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4.21k
⌀ | subject_name
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values | topic_name
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values |
|---|---|---|---|---|---|---|---|---|---|---|
841fa263-7535-4d40-ae25-cddb831b5254
|
A 22 years old gravida 3 para 2 lady delivers a normal child followed by delivery of an intact placenta. Following delivery, the lady develops severe per vaginal bleeding after 30 minutes. On table sonogram revealed retained placental tissue. What is the suspected type of placenta?
|
Membranous placenta
|
Placenta fenestrae
|
Placenta accreta
|
Placenta succenturiata
| 3
|
single
|
Ans: D. Placenta succenturiataSuccenturiate lobeSmall accessory lobes develop at a small distance from the main placentadeg.These lobes have vessels that course through the membranesdeg.If these vessels overlie the cervix to create a vasa pre, they can cause dangerous fetal hemorrhage if torndeg.An accessory lobe may be retained in uterus after delivery & cause postpaum uterine
|
Gynaecology & Obstetrics
| null |
f2c94aa9-36ec-4b01-9a6c-11624e14ffed
|
In ALL patient; at which stage can the orthodontic treatment be done:
|
During chemotherapy
|
Before chemotherapy
|
2 years after remission
|
Any time as not affected by ALL
| 0
|
multi
| null |
Dental
| null |
e4281c68-9e8b-4802-9c1d-edf0de6c7195
|
Which diseases are infectious but not communicable?
|
Measles
|
Mumps
|
Scarlet fever
|
Tetanus
| 3
|
single
| null |
Pathology
| null |
70c81c38-0fc8-44d3-9677-4b9845e39a50
|
Deepening the pulpal floor during cavity preparation
provides for
|
Outline form
|
Retention form
|
convenience form
|
Resistance form
| 3
|
single
| null |
Dental
| null |
65d2a97a-75ed-4658-860f-9acab69d88d1
|
Clinically acceptable limit of run out:
|
0.012
|
0.023
|
0.15
|
0.032.
| 1
|
multi
| null |
Dental
| null |
b3f181b1-dcd4-44d6-a008-628ed7b39cdc
|
A 30-year-old gentleman has exce' cep at work attributed to sleep discomfo at night. He also has recent history of falling while paying with friends. What are the other features that can be seenassociated with his condition?
|
Paralysis during sleep-wake transition with hallucinations
|
Snoring with witnessed sleep apnea
|
Pain in the legs before going to sleep
|
Generalized seizures in the wake state
| 0
|
multi
|
Answer: a. Paralysis during sleep-wake transition with hallucinations (Ref. Harrivon 19/c p189, 18/e p265History of fall is highly suggestive of atonia/paralysis and may be due to Narcolepsy.
|
Medicine
| null |
15d397c9-5a33-4c5e-b48e-a1625e079630
|
Improved Drinking water source protect from
|
Fecal matter
|
Teratogenic
|
Inorganic
|
Not Recalled
| 0
|
multi
| null |
Dental
| null |
c138ad82-08de-476f-b7cc-037bb25ef376
|
Most constant and valuable trait to differentiate among maxillary 1st , 2nd and 3rd molars is
|
Relative position of DL groove
|
Relative position of ML groove
|
ML cusp size
|
Oblique ridge size
| 0
|
single
|
Relative position of DL groove is most constant and valuable trait. As DL cusp becomes smaller as we move distally from 1st molar to 3rd molar.
|
Dental
| null |
f6cf71c5-7ca4-43a2-893a-f459548c5132
|
The odontoblasts killed during cavity preparation are derived from:
|
Unaffected odontoblasts from the pulp
|
Undifferentiated cells
|
Histocytes
|
Osteoblasts
| 1
|
single
| null |
Dental
| null |
883b1e5a-141b-4b1c-bdd2-3126554f9624
|
All are true about aneuploidy except:
|
30% of trisomy 21 fetus die in utero
|
80% of trisomy 18 fetus die in uero
|
Occurrence of aneuploidy has no relation with the progression of mother's age
|
The recurrence risk for nondysjunctional aneuploidy is 1% higher
| 2
|
multi
|
Aneuploidy
Each human cell consists of 23 pair of chromosomes i.e., the normal chromosome number is 46
Aneuploidy is a deviation from the normal number of 46 chromosome. Which could be be 47 or 45 chromosomes or it can be defined as state of having chromosome number that is not multiple of 23.
Nondisjunction
Nondisjunction is failure of paired homologus chromosomes to separate during the first meiotic division that leads to the production of gametes (ova and spermatozoa).
Thus, some gametes receive two and other receive none of the involved pair. After the second meiotic division the resulting gametes will have 24 and 22 chromosomes respectively. Such gametes are aneuploid.
Anaphase lag
In anaphase lag, one homologus chromosome in meiosis or one chromatid in mitosis lags behind and is left out of the cell nucleus. This results in one normal cell and one cell with monosomy.
Survival of Aneuploidy
Monosomy or trisomy involving the sex chromosome are compatible with life and are usually associated with variable degree of phenotypic abnormalities.
Monosomy involving an autosome generally represents loss of too much genetic information to permit live births or even embryogenesis.
With the exception of trisomy 21 all others will produce severely handicapped infants who almost invariably die at an early age.
Estimated abortion rate in early pregnancy
|
Gynaecology & Obstetrics
| null |
cb22bfd6-e7d0-4944-8677-45b1a3d35c21
|
The following is the ovum of a helminth. What is true about the helminth?
|
Transmission is through ingestion of infected pork
|
Both adult and larval stages are seen in humans
|
The helminth causes a transient self-resolving infection in humans
|
Drug of choice for this condition is albendazole
| 1
|
multi
|
Ans: b. Both adult and larval stages are seen in humans(Ref: Paniker's 7/e p135, 6/e p156)The given image is the egg of Hymenolepis nano showing characteristic polar filaments, polar knobs, yolk granules and,6 hooklets (hexacanth) in the oncosphere (embryo).Both adult and larval stages of this species are seen in humans.It causes a transient infection in humans but does not resolve on its own and has to be treated.
|
Microbiology
| null |
00eaa1c4-c041-4172-ab04-51205c84410f
|
Progenitor hematopoietic stem cells originate in
|
Bone marrow
|
Thymus
|
Lymph Node
|
Spleen
| 0
|
single
| null |
Medicine
| null |
21be2f06-388b-47cb-8264-b03a82a65839
|
Long face syndrome patient with increased lower facial height, the palatal plane will be:
|
Posteriorly downward
|
Upward posteriorly
|
Downward anteriorly
|
No change
| 0
|
single
|
Vertical type 1 is suggestive of ‘long face syndrome’ or ‘steep mandibular plane angle’ type of class II. The functional occlusal plane is also steep associated with a palatal plane that is tipped downward.
In long face individuals, who have excessive lower anterior face height, the palatal plane rotates down posteriorly, often creating a negative rather than the normal positive inclination to the true horizontal. The mandible shows an opposite, backward rotation, with an increase in the mandibular plane angle.
Ref: Orthodontics: Diagnosis and Management of Malocclusion and Dentofacial Deformities, 3e, Om P. Kharbanda pdf no 2526
|
Dental
| null |
52e0bdf3-57a4-4dd6-ba5c-e9facb82e61f
|
Which of these is most commonly used as pre-anesthetic medication?
|
Atropine
|
Promethazine
|
Scopolamine
|
Glycopyrrolate
| 3
|
single
|
Ans: D. Glycopyrrolate(Ref: Miller 7/e p293; KDT 366, 117)Glycopyrrolate is most commonly used as pre-anesthetic medication.An anlicholinergic drug used for reducing secretions in the mouth, throat, airway, and stomach before surgery.Used before and during surgery to block ceain reflexes and to protect against ceain side effects of some medicines.
|
Anaesthesia
| null |
24116727-d6db-412a-8568-8f9818ecf2b6
|
If a permanent first molar is lost, the permanent second molar drifts to the:
|
Buccal side
|
Distal side
|
Mesial side
|
Lingual side
| 2
|
single
| null |
Dental
| null |
574f8c1a-3c90-4c56-b5ef-6d0a965ab942
|
The best marker for neural tube defect is:
|
Acetyl glucosonidase
|
Acetyl cholinesterase
|
Alpha fetoprotein
|
Chorionic gonadotrophin
| 1
|
single
| null |
Gynaecology & Obstetrics
| null |
db465e84-d92a-49f2-a5f9-3c0c771aa507
|
Transmits which disease
|
Kyasanur forest disease
|
Scrub typhus
|
Japanese encephalitis
|
Leptospirosis
| 1
|
single
|
Trombiculid mite is a vector of chiggerosis or Scrub typhus which is caused by Orientia Tsutsugamushi. Scrub typhus causes fever, myalgia and black Eschar. Kyasanur forest disease is transmitted to humans through the bite of infected hard ticks. Japanese encephalitisvirus is transmitted to humans through the bite of infected Culex species mosquitoes, paicularlyCulex tritaeniorhynchus. Leptospirosis transmitted through rodents
|
Microbiology
|
AIIMS 2019
|
50d62af7-c4dc-4ea7-93fa-c235c4bb6b2f
|
A female come to gynaeoPD for preconceptual counseling, with history of two second trimester aboions. What is the next investigation you will advice
|
TVS
|
hysteroscopy
|
Endometrial biopsy
|
chromosomal abnormalities
| 0
|
single
|
Ans: A. TVSRef: Williams Obstetrics 24h ed"Most common cause of second trimester aboion is cervicouterine abnormalities.Next step would be to do an ultrasound and look for any structural uterine anomaly.Chromosomal abnormalities are common cause of aboftions in first trimester.
|
Gynaecology & Obstetrics
| null |
395fe24f-c2bc-4138-ae4e-6ca00e1ab0fd
|
The pattern of change of disease of mortality and morbidity where the pandemics of infection are replaced by degenerative and manmade disorders as the main cause of morbidity and mortality is known as?
|
Epidemiological transition
|
Demographic transition
|
Paradoxical transition
|
Reversal of transition
| 0
|
single
| null |
Dental
| null |
77997eca-fce9-4840-916d-b373c61c411d
|
IV loading dose of MgSo4 prophylaxis in pre-eclampsia?
|
8ml MgSo4+10ml of NS
|
10ml MgSo4+10ml of NS
|
8ml MgSo4+12ml of NS
|
12ml MgSo4+8 ml of NS
| 2
|
single
|
Ans. C.8ml MgSo4+12ml of NSDose: 4-5 g (diluted in 250 mL NS/D5W) IV in combination with either :Up to 10 g (10 mL of undiluted 50% solution) divided and administered IM into each buttock orAfter initial IV dose, 1-3 g/hr IV.MgSO4 is continued 24 hours after delivery to prevent postpaum eclampsia
|
Gynaecology & Obstetrics
| null |
46888949-6478-4384-acdb-344f246616ba
|
Bond found in GIC is:
|
Covalent bond
|
Ionic bond
|
Hydrogen bond
|
Metallic bond
| 1
|
multi
| null |
Dental
| null |
7f8086d8-e91b-40fc-8d8c-55cc74f84d6c
|
An adolescent male patient came with pain in calf muscles on exercise. On biopsy excessive amount of glycogen present was found to be present in the muscle. What is the most likely enzyme deficiency?
|
Muscle debranching enzyme
|
Phosphofructokinase I
|
Glucose 6 phosphatase
|
Phosphorylase enzyme
| 3
|
single
|
Muscle cramps on exercise is a diagnostic feature of McArdle's disease. In this disease, due to deficiency of muscle glycogen phosphorylase, glycogen stored in muscle cannot be utilized for glucose production causing Muscle cramps and pain on doing strenuous work or exercise. Refer to the table for other symptoms. Type Name Enzyme deficiency Organ Clinical features I Von Gierke's disease Glucose 6-phosphatase Liver , Kidney Glycogen accumulation in liver and kidney Hypoglycemia lactic acidemia ketosis Hyperlipidemia II Pompe's disease Lysosomal alpha-1,4 glucosidase (acid maltase) All organs glycogen accumulation in lysosome in all organ hea is mostly affected* death occur at early age due to hea failure III Cori's disease Amylo alpha-1,6-glucosidase (debranching enzyme) Liver muscles and Hea fasting hypoglycemia hepatomegaly in infancy accumulation of characteristics branched polysaccharides (limit dextrin) muscles weakness IV Anderson's disease Glucosyl 4-6 transferase(branching enzyme) Most tissue A rare disease, glycogen with only few branches accumulate; cirrhosis of liver Death before 5 years of age dur to hea failure or liver failure V McArdle's disease Muscle glycogen phosphorylase Skeletal tissue Muscles glycogen is very high but cannot be used during exercise Cannot perform strenuous exercise Muscles cramps Blood lactate and pyruvate do not increase after exercise VI Her's disease Liver glycogen phosphorylase Liver Liver is increased in size because liver glycogen cannot conve to glucose Mild hypoglycemia and ketosis Good prognosis VII Tarui's disease Phosphofructokinase Skeletal muscles and RBC Muscles cramps due to exercise Blood lactate is elevated Hemolysis occur
|
Biochemistry
|
AIIMS 2018
|
395a115c-ac63-49db-8cca-eaef6396794a
|
A 20-year-old male presents with hard painless testicular swellingon investigation AFP is 3080. No paraaoic or iliac nodes as well as no mediastinal lymph nodes found. usG shows uniform echotexture and small areas of necrosis surrounding structures are normal.What is the next best steP:
|
FNAC
|
Trucut bioPsY
|
High inguinal orchidectomy
|
PET-CT
| 2
|
multi
|
Ans. C. High inguinal orchidectomyRe.f: Sabiston textbook of surgery,2AI' ed., ch-72, pg. 2102-2104Initial treatment of suspected testicular tumour is radical inguinal orchiectomy, which involves removal of the testicle and sperrnatic cord at the level of the inguinal ring.Because of the characteristic and well-described lymph drainage of the testicle there is no role or trans-scrotal biopsy or orchiectomy.
|
Surgery
| null |
21d61ebe-1fce-4629-b499-37b681908cc0
|
What would be the ideal management of a woman with infeilty who is detected to have bilateral cornual block on hysterosalpingography?
|
Tuboplasty
|
In-vitro feilization
|
Hydrotubation
|
Hysteroscopy and laparoscopy
| 3
|
single
|
Ans. d. Hysteroscopy and laparoscopy (Ref The Infeility Manual/p266-267; Practical approach to infeility management by aiilr Rcensal/p33:Hysteroscopy and laparoscopy would be the ideal management of a woman with infeility who is detected to have bilateral cornual block on hysterosalpingography.
|
Gynaecology & Obstetrics
| null |
de803c1d-d6b5-49b1-ba45-ed4abe3ec0ef
|
Following renal disorder is associated with worst pregnancy outcome:
|
Systemic lupus erythromatosus
|
IgA nephropathy
|
Autosomal dominant polycystic kidney disease
|
Scleroderma
| 3
|
single
|
Prognostic indicators in renal disease and pregnancy:
Most reliable prognostic indicator of the outcome of pregnancy is the presence of hypertension. The fetal prognosis for women with chronic renal disease is favorable as long as they do not develop superimposed preeclampsia.
Second to hypertension, the most valuable prognostic index for patients with chronic renal disease during pregnancy is the degree of renal function impairment:
– In patients with normal or only midly impaired renal function, pregnancy does not accelerate renal damage
– In patients with moderate renal insufficiency (serum creatinine of 1.4 mg/dL or greater before pregnancy or creatinine clearance <30 ml/min. there is a decline in renal function during pregnancy).
Another important prognostic sign is the presence or absence of proteinuria. As a general rule, if the patient has 2+ or more protein in qualitative tests or 3 g or more in 24 hours urine collections at the beginning of pregnancy, the tendency will be toward increased protein losses and development of nephritic syndrome during pregnancy.
The histologic characteristics of the renal lesion also have prognostic value.
|
Gynaecology & Obstetrics
| null |
66fd611c-468f-409d-b6b2-c2952511f4a0
|
Shape of 1st Maxillary molar
|
Rhomboid
|
Rounded triangular
|
Trapezoid
|
Square
| 0
|
single
| null |
Dental
| null |
01dc74dc-0e66-44a9-a4c2-7594d49b8c88
|
Topical steroids is most effective in:
|
Dermal atrophy
|
Eczematous dermatitis
|
Bullous lesions due to HSV
|
Herpes Zoster
| 1
|
single
|
Acute Phase of Eczematous dermatitis - Spongiosis (oozing out lesion) - Coicosteroids ( Topical+systemic) Chronic phase of Eczematous dermatitis - Lichenification Rx - Coicosteroids & topical calcineurin inhibitor Systemic : Azathioprine
|
Dental
|
AIIMS 2019
|
e342fc89-9875-4188-9009-b9065fdf5b9c
|
Stable element in Ti6Al4V in alpha phase is?
|
V
|
Al
|
Ti
|
Al, V
| 1
|
single
|
Alpha titanium wires are manufactured from grade V titanium alloy containing 6% aluminum and 4% vanadium. These wires have good formability and stiffness equal to that of stainless steel. These wires possess poor spring back, and hence their use in orthodontics is limited for applying torque at the finishing stage. Aluminum is used to stabilize the alloy in alpha phase.
GRADE V TITANIUM ALLOY (Ti6Al4V, OR Ti6-4)
6% Aluminum
4% Vanadium
0.25% Iron
0.2% Oxygen
Textbook of ORTHODONTICS Sridhar Premkumar
|
Dental
| null |
d239a8a4-bc54-453e-805f-068d00381a1b
|
All of the following carry proprioception from head and neck except:
|
Facial nerve
|
Trigeminal nerve
|
Glossopharyngeal nerve
|
Cranial accessory nerve
| 3
|
multi
| null |
Anatomy
| null |
00b083b3-b213-4b45-bbc4-301c4156576c
|
Which of the following is not true about latent phase of labour?
|
According to ACOG it stas after 3-4 cm cervical dilatation but they are planning to increase it to 5 cm
|
Begins at the end of active phase and is a pa of 1st stage of labour
|
Patient may present with false labour due to mild cramps
|
Stas with contractions of the uterus
| 2
|
multi
|
Answer- C. Patient may present with false labour due to mild crampsIt stas at the point at which mother perceives true labour pains and ends when cervix is 3cm dilated and 1.5 cm/hour for parous cervix.Duration in nulliparous is 6-8 hours and 5.3 hours in multiparous (average 4-6 hours).Mainly concerned with cervical effacement
|
Gynaecology & Obstetrics
| null |
c11f2ef3-043b-4b7a-856e-1bd527cb4d7a
|
A patient with a history of fall after hypoglycemic episode presents with pain in bilateral preauricular region and deviation of the mandible to right side on mouth opening, probable diagnosis will be
|
Fracture of right condyle
|
Fracture of left condyle
|
Dislocation of left condyle
|
Dislocation of both condyles
| 0
|
multi
| null |
Surgery
| null |
25883737-550d-4264-ad32-bc1a320ca9a7
|
The instrument shown in fig is used for
|
Rapid separation
|
Slow separation
|
Not used for separation
|
Depends on force for separation
| 1
|
single
|
The image shows Orthodontic brass ligature wire which brings about slow separation of teeth not more than 0.5mm.
|
Dental
| null |
1cb974a5-a714-4590-8ba8-9989c6620e23
|
Tongue develops from all of the following except
|
Tuberculum impar
|
Hypobranchial eminence
|
Lingual swellings
|
Arytenoid swellings
| 3
|
multi
| null |
Anatomy
| null |
01c50678-d06f-4894-b7b7-0562a413164e
|
Polishing of composite is problematic due to
|
Soft matrix and hard filler particles
|
Hard filler particles
|
Hardness of matrix and filler particles
|
None of the above
| 0
|
multi
| null |
Dental
| null |
889673c1-cf2a-44a3-a0db-7e4f0a5a52de
|
Lithium should be stopped how many days before anaesthesia
|
1 day
|
2 days
|
3 days
|
4 days
| 2
|
single
| null |
Pharmacology
| null |
772be35c-73b9-43c4-8fc6-9ee4efb8dd27
|
A 10 year old boy presents with midline swelling arising from cerebellum the diagnosis is –
|
Astrocytoma
|
Glioblastoma multiforme
|
Ependymoma
|
Medulloblastoma
| 3
|
single
|
Midline swelling arising from cerebellum in a child favour the diagnosis of medulloblastoma.
Robbin's states
"In children medulloblastomas are located in midline but in adults they are found in lateral locations".
Note -
Astrocytoma is also a posterior fossa tumor, but it does not commonly present as midline mass.
|
Pediatrics
| null |
21ee7c81-f9b4-444a-a545-3f9d2b2d4fea
|
Mast cells are
|
Absent in both inflamed and normal pulp.
|
Present in normal pulp
|
Present in inflamed pulp only.
|
Absent in inflamed pulp only.
| 2
|
multi
| null |
Dental
| null |
2709dce6-0e84-4d28-a531-630df39e7298
|
Which of the following is associated with a low
concentration of ionized calcium in the serum?
|
Hypothyroidism
|
Osteogenesis imperfecta
|
Paget's disease of the bone
|
Tetany
| 3
|
single
| null |
Pathology
| null |
bcc3680a-8167-4c75-ba0c-b7c94cb440b6
|
All of the following are done to remove Confounding except
|
Randomization
|
Random Selection
|
Matching
|
Blinding
| 1
|
multi
|
Confounding factor - related to both the exposure and the outcome It leads to mistaken outcomes in the study, which leads to error in the study. Endemic Goitre is usually found in high altitudes, showing thereby an association between the two. However, we know that the goiter is not because of altitude but because of environmental deficiency of Iodine. Methods used to control confounding: Methods used to control confounding: METHOD UTILITY IN CONTROLLING CONFOUNDING 1. Randomization Most ideal method 2. Restriction Limiting study to people who have paicular characteristics 3. Matching Mostly useful in case control studies 4. Stratification Useful for larger studies 5. Statistical Modeling When many confounding variables exist simultaneously 6. Blinding Bias is also a type of confounding
|
Social & Preventive Medicine
|
AIIMS 2019
|
a9b0fecd-41ee-4e52-87a9-12e7048e6615
|
Asseion: In a patient admitted to hospital for community acquired pneumonia, combination therapy of beta lactams and azithromycin is given.Reason : This combination covers gram positive organisms and anaerobes.
|
Both reason and asseion are true
|
Asseion is true but reason is false.
|
Asseion is true but reason is paially true for asseion
|
Both asseion & reason are not true.
| 1
|
multi
|
Ans. B. Asseion is true but reason is false.* Combination is given to cover atypical bacteria.* The CDC and others recommend outpatient oral empirical antibiotics with a macrolide, doxycycline, or an oral betalactam (amoxicillin, cefuroxime , or amoxicillin/clavulanate ) or inpatient treatment with an intravenous betalactam (cefuroxime, ceftriaxone , cefotaxime ) or a combination of ampicillin/sulbactam (Unasyn) with a macrolide
|
Pharmacology
| null |
791f4a8a-a060-4a91-9810-7bdd4f4d500e
|
Heart of controlled trial?
|
Blinding
|
Experiment
|
Randomization
|
Intervention
| 2
|
single
| null |
Dental
| null |
1c5c10da-6c39-43e4-92f7-cf01b0c894c5
|
Definitive treatment for the condition shown in radiograph below is?
|
Apexogenesis
|
Revascularisation
|
Calcium Hydroxide apexification
|
MTA barrier formation
| 3
|
single
| null |
Dental
| null |
da529e73-61fe-4b52-81b1-8686b6a62ffd
|
A patient is taking drugs for rheumatoid ahritis and has a history of cataract surgery 1 year back, the patient presented with sudden painless loss of vision, probable diagnosis is?
|
CME
|
Macularhole
|
Chloroquine toxicity
|
Chronic choroiditis
| 2
|
single
|
Patient of rheumatoid ahritis are given hydroxychloroquine which cause painless loss of vision due to bull's eye maculopathy characterized by a foveolar island of pigment surrounded by a depigmented zone of RPE atrophy, which is itself encircled by a hyperpigmented ring (A). There is moderate to severe reduction in VA (6/36-6/60). A more substantial macular lesion follows, with widespread RPE atrophy surrounding the fovea (B). Later retinal aerioles may become attenuated, and pigment clumps can form in the peripheral retina.(C)
|
Ophthalmology
|
AIIMS 2018
|
40013980-4b7a-4cc7-8c38-f2f45215bcbf
|
Tumor cells in chronic lymphocytic leukemia or small lymphoblastic lymphoma (CLL/SLL) arisefrom which of the following?
|
Mature B cell
|
Naive B cell
|
Centrocytes of germinal center
|
Progenitor B-cell
| 1
|
multi
|
DNA sequencing has revealed that the Ig genes of some CLL/SLL are somatically hypermutated whereas others are not, suggesting that the cell of origin may be either a post germinal center memory B cell or a naive B cell. For unclear reasons, tumors with unmutated Ig segments (those putatively of naive B-cell origin) pursue a more aggressive course. Impoant points about CLL: CLL is the most common leukemia of adults in the Western world. CLL is the cancer which is associated with presence of Autoimmune Hemolytic Anemia. CLL is the cancer which is not associated with Radiation exposure. CLL patient blood sample contains large numbers of small round lymphocytes with scant cytoplasm. Some of these cells are usually disrupted in the process of making smears, producing so-called Smudge cells. These patients are best identified with the help of Tumor cells exhibiting specific type of CD markers paicularly -CD19, CD20, CD23, CD5.
|
Pathology
|
AIIMS 2017
|
cef58dc3-f340-4f76-909d-8f9fb4866e29
|
Positive pivot shift test in knee is because of injury to -
|
Posterior cruciate ligament
|
Anterior cruciate ligament
|
Medial meniscus
|
Lateral meniscus
| 1
|
single
|
COLLATERAL LIGAMENT INJURY
The most common mechanism of ligament disruption of knee is abduction (valgus), flexion and internal rotation of femur on tibia which usually occur in sports in which the foot is planted solidly on the ground and leg is twisted by rotating body.
The medial structures medial (tibial) collateral ligament (MCL) and medial capsular ligament are first to fail, followed by ACL tear, if the force is of sufficient magnitude. The medial meniscus may be trapped between condyles and have a peripheral tear, thus producing unhappy triad of 0’ Donoghue.
Main test for MCL (medial collateral ligament) is valgus (abduction) stress in 30° of knee flexion. (Because in full extension it is indicative of combined MCL, posterior oblique ligament injury and posterior cruciate ligament injury).
Varus (Adduction) stress test in 30° flexion (removes the lateral stabilizing effect of iliotibial band so that the lateral collateral ligament can exclusively be examined).
Apleys distraction test is used for collateral ligaments.
|
Orthopaedics
| null |
41e1a56c-4471-4566-9902-e54861939e72
|
An apical radiolucent area present in central incisor
after 4 months of RCT is due to:
|
Inadequate obturation & leakage from main canal
|
Leakage from accessory canal
|
Leakage from gingival crevice
|
Leakage from access opening
| 0
|
single
| null |
Dental
| null |
1d405e6b-5cd9-4ff7-ba6d-f7f748ad6050
|
Low apparent volume of distribution of drug indicates that:
|
Drug has low half life
|
Drug has low bioavailability
|
Drug has low efficacy
|
Drug is not extensively distributed to tissue
| 3
|
single
|
Vd means "the plasma volume that would accommodate all the drug in the body, if the concentration throughout was same as in plasma". Drugs with high volume of distribution are more distributed in body and vice-versa. Low volume of distribution tells that most of the drug is retained in plasma.
|
Pharmacology
|
AIIMS 2018
|
69a34f1e-09bd-4364-b763-f28c6ddf772a
|
All of the following are true about lumbar puncture except:
|
Level of needle inseion should be L I -L2 veebral junction
|
The bevel end of needle should face up
|
Needle should be inseed in a slightly cephalad direction
|
Legs should be straightened for CSF pressure measurement
| 0
|
multi
|
Ans: A. Level of needle inseion should be L I -L2 veebral junction(Ref: Harrison 19Ie p443-e2)The spinal cord ends at L3 veebrae in children and L1 in adults.With a safe margin, lumbar puncture should be performed at L3-L4 or L4-L5 interspace.A useful anatomic guide is a line drawn between the posterior superior iliac crests, which corresponds closely to the level of the L3--L4 interspace.The interspace is chosen following gentle palpation to identify the spinous processes at each lumbar level.The LP needle (typically 20- to 22-gauge) is inseed in the midline, midway between two spinous processes, and slowly advanced.The bevel of the needle should be maintained in a horizontal position, parallel to the direction of the dural fibers and with the flat poion of the bevel pointed upward; this minimizes injury to the fibers as the dura is penetrated.
|
Anaesthesia
| null |
4e9c6e74-1604-4599-91c2-02d22adcb765
|
Hormone Replacement therapy is not indicated in:
|
Hot flashes
|
Prevention of CAD
|
Osteoporosis
|
Vaginal atrophy
| 1
|
single
|
H indicated in menopausal women to overcome the sho term and long term consequences of estrogen deficiency. Indications of hormone replacement therapy in a menopausal woman Relief of vasomotor symptoms: hot flushes Prevention and treatment of osteoporosis Urogenital atrophy Premature Menopause Hormone Replacement Therapy is NOT indicated for prevention or treatment of cardiovascular disease. Natural estrogens produced in the body till menopause are cardioprotective, however Hormone Replacement Therapy (containing exogenous estrogens and progesterones)is not cardioprotective, n fact it is detrimental to hea when used for long term.
|
Gynaecology & Obstetrics
|
AIIMS 2019
|
7837431a-55a0-4471-8810-6ca014c03a35
|
If sodium channel inactivation is prolonged then which property of nerve conduction is hampered?
|
Decreased relative refractory period
|
Increased conduction blockade
|
Increased upward stroke velocity
|
Decreased downward stroke velocity of refractory period.
| 2
|
single
| null |
Physiology
| null |
b3c55a62-5e13-402f-a6d4-6d8feb954d95
|
Largest cusp is
|
Mesiolingual cusp of upper 1st molar
|
Mesiolingual cusp of Upper 2nd molar
|
Buccolingual cusp of Upper 1st molar
|
Buccolingual cusp of lower 2nd molar
| 0
|
single
| null |
Dental
| null |
8604f600-1e0e-432d-8113-0bea0db44951
|
Which of following causes lysis of clot :
|
Fibrin
|
Plasmin
|
Hyaluronidase
|
Coagulase
| 1
|
single
| null |
Physiology
| null |
b8e55476-5037-418e-afe3-2d7ca5174a31
|
The oral findings in erythroblastosis fetal's include
|
Dentinal dysplasia
|
Hypoplastic teeth
|
Pigmented teeth
|
All of the above
| 2
|
multi
| null |
Pathology
| null |
822d5c68-39fe-40e8-97ef-f50d7af91ebb
|
A neonate develops encephalitis without any skin lesions. Most probable causative organisms is –
|
HSV I
|
HSV II
|
Meningococci
|
Streptococci
| 1
|
single
|
Herpes simplex viruses
Herpes simplex is an important cause of encephalitis in the neonate, the infection acquired during delivery from the vaginal tract.
But it cause vesicular, ulcerative skin lesions
Even though it causes skin lesions, its our best option, as Nelson writes -
" The hallmark of neonatal HSV infection- the vescicular ulcerative skin lesions are presnt in only 30 to 43% of children at presentation; one third will never manifest skin lesions."
Out of the.two types of Herpes; Neonatal herpes is mainly caused by type II IISV (75 to 80%).
About other options
Meningpcocci
Its a rare cause of infection in neonates as neonates have antibodies (from mother) against meningiococcus which protects them for the initial 3 to 6 months of life.
Streptococci
Though streptococcus B is a common infection of neonates, it does not cause encephalitis.
RAIN TUMORS
You will frequently read the terms --> Infratentorial, supratentorial, Posterior cronial fossa in relation of Brain tumours, so I am giving very brief introduction
Supratentorial region of the brain is located above the tentorium cerebelli; and contains the cerebrum.
The infratentorial region of the brain is located below the tentorium cerebelli and contains the cerebellum and brainstem.
Brain stem and cerebellum are contained in the posterior cranial fossil.
As brain stem and cerebellum are infratentorial in location and contained in posterior cranial fossa -› Their tumors are infratentorial posterior fossa tumors, e.g., cerebellar astrocytoma, brainstem glioma, medulloblastoma (cerebeller).
|
Pediatrics
| null |
24e4fee0-172f-4eac-87e5-030f3b409318
|
Which one of the following is most elastic?
|
α titanium
|
β titanium
|
Chrome-cobalt-nickel
|
Nickel titanium
| 3
|
single
| null |
Dental
| null |
a0e568c4-2af5-479e-8c61-abffa1ffa11f
|
Latent period of distraction osteogenesis in 8 months old child is
|
0-2 days
|
5-7 days
|
4-6 weeks
|
31-40 days
| 0
|
single
| null |
Surgery
| null |
75037cd8-82e0-4544-b8b4-39b0c3c894e8
|
Which of the following methods is used for calculation of anatomical dead space?
|
Xenon dilution technique
|
Bohler's method
|
Spirometry
|
Single breath nitrogen test
| 3
|
single
|
Ans: D. Single breath nitrogen test(Ref: Ganong 25/e p633, 634, 24/e p633, 634)Anatomical dead space - Calculation:By Bohr's equation - Uses single breath nitrogen inhalation technique.Xenon/Helium dilution technique:Used to measure functional residual capacity of lung.Spirometry:Cannot measure residual or dead space volumes.
|
Physiology
| null |
e4927cf9-d5c2-4d7e-ab5b-7429e206275e
|
The virulence factors of Neisseria gonorrhea include all of the following except:
|
Outer membrane proteins
|
IgA Protease
|
M-Proteins
|
Pili
| 2
|
multi
| null |
Microbiology
| null |
12b43c0e-c864-4257-90ea-4641077d19ba
|
Hard swelling at the angle of mandible with numerous draining sinuses is most likely:
|
Actinomycosis
|
Ludwig's angina
|
Mucormycosis
|
Cellulitis
| 0
|
single
| null |
Pathology
| null |
3d3d18de-8e78-4d58-90f4-2c9257c76a5e
|
Which fracture results in the given deformity?
|
Supracondylar fracture of humerus
|
Lateral condylar fracture
|
Olecranon fracture
|
Radial head fracture
| 0
|
single
|
The image shows cubitus varus. Supracondylar fracture of humerus causes cubitus varus and Gunstock deformity. Lateral condylar fracture causes cubitus valgus
|
Orthopaedics
|
AIIMS 2018
|
ba4a3d15-f1cf-4072-b836-ecf2785657e3
|
Which does not cross placenta:
|
Heparin
|
Morphine
|
Naloxone
|
Warfarin
| 0
|
single
|
Heparin does not cross placenta and is safe during pregnancy.
It is the drug of choice for the management and prophylaxis of venous thromboembolism during pregnancy.
|
Gynaecology & Obstetrics
| null |
ec6114a9-5426-4d90-bdde-2511889a20ec
|
A middle aged female presents with slowly progressive weakness of lower limbs, spasticity and recent onset hesitancy of Micturition. On neurological examination there is evidence of dorsal myelopathy. MRI scan of spine reveals middorsal intradural contrast enhancing mass lesion. Diagnosis is:
|
Intradural lipoma
|
Dermoid cyst
|
Meningioma
|
Epidermoid cyst
| 2
|
single
|
Ans. c. Meningioma (Ref. Harrison 19/e p602, I 8/e p3388; Chapman 4/e p431; Sahicton /9/e p 1888- 1889; Schwa/17 9/e p1540- I 541: Bailey 26/e p614, 25/e p633)Diagnosis in a middle aged female with slowly progressive weakness of lower limbs, spasticity and recent onset hesitancy of micturition with evidence of dorsal myelopathy and middorsal intradural contrast enhancing mass lesion on MRI is meningioma.
|
Radiology
| null |
3fce14e2-4c78-4633-9345-b7f73336dea7
|
Sodium bicarbonate when given with local anaesthetics has which of the following effect?
|
Increases speed and quality of anaesthesia
|
Decreases diffusion of the anaesthetic drug
|
Causes rapid elimination of the Local anesthetic
|
Decreases speed and quality of anaesthesia
| 0
|
single
| null |
Surgery
| null |
2cde59aa-666b-4fa6-802b-74ecdd525bfb
|
12 years old Shyam presented with gross hematuria with 80% dysmorphic RBC's 2 days after a attack of upper respiratory tract infection diagnosis is –
|
Microangiopathic thrombotic anaemia
|
IgA Nephropathy
|
PSGN
|
H.S. purpura
| 1
|
single
|
The patient is having glomerulo nephritis (gross hematuria and dysmorphic RBC's) 2 days after upper respiratory tract infection.
Three conditions can manifest like this —> IgA nephropathy, Post streptococcal glomerulonephritis, H.S. Purpura.
|
Pediatrics
| null |
39af86fb-6d6a-4d2f-b1cc-670989ca78b8
|
Metapex is a combination of which of these?
|
Calcium hydroxide +ZoE
|
ZoE + Iodoform
|
Calcium hydroxide + iodoform
|
Calcium hydroxide + GIC
| 2
|
single
| null |
Dental
| null |
4a1231e6-deb4-4c50-9dcd-d71fcd9021a2
|
Fibres of periodontal ligament embedded in the bone are
|
Sharpey's fibres
|
Tomes fibres
|
Elastic fibres
|
Ray's fibres
| 0
|
single
| null |
Dental
| null |
9698b531-5c6a-41f5-ad09-9eaa05779681
|
A patient presented with intermittent fever, no weight loss, no anorexia, but with a retroperitoneal mass. Peripheral smear findings were normal. Microscopy of the mass is given. What's the diagnosis?
|
NHL
|
Castleman disease
|
Angiolymphoid hyperplasia
|
Ig G4 disease
| 1
|
single
|
Onion skin appearance of lymph node is characteristic for Castleman disease It is alympho proliferative disorder. It has 2 variants: Unicentric Has 2 variants: 1)Highly vasculara More common , patients are asymptomatic Histology: -Twinning- Presence of two germinal centers -Onion skin pattern-Lymphocytes causes thickening of mantle zone -Lollipop lesions- Sclerosed blood vessel that infiltrate lymph node germinal center Multicentric ?Associated with immune suppression ?Presents as : Hepatomegaly Splenomegaly Night sweats Fever 2)Plasma cell varianta Less common, patients are symptomatic: - Weight loss -Night sweats -Fever Histology: Plasma cells in interfollicular areas causing hyperplasia of germinal center Lymph node architecture is distoed but LN is preserved in unicentric variant
|
Pathology
|
AIIMS 2018
|
e6189f82-de06-4469-b26b-1fab6e72fab8
|
A healthy middle-aged man was arguing with his brother and got emotionally upset due to the arguments with his brother, he suddenly developed chest pain and collapsed. When brought to the hospital' hewas declared dead.What is the diagnosis?
|
Takotsubo cardiomyopathy
|
Dilated cardiomyopathy
|
Arhmogenic right ventricle dysplasia
|
Chronic ischemic cardiomyopathy
| 0
|
multi
|
Ans: A. Takotsubo cardiomyopathyRef Harrison, 18't' ed., pg, 1964* Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which there is a sudden temporary weakening of the muscular poion of the hea.* This weakening may be triggered by emotional stress, such as the death of a loved one, a break-up, rejection from a paner or constant anxiety. - "Broken hea syndrome".* Stress cardiomyopathy is now a well-recognized cause of acute hea failure, lethal ventricular arrhythmias, and ventricular rupture.
|
Medicine
| null |
73828c81-172b-4aec-b517-c0d345c4749d
|
Out of Syphilitic glossitis, Plummer Vinson syndrome, Mikulicis syndrome and hepatitis A; which of these predispose to squamous cell carcinoma
|
Syphilitic glossitis and plummer Vinson syndrome
|
Syphilitic glossitis and Mikulicz's syndrome
|
Plummer Vinson disease and hepatitis A
|
hepatitis A and Mikulicz's Syndrome
| 0
|
single
| null |
Pathology
| null |
0c51b741-85ed-462a-ad9f-fbb731df845d
|
Calcification of third molar begins at:
|
8 months
|
18 months
|
8 years
|
16 years
| 2
|
single
| null |
Dental
| null |
9138af01-4f96-4301-9817-8662fc2a0012
|
Allergy in immediate perioperative period is due to:
|
Opioids
|
LA agents
|
Induction agents
|
Neuromuscular blockers
| 3
|
multi
|
Ans: D. Neuromuscular blockers(Ref: Miller 7/e p884)Most common cause of perioperative anaphylaxis is muscle relaxants and antibiotics followed by opioids and intravenous anesthesia.Most Common Drugs Involved in Perioperative AnaphylaxisSubstanceMost commonly associatedMuscle relaxantsSuccinylcholine, rocuronium,atracuriumdegNatural rubber latexLatex gloves, tourniquets, Foley cathetersAntibioticsPenicillin & other beta-lactamsdegHypnoticsPropofol, thiopentaldegColloidsDextran, gelatindegOpioidsMorphine, meperidinedegOther substancesParacetamol, aprotinin,chymopapain, protamine,bupivacaine
|
Anaesthesia
| null |
53ba17a3-bd10-4e5f-bf50-95306abb21b7
|
A child transfers objects from one hand to other. What does it imply?
|
Visual motor co-ordination
|
Explores small object
|
Object release
|
Comparison of objects
| 3
|
multi
|
GROSS MOTOR MILESTONE DEVELOPMENTAL IMPLICATION Holds head steady while sitting Allows more visual interaction Sits without suppo Increasing exploration Walks alone Exploration, controls proximity to parents FINE MOTOR MILESTONE DEVELOPMENTAL IMPLICATION Hand regard Self discovery of hands Reaches for objects Visuomotor coordination Palmar grasp gone Voluntary release Transfers object hand to hand Comparison of others Thumb -finger grasp Able to explore small objects Scribbles Visuomotor coordination Builds tower of 2 cubes Uses objects in combination SOCIAL MILESTONE DEVELOPMENTAL IMPLICATION Social smile More active social paicipation Follows 1 step command with gestures Non -verbal communication Points to objects Interactive communication Uncovers toy(after seeing it hidden) object permanence Pretends to drink from cup Symbolic thought Uses stick to reach toy Links actions to solve problems LANGUAGE MILESTONE DEVELOPMENTAL IMPLICATION Monosyllabic babble Experimentation with sound 1-step command without gesture Verbal receptive language Says "mama "or "dada" Expressive language Speaks first real world Beginning of labelling Speaks 4-6 words Acquisition of object and personal names Speaks 2-word sentences Beginning grammatization
|
Pediatrics
|
AIIMS 2020
|
9013e6c6-35da-4df1-a83a-a907ae206135
|
Heparin acts which of the following adjuvants?
|
Antithrombin III
|
Protein C
|
Protein S
|
Thrombomodulin
| 0
|
single
|
Ans: A. Antithrombin IIIRef: Goodman & Gilman, 13th ed, pg. 588Heparin binds to antithrombin III (AT-lll) and accelerate the rate at which it inhibits various coagulation proteases.
|
Pharmacology
| null |
80d3c4e2-26a3-46c1-9e01-9f898b93708b
|
In submandibular surgery incision is given 2 cm below the border of mandible to preserve which nerve?
|
Marginal mandibular nerve
|
Mental Nerve
|
Long buccal nerve branch of facial
|
Inferior alveolar nerve
| 0
|
single
|
The mandibular branches of the facial nerve run parallel to the lower border of the mandible, mostly below it. Of them, the marginal mandibular nerve follows almost exactly the lower border. Hence, to avoid sectioning of this nerve and causing loss of motor supply to lower lip and mentalis, we give the submandibular incision at lest 2 cm of 2-finger width below the lower border of mandible.
|
Surgery
| null |
2880abd7-1ec6-4456-823e-e5d00159dfec
|
What drug is used for prophylaxis against Pneumocystis jirovecii in patients on chemotherapy?
|
Cotrimoxazole
|
Amoxicillin
|
Dexamethasone
|
Cephalosporin
| 0
|
single
|
Answer- A. CotrimoxazoleDrug of choice for prophylaxis and treatment of pneumocystis infection in both immunocompetent as well as immunocompromised is cotrimoxazole.Cyclospora, Isospora & Pneumocystis jiroveci - Cotrimoxazole
|
Pharmacology
| null |
e3b61d23-b64b-4b3e-86a8-5b0c08cfd375
|
Which disease affects neurons only
|
Spinocerebellar ataxia
|
Supranuclear palsy
|
Corticobasillar degeneration
|
Multiple system atrophy
| 0
|
single
| null |
Medicine
| null |
4a531e44-3ced-400a-8b2b-fa451d885dde
|
Electrical conductivity speed of A α fibres ?
|
70-120
|
50-70
|
30-51
|
20-Oct
| 0
|
single
| null |
Dental
| null |
aa84299f-e4a1-4123-bb64-e280c6a06f23
|
Raised serum alkaline phosphatase is seen in all except:
|
Pagets disease
|
Multiple myeloma
|
Osteomalacia
|
Hyperthyroidism
| 1
|
multi
| null |
Medicine
| null |
1fd04b32-9f12-4f3a-9df0-425c967704af
|
A 24 years old female presented with amenorrhea for 3 months. LH and FSH levels are elevated three times the normal value. What is the next best step?
|
Urinary HCG level
|
Check serum estradiol levels
|
Progesterone challenge test and look for withdrawal bleeding
|
Ultrasound of abdomen and pelvis
| 1
|
multi
|
Answer- B. Check serum estradiol levelsLH and FSH levels by the third montlt of pregnancy are steady st a low level. HCG takes over tlte function of LH after feilization and inhibils production on LH . Inhibin A produced by fetal trophoblasts suppresses maternal FSH secretion. Hence, 3 times elevation of LH and FSH points towards premature ovariun failure. Serum estradiol levels should be measured to confirm the diognosis
|
Gynaecology & Obstetrics
| null |
d5d4cd74-e0f0-4e39-bc84-cc7551c627bd
|
A patient with tubercular meningitis was taking ATT regularly. At end of 1 month of regular intake of drugs deterioration in sensorium is noted in condition of the patient. Which of the following investions is not required on emergency evaluation ?.
|
MRI
|
NCCT
|
CSF examination
|
Liver function tests
| 3
|
single
|
Ans. D (Ref Harrison 19/e pi 111, ThIe p3414)When bacterial meningitis is suspected, blood cultures should be immediately obtained and empirical antimicrobial and adjunctive dexamethasone therapy initiated without delay.The diagnosis of bacterial meningitis is made by examination of the CSF. The need to obtain neuroimaging studies (CT or MRI) prior to LP requires clinical judgment.
|
Medicine
| null |
f13fe47a-739d-40b0-8616-09dc24d83ff7
|
A 10-year old boy was presented with a mass in abdomen. On imaging, the para-aoic lymph nodes were enlarged. On biopsy, starry sky appearance was seen. What is the underlying abnormality?
|
p53 gene mutation
|
Rb gene mutation
|
Translocation involving BCR-ABL gene
|
Translocation involving Myc gene
| 3
|
single
|
Ans: D. Translocation involving Myc geneStarry eye pattern on biopsy - Highly suggestive of Burkitt lymphoma.All forms of Burkitt lymphoma associated with translocations of c-MYC gene on chromosome 8.Burkitt lymphoma:Tumor exhibiting high mitotic index & contains numerous apoptotic cells.Nuclear remnants of apoptopic cells are phagocytosed by interspersed benign macrophages.These phagocytes with abundant clear cytoplasm, creating a characteristic "starry sky" pattern."Etiology:All forms of Burkitt lymphoma are associated with translocations of c-MYC gene on chromosome S.Genetic mutation & associated conditions:TranslocationGene (Chromosome)Malignancy(9;22) (q34;q11)ABL-BCRChronic myeloid leukemia(11;14)(q13;q32)BCL1-IgHMantle cell lymphoma(8;21)RUNX1-RUNX1T1 (15;17)PML-RARAAcute myeloid leukemia(16;16)CBFB-MYH11 (11;22)(q24;q12)FLII-EWSEwing's sarcoma(8;14)(q24;q32)MYC-IgHBurkitt's lymphoma B cell acute lymphocytic leukemiaInv (2p13;p11.2-14)REL-NRGNon-Hodgkin's lymphoma(1;3)(p34;p21)TAL1-TCTAQAcute T cell leukemia(Ref: Robbins 9/e p597)
|
Pathology
| null |
48dacd47-50fa-488e-9ab1-e36dd7e661f2
|
A child is brought to the clinic with complaint of irregular teeth. The maxillary central incisor is rotated in an otherwise normal occlusion. What should the next step be?
|
Check for supernumerary teeth
|
Resection of supracrestal fibers
|
Exert a couple on tooth
|
Fixed orthodontic appliances given
| 0
|
multi
| null |
Dental
| null |
9468ca2d-bf9d-4819-8e72-15c5d9c6df2f
|
A pregnant female presents with fever. On lab investigation her Hb was decreased (7 mg%), TLC was normal and platelet count was also decreased. Peripheral smear shows fragmented RBCs. Which is least probable diagnosis?
|
DIC
|
TTP
|
HELLP syndrome
|
Evans syndrome
| 3
|
single
|
The clinical scenario of the patient shows the following signs and symptoms:
Fever
Anemia
Thrombocytopenia
Normal total leukocyte count
Fragmented RBCs (Schistocytes) on peripheral smear.
Now let us review each option one by one
Option (a): DIC
Harrison 20/e, p 979
DIC may present with sudden onset of fever (as the M/c cause of D/c is sepsis)
Excessive bleeding may lead to anemia
Platelet consumption may lead to thrombocytopenia
Leukocyte count is not affected
Intravascular microangiopathic hemolysis can lead to schistocytes on peripheral smear.
Williams Obs 23/e, p 786
Option (b): TTP i.e Thrombotic thrombocytopenic purpura.
TTP presents with a pentad of:
Fever
Microangiopathic haemolytic anemia, leading to anemia and fragmentation of RBCs
Thrombocytopenia
Neurologic symptoms
Renal failure.
Option (c): HELLP syndrome
HELLP syndrome presents with the combination of:
Hemolysis because of which fragmented RBC’s may be seen
Elevated liver enzymes and
Low platelet count
Fever may or may not be present.
Oprion (d): Evans syndrome
Hoffman: Hematology: Basic Principle and Practice, 5/e
Evans syndrome is an autoimmune disease in which an individual’s antibodies attack their own red blood cells and platelets.
Its overall pathology resembles a combination of autoimmune haemolytic anemia and idiopathic thrombocytopenic purpura.
Autoimmune hemolysis leads to the formation of spherocytes and not schistocytes.
Schistocytes are fragmented RBCs that are the result of microangiopathic hemolysis.
Autoiminune destruction of RBCs leads to the formation of spherocytes.
Hence, Evans syndrome is the least likely possibility in this clinical scenario.
|
Gynaecology & Obstetrics
| null |
2a585c66-7605-44fb-a4fe-63ce327a3b59
|
Coefficient of thermal expansion of which of following is most similar to that of tooth?
|
Gold inlay
|
Acrylic resin
|
Silicate cement
|
Gold foil
| 2
|
single
| null |
Dental
| null |
5029ecd7-0f3f-495a-b662-b45589a2f9d7
|
A baby is born with meconium stained liquor which of the following is taken account of in terming a baby vigorous except –
|
Tone
|
Colour
|
HR
|
Respiration
| 1
|
multi
|
Resuscitation of neonate born through meconium-stained liquer (MSL)
When baby passes meconium in utero, there is a chance that the mecomium will be aspirated into infant's mouth and potentially into the trachea and lungs.
Appropriate steps must be taken immediately after delivery to reduce the risk of serious consequences resulting from aspiration of meconium.
Intrapartum nasopharyngeal suctioning just after the delivery of head is no longer recommended as it does not reduce the risk of meconium aspiration syndrome and, on rare occasions, may cause nasophagngeal trauma or a cardiac arrhythmia.
The first step after delivery is to identify whether the newborn is vigrous or non-vigrous : -
A) Vigrous newborn
A newborn is classified as vigrous, if he has all the three signs are present : -
Strong respiratory effort
Good muscle tone
Heart rate greater than 100
The vigrous child does not require any tracheal suctioning and the usual initial steps of resuscitation are provided, i.e., provide warniith, positioning, suctioning of mouth and nose (not tracheal suctioning); Dry, stimulate and 02 if necessary.
B) Non-vigrous newborn
If any of the above three signs is present, the newborn is classified as non-vigrous.
For non-vigrous child, the initial steps are modified : -
Place the baby under radiant wanner and postpone suctioning to prevent stimulation of posterior pharyngeal wall that can cause bradycardia.
Residual meconium in the mouth and posterior pharynx should be removed by suctioning under direct vision using a laryngoscope.
The trachea should then be intubated and mechonium suctioned from the lower airway. Tracheal suctioning is best done by applying suction directly to the endotracheal tube.
After providing initial steps, the further management is same as with resucitation for other conditions.
|
Pediatrics
| null |
fc14ffd0-c656-43ae-85a4-369a07cb8465
|
Guiding planes help in:
|
For better clasp prediction
|
Vertical to occlusal plane
|
Balanced occlusion
|
Avoid precision attachment
| 0
|
single
| null |
Dental
| null |
fd2aca85-4353-4ac2-9eac-0a043f681685
|
Which of the following arteries does not supply the circle of Willis?
|
Anterior cerebral
|
Middle cerebral
|
Posterior-inferior cerebral
|
Posterior communicating
| 2
|
single
| null |
Anatomy
| null |
2975d2c6-d494-4adf-ba6e-97df6cd7f341
|
Which of the following muscle do NOT work for inversion of foot?
|
Extensor hallucis longus
|
Tibialis anterior
|
Tibialis posterior
|
Peroneus longus
| 3
|
multi
|
Movement Muscle Accessory muscle INVERSION Tibialis anterior Tibialis posterior Extensor hallucis longus Flexor digitorum longus Flexor hallucis longus EVERSION Peroneus longus Peroneus brevis Peroneus teius
|
Anatomy
|
AIIMS 2018
|
ae3d3724-3fd3-433f-9f38-53dfc516e32f
|
X,Y,Z are the ee ions pet meaule..\\ and V=-30. If at resting membrane potential (RMP), when there is no net electro genic transfer, what is the value of Z?
|
20
|
-20
|
80
|
-80
| 2
|
single
|
Ans. c. +80 Resting membrane potential (RMP) is the static state of a membrane, where the net transmembrane electric flux is zero. Non-electrogenic transfer at RMP means X+Y+Z = 0 . Since X = -50 and Y= -30, then Z must be +80 since (-80 +80 = 0)
|
Physiology
| null |
218972be-3960-421c-bdc4-8a7627c5e548
|
A child presented at 18 months of age who has never been vaccinated before. Which vaccines will you administer?
|
DPT, OPV and MMR
|
Pentavalent vaccine alone
|
BCG and OPV
|
MMR, OPV, Rotavirus
| 0
|
single
|
Age Vaccine At bih BCG, bOPV-0, Hep B-0 6 weeks bOPV-1, Pentavalent-1, Rotavirus-1*, fIPV-1, PCV-1* 10 weeks bOPV-2, Pentavalent-2, Rotavirus-2* 14 weeks bOPV-3, Pentavalent-3, Rotavirus-3*, fIPV-2, PCV-2* 9 months MR-1*, JE-1*, PCV-3* 16-24 months DPT-B1, bOPV-B, JE-2*, MR-2* 5-6 years DPT-B2 11-13 yrs HPV-1*, HPV-2* BCG and Pentavalent can be given only up to 1st yr. of age, as per national immunization schedule
|
Pediatrics
|
AIIMS 2017
|
5e4ed012-82d6-41c4-840f-6301167cf8f4
|
For propofol all are true except
|
Has a rapid recovery rate
|
Used for induction & maintenance of anesthesia
|
Causes vomiting after use
|
Causes sedation
| 2
|
multi
| null |
Surgery
| null |
5aee6779-b362-43fd-acd1-10790f873db9
|
Following a blunt trauma abdomen, a patient had renal laceration and urinoma. Even after 12 days, urinoma persisted, but the patient was stable and there was no fever. Next step in management would be:
|
Percutaneous exploration and repair
|
Wait and watch
|
J-shaped urinary stent
|
Percutaneous nephrostomy
| 2
|
multi
|
Ans. c. J-shaped urinary stentManagement of urinoma is by endoscopic intervention, with cystoscopy, retrograde pyelography, placement of a ureteral stent, urethral catheter drainage, and intravenous antibiotics."Although most post-traumatic urinomas are asymptomatic and have a spontaneous resolution rate approaching 85%, urinomas will occasionally persist.A small amount of urinary extravasation is usually not significant as long as they do not become infected.Initially, we treat the trauma by ureteric stentingOnly for large urinoma, we drain by percutaneous drainage.
|
Surgery
| null |
30bbcf29-59e9-4d70-9616-e37190efe906
|
Which of the following is unlikely to cause enamel hypoplasia?
|
Rickets
|
Fluoride
|
Congenital syphilis
|
Cleidocranial dysostosis
| 3
|
single
| null |
Pathology
| null |
2be4ec28-ff65-4ba0-9a8f-346a819c99f1
|
Thiamine deficiency decreases cellular metabolism because:
|
Thiamine is a coenzyme for pyruvate dehydrogenase and alfa-ketoglutarate dehydrogenases
|
Activity of transketolase is inhibited
|
It is required for the process of transamination
|
It is a cofactor in oxidative reduction
| 0
|
single
|
Thiamine deficiency results in decreased energy production because TPP interferes with its coenzyme for pyruvate and alphaketoglutarate dehydrogenase.Chronic peripheral Neuritis, Beriberi & Wemicke Encephalopathy with Korsakoff's Psychosis.Thiamin requirements increase in excess intake of carbohydrates and its deficiency leads to decreased energy production
|
Biochemistry
| null |
7085009a-0a8d-4282-ab69-0aec3ef446ad
|
In a bus accident, which patient is given more priority to
shift to the hospital?
|
Severe haemorrhage with leg fracture
|
Head injury
|
Circulation shock
|
Airway obstruction
| 0
|
single
| null |
Surgery
| null |
a7372237-057a-44b5-8821-51c14b52b8ee
|
Excessive bleeding during oral surgery can be decreased in which position?
|
Head up
|
Head down
|
Prone
|
Supine
| 0
|
single
| null |
Surgery
| null |
1ffbf5bf-f16b-4263-b979-73eccca481db
|
Incidence of 2 canals in mandibular incisors is
|
3 - 12%
|
12 - 20%
|
20 - 41%
|
Less than 3%
| 2
|
single
| null |
Dental
| null |
f3fac8a7-d3e8-4d02-b4eb-4ac18da8e7c0
|
What is the use of the given instrument:
|
To hold bone and plate
|
To hold bone fragments with traction
|
To cut the bone
|
For creating a gap in wound
| 0
|
single
|
For creating a gap in wound Bone Cutter Bone Nibbler Double Action Bone Holding Forceps Bone Plate Holding Forceps Fergusson Bone Holding Forceps Lane Bone Holding Forceps Dynamic Compression Plate (DCP) Locking Compression Plate (LCP) Limited Contact Dynamic CompressionPlate (LCDCP) Screws Osteotome Bone Curette
|
Orthopaedics
|
AIIMS 2019
|
bf0eabec-95a0-46e1-a9b7-dae6c29dadde
|
Asphyxial injury in a term baby is characterized by all except –
|
Seizures
|
Differential hypotonia (lower limbs > upper limbs)
|
Altered sensorium
|
Difficulty in clearing oral secretions
| 1
|
multi
|
Effects ofAsphaxia :
Central nervous system- Cardiovascular
Hypoxic ischemic encephalopathy o Myocardial ischemia
Infarction o Poor contractility
Intracranial hemorrhage o Tricuspid insufficiency
Seizures o Hypotension
Cerebral edema o Pulmonary
Hypotonia o Pulmonary hypertension
Hypertonia o Pulmonary hemorrhage
o Respiratory distress syndrome
Renal —> Acute tubular or cortical necrosis
Adrenal —> Adrenal hemorrhage
Metabolic --> SIADH, Hyponatremia, Hypoglycemia, Hypocalcemia, Myoglobinuria
Integument -+ Subcutaneous fat necrosis
Hematology -p DIC
Gastrointestinal —> Perforation, Ulceration with hemorrhage, Necrosis
During asphyxia the infant may remain hypotonic or change from hypotonia to extreme hypertonia or their tone may appear normal. These changes are seen simultaneously and the change in muscle tone is also of the same degree in both the limbs.
|
Pediatrics
| null |
ff42704e-3996-4abe-a5b6-574344e7aaf0
|
Which of the following is not an etiological factor for pancreatitis?
|
Abdominal trauma
|
Hyperlipidemia
|
Islet cell hyperplasia
|
Germline mutations in the cationic trypsinogen gene
| 2
|
single
|
Ans. c. Islet cell hyperplasiaGallstones including microlithiasis (MC). Alcohol (2"d MC). Hyperiglyceridemia. ERCPO. Blunt abdominal trauma
|
Surgery
| null |
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