a)Mesoderm
b)Endoderm
c)Neuralcrest
d)Neuroectoderm
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CorrectAnswer-CAnswer-C.Neuralcrest
Branchialorpharyngealarchesaremassesofmesodermcovered
byectodermandlinedbyendoderm.Withinthesemasses,muscular
andskeletalcomponentsdevelop,aswellasaorticarchesand
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nervenetworks.Thearchesareseparatedbygrooves,visibleonthesurfaceoftheembryoaspharyngealcleftsandintheinterioras
thepharyngealpouches
Inthehumanembryo,thearchesarefirstseenduringthe4thweek
ofdevelopment.
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Theyappearasaseriesofoutpouchingsofmesodermonbothsidesofdevelopingpharynx.
Theneuralcrestarebilaterallypairedstripsofcellsarisinginthe
ectodermatthemarginsoftheneuraltube.Thesecellsmigrateto
manydifferentlocationsanddifferentiateintomanycelltypeswithin
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theembryo.NeuralCrestDerivatives
Akeyfeatureofneuralcrestisthemigrationintootherembryonic
tissuestoformspecificneuralandnon-neuralpopulationsand
structures.
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Cranialneuralcrestmigration-dorsolaterallyandintopharyngealarches
craniofacialmesenchyme-cartilage,bone,cranialneurons,glia,
andconnectivetissuesoftheface
pharyngealarchesandpouches-thymiccells,toothodontoblasts,
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middleearbones(ossicles),striavasculariscells,andjaw(mandible)
Inthebodyregion,neuralcrestcellsalsocontributetheperipheral
nervoussystem(bothneuronsandglia)consistingofsensory
ganglia(dorsalrootganglia),sympatheticandparasympathetic
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gangliaandneuralplexuseswithinspecifictissues/organs.Intheheadregion,neuralcrestcellsmigrateintothepharyngeal
archesformingectomesenchymecontributingtissueswhichinthe
bodyregionaretypicallyderivedfrommesoderm(cartilage,bone,
andconnectivetissue).
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NeuralCrestOriginSystem
CellType
PeripheralNervous Neurons-sensoryganglia,sympatheticand
System
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parasympatheticganglia,entericnervous(PNS)
system,andplexuses
Neuroglialcells,olfactoryensheathingcells
Schwanncells
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EndocrineAdrenalmedulla
Calcitonin-secretingcells
CarotidbodytypeIcells
Integumentary
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EpidermalpigmentcellsFacialcartilage
Facialandanteriorventralskullcartilageand
andbone
bones
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SensoryInnerear,cornealendotheliumandstroma
Connectivetissue Toothpapillae
smoothmuscle,andadiposetissueofskinof
headandneck
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Connectivetissueofmeninges,salivary,lacrimal,thymus,thyroid,andpituitaryglands
Connectivetissueandsmoothmuscleinarteries
ofaorticarchorigin
2.Hardpalatecontains:
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a)Keratinised,submucosa,minorsalivaryglandb)Keratinised,absentsubmucosallayer,minorsalivarygland
c)Nonkeratinised,submucosallayer,minorsalivarygland
d)Nonkeratinised,absentsubmucosa,minorsalivarygland
CorrectAnswer-A
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Answer-A.Keratinised,submucosa,minorsalivaryglandThehardpalateislocatedontheroofoftheoralcavity,posterior
andmedialtothealveolarprocessofthemaxilla.
Thebonystructureisformedbythepalatineprocessesofthe
maxillaandthehorizontalplatesofthepalatinebones.
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Theperiosteumiscoveredbyafirmlyattachedmucosacentrally,althoughasubmucosaisapparentlaterallycontainingvessels.The
hardpalateiscontinuouswiththesoftpalateposteriorly.
MacroscopicFeatures
Thehardpalateistypicallyapalepinkcolourandmayhavean
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orangepeelappearancefromthepalatinesalivaryglands(morecommonposteriorly).
MicroscopicFeatures
Thehardpalateislinedwithakeratinisingstratifiedsquamous
epithelium,tightlyboundtotheunderlyingperiosteumofthe
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palatinebone/maxilla.Thereisminimalsubmucosa,whichbecomesmoreprominentposteriorly.
3.Whatisthetensorofvocalcords:
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a)Cricothyroidb)LateralCricoarytenoid
c)Thyroarytenoids
d)Posteriorcricoarytenoids
CorrectAnswer-A
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Answer-A.CricothyroidCricothyroid:
Tensorofvocalcords.
Lateralcricoarytenoid: Abductorofvocalcords.
Thyroarytenoid:
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Relaxorofvocalcords.Posterior
Abductorofvocalcords
cricoarytenoid:
MusclesactingontheLarynx
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MovementMuscles
ElevationofLarynx Thyrohyoid,mylohyoid
Depressionoflarynx Sternothyroid,sternohyoid
Openinginletof
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Thyroepiglotticuslarynx
Closinginletof
Aryepiglotticus
larynx
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Abductorofvocal Posteriorcricoarytenoidonlycords
Adductor
Lateralcricoarytenoidtransverse&oblique
ofvocalcords
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arytenoidsTensorofvocal
cords
Cricothyroid
Relaxerofvocal
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Thyroarytenoidcords
4.Uretericbuddevelopsfrom:
a)Mesonephros
b)Metanephros
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c)Pronephrosd)Genitalsinus
CorrectAnswer-A
Answer-A.Mesonephros
Theuretericbud,alsoknownasthemetanephrogenic
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diverticulum,isaprotrusionfromthemesonephricductduringthedevelopmentoftheurinaryandreproductiveorgans.
Itlaterdevelopsintoaconduit(channel)forurinedrainagefromthe
kidneys,which,incontrast,originatefromthemetanephric
blastema.
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Themetanephrogenicblastemaormetanephricblastema(ormetanephricmesenchyme,ormetanephricmesoderm)isoneofthe
twoembryologicalstructuresthatgiverisetothekidney,theother
beingtheuretericbud.
5.AboutWeber'ssyndromewhichis
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incorrect:a)Contralateralhemiplegia
b)IpsilateralOculomotornervepalsy
c)ContralateralParkinsonism
d)Anteriorcerebralpeduncle
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CorrectAnswer-DAnswer-D.Anteriorcerebralpeduncle
Weber'ssyndrome(superioralternatinghemiplegia)isaform
ofstrokecharacterizedbythepresenceofan
ipsilateraloculomotornervepalsyand
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contralateralhemiparesisorhemiplegia.Itiscausedbymidbraininfarctionasaresultofocclusionof
theparamedianbranchesoftheposteriorcerebralarteryor
basilarbifurcationperforatingarteries.
Thislesionisusuallyunilateralandaffectsseveralstructuresin
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themidbrain:Contralateralparkinsonismbecauseitsdopaminergicprojections
tothebasalgangliainnervatetheipsilateralhemispheremotorfield,
leadingtoamovementdisorderofthecontralateralbody.
Contralateralhemiparesisandtypicaluppermotorneuronfindings.
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Itiscontralateralbecauseitoccursbeforethedecussationinthemedulla.
Difficultywithcontralaterallowerfacialmusclesandhypoglossal
nervefunctions.
IpsilateralOculomotornervepalsywithadroopingeyelidand
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fixedwidepupilpointeddownandout.Thisleadstodiplopia.6.AboutSibson'sfasciawhichisincorrect:
a)Attachedtotheinnerborderof2ndrib
b)Coversapicalpartoflung
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c)Partofscalenusanteriormuscled)Vesselpassabovethefascia
CorrectAnswer-A
Answer-A.Attachedtotheinnerborderof2ndrib
ThesuprapleuralmembraneisknownasSibson'sfascia.
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Itreferstoathickeningofconnectivetissuethatcoverstheapexofeachhumanlung.
Itattachestotheinternalborderofthefirstribandthetransverse
processesofvertebraC7.
Suprapleuralmembrane/Sibson'sfascia
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7.Thrombosisofposteriorinferiorcerebellar
arterycauses:
a)Lateralmedullarysyndrome
b)Webersyndrome
c)Medialmedullarysyndrome
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d)noneCorrectAnswer-A
Answer-A.Lateralmedullarysyndrome
Theposteriorinferiorcerebellarartery(PICA),thelargestbranch
ofthevertebralartery,isoneofthethreemainarterialblood
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suppliesforthecerebellum,partofthebrain.Occlusionoftheposteriorinferiorcerebellararteryoroneofits
branches,orofthevertebralarteryleadstolateralmedullary
syndromealsocalledWallenbergsyndrome
8.Broca'sareasituatedin:
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a)Inferiorfrontalgyrusb)Superiortemporalgyrus
c)Angulargyrus
d)Noneoftheabove
CorrectAnswer-A
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Answer-A.InferiorfrontalgyrusBroca'sareaortheBrocaarea(44)isaregioninthefrontallobeof
thedominanthemisphere(usuallytheleft)ofthehominidbrainwith
functionslinkedtospeechproduction.
Inabilitytospeakafterinjurytotheposteriorinferiorfrontalgyrusof
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thebrain.PierrePaulBrocaheidentifiedthisregion,knownasBroca'sarea.
DifficultyinlanguageproductionasBroca'saphasia,also
calledexpressiveaphasia.
Broca'sareaisnowtypicallydefinedintermsofthepars
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opercularisandparstriangularisoftheinferiorfrontalgyrus.BROCA'SAREA(showninred).Coloredregionisparsopercularis
andparstriangularisoftheinferiorfrontalgyrus.Broca'sareaisnow
typicallydefinedintermsoftheparsopercularisandpars
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triangularisoftheinferiorfrontalgyrus.9.Acutetonsillitiseffectswhichnerve:
a)GlossopharyngealNerve
b)FacialNerve
c)Trigeminalnerve
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d)VagusNerveCorrectAnswer-A
Answer-A.GlossopharyngealNerve
Thenervessupplyingthepalatinetonsilscomefromthemaxillary
divisionofthetrigeminalnerveviathelesserpalatinenerves,and
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thetonsillarbranchesoftheglossopharyngealnerve.Theglossopharyngealnervecontinuespastthepalatinetonsiland
innervatestheposterior1/3ofthetonguetoprovidegeneraland
tastesensation.Thisnerveismostlikelytobedamagedduring
atonsillectomy,whichleadstoreducedorlostgeneralsensation
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andtastesensationtotheposteriorthirdofthetongue.Relationsoftonsillarbed
10.StructuresnotpassingthroughAortic
opening:
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a)Azygosveinb)Aorta
c)Thoracicduct
d)Vagus
CorrectAnswer-D
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Answer-D.VagusAorticopening(Aortichiatus)isoneofthethreemajorapertures
throughthediaphragm&liesatthelevelofT12.
Severalstructurespassthroughtheaortichiatus:aorta,azygos
vein,thoracicduct.
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Vaguspassesthroughtheoesophagealhiatus.11.WhatshouldbethevalueofBMItobe
consideredas"Lethal"inmen?
a)12
b)18
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c)13d)14
CorrectAnswer-C
Answer:C?13
BMIValueof13isconsideredas"Lethal"inmen.
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Bodymassindex(BMI)isanestimateoftotalbodyfatmassSimplyanindexofweightforheight.
Formula:
Weightinkilogramsdividedbythesquareofheightinmeters.
Bodymassindex=Weight(kg)/(Height)2(m)
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Uses:Usedtoclassifyanddefineunderweight,overweight&obesityin
adults.
Classification&Metrics:
WorldHealthorganizationcategorizedBMIvaluesinto:
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ClassificationBMIvalue
Normalweight
18.5to24.9kg/m2
Underweight
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<18.5Pre-obesity(Pre-OB)
25to29.9kg/m2
Obesity(OB)
>30kg/m2
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ClassIobesity30.0-34.9kg/m2
ClassIIobesity
ClassIIIobesity(Morbidform)
ClassIIIobesity(Morbidform)
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35.0-39.9kg/m2Morethan40kg/m2
BMIvalueconsideredlethalforMenis13
FemaleswithstandandsurviveevenatlowerBMIrateupto11.
12.Whichreceptorsareblockedin
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MyastheniaGravis?a)Achreceptors
b)Ca++receptors
c)Na2+receptors
d)Opioidreceptors
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CorrectAnswer-AAnswer:A-Achreceptors
Anautoimmunedisease
Antibodymediatedautoimmuneattackofacetylcholine
receptors.
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Inabilityofneuromuscularjunctionstotransmitsignalsfromnervetomuscle
Resultinginmuscleweaknessandfatigability.
Unresponsiverespiratorymusclesmaycauserespiratoryfailurein
severecases.
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AnalysisofneuromusculartransmissionrevealDecreaseinacetylcholinereceptors(AChRs)
Lossofpost-junctionalfolds.
Circulatingantibodiestoacetylcholinereceptorspositive.
Diagnosis:
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Clinicaltest:Strengthimprovementinresponsetoadministrationofanticholinesteraseagents.
Treatment:
Anti-cholinesterasedrugs:Allowsaccumulationoflargeramounts
ofacetylcholineinsynapticjunctions.
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Neostigmine.13.WhatisthecharacteristicpatternseeninBrownsequard
syndrome-
a)C/Llossofjointsenseandposition
b)C/Llossofpain
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c)I/Llossofcompletesensoryfunctionsd)C/Lmotorfunctions
CorrectAnswer-B
Answer:B-Contralaterallossofpainsensations
Ifthespinalcordiscompletelytransected?Allthesensationsand
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motorfunctionsdistaltosegmentoftransectionareblocked.Transectionofspinalcordonsinglesideresultsin"Brown
SequardSyndrome"
Functionsaffected:
Function
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PositionDescription
affected
Motor
Ipsilateralside
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Completelossofmotorfunctionsbelowthelevelof
transection
Sensory
Combinedeffects Somesensoryfunctionsare
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observedlostontransectedsideand
othersonoppositeside.
Onthe
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ResultofdisturbanceinContralateral
Spinothalamicpathway.
side:
Lossobserved2to6
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Sensationofpain, segmentsbelowthelevelofcold,&heat
transection.
DiscreteCrude
Poorlylocalized(Still
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touchpersists).
Partialtransmissionoccursin
oppositeSpinothalamictract
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14.WhenVa/Qisinfinity?
a)PartialpressureofO2becomeszero
b)NoexchangeofO2&CO2
c)PartialpressureofCO2alonebecomeszero
d)PartialpressurebothCO2andO2remainnormal
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CorrectAnswer-BAnswer:B-NoexchangeofO2&CO2
Varepresentstheventilationinalveoli.
Qrepresentsthebloodflowthroughthealveolus.
TheratioofVaandQexplainstherespiratoryexchangewhenthere
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isanimbalancebetweenalveolarventilationandalveolarbloodflow.Theventilation-perfusionratioisconsiderednormalthereisanequal
amountofbloodflow&ventilationthroughalveolus.
Va/qratioisZero-
Thereisinadequateornil,butperfusionpersists
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Va/qratioisinfinity-Thereisadequateventilationbutnoperfusion.
BothintheZeroandinfinityVa/Qratio,thereisnoexchangeof
gasesthroughtherespiratorymembranesofcorrespondingalveoli.
WhenVa/Qratioisinfinity,
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ThealveolarairequilibratesthehumidifiedinspiredairNoexchangeofoxygenandcarbon-di-oxideoccurs.
PartialpressuresoftheO2andCO2are149mmHg&0mmHg
respectively
15.Cwaveisseenin-
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a)Iso-volumetriccontractionb)Slowfillingatendofdiastole
c)Endofsystole
d)Startofdiastole
CorrectAnswer-A
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Ans.A.Iso-volumetriccontractionCwave:
ProducedbybulgingoftricuspidvalveintorightatriumduringIso-
volumetriccontractionofrightventricle.
16.Alphawavesareseenduring?
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a)Sleepb)REMmovements
c)Relaxedstate
d)Activestate
CorrectAnswer-C
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Answer:C-RelaxedstateRegardedasnormalwavefront
Occurwhenatrestandeyesclosedwithactive/wanderingmind
ie.,associatedwithadecreasedlevelofattention(either
duringrelaxed/subconsciousthinking)
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RegularRhythm(Frequency8-13HzAmplitude-50-100V)17.Inhypovolemicshockthereis-
a)Afferentarteriolarconstriction
b)Efferentarteriolarconstriction
c)Increasedbloodflowtokidney
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d)NormalcardiacoutputCorrectAnswer-A
Answer:A.Afferentarterioleconstriction
Inadequatecirculationvolume.
Poorvenousreturntoheartwilldecreasethestrokevolume&
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cardiacoutput.Compensationbytachycardia&increasedsystemicvascular
resistance(SVR).
Becomecoldperipherally(shutdown).
Mostcommoncauses-Fluidlossofanyetiology
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HemorrhageSalt&waterloss
Sepsis
Burns
18.Componentsresponsibleforcounter
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currentmechanisminkidneyareallexcept:
a)Sodiumoutflowinthickascendinglimb
b)Wateroutflowinthindescendinglimb
c)Sodiumoutflowinthinascendinglimb
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d)FlowoftubularfluidfromPCTtoDCTCorrectAnswer-C
Answer:C.Sodiumoutflowinthinascendinglimb
Counter-currentsystemoccursinkidney
Asysteminwhichinflowrunsparallelto,counterto,andinclose
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proximitytotheoutflowforsomedistance.2countercurrentmechanismsavailable:
CountercurrentmultiplieratLoopofHenle
Generatehighmedullaryosmoticgradientpressure
Countercurrentexchangeratvasarectaofmedullarycapillaries
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HelpsinmaintainthemedullaryosmoticpressuregradientSubstancesinvolvedincountercurrentmechanisminclude:
Sodiumactivelyabsorbedwithco-transportofpotassium&chlorine
inthickascendinglimbofloopofHenle.
WaterreabsorbedinthindescendinglimbofloopofHenle.
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Ureadiffuseoutfromthemedullarycollectingductsintomedullaryinterstitium.
19.Glucoseisabsorbedinintestineby?
a)Secondaryactivetransport
b)Facilitateddiffusion
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c)Simplediffusiond)Primaryactivetransport
CorrectAnswer-B
Answer:B.Facilitateddiffusion
Facilitateddiffusionisadiffusionoflargewatersolublemoleculeby
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acarrierprotein.Glucoseandaminoacidsaretransportedacrossthemembraneby
thismethod.
20.Insulinlikegrowthfactorissecretedby:
a)Liver
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b)Pituitaryglandc)Pancreas
d)Adrenalglands
CorrectAnswer-A
Answer:A.Liver
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Growthhormoneactsonthelivertoformsmallproteinscalled"Somatomedins"
Somatomedinsincreasesbonegrowthinallaspect
Effectsaresimilartoinsulin,hencereferredtoas"Insulin-like
GrowthFactor"(IGF).
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Fourtypesavailable-MostimportantisSomatomedinC-Specificallyreferredtoas
"Insulin-GrowthFactor-1/IGF-1"
Bindstoacarrierproteininblood
Hence,alongerdurationofactionthangrowthhormone.
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Half-life-about20Hrs(comparedtogrowthhormone-20mins)BloodconcentrationofIGF-1followsthelevelsofgrowthhormone.
GrowtheffectsofGHaremostlyattributedtosomatomedin(rather
thanitsdirecteffectonbones&peripheraltissues)
21.WhatisProsopagnosia?
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a)Impairmentofconsciousnessb)Beingunawareofone'sproblems
c)Difficultyinidentifyingknownfaces
d)Failuretoidentifyobjects
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans.C.Difficultyinidentifyingknownfaces.Afeatureofanxietydisorder
Prosopagnosiaisdifficultyinidentifyingknownfaces
Otherfeaturesofanxietydisorderinclude,
Memoryimpairmentwithoutimpairmentofconsciousness
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Beingunawareofone'sproblem(Agnosognosia)22.Tyrosinosisiscausedduetodeficiencyof
whichenzyme?
a)Fumarylacetoacetatehydrolase.
b)p-hydroxyphenylpyruvatedehydrogenase.
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c)Tyrosinetransaminase.d)Tyrosineligase.
CorrectAnswer-A
Answer:A.Fumarylacetoacetatehydrolase
Severalmetabolicdisordersareassociatedwiththetyrosine
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catabolicpathway.TheprobablemetabolicdefectintypeItyrosinemia(tyrosinosis)isatfumarylacetoacetatehydrolase.
Itischaracterizedbybuildupoftoomuchoftheaminoacidtyrosine
inthebloodandtissuesduetoaninabilitytometabolizeit
Thetherapyemploysadietlowintyrosineandphenylalanine.
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Untreatedacuteandchronictyrosinosisleadstodeathfromliverfailure.
23.Lesch?Nyhansyndromeiscausedby
deficiencyofwhichenzyme?
a)OrotatePhosphoribosyltransferase
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b)Uracilphosphoribosyltransferasec)QuinolinatePhosphoribosyltransferase
d)Hypoxanthine-guaninephosphoribosyltransferase(HGPRT)
CorrectAnswer-D
Answer:D.Hypoxanthine-guaninephosphoribosyltransferase
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(HGPRT)Theconditioniscalledksch-Nyhanslmdrome,inwhichthereis
completedeficiencyofHGPRT.
HGPRTdeficiencycausesdecreasedutilization
ofPRPPinsalvagepathway.
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ThisresultsinincreasedproductionofpurinenucleotidefromPRPPviade-novopathway.
Thediseaseischaracterizedbyhyperuricemia,
goutyarthritis,urinarystones,neurologicalsymptoms.
24.Fishodorsyndromeiscausedby
--- Content provided by FirstRanker.com ---
deficiencyofwhichenzyme?a)Fumarylacetoacetatehydrolase
b)Methanemonooxygenase
c)Monooxygenase3(FMO3)
d)D-aminoacidoxidase
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer:C.Monooxygenase3(FMO3)
Trimethylaminuria,orfishodorsyndrome(FOS),isacondition
characterizedbythepresenceoftrimethylamine(TMA)--atertiary
aminewhoseodorisdescribedasresemblingthatofrottingfish--in
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theurine,sweat,andexpiredair.ThecauseofthesyndromeisrootedinthedysfunctionalmetabolismofTMA,whichisnormally
oxidizedbyflavinmonooxygenase3(FMO3)intonon-odorous
trimethylamine-N-oxide(TMAO).
MostpatientswithFOSareeventuallydiagnosedwithprimary
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trimethylaminuria,whichiscausedbyadeficiencyinFMO3thatisinheritedinanautosomalrecessivefashion.
Thediagnosisismadeonthebasisoftheclinicalpresentationand
urinalysis.UrinecanbeanalyzedfortheconcentrationofbothTMA
andTMAO,andtheresultsmaybegivenasanoxidizingratiobased
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ontheformula-TMAO/(TMAO+TMA)x100%.Shortcoursesoforalneomycin,metronidazole,andamoxicillinhave
beenreportedtobeusefulinsomecases.
25.Galactosemiaisduetodeficiencyof
whichenzymes
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a)Galactose-1-phosphateuridyltransferaseb)HGPRT
c)Galactokinase
d)Epimerase
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:A.Galactose-1-phosphateuridyltransferaseGalactosaemia(Britishgalactosaemia)isararegeneticmetabolic
disorderthataffectsanindividual'sabilitytometabolizethesugar
galactoseproperly.Galactosemiafollowsanautosomalrecessive
modeofinheritancethatconfersadeficiencyinanenzyme
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responsibleforadequategalactosedegradation.26.Whichofthefollowingismostabundant
endproductoffattyacidsynthesis-
a)Oleicacid
b)Palmiticacid
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c)Arachidonicacidd)Glucose
CorrectAnswer-B
Answer:B.Palmiticacid
Fattyacidaresynthesizedbyextramitochondrialsystem.
--- Content provided by FirstRanker.com ---
Thissystemispresentinmanytissuesincludingliverkidneybrainlungmammaryglandandadiposetissues.
AcetylCoAisimmediatesubstrate.
Theendproductsofthissynthesisareusuallythesaturatedfatty
acidspalmitateandstearatewiththelatterpredominating.
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27.AboutDNApolymeraseIwhichoneis
correct?
a)Notrequiredinbacteria
b)RepairanydamagewithDNA
c)Involvedinokazakifragment
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d)ParticipateinDNAreplicationCorrectAnswer-A
Answer:A.Notrequiredinbacteria
DNApolymeraseIparticipatesintheDNAreplicationof
prokaryotes.FunctionofPolIismainlytorepairanydamagewith
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DNA,butitalsoservestoconnectokazakifragmentsdeletingRNAprimersandreplacingthestrandwithDNA.
28.Whatdoeschaperonesassistin?
a)ProteinCleavage
b)ProteinFolding
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c)ProteinDegradationd)ProteinModification
CorrectAnswer-B
Answer:B.ProteinFolding
FoldingofProteinsinVivoIsPromotedbyChaperones
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29.Fishyodouroccursduetodeficiencyof
thisvitaminfromdiet-
a)Biotin
b)Thiamine
c)Riboflavin
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d)Vit.ACorrectAnswer-C
Answer:C.Riboflavin
VitaminB2orriboflavindeficiencycanbringaboutafishyodorin
thebody.
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*Fish-odorsyndrome,alsocalledtrimethylaminuria,isararemetabolicdisordercausedbytheabsenceofenzynen-oxidase(A
Flavincontainingmonooxygenase,3(FMO3).Genefortrimethylamineoxidase
hasbeenmappedonchromosomeI(Iq23-q25).
*Trimethylamineisnormallyproducedintheintestinefromthe
--- Content provided by FirstRanker.com ---
breakdownofdietarycholineandtrimethylamineoxidebybacteria.*Eggyolkandliverarethemainsourcesofcholine,andfishisthe
majorsourceoftrimethylamineoxide.
*Trimethylamineisabsorbedand
oxidizedintheliverbytrimethylamineoxidase(flavin-
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containingmonooxygenases)totrimethylamineoxide,whichisodorlessandexcretedintheurine.Deficiencyofthe
enzymeresultsinmassiveexcretionoftrimethylamineinurine.
*Consequently,tothesepatientssuchfoodsmaytaste
likerottenfishandimportafishyodortotheir
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salvia,sweatandurine.Treatment
*Restrictionoffish,eggs,liverandothersourcesofcholine
(suchasnutsandgrains)inthedietsignificantlyreducetheodor.
-Treatmentwithshortcourseoforal
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metronidamle,neomycinorlactulosecausestemporaryreductioninthebodyodor.
*RiboflavinsupplementcanbegiventoenhanceresidualFMO3
activity.
30.VMAisexcretedinurineinwhich
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condition-a)Alkaptonuria
b)Phenylketonuria
c)Pheochromocytoma
d)Diabeticketoacidosis
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer:C.Pheochromocytoma
VMAistheendproductofcatabolismofcatecholamines.
Inpheochromocytomaandneuroblastomathereisexcessive
synthesisofcatecholamineswhichcausesenhancedsynthesisof
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VMAanditsexcretionintheurine.VMAistheurinaryproductofbothepinephrineandnorepinephrine.
Itisagoodscreeningtestforpheochromocytoma,andisalsoused
todiagnoseandfollowupneuroblastomaandganglioneuroma.
31.InCystinuriaallofthefollowingamino-
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acidsreabsorptiondefectispresent,except
a)Lysine
b)Citrulline
c)Arginine
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d)OrnithineCorrectAnswer-B
Ans.is'B'i.e.,Citrulline
Typesofcystinuria
*Type-I:Itishomozygouswithafullyrecessiveform.Thepatient
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excretesalargequantityofcystine,ornithine,lysine,andarginine.GeneinvolvedisrBATonchromosome-2.
*Type-II&III:Theseareheterozygous
variantsofincompletelyrecessiveforms.Theyexcrete
cystine,ornithine,lysine,andargininemorethannormal
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butlessthanthehomozygousstate(Type-I).GeneinvolvedisSLC7A9onchromosome79.
Cystinuria
*BiochemicalDefect:Anautosomalrecessivedisorderthatresults
intheformationofadefectiveaminoacidtransporterintherenal
--- Content provided by FirstRanker.com ---
tubuleandintestinalepithelialcells.*Pathophysiology:Theaminoacidtransporterisresponsiblefor
transportingcystine,ornithine,lysine,andarginine.Defectivetubular
reabsorptionoftheseaminoacidsinthekidneysresultsinincreased
cystineintheurine,whichcanprecipitateandcausekidneystones.
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*ClinicalManifestations:Cystinekidneystonespresentingwithsevere,intermittentflankpainandhematuria.
*Labfindings:Increasedurinaryexcretionofcystine,ornithine,
arginine,andlysineonurineaminoacidchromatography;hematuria
andcystinecrystals(hexagonal)onthecoolingofacidifiedurine
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sediment.*Imaging:RadiopaquekidneystonesonCTscan.Themost
specifictestisthecyanide?nitroprussidetest
*Treatment:Low-methioninediet;increasedfluidintake;
acetazolamidetoalkalinizetheurine.Ifthisfailsthenpatientsare
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usuallystartedonchelatingtherapywithpenicillamine.32.FibrinopeptideAandfibrinopeptideBare
acidicduetothepresenceofwhichamino
acidsinitsstructure-
a)Serineandthreonine
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b)Glutamateandaspartatec)Histidineandlysine
d)Glutamineandvaline
CorrectAnswer-B
Answer:B.Glutamateandaspartate
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TheN-terminalAandBportionsoftheAandBchainsaretermedfibrinopeptideA(FPA)andfibrinopeptideB(FPB),respectively.
Thesedomainsarehighlynegativelychargedasaresultofan
abundanceofaspartateandglutamateresidues.
Thenegativechargescontributetothesolubilityoffibrinogenin
--- Content provided by FirstRanker.com ---
plasmaandimportantlyalsoservetopreventaggregationbycausingelectrostaticrepulsionbetweenfibrinogenmolecules.
33.HIAAinurinepresentin?
a)Alkaptonuria
b)Albinism
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c)Carcinoidd)Phenylketonuria
CorrectAnswer-C
Answer:C.Carcinoid
Carcinoidsyndromedevelopsinsomepeoplewithcarcinoidtumors
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andischaracterizedbycutaneousflushing,abdominalcramps,anddiarrhea.
Carcinoidtumouroccurthroughoutthegastrointestinaltract,most
commonlyintheappendix,ileumandrectumindecreasingorderof
frequency.
--- Content provided by FirstRanker.com ---
Right-sidedvalvularheartdiseasemaydevelopafterseveralyears.Thesyndromeresultsfromvasoactivesubstances(including
serotonin,bradykinin,histamine,prostaglandins,polypeptide
hormones)secretedbythetumor,whichistypicallyametastatic
intestinalcarcinoid.
--- Content provided by FirstRanker.com ---
Diagnosisisclinicalandbydemonstratingincreasedurinary5-hydroxyindoleaceticacid(HIAA).
Tumorlocalizationmayrequirearadionuclidescanorlaparotomy.
Treatmentofsymptomsiswithsomatostatinoroctreotide,but
surgicalremovalisperformedwherepossible;chemotherapymay
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beusedformalignanttumors.34.Warthinfinkeldeycellsareseenin
a)Measles
b)Rubella
c)Rabies
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d)TyphoidCorrectAnswer-A
Answer:A.Measles
MultinucleatedcellslikeWarthinFinkeldeyareseeninMeasles
Measlesvirusinfectsbyinvasionofrespiratoryepithelium.
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Localmultiplicationleadstoviremia(day2-3),thenspreadtoREsystem.
TwotypesofMultinucleatedgiantcellsinbothepidermis&oral
epitheliumby7-11days.
WarthinFinkeldeycellsofreticuloendothelialsystem
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Epithelialgiantcellsofrespiratory&otherepithelia.Warthin?Finkeldeycell:
Typeofgiantmultinucleatecellfoundinhyperplasticlymphnodes
earlyinthecourseofmeasles
Underthelightmicroscope,thesecellsconsistofalarge,grape-like
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clusterofnuclei.AlsowithHIV-infectedindividualsandKimuradisease.
Rarelyinneoplastic(e.g.lymphoma)&non-neoplasticlymphnode
disorders.
Unknownorigin;Reportsofstainingwithmarkerssimilartofollicular
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dendriticcells,includingCD21.35.CD59markerofwhichdisease
a)PNH
b)PTEN
c)BRR
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d)CowdensyndromeCorrectAnswer-A
Answer:A.Paroxysmalnocturnalhemoglobinuria(PNH)
Paroxysmalnocturnalhemoglobinuria(PNH)isadisease,dueto
acquiredmutationsin"Phosphatidylinositol
--- Content provided by FirstRanker.com ---
GlycanComplementationGroupA"gene(PIGA)..Associatedwithdeficiencyofglycosylphosphatidylinositol
(GPI)anchorproteinsalongwithabsenceofexternalsurface
membraneproteinsattachingtoit.
CD55(DAF)andCD59(MIRL)aretwosuchcomplementdefence
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proteinsCD59deficiency:
CommonfindinginRBCs&WBCsofpatientswithchronic
hemolysissufferingfromPNH
Diagnosis:
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Thedefinitediagnosisbasedondemonstrationofasubstantialproportionofpatient'sRBChavingincreasedsusceptibilityto
complement(C),duetothedeficiencyontheirsurfaceofproteins
(particularlyCD59&CD55)
36.Opsoninis
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a)C3ab)C3b
c)C5a
d)C6
CorrectAnswer-B
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Answer:B.C3bTheprocessofcoatingaforeignparticletargeting&preparingitfor
phagocytosisprocessis"Opsonization".Substancesinvolvedare
opsonins.
MainopsoninsfromcomplementsystemisC3
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Examplesofopsoninsinclude:Antibodies:
IgGandIgA
Componentsofthecomplementsystem:
C3b,C4b,andiC3b
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MannoseBindingLectin(MBL):InitiatestheformationofC3b
MembraneAttackComplex(MAC)
IncludesC5b,C6,C7,C8&polymericC9
Opsonization&complementproteins:
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MainlyC3b,iC3b&C4bC3:
Mostabundantproteinofallcomplementaryproteins,
CleavesintoC3aandC3b
C3a-
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Bindsandactivatesmastcells&basophils,releasehistamine.C3b-
Mostcriticalcomponentinbothclassical&alternativepathway
C3battachestobacterialsurfacesforopsonizationbyphagocytes
37.Bernard?Souliersyndromedueto
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deficiencyofa)Gp2b/3a
b)Gp1b
c)vWf
d)TNF
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CorrectAnswer-BAnswer:B.Gp1b
Bernard?Souliersyndrome(BSS)/HemorrhagicParous
ThrombocyticDystrophy
Rareautosomalrecessivecoagulopathy
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Causesadeficiencyofglycoprotein1b(Gp1b),receptorforvonWillebrandfactor.
38.Cowdensyndrome
a)P53
b)PTEN
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c)Rbd)Ras
CorrectAnswer-B
Answer:B.PTEN
"PhosphataseandTensin"homolog(PTEN)-proteininhumans
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encodedbythePTENgene.Genemutationspromotesdevelopmentofcancers.
Cowden'sdisease/MultipleHamartomaSyndrome-
PartofPTENhamartomatumorsyndrome
Anautosomaldominantsyndrome
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Trichilemmomas-NumeroustumorsofhairfolliclesinfaceMultiplehamartomatouspolypsinGItract.
Veryhighriskofbreast&thyroidcarcinoma
Treatment:
B/Lmastectomiesrecommended
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Contraindicatedaremammography&otherradiationexposureofbreasttissue
39.Chromosomeinvolvedinmyotonic
dystrophyis
a)Chromosome19
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b)Chromosome20c)Chromosome21
d)Chromosome22
CorrectAnswer-A
Answer:A-Chromosome19
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Myotonicdystrophyistransmittedbymutationinan'unstabletrinucleotiderepeatsequence'ingene19q133.
Features:
Anautosomaldominantdisorder
Mostcommonadultmusculardystrophy
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Characteristicsfeature:Myopathyisdistal(incontrasttoothermyopathies-mostly
proximal).
MuscleatrophyselectivelyinvolvestypeIfibresonly
Appearsby5years,causesaslowrelaxationofhand
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gripfollowingaforcedvoluntaryclosure.40.TRALIoccurswithinhowmanyhoursof
transfusion?
a)48Hrs
b)72Hrs
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c)6Hrsd)12Hrs
CorrectAnswer-C
Answer:C-6Hrs
Transfusion-RelatedAcuteLungInjury(TRALI)-Syndrome
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characterizedbyacuterespiratorydistressfollowingtransfusion.
Symptoms:
Typicallydevelopduring,orwithin6hoursoftransfusion.
Rapidonsetofdyspnea&tachypnea.
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Associatedfever,cyanosis,&hypotension.Clinicalexamination:
Revealsrespiratorydistress.
PulmonarycracklesmaybepresentwithnosignsofCHFor
volumeoverload.
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CXR-EvidenceofB/LpulmonaryedemaunrelatedtoCHF(non-cardiogenicpulmonaryedema),
Bilateralpatchyinfiltratesrapidlyprogressingtocomplete"white
out"indistinguishablefromAcuteRespiratoryDistressSyndrome
(ARDS).
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41.Kidneyrespondstoshockby
a)Decreasesrenalbloodflow
b)Increasesafferentarterioleresistance
c)GFRremainsunaltered
d)Perfusionofkidneyincreases
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CorrectAnswer-BAnswer:B-Increasesafferentarterioleresistance
Kidneyutilizesthefollowingmechanismsasaresponseto
shock:
Releaseofaldosteronefromhypoxickidney
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ReleaseofADHduetodecreasedeffectivecirculatingbloodvolume.
ReducedGFRduetoarterioleconstriction
Tissuefluidshiftintoplasmaduetoloweredhydrostaticpressure
(Hypotension)
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42.Whichofthefollowingisepithelialtumor
ofstomach?
a)Carcinoid
b)Lymphoma
c)GIST
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d)GastricadenocarcinomaCorrectAnswer-D
Answer:D-Gastricadenocarcinoma
Malignantepithelialtumororiginatingfromglandularepithelium
ofgastricmucosa.
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Aggressivelyinvadethegastricwall.Laurenclassification:
Twotypesofgastricadenocarcinomaarepresent.
Intestinaltype
Diffusetype
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Intestinaltype-IrregulartubularstructuresDiffusetype-Mucinous&colloidal"Leather-bottlestomach"
43.IdentifyanXlinkeddisorder?
a)Colorblindness
b)Thalassemia
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c)Azoospermiad)RetinitisPigmentosa
CorrectAnswer-A
Answer:A-Colorblindness
Hereditarycolorblindness/Achromatopsia
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Theabilitytoappreciateoneormoreprimarycolorisdefective(anomalous)orabsent(anopia)
DuetomutationsinXchromosome
Red&greenpigmentconescodedbyXchromosome;Bluecoded
onchromosome7
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MorecommoninmalesthanfemalesAcquired-(Opticnerve/maculardamage)
Ishiharachart-
Testred/greencolorblindness-Farnsworth100huetest
Others:
--- Content provided by FirstRanker.com ---
Azoospermia&RetinitisPigmentosa-Y-chromosomelinkeddisorderThalassemia-Inherited(Autosomalrecessivepattern)blood
disorderscharacterizedbyabnormalhemoglobinproduction.Genes
inChromosome11and16involved.
44.HAndLvarietyseenin
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a)Mixedcellularityhodgkinb)Lymphocytedepleted
c)Lymphocytepredominance
d)Nodularsclerosis
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer:C-LymphocytepredominanceHodgkinlymphoma(HL)-common"MalignantLymphomas"
2entities:
ClassicalHL(cHL)
NodularLymphocyte?predominantHL(NLPHL).
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Cells:ClassicalHL-HodgkinandReed/Sternberg(HRS)cells
NodularLymphocytepredominantHL-Lymphocytic&Histiocytic
(L&H)cells
45.Stellategranulomaseenin
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a)Sarcoidosisb)Catscratchdisease
c)Cryptococcosis
d)Histoplasmosis
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B-CatscratchdiseaseBacterialinfectioncausesbyBartonellahenselae
Acquiredinfectedcat/kittenscratch
Histology:
Characterizedbygranulomatousinflammationoflymphnodes.
--- Content provided by FirstRanker.com ---
SkinlesiondemonstratesacircumscribedfocusofnecrosisRegionallymphnodesdemonstratefollicularhyperplasiawith
centralstellatenecrosiswithneutrophils,surroundedbypalisading
histiocytes(suppurativegranulomas)&sinusespackedwith
monocytoidBcells,usuallywithoutperifollicularandintrafollicular
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epithelioidcells.46.Whichbestexplains"Flippingeffect"?
a)LDH1>LDH2
b)LDH2>LDH1
c)LDH2>LDH3
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d)LDH3>LDH2CorrectAnswer-A
Answer:A-LDH1>LDH2
Lactatedehydrogenase,tetramericenzymewith4subunits,
4Subunitswith2isoforms-Hisoform(Heart)&Misoform
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(Muscle)Heart&RBCs-LDH-1(4H);
Reticuloendothelialsystem-LDH-2(3H1M)
Lungs-LDH-3(2H2M)
Kidneys,placenta,&pancreas-LDH-4(1H3M)
--- Content provided by FirstRanker.com ---
Liver&striatedmuscle-LDH-5(4M)Uses:
LDHlevelsaremoreinRBC
HelpfulinassessmentofHemolysis/Tissuebreakdown
Flippingeffect:
--- Content provided by FirstRanker.com ---
UsuallyLDH2inpredominantinserum&LDH1ispredominantinheart
HigherlevelsofLDH1thanLDH2(Flippedpattern)issuggestiveof
myocardialinfarction
DamagedcardiactissuesreleaseLDH1intobloodstream.
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47.Nudemiceisnotresistanttoxenograft
duetoabsenceof
a)Bcell
b)Tcell
c)Bothbandtcell
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d)NoneCorrectAnswer-B
Answer:B-Tcell
Nudemicelacks"Thymus"&cannotgeneratematureT
lymphocytes.
--- Content provided by FirstRanker.com ---
AbsenceofT-lymphocytesmakesitunabletomountadaptiveimmuneresponsesrequiringCD4,helperTcells,CD8and
cytotoxicTcells.
Adaptiveimmuneresponsesthatremainunresponsivetonude
miceinclude:
--- Content provided by FirstRanker.com ---
Antibodyformation(CD4+helperTcells)Cell-mediatedimmuneresponses(CD4+and/orCD8+Tcells)
Delayed-typehypersensitivityresponses(CD4+Tcells)
Killingofvirus-infectedormalignantcells(CD8+cytotoxicTcells)
Graftrejection(bothCD4+&CD8+Tcells)
--- Content provided by FirstRanker.com ---
Uses:Laboratorystudyanimal-Insightsintoimmunesystem,leukemia,
solidtumors,AIDS&otherimmunedeficiencydiseases.
AbsenceoffunctioningTcellspreventsthemrejectingtheallografts
&Xenografts.
--- Content provided by FirstRanker.com ---
48.Anaplasiais
a)Changingonetypeofepitheliumtoanother
b)Nuclearchromatin
c)Lackofdifferentiation
d)Morphologicalchanges
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer:C-Lackofdifferentiation
Referstoalackofdifferentiationinneoplasticcells.
Well-differentiatedtumorsresembletheirtissueoforigin
Poorly-differentiatedorundifferentiated(anaplastic)tumorcells
--- Content provided by FirstRanker.com ---
appearprimitiveandlackspecializationalonganyparticularcellline.49.Whichlevelofprolactindefinitelysuggest
prolactinoma?
a)300ng/ml
b)150ng/ml
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c)200ng/mld)100ng/ml
CorrectAnswer-C
Answer:C-200ng/ml
Prolactinomasarethemostcommontypeofhyperfunctioning
--- Content provided by FirstRanker.com ---
pituitaryadenoma.Benigntumorsofpituitaryglandproducingprolactin.
Hyperprolactinemiacausesamenorrhea,galactorrhea,lossoflibido,
andinfertility.
Becausemanymanifestationsofhyperprolactinemia(e.g.,
--- Content provided by FirstRanker.com ---
amenorrhea)aremoreobviousinpremenopausalwomenthaninmenorpostmenopausalwomen,prolactinomasusuallyare
diagnosedatanearlierstageinwomenofreproductiveagethanin
otherpersonssoaffected.
Higherbloodprolactinconcentrationsareseen.
--- Content provided by FirstRanker.com ---
mildelevationsofserumprolactin(lessthan200g/L)inapatientwithapituitaryadenomadonotnecessarilyindicateaprolactin-
secretingneoplasm.
50.Laxativeabusecauseswhichofthe
followingrenalstones?
--- Content provided by FirstRanker.com ---
a)Uricacidb)Ammoniumurate
c)Struvite
d)Caoxalate
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B-AmmoniumurateBasedonthechemicalnaturetwotypesofkidneystones:
Calciumoxalate(majority).
OthersincludeUricacid,Struvite(Infectedstones),andCystine
stones(rarehereditarymetabolicdisorder
--- Content provided by FirstRanker.com ---
Characteristicstoneformationinlaxativeabuse:Laxativeabuseactsafactorinkidneystoneformation.
Laxativeabusecausespotassiumloss
Asacompensationmechanismkidneyproduceslargeamountof
ammonium.
--- Content provided by FirstRanker.com ---
Resultinginformationofuncommonstonetype-ammoniumacidurate.
51.Whichofthefollowingcanresultin
dactylitis
a)Hemophilia
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b)Vonwillebranddisease1c)Measles
d)SickleCellAnemia
CorrectAnswer-D
Answer:D-SickleCellAnemia
--- Content provided by FirstRanker.com ---
Dactylitis(Hand-FootSyndrome)isseeninsicklecellanemiaSeverepainaffectingthebonesofhands,feet,orboth.
Often1stsymptomofsicklecellanemiainbabies.
52.Whichchromosomeisresponsibleforthe
productionofMIF?
--- Content provided by FirstRanker.com ---
a)Chromosome16b)Chromosome22
c)XChromosome
d)Ychromosome
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Answer:D-YChromosomeAnti-MullerianHormone(AMH)/MullerianInhibitingFactor(MIF);
Mullerian-inhibitingHormone(MIH)/Mullerian-inhibitingSubstance
(MIS).
AMH-DownstreamgenesregulatedbySRYpathway
--- Content provided by FirstRanker.com ---
SRY-Genein"Sexdeterminingregion"-shortarmofYchromosome-Testisdeterminingfactor.
SecretedbySertolicellsofthetestes.
TheproductionofAMHiscontrolledbytwoautosomalgeneloci.
Hormonecode
--- Content provided by FirstRanker.com ---
Receptorcode.Glycoproteinhormone
Relatedtoinhibin&activin
Memberofthetransforminggrowthfactor-(TGF-)
Keyrolesareingrowthdifferentiationandfolliculogenesis.
--- Content provided by FirstRanker.com ---
53.SiteofactionofamphotericinBis:
a)Ribosomes
b)Cellwall
c)Plasmamembrane
d)Protein
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAnswer:-B-Cellwall
PolyenedrugcompoundslikeAmphotericinBactsoncell
membrane-
AmphotericinB,antifungalagent.
--- Content provided by FirstRanker.com ---
ChemicallyapolyenecompoundObtainedfromStreptomycesnodosus.
Polyeneshaveahighaffinityfor"ergosterol"presentinthefungal
cellmembrane.
Bindsandgetsinsertedintothecellmembraneforming"Micropore".
--- Content provided by FirstRanker.com ---
Markedincreaseinpermeabilityofcellmembrane.PolyenedrugcompoundslikeAmphotericinBactsoncell
membrane
AmphotericinB,antifungalagent.
Chemicallyapolyenecompound
--- Content provided by FirstRanker.com ---
ObtainedfromStreptomycesnodosus.Polyeneshaveahighaffinityfor"ergosterol"presentinthefungal
cellmembrane.
Bindsandgetsinsertedintothecellmembraneforming"Micropore".
Markedincreaseinpermeabilityofcellmembrane.
--- Content provided by FirstRanker.com ---
54.Whichantiretroviraldrugalsohasanti
hepatitisactivity?
a)Abacavir
b)Tenofovir
c)Nevirapine
--- Content provided by FirstRanker.com ---
d)EmtricitabineCorrectAnswer-D
Answer:D-Emtricitabine
Emtricitabine,NRTIdrugwithbothantiretroviral&anti-hepatitis
properties
--- Content provided by FirstRanker.com ---
NucleosidereversetranscriptaseinhibitorforthepreventionandtreatmentofHIVinfectioninadultsandchildren.
Alsousedincombinationwithtenofovir
55.Drugofchoiceforresistantrheumatic
chorea?
--- Content provided by FirstRanker.com ---
a)Valproateb)Haloperidol
c)Diazepam
d)Probenecid
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:-A-ValproateValproate,Sulpiride,&diazepamareusedforsymptomatic
treatment.
AcuteRheumaticFever:
AbnormalimmuneresponsetogroupAstreptococcalinfection
--- Content provided by FirstRanker.com ---
Commonlyaffectingthejoints,heart,brain,andskin.Symptoms:Arthritis,relatedtocarditis&chorea.
Sydenham'schorea/Choreaminor
Characterizedbyrapid,uncoordinatedjerkingmovementsprimarily
affectingtheface,handsandfeet.
--- Content provided by FirstRanker.com ---
Signs&symptomsofchoreausuallydonotrespondwelltotreatmentwithantirheumaticagents
Symptomatictreatmentincludeanticonvulsants(eg,valproate,
carbamazepine)andneuroleptics(eg,pimozide,haloperidol,
risperidone,olanzapine
--- Content provided by FirstRanker.com ---
56.AtpKa=pH-
a)Conc.ofdrugis50%ionicand50%non-ionic
b)Absorptionofdrugis50%ionicand50%ionic
c)Concofdrugis75%ionicand25%non-ionic
d)Concofdrugis25%ionicand75%non-ionic
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer:A-Concentrationofdrugis50%ionic&50%Non-
ionic
NumericallyequalpKa&pHrepresents50%drugionization
pKaisnegativelogarithmofacidicdissociationofweakelectrolyte.
--- Content provided by FirstRanker.com ---
Onequalconcentrationsofionized&unionizeddrugs,log1iszero.
Thus,whenpKaisnumericallyequaltopH
(pKa=pH)50%drugisionized.
57.Physiologicaldoseofhydrocortisone
--- Content provided by FirstRanker.com ---
(mg/kg/day)is-a)5mg/kg/day
b)10mg/kg/day
c)15mg/kg/day
d)20mg/kg/day
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAnswer:-B-10mg/kg/day
Thenormalrateofsecretionoftwoprinciplecorticoids
Hydrocortisone-10mg/kg/day(nearlyhalfinmorninghours)
Aldosterone-0.125mg/daily
--- Content provided by FirstRanker.com ---
58.Whatismechanismofactionofcolchicine
inacutegout?
a)Inhibitionofpurinemetabolism
b)Inhibitionofuricacidconversion
c)Migrationofleukocytes
--- Content provided by FirstRanker.com ---
d)Leukocytes,lymphocytesinhibitionµtubularinhibitorCorrectAnswer-D
Answer:D-Leukocytes,Lymphocytesmigrationinhibition&
microtubularinhibitor.
Colchicineactsbyinhibitingthegranulocytemigrationintothe
--- Content provided by FirstRanker.com ---
inflamedjoint.AnalkaloidfromColchiumautumnale
Specificallysuppressesgoutyinflammation.
Doesn'tinhibitthesynthesisorpromotetheexcretionofuricacid.
Mechanismofaction:
--- Content provided by FirstRanker.com ---
Colchicineactsby,inhibitsthereleaseofglycoproteinBindstofibrillarproteintubulesinhibitinggranulocyte
migrationintotheinflamedjoint.
Anacuteattackofgoutstartsbyprecipitationofuratecrystalsin
synovialfluid.
--- Content provided by FirstRanker.com ---
InflammatoryresponsestartswithgranulocytemigrationintojointPhagocytosinguratecrystalsreleasingglycoprotein
Glycoproteinincreaseslacticacidproductionandreleasing
lysosomalenzymescausingmorejointdestruction.
59.Basiliximabisan-
--- Content provided by FirstRanker.com ---
a)IL-1receptorantagonistb)Anti-CD3antibody
c)IL-2receptorantagonist
d)TNFinhibitor
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer:-C-IL-2receptorantagonistBasiliximabexhibitshighaffinitytowardsIL-2receptor,
inhibitingit.
Anti-CD-25antibody
HighaffinityforIL-2receptor
--- Content provided by FirstRanker.com ---
Shortplasmahalflife-1weekUsefulinpreventingtransplantrejectionreactions.
Adverseeffects-Anaphylacticreactions&opportunisticinfections.
60.Pirenzapineisused-
a)Gastriculcer
--- Content provided by FirstRanker.com ---
b)Glaucomac)Hypertension
d)Congestivecardiacfailure
CorrectAnswer-A
Answer:A-GastricUlcer
--- Content provided by FirstRanker.com ---
Pirenzepine,aselectiveM1anticholinergicdruginhibitinggastricacidsecretion.
Lowtherapeuticdoserange.
Usedfortreatinggastriculcer.
61.Whichofthefollowingantipsychotichave
--- Content provided by FirstRanker.com ---
increasedprolactinsecretion-a)Olanzapine
b)Ziprasidone
c)Clozapine
d)Risperidone
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAnswer:-D-Risperidone
Significantriseinprolactinlevelsduringrisperidonetherapyis
observed.
Risperidone-Antipsychoticdrugwithcombined5-HT2aand
--- Content provided by FirstRanker.com ---
dopamineD2antagonistactivityHighaffinitytoalpha1,alpha2andH1receptors
MorepotentD2blockerthanclozapine
Amelioratessymptomsofschizophrenia
Prolactinlevelsriseduringrisperidonetherapy,butless
--- Content provided by FirstRanker.com ---
epileptogenicthanclozapine.Producesextrapyramidalsideeffectsarelessonlyatlowerdoses
(<6mg/day).
Blockadeofthesecontributetoefficacyandsideeffectslikepostural
hypotension.
--- Content provided by FirstRanker.com ---
Frequentlycausesagitation.62.Whichofthefollowingisglucocorticoid
synthesisinhibitor?
a)Mifepristone
b)Flutamide
--- Content provided by FirstRanker.com ---
c)Finasterided)Metyrapone
CorrectAnswer-D
Answer:D-Metyrapone
Inhibits1113-Hydroxylaseinadrenalcortex
--- Content provided by FirstRanker.com ---
Preventsthesynthesisofhydrocortisone63.Whichofthefollowingstatementsis
incorrectw.r.tPrasugrel?
a)Notaprodrug
b)P2Ypurinergicreceptorblocker
--- Content provided by FirstRanker.com ---
c)Hasastrongantiplateletactivityd)CausesintracranialhemorrhageinTIApatients.
CorrectAnswer-A
Answer:A-Notaprodrug
Prasugrelisaprodrug,similartoClopidogrel
--- Content provided by FirstRanker.com ---
ThienopyridinedrugclassIrreversibleantagonistofP2Y12ADPreceptors
Rapidlyabsorbed,completelyactivated&exertsmore
consistentplateletinhibition.
Stronganti-plateletactivity
--- Content provided by FirstRanker.com ---
Bleedingcomplicationsaremoreseriousandfrequent.Contraindicatedinpatientswithhistoryofischemicstrokes
andTIA's
64.Q-Telongationisseeninwhichdrug?
a)Quinidine
--- Content provided by FirstRanker.com ---
b)Amiodaronec)MagnesiumSulfate
d)Lignocaine
CorrectAnswer-A
Answer:A-Quinidine
--- Content provided by FirstRanker.com ---
SpecificpatternofQ-Tprolongationisreferredtoas"Torsadesdepointes"
DrugscausingTorsadesdePointes
Quinidine(mostcommon)
Sotalol
--- Content provided by FirstRanker.com ---
ProcainamideDisopyramide
Phenothiazines
Tricyclicantidepressants
65.Sacubitrilis,
--- Content provided by FirstRanker.com ---
a)ACEinhibitorb)Neutralendopeptidaseinhibitor
c)Calciumchannelinhibitor
d)Betaadrenergicblocker
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B-Neuro-endopeptidaseinhibitorSacubitril,aprodruginhibitingneuro-endopeptidaseenzyme
ActivatedtoSacubitril,
Inhibitingenzymeneprilysin(Neutralendopeptidases)
Combinationdrugusedinheartfailurepatients
--- Content provided by FirstRanker.com ---
UsuallycombinedwithACEinhibitorslikevalsartaninratioof1:166.Niacintherapyiscontraindicatedin
diabetesbecause-
a)Increasesthebloodsugarlevels
b)Causesscleroderma
--- Content provided by FirstRanker.com ---
c)Difficulttogiveinjectiond)Increasesthemetabolismoforalhypoglycemicdrugs
CorrectAnswer-A
Answer:A-increasesthebloodsugarlevels
Niacintherapyhaspotentialeffectsonbloodsugarlevels.
--- Content provided by FirstRanker.com ---
Increasesthebloodglucoselevelsindiabetespatients67.Endothelinactsthroughwhichreceptors?
a)cAMP
b)cGMP
c)Na+receptors
--- Content provided by FirstRanker.com ---
d)CalciumreceptosCorrectAnswer-A
Answer:A-cGMP
Endothelin-1(ET-1)isapotentendogenousvasoconstrictor,mainly
secretedbyendothelialcells.
--- Content provided by FirstRanker.com ---
68.Whichisthecentrallyactingalpha2
agonistmusclerelaxant-
a)Diazepam
b)Bromocriptine
c)Tizanidine
--- Content provided by FirstRanker.com ---
d)MethocarbamolCorrectAnswer-C
Answer:-C-Tizanidine
Centralalpha2adrenergicagonist
Mechanismofaction:
--- Content provided by FirstRanker.com ---
InhibitsthereleaseofexcitatoryaminoacidsinspinalinterneuronsFacilitatestheinhibitorytransmitterglycine
Inhibitspostsynapticreflexes
Reducingmuscletone,frequencyofmusclespasms.without
reducingthestrengthofmuscle.
--- Content provided by FirstRanker.com ---
Indications:Spasticityinneurologicaldisorders
Painfulmusclespasmofspinalorigin.
Contraindications:
Patientsonantihypertensivesspeciallyclonidine.
--- Content provided by FirstRanker.com ---
69.Apixabanis-
a)Antithrombininhibitor
b)DirectXainhibitor
c)Plateletactivator
d)ClottingFactorXII
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAnswer:B-DirectXainhibitor
DirectXainhibitor
Anticoagulantfortreatment&prophylaxisofvenousthromboembolic
events
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DVT&PE70.Anaerobesareresistantintrinsically
against-
a)Betalactamantibiotics
b)Aminoglycosides
--- Content provided by FirstRanker.com ---
c)Azithromycind)Metronidazole
CorrectAnswer-B
Answer:B-Aminoglycosides
Anaerobicbacteriaparticularlyareresistantto
--- Content provided by FirstRanker.com ---
aminoglycosidesduetolackofoxidativemechanismtodrivedruguptakingprocess.
Intrinsicresistance/Insensitivity:
Innateabilityofbacteriatoresistactivityofparticularantimicrobial
agent
--- Content provided by FirstRanker.com ---
Inherentstructuralorfunctionalcharacteristicsallowsfortoleranceofaparticulardrugorantimicrobialclass.i.e.,Susceptibilitytothat
particulardrugisreduced.
71.Whichisnotbacteriostaticantibiotic-
a)Clindamycin
--- Content provided by FirstRanker.com ---
b)Vancomycinc)Tetracycline
d)Cephalosporins
CorrectAnswer-B
Answer:B-Vancomycin
--- Content provided by FirstRanker.com ---
BacteriostaticantibioticsLimitbacterialgrowthbyinterferingwithbacterialprotein
production,DNAreplication,orotheraspectsofbacterialcellular
metabolism.
Tetracyclines,sulfonamides,clindamycin,
--- Content provided by FirstRanker.com ---
spectinomycin,trimethoprim,chloramphenicol,macrolidesandlincosamides.
Bactericidalantibiotics
Inhibitcellwallsynthesis(Irreversiblekilling)
Aminoglycosides.cephalosporins.fluoroquinolones.metronidazole.
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penicillin.vancomycin72.Whichofthefollowingcausesmelanosis
coli?
a)Senna
b)Sorbitol
--- Content provided by FirstRanker.com ---
c)MagnesiumSulphated)Bisacodyl
CorrectAnswer-A
Answer:A-Senna
Laxativeabusewithdrugslikesennacausemelanosiscoli
--- Content provided by FirstRanker.com ---
Anthranoidlaxatives(aloe,cascarasagrada,andsenna)arederivedfromnaturallyoccurringplants
Consideredtobestimulantlaxatives.
Safershorttermuse.
Longtermabusecancausemelanosiscoli&possibly
--- Content provided by FirstRanker.com ---
increasesriskofcoloniccancer.73.Whichamongthefollowingwillthechoice
ofantibioticforabedriddenpatientwith
catheter-relatedUTIandpneumonia.
a)Amoxicillin
--- Content provided by FirstRanker.com ---
b)BetaLactamantibioticswithbetalactamasec)3rdgencephalosporins
d)2ndgencephalosporins
CorrectAnswer-B
Answer:B-BetaLactamAntibiotics
--- Content provided by FirstRanker.com ---
ContainsbetalactamaseenzymeforpotentactionagainstorganismscausingUTI
74.Mycoplasmaisresistantto-
a)Ceftriaxone
b)Cephalosporins
--- Content provided by FirstRanker.com ---
c)Aminoglycosidesd)Fluoroquinolones
CorrectAnswer-A
Answer:A-Ceftriaxone
MycoplasmashowsresistancetowardsCeftriaxone,athird
--- Content provided by FirstRanker.com ---
generationcephalosporin(betalactamantibiotic)Lackofcellwallinmycoplasmasmakesthemintrinsically
resistantto-lactams&toallantimicrobialsthattargetcellwall.
Mycoplasmapneumoniae:
Mycoplasmapneumoniaeisapathogenicmycoplasmaresponsible
--- Content provided by FirstRanker.com ---
forrespiratorytractinfectionsinhumans.First-linetreatment:macrolides&relatedantibiotics,tetracyclines
andfluoroquinolonesispreferred.
75.Tadalafilshouldnotbegivenwith:
a)Vasodilator
--- Content provided by FirstRanker.com ---
b)Antibioticsc)Vasoconstrictors
d)Valproate
CorrectAnswer-A
Answer:A-Vasodilators
--- Content provided by FirstRanker.com ---
Combinationwithvasodilatorsresultsinsuddenchangesofbloodpressurevalues
Tadalafilrelaxesmusclesofthebloodvesselsandincreases
bloodflowtoparticularareasofthebody.
Usedtotreaterectiledysfunction(Impotence),andsymptomsof
--- Content provided by FirstRanker.com ---
benignprostatichypertrophy(Enlargedprostate)Eg:Takingtadalafilwithvasodilatordruglikenitratecancause
sudden&seriousdecreaseinbloodpressure.
76.Estimatevolumeofringerlactateinfirst8
hrsfor40%burnsin50kgmalewith2?
--- Content provided by FirstRanker.com ---
burns?a)8lt
b)4lt
c)2lt
d)6lt
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAnswer:B.4lt
ParklandformulamostcommonlyusedIVfluid-LactatedRinger's
Solution
Fluidcalculation
--- Content provided by FirstRanker.com ---
4xweightinkgx%TBSAburnGive1/2ofthatvolumeinthefirst8hours
Giveother1/2innext16hours
Warning:Despitetheformulasuggestingcuttingthefluidrateinhalf
at8hours,thefluidrateshouldbegraduallyreducedthroughoutthe
--- Content provided by FirstRanker.com ---
resuscitationtomaintainthetargetedurineoutput,i.e.,donotfollowthesecondpartoftheformulathatsaystoreducetherateat8
hours,adjusttheratebasedontheurineoutput.
Exampleoffluidcalculation
50-kgmanwith40%TBSAburn
--- Content provided by FirstRanker.com ---
Parklandformula:4x50x40=8,000ml
Give1/2infirst8hours=4,000mlinfirst8hours
Adjustfluidratetomaintainurineoutputof50ml/hr
77.Posthumouschildis:
--- Content provided by FirstRanker.com ---
a)Childdeliveredafterdeathofbiologicalmotherb)Childdeliveredafterdeathofbiologicalfather
c)Bornafterdeathofparents
d)hasbeenabandonedbyparents
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B.ChilddeliveredafterdeathofbiologicalfatherAchildbornafterdeathofhis/herbiologicalfather
78.
M'naghtenrulecomesunderwhichsectionof
IPC?
--- Content provided by FirstRanker.com ---
a)Crpc84b)Cpc48
c)Ipc84
d)IPC48
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer:C.Ipc84M'naghtenrule(legaltestorrightorwrongtest):
Itstatesthatanaccusedpersonisnotlegallyresponsible,ifitis
clearlyprovedthatatthetimeofcommittingthecrime,personwas
sufferingfromsuchadefectofreasonfromabnormalityofmindthat
--- Content provided by FirstRanker.com ---
hedidn'tknowthenatureandqualityofacthewasdoingorthatwhathewasdoingwaswrongi.e.apersonisnotresponsibleifheis
notofsoundmind.
Itisacceptedinindiaaslawofcriminalresponsibilityandis
embodiedinsection841PCas-"nothingisanoffencewhichis
--- Content provided by FirstRanker.com ---
donebyaperson,whoatthetimeofdoingit,byreasonofunsoundnessofmindisincapableofknowingthenatureofact,or
thatheisdoingwhatiseitherwrongorcontrarytolaw".
79.Bluishdiscolorationofgastricmucosa
seeninwhichpoisoning?
--- Content provided by FirstRanker.com ---
a)Mercuryb)Cadmium
c)Amytalsodium
d)Arsenic
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer:C.AmytalsodiumS.
Poison
Color
No.
--- Content provided by FirstRanker.com ---
1.Coppersulfate,amytalcapsule
Blue
2.
Ferroussulfate
--- Content provided by FirstRanker.com ---
Green3.
Sulphurichydrochloric/aceticacid
Black/charred
4.
--- Content provided by FirstRanker.com ---
NitricacidYellow
5.
Carbolicacid
Buff/white
--- Content provided by FirstRanker.com ---
6.Arsenic
Whiteparticles
7.
Mercury
--- Content provided by FirstRanker.com ---
Slate8.
Cresols
Brown
80.Musclepain,nephropathycausedby
--- Content provided by FirstRanker.com ---
whichmetalpoisoninga)Arsenic
b)Cadmium
c)Mercury
d)Lead
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer:A.Arsenic
Nephropathyiscausedbymostofheavymetals.Musclepainis
associatedwitharsenic.
81.Whichisthefirstorgantoputrefy:
--- Content provided by FirstRanker.com ---
a)Brianb)Heart
c)Prostate
d)Kidney
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:A.BrianTheorderofputrefactionis-earliesttolastlarynx,trachea
Stomach,intestineliver,spleenBrain,LungsHeart,Kidney
Bladder,Uterus/ProstrateSkin,muscles,tendonlastly,
bones.)
--- Content provided by FirstRanker.com ---
82.Locardisfamousfor:
a)Theoryofexchange
b)Fingerprintstudy
c)Formulaforestimationofstature
d)Systemofpersonalidentificationusingthebodymeasurement
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer:A.Theoryofexchange
Edmundlocardisfamousfortheoryofexchange.
83.Whendoesbasiocciputfuseswith
basisphenoid?
--- Content provided by FirstRanker.com ---
a)18to22b)22to25
c)14-16
d)12-14
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:A.18to22Thebasioccipitalfuseswiththebasisphenoidatabout18to21
years.
84.Whatisthesmellofmummifiedbody?
a)Odourless
--- Content provided by FirstRanker.com ---
b)Putridc)Pungent
d)Offensive
CorrectAnswer-A
Answer:A.Odourless
--- Content provided by FirstRanker.com ---
Amummywillsmellodourless,thisisbecausetheinternalorgansareremoved(whicharethebiggestfactorsinthedecayprocess)
andreplacedwithnatron(whichdriesthemout,preventing'proper'
decay).Therestofthebodyisalsodriedusingnatron.
85.Patientpresentedwithproximaltubule
--- Content provided by FirstRanker.com ---
proteinuria.Whichmetalislikelytobeassociatedwithit?
a)Cadmium
b)Mercury
c)Gold
--- Content provided by FirstRanker.com ---
d)LeadCorrectAnswer-A
Answer:A.Cadmium
Earlykidneydamageandproteinuriaseeninpeople,occupationally
orenvironmentallyexposedtocadmium.
--- Content provided by FirstRanker.com ---
86.Whichofthefollowingconstitutional
articleisnotrelatedtochildren:
a)23
b)21-A
c)42
--- Content provided by FirstRanker.com ---
d)24CorrectAnswer-C
Answer:C.42
ConstitutionalGuaranteesthataremeantspecificallyfor
childreninclude:
--- Content provided by FirstRanker.com ---
Righttofreeandcompulsoryelementaryeducationforallchildreninthe6-14yearagegroup(Article21A)
Righttobeprotectedfromanyhazardousemploymenttilltheageof
14years(Article24)
Righttobeprotectedfrombeingabusedandforcedbyeconomic
--- Content provided by FirstRanker.com ---
necessitytoenteroccupationsunsuitedtotheirageorstrength(Article39(e))
Righttoequalopportunitiesandfacilitiestodevelopinahealthy
mannerandinconditionsoffreedomanddignityandguaranteed
protectionofchildhoodandyouthagainstexploitationandagainst
--- Content provided by FirstRanker.com ---
moralandmaterialabandonment(Article39(f))Righttoearlychildhoodcareandeducationtoallchildrenuntilthey
completetheageofsixyears(Article45)
Besides,ChildrenalsohaverightsasequalcitizensofIndia,
justasanyotheradultmaleorfemale:
--- Content provided by FirstRanker.com ---
Righttoequality(Article14)Rightagainstdiscrimination(Article15)
Righttopersonallibertyanddueprocessoflaw(Article21)
Righttobeingprotectedfrombeingtraffickedandforcedinto
bondedlabour(Article23)
--- Content provided by FirstRanker.com ---
Rightofminoritiesforprotectionoftheirinterests(Article29)Rightofweakersectionsofthepeopletobeprotectedfromsocial
injusticeandallformsofexploitation(Article46)
Righttonutritionandstandardoflivingandimprovedpublichealth
(Article47)
--- Content provided by FirstRanker.com ---
87.WhichofthestatementregardingFactory
actiscorrect
a)Childagelessthan14carryingseriousworkearnmoremoney
b)Lessthan14yrnotdoneforfactoryact
c)Morethan72hourworkperweek
--- Content provided by FirstRanker.com ---
d)Morethan82hoursaweekCorrectAnswer-B
Answer:B-Lessthan14yrnotdoneforfactoryact
TheFactoryActprohibitstheemploymentofchildrenbelow14years
anddeclares15to18yearsasbelongingtotheadolescentgroup.
--- Content provided by FirstRanker.com ---
Adolescentsrequirefitnesscertificatepriortoemploymentinajob.Actalsoprescribedamaximum48hoursperweek,notexceeding9
Hoursperdaywithatleasthalfhourrestafter5hourcontinuous
work.
88.Burkholderiacepaciaisresistanttowhich
--- Content provided by FirstRanker.com ---
ofthefollowingdrugs:a)Ceftazidime
b)Trimethoprim-sulfamethoxazole
c)Temocillin
d)Cefotetan
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAnswer:D.Cefotetan
B.cepaciacomplexstrainsareintrinsicallyresistanttoawiderange
ofantimicrobialagents,includingaminoglycosides,polymyxin,first
andsecondgenerationcephalosporins,andcarboxypenicillins
--- Content provided by FirstRanker.com ---
AntimicrobialagentsthatareeffectiveagainstB.cepaciacomplexincludemeropenem,ceftazidime,piperacillin,temocillin,and
trimethoprim-sulfamethoxazole.
89.ShinglesIscausedbywhichofthe
following?
--- Content provided by FirstRanker.com ---
a)Varicella-zosterb)Herpessimplex
c)CMV
d)None
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.Varicella-zosterShingles,alsocalledherpeszoster,isapainfulskinrash.
Shinglesiscausedbyreactivationofthevaricellazostervirus,the
samevirusthatcauseschickenpox.
90.Ureabreathtestisusedfordiagnosisof:
--- Content provided by FirstRanker.com ---
a)H.pylorib)Campylobacterjejuni
c)E.coli
d)Lactobacillus
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:A.H.pyloriTheureabreathtestisarapiddiagnosticprocedureusedtoidentify
infectionsbyHelicobacterpylori,aspiralbacteriumimplicatedin
gastritis,gastriculcer,andpepticulcerdisease.Itisbaseduponthe
abilityofH.pyloritoconvertureatoammoniaandcarbondioxide
--- Content provided by FirstRanker.com ---
91.Hyperacutegraftrejectionoccursafter
howmuchtime?
a)24hours
b)2weeksright
c)Inminutes
--- Content provided by FirstRanker.com ---
d)YearsCorrectAnswer-C
Answer:C.Inminutes
HyperacuteTransplantRejectionoccursalmostimmediatelyandis
oftenevidentwhileyouarestillinsurgery.Itiscausedbyaccidental
--- Content provided by FirstRanker.com ---
ABOBloodtypemismatchingofthedonorandrecipientwhichalmostneverhappensanymore..Acuteonsetisinfewweeksto
month.Chroniconsetisfrommonthstoyears.
92.Australianantigenforhepatitisbis?
a)HbSag
--- Content provided by FirstRanker.com ---
b)HbEagc)HbDag
d)HbVDna
CorrectAnswer-A
Answer:A.HbSag
--- Content provided by FirstRanker.com ---
HBsAg(alsoknownastheAustraliaantigen)isthesurfaceantigenofthehepatitisBvirus(HBV).ItindicatescurrenthepatitisB
infection.
93.Whichfungusismostcommonly
associatedwithorbitalcellulitisin
--- Content provided by FirstRanker.com ---
patientswithdiabeticketoacidosis.a)Candida
b)Mucor
c)Aspergillus
d)Rhizopus
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer:C.Aspergillus
Orbitalcellulitistermisreservedforinfectionsbehindtheorbital
septumwhichmayormaynotspillovertolids.BacterialOCismore
commoninchildrenandfulminantinfection(&ischemicinfarction)
--- Content provided by FirstRanker.com ---
withMucororAspergillustypicallyaffectspatientswithdiabetes(espketoacidosis)andimmunosuppression.PresentationisExtensive
swellingoflidswithchemosisoftenobscureproptosis(i.e.most
commonlylateral&downwards).Proptosiswithimpairedmobility
resultingindiplopiaPainissevere,increasedbymovementofeye
--- Content provided by FirstRanker.com ---
orpressureUnilateral,tender,warm&redperiorbitaledema,painfulophthalmoplegia.
94.SabinFeldmandyetestisusedfor
diagnosisofwhichofthefollowing
condition:
--- Content provided by FirstRanker.com ---
a)Botulismb)Toxoplasmosis
c)Sarcoidosis
d)Yellowfever
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B.ToxoplasmosisASabin?Feldmandyetestisaserologictesttodiagnosefor
toxoplasmosis
95.AcuteHemorrhagicConjunctivitisis
causedbywhichofenterovirustype?
--- Content provided by FirstRanker.com ---
a)69b)68
c)70
d)71
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer:C.70Acutehemorrhagicconjunctivitis(AHC)ischaracterized
byconjunctivalcongestion,vasculardilatation,andonsetofedema
.Serologicstudieshavebeenusefulinshowingthepresenceof
neutralizingantibodiestoCoxsackiegroupA24(CA24)and
--- Content provided by FirstRanker.com ---
enterovirusE70(EV70)strainsasthecausativeagent.96.Echinococcusgranulosusarecommonly
seeninwhichofthegivenanimals:
a)Dog
b)Cat
--- Content provided by FirstRanker.com ---
c)Foxd)Pig
CorrectAnswer-A
Answer:A.Dog
Echinococcusgranulosus,alsocalledthehydatidworm,hyper
--- Content provided by FirstRanker.com ---
tape-wormordogtapeworm.Domesticdogs(Canisfamiliaris)havebeenrecognisedasthedefinitivehostoftheparasite.
97.Ananaerobecausingmultipleabscess
withdischargingsinuses,demonstrating
sulphurgranulesinpusis?
--- Content provided by FirstRanker.com ---
a)Actinomycetesb)Nocardia
c)Salmonella
d)Tularemia
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:A.ActinomycetesActinomycosisisararesubacutetochronicinfectioncausedbythe
gram-positivefilamentousnon-acidfastanaerobictomicroaerophilic
bacteria,Actinomyces.
Thechronicformhasmultipleabscessesthatformsinustractsand
--- Content provided by FirstRanker.com ---
areassociatedwithsulfurgranules.About70%ofinfectionsareduetoeitherActinomycesisraeliiorActinomycesgerencseriae.
Thecharacteristicofthediseaseisthesulfurgranuleswhichare
yellow.Theyareformedprimarilybymycelialfragmentswithsome
proteinaceouspolysaccharidecomplexes,whichactasaresistance
--- Content provided by FirstRanker.com ---
mechanismtoavoidandinhibitphagocytosis.Multipleabscesswithdischargingsinuses,demonstratingsulphur
granulesinpusarecharacteristicsofactinomycetes
98.Wholebloodisusedasasamplefor
whichtest?
--- Content provided by FirstRanker.com ---
a)Bacteriab)IGRA
c)Genexpert
d)Virus
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B.IGRAInterferon-GammaReleaseAssays(IGRAs)arewhole-bloodtests
thatcanaidindiagnosingMycobacteriumtuberculosisinfection
99.Whichorganismcausingacutebacterial
prostatitis?
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a)Enterococcusb)Streptococcusviridans
c)Peptostreptococcus
d)E.coli
CorrectAnswer-D
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Answer:D.E.coliAerobicgram-negativebacilliarethepredominantpathogensin
bacterialprostatitis.E.colicause50%?80%ofcases;other
pathogensincludeEnterobacteriaceae(eg,KlebsiellaandProteus,
whichaccountfor10%?30%ofcases),Enterococcusspecies(5%?
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10%)100.Whichofthefollowingorganism
releaseshistamineandcausescombroid
fishpoisoning-
a)Salmonella
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b)Staphylococcusc)P.aeruginosa
d)Weissella
CorrectAnswer-C
Answer:C.P.aeruginosa
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Scombroidpoisoningisoneofthemostcommoncausesofmorbidityassociatedwithfishintakewhichhavenotbeen
refrigeratedproperlyfromthetimetheywerecaughtuntilthetime
theywereserved.Bacteriaactoncompoundsinthefish,releasing
histamine.Processisinducedbyenzymesproducedbyprimarily
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entericgram-negativebacteria(e.g.,Morganellamorganii,Escherichiacoli,KlebsiellaspeciesandPseudomonasaeruginosa)
foundinthefish'scutisandintestines.,.
101.Whoisthefatherofmicrobiology?
a)A.V.L.hook
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b)Robertbrownc)J.CBose
d)Pasteur
CorrectAnswer-A
Answer:A.A.V.L.hook
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"AntonivanLeeuwenhoek"iscommonlyknownas"theFatherofMicrobiology.
AntoniePhilipsvanLeeuwenhoek(24thOct,1632?26thAug,
1723)isknownas'TheFatherofMicrobiology'.Hewasknownso
becauseofhiscontributionstowardstheestablishmentof
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microbiology.HewasscientistfromDelft,Netherlandsandisconsideredtobe'TheFirstMicrobiologistintheWorld'.
leeuwenhoekiscalledasfatherofmicrobiology.Hewasthefirst
persontoseebacteriathroughhisselfmadesinglelensed
microscope.Andhenamedthem"animalcules".LouisPasteuris
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knowas"fatherofmordenmicrobiology".102.Cutaneouslarvamigranscausedby
whichorganism?
a)Strongyloides
b)Toxocaracanis
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c)Ancylostomabraziliensed)Necatoramericanus
CorrectAnswer-C
Answer:C.Ancylostomabraziliense
Cutaneouslarvamigrans(CLM)
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/Itisaskindiseaseinhumans,causedbythelarvaeofvariousnematodeparasitesofthehookwormfamily(Ancylostomatidae).
ThemostcommonspeciescausingthisdiseaseintheAmericasis
Ancylostomabraziliense.
Theseparasitesliveintheintestinesofdogs,catsandwildanimals
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andshouldnotbeconfusedwithothermembersofthehookwormfamilyforwhichhumansaredefinitivehosts,namelyAncylostoma
duodenaleandNecatoramericanus.
Colloquiallycalledcreepingeruptionduetoitspresentation,the
diseaseisalsosomewhatambiguouslyknownas"grounditch"or(in
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somepartsoftheSouthernUSA)"sandworms",asthelarvaeliketoliveinsandysoil.
Anothervernacularnameisplumber'sitch.
ThemedicaltermCLMliterallymeans"wanderinglarvaeintheskin"
103.Afterkidneytransplantationwhich
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organismsinfectionismorelikelytohappens-
a)CMV
b)Klebsiella
c)Streptococcus
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d)StaphylococcusCorrectAnswer-A
Answer:A.CMV
CMVisthemostcommonviralinfectionafterKidney
Transplantation.MostcommonCMVsyndromeinkidneytransplant
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patientisfever(mostcommon),leukopenia,hepatosplenomegaly,myalgiaandarthralgia.
104.Incidenceofadiseaseis4per1000of
populationwithdurationof2years.
Calculatetheprevalence?
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a)8/1000b)4/1000
c)2/1000
d)6/1000
CorrectAnswer-A
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Ans.A.8/1000Prevalence=(IncidenceRate)x(AverageDurationofDisease)
105.Cytotoxicandexpireddrugdisposalis
donebywhichmethod?
a)Dumping
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b)Autoclavec)Landfill
d)Burning
CorrectAnswer-C
Ans.C.Landfill
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ColourTypeof
Treatment
WasteCategory
coding
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Containeroptions
Humanandanimal
wastes,Microbialand Incineration/
Yellow
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PlasticBagsBiologicalwastesand DeepBurial
soiledwastes
(Cat1,2,3and6)
Microbiologicaland
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Autoclave/Disinfected
Biologicalwastes,
Microwave/
Red
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container/Soiledwastes,Solid
Chemical
Plasticbags
wastes
--- Content provided by FirstRanker.com ---
Treatment)(Cat3,6,7)
Autoclave/
Microwave/
Plasticbag,
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WastesharpsandBlue/White/
Chemical
Punctureproof solidwaste
Transparent
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Treatmentcontainer
(Cat4&7)
Destruction
andShredding
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Discardedmedicines,
Disposalin
Black
Plasticbag
--- Content provided by FirstRanker.com ---
Cytotoxicdrugs,securedland
Incinerationashand fills
chemicalwaste
(Cat5,9&10)
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GeneralwastesuchDisposedin
Plastic
Green
asofficewaste,food
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securedContainer
waste&gardenwaste landfills
106.ForNRRtobe1coupleprotectionrate
shouldbe?
--- Content provided by FirstRanker.com ---
a)50%b)60%
c)55%
d)75%
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans.B.60%CoupleProtectionRate(CPR)
Itisanindicatoroftheprevalenceofcontraceptivepracticeinthe
community
Definition:thepercentageofeligiblecoupleseffectivelyprotected
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againstchildbirthbyoneortheotherapprovedmethodsoffamilyplanning
Sterilization
IUD
Condom
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OCP'sNRR=1canbeachievedonlyiftheCPR>60%
107.NewRNTCPsoftwareonlinetomonitor
TBcontrolprogrammeis-
a)NIKSHAY
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b)NICHAYc)E-DOTS
d)NIRBHAI
CorrectAnswer-A
Ans.A.NIKSHAY
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TokeepatrackoftheTBpatientsacrossthecountry,theGovernmentofIndiahasintroducedasystemcalledNIKSHAY.
ThewordiscombinationoftwoHindiwordsNIandKSHAYmeaning
eradicationoftuberculosis.
NIKSHAY(www.nikshay.gov.in)isawebenabledapplication,which
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facilitatesmonitoringofuniversalaccesstoTBpatientsdatabyallconcerned.
ThesystemhasbeendevelopedjointlybytheCentralTBDivisionof
theMinistryofHealthandFamilyWelfareandNationalInformatics
Centre(NIC)anditwaslaunchedbytheGovernmentofIndiain
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June2012withissueofrequiredadministrativedirectionsfromCentralTBDivisionforuseofNIKSHAY
108.Studyunitofecologicalstudyis
a)Population
b)Patient
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c)Communityd)Case
CorrectAnswer-A
Ans.A.Population
Inecologicalstudiestheunitofobservationisthepopulationor
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community.Diseaseratesandexposuresaremeasuredineachofaseriesof
populationsandtheirrelationisexamined.
Oftentheinformationaboutdiseaseandexposureisabstractedfrom
publishedstatistics.
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109.InascreeningtestforDMoutof1000
population,90werepositive.Thenthe
goldstandardtestwasdoneinwhich
100werepositive.Calculatethe
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sensitivity?a)90/100
b)100/110
c)80/100
d)100/100
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CorrectAnswer-AAns.A.90/100
So,Truepositive(a)=90
Falsenegative(c)=10
Sensitivity=a/(a+c)=90/100
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Sensitivity=a/(a+c)=90/100
110.Whatisthemasschemoprophylaxisfor
meningococcalmeningitis?
a)Rifampicin
b)Chloramphenicol
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c)Tetracyclined)Penicillin
CorrectAnswer-A
Ans.A.Rifampicin
RecommendedChemoprophylaxisforHigh-RiskClose
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Contacts:Age
Dose
Duration
Cautions
--- Content provided by FirstRanker.com ---
RIFAMPICIN:<1
5mg/kg
Oralevery12hrs
month
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2days>1
10mg/kg Oralevery12hrs Notrecommendedforusein
month
2day
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pregnancyCEFTRIAXONE:
<15
125mg
IMsingledose
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years>15
250mg
IMsingledose
years
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CIPROFLOXACIN>18
500mg
Oralsingledose
Notrecommendedforusein
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yearspregnancy
111.Whichamongthefollowingisanactive
formofchlorination?
a)Hypochloriteion
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b)Hydrogenchloridec)Hypochlorousacid
d)Chlorideion
CorrectAnswer-C
Ans.C.Hypochlorousacid
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Thedisinfectingactionofchlorineispredominantlyduetohypochlorousacid.
Hypochlorousacidisthemosteffectiveformofchlorineanditis
almost70-80timesmoreeffectivethanhypochloriteions.
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112.Kala-Azarisfoundinallendemicareasexcept.
a)WestBengal
b)UP
c)Bihar
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d)AssamCorrectAnswer-D
Ans.D.Assam
UP,WestBengalBiharAndJharkhandaretheendemicstates
ofkalaAzar
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113.Riskamongexposedtoriskamongnon
exposedisdefinedtobe?
a)Relativerisk
b)Oddsratio
c)Attributablerisk
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d)NoneoftheaboveCorrectAnswer-A
Ans.A.Relativerisk
Peventwhenexposed
RR= Peventwhennotexposed
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Instatisticandepidemiology,relativeriskorriskratio(RR)istheratiooftheprobabilityofaneventoccurring(forexample,developing
adisease,beinginjured)inanexposedgrouptotheprobabilityof
theeventoccurringinacomparison,non-exposedgroup.
RR=1meansthatexposuredoesnotaffecttheoutcome
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RR<1meansthattheriskoftheoutcomeisdecreasedbytheexposure
RR>1meansthattheriskoftheoutcomeisincreasedbythe
exposure
114.Pasteurizationisdoneat-
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a)73oCFor20minb)63oCFor30min
c)72oCFor30seconds
d)63oCFor30seconds
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans.B.63oCFor30minPasteurizationofmilk,widelypracticedinseveralcountries,notably
theUnitedStates,requirestemperaturesofabout63?C(145?F)
maintainedfor30minutesor,alternatively,heatingtoahigher
temperature,72?C(162?F),andholdingfor15seconds(andyet
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highertemperaturesforshorterperiodsoftime).115.Idealtimegapbetween2livevaccination
-
a)2weeks
b)4weeks
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c)8weeksd)12weeks
CorrectAnswer-B
Ans.B.4weeks
Ifliveparenteral(injected)vaccines(MMR,MMRV,varicella,zoster,
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andyellowfever)andliveintranasalinfluenzavaccine(LAIV)arenotadministeredatthesamevisit,theyshouldbeseparatedbyatleast
4weeks.
116.Susceptiblepersondevelopeddisease
withinrangeofIPaftercomingincontact
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withprimarycase-a)Secondaryattackrate
b)Casefatalityrate
c)Primaryattackrate
d)Tertiaryattackrate
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CorrectAnswer-AAns.A.Secondaryattackrate
SecondaryAttackRate(SAR)Numberofexposedpersons
developingthediseasewithintherangeoftheincubationperiod,
followingexposuretoprimarycase.
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117.Outof100womenwhowereofferedocp
forcontraception10womengot
pregnantwhenfollowedfor24months.
WhatisPearl'sindex?
a)10
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b)5c)4
d)2
CorrectAnswer-B
Ans.B.5
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NumberofPregnancies*12Pearl-Index=
*100
NumberofWomen*NumberofMonths
PearlIndex=10x12x100/100x24=5
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118.Whichofthefollowingdonotcause
hardnessofwater?
a)Calciumcarbonate
b)Calciumsulphate
c)Calciumbicarbonate
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d)MagnesiumbicarbonateCorrectAnswer-A
Ans.A.Calciumcarbonate
Temporaryhardnessisatypeofwaterhardnesscausedbythe
presenceofdissolvedbicarbonateminerals(calciumbicarbonate
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andmagnesiumbicarbonate).Permanenthardnessiscausedbydissolvedcalciumsulfate(which
isnotremovedbyboiling).
119.Whichofthefollowingisnotanexample
ofdirecttransmissionincommunicable
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diseases?a)Transplacental(vertical)
b)Soil
c)Respiratory
d)STD
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CorrectAnswer-CAns.C.Respiratory
Themodesoftransmissionofinfectiousdiseasescanbe
classifiedas:
DirectTransmission.Directcontact;Dropletinfection;Contactwith
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soil;Inoculationintoskinormucosa;Transplacental(vertical)transmission.
IndirectTransmission.Vehicle-borne;Water;food/milk;Vector-
borne.Mechanical;Biological.Airborne.
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120.Water'sviewisusedtoobtaindiagnosticinformationof:
a)Maxillarysinus
b)Ethmoidalsinuses
c)Frontalsinus
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d)SphenoidsinusCorrectAnswer-A
ANSWER:A.Maxillarysinus
Waters'view(alsoknownastheOccipitomentalview)isa
radiographicview,whereanX-raybeamisangledat45?tothe
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orbitomeatalline.Therayspassfrombehindtheheadandareperpendiculartothe
radiographicplate.
Itiscommonlyusedtogetabetterviewofthemaxillarysinuses.
121.Tracheostomyindicationis:
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a)Vocalcordreplacementb)Pharynxreplacement
c)Tracheomalacia
d)Foreignbodyobstructingairway
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Answer-D.ForeignbodyobstructingairwayIndicationsoftracheostomy:
Upperrespiratorytractobstruction;Laryngeal,supralaryngeal,and
trachealcauses.(Causesofstridor)
Lowerrespiratorytractobstruction:(Secretoryobstruction,Wetlung
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syndrome).122.Caldwell'sviewisusedfor:
a)Maxillarysinus
b)Frontalsinus
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c)Ethmoidalsinusd)Alloftheabove
CorrectAnswer-B
Answer-B.Frontalsinus
Caldwell'sview(orOccipitofrontalview)isaradiographicviewof
--- Content provided by FirstRanker.com ---
skull,whereX-rayplateisangledat20?toorbitomeatalline.Therayspassfrombehindtheheadandareperpendicularto
radiographicplate.
Itiscommonlyusedtogetbetterviewoffrontalsinuses.
123.Astigmatisminemmetropiceyeof
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elderlypersoncontributeto:a)+1d
b)+2D
c)+3d
d)+4d
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CorrectAnswer-CAnswerC.+3d
Laservisionenhancements
Whenplanningpresbyopia-correctingIOL(Intraocularlens)surgery
inapatientwithahighlevelofpre-existingastigmatism(ie,more
--- Content provided by FirstRanker.com ---
than3D),abiopticsapproach(ie,IOLfollowedbylaservisionenhancement)maybeneeded.
LRIsaloneareunlikelytocorrecttheastigmatismcompletely.Limbal
RelaxingIncisions(LRI)arearefractivesurgicalprocedureto
correctminorastigmatismintheeye.
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Thereareseveraldifferentstrategiesfortheseplannedlaservisionenhancements.Thefirstistoperformthepresbyopia-correctingIOL
surgeryfollowedbyLASIKorPRK.
124.100dayGlaucomaseeninwhichofthe
followingcondition:
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a)Centralretinalveinocclusion(CRVO)b)Neovascularglaucoma
c)Centralretinalarteryocclusion(CRAO)
d)SteroidinducedGlaucoma
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A,Centralretinalveinocclusion(CRVO)100daysglaucomaisaneovascularglaucomaoccurringin
CRVO.
CentralRetinalveinocclusion(CRVO)
1.Predisposingfactors:-
--- Content provided by FirstRanker.com ---
Increasingage?seenin6th-7th-decadesoflife.Systemichypertensionisthemostcommoncause.
Blooddyscrasias?hyperviscosityduetochronicleukemias
andpolycythemia
RaisedIOP(POAG)
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Periphlebitis?sarcoidosis,Beh?et'sdisease2.ClassificationofCRVO:-
Non?Ischemic
Ischemic
3.ClinicalFeatures:-
--- Content provided by FirstRanker.com ---
TortuosityanddilationofretinalveinsFlameshapedhemorrhage?developinthenervefiberlayerofthe
retina,especiallyaroundtheopticdisc,asaresultofthehigh
intravascularpressurethatdilatestheveinsandcollateralvessels.
Cotton?woolspotsandappearanceofcollateralsattheopticdisc
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areitsprominentdiagnosticsigns.Opticdiscedemaandhyperemiaareseen.
4.Complications:-Rubeosisiridisandneovascularglaucoma
(NVG)occurinmorethan50percentcaseswithin3months(so
alsocalledas90daysglaucoma),afewcasesdevelopvitreous
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hemorrhageandproliferativeretinopathy.5.Treatment:-Panretinalphotocoagulation(PRP)orcryo-
application,ifthemediaishazy,mayberequiredtoprevent
neovascularglaucomainpatientswithwidespreadcapillary
occlusion.
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Photocoagulationshouldbecarriedoutwhenmostoftheintraretinalbloodisabsorbed,whichusuallytakesabout3-4months.
100-dayglaucomaorNVGresultsfromconditionswhichleadto
neovascularizationintheeyeeg.PDR,CRVO,Retinalmalignancies
andrarelyinCRAO.
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Hemorrhagicglaucomaisalsoknownas100dayglaucomabecauseitstarts3monthsaftertheepisodeofcentral
retinalveinocclusion.
125.QRothspotsisseenin:
a)Uvealmelanoma
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b)Acuteleukaemiac)Botha&b
d)Noneoftheabove
CorrectAnswer-B
Answer-B.Acuteleukaemia
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Roth'sspotsareretinalhemorrhageswithwhiteorpalecenters.Composedofcoagulatedfibrinincludingplatelets,focalischemia,
inflammatoryinfiltrate,infectiousorganisms,orneoplasticcells.
Roth'sspotsmaybeobservedinleukemia,diabetes,subacute
bacterialendocarditis,perniciousanemia,ischemicevents,
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hypertensiveretinopathyandrarelyinHIVretinopathy.Roth'sspotsarenamedafterMoritzRoth.
126.Yokemuscleofrightlateralrectus:
a)Ltmedialrectus
--- Content provided by FirstRanker.com ---
b)Ltsuperiorrectusc)Ltlateralrectus
d)Ltinferioroblique
CorrectAnswer-A
Answer-A.Ltmedialrectus
--- Content provided by FirstRanker.com ---
Contralaterallypairedextraocularmusclesthatworksynergisticallytodirectthegazeinagivendirection.
Forexample,indirectingthegazetotheright,therightlateral
rectusandleftmedialrectusoperatetogetherasyokemuscles.
YokeMuscles:2Muscles(1ineacheye)thataretheprimemovers
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oftheirrespectiveeyesinagivenpossitionoofgazeFor-Example-whentheeyesmoveintorightgaze(dextroversin),
therightlateralrectus&theleftmedialrectusmuscleareyoke
muscles.
127.SevereConjunctivitiscausedby:
--- Content provided by FirstRanker.com ---
a)Neisseriab)Staphylococcus
c)Streptococcus
d)Haemophilus
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
ANSWER-A.NeisseriaThemostcommoncausesofacutebacterialconjunctivitisare
Staphylococcusaureus,Streptococcuspneumoniae,and
Haemophilusinfluenzae.
HyperacutecasesareusuallycausedbyNeisseriagonorrhoeaeor
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N.meningitidis.Chroniccasesofbacterialconjunctivitisarethoselastinglongerthan
3weeks,andaretypicallycausedbyStaphylococcusaureus,
Moraxellalacunata,orgram-negativeentericflora.
Neisseriagonorrhoeaecausesgonococcalconjunctivitis,which
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usuallyresultsfromsexualcontactwithapersonwhohasagenitalinfection.
Theincidenceratesofgonococcalconjunctivitisincreaseduring
springandsummer.
Thisisapotentiallydevastatingocularinfection,becauseN.
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gonorrhoeaecancausesevereulcerativekeratitis,whichmayrapidlyprogresstocornealperforation.
128.WhichisexampleoftheSimpleMyopic
Astigmatismamongtheprescriptions
givenbelow:
--- Content provided by FirstRanker.com ---
a)Rx(+)sphereb)Rxwillbeplano(-)
c)Rxwillbe(-)sphere
d)(-)(+)(+)(-)onboth90and180degreeaxis
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B.Rxwillbeplano(-)Wheneyewearprescriptionsarewritten,theycanbeclassifiedinto
differentareasdependingonthepowerorrefractiveerror.
Therearesevencategoriestowhichprescriptionscanfall:
1. SimpleHyperopia,theRxwillbe(+)sphere
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2. SimpleMyopia,theRxwillbe(-)sphere3. SimpleMyopicAstigmatism,theRxwillbeplano(-)
4. SimpleHyperopicAstigmatism,theRxwillbe(+)
5. CompoundHyperopicAstigmatism,majormeridianpowerwillbe
(+)(+)onboth90and180degreeaxis
--- Content provided by FirstRanker.com ---
6. CompoundMyopicAstigmatism,majormeridianpowerwillbe(-)(-)onboth90and180degreeaxis
7. MixedAstigmatism,majormeridianpowerswillbeopposites(-)
(+)(+)(-)onboth90and180degreeaxis
129.Blowoutfractureoforbitinvolves:
--- Content provided by FirstRanker.com ---
a)Floorb)Medialwall
c)Lateralwall
d)Roof
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A.FloorOrbitalfloorfracture,alsoknownas"blowout"fractureoftheorbit.
Blowoutfractureoforbitinvolves:
1. Fracturesoftheorbitalfloorarecommon:itisestimatedthatabout
10%ofallfacialfracturesareisolatedorbitalwallfractures(the
--- Content provided by FirstRanker.com ---
majorityofthesebeingtheorbitalfloor),andthat30-40%ofallfacialfracturesinvolvetheorbit.
2. Theanatomyoftheorbitalfloorpredisposesittofracture.
3. Theinferiororbitalneurovascularbundle(comprisingtheinfraorbital
nerveandartery)courseswithinthebonyflooroftheorbit;theroof
--- Content provided by FirstRanker.com ---
ofthisinfraorbitalcanalisonly0.23mmthick,andtheboneoftheposteriormedialorbitalflooraverages0.37mmthick.
4. Bycontrast,theboneofthelateralportionoftheorbitalfloor
averages1.25mmthick,over5timesthethicknessoftheboneover
theneurovascularbundle.Asonemightsuspect,itisthisverythin
--- Content provided by FirstRanker.com ---
areaoftheorbitalflooroverlyingtheneurovascularbundlewhereisolatedorbitalfloorfracturesinvariablyoccur.
130.Whichofthefollowingisendogenous
pyrogen
--- Content provided by FirstRanker.com ---
a)PGE2b)PGD2
c)PGF2alpha
d)PGI2
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:-A.PGE2Pyrogen
Pyrogensaresubstancesthatcausefever.
Pyrogensmaybeexogenousorendogenous
ExogenousBacterialtoxins
--- Content provided by FirstRanker.com ---
EndogenousIL-1,TNF-a,IL-6,Interferons,Ciliaryneurotrophicfactor
ThesepyrogensincreasethelevelofPGE,inthehypothalamusthat
elevatesthethermoregulatorysetpointandcausesfever.
131.InBarttersyndromedefectisseenin:
--- Content provided by FirstRanker.com ---
a)DefectinPCTb)DefectinDCT
c)Defectinthickascendinglimbofloopofhenle
d)None
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer:C-DefectinthickascendinglimbofloopofhenleAutosomalrecessivedisorder.
Geneticdefectinthethickascendinglimboftheloopofhenle
DefectsinNa-K-2C/coLtransporter,KorCl
channelsresultinlackofconcentratingability
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132.Notseeninallergicpulmonary
aspergillosisis
a)HighIgElevel
b)Recurrentpneumonia
c)Occurrenceinpatientswitholdcavitarylesions
--- Content provided by FirstRanker.com ---
d)PleuraleffusionCorrectAnswer-B
Answer:B-Recurrentpneumonia
Allergicbronchopulmonaryaspergillosisisapulmonary
hypersensitivitydisordercausedbyallergytofungalantigensthat
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colonizethetracheobronchialtree.Itmostcommonlyoccursinatopicasthmaticindividualsinresponse
toantigenofaspergillusspecies.
Maindiagnosticcriteria
ClinicalhistoryofAsthmaQ
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Pulmonaryinfiltrates(transient/fleetingorfixed)QPeripheraleosinophilia(>1000/,uL)Q
ImmediateskinreactivitytoAspergillusantigen(whealandflare
response)
SerumprecipitinstoA.fumigatus
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ElevatedserumIgElevels(>100Ong/ml)Central/proximalbronchiectasis
Secondarydiagnosticcriteria
Historyofbrownishplugsinsputum
Identification/cultureofA.,fumigatusfromsputum
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Lateskinreactivitytoaspergillusantigen-CMDTElevatedIgE(andIgG)classantibodiesspecificforA.fumigatus-
Harrisons
Note
ElevatedIgE(andIgG)classantibodiesspecificforA.fumigatushas
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beenmentionedasasecondarydiagnosticcriteriainHarrison'stextbookwhileFishman'stextbookincludesthisasamain/major
diagnosticcriteria.
133.PseudoPPulmonale
a)Hypokalemia
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b)Hyponatremiac)Hypocalcemia
d)Hypercalcemia
CorrectAnswer-A
Answer:A.Hypokalemia
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Insomecasestherecanbeanotched(orbifid)p-waveknownas"pmitrale",indicativeofleftatrialhypertrophywhichmaybecausedby
mitralstenosis.Theremaybetallpeakedp-waves.Thisiscalled"p-
pulmonale"andisindicativeofrightatrialhypertrophyoften
secondarytotricuspidstenosisorpulmonaryhypertension.
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Asimilarpicturecanbeseeninhypokalemia(knownas"pseudop-pulmonale").
134.AutomaticImplantableCardioverter
Defibrillator,(AICD)implantationisdone
forwhichoffollowingconditions:
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a)Brugadasyndromeb)Ventricularfibrillation
c)AcutecoronarysyndromewithlowEF
d)Alloftheabove
CorrectAnswer-D
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Answer:D.AlloftheaboveAnAutomaticImplantableCardioverterDefibrillator,(AICD),isa
smallelectronicdevicethatisimplantedintoyourchesttomonitor
andcorrectanabnormalheartrhythm,orarrhythmia.Thesedevices
areusedtotreatseriousandlife-threateningarrhythmiasandare
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themosteffectivewayofdoingso.Brugadasyndromeisaconditionthatcausesadisruptionofthe
heart'snormalrhythm.
Ventricularfibrillationisaheartrhythmproblemthatoccurswhen
theheartbeatswithrapid,erraticelectricalimpulse.
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Acutecoronarysyndromeisatermusedtodescribearangeofconditionsassociatedwithsudden,reducedbloodflowtotheheart.
135.Whatisthelineoftreatmentfor
intractableSydenhamchorea?
a)Haloperidol
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b)Valproatec)Warfarin
d)Risperidone
CorrectAnswer-B
Answer:B.Valproate
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Sydenham'schorea(SC)/Choreaminor/Rheumaticchorea(RC)/St.Vitus'sDance
Majordiagnosticcriteriaforrheumaticdisease
Mostcommonacquiredchoreaduringchildhood
Characterizedbyrapid,uncoordinatedjerkingmovementsprimarily
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affectingtheface,handsandfeetBenzodiazepinesfacilitatetheactionofGABAandvalproate
enhancestheactiononGABA,hencetheseagentsareusedtotreat
chorea
136.Neurofibromatosis1criteriaexcept
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a)Braintumorb)Acousticneuromas
c)Pseudoarthrosis
d)Cafe-au-laitspots
CorrectAnswer-B
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Answer:B-AcousticneuromasClinicaldiagnosisrequirespresenceofatleast2of7criteriato
confirmpresenceofneurofibromatosis,type1.
Despitesuspicion,mostsignsdonotappearuntillatechildhood/
adolescent
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The7clinicalcriteriausedtodiagnoseNF1areasfollows:Sixormorecaf?-au-laitspots/hyperpigmentedmaculesgreater
thanorequalto5mmindiameterinprepubertalchildren&15mm
postpubertal
Axillaryoringuinalfreckles(>2)
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TwoormoretypicalneurofibromasoroneplexiformneurofibromaOpticnerveglioma
Twoormoreirishamartomas(Lischnodules)(oftenidentifiedonly
throughslit-lampexamination)
Sphenoiddysplasiaortypicallong-boneabnormalitiessuchas
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pseudarthrosisStrongfamilyhistory(1stdegreerelativewithNF1)
137.Mostcommonsiteofchronicgastric
ulcer
a)Pyloricantrum
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b)Upperpartoflessercurvaturec)Lowerpartoflessercurvature
d)Segmentoflargeintestine
CorrectAnswer-A
Answer:A-Pyloricantrum
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Amajorcausativefactor(60%ofgastric&upto50?75%ofduodenalulcers)ischronicinflammationduetoHelicobacter
pylorithatcolonizestheantralmucosa.
138.ApproximatetimeintervalbetweenHIV
infection&manifestationofAIDSis?
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a)7.5yrb)10yr
c)12yr
d)11yr
CorrectAnswer-B
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Answer:B-10yearsTheapproximatetimeframerequiredforincubationisusually10
years.
mediantimefrominfectiontothedevelopmentofAIDSinadultsis
about9years.AsmallproportionofuntreatedHIV-infectedpeople
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arelong-termnon-progressors,withCD4countsinthereferencerangefor10yearsormore.Somelong-termnon-progressorshave
undetectableviralloadsandareknownas`elitecontrollers'.
139.Heller'smyotomyisdonefor
a)Zenker'sdiverticulum
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b)Achalasiacardiac)Bunions
d)Kneearthroscopy
CorrectAnswer-B
Answer:B-Achalasiacardia
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Achalasia,adisorderofesophaguscharacterizedbyprogressiveinabilitytoswallowsolids&liquids.
Causesincludeweakenedesophagealmuscles&issueswithlower
esophagealsphincterrelaxation
HellerMyotomy,surgicalprocedureofferslongtermsymptomatic
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relieftothesepatients.Itinvolvesweakeningofmusclesatgastroesophagealjunction,
allowingthevalvebetweenoesophagus&stomachtoremainopen.
140.Myocardialstunningpatternnot
matchingtheECG.Whatisthe
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diagnosis.a)Takotsubocardiomyopathy
b)Restrictivecardiomyopathy
c)Brigade'scardiomyopathy
d)Pericardialsomething
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer:A-Takotsubocardiomyopathy
"MyocardialStunning"isastatewherecertainsegmentsof
myocardium(correspondingtoareaofmajorcoronary
occlusion)showsformsofcontractileabnormality.
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Asegmentaldysfunctionpersistingforavariableperiodoftime,abouttwoweeks,evenafterischemiahasbeenrelieved(byfor
instanceangioplastyorcoronaryarterybypasssurgery).
Takotsubocardiomyopathy/Takotsubosyndrome,atemporary
conditionwhereyourheartmusclebecomessuddenlyweakenedor
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'stunned'.141.Alternativedrugforcardiacarrestin
placeofepinephrineis?
a)Amiodaroneinfusion
b)Atropine
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c)Highdosevasopressind)Adenosine
CorrectAnswer-C
Answer:C-Highdosevasopressin
Vasopressinisanalternativevasopressorathighdoses,causes
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vasoconstrictionbydirectlystimulatingsmoothmuscleV1receptors.
AmericanHeartAssociation(AHA)guidelinesstates"Vasopressinis
areasonablefirst-linevasopressorinpatientswithventricular
fibrillationorpulselessventriculartachycardia.Additionally,the
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guidelinescommentthatonedoseofvasopressin40Umayreplacethefirstorseconddoseofepinephrineinallpulselesssudden
cardiacarrestscenarios,includingasystoleandpulselesselectrical
activity.
142.Patientpresentingwithcutaneous
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vasculitis,glomerulonephritis,peripheralneuropathy,Whichinvestigationistobe
performednextthatwillhelpyou
diagnosethecondition?
a)ANCA
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b)RAfactorc)Hbsag
d)MIF
CorrectAnswer-A
Answer:A-ANCA
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Anti-neutrophilcytoplasmicantibodies(ANCAs):Groupofautoantibodies
IgGtypemainly,
Producedagainstantigensincytoplasmofneutrophilgranulocytes&
monocytes.
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Particularlyassociatedwithsystemicvasculitis,socalled"ANCA-associatedvasculitis".
143.Cryoglobulinemia
a)Hepatitisc
b)Ovariancancer
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c)Diabetesd)Leukemia
CorrectAnswer-A
Answer:A.HepatitisC
Cryoglobulinemia/Cryoglobulinemicdiseasewithlargeamountsof
--- Content provided by FirstRanker.com ---
cryoglobulinsinbloodCryoglobulinsareproteins(mostlyimmunoglobulinsthemselves)
Becomeinsolubleatreducedtemperatures.
MixturesofmonoclonalorpolyclonalIgM,IgG,and/orIgA&blood
complementproteinslikeC4areassociatedwithcasesofinfectious
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diseases,particularlyHepatitisCinfection,144.Causesofhypokalemicmetabolic
alkalosiswithhypertension
a)Liddlesyndrome
b)Barttersyndrome
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c)Gitelmansyndromed)Renaltubularacidosis
CorrectAnswer-A
Answer:A.Liddlesyndrome
Liddlesyndrome-Rarehereditarydisorder
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Increasedactivityoftheepithelialsodiumchannel(E-NaCh)Activatingkidneystoexcretepotassiumretainingexcessivesodium
&water,leadingtohypertension.
145.GoldcriteriaforverysevereCOPD
a)Fev1/Fvc<70andFev1<30
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b)Fev1/Fvc<70andFev1<70c)Fev1/Fvc<70andFev1<50
d)BothAandC
CorrectAnswer-A
Answer:A.Fev1/Fvc<70andFev1<30
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COPDshouldbeconsideredinanypatientwhohasdyspnea,chroniccoughorsputumproduction,and/orahistoryofexposureto
riskfactorsforthedisease.
Spirometryisrequiredtomakethediagnosis.
Presenceofpost-bronchodilatorFEV1/FVC<0.70confirmsthe
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presenceofpersistentairflowlimitation.StageIV/VerySevereCOPD
Severeairflowlimitation(FEV1/FVC<70%;FEV1<.30%predicted)
orFEV1<50%predictedpluschronicrespiratoryfailure.
PatientsmayhaveVerySevere(StageIV)COPDevenifFEV1is>
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30%predicted.146.ABPIincreasesartificiallyin
a)Arteriosclerosiscalcifiedarteries
b)Ischemiculcers
c)Intermittentclaudication
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d)DVTCorrectAnswer-A
Answer:A.Arteriosclerosiscalcifiedarteries
Theankle-brachialpressureindex(ABPI)/Ankle-Brachialindex
(ABI):
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Ratioofbloodpressureatankletobloodpressureinupperarm(brachium).
Comparedtoarm,lowerbloodpressureinlegsuggestsblocked
arteriesduetoperipheralarterydisease(PAD).
Anklebrachialpressureindex(ABPI)isamethodforthe
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quantificationofperipheralvasculardiseasethatresultsfromadvancedatherosclerosis.
147.Minimaldysfunctionsyndromeseenin
a)Dyslexia
b)ADHD
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c)Mentalsubnormalityd)Down'ssyndrome
CorrectAnswer-A
Answer:A.Dyslexia
ClinicalfeatureofMinimaldysfunctionsyndromeincludesdyslexia.
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Minimalbraindysfunction:Neurodevelopmentaldisorder.
Characterizedbyevidencesofimmaturityinvolvingcontrolof
activity,emotions,&behavior
Specificlearningdisabilitiesinvolvingthecommunicatingskills
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neededinreading,writing,andmathematics.Inabilitytomaintainattention&concentration
Inabilitytoskillfullyblendtheauditory&visualfunctionsessentialin
languageperformance
148.VanNuysprognosticindexisnotbased
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on:a)Age
b)Microcalcification
c)Size
d)ERstatus
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CorrectAnswer-DAnswer:D.ERstatus
DCISmaybeclassifiedusingtheVanNuyssystem,whichcombines
the
1. Patient'sage,
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2. TypeofDCIS3. Presenceofmicrocalcification,
4. Theextentofresectionmargin
5. Thesizeofthedisease.
VanNuysPrognosticIndex
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ParameterScore1
Score2
Score3
VanNuys
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Group1Group2
Group3
Classification
Non-high
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Non-HighHighnuclear
nucleargrade
nucleargrade gradewithor
withoutnecrosis withnecrosis
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withoutnecrosisMargins
10mm
1?9mm
Size
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16?40mm>40mm
Age
>60
40?60
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<40149.Commoncauseofchronicpancreatitis
a)Chronicalcohol
b)Chronicpancreaticcalculi
c)pancreasdivisum
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d)GallbladderstonesCorrectAnswer-A
Answer:A.Chronicalcohol
"Worldwide,alcoholconsumptionandabuseisassociatedwith
chronicpancreatitisinupto70%ofcases"
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150.ThefollowingstatementaboutKeloidis
true
a)Itcontaingrowthfactor
b)Extendedexcisionisthetreatmentofchoice
c)Itdonotextendbeyondthewound
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d)NoneoftheaboveCorrectAnswer-A
Answer:A.Itcontaingrowthfactor
Vaccinations,injections,insectbites,earpiercing,ormayarise
spontaneously.
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Keloidstendtooccur3monthstoyearsaftertheinitialinsult,andevenminorinjuriescanresultinlargelesions.
Theyvaryinsizefromafewmillimeterstolarge,pedunculated
lesionswithasofttorubberyorhardconsistency.
Althoughtheyprojectabovesurroundingskin,theyrarelyextendinto
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underlyingsubcutaneoustissues.Certainbodysiteshaveahigherincidenceofkeloidformation,
includingtheskinoftheearlobeaswellasthedeltoid,presternal,
andupperbackregions.
Theyrarelyoccuroneyelids,genitalia,palms,soles,oracross
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joints.Keloidsrarelyinvolutespontaneously,whereassurgicalintervention
canleadtorecurrence,oftenwithaworseresult.
151.Whichofthefollowinglayersarecut
duringfasciotomy?
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a)Skinb)Skin+subcutaneousfascia
c)Skin+subcutaneoustissue+Superficialfascia
d)Skin+subcutaneoustissue+Superficialfascia+deepfascia
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Answer:D.Skin+subcutaneoustissue+Superficialfascia+deepfascia
Fasciotomyorfasciectomyisasurgicalprocedurewherecomplete
openingofallfascialenvelopeisdonetorelievetensionorpressure
commonlytotreattheresultinglossofcirculationtoanareaoftissue
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ormuscle.Fasciotomyisalimb-savingprocedurewhenusedtotreatacutecompartmentsyndrome.
152.Whichstatementisnottrueregarding
crohn'sdisease:
a)Rectumisnotinvolved
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b)Continuouslesionvisualizedinendoscopyc)Noncaseatinggranulomas
d)Cobblestoneappearance
CorrectAnswer-B
Answer:B.Continuouslesionvisualizedinendoscopy
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Crohn'sdiseaseisfrequentlyassociatedwith"skiplesions,"discontinuousareasofactivediseaseinthecolonand
smallintestinewithinterveningsegmentsthatappearnormal.
153.Whichisthebestinvestigationfor
carcinomaheadofpancreas:
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a)Guidedbiopsyb)ERCP
c)Transduodenal/transperitonealsampling
d)EUS
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Answer:DMedicalimagingtechniques,suchascomputedtomography(CT
scan)andendoscopicultrasound(EUS)areusedbothtoconfirmthe
diagnosisandtohelpdecidewhetherthetumorcanbesurgically
removed
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154.Anabdominalmassisbest
demonstratedincongenitalhypertrophic
pyloricstenosisby:
a)Inpalpationovertheepigastrium
b)Inlefthypochondriac
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c)Rightiliacfossad)Duringfeeding
CorrectAnswer-D
Answer:D.Duringfeeding
Congenitalhypertrophicpyloricstenosis
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PresentationVomitingisthepresentingsymptom(childvomitsmilkandnobileis
present)
Immediatelyaftervomitingthechildishungryi.e.lossofappetite
doesnotoccur.
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Weightlossisstrikingandrapidlytheinfantbecomesemaciatedanddehydrated.
However,greaterawarenessofpyloricstenosishasledtoearlier
identificationofpatientsandhencewithfewerincidencesofchronic
malnutritionandseveredehydration-Nelson10th/1130
--- Content provided by FirstRanker.com ---
Thediagnosisisusuallymadewithatestfeed:Inthis,thebabyisfedwiththebottlebyanurseormotherandsurgeon:
IHPS/CHPScanbediagnosedclinically.Duringatestfeed,thereis
visiblegastricperistalsispassingfromlefttorightacrosstheupper
abdomenandinarelaxedbaby,thepyloric'tumor'ispalpableasan
--- Content provided by FirstRanker.com ---
'olive'intherightupperquadrant.Thediagnosiscanbeconfirmedbyanultrasound,whichshows
thethickenedpyloricmuscle.
155.CalculateGCSof25yearoldheadinjury
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patientwithfollowingparametersconfused,openingeyesinresponseto
pain,localizingpainwillbe-
a)6
b)11
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c)12d)7
CorrectAnswer-B
Answer:B.11
Glasgowcomascale:
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156.RETproto-oncogeneisassociatedwith
thedevelopmentof
a)Medullarycarcinomathyroid
b)Astrocytoma
c)Paraganglioma
--- Content provided by FirstRanker.com ---
d)HurthlecelltumorthyroidCorrectAnswer-A
Answer:A.Medullarycarcinomathyroid
RETproto-oncogeneisagrowthfactorreceptor(receptortyrosine
kinase)
--- Content provided by FirstRanker.com ---
TheRETproteinisareceptorfortheglialcellline-derivedneurotrophicfactorandstructurallyrelatedproteinsthatpromotecell
survivalduringneuraldevelopment.
RETisnormallyexpressedinthefollowingcells
ParafollicularCcellsofthethyroid
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AdrenalmedullaMedullarycarcinomamayoccurincombinationwithadrenal
phaeochromocytomaandhyperparathyroidism(HPT)(usuallydueto
hyperplasia)inthesyndromeknownasmultipleendocrineneoplasia
type2A(MEN-2A).
--- Content provided by FirstRanker.com ---
Thesearetumorsoftheparafollicular(Ccells)derivedfromtheneuralcrestratherthanthecellsofthethyroidfollicleasareother
primarythyroidcarcinomas
Whenthefamilialformisassociatedwithprominentmucosal
neuromasinvolvingthelips,tongueandinneraspectoftheeyelids,
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withaMarfanoidhabitus,thesyndromeisreferredtoasMENtype2B.
RETassociations:MEN2a,MEN2b,Familialmedullarycarcinoma
thyroid.
157.Cutoffforsurgeryinanabdominalaortic
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aneurysminasymptomaticpatients-a)5.5cm
b)6.5cm
c)7.5cm
d)8.5cm
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CorrectAnswer-AAnswer:A.5.5cm
Operativerepairoftheaneurysmwiththeinsertionofa
prostheticgraftorendovascularplacementofaorticstentgraft
isindicatedfor:
--- Content provided by FirstRanker.com ---
Abdominalaorticaneurysmsofanysizethatareexpandingrapidlyorareassociatedwithsymptoms.
Forasymptomaticaneurysms,abdominalaorticaneurysmrepairis
indicatedifthediameteris>5.5cm.
158.Whichofthefontanelleisthelastto
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close?a)Anterolateral
b)Anterior
c)Lateral
d)Occipital
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CorrectAnswer-BAns.B.Anterior
Theposteriorfontanellenormallycloses2to3monthsafterbirth
Thesphenoidalfontanelleisthenexttoclosearound6monthsafter
birth
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Themastoidfontanelleclosesnextfrom6to18monthsafterbirth;Theanteriorfontanelleisgenerallythelasttoclosebetween18?24
months.
159.WhichenzymedeficiencycausesLesch?
Nyhansyndrome?
--- Content provided by FirstRanker.com ---
a)Hypoxanthine-guaninephosphoribosyltransferase(HGPRT)b)Xanthineoxidase
c)Adeninephosphoribosyltransferase(APRT)
d)AMPdeaminase
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.Hypoxanthine-guaninephosphoribosyltransferase(HGPRT)
Lesch?Nyhansyndrome(LNS),alsoknownasjuvenilegout,isa
rareinheriteddisordercausedbyadeficiencyoftheenzyme
hypoxanthine-guaninephosphoribosyltransferase(HGPRT),
--- Content provided by FirstRanker.com ---
producedbymutationsintheHPRTgenelocatedontheXchromosome
160.Whichvaccineisnotincludein
indradhanushmission?
--- Content provided by FirstRanker.com ---
a)Tuberculosisb)Measles
c)JapaneseEncephalitis
d)Diphtheria
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans.C.JapaneseEncephalitisTheMissionIndradhanush,depictingsevencoloursofthe
rainbow,targetstoimmunizeallchildrenagainstsevenvaccine
preventablediseasesnamely:
Diphtheria
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PertussisTetanus
ChildhoodTuberculosis
Polio
HepatitisB
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Measles.161.WhichamongthefollowingistheMost
commoncauseforneonatalblindness?
a)Neisseriagonorrhoeae
b)Chlamydiatrachomatis
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c)Klebsiellad)Enterobacter
CorrectAnswer-A
Ans.A.Neisseriagonorrhoeae
Ophthalmianeonatorum(ON)isdefinedasapurulentconjunctivitis
--- Content provided by FirstRanker.com ---
occurringduringthefirstfourweeksoflife.ThetwomostcommoncausativeagentsareNeisseriagonorrhoeae
andChlamydiatrachomatis,theformerbeingofmoreconcernhere
becauseofitspropensitytocauseblindness.
162.MusclesaffectedinDequervain
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tenosynovitis-a)Abductorpollicislongusandextensorpollicisbrevis
b)Adductorpollicislongusandextensorpollicisbrevis
c)AbductorpollicislongusandFlexorpollicisbrevis
d)AdductorpollicislongusandFlexorpollicisbrevis
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns.A.Abductorpollicislongusandextensorpollicisbrevis
DeQuervainsyndrome,isatenosynovitisofthesheathortunnel
thatsurroundstwotendonsthatcontrolmovementofthethumb.
DeQuervainsyndromeinvolvesnon-inflammatorythickeningofthe
--- Content provided by FirstRanker.com ---
tendonsandthesynovialsheathsthatthetendonsrunthrough.Thetwotendonsconcernedarethoseoftheextensorpollicisbrevis
andabductorpollicislongusmuscles.
163.WhatismeantbyPerilunatedislocations
?
--- Content provided by FirstRanker.com ---
a)Lowerradius,scaphoidandlunateandcapitateallinsameplane
b)Lowerradius,scaphoidandcapitateinalignment,lunatealone
outofplane
c)Lowerradius,scaphoidandLunateinalignment,capitatealone
--- Content provided by FirstRanker.com ---
isoutofplaned)Bothlunateandcapitateareoutofplane
CorrectAnswer-B
Ans.B.Lowerradius,scaphoidandcapitateinalignment,lunate
aloneoutofplane
--- Content provided by FirstRanker.com ---
Perilunatedislocationandperilunatefracturedislocationareinjuriesthatinvolvetraumaticruptureoftheradioscaphocapitate(RSC)
ligament,thescapholunateinterosseousligament,andthe
lunotriquetralinterosseousligament.
Lateralradiographswillreveallossofcollinearitybetweenthe
--- Content provided by FirstRanker.com ---
capitate,lunate,andradiusTypicallythecapitateislocateddorsaltothelunateandisaligned
withtheradius
164.Fallenfragmentsign-
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a)Simplebonecystb)Osteosarcoma
c)Adamantinoma
d)Aneurysmalbonecyst
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.SimplebonecystThefallenfragmentsignreferstothepresenceofabonefracture
fragmentrestingdependentlyinacysticbonelesion.Thisfindingis
saidtobepathognomonicforasimple(unicameral)bonecyst
followingapathologicalfracture.
--- Content provided by FirstRanker.com ---
Althoughithasoccasionallybeenreportedwithothercysticlesions,e.g.eosinophilicgranuloma
165.Youarepostedasaninternin
causality.Whichamongthefollowing
patientswithfracturewillbeyour1st
--- Content provided by FirstRanker.com ---
prioritytocallorthoPGandinform?a)Patient'sfingerisblackening
b)Patientcan'textendhisarm
c)A10cmabrasion
d)IntraarticularfractureofElbowJoint
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns.A.Patient'sfingerisblackening
BlackeningoffingerafterFractureisanindicationofcutofofblood
supplythatmayleadtoseverecomplicationlikegangrene.Sothis
shouldbethefirstPrioritytotreatamongalltheaboveoptions
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166.InRheumatoidarthritis,whichtypeof
cellsareprominentlypresent?
a)Bcells
b)Tcells
c)Macrophages
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d)DendriticcellsCorrectAnswer-C
Ans.C.Macrophages
Synovialliningorintimallayer:Normally,thislayerisonly1-3cells
thick.InRA,thisliningisgreatlyhypertrophied(8-10cellsthick).
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Primarycellpopulationsinthislayerarefibroblastsandmacrophages.
167.8thand9thribcostalcartilageforms
whichtypeofjoint?
a)Costochondraljoint
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b)Interchondraljointc)Synovialjoint
d)Costovertebraljoint
CorrectAnswer-C
Ans.C.Synovialjoint
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Thesixth,seventh,eighth,ninthandtenthcostalcartilagesarejointedwitheachotheralongthebordersbysynovialjoints.
Costochondraljointmeansthejointbetweentheribanditscostal
cartilage.
Thefirstcostalcartilageofbothsidesattachtothemanubrium
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sterni.Atthisjoint,nomovementispossible.Thesecondcostalcartilagearticulateswiththebodyofsternumand
themanubriumsternibyasynovialjointwheremovementis
possible.
Thethirdtoseventhcostalcartilagesarticulatewithlateralborderof
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thebodyofsternumatmobilesynovialjoints.168.Tomsmithsepticarthritisis-
a)AcuteGonococcalarthritis
b)Smallpoxarthritis
c)Septicarthritisofinfancy
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d)ChronicpyogenicarthritisCorrectAnswer-C
Ans.C.Septicarthritisofinfancy
Septicarthritisofinfancy(Tomsmithsepticarthritis)
Itisasepticarthritisofhipseenininfants
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Theonsetisacutewithrapidabscessformation,whichmayburstoutorbeincisedandhealsrapidly.
Telescopetestispositive
Clinicallythisconditionresemblesacongenitaldislocationofhip
169.Whichofthefollowingiscorrect
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regardingplacenta?a)Placentalarteryprovidesnutrientsthroughumbilicalcordto
baby
b)PlacentahasWharton'sjelly
c)Placentahas2veinsand1artery
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d)EstrogenissecretedbyplacentaCorrectAnswer-B
Ans.B.PlacentahasWharton'sjelly
Theumbilicalcordisastructurethatprovidesvascularflowbetween
thefetusandtheplacenta.
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Itcontainstwoarteriesandonevein,whicharesurroundedandsupportedbygelatinoustissueknownasWharton'sjelly.
170.Acutefattylivercommonlyseenin
pregnancyat-
a)3rdtrimester
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b)1sttrimesterc)Immediatepostpartum
d)Intrapartum
CorrectAnswer-A
Ans.A.3rdtrimester
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Acutefattyliverofpregnancy(AFLP)isarare,potentiallyfatalcomplicationthatoccursinthethirdtrimesterorearlypostpartum
period.
Acutefattyliverofpregnancyismorecommonlyassociatedwith:
Malefetus
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FirstpregnancyMaternalobesity
Itisduetodefectinthelong-chain-3-hydroxyacyl-CoA-
dehydrogenasepathway.
Itisuncommoninsubsequentpregnancies.
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171.Establishmentoffetoplacental
circulationseenat-
a)11to13days
b)20to22days
c)7days
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d)25to26daysCorrectAnswer-B
Ans.B.20to22days
ImportantEventsFollowingFertilization
0'hour
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Fertilization(day-15fromLMP)30hours
2cellstage(blastomeres)
40?50hours
4cellstage
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72hours12cellstage
96hours
16cellstage.Morulaenterstheuterinecavity
5thday
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Blastocyst4?5thday
Zonapellucidadisappears
5?6thday
Blastocystattachmenttoendometrialsurface
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6?7thdayDifferentiationofcytoandsyncytiotrophoblastlayers
10thday
SynthesisofhCGbysyncytiotrophoblast
9?10thday
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Lacunarnetworkforms10?11thday
Trophoblastsinvadeendometrialsinusoids
establishinguteroplacentalcirculation
Interstitialimplantationcompletedwithentire
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decidualcoverage13thday
Primaryvilli
16thday
Secondaryvilli
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16thday
Secondaryvilli
21stday
Tertiaryvilli
21st?22nd
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Fetalheart.Fetoplacentalcirculationday
172.Fimbriectomyprocedureisknownas-
a)Uchidamethod
b)Irvingmethod
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c)Madlenertechniqued)Kroenermethod
CorrectAnswer-D
Ans.D.Kroenermethod
Uchidatechnique--Asalinesolutionisinjectedsubserosalinthe
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midportionofthetubetocreateableb.Irvingmethod--Thetubeisligatedoneithersideandmidportionof
thetube(betweentheties)isexcised.
Madlenertechnique-Itistheeasiestmethod.Theloopofthetubeis
crushedwithanarteryforceps.
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Kroenermethodoffimbriectomyisnotacommonprocedure173.RDAofiodineinlactationinmicrogram-
a)150
b)220
c)100
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d)250CorrectAnswer-D
Ans.D.250
Toaccommodateincreasediodineneedsduringpregnancyand
lactation,theiodineRDAis220mcg/dayforpregnantwomenand
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250mcg/dayforlactatingwomen174.WhichOneofthefollowingisnota
causeofsecondaryPostpartum
Haemorrhage?
a)Placentaprevia
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b)Retainedbitsofplacentac)Endometritis
d)Polyp
CorrectAnswer-A
Ans.A.Placentaprevia
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CausesofsecondaryPostpartumHaemorrhageare:Retainedbitsofplacenta
Postpartuminfection
InfectionofCervicalandVaginalTears
PuerperalInversionofUterus
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UterinePolyporFibroid:Undiagnosedcarcinomaofcervix
Chorion-epithelioma
175.Besttimetodoquadrupletest
a)8-12weeks
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b)11-15weeksc)15-20weeks
d)18-22weeks
CorrectAnswer-C
Ans.C.15-20weeks
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Thequadscreenisdoneinthesecondtrimester,usuallybetween15and20weeksofpregnancy.
Ideally,thetestshouldbeperformedinconjunctionwithfirst-
trimesterscreeningtests.
176.Drugthatisusedforfetallungmaturity
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is:a)Dexamethasone
b)Folicacid
c)Beclomethasone
d)None
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CorrectAnswer-AAns.A.Dexamethasone
Betamethasoneanddexamethasonearecorticosteroids,alsocalled
glucocorticoids,thataregivenbeforebirth(antenatally)tospeedup
apretermfetuseslungdevelopment.
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Eitherisusedwhenamotherisinpretermlaborandbirthmayoccurin24to48hours.
177.InUterineprolapsehowtoknowifringis
inplace?
a)Ifnotexpelledafterincreasedabdominalpressure
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b)IfBleedingdoesnotoccurc)Ifpatientfeelsdiscomfort
d)None
CorrectAnswer-A
Ans.A.Ifnotexpelledafterincreasedabdominalpressure
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Avaginalpessaryisaremovabledeviceplacedintothevagina.Itisdesignedtosupportareasofpelvicorganprolapse.
Avarietyofpessariesareavailable,includingtheringpessaries
Ifnotexpelledafterincreasedabdominalpressureringpessaryis
supposedtobeplacedinplace
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178.HTindicatedinmenopausalwomen
a)Hotflash
b)Cabreast
c)Endometriosis
d)Uterinebleeding
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CorrectAnswer-AAns.A.Hotflash
HormoneTherapy(HT)isoneofthegovernment-approved
treatmentsforreliefofmenopausalsymptoms.
Thesesymptoms,causedbylowerlevelsofestrogenat
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menopause,include:Hotflashes,
Sleepdisturbances,and
Vaginaldryness.
HTisalsoapprovedforthepreventionofosteoporosis.
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179.Dilatation&curettage(D&C)is
contraindicatedin-
a)Pelvicinflammatorydisease(PID)
b)Endometriosis
c)Ectopicpregnancy
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d)NoneCorrectAnswer-A
Ans.A.Pelvicinflammatorydisease(PID)
PredisposingriskfactorsforPIDare:
Sexualcontact
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HistoryofSTIProceduresinvolvingtheupperfemalegenitaltractincluding:
Dilatation&curettage(D&C)
Recentintrauterinedevice(IUD)insertion
Therapeuticabortion(T/A)
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180.Whichofthesestepsisfollowedfirstfor
themanagementofshoulderdystocia
afterMcRobertsmaneuver?
a)Sharpflexionofhipjointstowardsabdomen
b)Suprapubicpressure
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c)90degreerotationofposteriorshoulderd)Emergencyc-section
CorrectAnswer-B
Ans.B.Suprapubicpressure
Applyingagentlesuprapubicpressureisthefirststepin
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managementofshoulderdystociaafterMcRobertsmaneuver.Mnemonic"HELPERR"asaguidefortreatingshoulder
dystocia:
"H"standsforhelp
"E"standsforevaluateforepisiotomy.
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"L"standsforlegs(pullyourlegstowardyourstomachMcRobertsmaneuver)
"P"standsforsuprapubicpressure
"E"standsforentermaneuvers(internalrotationofbaby'sshoulders)
"R"standsforremovetheposteriorarmfromthebirthcanal.
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"R"standsforrollthepatient.181.Truehermaphroditismkaryotype:
a)45X0streakedgonads
b)46XXOvotestis
c)47XY+9
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d)47XXCorrectAnswer-B
Ans.B.46XXOvotestis
Truehermaphroditeorovotesticulardisorderofsexualdifferentiation
(OVO-DSD)isoneoftherarestvarietyofallintersexanomalies.
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Inabout90%ofcases,patientshave46XXkaryotype.Rarely,46XY/46XXmosaicismmayoccur.
182.Peripartumcardiomyopathyoccursat-
a)Within7days
b)Within6weeks
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c)Within24monthsd)Within5months
CorrectAnswer-D
Ans.D.Within5months
PPCMisastructuralheartmusclediseasethatoccursinwomen
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eitherattheendofpregnancyoruptofivemonthsaftergivingbirth.Pearson'sdiagnosticcriteriaforperipartumcardiomyopathy:
Developmentofcardiacfailureinthelastmonthofpregnancyor
within5monthsafterdelivery
Absenceofanidentifiablecauseforthecardiacfailure
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Absenceofrecognizableheartdiseasepriortothelastmonthofpregnancy,and
Leftventricularsystolicdysfunctiondemonstratedbyclassic
echocardiographiccriteria,suchasdepressedejectionfractionor
fractionalshorteningalongwithadilatedleftventricle.
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183.Nervemostlycompressedinpregnancy
puerperium:
a)Radialnerve
b)Mediannerve
c)Femoralnerve
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d)FacialnerveCorrectAnswer-C
AnsC.Femoralnerve
Themostcommonpostpartumnerveinjuryisfootdropduetoinjury
totheperonealnerveandinjurytothelateralfemoralcutaneous
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nerve.Obstetriciansmayconsiderfrequentpositionchangesinlabor,
avoidanceofprolongedhipflexion,andshorteningthepushingtime
byallowingforpassivedescentofthefetusbeforepushingbegins
asmeansofavoidinglateralfemoralcutaneousnerveinjury.
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184.Inpregnancywhichofthefollowinglevel
isalteredmostly:
a)TotalT3
b)FreeT3
c)FreeT4
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d)TSHCorrectAnswer-A
AnsA.TotalT3
TotalT3levelsarealteredthroughoutpregnancy.
Hormonesduringpregnancy:
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IncreasedDecreased
Unchanged
GrowthHormone
Luteinizinghormone ADH
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Follicle-stimulatingFree
hormone
T3,FreeT4
Di-Hydro
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ProlactinEpiAndroSterone
TotalT3,TotalT4
Aldosterone
Testosterone,Androstenodione
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andcortisolInsulin(duetoinsulinresistance)
Estrogen
Progesterone
TotalT3andtotalT4increaseduetostimulationofthyroidtissueby
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hCGduringtheearlyperiodofgestation.ButthereisnochangeinfreeT3andT4duetoincreaseinTBG.
ThisleadstotransientfallinTSHduringanearlyweeksofgestation.
ThelevelofTSHreachesnormallevelduringsecondandthird
trimester.
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185.Paget'sisassociatedwithwhichother
cancer:
a)Vulva
b)Vagina
c)Cervix
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d)UterusCorrectAnswer-A
Ans.A.Vulva
ExtramammaryPaget'sdisease(EMPD),alsoextramammaryPaget
disease,isarare,slow-growing,usuallynoninvasiveintraepithelial
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(intheskin)adenocarcinomaoutsidethemammaryglandandincludesPaget'sdiseaseofthevulvaandtheextremelyrarePaget's
diseaseofthepenis.
186.WhatismeantbySuperfecundation?
a)Fertilizationoftwoormoreovainoneintercourse
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b)Fertilizationoftwoormoreovaindifferentintercoursesinsamemenstrualcycle
c)Fertilizationofovaandthenit'sdivision
d)Fertilizationofsecondovumfirstbeingimplanted
CorrectAnswer-B
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Ans.B.Fertilizationoftwoormoreovaindifferentintercoursesinsamemenstrualcycle
Superfecundationisthefertilizationoftwoormoreovafromthe
samecyclebyspermfromseparateactsofsexualintercourse,
whichcanleadtotwinbabiesfromtwoseparatebiologicalfathers.
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Thetermsuperfecundationisderivedfromfecund,meaningtheabilitytoproduceoffspring.
187.Fetalheartstartscontractingat-
a)10-12days
b)10-12weeks
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c)3-5weeksd)3-5month
CorrectAnswer-C
Ans.C3-5weeks
Thefetalheartstartscontractingatapproximately23daysof
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gestation.188.
Anesthesiaofchoiceforcesareansectionin
severepre-eclampsia:
a)Spinal
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b)GAc)Epidural
d)Spinal+epidural
CorrectAnswer-C
Ans.C.Epidural
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ContinuousEpiduralAnesthesiaisthefirstchoiceforpatientswithpreeclampsiaduringlabour,Vaginaldeliveryandcesareansection.
Preeclampsiapatientshaveariskofsevereairwayedema,which
makesintubationdifficult
ContinuousEpiduralAnesthesiacanimproveuteroplacental
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perfusionandalsodecreasecatecholaminesecretions.189.Whichofthefollowingisnotahigh-risk
pregnancy?
a)Previoushistoryofmanualremovalofplacenta
b)Anemia
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c)Diabetesd)Obesity
CorrectAnswer-A
Ans.A.Previoushistoryofmanualremovalofplacenta
HighRiskPregnancyisseenin:
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Cardiovascularandrenalfactors:Moderatetoseverepreeclampsia
Chronichypertension
Severeheartfailure(classII-IV,NYHAclassification)
Moderatetosevererenaldisorders
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Metabolicdisorders:Obesity
Insulin-dependentdiabetes
Previousendocrineablation
Obstetrichistory:
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FetalexchangetransfusionbecauseofRhincompatibilityStillbirth
Lateabortion(16?20wk)
Post-termpregnancy(>42wk)
Pretermnewborn(<37wkand<2500g)
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Intrauterinegrowthrestriction(weight<10thpercentileforestimatedgestationalage)
Polyhydramnios
Multifetalpregnancy
Previousbrachialplexusinjury
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AbnormalfetalpositionOtherdisorders:
Abnormalcervicalcytologicfindings
Sicklecelldisease
Severeanemia
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ThrombophiliaAutoimmunedisorders
Anatomicabnormalities:
Uterinemalformation
Insufficient(incompetent)cervix
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Exposuretoteratogens:GroupBstreptococcalinfections
Smoking>10cigarettes/day(associatedwithprematureruptureof
membranes)
Currentpregnancycomplications:
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Pretermlaborat<37WksPretermprematureruptureofmembranes
Moderatetoseverepreeclampsia
Polyhydramnios(hydramnios)oroligohydramnios
Post-term(>42wk)
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UterinerupturePlacentaprevia
Abruptioplacentae
Chorioamnionitis
Prolapsedcord
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Fetalbradycardiafor>30minFetaltachycardiafor>30min
Fetalweight<2.5kg
Fetalweight>4kg
FetalacidosispH7
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190.Whichofthefollowingisnotusedin
preeclampsia?
a)Methyldopa
b)Atenolol
c)Labetalol
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d)HydralazineCorrectAnswer-B
Ans.B.Atenolol
Choiceofanti-hypertensivesinpregnancy
PIH/pre-eclampsia/severepre-eclampsia:Labetalol
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AcuteHypertension/Hypertensioncrisis:IVlabetalol>Nifedipine>Hydralazine
ChronicHypertensioninpregnancy:Labetalol>Methyldopa.
191.Cutismarmorataoccursduetoexposure
to?
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a)Coldtemperatureb)Dust
c)Hottemperature
d)Humidity
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.ColdtemperatureCutismarmorataisaconditionwhereintheskinhasapinkishblue
mottledormarbledappearancewhensubjectedtocold
temperatures.
Itisseenthroughoutinfancyandin50%ofchildren.
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Rewarmingrestorestheskintonormal.Itiscausedbysuperficialsmallbloodvesselsintheskindilatingand
contractingatthesametime.
192.Murphy'seyeisseenin-
a)Macintoshlaryngoscope
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b)Endotrachealtubec)LMA
d)Flexiblelaryngoscope
CorrectAnswer-B
Answer:B-EndotrachealTube
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The"Murphyeye"istheeponymousnameforaholeonthesideofmostendotrachealtubes(ETTs)thatfunctionsasavent,and
preventsthecompleteobstructionofthepatient'sairway,shouldthe
primarydistalopeningofanETTbecomeoccluded
193.ModifiedMallamPatigradingisusedin
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assessmentof-a)Difficultintubation
b)Airwayobstruction
c)Deathduetoaspiration
d)Intubation
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CorrectAnswer-AAnswer:A-Difficultyinintubation
ModifiedMallampaticlassification
Class0:Abilitytoseeanypartoftheepiglottisuponmouthopening
andtongueprotrusion
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ClassI:Softpalate,fauces,uvula,pillarsvisibleClassII:Softpalate,fauces,uvulavisible
ClassIII:Softpalate,baseofuvulavisible
ClassIV:Softpalatenotvisibleatall
Test:Theassessmentisperformedwiththepatientsittingup
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straight,mouthopenandtonguemaximallyprotruded,withoutspeakingorsaying"ahh."
Difficultlaryngoscopy:Goodaccuracy(areaunderSummary
ReceiverOperatingCharacteristic[SROC]curve0.89?0.05)
Difficultintubation:Goodaccuracy(areaunderSROCcurve0.83
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?0.03)Difficultmaskventilation:Poorpredictor
Usedalone,theMallampatitestshavelimitedaccuracyfor
predictingthedifficultairwayandthusarenotusefulscreeningtests
Mallampaticlassificationisonlyoneof11nonreassuringfindings
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duringairwayexamination194.Whichnerveistestedforadequacyof
anaesthesia-
a)MedianNerve
b)UlnarNerve
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c)Radialnerved)Mandibularnerve
CorrectAnswer-A
Answer:A-Mediannerve
Mediannerveblockcanbeevaluatedbytestingthelateralaspectof
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theringfinger195.Mosteffectivecircuitinspontaneous
anaesthesiais-
a)MaplesonA
b)MaplesonB
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c)MaplesonCd)MaplesonD
CorrectAnswer-A
Answer:A-MaplesonA
MAPLESONA-(Magill)CIRCUIT
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UsefulinspontaneousventilationThepatientinspireswhateverisinthetube,usingthebagasa
volumereservoir.
Oneatedtubeandincomingfreshgas.Whenthebagisfull,exhaled
alveolargasisventedfrxpiration,thebagrefillsfromacombination
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ofexpiredgasgoingbackupthecorrugomtheexhalevalve,andthenduringanyexpiratorypause,FGFpushestheremaining
alveolargasout.
TheoreticallyFGF=0.7xValvshouldpreventsignificantrebreathing
becausedeadspacegas(fresh)isnotwasted,butFGF=VAmore
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reliablypreventsrebreathing.Tubevolumemustexceed(Vt-Vd)oralveolargascouldcontaminate
thebag.
InadequateFGFcausesrebreathing.Difficulttodetectfromthe
CO2waveformalone-allthathappensisthattherapidfallon
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inspirationisdelayed.IfVAexceedstubingvolume,CO2entersthebagandwillbeseenoninspirationonthecapnogram.
Controlledventilation
Iftheanaesthetistfullyclosedthevalvewhilesqueezingthebagand
didn'topenituntiljustbeforethebagfilled,thiscircuitwouldbeOK.
--- Content provided by FirstRanker.com ---
Morecommonlythevalveispartiallyclosed-enoughtopermitadequatetidalvolumesdespiteparallellossofgasoutthevalve.
FGFmustbeincreasedtocompensateforgaslostduringinspiration
-typically2.5xminuteventilation.
TheLacksystem
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Aco-axialMagill,withtheexpiratoryvalvebroughtcoaxiallybacktotheFreshGasoutlet.Notpopularduetoinefficiencyduring
controlledventilation.
196.Whatismechanismofactionof
Curaniumdrugsasmusclerelaxant?
--- Content provided by FirstRanker.com ---
a)PersistentlydepolarizingatNeuromuscularjunctionb)ActcompetitivelyonAchreceptorsblockingpost-synaptically
c)RepetitivestimulationofAchreceptorsonmuscleendplate
d)Inhibitingthecalciumchannelonpresynapticmembrane
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B-ActcompetitivelyonAchreceptorsblockingpost-synaptically
Candocuroniumiodideisanaminosteroidneuromuscular-blocking
drugorskeletalmusclerelaxantinthecategoryofnon-depolarizing
neuromuscular-blockingdrugs.
--- Content provided by FirstRanker.com ---
ActsonAchreceptorscompetitivelypost-synapticallyblockingthem.Potentialadjunctiveuseinanaesthesiatofacilitateendotracheal
intubation&provideskeletalmusclerelaxation.
Candocuroniumdemonstratedashortdurationandarapidonsetof
action,withlittleornoganglionblockingactivity,anditwasonly
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slightlylesspotentthanpancuronium197.Dyeusedindiagnosisofesophageal
perforation:
a)Iohexol
b)Bariumsulphate
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c)Gadoliniumd)Iodinedye
CorrectAnswer-B
Answer-B.Bariumsulphate
Bariumsulfateinsuspensionisfrequentlyusedmedicallyasa
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radiocontrastagentforX-rayimagingandotherdiagnosticprocedures.
ItismostoftenusedinimagingoftheGItractduringwhatis
colloquiallyknownasa"bariummeal".
Fluoroscopy
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mostsensitivewithinthefirst24hours.patientexaminedsemi-supine(~20degrees)onfluoroscopytable
awater-solubleagentshouldbeusedinitiallyasbariumcancause
mediastinitis
esophagealperforationmayberepresentedasmucosalirregularity
--- Content provided by FirstRanker.com ---
orgrossextraluminalcontrastextravasationsomeauthorssuggesttheuseofsmallamountsofloworhigh
concentrationsofbariumifnoleakisevidentoninitialscreeningwith
watersolublecontrast
Iohexol,tradenamesOmnipaqueamongothers,isacontrast
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agentusedduringX-rays.Thisincludeswhenvisualizingarteries,veins,ventriclesofthebrain,theurinarysystem,andjoints,aswell
asduringcomputertomography.Itisgivenbymouth,injectionintoa
vein,orintoabodycavity.
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198.Braggpeakeffectpronouncedin:a)Xray
b)Proton
c)Neutron
d)Electron
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CorrectAnswer-BAnswer-B.Proton
Nowadaysprotontherapy(PT)representsanestablishedalternative
tophotonradiotherapyforthetreatmentofspecifictypesofcancer.
Thetherapeuticuseofprotonbeams(andofchargedparticlesin
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general)ismotivatedprimarilybytheirinverteddepth-doseprofilecomparedtophotons,beingcharacterizedbytheso-calledBragg
peak.
Severalbeamsofdifferentenergycanthenbecombinedinorderto
achievetheprescribeddoseinaregionaslargeasthetarget
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volume,resultingintheproductionofwhatisdefinedastheSpread-OutBraggPeak(SOBP).
199.SaltandPepperpotappearanceofskull
seenin:
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a)Hyperparathyroidismb)Multiplemyeloma
c)Hyperthyroidism
d)Pseudohyperparathyroidism
CorrectAnswer-A
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Answer-A.HyperparathyroidismPepperpotskullisoccasionallyusedinplaceofsaltandpepper
skulltodescribethetypicalradiographicappearanceofmultiple
smallradiolucentlesionsoftheskullvault.
Inprimaryhyperparathyroidism,extensiveresorptionboneinthe
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skullincombinationwithcysticareasofosteopeniaaretermedpepperpotskull.
Classicallyseeninhyperparathyroidism,andisoccasionallyused
(inaccurately)todescribetheraindropskullofmultiplemyeloma.
:SullX-raywithatypical"pepper-pot"appearance
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200.ImagingtechniquesusedinUterus
anomaliesEXCEPT:
a)HSG
b)MRIguidedHSG
c)CTguidedHSG
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d)USGCorrectAnswer-C
AnswerC.CTguidedHSG
Imagingstudies,suchasahysterosalpingogram
(HSG)andultrasound,oranMRIarerequiredtovisualisethe
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uterusandconfirmthatacongenitaluterineanomalyispresent.Ahysterosalpingogramisnotconsideredasusefulduetothe
inabilityofthetechniquetoevaluatetheexteriorcontourofthe
uterusanddistinguishbetweenabicornuateandseptateuterus.
Inaddition,laparoscopyand/orhysteroscopymaybeindicated.
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201.Semensqueeze
a)Erectiledysfunction
b)Prematureejaculation
c)Retrogradeejaculation
d)Antegradeejaculation
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CorrectAnswer-BAnswer:B-PrematureEjaculation
SqueezeTechnique:
VariationoftheMastersandJohnsonmethod.
Asamanapproachesclimax,eitherheorhispartnersqueezesthe
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tipofthepenisjustbelowtheheadofthepenisasheapproachesthepointofclimax.
Pressureisheldthereuntilthesensationofimpendingorgasm
diminishes.
Thispressurecanevenbehelduntilthereissomereductionin
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erection.Theprocesscanthenbestartedoveragainsothatovertimeaman
prolongsthetimeperioduntilhereachesejaculation.
Usefultotreatcasesofprematureejaculation
202.ApatientwithahistoryofRTAbefore2
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monthspresentswithcomplaintsofdreamsofaccidents.Heisableto
visualizethesamescenewheneverhe
visitstheplace.Henceisafraidtogo
backtotheaccidentsite.Identifythe
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typeofdisorderthathemightbesufferingfrom?
a)Adjustmentdisorder
b)PTSD
c)Anxietydisorder
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d)OCDCorrectAnswer-B
Answer:B-Post-traumaticStressdisorder
Post-traumaticstressdisorder,basicallyatypeofanxiety
disorder
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Thoughitsharesfeatureswithotheranxietydisorders,hasitsownspecificcharacteristicsinpresentation.
Criteria1:
Etiologicallysignificanttraumashouldbepresenttobeclassified
underthiscondition.
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Criteria2:"Intentionality"or"aboutness",animportantfactorinPTSD.
PTSDconcernswithmemoryintrusionofpaststressorsintopresent.
Nightmares,flashbacks,orrelivingexperiencesshouldberelatedto
thepastexperience.
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Criteria3:Avoidastimulusoractivitythatprovokesthememoryofpastevent.
203.Freud'stheoryofdreamincludesall
except:
a)Displacement
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b)Condensationc)Symbolisation
d)Correlation
CorrectAnswer-D
Answer:-D-Correlation
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SigmundFreudtheoryofdream:Dreamworkinvolvestheprocessofcondensation,displacement,
andsecondaryelaboration.
Conceptofunconsciousmind:
PrimaryassumptionofFreudiantheoryisthattheunconsciousmind
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governsbehaviortoagreaterdegreethanpeoplesuspect.Goalofpsychoanalysisistomaketheunconscious,conscious.
Theoryofdream:
Freudtheoryofdreamelaboratesthestateofunconsciousmindwith
respecttodreaminterpretation,
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Processinvolvedincludecondensation,displacement,andsecondaryelaboration.
Displacementtakesplacewhenwetransformthepersonorobject
wearereallyconcernedabouttosomeoneelse.
Theprocessofcondensationisthejoiningoftwoormore
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ideas/imagesintoone.204.Expressionandconsequentreleaseof
previouslyrepressedemotioniscalled
as
a)Regression
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b)Dissociationc)Abreaction
d)Alloftheabove
CorrectAnswer-C
Answer:C-Abreaction
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Theexpressionandconsequentreleaseofapreviouslyrepressedemotion,achievedthroughrelivingtheexperiencethatcausedit.
Donetypicallythrough
Hypnosis
Suggestion
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205.Allarehabitdisorderexcept
a)Nailbiting
b)Thumbsucking
c)Tempertantrum
d)Tics
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CorrectAnswer-CAnswer:C-Tempertantrum
Definition:
Habitdisorderisatermusedtodescribeseveralrelateddisorders
linkedbythepresenceofrepetitiveandrelativelystablebehaviour
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thatseemtooccurbeyondtheawarenessofthepersonperformingthebehaviour.
Thefirstgroupofhabitdisorderincludes"TicDisorder"
Ticsareinvoluntarymovements,sounds,orwordsthataresudden,
rapid,recurrentandnon-rhythmic"
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InadditiontoTD's,body-focussedbehaviours,Recurrenthairpulling-Trichotillomania(TTM)
Skinpicking(SP)
Nailbiting,areincludedwithinhabitdisorders.
Headbanging,rockingofbody,teethgrinding&thumbsucking
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arerepetitivedisorders.Seeninchildrenbetweenagegroupof6monthsto2years.
Benign&self-limited.
Themovementsserveameansoftensiondischarginginchildren.
Aschildrenbecomeolder,theylearntoinhibitsomeoftheirrhythmic
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patterns.Undueattentionbyparentscanleadtoaggravationofthese
problems.
206.Newnameofmentalretardation
accordingtoAmericanAssociationof
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MentalRetardationa)FeebleMindedness
b)Madness
c)Intellectualdisability
d)Mentallyunstable
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CorrectAnswer-CAnswer:C-Intellectualdisability
Intellectualdisability(ID),alsoknownasgenerallearningdisability,
Mentalretardation(MR),isageneralizedneurodevelopmental
disordercharacterizedbysignificantlyimpairedintellectualand
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adaptivefunctioning.207.Now-a-daysDownsyndromeIsreferred
toas.
a)Submentaldisorder
b)Oligophrenia
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c)Madnessd)Mentallyunstable
CorrectAnswer-A
Answer:A-Submentaldisorder
MajorityofchildrenwithDownsyndromefunctioninmildto
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moderaterangeofmentalretardation.Downsyndrome/Trisomy21-
Geneticdisordercausedbypresenceofallorpartofathirdcopy
ofchromosome21.
Typicallyassociatedwithphysicalgrowthdelays,characteristicfacial
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featuresandmildtomoderateintellectualdisability.208.A55yearsagedchronicalcoholicmale,
presentedwithirrelevanttalks,tremor
andsweating.Hehadhislastdrink3
daysback.Whatwilltheprobable
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diagnosis?a)Deliriumtremens
b)Korsakoffpsychosis
c)Post-Acutewithdrawalsyndrome
d)Discontinuationsyndrome
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CorrectAnswer-AAnswer:A-DeliriumTremens
Thedescriptionofsymptomsisrelatedtothecondition"Delirium
Tremens"
DeliriumTremens/AlcoholWithdrawalDelirium(AWD):
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Mostsevereformofethanolwithdrawalmanifestedby,Alteredmentalstatus(Globalconfusion)
Autonomichyperactivity(Sympatheticoverdrive)
Mechanism:
Alcoholabuseaffectsneurotransmittersystemsinbrainmainlyby,
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LossofGABAinhibitorymechanism-Reduceschlorideioninflux.
AlcoholactsasNMDAreceptorantagonist-Withdrawalincreases
theexcitatoryneurotransmitter.
Theclinicalmanifestationsofethanolwithdrawalarecombination
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effectsofGABA&NMDAreceptoractivity.Thuscausingtremors,diaphoresis,tachycardia,anxiety&in
severecasesSeizure.
209.Identifythetypeofmuscleshowninthe
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imagebelow.a)Cruciate
b)Multipennate
c)Parallel
d)Unipennate
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CorrectAnswer-BAnswer-B.Multipennate
Themuscledepictedaboveisthepectoralismajor.
PectoralisMajorhasmultiplerowsofdiagonalfibreswithasingle
tendon,Henceisamultipennatemuscle.
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210.Functionofthemuscleshowninpicture:
a)Flexion
b)Extension
c)Adduction
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d)AbductionCorrectAnswer-A
Answer-A.Flexion
Lumbricalsarefourshorthandmuscleslocatedinthemetacarpus
deeptothepalmarfascia.
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Thelumbricalsareintrinsicmusclesofthehandthatflexthemetacarpophalangealjointsandextendtheinterphalangealjoints.
Thelumbricalsareusedduringanupstrokeinwriting.
211.Followingimageisalsoknownas?
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a)5-hydroxytryptamine(5-HT)b)N-methylphenylamine
c)3-Methoxytyramine
d)Phenethylamine
CorrectAnswer-A
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Ans:A.5-hydroxytryptamine(5-HT)Serotonin/5-hydroxytryptamine(5-HT)isamonoamine
neurotransmitter.
Followinghydroxylationoftryptophanto5-hydroxytryptophanby
livertryptophanhydroxylase,subsequentdecarboxylationforms
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serotonin(5-hydroxytryptamine),apotentvasoconstrictorandstimulatorofsmoothmusclecontraction.
212.Choosethebestmethodofdiagnosisfor
theclinicalsignrepresentedinthe
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image.a)Serumcopper
b)Serumceruloplasmin
c)Karyotyping
d)PCR
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CorrectAnswer-BAnswer:B-SerumCeruloplasmin
Imagerepresents"Kayser-Fleischer"ring
KFringisgoldenbrownringduetodepositionofcopperin
Descement'smembraneofcornea.
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Clinicalfeatureof"Wilson'sdisease"Wilson'sDisease:
Rareautosomalrecessivedisease.
Characterizedbyabnormalcoppermetabolism
Ophthalmicpresentation:
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Depositionofcopperinposteriorcapsuleoflensresultsinsunflowercataract.
Diagnosis:
Sternlieb'scriteria:
PresenceofKFrings
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Decreasedserumceruloplasmin(coppercontainingenzyme/ferroxidase)levels
Measuringhepaticcopperlevelsinliverbiopsy
24-Hrurinecopperexcretion
KayserFleischerring:
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Excesscirculatingcopperdepositsindescemet'smembrane.Usuallygoldenbrownlocatedinperipheralcornea,beginningat
schwalbe'slineupto5mmintocornea.
DetectedviaGonioscopyinearlierstage&seenbynakedeyesin
advancedstage.
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213.Identifytheconditionrepresentedinthe
image.
a)Seminoma
b)Germcelldifferentiatetumor
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c)Non-seminomad)Teratoma
CorrectAnswer-A
Answer:A-Seminoma
Seminoma-Germcelltumoroftesticle/rarelymediastinumorother
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extra-gonadallocations.Malignantneoplasm;
Oneofmosttreatable&curablecancers;
Survivalrate>95%ifdiscoveredinearlystages.
Usuallyunaffectedfertility&othersexualfunctionsremainsintact.
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OriginatesingerminalepitheliumofseminiferoustubulesHistology:
Typicallyprominentlymphocyticinfiltrateinthefibrousstroma
separatingtheclustersoftumorcells.
Treatment:
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Requiresremovalofonetesticle.214.Identifytheconditionshowninthe
image.
a)LobarPneumonia
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b)Bronchopneumoniac)Acuteglomerulonephritis
d)Congestedkidney
CorrectAnswer-A
Answer:A-LobarPneumonia
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ImagedepictstheredhepatizationoflungsRedhepatizationisseeninconditionslikelobarpneumonia.
LobarPneumonia:.
Pneumococcalpneumonia-Mostcommoncauseoflobar
pneumonia
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Progressesfromaredhepatizationphasetoagrayhepatizationphase
Redhepatization:
Characterizedbyconsolidationofairspacesoflungs.
C/Srevealslungsappearbrown-red,firm,&airless.resemblingliver.
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Histological:
Congestedalveolarcapillaries&alveolarspacesarefilledwith
erythrocytes,neutrophils,andfibrin.
Redcellsdisintegrate,withpersistenceoftheneutrophilsandfibrin.
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215.Identifytheconditionrepresentedinbelowimage
a)Miliarytuberculosis
b)Bronchiectasis
c)COPD
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d)LungcancerCorrectAnswer-A
Answer:A-Miliarytb
Miliarytuberculosis(TB)iswidespreaddisseminationof
Mycobacteriumtuberculosis
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Resultofhematogenousspread.Distinctivepatternseenonachestradiograph
Tinysizedlesions(1?5mm),seenastinyspotsdistributed
throughoutlungfieldsappearingsimilartomilletseeds
Hence,theterm"miliary"tuberculosis.
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MiliaryTBmayalsoinfectliver&spleen.216.Identifytheorganismrelatedtoblood
smearimage-
a)P.falciparum
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b)S.Typhic)Treponemapallidum
d)Toxoplasmagondii
CorrectAnswer-A
Answer:A.-->P.falciparum
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Malariaparasitecanbeseeninthebloodsmearofpatientsaffectedbythediseaseatspecificstagesinthedisease.
Plasmodiumfalciparum--ring-shapedtrophozoite.Theredbloodcell
containingfourring-shapedtrophozoites.
Notetheveryhighpercentageofredcellscontainingringforms.
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Thishigh-levelparasitemiaismoreoftenseeninPlasmodiumfalciparuminfectionthanininfectionbytheotherplasmodia.
Thethicksmearsallowdetectionwhereasthethinsmearsallow
identificationofthespecies.Thisthinsmearshowsmultiplemalaria
trophozoitesinsideredbloodcells(Earlyringform).However,
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trophozoitescanalsobeseenoutsideredbloodcells.217.Whichisthickenednerveshownhere:
a)FacialNerve
b)Greaterauricularnerve
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c)VagusNerved)GlossopharyngealNerve
CorrectAnswer-B
Answer-B.Greaterauricularnerve
Thegreaterauricularnerveisacutaneousbranchofthecervical
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plexusthatinnervatestheskinoftheauricleaswellasskinovertheparotidglandandmastoidprocess.Thegreaterauricularnervealso
suppliesbranchesthatinnervatethedeeplayeroftheparotidfascia.
Origin
ThegreaterauricularnervearisesfromtheventralramiofC2and
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C3spinalnerves,althoughitreceivesconsiderablymorefibresfromC2.
Course
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Thegreaterauricularnerveemergesalongtheposterioraspectofthesternocleidomastoidmuscleatthepunctumnervosum(Erb
point)andascendsverticallyacrosstheobliquesternocleidomastoid
muscle.Whenthegreaterauricularnerveapproachestheinferior
poleoftheparotidglanditdividesintoanteriorandposteriorterminal
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branches.218.Whichtypeofretractorisshowninthe
image
a)Morrisretractor
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b)Czernyretractorc)Richardsonretractor
d)Lowerlidretractor
CorrectAnswer-A
Answer:A.Morrisretractor
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Morrisretractor-Thisisabigretractorwhichisusefulforgivingmaximumexposure
inlargeincisionssuchasthoseusedintheabdomen.
ltcanbeusedtoimprovevisibilityononesideofanincision(by
puttingfirmlyinthatdirection);soisvaluableduringtheinitialphase
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ofalaparotomy.SirHenryMorris(1844-1926)wasasurgeonattheMiddlesex
Hospital.London,UK.
219.Whichofthefollowingstatementistrue
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aboutsuturematerialintheimage:a)Madeofrabbitsubmucosa
b)Madeofcatsubmucosa
c)Notdegraded
d)Degradedbyenzymaticdegradation
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CorrectAnswer-DAnswer:D.Degradedbyenzymaticdegradation
Catgut-
Types-plain
Rawmaterial-Collagenderivedfromhealthysheeporcattle
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Tensilestrengthretentioninvivo-Lostwithin7-10days.Markedpatientvariability.Unpredictableandnotrecommended.
Absorptionrate-Phagocytosisandenzymaticdegradationwithin7-
10days
Tissuereaction-high
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Contraindications-Notforuseintissuesthathealslowlyandrequireprolongedsupport.Syntheticabsorbableissuperior.
Uses-Ligatesuperficialvessels,suturesubcutaneoustissues.
Stomasandothertissuesthathealrapidly.
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220.APatienthashistoryofRTA2yearsback,atthesamesighthedeveloped
painandswelling.Xrayshowsthe
followingfeatures.Whatwillbethe
diagnosis?
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a)Osteogenicsarcomab)Ewing'ssarcoma
c)Chronicosteomyelitis
d)Multiplemyeloma
CorrectAnswer-C
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Ans.C.ChronicosteomyelitisGarr?sclerosingosteomyelitis,orchronicnonsuppurativesclerosing
osteomyelitis,isaformofchronicosteomyelitis.
Mildinflammationandinfectionleadtosubperiostealbone
deposition.
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Thediseaseisfrequentlyasymptomatic.Thecharacteristicradiographicappearanceisanareaofperiosteal
proliferationsurroundedbysuccessivelayersofcondensedcortical
bone(arrows),describedasanonionskinappearance.
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221.IdentifythebonenumberedintheX-ray
belowthatmostcommonlyfracture
whenapersonfallsonoutstretched
hands?
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a)1b)2
c)3
d)4
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.1Adistalradiusfracture,alsoknownasawristfracture,isabreakof
thepartoftheradiusbonewhichisclosetothewrist.
Symptomsincludepain,bruising,andswellingofrapidonset
Thewristmaybedeformed.
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Inyoungerpeople,thesefracturestypicallyoccurduringsportsoramotorvehiclecollision.Inolderpeople,themostcommoncauseis
fallingonanoutstretchedhand.
fallingonanoutstretchedhand.
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SpecifictypesincludeColles,Smith,Barton,andHutchinsonfractures
222.IdentifytheconditionshownintheCT
Scanimagebelow.
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a)Dandywalkermalformationb)Cerebellarvermishypoplasia
c)Megacisternamagna
d)None
CorrectAnswer-A
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Ans.A.Dandywalkermalformation223.IdentifytheXrayHSGShownbelow:
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a)Septateuterusb)Uterusdidelphys
c)Unicornuateuterus
d)Bicornuateuterus
CorrectAnswer-C
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Ans.C.Unicornuateuterus224.InawomancomplainingofAUB
followingimagewasseeninendoscopic
examinationofuterus.Whatwillbethe
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diagnosis?a)Leiomyoma
b)Adenomyosis
c)Ovarianneoplasm
d)Carcinomaofuterus
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CorrectAnswer-AAns.A.Leiomyoma
Leiomyomaisthemostcommonpelvictumorinwomen
Benign,originatefrommyometrialsmoothmuscles
Symptomsinclude:
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AUBPelvicpainandpressure
Infertilityoradversepregnancyoutcome
225.Identifythefollowinglesion.
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a)Beckernevusb)Hypopigmentedmacule
c)Spitznevus
d)Epidermalnevus
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.BeckerNevus:
Usuallystartsinadolescenceasanirregularsmooth
hyperpigmentedmacule.
Usuallyinvolvestheshoulder,anteriorchestandscapularregion.
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Slowlygrowsinsizeofapalmwileacquiringthickdarkhair.Oftenlesionresemblingacnevulgarisindifferentstagesmayappear
onthesurface.
Notreatmentisrequired.
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226.Achildhasarashasshowninthepicture.Hisfamilyhistoryispositivefor
asthma.Whatcouldbethemost
probablediagnosis?
a)Seborrheicdermatitis
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b)Atopicdermatitisc)Allergiccontactdermatitis
d)Erysipelas
CorrectAnswer-C
Ans.C.Allergiccontactdermatitis
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ACDisaformofcontactdermatitisthatmanifestsasanallergicresponsecausedbycontactwithasubstance.Itsahypersensitive
reactioncharacterisedbythepresenceofrashoraskinlesioninthe
formofpapules,blistersorvesiclesetc.Thedifferentialfeatures
are
--- Content provided by FirstRanker.com ---
Itisconfinedtotheareawherethetriggertouchedthezone,Itoccursafteradayortwooftheexposureand
Thesymptomsreappearwhenincontactwiththeallergen.
Thesymptomsreappearwhenincontactwiththeallergen.
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227.Spotradiographfromadoublecontrastesophagram.Imagerepresents:
a)Esophagealatresia
b)Esophagealstenosis
c)Felineoesophagus
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d)TracheoesophagealfistulaCorrectAnswer-C
Answer-C.Felineoesophagus
Inthegivenimage,therearenumerous1-2mmradiolucentfoldsacrosstheesophagus.
Thefoldsareangledconcerningtothecenteroftheesophagusina"herringbone"pattern.
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Thefoldsoccurtransiently.Thefelineesophagusalsoisknownasanoesophagealshiver,referstothetransient
transversebandsseeninthemidandloweresophagusonadouble-contrastbarium
swallow.
Thesefinemucosalfoldsareatransientfindingproducedbycontractionofthemuscularis
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mucosa.Asimilarappearancemaybeseenincats.ItisusuallyanormalvariantbutmaybeassociatedwithGERD.
Thesefinefoldsareprobablyofnosignificanceandrelatetothetechniqueastheyare
mostandrelatetothetechniqueastheyaremostoftenseenwhentheesophagusinonly
partiallydistended.
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RadiographicfeaturesThefoldsare1-2mmthickandrunhorizontallyaroundtheentirecircumferenceofthe
oesophageallumen.Thefindingsaretransient,seenfollowingrefluxandnotduring
swallowing.Theappearanceisconfinedtothedistaltwo-thirdsofthethoracicesophagus.
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228.MRIofskullrepresents:a)VeinofGalen
b)DandywalkerSyndrome
c)Pneumocephalus
d)Crouzonsyndrome
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CorrectAnswer-AAnswerA.VeinofGalen
TheveinofGalenislocatedunderthecerebralhemispheresand
drainstheanteriorandcentralregionsofthebrainintothesinuses
oftheposteriorcerebralfossa.
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TheveinofGalen,alsoknownasthegreatcerebralveinorgreatveinofGalen,isashorttrunkformedbytheunionofthetwo
internalcerebralveinsandbasalveinsofRosenthal.Itliesinthe
quadrigeminalcistern.Itcurvesbackwardandupwardaroundthe
posteriorborderofthespleniumofthecorpuscallosumtodraininto
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theconfluenceoftheinferiorsagittalsinusandtheanteriorextremity
ofthestraightsinus.
AneurysmalmalformationsofVeinofGalenMalformations(VGAM)
typicallyresultsinhighoutputcongestiveheartfailureormay
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representdevelopmentaldelay,hydrocephalusandseizures.VGAMresultsfromaneurysmalmalformationwitharteriovenous
shuntingofblood.
229.Whatisadiagnosisbasedonagiven
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image:a)Uterusdidelphys
b)BicornuateUterus
c)UnicornuateUterus
d)Septateuterus
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CorrectAnswer-CAnswer-C.UnicornuateUterus
Aboveimageisunicornuateuterusasseenona
hysterosalpingogramrepresents:
ThisresultsfromfailureofnormaldevelopmentofoneM?llerianduct
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andisassociatedwithincreasedspontaneousabortionandobstetriccomplications,andrenalabnormalities.
OnT2-weightedMRimages,theunicornuateuterusdemonstratesa
curved,elongateduteruswithtaperingofthefundalsegmentoff
midline(the`banana-like'configuration)bestseenontheaxial
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oblique(longaxis)images.230.X-rayofskullshowingwhichlesionsin
thebrain:
a)Paget'sdisease
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b)Multiplemyelomac)Osteosarcoma
d)Osteomyelitis
CorrectAnswer-A
Answer-A.Paget'sdisease
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Pagetdiseaseoftheboneisacommon,chronicbonedisordercharacterizedbyexcessiveabnormalboneremodeling.Itfrequently
affectsthepelvis,spine,skullandproximallongbonesandhas
characteristicradiographicfeatures.
Radiographicfeatures
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Theconditionisfoundmostcommonlyinthesacrumandlumbarspine,followedbyskull,pelvis,andfemur.
Intheskull,thediseasebeginsasadestructiveprocessaffecting
theoutertableandsparingtheinnertable.
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Thefullpictureofosteoporosiscircumscriptaisrarelyseen.Inthereparativestage,sclerosisoftheinnertableispronounced,andlater
thediploicspacesandtheoutertablebecomethickened.
Aclassical,widespread'cottonwool'effectresults.
Thecranialcavityisnotencroachedupon.
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231.CTofThoraxrepresents:
a)AscendingAorticdissection
b)DescendingAorticdissection
c)Aorticaneurysm
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d)CysticfibrosisCorrectAnswer-B
AnswerB.DescendingAorticdissection
Aorticdissectionisadevastatingdiseasethatoccursasaresultof
thedegenerationofthethoracicaorta.
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Middle-agedmenarethemostoftenaffectedwithonly5%ofdissectionsoccurringintheunder40agegroup.
Theclassicalpresentationisthesuddenonsetofarazor-sharppain
betweenshoulderblades.
Therearetwomajortypesofclassification,theDeBakeyandthe
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Stanford.
TheStanfordclassificationissimplerwithtwotypesof
dissectiondescribed,TypeAandTypeB.TypeAisequivalenttoa
DeBakeyTypeIorType11dissection,involvingtheascending
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arch,whereasTypeBjustinvolvesthedescendingaorta.TypeAisgenerallytreatedwithurgentsurgerywithTypeBgenerallybeing
treatedconservatively.
Signonchestradiograph-
Themostcommonabnormalityisthewideningofthemediastinum
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whichisoftenassociatedwithanindistinctoutlineoftheaortaoranirregularwavycontour.
Morecharacteristicbutalessfrequentradiologicalfindingis
localizeddilatationoftheaorticknuckleandupperdescendingaorta,
givingrisetoaprominenthumpsignwhichwillindicateaneurysmal
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dilatationorunfoldingofthearch.
TheCTscanwillshowthetrueandfalselumensassociatedwith
dissection.
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232.CTscanofabdomenshowinganareathatbranchingintotheliver.Identifythe
structure?
a)SVC
b)IVC
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c)Portalveind)Splenicvein
CorrectAnswer-C
Ans:C.Portalvein
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Theportalveinorhepaticportalveinisabloodvesselthatcarries
bloodfromthegastrointestinaltract,gallbladder,pancreas,and
spleentotheliver.
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TheliverisfurthersubdividedintoCouinaudsegmentsbasedonthevascularsupply.
ThecaudatelobeorsegmentIhaveautonomousbloodsupplyfrom
bothleftandrightbranchesoftheportalveinandhepaticartery
alongwithindependentvenousdrainagedirectlyintotheIVC.
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233.Identifyartery`X'inthegiven
angiographyanatomyimage:
a)Superiormesentericartery
b)Subclavianartery
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c)Celiacarteryd)Brachiocephalicartery
CorrectAnswer-A
Answer?A.Superiormesentericartery
Thesuperiormesentericartery(SMA)isamajorarteryofthe
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abdomen.Itarisesfromtheabdominalaorta,andsuppliesarterialbloodtotheorgansofthemidgut?whichspansfromthemajor
duodenalpapilla(oftheduodenum)totheproximal2/3ofthe
transversecolon.
AnatomicalPosition
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Thesuperiormesentericarteryisthesecondofthethreemajoranteriorbranchesoftheabdominalaorta(theothertwoarethe
coeliactrunkandinferiormesentericartery).Itarisesanteriorlyfrom
theabdominalaortaattheleveloftheL1vertebrae,immediately
inferiortotheoriginofthecoeliactrunk.
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Afterarisingfromtheabdominalaorta,thesuperiormesentericarterydescendsdowntheposterioraspectoftheabdomen.At
thispoint,ithasseveralimportantanatomicalrelations:
AnteriortotheSMA?pyloricpartofthestomach,splenicveinand
neckofthepancreas.
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PosteriortotheSMA?leftrenalvein,uncinateprocessofthepancreasandinferiorpartoftheduodenum.
Theuncinateprocessistheonlypartofthepancreasthathooks
aroundthebackoftheSMA.
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MajorBranchesThesuperiormesentericarterythengivesrisetovariousbranches
thatsupplythesmallintestines,cecum,ascendingandpartofthe
transversecolon(fig).
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234.Awomanshowssymptomsofmassivepulmonarythromboembolism.Thegross
appearanceofliverautopsyisshown.
Whichofthefollowingstatementbest
characterizesthepatient'scondition?
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a)MetastasisfromPEb)Angiosarcoma
c)Colonicadenocarcinomawithmetastasis
d)Locallyinvadedhepatocellularcarcinoma
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer:C.ColonicadenocarcinomawithmetastasisThefigureshowsappearanceofmetastaticlesionsfromamalignant
neoplasmwithmultipletumormasses
Theliveristhemostcommonsiteofmetastasesfortumorsitesthat
draininitiallyviatheportalcirculation.Metastaticliverdiseaseis
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foundin10%to25%ofpatientshavingsurgeryforprimarycolorectalcancer
colorectalcancer
Surgicalresectionisthemosteffectivetherapyformetastatic
colorectalcancerisolatedtotheliver.
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235.WhatisthestructureseeninthegivenX-
raybelow
a)Stent
b)Surgicalclips
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c)Foleycatheterd)Intravesicalwire
CorrectAnswer-A
Ans.A.Stent
PlainabdominalX-rayshowingastentintherightandleftureter.
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Uretericstents,alsoknownasdoubleJstentsorretrogradeuretericstents,isaurologicalcatheterthathastwo"J-shaped"
(curled)ends,whereoneisanchoredintherenalpelvisandthe
otherinsidethebladder.
Ureteralstentsareimplantsusedtoprovidedrainageoftheupper
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urinarytractwhenobstructionoftheureterispresentoranticipated.Thisobstructionmaybeduetointernalorexternalissues,suchas
edemaaftermanipulationoftheureter,ureteralstricture,passageof
stonefragmentsorexternalcompressionoftheureter.Stentsare
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alsofrequentlyusedinreconstructivesurgery.Stent-relatedcomplications
DevelopmentofUTIsorformationofencrustations,complicating
subsequentstentremoval.
bilateraluretericstents
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236.Whatisthediagnosisbasedonthe
followingX-ray?
a)UterineFibroid
b)BladderCarcinoma
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c)Bladderstoned)RenalTuberculosis
CorrectAnswer-C
Ans.C.Bladderstone
Multiplebladdercalculi.Fourovalradiopaquebladderstonesare
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visiblecentrallyinthepelvis.Mostbladdercalculiareroundoroval,buttheymayalsobeamorphous,laminated,orevenspeculated.
Calculimayformasaresultofinfection(especiallywithproteusin
anabnormallyfunctioningbladder)whenthecalculiaremagnesium
ammoniumphosphateandapatite.
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Calculiareoftenasymptomaticbutmaypresentwithhaematuria,suprapubicpain,disruptionoftheurinestreamorrecurrentinfection.
Theymayappearasradiopaquespiculated(jackstone),laminatedor
amorphouslesions.
Aswithuppertractcalculi,oncontrastinvestigations,theyare
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usuallyseenasfillingdefects,astheyaremostlylessradiopaquethancontrast.
Ultrasoundreliablydemonstratesthemashighlyechogenic
mobilefoci,especiallywhenthebladderisfull.
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237.Aredsofttofirmswellingonsternum
thatonbiopsyshowsfollowing
histology.Whatisthediagnosis?
a)Hemangioma
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b)Osteochondromac)Osteoidosteoma
d)Pagetdisease
CorrectAnswer-A
Ans.A.Hemangioma
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ClinicalpresentationThesetumoursareslowgrowingandaregenerallyasymptomatic
unlesstheyexertmasseffectonsensitivestructures.Occasionally
theymaypresentasaswellingorapalpablemass,especiallyinthe
skull.Whenlargeandstrategicallylocatedtheymaypresentwitha
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pathologicalfracture.Iftheyarehigh-flowlesions,shunt-relatedsymptomsmayalsobe
present.
Pathology
Primaryintraosseoushaemangiomasareslowgrowingvascular
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neoplasms,usuallylocatedinthemedullarycavity.Theyareclassifiedasbenign,butrarelymaybelocallyaggressive.
Histology
Histologically,intraosseoushaemangiomasdemonstrate
hamartomatousvasculartissuewithinendothelium,butmayalso
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containfat,smoothmuscle,fibroustissue,andthrombi.238.Whichofthefollowingiscarryingagent
forthediseasewithgivencharacteristic
onpolarizedmicroscopy?
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a)Anophelesb)Ixodesscapularisticks
c)Louse
d)Ratflea
CorrectAnswer-B
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Answer:B.IxodesscapularisticksBabesiosisinfectstheRBCsandresidesinsidetheRBCs(
intraerythrocytic).
IntraerythrocyticinfectionofBabesiosisischaracterizedbythe
maltesecross.
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TheMaltesecrossisacharacteristicarrangementofparasiteswithintheerythrocytesParasiteswithinerythrocytesarearrangedsuch
thatpointedendsoffourparasitescomeincontacttherebygivinga
tetradconfigurationresemblingamaltesecross.
Tetradformsor'Maltesecross'appearanceisconsidered
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pathognomicofBabesiosis.
BabesiosiscaneasilybeconfusedwithP.falciparummalaria.
FollowingtwofeaturesdistinguishBabesiosisfrommalaria
PresenceofmaltesecrossinBabesiosis(absentinmalaria)
AbsenceofpigmentHemozoininBabesiosis(presentinmalaria)
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Note-Maltesecrossisalsoseenincryptococcusandaspergillus.239.Chordomaarisesfrom:
a)Pharyngealbursa
b)Notochord
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c)Rathke'spouchd)Luschka'sbursa
CorrectAnswer-B
Answer:-B.Notochord
Chordomaisarareslow-growingneoplasmthoughttoarisefrom
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cellularremnantsofthenotochord.Chordomascanarisefromboneintheskullbaseandanywhere
alongthespine.Thetwomostcommonlocationsarecraniallyatthe
clivusandinthesacrumatthebottomofthespine.
Therearethreehistologicalvariantsofchordoma:classical(or
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"conventional"),chondroidanddedifferentiated.240.WhatistheeffectofProgesteroneonly
pills?
a)Completelysuppressesovulation
b)Thinliningofuterus
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c)Thickcervicalmucusd)Alloftheabove
CorrectAnswer-D
Answer:D.Alloftheabove
Progestogen-onlypills/Progestin-onlyPills(POP)/Morning
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afterpills-Contraceptivepills
Containonlysyntheticprogestins&doesn'tcontainestrogen.
Mechanism:
Mucusthickeningintheneckofthewomb:
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Penetrationofspermtoreacheggandwombbecomesdifficult.Preventsovulation:
Theliningoftheuterusbecomesthin
Fertilizedeggimplantationisprevented
Advantages:
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Doesn'tinterferewithbreastfeedingAlsohelpsinpremenstrualsymptomsandpainfulperiods
241.Whichmetalresultsin"Saturninegout"
formation?
a)Cadmium
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b)Leadc)Beryllium
d)Mercury
CorrectAnswer-B
Answer:B.Lead
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Onemanifestationofchronicleadtoxicityistherheumatologicentityknownassaturninegout.
Illicitlydistilledbeveragesmayinadvertentlycontainharmfultoxins,
likemetalliclead.
Leadhasbeenknowntoplayaroleinpurinemetabolism&renal
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insufficiency242.Whichdrugdecreasesthebone
resorptioninosteoporosis?
a)Teriparatide
b)Risedronate
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c)Cortisoned)Cimetidine
CorrectAnswer-B
Answer:B-Risedronate
Risedronatebisphosphonatesinhibitsboneresorptionby
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actionsonosteoclastprecursorsinosteoporosispatientsRisedronate:
Aminobisphosphonate
Indications:
Prevention&treatmentofosteoporosis
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Mechanismofaction:Inhibitsboneresorptionbyactiononosteoclasts
Reduceboneremodelling
Morepotentinblockingthebonedissolutionprocess.
Teriparatide,anPTHanalog,recombinanthumanPTHisalsoused,
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yetinseverecasesofosteoporosis,improvingtheskeletalmicroarchitecture
243.Phenylketonuriaisduetodeficiencyof:
a)Phenylalanine
b)Phenylalaninehydroxylase(PAH)
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c)Phenylened)Allofthese
CorrectAnswer-B
AnswerB.Phenylalaninehydroxylase(PAH)
Abirthdefectthatcausesanaminoacidcalledphenylalanineto
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buildupinthebody.PKUisanautosomalrecessivemetabolicgeneticdisorder.
PKUischaracterizedbyhomozygousorcompound
heterozygousmutationsinthegeneforthehepatic
enzymephenylalaninehydroxylase(PAH),renderingit
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nonfunctional.Thisenzymeisnecessarytometabolizetheamino
acidphenylalanine(Phe)totheaminoacidtyrosine(Tyr).When
PAHactivityisreduced,phenylalanineaccumulatesandis
convertedintophenylpyruvate(alsoknownasphenylketone),which
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canbedetectedintheurine.ThePAHgeneislocatedonchromosome12inthebands12q22-
q24.1.Morethan400disease-causingmutationshavebeenfoundin
thePAHgene.
244.WHICHISNOTCORRECT:
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a)MRIneededtoaccesshaemorrhageb)GCSassessmenthelpsinprognosis
c)Haematomamustbeoperated
d)alloftheabove
CorrectAnswer-C
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Answer-C.HaematomamustbeoperatedTreatmentofhematomadependsonthelocation,symptoms,and
theclinicalsituation.Somemayrequirenotreatmentatallwhile
othersmaybedeemedamedicalemergency.
Simpletherapiesathomemaybeutilizedintreatingsuperficial
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(undertheskin)hematomas.Mostinjuriesandbruisescanbetreatedwithresting,icing,compression,andelevatingthearea.This
isrememberedbytheacronymRICE.
Thesemeasuresusuallyhelptoreduceinflammationanddiminish
itssymptoms.
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RestIce(Applytheiceorcoldpackfor20minutesatatime,4to8times
aday.)
Compress(Compressioncanbeachievedbyusingelastic
bandages.)
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Elevate(Elevationoftheinjuredareaabovetheleveloftheheartisrecommended.)
Medicaltreatmentforahematoma
Forcertainsmallandsymptom-freehematomasnomedical
treatmentmaybenecessary.Ontheotherhand,symptomatic
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hematomasorthoselocatedincertainlocationssometimesrequiremedicalorsurgicaltreatment.
Eventhoughnospecificmediationisavailableforthetreatmentof
hematomas,managementofanyrelatedsymptomscanbeachieved
bymedications.Forexample,painfromahematomacanbetreated
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withpainmedicationssuchasacetaminophen(Tylenol).Surgicaldrainageisacommonmethodoftreatmentforcertain
hematomas.
245.Maastrichtclassificationofdonation
aftercardiacdeath.Whatcategoryis
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stage3?a)Awaitingcardiacarrest
b)Broughtindead
c)Unsuccessfulresuscitation
d)Cardiacarrestafterbrain-stemdeath
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CorrectAnswer-AAnswer:A>Awaitingcardiacarrest
Thefirstlevelofdefinitionissimpleandbasedonwhetherthe
situationisuncontrolled(categoriesIandII)orcontrolled(categories
III,IV,andV).
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CategoryI,thepatientisdeclared"deadonarrival"and,CategoryII,thereisan"unsuccessfulresuscitation"whetherit
occurredoutorinthehospitalforbothsituations.
CategoryIIIisthemostusualsituationinwhichthetreating
physicianandfamilyare"awaitingcardiacarrest"todeclarethe
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deathofthepatient.CategoryIVisalwayscharacterizedby"cardiacarrestduringbrain
death."ThespecialsituationoftheBelgianlawallowingthe
euthanasiaiselaborated
CategoryV"euthanasia,"andincludespatientswhograntaccessto
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medicallyassistedcirculatorydeath.Organdonationaftereuthanasiaisallowedunderthescopeofdonationaftercirculatory
246.Whatisthecauseofmyocardialshock
otherthanMI?
a)acutemitralregurgitation
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b)ventricularseptalrupturec)isolatedrightventricularshock
d)alloftheabove
CorrectAnswer-D
Answer:D>Alloftheabove
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Leftventriculardysfunction(LVD)-Mostfrequentcauseofcardiogenicshock
Followedby,
Acutemitralvalveregurgitation
Ventricularseptaldefect
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IsolatedrightventricularshockTamponade/cardiacrupture
247.Nitricoxideactsbyincreasing?
a)BRCA1
b)BRCA2
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c)Interleukind)cGMP
CorrectAnswer-D
Answer:D>cGMP
Nitricoxidediffusestothesurroundingsmoothmuscle
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cells,increasingcGMP.Cyclicguanosinemonophosphate(cGMP)
Cyclicnucleotidederivedfromguanosinetriphosphate(GTP).
Function:
cGMPactsasasecondmessengermuchlikecyclicAMP.
--- Content provided by FirstRanker.com ---
Mechanismofaction:Activationofintracellularproteinkinasesinresponsetothebinding
ofmembrane-impermeablepeptidehormones.
248.Positiveacidschiffmacrophagesseenin
?
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a)Whipplesdiseaseb)Crohnsdisease
c)AIDS
d)Noneoftheabove
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:A>Whipplesdisease.Thetraditionallaboratorydiagnosisisbasedonlightmicroscopy,
whichshowsdiastase-resistant,periodicacid-Schiff(PAS)-positive,
non-acid-fastgranulesin.....Thedistinctioncouldbemade
byacid-faststaining,whichispositiveforpatientsinfectedwithM.
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aviumandnegativeforthosewithWhipple'sdisease.249.Aboypresentedwithmultiplenon
suppurativeosteomyelitiswithsicklecell
anaemia.Whatwillbethecausative
organism?
--- Content provided by FirstRanker.com ---
a)Salmonellab)S.aureus
c)H.influenzae
d)Enterobacterspecies
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.SalmonellaFollowingarethevariousmicro-organisminvolvedin
osteomyelitis
Agegroup
Mostcommonorganisms
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Newborns(younger S.aureus,Enterobacterspecies,andgroupAthan4mo)
andBStreptococcusspecies
Children(aged4mo S.aureus,groupAStreptococcusspecies,
to4y)
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Haemophilusinfluenzae,andEnterobacterspecies
Children,
S.aureus(80%),groupAStreptococcus
adolescents(aged4 species,H.influenzae,andEnterobacter
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ytoadult)species
Adult
S.aureusandoccasionallyEnterobacteror
Streptococcusspecies
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SicklecellanemiaSalmonellaspeciesaremostcommonin
patients
patientswithsicklecelldisease
250.Termpathologyrefersto:
--- Content provided by FirstRanker.com ---
a)Workb)Function
c)Details
d)Explains
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.WorkPathologyisthemedicaltermforthewayadiseaseworks.
Thescienceofthecausesandeffectsofdiseases,especiallythe
branchofmedicinethatdealswiththelaboratoryexaminationof
samplesofbodytissuefordiagnosticorforensicpurposes.
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251.1yrchildweighing6kgissufferingfrom
AcuteGastroenteritisalongwithsignsof
sunkeneyes&skinpinchgoingbackto
normalveryrapidly.Whatwillbeyour
management?
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a)RLinfusion120mlinthefirsthourfollowedby360mlinthenext5hours
b)RLINFUSION180mlinthefirsthourfollowedby420mlinthe
next5hours
c)RLINFUSION180MLINthefirsthourfollowedby480mlinthe
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next5hoursd)RLINFUSION240mlinthefirsthourfollowedby360mlinthe
next5hours
CorrectAnswer-B
Ans.B.RLINFUSION180mlinthefirsthourfollowedby420ml
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inthenext5hoursSeveredehydrationconstitutesamedicalemergencyrequiring
immediateresuscitationwithintravenousfluids.
Intravenousaccessshouldbeobtained,andpatientsshouldbe
administeredabolusof20-30mL/kglactatedRinger's(LR)or
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normalsaline(NS).Ifpulse,perfusion,and/ormentalstatusdonotimprove,asecond
bolusshouldbeadministered.
Afterthis,thepatientshouldbegivenaninfusionof70mL/kgLRor
NSover5hours(children<12months)or2.5hours(olderchildren).
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Ifnoperipheralveinsareavailable,anintraosseouslineshouldbeplaced.Serumelectrolytes,bicarbonate,urea/creatinine,and
placed.Serumelectrolytes,bicarbonate,urea/creatinine,and
glucoselevelsshouldbesent.
252.Whatconstitutesmalpighianlayer?
--- Content provided by FirstRanker.com ---
a)Corneumlucidumb)Corneumspinosum
c)Spinosumandbasale
d)Basalegranulosum
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans.C.SpinosumandbasaleTheMalpighianlayeroftheskinisgenerallydefinedasboththe
stratumbasaleandstratumspinosumasaunit,althoughitis
occasionallydefinedasthestratumbasalespecifically,orthestratum
spinosumspecifically.ItisnamedafterMarcelloMalpighi.
--- Content provided by FirstRanker.com ---
253.Mechanismofactioncolchicineinacute
gout
a)Uricacidnephrolithiasis
b)DeficiencyofenzymeXanthineoxidase
c)Increaseinserumurateconcentration
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d)RenaldiseaseinvolvinginterstitialtissuesCorrectAnswer-B
Ans.B.DeficiencyofenzymeXanthineoxidase.
Goutisahereditarydisorderwithincreaseinserumuricaciddue
toincreasedproduction,ordecreasedexcretionofuricacidanduric
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salt.Thoughttobecausedbylackofanenzymeneededtocompletely
metabolisepurinesforrenalexcretion.
Table1.MetabolicRiskFactorsforGout
Obesity,eating13w-1nel-richfoods(highlevelsofmeatand
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seafoodconsumption)Excessivealcoholintake
Metabolicsyndrome
Obesity
Hypertension
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HyperlipiderniaHyperglycemia
Type2diabetesmellitus
Hypertension
Hyperlipidernia
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Serumurate--elevatingmedicationsHistoryofurolithiasis
Chronickidneydisease,glomerular,orInterstitialrenaldisease;
Chronickidneydisease,glomerular,orInterstitialrenaldisease;
polycystickidneydisease
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Potentialgeneticoracquiredcauseofuricacidoverproduction,includingmalignancy
Lead,orheavy-metalintoxication
254.Oxygentherapymaynotbeusefulin
a)Asthma
--- Content provided by FirstRanker.com ---
b)Pneumoniac)Subglotticstenosis
d)Pulmonaryfibrosis
CorrectAnswer-D
Ans:D.Pulmonaryfibrosis
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ManyEMSprotocolsindicatethatoxygenshouldnotbewithheldfromanypatient,whileotherprotocolsaremorespecificor
circumspect.However,therearecertainsituationsinwhichoxygen
therapyisknowntohaveanegativeimpactonapatient'scondition
likeparaquatpoisoning,pulmonaryfibrosisandlungdamage
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resultingfrombleomycintreatment.255.Newbornbabywithheartratelessthan
60beatsperminutecanberesuscitated
byallexcept
a)chestcompression
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b)oxygentherapyc)tactilestimulation
d)slappingtheback
CorrectAnswer-D
Ans:D.slappingtheback
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Thefirstthreesareindicatedwhileslappingthebackisnotrecommendedinanewbornwhohas
Heartratelessthan60beatsperminute.
256.Mobitztype2seconddegreeAVblockis
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seeninallexcept:a)Hypothyroidism
b)CoronaryArteryDisease
c)Sarcoidosis
d)Cushingsyndrome
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAns:D.Cushingsyndrome
Delayorlackofconductionthroughtheatrioventricular(AV)node
andbelowhasmultiplecauses.Degenerativechanges(eg,fibrosis,
calcification,orinfiltration)arethemostcommoncauseofnon-
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ischeamicAVblock.IdiopathicfibrosisorcalcificationoftheAVconductionsystem,commonlyseenintheelderly,cancause
completeAVblock.
CausesofMobitztype2seconddegreeAVblockare-
Damageoftheconductionsystemfromcoronaryarterydisease,
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valvesurgery,myocardialinfarction,myocarditis,infiltrativecardiomyopathies(sarcoidosis,hemochromatosis),myxedema,
Lymedisease,neuromusculardisease,andAVjunctionablation[6]
257.Whencanonediagnoseacute
respiratorydistressinachild?
--- Content provided by FirstRanker.com ---
a)Within7daysofknownclinicalinsultb)Respiratoryfailurenotfullyexplained
c)Leftventriculardysfunction
d)Alloftheabove
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Ans:D.AlloftheabovePediatricCriticalCareMedicine2015
Excludepatientswith1:m11-natalrelatedlung
Age
disease
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IimingWithin7daysofknownclinicalInsult
originof
Respiratoryfailurenotfullyexplainedbycardiacfailure
Edema
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orfluidoverloadChestChest
imagingfindingsofnewinfiltrate(siconsigentwithacute
Imaging
pulmonary
--- Content provided by FirstRanker.com ---
Noninvasivemechanical lovasivemechanicalventilation
ventilation-
PARRS(Noseverity
Mild
--- Content provided by FirstRanker.com ---
Moderate Severegratification)
Oxygenation Fullface-maskbi-level
EK01<
O1t16
--- Content provided by FirstRanker.com ---
ventilationor4501c8
16
CiSt
CPAPz5crnHAa
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Ss09.c7.51 7.5OSI1233
PFratios300
<12.31
SFratio52E4I
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Specia-lPopulationstandardCriteriaaboveforage,timing,originofedema
Cyanotic
Cyanotic
andchestimagingwithanacutedeteriorationIn
--- Content provided by FirstRanker.com ---
Heartoxygenationnotexplainedbyunderlyingcardiac
Disease
disease.
standardCriteriaaboveforage,timing,andoriginof
--- Content provided by FirstRanker.com ---
Chronicedemawithchestimagingconsistentwithnewinfiltrate
Lung
andacutedeteriorationinoxygenationfrom
Disease
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baselinewhichmeetoxygenationcriteriaabove_StandardCriteriaforage,timingandoriginofedema
Left
withchestimagingchangesconsistentwithnew
Ventricular infiltrateandacutedeteriorationinoxygenationwhich
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dysfunction meetcriteriaabovenotexplainedbyleftventriculardysfunction.
258.A6-year-oldboyexperiencedlife
threateningshock,hisCTscanshowed
largeamountofascites,bowelwall
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thickeningandpoororabsentenhancementofthestrangulatedbowel
segment,showinggangrenousbowelon
surgicalexploration.
Trueaboutanastomosisis-
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a)Shouldbedonebycontinuouslayersasittakeslesstimeb)ShouldbeDonewithcatgut
c)ShouldbeDonebysinglelayerseromuscularlembertsutures
d)ShouldbeDonebySinglelayertakingsubmucosa
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
AnsC.ShouldbeDonebysinglelayerseromuscularlembertsutures
DiagnosisisofcongenitalIHwithstrangulatedsmallbowelwith
gangrenoussmallbowel
Transmesentericherniawasthemostcommontypeinolderchildren
--- Content provided by FirstRanker.com ---
aswellasinneonates.IHresultsfromincompleteclosureofsurgicallycreatedmesenteric
defects,andusuallyacquiredresultingfrompreviousabdominal
surgeryespeciallyRoux-en-Yanastomosis
Anastomosisshouldbedonebysinglelayerseromuscularlembert
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suturesTheLambertsuturegenerallyisusedinabdominalsurgery.Itisan
invertingsuture,thatcanbeeithercontinuousorinterrupted,usedto
invertingsuture,thatcanbeeithercontinuousorinterrupted,usedto
jointwosegmentsofanintestinewithoutenteringthelumen(the
--- Content provided by FirstRanker.com ---
innerchannelthroughwhichstomachcontentsflow).259.InACLSwhichdrugcanbegiven
followingventricularfibrillationafter
cardiacarrestotherthanepinephrine?
a)Amiodarone
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b)Dopaminec)Adenosine
d)Atropine
CorrectAnswer-A
Ans.A.Amiodarone
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V-FiborVFisthemostcommonrhythmthatoccursimmediatelyaftercardiacarrest.Inthisrhythm,theheartbeatswithrapid,erratic
electricalimpulses.
Treatment:
Shock/Defibrillation:every2minutesinasingleoneshock,
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successive,shockableincrements200joules-FollowedbyimmediateCPRfor2minutes/giveand
circulateadrug(s)
300joules-FollowedbyimmediateCPRfor2minutes/giveand
circulateadrug(s)
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360joules-FollowedbyimmediateCPRfor2minutes/giveandcirculateadrug(s)
Drugs:
GiveEpinephrine1mgofa1:10,000solu,onevery3to5minutes
[NoLimit]
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Giveeither:Amiodarone[ifnotcontraindicated,canbegiven2x]:300mgfirst
dose/150mgseconddoseat3to5minutesincrements.
Lidocaine:Firstdose:1mg/kgor1.5mg/kg.Canrepeatitathalfthe
originaldoseuptoatotalof3mg/kg[Secondandremainingdoses
--- Content provided by FirstRanker.com ---
aregivenateither0.5mg/kgor0.75mg/kgdependingonyourstar,ngdosage.]
260.Whichofthefollowingstatementisfalse
aboutMRvaccinationcampaign
launchedbyWHO?
--- Content provided by FirstRanker.com ---
a)Childrenfrom9monthstolessthan15vaccinatedb)Congenitalrubellasyndrome(CRS),responsibleforirreversible
birthdefects
c)Indiahasnotyetlaunchedthiscampaign
d)Willreplaceroutineimmunizationformeaslesvaccine
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer:C.Indiahasnotyetlaunchedthiscampaign
Oneoftheworld'slargestvaccinationcampaignagainstmeasles,a
majorchildhoodkillerdisease,andcongenitalrubellasyndrome
(CRS),responsibleforirreversiblebirthdefects.
--- Content provided by FirstRanker.com ---
India,alongwithtenotherWHOSouthEastAsiaRegionmembercountries,haveresolvedtoeliminatemeaslesandcontrol
rubella/congenitalrubellasyndrome(CRS)by2020
Allchildrenfrom9monthstolessthan15yearsofagewillbegiven
asingleshotofMeasles-Rubella(MR)vaccinationduringthe
--- Content provided by FirstRanker.com ---
campaignFollowingthecampaign,MRvaccinewillbecomeapartofroutine
immunizationandwillreplacemeaslesvaccine,currentlygivenat9-
12monthsand16-24monthsofageofchild.
Forthosechildrenwhohavealreadyreceivedsuchvaccination,the
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campaigndosewouldprovideadditionalboostingtothem.261.Whichofthefollowingtrueregarding
HemophiliaA
a)SerumlevelsoffactorVIIIaredecreased
b)DeficiencyoffactorIX
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c)PTincreasedd)FITdecreased
CorrectAnswer-A
Answer:A.SerumlevelsoffactorVIIIaredecreased
HemophiliaisanXlinkeddisorderofcoagulationcausedbythe
--- Content provided by FirstRanker.com ---
deficiencyinacirculatingplasmaprotein.HemophiliaAiscausedbythedeficiencyoffactorVIII,andhemophiliaBiscausedbythe
deficiencyoffactorIX.
ItisPTTwhichisaffected(increased)andnotPT(unaffected).
FactorVIIIisinvolvedintheintrinsicpathwaywhichismeasuredby
--- Content provided by FirstRanker.com ---
PTTandnotinextrinsicpathwaywhichismeasuredasPT.Bleedingisthecommonmanifestationofhemophiliaandthe
commonbleedingmanifestationsarehemarthoses,hematomas,
mucocutaneousbleeding,intracranialbleeding,hematuriaand
pseudotumor.
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262.Markedbleedingisseeninwhichof
followingconditions?
a)VMAdisease
b)HaemophiliaA
c)HaemophiliaB
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d)ALLCorrectAnswer-D
Answer:D.ALL
Bleedingdisorderscanbeinheritedoracquired.Inheriteddisorders
arepasseddownthroughgenetics.Acquireddisorderscandevelop
--- Content provided by FirstRanker.com ---
orspontaneouslyoccurlaterinlife.Somebleedingdisorderscanresultinseverebleedingfollowinganaccidentorinjury.Inother
disorders,heavybleedingcanhappensuddenlyandfornoreason.
Therearenumerousdifferentbleedingdisorders,butthefollowing
arethemostcommonones:
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HemophiliaAandBareconditionsthatoccurwhentherearelowlevelsofclottingfactorsinyourblood.Itcausesheavyorunusual
bleedingintothejoints.Thoughhemophiliaisrare,itcanhavelife-
threateningcomplications.
FactorII,V,VII,X,orXIIdeficienciesarebleedingdisorders
--- Content provided by FirstRanker.com ---
relatedtobloodclottingproblemsorabnormalbleedingproblems.vonWillebrand'sdiseaseisthemostcommoninheritedbleeding
disorder.ItdevelopswhenthebloodlacksvonWillebrandfactor,
whichhelpsthebloodtoclot.
263.Reedsternbergcellsarefoundin
--- Content provided by FirstRanker.com ---
a)Hodgkin'sdiseaseb)Sicklecellanaemia
c)Thalassemia
d)CML
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
ReedSternbergcellsareyouderivedfromBlymphocytes,classicallyconsideredcrippledgerminalcenterBcells,Seenagainst
aseaofBcellswhichgivethetissueamoth-eatenappearance.
Theyarelargeandareeithermultinucleatedorhaveabibbed
nucleus(thusresemblingan"owl'seye"appearance)withprominent
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eosinophilicinclusion-likenucleoli.TheyareCD30andCD15positive,usuallynegativeforCD20and
CD45.
Thepresenceofthesecellsisnecessaryforthediagnosisof
Hodgkin'slymphoma-theabsenceofReed-Sternbergcellshasvery
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highnegativepredictivevalue.Theycanalsobefoundinreactivelymphadenopathy(suchas
infectiousmononucleosis,carbamazepineassociated
lymphadenopathy)andveryofteninothertypesofnon-Hodgkin
lymphomas.
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264.BywhichmethodforeignDNAis
introducedintoacellbyavirusorviral
vector?
a)Transduction
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b)Transcriptionc)Lysogenicconversion
d)Transformation
CorrectAnswer-A
Ans.A.Transduction
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TransductionistheprocessbywhichforeignDNAisintroducedintoacellbyavirusorviralvector.Anexampleistheviraltransfer
ofDNAfromonebacteriumtoanother.
265.Whichoneofthefollowingshows
allostericinhibition?
--- Content provided by FirstRanker.com ---
a)Malonicacid&succinateb)2,3BPG
c)Aminoacidalanine&pyruvatekinase
d)Citrate
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B.2,3BPGNegativeallostericmodulation(alsoknownasallosteric
inhibition)occurswhenthebindingofoneliganddecreasesthe
affinityforsubstrateatotheractivesites.Forexample,when2,3-
BPGbindstoanallostericsiteonhemoglobin,theaffinityfor
--- Content provided by FirstRanker.com ---
oxygenofallsubunitsdecreases.266.Whichofthefollowingisseenin
seropositiverheumatoidarthritis?
a)Multiplejointsaffected
b)Symmetricaljointsymptoms
--- Content provided by FirstRanker.com ---
c)Jointpainandswellingd)All
CorrectAnswer-D
Answer:D.All
PositiveforRheumatoidfactorinbloodisseropositivity.
--- Content provided by FirstRanker.com ---
Patientswithpositiverheumatoidfactorusuallypresentwithsymptomslike
Jointdeformities&disability
Symmetricalinvolvementofjoints
Inflammation
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Swellingandpainfulinmultiplejoints,especiallyofhandsandfeet.
Morningstiffness(shortterm)
Developmentoffirmlumpsnearjoints-"Rheumatoidnodules"
Deteriorationofbone&cartilage(X-rayfindings)
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267.Whichofthefollowingisnotseenin
Anteriormediastinum
a)Thyroidtumour
b)Thymoma
--- Content provided by FirstRanker.com ---
c)Lymphomad)Neurogenictumor
CorrectAnswer-D
Answer:D.Neurogenictumor
Theanteriormediastinumistheportionofthemediastinumanterior
--- Content provided by FirstRanker.com ---
tothepericardiumandbelowthethoracicplane.Itformstheanteriorpartoftheinferiormediastinum
containsthethymus,lymphnodes,andmaycontaintheportionsof
aretrosternalthyroid.
MediastinalTumorsandOtherMasses
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SuperiorAnterior
Posterior
Middle
Mediastinum
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MediastinumMediastinum
Mediastinum
Neurogenic
Bronchogenic
--- Content provided by FirstRanker.com ---
LymphomaThymoma
tumors
cyst
Thymoma
--- Content provided by FirstRanker.com ---
TeratomaLymphoma
Pericardialcyst
Gastroenteric
Thyroidlesions
--- Content provided by FirstRanker.com ---
LymphomaLymphoma
hernia
Metastatic
Thyroidlesions
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carcinomaParathyroid
Parathyroid
tumors
tumors
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268.Struvitestoneiscausedbywhichmetal?
a)Magnesium
b)Calcium
c)sodium&potassium
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d)both(a)&(b)CorrectAnswer-A
Ans.A.Magnesium
Struvite,acrystallinesubstanceiscomposedofmagnesium
ammoniumphosphate(MgNH4PO4?6H2O).
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Struviteurinarystoneshavealsobeenreferredtoas"infectionstones"and"triplephosphate"stones.
Struvitestonescanbecausedbyalkalineurine,steroidtherapy,
abnormalretentionofurine,aurinarytractinfection,oranother
disorderoftheurinarytract.
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Therearefiveprimarytypesofcommonlyencounteredurinarystones,i.e.,calciumoxalate,calciumphosphate,magnesium
ammoniumphosphate,uricacid,andcystine.
269.Whichofthefollowingstatementsabout
Gravesdiseaseisfalse?
--- Content provided by FirstRanker.com ---
a)Resultsinhyperthyroidismb)Autoimmunedisorder
c)CommoninMale
d)ReferredasToxicdiffusegoitre
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans.C-CommoninmaleGraves'disease:
Autoimmunesystemdisorder
Bothmenandwomengetaffected;
Yet,10timesmorecommoninwomenthanmen
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Affectsyoungerwomen<40yearsResultsinoverproductionofthyroidhormones(hyperthyroidism).
Signsandsymptoms:
Anxiety
Irritability
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HeatsensitivityIncreasedperspiration/warmandmoistskin
Weightloss
Goiter(Glandularenlargement)
Menstrualcyclechanges
--- Content provided by FirstRanker.com ---
Erectiledysfunction/reducedlibidoGravesOphthalmopathy-Bulgingeyes-Exophthalmos
Gravesdermopathy-Thick,redskinonshins/topoffeet.
Antibodyforgravesdisease-Thyrotropinreceptorantibody
(TRAb)actsontheregulatorypituitaryhormoneinterferingthe
--- Content provided by FirstRanker.com ---
normalsecretionofthyroxine.TRAboverridesnormalregulationcausinganoverproductionof
thyroidhormones(hyperthyroidism).
270.Aldosteronesynthesisisstimulatedbywhichofthe
following?
--- Content provided by FirstRanker.com ---
a)ACTHb)Hyperkalemia
c)Hypernatremia
d)Exogenoussteroids
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans.B.HyperkalemiaMineralocorticoidsecretionisstimulatedbyhyperkalemia,
angiotensin-II,ACTHandhyponatremia,inreducingorderof
efficacy.
1.Aldosteronesecretioninresponsetohyperkalemiaisthemost
--- Content provided by FirstRanker.com ---
importantandformsthebasisforrenalregulationofbodypotassiumbalance.
2.StimulationofaldosteronebyangiotensinII(throughtherenin-
angiotensinsystem)isimportantforthecorrectionofhypovolemia
andhypotensioninconditionslikesaltdepletionorrenalischemia.
--- Content provided by FirstRanker.com ---
3.StimulationofaldosteronesecretionbyACTHresultsindiurnalvariationofaldosteronesecretion.However,ACTHisnotan
importantphysiologicalregulatorforaldosteronesecretion.
4.Hyponatremiaisaweakstimulatorofaldosteronesecretion
271.Whichofthefollowingisfalseabout
--- Content provided by FirstRanker.com ---
Alzheimer'sdisease?a)Onein10peopleage65andolderhasAlzheimer'sdisease
b)Alzheimer'sdiseaseiscurable
c)Causedementia
d)Alloftheabove
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns.B.Alzheimer'sdiseaseiscurable
Alzheimer'sdiseaseAlsocalled:seniledementia.Aprogressive
diseasethatdestroysmemoryandotherimportantmental
functions.
--- Content provided by FirstRanker.com ---
Memorylossandconfusionarethemainsymptoms.Currently,thereisnocureforAlzheimer's.Butdrugandnon-drug
treatmentsmayhelpwithbothcognitiveandbehavioralsymptoms.
ThetreatmentsavailableforAlzheimer'sdonotsloworstop
theprogressionofthedisease,buttheymayhelpwiththe
--- Content provided by FirstRanker.com ---
symptomsforatime.TherearethreecholinesteraseinhibitorstotreatAlzheimer's:
Donepezil(Aricept)
Rivastigmine(Exelon)
Galantamine(Reminyl)
--- Content provided by FirstRanker.com ---
Peoplemayexperience:Cognitive:mentaldecline,difficultythinkingandunderstanding,
confusionintheeveninghours,delusion,disorientation,
forgetfulness,makingthingsup,mentalconfusion,difficulty
concentrating,inabilitytocreatenewmemories,inabilitytodosimple
--- Content provided by FirstRanker.com ---
maths,orinabilitytorecognisecommonthingsBehavioural:aggression,agitation,difficultywithselfcare,
irritability,meaninglessrepetitionofownwords,personalitychanges,
restlessness,lackofrestraint,orwanderingandgettinglost
Mood:anger,apathy,generaldiscontent,loneliness,ormood
--- Content provided by FirstRanker.com ---
swingsPsychological:depression,hallucination,orparanoia
Alsocommon:behavioralsymptoms,inabilitytocombinemuscle
movements,jumbledspeech,orlossofappetite
272.Whichofthefollowingistrueabout
--- Content provided by FirstRanker.com ---
vitaminK?a)Anticoagulant
b)Prolonguseofantimicrobialleadstodeficiency
c)Dietaryallowanceis15-20mg
d)Alloftheabove
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns.B.Prolonguseofantimicrobialleadstodeficiency
Certainpeopleareatincreasedriskifthey:
takecoumarinanticoagulantssuchaswarfarin,whichthinsthe
blood
--- Content provided by FirstRanker.com ---
aretakingantibioticshaveaconditionthatcausesthebodytonotabsorbfatproperly(fat
malabsorption)
haveadietthatisextremelylackinginvitaminK
VitaminKisagroupofstructurallysimilar,fat-solublevitaminsthe
--- Content provided by FirstRanker.com ---
humanbodyrequiresforcompletesynthesisofcertainproteinsthatareprerequisitesforbloodcoagulationandwhichthebodyalso
needsforcontrollingbindingofcalciuminbonesandothertissues
ThebodyneedsvitaminKtoproduceprothrombin,aproteinand
clottingfactorthatisimportantinbloodclottingandbone
--- Content provided by FirstRanker.com ---
metabolism.WithoutvitaminK,bloodcoagulationisseriouslyimpaired,and
uncontrolledbleedingoccurs.Preliminaryclinicalresearchindicates
thatdeficiencyofvitaminKmayweakenbones,potentiallyleading
toosteoporosis,andmaypromotecalcificationofarteriesandother
--- Content provided by FirstRanker.com ---
softtissuesDietaryallowanceforadultsperday-50-100mg.
273.Whichdrugsneedscontinuous
monitoringofprothrombintime?
a)Aspirin
--- Content provided by FirstRanker.com ---
b)Lepirudinc)Digoxin
d)Coumadin
CorrectAnswer-D
Ans.D.Coumadin
--- Content provided by FirstRanker.com ---
Coumadin(warfarin)isananticoagulant.Warfarinisacoumarinanticoagulantusedfortheprophylaxisand
treatmentofthromboemboliccomplicationsassociatedwithcardiac
valvereplacementandatrialfibrillation,aswellastheprophylaxis
andtreatmentofvenousthrombosisandpulmonary
--- Content provided by FirstRanker.com ---
embolism.Increasedmetabolismofwarfarinresultsininsufficientprolongationofprothrombintime.
274.Whichofthefollowingaretheriskfactor
forcutaneouslymphoma?
a)Age
--- Content provided by FirstRanker.com ---
b)Genderc)Weakenedimmunesystem
d)All
CorrectAnswer-D
Answer:D.All
--- Content provided by FirstRanker.com ---
RiskFactorsforLymphomaoftheSkinAgeAgeisanimportantriskfactorforthisdisease,withmostcases
occurringinpeopleintheir50sand60s.Butsometypesofskin
lymphomacanappearinyoungerpeople,eveninchildren.
GenderandraceMost(butnotall)typesofskinlymphomaaremore
--- Content provided by FirstRanker.com ---
commoninmenthaninwomen.MostalsotendtobemorecommoninAfrican-Americansthaninwhites.Thereasonsforthisarenot
known.
WeakenedimmunesystemSkinlymphomasmaybemorecommon
inpeoplewithacquiredimmunodeficiencysyndrome(AIDS),who
--- Content provided by FirstRanker.com ---
haveaweakenedimmunesystem.Theymayalsobemorecommoninpeoplewhohavehadanorgantransplantsuchasaheart,kidney
orlivertransplant.Thesepeoplemusttakedrugsthatsuppresstheir
immunesystem,whichmayraisetheriskofskinlymphoma(or
lymphomasinotherpartsofthebody).
--- Content provided by FirstRanker.com ---
InfectionsInfectionwiththehumanimmunodeficiencyvirus(HIV),thevirusthatcausesAIDS,mayincreaseaperson'sriskofskin
lymphoma.
275.WhichisnotincludedinAIDSrelated
complex?
--- Content provided by FirstRanker.com ---
a)Ectopicpregnancyb)Recurrentgenitalcandidiasis
c)Generalisedlymphadenopathy
d)Chronicdiarrhea
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A.EctopicpregnancyHIVsymptoms:AIDSrelatedcomplex(ARC)
ItbelongstoclassBofHIVsymptoms.Thepatientsatthisstage
havevariousdiseasesthatoccurbecausetheHIvirushas
weakenedtheimmunesystem.
--- Content provided by FirstRanker.com ---
ThefollowingHIVsignsmayhavepatientswithARC:Long-lastingdiarrhea(overfourweeks)
Unintendedheavyweightloss
Longlastingfever
Nightsweats
--- Content provided by FirstRanker.com ---
BacterialinfectionscausedbybacteriaBacterialbloodpoisoning(sepsis)
Phthisis
Herpeszoster
Oralhairyleukoplakia(whitishchangesonthelateraltongueborder)
--- Content provided by FirstRanker.com ---
FungicausedbyfungiHIVsymptoms?Women:vaginalinflammationcausedbyfungi,
malignantchangesinthecervix
276.Whichisthetreatmentofchoicefor
irradiationinChordoma?
--- Content provided by FirstRanker.com ---
a)Protonsb)Electrons
c)Gammaradiation
d)3D-CRT
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer:A-ProtonTherapyChordoma:
Slow-growingneoplasm
Arisingfromcellularremnantsofnotochord.
Arisefromboneinskullbaseandalongspinalcord.
--- Content provided by FirstRanker.com ---
Mostcommonlocations-Craniallyatclivus
Insacrumatbottomofspine
Radiationtherapy:
Arerelativelyradioresistant
--- Content provided by FirstRanker.com ---
Highdosesofradiationrequiredtocontrol.Hence,highfocusradiationlikeprotontherapyandcarbonion
therapyarepreferredthanconventionalradiationmethods.
Closeproximitytovitalstructureslikebrainstem,requireshigh
precisionandaccuracyforanyplannedsurgicalresection.
--- Content provided by FirstRanker.com ---
Radiationwithhighaccuracyandminimaldamagewithmaximalsafetyisdelivered.
277.Whatdifferentiatesdeliriumfrom
dementia?
a)Confusion
--- Content provided by FirstRanker.com ---
b)Difficultyincommunicatingc)Hallucination
d)Suddenchange
CorrectAnswer-D
Answer:D.Suddenchange
--- Content provided by FirstRanker.com ---
DeliriumAlsocalledtheacuteconfusionalstate,deliriumisamedical
conditionthatresultsinconfusionandotherdisruptionsinthinking
andbehavior,includingchangesinperception,attention,moodand
activitylevel.
--- Content provided by FirstRanker.com ---
Indementia,changesinmemoryandintellectareslowlyevidentovermonthsoryears.Deliriumisamoreabruptconfusion,emerging
overdaysorweeks,andrepresentsasuddenchangefromthe
person'spreviouscourseofdementia.Thinkingbecomesmore
disorganized,andmaintainingacoherentconversationmaynotbe
--- Content provided by FirstRanker.com ---
possible.Thehallmarkseparatingdeliriumfromunderlyingdementiais
inattention.Theindividualsimplycannotfocusononeideaortask.
278.Genitalwartsarecausedbywhichvirus?
a)Herpessimplex
--- Content provided by FirstRanker.com ---
b)Humanpapillomac)Cytomegalovirus
d)Varicellazoster
CorrectAnswer-B
Ans.B.Humanpapilloma
--- Content provided by FirstRanker.com ---
Genitalwartsaresoftgrowthsthatappearonthegenitals.Genitalwartsareasexuallytransmittedinfection(STI)causedbycertain
strainsofthehumanpapillomavirus(HPV).Theseskingrowthscan
causepain,discomfort,anditching.
279.Whichdrugregimenisgivenina
--- Content provided by FirstRanker.com ---
pregnantwomanwithHIVinfection?a)Tenofovirdisoproxilfumaratewithemtricitabine
b)Tenofovirdisoproxilfumaratewithlamivudine
c)Abacavirwithlamivudine
d)All
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAns.D.All
PreferredRegimensforHIVAntiretroviralTherapy(ART)in
Pregnancy
Two-NRTIbackbone
--- Content provided by FirstRanker.com ---
Regimensincludethefollowing:Tenofovirdisoproxilfumaratewithemtricitabine(TDF/FTCco-
formulated)ortenofovirdisoproxilfumaratewithlamivudine(3TC)
oncedaily(usewithcautioninrenalinsufficiency)or
Abacavirwithlamivudine(ABC/3TC)oncedaily(onlyifHLA-B5701?
--- Content provided by FirstRanker.com ---
negative);avoidcombinationwithritonavir-boostedatazanavirifthepretreatmentHIVviralloadexceeds100,000copies/mL.
ForwomenwhohavenevertakenHIVmedicines,thepreferredHIV
regimenshouldincludetwonucleosidereversetranscriptase
inhibitors(NRTIs)plusanintegrasestrandtransferinhibitor
--- Content provided by FirstRanker.com ---
(INSTI),anon-nucleosidereversetranscriptaseinhibitor(NNRTI),oraproteaseinhibitor(PI)withlow-doseritonavir(brand
name:Norvir).
Theregimengenerallyshouldincludeatleastoneofthe
followingNRTIsthatpasseasilyacrosstheplacenta:
--- Content provided by FirstRanker.com ---
abacavir(brandname:Ziagen)emtricitabine(brandname:Emtriva)
lamivudine(brandname:Epivir)
tenofovirdisoproxilfumarate(brandname:Viread)
zidovudine(brandname:Retrovir)
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280.Whichofthefollowingstructure
developsfromdorsalmesentery?
a)Greateromentum
b)Lesseromentum
c)Liver
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d)DiaphragmCorrectAnswer-A
Ans.A.Greateromentum
Theportionofthedorsalmesenterythatattachestothegreater
curvatureofthestomach,isknownasthedorsalmesogastrium.The
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partofthedorsalmesenterythatsuspendsthecolonistermedthemesocolon.Thedorsalmesogastriumdevelopsintothegreater
omentum.
281.WhichofthefollowingisthebestStent
forFemoropoplitealBypass?
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a)Dacronb)Reversedsaphenous
c)PTFE
d)None
CorrectAnswer-C
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Answer:C-PTFE-coveredself-expandingnitinolstentsPTFE-coveredstentsareengineeredwitha30?100-micronpore
sizetoallowfortheendothelialliningofthestent-graftandvessel
healing.
Thetwomaingrafttypesusedforlowerextremitybypassesarethe
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greatsaphenousveinsandpolytetrafluoroethylene(PTFE)grafts.Oneofthemostwidelyusedstent-graftsinthetreatmentofchronic
lowerextremityischemiaistheViabahnendoprosthesis(Gore
Medical,Flagstaff,Ariz).
Itisconstructedwithexpandedpolytetrafluoroethylene(ePTFE)liner
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attachedtoanexternalnitinolstent.Theinnersurfaceisbondedwithheparin.
282.Trileneisdegradedby:
a)EnzymaticDegradation
b)NonEnzymaticdegradation
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c)ChemicalDegradationd)None
CorrectAnswer-A
Answer:A.EnzymaticDegradation
Trileneortrichloroethyleneisagoodanalgesic,lessdepressant,
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andnon-flammable.Cardiacdysrhythmia,ortachypnoeamayoccurduring
administration.
Itshouldnotbeusedintheclosedcircuitasitreactswithsoda-lime
toproduceatoxicgas(phosgene).
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Recoveryisslowandnauseaaswellasvomitingmaybepresent.Itshouldnotbeusedwithadrenalineinfiltrationlestdysrhythmiabe
convertedtoventricularfibrillation.
Degradation:
Broughtaboutbyenzymaticdegradation
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Theenzymethatstartsonebranchofthispathway,toluene1,2-dioxygenase,hasmanyothercatalyticabilities,whichare
documentedinatableoftheReactionsofToluene1,2-Dioxygenase.
Thespontaneousdegradationoftrichloroethyleneepoxidecan
produceasmanyasfourproducts:dichloroacetate,carbon
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monoxide,glyoxylate,andformate.Thenumber,type,andproportionofproductsseendependsonthelocalenvironment.
283.Theearliestfeatureof3rdcranialnerve
involvementindiabetesmellituspatient
is-
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a)Normallightreflexb)Abnormallightreflex
c)Normallightandaccommodationreflex
d)Abnormallightandaccommodationreflex
CorrectAnswer-A
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Answer:A.NormallightreflexTheoculomotornerveisthethirdcranialnerve.Itenterstheorbit
viathesuperiororbitalfissureandinnervatesmusclesthatenable
mostmovementsoftheeyeandthatraisetheeyelid.Thenervealso
containsfibersthatinnervatethemusclesthatenablepupillary
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constrictionandaccommodation(abilitytofocusonnearobjectsasinreading).Theoculomotornerveisderivedfromthebasalplateof
theembryonicmidbrain.Inpeoplewithdiabetesandolderthan50
yearsofage,anoculomotornervepalsyoccurs.
284.Duringsquintsurgery,anesthesiologist
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seesthemachineandseethebpsuddenlydropsto40.Whatwillbebest
immediatemanagement-
a)Giveatropine
b)Increaselevelofanesthesia
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c)Askthesurgeontostopthesurgeryd)Giveadrenaline
CorrectAnswer-D
Answer:D.Giveadrenaline
Adrenalineshouldbegiventoraisethebloodpressure.
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Epinephrine,alsoknownasadrenalinoradrenaline,isahormone,neurotransmitter,andmedication.Epinephrineis
normallyproducedbyboththeadrenalglandsand
certainneurons.
Itplaysanimportantroleinthefight-or-flightresponseby
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increasingbloodflowtomuscles,outputoftheheart,pupildilation,andbloodsugar.Itdoesthisbybinding
toalphaandbetareceptors.
Physiologicresponsestoepinephrinebyorgan
Organ
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EffectsHeart
Increasesheartrate;contractility;conductionacross
AVnode
Lungs
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Increasesrespiratoryrate;bronchodilationSystemic
Vasoconstrictionandvasodilation
Liver
Stimulatesglycogenolysis
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Systemic
Triggerslipolysis
Systemic
Musclecontraction
285.Allarespecialvisceralefferentcolumn
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except-a)Glossopharyngealn
b)Nucleusambiguus
c)vagusnerve
d)trigeminalnerve
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CorrectAnswer-BAnswer:B.Nucleusambiguus
Specialvisceralefferentfibers(SVE)aretheefferentnervefibers
thatprovidemotorinnervationtothemusclesofthepharyngeal
archesinhumans,TheonlynervescontainingSVEfibersarecranial
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nerves:thetrigeminalnerve(V),thefacialnerve(VII),theglossopharyngealnerve(IX),thevagusnerve(X)andtheaccessory
nerve
286.WhichofthefollowingconditionisNOT
causedbyParvovirusB19?
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a)Roseolainfantumb)Aplasticanemiainsicklecelldisease
c)Fetalhydrops
d)Erythemainfectiosum
CorrectAnswer-A
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Answer:A.RoseolainfantumPrimaryinfectionbyparvovirusB19oftenproducesanacute,
severe,andsometimesfatalanemiamanifestedasarapidfallinred
bloodcellcountandhemoglobin.
Thesepatientsmaypresentinitiallywithnoclinicalsymptomsother
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thanfever;thisiscommonlyreferredtoasaplasticcrisis.Erythemainfectiosum(alsoreferredtoasfifthdiseaseoracademy
rash)isamorecommondiseasethatisclearlyattributableto
parvovirusB19.
ActivetransplacentaltransmissionofparvovirusB19canoccur
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duringprimaryinfectionsinthefirst20weeksofpregnancy,sometimesresultinginstillbirthoffetusesthatareprofoundly
anemic.
Theprogresscanbesoseverethathypoxicdamagetotheheart,
liver,andothertissuesleadstoextensiveedema(hydropsfetalis).
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287.Whichofthefollowingstatementsisnot
trueaboutiliolumbarligament?
a)Upperfibresattachedtoiliaccrest
b)Lowerfibresattachedtobaseofsacrum
c)Helpinmaintaininglumbosacraljointstability
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d)UpperattachmenttotransverseprocessofT12CorrectAnswer-D
Answer:D-UpperattachmenttotransverseprocessofT12
TheligamentattachestoL5
Iliolumbarligament:
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Strongligamentpassingfromthetipoftransverseprocessoffifthlumbarvertebratoposteriorpartofinnerlipofiliaccrest
Upperbandsgetsattachedtotheiliaccrest.
Lowerbandsgetsattachedtobaseofsacrum.
Majorfunctionistostrengthenthelumbosacraljoint.
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288.Wherewillbetheplacementlocationfor
AuditoryBrainstemImplant?
a)Scalatympani
b)Recessof4thventricle
c)IAC
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d)backofearCorrectAnswer-B
Answer:B-Recessof4thventricle.
Theimplantisusuallyplacedinthelateralrecessofthefourth
ventricleatthetimeoftumorresectiontostimulatethe
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cochlearnucleusAuditoryBrainstemImplant(ABI):
TumorresectionsurgeryinNFpatientsresultincochlearnerve
damageorlossoffunctionofnerveresultingindeafness.
ABIareusefulinrestoringauditoryperceptiontodeafpatientswith
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neurofibromatosistype2(NF2)Alsousedintreatmentofcongenitallydeafchildrenwithcochlear
malformationsorcochlearnervedeficiencies.
Placementlocation:Lateralrecessof4thventricle
289.Whichconditionisassociatedwith
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Congenitaladrenalhypoplasia?a)Malepseudohermaphroditism
b)Femalepseudohermaphroditism
c)Truepseudohermaphroditism
d)Sequentialpseudohermaphroditism
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CorrectAnswer-BAnswer-B-
CongenitalAdrenalHyperplasia:
Thisisthemostcommoncauseofandrogenicexcessinfetuseswith
femalepseudohermaphroditism.
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Thehyperplasticglandssynthesizedefectiveenzymesthatcauseimpairedcortisolsynthesis.
ThisleadstoexcessivepituitaryACTHthesecretionofthefetal
adrenalglandswithsecretionoflargeamountsofcortisol
precursors,includingandrogenicprehormones.
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Theseprehormones,forexample,androstenedione,areconvertedtotestosteroneinfetalextra-adrenaltissues.
290.Whichistrueregardingataxia
telangiectasia:
a)IncreaseinAFP
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b)Increasestheriskofsquamouscellcarcinomac)Autosomaldominant
d)Noneofabove
CorrectAnswer-A
Answer:A-IncreaseinAFP
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Increaseinalpha-fetoproteinisobservedinAtaxiatelangiectasia
Ataxia-telangiectasia/Ataxia-telangiectasiasyndrome/Louis-Bar
syndrome
Rare,neurodegenerative,autosomalrecessivedisordercausing
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severedisability.Ataxiareferstopoorcoordination;Telangiectasiareferstosmall
dilatedbloodvessels.
Partsaffected:
Cerebellum-movement&coordinationdifficulties
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Immunesystem-Predisposingtoinfections.Geneticrepairsystem-PreventingprocessforrepairingDNA-
Cancerrisk
Features:
Increasedincidenceoflymphoma&Leukemia
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Increasedalpha-FetoproteinlevelsOculomotorapraxia(difficultyincoordinationbetweenhead&eye
movements)
Dysarthria
291.Adiabeticpatient2daysafterpost
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cataractsurgerydevelopsdevelopshypopyon.Whatwillbethe
management?
a)Intravitrealantibiotics
b)Eyedrops
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c)Surgeryd)Notreatmentrequired
CorrectAnswer-A
Ans.A.Intravitrealantibiotics
292.
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WhatistheThinnestpartofneuro-retinalrim
accordingtoISNTrule?
a)Inferior
b)Superficial
c)Temporal
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d)MedialCorrectAnswer-C
Ans.C.Temporal
TheISNTruleisaneasywaytorememberhowtheopticnerveis
supposedtolookinanormaleye.Normallytheneuro-retinalrimis
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thickestInferiorlyandthinnestTemporally.Withglaucoma,however,youbegintoseeverticalthinning,withatrophyalongtheinferiorand
superiorrims.
293.Leidenthrombophiliaiscausedby
mutationaldeficiencyofwhichofthe
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followingfactors?a)FactorV
b)FactorVII
c)FactorIX
d)FactorX
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CorrectAnswer-AAns.A.FactorV
FactorVLeidenthrombophiliaisaninheriteddisorderofblood
clotting.FactorVLeidenisthenameofa
specificmutation(geneticalteration)thatresultsinthrombophilia,or
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anincreasedtendencytoformabnormalbloodclotsinbloodvessels.FactorVLeidenisthemostcommoninheritedformof
thrombophilia.
294.Anteversionofuterusismaintainedby?
a)Cardinalligament
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b)Uterosacralligamentc)Pubocervicalligament
d)Roundligament
CorrectAnswer-D
Ans.D.Roundligament
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Inmostwomen,theuterusisantevertedandanteflexed.Thefunctionoftheroundligamentismaintenanceoftheanteversionof
theuterus(apositionwherethefundusoftheuterusisturned
forwardatthejunctionofcervixandvagina)duringpregnancy.
Normally,thecardinalligamentiswhatsupportstheuterineangle
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(angleofanteversion).295.Long-standingpelvicinflammationmay
leadtowhichofthefollowing
conditions?
a)Pyometra
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b)Uterinepolyposisc)Pseudopregnancy
d)Cysticendometrialhyperplasia
CorrectAnswer-A
Ans.A.Pyometra
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Pyometraiscollectionofpusduetoobstructionofflowintheuterinecavity.
ItmaybeduetoLong-standingPIDorsecondarytocervical
stenosis.
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