content listlengths 1 1 | teacher_response stringlengths 21 4.24k | answer stringclasses 4
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{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following statements about Hepatitis C is TRUE?\nChoices:\nA. DNA virus\nB. Most common indication for Liver transplantation\nC. Does not cause Liver cancer\nD. Does not cause co infection with hepat... | Progression to cirrhosis or hepatocellular carcinoma is a major cause of morbidity and the most frequent indication of liver transplantation in adults in united states. Ref: Kliegman, Behrman, Jenson, Stanton (2008), "Nelson Textbook of Pediatrics", Chapter 355, "Viral Hepatitis", Volume 2, Page 1687; Harrison's Principles of Internal Medicine, 17th Edition, Pages 1939, 1963, 1984; Current Gastroenterology, 2nd Edition, Page 556
<answer>(B)</answer> | B |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Vitamin–B6 deficiency is seen with the use of all of the following drugs except :\nChoices:\nA. Cycloserine\nB. Cyclosporine\nC. INH\nD. d–Penicillamine\n</Question>\nAt the end present your answer in <answer> a... |
<answer>(B)</answer> | B |
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{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Tumour marker of endodermal sinus tumour of ovary :\nChoices:\nA. a feto proteins\nB. CA 125\nC. HCG\nD. CEA\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B,... | a feto proteins
<answer>(A)</answer> | A |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Highest concentration of potassium is seen in -\nChoices:\nA. Jejunum\nB. ileum\nC. Duodenum\nD. Colon\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C, or... | • Maximum K+ concentration: Colon (30 mEq/L) >Saliva (25 mEq/L)
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Genu recurvatum is seen in:\nChoices:\nA. Rheumatoid ahritis\nB. Poliomyelitis\nC. Rickets\nD. All of the above\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A,... | Genu Recurvatum or hyperextension of knee is seen in: Trauma R.A Rickets Poliomyelitis Charcots Congenital (Due to Intrauterine positioning) - self resolving
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Acute radiation hepatic damage is most marked between -\nChoices:\nA. 1-7 days\nB. 7-21 days\nC. 21-40 days\nD. 40-100 days\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercas... | Ans. is 'd' i.e., 40-100 days o Acute radiation damage normally affects rapidly proliferating tissue : - i) Hematopoietic tissue Latent period 2-3 weeks. ii) Epithelium of GIT --> Latent period 3-5 days. iii) Lymphoid tissue o Acute radiation damage also affects the CNS Latent period 15 minutes to 3 hours. o Hepatic radiation damage is not acute, it is subacute and appears within 90 days.
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Uterine artery is a branch of\nChoices:\nA. External iliac artery\nB. Superior vesical\nC. Internal iliac artery\nD. Aorta\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase... | Ans C Ref: Williams Obstetrics page 26Vascular supply of uterus is derived principally from uterine artery which is amain branch of internal iliac artery. Sheila Balakrishnan (Ob-stetric) page 16Internal iliac artery is the feeding vessel of pelvis Anterior division:Parietal branches- ObturatorPosterior division-has only parietal branchesDiolumbar Inferior glutealInternal pudendalVisceral branches- Superior vesical Lateral Sacral Obliterated umbilicalInferior vesicalMiddle rectalUterine & vaginal Superior gluteal
<answer>(C)</answer> | C |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Best marker of gestational age in 2nd trimester is:\nChoices:\nA. Biparietal diameter\nB. Head circumference\nC. CRL\nD. Femur length\n</Question>\nAt the end present your answer in <answer> and </answer> using a... | Ans. is a, i.e. Biparietal diameterRef Williams Obs. 24/e, p 198; USG in Obs. and Gynae by Callen 4/e, p 208"In the second trimester the BPD most accurately reflects the gestational age, with a variation of 7 to 10 day."Ref. Williams 24/e, p 198Prediction of fetal gestational age using ultrasound biometric parametersRef Bedside Obs/Gynae by Richa Saxena, p 191Period of gestationUltrasound parameter to be used8 weeks to 12 weeksCrown-rump length measurementSecond trimesterBPD, HCThird trimesterFemur lengthNote: In brachycephaly or Dolichocephaly - HC is better parameter in 2nd trimester than BPD as HC is unaffected by the shape of fetal head.
<answer>(A)</answer> | A |
[
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"content": "Given the following question and candidate answers, choose the best answer. <Question>All are ‘celsus’ signs of inflammation except:-\nChoices:\nA. Cyanosis\nB. Pain\nC. Swelling\nD. Redness\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C, ... | o Cardinal signs of acute inflammation (celsus' signs): Rubor (redness), tumor (swelling), color (warmth),Dolor (pain).
<answer>(A)</answer> | A |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>A six-year-old girl has brief, irregular contractions in her feet; symptoms are suspected to be a result of an untreated strep infection. What is the diagnosis?\nChoices:\nA. Chorea gravidarum\nB. Chorea major\nC... | Sydenham chorea (St. Vitus dance) - commonest chorea. occurs mainly in girls as a sequela to rheumatic fever. Chorea major (Huntington's disease) -inherited disorder manifests as choreiform movements and progressive dementia. Chorea gravidarum occurs during the 2nd trimester of pregnancy. Ballism and hemiballism -violent flinging movement of one or both extremities due to infarct of the subthalamic nucleus.
<answer>(D)</answer> | D |
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{
"content": "Given the following question and candidate answers, choose the best answer. <Question>In gene cloning, largest fragment can be incorporated in:\nChoices:\nA. Plasmid\nB. Bacteriophage\nC. Cosmid\nD. Retrovirus\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercas... | C i.e. Cosmid
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>In hereditary spherocytosis mutation, not seen is?\nChoices:\nA. Ankyrin\nB. Spectrin\nC. Band-3\nD. Na+ Cl- channel protein\n</Question>\nAt the end present your answer in <answer> and </answer> using an upperc... |
<answer>(D)</answer> | D |
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{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Ashleaf spots are seen in: March 2007\nChoices:\nA. Psoriasis\nB. Tuberous sclerosis\nC. Multiple sclerosis\nD. Pemphigus vulgaris\n</Question>\nAt the end present your answer in <answer> and </answer> using an u... | Ans. B: Tuberous Sclerosis Tuberous sclerosis/ tuberous sclerosis complex (TSC) is a rare, multi-system genetic disease that causes benign tumours to grow in the brain and on other vital organs such as the kidneys, hea, eyes, lungs, and skin. TSC is caused by mutations on either of two genes, TSC1 and TSC2, which encode for the proteins hamain and tuberin respectively. These proteins act as tumour growth suppressors, agents that regulate cell proliferation and differentiation. The physical manifestations of tuberous sclerosis are due to the formation of hamaia (malformed tissue such as the coical tubers), hamaomas (benign growths such as facial angiofibroma and subependymal nodules) and, very rarely, cancerous hamaoblastomas. Central nervous system Classic intracranial manifestations of tuberous sclerosis include subependymal nodules and coical/ subcoical tubers. Kidneys Between 60 and 80% of TSC patients have benign tumors (hamaomas) of the kidneys called angiomyolipomas (AML) frequently causing hematuria. Lungs Patients with TSC can develop progressive replacement of the lung parenchyma with multiple cysts. This process is identical to another disease called lymphangioleiomyomatosi (LAM). Hea Rhabdomyomas are benign tumors of striated muscle. Skin The most common skin abnormalities include: - Facial angiofibromas ("adenoma sebaceum"): A rash of reddish spots or bumps, which appear on the nose and cheeks in a butterfly distribution. - Ungual or subungual fibromas: Small fleshy tumors that grow around and under the toenails or fingernails. - Hypomelanic macules ("ash leaf spots"): White or lighter patches of skin that may appear anywhere on the body and are caused by a lack of melanin. These are usually the only visible sign of TSC at bih. In fair-skinned individuals a Wood's lamp (ultraviolet light) may be required to see them. - Forehead plaques: Raised, discolored areas on the forehead. - Shagreen patches: Areas of thick leathery skin that are dimpled like an orange peel, usually found on the lower back or nape of the neck. Eyes Retinal lesions, called astrocytic hamaomas, appear as a greyish or yellowish-white lesion in the back of the globe on ophthalmic examination.
<answer>(B)</answer> | B |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>An elderly man presents with features of dementia, ataxia, difficulty in downward gaze and a history of frequent falls. Likely diagnosis is:\nChoices:\nA. Parkinsons disease\nB. Progressive supranuclear gaze pals... | Answer is B (Supranuclear gaze palsy): Progressive supranuclear palsy should always be considered when a middle aged/elderly persons presents with a history of repeated falls, & difficulty in downward or horizontal gaze. Steel Richardson syndrome Nature of disorder Is a degenerative disorder where in there occurs loss of neurons in pas of our CNS which are involved with maintenance of posture & equilibrium, namely the Mid brain, Pons, Basal ganglion and cerebellum. The clinical features are characteristic "Progressive supranuclear palsy should be considered whenever a middle aged or elderly person person presents with history of repeated falls and has an extrapyramidal syndrome accompanied by nuchal dystonia and paralysis of voluntary down gaze" Factors which distinguish this from Parkinson's marked impairment of voluntary downward gaze and horizontal gaze. extended rather than flexed dystonic posturing absence of tremor poor response to antiparkinsonian medication
<answer>(B)</answer> | B |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Five cusps are present in:\nChoices:\nA. Maxillary first molar only\nB. Mandibular first molar only\nC. Maxillary and mandibular first molar\nD. Maxillary and Mandibular second molar\n</Question>\nAt the end pres... |
<answer>(C)</answer> | C |
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{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Cholera toxin binds to which receptors in intestine-\nChoices:\nA. Sphingosine through A subunit\nB. Sphingosine through B subumit\nC. GM1 gangliosides through A subunit\nD. GM1 gangliosides through B subunit\n</... | Ans. is 'd' i.e., GM1 gangliosides through B subunito V. cholerae produces cholera toxin, the model for enterotoxins, whose action on the mucosal epithelium is responsible for the characteristic diarrhoea of the cholera. Cholera toxin resembles heat labile toxin of E. coli.o Cholera toxin is a protein complex made up of six subunits --> a single copy of'A' subunit (Port A) and five copies of 'ET subunit (Part B). 'A' subunit has two fragments; Ai and A2. Cholera toxin |||A subunit (active part)B subunit|||| |Al fragmentA2 fragmentBinds to GM1 Ganglioside|| A DP ribosylation of G-proteinLinks the A, fragment to B subunit|Stimulation of adenyl cyclase and increased production of cAMPo cAMP inhibits the absorptive sodium transport system (decreases sodium & chloride reabsorption) and activates the secretory chloride transport system (increases chloride and bicarbonate secretion)o This leads to accumulation of sodium choride in the intestinal lumen.o Accumulated sodium chloride draws water into the lumen due to increased osmolality leading to watery diarrhoea.o Cholera toxin production is determined by a filamentous phage integrated with bacterial chromosome.o Endotoxin has no role in pathogenesis.
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>The most appropriate management for maintaining patency of ductus arteriosus in a neonate is –\nChoices:\nA. Prostaglandin E1\nB. Oxygen\nC. Nitric oxide\nD. Indomethacin\n</Question>\nAt the end present your ans... | Ductus arteriosus remains patent in the uterus in the fetal life because of high level of vasodilators especially prostaglandin E2 in the blood.
After birth the prostaglandin synthesis is inhibited by inhibition of cycloxygenase at birth.
So if the patency of ductus arteriosus has to be maintained → prostaglandins should be given.
The drug which is specifically used for this is prostaglandin E1 (Misoprost, Rioprostil)
If the ductus arteriousus has to be closed, prostaglandin synthesis inhibitor - Indomethacin should be given.
<answer>(A)</answer> | A |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Coin shaped eczema is :\nChoices:\nA. Nummular eczema\nB. Atopic ecema\nC. Infantile eczema\nD. Endogenous eczema\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (... | A. i.e. Nummular eczema Circular or oval coin shaped lesionsQ are seen in nummular (discoid) eczema. Dermatitis / Eczema Nummular (Discoid) Eczema More frequently a disease of middle aged adult (50-65 years) men. However a second peak around 15-25 years in women and rarely childhood onset (at 5 years age) is also seen. Dry skin in elderly is a contributory factor. Diagnostic lesions is a well demarcated, coin shaped eryrhematous plaqueQ arising, quite rapidly, from the confluence of tiny, closely set, thin walled papules and papulovesicles. Pin point oozing, crusting and scaling eventuate. Pruritis varies from severe (in acute phase) to minimal. Later central clearing (resolution) and peripheral extension leads to annular or ring shaped lesions. Secondary lesions in a mirror-image configuration on opposite side of body and reactivation of apparently dominant lesions (paicularly on premature discontinuation of treatment) is very characteristic. Common locations are trunk or extensor surfaces of extremities, paicularly on the pretibial areas (in men) or dorsal aspects of hands (in women). Differential Diagnosis: Contact dermatitis should be suspected in chronic recalcitrant and unusually severe case where patches are few, asymmetrical and of unusual configuration. Psoriasis has usually more well defined, thickened, scaly and more number of plaques. Bowen's disease usually has 1 or 2 red, scaly patches mostly restricted to light exposed areas. Treatment is similar to that of atopic dermatitis. Contact Dermatitis I. Air borne C.D.Q - Is due to pahenium (congress grass)Q II. Primary irritant C.D - Due to direct contact with toxic irritating materialQ - Palmar surface of handsQ are m.c. involved III. Allergic C.D. - Due to contact with an agent to which delayed hypersensitivity has developed. - Ex-Nickel (m.c.)Q dye, cosmetics, local anesthetic. Seborrheic Dermatitis Occurs on hairy sites, flexures or on central trunk. It is chracterized by: Itching or burning Severe dandruffQ Greasy yellow scalesQ over erythematous patch (stuck on appearance) Cradle capQ is seen in pityriasis capitis complicated by seborrheic dermatitis.
<answer>(A)</answer> | A |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>False about Sjögren’s syndrome is\nChoices:\nA. Female : male ratio is 10:1\nB. Destruction of salivary glands\nC. Lymphocytic infiltration of glands\nD. Anti smith antibodies are present\n</Question>\nAt the end... | Anti RO and anti-la antibodies are specific for Sjögren’s syndrome.
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>A child can make a tower of 6 cubes at the age of?\nChoices:\nA. 36 months\nB. 18 months\nC. 12 months\nD. 24 months\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase lette... | A child can make a tower of 6 cubes at 2 years. -tower of 2 cubes at 15 months, 3 cube tower at the age of 18 months
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>The diagnostic method of submandibular sialolithiasis is\nChoices:\nA. USG\nB. Sialography\nC. Plain X-ray\nD. CT scan\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase let... | Ans. (c) Plain X-rayRef: Bailey and Love 27th Edition Page 780* MC cause of Submandibular duct obstruction is Stones in Gland and Duct.* 80% stones are radio opaque and hence X ray is diagnostic.* 80% of salivary stones are seen in Submandibular duct.* Stones distal to Lingual nerve (Beyond 2nd Molar) - Duct lay opening and stone removal is enough
<answer>(C)</answer> | C |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>A 60 year old woman presents after 4 days of cataract surgery with history of pain and decrease in vision after an initial Improvement. Diagnosis is\nChoices:\nA. After cataract\nB. Endophthalmitis\nC. Iris prola... | Bacterial endophthalmitis is most dreaded complication over all.
Pain, diminition of vision after improvement s/o endopthalmitis.
<answer>(B)</answer> | B |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Schiller- Duval bodies are seen in\nChoices:\nA. Teratoma\nB. Seminoma\nC. Yolk sac tumour\nD. Chorio - carcinoma\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (... | (Yolk - sac tumour) (736 - HM 5th) (692- Basic pathology 8th)YOLK-SAC-TUMOUR (synonyms - Endo dermal sinus tumurs, orchioblastoma, Infantile embryonal carcinoma)* This characteristic tumour is the most common testicular tumour of infants and young children up to the age of 4 years* AFP levels are elevated in 100% cases of yolk sac tumoursMicroscopic - The tumour cells may form distinctive perivascular structures resembling the yolk sac or endodermal sinuses of the rat placenta called Schiller - Duval bodies* There may be presence of both intracellular and extra cellular PAS positive hyaline globulesCHORIOCARCINOMA - M/E - Characteristic feature is the identification of intimately related syncytiotrophoblast and cyto trophoblast without formation of definite placental type villiTERATOMA - Honey - combed areas and foci of cartilage and boneSEMINOMA - Commonest malignant tumour of the testis and corresponds to dysgerminoma in femaleM/F. shows lobules of monomorphic seminoma cells separated by delicate fibrous stroma containing lymphocytic infiltration
<answer>(C)</answer> | C |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>A 78-year-old man is brought to the hospital because of persistent nausea and vomiting. On examination he appears dry, his abdomen is soft, and the JVP is not visible. Laboratory investigations reveal hypernatrem... | The largest volume of water is reabsorbed in the nephron at the proximal convolution. Maximally concentrated urine depends on ADH, which allows distal convoluted tubes and collecting ducts to become permeable to water.
<answer>(B)</answer> | B |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Which one of the following amino acids is most likely to be found in the trans membrane region of a protein?\nChoices:\nA. Lysine\nB. Arginine\nC. Leucine\nD. All\n</Question>\nAt the end present your answer in <... | Ans:C.)Leucine. Cell membrane is a complex structure composed of lipid, proteins and carbohydrate. Membrane lipids form bilayer. The unique characteristic of this layer is that it has its hydrophobic ends in the centre of membrane while its hydrophilic ends lie on the outer surface of membrane. Hydrophobhic or Non polar aminoacid are present in transmembrane region. Hydrophillic or polar amino acids are present on outer surface of membrane. Leucine is a hydrophobic a.a so it lies in transmembrane region Polar Amino Acids (Hydrophilic)Charged Acidic Amino acids-Aspaic Acid (Aspaate), Glutamic Acid (Glutamate) Basic Amino Acids-Histidine, Arginine,Lysine Uncharged Aliphatic amino acid with hydroxyl group as side chain: Serine, Threonine Aliphatic amino acids with amide group: Asparagine, Glutamine Simple Amino acid: Glycine alone Sulfur containing Aminoacid: Cysteine alone. Nonpolar Amino Acids (Hydrophobic) Simple amino acid: Alanine alone Sulfur containing amino acid: Methionine alone Aromatic Amino acids except Histidine . All branched chain amino acids: Leucine,Isoleucine and Valine Imino acid: Proline
<answer>(C)</answer> | C |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following is not found in cerebral palsy?\nChoices:\nA. Hypotonia\nB. Microcephaly\nC. Ataxia\nD. Flaccid paralysis\n</Question>\nAt the end present your answer in <answer> and </answer> using an upp... | Cerebral palsy is a static encephalopathy and a disorder of posture and movement often associated with seizures and deficit in the motor, language, and social milestones due to insult to the developing brain.MICROCEPHALY is a feature of cerebral palsy because of insult to the developing brain.DYSTONIC CP is associated with hypotoniaEXTRAPYRAMIDAL CP is associated with ataxiaCerebral palsy is an upper motor neuron disease characterized by rigidity.Flaccid paralysis is a feature of lower motor neuron disease. Hence flaccid paralysis not a feature of cerebral palsy.Spastic cerebral palsy is the common type( 65%)Spastic CP - prognosis for normal intellectual development is good compared to other types of cerebral palsy.BIH ASPHYXIA accounts for only 8 -10% of cerebral palsy.
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Paget's disease after 10years develops into-\nChoices:\nA. Osteosarcoma\nB. Fibrous coical defect\nC. Osteoid osteoma\nD. Ankylosing spondylitis\n</Question>\nAt the end present your answer in <answer> and </answ... | *Osteosarcoma is a rare long-term complication of Paget's disease. Complications of Paget disease: Common complications of Paget disease include osseous deformities, fractures, Osteoahrosis, basilar impression, spinal stenosis, and neurologic abnormalities. Other less commonly encountered complications are bone tumor, soft-tissue mass, osteomyelitis, extramedullary hematopoiesis, rheumatoid ahritis and its variants, and crystal deposition disease. Ahropathy Osteoahrosis is a common complication in Paget disease. This complication results from altered biomechanics across grossly abnormal bones and joints, producing cailaginous and osseous degeneration. The hip and the knee are the aiculations most frequently affected. The pattern of narrowing of the aicular space in Paget disease differs in appearance from that in primary degenerative joint disease. With acetabular involvement, either medial or axial joint space narrowing is seen; with involvement of both the acetabulum and the femoral head, axial joint space loss can occur; and with isolated femoral head involvement, superior joint space loss is noted. Acetabular protrusion may complicate pagetic involvement of the acetabulum. Notably, the formation of osteophytes is not a prominent feature of the disease. Rheumatoid ahritis and its variants, as well as crystal deposition ahropathy, also have been associated with Paget disease. Ref: Turek Ohopaedics 6th/e p.274-275
<answer>(A)</answer> | A |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following statements on lymphoma is not True-\nChoices:\nA. A single classification system for Hodgkin's disease (HD) is almost universally accepted\nB. HD more often tends to remain localized to a s... |
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Air pollution may cause -\nChoices:\nA. Dermatitis\nB. Carcinoma bronchus\nC. Bronchiectasis\nD. Pneumonia\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C... | Approximately 17% of annual premature lung cancer deaths in adults are attributed to exposure to carcinogens from household air pollution caused by cooking with solid fuels like wood charcoal and coal. Other effects: Respiratory tract infections Bronchial hyperactivity impaired lung defence bronchiolitis obliterans Asthma, COPD impaired neuropsychological development in paediatrics Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 797
<answer>(B)</answer> | B |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Virchow's triad includes all of the following, EXCEPT-\nChoices:\nA. Venous stasis\nB. Injury to veins\nC. Blood hypercoagulability\nD. Venous thrombosis\n</Question>\nAt the end present your answer in <answer> a... | Virchow's triad refers to three primary influences that predispose to thrombus formation.
Endothelial injury (or vascular injury)
Stasis or turbulence of blood flow
Blood hypercoagulability
Virchow's triad should be the cornerstone for assessment of risk factors for deep venous thrombosis.
Stasis can occur with venous insufficiency, severe heart failure, or prolonged bed rest or immobility of an extremity following coma, pelvic or limb fracture, paralysis, extended aeroplane travel, or a lengthy operation.
Endothelial injury can result from direct trauma (severed vein, venous cannulation, or transvenous pacing) or local irritation secondary to the infusion of chemotherapy, previous DVT, or phlebitis.
Damaged endothelium leads to platelet aggregation, degranulation and formation of thrombosis as well as vasoconstriction ad activation of the coagulation cascade.
The hypercoagulable state can be inherited or acquired.
These are
def. of antithrombin III, protein C or S
increased homocysteine
factor V Leiden mutation
prothrombin gene mutation
antiphospholipid syndrome
paroxysmal nocturnal hemoglobinuria
malignancy (lung cancer - most commonly pancreas, prostate, breast, ovary etc...)
nephrotic syndrome
pregnancy, high dose estrogen therapy or OCPs.
Some important questions on deep vein thrombosis
Homan's sign → Calf tenderness on forced ankle dorsiflexion.
Phlegmasia alba dolens → Painful white leg
Phlegmasia cerulea dolens → Painful blue leg
Moses Sign → Calf tenderness on direct pressure on the calf
Pratt's Sign → Calf tenderness on squeezing the calf from the sides. Duplex ultrasound is the diagnostic modality of choice in deep vein thrombosis.
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Zidovudine causes :\nChoices:\nA. Neurotoxicity\nB. Nephrotoxicity\nC. Neutropenia\nD. Ototoxicity\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C, or D).... |
<answer>(C)</answer> | C |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Pre auricular sulcus is useful for:\nChoices:\nA. Determination of age\nB. Identification of sex\nC. Determination of race\nD. Cause of death\n</Question>\nAt the end present your answer in <answer> and </answer>... | Identification of sex
<answer>(B)</answer> | B |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Strontium ranelate is approved for treatment of:\nChoices:\nA. Asthma\nB. Cystic fibrosis\nC. UTI\nD. Osteoporosis\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter ... | Strontium ranelate is approved in several European countries for the treatment of osteoporosis. It increases bone mass throughout the skeleton; in clinical trials, the drug reduced the risk of veebral fractures by 37% and nonveebral fractures by 14%. It appears to be modestly antiresorptive, while at the same time not causing as much of a decrease in bone formation (measured biochemically). Ref: Harrison's principle of internal medicine 17th edition, chapter 338.
<answer>(D)</answer> | D |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following is excreted in saliva\nChoices:\nA. Tetracyclines\nB. Ampicilline\nC. Lithium\nD. Chloramphenicol\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase l... | (Lithium) (416-670 KDT) (435-KDT 6th)LITHIUM - is excreted in sweat and saliva also salivary concentration is proportional to serum concentration and may be usedfor non invasive monitoring* Lithium is excreted in breast milk, Mothers on lithium should not breast feed (416 - KDT)Tetracyclines - are concentrated in liver spleen and bind to the connective tissue in bones and joint* They are secreted in milk in amounts sufficient to affect the suckling infants
<answer>(C)</answer> | C |
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"content": "Given the following question and candidate answers, choose the best answer. <Question>Catamite refers to:\nChoices:\nA. All passive sodomy\nB. Passive sodomy young aged\nC. Passive sodomy in elderly\nD. Passive sodomy in female\n</Question>\nAt the end present your answer in <answer> and </answer>... | Ans. b. Passive sodomy young agedGerontophilia: When the passive agent is an adult.Pederasty: When the passive agent is child who is known as catamite.Pedophile: An adult who repeatedly engages in sexual activity with children.
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>An average patient with maxillofacial trauma requires how much of daily sodium?\nChoices:\nA. 100 mmol\nB. 50-60 mmol\nC. 10 mmol\nD. 1000 mmol\n</Question>\nAt the end present your answer in <answer> and </answe... |
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>A 29 years old person is known diabetic on oral hypoglycemic agents since 3 years. He has lost weight and never had DKA. His grand father is diabetic but his father is non diabetic. Which of the following is the ... | Since the patient in the question has a positive family history of diabetes, never had DKA and his diabetes being managed by oral hypoglycemic agents (non insulin dependence) suggests a possible diagnosis of Type II DM or MODY. Although weight loss and young age of presentation is more consistent with MODY, absence of Diabetes in his father makes MODY an unlikely diagnosis as MODY is inherited in an autosomal dominant manner and veical transmission through at least two generations is required for its diagnosis. So he is most likely suffering from Type II DM. Ref: Harrison's Internal Medicine, 18th Edition, Chapter 344; Current Medical Diagnosis and Treatment, 2012, Chapter 27
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Inheritance of ichthyosis vulgaris is\nChoices:\nA. X linked recessive\nB. X linked dominant\nC. Autosomal recessive\nD. Autosomal dominant\n</Question>\nAt the end present your answer in <answer> and </answer> u... | Ichthyosis vulgaris is a type of ichthyosis, a group of related skin conditions that interfere with the skin's ability to shed dead skin cells, causing extremely dry, thick skin. Extremely dry, scaly skin is known as xerosis. Ichthyosis vulgaris (also known as "Autosomal dominant ichthyosis," and "Ichthyosis simplex") is a skin disorder causing dry, scaly skin. It is usually an autosomal dominant inherited disease (often associated with filaggrin), although a rare non-heritable version called acquired ichthyosis exists. Ref Harrison20th edition pg 1232
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>The intravesical pressure rises abruptly when the bladder volume is about\nChoices:\nA. 400 ml\nB. 300 ml\nC. 200 ml\nD. 100 ml\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppe... | The relation between intravesical pressure and volume can be studied by inseing a catheter and emptying the bladder, then recording the pressure while the bladder is filled with 50-mL increments of water or air(cystometry). A plot of intravesical pressure against the volume of fluid in the bladder is called a cystometrogram). The curve shows an initial slight rise in pressure when the first increments in volume are produced; along, nearly flat segment as fuher increments are produced; and a sudden, sharp rise in pressure as the micturition reflex is triggered. These three components are sometimes called segments Ia, Ib, and II. The first urge to void is felt at a bladder volume of about 150 mL, and a marked sense of fullness about 400 mL. The flatness of segment Ib is a manifestation of the law of Laplace. This law states that the pressure in a spherical viscus is equal to twice the wall tension divided by the radius. In the case of the bladder, the tension increases as the organ fill, but so does the radius. Therefore, the pressure increase is slight until the organ is relatively full. Ref: Ganong&;s review of medical physiology,23rd edition, page: 661
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>A patient with psoriasis was started on systemic steroids. After stopping the treatment, patient developed universally red scaly skin with plaques losing their margins all over his body. The most likely cause is ... | Clues in this question are -
Withdrawal of steroids
Plaques losing their margins
Generalized lesion
All suggest erythrodermic psoriasis.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Epidemic marker of TB -\nChoices:\nA. Sputum AFB positivity rate\nB. Tuberculin test positivity rate\nC. Chest x-ray positivity rate\nD. None of the above\n</Question>\nAt the end present your answer in <answer> ... | Ans. is 'a' i.e., Sputum AFB Positivity rate o Case finding tools in TB are :-1) Sputum microscopy# It is the method of choice2) Sputum culture# It is 2nd in importance (after sputum microscopy) in a case finding programme.3) Mass miniature radiography# It has been stopped as a general measure of case finding.4) Tuberculin test# It is of little value as a case finding tool as it has no diagnostic value.o The number of bacilli seen in a smear reflects disease severity and patient infectivity.o Therefore, it is important to record the number of bacilli seen in each smear.Number of bacilliResult reportedNo. AFB per 100 oil immersion fields01-9 AFB per 100 oil immersion fieldsScanty (or number AFB seen)10-99 AFB per 100 oil immersion fields+ (1+)1-10 AFB per oil immersion fields++ (2+)> 10 AFB per oil immersion fields+++ (3+)
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Patients with chronic pancreatitis gives chain of lakes appearance in ERCP examination. Management is\nChoices:\nA. Total pancreatectomy\nB. Sphicteroplasty\nC. Side to side pancteaticojejunostomy\nD. Resecting t... | Surgical procedures in chronic pancreatitis Ideal procedure : DPPHR(Beger's procedure) In presence of poal vein thrombosis : Frey's Small duct disease : V- Shaped excision Disease recurrence in body and tail (after DPPHR, Whipple's or Longmire-Transverso procedure) : V-shaped drainage Disease limited to tail: Spleen - preserving distal pancreatectomy Ref: Sabiston 20th edition Pgno :1535
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Best treatment to prevent gas gangrene -\nChoices:\nA. Thorough debridement\nB. Anti serum\nC. Vaccnation\nD. Antibiotics\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase ... |
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Regarding raised intracranial tension in adults, true is -\nChoices:\nA. Sutural diastasis\nB. No Papilloedema\nC. May present with vomiting, headache and blurred vision\nD. No systemic symptom\n</Question>\nAt t... |
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>False about Criggler najar syndrome?\nChoices:\nA. Absence of UDPG enzyme\nB. Normal liver biopsy\nC. Conjugated hyperbilirubinemia\nD. Type 1 is more severe\n</Question>\nAt the end present your answer in <answe... | Ans. is 'c' i.e., Conjugated hyperbilirubinemia Criggler-Najjar Syndrome* CN syndrome is a congenital unconjugated hyperbilirubinemia. Basic defect is either reduced or absent UDPG transferase.* There are two types of CN syndrome:-1) Type I# It is an autosomal recessive disorder in which UDPG transferase is absent. Thus phenobarbitone has no effect (as enzyme is absent).# It is more severe hyperbilirubinemia than type II. There may be kernicterus. LFTs and liver histology are normal.2) Type II# It is an autosomal dominant disorder in which UDPG transferase is reduced. Phenobarbitone can reduce unconjugated Bilirubin by inducing UDPG transferase.# LFTs and liver histology are normal and there is no kernicterus
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>All are ECG changes in hypokalemia, except\nChoices:\nA. U wave\nB. ST segment sagging\nC. T-wave flattening or inversion\nD. QT interval prolongation\n</Question>\nAt the end present your answer in <answer> and ... |
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>CO acts by inhibiting which component of respiratory chain ?\nChoices:\nA. Cytochrome b\nB. cytochrome C oxidase\nC. NADH CoQ reductase\nD. Oxidative phosphorylation\n</Question>\nAt the end present your answer i... | Inhibitors of Electron transpo chain (Respiratory chain)Complex I :- Barbiturates (amobarbital), piercidin A, rotenone, chlorpromazine, guanithidine.Complex II :- Carboxin, TTFA, malonate.Complex III :- Dimercaprol, BAL, actinomycin A, Naphthyloquinone.Complex IV (cytochrome c oxidase) :- Carbon monoxide (CO), cyanide (CN), H2S, azide (N3-)
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>The components of initial steps of ventilation include:\nChoices:\nA. Drying & Positioning\nB. Clearing Airway\nC. Provision of tactile stimulus\nD. All of the above\n</Question>\nAt the end present your answer i... | Ans. D. All of the aboveThe components of initial steps include: Drying, positioning, clearing airway and provision of tactile stimulus. The baby should be placed under the radiant warmer, dried if already not done. The baby must be positioned with neck slightly extended by placing the shoulder roll. The airway would need to be cleared with mucus extractor and if the infant is still not breathing, then tactile stimulus by flicking soles or rubbing the back may be carried out to initiate breathing.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>In TCA cycle, citrate is conveed into cis-aconitate by which mechanism?\nChoices:\nA. Loss of H+\nB. Loss of phosphate\nC. Loss of H2O molecule\nD. Loss of carbon dioxide molecule\n</Question>\nAt the end present... | 2nd Step: Formation of Isocitrate, Citrate is isomerized to isocitrate by aconitase (Step 2, Fig.18.2). This reaction is a two-step process. At first, one water molecule is removed from citrate forming cis aconitate; a transient compound with a very sho half-life. Immediately, one water molecule is added to aconitate to form isocitrate. Thus the position of the hydroxyl group is shifted.Ref: DM Vasudevan, 7th edition
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>A 10-year-old boy with a 2-week history of an upper respiratory infection was admitted to the hospital with malaise, fever, joint swelling and diffuse rash. The patient is treated and discharged. However, the pat... | Rheumatic fever develops after antibodies to surface antigens of group A (beta-hemolytic) streptococci cross react with similar antigens found in the hea, joints and connective tissue of the skin. Cardiac lesions caused by acute rheumatic fever include endocarditis, myocarditis and pericarditis, or all three combined. Chronic rheumatic endocarditis causes fibrous scarring and deformity of cardiac valves, leading to hea murmurs and functional defects. None of the other pathogens cause rheumatic hea disease.
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>A 30-year old epileptic female, Kamla on Phenytoin therapy, developed weakness and fatigue. Blood examination revealed Hb= 4.6 gm. MCV=102 fl and MCH =40 pg/dl. What is the most probable diagnosis?\nChoices:\nA. ... | Phenytoin can cause folic acid deficiency resulting in megaloblastic anemia. This is confirmed by raised MCV and MCH in the blood examination. REF: KD TRipathi 8th ed.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Pure word blindness occurs due to lesion in\nChoices:\nA. Anterior cerebral aery\nB. Posterior cerebral aery\nC. Middle cerebral aery\nD. Spinal aery\n</Question>\nAt the end present your answer in <answer> and <... | Answer- B. Posterior cerebral aeryPure alexia almost always involves an infarct to the left posterior cerebral aery which perfuses the splenium of the corpus callosum and left visual coex, among other things)
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>According to IUB classification of enzyme, 4th digit in enzyme refers to ?\nChoices:\nA. Main class\nB. Subclass\nC. Sub-subclass\nD. Individual enzyme\n</Question>\nAt the end present your answer in <answer> and... | The classification of enzyme was described in 1961 by enzyme commission of the international Union of Biochemistry (IUB). According to this classification, each enzyme code number or 'EC' number, consisting of four digits:- The first digit indicates the main class; that characterizes the type of reaction they catalyzed. Second digit indicates the subclass. This indicates the type of group involved in the reaction. Third digit indicates the sub-subclass, which denotes the substrate on which enzyme acts. The fouh digit specifies the individual enzyme. It indicates the systematic serial number and name. For example, lactate dehydrogenase (LDH) : EC (1.1.1.27) The first number indicates that the enzyme is an oxidoreductase. Second number indicates that the enzyme acts on the CH-OH group which is the donor of hydrogen. The third number indicates that the acceptor is NAD.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Best way to dispose e-waste is\nChoices:\nA. Burning\nB. Recycling\nC. In a landfill\nD. Incineration\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C, or ... |
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Treatment of choice for bleeding gastric ulcer is\nChoices:\nA. Gastrectomy\nB. Antrectomy\nC. Under running of ulcer\nD. Vagotomy and drainage\n</Question>\nAt the end present your answer in <answer> and </answe... | Bleeding gastric ulcers. Treatment of bleeding gastric ulcers depends on their cause and location; however, the initial approach is similar to duodenal ulcers. Patients require resuscitation, monitoring, and endoscopic investigation. Up to 70% of gastric ulcers are H. pylori-positive, so an attempt should be made to control the bleeding endoscopically, with multiple biopsy specimens of the ulcer obtained to rule out malignancy and concurrently obtained biopsy specimens of the body and antrum to test for H.pylori infection. Patients whose bleeding can be controlled and who are H. pylori-positive should undergo subsequent treatment for H. pylori infection. For bleeding that cannot be controlled, operative intervention again depends on the type of gastric ulcer. In all cases, the ulcer should ideally be excised with the addition of vagotomy depending on the cause of the ulcer (mostly for intractable ulcers that are not due to H. pylori infection or NSAID usage that can be stopped). Ref: Sabiston Textbook of Surgery 20th edition Pgno: 1209
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following indicates hypoperfusion?\nChoices:\nA. Systolic BP<90 mm Hg\nB. Lactic acidosis\nC. Oliguria\nD. All of the above\n</Question>\nAt the end present your answer in <answer> and </answer> usin... | Ans. (d) All of the aboveRef: Bailey and Love Principles and Practice of Surgery, 26th ed p-13-18Indicators of hypoperfusion* Systolic BP <90mm.hg* Mean blood pressure by 30mmofHg* Acidosis* Elevated lactate level* Oliguria.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of these is true of fetal haemoglobin?\nChoices:\nA. HbF binds more avidly to to 2,3 DPG\nB. HbF is completely replaced by HbA at the time of bih\nC. HbA first appears in fetal blood at 11 weeks when bone m... | Hb F binds less avidly to 2,3 DPG than HbA and thus has higher affinity for oxygen than HbA Almost 65 to 90% of haemoglobin at bih is HbF. After bih HbF gamma gene is switched off and HbA beta gene is switched on so more and more HbA is formed. Sickle cell patients have relatively high amounts of fetal Hb. HbA first appears in fetal blood at 11 weeks when bone marrow stas hematopoesis Remember: The fetal hemoglobin stas appearing at 11 weeks, but the 'Switch - Over' from Fetal hemoglobin's utilisation for oxygen transpo to Adult haemoglobin for oxygen transpo happens at 30-32 weeks...
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Intra aireal injection of thiopentone causes:\nChoices:\nA. Vasospasm\nB. Vasodialation\nC. Necrosis of vessel wall\nD. Hypotension\n</Question>\nAt the end present your answer in <answer> and </answer> using an ... | A i.e. Vasospasm
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Acute intravascular hemolysis can be caused by infection due to all of the following organisms except-\nChoices:\nA. Clostridium tetani\nB. Bartonella bacilliformis\nC. Plasmodium falciparum\nD. Babesia microti\n... | Organisms that parasitize RBCs can directly lyse them and can cause intravascular hemolysis.
Intracellular parasites; reside within RBCs: Plasmodium spp., Babesia spp., Bartonella baciliformis
Clostridium tetani is not intracellular parasite; it can cause hemolysis indirectly by production of tetanolysin toxin, but it not intravascular hemolysis.
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Following group of drugs is not the first line in the management of chronic pain?\nChoices:\nA. Opioids\nB. Antiepileptics\nC. Serotonergic drugs\nD. Dopamine antagonist\n</Question>\nAt the end present your answ... | Ans. is 'd' i.e., Dopamine antagonist
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Investigation of choice in SAH: NIMHANS 07; FMGE 11\nChoices:\nA. CT scan\nB. MRI\nC. X-ray skull\nD. Radionuclide scan\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase le... | Ans. CT scan
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>A 30 year old female, married since one year, present to the psychiatry clinic with hyperactivity since 2 weeks. A diagnosis of mania is made. She had 3 prior episodes of mania in last 5 years and every time afte... | *Benzodiazepine plus lithium is drug of choice for acute mania. However both of them are avoided in pregnancy because of teratogenic effects. *Antipsychotics are preferred drugs for mania in pregnancy. Atypical antipsychotics like olanzapine are preferred over typical antipsychotics like haloperidol. *As olanzapine is not in the option, next best answer to choose is haloperidol. REF: KATZUNG 14TH ED.
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Sézary-Lutzner cells are seen in\nChoices:\nA. ALCL\nB. Hairy cell leukemia\nC. Mycosis fungoides\nD. PTCL\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C... | Cutaneous T cell lymphoma (CTCL) represents a spectrum of lymphoproliferative disorders affecting the skin. Two different clinical types of malignant T-cell disorders were originally recognized: mycosis fungoides, a chronic proliferative process; and a more aggressive nodular eruptive variant, mycosis fungoides d'emblée. Lesions of mycosis fungoides usually involve truncal areas and include scaly, red -brown patches; raised, scaling plaques that may even be confused with psoriasis; and fungating nodules. In some individuals, seeding of the blood by malignant T cells is accompanied by diffuse erythema and scaling of the entire body surface (erythroderma), a condition known as Sézary syndrome. The histologic hallmark of CTCL of the mycosis fungoides type is the presence of the Sézary-Lutzner cells. These are T-helper cells (CD4+) that characteristically form band-like aggregates within the superficial dermis ( Fig. 25-19B ) and invade the epidermis as single cells and small clusters (Pautrier microabscesses). These cells have markedly in folded nuclear membranes, imparting a hyperconvoluted or cerebriform contour. Although patches and plaques show pronounced epidermal infiltration by Sézary-Lutzner cells (epidermotropism), in more advanced nodular lesions the malignant T cells often lose this epidermotropic tendency, grow deeply into the dermis, and eventually spread systemically.
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Nlicroaneu 'lestation ofdiabetic retii6;patily. Which uf Ling layer isinvolved in diabetic etinopathv?\nChoices:\nA. Outer plexiform layer\nB. Inner nuclear layer\nC. Layer of rods and cones\nD. Retinal pigment e... | Ans. b. Inner nuclear layer
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>True about smoldering myeloma is -\nChoices:\nA. Monoclonal gammopathy\nB. Lytic bone lesion\nC. Hypercalcemia\nD. Bone marrow plasma cell > 10%\n</Question>\nAt the end present your answer in <answer> and </answ... | Smoldering multiple myeloma (SMM) is an early precursor to a rare blood cancer known as multiple myeloma, which affects plasma cells. This type of cancer produces ceain proteins that can be measured in both blood and urine. These proteins show up before a person has any symptoms of cancer. Ref Davidson 23rd edition pg 789
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Eruption of Mandibular 1st molar occur at\nChoices:\nA. 8 years\nB. 7 years\nC. 9 years\nD. 6 years\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C, or D)... |
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following is false about Takotsubo Cardiomyopathy\nChoices:\nA. Due to major catecholamine discharge\nB. Lv Contractile dysfunction\nC. Presents with acute chest pain\nD. Echo never reverts back to n... | Echo comes back to normal in two weeks.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Nipple confusion means?\nChoices:\nA. Baby fed with a bottle finding it difficult and confusing to suckle at breast\nB. Baby not able to suckle with bottle\nC. Baby not able to feed with spoon\nD. Baby not able t... | Ans. (a) Baby fed with a bottle finding it difficult and confusing to suckle at breastRef: OP Ghai 8th ed./153* A problem that may beset a bottlefed baby in which it forgets how to nurse on mother' nipple* Breastfeeding requires far more vigorous mouth and tongue motions and greater muscle coordination than bottlefeeding.* On bottle nipples or even pacifiers, a newborn can forget how to nurse properly.* This confusion can lead to diminished or discontinued nursing. Nipple confusion is usually not a concern after the early weeks, once the baby is nursing well.
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>ALL of the following statement regarding the ECG in acute pericarditis are true except -\nChoices:\nA. T wave inversions develop before ST elevation retur to baseline\nB. Global ST segment elevation is seen in ea... | Ref: R.Alagappan Manual for Medicine 4th Edition pg no:112 Acute Pericarditis ECG shows * Sinus tachycardia * An elevated, concave upwards S-T segment * Upright, tall, peaked T-waves (earliest change) * No reciprocal changes in the opposite leads.
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Maturation index in mid-secretory phase of menstrual cycle is\nChoices:\nA. 0/95/5\nB. 80/20/0\nC. 0/70/30\nD. 0/40/60\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase let... | Basics: Estrogen Promotes, Progesterone inhibits Squamous cell maturation The lateral vaginal wall cells can be sampled by scraping them with a spatula and then plating them on a slide. Sample often obtained simultaneous with Pap smear. (Students should not confuse that squamous cells sampled from the lateral vaginal wall is same as taking a paps smear from the cervix) The vagina is sampled at middle third of lateral vaginal wall. This is used for detecting hormonal effects in menopausal and postmenopausal women, though this will have a paicular value in all stages of a woman's life This is Indicated for : Assessment of ovarian function. -During pubey & reproductive, menopausal & post menopausal years -Assessment of ovarian function in menstrual disorders -Can also be used for diagnosing ovulation. Maturation Index (MI)The vaginal epithelium has Basal, Parabasal, Intermediate and Superficial cells. 100 exfoliated cells are counted and the MI is defined as ratio of parabasal to intermediate to superficial cells of vaginal epithelium. These cells are as presented as a 3 pa ratio with the Para basal cells staed 1st , intermediate cells 2nd & superficial cells 3rd. For eg: MI = 80 /20 / 0 Indicates :80 % - Parabasal cells 20 % - Intermediate cells 0 % - Superficial cells Increase in estrogen levelenlarges the parabasal cells to become intermediate cells and then this will continue to enlarge & mature into keratinized superficial cells. The superficial cells are most abundant during proliferating phase. These cells are polygonal with abundant eosinophilic cytoplasm. There will be more deposition of glycogen in the vaginal epithelium. High estrogenic effect in a vaginal smear is recognized by a clean background & increased eosinophilic & karyopyknotic indices(Given below). High progesterone levels promotes proliferation of intermediate squamous epithelium. These cells are polygonal in shape -with abundant bluish cytoplasm & seen during secretory phase. Parabasal cells are Immature squamous cell which are round to oval. Nucleus is relatively large. Hence, in a lateral vaginal wall smear, if the cells show... Shift to left - atrophic effect. Shift to right - Increased estrogen effect. More mid-zone cells - Progesterone effect With increasing estrogen, the MI is 0/10/90 With increasing Progesterone the ratio is 0/90/10 With increasing Androgen it is 20/80/0 With Pre Ovulatory phase it is 0/40/60 With Post ovulatory phase it is 0/70/30 During menopause it is 0/80/20 Late menopause 100/0/0 EOSINOPHILIC INDEX (EI)Ratio of eosinophillic cells to basophillic cells. This is given in a ratio. Parabasal cells not counted. Karyopyknotic Index (KI)Ratio of Superficial cells to Intermediate cells
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Best blood product to be given in a patient of multiple clotting factor deficiency with active bleeding:\nChoices:\nA. Whole blood\nB. Packed RBCs\nC. Fresh frozen plasma\nD. Cryoprecipitate\n</Question>\nAt the ... | Ans. c. Fresh frozen plasma (Ref: Harrison 19/e p138 e-3 18/e p953. Sabiston 19/e p588)Best blood product to be given in a patient of multiple clotting factor deficiency with active bleeding is fresh frozen plasma."FFP contains stable coagulation factors and plasma proteins: fibrinogen, antithrombin, albumin, as well as proteins C and S. Indications for FFP include correction of coagulopathies, including the rapid reversal of warfarin: supplying deficient plasma proteins: and treatment of thrombotic thrombocytopenic purpura. "--Harrison 19/e p138 e-3Fresh-frozen Plasma (FFP)FFP is produced from the separation of plasma from donated bloodQ.Stored at -18degC and has a shelf life of 1 yearQ.Each unit contains 400 mg of fibrinogen and 1 unit activity of each of the clotting factorsQ,Most labile clotting factors (V & VIII) may be diminishedQ proportional to shelf life.FFP contains stable coagulation factors & plasma proteins: fibrinogen, antithrombin, albumin, proteins C & SQ.Indications for FFP* Correction of coagulopathies:* Rapid reversal of warfarinQ* Supplying deficient plasma proteinsQ* Treatment of thrombotic thrombocytopenic purpuraQPatients who are IgA-deficient and require plasma support should receive FFP from IgA-deficient donors to prevent anaphylaxis.FFP should not be routinely used to expand blood volumeQ.FFP: An acellular component & does not transmit intracellular infections, e.g., CMV.Characteristics of Selected Blood ComponentsComponentVolume (mL)ContentClinical ResponseWhole Blood450 +- 45* No elements removed* Contains RBCs. WBCs, plasma & platelets (WBCs & platelets may be non-functionalQ)* Not for routine use* Used for acute massive bleeding, open heart surgery & neonatal total exchangePacked RBCs180-200* RBCs with variable leukocyte content & small amount of plasma* Increase Hb 1 gm/dL & hematocrit 3%cPlatelets50-70* 5.5 x 1010/RD unit* Increase platelet count 5000-10,000/uL0FFP200-250* Plasma proteins: Coagulation factors, proteins C & S, antithrombin0* Increases coagulation factors about 2%Cryoprecipitate10-15* Cold-insoluble plasma proteins, fibrinogen, factor VIII, vWFdeg* Topical fibrin glue, also 80 IU factor VIIIQCryoprecipitateCryoprecipitate is a source of fibrinogenQ, factor VIIIQ and von Willebrand factor (vWF)Q.It is ideal for supplying fibrinogen to the volume-sensitive patient.Stored at < -18degC1 unit of cryoprecipitate contains 80-145 units of Factor VIII & 250 mg of fibrinogenQ.Cryoprecipitate is pooled from many donors, so there are maximum chances of disease transmission among all blood productsQ.Cryoprecipitate may also supply vWF to patients with dysfunctional (type II) or absent (type III) von Willebrand disease.
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>The most common cause of hypoparathyroidism is:\nChoices:\nA. Idiopathic\nB. Familial\nC. Postradiation\nD. Surgical removal\n</Question>\nAt the end present your answer in <answer> and </answer> using an upperca... | Surgical removal of the gland is the most common cause for hypoparathyroidism.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Renal biopsy in a patient of microscopic polyangiitis (MPA) will yield which of the following findings?\nChoices:\nA. Subepithelial humps on electron microscopy\nB. Deposits showing apple-green birefringence on p... | Option A: Feature seen in MGN Option B: Feature seen in Amyloidosis Option C: Pauci-immune crescentic glomerulonephritis
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following are indications of dialysis in a patient with suspected poisoning?\nChoices:\nA. Prolonged coma\nB. Hepatic and renal failure\nC. Plasma levels in fatal range of the toxin\nD. All of the ab... | Ans. D. All of the aboveIndications of Dialysis in a patient with suspected poisoning are:Prolonged coma, Hepatic and renal failure, Plasma levels in fatal range, when removal of toxin is possible only dialysis (e.g. barbitutates, chloral hydrate, ethylene glycol, theophylline, salicylates and heavy metals)
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Fibers are maximum in\nChoices:\nA. Wheat\nB. Oat\nC. Rice\nD. Corn\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C, or D).",
"role": "user"
}
] | Ans. is 'd' i.e., Corn Wheat bran42.2Oat bran22.2Soy bran70.0Corn bran82.3Rice bran38.0Barley bran70-0
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following is not a part of P. versicolor treatment -\nChoices:\nA. Selenium sulfide\nB. Ketoconazole\nC. Griseofulvin\nD. Clotrimazole\n</Question>\nAt the end present your answer in <answer> and </a... | Ans. is 'c' i.e., Griseofulvin o Griseofulvin is not effective against P. versicolor.Pityriasis versicolor (Tinea versicolor)o Tinea versicolor is a misnomer as it is not caused by dermatophyte; Pityriasis versicolor is more appropriate term. It is caused by a nondermatophyte fungus called Pityrosporum ovale (Malasezia furfur). It usually affectsjoww adults.Clinical featureso There are multiple small scaly hypopigmented macules (macules may be hyperpigmented also). Scaling is furfuraceous or rice powder like. Macules start around the hair follicles and then merge with each other to form large areas. Affects trunk and shoulders (mainly chest and back). There may be loosening of scales with finger nails - Coupled onle or stroke of nail. Lesions are recurrent in nature (may reappear after treatment).Diagnosis of P. versicoloro Examination of scales in 10% KOH shows short hyphae and round spores (Sphagetti and meat ball appearance). Wood's lamp shows apple green fluorescence (blue-green fluorescence). Skin surface biopsy - A cyanoacrylate adhesive (crazy glue) is used to remove the layer of stratum comeum on glass slide and then stained with PAS reagent.Treatment of P.versicolor1) Systemic agents:- Systemic azoles provide a convenient therapeutic option. Drugs used are ketoconazole, Fluconazole or intraconazole.2) Topical antifungals Topical antifungals used are:-i) Azoles - Clotrimazole, econazole, Miconazole, Ketoconazole.ii) Others - Selenium Sulfide, Sodium thiosulphate, Whitfield's ointment (3% salicylic acid + 6% Benzoic acid).
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>All the following are true about naegleria fowleri expect\nChoices:\nA. Cause primary Amoebic meningo encephalitis\nB. Also called Brain eating amoeba\nC. Infective form is trophozoites\nD. Clinical course is sub... | Clinical course is always acute.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Persistent belief of medical illness despite adequate investigation is\nChoices:\nA. Hypochondriasis\nB. Delusional disorder\nC. Factitious disorder\nD. conversion disorder\n</Question>\nAt the end present your a... | (A) Hypochondriasis > Hypochondriasis is a persistant preoccupation with fear or belief of having disease, based on persons own interpretation of normal body function or minor physical abnormality.> This preoccupation persists despite repeated reassurance based on appropriate clinical examination and thorough investigation.> The patient in question is persistently preoccupied about her disease (headache) despite of all normal investigations and seeks another consultation as she still insists that there is something wrong in her head.
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Corneal lesion seen in Hutchinson triad associated with congenital syphilis is: September 2006\nChoices:\nA. Disciform keratitis\nB. Interstitial keratitis\nC. Phylectenular keratitis\nD. Mooren ulcer\n</Question... | Ans. B: Interstitial keratitis Hutchinson's triad is named after Sir Jonathan Hutchinson. It is a common pattern of presentation for congenital syphilis, and consists of three phenomena: interstitial keratitis, Hutchinson incisors (notching of the two upper central incisors in the permanent dentition), and eighth nerve deafness
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following does not occur in mitochondria?\nChoices:\nA. TCA cycle\nB. HMP Shunt\nC. Urea cycle\nD. Beta oxidation of fatty acids\n</Question>\nAt the end present your answer in <answer> and </answer>... |
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Most common histological type of the thyroid carcinoma is:\nChoices:\nA. Medullary type\nB. Follicular type\nC. Papillary type\nD. Anaplastic type\n</Question>\nAt the end present your answer in <answer> and </an... | Thyroid cancers are classified according to their histopathological characteristics and they are: ? Papillary thyroid cancer (75% to 85% of cases ) - often in young females - excellent prognosis ? Follicular thyroid cancer (10% to 20% of cases ) ? Medullary thyroid cancer (5% to 8% of cases)- cancer of the parafollicular cells, often pa of MEN-2 syndrome. ? Anaplastic thyroid cancer (Less than 5%). It is not responsive to treatment and can cause pressure symptoms. ? O thers ? ? Lymphoma ? ? Squamous cell carcinoma, sarcoma Ref: Robbin's Basic Pathology, 7th Edition, Page 1177; Harrison's Internal Medicine, 18th Edition, Page 2243; Bailey and Love's Sho Practice of Surgery, 25th Edition, Page 792
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Kayser Fleischer ring is found in which layer of cornea?\nChoices:\nA. Bowman's Capsule\nB. Substantia propria\nC. Descemet's membrane\nD. Endothelium\n</Question>\nAt the end present your answer in <answer> and ... | Kayser-Fleischer rings take the form of a crescentic rusty-brown discoloration of the deepest layer of the cornea (Descemet membrane). In the purely hepatic stage of the disease, the rings may not be evident (in 25 percent of cases), but they are viually always present (if properly sought) once the neurologic signs manifests. A slit-lamp examination may be necessary for their early detection, paicularly in brown-eyed patients, but in the majority of patients with neurologic signs the rings can be visualized with the naked eye or with the aid of an indirect ophthalmoscope focused on the limbus. Also Know: Kayser-Fleischer rings are a sign of Wilson's disease, which involves abnormal copper handling by the liver resulting in copper accumulation in the body and is characterised by abnormalities of the basal ganglia of the brain, liver cirrhosis, splenomegaly, involuntary movements, muscle rigidity, psychiatric disturbances, dystonia and dysphagia. The combination of neurological symptoms, a low blood ceruloplasmin level and KF rings is diagnostic of Wilson's disease. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 37. Inherited Metabolic Diseases of the Nervous System. In A.H. Ropper, M.A. Samuels (Eds),Adams and Victor's Principles of Neurology, 9e.
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Best disinfectant for endoscopes is: (D. REPEAT 2012)\nChoices:\nA. Hypochlorite\nB. Formaldehyde\nC. Glutaraldehyde\nD. Chlorhexidine\n</Question>\nAt the end present your answer in <answer> and </answer> using ... | Ref: Russel, Hugo and Ay tiff e's Principles and Practice of Disinfection, Preservation and Sterilization, 4th edition, Page 568Explanation:Activated 2% alkaline glutaraldehyde is used for decontaminating flexible endoscopes.Advantageso Relatively non-corrosiveo Will kill spores with prolonged exposure (3- 10 hours).Disadvantageso Toxic.o Irritant.Possible alternatives:o Orthophthalaldehyde (OPA) peracetic acid.o Chlorine dioxide (ClO2) products (such as Tristel).o Superoxidized water (Sterilox).Advantages of these newer agents are - rapidly sporicidal, mycohactericidal and viricidal.BUT remember - No agent is clearly superior to the others and a thorough assessment needs to be performed before an alternative agent is chosen.Commonly Used DisinfectantsDisinfectantUseActive againstEthyl alcohol*Skin antisepticsBactcncidal but not sporicidalIsopropylalcohol* Disinfection of suture material* Clinical thermometersBactericidal but not sporicidalMethyl alcohol* Cabinets * IncubatorsActive against bacteria and fungal sporesFormaldehyde* OT fumigationBactericidal, Spori cidal and VirucidalGlutaraldehyde* Bronchoscopes* Endoscopes* CystoscopesBactericidal, Spori cidal andVirucidal (less toxic/ irritant)Hypochlorite* Blood spillBactericidal, Spori cidal and VirucidalChlorhexidine* Treatment of woundsBactericidal, Mod erate Sporicidal and VirucidalEthylene oxide* Heart lung machines* Respirators* Dental equipmentBactericidal, Spori cidal and Virucidal i highly penetrating gas)
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>In polycythemia vera all are true except\nChoices:\nA. High ESR\nB. Decreased levels of erythropoitin\nC. Thrombocystosis\nD. Increased leukocyte alkaline phosphates\n</Question>\nAt the end present your answer i... | (A) (High ESR) (1049-Davidson 22nd) (898-900-H 18(tm) (339- Harshmohan 7th) (619- Robbins)POLYCYTHEMIA VERA* PCV is strongly associated with activating point mutations in the tyrosine kinase JAK2* PCV is characterized by increased marrow production of red cells, granulocytes and platelets (panmyelosis)* But it is the increase in red cells (polycythemia) that is responsible for mcst of the clinical symptomsPresence of JAK-2 mutation is a Maror criterion for diagnosis of polycythemia vera according to the WHO criteria for the diagnosis of polycythemia vera.Low Eryhropoetin levels, Thrombocytosis and increased LAP scores are al1 minor criteria for diagnosis of polycythemia vera.JAK-2 Mutation and polycythemia Vera* JAK-2 is a member of an evolutionarily well conserv ed, non receptor tyrosine kinase family and serves as the cognate tyrosine kinase for the erythropoietin receptors* A mutation in the tyrosine kinase 'AK-2 appears to have a central role in the pathogenesis of PV by causing constitutive activation of the kinase* The presence of JAK-2 mulation thus allows for the exclusion of a reactive erythrocytosis. The 2001 WHO criteria for diagnosis of PV were however developed prior to the discovery of this important mutation and hence revised WHO criteria have been developed that include presence of JAK-2 mutation as a major criterion for diagnosis.NoteAlthough presence of JAK-2 mutation is a major criterion for diagnosis of PV, the presence of JAK-2 mutation alone is not diagnostic of PV, JAK-2 mutations may also be seen in other myeloproliferative disorders such as Essential Thrombocytosis (ET) and chronic Idiopathic Myelofibrosis (CIMF)Various major and minor criteria used for the diagnosis of polycythemia vera in various classification system (WHO criteria (revised and oldVpolvcythemia Vera study group criteria)MajorMinor* JAK2 V617 F mutation* Hemoglobin > 18.5 g/dl in men 16.5 g/dl in women* Increased red blood mass* Splenomegaly* Clonal genetic abnormality other than Philadelphia chromosome or BCR/ABL in marrow* Endogenous erythroid colony formation in vitro* Normal arterial O2 saturation (>92%)* Thrombocytosis (>400 x 109/L)* Leucocytosis ) WBC >12 x 109/L* Increased leukocyte alkaline phosphatase (LAP> 100U)* Increased serum B12/binders (B12 > 900 pg/ml; unbound B12 binding capacity > 2200 pg/ml)* Low serum erythroprotein levels.* Panmyelosis with prominent erythoid and megakaryocytic hyperplasia an bone marrow biopsyRevised WHO criteria (proposed) for thes diagnosis of polycythemia veraRevised WHO criteria (proposed) for the diagnosis fo polycythemia veraMaior criteria* Hemoglobin >18.5 g/dl in men >16.5 g/dl in women or evidenced on increased red cell volume* Presence of JAK2 mutationMinor criteria* Hypercellular bone marrow biopsy with panmyelosis with prominent erythroid, granulocytic, and megakaryocytic hyperplasia ** Low serum erythropoietin level* Endogenous erythroid colony formation in vitroWHO Criteria for the diagnosis of plvcvthemia Vera (prior to the proposed new criterion)WHO criteria (previous) for the diagnosis of plycythemia veraMaior criteria* Red blood cell mas >25% above mean normal predicted value, or Hb >18.5 g/dl in men, 16.5g/dl in women* Splenomegaly on palpation* Clonal genetic abnormality other than Philadelphia chromosome of BCR/ABL in marrow* Endogenous erythroid colony formation in vitroMinor criteria* Thrombocytosis > 400x 199/L* WBC > 12x 109 /L* Panmyelosis with prominent erythroid and megakaryocytic hyperplasia on bone marrow biopsy* Low serum erythropoietin levels.ESR is only indirect measurement of serum acute phase protein concentrations particularly fibrogen.| ESR| ESR* Infections* Inflammatory disease Temporal arteritis, poly myalgia rheumatic, Rheumatic fever)* Malignant neoplasm* Paraproteinemias* Pregnancy* CRF* Gi disease (ulcerative & regional colitis)* Polycythemia* Sickle cell anemia spherocytosis anisocytosis.* Hypofibrogenemia* Hypogammaglobulinemias* CHF* Micro cytosis* Highdoses corticosteroids* ESR is elevated in multiple myeloma (serum alkaline phosphatase is normal in multiple myeloma, even with extensive involvement. This is because with there is no osteoblastic activity usually).
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Failure of descent of thyroid analage can be seen in the\ntongue\nChoices:\nA. In anterior 2/3 of dorsal aspect\nB. In posterior 1/3 of dorsal aspect\nC. Near the base of tongue close to foramen caecum\nD. In ant... |
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>A neurosurgeon saw a child with precocious pubey and uncontrollable laughing. He suggested the parent of child to get a MRI done to evaluate for the possibility of?\nChoices:\nA. Craniopharyngioma\nB. Hypothalami... | Hypothalamic hamaomas and gangliocytoma may arise from astrocytes, oligodendrocytes, and neurons with varying degrees of differentiation. These tumors may overexpress hypothalamic neuropeptides, including GnRH, GHRH, and CRH. With GnRH-producing tumors, children present with precocious pubey, psychomotor delay, and laughing-associated seizures. Medical treatment of GnRH-producing hamaomas with long-acting GnRH analogues effectively suppresses gonadotropin secretion and controls premature pubeal development. Ref:Melmed S., Jameson J.L. (2012). Chapter 339. Disorders of the Anterior Pituitary and Hypothalamus. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e.
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>The principle that is the spinal cord dorsal roots are sensory and the ventral roots are motor is known as\nChoices:\nA. Laplace's law\nB. Bell-Magendie's law\nC. Frank Starling's law\nD. Weber-Fechner's law\n</Q... | In the spinal cord fact that the dorsal roots are sensory and the ventral roots are motor is called Bell-Magendie law. The anterior spinal nerve roots contain only motor fibers and posterior roots only sensory fibers and that nerve impulses are conducted in only one direction in each case. Ref: guyton and hall textbook of medical physiology 12 edition page number:672,673,674
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>The chemotherapy drug fluorouracil undergoes a series of chemical changes in vivo that result in a covalent complex such that it is bound to both thymidylate synthase and methylene-tetrahydrofolate. The inhibitio... | Since rapidly multiplying cancer cells are dependent upon the synthesis of deoxythymidilate (dTMP) from deoxyuridylate (dUMP), a prime target in cancer therapy has been inhibition of dTMP synthesis. The anticancer drug fluorouracil is conveed in vivo to fluorodeoxyuridylate (FdUMP), which is an analogue of dUMP. FdUMP irreversibly forms a covalent complex with the enzyme thymidylate synthase and its substrate N5,N10-methylene- tetrahydrofolate. This is a case of suicide inhibition, where an enzyme actually paicipates in the change of a substrate into a covalently linked inhibitor that irreversibly inhibits its catalytic activity.
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>A female comes with froathy, green vaginal discharge of 5 days duration. There was \"strawberry cervix\" on examination. Drug of choice for the infection is:\nChoices:\nA. Metronidazole\nB. Tetracycline\nC. Fluco... | Above symptoms are suggestive of infection by Trichomonas.vaginalis, which is treated by T.Metronidazole 2g stat (or T.Secnidazole 2g stat)
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>A common finding in osteomalacia is-\nChoices:\nA. Low serum phosphate\nB. Normal level of 1,25 di-hydroxy vit D3\nC. Low serum calcium\nD. Increased hydroxy proline in urine\n</Question>\nAt the end present your... | Osteomalacia is a feature of long standing hypophoshatemia, which may be a consequence of renal phosphate wasting or chronic use of etidronate or phosphate binding antacids.Serum levels of 1,25(OH)2D levels are low despite normal 25(OH)D levels and elevated PTH.Occurs. in conditions of Increased Calcium level.and there is decreased hydroxy pro line in urine( Harrison 17 pg 2375)
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Which of the following is not a contraindication in\nthe therapy with opioids\nChoices:\nA. Use in head injury patient\nB. Use in impaired pulmonary function\nC. Use of agonist with mixed agonist-antagonist\nD. U... |
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Remitting and relapsing features are associated with\nChoices:\nA. Multiple Sclerosis\nB. Guillain-Barre syndrome\nC. Parkinson's disease\nD. Subdural haematoma\n</Question>\nAt the end present your answer in <an... | (A) Multiple Sclerosis # Classification of Multiple Sclerosis> Progression of MS subtypes> Several subtypes, or patterns of progression, have been described. Subtypes use the past course of the disease in an attempt to predict the future course. They are important not only for prognosis but also for therapeutic decisions. In 1996 the United States National Multiple Sclerosis Society standardized four subtype definitions Relapsing remitting Secondary progressive Primary progressive Progressive relapsing> Relapsing-remitting subtype is characterized by unpredictable relapses followed by periods of months to years of relative quiet (remission) with no new signs of disease activity. Deficits suffered during attacks may either resolve or leave sequelae, the latter being more common as a function of time.> This describes the initial course of 85-90% of individuals with MS.> When deficits always resolve between attacks, this is sometimes referred to as benign MS.> The relapsing-remitting subtype usually begins with a clinically isolated syndrome (CIS). In CIS, a patient has an attack suggestive of demyelination, but does not fulfill the criteria for multiple sclerosis.> However only 30 to 70% of persons experiencing CIS later develop MS.> Guillain-Barre syndrome is an acute inflammatory demyelinating polyneuropathy (AIDP), an autoimmune disorder affecting the peripheral nervous system, usually triggered by an acute infectious process. It is included in the wider group of peripheral neuropathies.
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Protein content in 100 grams of cow milk\nChoices:\nA. 4.3\nB. 3.2\nC. 2.2\nD. 1.2\n</Question>\nAt the end present your answer in <answer> and </answer> using an uppercase letter (A, B, C, or D).",
"role": "... | Ans. is 'b' i.e., 3.2
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>False about mechanism of action of anticonvulsants is :\nChoices:\nA. Ethosuximide – K+ channel opener\nB. Phenytoin – Na+ channel blocker\nC. Diazepam – Facilitates GABA action\nD. Gabapentin – Increase GABA rel... |
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>All of the following are true about bilhemia except:\nChoices:\nA. Biliary pressure is more than poal pressure\nB. ERCP is diagnostic and therapeutic\nC. Death occurs due to embolism of bile in lungs\nD. Patient ... | BILHEMIA: The bile stas flowing into systemic veins. M.C cause- CBD obstruction (CBD stone) Characteristics: rapidly increasing jaundice, marked hyperbilirubinemia, liver enzymes are normal, septicemia, can be fatal due to massive embolization of bile into lungs. IOC - ERCP (diagnostic & therapeutic) Management - decrease intrabiliary pressure by stenting or sphincterotomy.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>In the Clarke's level of tumor invasion of malignant melanoma level 3 refers to:\nChoices:\nA. All tumor cells above basement membrane\nB. Invasion into reticular dermis\nC. Invasion into loose connective tissue ... | Clark's level ( on the basis of depth of invasion): EPIRS 1. Melanoma restricting to epidermis & appendages 2. Invading Papillary dermis without filling it 3. Reach Interface of papillary & reticular dermis 4. Invading reticular dermis 5. Invading subcutaneous tissue.
<answer>(D)</answer> | D |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>True about Bacillus anthracis -a) Zoonotic diseaseb) Man to man transmission possiblec) Agent for bioterrorismd) Antibiotic has no rolee) Mc Faydean's reaction seen\nChoices:\nA. acd\nB. bde\nC. ace\nD. ade\n</Qu... |
<answer>(C)</answer> | C |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Most characteristic anomaly in infant of a diabetic mother:\nChoices:\nA. Caudal regression\nB. VSD\nC. Spina bifida\nD. Anencephaly\n</Question>\nAt the end present your answer in <answer> and </answer> using an... | Caudal regression
<answer>(A)</answer> | A |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Cholinesterase activators are useful for the treatment of which poisoning?\nChoices:\nA. Paraquat\nB. Parathion\nC. Carbamates\nD. Organochlorocompounds\n</Question>\nAt the end present your answer in <answer> an... |
<answer>(B)</answer> | B |
[
{
"content": "Given the following question and candidate answers, choose the best answer. <Question>Peri-natal transmission of hepatitis B is maximum in:\nChoices:\nA. 1st trimester\nB. 2nd trimester\nC. 3rd trimester\nD. During labour and delivery\n</Question>\nAt the end present your answer in <answer> and </... | Peri-natal transmission of hepatitis B is maximum in 3rd trimester. Maximum chances of perinatal transmission :- Disease Maximum chances Varicella 1 trimester Rubella 1 trimester Syphilis III trimester Toxoplasmosis III trimester Hepatitis B III trimester HIV During delivery
<answer>(C)</answer> | C |
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