecreasedchestmovementC,Decreasebreathing
soundD,Hyper-resonantnoteonpercussion
Inpneumothorax,intra-pleuralpressureequilibrateswiththe
--- Content provided by FirstRanker.com ---
ambientbarometricpressureandthelung'snaturalrecoiltendencycausesittocollapse.
Pneumothoraxtendstocausecollapseofthelungsandadecreased
compliance.
ClosedPneumothorax-
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ReducedchestmovementHyper-resonantnoteonpercussion
Absentairentry
Mediastinalshifttooppositeside
Cointest
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OpenPneumothorax-Crackpotsoundonpercussion
Amphoricbreathsounds
Displacementofmediastinumwithrespiration
Increasingbreathlessness,cyanosis&tachycardia
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184.WhichofthefollowingincludedinATPIII
criteriaforMetabolicsyndrome:
a)B.P130/85
b)Triglyceride150mg/dl
c)Fastingglucose100
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d)Waistcircumferenceinfemale>80cme)None
CorrectAnswer-A:B:C
Answer-A,B.P130/85B,Triglyceride150mg/dlC,Fasting
glucose100
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CriteriaHarmonized
NCEP(2001) IDF(2005)
WHO(1998)
(2009)
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WC:Z90DM.IFG.IGT,
Prerequisite
None
cm(men) None
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IR&
280cm
(women)t
No.ofother
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and22of:23of.
and22of: 23of:
criteria
Already
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BMI:230&for WC:3102WC:Z90cm
Obesity
considered
WHR:>0.9
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cm(men)&(men)e.
as
(men)&
388cm
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perquisite 3$0cm>0.85
(women)
criterion
(women)t
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(women)3130/135or Z:130/85
3130/85or
BP(mmHg)
Z140/90
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RxorRx
Rx
BP(mmHg)
Z140/90
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RxorRx
Rx
<35(men)&
<40(men)
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HDL-C(mg/di)<39(women) <40(men)&
<40(men)&
&
or
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<50<50
<50(women)
(women)
(women)or
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orRxorRx
Rx
TG(mg/d1)
Z150
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150orRx2l50orRx kis()orRx
Fastingglucose
2100or
2110,la
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2100orRx2100orfix
(mg/d1)
No
Urinary
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albumin220ug/minor
Microalbuminuria albumin-
creatinine
ratio>30
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mg/gtRecommendedwaistcircumferencethresholdsfortheabdominal
obesityinpeopleofAsianorigin.
185.Whichofthefollowingis/aretrueabout
inflammatoryboweldisease:
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a)SmokingdecreasesriskofCrohn'sdisease&increasesriskofulcerativecolitis
b)PANCA-ulcerativecolitis
c)Linearulcer-Crohn'sdisease
d)Pseudopolyp-Crohn'sdisease
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e)Cobblestoning-ulcerativecolitisCorrectAnswer-B:C
Answer-(B)PANCA-ulcerativecolitis(C)Linearulcer-Crohn's
disease
ULCERATIVE
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CROHN'SDISEASECOLITIS
Wateryorbloody
Chronicdiarrhea
diarrhea
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RectaldischargeofAbdominalpain
mucus,perforation
Weightloss,pyrexia,
Proctitis
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abdominalmassAcuteintestinal
Colitis
obstruction
Multipleperianal
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Proctosigmoditisfissures,fistula
&abscess
Toxicrnegacolon,
Fatwrappings
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severehemorrhage{creepingrnesentry)
ULCERATIVE CROHN'SDISEASE
COLITIS
Gross-
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Gross?Onlythe
Inflammatoryinvolvesfullthicknessofbowelwall
mucosa
thicknessofbowelwallinvolvingserosa
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involvedCobblestoneappearance
Superficial
Deepfissuredulcers
ulceration
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LymphadenopathyExudation
Fistulapresent
Pseudopolyps Skipareas
Micro-
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Cryptabscesscommon
Micro?
Inflammatory Noncaseatinggiantcellgranulomapresent
polyps
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Pipestemcolon
ULCERATIVE
CROWN'SDISEASE
COLITIS
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Age-2ndto4th&7thtoAge-2ndto4thdecade
9Thdecade
Gender-bothare
Femalesaremore
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equallyaffectedaffected
Etiology-
Etiology?
Morecommoninnon/
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Morecommoninexsmokers
smokers
Anatomical
Anatomical
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distribution?distribution-
Commonestinileum
Alwaysinvolvesrectum 160%)
&descending
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Anallesionsarecolon/sigmoid
common
186.Herpesencephalitisfindingsare:
a)Mostcommonlyinvolvesfrontal&temporallobe
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b)Commonlyinvolvesbasalgangliac)HyperintenselesionintemporallobeonT1-weightedimages
d)HyperintenselesionintemporallobeonT2-weightedimages
e)None
CorrectAnswer-A:D
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Answer-(A)Mostcommonlyinvolvesfrontal&temporallobe(D)HyperintenselesionintemporallobeonT2-weighted
images
HSVencephalitis-
Examplesoffocalfindingsinclude:
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1. areasofincreasedsignalintensityinthefrontotemporal2. focalareasoflowabsorption,masseffect,andcontrast
enhancementonCT
3. periodicfocaltemporallobespikesonabackgroundofsloworlow-
amplitude("flattened")activityonEEG
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80%willhaveabnormalitlesinthetempotallobe.HyperintenseonT2-images.
187.Paradoxical/reversesplittingofsecond
heartsoundis/areseenin:
a)AS
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b)PSc)Completeleftbundlebranchblock
d)Pulmonaryarterialhypertension
e)All
CorrectAnswer-A:C
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Answer-(A)AS(C)CompleteleftbundlebranchblockLeftBundleBranchBlock(LBBB)istypicallyassociatedwith
ReversedorParadoxicalSplittingofS2
ParadoxicalsplittingofsecondheartsoundiscausedbydelayedA2
orearlyP2.LeftBundleBranchBlock(LBBB)isassociatedwith
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delayedAorticclosure(delayedA2)duetodelayedelectricalactivationoftheleftventricle.
ASDandRBBBareassociatedwithawidephysiological(non-
paradoxical)splitofsecondheartsoundduetodelayedpulmonic
closure(DelayedP2)whileVSDisassociatedwithawide
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physiological(non-paradoxical)splitsecondheartsoundfromearlyaorticclosure(EarlyA2).
188.Whichofthefollowingcausesacute
pancreatitis:
a)Hypertriglyceridemia
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b)Hypercalcemiac)Steroid
d)Stavudine
e)Gallstone
CorrectAnswer-A:B:C:E
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Answer-(A)Hypertriglyceridemia(B)Hypercalcemia(C)Steroid(E)Gallstone
Gallstones(mostcommon)
Alcoholabuseisthesecondcauseofacutepancreatitis.
Occultdiseaseofthebiliarytreeorpancreaticducts,especially
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microlithiasis,sludge.Hypertriglyceridemia
Pancreasdivisum
Pancreaticcancer
SphincterofOddidysfunction
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CysticfibrosisDrugs-Steroids,Azathioprine,Valproate,Estrogens,L-
Asparaginase,6-mercaptopurine,Sulfonamides,Tetracycline,Anti-
retroviralagents,Thiazidediuretics
Familialorgenetic
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HyperparathyroidismHypercalemia
PostERCP
Mostcommoncausesinchildren:bluntabdominalinjuries,
Mostcommoncausesinchildren:bluntabdominalinjuries,
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multisystemdisease(hemolyticuremicsyndromeandinflammatoryboweldisease)biliarystonesormicrolithiasis(sludging),anddrug
toxicity