preventeddueto?
a)Berryligament
b)Pretrachealfascia
c)Sternothyroidmuscle
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d)ThyrohyoidmembraneCorrectAnswer-B
Ans:B.Pretrachealfascia
Thethyroidglandiscoveredbyathinfibrouscapsule,whichhasan
innerandanouterlayer.Theinnerlayerextrudesintotheglandand
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formstheseptumthatdividesthethyroidtissueintomicroscopiclobules.
Theouterlayeriscontinuouswiththepretrachealfascia,attaching
theglandtothecricoidandthyroidcartilagesviaathickeningofthe
fasciatoformtheposteriorsuspensoryligamentofthethyroidgland
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alsoknownasBerry'sligament.Thiscausesthethyroidtomoveupanddownwiththemovementofthesecartilageswhenswallowing
occurs.
Gray'sAnatomy:TheAnatomicalBasisofClinicalPractice,41e
,Pageno470
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2.Thereasonforthelongleftrecurrent
laryngealnerveisduetothepersistenceof
whicharchartery?
a)3rdarch
b)4tharch
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c)5tharchd)2ndarch
CorrectAnswer-B
Ans:B.4tharch
LeftRLNwindsaroundthearchofaorta
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Archofaortaisderivedfromthe4tharchLangmansMedicalEmbryology13thedition(Pageno88,239)
3.Ligationofthehepaticarterywillimpair
bloodsupplyin
a)RightgastricandRightgastroepiploicartery
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b)RightgastricandLeftgastricarteryc)Rightgastroepiploicandshortgastricvessels
d)Rightgastricandshortgastricvessels
CorrectAnswer-A
Ans:A.RightgastricandRightgastroepiploicartery
--- Content provided by FirstRanker.com ---
TherightgastricarteryisabranchofthecommonhepaticarteryTherightgastroepiploicarteryisabranchofthegastroduodenal
arterywhichisabranchofthecommonhepaticartery
Theleftgastricarteryisabranchoftheceliactrunk
Shortgastricvesselsarisefromthesplenicartery
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Gray'sAnatomy:TheAnatomicalBasisofClinicalPractice,41stEdition(Pagenos1116and1117)
4.Wolffianductremnantinfemaleis
a)PouchofDouglas
b)Uterovesicalpouch
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c)Gartner'scystd)Broadligament
CorrectAnswer-C
Ans:C.Gartner'scyst
Gartner'scysts,sometimesincorrectlyreferredtoasvaginal
--- Content provided by FirstRanker.com ---
inclusioncysts,arethemostcommonbenigncysticlesionsofthevagina.
Theyrepresentembryologicalremnantsofthecaudalendofthe
mesonephric(Wolffian)duct.
Gartner'sductsarefoundinabout25%ofadultwomen.Almostone
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percentoftheseductsevolveintoGartner'sductcyst.Ref:AcaseofGartner'scystofvagina,J.AnesthCritcare
OpenAccess,2017,00259.
5.Nervesupplyoftheextraocularmusclesis
constitutedbyallexcept
--- Content provided by FirstRanker.com ---
a)Ophthalmicnerveb)Oculomotornerve
c)Trochlearnerve
d)Abducentnerve
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.OphthalmicnerveLateralrectusissuppliedby6thcranialnerve(abducentnerve)
Superiorrectusissuppliedby4thcranialnerve(trochlearnerve)
Alloftheremainingextraocularmusclesaresuppliedbythe
oculomotornerve.Theophthalmicnerveisabranchofthe
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trigeminalnerveandispurelysensoryinnature.BDC7thedition,volume3,pgno.215.
6.Claudicationduetopoplitealfemoral
incompetenceisprimarilyseenin
a)Thigh
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b)Calfc)Buttocks
d)Feet
CorrectAnswer-B
Ans:B.Calf
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CalfAortaandCommonIliac-Buttocks
FemoralArtery-Thigh
Superficialfemoralartery-Calfandpoplitealartery
PosteriortibialArtery-Feet
--- Content provided by FirstRanker.com ---
BDC7thedition,volume2,pageno137.7.Whichmuscleisparalyzedifthereis
hyperextensionofmetacarpophalangeal
jointandflexionoftheinterphalangeal
joint?
--- Content provided by FirstRanker.com ---
a)Extensordigitorumb)Interosseiandlumbricals
c)Adductorpollicis
d)Pronatorquadratusmuscle
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:B.InterosseiandlumbricalsHyperextensionofmetacarpophalangealjointandflexionofthe
interphalangealjointisduetopalsyoflumbricalsandinterossei
muscles.
TheactionofLumbricals:FlexionofMCP,ExtensionofIPjoint
--- Content provided by FirstRanker.com ---
TheactionofPalmarinterossei:AdductionoffingersTheactionofDorsalinterossei:Abductionoffingers
Ref:BDC,7thedition,volume1,pgno.163.
8.Tumouroftheuncinateprocessofthe
pancreaswillcompresswhichartery
--- Content provided by FirstRanker.com ---
a)Portalveinb)Superiormesentericartery
c)Inferiormesentericartery
d)Commonhepaticartery
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:B.SuperiormesentericarteryThesuperiormesentericarterypassesanteriortotheuncinate
process
Posteriorly,theuncinateprocessisrelatedtoaorta.
Ref:BDC,7thedition,vol2,page-328.
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9.Aboymetwithamotorbikeaccident.CT
brainshowsinjurytotheposteriorendof
thesuperiortemporalgyrus.Heislikelyto
sufferfrom
a)Fluentaphasia
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b)Non-fluentaphasiac)Conductionaphasia
d)Noneoftheabove
CorrectAnswer-A
Ans:A.Fluentaphasia
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FluentaphasiaLesionsintheposteriorportionoftheleftSTGwereassociatedwith
thelossoftheabilitytocomprehendandproducespokenwords
whicharecalledas"fluentaphasia"
BDC7thedition,volume4,pageno129.
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10.A65-year-oldladypresentswitha
vascularinjurytotheinferiorfrontal
gyrus.Whichfunctionalareawould
mostlybeaffected
a)Visual
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b)Auditoryssc)Wernicke
d)Motorspeech
CorrectAnswer-D
Ans:D.Motorspeech
--- Content provided by FirstRanker.com ---
Motorspeechdefectisalsocalledapraxiaofspeech.InjurytotheBroca'sarea/leftinferiorfrontalgyruscausesmotor
speechdefect.
BDC7thedition,volume4,pageno129.
11.Whereisthehighestoxygen
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concentrationpresentsinfetalcirculationa)SVC
b)IVC
c)Rightventricle
d)Aorta
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns:B.IVC
Highlyoxygenatedbloodfromtheplacentaiscarriedtothe
fetusbytheumbilicalvein,whichisshuntedtotheinferiorvena
cava.
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NelsonTextbookofPediatrics20thEdition(Pageno2161)12.WhenthevalueofV/qisinfinity,it
means?
a)NoO2goesfromalveolitobloodandnoco2goesfromblood
toalveoli
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b)Deadspacec)ThePO2ofalveolarairis159mmHgandPCO2is40mmHg
d)PartialpressureofO2andCO2areequal
CorrectAnswer-B
Ans:B.Deadspace
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DeadspaceAnareawithventilationbutnoperfusion.
*V/Qundefined,thoughapproachinginfinity.
InterpretationsofV/Qratiovalues:
*Valueis0.8
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-Ventilation-Perfusionmatching*IfV/Qis>0.8?
-Thismeansmoreventilationthanperfusion.
*IfV/Qis<0.8?
-V/Qmismatch
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Ref:ArvindArorareviewbookofphysiology(p.240-241)13.Proteoglycanpresentintheglomerular
basementmembraneis?
a)Keratansulphate1
b)Keratansulphate2
--- Content provided by FirstRanker.com ---
c)Heparansulphated)Chondroitinsulphate
CorrectAnswer-C
Ans:c.Heparansulphate
Theglomerularmembrane(orthefiltrationbarrier)isthefiltration
--- Content provided by FirstRanker.com ---
surfacethroughwhichthefluidisfilteredoutfromtheblood.Theglomerularmembrane(filtrationbarrier)comprises:
*Theglomerularcapillaryendothelium.
*Thebasementmembrane(basallamina).
*TheBowman'svisceralepithelium(podocytes).
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*Importantconstituentsofglomerularmembraneinclude,-Laminin
-Type4collagen
-Nidogen
-Proteoglycans-(Heparansulphate)
--- Content provided by FirstRanker.com ---
Ref:ArvindArorareviewbookofphysiology(p.371-372)14.35yroldfemalewaswatchingTVforlong
hourswithhandsunderherhead.She
complainsoftinglingsensationoverher
arm.Whichtypeofnervefibersismost
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likelytobeaffected?a)Fibers
b)B-fibers
c)C-Fibers
d)Sympatheticnervefibers
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Fibers
A-
Features:
Functions:
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Highdelta Diameter-
Pain-
susceptibleto
1-5
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-"Fast/Epicritic/First"pain. PressureMyelination-
-Sincefibersarerelatively
Somemyelination fast
Conduction-5-30 Temperature
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PressureTouch
Ref:ArvindArorareviewbookofphysiology(p.58-59)
15.Thereflexinwhichthereisinhibitionof
gastricemptyingwhenthereisacidand
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hypertonicsolutionintheduodenum?a)Enterogastric
b)Gastroileal
c)Gastrocolic
d)Myenteric
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Enterogastric
Theenterogastricreflexisoneofthethreeextrinsicreflexesofthe
gastrointestinaltract,theothertwobeingthegastroilealreflexand
thegastrocolicreflex.
--- Content provided by FirstRanker.com ---
Theenterogastricreflexisstimulatedbyduodenaldistension.ItcanalsobestimulatedbyapHof3-4intheduodenumandbyapHof
1.5inthestomach.
Themainneuralinfluenceingastricemptyingisthoughttobe
mediatedviaaninhibitorymechanismreferredtoasthe
--- Content provided by FirstRanker.com ---
enterogastricreflex.Fats,fattyacids,soaps,proteindigestiveproducts,acids,andhypertonicsolutionsinthesmallintestineinhibit
motility.
Ref:https://www.gastrojournal.org/article/S0016-5085(75)80295-
2/pdf
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16.Inmultiplesclerosis,slowconductionof
motorandthesensorypathwaysisdue
to?
a)DefectinthenodeofRanvier
b)Lossofmyelinsheath
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c)Leakingofsodiumchannelsd)Leakingcalciumchannels
CorrectAnswer-B
Ans:B.Lossofmyelinsheath
MultipleSclerosis(MS)isadisablingprogressiveneurological
--- Content provided by FirstRanker.com ---
disorderThepathophysiologyofMSresultsindisruptionorlossofaxonal
myelininthecentralnervoussystem(CNS),leadingtotheformation
ofscartissue(sclerosis).
Demyelinationproducesalterationsinsaltatoryconduction,slowed
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conductionvelocity,andapredispositiontoconductionblockRef:https://www.physiology.org/doi/pdf/10.1152/japplphysiol.00460.2010
17.Whichofthefollowingclottingfactorinapatienton
Warfarintherapy,wouldhavedecreasedgamma
carboxyglutamateresidue?
--- Content provided by FirstRanker.com ---
a)Factor2b)Factor11
c)Tissuefactor
d)Factor5
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.Factor2VitaminKisacofactorfortheenzymaticconversionofglutamicacid
(Glu)residuestogamma-carboxyglutamicacid(GLA)invitaminK-
dependentproteins,viatheendoplasmicreticulumresidentvitamin
K-dependentgamma-glutamylcarboxylase.
--- Content provided by FirstRanker.com ---
Thiscarboxylaseactivityisfoundinessentiallyallmammaliantissues,anditsreactionproduct,Gla,hasbeenobservedinboth
vertebratesandinvertebrates;bothplayanimportantbiologicalrole
inproteinfunction.
VitaminK?dependentclottingfactordeficiency(VKCFD)isarare
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autosomalrecessivebleedingdisorderthatoftenpresentswithseverehemorrhageduringinfancy.
Arareinheritedformofdefective-carboxylationresultinginthe
earlyonsetofbleedingwasfirstdescribedbyMcMillanandRoberts
in1966andsubsequentlyhasbeentermedvitaminK?dependent
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clottingfactordeficiency(VKCFD).CombineddeficiencyofvitaminK?dependentclottingfactorsII,VII,
IX,andX(andproteinsC,S,andZ)isusuallyanacquiredclinical
problem,oftenresultingfromliverdisease,malabsorption,or
warfarinoverdose.
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Patientsplasmashowedlessthan3%activityoffactorsII,VII,IX,
andX.
18.Bloodstoredincitrate-phosphate-dextroseisbetterfor
hypoxicpatientsthanacidic-citrate-dextrosebecause?
a)IthaslessP50
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b)Itislessacidicc)Thefallin2,3DPGisless
d)Noneoftheabove
CorrectAnswer-C
Ans:C.Thefallin2,3DPGisless
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TheinfusionofACDbloodcausedP50and2,3-DPGconcentrationtodecreasesignificantly.
Theinfusionofbloodstoredincitratephosphatedextrose(CPD)did
notsignificantlyincreasetheoxygenaffinity.
Tocompensatefortheincreasedoxygenaffinity,theremustbea
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riseincardiacoutputormorelikelyadecreaseinvenousPO2.ThetransfusionofCPDblood,therefore,ismorefavorableinterms
ofoxygensupply,particularlyinpatientswhohavehadcardiac
surgery.
19.Whichofthefollowingisreferredtoasthe"Windowofthe
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limbicsystem"?a)Hypothalamus
b)Amygdala
c)Hippocampus
d)Thalamus
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CorrectAnswer-BAns.Bi.e.Amygdala.
*Theamygdalahasbeencalledthe"window"throughwhichthe
limbicsystemseestheplaceofthepersonintheworld.
*Theamygdalareceivesneuronalsignalsfromallportionsofthe
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limbiccortex,aswellasfromtheneocortexofthetemporal,parietal,andoccipitallobes,especiallyfromtheauditoryandvisual
associationareas.
20.Cerebralbloodflowisregulatedbyall
except:
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a)Bloodpressureb)ArterialPCO2
c)Potassiumions
d)A&C
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Ans.A&C.i.e.Bloodpressure&PotassiumionsThetotalcerebralbloodflowisheldconstantinfaceofconsiderable
changesinthesystemicbloodpressure(60-150mmHg)".-
Principlesofmedicalphysiology.
"Cerebralbloodflowisnotaffectedoverafairlywidevariationin
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arterialbloodpressure".-RKMarya.Regulationofcerebralbloodflow:
l)Autoregulation:-Duetotheinherentpropertyofbloodvessels,
explainedbymyogenictheory.
2)Metabolicregulation:CBFvariesdirectlywithmetabolicactivity.
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FactorsaffectingregulationarePCO2,PO2,K+,andadenosine.AmongthisPCO2isthemostimportantone.
3)Sympatheticinnervation:-Importantonlyincaseswithvery
severeelevationofBBe.g.inverystrenuousexercises.
4)Intracranialpressure:-ByCushingreflex.
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5)Others:Bloodviscosity.21.Hepcidininhibits?
a)Absorptionofcobalamine
b)Transferofironintoenterocytes
c)Folicacidsynthesis
--- Content provided by FirstRanker.com ---
d)RespiratoryoxidaseCorrectAnswer-B
Ans.is'b'i.e.,Transferofironintoenterocytes
Hepcidinisanironmetabolismregulatoryhormonethatinhibitsiron
absorption(transferofironintoenterocytes).
--- Content provided by FirstRanker.com ---
Ascorbicacid(vitaminC)formssolublecomplexeswithironandreducesironfromtheferrictotheferrousstate,
therebyenhancingironabsorption.
Tannins,presentintea,forminsolublecomplexeswithiron
andloweritsabsorption.
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22.Whichofthefollowingtechniqueisused
tostudycurrentflowacrossasingleion
channel?
a)Patchclamp
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b)Voltageclampc)lontophoresis
d)Galvanometry
CorrectAnswer-A
Ans.a.Patch-clamp
--- Content provided by FirstRanker.com ---
Patch-clampisatechniquetorecordioncurrentflowthroughasingleproteinchannel.
Thepatch-clamptechniqueisalaboratorytechniquein
electrophysiology,thatallowsthestudyofsingleormultiple
ionschannelsincells.
--- Content provided by FirstRanker.com ---
Thetechniquecanbeappliedtoawidevarietyofcellsbutisespeciallyusefulinthestudyofexcitablecellssuchasneurons,
cardiomyocytes,musclefibers,andpancreaticbetacells.
Itcanalsobeappliedtothestudyofbacterialionchannels
especiallypreparedgiantspheroplasts.
--- Content provided by FirstRanker.com ---
Inthepatch-clampexperiment,asmallpipetteiscarefullymaneuveredtosealoffaportionofacellmembrane.Thepipette
hasanelectrodebathedinanappropriatesolutionthatallowsforthe
recordingofelectricalchangesthroughanyporeinthemembrane.
23.A4-year-oldboyofafirst-degree
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consanguineouscouplewasnotedbytheparentstohavedarkeningoftheurineto
analmostblackcolorwhenitwasleft
standing.Hehasanormalsibling,and
therearenoothermedicalproblems.
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Growthanddevelopmenttodatearenormal.Whichofthefollowingismost
likelytobeelevatedinthispatient?
a)Methylmalonate
b)Homogentisate
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c)Phenylpyruvated)-Ketoisovalerate
CorrectAnswer-B
Ans:B.Homogentisate.
*Alkaptonuriaisararemetabolicdiseaseinvolvingadeficiencyin
--- Content provided by FirstRanker.com ---
homogentisicacidoxidase,andthesubsequentaccumulationofhomogentisicacidintheurine,whichturnsdarkuponstanding.
*Theelevationof
methylmalonate(duetomethylmalonylCoAmutasedeficiency),
Phenylpyruvate(duetophenylalaninehydroxylasedeficiency),
--- Content provided by FirstRanker.com ---
-ketoisovalerate(duetobranched-chain-ketoaciddehydrogenasedeficiency),
Homocysteine(duetocystathionine-synthasedeficiency)
*Alloftheseareinconsistentwithahealthychildwithadarkeningof
theurine.
--- Content provided by FirstRanker.com ---
*Reflippincott'sIllustratedreviews,5thedition,AminoAcidDegradationandSynthesis,Pg276.
24.Whichofthefollowingistrueabout
differentstructuresofprotein?
a)Secondarystructureisthethree-dimensionalstructureof
--- Content provided by FirstRanker.com ---
proteinb)Secondarystructureisstabilizedbydisulfidebonds
c)Primary,secondaryandtertiarystructuresdestroyedduring
denaturation
d)Secondaryandtertiarystructuredependsonthesequenceof
--- Content provided by FirstRanker.com ---
aminoacidsCorrectAnswer-D
Ans:D.Secondaryandtertiarystructuredependsonthe
sequenceofaminoacids
Explanation
--- Content provided by FirstRanker.com ---
Proteinsarearrangedinanyofthefollowingfourstructuresviz:
*Primary
Thesequenceofaminoacidsinaproteiniscalledtheprimary
structureoftheprotein.chain
--- Content provided by FirstRanker.com ---
*Secondary-Thepolypeptidebackbonedoesnotassumearandomthree-
dimensionalstructure,butinsteadgenerallyformsregular
arrangementsofaminoacidsthatarelocatedneartoeachotherin
thelinearsequence.The-helix,-sheet,and-bend(-turn)are
--- Content provided by FirstRanker.com ---
examplesofsecondarystructuresfrequentlyencounteredinproteins.
*Tertiary
-Itreferstothethree-dimensionalarrangementofapolypeptide
chainthathasassumeditssecondarystructure.Disulfidebonds
--- Content provided by FirstRanker.com ---
betweencysteineresiduesmaystabilizethetertiarystructure.
Proteindenaturationresultsintheunfoldinganddisorganizationof
theprotein'ssecondaryandtertiarystructures,whicharenot
accompaniedbyhydrolysisofpeptidebonds
*Quaternary
--- Content provided by FirstRanker.com ---
-Thequaternarystructurerequiresmorethanonepolypeptidechain.Thesechainsassociatethroughnoncovalentinteractions.
Reflippincott'sIllustratedreviews,5thedition,Structureof
Protein,Pg13
25.Theinsulinglucagonratiodecreased.The
--- Content provided by FirstRanker.com ---
enzymeisactiveatthistime?a)Glucokinase
b)Hexokinase
c)Phosphofructokinase
d)Glucose6phosphatase
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAns.D.Glucose6phosphatase
Explanation
Lowinsulin:glucagonratio(IGR)stimulatesmobilizationofstored
nutrients,increasesglycogenolysisandgluconeogenesis,and
--- Content provided by FirstRanker.com ---
promotesthebreakdownofadiposetissueintofreefattyacidsandglycerol.
DecreasesInsulin/glucagonratioshowsthefastingstage.
Glucokinase,Hexokinase,andphosphofructokinaseareglycolytic.
Onlygluconeogenicisglucose6phosphatase.
--- Content provided by FirstRanker.com ---
Ref-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC480181426.Ochronosisisduetotheaccumulation
of?
a)Homogentisicacid
b)Homogentisicacid
--- Content provided by FirstRanker.com ---
c)Xanthurenated)Glyoxylate
CorrectAnswer-A
Ans:A.Homogentisicacid
Alkaptonuriaisanautosomalrecessiveconditionduetothe
--- Content provided by FirstRanker.com ---
deficiencyofhomogentisate1,2dioxidase.Thisresultsintheexcretionofhomogentisicacidinurine.iscompatiblewithafairly
normallife.
Theonlyabnormalityistheblackeningofurineonstanding.
Homogentisicacidisoxidizedbypolyphenoloxidaseto
--- Content provided by FirstRanker.com ---
benzoquinoneacetate.Itisthenpolymerizedtoblackcoloredalkaptonbodies.
Bythe3rdor4thdecadeoflife,thepatientmaydevelopochronosis
(depositionofalkaptonbodiesinintervertebraldiscs,cartilagesof
nose,pinnaoftheear).Blackpigmentsaredepositedoverthe
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connectivetissuesincludingjointcavitiestoproducearthritis.Nospecifictreatmentisrequired.Butminimalproteinintakewith
phenylalaninelessthan500mg/dayisrecommended.
Ref-DMVasudevan-Textbookofbiochemistryformedicalstudents,
6thedn,AromaticAminoAcids,andAminoAcidurias,pg208.
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27.Bilirubininserumcanbemeasuredby
a)VandenBerghreaction
b)Ehrlich'sReaction
c)Schlesinger'sReaction
d)Fouchet'sReaction
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.VandenBerghreaction
BilirubinismostcommonlydeterminedbythevandenBergh
reaction,inwhichdiazotizedsulfanilicacidreactswithbilirubinto
formredazodipyrroles
--- Content provided by FirstRanker.com ---
Thesearemeasuredcolorimetrically.Inaqueoussolution,thewater-soluble,conjugatedbilirubinreactsrapidlywiththereagent(within
oneminute),andissaidtobe"direct-reacting."Theunconjugated
bilirubin,whichismuchlesssolubleinaqueoussolution,reacts
moreslowly.
--- Content provided by FirstRanker.com ---
However,whenthereactioniscarriedoutinmethanol,bothconjugatedandunconjugatedbilirubinaresolubleandreactwiththe
reagent,providingthetotalbilirubinvalue.The"indirect-reacting"
bilirubin,whichcorrespondstotheunconjugatedbilirubin,is
obtainedbysubtractingthedirect-reactingbilirubinfromthetotal
--- Content provided by FirstRanker.com ---
bilirubinNote:Innormalplasma,onlyabout4%ofthetotalbilirubinis
conjugatedordirect-reacting,becausemostaresecretedintobile.
Ref-Lippincott'sIllustratedreviews,5thedition,Conversionofamino
acidsinspecializedproducts,Pg285.
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28.IfasampleofDNAifadenineis28%what
willbetheamountofCytosinepresent
a)23%
b)25%
c)46%
--- Content provided by FirstRanker.com ---
d)22%CorrectAnswer-D
Ans:D.22%
ThebasesofonestrandofDNAarepairedwiththebasesofthe
secondstrandsothatadenineisalwayspairedwiththymineand
--- Content provided by FirstRanker.com ---
cytosineisalwayspairedwithguanine.Therefore,onepolynucleotidechainoftheDNAdoublehelixisalwaysthe
complementoftheother.Giventhesequenceofbasesonone
chain,thesequenceofbasesonthecomplementarychaincanbe
determined.
--- Content provided by FirstRanker.com ---
Note:ThespecificbasepairinginDNAleadstotheChargaffRule:InanysampleofdsDNA,theamountofadenineequalstheamount
ofthymine,theamountofguanineequalstheamountofcytosine,
andthetotalamountofpurinesequalsthetotalamountof
pyrimidines.
--- Content provided by FirstRanker.com ---
Thebasepairsareheldtogetherbyhydrogenbonds:twobetweenAandTandthreebetweenGandC(Figure29.5).Thesehydrogen
bonds,plusthehydrophobicinteractionsbetweenthestacked
bases,stabilizethestructureofthedoublehelix.
Ref-lippincott'sIllustratedreviews,5thedition,thestructureofDNA,
--- Content provided by FirstRanker.com ---
pg39729.Whichofthefollowingvitaminathigher
dosescausescystoidmacularedema-
a)VitA
b)VitD
--- Content provided by FirstRanker.com ---
c)VitEd)Niacin
CorrectAnswer-D
Ans:D.Niacin
Cystoidmacularedema(CME)isaconditionthatinvolvesthe
--- Content provided by FirstRanker.com ---
macula,causingpainlessvisionloss.Niacin(nicotinicacid,vitaminB3,vitaminPP),onecomponentofthe
dietarysupplementtakenbythepatient,isavitaminpreparation
usuallyusedforthetreatmentoflipiddisorders
Fraunfelderetal.reportedthat3gormoreperdayofnicotinicacid
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couldcausemanyocularsideeffectssuchasblurredvision,eyelidedema,toxicamblyopia,proptosis,lossofeyelashesoreyebrow,
superficialpunctatekeratitis,andcystoidmacularedema,which
representsthemostseriousocularcomplications.Alltheseadverse
effectsarereversiblewithdiscontinuationofniacintherapy
--- Content provided by FirstRanker.com ---
Ref-CaseReportsinOphthalmologicalMedicine,Volume2013,ArticleID713061,5page
30.TruestatementregardingHuntington's
choreais
a)Thereisalossoffunctiontypeofmutation
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b)Itisanautosomalrecessivec)Itisatrinucleotiderepeatexpansiontypeofdisorder
d)IncreasednumberofCAArepeats
CorrectAnswer-C
Ans:C.Itisatrinucleotiderepeatexpansiontypeofdisorder
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Huntington'schoreaisanautosomaldominantdisorderwithanincreasednumberofCAGrepeats.Clinicallymanifestedas
involuntaryjerkymovements,mooddisturbancesandfinallysevere
dementia.
Ref-Langebiochemistryandgeneticsflashcards,Huntington's
--- Content provided by FirstRanker.com ---
disease,pg16131.AdditionofwhichAminoAcidwill
increaseUVabsorption
a)Tryptophan
b)Leucine
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c)Prolined)Arginine
CorrectAnswer-A
Ans:A.Tryptophan
AminoAcidAbsorbUVLight
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AminoAcidsthatabsorb250-290nm(Maximumat280nm)UVlightaretryptophan,phenylalanine,tyrosine.
ThemaximumabsorptionofUVlightisbytryptophan.
Asitabsorbsultravioletlightabouttentimesmoreefficientlythan
phenylalanineortyrosine,tryptophanmakesthemajorcontribution
--- Content provided by FirstRanker.com ---
totheabilityofmostproteinstoabsorblightintheregionof280nm.TryptophanandtyrosineabsorbUVatapproximately280nrn.
UVabsorptionspectroscopyisutilizedtomeasureprotein
concentration.TheabsorptionspectrumofaproteinintheUV
wavelengthrangeistheresultofabsorptionoflightbythearomatic
--- Content provided by FirstRanker.com ---
aminoacids(250-320nm),thedisulfidebonds(250-300nm)andthecarbonylgroupofthepeptidebond(190-210).
Remember
AromaticAminoAcidsabsorbUVLights
Aminoacidsarecolourlessbecausetheydonotabsorbvisible
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light.Ref-Rebeccajames-selfassessmentandreviewofbiochemistry,
3rdedn,Chemistry,andMetabolismofAminoAcids,Pg7
32.V-RichestsourceofvitaminB12?
a)Meat
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b)Greenleafyvegetablesc)Cornoil
d)Sunfloweroil
CorrectAnswer-A
Ans:A.Meat
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*VitaminB12isnaturallyfoundinanimalproducts,includingfish,meat,poultry,eggs,milk,andmilkproducts.
*Synonymsarecobalamin,extrinsicfactor(EF)ofCastleandanti
perniciousanemiafactor.VitaminB12iswater-soluble,heatstable
andredincolor.Itissatisfiedbyanyofthefollowinggroups:
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cyanide,hydroxyl,adenosylormethyl.*Cyanocobalamin-Oralpreparationsareinthisform.
*Hydroxycobalamin-Injectablepreparationsareinthisform.
*Adenosylcobalamin-Thisisthemajorstorageform,seeninthe
liver.
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*Methylcobalamin-Thisisthemajorformseeninbloodcirculationaswellasinthecytoplasmofcells.
*VitaminB12isgenerallynotpresentinplantfoods,butfortified
breakfastcerealsareareadilyavailablesourceofvitaminB12with
highbioavailabilityforvegetarians.
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*RichsourceofvitaminB12-Beef,liver,andchicken.
-Fishandshellfishsuchastrout,salmon,tunafish,andclams.
-Fortifiedbreakfastcereal.
-Low-fatmilk,yogurt,andcheese.
--- Content provided by FirstRanker.com ---
-Eggs.Ref-DMVasudevan-Textbookofbiochemistryformedical
students,6thedn,Nutrition,pg404.
33.Whichaminoacidisusedtosynthesize
Nitricoxide?
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a)Glycineb)Arginine
c)Tyrosine
d)Threonine
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:B.ArginineNitricoxideisformedfromargininebytheenzymenitricoxide
synthase(NOS).Itcontainsheme,FAD,FMN,NADPH,and
tetrahydrobiopterin.
Nitricoxidehasaveryshorthalf-life(3-4seconds).NOcombines
--- Content provided by FirstRanker.com ---
withoxygentoformNO2.Thesenitritesareexcretedthroughurine.Reactingwithhemoglobin,NOisconvertedtoNO3;andnitratesare
alsoexcretedintheurine.TheverylowquantityofNOisexpelled
throughthelung.
Arginineisahighlybasic,semi-essentialaminoacid.Itisglucogenic
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innature.34.TrueAboutNoncompetitiveantagonist-
a)Kmremainssame,Vmaxdecreases
b)Kmremainssame,Vmaxdecreases
c)Kmdecreases,Vmaxincreases
--- Content provided by FirstRanker.com ---
d)Kmincreases,VmaxincreasesCorrectAnswer-A
Ans:A.Kmremainssame,Vmaxdecreases
Noncompetitiveinhibitionoccurswhentheinhibitorandsubstrate
bindatdifferentsitesontheenzyme.Thenoncompetitiveinhibitor
--- Content provided by FirstRanker.com ---
canbindeitherthefreeenzymeortheEScomplex,therebypreventingthereactionfromoccurring.
EffectonVmax:Noncompetitiveinhibitioncannotbeovercomeby
increasingtheconcentrationofthesubstrate.Thus,noncompetitive
inhibitorsdecreasetheapparentVmaxofthereaction.
--- Content provided by FirstRanker.com ---
EffectonKm:Noncompetitiveinhibitorsdonotinterferewiththebindingofsubstratetoenzyme.Thus,theenzymeshowsthesame
Kminthepresenceorabsenceofthenon-competitiveinhibitor.
EffectonLineweaver-Burkplot:Noncompetitiveinhibitionisreadily
differentiatedfromcompetitiveinhibitionbyplotting1/voversus1/[S]
--- Content provided by FirstRanker.com ---
andnotingthattheapparentVmaxdecreasesinthepresenceofanon-competitiveinhibitor,whereasKmisunchanged
Ref-lippincott'sIllustratedreviews,5thedition,InhibitionofEnzyme
Activity,pg61.
35.Wernersyndromeassociatedwith
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prematureagingiscausedduetoadefectinwhichofthefollowing?
a)Telomerase
b)Caspase
c)DNAtopoisomerase
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d)DNAhelicaseCorrectAnswer-D
Ans:D.DNAhelicase
Wernersyndromeisahumanautosomalrecessivedisorderthat
displayssymptomsofprematureaging,includingearlygrayingand
--- Content provided by FirstRanker.com ---
thinningofhair,wrinklingandulcerationofskin,atherosclerosis,osteoporosis,andcataracts.
Inaddition,Wernersyndromepatientsexhibitanincreased
incidenceofdiabetesmellitustype2,hypertension,andarehighly
disposedtotheemergenceofbenignandmalignantneoplasms.
--- Content provided by FirstRanker.com ---
WernersyndromecausedbymutationoftheWRNgene,amemberoftheRecQDNAhelicasefamily.
Ref-https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3237395/
36.Whichofthefollowingdietaryfiberis
insolubleinwater?
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a)Pectinb)Lignin
c)Hemicellulose
d)Cellulose
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:B.LigninTheunavailableorindigestiblecarbohydratesinthedietarecalled
dietaryfiber.
Dietaryfiberisnecessarytomaintainthenormalmotilityofthe
gastrointestinaltract.Theyarechiefly-
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Cellulose-Retainswaterinfeces,promotesperistalsis,increasesbowelaction
Lignin-Antioxidant,increasesbileacidexcretion,
hypocholesterolemic.
Pectins-PartiallyAbsorbwater,slowsesterifiedgastricemptying,
--- Content provided by FirstRanker.com ---
bindsbileacids,increasestheirexcretionHemi-cellulose-Retainswaterinfeces,cellulose,increasesbileacid
anduronicacidexcretion.
Ref-DMVasudevan-Textbookofbiochemistryformedical
students,6thedn,EnergyMetabolismandNutrition.Pg435.
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37.AccordingtoNCEP-ATPIII,whichamong
thefollowinghavenotbeenincludedin
metabolicsyndrome?
a)HighLDL
b)Hypertriglyceridemia
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c)CentralObesityd)Hypertension
CorrectAnswer-A
Answer-A.HighLDL
Metabolicsyndromereferstotheco-occurrenceofseveralknown
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cardiovascularriskfactors,includinginsulinresistance,obesity,atherogenicdyslipidemia,andhypertension.Theseconditionsare
interrelatedandshareunderlyingmediators,mechanisms,and
pathways.
CriteriafortheDiagnosisofMetabolicSyndrome
--- Content provided by FirstRanker.com ---
Elevatedwaistcircumference:(Formen>90cmandforwomen,>80cm).
Elevatedtriglycerides:>150mg/dL
ReducedHDL("good")cholesterol:Formen,<40mg/dL;forwomen,
<50mg/dL
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Elevatedbloodpressure:>130/85mmHgElevatedfastingglucose:>100mg/dL
Insulinresistance(hyperinsulinemia)
Additionalparametersinclude:coagulationabnormalities,
hyperuricemia,microalbuminurianon-alcoholicsteatohepatitis
--- Content provided by FirstRanker.com ---
(NASH)andincreasedCRP.Diagnosisismade,ifany3outofthe5criteriagivenabove.
Ref-DMVasudevan-Textbookofbiochemistryformedical
students,6thedn,Clinical,andAppliedBiochemistry,pg286
38.Whichofthefollowingisthebasisforthe
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intestine-specificexpressionofapoproteinB-48?
a)DNArearrangementandloss
b)DNArearrangementandloss
c)RNAalternativesplicing
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d)RNAeditingCorrectAnswer-D
Ans:D.RNAediting.
TheproductionofapoB-48intheintestineandapoB-100inliveris
theresultofRNAeditingintheintestine,whereasensecodonis
--- Content provided by FirstRanker.com ---
changedtoanonsensecodonbypost-transcriptionaldeaminationofCtoU.DNArearrangementandtransposition,aswellasRNA
interferenceandalternatesplicing,doaltergeneexpression,butare
notthebasisofapoB-48tissue-specificproduction.
Reference-Lippincott'sIllustratedReviews:Biochemistry,5th
--- Content provided by FirstRanker.com ---
edition,RegulationofGeneExpression,Pg464.39.A30-year-oldmalecamewithcomplaints
ofswellingaroundthekneejoint.
Histopathologicalexaminationofthe
swellingdemonstratedmanygiantcells
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interspersedwithmononuclearcells.Whatistheprobablediagnosis
a)Osteosarcoma
b)Ewing'ssarcoma
c)Giantcelltumour
--- Content provided by FirstRanker.com ---
d)ChondrosarcomaCorrectAnswer-C
Correctans:C
GCTsarelargeandred-brownandoftenshowcysticdegeneration.
Theyarecomposedofuniformovalmononuclearcellsandscattered
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osteoclast-typegiantcellscontaining100ormorenuclei.Mitoticfiguresaretypicallyfrequent.
Necrosis,hemorrhage,andreactiveboneformationalsoare
commonlypresent.
RefRobbin'sbasicsofpathology9theditionpageno.781
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40.30yearsoldcamewithcomplaintsofeasy
fatigability,exertionaldyspnea,and
weightloss.Shealsocomplainsof
frequentfalls.physicalexamination
revealedtherewasabilateraldecreasein
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vibrationsense.Herhemoglobinlevelswere8.2g%.Shewastreatedwithfolate.
Heranemiaimprovedbutneurological
symptomsworsened.Whichofthe
followingisthemostprobablereasonfor
--- Content provided by FirstRanker.com ---
hercondition?a)Folatenotabsorbed
b)Unmaskedpyridoxinedeficiency
c)DeficiencyoffolatereductaseinCNS
d)FolatetherapycausedrapiduseofVitB12storesaggravating
--- Content provided by FirstRanker.com ---
symptomsCorrectAnswer-D
Ans:D.FolatetherapycausedrapiduseofVitB12stores
aggravatingsymptoms
VitaminB12isrequiredfortherecyclingoftetrahydrofolate,theform
--- Content provided by FirstRanker.com ---
offolatethatisneededforDNAsynthesis.Inkeepingwiththisrelationship,theanemiaofvitaminB12
deficiencyisreversedwiththeadministrationoffolate.Bycontrast,
folateadministrationdoesnotpreventandmay,infact,worsenthe
neurologicsymptoms
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41.A45-year-oldmanwhoisachronic
smokercametotheclinicwitha
complaintofcough.Thephysician
examinesthepatientandtakesabiopsy,
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thepictureinthebiopsywasasthedescriptionbelow.Whichofthefollowing
cellularchangeshashappenedtothis
patient?
a)Hyperplasia
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b)Dysplasiac)Metaplasia
d)CIN3
CorrectAnswer-B
Ans:C.Metaplasia
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Metaplasiaisareversiblechangeinwhichoneadultcelltype(epithelialormesenchymal)isreplacedbyanotheradultcelltype.
(epithelialormesenchymal)isreplacedbyanotheradultcelltype.
squamousmetaplasiaoftherespiratoryepitheliumoftencoexists
withlungcancerscomposedofmalignantsquamouscells.
--- Content provided by FirstRanker.com ---
cigarettesmokinginitiallycausessquamousmetaplasia,Ref:Robbin'sbasicsofpathology9theditionpageno.5
42.A30-year-oldwomanpresentswith
thyroidswelling.Oninvestigations,her
TSHlevelsarefoundtobeelevated.
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Postoperativereportsshowedlymphocyticinfiltrationandhurthlecells.
Amostprobablediagnosisis?
a)Gravesdisease
b)Hashimoto'sthyroiditis
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c)Follicularcarcinomad)Medullarycarcinomathyroid
CorrectAnswer-B
Ans:B.Hashimoto'sthyroiditis
Hashimotothyroiditisisthemostcommoncauseofhypothyroidism
--- Content provided by FirstRanker.com ---
whichischaracterizedbygradualthyroidfailuresecondarytotheautoimmunedestructionofthethyroidgland.
Itismostprevalentbetweentheagesof45and65yearsandis
morecommoninwomenthaninmen,ultimatelyleadingtoavarying
degreeoffibrosisandthyroidenlargement.
--- Content provided by FirstRanker.com ---
ThethyroidusuallyisdiffuselyandsymmetricallyenlargedThecutsurfaceispaleandgray-taninappearance,andthetissueisfirm
andsomewhatfriable.
Microscopicexaminationrevealsthewidespreadinfiltrationofthe
parenchymabyamononuclearinflammatoryinfiltratecontaining
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smalllymphocytes,plasmacells,andwell-developedgerminalcenters.
Thethyroidfolliclesareatrophicandarelinedinmanyareasby
epithelialcellsdistinguishedbythepresenceofabundant
eosinophilic,granularcytoplasm,termedHurthle,oroxyphilcells.
--- Content provided by FirstRanker.com ---
43.Whichofthefollowingwillbeseenon
cardiacbiopsyofapatientwhohadapost
MIreperfusioninjury?
a)Wavinessoffibres
b)Eosinophiliccontractionbands
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c)Neutrophilsincardiaccellsd)Swellingofcells
CorrectAnswer-B
Ans:B.Eosinophiliccontractionbands
Microscopically,irreversiblydamagedmyocytessubjectto
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reperfusionshowcontractionbandnecrosis;Inthispathologicprocess,intenseeosinophilicbandsof
hypercontractedsarcomeresarecreatedbyaninfluxofcalcium
acrossplasmamembranesthatenhancesactin-myosin
interactions.
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44.Lossoffootprocessisclassicalincase
of?
a)Membranousglomerulitis
b)Segmentalglomerulosclerosis
c)IgAnephropathy
--- Content provided by FirstRanker.com ---
d)DiabeticnephropathyCorrectAnswer-B
Ans:B.Segmentalglomerulosclerosis
Focalsegmentalglomerulosclerosis(FSGS)ischaracterizedby
sclerosis,hyalinosis,adhesions/synechiaeformation,resultingin
--- Content provided by FirstRanker.com ---
segmentalobliterationofglomerularcapillaries.OnEM,footprocesseffacementisthepredominantfindingwithoutsignificantbasement
membraneabnormalities.Immunofluorescenceshowsstainingfor
IgMandC3inscleroticareas.Juxtamedullarynephronsareaffected
firstandhenceinadequatesamplingmaymissfocallesions.
--- Content provided by FirstRanker.com ---
https://www.ncbi.nlm.nih.gov/books/NBK532272/45.Whichofthefollowingfactorsplaya
majorroleintheinitiationofthrombus
formation?
a)Vasoconstriction
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b)Coagulationcascadeactivationc)Plateletsactivation
d)Endothelialinjury
CorrectAnswer-D
Ans:D.Endothelialinjury
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Thethreeprimaryabnormalitiesthatleadtothrombusformation(calledVirchow'striad)are
(1)endothelialinjury,
(2)stasisorturbulentbloodflow,and
(3)hypercoagulabilityoftheblood.
--- Content provided by FirstRanker.com ---
Ref:robbins9theditionchapter446.A33-year-oldmanpresentswitha5-week
historyofcalfpain,swelling,andlow-
gradefever.Serumlevelsofcreatinine
kinaseareelevated.Amusclebiopsy
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revealsnumerouseosinophilsalsoshehadperipheralbloodeosinophilia.Which
ofthefollowinginterleukinsisprimarily
responsiblefortheincreasein
eosinophilsinthispatient?
--- Content provided by FirstRanker.com ---
a)IL2b)IL4
c)IL1
d)IL6
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:B.IL447.WhichofthefollowingistrueaboutPAN?
a)Microscopyshowsfibrinoidnecrosisinlargearteries
b)ANCAispositive
c)30%ofpeoplehaveHbsAgpositive
--- Content provided by FirstRanker.com ---
d)PatienthavehypogammaglobulinemiaCorrectAnswer-C
Ans:C.30%ofpeoplehaveHbsAgpositive
Polyarteritisnodosa(PAN)isanecrotizingvasculitisinvolvingsmall
andmedium-sizedmusculararteriesofmultipleorgansandtissues.
--- Content provided by FirstRanker.com ---
Thediseaseoccursmorecommonlyinadultmalesthanfemales.Mostcommonlyaffectedorgans,indescendingorderoffrequencyof
involvement,arethekidneys,heart,gastrointestinaltract,kidneys,
andmuscle.
Theconditionresultsfromimmunologicresponsetoanidentifiable
--- Content provided by FirstRanker.com ---
antigenthatmaybebacteria(e.g.streptococci,staphylococci,mycobacteria),viruses(e.g.hepatitisBvirus,influenzavirus,CMV),
malarialparasite,certaindrugs,andchemicals.
ThereisnoassociationwithANCA,[7]butabout30%ofpeoplewith
PANhavechronichepatitisBanddepositscontainingHBsAg-
--- Content provided by FirstRanker.com ---
HBsAbcomplexesinaffectedbloodvessels,indicatinganimmunecomplex-mediatedcauseinthatsubset.InfectionwiththeHepatitis
CvirusandHIVareoccasionallydiscoveredinpeopleaffectedby
PAN.
Leukocytoclasticvasculitis,characterizedbyfibrinoidnecrosiswith
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neutrophilicinfiltrateinthevesselwall.Manyoftheneutrophilsarefragmented.Thisformisfoundinvasculitiscausedbydepositsof
immunecomplexes.
48.A23-year-oldmalepresentedwitha
historyoffatigueandtiredness.On
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investigation,hewasfoundtohaveHbvaluesof9gm%,MCVof101FL.
peripheralsmearexaminationshowed
microcyticRBCandhypersegmented
neutrophils.Whichismostprobable
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etiologya)Leadpoisoning
b)Irondeficiencyanemia
c)Chronicalcoholism
d)Hemolyticanemia
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Leadpoisoning
Findings
MicrocyticAnemia-IronDeficiency
HypersegmentedNeutrophils-B12andFolicAcidDeficiency
--- Content provided by FirstRanker.com ---
Young&NoH/oOfAlcoholConsumption[PatientcamewithahistoryofFatigueandTiredness]-ChronicAlcoholismcanberuled
out
HemolyticAnemia-maydemonstrateredbloodcellfragments
calledschistocytes,redbloodcellsthatlooklikespheres
--- Content provided by FirstRanker.com ---
(spherocytes),and/orredbloodcellsmissingsmallpieces(bitecells).Anincreasednumberofnewlymaderedbloodcells
(reticulocytes)mayalsobeasignofbonemarrowcompensationfor
anemia.
anemia.
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SoMostProbableAnswerwouldbeLeadPoisoning[Tiredness&Fatigue]
49.Whatisthemainfeatureofchemotaxisas
observedinwhitebloodcells?
a)Increasedrandommovementofneutrophils
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b)Increasedadhesivenesstointimac)Increasedphagocytosis
d)Unidirectionallocomotionofneutrophils
CorrectAnswer-D
Ans:D.Unidirectionallocomotionofneutrophils
--- Content provided by FirstRanker.com ---
Chemotaxisisdefinedasaunidirectionalmovementofleukocytesuptoaconcentrationgradientofchemotacticmolecules.All
granulocytes,monocytesandtoalesserextentlymphocytes
respondtochemotacticstimuliwithvaryingratesofspeed.
Chemoattractantsareexogenousorendogenous.Exogenous
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agentsarebacterialproducts.Endogenousmediatorsare:ComponentsofcomplementpathwayC5a
ProductsoflipoxygenasepathwayLTB4
Cytokinesparticularlythoseofchemokinefamilies.
50.Whichofthefollowinganticancerdrugs
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arecompetitiveinhibitorsoftyrosinekinase?
a)Imatinibandsunitinib
b)Letrozole
c)Bicalutamide
--- Content provided by FirstRanker.com ---
d)FulvestrantCorrectAnswer-A
Ans.is'a'i.e.,Imatinibandsunitinib
Moleculartargetedagents
Tyrosinekinaseinhibitors
--- Content provided by FirstRanker.com ---
CompetitiveinhibitorsImatinib,Nilotinib,Sunitinib,Dasatinib,Erlotinib,Gefitinib,Lapatinib,Sorafenib(Rememberallendwith
'nib').
MonoclonalantibodiesCetuximab,panitumumab.
HER2/neu(ERBB2)inhibitorsMonoclonalantibody-Trastuzumab.
--- Content provided by FirstRanker.com ---
TargetedantibodyGemtuzumab(antiCD-33),Rituximab(anti-CD20),Alemtuzumab(antiCD-52).
Vascularendothelialgrowthfactor(VEGF)inhibitorMonoclonal
antibody-Bevacizumab.
ProteosomeinhibitorsBortezomib.
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HistonedeacetylaseinhibitorVorinostatDNA-methyltransferaseinhibitor5-azacytidine,2-deoxy-5
azacytidine.
All-trans-retinoicacid.
Biologicalresponsemodifier-RecombinantIL-2(aldesleukin,
--- Content provided by FirstRanker.com ---
denileukin).51.Whichisnotaprokineticagent?
a)Dopamineantagonist
b)5HT4agonist
c)Macrolides
--- Content provided by FirstRanker.com ---
d)DiphenylmethaneCorrectAnswer-D
Ans:D.Diphenylmethane
Prokineticdrugs:
Thesearedrugsthatpromotegastrointestinaltransitandspeed
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gastricemptyingbyenhancingcoordinatedpropulsivemotility.Thisexcludestraditionalcholinomimeticsandanti-ChEswhich
producetonicandlargelyuncoordinatedcontraction.
Drugsincluded:
Metoclopramide,
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Domperidone,Cisapride,
Mosapride,
Itopride
Ref:K.D.Tripathi7thEdition.Page663-665
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52.Whichofthefollowingdrugsactby
inhibitingDNAreplication?
a)6Mercaptopurine
b)ActinomycinD
c)MitomycinC
--- Content provided by FirstRanker.com ---
d)AsparaginaseCorrectAnswer-A
Ans:A.6Mercaptopurine
6-MercaptopurineactsbyinhibitingDNAreplication.
Antimetabolites:
--- Content provided by FirstRanker.com ---
TheseareanaloguesrelatedtothenormalcomponentsofDNAorofcoenzymesinvolvedinthenucleicacidsynthesis.
Theycompetitivelyinhibittheutilizationofthenormalsubstrateor
getthemselvesincorporatedformingdysfunctionalmacromolecules.
Includes:
--- Content provided by FirstRanker.com ---
Folateantagonist-Methotrexate(Mtx)Purineantagonist-6-Mercaptopurine(6-MP)
Pyrimidineantagonist-5-Fluorouracil(5-FU)
Purineantagonists
Mercaptopurine(6-MP)andthioguanine(6-TG).
--- Content provided by FirstRanker.com ---
Thesearehighlyeffectiveantineoplasticdrugs.Aftersynthesisinthebodytothecorrespondingmono
ribonucleotides,theyinhibittheconversionofinosine
monophosphatetoadenineandguaninenucleotidesthatarethe
buildingblocksforRNAandDNA.
--- Content provided by FirstRanker.com ---
Thereisalsofeedbackinhibitionofdenovopurinesynthesis.TheyalsogetincorporatedintoRNAandDNAwhichare
dysfunctional.
Ref:K.D.Tripathi7thEdition.Page.858,862?863
53.DOCforOnychomycosis?
--- Content provided by FirstRanker.com ---
a)Terbinafineb)Fluconazole
c)Nystatin
d)Itraconazole
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.TerbinafineOnychomycosis(afungalinfectionofthenail,usuallycausedbya
dermatophyte).
Onychomycosisismoredifficulttotreatthanmostdermatophytosis
becauseoftheinherentslowgrowthofthenail.
--- Content provided by FirstRanker.com ---
Olderantifungalagents(ketoconazoleandgriseofulvin)areunsuitableforonychomycosisbecauseoftheirrelativelypoor
efficacyandpotentialadverseeffects.
Threerecentlydevelopedantimycoticagents(fluconazole,
itraconazole,andterbinafine)offerhighcureratesandgoodsafety
--- Content provided by FirstRanker.com ---
profiles.Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88888/
54.Theophyllinebywhatmechanismcauses
diuresis?
a)PDE3inhibition
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b)PDE4inhibitionc)Beta2agonistaction
d)AdenosineA1receptorantagonism
CorrectAnswer-D
Ans:D.AdenosineA1receptorantagonism
--- Content provided by FirstRanker.com ---
Themildlydiureticactionsofbothmethylxanthinesaremainlytheresultofinhibitionoftubularfluidreabsorptionalongtherenal
proximaltubule.
Basedupontheuseofspecificadenosinereceptorantagonistsand
theobservationofacompletelossofdiuresisinmicewithtargeted
--- Content provided by FirstRanker.com ---
deletionoftheA1ARgene,transportinhibitionbymethylxanthinesismediatedmainlybyantagonismofadenosineA1receptors(A1AR)
intheproximaltubule.
Methylxanthinesareweakrenalvasodilators,andtheyactas
competitiveantagonistsagainstadenosine-inducedpreglomerular
--- Content provided by FirstRanker.com ---
vasoconstriction.Caffeineandtheophyllinestimulatethesecretionofreninby
inhibitionofadenosinereceptorsandremovalofthegeneral
inhibitorybrakefunctionofendogenousadenosine.
Sinceenhancedintrarenaladenosinelevelsleadtoreduced
--- Content provided by FirstRanker.com ---
glomerularfiltrationrateinseveralpathologicalconditionstheophyllinehasbeentestedforitstherapeuticpotentialintherenal
impairmentfollowingtheadministrationofnephrotoxicsubstances
suchasradiocontrastmedia,cisplatin,calcineurininhibitorsor
followingischemia-reperfusioninjury.
--- Content provided by FirstRanker.com ---
Ref:https://www.ncbi.nlm.nih.gov/pubmed/20859805
55.Whichofthefollowingantimicrobials
shouldnotbegiventoachronic
asthmaticpatientmanagedon
theophyllinetherapy?
--- Content provided by FirstRanker.com ---
a)Erythromycinb)Amoxicillin
c)Cefotaxime
d)Cotrimoxazole
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.ErythromycinDrugswhichinhibittheophyllinemetabolismandincreaseitsplasma
levelareErythromycin,Ciprofloxacin,Cimetidine,Oral
contraceptives,Allopurinol;
Thedoseshouldbereducedto2/3.
--- Content provided by FirstRanker.com ---
Ref:K.D.Tripathi7thEdition.Page.226-22756.DOCofprophylaxisformotionsickness?
a)Promethazine
b)Prochlorperazine
c)Metoclopramide
--- Content provided by FirstRanker.com ---
d)ItoprideCorrectAnswer-A
Ans:A.Promethazine
Motionsickness:
Antiemeticswiththeanticholinergic-antihistaminepropertyarethe
--- Content provided by FirstRanker.com ---
firstchoicedrugsformotionsickness.Antidopaminergicandanti-HT3drugsarelesseffective.
Allanti-motionsicknessdrugsactbetterwhentaken?1hour
beforecommencingthejourney.
Oncesicknesshasstarted,itismoredifficulttocontrol;higher
--- Content provided by FirstRanker.com ---
doses/parenteraladministrationmaybeneeded.DrugsIncluded:
Promethazine,diphenhydramine,dimenhydrinate:
Thesedrugsaffordprotectionofmotionsicknessfor4?6hours.
Promethazinetheoclate:
--- Content provided by FirstRanker.com ---
Thissaltofpromethazinehasbeenspeciallypromotedasanantiemetic,buttheactiondoesnotappeartobesignificantly
differentfrompromethazineHCl.
57.Whichofthefollowingantihypertensive
drugisavoidedinpatientswithhigh
--- Content provided by FirstRanker.com ---
serumuricacidlevels?a)Hydrochlorothiazide
b)Enalapril
c)Prazosin
d)Atenolol
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Hydrochlorothiazide
Long-termuseofhigherdosethiazidesinhypertensionhascaused
ariseinblooduratelevels.
Ref:K.D.Tripathi7thEdition.Page.585
--- Content provided by FirstRanker.com ---
58.Mechanismofresistancetopenicillinsvia
beta-lactamaseis
a)Alteredpenicillin-bindingproteins
b)Drugefflux
c)Breaksdrugstructure
--- Content provided by FirstRanker.com ---
d)Alterationin50SribosomestructureCorrectAnswer-C
Ans:C.Breaksdrugstructure
-lactamasesareproducedbystaphylococci,Haemophilus,
gonococci,etc.whichinactivatepenicillinG.
--- Content provided by FirstRanker.com ---
The-lactamasesmaybepresentinlowquantitybutstrategicallylocatedperiplasmically(asingram-negativebacteria)sothatthe
drugisinactivatedsoonafterentry,ormaybeelaboratedinlarge
quantities(bygram-positivebacteria)todiffuseintothemediumand
destroythedrugbeforeentry.
--- Content provided by FirstRanker.com ---
Beta-lactamantibioticssharethestructuralfeatureofabeta-lactamring.
Thisfeatureisresponsiblefortheinhibitionofbacterialcellwall
synthesis.
Thetargetmoleculesarepeptidoglycancross-linkingenzymes(e.g.
--- Content provided by FirstRanker.com ---
transpeptidasesandcarboxypeptidases)whichcanbindbeta-lactamantibiotics(penicillin-bindingproteins,PBP).
Bacterialcelldeathisinitiatedbybeta-lactamantibiotic-triggered
releaseofautolyticenzymes.
Incontrasttogram-positivebacteria(absenceofanouter
--- Content provided by FirstRanker.com ---
membrane),theantibiotichastopenetratethroughporinsoftheoutermembraneofgram-negativebacteriabeforetouchingPBP's.
Bacterialresistancetobeta-lactamantibioticsincludesmodification
ofporins(permeabilitybarrier)andoftargets(lowaffinityofPBP's
forthedrug),productionofinactivatingenzymes(beta-lactamases)
--- Content provided by FirstRanker.com ---
andinhibitionofreleaseofautolyticenzymes.Ref:K.D.Tripathi7thEdition.Page.717?720
ncbi.nlm.nih.gov/pubmed/8314292
59.Apatientonlithiumtherapydeveloped
hypertension.HewasstartedonThiazide
--- Content provided by FirstRanker.com ---
forhypertension.Afterafewdays,hedevelopedcoarsetremorsandother
symptomssuggestiveoflithiumtoxicity.
Whatistheprobablemechanismof
interaction?
--- Content provided by FirstRanker.com ---
a)Thiazideincreasesthetubularreabsorptionoflithiumb)Thiazideinhibitsthemetabolismoflithium
c)Thiazidesactasanaddonthedrugtolithium
d)Alloftheabove
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.ThiazideincreasesthetubularabsorptionoflithiumDrugInteraction:
Diuretics+Lithium=Decreasedexcretion--riseinLi+level-
toxicity;
Diuretics(thiazide,furosemide)bycausingNa+losstopromote
--- Content provided by FirstRanker.com ---
proximaltubularreabsorptionofNa+aswellasLi+plasmalevelsoflithiumrise.Potassium-sparingdiureticscausemilderLi+
retention.
Management:Reducedoseoflithiumandmonitorlevel.
Ref:K.D.Tripathi7thEdition.Page.449,932
--- Content provided by FirstRanker.com ---
60.Whichdrugactsviathetyrosinekinase
receptor?
a)Insulin
b)TSH
c)LH
--- Content provided by FirstRanker.com ---
d)MSHCorrectAnswer-A
Ans:A.Insulin
Insulinactsonspecificreceptorslocatedonthecellmembraneof
practicallyeverycell,buttheirdensitydependsonthecelltype:liver
--- Content provided by FirstRanker.com ---
andfatcellsareveryrich.Theinsulinreceptorisareceptortyrosinekinase(RTK)whichisa
heterotetramericglycoproteinconsistingof2extracellularand2
transmembranesubunitslinkedtogetherbydisulfidebonds.
Ref:K.D.Tripathi7thEdition.Page.261
--- Content provided by FirstRanker.com ---
61.Pegloticaseisusedforthetreatmentofan
Ankylosingspondylosis
a)ReactiveArthritis
b)CPPD
--- Content provided by FirstRanker.com ---
c)Chronictophaceousgoutd)RefractoryRheumatoidarthritis
CorrectAnswer-C
Ans:C.Chronictophaceousgout
Pegloticase:
--- Content provided by FirstRanker.com ---
Pegloticaseisamedicationforthetreatmentofthesevere,treatmentofrefractorychronicgout.
Itisathird-linetreatmentinthoseinwhomothertreatmentsarenot
tolerated.
RefGoutandothercrystalarthropathiesbyRobertTerkettaud]
--- Content provided by FirstRanker.com ---
62.Fluoroquinolonecontraindicatedinliver
diseaseis
a)Levofloxacin
b)Pefloxacin
c)Ofloxacin
--- Content provided by FirstRanker.com ---
d)LomefloxacinCorrectAnswer-B
Ans:B.Pefloxacin
Pefloxacinhaslongert?:accumulatesonrepeateddosing
achievingplasmaconcentrationstwiceashighasafterasingle
--- Content provided by FirstRanker.com ---
dose.Becauseofthis,itiseffectiveinmanysystemicinfectionsaswell.
Thedoseofpefloxacinneedstobereducedinliverdisease,butnot
inrenalinsufficiency.
Ref:K.D.Tripathi7thEdition.Page.713
--- Content provided by FirstRanker.com ---
63.Atahighaltitudeof3000m,aperson
complainsofbreathlessness.Allofthe
followingcanbeusedforthe
managementofthispersonexcept?
a)Intravenousdigoxin
--- Content provided by FirstRanker.com ---
b)Oxygensupplementationc)Immediatedescent
d)Acetazolamide
CorrectAnswer-A
Ans:A.Intravenousdigoxin
--- Content provided by FirstRanker.com ---
ManagementofAMSfollowsthreeaxioms:a)furtherascentshouldbeavoideduntilthesymptomshaveresolved,b)patientswithno
responsetomedicaltreatmentshoulddescendtoaloweraltitude
andc)ifandwhenHACOissuspected,patientsshouldurgently
descendtoaloweraltitude.
--- Content provided by FirstRanker.com ---
Descentandsupplementaryoxygenarethetreatmentsofchoiceandforsevereillness,thecombinationprovidesoptimaltherapy.
Remarkably,adescentofonly500to1000musuallyleadsto
resolutionofacutemountainsicknesswhilehigh-altitudecerebral
edema(HACO)mayrequirefurtherdescent.Simulateddescentwith
--- Content provided by FirstRanker.com ---
portablehyperbaricchambers,nowcommonlyavailableinremotelocations,arealsoeffective.
Medicaltherapybecomescrucialwhenthedescentisnot
immediatelypossible.
Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923381/#!po=31.2500
--- Content provided by FirstRanker.com ---
64.ApatientwithdiabetesandCOPD
developedpostoperativeurinary
retention.Whichofthefollowingdrugs
canbeusedforshorttermtreatmentto
relievethesymptomsofthisperson?
--- Content provided by FirstRanker.com ---
a)Bethanecholb)Methacholine
c)Terazosin
d)Tamsulosin
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.BethanecholBethanecholisapreferreddruginthetreatmentofpostpartum
andpostoperativenonobstructiveurinaryretention,anditalso
cancounteractbladderdysfunctionoftenseenwithphenothiazines
andtricyclicantidepressants.
--- Content provided by FirstRanker.com ---
Itcanaffordsymptomaticreliefincongenitalmegacolonandgastroesophagealrefluxbutisrarelyusedforthese.
Ref:https://www.pdr.net/drug-summary/Urecholine-
bethanechol-chloride-801,
K.D.Tripathi7thEdition.Page.104
--- Content provided by FirstRanker.com ---
65.Drugofchoiceforinvasiveaspergillosis
is
a)Posaconazole
b)Voriconazole
c)LiposomalAMB
--- Content provided by FirstRanker.com ---
d)CaspofunginCorrectAnswer-B
Ans:B.Voriconazole
ThepreferredtreatmentofprimaryIAisvoriconazole,whichhas
beenfoundtobesuperiortoamphotericinB.
--- Content provided by FirstRanker.com ---
Azolesinterferewiththesynthesisofergosterolfoundinthefungalcellmembrane,whereaspolyenes--suchasamphotericinB--
interferewithergosterolfunction.
Anechinocandinthatdisruptsfungalcellwallsynthesis?
caspofungin--anditraconazolehavebeenapprovedforsalvage
--- Content provided by FirstRanker.com ---
therapyofIA.Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4200583/
66.Whichofthefollowingdrugsactsby
inhibitingthetranscriptionofDNAto
RNA?
--- Content provided by FirstRanker.com ---
a)Rifampicinb)Nitrofurantoin
c)Ciprofloxacin
d)Novobiocin
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.RifampicinOverallinhibitionofRNAsynthesisbyrifampiciniscausedbya
destabilizingeffectonthebindingoftheintermediate
oligonucleotidestotheactiveenzyme-DNAcomplex.
RifampicinitselfcanonlyinteractspecificallywithRNApolymerase
--- Content provided by FirstRanker.com ---
iftheenzymeisfreeorinabinarycomplexwithDNA.Ref:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC327649/
67.Apatientwasrecentlystartedon
Fluphenazine.Afewweekslater,he
developedtremors,rigidity,bradykinesia,
--- Content provided by FirstRanker.com ---
andexcessivesalivation.Thefirstlineofmanagementforthispatientis
a)Selegiline
b)Trihexyphenidyl
c)Pramipexole
--- Content provided by FirstRanker.com ---
d)AmantadineCorrectAnswer-B
Ans:B.Trihexyphenidyl
*Fluphenazinemayblocktheeffectsofagentsusedtotreat
Parkinson'sdiseasesuchaslevodopa/carbidopa.
--- Content provided by FirstRanker.com ---
*Trihexyphenidylisanantispasmodicdrugthatexertsadirectinhibitoryeffectontheparasympatheticnervoussystem.
-Italsohasarelaxingeffectonsmoothmuscle.
-ItisindicatedinallformsofParkinsonism.
*Trihexyphenidylworksasananticholinergicandisusedforthe
--- Content provided by FirstRanker.com ---
treatmentoftremors,spasms,stiffness,andweakmusclecontrolseeninpatientswithParkinson'sdisease.
-Itcanalsobeusedforthepreventionortreatmentofsimilar
muscularconditionswhicharecausedbycertaincentralnervous
system(CNS)drugssuchasfluphenazine,haloperidol,
--- Content provided by FirstRanker.com ---
chlorpromazine.Ref:https://www.ncbi.nlm.nih.gov/books/NBK519488/,https://www.ncbi.nlm.nih.gov/books/NBK519488/
68.Apersonwasgivenamusclerelaxantthat
competitivelyblocksnicotinicreceptors.
Whichofthefollowingdrugsisusedfor
--- Content provided by FirstRanker.com ---
reversalofmusclerelaxationaftersurgery?
a)Neostigmine
b)Carbachol
c)Succinylcholine
--- Content provided by FirstRanker.com ---
d)PhysostigmineCorrectAnswer-A
Ans:A.Neostigmine
Neostigminehasbeentraditionallyusedastheagentofchoice
toreverseNeuromuscularBlockade(NMB)aftermuscleparalysis
--- Content provided by FirstRanker.com ---
duringgeneralanesthesia.Anticholinesterases(neostigmine)aregenerallyusedtoreversethe
effectsofneuromuscularblockingagents.
Ref:https://www.hindawi.com/journals/cria/2017/8197035/
69.Zero-orderkineticsisotherwiseknownassaturationkinetics.Itisindependent
--- Content provided by FirstRanker.com ---
of:a)Plasmaconcentration
b)Clearance
c)Volumeofdistribution
d)Halflife
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns.A.Plasmaconcentration
Inzero-orderkineticsorsaturationkinetics,eliminationmechanisms
becomesaturatedandunabletoprocessmoredrugswhendrug
concentrationsrise.
--- Content provided by FirstRanker.com ---
Consequently,fordrugsthatareeliminatedbyzero-orderkinetics,aconstantamountofdrugiseliminatedperunittime
regardlessofdrugplasmaconcentration.
70.Whichofthefollowinganticancerdrugs
arecompetitiveinhibitorsoftyrosine
--- Content provided by FirstRanker.com ---
kinase?a)Imatinibandsunitinib
b)Letrozole
c)Bicalutamide
d)Fulvestrant
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns.is'a'i.e.,Imatinibandsunitinib
Moleculartargetedagents
Tyrosinekinaseinhibitors
CompetitiveinhibitorsImatinib,Nilotinib,Sunitinib,Dasatinib,
--- Content provided by FirstRanker.com ---
Erlotinib,Gefitinib,Lapatinib,Sorafenib(Rememberallendwith'nib').
MonoclonalantibodiesCetuximab,panitumumab.
HER2/neu(ERBB2)inhibitorsMonoclonalantibody-Trastuzumab.
TargetedantibodyGemtuzumab(antiCD-33),Rituximab(anti-
--- Content provided by FirstRanker.com ---
CD20),Alemtuzumab(antiCD-52).Vascularendothelialgrowthfactor(VEGF)inhibitorMonoclonal
antibody-Bevacizumab.
ProteosomeinhibitorsBortezomib.
HistonedeacetylaseinhibitorVorinostat
--- Content provided by FirstRanker.com ---
DNA-methyltransferaseinhibitor5-azacytidine,2-deoxy-5azacytidine
All-trans-retinoicacid.
Biologicalresponsemodifier-RecombinantIL-2(aldesleukin,
denileukin)
--- Content provided by FirstRanker.com ---
71.Whichofthefollowingisthelawonchild
sexualabuseinIndia?
a)ChildSexualAbusePreventionAct
b)ProtectionOfChildrenfromSexualOffencesAct(POCSO)
c)ChildWelfareAct
--- Content provided by FirstRanker.com ---
d)SexualOffencesActCorrectAnswer-B
Ans:B.POSCOAct
TheProtectionofChildrenfromSexualOffences(POSCO)Act,
2012,2019
--- Content provided by FirstRanker.com ---
ItisapplicabletothewholeofIndia.Itdefinesachildasanypersonbelowtheageof18yearsand
providesprotectiontoallchildren
OffencescoveredundertheAct:
PenetrativeSexualAssault
--- Content provided by FirstRanker.com ---
AggravatedPenetrativeSexualAssaultSexualAssault
AggravatedSexualAssault
SexualHarassmentoftheChild
UseofChildforPornographicPurposes
--- Content provided by FirstRanker.com ---
72.PunishmentofperjurycomesunderIPC
section?
a)IPC191
b)IPC192
c)IPC193
--- Content provided by FirstRanker.com ---
d)IPC197CorrectAnswer-C
Ans:C.IPC193
Definespunishmentforfabricatingfalseevidence
Thewitnessisliabletobeprosecutedforperjury,andthe
--- Content provided by FirstRanker.com ---
imprisonmentmayextenduptosevenyears.193IPC:punishmentforfalseevidence,(punishmentforperjury):
imprisonmentupto7yearsandalsoliableforfine
I91IPC:Givingfalseevidence(perjury)underoath.
I92IPC:Fabricatingfalseevidence(perjury)
--- Content provided by FirstRanker.com ---
THEESSENTIALSOFFORENSICMEDICINEANDTOXICOLOGY-Dr.K.S.NARAYANREDDY33rdedition-pg-13
73.Whencivilnegligenceisbroughtup
againstadoctor,theonusofprooflies
upon-
--- Content provided by FirstRanker.com ---
a)Judicialfirst-degreemagistrateb)Policenotbelowthelevelofsub-inspector
c)Doctor
d)Patient
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Ans:D.Patient"Generallyspeaking,itisforthepatientinanactionfornegligenceto
establishtheguiltofthedoctor,whoseinnocenceisotherwise
assumed."-Parikh
However,incaseswheretheruleofresipsaloquiturisapplied,the
--- Content provided by FirstRanker.com ---
patientneednotprovenegligence.Resipsoloquiturmeansthat"thethingorfactspeaksforitself."Thepatienthastomerelystatewhat
accordingtohimwastheactofnegligence.
Civilnegligence
Whenapatient(orhisrelative,incaseofpatient'sdeath)filessuitin
--- Content provided by FirstRanker.com ---
acivilcourttogetcompensationfromhisdoctorfortheinjuryordeathofthepatientduetodoctor'snegligence.
Adoctorfilesacivilsuittogetfeesfromhispatient,whorefusesto
payallegingnegligence.
Notethat?
--- Content provided by FirstRanker.com ---
Evenifadoctorisnegligent,apatientisnotentitledtoanycompensationifnodamagehasoccurred.
Anerrorindiagnosisortreatmentisnotnegligenceprovidedproper
careandskillhasbeenexercised.
Contributorynegligenceisnotadefenseincriminal
--- Content provided by FirstRanker.com ---
negligence.(Contributorynegligenceisanynegligenceonthepartofthepatientorhisattendant,whichalongwiththedoctor's
negligence,contributedtotheinjury)
CriminalnegligencecasesaredealtwithunderI.P.C.section304A.
74.Relativesofapatienttoldduring
--- Content provided by FirstRanker.com ---
postmortemexaminationthatthepersonhadatattoo-whichwasnowinvisible.
Howtoidentify?
a)ExaminetheLymphnode
b)Spectrophotometer
--- Content provided by FirstRanker.com ---
c)Ordinarylightd)X-ray
CorrectAnswer-A
Answer-A-ExaminetheLymphnode
Tattoomarksarepermanentwhendyepenetratesthedermis.
--- Content provided by FirstRanker.com ---
Infraredphotographymakesoldtattoosreadilyvisible.Afadedtattoomarkbecomesvisiblebytheuseofultravioletlamp4
orrubbingthepartandexaminingwithamagnifyinglens.
Marksarerecognizedevenindecomposedbodies(Aret)whenthe
epidermisisremoved.Lymphnodesnearthetattoomarkshow
--- Content provided by FirstRanker.com ---
pigmentdeposition.75.TrueabouthymeninChildrapeis-
a)Hymeneasilytearsbecauseitisthin
b)Hymeneasilytearsbecauseitisinthefront
c)Hymenhardlytearsbecauseitishighlyelastic
--- Content provided by FirstRanker.com ---
d)HymenhardlytearsbecauseitissituateddeepCorrectAnswer-D
Answer-D-Hymenhardlytearsbecauseitissituateddeep
Thehymenmaynotruptureafterrapeif:
Penetrationwasnotfull
--- Content provided by FirstRanker.com ---
Thehymenistough,fleshyandelasticInayoungchild,fullpenetrationmaynotoccur
GautamBiswasReviewofforensicmedicine&Toxicology2/e;pg-
332
https://www.who.int/violence_injury_prevention/resources/publications/en/guidelines_chap7.pdf
--- Content provided by FirstRanker.com ---
76.Magnan'ssymptomsarerelatedto
a)Cocainepoisoning
b)Cannabis
c)Cannabis
d)Alcohol
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer:A.Cocainepoisoning
Magnan'ssignorSymptomisaclinicalsigninwhichpeople
withcocaineaddictionexperienceparaesthesiawhichfeelslikea
constantlymovingforeignbodies,(cocainebugs)suchasfinesand
--- Content provided by FirstRanker.com ---
orpowder,undertheskin.Itisthemosttactilehallucination.Degenerationofthecentralnervoussystemoccurs,andthepatient
maysufferfromhallucinations,convulsions,delirium,andinsanity.
Magnan'ssymptomorcocainebugsischaracteristic,inwhichthere
isafeelingasifgrainsofsandarelyingundertheskinorsome
--- Content provided by FirstRanker.com ---
smallinsectsarecreepingontheskingivingrisetoitchingsensation(formication,tactilehallucination)withresultantexcoriation,leading
toirregularscratchesandulcers.
THEESSENTIALSOFFORENSICMEDICINEANDTOXICOLOGY
ByDr.K.S.NARAYANREDDY33/e-pg-603
--- Content provided by FirstRanker.com ---
77.ParentsoftheChildcomplainsof
assaultedbyoneoftheirrelativesand
analpaininachild,Oninvestigationtest
showsyellowiodinecrystalswithpicric
acid-whatisthenameofthetest?
--- Content provided by FirstRanker.com ---
a)Florencetestb)Barberio'stest
c)Acidphosphatasetest
d)CreatinePhosphokinase
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer:B.Barberio'stestItdetectsspermin(secretedbytheprostate)andusesanaqueous
oralcoholicsolutionofpicricacid.
Asaturatedaqueousoralcoholicsolutionofpicricacid,whenadded
tothespermaticfluid,producesyellowneedle-shapedrhombic
--- Content provided by FirstRanker.com ---
crystalsofsperminepicrate.Thereactionprobablydependsonthepresenceofprostaticsecretion.
TheAcidPhosphataseTest:Theprostaticsecretionelementof
seminalfluidcontains500to1000timesgreateracidphosphatase
thananyotherbodyfluid.Humanredcells,semenofhigherapes,
--- Content provided by FirstRanker.com ---
andjuiceofcauliflowerhaveacidphosphataselevelsimilartothatofhumansemen
THEESSENTIALSOFFORENSICMEDICINEANDTOXICOLOGY
ByDr.K.S.NARAYANREDDY33/e-pg-434
78.TheMagistratecandetainthemaximum
--- Content provided by FirstRanker.com ---
numberofdaysforamentallyillpersonaspermentalhealthcareis
a)30days
b)90days
c)50days
--- Content provided by FirstRanker.com ---
d)100daysCorrectAnswer-A
Ans:A.30days
*IftheMagistrateissatisfiedthatitisnecessarytodetainthe
allegedmentallyillpersoninapsychiatrichospital,hepassesa
--- Content provided by FirstRanker.com ---
ReceptionOrder(orderforadmissionanddetention),whichisvalidfor30days.Ifheisnotsatisfied,hemayrefusetheapplication,
givinghisreasonsinwriting,acopyofwhichissuppliedtothe
applicant.
*AdmissionUnderSpecialCircumstance
--- Content provided by FirstRanker.com ---
-Amentallyillpersonmaynotbeabletoexpresshiswillingnessforadmissionasavoluntarypatient,Suchpersoncanbeadmittedin
apsychiatrichospital(psychiatricnursinghome)foraperiodof90
daysifanapplicationismadebyarelativesandfriends
79.Vectorforzikavirusis-
--- Content provided by FirstRanker.com ---
a)Aedesb)Culex
c)Anopheles
d)Noneofthese
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.AedesZikavirusdiseaseiscausedbytheZikavirus,whichisspreadto
peopleprimarilythroughthebiteofaninfectedmosquito(Aedes
aegyptiandAedesalbopictus).Theviruscanalso
betransmittedthroughsex.
--- Content provided by FirstRanker.com ---
Thesearethesamemosquitoesthatspreaddengueandchikungunyaviruses.
Amosquitogetsinfectedwithaviruswhenitbitesaninfected
personduringtheperiodoftimewhentheviruscanbefoundinthe
person'sblood,typicallyonlythroughthefirstweekofinfection.
--- Content provided by FirstRanker.com ---
MedicalMicrobiologyandImmunology14/e-pg;39580.AllaretrueregardingJapanese
encephalitisexcept?
a)Causedbyflavivirus
b)Humansaredead-endhosts
--- Content provided by FirstRanker.com ---
c)Transmittedbyculexd)Cattlesareamplifierhosts
CorrectAnswer-D
Ans.is'd'i.e.,Cattlesareamplifierhosts
Japaneseencephalitis
--- Content provided by FirstRanker.com ---
CausedbyagroupBarbovirus(flavivirus)ItisaZoonoticdiseaseieinfectingmainlyanimalsandincidentally
man.
Insouth,epidemicshaveoccuredinKarnataka,Andhrapredesh,
TamilNadu,andKerala.
--- Content provided by FirstRanker.com ---
Human,cattle,andhorsesaredead-endhostsasthediseasemanifestsasfatalencephalitis.
Pigsactasanamplifyinghostandhaveaveryimportantroleinthe
epidemiologyofthedisease.
Infectioninswineisasymptomatic,exceptinpregnantsows,when
--- Content provided by FirstRanker.com ---
abortionandfetalabnormalitiesarecommonsequelae.ThemostimportantvectorisCulextritaeniorhynchus,whichfeeds
oncattleinpreferencetohumans.
ThenaturalhostsoftheJapaneseencephalitisvirusarebirds,not
humans.
--- Content provided by FirstRanker.com ---
InNovember2011,theJapaneseencephalitisviruswasreportedinCulexbitaeniorhynchusinSouthKorea
81.Allofthefollowingis/arehaving
superantigenPropertyExcept
a)Vibriocholera
--- Content provided by FirstRanker.com ---
b)Streptococcalpyrogenicc)Staphylococcalenterotoxins
d)Noneofthese
CorrectAnswer-A
Answer-A-VibrioCholera
--- Content provided by FirstRanker.com ---
SAgsareproducedbysomepathogenicvirusesandbacteriamostlikelyasadefensemechanismagainsttheimmunesystem.
Toxicshocksyndrometoxin(TSST-1),epidermolytictoxinandother
staphylococcalenterotoxinaresuperantigens.
ThesesuperantigenscanbindMHCmoleculesoutsidethepeptide-
--- Content provided by FirstRanker.com ---
bindingcleft.Consequently,superantigencanactivateupto10%ofT-cellsina
nonspecificmannerwhichinturnleadstothereleaseoflarge
quantitiesofcytokines.
Jawetz27/e-pg-135
--- Content provided by FirstRanker.com ---
82.TypeAbioterrorismAgent-
a)Chikungunya
b)Anthrax
c)Hendra
d)Influenza
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAnswer-B-Anthrax
CategoryAagents-consistsoftheagentsthatareconsideredthe
highestrisk
IncludedamongCategoryBagentsisonethatcouldconceivably
--- Content provided by FirstRanker.com ---
threatenwaterandfoodsafety.CategoryCincludespathogensthatareconsideredemerging
infectiousdiseasethreatsandwhichcouldbeengineeredformass
dissemination.
CategoryA
--- Content provided by FirstRanker.com ---
CategoryBCategoryC
Anthrax
Caliciviruses
AntimicrobialResistance
--- Content provided by FirstRanker.com ---
BotulismChikungunya
Hendra
Dengue
Cholera
--- Content provided by FirstRanker.com ---
Influenza(highlypathogenicstrains)Ebola
E.coliO157:H7 MERS
Hantavirus HepatitisA
Nipah
--- Content provided by FirstRanker.com ---
LassaRicintoxin
Prions
Marburg
Salmonella
--- Content provided by FirstRanker.com ---
RabiesPlague
Typhusfever
SARS
Smallpox Yellowfever
--- Content provided by FirstRanker.com ---
Tick-BorneencephalitisTularemia Zika
Tuberculosis
Jawetz27/e-pg-417
83.CulturemediausedforE.coli0157:H7is
--- Content provided by FirstRanker.com ---
a)SMACb)WilsonandBlairmedium
c)PotassiumtelluriteinMcleod'smedium
d)Deoxycholatecitrateagar(DCA)
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A-SMACAnenterohemorrhagicbacterialstrain,E.coliO157:H7infectsthe
alimentarytractandinducesabdominalcrampswithhemorrhagic
diarrhea.TransmissionofE.coliO157:H7occursviathefecal-oral
routeafterconsumptionofcontaminated,undercookedliquidsand
--- Content provided by FirstRanker.com ---
foods.MacConkey-SorbitolChromoSelectAgar(SMAC)isrecommended
forselectiveisolationofEscherichiacoli0157:H7fromfoodand
animalfeedingstuffs.
MacConkeySorbitolAgarisbasedontheformulationdescribedby
--- Content provided by FirstRanker.com ---
RappaportandHenigh.Themediumcontainssorbitolinsteadoflactoseanditisrecommendedforthedetectionofenteropathogenic
strainsofE.coli0157:H7whichfermentslactosebutdoesnot
fermentsorbitolandhenceproducecolorlesscolonies.
SorbitolfermentingstrainsofE.coliproducepink-redcolonies.The
--- Content provided by FirstRanker.com ---
redcolorisduetotheproductionofacidfromsorbitol,absorptionofneutralredandasubsequentcolourchangeofthedyewhenthepH
ofthemediumfallsbelow6.8.
https://www.sigmaaldrich.com/analytical-
chromatography/microbiology/microbiology-products.html?
--- Content provided by FirstRanker.com ---
TablePage=1829764784.DonovanosisisCausedBy-
a)H.ducreyi
b)Leishmaniadonovani
c)K.granulomatis
--- Content provided by FirstRanker.com ---
d)TreponemapallidumCorrectAnswer-C
Answer-C-K.Granulomatis
Donovanosisisasexuallytransmittedgenitalulcerdisease.
Thebacteriumthatcausesdonovanosis(Klebsiella
--- Content provided by FirstRanker.com ---
granulomatis)infectstheskinaroundthegenitals,groinoranalareaandcausesulcersanddestructionoftheskin.
85.FungalInfectionwhichisacquiredby
traumaticinoculationis?
a)Sporothrix
--- Content provided by FirstRanker.com ---
b)Blastomycosisc)Coccidioides
d)Paracoccidioides
CorrectAnswer-A
Answer-A-Sporothrix
--- Content provided by FirstRanker.com ---
Sporothrixschenckiiisathermallydimorphicfungusthatlivesonvegetation.Itisassociatedwithavarietyofplants,grasses,trees,
sphagnummoss,rosebushes,andotherhorticulturalplants.
TheconidiaorhyphalfragmentsofS.schenckiiareintroducedinto
theskinbytrauma.
--- Content provided by FirstRanker.com ---
Followingatraumaticintroductionintotheskin,S.schenckiicausessporotrichosis,achronicgranulomatousinfection.
Thismanifestationmimicschroniccavitarytuberculosisandtendsto
occurinpatientswithimpairedcell-mediatedimmunity.
Jawetz27/e-pg-670
--- Content provided by FirstRanker.com ---
86.Whichofthefollowingisnotinvolvedin
urethritis
a)Trichomonas
b)H.ducreyi
c)Chlamydia
--- Content provided by FirstRanker.com ---
d)GonococcusCorrectAnswer-B
Answer-B-H.ducreyi
Bacteriathatcommonlycauseurethritistoinclude:
E.coliandotherbacteriapresentinthestool
--- Content provided by FirstRanker.com ---
Gonococcus,whichissexuallytransmittedandcausesgonorrhea.Chlamydiatrachomatis,whichissexuallytransmittedand
causeschlamydia.
Theherpessimplexvirus(HSV-1andHSV-2)canalsocause
urethritis.Trichomonasisanothercauseofurethritis
--- Content provided by FirstRanker.com ---
-https://www.webmd.com/a-to-z-guides/urethritis-symptoms-causes-treatments#1;Jawetz27/e-pg-746
87.Apatientcomplainsaboutnausea,
vomitingandstomachcrampsafter
attendingasocialgatheringparty,which
--- Content provided by FirstRanker.com ---
causativeorganismislikelyresponsibleforFoodPoisoningwithin3hours.
a)Staphylococcusaureus
b)Salmonella
c)Clostridiumbotulinum
--- Content provided by FirstRanker.com ---
d)ClostridiumperfringensCorrectAnswer-A
Answer-A-Staphylococcusaureus
Staphfoodpoisoningischaracterizedbyasuddenstartofnausea,
vomiting,andstomachcramps.Mostpeoplealsohavediarrhea.
--- Content provided by FirstRanker.com ---
Symptomsusuallydevelopwithin30minutesto6hoursaftereatingordrinkinganitemcontainingStaphtoxinandlastnolongerthan1
day.Severeillnessisrare.
Theillnesscannotbepassedfromonepersontoanother.
https://www.cdc.gov/foodsafety/diseases/staphylococcal.html
--- Content provided by FirstRanker.com ---
88.A46-year-oldwomanwithHIVcomplains
severepersistentdiarrhea,Histological
Investigationwasperformed,Identifythe
organismcausingdiarrheainHIVPatient.
a)Cryptosporidium
--- Content provided by FirstRanker.com ---
b)Staphylococcusaureusc)Salmonella
d)Clostridiumbotulinum
CorrectAnswer-A
Answer-A-Cryptosporidium
--- Content provided by FirstRanker.com ---
*TheoriginofinfectiousdiarrheainpatientswithAIDScanbedividedinto2generalcategories:thatcausedbycommon
pathogensandthatcausedbyopportunisticpathogens.
*ThemostcommoninfectiousorganismscausingAIDS-related
diarrheainclude
--- Content provided by FirstRanker.com ---
-Cytomegalovirus(CMV)-TheparasitesCryptosporidium,
-Microsporidia
-Giardialamblia
*AndthebacteriumMycobacteriumavium-intracellulare(MAC).
--- Content provided by FirstRanker.com ---
*Otherbacteriaandparasitesthatcausediarrhealsymptomsinotherwisehealthypeoplemaycausemoresevere,prolongedor
recurrentdiarrheainpeoplewithHIVorAIDS
https://aidsinfo.nih.gov/news/175/aids-related-diarrhea
89.OrganismCausingLGV
--- Content provided by FirstRanker.com ---
a)Chlamydiatrachomatisb)Neisseriagonorrhoeae
c)Treponemapallidum
d)Haemophilusducreyi
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A-ChlamydiatrachomatisLymphogranulomavenereum(LGV)isalong-term(chronic)
infectionofthelymphaticsystem.
Itiscausedbyanyofthe3differenttypes(serovars)ofthe
bacteriaChlamydiatrachomatis.
--- Content provided by FirstRanker.com ---
Thebacteriaarespreadbysexualcontact.Theinfectionisnotcausedbythesamebacteriathatcausegenitalchlamydia.
Chlamydiatrachomatiscauseseye(conjunctivitis,trachoma),
respiratory(pneumonia),andgenitaltract(urethritis,
lymphogranulomavenereum)infections.
--- Content provided by FirstRanker.com ---
DiagnosismadewiththenucleicacidtestforC.trachomatis,LGVserovarsdiagnosedserologically.
LangeReviewofMedicalMicrobiology&Immunology14/e208
90.Whichinterleukinresponsiblefor
producingIgEfromBcells
--- Content provided by FirstRanker.com ---
a)IL1b)IL3
c)IL4
d)BothB&C
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer-C,IL4IgEisproducedbyplasmacellslocatedinlymphnodesdrainingthe
siteofantigenentryorlocally,atthesitesofallergicreactions,by
plasmacellsderivedfromgerminalcentersdevelopingwithinthe
inflamedtissue.
--- Content provided by FirstRanker.com ---
IgEantibodyproductionrequiresTH2cellsthatproduceinterleukin-4(IL-4)andIL-13anditcanbeinhibitedbyTH1cellsthatproduce
interferon-(IFN-).
https://www.ncbi.nlm.nih.gov/books/NBK27117/
91.HbsAgisbasedonwhichprinciple
--- Content provided by FirstRanker.com ---
a)Immunochromatographyassaysb)Chemiluminescence
c)ELISA
d)Immunofluorescence
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A-ImmunochromatographyassaysHBVchroniccarriersarethoseinwhomHBsAgpersistsformore
than6monthsinthepresenceofHBeAgoranti-HBe.HBsAgmay
persistforyearsafterthelossofHBeAg.Themostusefuldetection
methodsareenzyme-linkedImmunosorbentassayforHBV
--- Content provided by FirstRanker.com ---
antigensandantibodiesandPCRforviralDNA-Jawetz27/epg-504
Serologicalassaysdetectthehostimmuneresponse(antibodiesto
HCV)oraviralantigen(HBsAg,HCVcAg).Theyarebasedonthe
immunoassayprincipleandareavailableintheformofrapid
--- Content provided by FirstRanker.com ---
diagnostictests(RDTs)orlaboratory-basedenzymeimmunoassays(EIAs),chemiluminescenceimmunoassays(CLIAs)and
electrochemiluminescenceimmunoassays(ECLs).-
https://www.ncbi.nlm.nih.gov/books/NBK442281/
92.NosocomialInfectionoccurswithin?
--- Content provided by FirstRanker.com ---
a)A-48b)B.72
c)C.24
d)D.50
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A-48hoursAhospital-acquiredinfection(HAI),alsoknownasanosocomial
infection,isaninfectionthatisacquiredinahospitalorotherhealth
carefacility.
Nosocomialinfectionscanbedefinedasthoseoccurringwithin48
--- Content provided by FirstRanker.com ---
hoursofhospitaladmissionorwithin3daysofdischargeor30daysofoperation.
Somewellknownnosocomialinfectionsinclude:
ventilator-associatedpneumonia,
Methicillin-resistantStaphylococcusaureus,
--- Content provided by FirstRanker.com ---
Candidaalbicans,Acinetobacterbaumannii,
Clostridiumdifficile,
Tuberculosis,
Urinarytractinfection,Vancomycin-resistantEnterococcus,and
--- Content provided by FirstRanker.com ---
Legionnaires'disease.https://www.ncbi.nlm.nih.gov/books/NBK441857/
93.Whichofthefollowingcellcomponents
producedbyNeisseriagonorrhoeaeis
responsibleforattachmenttohostcells?
--- Content provided by FirstRanker.com ---
a)Lipooligosaccharideb)Pili(fimbriae)
c)IgA1protease
d)Outermembraneporinprotein
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B-Pili(fimbriae)Piliarehair-likeappendagesthatextenduptoseveralmicrometers
fromthegonococcalsurface.Theyenhanceattachmenttohostcells
andresistancetophagocytosis.Theyaremadeupofstackedpilin
proteins.
--- Content provided by FirstRanker.com ---
Theaminoterminalofthepilinmolecule,whichcontainsahighpercentageofhydrophobicaminoacids,isconserved.Theamino
acidsequencenearthemidportionofthemoleculealsois
conserved;thisportionofthemoleculeservesinanattachmentto
hostcellsandislessprominentintheimmuneresponse.
--- Content provided by FirstRanker.com ---
Theaminoacidsequencenearthecarboxyl-terminalishighlyvariable;thisportionofthemoleculeismostprominentinthe
immuneresponse.ThepilinsofalmostallstrainsofN.gonorrhea
areantigenicallydifferent,andasinglestraincanmakemany
antigenicallydistinctformsofpilin
--- Content provided by FirstRanker.com ---
Jawetz27/e-pg-28294.Wherewillyouputchemicalliquid
biomedicalwaste
a)White
b)Yellow
--- Content provided by FirstRanker.com ---
c)Blued)Red
CorrectAnswer-B
Ans.Byellow
Chemicalwasteiscategorizedintotheyellowcategory.the
--- Content provided by FirstRanker.com ---
hazardouschemicalandcytotoxicwasteisayellowcategorywithaspecialsignof"CYTOTOXIC"waste.
Anotherliquidwasteasbodysecretionsiscategorizedintothe
yellowcategoryofbiomedicalwasteguidelines,2016
Park'sPSM24thed.Pageno.831
--- Content provided by FirstRanker.com ---
95.Maximumworkhoursforaperson
includingovertimeunderthefactoriesact:
a)48
b)50
c)60
--- Content provided by FirstRanker.com ---
d)100CorrectAnswer-C
Ans:C.60hours.
Factoriesactpermitsworkfor48hoursperweekwith2hoursof
overtimeeveryday.
--- Content provided by FirstRanker.com ---
makingitapproximately60hoursofmaximumworkasperthefactoriesactofIndia
Park'sPSM24thed.Pageno.852
96.Thevaccinetobegivenafterdisaster
a)vaccinationagainsttyphoid
--- Content provided by FirstRanker.com ---
b)vaccinationagainstcholerac)vaccinationagainsttyphoidandcholera
d)vaccinationagainsttetanus
CorrectAnswer-D
Ans.D.vaccinationagainsttetanus.
--- Content provided by FirstRanker.com ---
Themajorconcernforanyoneexposedtounsanitaryconditionsisthattheyshouldbeuptodatewiththetetanus-containingvaccine
becauseiftheyareinjured(asiscommonindisastersettings)the
injuryislikelytobecontaminated.
Routinelyrecommendedvaccinesarerecommendedforevacuees,
--- Content provided by FirstRanker.com ---
justliketheyareforeveryoneelse.Choleraandtyphoidvaccinedonothaveanyevidenceformass
vaccinationduetothelowlevelofexposureandprevention
TetanusandHepBvaccineisrequired.
97.WhatistheMONICAproject?
--- Content provided by FirstRanker.com ---
a)MultinationalmonitoringoftrendsanddeterminantsinCardiovascularDisease
b)Multinationaloftrendsanddeterminantsincerebrovascular
disease
c)Multinationalmonitoringoftrendsanddeterminantsindiabetes
--- Content provided by FirstRanker.com ---
d)Multinationalmonitoringoftrendsanddeterminantsincongenitalheartdisease
CorrectAnswer-A
Ans:A.Multinationalmonitoringoftrendsanddeterminantsin
CardiovascularDisease
--- Content provided by FirstRanker.com ---
TheWHOhascompletedaprojectknownasMONICA"(multinationalmonitoringoftrendsanddeterminantsin
cardiovasculardiseases)"toelucidatethisissue.
Forty-onecentersin26countrieswereparticipatinginthisproject,
whichwasplannedtocontinuefora10yearperiodendingin1994.
--- Content provided by FirstRanker.com ---
Park'sPSM24thed.Pageno.38598.Extendedsicknessbenefitfor
tuberculosisundertheESIActis:
a)91days
b)1-year
--- Content provided by FirstRanker.com ---
c)2yearsd)4years
CorrectAnswer-C
Ans.C.2years
EXTENDEDSICKNESSBENEFIT:Inadditionto91daysof
--- Content provided by FirstRanker.com ---
sicknessbenefitinsuredpersonssufferingfromcertainlong-termdiseasesareentitledtoExtendedSicknessBenefitasshownbelow,
foramaximumperiodoftwoyears.
ExtendedSicknessBenefitwitheffectfrom1.1.2000ispayable,in
thecasewheretheinsuredpersonhasbeenincontinuous
--- Content provided by FirstRanker.com ---
employmentfor2yearsTuberculosisPark'sPSM24thed.Pageno.854
99.Apersonreports4hoursafterhavinga
cleanwoundwithoutlaceration.Hehad
takenTT10yearsbefore.thenextstepin
--- Content provided by FirstRanker.com ---
managementis:a)FullcourseTetanusvaccinetobegiven
b)FulldoseTTwithTIG
c)Single-doseTT
d)Noneedforanyvaccine
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAns.C.Single-doseTT
Apatientwithwoundlessthan6hoursoldifclean,non-penetrating
andwithnegligibletissuedamageifhadacompletecourseoftoxoid
oraboosterdosemorethan10yearsago(categoryC)shouldbe
--- Content provided by FirstRanker.com ---
treatedwithToxoid1dose.Park'sPSM24thed.Pageno.331
100.RecentInfluenzaPandemicwasdueto:
a)H1N1
b)H5N1
--- Content provided by FirstRanker.com ---
c)H7N7d)H3N2
CorrectAnswer-A
Ans.A.H1N1
H1N1?swineflu?causethemajorfluPandemic(1918and2009)
--- Content provided by FirstRanker.com ---
H5N1?avianinfluenza.maycausesporadicoutbreaksorepidemics.Itisassociatedwithhighmortality.
101.MissionIndradhanushisfor:
a)Non-communicablediseases
b)Universalimmunization
--- Content provided by FirstRanker.com ---
c)Familyplanningd)Safewaterandsanitation
CorrectAnswer-B
Ans.B.Universalimmunization
TheMinistryofHealth&FamilyWelfarehaslaunched"Mission
--- Content provided by FirstRanker.com ---
IndraDhanush",depictingsevencoloursoftherainbowinDecember2014,tofullyimmunizemorethan89lakhchildrenwhoareeither
unvaccinatedorpartiallyvaccinated;thosethathavenotbeen
coveredduringtheroundsofroutineimmunizationforvarious
reasons.
--- Content provided by FirstRanker.com ---
Theywillbefullyimmunizedagainstsevenlife-threateningvaccine-preventablediseaseswhichincludediphtheria,whoopingcough,
tetanus,polio,tuberculosis,measles,andhepatitis-B.
Inaddition,vaccinationagainstJapaneseEncephalitisand
HaemophilusinfluenzatypeBwillbeprovidedinselected
--- Content provided by FirstRanker.com ---
districts/statesofthecountry.Pregnantwomenwillalsobeimmunizedagainsttetanus.
Ref.Park'sPSM24thed.Page462
102.Astudyhadanormaldistributionwith
themedianvalueas200andstandard
--- Content provided by FirstRanker.com ---
deviation20.68%willfallbetweena)160-240
b)170-230
c)180-220
d)190-210
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAns.C.180-220
Asthemedianvalueis200andthestandarddeviationis20,the
normaldistributionis:
68%ofthepopulationwillhavevaluesbetween?median+/-1SD=
--- Content provided by FirstRanker.com ---
220+/-20=180-22095%ofthepopulationwillhavevaluesbetween?median+/-2SD=
220+/-40=160-240
Note:intheMCQ,asthedatashowsanormaldistribution,the
medianwillbeequaltomeanandthemode.
--- Content provided by FirstRanker.com ---
Park'sPSMEd.24thpageno.885103.Whichofthefollowingisa
technique/methodbasedonbehavioural
sciences
a)Managementbyobjectives
--- Content provided by FirstRanker.com ---
b)Networkanalysisc)Systemsanalysis
d)Decisionmaking
CorrectAnswer-A
Ans.A.Managementbyobjectives
--- Content provided by FirstRanker.com ---
Themethodsbasedonbehaviouralsciencesincludeorganizationaldesign
personalmanagement
Managementbyobjectives
informationsystems
--- Content provided by FirstRanker.com ---
communicationTheQuantitativemethodsinclude:
cost-benefitanalysis
cost-effectiveanalysis
input-outputanalysis
--- Content provided by FirstRanker.com ---
networkanalysisasPERTandCPMPlanningprogrammingbudgetingsystems
decisionmaking
Ref:Park's25ed,PAgeno.934
104.Asperthesustainabledevelopment
--- Content provided by FirstRanker.com ---
goals,ThetargetforMMRistoachievematernaldeathsof
a)<70/Laclivebirths
b)<100/laclivebirths
c)<7/1000livebirths
--- Content provided by FirstRanker.com ---
d)<10/1000livebirthsCorrectAnswer-A
Ans:A.<70/Laclivebirths
By2030,reducetheglobalmaternalmortalityratiotolessthan70
per100,000livebirths.
--- Content provided by FirstRanker.com ---
Park'sPSM24thed.Pageno.28Table:4105.Thebestmethodforroutinemonitoring
ofairpollution
a)Sulphurdioxide,smoke,andparticulatematter
b)Sulphurdioxide,Hydrogensulphide,carbonmonoxide
--- Content provided by FirstRanker.com ---
c)Carbondioxide,hydrogensulphide,leadd)Sulphurdioxide,Leadandparticulatematter
CorrectAnswer-D
Ans.DSulphurdioxide,Leadandparticulatematter
Airqualityindexconsistsof:
--- Content provided by FirstRanker.com ---
Particulatematter(lessthan2.5micrometersand10micrometer?PM2.5andPM10)
Nitrogendioxide(NO2)
Sulphurdioxide(SO2)
Carbonmonoxide(CO)
--- Content provided by FirstRanker.com ---
Ozone(O3)Ammonia(NH3)
Lead(Pb)
Reference:https://pib.gov.in/newsite/PrintRelease.aspx?
relid=110654
--- Content provided by FirstRanker.com ---
106.Thevariationindataiscomparedwith
anotherdatasetby:
a)Variance
b)Coefficientofvariation
c)Thestandarderrorofmean
--- Content provided by FirstRanker.com ---
d)StandarddeviationCorrectAnswer-B
Ans.B.Coefficientofvariation
Variance:IsthesquareofSDwhichtellsaboutthestandard
deviation
--- Content provided by FirstRanker.com ---
Coefficientofvariation:Itmayhelpbycomparingthevariationsinthedataset
Thestandarderrorofthemean:Itistocomparethemeansofthe
datasetswhichhaveadifferentsamplesize,centraltendency,and
standarddeviations
--- Content provided by FirstRanker.com ---
Standarddeviation:ItisthedeviationofvaluesfromthemeanRef.FundamentalsofBiostatistics-7thEdition(Pg20,21)
107.Inwhichofthefollowingmethodsof
managementisthebenefitmeasuredin
naturalunits?
--- Content provided by FirstRanker.com ---
a)Programbudgetingsystemb)Networkanalysis
c)Cost-effectiveanalysis
d)Cost-benefitanalysis
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans.C.Cost-effectiveAnalysisIncost-effectiveanalysis(CEA),benefitsaremeasuredinnatural
unitsoftheoutcomesoftheprograms(life-yearsgained,cases
prevented,etc.)andthecostsaremeasuredinmonetaryunits.
ThemostcomprehensiveindicatorofCEAisQuality-AdjustedLife
--- Content provided by FirstRanker.com ---
Years(QALYs).Park'sPSM24thed.Pageno.908
108.Thedifferencebetweentheincidencein
theexposedandnon-exposedgroupis
--- Content provided by FirstRanker.com ---
bestgivenby:a)Relativerisk
b)Attributablerisk
c)Populationattributablerisk
d)Oddsratio
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns.BAttributableRisk
AttributableRisk
AttributableRiskisthedifferenceinincidenceratesorproportionsof
diseaseordeathbetweenanexposedandnon-exposedgroup.
--- Content provided by FirstRanker.com ---
Itisexpressedinpercentageandgivestheextenttowhichthediseasecanbeattributedtotheexposureinacohortstudy.
Reference:Park25thEdition,pageno:86
109.Ifonevariableisgiventhenyoucanfind
anothervariableby
--- Content provided by FirstRanker.com ---
a)Coefficientofvariationb)Coefficientofcorrelation
c)Coefficientofregression
d)Coefficientofdetermination
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans.C.CoefficientofregressionThecoefficientofcorrelationtellsaboutthestrengthofassociation
butnotaboutquantity.Ontheotherhand,thecoefficientof
regressionisusedforquantification.
Ifwewishtoknowinanindividualcasethevalueofonevariable,
--- Content provided by FirstRanker.com ---
knowingthevalueoftheother,wecalculatewhatisknownastheregressioncoefficientofonemeasurementtotheother.Itis
customarytodenotetheindependentvariablebyxandthe
dependentvariablebyy.
110.Prospectivescreeningisdoneincase
--- Content provided by FirstRanker.com ---
of?a)Neonateforthyroiddiseases
b)Immigrantscreening
c)Papsmearfor45-yearfemale
d)Diabetesmellitusfor40-yearmale
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns.B.ImmigrantScreening
Screeningofimmigrantstoacountryisanexampleofprospective
screening.
Prospectivescreening:
--- Content provided by FirstRanker.com ---
PeoplescreenedforothersbenefitTheessentialpurposeiscasedetection
Requestedforscreeningfordiseasecontrol;specificrequestfrom
theauthority
111.Aresearcherwantedtoprovethe
--- Content provided by FirstRanker.com ---
relationbetweenCOPDandsmoking.Hecollectedpatientsrecordsfrom
governmenthospitalsandrecordsof
cigarettesalesfromthefinanceand
taxationdepartment.Thisisanexample
--- Content provided by FirstRanker.com ---
ofwhichstudydesign:a)Cross-sectional
b)Posologicalstudy
c)Ecologicalstudy
d)Operationsresearch
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAns.C.Ecologicalstudydesign
Thisisanexampleofanecologicalstudy.
AnecologicalstudyisatypeofObservationalstudywhere
informationiscollectedonagroup(orpopulation)ratherthanon
--- Content provided by FirstRanker.com ---
individualmembersandthenanalyzed.Heretheassociationbetweenasummarymeasureofsaleof
cigarettes(riskfactor)andasummarymeasureofthenumberof
casesofCOPD(outcome)isstudied.
112.Astudywasdonetoassessmalnutrition
--- Content provided by FirstRanker.com ---
amongyoungchildren.100childrenwereselectedeachfromruralandurban
areas.Outofthese,30amongruraland
20amongurbanwerefoundtobe
malnourished.whichofthefollowing
--- Content provided by FirstRanker.com ---
statisticaltestisusedtocomparethedatasets?
a)Pairedt-test
b)Chi-square
c)Thestandarderrorofmean
--- Content provided by FirstRanker.com ---
d)ANOVACorrectAnswer-B
Ans.B.Chi-squaretest
Chi-square(x2)Testoffersanalternatemethodoftestingthe
significanceofthedifferencebetweentwoproportions.Ithasthe
--- Content provided by FirstRanker.com ---
advantagethatitcanalsobeusedwhenmorethantwogroupsaretobecompared.
Park'sPSM24thed.Pageno.889
113.Theactivedisinfectantpropertyof
bleachingpowderisdueto:
--- Content provided by FirstRanker.com ---
a)Chlorineb)Hypochloricacid
c)Hypochlorousacid
d)Chloramines
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans.C.HypochlorousacidHypochlorousacidisthemosteffectiveformofchlorineforwater
disinfection.
Theactivecomponentofbleachingpowder,CaOCl2,is
hypochlorousacid.
--- Content provided by FirstRanker.com ---
Thedisinfectingactionofchlorineismainlyduetohypochlorousacid,andtoasmallextentduetothehypochloriteions.
Park'sPSM24thed.Pageno.138
114.Motherdoesnottransmitwhatantibody
tothebaby?
--- Content provided by FirstRanker.com ---
a)Poliob)Diphtheria
c)Diphtheria
d)Tetanus
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.PolioWhengivenduringpregnancy,theTdapvaccineboostsantibodies
inthemother,whicharetransferredtoherdevelopingbaby.Early
third-trimesteradministrationoptimizesneonatalantibodylevels.
Ref.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168293/pdf/ciu327.pdf
--- Content provided by FirstRanker.com ---
1)115.Voluntaryadmissioncanbedone
maximumuptohowmuchtime
accordingtoMHA2017
a)48hrs
--- Content provided by FirstRanker.com ---
b)7Daysc)30Days
d)90Days
CorrectAnswer-D
Ans.D.90Days
--- Content provided by FirstRanker.com ---
Ifadmissionrequiresmorethan30daysorreadmissionwithin7days(section90),theyshouldbeexaminedbytwopsychiatristsand
canbeadmittedforamaximumperiodof90daysiftheysatisfy
normsasperthissectionoftheactandhavetoinformtheboardfor
permission,takingaccountofADandconsentshouldbereviewed
--- Content provided by FirstRanker.com ---
fortnightlyalongwithplanningforcommunity-basedtreatment.http://www.amhonline.org/article.asp?issn=2589-
9171;year=2018;volume=19;issue=1;spage=9;epage=14;aulast=Neredumilli
116.Bloodbagsaredisposedofin
a)Yellowbag
--- Content provided by FirstRanker.com ---
b)Blackbagc)Redbag
d)Whitebag
CorrectAnswer-C
Ans:C.Redbag
--- Content provided by FirstRanker.com ---
Theblackbagisusedforcollectingdrywastematerialwhichisnotinfectious.
Materialslikepaper,plastics,cardboardboxes,andotherdrywaste
generatedinthehospitalofficeorinthewardsaredisposedofin
thisbag.
--- Content provided by FirstRanker.com ---
Thisisnotbiomedicalwaste.Theredbagisusedforthedisposalofplasticscollectedfrom
operationtheaters,ICUsandwards.
Theyellowbagisusedforhighlyinfectiousitemslikeapathological
waste,humananatomicalwastesuchasbodyparts,amputated
--- Content provided by FirstRanker.com ---
parts/organs,tumors,placentas,abortedordeadfetuses,blood-soakedcottonbandages,animaltissues,organs,carcasses,etc.
BlueorWhiteopaquebagisusedforcollectingthesegregated
metalsharpssuchasneedles,blades,saws,scalpels,andglass
pieces.
--- Content provided by FirstRanker.com ---
RefPark23'/ep.793-794]117.AbsolutecontraindicationforIUD(Intra
UterineContraceptiveDevice)areall
except?
a)Pregnancy
--- Content provided by FirstRanker.com ---
b)Undiagnosedvaginalbleedingc)Pelvicinflammatorydisease
d)Uterinemalformation
CorrectAnswer-D
Ans.is'di.e.,Uterinemalformation
--- Content provided by FirstRanker.com ---
ContraindicationsABSOLUTE:
Suspectedpregnancy
Pelvicinflammatorydisease
Vaginalbleedingofundiagnosedetiology
--- Content provided by FirstRanker.com ---
Cancerofthecervix,uterusoradnexaandotherpelvictumoursPreviousectopicpregnancy
RELATIVE:
Anaemia
Menorrhagia
--- Content provided by FirstRanker.com ---
HistoryofPID(PelvicInflammatoryDisease)sincelastpregnancyPurulentcervicaldischarge
Distortionsoftheuterinecavityduetocongenitalmalformations,
fibroid
Unmotivatedperson
--- Content provided by FirstRanker.com ---
118.Whichofthefollowingiswater-related
disease
a)Yellowfever
b)Scabies
c)Cholera
--- Content provided by FirstRanker.com ---
d)DysenteryCorrectAnswer-A
Ans.is'a'i.e.,Yellowfever
*Watercancausediseasenotonlybydrinkingbutalsobyvarious
othermodes,directlyorindirectly.
--- Content provided by FirstRanker.com ---
*Dependinguponthetypeoftransmission,thediseasesareclassified.
*PublicHealthClassificationofWaterbornediseases
*Waterbornediseases:Occurduetodrinkingcontaminatedwater,
transmittedbythefaeco-oralroute.Examples:Typhoid,Cholera.
--- Content provided by FirstRanker.com ---
Dysentery,ViralHepatitisA*Waterwasheddiseases:Includeinfectionsoftheouterbody
surfacewhichoccurduetoinadequateuseofwaterorimproper
hygiene.Examples:Scabies,Trachoma,Typhus,Bacillary
dysentery,Amoebicdysentery
--- Content provided by FirstRanker.com ---
*Water-baseddiseases:Referstoinfectionstransmittedthroughanaquaticinvertebrateanimal.Examples:Schistosomiasis.
Dracunculiasis(Guineawormdisease)
*Water-relateddiseases(Waterbreedingdiseases):Areinfections
spreadbyinsectsthatdependonwater.Examples:Malaria,
--- Content provided by FirstRanker.com ---
Filariasis,Dengue,Yellowfever,Onchocerciasis119.InVision2020,thetargetforSecondary
Sevicecenterisforhowmuch
population?
a)10000
--- Content provided by FirstRanker.com ---
b)50000c)1lac
d)5lac
CorrectAnswer-D
Ansis'd'i.e.5lac
--- Content provided by FirstRanker.com ---
Vision2020:TheRighttoSight,isaglobalinitiativelaunchedbyWHOin1999inabroadcoalitionwitha'TaskForceofInternational
Non-GovernmentalOrganisations(NGOs)'tocombatthegigantic
problemofblindnessintheworld.
Theobjectiveistoeliminateavoidableblindnessbytheyear2020
--- Content provided by FirstRanker.com ---
andtoreducetheglobalburdenofblindness.ThegovernmentofIndiahasadopted'Vision2020:RighttoSight'undertheNational
ProgrammeforControlofBlindness.
BasedontherecommendationsofWHO,thereisaneedtodevelop
theinfrastructurepyramidwhichincludes
--- Content provided by FirstRanker.com ---
I.PrimarylevelVisionCentresThereisaneedtodevelop20000visioncenters,
AnEachwithoneOphthalmicAssistantorequivalent(Community-
basedMLOP),Coveringapopulationof50000.
2.ServiceCentres.
--- Content provided by FirstRanker.com ---
Thereisaneedtodevelop2000servicecentersatthesecondarylevel.
Eachwithtwoophthalmologistsand8paramedics(Hospital-based
MLOP),andoneeyecaremanager,Coveringapopulationof5lacs.
3.TrainingCentres
--- Content provided by FirstRanker.com ---
Thereisaneedtodevelop200'TrainingCentres'forthetrainingofOphthalmologists,Coveringapopulationof50lacs.
4.CentreofExcellence(COE)
Thereisaneedtodevelop20COEwithwelldevelopedallsub-
specialtiesofOphthalmology,Coveringapopulationof5crores.
--- Content provided by FirstRanker.com ---
120.CA-125isamarkerforthescreeningof
ovariancancer.Tocharacterizethistest,
histopathologicalconfirmationofovarian
cancerwasdoneinacohortofpatients.
60/100womenwhotestedpositivefor
--- Content provided by FirstRanker.com ---
thistesthadovariancancerand20/100womenwhotestednegativehadovarian
cancer.Whatisthenegativepredictive
valueofthistest?
a)20/100
--- Content provided by FirstRanker.com ---
b)40/100c)60/100
d)80/100
CorrectAnswer-D
Ans:D.80/100
--- Content provided by FirstRanker.com ---
Negativepredictivevalue(NPV):Abilityofascreeningtesttoidentifycorrectlyallthosewhodon'thavethedisease,outofallthosewho
testnegativeonascreeningtest.
NegativePredictiveValue(NPV)=Numberoftrue
--- Content provided by FirstRanker.com ---
negatives/(Numberoftruenegatives+numberoffalsenegatives).Diseasepresent Diseaseabsent
TestPositive 60(a:TP)
40(b:FP)
TestNegative 20(c:FN)
--- Content provided by FirstRanker.com ---
80(d:TN)Total
80
120
Truenegatives=80
--- Content provided by FirstRanker.com ---
Totalnegatives=100Negativepredictivevalue=80/100=80%.
121.Screeningisnotusefulinwhich
carcinoma
a)Carcinomaprostate
--- Content provided by FirstRanker.com ---
b)Carcinomacolonc)Carcinomabreast
d)Testiculartumor
CorrectAnswer-D
Ans:D.Testiculartumor
--- Content provided by FirstRanker.com ---
Screeningisnotusefulintesticulartumors.ScreeningRecommendationsforAsymptomaticSubjects:
Breast:
Self-examination.
Clinicalexamination.
--- Content provided by FirstRanker.com ---
Mammography.MRI.
Cervical:
Paptest(cytology).
HPVtest
--- Content provided by FirstRanker.com ---
Colorectal:Sigmoidoscopy
Fecaloccultbloodtesting(FOBT)
Colonoscopy
FecalDNAtesting
--- Content provided by FirstRanker.com ---
Fecalimmunochemicaltesting(FIT)CTcolonography
Lung:
Low-dosecomputedtomography
(CT)scan
--- Content provided by FirstRanker.com ---
OvarianCA:
CAmarker-125
Transvaginalultrasound
Prostate:
Prostate-specificantigen(PSA)
--- Content provided by FirstRanker.com ---
Digitalrectalexamination(DRE)Skin:
Completeskinexamination
122.Admissionratebiasis?
a)Reportingbias
--- Content provided by FirstRanker.com ---
b)Responsebiasc)Berkesonianbias
d)None
CorrectAnswer-C
Ans.is'c'i.e.,Berkesonianbias
--- Content provided by FirstRanker.com ---
SelectionbiasSelectionbiasisdistortionthatresultsfromtheprocedureusedto
selectsubjectsandfromfactorsthatinfluencestudyparticipation.
Groupstobecomparedaredifferentiallysusceptibletotheoutcome
evenbeforetheexperimentalmaneuverisperformed.
--- Content provided by FirstRanker.com ---
Selectionbiasmaybeofthefollowingtypes.1.Surveillance/detectionbias
Apotentialartifactinepidemiologicdatacausedbytheuseofa
particulardiagnostictechniqueortypeofequipment.
Forexample,cancerratesmayvaryindifferentregionsorperiods,
--- Content provided by FirstRanker.com ---
notbecauseofanactualdifferenceintheincidenceofdiseasebutbecauseofdifferentdiagnostictechnologies.
Ifthediagnostictestisbeingusedinoneregionismoresensitive
thanotherregions,thecancerrateswillbehighinthatregioneven
withouttheexistenceofanactualdifference.
--- Content provided by FirstRanker.com ---
2.Neymansurvivalbias(Incidence-Prevalencebias)Thistypeofbiasisduetomissingfatalcases,mildcasesorcases
ofshorterdurationfromthestudy.
Forexample,inastudyofbreastcancer,wecanchoosetwo
differenttypesofcases:?
--- Content provided by FirstRanker.com ---
IncidentcasesAllbreastcancerpatientsnewlydiagnosedduringagiventime.
PrevalentcasesAllbreastcancerpatientswhoarealiveduringa
giventimeframe.
Thesecanleadtodifferentresultsbecausetheprobabilityoffinding
--- Content provided by FirstRanker.com ---
acaseinagiventimeframeisrelatedtomortalityrisk.Thosepatientswhohayamildformofthediseaseandsurvivefora
relativelylongtimehaveagoodchanceofbeingaroundonthedate
ofdatacollection.Thosepatientswhodiequicklyareunlikelytobe
aroundonthatdate.
--- Content provided by FirstRanker.com ---
3.ReferralbiasorvolunteerbiasVolunteerorreferralbiasoccursbecausepeoplewhovolunteerto
participateinastudy(orwhoarereferredtoit)areoftendifferent
thannon-volunteers/non-referral.
Thisbiasusuallyfavoursthetreatmentgroup,asvolunteerstendto
--- Content provided by FirstRanker.com ---
bemoremotivatedandconcernedabouttherehealth.4.Responsebias
Thisoccurswhenthosewhorespondtoasurveydifferinimportant
waysfromthosewhodonotrespond.
Thisbiascanworkineitherdirection,i.e.,ifbiasoccurs,whenthose
--- Content provided by FirstRanker.com ---
whodonotrespondtoasurveydifferinimportantwaysfromthosewhorespond,itiscallednonrespondentbias.
5.Berkesonianbias
Berkesonianbiasresultsfromthegreaterprobabilityofhospital
admissionforpeoplewithtwoormorediseasesthanforpeoplewith
--- Content provided by FirstRanker.com ---
onedisease.So,itisalsoknownasadmissionratebias.Forexample,Ifbreastcanceristheexposureofinterest(diseases
areoftentreatedasexposuresinhospital-basedcase-control
studies)andmeningiomaisthecasediseasethenpeoplewithboth
breastcancerandmeningiomacouldbehospitalizedforeither
--- Content provided by FirstRanker.com ---
breastcancerormeningiomaorboth.However,peoplewithonlybreastcancerorwiththeonly
meningiomacouldbehospitalizedbecauseofoneofthese
diseases.
Therefore,agreaterproportionofpeopleinthecommunitywithboth
--- Content provided by FirstRanker.com ---
breastcancerandmeningiomawouldbeadmittedtothehospitalthanpeoplewithmeningiomaonly.
So,Berkesonianbiasoccurswhenbothexposure(e.g.,breast
cancerintheaboveexample)anddisease(e.g.,meningiomain
aboveexample)affecttheselection
--- Content provided by FirstRanker.com ---
123.Stimulationoftheexternalauditorycanal
leadstocoughduetowhichnerve
a)AuricularbranchVagus
b)Greaterauricularnerve
c)Auriculotemporalnerve
--- Content provided by FirstRanker.com ---
d)FacialNerveCorrectAnswer-A
Ans:A.AuricularbranchVagusnerve.
>AuricularbranchofVagus(Arnold'snerve)andFacialnerve
continuesinwardstosupplytheposteriorwallandflooroftheEAC.
--- Content provided by FirstRanker.com ---
>Thecoughresponsecausedwhilestimulatingtheearcanalismediatedbythevaguswhichalsosuppliesthelarynx.
(Re/.Shambaugh,6thed.,page45)
124.
wideningofthecartilaginouspartoftheextra
--- Content provided by FirstRanker.com ---
auditorycanalcalled.a)Otoplasty
b)Myringoplasty
c)Tympanoplasty
d)Meatoplasty
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAns.(d)Meatoplasty.
Meatoplastyisanoperativetechniquetowidenthelateral
cartilaginouspartoftheexternalauditorycanal.
Otoplasty-isaproceduretochangetheshape,positionorsizeof
--- Content provided by FirstRanker.com ---
theears.Myringoplasty-closureoftheperforationofparstensaofthe
tympanicmembrane
Tympanoplasty-surgicaltechniquetorepairadefectinthe
tympanicmembranewiththeplacementofagraft,eithermedialor
--- Content provided by FirstRanker.com ---
lateraltothetympanicmembraneannulusref:https://vula.uct.ac.za/access/content/group/ba5fb1bd-be95-
48e5-81be-586fbaeba29d/Meatoplasty.pdf
125.TubercularOtitismediaischaracterized
byallexcept
--- Content provided by FirstRanker.com ---
a)Painfulotorrheab)Multipleperforations
c)Palegranulations
d)Foul-smellingeardischarge
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.Painfulotorrhea.>Tuberculosisofmiddleearisacomparativelyrareentityusually
seeninassociationwithorsecondarytopulmonarytuberculosis,the
infectionreachesthemiddleearthroughtheeustachiantube
>Itischaracterizedbypainlessotorrhoeawhichfailstorespondto
--- Content provided by FirstRanker.com ---
theusualantimicrobialtreatment>patientwithevidenceoftubercleinfectionelsewherefollowedby
multipletympanicmembraneperforations,abundantgranulation
tissue,andbonenecrosis,preauricularlymphnodeenlargement
https://www.ncbi.nlm.nih.gov/pubmed/21522113
--- Content provided by FirstRanker.com ---
126.Partialandfullclosuredonein
a)Atrophicrhinitis
b)Allergicrhinitis
c)Vasomotorrhinitis
d)Occupationalrhinitis
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns.A.Atrophicrhinitis
ATROPHICRHINITIS
>Itisaformofchronicrhinitisassociatedwithatrophyof
nasalmucosa,mucousglands,nerves,andvessels.
--- Content provided by FirstRanker.com ---
>Itcanbeprimaryorsecondary.>Thesurgicaloptionsaimtoreducethesizeoftheroomy
cavitiestopreventtheexposuretodryingeffectsofair
andcrustsformationandthushelpregenerationofnasalmucosa.
Fullclosure-Young'soperation
--- Content provided by FirstRanker.com ---
Partialclosure-Modifiedyoung'soperation.(Ref.Cummings,6thed.,695)
127.OccipitomentalviewofPNSX-raycalled
as
a)Caldwellview
--- Content provided by FirstRanker.com ---
b)Waterviewc)Townview
d)Pineview
CorrectAnswer-B
Answer:b.Waterview
--- Content provided by FirstRanker.com ---
OccipitomentalviewofPNSX-raycalledasWaterview128.Whatcausesshiftingfluid?
a)ExudativeRetinaldetachment
b)TractionalRetinalDetachment
c)Rhegmatogenousretinaldetachment
--- Content provided by FirstRanker.com ---
d)RetinodialysisCorrectAnswer-A
Ans.a.ExudativeRetinaldetachment.
>Inexudativeretinaldetachment,thesubretinalfluidmaybe
confinedtoalocalizedarea,usuallytheposteriorpole,ormay
--- Content provided by FirstRanker.com ---
extendtotheperiphery,evenformingbullousretinaldetachment.>Thecharacteristicfeatureofasignificantexudativeretinal
detachmentisthepresenceofshiftingsubretinalfluid.
>Thefluidshiftstothemostdependentlocationwhenpatients
changebodyposition.
--- Content provided by FirstRanker.com ---
https://clinicalgate.com/nonrhegmatogenous-retinal-detachment/129.Conjunctivalinjection,pharyngeal
injection,polymorphicrash,cervical
lymphadenopathycanbeseenin
a)Kawasakisyndrome
--- Content provided by FirstRanker.com ---
b)Measlesc)Thrombocytopenia
d)Mumps
CorrectAnswer-A
Ans:a.Kawasakisyndrome.
--- Content provided by FirstRanker.com ---
>Kawasakidiseaseisageneralizedvasculitisthataffectsmedium-sizedarteries.
>Itischaracterizedbysystemicinflammationthatmanifestsas
persistentfever,erythemaofthemucousmembranes,bilateral
nonexudativeconjunctivitis,rash,swellingandrednessofthehands
--- Content provided by FirstRanker.com ---
andfeet,andcervicallymphadenopathyRef:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3034467/
130.IncongruousHomonymoushemianopia
withWernicke'shemianopiapupilisseen
withthelesionof
--- Content provided by FirstRanker.com ---
a)Opticradiationb)Lateralgeniculatebody
c)Optictract
d)Anterioroccipitalcortex
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans:c.Optictract>AnterioroptictractlesionproducesIncongruousHomonymous
hemianopia,decreasedvisualacuity,afferentpupil
defect(Wernicke'shemianopiapupil)andatrophyofopticdiscswith
characteristicBow-tieatrophyarecontralateral.
--- Content provided by FirstRanker.com ---
>AcompleteHomonymoushemianopiaresultsfromposterioroptictractlesions.
Ref:https://books.google.co.in/books?
id=bDpI9n4q3e0C&pg=PA376&lpg=PA376&dq=Incongruous+Homonymous+hemianopia+with+Wernicke%27s+hemianopic+pupil&source=bl&ots=36lTWDpqEI&sig=ACfU3U1mJNezirKF_11Ku5xpqqmWX6mdQw&hl=en&sa=X&ved=2ahUKEwio2-
fCi_bmAhUoxzgGHf56An8Q6AEwFXoECAoQAQ#v=onepage&q=Incongruous%20Homonymous%20hemianopia%20with%20Wernicke's%20hemianopic%20pupil&f=false
--- Content provided by FirstRanker.com ---
131.Thepatientcamewithproptosis,
restrictionofeyemovements,andwas
Euthyroid.Whatcouldthisbefrom?
a)OrbitalCellulitis
b)OrbitalLymphoma
--- Content provided by FirstRanker.com ---
c)Orbitalpseudotumord)Thyroidophthalmopathy
CorrectAnswer-C
Ans:C.Orbitalpseudotumor
>Proptosisandrestrictedeyemovementismostcommonly
--- Content provided by FirstRanker.com ---
associatedwiththyroidophthalmopathy>ButinquestionaskedisEuthyroid.
>So,thebestoptiontoselectisOrbitalpseudotumor(Idiopathic
orbitalinflammatorysyndrome)
Ref.ComprehensiveOphthalmologybyAKKhurana-6th
--- Content provided by FirstRanker.com ---
EditionPageno335132.Prerequisiteforsympathetic
ophthalmitis
a)Penetratinginjurytotheeye
b)Bluntoculartumor
--- Content provided by FirstRanker.com ---
c)Chemicalinjuryd)Urinarytractinfection
CorrectAnswer-A
Ans:a.Penetratinginjurytotheeye.
>Sympatheticophthalmiaisararetypeofuveitisthatcausessmall
--- Content provided by FirstRanker.com ---
abnormalclumpsofcells(granulomas)toform.>Thisdisorderoccursintheuninjuredeyeafterapenetratinginjury
(suchaswhenapencil,pen,orstickpuncturestheeye)orsurgery
totheother(injured)eye.
Ref:https://www.msdmanuals.com/en-in/home/eye-disorders/uveitis-
--- Content provided by FirstRanker.com ---
and-related-disorders/sympathetic-ophthalmia.133.Photostresstesttodifferentiate
a)Lensandcornea
b)ThemaculaandOpticnervediseases
c)Cataractandglaucoma
--- Content provided by FirstRanker.com ---
d)RetinalandvitreousdiseasesCorrectAnswer-B
Ans:b.ThemaculaandOpticnervediseases.
>Todistinguishopticnerveconductiondefectsfromthe
maculardiseaseinpatientswithotherwiseunexplainedlossof
--- Content provided by FirstRanker.com ---
centralvisionwefirstdeterminedthebestvisualacuitywithcorrectionatdistanceinunilateraldefects.
>Thenormaleyewastestedfirstandphotostressedforten
secondsbylookingatanordinarypenlightheld2to3cmfromthe
eye.
--- Content provided by FirstRanker.com ---
>ThetimerequiredtoreadthreelettersonthreeSnellentestlinesjustlargerthanthebestacuitywasusedastheendpoint.
>Recoverytimewillbeprolongedwithmaculopathy.
>Prolongedrecoverytimewillnotbeobservedinpatientswho
haveopticnervedisease.
--- Content provided by FirstRanker.com ---
https://www.ncbi.nlm.nih.gov/pubmed/836667134.Whichlayerofcorneahelpsinthe
hydrationofstromaofcornea
a)Endothelium
b)Epithelium
--- Content provided by FirstRanker.com ---
c)Descemetmembraned)Stroma
CorrectAnswer-A
Ans:a.Endothelium
>Thecornealendotheliumisresponsibleformaintainingthe
--- Content provided by FirstRanker.com ---
hydrationofthecornea.>Thisisthrougha"Pump-Leak"mechanismwheretheactive
transportpropertiesoftheendotheliumrepresentthe"Pump"and
thestromalswellingpressurerepresentsthe"Leak"
Ref:https://www.researchgate.net/publication/51238307_Molecular_Mechanisms_Underlying_the_Corneal_Endothelial_Pump
--- Content provided by FirstRanker.com ---
135.A65oldmalewithahistoryof
hypertensionanddiabetes,presentsto
theOPDwithcomplaintsofdiplopiaand
squint.Onexamination,thesecondary
deviationismorethantheprimary
--- Content provided by FirstRanker.com ---
deviation.Whichofthefollowingismostlikelydiagnosis
a)concomitantsquint
b)paralyticsquint
c)Restrictivesquint
--- Content provided by FirstRanker.com ---
d)PseudosquintCorrectAnswer-B
Ans:b.paralyticsquint.
>Paralyticorincomitantsquintoccurswhenthereisanacquired
defectofthemovementofaneye.
--- Content provided by FirstRanker.com ---
>Thesquint(anddoublevision)ismaximallydemonstratedbylookinginthedirectionofactionoftheweakenedmuscle.
>ParalyticsquintsoccurduetodiseaseoftheIII,IVandVIcranial
nerves.
Ref:https://www.gponline.com/basics-
--- Content provided by FirstRanker.com ---
strabismus/ophthalmology/article/1055827136.Esotropiaiscommonin
a)Myopia
b)Hypermetropia
c)Emmetropia
--- Content provided by FirstRanker.com ---
d)AstigmatismCorrectAnswer-B
And:B.Hypermetropia
>Patientswithrefractiveesotropiaaretypicallyfarsighted
(hyperopic).
--- Content provided by FirstRanker.com ---
>Thismeansthattheeyesmustworkhardertoseeclearly,particularlywhentheobjectofregardisupclose.
https://aapos.org/glossary/accommodative-esotropia
137.Anextrarowofciliaposteriortothegrey
line
--- Content provided by FirstRanker.com ---
a)Distichiasisb)Tylosis
c)Madarosis
d)Trichiasis
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
And:a.Distichiasis>Distichiasisisararedisorderdefinedastheabnormalgrowthof
lashesfromtheorificesofthemeibomianglandsontheposterior
lamellaofthetarsalplate.
Ref:https://emedicine.medscape.com/article/1212908-overview
--- Content provided by FirstRanker.com ---
138.Thepatientcamewithunilateral
ProptosisandbilateralAbducentnerve
palsy.Thiscouldbefrom
a)Cavernoussinus
b)Orbitalcellulitis
--- Content provided by FirstRanker.com ---
c)Orbitalpseudotumord)Orbitallymphoma
CorrectAnswer-A
Ans:a.Cavernoussinus
>Proptosisisinitiallyseenunilaterallyultimatelybecomesbilateral.
--- Content provided by FirstRanker.com ---
>6thcranialnerve(Abducent)passesthroughthecavernoussinus.soincavernoussinusthrombosisbilateralabducenspalsyis
seen.
Parson'sDiseasesoftheEye-Ed.22Pg497
139.Thecharacteristicfindingoffungal
--- Content provided by FirstRanker.com ---
ulcers?a)Satellitelesions
b)Dendriticulcer
c)Ringabscess
d)Whitehypopyon
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnd.a.Satellitelesions
>Fungalkeratitisorkeratomycosisreferstoaninfectiveprocessof
thecorneacausedbyanyofthemultiplepathologicfungicapableof
invadingtheocularsurface.
--- Content provided by FirstRanker.com ---
>whentheepithelialintegrityisbrokeneitherduetotraumaorocularsurfacediseaseandtheorganismgainsaccessintothetissueand
proliferates.
>Multifocalstromalinfiltratesor"satellitelesions"havebeen
consideredacharacteristicfeatureoffungalkeratitis.
--- Content provided by FirstRanker.com ---
Ref:https://eyewiki.aao.org/Fungal_Keratitis140.Adrugusedinapatientwithincreased
IOPandopticdiscchanges,ciliary
congestionfordecreaseIOPactsby
increasinguveoscleraloutflowis
--- Content provided by FirstRanker.com ---
a)Latanoprostb)Pilocarpine
c)Dorzolamide
d)Timolol
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:a.Latanoprost>LatanoprostselectivelystimulatestheprostaglandinF2alpha
receptorandthisresultsinadecreasedintraocularpressure(IOP)
viatheincreasedoutflowofaqueoushumor,whichisoften
implicatedincasesofelevatedintraocularpressure.
--- Content provided by FirstRanker.com ---
Ref:https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.drugbank.ca/drugs/DB00654&ved=2ahUKEwicmYHW5PjmAhU94HMBHZG6ADcQFjANegQIAxAB&usg=AOvVaw34z-
Nz08_cOFzeYemAzeWf&cshid=1578651404060
141.ApatientdiagnosedwithRheumatoid
arthritiswasonmedications.After2
--- Content provided by FirstRanker.com ---
years,hedevelopedablurringvisionandwasfoundtohavecornealopacity.
Whichdrugismostlikelytocausethis?
a)Sulfasalazine
b)Chloroquine
--- Content provided by FirstRanker.com ---
c)Methotrexated)Leflunomide
CorrectAnswer-B
Ans:B.Chloroquine
Inlong-termchloroquinetherapyOcularcomplicationswere
--- Content provided by FirstRanker.com ---
observed>Thistherapyisusuallyusedinpatientswithrheumatoidarthritis,
lupuserythematosus,sarcoidosis,discoidlupus,andotherchronic
"collagendisease".
>Retinalchanges,cornealopacifications,blurringofvisionaresome
--- Content provided by FirstRanker.com ---
complicationsseeninlongtermuseofChloroquine.Ref:https://www.ncbi.nlm.nih.gov/pubmed/1427503
142.Nutcrackeresophagus,thecorrect
statementis
a)Thereisextremelyforcefulperistalticactivityleadingto
--- Content provided by FirstRanker.com ---
episodesofchestpainanddysphagiab)Thereisnomedicalt/tavailable
c)TypeofoesophagealMalignancy
d)None
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.Thereisextremelyforcefulperistalticactivityleadingtoepisodesofchestpainanddysphagia
NutCrackerOesophagusisahypermotilitydisorderwithhigh
amplitudeperistalsis.Itisaconditioninwhichextremelyforceful
peristalticactivityleadstoepisodicchestpainanddysphagia.
--- Content provided by FirstRanker.com ---
Treatmentiswithnitratesornifedipine.Ref.davidsonsprinciplesandpractice23rdeditionpageno.795
143.Whichofthefollowingcriteriaisusedto
assesstheprognosisoftheliver
conditionasrepresentedinthepicture
--- Content provided by FirstRanker.com ---
below?a)Childpughscore
b)Milanscore
c)Meldscore
d)Alvaradoscore
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Childpughscore
theliverconditionasrepresentedinthepictureabovedemonstrates
livercirrhosis.
Child-Pughscore(ortheChild?Turcotte?PughscoreorChild
--- Content provided by FirstRanker.com ---
Criteria)isusedtoassesstheprognosisofchronicliverdisease,mainlycirrhosis.
Itisnowusedtodeterminetheprognosis,aswellastherequired
strengthoftreatmentandthenecessityoflivertransplantation.
Factor
--- Content provided by FirstRanker.com ---
12points
3points
point
Totalbilirubin
--- Content provided by FirstRanker.com ---
<34 34-50>50
(mol/L)
Serumalbumin >35 28-35
<28
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(g/L)PTINR
<1.7 1.71-2.30
>2.30
Ascites
--- Content provided by FirstRanker.com ---
None MildModerateto
Severe
Hepatic
None GradeI-II(orsuppressed
--- Content provided by FirstRanker.com ---
GradeIII-IV(orHepatic
None GradeI-II(orsuppressed
GradeIII-IV(or
encephalopathy
--- Content provided by FirstRanker.com ---
withmedication)refractory)
Interpretation:
Points Class Oneyearsurvival Two-yearsurvival
5?6
--- Content provided by FirstRanker.com ---
A100%
85%
7?9
B
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81%57%
10?15 C
45%
35%
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144.Suddenonsetheadachewithneck
rigidity?
a)Intraparenchymalhemorrhage
b)Sah
c)Meningitis
--- Content provided by FirstRanker.com ---
d)NoneoftheaboveCorrectAnswer-B
Ans:b.Sah
suddenonsetofasevereheadache(oftendescribedas"theworst
headacheofmylife")
--- Content provided by FirstRanker.com ---
nauseaandvomitingstiffneck
sensitivitytolight(photophobia)
blurredordoublevision
lossofconsciousness
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seizures145.Vegetationinmitralvalveseeninwhich
condition
a)Libmansacks
b)Infectiveendocarditis
--- Content provided by FirstRanker.com ---
c)NBTEd)Rheumaticfever
CorrectAnswer-B
Ans:B.Infectiveendocarditis
Infectiveendocarditisischaracterizedbylesions,knownas
--- Content provided by FirstRanker.com ---
vegetations,whichisamassofplatelets,fibrin,microcoloniesofmicroorganisms,andscantinflammatorycells.Inthesubacuteform
ofinfectiveendocarditis,thevegetationmayalsoincludeacenterof
granulomatoustissue,whichmaybefibrosedorcalcified.
146.Waterhammerpulseisseenin
--- Content provided by FirstRanker.com ---
a)Aorticregurgitationb)Mitralstenosis
c)Aorticstenosis
d)Leftventricularfailure
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.AorticregurgitationWaterhammerpulse
Itisalargeboundingpulse,associatedwithanincreasedstroke
volumeoftheleftventricleandadecreaseintheperipheral
resistance,leadingtowidepulsepressure.
--- Content provided by FirstRanker.com ---
Thepulsestrikesthepalpatingfingerwitharapid,forcedjerkandquicklydisappears.
Itisbestfeltintheradialarterywiththepatient'sarmelevated.
Itisseeninaorticregurgitation.
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147.Whatwillyoudowhen3yrsoldchildparentscometophcwithfever,cough
since5dayswithchestindrawing
presentundermnciclassification
a)Giveantipyreticsonly
--- Content provided by FirstRanker.com ---
b)Giveantibioticsandfollowupc)Referurgentlytotertiarycare
d)Giveantibioticsandrefertotertiarycare
CorrectAnswer-D
Ans:D.Giveantibioticsandrefertotertiarycare
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148.Whatpoisonwillyoudetectinskeleton
evenafteremaciation
a)Lead
b)Arsenic
c)Mercury
--- Content provided by FirstRanker.com ---
d)CadmiumCorrectAnswer-B
Ans:B.Arsenic
Arseniccanbedetectedeveninconflagratedhumanbones.Hence,
itispossibletodetectpoisoningbyarsenicevenwhenthebodyhas
--- Content provided by FirstRanker.com ---
beenburntforalongtime.FMT2ndeditionPageno.184
149.Ph7.2,HCO3-(10or12),pco2-35,
metabolicacidosisdueto
a)K+excretionbythekidney
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b)Co2expirationbylungsc)H+excretionbythekidney
d)Hco3lossbykidney
CorrectAnswer-D
Ans:D.Hco3lossbykidney
--- Content provided by FirstRanker.com ---
Inthequestion,pHisdecreased(acidosis)&pCO2isdecreased(Normal=40-45mmHg).
AdecreasedpCO2willtrytoincreasepH,henceitmustbea
secondarycompensatingmechanism.
So,theprimarymechanismcausingtheacid-baseimbalancemust
--- Content provided by FirstRanker.com ---
beadecreaseinserumbicarbonateconcentrationi.e.metabolicacidosis.
150.ImpairedfunctionofAquaporinresultsin
a)Liddelsyndrome
b)NephrogenicDI
--- Content provided by FirstRanker.com ---
c)Cysticfibrosisd)Bartersyndrome
CorrectAnswer-B
Ans:B.NephrogenicDI
Aquaporins,alsocalledwaterchannels,areintegralmembrane
--- Content provided by FirstRanker.com ---
proteinsfromalargerfamilyofmajorintrinsicproteinsthatformporesinthemembraneofbiologicalcells,mainlyfacilitatingthe
transportofwaterbetweencells.
Geneticdefectsinvolvingaquaporingeneshavebeenassociated
withseveralhumandiseasesincludingnephrogenicdiabetes
--- Content provided by FirstRanker.com ---
insipidusandneuromyelitisoptica.151.Mostseriouscomplicationofmeaslesis:
September2008
a)Croup
b)Meningo-encephalitis
--- Content provided by FirstRanker.com ---
c)Otitismediad)Pneumonia
CorrectAnswer-B
Ans.B:Meningo-encephalitis
Measlesisahighlycommunicableacutedisease.Itisalsoknownas
--- Content provided by FirstRanker.com ---
rubeolaandismarkedbyprodromalfever,cough,coryza,conjunctivitis,andpathognomonicenanthem(i.e.,Koplikspots),
followedbyanerythematousmaculopapularrashonthethirdto
seventhday.
Infectionconferslife-longimmunity.
--- Content provided by FirstRanker.com ---
Ageneralizedimmunosuppressionthatfollowsacutemeaslesfrequentlypredisposespatientstobacterialotitismediaand
bronchopneumonia.
Inapproximately0.1%ofcases,measlescausesacutemeningo-
encephalitis,whichisthemostseriouscomplication.Subacute
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sclerosingpanencephalitis(SSPE)isararechronicdegenerativediseasethatoccursseveralyearsaftermeaslesinfection.
152.ThemostcommoncauseofdeathinSLE
inchildren
a)Lupusnephritis
--- Content provided by FirstRanker.com ---
b)Lupuscerebritisc)Libmansacksendocarditis
d)Anemiaandinfections
CorrectAnswer-A
Ans:A.Lupusnephritis
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MajorcausesofdeathinpediatricSLEinclude:1. Renaldisease(lupusnephritis)
2. Severediseaseflare
3. Infections
153.ApatienthavingmultipleGallstonesand
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shows8mmdilationand4stonesinCBD,besttreatmentmodalitiesare?
a)Cholecystectomywithcholedocholithotomyatthesamesetting
b)ESWL
c)CholecystectomyandwaitforERCP
--- Content provided by FirstRanker.com ---
d)AllCorrectAnswer-A
Ans:A.Cholecystectomywithcholedocholithotomydoneatthe
samesitting
ManagementofsuspectedorprovenCBDstonesassociatedwith
--- Content provided by FirstRanker.com ---
gallbladderstonesForgallstones-laparoscopiccholecystectomyistheprocedureof
choice.
ForCBDstonestwothingscanbedone:
1)Ifthesurgeonisexperiencedinlaparoscopictechniquesof
--- Content provided by FirstRanker.com ---
CBDstoneremovalthenbothcholecystectomyandcholedocholithotomyaredoneinthesamesitting.
CBDstonesarefirstconfirmedbyanintraoperativecholangiogram
thenthestonesareremovedlaparoscopicallyviathecysticductor
bycholedochotomy.
--- Content provided by FirstRanker.com ---
2)IfthesurgeonisnotexperiencedwithlaparoscopicmethodsofCBDstoneremoval,preoperativeendoscopicsphincterotomywith
stoneremovalandlaterlaparoscopiccholecystectomyisdone.
Laparoscopiccholecystectomywithcholedocholithotomyinthe
samesittingisthepreferredtechnique(providedthesurgeonis
--- Content provided by FirstRanker.com ---
experienced)Butonemustkeepinmindherethat
"forelderly,poor-riskpatientswithgallstonesandCBDstones,some
haverecommendedERCPandsphincterotomyasthesole
treatment,leavinggallbladderandstonesinsitu".-Maingot's10/e
--- Content provided by FirstRanker.com ---
Usuallythegallstonesinthesepatientsremainasymptomaticandiftheneedarisescanbemanagedbycholecystectomy
154.Pulmonaryplethoraisseenwithall
except:
a)TGS
--- Content provided by FirstRanker.com ---
b)Ebsteinanomaliesc)Hypoplasticleftheartsyndrome
d)Doubleoutletrightventricle
CorrectAnswer-B
Ans:B.Ebsteinanomalies
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PulmonaryplethoraisseeninTOF
TA
Ebstein'sanomaly
Pulmonaryatresia
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155.20yearsoldmanpresentedwiththe
complaintofswellingofthewristforthe
lasttwoyears.histopathological
examinationshowedspindle-shaped
cellsandverocaybodieswhatisthe
--- Content provided by FirstRanker.com ---
diagnosis?a)Lipoma
b)Dermoidcyst
c)Neurofibroma
d)Schwannoma
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAns:D.Schwannoma
spindlecellsandverocaybodiesareseeninschwannoma
isatumorofthetissuethatcoversnerves,calledthenervesheath.
ThesetumorsdevelopfromatypeofcellcalledaSchwanncell,
--- Content provided by FirstRanker.com ---
whichgivesthemtheirname.Schwannomasareoftennotcancerous(benign).
Themostcommontypeofschwannomaisvestibularschwannoma.
Itaffectsthenerveresponsibleforbalance(alsocalledthevestibular
nerve).Itcancauseinnereardeafnessbecausethehearingand
--- Content provided by FirstRanker.com ---
balancenerveruntogether,andasthetumorgrowsitdamagesthehearingnerve(cochlearnerve).Becauseofthisdoctorusedtocall
themacousticneuromas.
Microscopically,thetumoriscomposedoffibrocellularbundles
formingthewhorledpattern.
--- Content provided by FirstRanker.com ---
Thereareareasofdenseandcompactcellularity(AntoniApattern)alternatingwithlooseacellularareas(AntoniB
pattern).AreasofAntoniApatternshowpalisadednuclei
calledVerocaybodies.
Nervefibersareusuallyfoundstretchedoverthecapsulebutnot
--- Content provided by FirstRanker.com ---
withinthetumor.Areasofdegenerationcontainhaemosiderinandlipid-laden
macrophages.
SchwanncellscharacteristicallyexpressS-100protein.
Aschwannomararelyeverbecomesmalignant.
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156.Hemodynamicallyunstablepatientwith
SVT
a)IVIBUTILIDE
b)IVDILTIAZEM
--- Content provided by FirstRanker.com ---
c)CARDIOVERSIONd)Ivbeta-blockers
CorrectAnswer-C
Ans:C.CARDIOVERSION
157.AFemalepatientwasonlithiumfor
--- Content provided by FirstRanker.com ---
bipolardisorderfor6months.shefastedforsomedaysduetoreligiouscondition
andlaterpresentedwith
seizures,tremors,confusionand
weakness.Whatinvestigationshaveto
--- Content provided by FirstRanker.com ---
bedonetodiagnoseherconditiona)serumelectrolytes
b)serumlithium
c)ECG
d)MRI
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns:B.serumlithium
Becauseofitseffectsonmultiplebodysystems,includingbutnot
limitedtorenal,hematologic,andthyroidsystems,appropriate
baselinestudiesmustprecedethestartoflithiumtherapy.
--- Content provided by FirstRanker.com ---
Theminimalteststobedoneincludeserumcreatinine,electrolytes,thyroidfunctiontests,andacompletebloodcountwithdifferential.
Additionally,becauseofitscardiaceffect,anECGisindicated.Any
womanthoughttobepregnantshouldhaveapregnancytest.
Ref:NurcombeB.(2008).Chapter12.DiagnosticFormulation,
--- Content provided by FirstRanker.com ---
TreatmentPlanning,andModesofTreatmentinChildrenandAdolescents.InM.H.Ebert,P.T.Loosen,B.Nurcombe,J.F.
Leckman(Eds),CURRENTDiagnosis&Treatment:Psychiatry,2e.
158.Lithiumcauses:
a)Hypokalemia
--- Content provided by FirstRanker.com ---
b)Hyperkalemiac)Hypocalcemia
d)Hypercalcemia
CorrectAnswer-A
Ans:A.Hypokalemia
--- Content provided by FirstRanker.com ---
Sideeffectsoflithium1. Neurological:-Tremoristhecommonestsideeffectoflithium.Other
CNSsideeffectsaregiddiness,ataxia,motorincoordination,
hyperreflexia,mentalconfusion,nystagmus.
2. Renal:-Nephrogenicdiabetesinsipiduswithpolyuria&polydipsia.
--- Content provided by FirstRanker.com ---
AmilorideistheDOCforLithiuminducednephrogenicDI.3. Cardiovascular:-Effectsaresimilartohypokalemia.Themost
commonECGchangeisTwavedepression.
4. Endocrine:-Goitre,hypothyroidism
5. GIT:-Nausea,vomiting,diarrhea,metallictest,abdominalpain.
--- Content provided by FirstRanker.com ---
6. Dermatological:-Acneiformeruptions,papulareruption,exacerbationofpsoriasis.
7. Teratogenicity:-Ebstein'sanomalyinthefetus.
159.A50-year-oldmanpresentswith
paresthesia.HB-6.8g/dl.Peripheral
--- Content provided by FirstRanker.com ---
smearshowsmacrocytosisandneutrophilswithhypersegmented
nuclei.endoscopyrevealsatrophic
gastritis.amostprobablediagnosisis
a)Folatedeficiency
--- Content provided by FirstRanker.com ---
b)VitaminB12deficiencyc)Riboflavindeficiency
d)Irondeficiency
CorrectAnswer-B
Ans:B.VitaminB12deficiency
--- Content provided by FirstRanker.com ---
Macrocytosisandhypersegmentedneutrophilsonperipheralsmear,poorabsorption(Atrophicgastritis)suggestthediagnosisofB12
deficiency.
Thepresenceofanemia(Hb=6gm%)Macrocytosis(MCV=104)and
decreasedvitaminB12levels(B12=60pg/ml)suggestsadiagnosis
--- Content provided by FirstRanker.com ---
ofmegaloblasticanemiaduetovitaminB12deficiency.Thepatientinquestionthushasmacrocyticanemiaduetovitamin
B12deficiency.
160.Alltransretinoicacidisusedinthe
treatmentoftumourassociatedwith
--- Content provided by FirstRanker.com ---
a)BCR-ABLb)PML-RARA
c)CMYC
d)CEBPA
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:B.PML-RARAAll-transretinoicacid(ATRA)isanactivemetaboliteofvitaminA
underthefamilyretinoid.
Retinoids,throughtheircognatenuclearreceptors,exertpotent
effectsoncellgrowth,differentiationandapoptosis,andhave
--- Content provided by FirstRanker.com ---
significantpromiseforcancertherapyandchemoprevention.DifferentiationtherapywithATRAhasmarkedamajoradvanceand
becomethefirstchoicedruginthetreatmentofacutepromyelocytic
leukemia(APL).
All-transretinoicAcidisusedinthetreatmentforAcute
--- Content provided by FirstRanker.com ---
PromyelocyticLeukemia(PML)161.RenaltubularacidosiswithABGvalue
pH=7.24P02=80;PaCO2=36Na=131;
HCO3=14Cl=90;BE=-13Glucose=
135aboveABGpicturesuggest?
--- Content provided by FirstRanker.com ---
a)Respiratoryacidosisb)Respiratoryalkalosis
c)Metabolicacidosis
d)Metabolicalkalosis
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans:C.MetabolicacidosisThegivenvalueshavelowpH,andlowHCo3Indicatemetabolic
acidosis
PCO2inlowernormalrange(normalvalue35-45mm/hg)
162.Patientwithpulmonaryfibrosis.Which
--- Content provided by FirstRanker.com ---
antiarrhythmicdrugshouldnotbegivena)Amiodarone
b)Flecainide
c)Ivibutilide
d)lidocaine
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Amiodarone
Amiodaroneanditsmetabolitescanproducelungdamagedirectly
byacytotoxiceffectandindirectlybyanimmunologicalreaction.
ThelatterissupportedbythefindingofcytotoxicTcellsin
--- Content provided by FirstRanker.com ---
bronchoalveolarlavage(BAL)fluidfrompatientswithdiagnosedAPT.AmiodaronemayinducetheproductionoftoxicO2radicals,
whichcandirectlydamagecells
163.A42-year-oldpatientwithobstructive
jaundice.Alp,Ggt,haptoglobinall
--- Content provided by FirstRanker.com ---
increased.Themostlikelycauseis:a)Alcohol
b)Lead
c)Chronicrf
d)Noneoftheabove
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Alcohol
Anindicatorthatshouldmaketheclinicianhighlysuspiciousof
alcohol-relatedliverinjuryisAST:ALTratioof2:1ormore.
Gamma-glutamyltransferase(GGT)isanothersensitivebutnon-
--- Content provided by FirstRanker.com ---
specificmarkerforthehepaticinjurywhichcannotbeusedsolelytodiagnosealcohol-relatedhepaticinsult.
LevelsofGGTgreaterthantwicethenormalvaluesinadditionto
AST:ALTratio>2stronglyindicatealcohol-inducedliverinjuryas
well.
--- Content provided by FirstRanker.com ---
164.ThedifferentiatingfeaturebetweenIBS
andorganicGIdiseaseis:
a)Diarrhea
b)Stoolcalprotectin
c)Painabdomen
--- Content provided by FirstRanker.com ---
d)MucusinstoolsCorrectAnswer-B
Ans:B.Stoolcalprotectin
BothorganicIBDandnon-organicfunctionaldisorderslikeIBS
exhibitverysimilarsymptomsresearchershaveidentifiedseveral
--- Content provided by FirstRanker.com ---
stool-basedbiomarkerstodifferentiatebetweenIBDandIBS.Thesebecomeespeciallycrucialwhentakingthenextsteptowards
decidinghowtomanagethedisease(e.g.therapeuticintervention,
etc.).Thosebiomarkersincludethefollowing:
Calprotectin
--- Content provided by FirstRanker.com ---
Alpha-1AntitrypsinLysozyme
SecretoryIgA
Albumin
165.Atienthasfatigue.Butnotgaining
--- Content provided by FirstRanker.com ---
weight.Bodywaswarm.Investigationwillshow:
a)LowTSHwithmoret3ort4
b)HighTSHwithnormalt3ort4
c)HighTSHwitheuthyroid
--- Content provided by FirstRanker.com ---
d)Increaseduptakeoft3,butdecreaset4CorrectAnswer-A
Ans:A.LowTSHwithmoret3ort4
166.WarminginFrostfrostbiteshouldbe
doneatwhattemperature:
--- Content provided by FirstRanker.com ---
a)37degreeb)42degree
c)44degree
d)46degree
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.37degreeAttemperaturebelowfreezing(dry-coldcondition)frostbiteoccurs
thetissuefreeze&icecrystalsforminbetweenthecells
Affectedpartshouldbewarmedusingwaterat44?isunder
Criticism,Warmingshouldlastabout20minutesatatime,Intakeof
--- Content provided by FirstRanker.com ---
hotfluidspromotesgeneralrewarming167.Whichofthefollowingisnotseenin
Pituitaryapoplexy
a)Headache
b)Hypertension
--- Content provided by FirstRanker.com ---
c)Hypotensiond)Vomiting
CorrectAnswer-C
Ans:C.Hypotension
FollowingareseeninPituitaryapoplexy
--- Content provided by FirstRanker.com ---
SeverehypoglycemiaSevereheadache(usuallyretro-orbital)
Impairedconsciousness
Fever
Visualdisturbances(visualfielddefect,visualacuity)
--- Content provided by FirstRanker.com ---
Ophthalmoplegia(ocularparesis)CausingdiplopiaHypotension&shock
Nausea/vomiting
Meningealsign
168.Lossofpain/temperaturesensationon
--- Content provided by FirstRanker.com ---
ipsilateralface&C/Lbodyduetothrombosisin
a)PICA
b)Posteriorcerebellarartery
c)Superiorcerebellarartery
--- Content provided by FirstRanker.com ---
d)NoneoftheaboveCorrectAnswer-A
Ans:A.PICA
.Mostcasesresultfromipsilateralvertebralarteryocclusion;
occlusionoftheposteriorinferiorcerebellararteryisresponsiblefor
--- Content provided by FirstRanker.com ---
it.VesselocclusionthatresultsinLateralMedullarysyndrome:
Vertebral(mostcommon)
Posteriorinferiorcerebellar(2ndmostcommon)
Superior,middleorInferiorlateralmedullaryarteries
--- Content provided by FirstRanker.com ---
Lateralmedullarysyndrome(Wallenbergsyndrome):Vertigo
Numbnessofipsilateralfaceandcontralaterallimbs
Diplopia
Dysphagia
--- Content provided by FirstRanker.com ---
DysarthriaAtaxia
Hoarseness
169.AllfoundinLVFexcept
a)Lungoligemia
--- Content provided by FirstRanker.com ---
b)Kerleyblinesc)Rales
d)Pedaledema
CorrectAnswer-A
Ans:A.Lungoligemia
--- Content provided by FirstRanker.com ---
ChestX-rayFeaturesofLeftventricularfailure:Cardiomegaly
Kerleylines
Prominentupperlobeveins
Bat'swingsshadow
--- Content provided by FirstRanker.com ---
PleuraleffusionKerleyBlineisduetointerstitialedema.
Prominentrightdescendingpulmonaryarteryisseeninacute
pulmonaryembolism.
170.Allofthefollowingshowlowglucosein
--- Content provided by FirstRanker.com ---
pleuralfluid,EXCEPT-a)Empyema
b)Malignantpleuraleffusion
c)Rheumatoidarthritis
d)Dressler'ssyndrome
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAnswerisD(Dressler'sSyndrome):
Dresslersyndromeisasecondaryformofpericarditisthatoccurs
inthesettingofinjurytotheheartorthepericardium(theouterlining
oftheheart).Itconsistsoffever,pleuriticpain,pericarditisand/or
--- Content provided by FirstRanker.com ---
pericardialeffusion.Thediseaseconsistsofpersistentlow-gradefever,chest
pain(usuallypleuritic),pericarditisand/orpericardialeffusion.The
symptomstendtooccur2?3weeksaftermyocardialinfarctionbut
canalsobedelayedafewmonths.Ittendstosubsideinafewdays,
--- Content provided by FirstRanker.com ---
andveryrarelyleadstopericardialtamponade.ElevatedESRisanobjectivebutnonspecificlaboratoryfinding.
Dressler'sSyndromeisnotassociatedwithlowglucoseinpleural
fluid.
RheumatoidArthritis,MalignancyandEmpyema(Bacterial
--- Content provided by FirstRanker.com ---
infections)areallestablishedcausesofpleuraleffusionwithlowglucose.
Pleuraleffusionwithlowglucose(<60mg/c11)
1. Malignancy
2. Bacterialinfections
--- Content provided by FirstRanker.com ---
3. Rheumatoidpleuritis171.A25yearsoldladywithahistoryoffever
for1monthpresentswithheadacheand
ataxia.Brainimagingshowsdilated
ventriclesandsignificantbasal
--- Content provided by FirstRanker.com ---
exudates.WhichofthefollowingwillbethemostlikelyCSFfinding:
a)Lymphocytosis,LowGlucose,Highprotein
b)Lymphocytosis,NormalGlucose,Highprotein
c)Lymphocytosis,LowGlucose,Normalprotein
--- Content provided by FirstRanker.com ---
d)Neutrophilia,Lowglucose,LowProteinCorrectAnswer-A
Ans:A.(Lymphocytosis,LowGlucose,Highprotein)
Presenceofsignificantbasalexudates,togetherwithdilated
ventricles(hydrocephalus)inayoungfemalewith
--- Content provided by FirstRanker.com ---
aprolongedhistoryoffeverandheadachesuggestsadiagnosisofTubercularMeningitis.
TubercularMeningitisischaracterizedbyLymphocyticPleocytosis,
LowGlucoseandHighProteinwithintheCSF.
ThepathologicalhallmarkofTubercularMeningitisisthe
--- Content provided by FirstRanker.com ---
predominantinvolvementofbasalcisternsthatareobservedbythepresenceofbasalinflammatorytissueexudate.
172.Whichofthefollowingdrugcanbegiven
inpatientsofprimarypulmonary
hypertension?
--- Content provided by FirstRanker.com ---
a)Icatibantb)Bosentan
c)Labetolol
d)Sodiumnitroprusside
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B.BosentanTreatmentforPrimarypulmonaryhypertension:
CALCIUMCHANNELBLOCKERS:
Patientswhorespondtoshort-actingvasodilatorsatthetimeof
cardiaccatheterizationshouldbetreatedwithcalciumchannel
--- Content provided by FirstRanker.com ---
blockers.Theendothelinreceptorantagonistsbosentanandambrisentanare
approvedtreatmentsofPAH
Bosentaniscontraindicatedinpatientswhoareoncyclosporineor
glyburideconcurrently.
--- Content provided by FirstRanker.com ---
173.ApatientarrivedinERfollowinganRTA
withhypotension,respiratorydistress
andsubcutaneousemphysemawithno
entryofairononeside.Whatwillbethe
bestmanagement?
--- Content provided by FirstRanker.com ---
a)Needledecompressionin5thintercostalspaceinthemidaxillaryline
b)ContinuePPV
c)ShifttoICUandincubate
d)SecureIVlineandstartfluidresuscitationafterinsertionofthe
--- Content provided by FirstRanker.com ---
wide-boreIVlineCorrectAnswer-A
Ans-A.Needledecompressionin5thintercostalspaceinthe
midaxillaryline
Atensionpneumothoraxdevelopswhena'one-wayvalve'airleak
--- Content provided by FirstRanker.com ---
occurseitherfromthelungorthroughthechestwall.Airissuckedintothethoraciccavitywithoutanymeansofescape,
completelycollapsingthencompressingtheaffectedlung.
Etiology-
Themostcommoncausesarepenetratingchesttrauma,bluntchest
--- Content provided by FirstRanker.com ---
traumawithparenchymallunginjuryandairleakthatdidnotspontaneouslyclose,iatrogeniclunginjury(e.g.duetocentral
venepuncture)andmechanicalpositivepressureventilation.
C/F-
Thepatientisincreasinglyrestlesswithtachypnoea,dyspnoeaand
--- Content provided by FirstRanker.com ---
distendedneckveinsTreatment-
Treatmentconsistsofimmediatedecompression,initiallybyrapid
insertionofalarge-borecannulaintothesecondintercostalspacein
themidclavicularlineoftheaffectedside,thenfollowedbyinsertion
--- Content provided by FirstRanker.com ---
ofachesttubethroughthefifthintercostalspaceintheanterioraxillaryline.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg367,920
174.TreatmentofRenalcellcarcinomaof
--- Content provided by FirstRanker.com ---
lessthan4cmwillbe-a)Partialnephrectomy
b)Radicalnephrectomy
c)Radicalnephrectomy+postoperativeradiotherapy
d)Radicalnephrectomy+chemotherapy
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Partialnephrectomy
Partialnephrectomyisnowbeingusedasprimarysurgicaltherapy
forpatientswithatumorlessthan4cminsize.EarlierRadical
nephrectomywasthetreatmentofchoicefortumorsofanysize.
--- Content provided by FirstRanker.com ---
Classicradicalnephrectomyconsistsofremovalofthekidney,perirenalfat,adrenalgland,andregionallymphnodes.MoststageI
andstageIItumors.
Partialnephrectomy-isindicatedforpatientswithaT1tumor
(accordingtotheUICCTNMstagingsystem)andanormal
--- Content provided by FirstRanker.com ---
contralateralkidney.Interventionshouldbeconsideredforgrowthto>3-4cmorby
>O.5cmperyear.
StageT1aN0M0
--- Content provided by FirstRanker.com ---
Partialnephrectomyrecommended.Thiscanbedoneviaopen/laparoscopic/roboticprocedures
StageT1bN0M0
PN(open/laparoscopic/robotic)incaseswheretechnicallyfeasible
LaparoscopicRNshouldbeofferedifaPNisnotfeasible
--- Content provided by FirstRanker.com ---
OpenRNiflaparoscopicsurgeryisnotpossible.StageT2N0M0
RN?open/laparoscopic/robotic
PN?open/laparoscopic/robotic
StageT3
--- Content provided by FirstRanker.com ---
RN?open,laparoscopicorrobotic-assistedResectionofvascularthrombosiswhenapplicable(usuallyopen)
Resectionofallgrossdiseaseincludinghilarorretroperitoneal
extension
PNmaybeattemptedinhighlyselectedcasesbyexperienced
--- Content provided by FirstRanker.com ---
surgeonsRef-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1420
https://www.researchgate.net/publication/263933944_Surgical_management_of_renal_cell_carcinoma_Canadian_Kidney_Cancer_Forum_Consensus
175.WhichisnotseeninAsepsisscore-
--- Content provided by FirstRanker.com ---
a)Erythemab)Induration
c)Serousdischarge
d)Purulentexudate
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B.IndurationCriterion
Points
Additionaltreatment
0
--- Content provided by FirstRanker.com ---
Antibioticsforwoundinfection10
Drainageofpusunderlocalanaesthesia
5
Debridementofwoundundergeneral
--- Content provided by FirstRanker.com ---
10anaesthesia
Serousdischarge
Daily0-5
Erythema
--- Content provided by FirstRanker.com ---
Daily0-5Purulentexudate
Daily0-10
Separationofdeeptissues
Daily0-10
--- Content provided by FirstRanker.com ---
Isolationofbacteriafromwound10
Stayasinpatientprolongedover14days
5
asresultofoundinfection
--- Content provided by FirstRanker.com ---
Ref-BaileyandLove,Shortpracticeofsurgery,27theditionpublishedin2018Pg48
176.Esophagealmanometrywasperformed-
itrevealedpanesophagealpressurization
withdistalcontractileintegrityas
--- Content provided by FirstRanker.com ---
>450mmHgpressureinthebody.Whatwillbethediagnosis?
a)Type1achalasia
b)Type2achalasia
c)Type3achalasia
--- Content provided by FirstRanker.com ---
d)JackhammeresophagusCorrectAnswer-C
Ans:C.Type3achalasia
TypeIachalasia(classicachalasia)-
ElevatedmedianIRP(>15mmHg),100%failedperistalsis(DCl
--- Content provided by FirstRanker.com ---
<100mmHg.s.cm)PrematurecontractionswithDCIvalues<450mmHg.s.cmsatisfy
criteriaforfailedperistalsis
TypeIIachalasia(withesophagealcompression)-
ElevatedmedianIRP(>15mmHg),100%failedperistalsis,
--- Content provided by FirstRanker.com ---
panesophagealpressurisationwith>20%ofswallows.
Contractionsmaybemaskedbyoesophagealpressurizationand
DCIshouldnotbecalculated.
Typelllachalasia(spasticachalasia)
--- Content provided by FirstRanker.com ---
ElevatedmedianIRP(>15mmHg),nonormalperistalsis,premature(spastic)
contractionswithDCI>450mmHg.s.cmwith>20%ofswallows
Maybemixedwithpanesophagealpressurization
'Diffuseesophagealspasm'andjackhammer(nutcracker)
--- Content provided by FirstRanker.com ---
esophagus-Spasticpressuresonmanometryof400-500mmHgmarked
hypertrophyofthecircularmuscleandacorkscrewesophaguson
bariumswallow.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
--- Content provided by FirstRanker.com ---
publishedin2018Pg1096,1099177.Whatwillbetheappropriate
managementforAbdominalaortic
aneurysm-
a)Monitortillsizereaches55mm
--- Content provided by FirstRanker.com ---
b)Immediatesurgeryc)USGmonitoringtill>70mmasymptomatic
d)Notreatment
CorrectAnswer-A
Answer-A.Monitortillsizereaches55mm
--- Content provided by FirstRanker.com ---
Anasymptomaticabdominalaorticaneurysminanotherwisefitpatientshouldbeconsideredforrepairif>55mmindiameter
(measuredbyultrasonography).
Regularultrasonographicassessmentisindicatedforasymptomatic
aneurysms<55mmindiameter.
--- Content provided by FirstRanker.com ---
75%ofaneurysmsaresuitableforendovascular(minimallyinvasive)repair,usuallyviathefemoralarteriesinthegroin.
Rupturedabdominalaorticaneurysmisasurgicalemergency.
SymptomaticAAA-
Anoperationisusuallyindicatedinpatientswhoareotherwise
--- Content provided by FirstRanker.com ---
reasonablyfit.Painmaybeawarningsignofstretchingoftheaneurysmsacandimminentrupture;surgeryshouldbeperformed
assoonaspossible(usuallyonthenextavailableoperatinglist).
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg961
--- Content provided by FirstRanker.com ---
178.WhatistheTstageofa2.5cmlung
carcinoma,notinvolvingthepleura?
a)T1a
b)T2
--- Content provided by FirstRanker.com ---
c)T1bd)T1c
CorrectAnswer-D
Ans:D.T1c
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
--- Content provided by FirstRanker.com ---
publishedin2018Pg927
179.In,theprimarysurveywhichisnot
included-
a)CECTtolookforbleeding
b)Exposureofthewholebody
--- Content provided by FirstRanker.com ---
c)ABCd)RecordingBP
CorrectAnswer-A
Answer?A.CECTtolookforbleeding
Theprimarysurveyaimstoidentifyandmanagethemost
--- Content provided by FirstRanker.com ---
immediatelylife-threateningpathologiesfirstandfollowscABCDE.1.c-Exsanguinatingexternalhemorrhage
2.A-airwaywithcervicalspinecontrol
3.B-Breathing&ventilation
4.C-Circulation&hemorrhage
--- Content provided by FirstRanker.com ---
5.D-Disability6.E-Exposure
Anassessmentofthehemodynamicstatusshouldbemadeto
identifyshockedpatients:theskinmaybepale,coolandsweaty,the
pulserateraisedtoover100perminuteandthebloodpressure
--- Content provided by FirstRanker.com ---
low.Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg323
180.MClocationofgastrinomainMEN-1
syndrome?
--- Content provided by FirstRanker.com ---
a)Duodenumb)Jejunum
c)Pancreas
d)Ileum
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A.DuodenumPETsoccurinaround50-60VoofMEN1patients.
Themostcommonfunctionaltumourisgastrinomainduodenum
followedbyinsulinoma.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
--- Content provided by FirstRanker.com ---
publishedin2018Pg856181.Patientshaveprecancerouslesionswith
abdominalswellingandinguinalnodes
areseen.Onexamination,
lymphadenopathywasfound.Themost
--- Content provided by FirstRanker.com ---
probablecarcinomarelatedtothisconditionwillbe?
a)capenis
b)CaTestis
c)caprostate
--- Content provided by FirstRanker.com ---
d)cabladderCorrectAnswer-A
Answer-A.capenis
Cancerpenisspreadstoinguinalnodes.
Amass,pruritusordischargeiscommon.Advancedtumoursmay
--- Content provided by FirstRanker.com ---
causefecalincontinencebytheinvasionofthesphincters.Analcanaltumoursarepalpableandirregularinduratedtender
ulceration.Sphincterinvolvementmaybeevident.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1371
--- Content provided by FirstRanker.com ---
182.Amanunderalcoholintoxicationhad
fallenintoamanholeandhadaperineal
injurywithswollenscrotumandupper
thighalongwithbloodatmeatus.The
patientishavingdifficultypassingurine
--- Content provided by FirstRanker.com ---
aswell.Whatwillbetheinjuryassociatedduetothistrauma?
a)Bladderrupture
b)Penilefracture
c)Bulbarurethra
--- Content provided by FirstRanker.com ---
d)MembranousurethraCorrectAnswer-C
Answer-C.Bulbarurethra
Thereisahistoryofablowtotheperineum,usuallyduetoafall
astrideinjury.Thebulbarurethraiscrushedupwardsontothepubic
--- Content provided by FirstRanker.com ---
bone,typicallywithsignificantbruising.Cyclingaccidents,loosemanholecoversandgymnasiumaccidents
astridethebeamaccountforanumberofcases.C/F
Thesignsofarupturedbulbarurethraareperinealbruisingand
hematoma,typicallywithabutterflydistribution.Thereisusually
--- Content provided by FirstRanker.com ---
bleedingfromtheurethralmeatusandretentionofurineisalsotypicallypresent.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1479,1480
183.Patientwithahistoryofcarcinoma
--- Content provided by FirstRanker.com ---
bladderpresentingwithdyspnoeawithclinicalsignsofDVTandtachycardia.
Theriskforthepatienttodevelop
Pulmonaryembolismaccordingto
WELL'sscore
--- Content provided by FirstRanker.com ---
a)Highb)Medium
c)Low
d)Cannotcommentwithoutd-dimervalues
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans.B.MediumWellscriteria
Score
High
>6.0
--- Content provided by FirstRanker.com ---
Moderate2.0to6.0
Low
<2.0
ModifiedWellscriteria Score
--- Content provided by FirstRanker.com ---
PElikely>4.0
PEunlikely
<or=4.0
ModifiedWellsCriteriaforDVT
--- Content provided by FirstRanker.com ---
VariableScore
Lowerlimbtraumaorsurgeryorimmobilisationin
1
plastercast
--- Content provided by FirstRanker.com ---
Bedriddenfor>3daysorsurgeryinthelast4weeks
1
Tendernessalongthelineoffemoralorpoplitealveins
1
Entirelimbswollen
--- Content provided by FirstRanker.com ---
1Calf>3cmlargercircumferencethantheotherside
1
10cmbelowthetibialtuberosity
1
--- Content provided by FirstRanker.com ---
Pittingedema1
Dilatedcollateralsuperficialveins(notvaricoseveins)
1
PreviousDVT
--- Content provided by FirstRanker.com ---
1Malignancy(includingtreatmentupto6monthsago)
1
Intravenousdrugabuse
3
--- Content provided by FirstRanker.com ---
AlternativediagnosismorelikelythanDVT-2
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg988
184.After4monthsofrenaltransplantation,a
--- Content provided by FirstRanker.com ---
patientcanlikelytodevelopwhichinfection-
a)EBV
b)CMV
c)Candida
--- Content provided by FirstRanker.com ---
d)HistoplasmaCorrectAnswer-B
Answer-B.CMV
Causesofallograftdysfunction
1.Early
--- Content provided by FirstRanker.com ---
Primarynon-function(irreversibleischaemicdamage)Delayedfunction(reversibleischaemicinjury)
Hyperacuteandacuterejection
Arterialorvenousthrombosisofthegraftvessels
Drugtoxicity(e.g.calcineurininhibitortoxicity)
--- Content provided by FirstRanker.com ---
Infection(e.9.cytomegalovirusdiseaseingraftMechanicalobstruction(ureter/commonbileduct)
2.Late
Chronicrejection
Arterialstenosis
--- Content provided by FirstRanker.com ---
Recurrenceoforiginaldiseaseinthegraft(glomerulonephritis,hepatitisC)
Mechanicalobstruction(ureter,commonbileduct)
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1551
--- Content provided by FirstRanker.com ---
185.Thepatientispresentwithfecal
peritonitisandduringlaparotomy,a
diverticularperforationisseen.Which
stageisclassifiedaccordingto
Hinchey'sstage?
--- Content provided by FirstRanker.com ---
a)1b)2
c)3
d)4
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Answer-D.4Hincheyclassificationofcomplicateddiverticulitis.
1. GradeIMesentericorpericolicabscess
2. GradellPelvicabscess
3. GradelllPurulentperitonitis
--- Content provided by FirstRanker.com ---
4. GradelVFaecalperitonitisRef-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1274
186.Ayoungmanmetwithamotorbike
accidentandhadinjuriestoileumand
--- Content provided by FirstRanker.com ---
jejunum.Thereforetheentireileumandpartialjejunumwereresected.Whichof
thefollowingwouldthepatientsuffer
from
a)VitaminB12deficiency
--- Content provided by FirstRanker.com ---
b)Atrophicgastritisc)Constipation
d)None
CorrectAnswer-A
Answer-A.VitaminB12deficiency
--- Content provided by FirstRanker.com ---
TheileumistheonlysiteofabsorptionofvitaminB12andbilesalts.Bilesaltsareessentialfortheabsorptionoffatsandfat-soluble
vitamins.
Followingresectionoftheileum,thelossofbilesaltsincreasesand
isnotmetbyanincreaseinsynthesis.
--- Content provided by FirstRanker.com ---
Thejejunumistheprincipalsitefordigestionandabsorptionoffluid,electrolytes,iron,folate,fat,proteinandcarbohydrate,butthe
absorptionofbilesaltsandvitaminB12onlyoccursintheterminal
ileum,wheretherearespecifictransporters.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
--- Content provided by FirstRanker.com ---
publishedin2018Pg283,1241187.Apatientafteraheavymealcomeswith
epigastricpain.Onexamination
tendernessandrigidityintheupper
abdomen.X-rayshowing
--- Content provided by FirstRanker.com ---
pneumomediastinum.Whatcanbethecause-
a)Spontaneousesophagealrupture
b)Penetratingforeignbodyinjurytoesophagus
c)Perforatedpepticulcer
--- Content provided by FirstRanker.com ---
d)RuptureofemphysematousbullaCorrectAnswer-A
Answer-A.Spontaneousesophagealrupture
Thisisaclinicalcaseofspontaneousesophagealrupture/
Boerhaave'ssyndrome
--- Content provided by FirstRanker.com ---
Theclinicalhistoryisusuallyofseverepaininthechestorupperabdomenafteramealoraboutofdrinking.
Mackler'striad,whichconsistsof(1)vomitingfollowedby(2)chest
painand(3)subcutaneousemphysemaduetoanesophageal
rupture.
--- Content provided by FirstRanker.com ---
Achestradiographisoftenconfirmedwithairinthemediastinum,pleuraorperitoneum.
InvestigationsChestX-ray--showspneumomdiastinum(`V'signof
Naclerio).
MRI/CTchest.
--- Content provided by FirstRanker.com ---
Totalcount.Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1073
SriramBhatM,SRB'sManualofSurgery,4theditionpublished
in2013,Pg856
--- Content provided by FirstRanker.com ---
188.Transplantationbetweenidenticaltwins-
a)Isograft
b)Allograft
c)Autograft
d)Xenograft
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer-A.Isograft
Graft:Itisthetransferoftissuefromoneareatoanotherwithoutits
bloodsupplyornervesupply.
Autograft:Itistissuetransferredfromonelocationtoanotheronthe
--- Content provided by FirstRanker.com ---
samepatient.Isograft:Itistissuetransferbetweentwogeneticallyidentical
individuals,i.e.betweentwoidenticaltwins.
Allograft:Itistissuetransferbetweentwogeneticallydifferent
members,e.g.kidneytransplantation(Humantohuman)
--- Content provided by FirstRanker.com ---
(Homograft).Xenograft:Itistissuetransferfromadonorofonespeciestoa
recipientofanotherspecies(Heterograft).
189.Thoracoscore,whatisnotthe
--- Content provided by FirstRanker.com ---
componenta)ASACLASSIFICATIONS
b)SURGERYPRIORITIES
c)Performancestatus
d)Expectedcomplicationspost-surgery
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAnswer-B.SURGERYPRIORITIES
TheThoracoscoreisthemostwidelyusedmodeltoassesstherisk
ofoperativemortalityinthoracicpatients
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
--- Content provided by FirstRanker.com ---
publishedin2018Pg915190.Retrosternalgoiterwhichistrue?
a)AllpatientsshouldundergoCTchest
b)Allpatientsrequireamediansternotomy
c)itreceivesbloodsupplyfromthoracicvessels
--- Content provided by FirstRanker.com ---
d)MajorityofretrosternalgoitresshouldbeoperatedimmediatelyCorrectAnswer-A
Answer-A.AllpatientsshouldundergoCTchest
Retrosternalgoitretendstoarisefromtheslowgrowthofa
multinodularglanddownintothemediastinum.
--- Content provided by FirstRanker.com ---
Itgetsitsbloodsupplyfromthemediastinumitself,notfromtheneck.
Investigations
AchestX-rayshowsasofttissueshadowunderthesternum.
Aradioactiveiodinestudyisdiagnostic.
--- Content provided by FirstRanker.com ---
CTscan/MRIisusefulandallpatientsshouldundergoit.Surgicalremovalofretrosternalthyroidisdone.(TOC)
Commonlyitcanberemovedthroughanincisionintheneck.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg810
--- Content provided by FirstRanker.com ---
SriramBhatM,SRB'sManualofSurgery,4theditionpublishedin2013,Pg498
191.TrueforKing'sCriteriawithacute
fulminantliverfailureexcept-
a)Age
--- Content provided by FirstRanker.com ---
b)Jaundice<7daysc)Serumbilirubin>17.5mg/dl
d)INR>3.5
CorrectAnswer-B
Answer-B.Jaundice<7days
--- Content provided by FirstRanker.com ---
King'sCollegecriteriaforlivertransplantationinAHF.APAP-associatedAHF-
pH?<?7.3
or
INR?>?6.5,serumcreatinine>3.4mg/dl,andgradeIII-IV
--- Content provided by FirstRanker.com ---
encephalopathyAllothercausesofAHF
INR>6.5
Or
Threeofthefollowingvariables:
--- Content provided by FirstRanker.com ---
1.Age40years2.ThecauseisnonA,nonBhepatitisoridiosyncraticdrugreaction
3.Durationofjaundicebeforeencephalopathy>7days
4.INR?>?3.5
5.Serumbilirubin>17.5mg/dl
--- Content provided by FirstRanker.com ---
APAP,acetaminophen;INR,internationalnormalizedratio.192.Apatientwhowaspostedforelective
inguinalherniasurgeryhashistoryMIfor
whichheunderwentCABG.Whatwill
youdoinpreoperativeassessment?
--- Content provided by FirstRanker.com ---
a)History+c/e+routinelabs+angiographytolookforstentpatency
b)History+c/e+routinelabs
c)History+c/e+routinelabs+stresstest
d)History+c/e+routinelabs+V/Qscan
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer-C.History+c/e+routinelabs+stresstest
InthegivenscenariothepatienthadundergoneCABGnotan
angioplasty,sothefirstoptionisruledout.
Withroutinelabtests,thestresstestshouldbeincludedtocheckthe
--- Content provided by FirstRanker.com ---
cardiacfunctionaspreoperativeassessment193.Historyoftraumawithastabinjuryto
therightlowerchestwithlowBPandlow
pulserate.ItcanbeimprovedwithIV
fluidsandafterresuscitationinthe
--- Content provided by FirstRanker.com ---
traumacenterpatient'sBPbecomesnormal.AchestX-rayshowedclearlung
fields.Whatwillbethenextstep-
a)EFAST
b)Keepimmediatechesttube
--- Content provided by FirstRanker.com ---
c)CECTabdomend)CECTchest
CorrectAnswer-A
Answer-A.EFAST
Investigationsaredrivenbythecardiovascularstatusofthepatient.
--- Content provided by FirstRanker.com ---
Intorsotrauma,thebestandmostsensitivemodalityisaCTscanwithintravenouscontrastforbluntinjuryifthepatientisstable.
Routineinvestigationintheemergencydepartmentofinjurytothe
chestisbasedonclinicalexamination,supplementedbychest
radiography.
--- Content provided by FirstRanker.com ---
Ultrasoundcanbeusedtodifferentiatebetweencontusionandtheactualpresenceofblood.
Extendedfocusedassessmentwithsonarfortrauma(eFAST)is
becomingthemostcommoninvestigation.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
--- Content provided by FirstRanker.com ---
publishedin2018Pg366,372194.Inapatientwithparathyroidadenoma,
howdoweconfirmtheremovalofthe
correctglandaftersurgery?
a)50%reductioninPTHafter10mins
--- Content provided by FirstRanker.com ---
b)50%reductioninPTHafter5minsc)25%reductioninPTHafter10mins
d)25%reductioninPTHafter5mins
CorrectAnswer-A
Answer-A.50%reductioninPTHafter10mins
--- Content provided by FirstRanker.com ---
MiamicriteriaTheIOPTHvaluesatbaseline(pre-incisionandpreexcision)andat
5and10minutesafterparathyroidectomywerereviewedaccording
totheMiamicriterion(>50%dropfromhighestbaselineIOPTHlevel
at10minutesafterexcision),criterion1(>50%dropfrompre-
--- Content provided by FirstRanker.com ---
incisionIOPTHlevelat10minutes),criterion2(>50%dropfromthehighestbaselineIOPTHlevelat10minutesandfinalIOPTHlevel
withinthereferencerange),criterion3(>50%dropfromthehighest
baselineIOPTHlevelat10minutesandfinalIOPTHlevellessthan
thepre-incisionvalue),criterion4(>50%dropfromthehighest
--- Content provided by FirstRanker.com ---
baselineIOPTHlevelat5minutes),andcriterion5(>50%dropfrompreexcisionIOPTHlevelat10minutes).
Ref-https://www.ncbi.nlm.nih.gov/pubmed/16702520
195.Flapcommonlyusedinbreast
reconstructionis?
--- Content provided by FirstRanker.com ---
a)DIEPbasedondeepinferiorepigastricvesselsb)TRAMbasedonsuperiorglutealvessels
c)Glutealflapbasedonthoracodorsalartery
d)Latissimusdorsiflapbasedontheinferiorepigastricartery
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A.DIEPbasedondeepinferiorepigastricvesselsDIEPflap(basedondeepinferiorepigastricvessels)
TRAMflapbasedonItiseithersuperiorpediclebasedonthe
superiorepigastricvesselsorinferiorpediclebasedontheinferior
epigastricvessels.
--- Content provided by FirstRanker.com ---
Latissimusdorsimuscle/myocutaneousflapItisbasedonthethoracodorsalartery,abranchofthesubscapularartery
Superiorglutealflapbasedonsuperiorglutealvessels.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg879
--- Content provided by FirstRanker.com ---
SriramBhatM,SRB'sManualofSurgery,4theditionpublishedin2013,Pg350,594
196.A30-year-oldmanispresentedwith
crampingglutealpainafterwalking
500m.Whichisthevesselinvolved
--- Content provided by FirstRanker.com ---
duringthis?a)Arterialdiseasewithaortoiliacinvolvement
b)Arterialdiseasewithfemoralarteryinvolvement
c)Femoralvenousinsufficiency
d)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer-A.Arterialdiseasewithaortoiliacinvolvement
Themusclegroupaffectedbyclaudicationisclassicallyone
anatomicallevelbelowthelevelofarterialdiseaseandisusuallyfelt
inthecalfbecausethesuperficialfemoralarteryisthemost
--- Content provided by FirstRanker.com ---
commonlyaffectedartery(70%ofcases).Aorto-iliacdisease(30%ofcases)maycausethighorbuttock
claudication.Buttockclaudicationinassociationwithsexual
impotenceresultingfromarterialinsufficiencyiseponymouslycalled
Leriche'ssyndrome.Itisveryrare.
--- Content provided by FirstRanker.com ---
Ref-BaileyandLove,Shortpracticeofsurgery,27theditionpublishedin2018Pg943
197.Whichisthemostcommonpancreatic
endocrineneoplasm?
a)Insulinoma
--- Content provided by FirstRanker.com ---
b)Gastrinomac)VIPoma
d)Glucagonoma
CorrectAnswer-A
Answer-A.Insulinoma
--- Content provided by FirstRanker.com ---
Insulinoma(70-80%)>Nonfunctionaltumours(30-35%)>gastrinoma(20-25%)
198.Anelderlymanwithalong-standing
moleoverthefacewhichisincreasingin
sizeandshowingirregularborders.What
--- Content provided by FirstRanker.com ---
willbethediagnosis?a)Superficialspreadingmelanoma
b)Lentigomaligna
c)Acralmelanoma
d)Nodularmelanoma
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer-A.Superficialspreadingmelanoma
Superficialspreadingmelanoma
Thisisthemostcommonpresentation(70%)usuallyarisinginapre-
existentnaevusafterseveralyearsofslowchange,followedby
--- Content provided by FirstRanker.com ---
rapidgrowthintheprecedingmonthsbeforepresentation.Nodularmelanoma(NM)Nodularmelanomaaccountsforl5%olall
MM.
Typicallyappearasblue/blackpapules,l-2cmindiameter,and
becausetheylackthehorizontalgrowthphase.
--- Content provided by FirstRanker.com ---
Lentigomalignamelanoma-Presentsasaslow-growing,variegatedbrownmaculeontheface,
neckorhandsoftheelderly.
Acrallentiginousmelanoma(ALM)ALMaffectsthesolesoffeet
andpalmsofhands.
--- Content provided by FirstRanker.com ---
Itusuallypresentsasaflat,irregularmaculeinlaterlife.Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg610
199.Whichparameterconclusivelyrulesout
malnutrition?
--- Content provided by FirstRanker.com ---
a)Edemab)Leanbodymass
c)Skinfoldthickness
d)NormalECFvolume
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans.B.LeanbodymassMeasuringweightandheightisthemostcommonwayofassessing
malnutritioninagivenpopulation.Suchuseofmeasurementsof
dimensionsofthehumanbodyisknownasanthropometry.
Anthropometryisawidelyused,inexpensiveandnoninvasive
--- Content provided by FirstRanker.com ---
measureofthegeneralnutritionalstatusofanindividualorapopulationgroup.Thethreecommonlyusedanthropometricindices
are:
-Weight-for-Age{WFA).
-Length-for-AgeorHeight-For-Age(HFA).
--- Content provided by FirstRanker.com ---
-Weight-for-LengthorWeight-for-Height{WFH).PEMreducesgrowthinchildren
Energyexpenditureinexcessofconsumptionleadstometabolizing
nutritionreservesintheformofstoredbodyfat.
Leanbodymassintheformofmuscleandevenorgantissuewill
--- Content provided by FirstRanker.com ---
alsobeconsumedifPEMpersists.itservesasareliableindicatorforPEM
Weightlossaccompaniestheinitialstagesofinadequateenergy
intakebut,ifprolonged,isfollowedbywasting,calledinitssevere
clinicalform,marasmus.
--- Content provided by FirstRanker.com ---
Inchildren,PEMdelaysorpermanentlystuntsgrowthandincreasesmorbidityandmortality.
Ref.ParkPSMed.24thPageno.677
200.A2yearsbabywith6.7kg,Hb%-6mg/dl
totalprotein3mg/dL,lowalbuminwith
--- Content provided by FirstRanker.com ---
distendedstomachbutnoproteinuria.Whatwillbethediagnosis?
a)Marasmus
b)Kwashiorkor
c)Indianchildhoodcirrhosis
--- Content provided by FirstRanker.com ---
d)NoneCorrectAnswer-B
Ans.B.Kwashiorkor
Kwashiorkorisaformofsevereacutemalnutrition(SAM)
characterizedbyedemaandapathy.
--- Content provided by FirstRanker.com ---
Edemaismostlikelytoappearfirstonthefeetandtheninthelowerlegs.Itcandevelopintogeneralizededemaaffectingthehands,
arms,andface.
Moonface
Skinchangesincludedepigmentationofskin,dermatoses,dark,
--- Content provided by FirstRanker.com ---
crackedpeelingpatches(flakypaintdermatosis)withpaleskinunderneaththatiseasilyinfected.
Hairissparse,easilypulledout,andmayturnreddish.
Flagsign:alternatingbandsofhypopigmentedandnormal
pigmentedareasonthehairstrand
--- Content provided by FirstRanker.com ---
Theliverisoftenenlargedwithfat(fattyLiver).Thechildrenaremiserableandapatheticandoftenrefusetoeat.
Musclewastingandgrowthfailureareseen.
Villousatrophyofsmallintestineanddiarrhea.
--- Content provided by FirstRanker.com ---
NelsonTextbookofPediatrics20thEditionPage:301201.InRDSinachild,whichcellsarefound
defective?
a)Type1pneumocytes
b)Type2pneumocytes
--- Content provided by FirstRanker.com ---
c)Bronchialepitheliumd)None
CorrectAnswer-B
Ans.B.Type2pneumocytes
TypeIcellsformthealveolarwallwhiletheTypeIIcellssynthesize
--- Content provided by FirstRanker.com ---
andsecretesurfactantDPCC.ThedefectinthebiosynthesisofDipalmitoylphosphatidylcholine
(DPPC),alsoknownasdipalmitoyllecithinleadstoRespiratory
distresssyndrome.
Ref.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880575/
--- Content provided by FirstRanker.com ---
202.Causeofgreenish-blackstoolina
neonate-
a)Meconium
b)Biliverdin
c)Bilirubin
--- Content provided by FirstRanker.com ---
d)UrochromeCorrectAnswer-B
Ans.B.Biliverdin
Fetalbowelcontentsconsistofvariousproductsofsecretion,such
asglycerophospholipidsfromthelung,desquamatedfetalcells,
--- Content provided by FirstRanker.com ---
lanugo,scalphair,andvernix.Italsocontainsundigesteddebrisfromtheswallowedamnionicfluid.Thedarkgreenish-blackis
causedbypigments,especiallybiliverdin.
Ref.WilliamsObstetricsEd.24thPageno.141
203.Atermbabyonbreastfeedingwith
--- Content provided by FirstRanker.com ---
bilirubin14mg/dLwhichofthefollowingistrue?
a)Exchangetransfusion
b)Continuetobreastfeed
c)Phototherapy
--- Content provided by FirstRanker.com ---
d)NoneCorrectAnswer-B
Ans.B.Continuetobreastfeed
Comparedwithformula-fednewborns,breastfedinfantsarethreeto
sixtimesmorelikelytoexperiencemoderatejaundice(totalserum
--- Content provided by FirstRanker.com ---
bilirubinlevelabove12mgperdL)orseverejaundice(totalserumbilirubinlevelabove15mgperdL.
Inabreastfednewbornwithearly-onsethyperbilirubinemia,the
frequencyoffeedingsneedstobeincreasedtomorethan10per
day.Iftheinfanthasadeclineinweightgain,delayedstooling,and
--- Content provided by FirstRanker.com ---
continuedpoorcaloricintake,formulasupplementationmaybenecessary,butbreastfeedingshouldbecontinuedtomaintainbreast
milkproduction.
Phototherapyusuallynotrecommendedwhenthetotalserum
bilirubinlevelisbelow15mgperdL.
--- Content provided by FirstRanker.com ---
Ref:https://www.aafp.org/afp/2002/0215/p599.html204.Truehermaphroditismkaryotype:
a)45X0streakedgonads
b)46XXOvotestis
c)47XY+9
--- Content provided by FirstRanker.com ---
d)47XXCorrectAnswer-B
Ans.B.46XXOvotestis
Truehermaphroditeorovotesticulardisorderofsexualdifferentiation
(OVO-DSD)isoneoftherarestvarietyofallintersexanomalies.
--- Content provided by FirstRanker.com ---
Inabout90%ofcases,patientshave46XXkaryotype.Rarely,46XY/46XXmosaicismmayoccur.
205.APGARscore3at1minuteindicates:
a)Mildlydepressed
b)Furtherresuscitationnotneeded
--- Content provided by FirstRanker.com ---
c)Severelydepressedd)Normal
CorrectAnswer-C
Ans.C.Severelydepressed
APGARCRITERIA:
--- Content provided by FirstRanker.com ---
ComponentScoreof
Scoreof1
Scoreof2
of
--- Content provided by FirstRanker.com ---
0backronym
blueat
nocyanosis
blueor
--- Content provided by FirstRanker.com ---
extremitiesbodyand
Skincolor
paleall
Appearance
--- Content provided by FirstRanker.com ---
bodypinkextremities
over
(acrocyanosis) pink
<100beatsper >100beats
--- Content provided by FirstRanker.com ---
Pulserateabsent
Pulse
minute
perminute
--- Content provided by FirstRanker.com ---
nogrimaceon
Reflex
response suctionor
cryon
--- Content provided by FirstRanker.com ---
irritabilityGrimace
to
aggressive
stimulation
--- Content provided by FirstRanker.com ---
grimacestimulation stimulation
flexedarms
andlegsthat
Activity
--- Content provided by FirstRanker.com ---
nonesomeflexion
Activity
resist
extension
--- Content provided by FirstRanker.com ---
Respiratoryweak,irregular, strong,robust
absent
Respiration
effort
--- Content provided by FirstRanker.com ---
gaspingcry
INTERPRETATION:
Thetestisgenerallydoneat1and5minutesafterbirthandmaybe
repeatedlaterifthescoreisandremainslow.
--- Content provided by FirstRanker.com ---
Scores7andabovearegenerallynormalScore4to6,fairlylow
Score:3andbelowaregenerallyregardedascriticallylowand
causeforimmediateresuscitativeefforts.
206.Awomandevelopedpainandcrawling
--- Content provided by FirstRanker.com ---
sensationonherlegsatnight.Clinicalhistoryofrestlesslegsyndrome.Drugof
choice?.
a)Pramipexole
b)Gabapentin
--- Content provided by FirstRanker.com ---
c)VitaminB12d)Irontablets
CorrectAnswer-A
Ans.apramipexole
Restlesslegsyndrome:
--- Content provided by FirstRanker.com ---
Subjectivesensation"creepy-crawly"feelinginthelimbs,andirresistibleurgetomovethelegswhenatrestorwhiletryingtofall
asleep.
Whentheindividualislyinginbedandrelaxing,heorsheis
disturbedbythesesensations.
--- Content provided by FirstRanker.com ---
Thenheorshemovesthelegsandagaintriestofallasleep.Thiscyclesometimescontinuesforhoursandresultsinprofound
insomnia.
Treatment:
Thedopaminergicagonists'pramipexoleandropiniroleareFDA
--- Content provided by FirstRanker.com ---
approvedandrepresentthetreatmentsofchoice.Ref.KaplanandSadock'sSynopsisofPsychiatry-11thEdition
(Pageno559)
207.HistoryofArthritisinvolving1stMCP
joint,otherPIP&DIPjoints,spareswrist
--- Content provided by FirstRanker.com ---
andankle.Whatcouldbethediagnosisa)Osteoarthritis
b)Rheumatoidarthritis
c)Psoriaticarthritis
d)Gout
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:a.Osteoarthritis
>Thedistalinterphalangeal(DIP)jointisactuallythemostcommon
locationonthebodyforosteoarthritis(OA).
>Thefrequencyofhandarthritis,OAattheDIPjointoccursin
--- Content provided by FirstRanker.com ---
approximately58%ofindividuals.>ThesymptomsofOAattheDIPjointcommonlyincludepainand
changestothesizeandshapeofthejoint.
https://www.3pointproducts.com/blog/health-arthritis-finger-
and-toe-conditions/dip-joint-osteoarthritis-how-to-treat-this-
--- Content provided by FirstRanker.com ---
common-form-of-arthritis208.12yroldChildadmittedtoICUwithblunt
traumaandfemurfracture-Pao260%
despite100%o2andrebreathermask,
CXRshowslungfieldsclearbutthe
--- Content provided by FirstRanker.com ---
patientremainsconfused.Whatismostlikelythediagnosis-
a)Pulmonarycontusion.
b)Fatembolismsyndrome.
c)Hypovolaemicshock.
--- Content provided by FirstRanker.com ---
d)Pulmonaryembolism.CorrectAnswer-B
Ans:b.Fatembolism.
Inthispatient,basedonthecasepresentationthereisRespiratory
Systeminvolvedaspao2is60,andCNSinvolvementasheisina
--- Content provided by FirstRanker.com ---
confusedstate.>So,thediagnosishereisFatembolismsyndrome.
>Embolizedfatwithincapillarybedscausedirecttissuedamageas
wellasinduceasystemicinflammatoryresponseresultingin
pulmonary,cutaneous,neurological,andretinalsymptoms.
--- Content provided by FirstRanker.com ---
>Gurd'sclinicaldescriptionoftheFESrenewedinterestinstudyingthissyndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665122/
209.A4yroldchildwhileplayingsuddenly
spunaroundhiselbowfromherservant
--- Content provided by FirstRanker.com ---
maid'shandandnowcontinuouslycryingnotallowinganyonetotouchhis
elbow.Heiskeepinghiselbowextended
.whatismostlikelythediagnosis-
a)Radialheadfracture
--- Content provided by FirstRanker.com ---
b)Pulledelbowc)supracondylarfracture
d)Elbowdislocation
CorrectAnswer-B
Ans:b.Pulledelbow
--- Content provided by FirstRanker.com ---
>Pulledelbow,alsocallednursemaid'selbow,isaradialheadsubluxationcausedbyaxialtractionorasuddenpulloftheextended
pronatedarm,anditisaverycommonphenomenon.
>Inthiscaseofpulledelbow,thechildusuallyavoidsmovingthe
affectedarm,holdingitclosetohisorherbody,withoutconsiderable
--- Content provided by FirstRanker.com ---
pain,andnoobviousswellingordeformitycanbeseen.>Whileafractureshouldbeexcluded,thepulledelbowcanusually
beidentifiedbasedonthispresentation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5999240/
210.Asexuallyactivefemalewiththeprofuse
--- Content provided by FirstRanker.com ---
frothyfoul-smellingdischargewithintenseitching.Strawberrycervix
revealedonexamination.Whatwillbe
thediagnosis?
a)Trichomonasvaginalis
--- Content provided by FirstRanker.com ---
b)Bacterialvaginosisc)Candidiasis
d)None
CorrectAnswer-A
Answer:a.Trichomonasvaginalis
--- Content provided by FirstRanker.com ---
Trichomonasvaginitis:ClinicalFeatures:
Thereissuddenprofuseandoffensivevaginaldischargeoften
datingfromthelastmenstruation.
Irritationanditchingofvaryingdegreeswithinandaroundthe
--- Content provided by FirstRanker.com ---
introitusarecommon.Thereisthepresenceofurinarysymptomssuchasdysuriaand
frequencyofmicturition.
Theremaybehistoryofprevioussimilarattacks
OnExamination:
--- Content provided by FirstRanker.com ---
Thereisthin,greenish-yellowandfrothyoffensivedischargepervaginum.
Thevulvaisinflamedwithevidencesofpruritus.
Vaginalexaminationmaybepainful.Thevaginalwallsbecomered
andinflamedwithmultiplepunctatehemorrhagicspots.Similarspots
--- Content provided by FirstRanker.com ---
arealsofoundoverthemucosaoftheportiovaginalispartofthe
cervixonspeculumexaminationgivingtheappearanceof
`strawberry'
Ref:DuttaGynaecology6theditionPageno.163-164
211.33yroldfemalewithheavymenstrual
--- Content provided by FirstRanker.com ---
bleedingfor6monthscomestothegynaecologyOPD.Onexamination,no
abnormalitywasseen.USGalso
appearednormal.Thepatientwastried
tobemanagedonnon-hormonal
--- Content provided by FirstRanker.com ---
treatmentbutitfailed.Whatwillbethenextmanagementstep?
a)Hormonaltherapy
b)Endometrialsampling
c)Hysterectomy
--- Content provided by FirstRanker.com ---
d)HysterectomyCorrectAnswer-B
Ans.B.Endometrialsampling
BeforestartingHormonaltherapyendometrialsamplingisdoneasif
hormonaltherapyprecedessamplingthesamplingresultswillbe
--- Content provided by FirstRanker.com ---
altered.AsalreadymentionedinquestiontheUSGandclinicalexamination
shownoabnormalityhencethediagnosiscan'tbemadeonthatso
fordiagnosisweneedtodoendometrialsamplingandseethe
hormonalpattern.Thenwecanproceedwithhormonaltherapy.
--- Content provided by FirstRanker.com ---
Ref.DuttaGynaecologyed.6thpageno.120212.Postmenopausalwomen1stlineofdrug
forosteoporosisis-
a)OCP
b)Bisphosphonates
--- Content provided by FirstRanker.com ---
c)Raloxifened)Strontium
CorrectAnswer-B
Ans.is.B.Bisphosphonates
Firstlineofmanagementofosteoporosis?Bisphosphonates
--- Content provided by FirstRanker.com ---
females.Alendronate,etidronate,pamidronate,andIbandronateare
bisphosphonateswhichinhibitboneresorption,andarevery
effectiveforbothosteoporosispreventionandtreatment.
Uses:
--- Content provided by FirstRanker.com ---
FirstlinedrugsfortreatingpostmenopausalosteoporosisPaget'sdisease
Osteolyticbonemetastasis.
Raloxifene:Itisaselectiveestrogenreceptormodulatorwhichis
alsousefulinmanagementofosteoporosisbutitisahormonal
--- Content provided by FirstRanker.com ---
preparation.213.Prolactinsecretedmaximumat-
a)24hrsafterdelivery
b)REM
c)2hrsrunning
--- Content provided by FirstRanker.com ---
d)24hourafterOvulationCorrectAnswer-A
Ans.A.24hrsafterdelivery
Prolactinismaximum24hrsafterdelivery.
Prolactinsecretionalsoincreasesduringstrenuousexerciseand
--- Content provided by FirstRanker.com ---
sleep(NREM).24hrsafterovulationestrogenhasanegativefeedbackeffecton
prolactinwhichdecreasesthelevelofprolactin.
214.Allareusedforpostcoitalcontraception
except-
--- Content provided by FirstRanker.com ---
a)CuTb)Ru486
c)Highdoseestrogen
d)Danazol
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Ans.D.DanazolEMERGENCYCONTRACEPTIVES:
Drug
Dose
PREGNANCY
--- Content provided by FirstRanker.com ---
RATELevonorgestrel
0.75mgstatand
0?1
after12hours
--- Content provided by FirstRanker.com ---
Ethinylestradiol50?g+2tabstatand2after 0?2
norgestrel0.25mg
12hours
Ethinylestradiol
--- Content provided by FirstRanker.com ---
2.5mgBd?5days0?0.6
Mifepristone
100mgsingledose
0?0.6
--- Content provided by FirstRanker.com ---
CopperIuds(Goldstandard)Insertionwithin5
0?0.1
days
(RU486Mifepristone)
--- Content provided by FirstRanker.com ---
30mgPO0?1
(ulipristalacetate)
Ref:DUTTAGYNAECOLOGYED.6THPAGENO.492
215.Apatientdeliveredathomewitha
--- Content provided by FirstRanker.com ---
completeperinealtearcametothehospitalafter2weeks.What
managementwillyouprefer?
a)Immediaterepair
b)Repair3weekspost-delivery
--- Content provided by FirstRanker.com ---
c)Repair6weekspost-deliveryd)Repair3monthspost-delivery
CorrectAnswer-D
Ans.D.Repair3monthspost-delivery
Therecenttearsshouldberepairedimmediatelyfollowingthe
--- Content provided by FirstRanker.com ---
deliveryoftheplacenta.Thisreducesthechanceofinfectionandminimizesbloodloss.
Incasesofdelaybeyond24hours,therepairistobewithheld.
Antibioticsshouldbestartedtopreventinfection.
Thecompletetearshouldberepairedafter3monthsifdelayed
--- Content provided by FirstRanker.com ---
beyond24hours.Incaseofanydoubttothegrade3rd-degreetear,itisadvisableto
classifytoahigherdegreeratherthanalowerdegree.
Ref.ObsDutta24theditionPageno.490
216.InModernobstetrics,forsensitizedRh-
--- Content provided by FirstRanker.com ---
negativemotherwhatshouldbedonetoevaluatetheconditionofthemother?
a)MCAdopplerpeaksystolicvolume
b)Fetalblood
c)Amniocentesis
--- Content provided by FirstRanker.com ---
d)BiophysicalprofileCorrectAnswer-A
Ans.A.MCAdopplerpeaksystolicvolume
Dopplerultrasound:SerialDopplerstudyofthemiddlecerebral
artery(MCA)-peaksystolicvelocity(PSV)isthemainstaytoassess
--- Content provided by FirstRanker.com ---
fetalanemia.Avalue>1.5multiplesofthemedian(MOMs)forthecorrespondinggestationalage,predictsmoderatetoseverefetal
anemia.
Thisvalue(between24weeksand35weeksofgestation),isan
indicationforcordocentesisandfetaltransfusion
--- Content provided by FirstRanker.com ---
MostcentershavereplacedserialamniocentesiswithserialMCADopplerstudies.
Ref.OBstetricsDuttaed.8thpg.391
217.A7weekspregnantladyhas1accidental
exposuretox-ray.Whichofthefollowing
--- Content provided by FirstRanker.com ---
shouldbedone?a)Continuepregnancy
b)Terminatepregnancy
c)Chromosomeanalysis
d)Preinvasivediagnostictesting
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns.A.Continuepregnancy
ExposuretoX-rayhasaverylowrangeofradsoingivencase
scenarioPregnancywillbecontinued.
Exposure>15radduringthesecondandthirdtrimesteror>5radin
--- Content provided by FirstRanker.com ---
thefirsttrimesterneedspatientcounseling.Electiveterminationofpregnancymaybeconsidered.
Ref.OBSDutta8theditionPageno.740
William'sObs24theditionPageno.931Tableno46-5
218.A32-year-oldwomancomplainsof
--- Content provided by FirstRanker.com ---
amenorrheasincethedeliveryofababy15monthspreviously,despitethefact
thatshedidnotbreastfeedherbaby.The
deliverywascomplicatedbyexcessive
hemorrhagethatrequiredatransfusion
--- Content provided by FirstRanker.com ---
of2.5litersofblood.Shehasalsobeenfatiguedandhasgainedanadditional
4.5Kgsincethebabywasborn.
Laboratorydatashowthefollowing:
SerumLH<1IU/L(normal,4-24IU/L)
--- Content provided by FirstRanker.com ---
Serumestradiol5pg/mL(normal,20-100pg/mL)
SerumTSH0.1mU/L(normal,0.5-5
mU/L)
SerumGH3ng/mL(normal,<5ng/mL)
--- Content provided by FirstRanker.com ---
SerumACTH28pg/mL(normal,10-50pg/mL)
Serumprolactin2ng/mL(normal,
Injectionof500gofTRHfailedto
producetheexpectedriseinbothserum
--- Content provided by FirstRanker.com ---
TSHandprolactin.Whichofthefollowingdiagnosesmostlikelyexplains
thefindingsinthispatient?
a)Hashimoto'sthyroiditis
b)Isolatedgonadotropindeficiency
--- Content provided by FirstRanker.com ---
b)Isolatedgonadotropindeficiency
c)Primaryamenorrhea
d)Sheehan'ssyndrome
CorrectAnswer-D
Ans.D.Sheehan'ssyndrome
--- Content provided by FirstRanker.com ---
Sheehan'ssyndromeItishypopituitarismduetoischemicdamagetothepituitaryresulting
fromexcessivehemorrhageduringparturition.
Thepituitaryisenlargedduringpregnancy;itismoremetabolically
active,andmoresusceptibletohypoxemia.
--- Content provided by FirstRanker.com ---
Furthermore,thebloodvesselsinthepituitarymaybemoresusceptibletovasospasmbecauseofthehighestrogen.
Inabout30%ofwomenwhohemorrhageexcessivelyduring
parturition,somedegreeofhypopituitarismeventuallybecomes
manifest.
--- Content provided by FirstRanker.com ---
Thesymptomsdependonhowmuchofthepituitaryisdamagedandwhatcelltypesaredestroyed.Thepatientdescribedaboveexhibited
persistentamenorrheaafterthedeliveryofherinfant.
Thisisduetothedestructionofpituitarygonadotrophsand
diminishedsecretionofgonadotropins(LH).
--- Content provided by FirstRanker.com ---
TherealsoappearstohavebeensignificantdestructionoflactotrophssinceTRHinjectionfailedtoinduceanincreasein
prolactin.
Hadthewomenattemptedtobreastfeedherinfant,afailureto
lactatemostlylikelywouldhaveoccurred.
--- Content provided by FirstRanker.com ---
Thiscaseisalsocharacterizedbysecondaryhypothyroidism.ThelowTSHandfailuretorespondtoTRHinjectionare
confirmatory.
CorticotrophsappeartohavebeensparedsinceplasmaACTHis
normal.
--- Content provided by FirstRanker.com ---
Itisnotclearwhethersomatotrophsweredamaged.FurthertestingwouldbeneededtoseeifGHreserveisdiminished.
Ref.WilliamObs.ed.24thpageno.798,1163
DuttaGynaecology6thed.Pageno.465
219.Meiosisoccursin
--- Content provided by FirstRanker.com ---
a)Adultovaryb)Prepubertaltestis
c)Atbirthinovary
d)All
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.is.A.AdultovaryMeiosis1iscompletedatpubertyhenceanswerisadultovary
Totalnumberofoocytesat20weeksofintrauterinelifeisabout6?7
million.Atbirth,thetotalnumberofprimordialfolliclesisestimatedto
beabout2million.Theprimaryoocytesdonotfinishthefirstmeiotic
--- Content provided by FirstRanker.com ---
divisionuntilpubertyisreached.Spermatogenesisoccursatpubertysoitcannothappenin
prepubertaltestis.
220.DCDAtwins,38wks,firsttwinbreech
motherhasBP140/96,1+proteinuria
--- Content provided by FirstRanker.com ---
what'sthemanagementa)ImmediateLSCS
b)Inductionat40weeks
c)Immediateinductionanddelivery
d)Inductionifsignsofpreeclampsia
--- Content provided by FirstRanker.com ---
CorrectAnswer-AANS.A.ImmediateLSCS
CASEDISCUSSION:
ThepatienthasmildpreeclampsiawithBP140/96,soTOPis37
weeks.
--- Content provided by FirstRanker.com ---
Thispatientis38weekssoimmediateterminationofpregnancyisrequired.
ThefirsttwinisbreechsothemodeofdeliveryisLSCShencethe
answerisA.
INDICATIONSOFCESAREANSECTION:
--- Content provided by FirstRanker.com ---
Theindicationsarebroadlydividedinto:Obstetric
Placentaprevia
Preeclampsia
Previouscesareansection
--- Content provided by FirstRanker.com ---
CordprolapseofthefirstbabyAbnormaluterinecontractions
Contractedpelvis.
Fortwins:
Boththefetusesoreventhefirstfetuswithnoncephalic(breechor
--- Content provided by FirstRanker.com ---
transverse)presentation
Twinswithcomplications:IUGR,conjoinedtwins
Monoamniotictwins
MonochorionictwinswithTTTS
Thecollisionofboththeheadsatbrimpreventingengagementof
--- Content provided by FirstRanker.com ---
eitherhead.Ref.OBSDutta8thedPageno.244
221.A36-weekoldpregnantladywith
previoustwindelivery.Whatisthe
Ovarianscore?
--- Content provided by FirstRanker.com ---
a)G2P1b)G2P2
c)G3P2
d)G3P3
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
ANS.A.G2P1Gravidaincludesallconfirmedpregnancies.Eachpregnancyisonly
countedonetime,evenifthepregnancywasmultiplegestations,
suchastwinsortriplets
Parityreflectsthetotalnumberofbirthsafter20weeks,notthetotal
--- Content provided by FirstRanker.com ---
numberofinfantsborn.Ref.OBSDutta8thedPageno.107
222.Misoprostolusedintheinductionof
labourisananalogueofwhichofthe
followingtypeofprostaglandin?
--- Content provided by FirstRanker.com ---
a)PGE1b)PGE2
c)PGI2
d)PGF2alpha
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
CorrectAns:A.PGE1MisoprostolisamethylesterofPGE1.
IndicationsofMisoprostol:
Itisusedforcervicalripening.
Transvaginallyitisusedforinductionoflabour.
--- Content provided by FirstRanker.com ---
UsesofProstaglandinsinObstetrics:Inductionofabortion
Terminationofmolarpregnancy
Inductionoflabour
Cervicalripeningpriortoinductionoflabour
--- Content provided by FirstRanker.com ---
AccelerationoflabourManagementofatonicpostpartumhemorrhage
Medicalmanagementoftubalectopicpregnancy
223.Inearlypregnancyclinicalsignsof
feelingthecervixandthebodyofbulky
--- Content provided by FirstRanker.com ---
uterusseparatedbecauseofsoftenedisthmusat6-8weeksofgestation:
a)Goodell'ssign
b)Chadwick'ssign
c)Piskacek'ssign
--- Content provided by FirstRanker.com ---
d)Hegar'ssignCorrectAnswer-D
CorrectAns:D.Hegar'ssign
At6to8weeksmenstrualage,thefirmcervixcontrastswiththenow
softerfundusandthecompressibleinterposedsoftenedisthmus
--- Content provided by FirstRanker.com ---
--Hegarsign224.13yroldchildvisitgynaecologyOPD
withacomplaintofnotattaining
menarchewithkaryotype46XX.On
examination,clitoromegalyisseen.
--- Content provided by FirstRanker.com ---
Whichenzymeismostlikelytobedeficientintheabovecondition?
a)21alpha-hydroxylase
b)11beta-hydroxylase
c)17alpha-hydroxylase
--- Content provided by FirstRanker.com ---
d)3beta-hydroxysteroiddehydrogenaseCorrectAnswer-A
Ans.A.21alpha-hydroxylase
TheconditiondescribedaboverepresentstheCongenitaladrenal
hyperplasia.
--- Content provided by FirstRanker.com ---
"Morethan90%ofCAHcasesarecausedby21-hydroxylasedeficiency"
Congenitaladrenalhyperplasia:
Itisduetoaninbornerrorofadrenalsteroidmetabolism,commonly
dueto21-hydroxylase(95%)andrarelydueto11-hydroxylaseor3
--- Content provided by FirstRanker.com ---
hydroxysteroiddehydrogenasedeficiency.Clinicalpresentation
Anambiguityofsexatbirth
Hirsutismandamenorrheamaybethepresentingfeaturesaround
pubertyinamilderform.
--- Content provided by FirstRanker.com ---
Thekaryotypeis46,XX.Ref.DuttaGynaecologyed.6thpageno.440
225.Amotherbroughther16-year-old
daughtertoGynaecologyOPDwitha
complaintofnotattendingmenarche.
--- Content provided by FirstRanker.com ---
ShegivesH/Ocyclicabdominalpain.Onfurtherexaminationmidline,abdominal
swellingseen.Perrectalexamination
revealsabulgingmassinthevagina.
Whichofthefollowingcanbemost
--- Content provided by FirstRanker.com ---
commonlyseen?a)Imperforatehymen
b)Transvaginalseptum
c)Vaginalagenesis
d)MRKH
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns.A.Imperforatehymen
Accordingtotheclinicalcase,patientssufferfromprimary
amenorrheaandcryptomenorrhea(cyclicabdominalpain).
Thegirlisagedabout14?16years.
--- Content provided by FirstRanker.com ---
Thechiefcomplaintsareperiodiclowerabdominalpain,whichmaybecontinuous,primaryamenorrheaandurinarysymptoms,suchas
frequency,dysuriaorevenretentionofurine.
Infact,insignificantcases,thepresentingfeaturemaybethe
retentionofurine.Thecauseofretentionisduetotheelongationof
--- Content provided by FirstRanker.com ---
theurethra.Anabdominalexaminationrevealsasuprapubicswelling,whichmay
beuterineorfullbladder.Priorcatheterizationrevealsthetruestate.
Vulvalinspectionrevealsatensebulgingmembraneofbluish
coloration
--- Content provided by FirstRanker.com ---
Ref.DuttaGynaecologyed.6thpageno.42226.Whichofthefollowingisnotan
estrogen-dependentpubertalchange?
a)Hairgrowth
b)Menstruation
--- Content provided by FirstRanker.com ---
c)VaginalCornificationd)Cervicalmucus
CorrectAnswer-B
Ans.B.Menstruation
Pubarcheordevelopmentofaxillaryandpubichairisdueto
--- Content provided by FirstRanker.com ---
testosterone(inboththesexes).Pubertyinfemales:
Involvesthebeginningofmenstrualcycles(menarche),breast
development(thelarche),andanincreaseinadrenalandrogen
secretion(adrenarche).
--- Content provided by FirstRanker.com ---
Estradiolinducesthedevelopmentofsecondarysexcharacteristics,includingthebreastsandreproductivetract,andincreasedfatinthe
hips.
Estrogensalsoregulatethegrowthspurtatpuberty,vaginal
cornification,andcervicalmucusproduction,induceclosureofthe
--- Content provided by FirstRanker.com ---
epiphyses,haveapositiveeffectinmaintainingboneformation,andcanantagonizethedegradingactionsofparathyroidhormoneon
bone.
Reference:RhoadesandTanner'sMedicalPhysiology,2ndedition
(Pageno:680)
--- Content provided by FirstRanker.com ---
227.A22-year-oldprimigravidavisitsANC
OPDwith20weeksPOG.Onexamination
uterineheightrevealsa16-week
size.USGshowsreducedliquor.What
willbethediagnosis?
--- Content provided by FirstRanker.com ---
a)Renalagenesisb)Fetalanemia
c)Barter'ssyndrome
d)Liddlesyndrome
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans.A.RenalagenesisThequestionstatesreducedliquorthatmeansoligohydramniosis
seen.
Oligohydramniosisdefinedasanamnioticfluidindexof5cmor
less.
--- Content provided by FirstRanker.com ---
Itisalmostalwayspresentwhenthereiseitherobstructionofthefetalurinarytractorrenalagenesis.
WilliamsObstetricsed24thpage237
228.MostcommonsiteforFertilizationis-
a)Ampulla
--- Content provided by FirstRanker.com ---
b)Isthmusc)Intramural
d)Fimbriae
CorrectAnswer-A
Ans.A.Ampulla
--- Content provided by FirstRanker.com ---
Fertilizationistheprocessoffusionofthespermatozoonwiththematureovum.
Itbeginswithspermeggcollisionandendswiththeproductionofa
mononucleatedsinglecellcalledthezygote.
Itsobjectivesare:
--- Content provided by FirstRanker.com ---
ToinitiatetheembryonicdevelopmentoftheeggandTorestorethechromosomenumberofthespecies.
Almostalways,fertilizationoccursintheampullarypartoftheuterine
tube.
Reference:DuttaObstetricsed.8thPageno23
--- Content provided by FirstRanker.com ---
229.Distensionmediausedforhysteroscopy
withbipolarcautery?
a)Glycine
b)NS
c)Co2
--- Content provided by FirstRanker.com ---
d)Dextran70CorrectAnswer-B
Ans.B.NS
Thedistendingmediacommonlyusedinhysteroscopyisnormal
saline
--- Content provided by FirstRanker.com ---
--Theuterinecavityisdistendedwithamediatoseparatetheuterinewallsandtohaveapanoramicview.Themediausedcould
beeitheragasoraliquid.
Carbondioxide(CO2)--iscommonlyusedfordiagnosticpurposes.
Itissolubleinbloodandissafe.
--- Content provided by FirstRanker.com ---
Hysteroflatorprovidesagasflowrateofamaximumof100mLperminuteandamaximumpressureof100mmHg.
Liquidmediaisusedforoperativeprocedures.
Normalsalinecanbeusedissuitableforbipolarcauterybutnot
suitableformonopolarelectrosurgery.Constantflowistobe
--- Content provided by FirstRanker.com ---
maintainedtoflushtheoperativearea.Ref.DuttaGynaecologyed.6thpageno.620,624
230.Besttreatmentoptionforseptateuterus-
a)TompkinsMetroplasty
b)Jonesmetroplasty
--- Content provided by FirstRanker.com ---
c)Strassmannmetroplastyd)Transcervicalhysteroscopicresectionoftheseptum
CorrectAnswer-D
Ans.D.Transcervicalhysteroscopicresectionoftheseptum
Hysteroscopicmetroplastyismorecommonlydone.
--- Content provided by FirstRanker.com ---
Resectionoftheseptumcanbedoneeitherbyaresectoscopeorbylaser.
Advantagesare:
1. Highsuccessrate(80?89%),
2. Shorthospitalstay
--- Content provided by FirstRanker.com ---
3. Reducedpostoperativemorbidity(infectionoradhesions)4. Subsequentchanceofvaginaldeliveryishighcomparedto
abdominalmetroplastywherethecesareansectionismandatory.
Othermethods:
Abdominalmetroplastycouldbedoneeitherbyexcisingtheseptum
--- Content provided by FirstRanker.com ---
(Strassman,Jones,andJones)orbyincisingtheseptum(Tompkins).
Ref.DuttaGynaecologyed.6thpageno.47
231.ApregnantfemalehadMeconium
stainedliquorandunderwentemergency
--- Content provided by FirstRanker.com ---
LSCS.Afewdayslaterherconditiondeteriorated.USGshowededematous
bowels.What'sthecause?
a)Meconiumperitonitis
b)Paralyticileus
--- Content provided by FirstRanker.com ---
c)Adhesiveintestinalobstructiond)Intra-abdominalabscess
CorrectAnswer-B
Ans.B.Paralyticileus
POSTOPERATIVECOMPLICATIONSOFLSCS:
--- Content provided by FirstRanker.com ---
Intestinalobstruction:Theobstructionmaybemechanicalduetoadhesionsorbands,orparalyticileusfollowingperitonitis.
Paralyticileusisanadynamicobstructioninwhichthereisafailure
oftransmissionofperistalticwaves
Clinicalfeatures:
--- Content provided by FirstRanker.com ---
Theresultantstasisleadstothefollowing:Accumulationoffluidandgasinthebowel
Withassociateddistension:markedandtympanitic
Vomiting(effortless)
Absenceofbowelsounds
--- Content provided by FirstRanker.com ---
AbsoluteconstipationDuttaobstetricsed.8thPageno.678
Bailey&Love'sShortPracticeofSurgery-27thEdition(Page
no1297)
232.18-year-oldgirlpresentswith6months
--- Content provided by FirstRanker.com ---
ofamenorrheawithh/olow-gradefever,weightloss,painabdomen,generalized
weaknesses.OnPRexamination,
palpableleft-sidedpelvicmassfelt...
Diagnosisis
--- Content provided by FirstRanker.com ---
a)Fibroidwithdegenerationb)TBpelviswithTuboovarianmass
c)Ectopicpregnancy
d)Granulosacelltumour
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans.B.TBpelviswithTuboovarianmassThetuberclesbursttopourthecaseousmaterialinsidethelumen
producingtubercularpyosalpinx,whichmayadheretotheovaries
andthesurroundingstructures.
Oftentheinfectionspreadsoutwardsproducingperisalpingitiswith
--- Content provided by FirstRanker.com ---
exudation,causingdenseadhesionswiththesurroundingstructurestuberculartubo-ovarianmass.
Clinicaldiagnosticfeatures:
Weakness,low-gradefever,anorexia,anemiaornightsweatsmay
bepresent.
--- Content provided by FirstRanker.com ---
Infertility:ItmaybeprimaryorsecondaryChronicpelvicpain
Vaginaldischarge--postcoitalbleedingorablood-stained
discharge.
Constitutionalsymptomssuchaslossofweight,malaise,anorexia,
--- Content provided by FirstRanker.com ---
pyrexia,andanemiaarepresentintheacutephaseofthedisease.
Menstrualabnormality:Inabout50percent,themenstrualfunctionis
normal.
PresenceofpelvicmasswithnodulesinthepouchofDouglas
palpable
--- Content provided by FirstRanker.com ---
Ref.GynaecologyDuttaed.6thPageno.139-142233.AChildisborn,coveredwithathick
membranouscoat,whatcouldbethe
possiblediagnosis?
a)Lamellarichthyosis
--- Content provided by FirstRanker.com ---
b)X-linkedichthyosisc)IchthyosisVulgaris
d)Ichthyosisacquista
CorrectAnswer-A
Answer-a.Lamellarichthyosis
--- Content provided by FirstRanker.com ---
Explanation-Ichthyosisisoneofthemostcommongenodermatoses.Itischaracterizedbydry(xerotic)scalyskinall
overthebody.Scalesaredull-brown-black.
Thebasicdefectisanimpairmentinthebarrierfunctionofskinand
inabilitytomaintainmoisture.Collodionbabyisthetermusedto
--- Content provided by FirstRanker.com ---
denotethenewbornbabywithichthyosis;thenewbornbabyisencasedinathick,shinymembranecoatcalledcollodionandis
seeninLamellarichthyosis
Ref-ArvindAroraskin,6thedition,pageno203
234.Mouthtomouthrespirationprovides
--- Content provided by FirstRanker.com ---
whatpercentageofoxygen?a)10%
b)16%
c)21%
d)100%
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns.B.16%
Mouthtomouthbreathingprovides0.8to1.2litersofexhaledairper
breathand16%ofoxygenwhichisenoughtosustainlife.
TheuseofAmbubagandroomairprovides21%O2.
--- Content provided by FirstRanker.com ---
TheAmericanHeartAssociationrecommendstidalvolumesof700to1000mLduringmouth-to-mouthventilation,butsmallertidal
volumesof500mLmaybeofadvantagetodecreasethelikelihood
ofstomachinflation,asmouth-to-mouthventilationgascontainsonly
17%oxygen,but4%carbondioxide.
--- Content provided by FirstRanker.com ---
235.Cancerpatientundergoesradiotherapy,
pickthetruestatementfor
radiosensitivityoftissues?
a)Rapidlydividingcellsareresistanttoradiation
b)GImucosaisoneofthemostradioresistanttissuesinthebody
--- Content provided by FirstRanker.com ---
c)Theintensityofradiationisinverselyproportionaltothesquareofdistancefromthesource
d)Smallbloodvesselsareleastresistanttoradiation
CorrectAnswer-C
Answer-C-Theintensityofradiationisinverselyproportional
--- Content provided by FirstRanker.com ---
tothesquareofdistancefromthesourceTheinversesquarelawdescribestheprincipleofdosereduction
asthedistancefromthesourceincreases.
Thedoseisproportionaltotheinverseofthesquareoftheradius.
Thusifyoudoublethedistanceyoureducethedosebyafactorof
--- Content provided by FirstRanker.com ---
four.Ref-1.ShafieiSA,HasanzadehH,ShafieiSA.Asimple
calculationmethodfordeterminationofequivalentsquarefield.
JMedPhys.2012;37(2):107-11.DOI:10.4103/0971-
6203.94746-FreetextatPubMed-Pubmedcitation
--- Content provided by FirstRanker.com ---
236.MostcommonDRUGcausing
dependence?
a)Cannabis
b)Cocaine
c)Heroin
--- Content provided by FirstRanker.com ---
d)AmphetamineCorrectAnswer-A
ANS-A.Cannabis
Cannabis-9millionusers,192millionusers(Acc.ToWHODrug
report2018)
--- Content provided by FirstRanker.com ---
Heroin(opioidderivative)-2.5lakhusersItisestimatedthat275millionpeopleusedillicitdrugs,suchas
cannabis,amphetamines,opioids,andcocaine,in2016which
translatesintoanannualprevalenceofillicitdruguseof5.6%.
Cannabisismostusedwith192millionusers.Some31million
--- Content provided by FirstRanker.com ---
peoplewhousedrugssufferfromdrugusedisorders.-(WHODrugreport2018)
Ref:ARVINDARORAreviewofpsychiatryp:64,WHODrug
report(2018)
237.MBBSstudentshewaschokingwith
--- Content provided by FirstRanker.com ---
dyspnea,chesttightness,anxietyandanimpendingsenseofdoomon
examinationallsystemicconditionswere
foundnormal,thenshewentto
psychiatry.Whatistheprobable
--- Content provided by FirstRanker.com ---
diagnosisofthecondition?a)Panicdisorder
b)Depression
c)Epilepsy
d)Asthma
--- Content provided by FirstRanker.com ---
CorrectAnswer-AANS-A.Panicdisorder
Panicdisorder-severeanxietywithchoking,chestpainand
palpitations.
Depression-lowmoodandlostinterestinactivities
--- Content provided by FirstRanker.com ---
Epilepsy-neurologicaldisorderwithwhole-bodyfatigueandmusclespasms
Anasthma-respiratorydisorderassociatedwithsymptomsofcough,
wheezing,etc
Ref:ARVINDARORAreviewofpsychiatryp:131
--- Content provided by FirstRanker.com ---
238.Apatientwithdepressionwasgiven
Imipraminefor2weeks.Relatives
noticedincreasedexcitement,colourful
clothes,increasedtalking.Whatisthe
nextstepinmanagement?
--- Content provided by FirstRanker.com ---
a)AntipsychoticwithImipraminecontinuedb)DiscontinueImipramineandstartValproate
c)ContinueImipraminealone
d)ManagewithValproatealone
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
ANS-A.AntipsychoticwithImipraminecontinuedTheconditionfromwhichthepatientaboveissufferingisabipolar
disorderwhichincludesbothdepressionandmania.
Soinordertotreatbothantidepressanti.eimipramineiscontinued
alongwithanantipsychoticsuchasphenothiazines,thioxanthenes,
--- Content provided by FirstRanker.com ---
etc.Antipsychoticorvalproatealonecannotreducethedepressionand
Imipraminealonecannotreducethemania.
Ref:ARVINDARORAreviewofpsychiatryp.no:111
239.APatientfallsdownoftenwith
--- Content provided by FirstRanker.com ---
behavioralchangeandenuresis.Whatistheconditionassociatedwithhim?
a)Frontotemporaldementia
b)Normalpressurehydrocephalus
c)Parkinson'sdisease
--- Content provided by FirstRanker.com ---
d)Alzheimer'sdiseaseCorrectAnswer-B
Ans-B.Normalpressurehydrocephalus
Frontotemporaldementia-Associatedwithpoorbehavioralcontrol,
decisionmaking,andlanguage.
--- Content provided by FirstRanker.com ---
Normal-pressurehydrocephalus-Associatedwithgaitdisturbance,behaviouralchange,enuresis,anddementia.
Parkinson'sdisease-Associatedwithtremorandmuscularstiffness
Alzheimer'sdisease-Associatedmainlywithmemorylossand
confusion
--- Content provided by FirstRanker.com ---
Ref:NormalPressureHydrocephalusByMichaelJ.Fritsch,UweKehler,UllrichMeierP.16;Oxfordtextbookofneurological
surgerybyAdelHelmyP.94
240.APatientwithdepressivesymptomsfor
6monthsandassociatedwith
--- Content provided by FirstRanker.com ---
auditoryhallucinationsfor2weeks.Whatistheprobablediagnosisofthe
condition?
a)Psychoticdepression
b)Schizoaffectivedisorder
--- Content provided by FirstRanker.com ---
c)Maniadepressiveillnessd)Schizophrenia
CorrectAnswer-A
Ans-A.Psychoticdepression
Psychoticdepression-Depressionalongwithpsychoticsymptoms
--- Content provided by FirstRanker.com ---
suchashallucinations,delusions,etc.Schizoaffectivedisorder-Symptomsofschizophreniaandmood
disturbancesoccurtogether.
Maniadepressiveillness-Maniadepressionalongwithpsychotic
symptoms.
--- Content provided by FirstRanker.com ---
SchizophreniaincludesallthesymptomsofschizophreniaRef:ArvindArorareviewofPsychiatrypage.103
241.Identifythetypeofjointinthegiven
picture
--- Content provided by FirstRanker.com ---
a)Syndesmosisb)Synarthrosis
c)Synovialjoint
d)Symphysis
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Ans:CsynovialjointThemarkedstructureisajointbetweenthetransverseprocess
ofvertebraandribs-acostotransversejoint.
Interchondral,Sternocostal,Costovertebral,andCostotransverse
areallplanetypesofsynovialjoints.
--- Content provided by FirstRanker.com ---
BDC,7thedition,volume1,pg234.242.Identifythemuscle.Whatisitsnerve
supply
a)Dorsalscapularnerve
--- Content provided by FirstRanker.com ---
b)Thoracodorsalnervec)Spinalaccessorynerve
d)Suprascapularnerve
CorrectAnswer-A
Ans:A.Dorsalscapularnerve
--- Content provided by FirstRanker.com ---
Markedmuscleislevatorscapulae.ItissuppliedbyC3,C4,andC5(dorsalscapularnerve)
243.Identifythecartilage
a)Hyalinecartilage
--- Content provided by FirstRanker.com ---
b)Elasticcartilagec)Articularcartilage
d)Fibrocartilage
CorrectAnswer-D
Ans:D.Fibrocartilage
--- Content provided by FirstRanker.com ---
FibrocartilageFibrocartilageischaracterizedbyalargeamountofirregularand
densebundlesofcollagenfibersinthematrix.Itconsistsof
alternatinglayersofcartilagematrixandthickdenselayersoftypeI
collagenfibers.
--- Content provided by FirstRanker.com ---
Ref.InderbirSingh'sTextbookofHumanHistology-8thEdition(Pagenos56-59)
244.Identifytheboundariesoftheanatomical
structureintheimage
--- Content provided by FirstRanker.com ---
a)Extensorpollicislongusb)Abductorpollicislongus
c)Styloidprocessoftheradius
d)Alloftheabove
CorrectAnswer-D
--- Content provided by FirstRanker.com ---
Ans:D.AlloftheaboveThemarkedstructureistheanatomicalsnuffbox.
Boundariesare:
Themedialborder(ulnarside)ofthesnuffboxisthetendonofthe
extensorpollicislongus.
--- Content provided by FirstRanker.com ---
Thelateralborder(radialside)isapairofparallelandintimatetendonsoftheextensorpollicisbrevisandtheabductorpollicis
longus.
Theproximalborderisformedbythestyloidprocessoftheradius
Thedistalborderisformedbytheapproximateapexofthe
--- Content provided by FirstRanker.com ---
schematicsnuffboxisoscelestriangle.Thefloorofthesnuffboxvariesdependingonthepositionofthe
wrist,butboththetrapeziumandprimarilythescaphoidcanbe
palpated.
--- Content provided by FirstRanker.com ---
245.Identifythecelltypemarkedinthecerebellum?
a)Basketcells
b)Granulecells
c)Golgicells
--- Content provided by FirstRanker.com ---
d)PurkinjecellsCorrectAnswer-D
Ans:D.Purkinjecells
Explanation:
--- Content provided by FirstRanker.com ---
ThePurkinjecellspresentthemoststrikinghistologicalfeatureofthecerebellum.
Elaboratedendritesextendintothemolecularlayerfromasingle
subjacentlayerofthesegiantnervecellbodies(calledthePurkinje
layer).
--- Content provided by FirstRanker.com ---
Onceinthemolecularlayer,thePurkinjecelldendritesbranchextensivelyinaplaneatrightanglestothetrajectoryoftheparallel
fibers.
Inthisway,eachPurkinjecellisinapositiontoreceiveinputfroma
largenumberofparallelfibers,andeachparallelfibercancontacta
--- Content provided by FirstRanker.com ---
verylargenumberofPurkinjecells(ontheorderoftensofthousands).
Ref:https://www.ncbi.nlm.nih.gov/books/NBK10865/
246.Identifythesleepwavemarkedinthe
--- Content provided by FirstRanker.com ---
EEGduringthesleep-wakecycle?a)Stage1sleep
b)REMsleep
c)Stage2sleep
d)Stage3sleep
--- Content provided by FirstRanker.com ---
CorrectAnswer-BAns:B.REMsleep
Explanation:
REM/ParadoxicalSleep:
Duetothe"presenceofrapideyemovement"recordedon
--- Content provided by FirstRanker.com ---
electrooculogram.Hasparadoxicalelevationofbrainactivity,metabolism&
physiologicalactivity.
"High-amplitudeslowwaves"replacedby"rapid,lowvoltageactivity
&betawave"-
--- Content provided by FirstRanker.com ---
Duringstage3&4REMsleep.FeaturesofREMsleep:
1.InEEGrecording:
Beta-wave.
Reappearanceofalphawave.
--- Content provided by FirstRanker.com ---
Saw-toothwave(lowvoltagefastactivity).Ponto-genital-occipitalspikes.
Ref:ArvindArorareviewbookofphysiology(p.204-205)
247.Casal'snecklaceisseenindeficiencyof:
--- Content provided by FirstRanker.com ---
a)VitaminAdeficiencyb)Niacin
c)Irondeficiencyanemia
d)VitaminB12deficiency
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:B.NiacinThedeficiencyofniacinleadstotheclinicalconditioncalled
pellagra.PellagraisanItalianword,meaning"roughskin".Pellagra
iscausedbythedeficiencyofTryptophanaswellasNiacin.Pellagra
isseenmoreinwomen;thismaybebecausetryptophanmetabolism
--- Content provided by FirstRanker.com ---
isinhibitedbyestrogenmetabolites.Thesymptomsofpellagraare:
Dermatitis:Intheearlystages,brightrederythemaoccurs,
especiallyinthefeet,ankles,andface.Increasedpigmentation
aroundtheneckisknownasCasal'snecklace.Thedermatitisis
--- Content provided by FirstRanker.com ---
precipitatedbyexposuretosunlight
Diarrhea:diarrheamaybemildorseverewithbloodandmucus.
Dementia:Itisfrequentlyseeninchroniccases.
Deliriumiscommoninacutepellagra.Irritability,inabilityto
concentrateandpoormemoryaremorecommoninmildcases.
--- Content provided by FirstRanker.com ---
Ataxiaandspasticityarealsoseen.Ref-DMVasudevan-Textbookofbiochemistryformedicalstudents,
6thedn,WaterSolubleVitamins,pg395.
248.AnHivpositivepatientwithaCD4
--- Content provided by FirstRanker.com ---
COUNTOF300/Cummpresentswithmucosallesionsinthemouthasshown
inthefigure.onmicroscopybudding
yeastsandpseudohyphaeareseen.A
mostprobablediagnosisis?
--- Content provided by FirstRanker.com ---
a)Candidiasisb)Hairyleukoplakia
c)Lichenplanus
d)Diphtheria
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
CorrectAns:A.CandidiasisMostcommonopportunisticinfectioninHIViscandidiasis
CandidiasisisafungalinfectionduetoanytypeofCandida.
Whenitaffectsthemouth,itiscommonlycalledthrush.
Signsandsymptomsincludewhitepatchesonthetongueorother
--- Content provided by FirstRanker.com ---
Signsandsymptomsincludewhitepatchesonthetongueorother
areasofthemouthandthroat.Othersymptomsmayinclude
sorenessandproblemsswallowing.
Whenitaffectsthevagina,itiscommonlycalledayeastinfection.
Signsandsymptomsincludegenitalitching,burning,andsometimes
--- Content provided by FirstRanker.com ---
awhite"cottagecheese-like"dischargefromthevagina.Robbin'sbasicsofpathology502,503
249.A25-Year-oldmalepresentedwitha2cm
thyroidnodule.Athyroidectomywas
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done.Thehistologypictureisgivenbelow.whatcouldbethediagnosis
a)Papillarycarcinomathyroid
b)Follicularadenoma
c)Gravesdisease
--- Content provided by FirstRanker.com ---
d)AdenomatousgoitreCorrectAnswer-A
Ans:A.Papillarycarcinomathyroid
Papillarycarcinomasmaymanifestassolitaryormultifocallesions
withinthethyroid.Insomecases,theymaybewell-circumscribed
--- Content provided by FirstRanker.com ---
andevenencapsulated;inotherinstances,theyinfiltratetheadjacentparenchymawithill-definedmargins.
Thelesionsmaycontainareasoffibrosisandcalcificationandoften
arecystic.Oncutsurface,theymayappeargranularandsometimes
containgrosslydiscerniblepapillaryfoci.
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Thedefinitivediagnosisofpapillarycarcinomacanbemadeonlyaftermicroscopicexamination.
Thenucleiofpapillarycarcinomacellscontainveryfinelydispersed
chromatin,whichimpartsanopticallyclearappearance,givingrise
tothedesignationgroundglassor"OrphanAnnieeye"nuclei.in
--- Content provided by FirstRanker.com ---
cross-sections.UnlikehyperplasticpapillarylesionsseeninGravesdisease,the
neoplasticpapillaehavedensefibrovascularcores.Concentrically
calcifiedstructurestermedpsammomabodiesoftenarepresent
withinthepapillae.
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FocioflymphaticpermeationbytumorcellsarepresentRobbin'sbasicsofpathology9theditionpageno.736
250.A5-year-oldchildpresentedwitha
historyofbloodinthestools.On
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examination,therewasapolypoidmassintherectum,abiopsyofwhichshowed
asbelow.Amostprobablediagnosisis?
a)Villousadenoma
b)Juvenilepolyp
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c)Vascularmalformationd)Serratedadenoma
CorrectAnswer-B
Ans:B.Juvenilepolyp
Thehistologicalpictureofjuvenilepolyps.Itconsistsof
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pedunculated,smooth-surfaced,reddishlesionsthatarelessthan3cmindiameteranddisplaycharacteristiccysticspacesoncut
sections.
Microscopicexaminationshowsthespacestobedilatedglands
filledwithmucinandinflammatorydebris
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Robbin'sbasicsofpathology9theditionpageno.592251.25-year-oldmanpresentsforaroutine
physicalexamination.Thepatientistall
andonexamination,hewasfoundto
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haveanearlydiastolicmurmur.Hisfamilypedigreeisgivenbelow.Whichof
thefollowingisthemodeofinheritance
bywhichthediseaseislikelytobe
transmitted?
--- Content provided by FirstRanker.com ---
a)ADb)AR
c)XLR
d)XLD
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.ADAutosomalDominant(AD)InheritanceDiseases
?Mutatedgenescanexpressthemselvesinaheterozygousstate.
?Usually,itcausesadefectinthesynthesisofstructuralQornon-
enzymeproteins.
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enzymeproteins.
?Thesehaveavariableonset.
?Thesearecharacterizedbyreducedpenetrance(individualsinherit
thegenebutcanbephenotypicallynormal)andvariable
expressibilityQ(thetraitisseenintheindividualscarryingthe
--- Content provided by FirstRanker.com ---
mutantgenebutisexpresseddifferentlyamongindividuals,e.g.patientsofneurofibromatosishavevariantfrombrownishskinspots
tomultipleskintumoursindifferentpatients).
252.A51-year-oldpersoncamewitha
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complaintofhematuria.Onexamination,hewasnormotensiveandhadpedal
edema.Investigationsrevealedthe
patienthadnoglucosuriaandhada
creatininevalueof9mg%.Renalbiopsy
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isasshownbelowwhichofthefollowinginvestigationsoneshoulddotoidentify
theetiologyofthedisease?
a)ANA
b)ANTIGBMantibodies
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c)HIVRNAd)Urineimmunoelectrophoresis
CorrectAnswer-B
Ans:B.ANTIGBMantibodies
Kidneybiopsy:Immunofluorescencedemonstratedlinearstaining
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withIgG,characteristicofanti-glomerularbasementmembrane
disease,alsoknownasGoodpasturesyndrome.
Anti?glomerularbasementmembrane(anti-GBM)antibodiesare
seeninGoodpasturesyndrome.Theycauseendothelialcellinjury
resultinginanephriticsyndromewithhematuria.
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Robbins&CotranPathologicBasisofDisease,9edPagenos912-914
253.A35-year-oldheterosexualpatient
diagnosedwithHIVhadahistoryof
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chronicwaterydiarrhea.Acolonoscopicbiopsyisshownbelow.Amostprobable
diagnosisis?
a)Giardia
b)CMV
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c)Microsporad)Cryptosporidium
CorrectAnswer-D
Ans:D.Cryptosporidium
DiseasecausedbyinfectionwithCryptosporidiumspecies,a
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protozoalparasiteTraditionallyconsideredacoccidianparasite,butrecentevidence
suggestsitmaybeagregarineparasite
Infectionismostcommonintheterminalileumandproximalcolon
Thediseasealsooccursintheproximalsmallintestine,distalcolon,
--- Content provided by FirstRanker.com ---
gallbladder,bileducts,andpancreasgallbladder,bileducts,andpancreas
Inimmunosuppressedpatients,chronicdiarrheaoccursthatisoften
debilitating,acalculouscholecystitis,sclerosingcholangitis,
pancreatitis,biliarystrictures,andrespiratorydiseasemayoccur
--- Content provided by FirstRanker.com ---
Intissuebiopsies,2-5mbasophilicroundbodiesareseenprotrudingfromtheapexofenterocytes("bluebeads")withinthecell
membrane;highlightwithGiemsastain
Villousatrophy,crypthyperplasia,cryptitisandincreasedmixed
inflammatorycellswithinthelaminapropriamaybeseen
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ref:Bennett:Mandell,Douglas,andBennett'sPrinciplesandPracticeofInfectiousDiseases,8thEdition,CDC
-Cryptosporidium
254.An11-yearboypresentedwithcoughfor
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15daysonexaminationhewasfoundtohavecervicallymphadenopathy.lymph
nodeexaminationshowedbelowfinding
whatcouldbethediagnosis
a)Leprosy
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b)Sarcoidosisc)TB
d)Syphilis
CorrectAnswer-C
Ans:C.TB
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HistologicalpictureshownaboveisoftuberculosisTuberculosisisacommunicablechronicgranulomatousdisease
causedbyMycobacteriumtuberculosis.Itusuallyinvolvesthelungs
butmayaffectanyorganortissueinthebody.
Typically,thecentersoftuberculousgranulomasundergocaseous
--- Content provided by FirstRanker.com ---
necrosis.histologicxamination,sitesofactiveinvolvementaremarkedbyacharacteristicgranulomatousinflammatoryreactionthat
formsbothcaseatingandnoncaseatinggranulomaswhichconsistof
epithelioidhistiocytesandmultinucleatedgiantcells.
Robbinsbasicsofpathology9theditionpageno.493
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255.A40yearoldpersonpresentedwith10*8
swellinginaretroperitoneal,biopsyfrom
thelesionisasshownbelow.Molecular
analysisdemonstratedt(12,16).Amost
--- Content provided by FirstRanker.com ---
probablediagnosisisa)Myxoidliposarcoma
b)Lipoma
c)Synovialsarcoma
d)Pleomorphicsarcoma
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns:A.Myxoidliposarcoma
Myxoidliposarcomaisthemostcommonhistologictype.
Itiscomposedofmonomorphic,fusiformorstellatecells
representingprimitivemesenchymalcells,lyingdispersedin
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mucopolysaccharide-richgroundsubstance.Occasionaltumourgiantcellsmaybepresent.Theprominent
meshworkofcapillariesformingchicken-wirepatternisa
conspicuousfeature
RefRobbin'sbasicsofpathologypageno.792.
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256.47.35-year-oldwomanwithalong
historyofdyspnea,chroniccough,
sputumproduction,andwheezingdies
ofrespiratoryfailurefollowingaboutof
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lobarpneumonia.Shewasnotasmokeroranalcoholic.Thelungautopsyis
shownintheimage.Whichofthe
followingunderlyingconditionwasmost
likelyassociatedwiththepathologic
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changesshownhere?a)Mutationindyneinarms
b)Cysticfibrosis
c)Alpha1antitrypsindeficiency
d)Antibodiesagainsttype4collagen
--- Content provided by FirstRanker.com ---
CorrectAnswer-CCorrectAnswer-C
Ans:C.Alpha1antitrypsindeficiency
Thephotomicrographaboveisfromapatientwithhereditaryalpha-
1-antitrypsindeficiency.Alpha-1-antitrypsinisnormallypresentin
--- Content provided by FirstRanker.com ---
serum,tissuefluidsandmacrophages.It'sabig-timeinhibitorofproteases(whicharedestructiveenzymessecretedbyneutrophils
duringinflammation).Goodthingtohavearound.
Patientswhoaredeficientinalpha-1-antitrypsinarelessableto
countertheeffectsofproteases,andtheelastictissueinthelungis
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eventuallydestroyed,producingemphysema(irreversibleenlargementoftheairspacesdistaltotheterminalbronchiole).
Inadditiontoemphysema,patientswithalpha-1-antitrypsin
deficiencymaydevelophepatitisandevencirrhosisfrom
accumulationofabnormally-foldedalpha-1-antitrypsinwithin
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hepatocytes.Theseproteinsarevisibleasbrightlyeosinophilicinclusionswith
regularhematoxylinandeosinstaining.Thediseasevariesinits
presentation;somecasesaresevereatbirth,andothersare
asymptomaticuntillaterlife.Inpatientswithsevereliverdisease,
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livertransplantationisthetreatmentofchoice.257.GraphshowingthreedrugsA,B&C.
Whichofthefollowingdrugsshownin
thegraphbelowhasthehighest
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potency?a)DrugA
b)DrugB
c)DrugC
d)BothDrugA&B
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CorrectAnswer-AAns:A.DrugA
Thelineontheleftismorepotent.
DrugAismorepotent.
DrugPotency:
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ThepositionofDRConthedoseaxisistheindexofdrugpotencywhichreferstotheamountofdrugneededtoproduceacertain
response.
ADRCpositionedrightwardindicateslowerpotency.
Relativepotencyisoftenmoremeaningfulthanabsolutepotency
--- Content provided by FirstRanker.com ---
andisgenerallydefinedbycomparingthedose(concentration)ofthetwoagonistsatwhichtheyelicitahalf-maximalresponse(EC50
).
Drugpotencyisclearlyafactorinchoosingthedoseofadrug.
Ref:K.D.Tripathi7thEdition.Page.54?55
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258.InthefollowingX-rayofthewrist,whatis
theexactage-
a)2yrs
b)8yrs
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c)6yrsd)9yrs
CorrectAnswer-C
Answer-C-6yrs
Assessmentsofskeletalmaturityinpre-pubertalchildrenare
--- Content provided by FirstRanker.com ---
primarilybasedontheepiphysealsizeofthephalangesastheyrelatetotheadjacentmetaphyses.
Duringthisstageofdevelopment,theossificationcentersforthe
epiphysisincreaseinwidthandthickness,andeventuallyassumea
transversediameteraswideasthemetaphysis
--- Content provided by FirstRanker.com ---
Moreweightisgiventothesizeoftheepiphysisinthedistalphalangesthantothatinthemiddlephalanges,andevenlessto
thatintheproximalphalanges.
http://www.chospab.es/biblioteca/DOCUMENTOS/Atlas_of_Hand_Bone_Age.pdf
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259.Identifythephenomenaa)ElectricBurn
b)CrocodileBurn
c)Scalds
d)Putrefaction
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CorrectAnswer-DAnswer-D-Putrefaction
Putrefactionisthedecompositionofthebodycarriedoutbythe
microbialaction.Aftercessationofhemostasis,thenaturalfloraof
thebodymigratesfromtheguttothebloodvesselsandspreadsall
--- Content provided by FirstRanker.com ---
overthebody.Externalmicro-organismsenterthebodythroughthealimentary
canal,respiratorytract,andopenwounds.Intheabsenceofbody
defenses/immunemechanisms,themicrobeskeepgrowing,asthey
feedupontheproteinsandcarbohydratesofthebloodandbody
--- Content provided by FirstRanker.com ---
parts.Theprincipalbacterialagentcausingputrefactionisthegram-
positive,anaerobic,androd-shapedClostridiumwelchii.
Itreleaseslecithinase,whichcauseshydrolysisoflecithinpresentin
thebloodcells,causingtheirlysis.Putrefactionbeginswithinan
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hourofdeath,butthepeakactivityofthemicrobesoccursaround
the24-hourtimeframe.
https://www.ncbi.nlm.nih.gov/books/NBK539741/
260.IdentifythefollowingImage
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a)Neisseriameningitidisb)Neisseriacinerea
c)Neisseriagonorrhoeae
d)Neisseriapolysaccharea
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Answer-A-NeisseriameningitidesNeisseriameningitidesoftenreferredtoasmeningococcus,isa
Gram-negativebacteriumthatcancausemeningitisandotherforms
ofmeningococcaldiseasesuchasmeningococcemia,life-
threateningsepsis.
--- Content provided by FirstRanker.com ---
N.meningitidisisagram-negativeproteobacteriumandmemberofthebacterialfamilyofNeisseriaceae.
N.meningitidisisafastidiousbacteria,dyingwithinhourson
inanimatesurfaces,andiseitheranencapsulatedor
unencapsulated,aerobicdiplococcuswitha"kidney"or"coffee-
--- Content provided by FirstRanker.com ---
bean"shape.Jawetz27/e-pg-287;
261.IdentifytheImage
a)Trichuristrichiura
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b)Ancylostomaduodenalec)Paragonimus
d)Strongyloides
CorrectAnswer-A
Answer-A-Trichuriasistrichiura
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Itisbrownincolourbeingbile-stained.Ithasatripleshell,theoutermostlayerofwhichisstainedbrown.
Itisbarrel-shapedandabout50umlongand25umwideinthe
middle,withaprojectingmucusplugateachpolecontainingan
unsegmentedovum
--- Content provided by FirstRanker.com ---
Theplugsarecolourless.Theeggfloatsinthesaturatedsaltsolution
Jawetz27/e-pg-724
262.Identifytheorganismcausingan
--- Content provided by FirstRanker.com ---
infectionontheupperarma)Tineacorporis
b)Tineacapitis
c)Tineacruris
d)Tineamanus
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer-A-TineaCorporis.
Dermatophytosisoftheglabrousskincommonlygivesrisetothe
annularlesionsofringworm,withaclearing,scalycentersurrounded
byaredadvancingborderthatmaybedryorvesicular.
--- Content provided by FirstRanker.com ---
Thedermatophytegrowsonlywithindead,keratinizedtissue,butfungalmetabolites,enzymes,andantigensdiffusethroughtheviable
layersoftheepidermistocauseerythema,vesicleformation,and
pruritus.
Thelesionsexpandcentrifugallyandactivehyphalgrowthisatthe
--- Content provided by FirstRanker.com ---
periphery,whichisthemostlikelyregionfromwhichtoobtainmaterialfordiagnosis.
Whentheinfectionoccursinthegroinarea,itiscalledTinea
cruris,orjockitch.
Tineamanusreferstotheringwormofthehandsorfingers.
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TineacapitisisdermatophytosisorringwormofthescalpandhairJawetz27/e-pg-668
263.ImmunoglobulinImageshownbelowis
of-
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a)IgAb)IgG
c)IgM
d)IgE
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:A.IgAIgAisthemajorimmunoglobulinresponsibleformucosalimmunity.
ThelevelsofIgAintheserumarelow,consistingofonly10?15%of
totalserumimmunoglobulinspresent.Incontrast,IgAisthe
predominantclassofimmunoglobulinfoundinextravascular
--- Content provided by FirstRanker.com ---
secretions.Inserum,IgAissecretedasamonomerresemblingIgG.Inmucous
secretions,IgAisadimerandisreferredtoassecretoryIgA.
ThissecretoryIgAconsistsoftwomonomersthatcontaintwo
additionalpolypeptides:theJchainthatstabilizesthemoleculeand
--- Content provided by FirstRanker.com ---
asecretorycomponentthatisincorporatedintothesecretoryIgAwhenitistransportedthroughanepithelialcell
Jawetz27/e-pg-138
264.A15yearsoldboypresentedwithfever
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andchillsfor3days.Onexamination,hewasfoundtohavedelayedskinpinch
timeanddryoralmucosa.Aperipheral
bloodsmearrevealedthefollowing
picture.Identifythepathogeninvolved?
--- Content provided by FirstRanker.com ---
a)Babesiab)Plasmodiumvivax
c)Plasmodiumfalciparum
d)Salmonellatyphi
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B-PlasmodiumfalciparumGivenclinicalpresentationsuggestiveofmalaria.
Doubleringsinerythrocytes&banana-shapedgametocytesona
peripheralbloodsmear-TypicalP.falciparuminfection.
peripheralbloodsmear-TypicalP.falciparuminfection.
--- Content provided by FirstRanker.com ---
Theearlyringformintheerythrocyteisverydelicateandtiny,measuringonlyone-sixthoftheredcelldiameter.Ringsareoften
seenattachedalongthemarginoftheredcell,theso-calledform
appliqueoraccole.
Binucleaterings(doublechromatin)arecommonresemblingstereo
--- Content provided by FirstRanker.com ---
headphonesinappearance.Severalringsmaybeseenwithinasingleerythrocyte.
Paniker'sTextbookofMedicalParasitology-8thedition,pg-73;
Jawetz27/e-medicalparasitology-pg-721
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265.Apatientcomplainsaboutpainfulblistersaroundtheangleofmouth
identifythepathogen
a)HerpesLabialis
b)Herpangina
--- Content provided by FirstRanker.com ---
c)Herpeszosterd)Epstein-Barr
CorrectAnswer-A
Answer-A-HerpesLabialis
Herpeslabialis,commonlyknownascoldsores,isatypeof
--- Content provided by FirstRanker.com ---
infectionbytheherpessimplexvirusthataffectsprimarilythelip.Symptomstypicallyincludeaburningpainfollowedbysmallblisters
orsores.Thefirstattackmayalsobeaccompaniedbyfever,sore
throat,andenlargedlymphnodes.
Relapsinginfectionsarelimitedtothemucosaofthehardpalateor,
--- Content provided by FirstRanker.com ---
inolderchildrenandadults,thelips.Thenumberofrelapsesdecreasesaftertheageof35years.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2602638/
266.Apatientwiththefollowingfeature
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shownintheimage.Thepatientreportshavinganother3-year-oldsiblingat
home,whoisfullyimmunizedasperthe
immunizationschedule.whatisthebest
measuretopreventdiphtheriainthe
--- Content provided by FirstRanker.com ---
siblingofthediphtheriacasechild.a)Givediphtheriatoxoidbooster
b)GiveafullcourseofDPTvaccine
c)Giveprophylacticerythromycin
d)Nothingisrequiredtobedone
--- Content provided by FirstRanker.com ---
CorrectAnswer-DAns.D.Nothingisrequiredtobedone
Asperthenationalimmunizationprotocol,eachchildreceivesDPT
boosterat16-24
months,andthenat5years.nowasthechildintheMCQis3years
--- Content provided by FirstRanker.com ---
oldandisimmunizedtodate,thechildmusthavereceivedtheDPTboosterinjectionjustwithinthelast2years.hencethechildis
protectedandprobablynoaddedimmune-preventionorvaccination
isrecommended.
Page174,25ed.PARK
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267.Themostcommonsiteoforiginofthe
diverticulumofthepharynxseeninthe
bariumswallowgivenbelowis
a)Betweenstylopharyngeusandpalatopharyngeus
--- Content provided by FirstRanker.com ---
b)Betweenmiddleandinferiorconstrictorc)Betweeninferiorconstrictorandesophagus
d)Betweenthyropharyngeusandcricopharyngeus
CorrectAnswer-D
Ans:(d)Betweenthyropharyngeusandcricopharyngeus
--- Content provided by FirstRanker.com ---
ThegivenpictureisthebariumswallowshowingZenker'sdiverticulum.
>Zenkerdiverticulum,apulsiondiverticulumofthehypopharynx,isa
rarelesionthatoccursinelderlypopulations.>Theconditionresults
inaclassicpresentationofsymptoms,withcomplicationsthat
--- Content provided by FirstRanker.com ---
includeaspirationandpneumonia,andismanagedbyendoscopicandsurgicalrepair.
Ref.ScottBroTon,Vol3;746
Ref.ScottBroTon,Vol3;746
Ref:https://emedicine.medscape.com/article/836858-overview.
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268.BattlesignimageBluishPurplecolour
behindmastoid?
a)Battlesign
b)Bezoldabscess
--- Content provided by FirstRanker.com ---
c)BothAandBd)Noneofthese
CorrectAnswer-A
Ans.(a)Battlesign.
>BattleSign(alsocalledBattle'sSign)isdefinedasbruisingover
--- Content provided by FirstRanker.com ---
themastoidprocess.Itisretroauricularormastoidecchymosisthatistypicallytheresultofheadtrauma.
ref:https://www.statpearls.com/kb/viewarticle/18169?
utm_source=pubmed
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269.Thepatientpresentswith,fever,dysphagia.Imageshowingpushing
tonsil.whatisthediagnosis?
a)Parapharyngealabscess
b)Retropharyngealabscess
--- Content provided by FirstRanker.com ---
c)Peritonsillarabscessd)Ludwig'sangina
CorrectAnswer-C
Ans.C.Peritonsillarabscess
Peritonsillarabscess,alsoknownasquinsy,isthelocalized
--- Content provided by FirstRanker.com ---
collectionofpusinperitonsillarspacebetweenthetonsillarcapsuleandsuperiorconstrictormuscle.
>Thetonsilisfoundpusheddownwardandmedially.
>Theuvulaisswollenandedematousandpushedtotheopposite
side.
--- Content provided by FirstRanker.com ---
>Thereisabulgeonthesoftpalateandanteriortonsillarpillar.>Mucousmaybeseenoverlyingthetonsillarregion.
ref:https://www.ncbi.nlm.nih.gov/books/NBK519520/
270.Thispatientgivesahistoryoftoothache
--- Content provided by FirstRanker.com ---
foroneweek.Whatisthediagnosis:a)Acuteparotitis
b)Angioneuroticedema
c)Ludwig'sangina
d)Parapharyngealabscess
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAns.C.Ludwig'sangina
>Thisisaninfectionofthesubmandibularspace,i.e.floorofthe
mouth.
>ThemostcommoncauseofLudwig'sanginaisdentalCaries.
--- Content provided by FirstRanker.com ---
>Thesubmandibularspaceisdividedinto2spacesbythemylohyoidmuscle(alsoknownastheoraldiaphragm).
>Thespaceabovethemylohyoidisknownassublingualspace.
Heretheinfectionspreadsfrompremolartooth.
>Thespacebelowthemylohyoidisknownassubmaxillaryspace
--- Content provided by FirstRanker.com ---
laterallyandsubmentalspaceinthecenter.>Infectiontothisspacefollowscariousmolars.
(Ref.ScottBrown,8thed.,VoI3;628)
271.Themovementislostin:
--- Content provided by FirstRanker.com ---
a)Thirdnervepalsyb)Trochlearpalsy
c)Sixthnervepalsy
d)Facialnervepalsy
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Ans:b.Trochlearpalsy>Thetrochlearnerveisthefourthcranialnerve(CNIV)andoneof
theocularmotornervesthatcontroleyemovement.
>Thetrochlearnerve,whilethesmallestofthecranialnerves,has
thelongestintracranialcourseasitistheonlynervetohaveadorsal
--- Content provided by FirstRanker.com ---
exitfromthebrainstem.>Itoriginatesinthemidbrainandextendslaterallyandanteriorlyto
thesuperiorobliquemuscle.
Ref:https://www.ncbi.nlm.nih.gov/books/NBK537244/
--- Content provided by FirstRanker.com ---
272.Identifytheconditiongivenbelowintheimage
a)Peutzjeghers
b)Juvenilepolyp
c)Villousadenoma
--- Content provided by FirstRanker.com ---
d)HyperplasticpolypCorrectAnswer-B
Answer-B.Juvenilepolyp
TheimageshownhereisJuvenilepolyp.
Thisisabrightred,glisteningpedunculatedsphere(cherrytumour),
--- Content provided by FirstRanker.com ---
whichisfoundininfantsandchildren.Itcancausebleeding,orpainifitprolapsesduringdefecation.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1327
--- Content provided by FirstRanker.com ---
273.BariumSwallowexaminationisshown.Whatcanbethemostprobable
diagnosis?
a)EsophagealCa
b)EsophagealRing
--- Content provided by FirstRanker.com ---
c)EsophagealTeard)AchalasiaCardia
CorrectAnswer-A
Answer-A.EsophagealCa
TheimageisEsophagealcarcinoma
--- Content provided by FirstRanker.com ---
Squamouscellcancerandadenocarcinomaarethemostcommontypes.
Theclassicappearanceofamidoesophagealproliferative
squamouscellcarcinoma.
Squamouscellcarcinomaoftheesophagusproducinganirregular
--- Content provided by FirstRanker.com ---
stricturewithshoulderedmargins.Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1086
274.Identifytheconditiongivenintheimage
--- Content provided by FirstRanker.com ---
below?a)Chroniclymphedema
b)Cushingsyndrome
c)Osteoporosis
d)None
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAnswer-A.Chroniclymphedema
Theimageshowsbuffalohumpappearanceofthefootseenin
chroniclymphedema.
Lymphoedemacharacteristicallyinvolvesthefoot.
--- Content provided by FirstRanker.com ---
Thecontouroftheankleislostthroughinfillingofthesubmalleolardepressions,a'buffalohump'formsonthedorsumofthefoot,the
toesappear'square'becauseofconfinementoffootwearandthe
skinonthedorsumofthetoescannotbepinchedbecauseof
subcutaneousfibrosis(Stemmer'ssign).
--- Content provided by FirstRanker.com ---
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg998
275.Identifytheconditiongivenbelow-
a)MCUwithBulbarurethralstricture
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b)MCUwithpenilestricturec)RGUwithmembranousstricture
d)RGUwithprostaticstricture
CorrectAnswer-A
Answer-A.MCUwithBulbarurethralstricture
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Thecommoncausesofurethralstricturesare:Inflammatory
1. Secondarytourethritis
2. Secondarytobalanitisxeroticaobliterans.(BXO)
Traumatic
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1. Bulbarurethralinjury2. Pelvicfractureurethraldisruptioninjury
Iatrogenic
1. Secondarytourethralinstrumentationincludingcatheterizationand
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transurethralprostatectomy2. Secondarytoradicalprostatectomy
3. Secondarytoradiotherapyforprostatecancer
Idiopathic
Ascendingurethrogramshowingurethralstricturesofthebulbar
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urethra.Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1482
276.Whatistheuseoftheinstrumentgiven
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intheimagebelow?a)Laparoscopicsterilisation
b)Removalofectopicpregnancy
c)Terminationofpregnancy
d)Laparoscopicprocedurestocreatepneumoperitoneum
--- Content provided by FirstRanker.com ---
CorrectAnswer-AAns.A.Laparoscopicsterilisation
Lapringapplicator:Duringatuballigation,a2cmto3cmsegmentof
thefallopiantubeisdrawninsideanarrowcone-shapedapplicator.
Thesilasticringpreviouslystretchedaroundtheapplicator,isthen
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releasedontothetuballoop.Oncethesilasticringcontracts,thefallopiantubeisblocked
Ref.https://www.surgicalinstruments.com/general-lap-bariatric-
instruments/fallopian-ring-applicator-for-tubal-ligation
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277.Identifytheimagebelow:a)Femalecondom
b)Malecondom
c)Chaaya
d)Today
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CorrectAnswer-AAns.A.Femalecondom
Thefemalecondom(Femidom):
Itisapouchmadeofpolyurethanethatlinesthevaginaandalsothe
externalgenitalia.Itis17cminlengthwithoneflexiblepolyurethane
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ringateachend.Theinnerringattheclosedendissmallercomparedtotheouterring.
Ref.Duttagynaecology6thed.Pageno.476
278.Whatconditionofthemotheris
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associatedwiththefollowingfetalanomaly?
a)ACEinhibitor
b)GDM
c)PregestationalDM
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d)ValproateCorrectAnswer-C
Ans.C.PregestationalDM
TheimageshowsCaudalregressionsyndrome
Thisrareanomalyischaracterizedbytheabsenceofthesacral
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spineandoftenportionsofthelumbarspine.Itisapproximately25timesmorecommoninpregnancieswithpregestationaldiabetes
Sonographicfindingsincludeaspinethatappearsabnormallyshort,
lacksthenormallumbosacralcurvatureandterminatesabruptly
abovetheleveloftheiliacwings.
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Becausethesacrumdoesnotliebetweentheiliacwings,theyareabnormallyclosetogetherandmayappear"shield-like."
Theremaybeabnormalpositioningofthelowerextremitiesanda
lackofnormalsofttissuedevelopment.
OBSWILLIAMSed.24pageno.204
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279.Interpretthepartogram.
a)CPD
b)Maternalexhaustion
c)Inadequateuterinecontractions
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d)RuptureuterusCorrectAnswer-A
Ans.A.CPD
Patientadmittedat7AM
Cervicaldilatation4cm
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Head:5/5thpalpableAfter2hrs
Cervicaldilatation:5cm
Cervicaldilatation:5cm
Head:3/5thpalpable
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After4hrs:11AMCervicaldilatation7cm
Head:2/5thpalpable
Cervicaldilatation:Reached10cm
Uterinecontractionisstrongafter4hrsbuttheDescentofthehead
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isstill2/5th(constantafter4hrs)Diagnosis:Arrestofdescent
Themostcommoncauseofthearrestofdescentiscephalopelvic
disproportion
Ref.https://hetv.org/resources/reproductive-
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health/impac/Symptoms/Unsatisfactory__progress_labour_S57_S67.htmlhttps://apps.who.int/iris/bitstream/handle/10665/58903/WHO_FHE_MSM_93.8.pdf?
sequence=1
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280.60yrfemalewithahistoryofintermittentbleedingwithUSGpicshownbelow.
Whatisthediagnosis?
a)Endometrialpolyp
b)Caendometrium
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c)Submucosalfibroidd)None
CorrectAnswer-A
AnsA.Endometrialpolyp
The3Dimagegivesabetterpictureofalargevesselpassingintoa
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polyp.
Endometrialpolyps:
Endometrialpolypsarelocalizedovergrowthofthebasalstroma
withcentralbloodvesselscoveredbysurfaceendometriummostly
risingfromthefundalarea.
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Itisimportanttomentionthattheliabilityofpolypstobleedfollowstheirpeculiarstructure.Eachpolyphasacentralfeedingvessel,soft
stromaandbacktobackglandularity.
Onlineref.http://www.gynaecologist4u.com/9.html
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281.WhatwillbetheHysteroscopicfindinginthegivenimage?
a)BilateralHydrosalpinx
b)Bilateralcornualblock
c)NormalHSG
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d)BicornuateuterusCorrectAnswer-A
Ans.A.BilateralHydrosalpinx
TheimageisHysterosalpingogramshowingbilateralhydrosalpinx
(fimbrialblock).
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Hysterosalpingogramshowingradio-opaqueshadowfillingtheuterinecavity.Thetubesofbothsidesaredistendedwiththeradio-
opaquedye.Thereisnoevidenceofperitonealspillage.
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NORMALHSGSHOWINGSPILLAGE
Hysterosalpingogramshowingbilateralcornualblock.
Hysterosalpingogramshowingbicornuateuterus.
Ref.DCDutta'sTextbookofGynecology6thEditionPageno.
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657-659,661282.Aladyontreatmentforinfertility
developedascites,abdominalpain&
dyspnea.
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USGofthepatientwasdoneshownbelow.Whatwillbethediagnosis?
a)PCOS
b)OHSS
c)Thecaluteincyst
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d)MucinouscystadenomasCorrectAnswer-B
ANS.B.OHSS
Ovarianhyperstimulationsyndrome(OHSS):
Itisaclinicalsymptomcomplexassociatedwithovarian
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enlargementresultingfromexogenousgonadotropintherapy.Symptomsmayincludeabdominalpainanddistension,ascites,
gastrointestinalproblems,respiratorycompromise,oliguria,
hemoconcentration,andthromboembolism.
Thesesymptomsmaydevelopduringovulationinductionorinearly
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pregnanciesthatwereconceivedthroughexogenousovarian
stimulation.
REF:DCDutta'sTextbookofGynecology6thEditionPAGENO.
529,530,661
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283.5-yearmalechildpresenttotheclinicwithH/OrecurrentinfectionOn
examinationhewasfoundtohave
rashesshownbelowintheimage.On
routinebloodinvestigation,lowplatelet
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countwasfoundwhatwillbethediagnosis?
a)WiskottAldrichsyndrome
b)Job'ssyndrome
c)ChediakHigashisyndrome
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d)NoneCorrectAnswer-A
Ans.A.WiskottAldrichsyndrome
WiskottAldrichsyndrome:Thereisamutationinthegeneencoding
Wiskott-Aldrichsyndromeprotein(WASP),whichislocatedon
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Xp11.23.TheX-linkeddiseaseischaracterizedbythrombocytopenia,eczema,andamarkedvulnerabilitytorecurrent
thrombocytopenia,eczema,andamarkedvulnerabilitytorecurrent
infection,resultinginearlydeath.
Plateletsaresmallinsize.
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ThereisaprogressivelossofTlymphocytesintheperipheralbloodandintheT-cellzones(paracorticalareas)ofthelymphnodes,with
variabledefectsincellularimmunity.
Patientsdonotmakeantibodiestopolysaccharideantigens,andthe
responsetoproteinantigensispoor.TheyarepronetodevelopB-
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celllymphomas.Robbins&CotranPathologicBasisofDisease,9ed:Pageno
242
284.Thepatientispresentingwiththe
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deformityofthefingerasshown.ThePIPisinvolvedbuttheDIPisspared
a)Osteoarthritis
b)Rheumatoidarthritis
c)PsoriaticArthritis
--- Content provided by FirstRanker.com ---
d)AnkylosingspondylitisCorrectAnswer-B
Ans:b.Rheumatoidarthritis
>Swan-neckdeformityofthefingerdescribeshyperextension
atthePIPjointwithflexionoftheDIPjoint
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>RheumatoidArthritisClinicalPresentationRef:https://www.medscape.com/answers/331715-5365/what-is-
a-swan-neck-deformity-of-the-finger-in-rheumatoid-arthritis-ra
285.Whatisthemostlikelydiagnosisgiven
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intheimage-a)Popeye'ssign
b)Griesingersign
c)Risingsunsign
d)Winnersign
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CorrectAnswer-AAnsa.Popeye'ssign
>presentedtotheorthopedicclinicwithalargebulgeonhisright
upperarm.
>Examinationrevealedanobviousdeformityintheanteriormid-
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upperarmthatmaybecomemoresignificantduringelbowflexion>ThistypicalfindingonphysicalexaminationisknownasPopeye
signorPopeyedeformity,whichiscausedbybulgingofthebiceps
musclebellyafterruptureofthebicepstendon
https://academic.oup.com/qjmed/article/112/12/931/5487419
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286.Thepatientispresentingwithpain
aroundthebaseofthethumb,tendons
involved-
a)APB&EBL
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b)APL&EPBc)APB&EPB
d)APL&EPL
CorrectAnswer-B
Ans:b.APL&EPB
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>TheconditionexplainedinthepatientisDeQuervain'sTenosynovitis
>DeQuervain'sTenosynovitisisapainfulinflammationoftendons
onthesideofthewristatthebaseofthethumb.
>Thesetendonsincludetheextensorpollicisbrevis(EPB)andthe
--- Content provided by FirstRanker.com ---
abductorpollicislongus(APL).>Thesemusclesarelocatedonthedorsalsideoftheforearmand
gotothelateralsideofthethumbthroughafibrous-osseoustunnel
madeoftheprocessusstyloideusradiiandtheextensor
retinaculum.
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retinaculum.
https://www.physio-
pedia.com/De_Quervain%27s_Tenosynovitis
Aclinicalcaseofabnormallengtharms,longfingersandtoes
Ans:Marfansyndrome(Ortho)
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287.Theshownangleintheimageisknown
as
a)Cobb'sangle
b)Bohler'sangle
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c)Fergusonangled)Baumann'sangle
CorrectAnswer-A
Ans:a.Cobb'sangle
>TheimageshowstheScoliosispatterninVertebra.
--- Content provided by FirstRanker.com ---
TheCobbAngleisusedasastandardmeasurementtodetermineandtracktheprogressionofscoliosis.
>Theangleofcurvatureismeasuredbydrawinglinesparalleltothe
upperborderoftheuppervertebralbodyandthelowerborderofthe
lowestvertebraofthestructuralcurve.
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>Thenerectingperpendicularsfromtheselinestocrosseachother,theanglebetweentheseperpendicularsbeingthe`angleof
curvature'
>ACobbangleof10degreesisregardedasaminimumangulation
>ACobbangleof10degreesisregardedasaminimumangulation
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todefineScoliosis.Ref:https://www.physio-pedia.com/Cobb%27s_angle
288.Whatisthediagnosisof55oldwomen
withachroniclowbackache-
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a)Osteoporosisb)Hurler'ssyndrome
c)Paget'sdisease
d)Renalosteodystrophy
CorrectAnswer-A
--- Content provided by FirstRanker.com ---
Ans:a.Osteoporosis>Osteoporosisis,forthemostpart,adiseaseofaging.
>Theolderseniorisathighriskforosteoporosis.
>Theriskforlowbonedensityincreaseswithageandsignificantly
impactsbonestrength.
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2685234/289.Identifytheconditionshowninthe
image?
a)IchthyosisVulgaris
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b)Syndromalichthyosisc)Leprosy
d)Sarcoidosis
CorrectAnswer-A
Answer-A.IchthyosisVulgaris
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Ichthyosisisoneofthemostcommongenodermatoses.Itischaracterizedbydry(xerotic)scalyskinalloverthebody.Scalesare
dull-brown-black.Thebasicdefectisanimpairmentinthebarrier
functionofskinandinabilitytomaintainmoisture.
Ichthyosiscanbedividedinto:-
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1. Inheritedichthyosis(IchthyosisVulgaris,X-linkedIchthyosis,Lamellarichthyosis,epidermolytichyperkeratosis).
2. Syndromalichthyosis
3. Acquiredichthyosis(Ichthyosisacquisita).
ThemostcommontypeofichthyosisisichthyosisVulgarisinwhich
--- Content provided by FirstRanker.com ---
thereisadeficiencyoffilaggrinaproteinfoundinthegranularlayerthereisadeficiencyoffilaggrinaproteinfoundinthegranularlayer
(stratumgranulosum)
Manydifferentmetaphorshavebeenusedtodescribethe
appearanceandtextureoftheskininvarioustypesandstagesof
--- Content provided by FirstRanker.com ---
ichthyosis,e.g.,alligatorskin,Crocodileskin(Sauroderms),Fishskinandporcupineskin.
Ref-ArvindAroraskin,6thedition,pageno203
290.Thepatientcamewithhistoryofbullae
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involving>30"A,bodysurfaceareaalongwitherosionsofthelipsandother
mucosaeforthepast7days.Whatisthe
mostprobableunderlyingetiology?
a)Bacterialinfection
--- Content provided by FirstRanker.com ---
b)Viralinfectionc)Drugs
d)Malignancy
CorrectAnswer-C
Ans:C.Drugs
--- Content provided by FirstRanker.com ---
TypicalofSteven-Johnsonsyndrome&toxicepidermalnecrolysis.Toxicepidermalnecrolysis(TEN):
Alsoreferredtoas"Lyell'ssyndrome".
Rare,life-threateningskincondition.
Usuallycausedbyadrugreaction.
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291.Whichofthefollowingdoestheimageof
Capnographbelowdepicts?
a)Duringinspiration
b)Inspirationwithcardiacoscillations
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c)Duringexpirationd)spontaneousrespiration
CorrectAnswer-D
Ans.D.spontaneousrespiration
Theimageinthegivenquestionshowsacapnographwithclefts
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duringphaseIIIwhichindicatesspontaneousbreathingeffortsbythepatientduringcontrolledmechanicalventilation.Alsoknown
ascurarenotchorcleft.
Ref:https://www.ncbi.nlm.nih.gov/pubmed/24132805
Miller'sAnesthesia8thedition(Pageno.1554)
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292.Identifythedeviceshownintheimage.
a)NasopharyngealAirway
b)EndotrachealTube(Cuffed)
c)GuedelAirway
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d)LaryngealMaskAirwayCorrectAnswer-D
Ans:D.)LaryngealMaskAirway
Laryngealmaskairway
Atypeofsupraglotticairway.
--- Content provided by FirstRanker.com ---
ItisalsoreferredtoasBrainmaskasitwasinventedbyDr.ArchiesBrain.
LMAprovidesanairwayintermediatebetweenthefacemaskand
trachealtube
Itisamedicaldevicethatkeepsapatient'sairwayopenduring
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anaesthesiaorunconsciousness.TheprincipleofLMAisthatitprovidesaneffectivegas-tightseal
aroundthelaryngealinletwithoutanythinghavingtopassthrough
thevocalcord.
LMAisveryeffectiveinmaintainingapatentairwayinthe
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spontaneouslybreathingpatient.Itiscomposedofanairwaytubethatconnectstoanellipticalmask
withacuffwhichisinsertedthroughthepatient'smouth,downthe
windpipe,andoncedeployedformsanairtightsealontoptheglottis
(unliketrachealtubeswhichpassthroughtheglottis)allowinga
--- Content provided by FirstRanker.com ---
secureairwaytobemanagedbyahealthcareprovider.LMAisavailablein8differentsizes
Disadvantage:
OneofthemajordisadvantagesofLMAisthatitssealaround
laryngealinletdoesnotalwayspreventaspiration.
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Therefore,LMAshouldnotbeusedwherethereisanincreasedriskofaspirationofstomachcontents,e.g.'fullstomachpatient.
293.IdentifytheconditionintheX-raygiven
below-
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a)TGAb)TAPVC
c)TOF
d)Ebstein'sanomaly
CorrectAnswer-C
--- Content provided by FirstRanker.com ---
Answer-C-TOFTheimageshownaboveisofTetralogyofFallotcondition.
Classicallythechestradiographdemonstratesa'boot-shaped'heart
withpoorlydevelopedlungvasculature.
Thediagnosisisconfirmedwithechocardiography.
--- Content provided by FirstRanker.com ---
Surgerytocorrectthetetralogyisthemainstayoftreatmentandisusuallycarriedoutat4-6
monthsofage,whenpossible.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg905
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294.Achestradiographobtainedamalewith
hypertension.Whatwillbethe
diagnosis?
a)TetralogyofFallot
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b)Ebstein'sAnomalyc)TAPVC
d)CoarctationofAorta
CorrectAnswer-D
Answer-D-CoarctationofAorta
--- Content provided by FirstRanker.com ---
Thechestradiographclassicallydemonstratesrib-notchingbecauseofdilatedposteriorintercostalvessels.Theheartisusuallyofnormal
sizeintheolderchildandshowsaclassical'threesign"replacing
thetypicalaorticknuckle.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
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publishedin2018Pg906295.Steeplesignisseeninwhichofthe
followingcondition?
a)Acuteepiglottitis
--- Content provided by FirstRanker.com ---
b)Acutelaryngotracheobronchitisc)Laryngealpapillomatosis
d)Bilateralabductorparalysis
CorrectAnswer-B
Answer-B-Acutelaryngotracheobronchitis
--- Content provided by FirstRanker.com ---
TheimagebelowindicatesAcutelaryngotracheobronchitis.Croupisusuallyofsloweronsetthanacuteepiglottitisandoccurs
mostcommonlyinchildrenunder2yearsofage.
Thechildrenhavebiphasicstridorandareoftenhoarsewitha
typicalbarkingcough.
--- Content provided by FirstRanker.com ---
Ref-BaileyandLove,Shortpracticeofsurgery,27theditionpublishedin2018Pg743
296.Identifytheradiologicalsigngiven
below-
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a)Diverticulitisb)Ischaemiccolitis
c)Appendicitis
d)None
CorrectAnswer-B
--- Content provided by FirstRanker.com ---
Answer-B-IschaemiccolitisSingle-contrastbariumenemashowsthenarrowingofthe
descendingcolonwithascallopedappearancewithulcerationorthe
classicaloedematous'thumbprinting'signinischaemiccolitis.
Plainfilmsarefrequentlytakenandoftenrevealsplenicflexure
--- Content provided by FirstRanker.com ---
irregularitywithamuralthickening.Ref-DavidSutton,TextbookofRadiologyandImaging,Volume
1,Edition7th,Pg653
Basicofradiology,Lange,2ndedition,Pg642
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297.Amiddle-agedmanwithaswellingoverthenecksincechildhoodwiththe
overlyingskinnotintactwhichhadabag
orworm-likeappearancewithablack
spotinthemiddle.Whatwillbethe
--- Content provided by FirstRanker.com ---
diagnosis?a)Cirsoidaneurysm
b)Varicocele
c)Plexiformneurofibroma
d)Lymphangioma
--- Content provided by FirstRanker.com ---
CorrectAnswer-CAnswer-C-Plexiformneurofibroma
PlexiformneurofibromasrepresentanuncommonvariantofNF-1in
whichneurofibromasarisefrommultiplenervesasbulgingand
deformingmassesinvolvingalsoconnectivetissueandskinfolds--
--- Content provided by FirstRanker.com ---
hencetheclinicaldescriptionoflesionsas"bagsofworms."Skinexaminationalsorevealedmultipleneurofibromasandcaf?-au-
laitmaculesonthetrunkandarms.
Ref-
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4753888/#!po=35.7143
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298.Identifytheradiologicalimagegiven
below-
a)Intussusception
b)Carcinomacolon
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c)Sigmoidvolvulusd)Sigmoidvolvulus
CorrectAnswer-A
Answer-A-Intussusception
Thisimageshowsintussusception.
--- Content provided by FirstRanker.com ---
Theclassicpresentationiswithepisodicabdominalpainandscreamingepisodesassociatedwiththepassageofbloodand
mucus('redcurrentjelly').
Theabdominalradiographmaydemonstrateanabsenceofbowel
gasintherightiliacfossawitharoundedsoft-tissuemassa
--- Content provided by FirstRanker.com ---
crescentofairattheapexofintussusception,orsmall-bowel
obstruction.
Ref-DavidSutton,TextbookofRadiologyandImaging,Volume
1,Edition7th,Pg872
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299.Namethesignseeninthegivenbelowimagerepresents-
a)Mickeymousesign
b)Stringsign
c)Tillauxsign
--- Content provided by FirstRanker.com ---
d)Stemmer'ssignCorrectAnswer-A
Answer-A-Mickeymousesign
TheMickeyMousesignissaidtorepresentthenormalanatomyof
thecommonfemoralartery,commonfemoralveinandgreat
--- Content provided by FirstRanker.com ---
saphenousveinonultrasoundattheleveljustinferiortotheinguinalcrease.
Reference-Coleridge-SmithP,LabropoulosN,PartschH,Myers
K,NicolaidesA,CavezziA.Duplexultrasoundinvestigationof
theveinsinthechronicvenousdiseaseofthelowerlimbs--UIP
--- Content provided by FirstRanker.com ---
consensusdocument.PartI.Basicprinciples.Europeanjournalofvascularandendovascularsurgery:theofficialjournalofthe
EuropeanSocietyforVascularSurgery.
300.A35-year-oldmalepresentswith
--- Content provided by FirstRanker.com ---
recurrentepisodesofabdominalpain,jaundice,andfatigueandunderwent
MRCP.Whatwillbethemostlikely
diagnosis?
a)Primarybiliarycirrhosis
--- Content provided by FirstRanker.com ---
b)Caroli'sdiseasec)Primarysclerosingcholangitis
d)Orientalcholangitis
CorrectAnswer-C
Answer-C-Primarysclerosingcholangitis
--- Content provided by FirstRanker.com ---
ThisimageshowsPSC.MRimagingofthebiliarysystem,especiallyMRCP,hasbecome
moreimportantinbiliaryimaging,includingthedetectionofcalculiof
thegallbladderandbiliarytree.
ThediagnosisofPSCisprincipallybasedonthefindingsat
--- Content provided by FirstRanker.com ---
cholangiography,inwhichirregular,narrowedbileductsaredemonstratedinboththeintrahepaticandextrahepaticbiliarytree.
Ref-BaileyandLove,Shortpracticeofsurgery,27thedition
publishedin2018Pg1167
Basicofradiology,Lange,2ndedition,Pg313
--- Content provided by FirstRanker.com ---
invalidquestionid