Instruction:
Difference between primary and secondary healing is -
A. More granulation tissue and fibrosis is seen in secondary healing
B. Scar is more cosmetic in secondary healing
C. Secondary healing occurs faster
D. Surgical wound heal commonly by secondary healing

Response:
Ans. is 'a' i.e., More granulation tissue and fibrosis is seen in secondary healing Primary Healingo Primary wound healing or healing by first intention occurs within hours of repairing a full-thickness surgical incision. This surgical insult results in the mortality of a minimal number of cellular constituents.Delayed Primary Healingo If the wound edges are not reapproximated immediately, delayed primary wound healing transpires. This type of healing may be desired in the case of contaminated woundsSecondary Healingo A third type of healing is known as secondary healing or healing by secondary intention. In this type of healing, a full-thickness wound is allowed to close and heal. Secondary healing results in an inflammatory response that is more intense than with primary wound healing. In addition, a larger quantity of granulomatous tissue is fabricated because of the need for wound closure. Secondary healing results in pronounced contraction of wounds.

So the answer to this question is A


Instruction:
Which of the following muscle lies between superficial and deep pas of submandibular salivary gland?
A. Hyoglossus
B. Styloglossus
C. Mylohyoid
D. Geniohyoid

Response:
Submandibular gland is a large salivary gland situated in the anterior pa of the digastric triangle. It is roughly J-shaped,being indented by the posterior border of the mylohyoid which divides into a larger pa superficial to the muscle,and a small pa lying deep to the muscle. Reference: B D Chaurasia's human anatomy; 5th edition, page.166.

So the answer to this question is C


Instruction:
Streptococcus causing rheumatic hea disease is
A. Streptococcus milleri
B. Streptococcus mutans
C. Streptococcus pyogenes
D. Streptococcus equisimilis

Response:
Streptococcus pyogenes infection leads to two impoant non-suppurative post-streptococcal sequelae - acute rheumatic fever and acute glomerulonephritis. This complication ensues 1-3 weeks after the acute infection so that the organism may not be detectable when sequelae set in. In rheumatic fever, carditis, including connective tissue degeneration of the hea valves and inflammatory myocardial lesions characterized by Aschoff nodules is seen. Occurs due to an antigenic cross-reaction between group A carbohydrate of Streptococcus pyogenes and cardiac valves Streptococcal antigens cross-reactive with human tissues Streptococcal antigen Human antigen Disease Hyaluronic acid Synol fluid Reactive ahritis Cell Wall M protein Myocardium ARF(Acute rheumatic fever) Cell Wall C carbohydrate Cardiac Valves ARF(Acute rheumatic fever) Peptidoglycan Skin antigens Guttate psoriasis Cytoplasmic membrane Glomerular vascular intima Acute glomerulonephritis (AGN) Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 215

So the answer to this question is C


Instruction:
Which one of the following is NOT an advantage of immediate dentures:
A. reduced post operative pain
B. easy adaptation
C. less chairside time
D. none of the above

Response:
None

So the answer to this question is C


Instruction:
A 60-year-old man with a chronic cough, bloody sputum, and marked weight loss is diagnosed as having tuberculosis. A "serpentine-like" colonial morphology is noted on Lowenstein-Jensen agar. This latter finding is caused by which of the following factors?
A. A large "slimy" capsule
B. Wax D
C. Coagulase
D. Cord factor

Response:
Ans. D. Cord factora. Virulent strains of M. tuberculosis grow in a characteristic "serpentine" cordlike pattern, whereas avirulent strains do not.b. Virulence of the organism is correlated with cord factor (trehalosedimycolate).

So the answer to this question is D


Instruction:
Which of the following behavioural problems would suggest an organic brain lesion
A. Formal thought disorder
B. Auditory hallucinations
C. Visual hallucinations
D. Depression

Response:
Visual hallucinations are more common in acute organic states with clouding of consciousness than in functional psychosis. Visual hallucinations are extremely rare in schizophrenia, so much so that they should raise a doubt about the diagnosis. Fish's Clincal Psychopathology 3rd edition, pages 23,24.

So the answer to this question is C


Instruction:
A patient with Carcinoma cheek has tumor of 2.5 cms located close to and involving the lower alveolus. A single mobile homotateral node measuring 6 cm is palpable. Based on these clinical findings TNM stage of the tumor is
A. T1 N1 Mo
B. T2 N2 Mo
C. T3 N1 Mo
D. T4 N2 Mo

Response:
None

So the answer to this question is B


Instruction:
The most important function of sentinel surveillance is
A. To determine the trend of disease in a population
B. To notify disease
C. To find the total amount of disease in a population
D. To plan effective control measures

Response:
Sentinel Surveillance

It estimates disease prevalence in a population.
It is a method for identifying the missing cases and thereby supplementing the notified cases.

So the answer to this question is C


Instruction:
Streak ovaries are seen in: CMC (Vellore) 09
A. Klinefelter syndrome
B. Turner syndrome
C. Down syndrome
D. Kallamann syndrome

Response:
Ans. Turner syndrome

So the answer to this question is B


Instruction:
All of the following are peripherally acting muscle relaxants except
A. Dantrolene
B. Pancuronium
C. Succinyl choline
D. Baclofen

Response:
Baclofen is a GABA - B agonist that acts centrally to produce muscle relaxation.

So the answer to this question is D


Instruction:
F factor integrates with bacterial chromosome to form -
A. HFr
B. F+r
C. F-
D. F

Response:
Factor: The F factor is the transfer factor that contains the genetic information necessary for the synthesis of sex pilus and for self-transfer but is devoid of other identifiable genetic markers such as drug resistance. Cells carrying the F factor have no distinguishing feature other than their ability to mate with F - cells and render them F+. he F factor is actually an episode and has the ability to exist in some cells in the integrated data or inseed into the host chromosome. Such cells are able to transfer the chromosomal gene to recipient cells with high frequency and are known as Hfr cells. following conjugation with an Hfr cell an F- only rarely becomes F+ though it receives chromosomal genes from the donors. REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8thEdition pg no:65

So the answer to this question is A


Instruction:
Floor space of 2 persons –
A. 70–90 sq.ft
B. 90–100 sq.ft
C. 50–70 sq.ft
D. 110–120 sq.ft

Response:
None

So the answer to this question is D


Instruction:
A 37-year-old woman comes to the emergency depament with sudden onset of left leg weakness. There is no history of any prior medical illness. On neurological examination, there is no wasting, muscle tone is normal, deep-tendon reflexes are normal, and plantars show 'flexor' response. The patient cannot raise her left leg off the bed while supine and is very worried that something is wrong. MRI brain does not reveal any abnormality. Which of the following is the most likely diagnosis?
A. Conversion disorder
B. Factitious disorder
C. Illness anxiety disorder
D. Malingering

Response:
This patient had a sudden onset of neurological symptoms , and the symptoms and clinical examination findings are inconsistent. This is a strong pointer towards conversion disorder. Please note that there is no la belle indifference (lack of concern for the symptoms) in this patient. La belle indifference is not seen in all patients with conversion disorder. In contrast to conversion disorders, patient with factitious disorders voluntarily produce the symptoms and the question gives a hint about it.

So the answer to this question is A


Instruction:
Most immunogenic in
A. 0 antigen
B. H antigen
C. Vi antigen
D. Somatic antigen

Response:
Ans. is 'b' i.e., H. antigen

So the answer to this question is B


Instruction:
Keratoconus is defined as: March 2013 (h)
A. Degeneration of conjunctiva
B. Cornea undergoes necrosis due to vitamin A deficiency
C. Cornea thins near the centre & bulges forwards
D. Recurrent corneal ulcerations of cornea

Response:
Ans. C i.e. Cornea thins near the centre & bulges forwards

So the answer to this question is C


Instruction:
Pseudocoma results from infarction or haemorrhage in-
A. Pons
B. Mid-brain
C. Medulla
D. Hypothalamus

Response:
None

So the answer to this question is A


Instruction:
Wernicke's hemianopic pupil is seen in the lesion of
A. Optic tract
B. Optic nerve
C. Optic chiasma
D. Occipital lobe (visual coex)

Response:
Wernickes hemianopic pupil is seen in the lesion of optic tracts - characterized by contralateral homonymous hemanopia with a characteristic pupillary response. Narrow beam of light when shown into the non-seeing pa of the retina, pupil fails to react while when shown into the seeing pa of the retina, pupillary constriction occurs. Make your concept - Homonymous means same side (i.e. right or left) - Heteronymous means opposite side (i.e. nasal or temporal) - Congruous means same shape or symmetric on both sides - Incongruous means different shape or asymmetric on both sides - Hemianopia means half side is involved - Generally Anterior lesions cause heteronymous, incongruous defects and posterior lesions cause more homonymous and congruous defects Impoant Points on Visual Pathway Lesions 1. Optic nerve lesion - I/l direct and c/ L consensual gone Causes - optic atrophy/ optic neuritis - avulsion optic nerve 2. Proximal pa of optic nerve - I/L blindness C/L hemianopia 1. Saggital chiasma lesion - Bitemporal hemianopia - Paial descending optic atrophy Causes - suprasellar aneurysm - tumors of pitutory craniopharyngioma - suprasellar meningioma 2. Lateral chiasma - Binasal hemianopia of pupillary reflex Causes - Distention of 3rd ventricle Since some fibres of other side there is crossover Binasal Hemianopia 3. Optic tract Lesion- - Contralateral homonymous hemianopia with incongruity - Bow tie pattern of optic atropy 5.Temporal lobe lesion - contralateral homonymous superior quadrantanopia (pie in the sky defect) 6. Parietal Lobe lesion- Pie in the floor. Contralateral homonymous inferior quadrantanopia Homonymous hemianopsia, also referred to as homonymous hemianopia is the loss of half of the field of view on the same side in both eyes. Left superior homonymous quadrantanopia Left inferior homonymous quadrantanopia 7.Keyhole visual field defects: Vascular lesion of Lateral Geniculate body 8. Occipital lobe lesion Congruous homonymous hemianopia with sparing of macula Cause: Occlusion of posterior cerebral aery Congruous Homonymous macular defect Cause: Bullet injury/ head injury Bilateral homonymous macular defect Cause: Bilateral occipital defect

So the answer to this question is A


Instruction:
Facial artery arises at the level of:
A. Below hyoid bone
B. Above hyoid bone
C. Hyoid bone
D. Above Styloid process

Response:
None

So the answer to this question is B


Instruction:
A 19 yrs old male has a small circumscribed sclerotic swelling over diaphysis of femur, likely diagnosis is:
A. Osteoclastoma
B. Osteosarcoma
C. Ewing's sarcoma
D. Osteoid osteoma

Response:
Sclerotic lesion over diaphysis of a long bone in a young patient indicative of osteoid osteoma. Ref: Essential Ohopedics By Maheshwari 2nd Edition, Page 213

So the answer to this question is D


Instruction:
After applying a statistical test, an investigator gets the ‘P value’ as 0.01. it means that
A. The probability of finding a significant difference is 1%
B. The probability of declaring a significant difference is 1%
C. The difference is not significant 1% times and significant 99% times
D. The power of the test used is 99%

Response:
None

So the answer to this question is B


Instruction:
Most common cause of acute tonsilitis ?
A. Streptococcus pneumoniae
B. H. Influenza
C. 13- hemolytic streptococci
D. Staphylococcus aureus

Response:
Ans. is 'c' i.e., 13- hemolytic streptococci Tonsils frequently serve as the site of acute infection, which causes acute tonsillitis. Tonsillitis is paicularly common in children, especially in school going age group. However, it can occur in adult also. Virus initiates an acute tonsillitis attack and predisposes to bacterial infection. 8-hemolytic streptococcus is the most common organism causing acute tonsillitis. Other bacteria causing acute tonsillitis are staphylococcus, hemophilus and pneumococcus.

So the answer to this question is C


Instruction:
Consequence of maternal use of cocaine is:
A. Hydrops
B. Sacral agenesis
C. Cerebral infarction
D. Hypertrichosis

Response:
Cocaine addiction can cause – miscarriage, intrauterine fetal death, PROM, preterm labour and IUGR.
It can lead to the following Malformations in the fetus:

Microcephaly, cutis aplasia, porencephaly, subependymal and periventricular cysts, ileal atresia, cardiac anomalies, visceral infarcts, limb reduction defects and genitourinary malformations.
It produces cerebral infarction and periventricular leukomalacia in the fetus.
The risk of malformations in the embryo/fetus is highest after the first trimester.

So the answer to this question is C


Instruction:
If the distance between the tip of tongue and insertion of lingual frenum is 6 mm, then it will be:
A. Mild ankyloglossia
B. Moderate ankyloglossia
C. Severe ankyloglossia
D. Complete ankyloglossia

Response:
Class 1 - Mild ankyloglossia - 12-15 mm
Class 2 - Moderate ankyloglossia - 8-11 mm
Class 3 - Severe ankyloglossia - 4-7 mm
Class 4 - Complete ankyloglossia - 0-3 mm.

So the answer to this question is C


Instruction:
Wredin's test is significant in live born fetus related to
A. Lungs
B. Stomach
C. Skull
D. Middle ear

Response:
Wredin's test After bih, the gelatinous substance in the middle ear is replaced by air through Eustachian tube. This is now considered as not a reliable test. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 351

So the answer to this question is D


Instruction:
Alpha waves are typically seen in which of the following states:
A. Deep sleep
B. Relaxed awake
C. Awake ale
D. Highly focused

Response:
Alpha waves are typically seen in a relaxed yet awake state. Alpha waves are one type of brain waves detected either by electroencephalography (EEG) that predominantly originate from the occipital lobe during wakeful relaxation with closed eyes. Alpha waves are reduced when eyes are opened (patient becomes ale : transition to Beta waves) or when patient drifts into sleep (Transition to Theta waves) Waves State Associated states Gamma waves Frequency: 32-100 Hz Conscious, Highly focused Heightened perception, Heightened learning & problem-solving tasks Beta waves Frequency: 13-32 Hz (Fast Dyschronous Activity) Conscious ale Active thinking (Active conversation; Making decisions; solving a problem; Focusing on a task; Learning a new concept Alpha Waves Frequency: 8-13 Hz (Synchronous Activity) Conscious Relaxed (Relaxed Awake with eyes closed) Physically and mentally relaxed They become detectable when the eyes are closed and the mind is relaxed They may also often be going during activities such as Yoga; mild meditation and visualisation Theta waves Frequency: 4-8 Hz (Slow rhythmic Activity) Reduced Consciousness Creativity, insight, dreams, reduced consciousness Most frequently, Theta waves are strongly detectable when we&;re dreaming in our sleep Deep Meditation and Dreaming Also in Day-dreaming Seen in Stage-1 NREM sleep Seen in REM sleep (Dreaming) Humans aroused at a time when they show the EEG characteristics of REM sleep generally repo that they were dreaming Delta waves Frequency : 0.5-4 Hz (Large Rhythmic Activity) Unconscious state Deep sleep (Dreamless) These are the slowest of all brain waves, and are strongest when we are enjoying restorative sleep in a dreamless state. Typically seen in NREM Sleep stage III and IV Ref: Guton and Hall 25th edition

So the answer to this question is B


Instruction:
Tissue bridges are seen in: DNB 10
A. Abrasion
B. Contusion
C. Laceration
D. Stab wound

Response:
Ans., Laceration

So the answer to this question is C


Instruction:
Cone biopsy is indicated in all the following conditions except :
A. Indefinite diagnosis on colposcopy
B. CIN-III
C. Cervical metaplasia
D. Microinvasive carcinoma

Response:
Ans. is c i.e. Cervical metaplasia ications of Cone bi biopsy or conization is both Diagnostic as well as therapeutic procedure. Complications of cone biopsyCone : Diagnostic Therapeutic Limits of the lesion can not be visualised with coloposcopy.deg The squamo-columnar junction is not seen at colposcopydeg In endocervical curettage - histological findings are positive for CIN-II or CIN - IIIdeg Micro invasive carcinoma or adenocarcinoma in situ is suspected based on biopsy, colposcopy or cytology results Lack of correlation between cytology, biopsy & colposcopy results Infectiondeg A Cervical stenosisdeg Incompetent osdeg Conisation for a lesion grossly suggestive of invasive cancer is not indicated, as it predisposes the patient to serious pelvic infections and bleeding. The diagnosis is confirmed by a simple biopsy / colposcopic directed biopsy. Remember : Spread of malignancy is not a complication of cone biopsy. Extra edge : AgNOR : It is a new molecular tumor marker which stands for silver stained nucleolar organizer DNA is present in dysplastic cells. They appear as black dots which increase in number but decrease in sizze with advancing dysplasia. The lesions with low counts often regress, whereas those with high counts progress and need treatment.

So the answer to this question is C


Instruction:
A 25 year old university student had a fight with the neighboring boy. On the next day, while out, he started feeling that two men in police uniform were observing this movement. When he reached home in the evening he was frightened. He expressed that police was after him and would arrest him. His symptoms represent:
A. Delusion of persecution
B. Ideas of reference
C. Passivity
D. Thought insertion

Response:
Delusion of Persecution :

The patient has delusions that he is being persecuted against, e.g. 'people are against me'.

Thought Insertion:

Subject experiences thoughts imposed by some external force on his passive mind.

Somatic Passivity :

Bodily sensations especially sensory systems, are experienced as imposed on the body by some external force e.g. Robot, X-ray waves

So the answer to this question is A


Instruction:
Lacunar cells are seen in
A. Lymphocyte predomninat HL
B. Lymphcyte depleted HL
C. Nodular sclerosis
D. Mixed cellularity

Response:
Hodgkins Lymphoma*Hodgkin lymphoma encompasses a group of lymphoid neoplasms*Arise almost invariably in a single lymph node or chain of lymph nodes and spread characteristically in a stepwise fashion to the anatomically contiguous nodes. Hence staging is impoant.*Its characterized by presence of noeplastic giant cells called as Reed-Sternbergs cell with two nuclear lobes, large inclusion-like nucleoli and abundant cytoplasm.Classification1.Nodular sclerosis2.Mixed cellularity3.Lymphocyte rich4.Lymphocyte depleted5.Lymphocyte predominanceCharacteristics of different subtypes of Hodgkin lymphomaSubtypeMorphology Background infiltrateImmunophenotypeNodular sclerosisLacunar cellsOccasional RS cellsT cells, esinophils, macrophages, plasma cellsCD15+ CD30+ EBV-Mixed cellularityMononuclear cells ( Hodgkin cell) & RS cellT cells, esinophils, macrophages, plasma cellsCD15+ CD30+ EBV+ (70%)Lymphocyte richMononuclear cells ( Hodgkin cell) & RS cellT cells richCD15+ CD30+ EBV+ (40%)Lymphocyte depletedFrequent RS cellsPaucity of background reactive cellsCD15+ CD30+ EBV+ (90%)Lymphocyte predominanceFrequent L&H (popcorn cells)Follicular dentritic cells and reactive B cellsCD15- CD30- EBV- CD20+Note: 1) L&H - lymphocytic and histiocytic variant of Hodgkin lymphoma seen in Lymphocyte predominant subtype. 2) CD 15 and 30 are the classical markers of Hodgkin lymphoma 3) Lymphocyte predominant is different from the other 4 subtypes of Hodgkin lymphoma. Hence called as a NONCLASSICAL variant.4) Prognosis Excellent - Nodular sclerosis, Mixed cellularity, Lymphocyte-rich, Lymphocyte predominant Less orable- Lymphocyte depleted(Ref: Robbins 8/e p618, 7/e p422-423)

So the answer to this question is C


Instruction:
NSAID used commonly for topical ocular use is-
A. Ibuprofen
B. Aceclofenac
C. Ketorolac
D. Acetaminophen

Response:
(Refer: AK Khurana Comprehensive Ophthalmology, 6th edition, pg no. 454 – 455)
Commonly used topicalocular NSAIDS

Ketorolac
Flurbiprofen
Diclofenac sodium

So the answer to this question is C


Instruction:
A patient with burns die within 24 hours. What could be the most probable cause:
A. Circulatory shock
B. Physical burn injury to the airways above the larynx
C. Physical burn injury to the airways below the larynx
D. Circumferential burn

Response:
Ans. B: Physical burn injury to the airways above the larynx Inflammatory and circulatory changes in burn patient produce a net flow of water, solutes and proteins from the intravascular to extravascular space. This flow occurs over the first 36 hours after the injury. As the burn size approaches 10-15% of the total body surface area (TBSA), the loss of intravascular fluid can cause a level of circulatory shock Once burned, the linings of nose, mouth, tongue, palate and larynx will sta to swell. After a few hours, they may sta interfere with the larynx and may completely block the airway, if action is not taken to secure an airway Physical burn injury to the airways below the larynx is a rare injury Circumferential burns may compromise circulation to a limb

So the answer to this question is B


Instruction:
Peripheral neuritis with characteristic ‘wrist drop’ or 'foot drop' is seen in:
A. Lead poisoning
B. Mercury poisoning
C. Copper poisoning
D. Bismuth poisoning

Response:
Lead intoxication is manifested by serious gastrointestinal disturbances which include nausea, vomiting, colic, and constipation. A peripheral neuritis also develops which may produce the characteristic wrist-drop or foot-drop.
Ref: Shafer's textbook of oral pathology 7th edition page 558

So the answer to this question is A


Instruction:
For Karyotype analysis of stillborns, recommended tissue sample is all except
A. Umbilical cord segment about 1.5 cm long
B. Fetal patella
C. Placental block taken below cord insertion
D. Fetal skin

Response:
Skin of Fetus is not recommended as tissue sample for karyotyping.

So the answer to this question is D


Instruction:
All of the following are used in the treatment of Thrombotic Thrombocytopenic Purpura, Except.
A. Plasmapharesis
B. Coicosteroids
C. Immunotherapy
D. Heparin

Response:
Answer is D (Hepari) Heparin and platelet transfusions are not used in the treatment of Thrombotic Thrombocytopenic Purpura Heparin and platelet transfusions are not used in treatment of TTP 'Heparin is not indicated in the treatment of TTP-HUS. Platelet transfusion is also not indicated and may worsen neurological symptoms and renal dysfunction. Platelet transfusion can lead to the geeration of new or expanding thrombi, as the infused platelets are transfused' - Cleveland Clinic. Internal Medicine Case Reviews (2003)/153 Plasmapharesis, Coicosteroids and Immunotheram may he used in treatment of TTP Plasmapharesis forms the mainstay of treatment for TTP. Coicosteroids and lmmunotherapy may be used as adjuncts to plasma exchange in refractory /relapsed cases.

So the answer to this question is D


Instruction:
Initial treatment of keloid
A. Topical steroid
B. Intralesional steroid
C. Excision
D. Radiotherapy

Response:
Answer- B. Intralesional steroidIntralesional injection of steroid (Triamcinolone acetate) is now recommended as the first line of t/t for keloid.

So the answer to this question is B


Instruction:
A person developing hatredness towards his brother starts, overcaring him and brings gifts to him.This is an example of
A. Sublimation
B. Passive aggression
C. Reaction formation
D. Dissociation

Response:
Reaction formation is a neurotic defense mechanism where an individual transforms his feelings into exact opposite.

So the answer to this question is C


Instruction:
All are non-proliferative glomerulonephritis, except:
A. Membranous glomerulonephritis
B. Mesangiocapillary glomerulonephritis
C. Diabetic glomerulosclerosis
D. Amyloidosis

Response:
Conditions with Proliferative Glomerulonephritis : SLE (paicularly class II) HIV Membranoproliferative/Mesangiocapillary glomerulonepritis Neoplasia (CLL and MALT lymphoma) Post streptococcal glomerulonephritis Rest all options are the conditions with non proliferative glomerulonephritis.

So the answer to this question is B


Instruction:
Leeway space is used during:
A. Early mesial shift.
B. Late mesial shift.
C. Mesial step.
D. None

Response:
None

So the answer to this question is B


Instruction:
Ether was first used by:
A. Preistly
B. Moon
C. Wells
D. Simpson

Response:
Moon

So the answer to this question is B


Instruction:
Serious infections can occur when absolute neutrophil count decreases to?
A. Less than 500/mL
B. Less than 800/mL
C. Less than 1000/mL
D. Less than 1500/mL

Response:
a. Less than 500/mL(Ref: Nelson's 20/e p 1048, Ghai 8/e p 357)Serious infections are most likely when the neutrophil count falls below 500 per mm3.

So the answer to this question is A


Instruction:
Toxic shock syndrome is caused by
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Streptococcus albicans
D. Enterococcus Durans

Response:
Toxic shock syndrome is a potentially fatal multisystem disease caused by Staphylococcus aureus. Present as fever, hypotension, myalgia, vomiting, diarrhea, mucosal hyperemia and an erythematous rash which desquamates subsequently. This is associated with infection of mucosal or sequestered sites by toxic shock syndrome toxin (TSST)-Producing S.aureus strains usually belonging to bacteriophage group I.TSST type I (formerly known as enterotoxin type F or pyrogenic exotoxin C)is most often responsible, though enterotoxin B or C may also cause the syndrome . Staphylococcal enterotoxins and TSST -1 are superantigens which are a potent activator of T lymphocytes. Being Vbeta-restricted T cell mitogens, such superantigens stimulates large numbers of T cells without relation to their epitope specificity. This leads to excessive and deregulated immune response, with the release of cytokines interleukins 1,2, tumour necrosis factor and interferon gamma. This explains multisystem involvement and florid manifestation in staphylococcal food poisoning and TSS. Soft tissue infections with some M types of S.pyogens (1,3,12,28) may sometimes cause a toxic shock syndrome resembling staphylococcal TSS. Streptococcal TSS and necrotizing fasciitis occur in persons not immune to the infecting M types Ref: Textbook of Microbiology; Ananthanarayanan and Panicker; Tenth Edition; Page No: 204, 215

So the answer to this question is B


Instruction:
An investigator is studying the impact seatbelts have on the severity of injuries incurred during a motor vehicle accident.

Which of the following study designs would be most appropriate for answering this question?
A. Case series
B. Case-control study
C. Cohort study
D. Clinical trial

Response:
None

So the answer to this question is B


Instruction:
Maximum damage to Napoleon’s army during his march to Moscow was done by
A. Diarrhea
B. Plague
C. Typhus
D. Typhoid

Response:
None

So the answer to this question is C


Instruction:
All are true for octeride except -
A. Used in Acromegaly
B. Used orally
C. Given in secretory diarrhea
D. Used in poal hypeension

Response:
Ans. is 'b' i.e., Used orally Octeride o It is synthetic somatostatin analogue. o It is more potent and longer acting than somatostatin --> preferred over somatostatin. o It is used in acromegaly, bleeding esophageal varices (poal hypeension) and secretory diarrhea associated with carcinoid, WDHA syndrome, gastrinoma and glucagonoma.

So the answer to this question is B


Instruction:
All of the following are known risk factors for the development of ovarian carcinoma except :
A. Family history of ovarian carcinoma
B. Use of oral pills
C. Use of Clomiphene
D. BRCA - 1 positive individual

Response:
Ans. is b i.e. Use of oral pills Oral pills decrease risk of developing ovarian carcinoma. Risk factor for ovarian cancer : Factors related to ovary Personal Factors Genetic disease PCOD Ovulation inducing drugs Exogenous estrogens Family history High dietry intake of saturated fat Nulliparity Turner syndrome - increases risk of dysgerminoma and gonadoblastoma Breast ovarian cancer syndrome - related to mutation in BRCA-1 & BRCA-2 HNPCC syndrome = Lynch II syndrome - associated with colon cancer, Facto. ....t.;;Aeasing ovarian cancer : Oral contraceptive pills (decrease risk by 50% for user of 5 years or longer) Pregnancy - (Risk reduction of 13 to 19% per pregnancy) Breast feeding - Chronic anovulation - Multiparity Tubal ligation, hysterectomy. Remember :A simple "Funda" Repeated ovulation increases the risk of ovarian cancer. So, anovulation, pregnancy, multiparity and breast feeding are protective against ovarian cancer.

So the answer to this question is B


Instruction:
In tetany hyperexcitability is due to
A. Low ca ++ causes T permeability to Na+
B. Prevent K. release
C. Prevent Na* & IC- release
D. I.Ca+' produce generation of AP

Response:
A i.e. Low Ca++ CausesT Na+ permeabilityA decrease in extra cellular Ca++ Concentration increases the excitability of nerve and muscle cells by decreasing the amount of depolarization necessary to initiate the change in Na+ & IC' conductance that produce the action potentialQ. In fact Ca++ needs to fall only 50% below the normal before spontaneous discharge occur from peripheral nerves, often causing tetany.The voltage gated calcium channels are slightly permeable to Na+ as well as Ca++;when they are activated both Na+ and Ca++ flow to interior of the fiber. When there is deficit of Ca2+ in ECF, Na+ channels become activated (opened) by very little change of membrane potential (from its very negative resting level to a less negative level). Therefore nerve fibers become highly excitable. Sometime discharging repetitively without provocation rather than remaining in resting stage.Conversely, an increase in ECF Ca++ stabilizes the membrane by decreasing excitability.

So the answer to this question is A


Instruction:
Which one of the following sites of endometriosis is not treated by medical therapy :
A. Rectosigmoid
B. Ovarian
C. Episiotomy
D. Pulmonary

Response:
Ovarian

So the answer to this question is B


Instruction:
Cervical cord injury does not cause:
A. Homer's syndrome
B. Loss of sensation over face
C. Spasticity of foot
D. None

Response:
Answer is B (Loss of sensation over face) Cervical cord injury is not associated with loss of sensations over face. Cervical cord injury may be associated with wasting and fasciculations over the limbs but not on the lower limbs.

So the answer to this question is B


Instruction:
Glucose-6 Phosphatase deficiency is seen in
A. Von Gierke disease
B. Tay sach disease
C. Pompe disease
D. Anderson disease

Response:
NameEnzyme DeficiencyClinical FeaturesVon Gierke diseaseGlucose-6-phosphataseGlycogen accumulation in liver and renal tubule cells;hypoglycemia; lactic acidemia; ketosis; hyperlipemiaRef: Harper&;s Biochemistry; 30th edition; Chapter 18 Metabolism of Glycogen; Page no: 179

So the answer to this question is A


Instruction:
Which hormone is conveed into active form in liver?
A. Coicosteroid
B. ACTH
C. Thyroid hormone
D. Estradiol

Response:
Ans. is'c'i.e., Thyroid hormone(Ref Principles of medical physiology lt p.71)Thyroxine (T4) is conveed to T, (active form) in liver (majority) and kidney.

So the answer to this question is C


Instruction:
Which toxin of streptococcus causes hemolysis -a) Streptolysin Ob) Streptolysin Sc) Streptodornase d) Hyaluronidase
A. ac
B. a
C. ad
D. ab

Response:
None

So the answer to this question is D


Instruction:
With regards to hereditary spherocytosis, which of the following is false
A. Usually has autosomal dominant inheritance
B. Caused by mutations in genes for proteins such as spectrin, ankrin or band 3
C. Red blood cells are destroyed in the spleen
D. Aplastic crises are common

Response:
Ans. is 'd' i.e., Aplastic Crisis are common Aplastic crisis are a rare/uncommon complication of Hereditary Spherocytosis typically caused by virally induced bone marrow suppression. The most common aetiological agent that induces Aplastic Crisis in patients with Hereditary Spherocytosis is Parvovirus B19 Hereditary spherocvtosis usually has autosomal dominant inheritance caused by mutation in genes for proteins such as spectrin. ankrin or band 3. The genes responsible for HS include akyrin, b spectrin, band-3-protein, a-spectrin, and protein 4.2. In approximately two-thirds to three-quaer of HS patients, inheritance is autosomal dominant. In the remaining patients, inheritance is non-dominant due to autosomal recessive inheritance of a de novo mutation. In patients with hereditary spherocvtosis Red blood cells are destroyed in the spleen The spleen plays a critical role in the pathobiology of HS, as destruction of spherocytes in the spleen is the primary cause of hemolysis in HS patients. Aplastic Crisis is an Uncommon Complication Aplastic crisis following virally induced bone marrow suppression are uncommon, but may result in severe anaemia with serious complications including congestive hea failure or even death. The most common aetiological agent in these cases is parvovirus B19. Parvovirus selectively infects erythropoietic progenitor cells and inhibits their growth

So the answer to this question is D