Datasets:
| {"id": "76181118-fd18-4db9-9046-0dbba3fa1e29", "question": "Which of the following is the least common bacteria responsible for Acute Exacerbation of Chronic Bronchitis", "opa": "Streptococcus pneumoniae", "opb": "Moraxella catarrhalis", "opc": "Haemophilus influenza", "opd": "Staphylocccus aureus", "cop": 3, "answer": "D", "exp": "Ans. is 'd' i.e., Staphylocccus aureus Most common bacterias associated with acute excerbation in COPD Hemophilus influenzae Moraxella catarrhalis Streptococcus pneumoniae", "explanation_word_count": 22, "prompt": "Which of the following is the least common bacteria responsible for Acute Exacerbation of Chronic Bronchitis\nA. Streptococcus pneumoniae\nB. Moraxella catarrhalis\nC. Haemophilus influenza\nD. Staphylocccus aureus\nReturn the correct option letter.", "reference": "Ans. is 'd' i.e., Staphylocccus aureus Most common bacterias associated with acute excerbation in COPD Hemophilus influenzae Moraxella catarrhalis Streptococcus pneumoniae\nD", "question_key": "which of the following is the least common bacteria responsible for acute exacerbation of chronic bronchitis", "split": "validation", "is_mia_member": false} | |
| {"id": "5e5ae4ff-31df-4fc5-b37b-1b6bf2a453b4", "question": "Rate of subsequent GTN in complete molar pregnancy?", "opa": "< 1 %", "opb": "1-5 %", "opc": "5-10 %", "opd": "15-20 %", "cop": 3, "answer": "D", "exp": "Complete moles have a 15 to 20 percent incidence of malignant sequelae, compared with 1 to 5 percent following paial moles.Reference: William's Obstetrics; 25th edition, chapter 20; Gestational trophoblastic diseases", "explanation_word_count": 26, "prompt": "Rate of subsequent GTN in complete molar pregnancy?\nA. < 1 %\nB. 1-5 %\nC. 5-10 %\nD. 15-20 %\nReturn the correct option letter.", "reference": "Complete moles have a 15 to 20 percent incidence of malignant sequelae, compared with 1 to 5 percent following paial moles.Reference: William's Obstetrics; 25th edition, chapter 20; Gestational trophoblastic diseases\nD", "question_key": "rate of subsequent gtn in complete molar pregnancy?", "split": "validation", "is_mia_member": false} | |
| {"id": "eb41904d-fcb4-4b37-a642-62c0fc10ef3a", "question": "The group of thumb sucking in which the thumb do not contact the lower incisors, according to Subtleny et al:", "opa": "Group I", "opb": "Group II", "opc": "Group III", "opd": "Group IV", "cop": 2, "answer": "C", "exp": "Subtleny et al (1973) noted four types of thumb-sucking depending upon the\n\nAmount of pushing of tongue inside the oral cavity\nThe contact between the thumb and the palate \nThe contact between the thumb and anterior teeth.", "explanation_word_count": 36, "prompt": "The group of thumb sucking in which the thumb do not contact the lower incisors, according to Subtleny et al:\nA. Group I\nB. Group II\nC. Group III\nD. Group IV\nReturn the correct option letter.", "reference": "Subtleny et al (1973) noted four types of thumb-sucking depending upon the\n\nAmount of pushing of tongue inside the oral cavity\nThe contact between the thumb and the palate \nThe contact between the thumb and anterior teeth.\nC", "question_key": "the group of thumb sucking in which the thumb do not contact the lower incisors, according to subtleny et al:", "split": "validation", "is_mia_member": false} | |
| {"id": "8aa6e833-0d9a-44bb-a7e1-54ec2ac85355", "question": "Characteristic feature of apoptosis", "opa": "Cell membrane intact", "opb": "Cytoplasmic eosinophilia", "opc": "Nuclear moulding", "opd": "Cell swelling", "cop": 0, "answer": "A", "exp": "Reference: Robbins Basic Pathology, 9th edition Page no: 18 Apoptosis is a pathway of cell death in which cells activate enzymes that degrade the cells' own nuclear DNA and nuclear and cytoplasmic proteins. Fragments of the apoptotic cells then break off, giving the appearance that is responsible for the name (apoptosis, \"falling off\"). The plasma membrane of the apoptotic cell remains intact, but the membrane is altered in such a way that the cell and its fragments become avid targets for phagocytes. The dead cell and its fragments are rapidly cleared before cellular contents have leaked out, so apoptotic cell death does not elicit an inflammatory reaction in the host.", "explanation_word_count": 109, "prompt": "Characteristic feature of apoptosis\nA. Cell membrane intact\nB. Cytoplasmic eosinophilia\nC. Nuclear moulding\nD. Cell swelling\nReturn the correct option letter.", "reference": "Reference: Robbins Basic Pathology, 9th edition Page no: 18 Apoptosis is a pathway of cell death in which cells activate enzymes that degrade the cells' own nuclear DNA and nuclear and cytoplasmic proteins. Fragments of the apoptotic cells then break off, giving the appearance that is responsible for the name (apoptosis, \"falling off\"). The plasma membrane of the apoptotic cell remains intact, but the membrane is altered in such a way that the cell and its fragments become avid targets for phagocytes. The dead cell and its fragments are rapidly cleared before cellular contents have leaked out, so apoptotic cell death does not elicit an inflammatory reaction in the host.\nA", "question_key": "characteristic feature of apoptosis", "split": "validation", "is_mia_member": false} | |
| {"id": "b4361373-18bd-40d9-bf70-6ceb1715d10b", "question": "Good pasture&;s syndrome is characterised by-", "opa": "Necrotisting hemorrhagic interstitial pneumonitis", "opb": "Alveolitis", "opc": "Patchy consolidation", "opd": "Pulmonary edema", "cop": 2, "answer": "C", "exp": "The lungs are heavy and have areas of red-brown consolidation due to diffuse alveolar hemorrhage. Microscopic examination shows focal necrosis of alveolar walls associated with intraalveolar hemorrhage, fibrous thickening of septa, and hyperophic type II pneumocytes. There is abundant hemosiderin due to earlier episodes of hemorrhage. The characteristic linear pattern of immunoglobulin deposition (usually IgG, sometimes IgA or IgM) that is the hallmark diagnostic finding in renal biopsy specimens also may be seen along the alveolar septa. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 519", "explanation_word_count": 85, "prompt": "Good pasture&;s syndrome is characterised by-\nA. Necrotisting hemorrhagic interstitial pneumonitis\nB. Alveolitis\nC. Patchy consolidation\nD. Pulmonary edema\nReturn the correct option letter.", "reference": "The lungs are heavy and have areas of red-brown consolidation due to diffuse alveolar hemorrhage. Microscopic examination shows focal necrosis of alveolar walls associated with intraalveolar hemorrhage, fibrous thickening of septa, and hyperophic type II pneumocytes. There is abundant hemosiderin due to earlier episodes of hemorrhage. The characteristic linear pattern of immunoglobulin deposition (usually IgG, sometimes IgA or IgM) that is the hallmark diagnostic finding in renal biopsy specimens also may be seen along the alveolar septa. Ref: ROBBINS BASIC PATHOLOGY 10th ed Pg no: 519\nC", "question_key": "good pasture&;s syndrome is characterised by-", "split": "validation", "is_mia_member": false} | |
| {"id": "74615a7a-488d-4b6b-8598-09551766b584", "question": "The number of live births/no of females 15-45 in the population denotes: (Repeat)", "opa": "General fertility rate", "opb": "Total fertility rate", "opc": "Gross reproduction rate", "opd": "Age specific fertility rate", "cop": 0, "answer": "A", "exp": "Ans: A (General fertility rate) Ref: Park's Preventive and Social Medicine, 22nd edition. & style=\"font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif\">Vital _rates. aspxExplanation:General fertility rate (GFR):* The number of births in a year divided by the number of women aged 15-44, times 1000. It focuses on the potential mothers only, and takes the age distribution into account.Gross reproduction rate (GRR)It is the average number of daughters that would be bom to a woman (or a group of women) if she survived at least to the age of 45 and conformed to the age-specific fertility rate of a given year. It is often regarded as the extent to which the generation of daughters replaces the preceding generation of females.This rate is similar to the net reproduction rate but it ignores the fact that some women will die before completing their childbearing yearsThe GRR is particularly relevant where sex ratios are significantly affected by the use of reproductive technologies.Total fertility rate (TFR)Also called as fertility rate, period total fertility rate (PTFR) or total period fertility rate (TPFR) It is the average number of children that would be born to a woman over her lifetime if:She were to experience the exact current age-specific fertility rates (ASFRs) through her lifetime.She were to survive from birth through the end of her reproductive life.It is obtained by summing the single-year age- specific rates at a given time.Net reproduction rate (NRR)It is defined as the number of daughters a woman would have in her lifetime if she were subject to prevailing age-specific fertility and mortality rates in the given year.When the NRR is exactly one, then each generation of women is exactly reproducing itself.NRR is particularly relevant where the number of male babies born is very highThis is a significant factor in world population, due to the high level of gender imbalance in the very populous nations of China and India.The gross reproduction rate (GRR), is the same as the NRR, except that--like the TFR--it ignores life expectancy.Latest Indian Data (Census 2011)Crude birth rate24.8General Fertility rate95.3Total Fertility rate3Gross reproduction rate1.4", "explanation_word_count": 364, "prompt": "The number of live births/no of females 15-45 in the population denotes: (Repeat)\nA. General fertility rate\nB. Total fertility rate\nC. Gross reproduction rate\nD. Age specific fertility rate\nReturn the correct option letter.", "reference": "Ans: A (General fertility rate) Ref: Park's Preventive and Social Medicine, 22nd edition. & style=\"font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif\">Vital _rates. aspxExplanation:General fertility rate (GFR):* The number of births in a year divided by the number of women aged 15-44, times 1000. It focuses on the potential mothers only, and takes the age distribution into account.Gross reproduction rate (GRR)It is the average number of daughters that would be bom to a woman (or a group of women) if she survived at least to the age of 45 and conformed to the age-specific fertility rate of a given year. It is often regarded as the extent to which the generation of daughters replaces the preceding generation of females.This rate is similar to the net reproduction rate but it ignores the fact that some women will die before completing their childbearing yearsThe GRR is particularly relevant where sex ratios are significantly affected by the use of reproductive technologies.Total fertility rate (TFR)Also called as fertility rate, period total fertility rate (PTFR) or total period fertility rate (TPFR) It is the average number of children that would be born to a woman over her lifetime if:She were to experience the exact current age-specific fertility rates (ASFRs) through her lifetime.She were to survive from birth through the end of her reproductive life.It is obtained by summing the single-year age- specific rates at a given time.Net reproduction rate (NRR)It is defined as the number of daughters a woman would have in her lifetime if she were subject to prevailing age-specific fertility and mortality rates in the given year.When the NRR is exactly one, then each generation of women is exactly reproducing itself.NRR is particularly relevant where the number of male babies born is very highThis is a significant factor in world population, due to the high level of gender imbalance in the very populous nations of China and India.The gross reproduction rate (GRR), is the same as the NRR, except that--like the TFR--it ignores life expectancy.Latest Indian Data (Census 2011)Crude birth rate24.8General Fertility rate95.3Total Fertility rate3Gross reproduction rate1.4\nA", "question_key": "the number of live births/no of females 15-45 in the population denotes: (repeat)", "split": "validation", "is_mia_member": false} | |
| {"id": "d7c28bdf-fdcd-4d61-b969-a2e597bea810", "question": "Backwash ileitis is seen in:", "opa": "Crohn's disease", "opb": "Ulcerative colitis", "opc": "Colonic carcinoma", "opd": "Ileal polyp", "cop": 1, "answer": "B", "exp": "BACKWASH ILEITIS: - Extends contiguously backward from cecum without skip regions. - It is seen in ulcerative colitis where eventhough small intestine is normal, mild mucosal inflammation of distal ileum is seen.", "explanation_word_count": 30, "prompt": "Backwash ileitis is seen in:\nA. Crohn's disease\nB. Ulcerative colitis\nC. Colonic carcinoma\nD. Ileal polyp\nReturn the correct option letter.", "reference": "BACKWASH ILEITIS: - Extends contiguously backward from cecum without skip regions. - It is seen in ulcerative colitis where eventhough small intestine is normal, mild mucosal inflammation of distal ileum is seen.\nB", "question_key": "backwash ileitis is seen in:", "split": "validation", "is_mia_member": false} | |
| {"id": "fffbc1a6-349b-410f-a8c5-b0e5cade4636", "question": "Disc with three germ layers are formed at which week of gestation -", "opa": "1 week", "opb": "3 week", "opc": "5 week", "opd": "10 week", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e., 3 weeks Preembryonic phase of developmento Preembryonic phase of development extends from day zero to 3 weeks (days 0-21).o This phase of development can be further subdivided into :-Fertilization and implantation (first week of development)First week of development begins immediately after fertilization, Changes during first week include -Cleavage of zygote - 0-3 days.Formation of morula, transportation to uterine cavity and conversion into blastocyst - 3-5 days.Implantation - 6-7 days.Stage of bilaminar germ disc (second week of development)The stage of bilaminar germ disc formation approximately occurs during second week of development.On 8th day after ovulation the embryoblast is converted to a bilominar disc consisting of following twolayers -Epiblast, the upper layer.Hypoblast, the lower layer.At the end of 2nd week -i) Some of cubical cells of hypoblast become columnar and form prochordal plate.Soon after the formation of prochordal plate, the primitive streak is formed by the proliferation of cells of epiblast.During this period following changes occurs :During 2nd week trophoblasts differentate into cytotrophoblast and syncytiotrophoblasts.Formation of amnion and amniotic cavityDevelopment of yolk sac and extraembiyonic mesoderm.Development of chorion.3. Stage of trilaminar germ disc (third week of dev elopment)The stage of trilaminar disc formation is marked by changes during third week of development.At the beginning of third week there occurs, the most characterstic event, the gastrulation, which establishes all three germ cells, changing embryonic disc from a bilaminar to a trilaminar structure. During this period, embryo may be referred as to gastrula.Other events during this period areFormation of primitive groove.Formation of germ cells.Formation of notochord.Spread of mesoderm and formation of buccopharynyeal and cloacal membrane.Appearance of allantois.Formation of neural tube (neurulation).Development of somites.Formation of intraembryonic colon.Formation of primordial cardiovascular system.", "explanation_word_count": 296, "prompt": "Disc with three germ layers are formed at which week of gestation -\nA. 1 week\nB. 3 week\nC. 5 week\nD. 10 week\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e., 3 weeks Preembryonic phase of developmento Preembryonic phase of development extends from day zero to 3 weeks (days 0-21).o This phase of development can be further subdivided into :-Fertilization and implantation (first week of development)First week of development begins immediately after fertilization, Changes during first week include -Cleavage of zygote - 0-3 days.Formation of morula, transportation to uterine cavity and conversion into blastocyst - 3-5 days.Implantation - 6-7 days.Stage of bilaminar germ disc (second week of development)The stage of bilaminar germ disc formation approximately occurs during second week of development.On 8th day after ovulation the embryoblast is converted to a bilominar disc consisting of following twolayers -Epiblast, the upper layer.Hypoblast, the lower layer.At the end of 2nd week -i) Some of cubical cells of hypoblast become columnar and form prochordal plate.Soon after the formation of prochordal plate, the primitive streak is formed by the proliferation of cells of epiblast.During this period following changes occurs :During 2nd week trophoblasts differentate into cytotrophoblast and syncytiotrophoblasts.Formation of amnion and amniotic cavityDevelopment of yolk sac and extraembiyonic mesoderm.Development of chorion.3. Stage of trilaminar germ disc (third week of dev elopment)The stage of trilaminar disc formation is marked by changes during third week of development.At the beginning of third week there occurs, the most characterstic event, the gastrulation, which establishes all three germ cells, changing embryonic disc from a bilaminar to a trilaminar structure. During this period, embryo may be referred as to gastrula.Other events during this period areFormation of primitive groove.Formation of germ cells.Formation of notochord.Spread of mesoderm and formation of buccopharynyeal and cloacal membrane.Appearance of allantois.Formation of neural tube (neurulation).Development of somites.Formation of intraembryonic colon.Formation of primordial cardiovascular system.\nB", "question_key": "disc with three germ layers are formed at which week of gestation -", "split": "validation", "is_mia_member": false} | |
| {"id": "d6b597c1-ad9a-4194-9dbd-e2965109a12f", "question": "Nerve supply of obturator internus is by", "opa": "L1-L3", "opb": "L4-S1", "opc": "L5-S2", "opd": "S1-S3", "cop": 2, "answer": "C", "exp": "OBTURATOR INTERNUS Fan-shaped Belly lies in pelvis and tendon in gluteal region.Action: lateral rotators of thigh at hip joint.supplied by nerve to obturator internus.Root value: L5,S1,S2Branches: obturator internus and superior gamellus.{Reference: BDC 6E page no.173}", "explanation_word_count": 42, "prompt": "Nerve supply of obturator internus is by\nA. L1-L3\nB. L4-S1\nC. L5-S2\nD. S1-S3\nReturn the correct option letter.", "reference": "OBTURATOR INTERNUS Fan-shaped Belly lies in pelvis and tendon in gluteal region.Action: lateral rotators of thigh at hip joint.supplied by nerve to obturator internus.Root value: L5,S1,S2Branches: obturator internus and superior gamellus.{Reference: BDC 6E page no.173}\nC", "question_key": "nerve supply of obturator internus is by", "split": "validation", "is_mia_member": false} | |
| {"id": "45c82b40-8ad8-4904-8e7a-2d8c425a06f5", "question": "Stretch laceration is seen in", "opa": "Blunt tangential impact", "opb": "Blunt perpendicular impact", "opc": "Horizontal crushing", "opd": "Impact by sharp objects with heavy base", "cop": 0, "answer": "A", "exp": "Stretch laceration These lacerations occur from over stretching of the skin and soft tissues due to heavy forceful impact exercising a localised pressure. Stretching of tissues can occur in run over by a motor vehicle. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 121", "explanation_word_count": 46, "prompt": "Stretch laceration is seen in\nA. Blunt tangential impact\nB. Blunt perpendicular impact\nC. Horizontal crushing\nD. Impact by sharp objects with heavy base\nReturn the correct option letter.", "reference": "Stretch laceration These lacerations occur from over stretching of the skin and soft tissues due to heavy forceful impact exercising a localised pressure. Stretching of tissues can occur in run over by a motor vehicle. Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 121\nA", "question_key": "stretch laceration is seen in", "split": "validation", "is_mia_member": false} | |
| {"id": "bb25601a-c81f-46af-bf91-8ccea09f55ee", "question": "The main apolipoprotein of LDL is", "opa": "A-II", "opb": "B-48", "opc": "B-100", "opd": "E", "cop": 2, "answer": "C", "exp": "The major apolipoproteins of HDL (a-lipoprotein) are apoAs. The main apolipoprotein of LDL (b-lipoprotein) is apo B (B-100), which is found also in VLDL. Chylomicrons contain a truncated form of apo B (B-48) that is synthesized in the intestine, while B-100 is synthesized in the liver. Apo E, found in VLDL, HDL, chylomicrons, and chylomicron remnants, is also freely transferable. Reference: Harper; 30th edition; Page no: 255", "explanation_word_count": 66, "prompt": "The main apolipoprotein of LDL is\nA. A-II\nB. B-48\nC. B-100\nD. E\nReturn the correct option letter.", "reference": "The major apolipoproteins of HDL (a-lipoprotein) are apoAs. The main apolipoprotein of LDL (b-lipoprotein) is apo B (B-100), which is found also in VLDL. Chylomicrons contain a truncated form of apo B (B-48) that is synthesized in the intestine, while B-100 is synthesized in the liver. Apo E, found in VLDL, HDL, chylomicrons, and chylomicron remnants, is also freely transferable. Reference: Harper; 30th edition; Page no: 255\nC", "question_key": "the main apolipoprotein of ldl is", "split": "validation", "is_mia_member": false} | |
| {"id": "d5e3c103-5d37-4607-98ad-66a2efbfb428", "question": "Which is NOT used in treatment of heroindependence?", "opa": "Disulfiram", "opb": "Buprenorphine", "opc": "Clonidine", "opd": "Lofexidine", "cop": 0, "answer": "A", "exp": "Disulfiram Pharmacological treatment of opioid dependence (Harrison 17' Ye p. 2732) Methadone maintenance: ? Methadone is a synthetic opioid chemically dissimilar but pharmacologically very similar to morphine. Methadone is used as substitution therapy in opioid dependence. The basic aim is to replace an opioid with another opioid that has the following propeies. - Lower abuse/addiction potential - Incapable of a giving a kick - Where tolerance develops slowly - Withdrawl syndrome develops gradually - Legally accessible - Can be taken orally and has a relatively long half life. These propeies of the drug help in blocking heroin induced euphoria while decreasing craving. - Methadone occupies the opioid receptor thus reducing the desire to take other opioids. - Addicts who are cooperative enough to take oral methadone experience reduced craving and less kick/buzz/rush from intravenous heroin because their opioid receptor are already occupied by methadone and the intravenous drug must compete with it. - This helps the patient to maintain abstinence for opioids. - Over three quaers off patients in well supervised clinics are likely to remain heroin free for 26 months. - After a period of maintenance (usually 6 months to -2. 1 year) the dose of methadone is gradually tapered off. Alternative medicines that have been used for maintenance treatment are:? Buprenorphine: - Buprenorphine is a paial agonist at the p receptor. Buprenorphine has several advantages over methadone. - Low overdose danger - Potentially easier detoxification than with methadone. - Probable ceiling effect in which higher doses do not increase euphoria. Opioid antagonists (Naltrexone) Naltrexone is a competitive opioid antagonist at it, cS, 7C It is long acting. It can be used orally to assist in the rehabilitation of ex opioid abusers who are fully withdrawn from opioids (otherwise it will induce an acute withdraw! syndrome). A patient who then takes an opioid fails to experience the \"kick\" or euphoria. Naltrexone does not reduce the craving. Use of clonidine in opioid withdrawl: -(Goodman Gilman 11th/e p. 619) Clonidine is an a2 adrenergic agonist that decreases adrenergic neurotransmission from locus ceruleus. Most of the autonomic symptoms of opioid withdrawl results from loss of opioid suppression of locus ceruleus. Clonidine acts distinct receptor but by cellular mechanisms that mimic opioid effects. So it can allete many of the symptoms of opioid withdrawl. Postural hypotension is common with opioid withdrawl, therefore, dose of clonidine, must be titrated according to the stage and severity of withdraw!. Ioxfexidine It is also an a2 adrenergic agonist. It has greater selectivity for a2Aadrenergic receptors and is associated with less hypotension.", "explanation_word_count": 406, "prompt": "Which is NOT used in treatment of heroindependence?\nA. Disulfiram\nB. Buprenorphine\nC. Clonidine\nD. Lofexidine\nReturn the correct option letter.", "reference": "Disulfiram Pharmacological treatment of opioid dependence (Harrison 17' Ye p. 2732) Methadone maintenance: ? Methadone is a synthetic opioid chemically dissimilar but pharmacologically very similar to morphine. Methadone is used as substitution therapy in opioid dependence. The basic aim is to replace an opioid with another opioid that has the following propeies. - Lower abuse/addiction potential - Incapable of a giving a kick - Where tolerance develops slowly - Withdrawl syndrome develops gradually - Legally accessible - Can be taken orally and has a relatively long half life. These propeies of the drug help in blocking heroin induced euphoria while decreasing craving. - Methadone occupies the opioid receptor thus reducing the desire to take other opioids. - Addicts who are cooperative enough to take oral methadone experience reduced craving and less kick/buzz/rush from intravenous heroin because their opioid receptor are already occupied by methadone and the intravenous drug must compete with it. - This helps the patient to maintain abstinence for opioids. - Over three quaers off patients in well supervised clinics are likely to remain heroin free for 26 months. - After a period of maintenance (usually 6 months to -2. 1 year) the dose of methadone is gradually tapered off. Alternative medicines that have been used for maintenance treatment are:? Buprenorphine: - Buprenorphine is a paial agonist at the p receptor. Buprenorphine has several advantages over methadone. - Low overdose danger - Potentially easier detoxification than with methadone. - Probable ceiling effect in which higher doses do not increase euphoria. Opioid antagonists (Naltrexone) Naltrexone is a competitive opioid antagonist at it, cS, 7C It is long acting. It can be used orally to assist in the rehabilitation of ex opioid abusers who are fully withdrawn from opioids (otherwise it will induce an acute withdraw! syndrome). A patient who then takes an opioid fails to experience the \"kick\" or euphoria. Naltrexone does not reduce the craving. Use of clonidine in opioid withdrawl: -(Goodman Gilman 11th/e p. 619) Clonidine is an a2 adrenergic agonist that decreases adrenergic neurotransmission from locus ceruleus. Most of the autonomic symptoms of opioid withdrawl results from loss of opioid suppression of locus ceruleus. Clonidine acts distinct receptor but by cellular mechanisms that mimic opioid effects. So it can allete many of the symptoms of opioid withdrawl. Postural hypotension is common with opioid withdrawl, therefore, dose of clonidine, must be titrated according to the stage and severity of withdraw!. Ioxfexidine It is also an a2 adrenergic agonist. It has greater selectivity for a2Aadrenergic receptors and is associated with less hypotension.\nA", "question_key": "which is not used in treatment of heroindependence?", "split": "validation", "is_mia_member": false} | |
| {"id": "85b77ecf-fb8d-4443-8fee-feb7e516f3b8", "question": "Not preserved in modified radical mastectomy is", "opa": "Cephalic vein", "opb": "Pectoralis minor", "opc": "Pectoralis major", "opd": "Branches of Inter costobrachial Nerve", "cop": 3, "answer": "D", "exp": "Ans. (d) Branches of Inter costobrachial Nerve(Ref. Bailey and Love 6th Edition Page 813)Structures preserved in MRM:* Axillary Vessels* Bells nerve* Cephalic vein* Nerve to Latissmus dorsi* Pectoralis Major", "explanation_word_count": 30, "prompt": "Not preserved in modified radical mastectomy is\nA. Cephalic vein\nB. Pectoralis minor\nC. Pectoralis major\nD. Branches of Inter costobrachial Nerve\nReturn the correct option letter.", "reference": "Ans. (d) Branches of Inter costobrachial Nerve(Ref. Bailey and Love 6th Edition Page 813)Structures preserved in MRM:* Axillary Vessels* Bells nerve* Cephalic vein* Nerve to Latissmus dorsi* Pectoralis Major\nD", "question_key": "not preserved in modified radical mastectomy is", "split": "validation", "is_mia_member": false} | |
| {"id": "9bd16030-a17d-4994-b5f7-90e1cd36f093", "question": "Athlete's foot is caused by?", "opa": "Candida", "opb": "Madurella", "opc": "Actinomycosis", "opd": "Dermatophytes", "cop": 3, "answer": "D", "exp": "Tinea pedis is a dermatophyte infection of feet and is also referred as Athlete's foot. Tenia pedis T. Rubrum most common Dull erythema with scales. Diagnosis: KOH exam - Thick scale, no leading edge Rx: Dry Feet Don't wear the same shoes everyday, Absorbent powders Rx Scale- keratolytic agents- Salicylic acid Topical: Allylamines may be more effective than azoles Steroids for severe inflammation.", "explanation_word_count": 62, "prompt": "Athlete's foot is caused by?\nA. Candida\nB. Madurella\nC. Actinomycosis\nD. Dermatophytes\nReturn the correct option letter.", "reference": "Tinea pedis is a dermatophyte infection of feet and is also referred as Athlete's foot. Tenia pedis T. Rubrum most common Dull erythema with scales. Diagnosis: KOH exam - Thick scale, no leading edge Rx: Dry Feet Don't wear the same shoes everyday, Absorbent powders Rx Scale- keratolytic agents- Salicylic acid Topical: Allylamines may be more effective than azoles Steroids for severe inflammation.\nD", "question_key": "athlete's foot is caused by?", "split": "validation", "is_mia_member": false} | |
| {"id": "8f41e0ba-a885-483e-bde1-9e47da941056", "question": "Which of the following is not a vascular malformation?", "opa": "Infantile haemangioma", "opb": "Salmon patch", "opc": "Po wine stain", "opd": "Naevus aneamicus", "cop": 0, "answer": "A", "exp": "Vascular bihmarks are broadly classified into: A) Vascular tumours B) Vascular malformations All the above mentioned conditions are vascular malformations except for haemangioma which is a vascular tumour. Note: salmon patch - synonyms --- stork bite or mark/ Nuchal stain Ref: Rook's textbook of dermatology, Edition-8, Page-18.40.", "explanation_word_count": 45, "prompt": "Which of the following is not a vascular malformation?\nA. Infantile haemangioma\nB. Salmon patch\nC. Po wine stain\nD. Naevus aneamicus\nReturn the correct option letter.", "reference": "Vascular bihmarks are broadly classified into: A) Vascular tumours B) Vascular malformations All the above mentioned conditions are vascular malformations except for haemangioma which is a vascular tumour. Note: salmon patch - synonyms --- stork bite or mark/ Nuchal stain Ref: Rook's textbook of dermatology, Edition-8, Page-18.40.\nA", "question_key": "which of the following is not a vascular malformation?", "split": "validation", "is_mia_member": false} | |
| {"id": "f47e6530-7928-427e-a7d5-7a906abbd7e2", "question": "A person was brought to emergency depament and was diagnosed with Supra ventricular tachycardia and suddenly he became unstable. What is the next line of management?", "opa": "Intravenous ibutilide", "opb": "DC Cardioversion", "opc": "Intravenous Diltiazem", "opd": "Intravenous Flecainide", "cop": 1, "answer": "B", "exp": "Here in the question vital are unstable. So the best therapy will be DC cardioversion. Treatment for Supra Ventricular tachycardia: Amiodarone forstablepatients DC Cardioversion forunstablepatients.", "explanation_word_count": 25, "prompt": "A person was brought to emergency depament and was diagnosed with Supra ventricular tachycardia and suddenly he became unstable. What is the next line of management?\nA. Intravenous ibutilide\nB. DC Cardioversion\nC. Intravenous Diltiazem\nD. Intravenous Flecainide\nReturn the correct option letter.", "reference": "Here in the question vital are unstable. So the best therapy will be DC cardioversion. Treatment for Supra Ventricular tachycardia: Amiodarone forstablepatients DC Cardioversion forunstablepatients.\nB", "question_key": "a person was brought to emergency depament and was diagnosed with supra ventricular tachycardia and suddenly he became unstable. what is the next line of management?", "split": "validation", "is_mia_member": false} | |
| {"id": "857cb53a-51a5-4b1e-8e0b-b6a99708e953", "question": "Anaemia due to antibodies against blood group antigens", "opa": "Hereditary spherocytosis", "opb": "G6PD deficiency", "opc": "Haemolytic disease of the newborn", "opd": "Alpha thalassemia major", "cop": 2, "answer": "C", "exp": "Answer- C. Haemolytic disease of the newbornHemolytic disease of thefetus and newborn (HDFN), also known as alloimmune HDFN or erythroblastosis fetalis, is caused by the destruction of reil blood cells (RBCs) of the neonate or fetus by maternal IgG antibodies.", "explanation_word_count": 40, "prompt": "Anaemia due to antibodies against blood group antigens\nA. Hereditary spherocytosis\nB. G6PD deficiency\nC. Haemolytic disease of the newborn\nD. Alpha thalassemia major\nReturn the correct option letter.", "reference": "Answer- C. Haemolytic disease of the newbornHemolytic disease of thefetus and newborn (HDFN), also known as alloimmune HDFN or erythroblastosis fetalis, is caused by the destruction of reil blood cells (RBCs) of the neonate or fetus by maternal IgG antibodies.\nC", "question_key": "anaemia due to antibodies against blood group antigens", "split": "validation", "is_mia_member": false} | |
| {"id": "41425fd5-5852-47d3-ac4d-9e1d855402d6", "question": "In HIV window period indicates -", "opa": "Time period between infection and onset of first symptoms", "opb": "Time period bebtween infection and detection of antibodies against HIV", "opc": "Time period between infection and minimum multiplication of the organism", "opd": "Time period between infection and maximum multiplication of the organism", "cop": 1, "answer": "B", "exp": "It may take 2-8 weeks to months for antibodies to occur after infection and during pa of this period the individual may be highly infectious. This seronegative infective stage is window period. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:579", "explanation_word_count": 42, "prompt": "In HIV window period indicates -\nA. Time period between infection and onset of first symptoms\nB. Time period bebtween infection and detection of antibodies against HIV\nC. Time period between infection and minimum multiplication of the organism\nD. Time period between infection and maximum multiplication of the organism\nReturn the correct option letter.", "reference": "It may take 2-8 weeks to months for antibodies to occur after infection and during pa of this period the individual may be highly infectious. This seronegative infective stage is window period. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO:579\nB", "question_key": "in hiv window period indicates -", "split": "validation", "is_mia_member": false} | |
| {"id": "ca06d177-cb7e-4b41-be31-1bbb70024a84", "question": "The dose of Dopamine used for renal vasodilatation is?", "opa": "2.5 ug/kg/min", "opb": "5-10 ug/kg/min", "opc": "10-20 ug/kg/min", "opd": "1-2 ug/kg/min", "cop": 3, "answer": "D", "exp": "Dopamine is used in the treatment of shock - cardiogenic, hypovolemic, and septic shock. It is especially useful when there is renal dysfunction and low cardiac output because dopamine increases renal blood flow and thereby GFR. Dopamine stimulates the hea - increases FOC, CO, BP. It is also sho acting. Its dose is 2-5 mcg /kg/ min for stimulating the hea (beta-1) least does- renal VD. 1-2 mcg /kg/ min- Dopamine receptor stimulation more than 10mcg /kg/ min not to be used as alpha receptors may get stimulated causing vasoconstriction From medical pharmacology Padmaja 4th edition page 97", "explanation_word_count": 93, "prompt": "The dose of Dopamine used for renal vasodilatation is?\nA. 2.5 ug/kg/min\nB. 5-10 ug/kg/min\nC. 10-20 ug/kg/min\nD. 1-2 ug/kg/min\nReturn the correct option letter.", "reference": "Dopamine is used in the treatment of shock - cardiogenic, hypovolemic, and septic shock. It is especially useful when there is renal dysfunction and low cardiac output because dopamine increases renal blood flow and thereby GFR. Dopamine stimulates the hea - increases FOC, CO, BP. It is also sho acting. Its dose is 2-5 mcg /kg/ min for stimulating the hea (beta-1) least does- renal VD. 1-2 mcg /kg/ min- Dopamine receptor stimulation more than 10mcg /kg/ min not to be used as alpha receptors may get stimulated causing vasoconstriction From medical pharmacology Padmaja 4th edition page 97\nD", "question_key": "the dose of dopamine used for renal vasodilatation is?", "split": "validation", "is_mia_member": false} | |
| {"id": "20ccdc4b-8f3a-47a8-962c-4ef2467f2de0", "question": "Which natural family planning method is based on Ogino Knauss theory ?", "opa": "BBT method", "opb": "Rhythm method", "opc": "Lactational aneronhea", "opd": "Withdrawal method", "cop": 1, "answer": "B", "exp": "In Knaus-Ogino method, the feile period is determined by subtracting 18 days from the shoest cycle and 10 days from the longest cycle which gives the first and the last day of feile period, respectively. This method will result in approximately 25 pregnancies per 100 woman years. The failure results from irregular ovulation or from irregular menstrual cycles. Some couples prefer this method on religious grounds or because they find other methods unacceptable. Reference: Shaw's Textbook of Gynaecology, 16th edition,page 265.", "explanation_word_count": 77, "prompt": "Which natural family planning method is based on Ogino Knauss theory ?\nA. BBT method\nB. Rhythm method\nC. Lactational aneronhea\nD. Withdrawal method\nReturn the correct option letter.", "reference": "In Knaus-Ogino method, the feile period is determined by subtracting 18 days from the shoest cycle and 10 days from the longest cycle which gives the first and the last day of feile period, respectively. This method will result in approximately 25 pregnancies per 100 woman years. The failure results from irregular ovulation or from irregular menstrual cycles. Some couples prefer this method on religious grounds or because they find other methods unacceptable. Reference: Shaw's Textbook of Gynaecology, 16th edition,page 265.\nB", "question_key": "which natural family planning method is based on ogino knauss theory ?", "split": "validation", "is_mia_member": false} | |
| {"id": "e8765060-69d9-4b9d-8866-37466c6272ef", "question": "Long chain fatty acid is transported into inner mitochondria membrane by", "opa": "Acyl carrier protein", "opb": "Acyl carnitine", "opc": "Simple diffusion", "opd": "Energy mediated", "cop": 1, "answer": "B", "exp": "Acyl carnitine \n\nActivated long chain fatty acid (acyl CoA) cannot penetrate the inner mitochondrial membrane.\nAcyl group of acyl CoA is transferred to carnitine, resulting in the formation of acylcarnitine.\n\n\nAcylcarnitine is then transported across the inner mitochondrial membrane into the mitochondrial matrix by translocase.\n\n\nOnce inside the mitochondrion, an acyl group of acylcarnitine is transferred back to CoA, resulting in the formation of acyl-CoA which undergoes β -oxidation.", "explanation_word_count": 68, "prompt": "Long chain fatty acid is transported into inner mitochondria membrane by\nA. Acyl carrier protein\nB. Acyl carnitine\nC. Simple diffusion\nD. Energy mediated\nReturn the correct option letter.", "reference": "Acyl carnitine \n\nActivated long chain fatty acid (acyl CoA) cannot penetrate the inner mitochondrial membrane.\nAcyl group of acyl CoA is transferred to carnitine, resulting in the formation of acylcarnitine.\n\n\nAcylcarnitine is then transported across the inner mitochondrial membrane into the mitochondrial matrix by translocase.\n\n\nOnce inside the mitochondrion, an acyl group of acylcarnitine is transferred back to CoA, resulting in the formation of acyl-CoA which undergoes β -oxidation.\nB", "question_key": "long chain fatty acid is transported into inner mitochondria membrane by", "split": "validation", "is_mia_member": false} | |
| {"id": "51f6ee67-b6e2-4709-8b38-20e6f34ab16a", "question": "Adrenaline, noradrenaline and dopamine act through?", "opa": "Two pass receptor", "opb": "Ligand gated channel", "opc": "Seven pass receptor", "opd": "One pass receptor", "cop": 2, "answer": "C", "exp": "Ans is 'c' i.e. Seven pass receptor o Adrenergic receptors (Adrenaline, noradrenaline) and dopamine receptors are G-protein coupled receptors which are heptahelical receptors, i.e., have seven transmembrane spanning segments (Seven pass receptors)", "explanation_word_count": 34, "prompt": "Adrenaline, noradrenaline and dopamine act through?\nA. Two pass receptor\nB. Ligand gated channel\nC. Seven pass receptor\nD. One pass receptor\nReturn the correct option letter.", "reference": "Ans is 'c' i.e. Seven pass receptor o Adrenergic receptors (Adrenaline, noradrenaline) and dopamine receptors are G-protein coupled receptors which are heptahelical receptors, i.e., have seven transmembrane spanning segments (Seven pass receptors)\nC", "question_key": "adrenaline, noradrenaline and dopamine act through?", "split": "validation", "is_mia_member": false} | |
| {"id": "8a8c22c0-0d84-4ef4-af7b-c575835facec", "question": "Most common physiological form of DNA -", "opa": "A-form", "opb": "B-form", "opc": "Z-form", "opd": "C-form", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e., B-form o DNA can exist in at least six forms, i.e. A, B, C, D, E and Z.o The B-form of DNA is the most common form of DNA and is right-handed helix.o It is the strandard DNA structure with 10 base pairs per turn.o Watson and Crick model describes the B-form of DNA.o Other forms of DNA are A-form (contains 11 base pairs per turn and is right handed helix) and Z-form (contains 12 base pairs per turn and is left handed helix).o Z-form is favored by alternating G-C sequences in alcohol and high salt solution; and is inhibited by alternating A-T sequnces (Note-B form has minimum base pairs per turn, i.e. 10).", "explanation_word_count": 122, "prompt": "Most common physiological form of DNA -\nA. A-form\nB. B-form\nC. Z-form\nD. C-form\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e., B-form o DNA can exist in at least six forms, i.e. A, B, C, D, E and Z.o The B-form of DNA is the most common form of DNA and is right-handed helix.o It is the strandard DNA structure with 10 base pairs per turn.o Watson and Crick model describes the B-form of DNA.o Other forms of DNA are A-form (contains 11 base pairs per turn and is right handed helix) and Z-form (contains 12 base pairs per turn and is left handed helix).o Z-form is favored by alternating G-C sequences in alcohol and high salt solution; and is inhibited by alternating A-T sequnces (Note-B form has minimum base pairs per turn, i.e. 10).\nB", "question_key": "most common physiological form of dna -", "split": "validation", "is_mia_member": false} | |
| {"id": "9da9027c-c2c7-4495-ac9d-675d588975d3", "question": "Histopathology of mitral Valve prolapsed shows what kind of change?", "opa": "Myxomatous", "opb": "Fibrinoid", "opc": "Granulomatous", "opd": "Fibrous", "cop": 0, "answer": "A", "exp": "In myxomatous degeneration of the mitral valve, one or both mitral leaflets are \"floppy\" and prolapse--they balloon back into the left atrium during systole. Mitral valve prolapse is a primary form of myxomatous mitral degeneration affecting some 0.5% to 2.4% of adults; thus, it is one of the most common forms of valvular hea disease in the Western world. Men and women are equally affected. (Robbins Basic Pathology,9th edition,pg no.403)", "explanation_word_count": 71, "prompt": "Histopathology of mitral Valve prolapsed shows what kind of change?\nA. Myxomatous\nB. Fibrinoid\nC. Granulomatous\nD. Fibrous\nReturn the correct option letter.", "reference": "In myxomatous degeneration of the mitral valve, one or both mitral leaflets are \"floppy\" and prolapse--they balloon back into the left atrium during systole. Mitral valve prolapse is a primary form of myxomatous mitral degeneration affecting some 0.5% to 2.4% of adults; thus, it is one of the most common forms of valvular hea disease in the Western world. Men and women are equally affected. (Robbins Basic Pathology,9th edition,pg no.403)\nA", "question_key": "histopathology of mitral valve prolapsed shows what kind of change?", "split": "validation", "is_mia_member": false} | |
| {"id": "7de3656f-998e-487a-aa1f-9bf2ab713115", "question": "Method of sterilization of syringes -", "opa": "Hot air oven", "opb": "Autoclaving", "opc": "Irradiation", "opd": "Ethylene dioxide", "cop": 0, "answer": "A", "exp": "Ans. is 'a' i.e., Hot air oven PROCEDURE OF STERILIZATION OF SOME IMPORTANT MATERIALMaterialMethods* Inoculating loop or wire, the tip of forceps and searing spatulasFlaming* Contaminated cloth, animal carcasses and pathological materialIncineration* Glasswares, syringes, petridishes, test tubes, Flasks, surgical instrumentsHot air oven* Most of the culture mediaAutoclaving or membrane filter* Sharp instruments5% cresol or hot air oven* Clinical thermometersSavlon* Cystoscopes, bronchoscopes and other endoscopes, corrugated rubber anaesthetic tubes, face masks, plastic endotracheal tubesGlutaraldehyde* MilkPasturisation* Suture material except catgutAutoclaving* CatgutIonizing radiation* Bacterial vaccinesVaccine bath* Dressing, aprons, gloves, catheters, surgical instruments except sharp instrumentsAutoclaving* Heat sensitive cathaters, Wards fumigation, laboratories, sick rooms operation theatresFormaldehyde gas or U.V. rays* Prepacked items such as syringes and cathetersInfrared radiation* Culture media containing gelatin or sugarTyndallisation", "explanation_word_count": 122, "prompt": "Method of sterilization of syringes -\nA. Hot air oven\nB. Autoclaving\nC. Irradiation\nD. Ethylene dioxide\nReturn the correct option letter.", "reference": "Ans. is 'a' i.e., Hot air oven PROCEDURE OF STERILIZATION OF SOME IMPORTANT MATERIALMaterialMethods* Inoculating loop or wire, the tip of forceps and searing spatulasFlaming* Contaminated cloth, animal carcasses and pathological materialIncineration* Glasswares, syringes, petridishes, test tubes, Flasks, surgical instrumentsHot air oven* Most of the culture mediaAutoclaving or membrane filter* Sharp instruments5% cresol or hot air oven* Clinical thermometersSavlon* Cystoscopes, bronchoscopes and other endoscopes, corrugated rubber anaesthetic tubes, face masks, plastic endotracheal tubesGlutaraldehyde* MilkPasturisation* Suture material except catgutAutoclaving* CatgutIonizing radiation* Bacterial vaccinesVaccine bath* Dressing, aprons, gloves, catheters, surgical instruments except sharp instrumentsAutoclaving* Heat sensitive cathaters, Wards fumigation, laboratories, sick rooms operation theatresFormaldehyde gas or U.V. rays* Prepacked items such as syringes and cathetersInfrared radiation* Culture media containing gelatin or sugarTyndallisation\nA", "question_key": "method of sterilization of syringes -", "split": "validation", "is_mia_member": false} | |
| {"id": "ca5d0fab-ed4a-42d6-a113-6e4ca70fd1fb", "question": "Which of the following surface glycoproteins is most often expressed in human hematopoietic stem cell -", "opa": "CD 22", "opb": "CD 40", "opc": "CD 15", "opd": "CD 34", "cop": 3, "answer": "D", "exp": "Hematopoietic progenitor cell antigen CD34 also known as CD34 antigen is a protein that in humans is encoded by the CD34 gene. CD34 is a cluster of differentiation first described independently by Civin et al. and Tindle et al. in a cell surface glycoprotein and functions as a cell-cell adhesion factor. It may also mediate the attachment of stem cells to bone marrow extracellular matrix or directly to stromal cells.The CD34 protein is a member of a family of single-pass transmembrane sialomucin proteins that show expression on early hematopoietic and vascular-associated tissue. However, little is known about its exact function. CD34 is also an impoant adhesion molecule and is required for T cells to enter lymph nodes. It is expressed on lymph node endothelia, whereas the L-selectin to which it binds is on the T cell. Conversely, under other circumstances CD34 has been shown to act as molecular \"Teflon\" and block mast cell, eosinophil and dendritic cell precursor adhesion, and to facilitate opening of vascular lumens. Finally, recent data suggest CD34 may also play a more selective role in chemokine-dependent migration of eosinophils and dendritic cell precursors. Regardless of its mode of action, under all circumstances CD34, and its relatives podocalyxin and endoglycan, facilitates cell migration.", "explanation_word_count": 207, "prompt": "Which of the following surface glycoproteins is most often expressed in human hematopoietic stem cell -\nA. CD 22\nB. CD 40\nC. CD 15\nD. CD 34\nReturn the correct option letter.", "reference": "Hematopoietic progenitor cell antigen CD34 also known as CD34 antigen is a protein that in humans is encoded by the CD34 gene. CD34 is a cluster of differentiation first described independently by Civin et al. and Tindle et al. in a cell surface glycoprotein and functions as a cell-cell adhesion factor. It may also mediate the attachment of stem cells to bone marrow extracellular matrix or directly to stromal cells.The CD34 protein is a member of a family of single-pass transmembrane sialomucin proteins that show expression on early hematopoietic and vascular-associated tissue. However, little is known about its exact function. CD34 is also an impoant adhesion molecule and is required for T cells to enter lymph nodes. It is expressed on lymph node endothelia, whereas the L-selectin to which it binds is on the T cell. Conversely, under other circumstances CD34 has been shown to act as molecular \"Teflon\" and block mast cell, eosinophil and dendritic cell precursor adhesion, and to facilitate opening of vascular lumens. Finally, recent data suggest CD34 may also play a more selective role in chemokine-dependent migration of eosinophils and dendritic cell precursors. Regardless of its mode of action, under all circumstances CD34, and its relatives podocalyxin and endoglycan, facilitates cell migration.\nD", "question_key": "which of the following surface glycoproteins is most often expressed in human hematopoietic stem cell -", "split": "validation", "is_mia_member": false} | |
| {"id": "25d17943-885a-4d0e-841f-147ed7a05d3a", "question": "A 72-year-old woman has had difficulty with vision in her right eye for 3 months. She also has pain in the right upper chest. The findings on physical examination include unilateral enophthalmos, miosis, anhidrosis, and ptosis on the right side of her face. A chest radiograph shows right upper lobe opacification and bony destruction of the right first rib. Which of the following conditions is most likely to be present in her?", "opa": "Bronchopneumonia", "opb": "Bronchiectasis", "opc": "Bronchogenic carcinoma", "opd": "Sarcoidosis", "cop": 2, "answer": "C", "exp": "Horner syndrome is a result of sympathetic autonomic nerve involvement by invasive pulmonary carcinoma. Such a neoplasm in this location with these associated findings is called a Pancoast tumor. Infectious processes such as pneumonia are unlikely to impinge on structures outside the lung. Bronchiectasis destroys bronchi within the lung. Sarcoidosis can result in marked hilar adenopathy with a mass effect, but involvement of the peripheral nervous system is unlikely. Likewise, tuberculosis is a granulomatous disease that can lead to hilar adenopathy, although usually without destruction of extrapulmonary tissues.", "explanation_word_count": 88, "prompt": "A 72-year-old woman has had difficulty with vision in her right eye for 3 months. She also has pain in the right upper chest. The findings on physical examination include unilateral enophthalmos, miosis, anhidrosis, and ptosis on the right side of her face. A chest radiograph shows right upper lobe opacification and bony destruction of the right first rib. Which of the following conditions is most likely to be present in her?\nA. Bronchopneumonia\nB. Bronchiectasis\nC. Bronchogenic carcinoma\nD. Sarcoidosis\nReturn the correct option letter.", "reference": "Horner syndrome is a result of sympathetic autonomic nerve involvement by invasive pulmonary carcinoma. Such a neoplasm in this location with these associated findings is called a Pancoast tumor. Infectious processes such as pneumonia are unlikely to impinge on structures outside the lung. Bronchiectasis destroys bronchi within the lung. Sarcoidosis can result in marked hilar adenopathy with a mass effect, but involvement of the peripheral nervous system is unlikely. Likewise, tuberculosis is a granulomatous disease that can lead to hilar adenopathy, although usually without destruction of extrapulmonary tissues.\nC", "question_key": "a 72-year-old woman has had difficulty with vision in her right eye for 3 months. she also has pain in the right upper chest. the findings on physical examination include unilateral enophthalmos, miosis, anhidrosis, and ptosis on the right side of her face. a chest radiograph shows right upper lobe opacification and bony destruction of the right first rib. which of the following conditions is most likely to be present in her?", "split": "validation", "is_mia_member": false} | |
| {"id": "31ea56d4-abd7-458a-b003-80e4b7b2d07f", "question": "Swimming pool granuloma is caused by", "opa": "Mycobacterium bovis", "opb": "Mycobacterium ulcerans", "opc": "Mycobacterium kansasii", "opd": "Mycobacterium marinum", "cop": 3, "answer": "D", "exp": "Mycobacterium marinum can cause cellulitis or granulomas on skin surfaces exposed to the water in aquariums or injured in swimming pools.", "explanation_word_count": 21, "prompt": "Swimming pool granuloma is caused by\nA. Mycobacterium bovis\nB. Mycobacterium ulcerans\nC. Mycobacterium kansasii\nD. Mycobacterium marinum\nReturn the correct option letter.", "reference": "Mycobacterium marinum can cause cellulitis or granulomas on skin surfaces exposed to the water in aquariums or injured in swimming pools.\nD", "question_key": "swimming pool granuloma is caused by", "split": "validation", "is_mia_member": false} | |
| {"id": "1de8acf1-a4e4-4a4a-8fd6-12f16f9e61fc", "question": "Sacral-teratoma/sacrococcygeal teratoma is a derivative of -", "opa": "Primitive streak", "opb": "Ectoderm", "opc": "Hypoblasts", "opd": "Cranial neuropore", "cop": 0, "answer": "A", "exp": "Answer- A. Primitive streakGastrulation & Hensen's node:In 2nd week - Gastrulation occurs - Establishes 3rd germ layer (mesoderm).Gastrulation begins with primitive streak formation in caudal region of epiblast.Primitive node or Hensen's node or primitive knot:Thickening formed at cranial end of primitive streak.Sacrococcygeal formation:Failure of Hensen's node to regress can lead to sacrococcygeal formation.Incomplete primitive streak regression - leaves caudal remnant - Sacrococcygeal teratoma.Arise from residual to totipotential cell rests (Hensen's node).Sacrococcygeal teratoma demonstrates tissue derived from all three cell layers.Contain varying propoions of mature & immature elements.", "explanation_word_count": 91, "prompt": "Sacral-teratoma/sacrococcygeal teratoma is a derivative of -\nA. Primitive streak\nB. Ectoderm\nC. Hypoblasts\nD. Cranial neuropore\nReturn the correct option letter.", "reference": "Answer- A. Primitive streakGastrulation & Hensen's node:In 2nd week - Gastrulation occurs - Establishes 3rd germ layer (mesoderm).Gastrulation begins with primitive streak formation in caudal region of epiblast.Primitive node or Hensen's node or primitive knot:Thickening formed at cranial end of primitive streak.Sacrococcygeal formation:Failure of Hensen's node to regress can lead to sacrococcygeal formation.Incomplete primitive streak regression - leaves caudal remnant - Sacrococcygeal teratoma.Arise from residual to totipotential cell rests (Hensen's node).Sacrococcygeal teratoma demonstrates tissue derived from all three cell layers.Contain varying propoions of mature & immature elements.\nA", "question_key": "sacral-teratoma/sacrococcygeal teratoma is a derivative of -", "split": "validation", "is_mia_member": false} | |
| {"id": "6f92da0c-6033-4706-acf6-0d0541cb4635", "question": "Beta blocker drug CONTRAINDICATED in asthma patients: September 2012", "opa": "Metoprolol", "opb": "Atenolol", "opc": "Propranolol", "opd": "Acebutolol", "cop": 2, "answer": "C", "exp": "Ans. C i.e. Propranolol Propranolol should be used with caution in people with: DM or hypehyroidism, since signs and symptoms of hypoglycemia may be masked. PVD and Raynaud's syndrome, which may be exacerbated Phaeochromocytoma, as hypeension may be aggravated without prior alpha blocker therapy Myasthenia gravis, may be worsened Other drugs with bradycardic effects Propranolol is contraindicated in patients with: Reversible airways disease, paicularly asthma or COPD Bradycardia ( Sick sinus syndrome AV block (second or third degree) Shock Severe hypotension Cocaine toxicity PVD/ Peripheral Vascular Disease", "explanation_word_count": 87, "prompt": "Beta blocker drug CONTRAINDICATED in asthma patients: September 2012\nA. Metoprolol\nB. Atenolol\nC. Propranolol\nD. Acebutolol\nReturn the correct option letter.", "reference": "Ans. C i.e. Propranolol Propranolol should be used with caution in people with: DM or hypehyroidism, since signs and symptoms of hypoglycemia may be masked. PVD and Raynaud's syndrome, which may be exacerbated Phaeochromocytoma, as hypeension may be aggravated without prior alpha blocker therapy Myasthenia gravis, may be worsened Other drugs with bradycardic effects Propranolol is contraindicated in patients with: Reversible airways disease, paicularly asthma or COPD Bradycardia ( Sick sinus syndrome AV block (second or third degree) Shock Severe hypotension Cocaine toxicity PVD/ Peripheral Vascular Disease\nC", "question_key": "beta blocker drug contraindicated in asthma patients: september 2012", "split": "validation", "is_mia_member": false} | |
| {"id": "aaaa9c5e-f605-4fd0-a334-0490793889fd", "question": "Lumbar sympathectomy is of value in the management of", "opa": "Intermittent claudication", "opb": "Distal ischaemia affecting the skin of the toes", "opc": "Aeriovenous Fistula", "opd": "Back pain", "cop": 1, "answer": "B", "exp": ". Ans: b (Distal ischemia affecting the skin of toes) (Ref. Textbook of surgery by S. Das-3rd ) - Indications for sympathectomy: 1. Circulatory insufficiency of the limbs (Limb warms, pain reduces and ulcers may show signs of regression) o Atherosclerosis (with rest pain, impending gangrene of toes) o Raynaud's Syndrome (temporary relief) o Buerger's disease 2. Hyperhidrosis 3. Causalgia", "explanation_word_count": 55, "prompt": "Lumbar sympathectomy is of value in the management of\nA. Intermittent claudication\nB. Distal ischaemia affecting the skin of the toes\nC. Aeriovenous Fistula\nD. Back pain\nReturn the correct option letter.", "reference": ". Ans: b (Distal ischemia affecting the skin of toes) (Ref. Textbook of surgery by S. Das-3rd ) - Indications for sympathectomy: 1. Circulatory insufficiency of the limbs (Limb warms, pain reduces and ulcers may show signs of regression) o Atherosclerosis (with rest pain, impending gangrene of toes) o Raynaud's Syndrome (temporary relief) o Buerger's disease 2. Hyperhidrosis 3. Causalgia\nB", "question_key": "lumbar sympathectomy is of value in the management of", "split": "validation", "is_mia_member": false} | |
| {"id": "93e61498-f9f5-4a2e-8d99-1ae6fa96997d", "question": "The active principle of this toxic seed is:", "opa": "Crotin", "opb": "Ricin", "opc": "Abrin", "opd": "Capsicin", "cop": 1, "answer": "B", "exp": "The given image is castor seed also known as Ricinus communis. Crushed seed is poisonous. It contains active principle- Ricin which leads to intense gastroenteritis and bloody diarrhoea.", "explanation_word_count": 28, "prompt": "The active principle of this toxic seed is:\nA. Crotin\nB. Ricin\nC. Abrin\nD. Capsicin\nReturn the correct option letter.", "reference": "The given image is castor seed also known as Ricinus communis. Crushed seed is poisonous. It contains active principle- Ricin which leads to intense gastroenteritis and bloody diarrhoea.\nB", "question_key": "the active principle of this toxic seed is:", "split": "validation", "is_mia_member": false} | |
| {"id": "4b8a55ae-835f-4690-86dc-b20d81e2be63", "question": "Treatment of choice in ventricular fibrillation is", "opa": "Sotalol", "opb": "Cardioversion", "opc": "Ibutilide", "opd": "Adenosine", "cop": 1, "answer": "B", "exp": "Refer kDT 7/e 538 A class of medications called beta blockers is commonly used in people at risk of ventricular fibrillation or sudden cardiac arrest. Implantable cardioveer-defibrillator (ICD). After your condition stabilizes, your doctor is likely to recommend implantation of an ICD. ... The ICD constantly monitors your hea rhythm", "explanation_word_count": 48, "prompt": "Treatment of choice in ventricular fibrillation is\nA. Sotalol\nB. Cardioversion\nC. Ibutilide\nD. Adenosine\nReturn the correct option letter.", "reference": "Refer kDT 7/e 538 A class of medications called beta blockers is commonly used in people at risk of ventricular fibrillation or sudden cardiac arrest. Implantable cardioveer-defibrillator (ICD). After your condition stabilizes, your doctor is likely to recommend implantation of an ICD. ... The ICD constantly monitors your hea rhythm\nB", "question_key": "treatment of choice in ventricular fibrillation is", "split": "validation", "is_mia_member": false} | |
| {"id": "74aca588-ebe5-49da-b607-2d0a54e2ec06", "question": "Most common side effect of vital teeth bleaching:", "opa": "Cervical resorption", "opb": "Discoloration", "opc": "Apical periodontitis", "opd": "Apical root resorption", "cop": 2, "answer": "C", "exp": "Cervical resorption is a common consequence of bleaching of non-vital teeth whereas apical periodontitis is a common sequel of bleaching of vital teeth. The possibility of cervical resorption can be reduced by sealing the root canal orifice with cavit to prevent percolation of bleaching agent or by keeping a paste of calcium hydroxide and sterile water in the pulp chamber.", "explanation_word_count": 60, "prompt": "Most common side effect of vital teeth bleaching:\nA. Cervical resorption\nB. Discoloration\nC. Apical periodontitis\nD. Apical root resorption\nReturn the correct option letter.", "reference": "Cervical resorption is a common consequence of bleaching of non-vital teeth whereas apical periodontitis is a common sequel of bleaching of vital teeth. The possibility of cervical resorption can be reduced by sealing the root canal orifice with cavit to prevent percolation of bleaching agent or by keeping a paste of calcium hydroxide and sterile water in the pulp chamber.\nC", "question_key": "most common side effect of vital teeth bleaching:", "split": "validation", "is_mia_member": false} | |
| {"id": "b39daf5b-1fec-402e-a4e9-2fab89797592", "question": "Phlebotomus argentipes is killed by", "opa": "Malathion", "opb": "DDT", "opc": "BHC", "opd": "Pyrethrum", "cop": 1, "answer": "B", "exp": "DDT (Dichloro-diphenyl-tricholoro ethane) Organo-chlorine Synthesized by Zeidler (1874); Insecticidal propeies discovered by Noble prize winner Paul Miller (1939) Techincal DDT : 70-80% para-para isomer (most active form) Mechanism of action : Contact (Nerve) poison (hours to kill) (Acetylcholinesterase inhibitor) DDT had 'No repellant action' but 'redidal action for 18 months' Dosage : 100-200 mg per sq.ft Sandflies (phlebotamus) has not demonstrated resistance to DDT Ref : Park 25th edition Pgno : 812-813", "explanation_word_count": 62, "prompt": "Phlebotomus argentipes is killed by\nA. Malathion\nB. DDT\nC. BHC\nD. Pyrethrum\nReturn the correct option letter.", "reference": "DDT (Dichloro-diphenyl-tricholoro ethane) Organo-chlorine Synthesized by Zeidler (1874); Insecticidal propeies discovered by Noble prize winner Paul Miller (1939) Techincal DDT : 70-80% para-para isomer (most active form) Mechanism of action : Contact (Nerve) poison (hours to kill) (Acetylcholinesterase inhibitor) DDT had 'No repellant action' but 'redidal action for 18 months' Dosage : 100-200 mg per sq.ft Sandflies (phlebotamus) has not demonstrated resistance to DDT Ref : Park 25th edition Pgno : 812-813\nB", "question_key": "phlebotomus argentipes is killed by", "split": "validation", "is_mia_member": false} | |
| {"id": "07b58048-9f24-45bd-975e-752130fe2500", "question": "Characteristic feature of Crohn's disease is?", "opa": "Skip lesions", "opb": "Toxic megacolon", "opc": "Fibrosis is rare", "opd": "Involvement is superficial", "cop": 0, "answer": "A", "exp": "Ans. is 'a' i.e., Skip lesions * A classic feature of CD is the sharp demarcation of diseased bowel segments from adjacent uninvolved bowelWhen multiple bowel segments are involved, the intervening bowel is normal - skip lesions.Crohn disease (Terminal ileitis or regional enteritis)* Any portion of intestine can be involved, but most commonly small intestine (especially distal ileum) is involved (in 40% cases). Both small intestine and colon are involved in 30% of cases, and only colon isinvolved in 30%.* In the affected segment, mesentric fat wraps around the bowel surface - creeping fat.* The intestinal wall is rubbery and thick, as a consequence of edema, inflammation, fibrosis, and hypertrophy of the muscularis propria - lumen is almost always narrowed - string sign on barium meal.* There are serpentine linear ulcer along the axis of bowel.* As the intervening mucosa tends to be relatively spared, the mucosa acquires a coarse texture - Cobblestone appearance.* Narrow fissures develop between the folds of the mucosa. Fissures can penetrate deeply through the bowel wall and leading to bowel adhesions and serositis. Further extension of fissures leads to fistula or sinus tract formation.* There is transmural inflammation affecting all layers of bowel wall.* Sarcoid like noncaseating granulomas may be present in all tissue layers.* Neutrophilic infiltration into the crypts results in formation of crypt abscess.* Fibrosis of the submucosa, muscularis propria, and mucosa eventually leads to stricture formation.* There is an increased incidence of cancer of GIT in patients with long-standing CD, but the risk of cancer in CD is considerably less than in patients with chronic UC.* On barium enema there is Hose pipe (lead pipe) appearnace and cobble - stone appearnace.* Screening test is presence of anti-Saccharomyces cerevisae antibody (ASCA). Antibody formation is common against cell wall of yeast, Saccharomyces cerevisae in patients of CD.* Extraintestinal manifestations of Crohn disease are skin manifestations (erythema nodosum), migratory polyarthritis, ankylosing spondylitis, sacroilitis, uveitis, clubbing, Hepatic pericholangitis and primary biliary cirrhosis.", "explanation_word_count": 318, "prompt": "Characteristic feature of Crohn's disease is?\nA. Skip lesions\nB. Toxic megacolon\nC. Fibrosis is rare\nD. Involvement is superficial\nReturn the correct option letter.", "reference": "Ans. is 'a' i.e., Skip lesions * A classic feature of CD is the sharp demarcation of diseased bowel segments from adjacent uninvolved bowelWhen multiple bowel segments are involved, the intervening bowel is normal - skip lesions.Crohn disease (Terminal ileitis or regional enteritis)* Any portion of intestine can be involved, but most commonly small intestine (especially distal ileum) is involved (in 40% cases). Both small intestine and colon are involved in 30% of cases, and only colon isinvolved in 30%.* In the affected segment, mesentric fat wraps around the bowel surface - creeping fat.* The intestinal wall is rubbery and thick, as a consequence of edema, inflammation, fibrosis, and hypertrophy of the muscularis propria - lumen is almost always narrowed - string sign on barium meal.* There are serpentine linear ulcer along the axis of bowel.* As the intervening mucosa tends to be relatively spared, the mucosa acquires a coarse texture - Cobblestone appearance.* Narrow fissures develop between the folds of the mucosa. Fissures can penetrate deeply through the bowel wall and leading to bowel adhesions and serositis. Further extension of fissures leads to fistula or sinus tract formation.* There is transmural inflammation affecting all layers of bowel wall.* Sarcoid like noncaseating granulomas may be present in all tissue layers.* Neutrophilic infiltration into the crypts results in formation of crypt abscess.* Fibrosis of the submucosa, muscularis propria, and mucosa eventually leads to stricture formation.* There is an increased incidence of cancer of GIT in patients with long-standing CD, but the risk of cancer in CD is considerably less than in patients with chronic UC.* On barium enema there is Hose pipe (lead pipe) appearnace and cobble - stone appearnace.* Screening test is presence of anti-Saccharomyces cerevisae antibody (ASCA). Antibody formation is common against cell wall of yeast, Saccharomyces cerevisae in patients of CD.* Extraintestinal manifestations of Crohn disease are skin manifestations (erythema nodosum), migratory polyarthritis, ankylosing spondylitis, sacroilitis, uveitis, clubbing, Hepatic pericholangitis and primary biliary cirrhosis.\nA", "question_key": "characteristic feature of crohn's disease is?", "split": "validation", "is_mia_member": false} | |
| {"id": "7ffe2d13-6dda-4d9c-af1a-6db9443ac0d3", "question": "Major constituent of surfactant is -", "opa": "Dipalmitoyl lecithine", "opb": "Dipalmitoyl cephaline", "opc": "Dipalmitoyl serine", "opd": "Dipalmitoyl inositol", "cop": 0, "answer": "A", "exp": "Ans. is 'a' i.e., Dipalmitoyl lecithin o The major (65%) constituent of surfactant is dipalmitoylphosphatidylcholine (dipalmitoyl-lecithin); which is a phospholipid.", "explanation_word_count": 20, "prompt": "Major constituent of surfactant is -\nA. Dipalmitoyl lecithine\nB. Dipalmitoyl cephaline\nC. Dipalmitoyl serine\nD. Dipalmitoyl inositol\nReturn the correct option letter.", "reference": "Ans. is 'a' i.e., Dipalmitoyl lecithin o The major (65%) constituent of surfactant is dipalmitoylphosphatidylcholine (dipalmitoyl-lecithin); which is a phospholipid.\nA", "question_key": "major constituent of surfactant is -", "split": "validation", "is_mia_member": false} | |
| {"id": "bc9b8f2c-1383-4357-9a0a-a9a435ad3a5a", "question": "Most common cause of death in aoic stenosis patients is: March 2005", "opa": "Pulmonary edema", "opb": "Atrial flutter", "opc": "IHD with ventricular fibrillation", "opd": "Cerebral embolism", "cop": 2, "answer": "C", "exp": "Ans. C: IHD with ventricular fibrillation Aoic stenosis can be a serious and potentially life threatening condition. Some of the possible complications include: Pulmonary oedema Cardiomegaly Congestive hea failure Hea arrhythmia. Some arrhythmias in the ventricles may be associated with cardiac death, such as 'ventricular fibrillation' .", "explanation_word_count": 46, "prompt": "Most common cause of death in aoic stenosis patients is: March 2005\nA. Pulmonary edema\nB. Atrial flutter\nC. IHD with ventricular fibrillation\nD. Cerebral embolism\nReturn the correct option letter.", "reference": "Ans. C: IHD with ventricular fibrillation Aoic stenosis can be a serious and potentially life threatening condition. Some of the possible complications include: Pulmonary oedema Cardiomegaly Congestive hea failure Hea arrhythmia. Some arrhythmias in the ventricles may be associated with cardiac death, such as 'ventricular fibrillation' .\nC", "question_key": "most common cause of death in aoic stenosis patients is: march 2005", "split": "validation", "is_mia_member": false} | |
| {"id": "e9f8e313-74ce-4ce0-a5d8-2ce7d7694d69", "question": "A mother is breast-feeding her 2-month-old infant. Which one of the following drug situations involving the mother is unlikely to cause effects in the nursing infant?", "opa": "Ciprofloxacin for a UT infection", "opb": "Amphetamine for weight loss", "opc": "Nystatin for a yeast infection", "opd": "Triazolam as a \"sleeping pill\"", "cop": 2, "answer": "C", "exp": "Drugs that are capable of crossing the blood-brain barrier penetrate most body tissues and can appear in the milk of the lactating mother. Though concentrations of such drugs may be low in breast milk, they may cause effects in an infant who perhaps weighs just a few kilograms. Fluoroquinolones also penetrate tissues, and because they are contraindicated in children, it seems appropriate not to risk infant exposure via breast milk. The \"safest\" drug situation concerns nystatin, which is used only via the topical route and, as a polyene, does not cross membrane barriers.", "explanation_word_count": 93, "prompt": "A mother is breast-feeding her 2-month-old infant. Which one of the following drug situations involving the mother is unlikely to cause effects in the nursing infant?\nA. Ciprofloxacin for a UT infection\nB. Amphetamine for weight loss\nC. Nystatin for a yeast infection\nD. Triazolam as a \"sleeping pill\"\nReturn the correct option letter.", "reference": "Drugs that are capable of crossing the blood-brain barrier penetrate most body tissues and can appear in the milk of the lactating mother. Though concentrations of such drugs may be low in breast milk, they may cause effects in an infant who perhaps weighs just a few kilograms. Fluoroquinolones also penetrate tissues, and because they are contraindicated in children, it seems appropriate not to risk infant exposure via breast milk. The \"safest\" drug situation concerns nystatin, which is used only via the topical route and, as a polyene, does not cross membrane barriers.\nC", "question_key": "a mother is breast-feeding her 2-month-old infant. which one of the following drug situations involving the mother is unlikely to cause effects in the nursing infant?", "split": "validation", "is_mia_member": false} | |
| {"id": "3d417287-b0ee-4389-8635-b2c222cfcc22", "question": "Upon Hysteroscopy which of the following cannot be seen:", "opa": "Tubal ostia", "opb": "Cervix", "opc": "Endometrium", "opd": "Tubal patency", "cop": 3, "answer": "D", "exp": "Hysteroscopy is best for diagnosing lesions within the uterine cavity Also: Abnormal Uterine Bleeding Oligomenorrhea amenorrhea, Recurrent Pregnancy loss Endometrial carcinoma, Un-explained infeility Suspected anomalies Missing IUCDs Diagnosing intra uterine submucous fibroids, Polyps, adhesions Septums etc.", "explanation_word_count": 36, "prompt": "Upon Hysteroscopy which of the following cannot be seen:\nA. Tubal ostia\nB. Cervix\nC. Endometrium\nD. Tubal patency\nReturn the correct option letter.", "reference": "Hysteroscopy is best for diagnosing lesions within the uterine cavity Also: Abnormal Uterine Bleeding Oligomenorrhea amenorrhea, Recurrent Pregnancy loss Endometrial carcinoma, Un-explained infeility Suspected anomalies Missing IUCDs Diagnosing intra uterine submucous fibroids, Polyps, adhesions Septums etc.\nD", "question_key": "upon hysteroscopy which of the following cannot be seen:", "split": "validation", "is_mia_member": false} | |
| {"id": "16107c24-4166-4db4-b831-4930e292f4a2", "question": "What is the investigation of choice for the diagnosis of colon cancer?", "opa": "Barium enema", "opb": "Colonoscopy + biopsy", "opc": "USG", "opd": "CT scan", "cop": 1, "answer": "B", "exp": "IOC for diagnosis of colon cancer- Colonoscopy + biopsy IOC for staging of colon cancer- CECT Most impoant prognostic factor- stage (TNM) Single independent most impoant prognostic factor- LN status", "explanation_word_count": 29, "prompt": "What is the investigation of choice for the diagnosis of colon cancer?\nA. Barium enema\nB. Colonoscopy + biopsy\nC. USG\nD. CT scan\nReturn the correct option letter.", "reference": "IOC for diagnosis of colon cancer- Colonoscopy + biopsy IOC for staging of colon cancer- CECT Most impoant prognostic factor- stage (TNM) Single independent most impoant prognostic factor- LN status\nB", "question_key": "what is the investigation of choice for the diagnosis of colon cancer?", "split": "validation", "is_mia_member": false} | |
| {"id": "41c6f497-7e0b-4be1-9855-15668b2a99ed", "question": "A child presents with respiratory distress. A vascular ring is suspected. Investigation of choice is:", "opa": "PET", "opb": "CT", "opc": "MR1", "opd": "Angiography", "cop": 2, "answer": "C", "exp": "MRI Sabiston writes-\"Initially, diagnosis is made by a high index of suspicion, and the barium swallow is the first investigation. Echocardiography can document an abnormal head and neck vessel branching pattern, excluding intracardiac abnormalities. MRI provides complete anatomic detail.\" A vascular ring is a condition in which an anomalous configuration of the arch and/or its associated vessels completely or incompletely surrounds the trachea and oesophagus causing compression of these structures. Neonates present with respiratory distress, older children present with stridor or dysphagia. The two most common types of complete vascular rings, which account for 85-95% of cases, are double aoic arch and right aoic arch with left ligamentum aeriosum. Tracheomalacia results from compression of the trachea by vascular rings. Surgical division of a vascular ring is the only definitive treatment.", "explanation_word_count": 131, "prompt": "A child presents with respiratory distress. A vascular ring is suspected. Investigation of choice is:\nA. PET\nB. CT\nC. MR1\nD. Angiography\nReturn the correct option letter.", "reference": "MRI Sabiston writes-\"Initially, diagnosis is made by a high index of suspicion, and the barium swallow is the first investigation. Echocardiography can document an abnormal head and neck vessel branching pattern, excluding intracardiac abnormalities. MRI provides complete anatomic detail.\" A vascular ring is a condition in which an anomalous configuration of the arch and/or its associated vessels completely or incompletely surrounds the trachea and oesophagus causing compression of these structures. Neonates present with respiratory distress, older children present with stridor or dysphagia. The two most common types of complete vascular rings, which account for 85-95% of cases, are double aoic arch and right aoic arch with left ligamentum aeriosum. Tracheomalacia results from compression of the trachea by vascular rings. Surgical division of a vascular ring is the only definitive treatment.\nC", "question_key": "a child presents with respiratory distress. a vascular ring is suspected. investigation of choice is:", "split": "validation", "is_mia_member": false} | |
| {"id": "d96d1a84-3c4f-474b-a464-525f195c0337", "question": "Characteristic subperiosteal bone resorption in Hyperparathyroidism is best seen at?", "opa": "Rib margins", "opb": "Medial margin of proximal humerus", "opc": "Radial border of middle phalanx", "opd": "Lamina dura", "cop": 2, "answer": "C", "exp": "Ans:C.)Radial border of middle phalanx The classic features of hyperparathyroidism are subperiosteal resorption, endosteal resorption, and osteopenia. Subperiosteal bone resorption classically affects the radial aspects of the proximal and middle phalanges of the 2nd and 3rd fingers medial aspect of tibia, femur, humerus lamina dura: floating teeth (not specific)", "explanation_word_count": 51, "prompt": "Characteristic subperiosteal bone resorption in Hyperparathyroidism is best seen at?\nA. Rib margins\nB. Medial margin of proximal humerus\nC. Radial border of middle phalanx\nD. Lamina dura\nReturn the correct option letter.", "reference": "Ans:C.)Radial border of middle phalanx The classic features of hyperparathyroidism are subperiosteal resorption, endosteal resorption, and osteopenia. Subperiosteal bone resorption classically affects the radial aspects of the proximal and middle phalanges of the 2nd and 3rd fingers medial aspect of tibia, femur, humerus lamina dura: floating teeth (not specific)\nC", "question_key": "characteristic subperiosteal bone resorption in hyperparathyroidism is best seen at?", "split": "validation", "is_mia_member": false} | |
| {"id": "a9d8158e-2d17-4a08-bbfc-ab2d48aeb5d2", "question": "Filament in X-ray machine is made up of: March 2005", "opa": "Molybdenum", "opb": "Tungsten", "opc": "Strontium", "opd": "Silver", "cop": 1, "answer": "B", "exp": "Ans. B: Tungsten The earliest material used was barium oxide; it forms a monoatomic layer of barium with an extremely low work function. More modern formulations utilize a mixture of barium oxide, strontium oxide and calcium oxide. Another standard formulation is barium oxide, calcium oxide, and aluminium oxide in a 5:3:2 ratio. Thorium oxide is used as well. Oxide-coated cathodes operate at about 800-1000 degC, orange-hot. They are used in most small glass vacuum tubes, but are rarely used in high-power tubes since they are vulnerable to high voltages and oxygen ions, and undergo rapid degradation under such conditions. Hot cathodes may be either directly heated, where the filament itself is the source of electrons, or indirectly heated, where the filament is electrically insulated from the cathode; this configuration minimizes the introduction of hum when the filament is energized with alternating current. The filament is most often made of tungsten. With indirectly heated cathodes, the filament is usually called the heater instead. The cathode for indirect heating is usually realized as a nickel tube which surrounds the heater.", "explanation_word_count": 176, "prompt": "Filament in X-ray machine is made up of: March 2005\nA. Molybdenum\nB. Tungsten\nC. Strontium\nD. Silver\nReturn the correct option letter.", "reference": "Ans. B: Tungsten The earliest material used was barium oxide; it forms a monoatomic layer of barium with an extremely low work function. More modern formulations utilize a mixture of barium oxide, strontium oxide and calcium oxide. Another standard formulation is barium oxide, calcium oxide, and aluminium oxide in a 5:3:2 ratio. Thorium oxide is used as well. Oxide-coated cathodes operate at about 800-1000 degC, orange-hot. They are used in most small glass vacuum tubes, but are rarely used in high-power tubes since they are vulnerable to high voltages and oxygen ions, and undergo rapid degradation under such conditions. Hot cathodes may be either directly heated, where the filament itself is the source of electrons, or indirectly heated, where the filament is electrically insulated from the cathode; this configuration minimizes the introduction of hum when the filament is energized with alternating current. The filament is most often made of tungsten. With indirectly heated cathodes, the filament is usually called the heater instead. The cathode for indirect heating is usually realized as a nickel tube which surrounds the heater.\nB", "question_key": "filament in x-ray machine is made up of: march 2005", "split": "validation", "is_mia_member": false} | |
| {"id": "9ab6c518-d764-4a06-987f-2d540ebbdfc9", "question": "A known alcoholic is brought to the emergency depament by his wife. The person has not consumed alcohol for the past two days due to religious reasons. The person complained of nausea, vomiting and dizziness. On the second day, he developed seizures, that progressed to generalized tonic clonic seizures (GTCs). Which of the following would be the best medication to manage the seizures of the patients?", "opa": "Sodium valproate", "opb": "Phenytoin", "opc": "Diazepam", "opd": "Clonidine", "cop": 2, "answer": "C", "exp": "Ans. c. DiazepamThe seizures in this patient, is due to alcohol withdrawal. Diazepam would be best medication to manage the seizure ofthe patient.'Long acting benzodiazepines such as chlordiazepoxide and diazepam or sho acting such as lorazepam can be used totreat mild-moderate uncomplicated alcohol withdrawal.'Chlordiazepoxide is preferred over diazepamfor treatment of alcohol withdrawal syndrome.", "explanation_word_count": 55, "prompt": "A known alcoholic is brought to the emergency depament by his wife. The person has not consumed alcohol for the past two days due to religious reasons. The person complained of nausea, vomiting and dizziness. On the second day, he developed seizures, that progressed to generalized tonic clonic seizures (GTCs). Which of the following would be the best medication to manage the seizures of the patients?\nA. Sodium valproate\nB. Phenytoin\nC. Diazepam\nD. Clonidine\nReturn the correct option letter.", "reference": "Ans. c. DiazepamThe seizures in this patient, is due to alcohol withdrawal. Diazepam would be best medication to manage the seizure ofthe patient.'Long acting benzodiazepines such as chlordiazepoxide and diazepam or sho acting such as lorazepam can be used totreat mild-moderate uncomplicated alcohol withdrawal.'Chlordiazepoxide is preferred over diazepamfor treatment of alcohol withdrawal syndrome.\nC", "question_key": "a known alcoholic is brought to the emergency depament by his wife. the person has not consumed alcohol for the past two days due to religious reasons. the person complained of nausea, vomiting and dizziness. on the second day, he developed seizures, that progressed to generalized tonic clonic seizures (gtcs). which of the following would be the best medication to manage the seizures of the patients?", "split": "validation", "is_mia_member": false} | |
| {"id": "a12cf0b7-c229-472a-aa38-62b85acc2f57", "question": "Which is the earliest feature of multiple sclerosis ?", "opa": "Internuclear opthalmoplegia", "opb": "Optic neuritis", "opc": "Cerebellar ataxia", "opd": "Diplopia", "cop": 1, "answer": "B", "exp": "Sudden onset of optic or retrobulbar optic neuritis without any associated CNS involvement can be interpreted as the first sign or only sign of multiple sclerosis provided other causes of optic neuritis are excluded. Reference: Current Medical Diagnosis and Treatment By Panda 3rd edition page 537.", "explanation_word_count": 45, "prompt": "Which is the earliest feature of multiple sclerosis ?\nA. Internuclear opthalmoplegia\nB. Optic neuritis\nC. Cerebellar ataxia\nD. Diplopia\nReturn the correct option letter.", "reference": "Sudden onset of optic or retrobulbar optic neuritis without any associated CNS involvement can be interpreted as the first sign or only sign of multiple sclerosis provided other causes of optic neuritis are excluded. Reference: Current Medical Diagnosis and Treatment By Panda 3rd edition page 537.\nB", "question_key": "which is the earliest feature of multiple sclerosis ?", "split": "validation", "is_mia_member": false} | |
| {"id": "2b999fc2-3556-4b9e-8324-3069dd1c1b3a", "question": "Which of the following is not an early adverse effect of methotrexate?", "opa": "Hepatic fibrosis", "opb": "Myelosupression", "opc": "Nausea", "opd": "Stomatitis", "cop": 0, "answer": "A", "exp": "Methotrexate (Mtx) It is one of the oldest and highly efficacious antineoplastic drugs; inhibits dihydrofolate reductase (DHFRase)-blocking the conversion of dihydrofolic acid (DHFA) to tetrahydrofolic acid (THFA) which is an essential coenzyme required for one carbon transfer reactions in de novo purine synthesis and amino acid interconversions. The inhibition is pseudoirreversible because Mtx has 50,000 times higher affinity for the enzyme than the normal substrate. Methotrexate has cell cycle specific actionkills cells in S phase; primarily inhibits DNA synthesis, but also affects RNA and protein synthesis. It exes major toxicity on bone marrow-low doses given repeatedly cause megaloblastic anaemia, but high doses produce pancytopenia. Desquamation and bleeding may occur in g.i.t Adverse Effects >10% Arachnoiditis with intrathecal administration Subacute toxicity with intrathecal administration (paralysis of extremities, cranial nerve palsy, seizure or coma) Demyelinating encephalopathy with cranial irradiation or other systemic chemotherapy Reddening of skin Hyperuricemia Ulcerative stomatitis Glossitis Gingivitis Nausea and vomiting Diarrhea Anorexia Intestinal perforation Mucositis (dose-dependent) Leukopenia Thrombocytopenia Renal failure Azotemia Nephropathy Pharyngitis 1-10% Alopecia Photosensitivity Rash Abdominal distress Malaise Fatigue Chills, fever Decreased resistance to infection Gastrointestinal hemorrhage Myelosuppression Disorders of lung, interstitial pneumonia (acute, chronic) Atrophy of liver, cirrhosis, hepatic fibrosis or necrosis, elevated liver function tests, hepatic failure REFERENCE: www.medscape.com, essentials of medical pharmacology(k.d.tripathi,sixth edition,page no:823)", "explanation_word_count": 218, "prompt": "Which of the following is not an early adverse effect of methotrexate?\nA. Hepatic fibrosis\nB. Myelosupression\nC. Nausea\nD. Stomatitis\nReturn the correct option letter.", "reference": "Methotrexate (Mtx) It is one of the oldest and highly efficacious antineoplastic drugs; inhibits dihydrofolate reductase (DHFRase)-blocking the conversion of dihydrofolic acid (DHFA) to tetrahydrofolic acid (THFA) which is an essential coenzyme required for one carbon transfer reactions in de novo purine synthesis and amino acid interconversions. The inhibition is pseudoirreversible because Mtx has 50,000 times higher affinity for the enzyme than the normal substrate. Methotrexate has cell cycle specific actionkills cells in S phase; primarily inhibits DNA synthesis, but also affects RNA and protein synthesis. It exes major toxicity on bone marrow-low doses given repeatedly cause megaloblastic anaemia, but high doses produce pancytopenia. Desquamation and bleeding may occur in g.i.t Adverse Effects >10% Arachnoiditis with intrathecal administration Subacute toxicity with intrathecal administration (paralysis of extremities, cranial nerve palsy, seizure or coma) Demyelinating encephalopathy with cranial irradiation or other systemic chemotherapy Reddening of skin Hyperuricemia Ulcerative stomatitis Glossitis Gingivitis Nausea and vomiting Diarrhea Anorexia Intestinal perforation Mucositis (dose-dependent) Leukopenia Thrombocytopenia Renal failure Azotemia Nephropathy Pharyngitis 1-10% Alopecia Photosensitivity Rash Abdominal distress Malaise Fatigue Chills, fever Decreased resistance to infection Gastrointestinal hemorrhage Myelosuppression Disorders of lung, interstitial pneumonia (acute, chronic) Atrophy of liver, cirrhosis, hepatic fibrosis or necrosis, elevated liver function tests, hepatic failure REFERENCE: www.medscape.com, essentials of medical pharmacology(k.d.tripathi,sixth edition,page no:823)\nA", "question_key": "which of the following is not an early adverse effect of methotrexate?", "split": "validation", "is_mia_member": false} | |
| {"id": "e7cebf15-acf9-42b0-a2b3-8de9bcd4750e", "question": "Disposal of Glass vaccine ls as Biomedical wastes is done by:-", "opa": "Incineration", "opb": "Autoclaving then Landfill", "opc": "Disinfection then recycling", "opd": "Encapsulation", "cop": 2, "answer": "C", "exp": "Disposal of glass vaccine ls and metallic body implants as biomedical wastes: Blue category. Treatment and disposal is done by Chemical treatment/autoclaving / Hydroclaving / Microwaving followed by Recycling.", "explanation_word_count": 28, "prompt": "Disposal of Glass vaccine ls as Biomedical wastes is done by:-\nA. Incineration\nB. Autoclaving then Landfill\nC. Disinfection then recycling\nD. Encapsulation\nReturn the correct option letter.", "reference": "Disposal of glass vaccine ls and metallic body implants as biomedical wastes: Blue category. Treatment and disposal is done by Chemical treatment/autoclaving / Hydroclaving / Microwaving followed by Recycling.\nC", "question_key": "disposal of glass vaccine ls as biomedical wastes is done by:-", "split": "validation", "is_mia_member": false} | |
| {"id": "139b754d-2485-41e5-a43b-046e79438f79", "question": "Maximum refraction takes place between?", "opa": "Air tear film", "opb": "Tear film and cornea", "opc": "Cornea and aqueous", "opd": "Aqueous lens", "cop": 1, "answer": "B", "exp": "Tear film and cornea REF: khurana 4th ed page 26 \"Maximum refraction in eye takes place between tear film and cornea\"", "explanation_word_count": 20, "prompt": "Maximum refraction takes place between?\nA. Air tear film\nB. Tear film and cornea\nC. Cornea and aqueous\nD. Aqueous lens\nReturn the correct option letter.", "reference": "Tear film and cornea REF: khurana 4th ed page 26 \"Maximum refraction in eye takes place between tear film and cornea\"\nB", "question_key": "maximum refraction takes place between?", "split": "validation", "is_mia_member": false} | |
| {"id": "1afd4912-7356-45a0-b99d-d44ce8077ea0", "question": "'Bulla spread sign' is seen in which of the following condition?", "opa": "Herpes gestationalis", "opb": "Bullous pemphigoid", "opc": "Pemphigus vulgaris", "opd": "Herpes simplex", "cop": 2, "answer": "C", "exp": "Pemphigus vulgaris is associated with positive Nikolsky sign and Asboe- Hansen sign or Bullae spread sign. In positive bullae spread sign, pressing the top of existing bullae will lead to spread of bullae to adjacent normal appearing skin. Positive Nikolsky sign refers to shearing of the epidermis by exeing lateral pressure on the normal skin adjacent to an active blister. Pemphigus vulgaris is an acquired chronic disease in which blisters develop on normal appearing skin and mucous membrane. In this condition the pemphigus antibodies attach to extracellular domain of desmoglein and interfere with its attachment to similar domains on other cells reducing cell cell adherence. It is characterised by the development of flaccid clear blister which rupture and evolve into an inflamed erosion. Ref: Blistering Skin Diseases By Lawrence S. Chan page 26.", "explanation_word_count": 132, "prompt": "'Bulla spread sign' is seen in which of the following condition?\nA. Herpes gestationalis\nB. Bullous pemphigoid\nC. Pemphigus vulgaris\nD. Herpes simplex\nReturn the correct option letter.", "reference": "Pemphigus vulgaris is associated with positive Nikolsky sign and Asboe- Hansen sign or Bullae spread sign. In positive bullae spread sign, pressing the top of existing bullae will lead to spread of bullae to adjacent normal appearing skin. Positive Nikolsky sign refers to shearing of the epidermis by exeing lateral pressure on the normal skin adjacent to an active blister. Pemphigus vulgaris is an acquired chronic disease in which blisters develop on normal appearing skin and mucous membrane. In this condition the pemphigus antibodies attach to extracellular domain of desmoglein and interfere with its attachment to similar domains on other cells reducing cell cell adherence. It is characterised by the development of flaccid clear blister which rupture and evolve into an inflamed erosion. Ref: Blistering Skin Diseases By Lawrence S. Chan page 26.\nC", "question_key": "'bulla spread sign' is seen in which of the following condition?", "split": "validation", "is_mia_member": false} | |
| {"id": "30eab9d9-1bc4-44ba-9779-28c970751430", "question": "Bidextrous grasp appears at:", "opa": "3 months", "opb": "4 months", "opc": "5 months", "opd": "6 months", "cop": 2, "answer": "C", "exp": "16 weeks - Tries to reach cube, but overshoots and misses. 20 weeks- Able to grasp voluntarily, Bidextrous approach 24 weeks- More mature grasp, Drops one cube when another is given. 28 weeks- Unidextrous approach, Bangs cube on table. Transfers. Retains one when another is given. Ref: Illingwoh's \" The development of young child and infant\" - page 278.", "explanation_word_count": 51, "prompt": "Bidextrous grasp appears at:\nA. 3 months\nB. 4 months\nC. 5 months\nD. 6 months\nReturn the correct option letter.", "reference": "16 weeks - Tries to reach cube, but overshoots and misses. 20 weeks- Able to grasp voluntarily, Bidextrous approach 24 weeks- More mature grasp, Drops one cube when another is given. 28 weeks- Unidextrous approach, Bangs cube on table. Transfers. Retains one when another is given. Ref: Illingwoh's \" The development of young child and infant\" - page 278.\nC", "question_key": "bidextrous grasp appears at:", "split": "validation", "is_mia_member": false} | |
| {"id": "d34b0ed9-c1e5-4e50-b0df-910484a527d6", "question": "Duration Of 2nd hea sound is", "opa": "0.15sec", "opb": "0.12 sec", "opc": "0.08 sec", "opd": "0.1 sec", "cop": 1, "answer": "B", "exp": "The second sound lasts about 0.12 s, with a frequency of 50 Hz. It is loud and sharp when the diastolic pressure in the aoa or pulmonary aery is elevated, causing the respective valves to shut briskly at the end of systole Second hea sound is due to sudden closure of semilunar valves at the end of systole. Ref: Ganong's Review of medical physiology 25th edition. Page: 542", "explanation_word_count": 65, "prompt": "Duration Of 2nd hea sound is\nA. 0.15sec\nB. 0.12 sec\nC. 0.08 sec\nD. 0.1 sec\nReturn the correct option letter.", "reference": "The second sound lasts about 0.12 s, with a frequency of 50 Hz. It is loud and sharp when the diastolic pressure in the aoa or pulmonary aery is elevated, causing the respective valves to shut briskly at the end of systole Second hea sound is due to sudden closure of semilunar valves at the end of systole. Ref: Ganong's Review of medical physiology 25th edition. Page: 542\nB", "question_key": "duration of 2nd hea sound is", "split": "validation", "is_mia_member": false} | |
| {"id": "bed9df31-10dc-4550-8ccf-b60049a63619", "question": "Community acquired pneumonia in person rearing sheep ?", "opa": "Coxeilla brunetti", "opb": "Histoplasma capsulatum", "opc": "Streptococcus Pneumonae", "opd": "Bacillus anthracis", "cop": 0, "answer": "A", "exp": "Ans. is 'a' i.e., Coxeilla brunetti C. burnetti is found in ticks, which transmit the agent to sheep, goats and cattle.Workers in Slaughterhouses and in plants that process wool and cattle hides have contracted the disease (Q fever) as a result of handling infected animal tissue.C. burnetti causes Q-fever which presents as interstitial pneumonia.", "explanation_word_count": 57, "prompt": "Community acquired pneumonia in person rearing sheep ?\nA. Coxeilla brunetti\nB. Histoplasma capsulatum\nC. Streptococcus Pneumonae\nD. Bacillus anthracis\nReturn the correct option letter.", "reference": "Ans. is 'a' i.e., Coxeilla brunetti C. burnetti is found in ticks, which transmit the agent to sheep, goats and cattle.Workers in Slaughterhouses and in plants that process wool and cattle hides have contracted the disease (Q fever) as a result of handling infected animal tissue.C. burnetti causes Q-fever which presents as interstitial pneumonia.\nA", "question_key": "community acquired pneumonia in person rearing sheep ?", "split": "validation", "is_mia_member": false} | |
| {"id": "151053f6-7975-474a-8b6d-391834e82991", "question": "Pulsus paradoxus is seen in -", "opa": "Cardiac tamponade", "opb": "Constrictive pericarditis", "opc": "Mitral stenosis", "opd": "Tricuspid regurgitation", "cop": 0, "answer": "A", "exp": "Pulsus paradoxus refers to a fall in systolic pressure >10 mmHg with inspiration that is seen in patients with pericardial tamponade but also is described in those with massive pulmonary embolism, hemorrhagic shock, severe obstructive lung disease, and tension pnuemothorax Pulsus paradoxus is measured by noting the difference between the systolic pressure at which the Korotkoff sounds are first heard (during expiration) and the systolic pressure at which the Korotkoff sounds are heard with each heabeat, independent of the respiratory phase. Between these two pressures, the Korotkoff sounds are heard only intermittently and during expiration. The cuff pressure must be decreased slowly to appreciate the finding. It can be difficult to measure pulsus paradoxus in patients with tachycardia, atrial fibrillation, or tachypnea. A pulsus paradoxus may be palpable at the brachial aery or femoral aery level when the pressure difference exceeds 15 mmHg. This inspiratory fall in systolic pressure is an exaggerated consequence of interventricular dependence. ref : Harrison&;s principle of internal medicine, 20th edition,pg no.1825", "explanation_word_count": 165, "prompt": "Pulsus paradoxus is seen in -\nA. Cardiac tamponade\nB. Constrictive pericarditis\nC. Mitral stenosis\nD. Tricuspid regurgitation\nReturn the correct option letter.", "reference": "Pulsus paradoxus refers to a fall in systolic pressure >10 mmHg with inspiration that is seen in patients with pericardial tamponade but also is described in those with massive pulmonary embolism, hemorrhagic shock, severe obstructive lung disease, and tension pnuemothorax Pulsus paradoxus is measured by noting the difference between the systolic pressure at which the Korotkoff sounds are first heard (during expiration) and the systolic pressure at which the Korotkoff sounds are heard with each heabeat, independent of the respiratory phase. Between these two pressures, the Korotkoff sounds are heard only intermittently and during expiration. The cuff pressure must be decreased slowly to appreciate the finding. It can be difficult to measure pulsus paradoxus in patients with tachycardia, atrial fibrillation, or tachypnea. A pulsus paradoxus may be palpable at the brachial aery or femoral aery level when the pressure difference exceeds 15 mmHg. This inspiratory fall in systolic pressure is an exaggerated consequence of interventricular dependence. ref : Harrison&;s principle of internal medicine, 20th edition,pg no.1825\nA", "question_key": "pulsus paradoxus is seen in -", "split": "validation", "is_mia_member": false} | |
| {"id": "ec63b22d-6127-497f-92d5-51c942133741", "question": "Most common complication of acute Otitis media in children:", "opa": "Deafness", "opb": "Mastoiditis", "opc": "Cholesteatoma", "opd": "Facial nerve palsy", "cop": 1, "answer": "B", "exp": "(b) Mastoiditis(Ref. Cummings, 6th ed., 2157; Scott Brown, 8th ed., Vol 2; 972)This is the most common complication following ASOM.Facial nerve palsy is an uncommon complication of ASOMDeafness (along with Pain and ear discharge) is the presenting feature of ASOMCholesteatoma is not associated with ASOM.", "explanation_word_count": 45, "prompt": "Most common complication of acute Otitis media in children:\nA. Deafness\nB. Mastoiditis\nC. Cholesteatoma\nD. Facial nerve palsy\nReturn the correct option letter.", "reference": "(b) Mastoiditis(Ref. Cummings, 6th ed., 2157; Scott Brown, 8th ed., Vol 2; 972)This is the most common complication following ASOM.Facial nerve palsy is an uncommon complication of ASOMDeafness (along with Pain and ear discharge) is the presenting feature of ASOMCholesteatoma is not associated with ASOM.\nB", "question_key": "most common complication of acute otitis media in children:", "split": "validation", "is_mia_member": false} | |
| {"id": "3d0b533d-f6b7-4caa-80d9-d8857d070e1e", "question": "Henoch Schonlein purpura presents with deposition of ?", "opa": "IgG", "opb": "IgA", "opc": "IgM", "opd": "IgE", "cop": 1, "answer": "B", "exp": "ANSWER: (B) IgAREF: Harrisons 17th ed chapter 319, CURRENT Medical Diagnosis & Treatment Chapter 20. Musculoskeletal & Immunologic DisordersHenoch-Schonlein purpura, the most common systemic vasculitis in children, occurs in adults as well. Typical features are palpable purpura, abdominal pain, arthritis, and hematuria. Pathologic features include leukocytodastic vasculitis with IgA deposition. The cause is not known.", "explanation_word_count": 51, "prompt": "Henoch Schonlein purpura presents with deposition of ?\nA. IgG\nB. IgA\nC. IgM\nD. IgE\nReturn the correct option letter.", "reference": "ANSWER: (B) IgAREF: Harrisons 17th ed chapter 319, CURRENT Medical Diagnosis & Treatment Chapter 20. Musculoskeletal & Immunologic DisordersHenoch-Schonlein purpura, the most common systemic vasculitis in children, occurs in adults as well. Typical features are palpable purpura, abdominal pain, arthritis, and hematuria. Pathologic features include leukocytodastic vasculitis with IgA deposition. The cause is not known.\nB", "question_key": "henoch schonlein purpura presents with deposition of ?", "split": "validation", "is_mia_member": false} | |
| {"id": "ffcb8f25-dc2c-479e-a9f9-24abd06852b6", "question": "Feature of hemorrhagic disease of new born is –", "opa": "Prolonged prothrombin time", "opb": "Defective platelet count", "opc": "Prolonged bleeding time", "opd": "Prolonged thrombin time", "cop": 0, "answer": "A", "exp": "Normal new borns are moderately deficient in vitamin K.\nThis deficiency increases on 3rd to 5th day when, vitamin K level falls further. The serum level of vitamin K starts increasing from 13th to 15th day of life and achieves adult level at 3 months.\nThis is normal, and does not produce any bleeding.\nIn hemorrhagic disease of the newborn there is delay in achieving the normal vitamin K level.\n\nClinical Features\n\nVitamin K deficiency produces severe bleeding.\nBleeding occurs from umbilical cord stump on 2nd/3rd day after birth.\nIntracranial bleding and large intramuscular hemorrhages may occur.\nIncreased prothronzbin time and increased partial thromboplastin time.\n\nT/T\n\nParenteral vitamin K therapy.", "explanation_word_count": 111, "prompt": "Feature of hemorrhagic disease of new born is –\nA. Prolonged prothrombin time\nB. Defective platelet count\nC. Prolonged bleeding time\nD. Prolonged thrombin time\nReturn the correct option letter.", "reference": "Normal new borns are moderately deficient in vitamin K.\nThis deficiency increases on 3rd to 5th day when, vitamin K level falls further. The serum level of vitamin K starts increasing from 13th to 15th day of life and achieves adult level at 3 months.\nThis is normal, and does not produce any bleeding.\nIn hemorrhagic disease of the newborn there is delay in achieving the normal vitamin K level.\n\nClinical Features\n\nVitamin K deficiency produces severe bleeding.\nBleeding occurs from umbilical cord stump on 2nd/3rd day after birth.\nIntracranial bleding and large intramuscular hemorrhages may occur.\nIncreased prothronzbin time and increased partial thromboplastin time.\n\nT/T\n\nParenteral vitamin K therapy.\nA", "question_key": "feature of hemorrhagic disease of new born is –", "split": "validation", "is_mia_member": false} | |
| {"id": "c0e0cfe5-8aa0-49ac-a874-8790053ef849", "question": "Which of the following is not used in the treatment of Pulmonary hypeension", "opa": "Calcium channel blockers", "opb": "Alpha blockers", "opc": "Prostacyclin", "opd": "Endothelin receptor antagonist", "cop": 1, "answer": "B", "exp": "Refer CMDT 2010/381 management of of idiopathic Pulmonary hypeension if the patient respond to vasodilators the Calcium channel blockers (including amlodipine diltiazem and Nifedipin) are the first line agents of drugs other drugs that can be used are phosphodiesterase inhibitors(sildenafil) Prostacyclin analogue(epoprostenol) Endothelin receptor blockers(bosenton)", "explanation_word_count": 47, "prompt": "Which of the following is not used in the treatment of Pulmonary hypeension\nA. Calcium channel blockers\nB. Alpha blockers\nC. Prostacyclin\nD. Endothelin receptor antagonist\nReturn the correct option letter.", "reference": "Refer CMDT 2010/381 management of of idiopathic Pulmonary hypeension if the patient respond to vasodilators the Calcium channel blockers (including amlodipine diltiazem and Nifedipin) are the first line agents of drugs other drugs that can be used are phosphodiesterase inhibitors(sildenafil) Prostacyclin analogue(epoprostenol) Endothelin receptor blockers(bosenton)\nB", "question_key": "which of the following is not used in the treatment of pulmonary hypeension", "split": "validation", "is_mia_member": false} | |
| {"id": "572e88e2-8214-4e2a-8a58-2f4573d8be38", "question": "Reactivation of VZV is known to occur in persons receiving immunosuppressive therapy. Which of the following is the best antiviral for treating this infection?", "opa": "Amantadine", "opb": "Boceprevir", "opc": "Ribavirin", "opd": "Valacyclovir", "cop": 3, "answer": "D", "exp": "Acyclovir and its derivatives valacyclovir (d), famciclovir, and penciclovir all are effective in treating active herpes zoster (shingles). There is some evidence that valacyclovir and famciclovir are better in speeding cutaneous healing and resolving pain than acyclovir. Only acyclovir may be used in children. Amantadine (a) blocks the M2 channel of influenza A virus, although the vast majority of strains circulating currently are resistant; boceprevir (b) is an inhibitor of HCV NS3/4A protease; ribavirin (c) is used in the treatment of HCV and respiratory syncytial virus; and zidovudine (e) is a nucleoside reverse transcriptase inhibitor used in the treatment of HIV.", "explanation_word_count": 102, "prompt": "Reactivation of VZV is known to occur in persons receiving immunosuppressive therapy. Which of the following is the best antiviral for treating this infection?\nA. Amantadine\nB. Boceprevir\nC. Ribavirin\nD. Valacyclovir\nReturn the correct option letter.", "reference": "Acyclovir and its derivatives valacyclovir (d), famciclovir, and penciclovir all are effective in treating active herpes zoster (shingles). There is some evidence that valacyclovir and famciclovir are better in speeding cutaneous healing and resolving pain than acyclovir. Only acyclovir may be used in children. Amantadine (a) blocks the M2 channel of influenza A virus, although the vast majority of strains circulating currently are resistant; boceprevir (b) is an inhibitor of HCV NS3/4A protease; ribavirin (c) is used in the treatment of HCV and respiratory syncytial virus; and zidovudine (e) is a nucleoside reverse transcriptase inhibitor used in the treatment of HIV.\nD", "question_key": "reactivation of vzv is known to occur in persons receiving immunosuppressive therapy. which of the following is the best antiviral for treating this infection?", "split": "validation", "is_mia_member": false} | |
| {"id": "f3ec29d5-b792-430b-bd5c-046504471423", "question": "Painful eye movement is a feature of?", "opa": "Optic neuritis", "opb": "Papilloedema", "opc": "Optic atrophy", "opd": "Optic nerve hypoplasia", "cop": 0, "answer": "A", "exp": "Ans. is 'a' i.e., Optic neuritis Clinical features of Optic neuritis* The condition is usually unilateral, except in toxic amblyopia. Major symptom of optic neuritis is profound vision loss and central vision is affected very early (in contrast to papilloedema). There is monocular sudden, progressive and profound loss of vision. The visual impairment is accompanied by disturbance of other visual functions such as loss of color vision (typically red desaturation) and reduced perception of light intensity. Occasionally patients may observe an altered perception of moving objects (Pulfrich phenomenon) or a worsening* of symptoms with exercise or an increase in body temperature (Uhthoff sign).* There is pain behind the eyeball, particularly in reterbulbar neuritis in which there is pain on eye movements, especially in upward and downward direction due to attachment of some fibres of superior rectus to the dura mater.* Visually evoked response (VER) shows reduced amplitude and delayed transmission time.", "explanation_word_count": 152, "prompt": "Painful eye movement is a feature of?\nA. Optic neuritis\nB. Papilloedema\nC. Optic atrophy\nD. Optic nerve hypoplasia\nReturn the correct option letter.", "reference": "Ans. is 'a' i.e., Optic neuritis Clinical features of Optic neuritis* The condition is usually unilateral, except in toxic amblyopia. Major symptom of optic neuritis is profound vision loss and central vision is affected very early (in contrast to papilloedema). There is monocular sudden, progressive and profound loss of vision. The visual impairment is accompanied by disturbance of other visual functions such as loss of color vision (typically red desaturation) and reduced perception of light intensity. Occasionally patients may observe an altered perception of moving objects (Pulfrich phenomenon) or a worsening* of symptoms with exercise or an increase in body temperature (Uhthoff sign).* There is pain behind the eyeball, particularly in reterbulbar neuritis in which there is pain on eye movements, especially in upward and downward direction due to attachment of some fibres of superior rectus to the dura mater.* Visually evoked response (VER) shows reduced amplitude and delayed transmission time.\nA", "question_key": "painful eye movement is a feature of?", "split": "validation", "is_mia_member": false} | |
| {"id": "242725ab-d6f9-49b6-b4ce-8eeae1decc27", "question": "Based on epidemiological studies, which of the following has been found to be most protective against colon cancer?", "opa": "High fiber diet", "opb": "Low fat diet", "opc": "Low selenium diet", "opd": "Low protein diet", "cop": 0, "answer": "A", "exp": "ENVIRONMENTAL FACTORS & ITS ASSOCIATED RISK TO CAUSE COLON CANCER: INCREASED RISK PROTECTIVE FACTORS High intake of dietary lipids Pelvic irradiation Streptococcus bovis endocarditis Ureterosigmoidostomy High fiber diet NSAIDs Hormone Replacement Therapy", "explanation_word_count": 31, "prompt": "Based on epidemiological studies, which of the following has been found to be most protective against colon cancer?\nA. High fiber diet\nB. Low fat diet\nC. Low selenium diet\nD. Low protein diet\nReturn the correct option letter.", "reference": "ENVIRONMENTAL FACTORS & ITS ASSOCIATED RISK TO CAUSE COLON CANCER: INCREASED RISK PROTECTIVE FACTORS High intake of dietary lipids Pelvic irradiation Streptococcus bovis endocarditis Ureterosigmoidostomy High fiber diet NSAIDs Hormone Replacement Therapy\nA", "question_key": "based on epidemiological studies, which of the following has been found to be most protective against colon cancer?", "split": "validation", "is_mia_member": false} | |
| {"id": "ac8f8e85-4d2d-4803-8310-0f51df7869e1", "question": "A double aoic arch is due to persistent ?", "opa": "Right 4th arch", "opb": "Right 6th arch", "opc": "Left 4th arch", "opd": "Left 6th arch", "cop": 0, "answer": "A", "exp": "Double aoic arch is most common vascular ring, caused by abnormal persistence of the distal segment of the RIGHT of 4th aoic arch. On lateral, arches are posterior to esophagus and anterior to trachea. Symptoms (of tracheal compression or difficulty swallowing) may begin at bih. Aoic arches: Aoic arches are sho vessels connecting ventral and dorsal aoae on each side they run within branchial (pharyngeal) arches are based gradually the 4th and 5th week, in 6 pairs in total the first, second and fifth pairs are developmental in perspective and they soon disappear.1. 1st aoic arch: disappears, a small poion persists and forms a piece of the maxillary aery.2. 2nd aoic arch: disappears, small poions of this arch contributes to the hyoid and stapedial aeries. 3. 3rd aoic arch: common carotid and initial segments of internal carotid aery.4. 4th aoic arch: has ultimate fate different on the right and left side on the left.RIGHT, the proximal segment of the right dorsal aoa persists and is incorporated into the R subclan aery whereas the distal segment regresses.LEFT, both the proximal and distal segments are retained and incorporated into the descending arch of the aoa.5. 5th aoic arch - is transient and soon obliterates.6. 6th aoic arch - pulmonary arch - RIGHT arch: the proximal segment is incorporated into the R pulmonary aery; the distal segment regresses. LEFT arch: the proximal segment is incorporated into the L pulmonary aery; the distal segment persists as the ductus aeriosus.Ref: Embryology for Medical Students, By Sudhir Sant, 2nd Edition, Page 133", "explanation_word_count": 253, "prompt": "A double aoic arch is due to persistent ?\nA. Right 4th arch\nB. Right 6th arch\nC. Left 4th arch\nD. Left 6th arch\nReturn the correct option letter.", "reference": "Double aoic arch is most common vascular ring, caused by abnormal persistence of the distal segment of the RIGHT of 4th aoic arch. On lateral, arches are posterior to esophagus and anterior to trachea. Symptoms (of tracheal compression or difficulty swallowing) may begin at bih. Aoic arches: Aoic arches are sho vessels connecting ventral and dorsal aoae on each side they run within branchial (pharyngeal) arches are based gradually the 4th and 5th week, in 6 pairs in total the first, second and fifth pairs are developmental in perspective and they soon disappear.1. 1st aoic arch: disappears, a small poion persists and forms a piece of the maxillary aery.2. 2nd aoic arch: disappears, small poions of this arch contributes to the hyoid and stapedial aeries. 3. 3rd aoic arch: common carotid and initial segments of internal carotid aery.4. 4th aoic arch: has ultimate fate different on the right and left side on the left.RIGHT, the proximal segment of the right dorsal aoa persists and is incorporated into the R subclan aery whereas the distal segment regresses.LEFT, both the proximal and distal segments are retained and incorporated into the descending arch of the aoa.5. 5th aoic arch - is transient and soon obliterates.6. 6th aoic arch - pulmonary arch - RIGHT arch: the proximal segment is incorporated into the R pulmonary aery; the distal segment regresses. LEFT arch: the proximal segment is incorporated into the L pulmonary aery; the distal segment persists as the ductus aeriosus.Ref: Embryology for Medical Students, By Sudhir Sant, 2nd Edition, Page 133\nA", "question_key": "a double aoic arch is due to persistent ?", "split": "validation", "is_mia_member": false} | |
| {"id": "674faf6b-981c-4808-94d2-e1dad7adaf3c", "question": "Anti-alpha fodrin autoantibodies are seen in", "opa": "Polymyositis", "opb": "Crohn's disease", "opc": "Sjogren's syndrome", "opd": "Grave's disease", "cop": 2, "answer": "C", "exp": "The presence of anti-alpha-fodrin autoantibodies has been repoed to be a highly specific and sensitive test for the diagnosis of Sjogren's syndrome (SjS). Anti-Ro/SSA, and anti-La/SSB autoantibodies are also seen in SjS. In polymyositis antisynthetase antibodies and anti Jo-1 antibodies are seen", "explanation_word_count": 44, "prompt": "Anti-alpha fodrin autoantibodies are seen in\nA. Polymyositis\nB. Crohn's disease\nC. Sjogren's syndrome\nD. Grave's disease\nReturn the correct option letter.", "reference": "The presence of anti-alpha-fodrin autoantibodies has been repoed to be a highly specific and sensitive test for the diagnosis of Sjogren's syndrome (SjS). Anti-Ro/SSA, and anti-La/SSB autoantibodies are also seen in SjS. In polymyositis antisynthetase antibodies and anti Jo-1 antibodies are seen\nC", "question_key": "anti-alpha fodrin autoantibodies are seen in", "split": "validation", "is_mia_member": false} | |
| {"id": "6ccb7f6b-d1d8-4f0a-b9b2-9ae9490f931b", "question": "Increased rouleaux formation in the peripheral blood is a characteristic feature of -", "opa": "Multiple myeloma", "opb": "Non-Hodgmin's lymphoma", "opc": "Tuberculosis", "opd": "Malaria", "cop": 0, "answer": "A", "exp": "Rouleaux in a Peripheral Smear, Multiple Myeloma. Rouleaux are linear aggregates of red blood cells that form in the presence of increased plasma proteins. This phenomenon differs from agglutination, in which red blood cells form grape like clusters due to the presence of antibodies bound to their surfaces Ref Davidson 23rd edition pg 976", "explanation_word_count": 53, "prompt": "Increased rouleaux formation in the peripheral blood is a characteristic feature of -\nA. Multiple myeloma\nB. Non-Hodgmin's lymphoma\nC. Tuberculosis\nD. Malaria\nReturn the correct option letter.", "reference": "Rouleaux in a Peripheral Smear, Multiple Myeloma. Rouleaux are linear aggregates of red blood cells that form in the presence of increased plasma proteins. This phenomenon differs from agglutination, in which red blood cells form grape like clusters due to the presence of antibodies bound to their surfaces Ref Davidson 23rd edition pg 976\nA", "question_key": "increased rouleaux formation in the peripheral blood is a characteristic feature of -", "split": "validation", "is_mia_member": false} | |
| {"id": "ff03f0f9-8eae-409f-9758-162678797ca7", "question": "A 30-year-old man is brought to the emergency department in respiratory distress following a shotgun wound to the face. There is a possible cervical spine injury. Which is the best way to gain rapid control of the airway?", "opa": "Nasotracheal intubation", "opb": "Percutaneous jet ventilation", "opc": "Cricothyroidotomy", "opd": "Endotracheal intubation", "cop": 2, "answer": "C", "exp": "In a patient with a massive midface injury, cricothyroidotomy or tracheostomy should be performed, depending on the urgency of the need for airway control (Figure below). Cricothyroidotomy can usually be performed more quickly than tracheostomy. Nasotracheal and endotracheal intubation may push blood and debris into the trachea.Cricothyroidotomy is recommended for an emergency surgical airway. Vertical incisions are preferred to avoid injury to the anterior jugular veins, which are located just lateral to the midline. Hemorrhage from these vessels will obscure vision and prolong the procedure. When making an incision in the cricothyroid membrane, the blade of the knife should be angled inferiorly to avoid injury to the vocal cords. A. Heavy silk suture for traction on the thyroid cartilage. B. Insertion of the cricothyroid tube.", "explanation_word_count": 126, "prompt": "A 30-year-old man is brought to the emergency department in respiratory distress following a shotgun wound to the face. There is a possible cervical spine injury. Which is the best way to gain rapid control of the airway?\nA. Nasotracheal intubation\nB. Percutaneous jet ventilation\nC. Cricothyroidotomy\nD. Endotracheal intubation\nReturn the correct option letter.", "reference": "In a patient with a massive midface injury, cricothyroidotomy or tracheostomy should be performed, depending on the urgency of the need for airway control (Figure below). Cricothyroidotomy can usually be performed more quickly than tracheostomy. Nasotracheal and endotracheal intubation may push blood and debris into the trachea.Cricothyroidotomy is recommended for an emergency surgical airway. Vertical incisions are preferred to avoid injury to the anterior jugular veins, which are located just lateral to the midline. Hemorrhage from these vessels will obscure vision and prolong the procedure. When making an incision in the cricothyroid membrane, the blade of the knife should be angled inferiorly to avoid injury to the vocal cords. A. Heavy silk suture for traction on the thyroid cartilage. B. Insertion of the cricothyroid tube.\nC", "question_key": "a 30-year-old man is brought to the emergency department in respiratory distress following a shotgun wound to the face. there is a possible cervical spine injury. which is the best way to gain rapid control of the airway?", "split": "validation", "is_mia_member": false} | |
| {"id": "f26b35a1-2941-4c0a-8a64-587d029bf987", "question": "Type - A Bioterrorism agent include:", "opa": "Coxiella burnetti", "opb": "Bacillus anthracis", "opc": "Clostridium perfirengens", "opd": "NIPAH virus", "cop": 1, "answer": "B", "exp": "Bacillus antracis is the most commonly used Type A bio terrorism agent. Cl. Perfringens and brucellosis - Type B bio-terrorism agent Nipah virus - Type C bio-terrorism agent Type A Type B Type C Can be easily disseminated High moality rates (MOST DANGEROUS) Public panic and disruption Can moderately disseminate Moderate morbidity + low morbidity (LESS DANGEROUS) Require enhanced diagnostic capacity Require enhanced surveillance Emerging pathogens Ease to production High morbidity and moality Anthrax(M/C used) Small Pox(Most dangerous) Plague Botulism(Most lethal toxin) Tularaemia VHFs like Ebola and Marburg virus Brucellosis Glanders Melioidosis Psittacosis Q fever Epidemic Typhus Cl. Perfringens Food safety threats Water safety threats Ricin toxin Staphylococcal toxin Hanta virus Nipah virus", "explanation_word_count": 114, "prompt": "Type - A Bioterrorism agent include:\nA. Coxiella burnetti\nB. Bacillus anthracis\nC. Clostridium perfirengens\nD. NIPAH virus\nReturn the correct option letter.", "reference": "Bacillus antracis is the most commonly used Type A bio terrorism agent. Cl. Perfringens and brucellosis - Type B bio-terrorism agent Nipah virus - Type C bio-terrorism agent Type A Type B Type C Can be easily disseminated High moality rates (MOST DANGEROUS) Public panic and disruption Can moderately disseminate Moderate morbidity + low morbidity (LESS DANGEROUS) Require enhanced diagnostic capacity Require enhanced surveillance Emerging pathogens Ease to production High morbidity and moality Anthrax(M/C used) Small Pox(Most dangerous) Plague Botulism(Most lethal toxin) Tularaemia VHFs like Ebola and Marburg virus Brucellosis Glanders Melioidosis Psittacosis Q fever Epidemic Typhus Cl. Perfringens Food safety threats Water safety threats Ricin toxin Staphylococcal toxin Hanta virus Nipah virus\nB", "question_key": "type - a bioterrorism agent include:", "split": "validation", "is_mia_member": false} | |
| {"id": "5a611243-f1b2-470a-ab10-4b48a3184dff", "question": "Which one of the following viruses may be human tumor virus?", "opa": "Epstein-Barr virus (EBV)", "opb": "HIV", "opc": "Papillomavirus", "opd": "Varicella-zoster virus (VZV)", "cop": 2, "answer": "C", "exp": "Only two human viruses have been confirmed as human tumor viruses. They include human T-cell lymphoma/leukemia virus (HTLV) and papillomavirus. Others, such as EBV, HSV, and hepatitis B and C, have been implicated as tumor viruses. The virus that causes chicken pox (VZV) is not know to be oncogenic.", "explanation_word_count": 50, "prompt": "Which one of the following viruses may be human tumor virus?\nA. Epstein-Barr virus (EBV)\nB. HIV\nC. Papillomavirus\nD. Varicella-zoster virus (VZV)\nReturn the correct option letter.", "reference": "Only two human viruses have been confirmed as human tumor viruses. They include human T-cell lymphoma/leukemia virus (HTLV) and papillomavirus. Others, such as EBV, HSV, and hepatitis B and C, have been implicated as tumor viruses. The virus that causes chicken pox (VZV) is not know to be oncogenic.\nC", "question_key": "which one of the following viruses may be human tumor virus?", "split": "validation", "is_mia_member": false} | |
| {"id": "8116a95c-929b-416d-93ce-766e2e6b6508", "question": "Which stain is used for Corynebacterium diphtheriae -", "opa": "Geimsa", "opb": "Albert", "opc": "PAS", "opd": "India ink", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e., Albert* The diphtheria bacillus was first observed and described by Klebs (1883) but was first cultivated by Loeffler (1884).* Therefore, it is known as Klebs - Loeffler bacillus (KLB).* Corynebacterium diphtheria is gram positive slender rod (bacilli) which is noncapsulated and non-motile.* The bacilli are arranged in a characteristic fashion in smears, being at various angles to each other, resembling the letter V or L - Chinese letter or cuneiform arrangement. There is chracteristic 'Clubbed appearance'.* Characteristic feature is irregular staining due to presence of granules, called Babes Ernest or volutin granules. These granules are also called metachromatic granules or polar bodies. These granules are composed of polymetaphosphate. Volutin granules are usually stained with Loeffler's methylene blue or toluidine blue and appear reddish violet. Special stains for volutin granules are Ponder's stain, Albert's stain and Neisser's stain.", "explanation_word_count": 138, "prompt": "Which stain is used for Corynebacterium diphtheriae -\nA. Geimsa\nB. Albert\nC. PAS\nD. India ink\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e., Albert* The diphtheria bacillus was first observed and described by Klebs (1883) but was first cultivated by Loeffler (1884).* Therefore, it is known as Klebs - Loeffler bacillus (KLB).* Corynebacterium diphtheria is gram positive slender rod (bacilli) which is noncapsulated and non-motile.* The bacilli are arranged in a characteristic fashion in smears, being at various angles to each other, resembling the letter V or L - Chinese letter or cuneiform arrangement. There is chracteristic 'Clubbed appearance'.* Characteristic feature is irregular staining due to presence of granules, called Babes Ernest or volutin granules. These granules are also called metachromatic granules or polar bodies. These granules are composed of polymetaphosphate. Volutin granules are usually stained with Loeffler's methylene blue or toluidine blue and appear reddish violet. Special stains for volutin granules are Ponder's stain, Albert's stain and Neisser's stain.\nB", "question_key": "which stain is used for corynebacterium diphtheriae -", "split": "validation", "is_mia_member": false} | |
| {"id": "feb6bcf6-ce01-418d-9632-1c7150716764", "question": "To achieve the objectives of vertical condensation, it is necessary to produce:", "opa": "A cylindrical canal", "opb": "A conical canal", "opc": "A tapering conical canal", "opd": "A straight canal", "cop": 2, "answer": "C", "exp": "The root canal preparation should develop a continuously tapering cone. This shape mimics the natural canal shape. Funnel-shaped preparation of canal should merge with the access cavity so that instruments will slide into the canal. Thus, the access cavity and root canal preparation should form a continuous channel.\nTextbook of endodontics, 3rd edition Nisha Garg, Amit Garg", "explanation_word_count": 57, "prompt": "To achieve the objectives of vertical condensation, it is necessary to produce:\nA. A cylindrical canal\nB. A conical canal\nC. A tapering conical canal\nD. A straight canal\nReturn the correct option letter.", "reference": "The root canal preparation should develop a continuously tapering cone. This shape mimics the natural canal shape. Funnel-shaped preparation of canal should merge with the access cavity so that instruments will slide into the canal. Thus, the access cavity and root canal preparation should form a continuous channel.\nTextbook of endodontics, 3rd edition Nisha Garg, Amit Garg\nC", "question_key": "to achieve the objectives of vertical condensation, it is necessary to produce:", "split": "validation", "is_mia_member": false} | |
| {"id": "0c348c34-c8c2-49c2-8269-3cd43e348214", "question": "Chromosomes are visualized through light microscope with resolution of:", "opa": "5 kb", "opb": "50 mb", "opc": "5 mb", "opd": "500 kb", "cop": 2, "answer": "C", "exp": "Chromosomes are visualized through light microscope with resolution of 5 mb.Karyotype analysis:Organize all chromosomes by homology, size and shape.Provide an overview of the whole genome.Detect both numerical and structural chromosomal aberrations (overall resolution is 5 Mega bases (Mb); breakpoint resolution is 5 to 15 Mb).", "explanation_word_count": 45, "prompt": "Chromosomes are visualized through light microscope with resolution of:\nA. 5 kb\nB. 50 mb\nC. 5 mb\nD. 500 kb\nReturn the correct option letter.", "reference": "Chromosomes are visualized through light microscope with resolution of 5 mb.Karyotype analysis:Organize all chromosomes by homology, size and shape.Provide an overview of the whole genome.Detect both numerical and structural chromosomal aberrations (overall resolution is 5 Mega bases (Mb); breakpoint resolution is 5 to 15 Mb).\nC", "question_key": "chromosomes are visualized through light microscope with resolution of:", "split": "validation", "is_mia_member": false} | |
| {"id": "e48321de-6eac-4c37-8094-12e301ea3588", "question": "Pulmonary hypoplasia with urinary problems is associated with", "opa": "Mobius syndrome", "opb": "Potter syndrome", "opc": "Patau Syndorme", "opd": "WAGR syndrome", "cop": 1, "answer": "B", "exp": "Potter syndromePotter syndrome refers to the typical physical appearance and associated pulmonary hypoplasia of a neonate as a direct result of oligohydramnios and compression while in utero.In Potter syndrome, the primary problem is kidney failure mostly due to renal agenesis. The kidneys fail to develop properly as the baby is growing in the womb.(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2554)", "explanation_word_count": 65, "prompt": "Pulmonary hypoplasia with urinary problems is associated with\nA. Mobius syndrome\nB. Potter syndrome\nC. Patau Syndorme\nD. WAGR syndrome\nReturn the correct option letter.", "reference": "Potter syndromePotter syndrome refers to the typical physical appearance and associated pulmonary hypoplasia of a neonate as a direct result of oligohydramnios and compression while in utero.In Potter syndrome, the primary problem is kidney failure mostly due to renal agenesis. The kidneys fail to develop properly as the baby is growing in the womb.(Refer: Nelson's Textbook of Pediatrics, SAE, 1st edition, pg no. 2554)\nB", "question_key": "pulmonary hypoplasia with urinary problems is associated with", "split": "validation", "is_mia_member": false} | |
| {"id": "13bf3aff-1e4b-44c5-84a3-042f8e4732a1", "question": "The following muscle is an opener of the glottis", "opa": "Lateral cricoarytenoid", "opb": "Posterior cricoarytenoid", "opc": "Transverse arytenoid", "opd": "Inter arytenoids", "cop": 1, "answer": "B", "exp": "1. Muscles which abduct the vocal cords: only posterior cricoarytenoids( safety muscles of larynx) 2. Muscles which adduct the vocal cords: * lateral cricoarytenoids * transverse aenoid * cricothyroid *thyroarytenoids 3. Muscles which tense the vocal cords: cricothyroid 4.muscles which relax the vocal cords: * thyroarytenoids * vocalis 4. Muscles which close the inlet of the larynx * oblique arytenoids * aryepiglottic 5.muscles which open the inlet of larynx : Thyroepiglotticus Ref BDC volume 3; 6th edition pg 258", "explanation_word_count": 65, "prompt": "The following muscle is an opener of the glottis\nA. Lateral cricoarytenoid\nB. Posterior cricoarytenoid\nC. Transverse arytenoid\nD. Inter arytenoids\nReturn the correct option letter.", "reference": "1. Muscles which abduct the vocal cords: only posterior cricoarytenoids( safety muscles of larynx) 2. Muscles which adduct the vocal cords: * lateral cricoarytenoids * transverse aenoid * cricothyroid *thyroarytenoids 3. Muscles which tense the vocal cords: cricothyroid 4.muscles which relax the vocal cords: * thyroarytenoids * vocalis 4. Muscles which close the inlet of the larynx * oblique arytenoids * aryepiglottic 5.muscles which open the inlet of larynx : Thyroepiglotticus Ref BDC volume 3; 6th edition pg 258\nB", "question_key": "the following muscle is an opener of the glottis", "split": "validation", "is_mia_member": false} | |
| {"id": "4f34d0c2-4067-48cb-a1d2-ad85eb247ccd", "question": "Investigation of choice for recurrent GIST:", "opa": "MIBG", "opb": "PET CT", "opc": "MRI", "opd": "CECT", "cop": 1, "answer": "B", "exp": "Ans BRecurrent GIST indicates a small residual focus which can be identified by functional imaging like PET. GIST is not a neuroendocrine tumour and hence does not show uptake of MIBG.", "explanation_word_count": 31, "prompt": "Investigation of choice for recurrent GIST:\nA. MIBG\nB. PET CT\nC. MRI\nD. CECT\nReturn the correct option letter.", "reference": "Ans BRecurrent GIST indicates a small residual focus which can be identified by functional imaging like PET. GIST is not a neuroendocrine tumour and hence does not show uptake of MIBG.\nB", "question_key": "investigation of choice for recurrent gist:", "split": "validation", "is_mia_member": false} | |
| {"id": "c56a6f28-4d7a-43b0-af71-7578e08c8019", "question": "Most common eye pathology in toxoplasma infection is: March 2009", "opa": "Corneal ulcer", "opb": "Retinochoroiditis", "opc": "Uveitis", "opd": "Cataract", "cop": 1, "answer": "B", "exp": "Ans. B: Retinochoroiditis Intraocular features of toxoplasmosis infections are: Macular scarring Retinochoroiditis Vitritis When human retinal pigment epithelium (RPE) cells are infected with Toxoplasma gondii, there is an increased production of several cytokines including interleukin 1beta (IL-18), interleukin 6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF), and intercellular adhesion molecule (ICAM). Patients with acquired toxoplasmic retinochoroiditis exhibit higher levels of IL-1 than asymptomatic patients. IL-10 polymorphisms associated with a low production of IL-10 also appear to be associated with the occurrence of toxoplasmic retinochoroiditis. Toxoplasma parasites are rarely identified in aqueous humor samples from patients with active ocular toxoplasmosis.", "explanation_word_count": 96, "prompt": "Most common eye pathology in toxoplasma infection is: March 2009\nA. Corneal ulcer\nB. Retinochoroiditis\nC. Uveitis\nD. Cataract\nReturn the correct option letter.", "reference": "Ans. B: Retinochoroiditis Intraocular features of toxoplasmosis infections are: Macular scarring Retinochoroiditis Vitritis When human retinal pigment epithelium (RPE) cells are infected with Toxoplasma gondii, there is an increased production of several cytokines including interleukin 1beta (IL-18), interleukin 6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF), and intercellular adhesion molecule (ICAM). Patients with acquired toxoplasmic retinochoroiditis exhibit higher levels of IL-1 than asymptomatic patients. IL-10 polymorphisms associated with a low production of IL-10 also appear to be associated with the occurrence of toxoplasmic retinochoroiditis. Toxoplasma parasites are rarely identified in aqueous humor samples from patients with active ocular toxoplasmosis.\nB", "question_key": "most common eye pathology in toxoplasma infection is: march 2009", "split": "validation", "is_mia_member": false} | |
| {"id": "f7d5db75-199e-43e9-a4b2-1032e126429a", "question": "Schwable's ring is seen in which layer of cornea", "opa": "Bowmann's membrane", "opb": "Stroma", "opc": "Descemet's membrane", "opd": "Substantia propria", "cop": 2, "answer": "C", "exp": "Ans. is 'c' i.e., Descemet's membrane Histology of cornea The cornea has five distinct layers (from superficial to deep) : ? Epithelium : - It is the outermost pa of cornea and is composed of stratified squamous non-keratinized epithelial cells. Bowman's membrane : - It is not a true membrane but simply a condensed superficial pa of stroma. destroyed, it does not regenerate. Stroma (Substantia propria) : - This layer constitutes most of the cornea (90% of thickness). It consists of collagen fibrils (lamellae) embedded in hydrated matrix ofproteoglycans. Descemet's membrane : - This layer bounds the stroma posteriorly. In the periphery it appears to end at the anterior limit of trabecular meshwork as Schwahle's ring. Endothelium : - It is a single layer of flat polygnonal cells. The endothelial cells contain 'active-pump' mechanism and is the most impoant layer in maintaining the transparency of cornea.", "explanation_word_count": 134, "prompt": "Schwable's ring is seen in which layer of cornea\nA. Bowmann's membrane\nB. Stroma\nC. Descemet's membrane\nD. Substantia propria\nReturn the correct option letter.", "reference": "Ans. is 'c' i.e., Descemet's membrane Histology of cornea The cornea has five distinct layers (from superficial to deep) : ? Epithelium : - It is the outermost pa of cornea and is composed of stratified squamous non-keratinized epithelial cells. Bowman's membrane : - It is not a true membrane but simply a condensed superficial pa of stroma. destroyed, it does not regenerate. Stroma (Substantia propria) : - This layer constitutes most of the cornea (90% of thickness). It consists of collagen fibrils (lamellae) embedded in hydrated matrix ofproteoglycans. Descemet's membrane : - This layer bounds the stroma posteriorly. In the periphery it appears to end at the anterior limit of trabecular meshwork as Schwahle's ring. Endothelium : - It is a single layer of flat polygnonal cells. The endothelial cells contain 'active-pump' mechanism and is the most impoant layer in maintaining the transparency of cornea.\nC", "question_key": "schwable's ring is seen in which layer of cornea", "split": "validation", "is_mia_member": false} | |
| {"id": "4b3f3e73-c9fe-4649-bc3c-7efac39cd361", "question": "Epitope spreading refers to:", "opa": "A type of mechanism of spread of malignant tumors", "opb": "One type of mechanism of HIV dissemination", "opc": "A mechanism for the persistence and evolution of autoimmune disease", "opd": "One of the mechanisms of apoptosis", "cop": 2, "answer": "C", "exp": "Epitope spreading is a phenomenon in which an immune response against one self antigen causes tissue damage This causes release of other antigens, and resulting in the activation of lymphocytes by these newly encountered epitopes. This is responsible for the persistence and progression of autoimmune diseases.", "explanation_word_count": 46, "prompt": "Epitope spreading refers to:\nA. A type of mechanism of spread of malignant tumors\nB. One type of mechanism of HIV dissemination\nC. A mechanism for the persistence and evolution of autoimmune disease\nD. One of the mechanisms of apoptosis\nReturn the correct option letter.", "reference": "Epitope spreading is a phenomenon in which an immune response against one self antigen causes tissue damage This causes release of other antigens, and resulting in the activation of lymphocytes by these newly encountered epitopes. This is responsible for the persistence and progression of autoimmune diseases.\nC", "question_key": "epitope spreading refers to:", "split": "validation", "is_mia_member": false} | |
| {"id": "c0677bbc-934a-43c9-9bef-db9eaaade8d2", "question": "Intrinsic factor of Castle is secreted by?", "opa": "Chief cells", "opb": "Mucous cells", "opc": "Parietal cells", "opd": "p cells", "cop": 2, "answer": "C", "exp": "Intrinsic factor, a mucoprotein secreted by the parietal cells, binds with vitamin B12 of dietary origin and greatly enhances absorption of the vitamin. Absorption occurs by an active process in the terminal ileum. Intrinsic factor secretion is enhanced by stimuli that evoke H+ output from parietal cells. Pernicious anemia is characterized by atrophy of the parietal cell mucosa, deficiency in intrinsic factor, and anemia. Subclinical deficiencies in vitamin B12 have been described after operations that reduce gastric acid secretion, and abnormal Schilling tests in these patients can be corrected by the administration of intrinsic factor. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.", "explanation_word_count": 115, "prompt": "Intrinsic factor of Castle is secreted by?\nA. Chief cells\nB. Mucous cells\nC. Parietal cells\nD. p cells\nReturn the correct option letter.", "reference": "Intrinsic factor, a mucoprotein secreted by the parietal cells, binds with vitamin B12 of dietary origin and greatly enhances absorption of the vitamin. Absorption occurs by an active process in the terminal ileum. Intrinsic factor secretion is enhanced by stimuli that evoke H+ output from parietal cells. Pernicious anemia is characterized by atrophy of the parietal cell mucosa, deficiency in intrinsic factor, and anemia. Subclinical deficiencies in vitamin B12 have been described after operations that reduce gastric acid secretion, and abnormal Schilling tests in these patients can be corrected by the administration of intrinsic factor. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e.\nC", "question_key": "intrinsic factor of castle is secreted by?", "split": "validation", "is_mia_member": false} | |
| {"id": "24016da5-5a15-4dbb-96c7-1e6a82daf48b", "question": "Corneal tattooing may be done with:", "opa": "Gold chloride", "opb": "Calcium chloride", "opc": "Copper sulfate", "opd": "Potassium permanganate", "cop": 0, "answer": "A", "exp": "Cosmetic tattoos (also known as 'permanent makeup'): They camouflage skin discolorations, such as bihmarks (hemangiomas) or scars, tattooing'hair follicles' into bald areas or corneal tattooing in perforating injury. India ink is the most commonly used dye for corneal tattooing. Two other methods exist: chemical dyeing with gold or platinum chloride and carbon impregnation.", "explanation_word_count": 53, "prompt": "Corneal tattooing may be done with:\nA. Gold chloride\nB. Calcium chloride\nC. Copper sulfate\nD. Potassium permanganate\nReturn the correct option letter.", "reference": "Cosmetic tattoos (also known as 'permanent makeup'): They camouflage skin discolorations, such as bihmarks (hemangiomas) or scars, tattooing'hair follicles' into bald areas or corneal tattooing in perforating injury. India ink is the most commonly used dye for corneal tattooing. Two other methods exist: chemical dyeing with gold or platinum chloride and carbon impregnation.\nA", "question_key": "corneal tattooing may be done with:", "split": "validation", "is_mia_member": false} | |
| {"id": "5fefcf37-95d9-4054-adf9-7639351386c7", "question": "Which of the following drugs should not be used with rivastigmine in patients with alzheimer's disease -", "opa": "SSRI", "opb": "Tricyclic antidepressant", "opc": "RIMA", "opd": "Atypical antidepressants", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e., Tricyclic antidepressant Rivastigmine (cholinesterase inhibitor) should not be used with drugs that have cholinergic antagonistic activity like tricyclic antidepressants (TCA) as the combination is counter productive.", "explanation_word_count": 31, "prompt": "Which of the following drugs should not be used with rivastigmine in patients with alzheimer's disease -\nA. SSRI\nB. Tricyclic antidepressant\nC. RIMA\nD. Atypical antidepressants\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e., Tricyclic antidepressant Rivastigmine (cholinesterase inhibitor) should not be used with drugs that have cholinergic antagonistic activity like tricyclic antidepressants (TCA) as the combination is counter productive.\nB", "question_key": "which of the following drugs should not be used with rivastigmine in patients with alzheimer's disease -", "split": "validation", "is_mia_member": false} | |
| {"id": "62466e0b-be2f-4308-a951-c996b842c48f", "question": "Type of necrosis occuring in brain?", "opa": "Coagulative", "opb": "Liquefactive", "opc": "Fibrinoid", "opd": "Caseous", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e., Liquefactive Coagulative necrosis This is most common type of necrosis. This type of necrosis is most frequently caused by sudden cessation of blood flow (ischemia) in organs such as hea (MI), Kidney (ATN), adrenal gland, and spleen. Note : Brain is the only exception, i.e.,. It is the only solid organ in which ischemia leads to liquifactive necrosis not coagulative necrosis. It is also seen with other types of injury e.g., liver necrosis in viral hepatitis, Coagulative necrosis of skin after burns (Thermal injury). Why there is predominant protein denaturation and no enzymatic digestion ? Hypoxia causes intracellular acidosis (has been explained earlier) .1, pH results in denaturation of proteins which includes not only structural proteins but also enzymes --) So, there is no enzymatic digestion. The necrotic cells retain their cellular outline for several days. Liquefactive necrosis It is the necrotic degradation of tissue that rapidly undergo softening and liquefaction because of the action of hydrolytic enzymes. It occurs after Infection i.e., suppurative inflammation (most common). Ischemic necrosis in brain. Note : Brain lacks any substantial suppoive stroma, so ischemic necrosis in brain is liquifactive unlike other organs where it is coagulative. Mechanism of liquefactive necrosis --> Microbes stimulates accumulation of inflammatory cells and these cells release lysosomal enzymes. Caseous necrosis It is a variant of coagulative necrosis. It is most commonly encountered when cell death is attributable to ceain organisms e.g., mycobacterium tuberculosis (TB) and fungi (Histoplasma, Coccidioidomycosis). Why is it called caseous necrosis, not coagulative necrosis ? In contrast to coagulative necrosis where tissue architecture is maintained, in caseous necrosis, the tissue architecture is completely obliterated. So, it has been called caseous because of its cheesy white appearance of the area of necrosis.", "explanation_word_count": 288, "prompt": "Type of necrosis occuring in brain?\nA. Coagulative\nB. Liquefactive\nC. Fibrinoid\nD. Caseous\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e., Liquefactive Coagulative necrosis This is most common type of necrosis. This type of necrosis is most frequently caused by sudden cessation of blood flow (ischemia) in organs such as hea (MI), Kidney (ATN), adrenal gland, and spleen. Note : Brain is the only exception, i.e.,. It is the only solid organ in which ischemia leads to liquifactive necrosis not coagulative necrosis. It is also seen with other types of injury e.g., liver necrosis in viral hepatitis, Coagulative necrosis of skin after burns (Thermal injury). Why there is predominant protein denaturation and no enzymatic digestion ? Hypoxia causes intracellular acidosis (has been explained earlier) .1, pH results in denaturation of proteins which includes not only structural proteins but also enzymes --) So, there is no enzymatic digestion. The necrotic cells retain their cellular outline for several days. Liquefactive necrosis It is the necrotic degradation of tissue that rapidly undergo softening and liquefaction because of the action of hydrolytic enzymes. It occurs after Infection i.e., suppurative inflammation (most common). Ischemic necrosis in brain. Note : Brain lacks any substantial suppoive stroma, so ischemic necrosis in brain is liquifactive unlike other organs where it is coagulative. Mechanism of liquefactive necrosis --> Microbes stimulates accumulation of inflammatory cells and these cells release lysosomal enzymes. Caseous necrosis It is a variant of coagulative necrosis. It is most commonly encountered when cell death is attributable to ceain organisms e.g., mycobacterium tuberculosis (TB) and fungi (Histoplasma, Coccidioidomycosis). Why is it called caseous necrosis, not coagulative necrosis ? In contrast to coagulative necrosis where tissue architecture is maintained, in caseous necrosis, the tissue architecture is completely obliterated. So, it has been called caseous because of its cheesy white appearance of the area of necrosis.\nB", "question_key": "type of necrosis occuring in brain?", "split": "validation", "is_mia_member": false} | |
| {"id": "e837fc9a-be3a-46f9-92e8-71a213b9696d", "question": "The usual location of glomus jugulare tumour is", "opa": "Epitympanum", "opb": "Hypotypanum", "opc": "Mastoid tip cells", "opd": "Internal auditory meatus", "cop": 1, "answer": "B", "exp": "Glomus jugulare tumour arises from the dome of jugular bulb and invades hypotympanum and jugular foramen causing neurological signs of IX and XII cranial nerve involvement. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 121", "explanation_word_count": 38, "prompt": "The usual location of glomus jugulare tumour is\nA. Epitympanum\nB. Hypotypanum\nC. Mastoid tip cells\nD. Internal auditory meatus\nReturn the correct option letter.", "reference": "Glomus jugulare tumour arises from the dome of jugular bulb and invades hypotympanum and jugular foramen causing neurological signs of IX and XII cranial nerve involvement. Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 121\nB", "question_key": "the usual location of glomus jugulare tumour is", "split": "validation", "is_mia_member": false} | |
| {"id": "09e0e6a4-c672-4118-826a-2865b0b72505", "question": "A newborn has been brought with seizures refractory to treatment and a continuous bruit through the anterior fontanelle. CT shows midline lesion with hypoechogenesity and dilated lateral ventricles. Most probable diagnosis is?", "opa": "Teratoma", "opb": "Vein of Galen malformation", "opc": "Arachnoid cyst", "opd": "Encephalocele", "cop": 1, "answer": "B", "exp": "ANSWER: (B) Vein of Galen malformationREF: Nelson Textbook of Pediatrics 17th edition page 1974, 2037, Wolfgang Dahnert Braindisorders. In: Radiology review manual 5th edition. Lippincott Williams and Wilkins, Phoenix,AZ 2002; 326-327.Vein of Galen aneurysmal malformationsVein of Galen aneurysmal malformations (VGAM) and Vein of Galen aneurysmal dilations (VGAD), which are the most frequent arteriovenous malformations in infants and fetusesVGAM consisted of a tangled mass of dilated vessels supplied by an enlarged artery. The malformation increases greatly in size with age, although the mechanism of the increase is unknown. Dilation of the great cerebral vein of Galen is a secondary result of the force of arterial blood either directly from an artery via an arteriovenous fistula or by w^ay of a tributary vein that receives the blood directly from an artery.Malformations often lead to cardiac failure, cranial bruits (pattern 1), hydrocephaly, and subarachnoid hemorrhage in neonatesPatients with smaller communications may not have cardiovascular manifestations but may later be disposed to hydrocephalus or seizure disordersArteriovenous malformations of the middle cerebral artery or vein of Galen may produce a loud bruit most prominent over the anterior fontanel, temporal region, or the orbits and are best heard through the diaphragm of the stethoscope.Testing for a malformed vein of Galen is indicated when a patient has heart failure which has no obvious cause. Diagnosis is generally achieved by signs such as cranial bruits and symptoms such as expanded facial veins. The vein of Galen can be visualized using ultrasound or Doppler.Contrast enhanced axial CT scan or MRI of the brain usually demonstrates a well-defined, multilobulated, intensely enhancing lesion, located within the cistern of velum interpositum. Dilatation of the ventricular system, periventricular white matter hypodensities as well as diffuse cerebral atrophy is the commonly associated findings.Treatment depends on the anatomy of the malformation as determined by angiography or Magnetic Resonance Imaging (MRI)Neurosurgical procedures to relieve hydrocephalus are important. A ventriculoperitoneal shunt may be required in some infants. Recent advances over the past few decades have made endovascular embolization the preferred method of treatment.A pediatric cardiologist should be consulted to manage high-output failure, if present.Seizures usually are managed with antiepileptic medicationsVein of Galen malformations are difficult to treat and are associated with a poor prognosis.", "explanation_word_count": 372, "prompt": "A newborn has been brought with seizures refractory to treatment and a continuous bruit through the anterior fontanelle. CT shows midline lesion with hypoechogenesity and dilated lateral ventricles. Most probable diagnosis is?\nA. Teratoma\nB. Vein of Galen malformation\nC. Arachnoid cyst\nD. Encephalocele\nReturn the correct option letter.", "reference": "ANSWER: (B) Vein of Galen malformationREF: Nelson Textbook of Pediatrics 17th edition page 1974, 2037, Wolfgang Dahnert Braindisorders. In: Radiology review manual 5th edition. Lippincott Williams and Wilkins, Phoenix,AZ 2002; 326-327.Vein of Galen aneurysmal malformationsVein of Galen aneurysmal malformations (VGAM) and Vein of Galen aneurysmal dilations (VGAD), which are the most frequent arteriovenous malformations in infants and fetusesVGAM consisted of a tangled mass of dilated vessels supplied by an enlarged artery. The malformation increases greatly in size with age, although the mechanism of the increase is unknown. Dilation of the great cerebral vein of Galen is a secondary result of the force of arterial blood either directly from an artery via an arteriovenous fistula or by w^ay of a tributary vein that receives the blood directly from an artery.Malformations often lead to cardiac failure, cranial bruits (pattern 1), hydrocephaly, and subarachnoid hemorrhage in neonatesPatients with smaller communications may not have cardiovascular manifestations but may later be disposed to hydrocephalus or seizure disordersArteriovenous malformations of the middle cerebral artery or vein of Galen may produce a loud bruit most prominent over the anterior fontanel, temporal region, or the orbits and are best heard through the diaphragm of the stethoscope.Testing for a malformed vein of Galen is indicated when a patient has heart failure which has no obvious cause. Diagnosis is generally achieved by signs such as cranial bruits and symptoms such as expanded facial veins. The vein of Galen can be visualized using ultrasound or Doppler.Contrast enhanced axial CT scan or MRI of the brain usually demonstrates a well-defined, multilobulated, intensely enhancing lesion, located within the cistern of velum interpositum. Dilatation of the ventricular system, periventricular white matter hypodensities as well as diffuse cerebral atrophy is the commonly associated findings.Treatment depends on the anatomy of the malformation as determined by angiography or Magnetic Resonance Imaging (MRI)Neurosurgical procedures to relieve hydrocephalus are important. A ventriculoperitoneal shunt may be required in some infants. Recent advances over the past few decades have made endovascular embolization the preferred method of treatment.A pediatric cardiologist should be consulted to manage high-output failure, if present.Seizures usually are managed with antiepileptic medicationsVein of Galen malformations are difficult to treat and are associated with a poor prognosis.\nB", "question_key": "a newborn has been brought with seizures refractory to treatment and a continuous bruit through the anterior fontanelle. ct shows midline lesion with hypoechogenesity and dilated lateral ventricles. most probable diagnosis is?", "split": "validation", "is_mia_member": false} | |
| {"id": "33e83183-efc7-45e3-ac38-35ed981696dc", "question": "Vande Matram Scheme is included in-", "opa": "RCH", "opb": "ICDS", "opc": "IMCI", "opd": "NRHS", "cop": 0, "answer": "A", "exp": "Ans. is 'a' i.e., RCH o New initiatives in RCH are : i) Training of PHC doctors in life saving anaesthetic skills for emergency obstetric care a FRUS ii) Setting up blood storage centres at FRUS. iil) Janani suraksha yojna iv) Vandernataram scheme v) Safe aboion services vi) Integrated management of childhood illnesses.", "explanation_word_count": 53, "prompt": "Vande Matram Scheme is included in-\nA. RCH\nB. ICDS\nC. IMCI\nD. NRHS\nReturn the correct option letter.", "reference": "Ans. is 'a' i.e., RCH o New initiatives in RCH are : i) Training of PHC doctors in life saving anaesthetic skills for emergency obstetric care a FRUS ii) Setting up blood storage centres at FRUS. iil) Janani suraksha yojna iv) Vandernataram scheme v) Safe aboion services vi) Integrated management of childhood illnesses.\nA", "question_key": "vande matram scheme is included in-", "split": "validation", "is_mia_member": false} | |
| {"id": "d21b10a3-6937-40ed-adda-7e9acb11b892", "question": "The most common organism causing acute osteomyelitis is", "opa": "S. aureus", "opb": "E. coli", "opc": "Pseudomonas", "opd": "S. pyogenes", "cop": 0, "answer": "A", "exp": "Microorganisms that Cause OsteomyelitisOrganismCommentFrequently Encountered BacteriaStaphylococcus aureusMost likely bacterial pathogen. Aggressive, invasive. Often metastatic foci with bacteremia Consider surgery earlyStaphylococci other than S. aureus (coagulase-negative) Usually associated with foreign material or implantsBiofilm productionStreptococciMay spread rapidly through soft tissuesEnterobacteriaceae (Escherichia coli, Klebsiella spp., others) Considerable variation in antibiotic susceptibility Increasing antibiotic resistance with overuse May become resistant to antibiotics during therapyPseudomonas aeruginosaIncreasingly resistant to the antibiotics. The frequent successor to other bacteria when initial therapy fails. Maybe related to contaminationUnusual OrganismsAnaerobic bacteriaUsually mixed with aerobic bacteriaMay be synergisticSurvival dependent on devitalized tissue Baonella henselaeAssociated with cat scratches and probably with fleasBrucella speciesProminent in developing countries, especially with unpasteurized milkFungiCandida the most likely genusConsiderable variation in susceptibility, depending on species Surgery may be helpful if the infection is invasiveMycobacterium tuberculosisMay involve any boneVeebral osteomyelitis common in some countriesMycobacteria other than M. tuberculosisNeed special culture media to recoverVirusesAssociated with some viral infections, including varicella and variolaRef: Harrison's infectious disease 2nd edition, p260", "explanation_word_count": 159, "prompt": "The most common organism causing acute osteomyelitis is\nA. S. aureus\nB. E. coli\nC. Pseudomonas\nD. S. pyogenes\nReturn the correct option letter.", "reference": "Microorganisms that Cause OsteomyelitisOrganismCommentFrequently Encountered BacteriaStaphylococcus aureusMost likely bacterial pathogen. Aggressive, invasive. Often metastatic foci with bacteremia Consider surgery earlyStaphylococci other than S. aureus (coagulase-negative) Usually associated with foreign material or implantsBiofilm productionStreptococciMay spread rapidly through soft tissuesEnterobacteriaceae (Escherichia coli, Klebsiella spp., others) Considerable variation in antibiotic susceptibility Increasing antibiotic resistance with overuse May become resistant to antibiotics during therapyPseudomonas aeruginosaIncreasingly resistant to the antibiotics. The frequent successor to other bacteria when initial therapy fails. Maybe related to contaminationUnusual OrganismsAnaerobic bacteriaUsually mixed with aerobic bacteriaMay be synergisticSurvival dependent on devitalized tissue Baonella henselaeAssociated with cat scratches and probably with fleasBrucella speciesProminent in developing countries, especially with unpasteurized milkFungiCandida the most likely genusConsiderable variation in susceptibility, depending on species Surgery may be helpful if the infection is invasiveMycobacterium tuberculosisMay involve any boneVeebral osteomyelitis common in some countriesMycobacteria other than M. tuberculosisNeed special culture media to recoverVirusesAssociated with some viral infections, including varicella and variolaRef: Harrison's infectious disease 2nd edition, p260\nA", "question_key": "the most common organism causing acute osteomyelitis is", "split": "validation", "is_mia_member": false} | |
| {"id": "e72cb452-8797-45c3-ab58-3f31f08542c1", "question": "Radiation exposure during infancy has been linked to which one of the following carcinoma -", "opa": "Breast", "opb": "Melanoma", "opc": "Thyroid", "opd": "Lung", "cop": 2, "answer": "C", "exp": "Ans. is 'c' i.e., Thyroid o Radiation induced cancerso Radiation may induce some non-lethal changes in DNA sequences which may cause malignant transformation.* Examples of Radiation induced cancersTypes of ExposureTypes of Cancer ObservedNeck irradiation during infancy for benign conditionsThyroid carcinomaRadiation therapy for others malignant tumorsThyroid carcinomaBreast cancerGastric cancerMelanomaLung cancerSarcomas in the fieldCranial irradiationCentral nervous system tumorsBreast irradiation for postpartum mastitisBreast cancerBrush-licking by radium dial paintersBone sarcomasUranium miningLung cancerIn utero exposureLeukemia", "explanation_word_count": 71, "prompt": "Radiation exposure during infancy has been linked to which one of the following carcinoma -\nA. Breast\nB. Melanoma\nC. Thyroid\nD. Lung\nReturn the correct option letter.", "reference": "Ans. is 'c' i.e., Thyroid o Radiation induced cancerso Radiation may induce some non-lethal changes in DNA sequences which may cause malignant transformation.* Examples of Radiation induced cancersTypes of ExposureTypes of Cancer ObservedNeck irradiation during infancy for benign conditionsThyroid carcinomaRadiation therapy for others malignant tumorsThyroid carcinomaBreast cancerGastric cancerMelanomaLung cancerSarcomas in the fieldCranial irradiationCentral nervous system tumorsBreast irradiation for postpartum mastitisBreast cancerBrush-licking by radium dial paintersBone sarcomasUranium miningLung cancerIn utero exposureLeukemia\nC", "question_key": "radiation exposure during infancy has been linked to which one of the following carcinoma -", "split": "validation", "is_mia_member": false} | |
| {"id": "9ade2a77-cb0f-4b60-9506-889092173c75", "question": "In an emphysematous patient with hullous lesion which is the best investigation to measure lung volumes", "opa": "Body plethysmography", "opb": "Helium dilution", "opc": "Trans diaphragmatic pressure", "opd": "DLCO", "cop": 0, "answer": "A", "exp": "Body plethysmography During pulmonary function testing, lung volumes are usually measured by the spirometer. But ceain lung volumes e.g., RV, FRC and TLC cannot be measured by spirometer because they include the volume of the gas left in the lung (i.e., this air cannot come out of the lung, however.forcefully one may expire). Two techniques are commonly used to measure the lung volumes. - Helium dilution method. - Body plethysmography. Helium dilution method In the helium dilution method, the subject repeatedly breathes in and out from a reservoir with a known volume of gas containing a trace amount of helium. The helium is diluted by the gas previously present in the lungs and very little is absorbed into the pulmonary circulation. From knowledge of the reservoir volume and the initial and final helium concentrations, the volume of the gas present in the lungs can he calculated. The helium dilution method may underestimate the volume of gas in lungs if there are slowly communicating airspaces such as bullae. In this situation, lung volumes can be measured more accurately with a body plethysmography a sealed box in which patient sits while panting against a closed mouthpiece. Because there is no airflow into or out of the plethysmography the pressure changes in the thorax during panting cause compression and rarefaction of gas in the lungs and simultaneous rarefaction and compression of gas in the plethysmograph. By measuring the pressure changes in the plethysmograph and at the mouthpiece the volume of gas in the thorax can he calculated using Boyle's law.", "explanation_word_count": 258, "prompt": "In an emphysematous patient with hullous lesion which is the best investigation to measure lung volumes\nA. Body plethysmography\nB. Helium dilution\nC. Trans diaphragmatic pressure\nD. DLCO\nReturn the correct option letter.", "reference": "Body plethysmography During pulmonary function testing, lung volumes are usually measured by the spirometer. But ceain lung volumes e.g., RV, FRC and TLC cannot be measured by spirometer because they include the volume of the gas left in the lung (i.e., this air cannot come out of the lung, however.forcefully one may expire). Two techniques are commonly used to measure the lung volumes. - Helium dilution method. - Body plethysmography. Helium dilution method In the helium dilution method, the subject repeatedly breathes in and out from a reservoir with a known volume of gas containing a trace amount of helium. The helium is diluted by the gas previously present in the lungs and very little is absorbed into the pulmonary circulation. From knowledge of the reservoir volume and the initial and final helium concentrations, the volume of the gas present in the lungs can he calculated. The helium dilution method may underestimate the volume of gas in lungs if there are slowly communicating airspaces such as bullae. In this situation, lung volumes can be measured more accurately with a body plethysmography a sealed box in which patient sits while panting against a closed mouthpiece. Because there is no airflow into or out of the plethysmography the pressure changes in the thorax during panting cause compression and rarefaction of gas in the lungs and simultaneous rarefaction and compression of gas in the plethysmograph. By measuring the pressure changes in the plethysmograph and at the mouthpiece the volume of gas in the thorax can he calculated using Boyle's law.\nA", "question_key": "in an emphysematous patient with hullous lesion which is the best investigation to measure lung volumes", "split": "validation", "is_mia_member": false} | |
| {"id": "b1d4c875-0782-4f10-9537-d52e1935bc6e", "question": "Metal on Metal articulation should be avoided in -", "opa": "Osteonecrosis", "opb": "Young female", "opc": "Inflammatory arthritis", "opd": "Revision surgery", "cop": 1, "answer": "B", "exp": "Based on the articulating surfaces of the prosthesis, THR may be of the following type:-\n\n\nMetal on poly: One surface is metallic (femoral side) and the other is of polyethene (on the acetabular side).\nMetal on metal: Both articulating surfaces are of metal.\nCeramic on ceramic: Both articulating surfaces are of ceramic.\n\nContraindications to Metal on Metal Bearing surfaces\n(Metal on Metal Total Hip Replacement or Metal on Metal Hip Resurfacing)\n\nPatients with Renal Insufficiency (Chronic Renal failure) (Kidney are chiefly responsible for eliminating metal ions from the blood)\nYoung females of childbearing age (Women who may potentially still have children) (Elevated levels of metal ions have harmful effects on the fetus)\nPatients with metal hypersensitivity\n\nContraindications to (Metal on Metal) Hip Resurfacing (Not contraindications to Metal on metal articulation)\n\nLoss of femoral head (severe bone loss: poor bone stock)\nLarge femoral neck cysts (poor bone stock: found at surgery)\nThe small or bone deficient acetabulum\n\nConditions that require caution: Associated with increased risk of failure\n\nTall thin patients\nFemale patients\nPatients with femoral head cysts > 1 cm (on preoperative radiographs)\nPatients with high body mass index > 35\nRheumatoid arthritis (Inflammatory arthritis) and Osteonecrosis (AVIV)\n\nRheumatoid arthritis (Inflammatory arthritis) and osteonecrosis of the hip/ perthe's disease were earlier considered contraindications/ semi- contraindications for Resurfacing. These have now shown to have successful results.", "explanation_word_count": 220, "prompt": "Metal on Metal articulation should be avoided in -\nA. Osteonecrosis\nB. Young female\nC. Inflammatory arthritis\nD. Revision surgery\nReturn the correct option letter.", "reference": "Based on the articulating surfaces of the prosthesis, THR may be of the following type:-\n\n\nMetal on poly: One surface is metallic (femoral side) and the other is of polyethene (on the acetabular side).\nMetal on metal: Both articulating surfaces are of metal.\nCeramic on ceramic: Both articulating surfaces are of ceramic.\n\nContraindications to Metal on Metal Bearing surfaces\n(Metal on Metal Total Hip Replacement or Metal on Metal Hip Resurfacing)\n\nPatients with Renal Insufficiency (Chronic Renal failure) (Kidney are chiefly responsible for eliminating metal ions from the blood)\nYoung females of childbearing age (Women who may potentially still have children) (Elevated levels of metal ions have harmful effects on the fetus)\nPatients with metal hypersensitivity\n\nContraindications to (Metal on Metal) Hip Resurfacing (Not contraindications to Metal on metal articulation)\n\nLoss of femoral head (severe bone loss: poor bone stock)\nLarge femoral neck cysts (poor bone stock: found at surgery)\nThe small or bone deficient acetabulum\n\nConditions that require caution: Associated with increased risk of failure\n\nTall thin patients\nFemale patients\nPatients with femoral head cysts > 1 cm (on preoperative radiographs)\nPatients with high body mass index > 35\nRheumatoid arthritis (Inflammatory arthritis) and Osteonecrosis (AVIV)\n\nRheumatoid arthritis (Inflammatory arthritis) and osteonecrosis of the hip/ perthe's disease were earlier considered contraindications/ semi- contraindications for Resurfacing. These have now shown to have successful results.\nB", "question_key": "metal on metal articulation should be avoided in -", "split": "validation", "is_mia_member": false} | |
| {"id": "ef3dd9e9-66a4-479f-aeed-f4a525f9c1f8", "question": "Wof are anti diabetic agents that acts by increasing insulin sensitivity, and so should be euglycemics", "opa": "Phenformin", "opb": "Pioglitazone", "opc": "Sitagliptin", "opd": "Liraglutide", "cop": 1, "answer": "B", "exp": "Thiazolidinedione (PPARg agonist) Pioglitazone:- Only one thiazolidinedione Pioglitazone is currently available. Mech of action:- This class of oral antidiabetic drugs are selective agonists for the nuclear peroxisome proliferator-activated receptor g (PPARg) which is expressed mainly in fat cells, but also in muscle and some other cells. It enhances the transcription of several insulin responsive genes. Glitazones tend to reverse insulin resistance by enhancing GLUT4 expression and translocation. Entry of glucose into muscle and fat is improved. Hepatic gluconeo- genesis is also suppressed. Activation of genes regulating fatty acid metabolism and lipogenesis in adipose tissue contributes to the insulin sensitizing action. Lipolysis and plasma fatty acid levels are reduced. Adipocyte turnover and differentiation is accelerated by glitazones. Thus, fatty tissue is a major site of their action. Improved glycaemic control results inlowering of circulating HbA1C and insulin levels in type 2 DM patients. Pioglitazone, in addition, lowers serum triglyceride level and raises HDL level without much change in LDL level, probably because it acts on PPARa as well to induce expression of reverse cholesterol transpoer and some apoproteins. Monotherapy with glitazones is not associated with hypoglycaemic episodes. Ref:- kd tripathi; pg num:-276,277", "explanation_word_count": 191, "prompt": "Wof are anti diabetic agents that acts by increasing insulin sensitivity, and so should be euglycemics\nA. Phenformin\nB. Pioglitazone\nC. Sitagliptin\nD. Liraglutide\nReturn the correct option letter.", "reference": "Thiazolidinedione (PPARg agonist) Pioglitazone:- Only one thiazolidinedione Pioglitazone is currently available. Mech of action:- This class of oral antidiabetic drugs are selective agonists for the nuclear peroxisome proliferator-activated receptor g (PPARg) which is expressed mainly in fat cells, but also in muscle and some other cells. It enhances the transcription of several insulin responsive genes. Glitazones tend to reverse insulin resistance by enhancing GLUT4 expression and translocation. Entry of glucose into muscle and fat is improved. Hepatic gluconeo- genesis is also suppressed. Activation of genes regulating fatty acid metabolism and lipogenesis in adipose tissue contributes to the insulin sensitizing action. Lipolysis and plasma fatty acid levels are reduced. Adipocyte turnover and differentiation is accelerated by glitazones. Thus, fatty tissue is a major site of their action. Improved glycaemic control results inlowering of circulating HbA1C and insulin levels in type 2 DM patients. Pioglitazone, in addition, lowers serum triglyceride level and raises HDL level without much change in LDL level, probably because it acts on PPARa as well to induce expression of reverse cholesterol transpoer and some apoproteins. Monotherapy with glitazones is not associated with hypoglycaemic episodes. Ref:- kd tripathi; pg num:-276,277\nB", "question_key": "wof are anti diabetic agents that acts by increasing insulin sensitivity, and so should be euglycemics", "split": "validation", "is_mia_member": false} | |
| {"id": "4e6c00e4-ba44-4455-af58-c60e7e1f5348", "question": "Otto Loewi is famous for discovery of", "opa": "Succinyl choline", "opb": "Acetyl choline", "opc": "Adrenaline", "opd": "Noradrenaline", "cop": 1, "answer": "B", "exp": "Otto Loewi is famous for discovery of acetylcholine for which he received a Nobel price. so the option 2.(Reference: www.nobelprize.org)", "explanation_word_count": 22, "prompt": "Otto Loewi is famous for discovery of\nA. Succinyl choline\nB. Acetyl choline\nC. Adrenaline\nD. Noradrenaline\nReturn the correct option letter.", "reference": "Otto Loewi is famous for discovery of acetylcholine for which he received a Nobel price. so the option 2.(Reference: www.nobelprize.org)\nB", "question_key": "otto loewi is famous for discovery of", "split": "validation", "is_mia_member": false} | |
| {"id": "53fd917b-acb7-4047-be3c-4a5ed9a74aa3", "question": "Kussmaul's breathing is seen in", "opa": "Metabolic acidosis", "opb": "Metabolic alkalosis", "opc": "Respiratory acidosis", "opd": "Respiratory alkalosis", "cop": 0, "answer": "A", "exp": "Kussmaul breathing is a deep and labored breathing pattern often associated with severe metabolic acidosis, paicularly diabetic ketoacidosis (DKA) but also kidney failure. Ref: guyton and hall textbook of medical physiology 12 edition", "explanation_word_count": 32, "prompt": "Kussmaul's breathing is seen in\nA. Metabolic acidosis\nB. Metabolic alkalosis\nC. Respiratory acidosis\nD. Respiratory alkalosis\nReturn the correct option letter.", "reference": "Kussmaul breathing is a deep and labored breathing pattern often associated with severe metabolic acidosis, paicularly diabetic ketoacidosis (DKA) but also kidney failure. Ref: guyton and hall textbook of medical physiology 12 edition\nA", "question_key": "kussmaul's breathing is seen in", "split": "validation", "is_mia_member": false} | |
| {"id": "dfe9c490-f6fa-4e7f-b9c9-d0b92ce9f74f", "question": "Most likely feature in Mayer-Rokitansky-Kuster-Hauser syndrome along with primary amenorrhea is:", "opa": "Ovary agenesis", "opb": "Absent secondary sexual characteristics", "opc": "Vaginal atresia", "opd": "Bicornuate uterus", "cop": 2, "answer": "C", "exp": "Mayer Rokitansky-Kuster-Hauser syndrome (Mullerian agenesis) Congenital hypoplasia or absence of the Vagina(Characteristic feature) in combination with abnormal or absent uterus, Second most common cause of Primary Amenorrhea, Karyotype- 46XX, Gonad- Ovary: normal and functional: responsible for normal external feminisation Mullerian structures don't develop. Primary amenorrhoea Paial or complete absence of vagina Wide array of uterine abnormalities Skeletal/renal and other associated abnormalities, A normal female appearance and secondary sexual characteristics", "explanation_word_count": 71, "prompt": "Most likely feature in Mayer-Rokitansky-Kuster-Hauser syndrome along with primary amenorrhea is:\nA. Ovary agenesis\nB. Absent secondary sexual characteristics\nC. Vaginal atresia\nD. Bicornuate uterus\nReturn the correct option letter.", "reference": "Mayer Rokitansky-Kuster-Hauser syndrome (Mullerian agenesis) Congenital hypoplasia or absence of the Vagina(Characteristic feature) in combination with abnormal or absent uterus, Second most common cause of Primary Amenorrhea, Karyotype- 46XX, Gonad- Ovary: normal and functional: responsible for normal external feminisation Mullerian structures don't develop. Primary amenorrhoea Paial or complete absence of vagina Wide array of uterine abnormalities Skeletal/renal and other associated abnormalities, A normal female appearance and secondary sexual characteristics\nC", "question_key": "most likely feature in mayer-rokitansky-kuster-hauser syndrome along with primary amenorrhea is:", "split": "validation", "is_mia_member": false} | |
| {"id": "c333f8a4-ced2-4f3e-9939-f66a1d25e442", "question": "A child presents with right ear hearing loss of three month duration. On examination, foul smelling purulent discharge is seen with perforation in pars flaccida. What is the MOST appropriate management?", "opa": "Topical antibiotics and decongestants for 4 weeks", "opb": "Tympano-mastoid exploration", "opc": "Aural toileting", "opd": "Type I tympanoplasty.", "cop": 1, "answer": "B", "exp": "The history and examination of the patient suggests atticoantral type of CSOM. It is also called unsafe or dangerous type; it involes posterosuperior pa of the cleft and is associated with attic or marginal perforation. The discharge is usually scanty, but always fouls smelling due to bone destruction. The mainstay of treatment for this type is surgery. The primary aim is to remove the disease process by tympano-mastoid exploration and render the ear safe.", "explanation_word_count": 74, "prompt": "A child presents with right ear hearing loss of three month duration. On examination, foul smelling purulent discharge is seen with perforation in pars flaccida. What is the MOST appropriate management?\nA. Topical antibiotics and decongestants for 4 weeks\nB. Tympano-mastoid exploration\nC. Aural toileting\nD. Type I tympanoplasty.\nReturn the correct option letter.", "reference": "The history and examination of the patient suggests atticoantral type of CSOM. It is also called unsafe or dangerous type; it involes posterosuperior pa of the cleft and is associated with attic or marginal perforation. The discharge is usually scanty, but always fouls smelling due to bone destruction. The mainstay of treatment for this type is surgery. The primary aim is to remove the disease process by tympano-mastoid exploration and render the ear safe.\nB", "question_key": "a child presents with right ear hearing loss of three month duration. on examination, foul smelling purulent discharge is seen with perforation in pars flaccida. what is the most appropriate management?", "split": "validation", "is_mia_member": false} | |
| {"id": "876df9ce-9f25-47c3-82e0-2fa2c2477fa8", "question": "An 8-month-old boy baby is evaluated because of repeated episodes of pneumococcal pneumoniA Serum studies demonstrate very low levels of IgM, IgG, and IgA This patient's condition is related to a deficiency of which of the following proteins?", "opa": "Adenosine deaminase", "opb": "Class III MHC gene", "opc": "Gamma chain of the IL-2 receptor", "opd": "Tyrosine kinase", "cop": 3, "answer": "D", "exp": "As the history is of recurrent infections with bacteria (pneumococcal pneumonia), it indicates primary humoral immunodeficiency. As this is occurring in a 8-month old male child, it indicates X-linked agammaglobulinaemia also called as buon's agammaglobulinaemia. In this disorder there is deficiency of the enzyme tyrosine kinase, which is required for B cell maturation", "explanation_word_count": 53, "prompt": "An 8-month-old boy baby is evaluated because of repeated episodes of pneumococcal pneumoniA Serum studies demonstrate very low levels of IgM, IgG, and IgA This patient's condition is related to a deficiency of which of the following proteins?\nA. Adenosine deaminase\nB. Class III MHC gene\nC. Gamma chain of the IL-2 receptor\nD. Tyrosine kinase\nReturn the correct option letter.", "reference": "As the history is of recurrent infections with bacteria (pneumococcal pneumonia), it indicates primary humoral immunodeficiency. As this is occurring in a 8-month old male child, it indicates X-linked agammaglobulinaemia also called as buon's agammaglobulinaemia. In this disorder there is deficiency of the enzyme tyrosine kinase, which is required for B cell maturation\nD", "question_key": "an 8-month-old boy baby is evaluated because of repeated episodes of pneumococcal pneumonia serum studies demonstrate very low levels of igm, igg, and iga this patient's condition is related to a deficiency of which of the following proteins?", "split": "validation", "is_mia_member": false} | |
| {"id": "8eecc14e-bf31-4f84-8e9f-3853bb5fdebc", "question": "Under FSS act, non-vegetarian Foods containing only eggs are labeled with What color mark ?", "opa": "Green", "opb": "Yellow", "opc": "Orange", "opd": "Brown", "cop": 3, "answer": "D", "exp": "As per act, any food containing egg is treated as non-vegetarian food \"Non- Vegetarian Food\" means an aicle of food which contains whole or pa of any animal including birds, fresh water or marine animals or eggs or products of any animal origin, but excluding milk or milk products, as an ingredient; Every package of \"Non-Vegetarian\" food shall bear a declaration to this effect made by a symbol and colour code as stipulated below to indicate that the product is Non-Vegetarian Food. The symbol shall consist of a brown colour filled circle inside a square with brown outline <img alt=\"non veg\" src=\" /> Ref - <a href=\"", "explanation_word_count": 106, "prompt": "Under FSS act, non-vegetarian Foods containing only eggs are labeled with What color mark ?\nA. Green\nB. Yellow\nC. Orange\nD. Brown\nReturn the correct option letter.", "reference": "As per act, any food containing egg is treated as non-vegetarian food \"Non- Vegetarian Food\" means an aicle of food which contains whole or pa of any animal including birds, fresh water or marine animals or eggs or products of any animal origin, but excluding milk or milk products, as an ingredient; Every package of \"Non-Vegetarian\" food shall bear a declaration to this effect made by a symbol and colour code as stipulated below to indicate that the product is Non-Vegetarian Food. The symbol shall consist of a brown colour filled circle inside a square with brown outline <img alt=\"non veg\" src=\" /> Ref - <a href=\"\nD", "question_key": "under fss act, non-vegetarian foods containing only eggs are labeled with what color mark ?", "split": "validation", "is_mia_member": false} | |
| {"id": "1d4e5e7e-ba32-4c1d-84b5-83ac08e7d836", "question": "Agnes Hunt traction is used for?", "opa": "Flexion deformity of hip", "opb": "Trochanteric fracture", "opc": "Fracture shaft of femur in adults", "opd": "Low backache", "cop": 0, "answer": "A", "exp": "Agnes Hunt traction is used for correction of mild flexion deformity of hip joint in poliomyelitis. Traction used for trochanteric fracture - Russell's traction Traction used for fracture shaft of femur in adults - Perkin's traction Traction used for low backache - Buck's traction Ref : maheswari 9th ed", "explanation_word_count": 45, "prompt": "Agnes Hunt traction is used for?\nA. Flexion deformity of hip\nB. Trochanteric fracture\nC. Fracture shaft of femur in adults\nD. Low backache\nReturn the correct option letter.", "reference": "Agnes Hunt traction is used for correction of mild flexion deformity of hip joint in poliomyelitis. Traction used for trochanteric fracture - Russell's traction Traction used for fracture shaft of femur in adults - Perkin's traction Traction used for low backache - Buck's traction Ref : maheswari 9th ed\nA", "question_key": "agnes hunt traction is used for?", "split": "validation", "is_mia_member": false} | |
| {"id": "4b3c5e0e-21bb-404b-b4be-dbc0414ecc96", "question": "The best way to manage Dermatitis Herpetiformis is ?", "opa": "Gluten free diet with minerals and vitamins", "opb": "Dapsone", "opc": "Acyclovir", "opd": "Steroids", "cop": 0, "answer": "A", "exp": "Gluten free diet is treatment of choice. Avoid BROW (barley, rye, oat, wheat) Rice, Maize, Millets can be given Patients with DH can be managed by two complementary methods: Medications Gluten free diet Dapsone is DOC not TOC as- It gives symptomatic relief- Antibody persists causing relapses Ab's seen are: 1.Anti transglutaminase III2.Anti endomysial antibody.", "explanation_word_count": 56, "prompt": "The best way to manage Dermatitis Herpetiformis is ?\nA. Gluten free diet with minerals and vitamins\nB. Dapsone\nC. Acyclovir\nD. Steroids\nReturn the correct option letter.", "reference": "Gluten free diet is treatment of choice. Avoid BROW (barley, rye, oat, wheat) Rice, Maize, Millets can be given Patients with DH can be managed by two complementary methods: Medications Gluten free diet Dapsone is DOC not TOC as- It gives symptomatic relief- Antibody persists causing relapses Ab's seen are: 1.Anti transglutaminase III2.Anti endomysial antibody.\nA", "question_key": "the best way to manage dermatitis herpetiformis is ?", "split": "validation", "is_mia_member": false} | |
| {"id": "5b58adfd-3fff-467d-b9de-e8379391b526", "question": "Golden yellow jelly fungus is -", "opa": "Ttursurans", "opb": "Tmontegrophytes", "opc": "Trenella mesenterica", "opd": "Efloccosum", "cop": 2, "answer": "C", "exp": "Ans. is 'c' i.e., Trenella mesenterica o The term jelly fungus is sometimes applied to any fungus with a jelly like fruiting body, but it is especially appropriate for the members of a group of texa traditionally assigned to the order Tremellaies.o Largest genus is Tremella. which consists of about 80 species.o Tremella mesenterica (witches butter) is a commonly encountered species which has orange to golden yellow fruiting bodies. Therefore it is also called as golden yellow jelly fungus or yellow brain or yellow trembler.", "explanation_word_count": 87, "prompt": "Golden yellow jelly fungus is -\nA. Ttursurans\nB. Tmontegrophytes\nC. Trenella mesenterica\nD. Efloccosum\nReturn the correct option letter.", "reference": "Ans. is 'c' i.e., Trenella mesenterica o The term jelly fungus is sometimes applied to any fungus with a jelly like fruiting body, but it is especially appropriate for the members of a group of texa traditionally assigned to the order Tremellaies.o Largest genus is Tremella. which consists of about 80 species.o Tremella mesenterica (witches butter) is a commonly encountered species which has orange to golden yellow fruiting bodies. Therefore it is also called as golden yellow jelly fungus or yellow brain or yellow trembler.\nC", "question_key": "golden yellow jelly fungus is -", "split": "validation", "is_mia_member": false} | |
| {"id": "dbaaee56-922e-4275-a1d3-913a979da2f1", "question": "Palivizumab is a humanized monoclonal antibody. For which of the following conditions has it been approved for?", "opa": "Coxsackievirus", "opb": "Avian influenzae", "opc": "Parainfluenzae", "opd": "Respiratory syncytial virus", "cop": 3, "answer": "D", "exp": "d. Respiratory syncytial virus(Ref: Nelson 20/e p 1608)Drug Use in RSV infectionPalivhzumabIt is a monoclonal antibody licensed for prophylaxis in high-risk infants during the RSV season, and does prevent about half of the expected hospitalizations in that population.RibavirinIt is an antiviral agent delivered as an aerosol that showed a modest beneficial effect on the course of RSV pneumonia, with some reduction in the duration of both mechanical ventilation and hospitalization. However, latest studies have failed to document a clear beneficial effect of ribavirin, and therefore this drug is no longer used for routine therapy of RSV disease.", "explanation_word_count": 99, "prompt": "Palivizumab is a humanized monoclonal antibody. For which of the following conditions has it been approved for?\nA. Coxsackievirus\nB. Avian influenzae\nC. Parainfluenzae\nD. Respiratory syncytial virus\nReturn the correct option letter.", "reference": "d. Respiratory syncytial virus(Ref: Nelson 20/e p 1608)Drug Use in RSV infectionPalivhzumabIt is a monoclonal antibody licensed for prophylaxis in high-risk infants during the RSV season, and does prevent about half of the expected hospitalizations in that population.RibavirinIt is an antiviral agent delivered as an aerosol that showed a modest beneficial effect on the course of RSV pneumonia, with some reduction in the duration of both mechanical ventilation and hospitalization. However, latest studies have failed to document a clear beneficial effect of ribavirin, and therefore this drug is no longer used for routine therapy of RSV disease.\nD", "question_key": "palivizumab is a humanized monoclonal antibody. for which of the following conditions has it been approved for?", "split": "validation", "is_mia_member": false} | |
| {"id": "df8221d3-031e-44d1-b259-859b44fd7df8", "question": "Which of the following is an intra-aicular tendon?", "opa": "Saorius", "opb": "Semitendinosus", "opc": "Anconeus", "opd": "Popliteus", "cop": 3, "answer": "D", "exp": "The popliteus tendon is located within the capsule of the knee joint making it an intra-aicular tendon. Saorius, Semitendinosus and Anconeus are not intra-aicluar tendons.", "explanation_word_count": 25, "prompt": "Which of the following is an intra-aicular tendon?\nA. Saorius\nB. Semitendinosus\nC. Anconeus\nD. Popliteus\nReturn the correct option letter.", "reference": "The popliteus tendon is located within the capsule of the knee joint making it an intra-aicular tendon. Saorius, Semitendinosus and Anconeus are not intra-aicluar tendons.\nD", "question_key": "which of the following is an intra-aicular tendon?", "split": "validation", "is_mia_member": false} | |
| {"id": "e086afec-9497-432b-ac84-19af4f460f6e", "question": "Which is a serine protease:", "opa": "Pepsin", "opb": "Trypsinogen 1", "opc": "HIV enzyme", "opd": "Chymotrypsin", "cop": 1, "answer": "B", "exp": "Ans. b. Trypsinogen 1Inherited predisposition to pancreatitisGene (chromosome location)Protein productFunctionPRSSl (7q34)Serine protease 1 (trypsinogen 1)Cationic trypsin. Gain-of-function mutations prevent self- inactivation of trypsinSPINK1 (5q32)Serine peptidase inhibitor, Kazal type 1Inhibitor of trypsin. Mutations cause loss-of-function, increasing trypsin activityCTRC (lp36)Chymotrypsin C (caldecrin)Degrades trypsin, protects the pancreas from trypsin-relatedinjuryCPA1 (7q32)Carboxypeptidase A1Exopeptidase involved in regulating zymogen activation", "explanation_word_count": 59, "prompt": "Which is a serine protease:\nA. Pepsin\nB. Trypsinogen 1\nC. HIV enzyme\nD. Chymotrypsin\nReturn the correct option letter.", "reference": "Ans. b. Trypsinogen 1Inherited predisposition to pancreatitisGene (chromosome location)Protein productFunctionPRSSl (7q34)Serine protease 1 (trypsinogen 1)Cationic trypsin. Gain-of-function mutations prevent self- inactivation of trypsinSPINK1 (5q32)Serine peptidase inhibitor, Kazal type 1Inhibitor of trypsin. Mutations cause loss-of-function, increasing trypsin activityCTRC (lp36)Chymotrypsin C (caldecrin)Degrades trypsin, protects the pancreas from trypsin-relatedinjuryCPA1 (7q32)Carboxypeptidase A1Exopeptidase involved in regulating zymogen activation\nB", "question_key": "which is a serine protease:", "split": "validation", "is_mia_member": false} | |
| {"id": "8b4a463c-0559-4398-b8ca-2489a5b68b9a", "question": "The commonest site for extra gonadal germ cell tumour", "opa": "Retroperitoneum", "opb": "Sacrococcygeal region", "opc": "Pineal gland", "opd": "Mediastinum", "cop": 3, "answer": "D", "exp": "Anterior Mediastinal Masses Thymoma (MC in anterior mediastinum) Lymphoma Germ cell tumors. Thyroid and parathyroid masses Bronchogenic cyst Aneurysm Germ cell tumors constitute 11% of Total tumors in anterior mediastinum Ref: Sabiston 20th edition Pgno : 1608", "explanation_word_count": 34, "prompt": "The commonest site for extra gonadal germ cell tumour\nA. Retroperitoneum\nB. Sacrococcygeal region\nC. Pineal gland\nD. Mediastinum\nReturn the correct option letter.", "reference": "Anterior Mediastinal Masses Thymoma (MC in anterior mediastinum) Lymphoma Germ cell tumors. Thyroid and parathyroid masses Bronchogenic cyst Aneurysm Germ cell tumors constitute 11% of Total tumors in anterior mediastinum Ref: Sabiston 20th edition Pgno : 1608\nD", "question_key": "the commonest site for extra gonadal germ cell tumour", "split": "validation", "is_mia_member": false} | |
| {"id": "2026a426-66cc-4b66-99aa-14c806bae0cc", "question": "Least common mode of transmission of HIV?", "opa": "Homosexual contact", "opb": "Heterosexual", "opc": "IV drug abuse", "opd": "Transfusion of blood products", "cop": 3, "answer": "D", "exp": "Ans. is 'd' i.e., Transfusion of blood product o Homosexual or Heterosexual contact -4 50-70% o IV drug abuse --> 25% o Recipient of blood and blood components --> 1% o Hemophiliaes receiving factor VIII or IX 0.5%", "explanation_word_count": 32, "prompt": "Least common mode of transmission of HIV?\nA. Homosexual contact\nB. Heterosexual\nC. IV drug abuse\nD. Transfusion of blood products\nReturn the correct option letter.", "reference": "Ans. is 'd' i.e., Transfusion of blood product o Homosexual or Heterosexual contact -4 50-70% o IV drug abuse --> 25% o Recipient of blood and blood components --> 1% o Hemophiliaes receiving factor VIII or IX 0.5%\nD", "question_key": "least common mode of transmission of hiv?", "split": "validation", "is_mia_member": false} | |
| {"id": "4c752db2-a761-4983-9595-999709ac1e22", "question": "Torus aoicus is an impression in the cavity of?", "opa": "Right atrium", "opb": "Left atrium", "opc": "Right ventricle", "opd": "Left ventricle", "cop": 0, "answer": "A", "exp": "Torus aoicus is a bulge in the right atrial wall anterosuperiorly above the membranous septum. It is superior to the coronary sinus and anterior to the fossa ovalis. It represents the deeper and anterior surface of the posterior sinus and cusp of the aoic valve.", "explanation_word_count": 45, "prompt": "Torus aoicus is an impression in the cavity of?\nA. Right atrium\nB. Left atrium\nC. Right ventricle\nD. Left ventricle\nReturn the correct option letter.", "reference": "Torus aoicus is a bulge in the right atrial wall anterosuperiorly above the membranous septum. It is superior to the coronary sinus and anterior to the fossa ovalis. It represents the deeper and anterior surface of the posterior sinus and cusp of the aoic valve.\nA", "question_key": "torus aoicus is an impression in the cavity of?", "split": "validation", "is_mia_member": false} | |
| {"id": "8ca2891a-ba0f-434a-b9f6-071529cb6885", "question": "Asthenospermia means:", "opa": "Immotile sperms", "opb": "Absent sperms", "opc": "Dead sperms", "opd": "Dysmorphic sperms", "cop": 0, "answer": "A", "exp": "Ans: A (Immotile sperms) Ref: Harrison's 18th edn.Explanation:Azoospermia - Absence of sperm in the ejaculate.Aspermia - Zero volume ejaculate.Oligospermia - Low numbers of sperm.Asthenospermia - Poor sperm motility.Teratospermia - Abnormal morphology (shape) of sperm.", "explanation_word_count": 35, "prompt": "Asthenospermia means:\nA. Immotile sperms\nB. Absent sperms\nC. Dead sperms\nD. Dysmorphic sperms\nReturn the correct option letter.", "reference": "Ans: A (Immotile sperms) Ref: Harrison's 18th edn.Explanation:Azoospermia - Absence of sperm in the ejaculate.Aspermia - Zero volume ejaculate.Oligospermia - Low numbers of sperm.Asthenospermia - Poor sperm motility.Teratospermia - Abnormal morphology (shape) of sperm.\nA", "question_key": "asthenospermia means:", "split": "validation", "is_mia_member": false} | |
| {"id": "4585fa39-1e0a-4c59-b37b-48465c795208", "question": "Which of the following pathways is activated by Insulin", "opa": "Ketone body synthesis", "opb": "Gluconeogenesis", "opc": "Glycolysis", "opd": "β Oxidation", "cop": 2, "answer": "C", "exp": "Insulin activates all anabolic pathways and also Glycolysis and PDH complex reaction.\nInsulin acts by dephosphorylation.\nGlucagon acts by phosphorylation.", "explanation_word_count": 20, "prompt": "Which of the following pathways is activated by Insulin\nA. Ketone body synthesis\nB. Gluconeogenesis\nC. Glycolysis\nD. β Oxidation\nReturn the correct option letter.", "reference": "Insulin activates all anabolic pathways and also Glycolysis and PDH complex reaction.\nInsulin acts by dephosphorylation.\nGlucagon acts by phosphorylation.\nC", "question_key": "which of the following pathways is activated by insulin", "split": "validation", "is_mia_member": false} | |
| {"id": "ea4ad9ac-e3de-436d-89c4-e9e3a96912c1", "question": "Which of the following is absorbed in the colon ?", "opa": "Iron", "opb": "Proteins", "opc": "Bile salts", "opd": "Electrolytes", "cop": 3, "answer": "D", "exp": "D i.e. Electrolytes- Maximum absorption or reabsorption of water from gastrointestinal tract occurs in jejunumQ.- Ca2+, Cl-, Fe2+, SO42-, long chain fatty acids and vitamins (except B12)are mainly absorbed in upper small intestine (i.e., jejunum & duodenum)Q.- Sodium (Na+) is mainly absorbed is upper & lower small intestine (jejunum, ileum) and colonQ. And K+ in upper mid & lower small intestine.- Sugars and amino acids are mainly absorbed in mid small intestine whereas bile salts, and vitamin B12 in lower small intestine (ileum)QSubstance absorbedSite: Small intestineColonUpper (Proximal Jejumummainly duodenum in mostcases except NaC1 & HCO3-)MidLower(distalileum)1. Na+3+2+3+3+2. Cl-3+2+++3. ca-3+2++ 4. Long chain fatty acid (absorption &conversion to triglycerides)3+2++05. Water soluble & fat soluble vitaminsexcept B123+2+006. Iron (Fe++)3+++?7. SO4--2++0?8. Pyrimidines (thymine & uracil)++ 9. K++++Secretion10. Sugars (glucose, galactose etc).2+3+2+011. Aminoacids2+3+2+012. Antibodies (in newborn)+2+3+?13. Bile salts++3+ 14. Vitamin B120+3+015. Betaine, Dimethylglycine, sacrosine 2+2+?", "explanation_word_count": 138, "prompt": "Which of the following is absorbed in the colon ?\nA. Iron\nB. Proteins\nC. Bile salts\nD. Electrolytes\nReturn the correct option letter.", "reference": "D i.e. Electrolytes- Maximum absorption or reabsorption of water from gastrointestinal tract occurs in jejunumQ.- Ca2+, Cl-, Fe2+, SO42-, long chain fatty acids and vitamins (except B12)are mainly absorbed in upper small intestine (i.e., jejunum & duodenum)Q.- Sodium (Na+) is mainly absorbed is upper & lower small intestine (jejunum, ileum) and colonQ. And K+ in upper mid & lower small intestine.- Sugars and amino acids are mainly absorbed in mid small intestine whereas bile salts, and vitamin B12 in lower small intestine (ileum)QSubstance absorbedSite: Small intestineColonUpper (Proximal Jejumummainly duodenum in mostcases except NaC1 & HCO3-)MidLower(distalileum)1. Na+3+2+3+3+2. Cl-3+2+++3. ca-3+2++ 4. Long chain fatty acid (absorption &conversion to triglycerides)3+2++05. Water soluble & fat soluble vitaminsexcept B123+2+006. Iron (Fe++)3+++?7. SO4--2++0?8. Pyrimidines (thymine & uracil)++ 9. K++++Secretion10. Sugars (glucose, galactose etc).2+3+2+011. Aminoacids2+3+2+012. Antibodies (in newborn)+2+3+?13. Bile salts++3+ 14. Vitamin B120+3+015. Betaine, Dimethylglycine, sacrosine 2+2+?\nD", "question_key": "which of the following is absorbed in the colon ?", "split": "validation", "is_mia_member": false} | |
| {"id": "e074ad4b-cfe3-4c7e-98fc-7b2e357c1082", "question": "Most common site of ectopic pancreatic tissue is?", "opa": "Stomach", "opb": "Jejunum", "opc": "Appendix", "opd": "Hilum of spleen", "cop": 0, "answer": "A", "exp": "Stomach'Accessory pancreatic tissue may be anywhere from the distal end of the esophagus to the tip of the primary intestinal loop. Most .frequently, it lies in the mucosa of the stomach and in Meckel's diveiculum, where it may show all of the histological characteristics of pancreas itself' - Langman's Embryology", "explanation_word_count": 49, "prompt": "Most common site of ectopic pancreatic tissue is?\nA. Stomach\nB. Jejunum\nC. Appendix\nD. Hilum of spleen\nReturn the correct option letter.", "reference": "Stomach'Accessory pancreatic tissue may be anywhere from the distal end of the esophagus to the tip of the primary intestinal loop. Most .frequently, it lies in the mucosa of the stomach and in Meckel's diveiculum, where it may show all of the histological characteristics of pancreas itself' - Langman's Embryology\nA", "question_key": "most common site of ectopic pancreatic tissue is?", "split": "validation", "is_mia_member": false} | |
| {"id": "3e3e65ae-7fe5-40da-a499-17e7416f0d20", "question": "Dissoscited sensory loss is seen in", "opa": "Synringomyelia", "opb": "Viatmain B12 deficiency", "opc": "Transverse myelitis", "opd": "Pellagra", "cop": 0, "answer": "A", "exp": "Refer Robbins page no 1258 Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in loss of feeling, paralysis, weakness, and stiffness in the back, shoulders, and extremities.", "explanation_word_count": 57, "prompt": "Dissoscited sensory loss is seen in\nA. Synringomyelia\nB. Viatmain B12 deficiency\nC. Transverse myelitis\nD. Pellagra\nReturn the correct option letter.", "reference": "Refer Robbins page no 1258 Syringomyelia is a generic term referring to a disorder in which a cyst or cavity forms within the spinal cord. This cyst, called a syrinx, can expand and elongate over time, destroying the spinal cord. The damage may result in loss of feeling, paralysis, weakness, and stiffness in the back, shoulders, and extremities.\nA", "question_key": "dissoscited sensory loss is seen in", "split": "validation", "is_mia_member": false} | |
| {"id": "b41d80ab-8e4c-482c-9837-bb9be343594a", "question": "Deficinecy of enzyme hexosaminidase, subunit causes -", "opa": "Tay - Sach's disease", "opb": "Hurler's syndrome", "opc": "Fabry disease", "opd": "Pompe disease", "cop": 0, "answer": "A", "exp": "Tay-Sachs Disease (GM2 Gangliosidosis: Deficiency in Hexosaminidase b Subunit) Gangliosidoses are characterized by accumulation of gangliosides, principally in the brain, as a result of a deficiency of a catabolic lysosomal enzyme. Depending on the ganglioside involved, these disorders are subclassified into GM1 and GM2 categories. Tay-Sachs disease, by far the most common of all gangliosidoses, is characterized by a mutation in and consequent deficiency of the b subunit of enzyme hexosaminidase A, which is necessary for the degradation of GM2. More than 100 mutations have been described; most affect protein folding or intracellular transpo. Referense:Robbins basic pathology pg no:229,230", "explanation_word_count": 99, "prompt": "Deficinecy of enzyme hexosaminidase, subunit causes -\nA. Tay - Sach's disease\nB. Hurler's syndrome\nC. Fabry disease\nD. Pompe disease\nReturn the correct option letter.", "reference": "Tay-Sachs Disease (GM2 Gangliosidosis: Deficiency in Hexosaminidase b Subunit) Gangliosidoses are characterized by accumulation of gangliosides, principally in the brain, as a result of a deficiency of a catabolic lysosomal enzyme. Depending on the ganglioside involved, these disorders are subclassified into GM1 and GM2 categories. Tay-Sachs disease, by far the most common of all gangliosidoses, is characterized by a mutation in and consequent deficiency of the b subunit of enzyme hexosaminidase A, which is necessary for the degradation of GM2. More than 100 mutations have been described; most affect protein folding or intracellular transpo. Referense:Robbins basic pathology pg no:229,230\nA", "question_key": "deficinecy of enzyme hexosaminidase, subunit causes -", "split": "validation", "is_mia_member": false} | |
| {"id": "fb1cc4f3-84a2-4064-9260-413f30f9338d", "question": "Maximum chances of ureteric injury are with;", "opa": "TAH", "opb": "Weheims hysterectomy", "opc": "Anterior colporrhaphy", "opd": "Vaginal hysterectomy", "cop": 1, "answer": "B", "exp": "Weheim's hysterectomy:includes Radical abdominal hysterectomy Bilateral extra peritoneal dissection Excision of iliac and pelvic lymph nodes for cancer of the cervix Ureter injury is the major complication Ref : Shaw Gynecology 17e pg 526.", "explanation_word_count": 33, "prompt": "Maximum chances of ureteric injury are with;\nA. TAH\nB. Weheims hysterectomy\nC. Anterior colporrhaphy\nD. Vaginal hysterectomy\nReturn the correct option letter.", "reference": "Weheim's hysterectomy:includes Radical abdominal hysterectomy Bilateral extra peritoneal dissection Excision of iliac and pelvic lymph nodes for cancer of the cervix Ureter injury is the major complication Ref : Shaw Gynecology 17e pg 526.\nB", "question_key": "maximum chances of ureteric injury are with;", "split": "validation", "is_mia_member": false} | |
| {"id": "f1b0c6e2-24cf-403f-aab3-9c102716fd5f", "question": "Vein draining to IVC is:", "opa": "Left testicular vein", "opb": "Rt suprarenal vein", "opc": "Lt. ovarian vein", "opd": "Lt. suprarenal vein", "cop": 1, "answer": "B", "exp": "B. i.e. Rt. Supra renal vein- Left testicular / ovarian / supra renal vein drain into left renal veinQ before entering to IVC.Right testicular / ovarian / suprarenal vein and both renal veins drain into IVCQ", "explanation_word_count": 34, "prompt": "Vein draining to IVC is:\nA. Left testicular vein\nB. Rt suprarenal vein\nC. Lt. ovarian vein\nD. Lt. suprarenal vein\nReturn the correct option letter.", "reference": "B. i.e. Rt. Supra renal vein- Left testicular / ovarian / supra renal vein drain into left renal veinQ before entering to IVC.Right testicular / ovarian / suprarenal vein and both renal veins drain into IVCQ\nB", "question_key": "vein draining to ivc is:", "split": "validation", "is_mia_member": false} | |
| {"id": "8e86ae12-29c7-43f7-b3cf-d0e8fe6ae7a5", "question": "Most common age group affected by streptococcus pyogenes -", "opa": "< 5 years", "opb": "5 -15 years", "opc": "20 - 25 years", "opd": "30 - 40 years", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e., 5 - 15 years o Sore throat (tonsillitis) is the most common manifestation of streptococcal infection and affects 5-15 years age group.", "explanation_word_count": 23, "prompt": "Most common age group affected by streptococcus pyogenes -\nA. < 5 years\nB. 5 -15 years\nC. 20 - 25 years\nD. 30 - 40 years\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e., 5 - 15 years o Sore throat (tonsillitis) is the most common manifestation of streptococcal infection and affects 5-15 years age group.\nB", "question_key": "most common age group affected by streptococcus pyogenes -", "split": "validation", "is_mia_member": false} | |
| {"id": "4d862c60-13c4-4382-b076-85887b793550", "question": "Parents are carrier of an autosomal recessive disorder. Chances of offspring to get affected?", "opa": "1:01", "opb": "1:02", "opc": "1:03", "opd": "1:04", "cop": 3, "answer": "D", "exp": "Ans. is 'd' i.e., 1:4 o If both parents are carrier, there are 25% chance (1 in 4) that the child will be affected.", "explanation_word_count": 21, "prompt": "Parents are carrier of an autosomal recessive disorder. Chances of offspring to get affected?\nA. 1:01\nB. 1:02\nC. 1:03\nD. 1:04\nReturn the correct option letter.", "reference": "Ans. is 'd' i.e., 1:4 o If both parents are carrier, there are 25% chance (1 in 4) that the child will be affected.\nD", "question_key": "parents are carrier of an autosomal recessive disorder. chances of offspring to get affected?", "split": "validation", "is_mia_member": false} | |
| {"id": "3cc1857d-18d6-4233-ae87-651027b33487", "question": "Normal value of fetal scalp pH is?", "opa": "6.9", "opb": "7", "opc": "7.1", "opd": "7.3", "cop": 3, "answer": "D", "exp": "ANSWER: (D) 7.3REF: COGT 10th ed table 8-7AVERAGE \"NORMAL\" FETAL SCALP AND CORD ACID-BASE VALUES Before LaborSecond Stage of LaborScalp pH7.377.3CO2 pressure (mm Hg)3843Bicarbonate (mmol/L)2121Base excess (mmol/L)-3-5 Umbilical VeinUmbilical ArteryCord pH7.327.26PO238.917.7PCO237.140Base deficit6.86.7", "explanation_word_count": 40, "prompt": "Normal value of fetal scalp pH is?\nA. 6.9\nB. 7\nC. 7.1\nD. 7.3\nReturn the correct option letter.", "reference": "ANSWER: (D) 7.3REF: COGT 10th ed table 8-7AVERAGE \"NORMAL\" FETAL SCALP AND CORD ACID-BASE VALUES Before LaborSecond Stage of LaborScalp pH7.377.3CO2 pressure (mm Hg)3843Bicarbonate (mmol/L)2121Base excess (mmol/L)-3-5 Umbilical VeinUmbilical ArteryCord pH7.327.26PO238.917.7PCO237.140Base deficit6.86.7\nD", "question_key": "normal value of fetal scalp ph is?", "split": "validation", "is_mia_member": false} | |
| {"id": "f831aafe-92ef-4dcb-aa1a-436b52a9b234", "question": "Most common skin manifestation seen after 2 days of radiation therapy is?", "opa": "Erythema", "opb": "Atopy", "opc": "Hyperpigmentation", "opd": "Dermatitis", "cop": 0, "answer": "A", "exp": "A i.e. Erythema Most common early (acute) manifestation of local skin reaction is erythemaQ which is followed by desquamation", "explanation_word_count": 20, "prompt": "Most common skin manifestation seen after 2 days of radiation therapy is?\nA. Erythema\nB. Atopy\nC. Hyperpigmentation\nD. Dermatitis\nReturn the correct option letter.", "reference": "A i.e. Erythema Most common early (acute) manifestation of local skin reaction is erythemaQ which is followed by desquamation\nA", "question_key": "most common skin manifestation seen after 2 days of radiation therapy is?", "split": "validation", "is_mia_member": false} | |
| {"id": "95402f8f-9fc6-4fbe-b0bf-0b93e29ec537", "question": "What is the net ATP's formed in glycolysis?", "opa": "5", "opb": "7", "opc": "10", "opd": "15", "cop": 1, "answer": "B", "exp": "ATP formation in glycolysis: Reaction Catalyzed by Method of ATP Formation ATP per mol of Glucose Glyceraldehyde 3-phosphate dehydrogenase Respiratory chain oxidation of 2 NADH 5 Phosphoglycerate kinase Substrate-level phosphorylation 2 Pyruvate kinase Substrate-level phosphorylation 2 Total 9 Consumption of ATP for reactions of hexokinase and phosphofructokinase -2 Net 7 Ref: Bender D.A., Mayes P.A. (2011). Chapter 18. Glycolysis & the Oxidation of Pyruvate. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.", "explanation_word_count": 80, "prompt": "What is the net ATP's formed in glycolysis?\nA. 5\nB. 7\nC. 10\nD. 15\nReturn the correct option letter.", "reference": "ATP formation in glycolysis: Reaction Catalyzed by Method of ATP Formation ATP per mol of Glucose Glyceraldehyde 3-phosphate dehydrogenase Respiratory chain oxidation of 2 NADH 5 Phosphoglycerate kinase Substrate-level phosphorylation 2 Pyruvate kinase Substrate-level phosphorylation 2 Total 9 Consumption of ATP for reactions of hexokinase and phosphofructokinase -2 Net 7 Ref: Bender D.A., Mayes P.A. (2011). Chapter 18. Glycolysis & the Oxidation of Pyruvate. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e.\nB", "question_key": "what is the net atp's formed in glycolysis?", "split": "validation", "is_mia_member": false} | |
| {"id": "512df70d-d91a-469e-a756-62427d8fbcec", "question": "In Kawasaki disease, desquamation and denudation of skin from fingers and toes occur at", "opa": "3rd - 6th weeks", "opb": "2nd - 3rd week", "opc": "After 1st week", "opd": "After 6 weeks", "cop": 1, "answer": "B", "exp": "Kawasaki disease can be divided into 3 clinical phases:Clinical phasedurationClinical featuresAcute febrile phase1-2 weeksfeverSubacute2-3 weeksDesquamation and peeling of fingers and toesCoronary aery aneurysmHigh risk of sudden deathConvalescence6-8weeksrecoveryKawasaki disease- Clinical Criteria1. Fever persisting at least for 5 days2. Presence of at least 4 of the following features. a) Changes in extremities:Acute: erythema of palms, soles, edema of hands and feetsSubacute: periungual peeling of fingers, toesb) Polymorphous exanthemac) Bilateral nonexudative bulbar conjunctival injectiond) Changes in lips and oral cavity(erythema, strawberry tongue)e) Cervical lymphadenopathy( unilateral and >1.5cm diameter)Other Features:GIANT CORONARY AERY ANEURYSMS (>8mm internal diameter)Thrombocytosis after 1st weekInduration of BCG inoculation site", "explanation_word_count": 104, "prompt": "In Kawasaki disease, desquamation and denudation of skin from fingers and toes occur at\nA. 3rd - 6th weeks\nB. 2nd - 3rd week\nC. After 1st week\nD. After 6 weeks\nReturn the correct option letter.", "reference": "Kawasaki disease can be divided into 3 clinical phases:Clinical phasedurationClinical featuresAcute febrile phase1-2 weeksfeverSubacute2-3 weeksDesquamation and peeling of fingers and toesCoronary aery aneurysmHigh risk of sudden deathConvalescence6-8weeksrecoveryKawasaki disease- Clinical Criteria1. Fever persisting at least for 5 days2. Presence of at least 4 of the following features. a) Changes in extremities:Acute: erythema of palms, soles, edema of hands and feetsSubacute: periungual peeling of fingers, toesb) Polymorphous exanthemac) Bilateral nonexudative bulbar conjunctival injectiond) Changes in lips and oral cavity(erythema, strawberry tongue)e) Cervical lymphadenopathy( unilateral and >1.5cm diameter)Other Features:GIANT CORONARY AERY ANEURYSMS (>8mm internal diameter)Thrombocytosis after 1st weekInduration of BCG inoculation site\nB", "question_key": "in kawasaki disease, desquamation and denudation of skin from fingers and toes occur at", "split": "validation", "is_mia_member": false} | |
| {"id": "1e20ee12-daa9-44b0-9449-0839b2f1e708", "question": "Which of the following is a DNA virus?", "opa": "Hepatitis A virus", "opb": "Hepatitis B virus", "opc": "Hepatitis C virus", "opd": "Hepatitis D virus", "cop": 1, "answer": "B", "exp": "Ans. b (Hepatitis B virus). (Ref. Harrison's medicine 17th/Table 16-4; Anantanarayan, 6th/511)Clinical situationLab findingProtective antibody against HBVHBsAgAcute HBV infection, highly infectiousHBsAg, HBeAg, IgM anti-HBC absChronic HBV infection or carrier state, highly infectiousHBsAg, HBeAg, IgG anti-HBC absChronic HBV infection, low infectivityHBsAg, IgM anti-HBC abs, anti-HBe +/-Remote HBV infection, infectivity very low or nilIgG anti-HBC abs, anti HBs +/-, anti-HBe +/-Viral HepatitisVirusHepatitis AHepatitis BHepatitis CHepatitis DHepatitis EType of virusViral familyssRNAHepatovirus; related to picornavirusPartially dsDNAHepadnavirusssRNAFlaviviridaeCircular defective ssRNA Subviral particle in Deltaviridae familyssRNA CalicivirusRoute of transmissionFecal-oral (contaminated food or water)Parenteral, sexual contact, perinatalParenteral; intranasal cocaine use is a risk factorParenteralFecal-oralMean incubation period2-4 weeks1-4 months7-8 weeksSame as HBV4-5 weeksFrequency of chronic liver diseaseNever10%>80%5% (coinfection); >70% for superinfectionNeverDiagnosisDetection of serum IgM antibodiesDetection of HBsAg or antibody to HBcAgPCR for HCV RNA; 3rd-generation ELISA for antibody detectionDetection of IgM and IgG antibodies; HDV RNA serum; HDAg in liverPCR for HEV RNA; detection of serum IgM and IgG antibodiesCarrier-++--Oncogenicity-++--", "explanation_word_count": 152, "prompt": "Which of the following is a DNA virus?\nA. Hepatitis A virus\nB. Hepatitis B virus\nC. Hepatitis C virus\nD. Hepatitis D virus\nReturn the correct option letter.", "reference": "Ans. b (Hepatitis B virus). (Ref. Harrison's medicine 17th/Table 16-4; Anantanarayan, 6th/511)Clinical situationLab findingProtective antibody against HBVHBsAgAcute HBV infection, highly infectiousHBsAg, HBeAg, IgM anti-HBC absChronic HBV infection or carrier state, highly infectiousHBsAg, HBeAg, IgG anti-HBC absChronic HBV infection, low infectivityHBsAg, IgM anti-HBC abs, anti-HBe +/-Remote HBV infection, infectivity very low or nilIgG anti-HBC abs, anti HBs +/-, anti-HBe +/-Viral HepatitisVirusHepatitis AHepatitis BHepatitis CHepatitis DHepatitis EType of virusViral familyssRNAHepatovirus; related to picornavirusPartially dsDNAHepadnavirusssRNAFlaviviridaeCircular defective ssRNA Subviral particle in Deltaviridae familyssRNA CalicivirusRoute of transmissionFecal-oral (contaminated food or water)Parenteral, sexual contact, perinatalParenteral; intranasal cocaine use is a risk factorParenteralFecal-oralMean incubation period2-4 weeks1-4 months7-8 weeksSame as HBV4-5 weeksFrequency of chronic liver diseaseNever10%>80%5% (coinfection); >70% for superinfectionNeverDiagnosisDetection of serum IgM antibodiesDetection of HBsAg or antibody to HBcAgPCR for HCV RNA; 3rd-generation ELISA for antibody detectionDetection of IgM and IgG antibodies; HDV RNA serum; HDAg in liverPCR for HEV RNA; detection of serum IgM and IgG antibodiesCarrier-++--Oncogenicity-++--\nB", "question_key": "which of the following is a dna virus?", "split": "validation", "is_mia_member": false} | |
| {"id": "2dbab889-293b-491d-b9f0-30b89b9addcc", "question": "A patient with H. pylori infection is treated with drugs. The best method to detect presence of residual H. pylori infection in this person is -", "opa": "Rapid urease test", "opb": "Urea breath test", "opc": "Endoscopy and biopsy", "opd": "Serum anti H. pylori titre", "cop": 1, "answer": "B", "exp": "<p>Davidson's principles and practice of medicine 22nd edition. *urea breath test is highly specific and sensitive.in detection of h pylori infection</p>", "explanation_word_count": 24, "prompt": "A patient with H. pylori infection is treated with drugs. The best method to detect presence of residual H. pylori infection in this person is -\nA. Rapid urease test\nB. Urea breath test\nC. Endoscopy and biopsy\nD. Serum anti H. pylori titre\nReturn the correct option letter.", "reference": "<p>Davidson's principles and practice of medicine 22nd edition. *urea breath test is highly specific and sensitive.in detection of h pylori infection</p>\nB", "question_key": "a patient with h. pylori infection is treated with drugs. the best method to detect presence of residual h. pylori infection in this person is -", "split": "validation", "is_mia_member": false} | |
| {"id": "f72628ec-2156-4c19-a022-a57f5a6d2d18", "question": "Not a constituent of air –", "opa": "H2", "opb": "N2", "opc": "O2", "opd": "CO2", "cop": 0, "answer": "A", "exp": "Air \n\nThe immediate environment of man comprises of air on which depends all forms of life.\nThe requirement for air is about 10-20 M3/day.\nThe constituents of air : -\n\n\nMajor → Nitrogen (N2) - 78.1 %, Oxygen (O2) - 20.93%, Carbon dioxide (CO2) - 0.03%\nMinor → Argon, neon, krypton, xenon, helium, water vapour, traces fo ammonia, suspended matter (dust, bacteria, spores, vegetable debris).", "explanation_word_count": 54, "prompt": "Not a constituent of air –\nA. H2\nB. N2\nC. O2\nD. CO2\nReturn the correct option letter.", "reference": "Air \n\nThe immediate environment of man comprises of air on which depends all forms of life.\nThe requirement for air is about 10-20 M3/day.\nThe constituents of air : -\n\n\nMajor → Nitrogen (N2) - 78.1 %, Oxygen (O2) - 20.93%, Carbon dioxide (CO2) - 0.03%\nMinor → Argon, neon, krypton, xenon, helium, water vapour, traces fo ammonia, suspended matter (dust, bacteria, spores, vegetable debris).\nA", "question_key": "not a constituent of air –", "split": "validation", "is_mia_member": false} | |
| {"id": "1dbdb511-4712-464b-a4bb-99884d2c95f8", "question": "Bulge sign in knee joint is seen after how much fluid accumulation ?", "opa": "100m1", "opb": "400m1", "opc": "200m1", "opd": "<30 ml", "cop": 3, "answer": "D", "exp": "Ans. is i.e., < 30 ml The bulge test is used to determine the presence of fluid in the knee joint. It is useful when only a little fluid is present in the joint. The suprapatellar bursa is first emptied of fluid by squeezing distally from about 15 cm above the patella. The medial compament of the knee join is emptied by pressing on the side of the joint with the free hand. The hand is then lifted away and then the lateral side is sharply compressed. If the test is positive, a ripple is seen on the flattened, medial surface. The test is negative if the effusion is tense - up to 120 ml. The bulge test is used to determine minimal fluid in the knee joint. It can detect as little as 4 - 6 ml of fluid in the knee joint.", "explanation_word_count": 137, "prompt": "Bulge sign in knee joint is seen after how much fluid accumulation ?\nA. 100m1\nB. 400m1\nC. 200m1\nD. <30 ml\nReturn the correct option letter.", "reference": "Ans. is i.e., < 30 ml The bulge test is used to determine the presence of fluid in the knee joint. It is useful when only a little fluid is present in the joint. The suprapatellar bursa is first emptied of fluid by squeezing distally from about 15 cm above the patella. The medial compament of the knee join is emptied by pressing on the side of the joint with the free hand. The hand is then lifted away and then the lateral side is sharply compressed. If the test is positive, a ripple is seen on the flattened, medial surface. The test is negative if the effusion is tense - up to 120 ml. The bulge test is used to determine minimal fluid in the knee joint. It can detect as little as 4 - 6 ml of fluid in the knee joint.\nD", "question_key": "bulge sign in knee joint is seen after how much fluid accumulation ?", "split": "validation", "is_mia_member": false} | |
| {"id": "82eb55d1-dcf2-472f-9842-f0bf5f9c28d1", "question": "Pain in early labour is limited to dermatomes-", "opa": "T11 T12 L1", "opb": "S1 S3", "opc": "L4 L5", "opd": "L2 L3", "cop": 0, "answer": "A", "exp": "Labor pain caused by uterine contractions and cervical dilation is transmitted through visceral afferent sympathetic nerves entering the spinal cord from T10 - L1. Later in labor, perineal stretching transmits painful stimuli through the pudendal nerve and sacral nerves S2 - S4.", "explanation_word_count": 40, "prompt": "Pain in early labour is limited to dermatomes-\nA. T11 T12 L1\nB. S1 S3\nC. L4 L5\nD. L2 L3\nReturn the correct option letter.", "reference": "Labor pain caused by uterine contractions and cervical dilation is transmitted through visceral afferent sympathetic nerves entering the spinal cord from T10 - L1. Later in labor, perineal stretching transmits painful stimuli through the pudendal nerve and sacral nerves S2 - S4.\nA", "question_key": "pain in early labour is limited to dermatomes-", "split": "validation", "is_mia_member": false} | |
| {"id": "03824c49-7586-407e-ba77-b72d12d3ffc4", "question": "Optic vesicle is derived from ?", "opa": "Neuroectoderm", "opb": "Surface ectoderm", "opc": "Endoderm", "opd": "Mesoderum", "cop": 0, "answer": "A", "exp": "Ans. is'a'i.e., Neuroectoderm(Ref Indo Khurana ernbryology p. 268)Formation of optic cupAn outgrowth from prosencephalon forms optic vesicle (neuroectodermal structure).Proximal pa of optic vesicle becomes constricted and elongated to form optic stalk.", "explanation_word_count": 34, "prompt": "Optic vesicle is derived from ?\nA. Neuroectoderm\nB. Surface ectoderm\nC. Endoderm\nD. Mesoderum\nReturn the correct option letter.", "reference": "Ans. is'a'i.e., Neuroectoderm(Ref Indo Khurana ernbryology p. 268)Formation of optic cupAn outgrowth from prosencephalon forms optic vesicle (neuroectodermal structure).Proximal pa of optic vesicle becomes constricted and elongated to form optic stalk.\nA", "question_key": "optic vesicle is derived from ?", "split": "validation", "is_mia_member": false} | |
| {"id": "35399572-4e81-45f5-8087-becbe709bd9b", "question": "An African presented with itching with rashes and inguinal lymph nodes. Skin snips shows microfilariae which are non-sheathed. The most probable organism will be:", "opa": "Wuchereria bancrofti", "opb": "Brugia malayi", "opc": "Brugia timori", "opd": "Mansonella streptocerca", "cop": 3, "answer": "D", "exp": "Mansonella streptocerca is transmitted by biting midges. The major clinical manifestations involve the skin and include pruritus, papular rashes, and pigmentation changes. Many infected individuals have inguinal adenopathy, although most are asymptomatic. The diagnosis is made by detection of the characteristic microfilariae in skin snips. Ivermectin is the treatment of choice for streptocerciasis. Non-sheathed microfilariae are: Onchocerca volvulus Mansonella ozzardi M. perstans M. streptocerca Sheathed microfilariae are: Wuchereria bancrofti Brugia malayi B. timori Loa loa Ref: Harrison's Online > Pa 8. Infectious Diseases > Section 19. Helminthic Infections > Chapter 218- Filarial and Related Infections, by Thomas B. Nutman, Peter F. Weller.", "explanation_word_count": 96, "prompt": "An African presented with itching with rashes and inguinal lymph nodes. Skin snips shows microfilariae which are non-sheathed. The most probable organism will be:\nA. Wuchereria bancrofti\nB. Brugia malayi\nC. Brugia timori\nD. Mansonella streptocerca\nReturn the correct option letter.", "reference": "Mansonella streptocerca is transmitted by biting midges. The major clinical manifestations involve the skin and include pruritus, papular rashes, and pigmentation changes. Many infected individuals have inguinal adenopathy, although most are asymptomatic. The diagnosis is made by detection of the characteristic microfilariae in skin snips. Ivermectin is the treatment of choice for streptocerciasis. Non-sheathed microfilariae are: Onchocerca volvulus Mansonella ozzardi M. perstans M. streptocerca Sheathed microfilariae are: Wuchereria bancrofti Brugia malayi B. timori Loa loa Ref: Harrison's Online > Pa 8. Infectious Diseases > Section 19. Helminthic Infections > Chapter 218- Filarial and Related Infections, by Thomas B. Nutman, Peter F. Weller.\nD", "question_key": "an african presented with itching with rashes and inguinal lymph nodes. skin snips shows microfilariae which are non-sheathed. the most probable organism will be:", "split": "validation", "is_mia_member": false} | |
| {"id": "101b1441-b74c-4b36-a375-fa14cdf94589", "question": "A 62-year-old farmer presented with a way plaque on the sole of the right foot since a year. Examination revealed a large, way, hyperpigmented plaque on the sole of the involved foot. What is the probable diagnosis?", "opa": "Tuberculosis verrucosa cutis", "opb": "Verruca vulgaris", "opc": "Mycetoma foot", "opd": "Lichen simplex Chronicus", "cop": 0, "answer": "A", "exp": "History suggestive of Tuberculosis verrucosa cutis / Anatomist's wa - Tuberculosis verrucosa cutis - Caused by exogenous inoculation of tubercle bacilli into skin of individuals with good immunity. Affects children/young adults who contract the bacteria by walking barefoot--> way plaque on the sole of the foot Sitting on ground contaminated with TB sputum--> lesion on buttocks. Skin HPE - dermal inflammation, epithelioid cell granuloma with central multinucleated Langhans giant cell. Caseous necrosis absent VIRAL WA ANATOMIST WA Numbers Multiple Single Induration Absent Present Scarring Absent Present(central) Discharge Absent Present( serous) Mycetoma foot- triad of painless subcutaneous mass,multiple sinusesanddischarge containing grains.", "explanation_word_count": 99, "prompt": "A 62-year-old farmer presented with a way plaque on the sole of the right foot since a year. Examination revealed a large, way, hyperpigmented plaque on the sole of the involved foot. What is the probable diagnosis?\nA. Tuberculosis verrucosa cutis\nB. Verruca vulgaris\nC. Mycetoma foot\nD. Lichen simplex Chronicus\nReturn the correct option letter.", "reference": "History suggestive of Tuberculosis verrucosa cutis / Anatomist's wa - Tuberculosis verrucosa cutis - Caused by exogenous inoculation of tubercle bacilli into skin of individuals with good immunity. Affects children/young adults who contract the bacteria by walking barefoot--> way plaque on the sole of the foot Sitting on ground contaminated with TB sputum--> lesion on buttocks. Skin HPE - dermal inflammation, epithelioid cell granuloma with central multinucleated Langhans giant cell. Caseous necrosis absent VIRAL WA ANATOMIST WA Numbers Multiple Single Induration Absent Present Scarring Absent Present(central) Discharge Absent Present( serous) Mycetoma foot- triad of painless subcutaneous mass,multiple sinusesanddischarge containing grains.\nA", "question_key": "a 62-year-old farmer presented with a way plaque on the sole of the right foot since a year. examination revealed a large, way, hyperpigmented plaque on the sole of the involved foot. what is the probable diagnosis?", "split": "validation", "is_mia_member": false} | |
| {"id": "e612fd02-144f-4369-b76a-6f915b27a4c6", "question": "Adenosine deaminase deficiency is seen in the following -", "opa": "Common variable immunodeficiency", "opb": "Severe combined immunodeficiency", "opc": "Chronic granulomatous disease", "opd": "Nezelof syndrome", "cop": 1, "answer": "B", "exp": "Severe combined immunodeficiencies include syndrome with severe deficiency of both humoral and cell mediated response. Adenosine deaminase deficiency is a distinct pattern of SCID. - ADA catalyses the conversion of adenosine to inosine in the purine metabolic pathway. This condition is associated with chondrocyte abnormalities. Reference : Anathanarayan & paniker's 9th edition, pg no:174,175 <\\p>", "explanation_word_count": 52, "prompt": "Adenosine deaminase deficiency is seen in the following -\nA. Common variable immunodeficiency\nB. Severe combined immunodeficiency\nC. Chronic granulomatous disease\nD. Nezelof syndrome\nReturn the correct option letter.", "reference": "Severe combined immunodeficiencies include syndrome with severe deficiency of both humoral and cell mediated response. Adenosine deaminase deficiency is a distinct pattern of SCID. - ADA catalyses the conversion of adenosine to inosine in the purine metabolic pathway. This condition is associated with chondrocyte abnormalities. Reference : Anathanarayan & paniker's 9th edition, pg no:174,175 <\\p>\nB", "question_key": "adenosine deaminase deficiency is seen in the following -", "split": "validation", "is_mia_member": false} | |
| {"id": "6c367321-76cc-4f83-8d90-4b0e17c16a01", "question": "Beta-Lactamases cause resistance to penicillins and cephalosporins by", "opa": "Breaking one chemical bond", "opb": "Breaking two chemical bonds", "opc": "Adding amino (NH2) groups to a molecule", "opd": "Inhibiting transpeptidase enzymes", "cop": 0, "answer": "A", "exp": "Penicillins and cephalosporins are called beta-Iactam drugs because of the impoance of the intact BETA-lactam ring for antimicrobial activity. -Lactamases inactivate these drugs by breaking the single bond in their BETA-lactam ring. BETA-Lactamases are coded for by either a transferable plasmid or by the genome of the organism. Plasmids are extrachromosomal genetic elements that may be transferred among unrelated bacteria. Ref: katzung 12th ed INtroduction to chemotherapy.", "explanation_word_count": 67, "prompt": "Beta-Lactamases cause resistance to penicillins and cephalosporins by\nA. Breaking one chemical bond\nB. Breaking two chemical bonds\nC. Adding amino (NH2) groups to a molecule\nD. Inhibiting transpeptidase enzymes\nReturn the correct option letter.", "reference": "Penicillins and cephalosporins are called beta-Iactam drugs because of the impoance of the intact BETA-lactam ring for antimicrobial activity. -Lactamases inactivate these drugs by breaking the single bond in their BETA-lactam ring. BETA-Lactamases are coded for by either a transferable plasmid or by the genome of the organism. Plasmids are extrachromosomal genetic elements that may be transferred among unrelated bacteria. Ref: katzung 12th ed INtroduction to chemotherapy.\nA", "question_key": "beta-lactamases cause resistance to penicillins and cephalosporins by", "split": "validation", "is_mia_member": false} | |
| {"id": "850d4f2c-54dd-41f7-98b6-2d73cb6806b5", "question": "Uncoupler in ETC -", "opa": "H2S", "opb": "Antimycin a", "opc": "2,4-dinitrophenol", "opd": "Barbiturates", "cop": 2, "answer": "C", "exp": "Ans. C. 2, 4-dinitrophenolUncouplers of oxidative phosphorylation in mitochondria inhibit the coupling between the electron transport and phosphorylation reactions and thus inhibit ATP synthesis without affecting the respiratory chain and ATP synthase (H(+)- ATPase). Physiological uncouplers- long chain fatty acids, thyroxin, calcium ions, brown adipose tissue Pathological uncouplers-2,4 dinitrophenol, 2,4 dinitroocresol, CCCP, FCCP, valinomycin, high dose aspirinClass with examplesAffected complex* or reactionInhibitors of electron transport Rotenone, Piericidin AAmytal, SeconalThenoyltrifluoroacetoneAntimycin A.DimercaprolHCN, H2 SHN3 , COI FMN-Q and or cytb(Fe3+)I FMN-Q and or cytb(Fe3+)II Peptide-FAD-Q and/or cytbIII cytb(Fe2+)-cytcl(Fe3+)(perhaps at NHI)IV cytc(Fe2+)-O2 IV cytc(Fe2+)-O2 Inhibitors of oxidative phosphorylation OiigomycinRutamycinAtractylateBongkrekateInhibit respiration (NADH-O2 or Succinate O2 ) when coupled to phosphorylationUncouplers of oxidative phosphorylation2,4 dinitrophenolDicoumarolValinomycin *Gramicidin A *Stimulate respiration when rate is limited by phosphorylation or blocked by oiigomycin.", "explanation_word_count": 135, "prompt": "Uncoupler in ETC -\nA. H2S\nB. Antimycin a\nC. 2,4-dinitrophenol\nD. Barbiturates\nReturn the correct option letter.", "reference": "Ans. C. 2, 4-dinitrophenolUncouplers of oxidative phosphorylation in mitochondria inhibit the coupling between the electron transport and phosphorylation reactions and thus inhibit ATP synthesis without affecting the respiratory chain and ATP synthase (H(+)- ATPase). Physiological uncouplers- long chain fatty acids, thyroxin, calcium ions, brown adipose tissue Pathological uncouplers-2,4 dinitrophenol, 2,4 dinitroocresol, CCCP, FCCP, valinomycin, high dose aspirinClass with examplesAffected complex* or reactionInhibitors of electron transport Rotenone, Piericidin AAmytal, SeconalThenoyltrifluoroacetoneAntimycin A.DimercaprolHCN, H2 SHN3 , COI FMN-Q and or cytb(Fe3+)I FMN-Q and or cytb(Fe3+)II Peptide-FAD-Q and/or cytbIII cytb(Fe2+)-cytcl(Fe3+)(perhaps at NHI)IV cytc(Fe2+)-O2 IV cytc(Fe2+)-O2 Inhibitors of oxidative phosphorylation OiigomycinRutamycinAtractylateBongkrekateInhibit respiration (NADH-O2 or Succinate O2 ) when coupled to phosphorylationUncouplers of oxidative phosphorylation2,4 dinitrophenolDicoumarolValinomycin *Gramicidin A *Stimulate respiration when rate is limited by phosphorylation or blocked by oiigomycin.\nC", "question_key": "uncoupler in etc -", "split": "validation", "is_mia_member": false} | |
| {"id": "ceedcccc-dcc1-4f04-bdcf-e05c7470b40a", "question": "Watershed area between SMA & IMA which commonly result in ischemia is", "opa": "Hepatic flexure", "opb": "Splenic flexure", "opc": "Rectosigmoid Junction", "opd": "Ileocolic Junction", "cop": 1, "answer": "B", "exp": "During times of blockage of one of the aeries that supply the watershed area, such as in atherosclerosis, these regions are spared from ischemia by viue of their dual supply. However, during times of systemic hypoperfusion, such as in disseminated intravesicular coagulation or hea failure, these regions are paicularly vulnerable to ischemia by viue of the fact that they are supplied by the most distal branches of their aeries, and thus the least likely to receive sufficient blood. Watershed areas are found in the brain, where areas are perfused by both the anterior and middle cerebral aeries, and in the intestines, where areas are perfused by both the superior and inferior mesenteric aeries", "explanation_word_count": 113, "prompt": "Watershed area between SMA & IMA which commonly result in ischemia is\nA. Hepatic flexure\nB. Splenic flexure\nC. Rectosigmoid Junction\nD. Ileocolic Junction\nReturn the correct option letter.", "reference": "During times of blockage of one of the aeries that supply the watershed area, such as in atherosclerosis, these regions are spared from ischemia by viue of their dual supply. However, during times of systemic hypoperfusion, such as in disseminated intravesicular coagulation or hea failure, these regions are paicularly vulnerable to ischemia by viue of the fact that they are supplied by the most distal branches of their aeries, and thus the least likely to receive sufficient blood. Watershed areas are found in the brain, where areas are perfused by both the anterior and middle cerebral aeries, and in the intestines, where areas are perfused by both the superior and inferior mesenteric aeries\nB", "question_key": "watershed area between sma & ima which commonly result in ischemia is", "split": "validation", "is_mia_member": false} | |
| {"id": "b4816029-73d3-4c73-af3a-df1cddbe4fa5", "question": "An anganwadi worker is trained for -", "opa": "3 months", "opb": "4 months", "opc": "5 months", "opd": "6 months", "cop": 1, "answer": "B", "exp": "-under ICDS Scheme, there is an anganwadi worker for a population of 400-800. - anganwadi worker is selected from the community itself - undergoes a training in various aspects of health, nutrition and child development for 4 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:903 <\\p>", "explanation_word_count": 47, "prompt": "An anganwadi worker is trained for -\nA. 3 months\nB. 4 months\nC. 5 months\nD. 6 months\nReturn the correct option letter.", "reference": "-under ICDS Scheme, there is an anganwadi worker for a population of 400-800. - anganwadi worker is selected from the community itself - undergoes a training in various aspects of health, nutrition and child development for 4 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:903 <\\p>\nB", "question_key": "an anganwadi worker is trained for -", "split": "validation", "is_mia_member": false} | |
| {"id": "8b2e7b95-16b4-4bc8-972b-f2b01090dce9", "question": "Which of the following bariatric procedures is primarily intended to induce weight loss through malabsorption and restriction?", "opa": "Adjustable gastric band", "opb": "Sleeve gastrectomy", "opc": "Roux-en-Y gastric bypass (RYGB)", "opd": "Duodenal switch", "cop": 2, "answer": "C", "exp": "Bariatric procedures are classified as restrictive, malabsorptive, or a combination of restrictive and malabsorptive in the mechanism of weight loss that they induce. Restrictive operations include adjustable gastric band and gastric sleeve, malabsorptive operations include duodenal switch and biliopancreatic diversion, and combined restrictive and malabsorptive procedures include the Roux-en-Y gastric bypass (RYGB).", "explanation_word_count": 52, "prompt": "Which of the following bariatric procedures is primarily intended to induce weight loss through malabsorption and restriction?\nA. Adjustable gastric band\nB. Sleeve gastrectomy\nC. Roux-en-Y gastric bypass (RYGB)\nD. Duodenal switch\nReturn the correct option letter.", "reference": "Bariatric procedures are classified as restrictive, malabsorptive, or a combination of restrictive and malabsorptive in the mechanism of weight loss that they induce. Restrictive operations include adjustable gastric band and gastric sleeve, malabsorptive operations include duodenal switch and biliopancreatic diversion, and combined restrictive and malabsorptive procedures include the Roux-en-Y gastric bypass (RYGB).\nC", "question_key": "which of the following bariatric procedures is primarily intended to induce weight loss through malabsorption and restriction?", "split": "validation", "is_mia_member": false} | |
| {"id": "12157c3f-bb08-4e35-bfab-e3c061e7a0ce", "question": "IP3/DAG pathway is activated by which of the following?", "opa": "Protein kinase A", "opb": "Protein kinase C", "opc": "Phospholipase C", "opd": "Phospholipase A", "cop": 2, "answer": "C", "exp": "ANSWER: (C) Phospholipase CREF: Guyton s physiology 12th edition page 890, KDT 6th edition page no 46See APPENDIX- 84 below \"ENDOCRINE GLANDS, HORMONES, AND THEIR FUNCTIONS AND STRUCTURE\"Phospholipase C catalyzes the breakdown of some phospholipids in the cell membrane, especially phosphatidylinositol biphosphate (PIP2), into two different second messenger products: inositol triphosphate (IP3) and diacylglycerol (DAG). The IP3 mobilizes calcium ions from mitochondria and the endoplasmic reticulum, and the calcium ions then have their owm second messenger effects, such as smooth muscle contraction and changes in cell secretion. DAG, the other lipid second messenger, activates the enzyme protein kinase C (PKC), which then phosphorylates a large number of proteins, leading to the cell's responseSummary:IP3/DAG is activated by Phospholipase CIP3/DAG activates protein kinase C (PKC) APPENDIX- 84ENDOCRINE GLANDS, HORMONES, AND THEIR FUNCTIONS AND STRUCTURE:REF: Guyton 11th edition page 907Gland,'TissueHormonesMajor FunctionsChemicalStructureHypothalamusThyrotropin-releasing hormone (TRH)Stimulates secretion of TSH and prolactinPeptideCorticotropin-releasing hormone (CRH)Causes release of ACTHPeptideGrowth hormone-releasing hormone (GHRH)Causes release of growth hormonePeptideGrowth hormoneinhibitory hormone (GHIH) (somatostatin)Inhibits release of growth hormonePeptideGonadotropin-releasing hormone (GnRH)Causes release of LH and FSHPeptideDopamine or prolactin- inhibiting factor (P1F)Inhibits release of prolactinAmineAnterior pituitaryGrowth hormoneStimulates protein synthesis and overall growth of most cells and tissuesPeptideThyroid-stimulating hormone (TSH)Stimulates synthesis and secretion of thyroid hormones (thyroxine and triiodothyronine)PeptideAdrenocorticotropic hormone (ACTH)Stimulates synthesis and secretion of adrenocortical hormones (cortisol, androgens, and aldosterone)PeptideProlactinPromotes development of the female breasts and secretion of milkPeptideFollicle-stimulating hormone (FSH)Causes growth of follicles in the ovaries and sperm maturation in Sertoli cells of testesPeptideLuteinizing hormone (LH)Stimulates testosterone synthesis in Leydig cells of testes; stimulates ovulation, formation of corpus luteum, and estrogen and progesterone synthesis in ovariesPeptidePosterior pituitaryAntidiuretic hormone (ADH) (also called vasopressin)Increases water reabsorption by the kidneys and causes vasoconstriction and increased blood pressurePeptideOxytocinStimulates milk ejection from breasts and uterine contractionsPeptideThyroidThyroxine (T4) and triiodothyronine (T3)Increases the rates of chemical reactions in most cells, thus increasing body metabolic rateAmineCalcitoninPromotes deposition of calcium in the bones and decreases extracellular fluid calcium ion concentrationPeptideAdrenal cortexCortisolHas multiple metabolic functions for controlling metabolism of proteins, carbohydrates, and fats; also has anti-inflammatory effectsSteroidAldosteroneIncreases renal sodium reabsorption, potassium secretion, and hydrogen ion secretionSteroidAdrenal medullaNorepinephrine, epinephrineSame effects as sympathetic stimulationAminePancreasInsulin (b cells)Promotes glucose entry in many cells, and in this way controls carbohydrate metabolismPeptide Glucagon (a cells)Increases synthesis and release of glucose from the liver into the body fluidsPeptideParathyroidParathyroid hormone (PTH)Controls serum calcium ion concentration by increasing calcium absorption by the gut and kidneys and releasing calcium from bonesPeptideTestesTestosteronePromotes development of male reproductive system and male secondary sexual characteristicsSteroidOvariesEstrogensPromotes growth and development of female reproductive system, female breasts, and female secondary sexual characteristicsSteroidProgesteroneStimulates secretion of \"uterine milk1' by the uterine endometrial glands and promotes development of secretory apparatus of breastsSteroidPlacentaHuman chorionic gonadotropin (HCG)Promotes growth of corpus luteum and secretion of estrogens and progesterone by corpus luteumPeptideHuman somatomammotropinProbably helps promote development of some fetal tissues as well as the mothers breastsPeptideEstrogensSee actions of estrogens from ovariesSteroidProgesteroneSee actions of progesterone from ovariesSteroidKidneyReninCatalyzes conversion of angiotensinogen to angiotensin I (acts as an enzyme)Peptide1,25-DihydroxycholecaldferolIncreases intestinal absorption of calcium and bone mineralizationSteroidErythropoietinIncreases erythrocyte productionPeptideHeartAtrial natriuretic peptide (ANP)Increases sodium excretion by kidneys, reduces blood pressurePeptideStomachGastrinStimulates HC1 secretion by parietal cellsPeptideSmall intestineSecretinStimulates pancreatic acinar cells to release bicarbonate and waterPeptideCholecystokinin (CCK)Stimulates gallbladder contraction and release of pancreatic enzymesPeptideAdipocytesLeptinInhibits appetite, stimulates thermogenesisPeptide GENERAL FEATURES OF HORMONE CLASSES. Group IGroup IITypesSteroids, iodothyronines, calcitriol, retinoidsPolypeptides, proteins, glycoproteins, catecholaminesSolubilityLipophilicHydrophilicTransport proteinsYesNoPlasma half-lifeLong (hours to days)Short (minutes)ReceptorIntracellularPlasma membraneMediatorReceptor-hormone complexcAMP, cGMP, Ca2+, metabolites of complex phosphoinositols, kinase cascades CLASSIFICATION OF HORMONES BY MECHANISM OF ACTIONI. HORMONES THAT BIND TO INTRACELLULAR RECEPTORS> Androgens> Estrogen> Calcitriol (l,252-D3)> Glucocorticoids> Mineralocorticoids> Progestins> Retinoic acid> Thyroid hormones (T3 and T4)II. HORMONES THAT BIND TO CELL SURFACE RECEPTORS/ HORMONES USING SECOND MESSENGER SYSTEMSAdenylyl Cyciase-cAMP secondmessenger systemIP3-DAG System or Phospholipase C SecondMessenger SystemCalcium Calmodulin system* Adrenocorticotropic hormone (ACTH)* Angiotensin II (epithelial cells)* Calcitonin* Catecholamines (b receptors)* Corticotropin-releasing hormone (CRH)* Follicle-stimulating hormone (FSH)* Glucagon* Human chorionic gonadotropin (HCG)* Luteinizing hormone (LH)* Parathyroid hormone (PTH)* Secretin* Somatostatin* Thyroid-stimulating hormone (TSH)* Melanocyte-stimulating hormone* Vasopressin (V2 receptor,epithelial cells)* Angiotensin II (vascular smooth muscles)* Catecholamines (a receptors)* Gonadotropin-releasing hormone (GnRH)* Growth hormone-releasing hormone (GHRH)* Oxytocin* Thyroid-releasing hormone (TRH)* Vasopressin (VI receptor, vascular smooth muscle)* Adenylyl cyclase* Phosphodiesterase* Ca2+ /calmodulin dependent protein kinases.* Phosphoprotein phosphatases* Phospholipase A2. and* Troponin C.cGMP second messenger system* Nitric oxide* Atrial natriuretic factor", "explanation_word_count": 733, "prompt": "IP3/DAG pathway is activated by which of the following?\nA. Protein kinase A\nB. Protein kinase C\nC. Phospholipase C\nD. Phospholipase A\nReturn the correct option letter.", "reference": "ANSWER: (C) Phospholipase CREF: Guyton s physiology 12th edition page 890, KDT 6th edition page no 46See APPENDIX- 84 below \"ENDOCRINE GLANDS, HORMONES, AND THEIR FUNCTIONS AND STRUCTURE\"Phospholipase C catalyzes the breakdown of some phospholipids in the cell membrane, especially phosphatidylinositol biphosphate (PIP2), into two different second messenger products: inositol triphosphate (IP3) and diacylglycerol (DAG). The IP3 mobilizes calcium ions from mitochondria and the endoplasmic reticulum, and the calcium ions then have their owm second messenger effects, such as smooth muscle contraction and changes in cell secretion. DAG, the other lipid second messenger, activates the enzyme protein kinase C (PKC), which then phosphorylates a large number of proteins, leading to the cell's responseSummary:IP3/DAG is activated by Phospholipase CIP3/DAG activates protein kinase C (PKC) APPENDIX- 84ENDOCRINE GLANDS, HORMONES, AND THEIR FUNCTIONS AND STRUCTURE:REF: Guyton 11th edition page 907Gland,'TissueHormonesMajor FunctionsChemicalStructureHypothalamusThyrotropin-releasing hormone (TRH)Stimulates secretion of TSH and prolactinPeptideCorticotropin-releasing hormone (CRH)Causes release of ACTHPeptideGrowth hormone-releasing hormone (GHRH)Causes release of growth hormonePeptideGrowth hormoneinhibitory hormone (GHIH) (somatostatin)Inhibits release of growth hormonePeptideGonadotropin-releasing hormone (GnRH)Causes release of LH and FSHPeptideDopamine or prolactin- inhibiting factor (P1F)Inhibits release of prolactinAmineAnterior pituitaryGrowth hormoneStimulates protein synthesis and overall growth of most cells and tissuesPeptideThyroid-stimulating hormone (TSH)Stimulates synthesis and secretion of thyroid hormones (thyroxine and triiodothyronine)PeptideAdrenocorticotropic hormone (ACTH)Stimulates synthesis and secretion of adrenocortical hormones (cortisol, androgens, and aldosterone)PeptideProlactinPromotes development of the female breasts and secretion of milkPeptideFollicle-stimulating hormone (FSH)Causes growth of follicles in the ovaries and sperm maturation in Sertoli cells of testesPeptideLuteinizing hormone (LH)Stimulates testosterone synthesis in Leydig cells of testes; stimulates ovulation, formation of corpus luteum, and estrogen and progesterone synthesis in ovariesPeptidePosterior pituitaryAntidiuretic hormone (ADH) (also called vasopressin)Increases water reabsorption by the kidneys and causes vasoconstriction and increased blood pressurePeptideOxytocinStimulates milk ejection from breasts and uterine contractionsPeptideThyroidThyroxine (T4) and triiodothyronine (T3)Increases the rates of chemical reactions in most cells, thus increasing body metabolic rateAmineCalcitoninPromotes deposition of calcium in the bones and decreases extracellular fluid calcium ion concentrationPeptideAdrenal cortexCortisolHas multiple metabolic functions for controlling metabolism of proteins, carbohydrates, and fats; also has anti-inflammatory effectsSteroidAldosteroneIncreases renal sodium reabsorption, potassium secretion, and hydrogen ion secretionSteroidAdrenal medullaNorepinephrine, epinephrineSame effects as sympathetic stimulationAminePancreasInsulin (b cells)Promotes glucose entry in many cells, and in this way controls carbohydrate metabolismPeptide Glucagon (a cells)Increases synthesis and release of glucose from the liver into the body fluidsPeptideParathyroidParathyroid hormone (PTH)Controls serum calcium ion concentration by increasing calcium absorption by the gut and kidneys and releasing calcium from bonesPeptideTestesTestosteronePromotes development of male reproductive system and male secondary sexual characteristicsSteroidOvariesEstrogensPromotes growth and development of female reproductive system, female breasts, and female secondary sexual characteristicsSteroidProgesteroneStimulates secretion of \"uterine milk1' by the uterine endometrial glands and promotes development of secretory apparatus of breastsSteroidPlacentaHuman chorionic gonadotropin (HCG)Promotes growth of corpus luteum and secretion of estrogens and progesterone by corpus luteumPeptideHuman somatomammotropinProbably helps promote development of some fetal tissues as well as the mothers breastsPeptideEstrogensSee actions of estrogens from ovariesSteroidProgesteroneSee actions of progesterone from ovariesSteroidKidneyReninCatalyzes conversion of angiotensinogen to angiotensin I (acts as an enzyme)Peptide1,25-DihydroxycholecaldferolIncreases intestinal absorption of calcium and bone mineralizationSteroidErythropoietinIncreases erythrocyte productionPeptideHeartAtrial natriuretic peptide (ANP)Increases sodium excretion by kidneys, reduces blood pressurePeptideStomachGastrinStimulates HC1 secretion by parietal cellsPeptideSmall intestineSecretinStimulates pancreatic acinar cells to release bicarbonate and waterPeptideCholecystokinin (CCK)Stimulates gallbladder contraction and release of pancreatic enzymesPeptideAdipocytesLeptinInhibits appetite, stimulates thermogenesisPeptide GENERAL FEATURES OF HORMONE CLASSES. Group IGroup IITypesSteroids, iodothyronines, calcitriol, retinoidsPolypeptides, proteins, glycoproteins, catecholaminesSolubilityLipophilicHydrophilicTransport proteinsYesNoPlasma half-lifeLong (hours to days)Short (minutes)ReceptorIntracellularPlasma membraneMediatorReceptor-hormone complexcAMP, cGMP, Ca2+, metabolites of complex phosphoinositols, kinase cascades CLASSIFICATION OF HORMONES BY MECHANISM OF ACTIONI. HORMONES THAT BIND TO INTRACELLULAR RECEPTORS> Androgens> Estrogen> Calcitriol (l,252-D3)> Glucocorticoids> Mineralocorticoids> Progestins> Retinoic acid> Thyroid hormones (T3 and T4)II. HORMONES THAT BIND TO CELL SURFACE RECEPTORS/ HORMONES USING SECOND MESSENGER SYSTEMSAdenylyl Cyciase-cAMP secondmessenger systemIP3-DAG System or Phospholipase C SecondMessenger SystemCalcium Calmodulin system* Adrenocorticotropic hormone (ACTH)* Angiotensin II (epithelial cells)* Calcitonin* Catecholamines (b receptors)* Corticotropin-releasing hormone (CRH)* Follicle-stimulating hormone (FSH)* Glucagon* Human chorionic gonadotropin (HCG)* Luteinizing hormone (LH)* Parathyroid hormone (PTH)* Secretin* Somatostatin* Thyroid-stimulating hormone (TSH)* Melanocyte-stimulating hormone* Vasopressin (V2 receptor,epithelial cells)* Angiotensin II (vascular smooth muscles)* Catecholamines (a receptors)* Gonadotropin-releasing hormone (GnRH)* Growth hormone-releasing hormone (GHRH)* Oxytocin* Thyroid-releasing hormone (TRH)* Vasopressin (VI receptor, vascular smooth muscle)* Adenylyl cyclase* Phosphodiesterase* Ca2+ /calmodulin dependent protein kinases.* Phosphoprotein phosphatases* Phospholipase A2. and* Troponin C.cGMP second messenger system* Nitric oxide* Atrial natriuretic factor\nC", "question_key": "ip3/dag pathway is activated by which of the following?", "split": "validation", "is_mia_member": false} | |
| {"id": "418f69be-e7da-45c0-9937-fc4b92f0741b", "question": "Membranous glomerulonephritis is associated with-", "opa": "Renal Venous thrombosis", "opb": "Hodgkin's disease", "opc": "Subepithelial immune deposits", "opd": "Hematuria", "cop": 0, "answer": "A", "exp": "Membranous nephropathy Membranous nephropathy is the most common cause of nephrotic syndrome in Caucasian adults. It is caused by antibodies (usually autoantibodies) directed at antigen(s) and venous thrombosis Antigens expressed on the surface of the podocytes, including the M-type phospholipase A2 receptor 1. While most cases are idiopathic, a propoion are associated with other causes, such as heavy metal poisoning, drugs, infections, lupus and tumours . Approximately one-third of patients with idiopathic membranous nephropathy undergo spontaneous remission, one-third remain in a nephrotic state, and one-third develop progressive CKD. High doses of glucocoicoids and cyclophosphamide may improve both the nephrotic syndrome and the long-term prognosis. However, because of the toxicity of these regimens, many nephrologists reserve such treatment for those with severe nephrotic syndrome or deteriorating renal function. Treatment of secondary membranous nephropathy is directed at the underlying cause. Ref Harrison20th edition pg 266", "explanation_word_count": 142, "prompt": "Membranous glomerulonephritis is associated with-\nA. Renal Venous thrombosis\nB. Hodgkin's disease\nC. Subepithelial immune deposits\nD. Hematuria\nReturn the correct option letter.", "reference": "Membranous nephropathy Membranous nephropathy is the most common cause of nephrotic syndrome in Caucasian adults. It is caused by antibodies (usually autoantibodies) directed at antigen(s) and venous thrombosis Antigens expressed on the surface of the podocytes, including the M-type phospholipase A2 receptor 1. While most cases are idiopathic, a propoion are associated with other causes, such as heavy metal poisoning, drugs, infections, lupus and tumours . Approximately one-third of patients with idiopathic membranous nephropathy undergo spontaneous remission, one-third remain in a nephrotic state, and one-third develop progressive CKD. High doses of glucocoicoids and cyclophosphamide may improve both the nephrotic syndrome and the long-term prognosis. However, because of the toxicity of these regimens, many nephrologists reserve such treatment for those with severe nephrotic syndrome or deteriorating renal function. Treatment of secondary membranous nephropathy is directed at the underlying cause. Ref Harrison20th edition pg 266\nA", "question_key": "membranous glomerulonephritis is associated with-", "split": "validation", "is_mia_member": false} | |
| {"id": "3430f397-1983-4e82-bfeb-2d08d9b013ce", "question": "Chickenpox is caused by", "opa": "Varicella-zoster virus", "opb": "Epstein-barr virus", "opc": "Pox virus", "opd": "Herpes simplex virus", "cop": 0, "answer": "A", "exp": "Ans. A. Varicella-zoster virus. (Ref. Harrison's medicine 17th ed. Chapter 173)Varicella-zoster virus# Varicella-zoster virus (VZV) causes two distinct clinical entities:- varicella (chickenpox) and- herpes zoster (shingles).# Chickenpox, a ubiquitous and extremely contagious infection, is usually a benign illness of childhood characterized by an exanthematous vesicular rash.# With reactivation of latent VZV (which is most common after the sixth decade of life), herpes zoster presents as a dermatomal vesicular rash, usually associated with severe pain.# Children between 5-9 yr age are most commonly affected.# Incubation period 14-17 days.# Secondary attack rate 72-90%.# Patients are infectious prior to onset of rash, during period of vesicle formation (4-5days) & until all vesicles are crusted.# Hallmark of infection is maculopapules, vesicles escabs in various stages.# Most common infectious complication of varicella is superficial bacterial infection of skin by Staph.# Most common extracutaneous site of affection by VZV is CNS.Recommendations for VZIG AdministrationExposure Criteria1. Exposure to person with chickenpox or zostera. Household: residence in the same householdb. Playmate: face-to-face indoor playc. HospitalVaricella: same 2- to 4-bed room or adjacent beds in large ward, face-to-face contact with infectious staff member or patient, visit by a person deemed contagiousZoster: intimate contact (e.g., touching or hugging) with a person deemed contagiousd. Newborn infant: onset of varicella in the mother <5 days before delivery or <48 h after delivery; VZIG not indicated if the mother has zoster2. Patient should receive VZIG as soon as possible but not >96 h after exposureCandidates (Provided They Have Significant Exposure) Include:1. Immunocompromised susceptible children without a history of varicella or varicella immunization2. Susceptible pregnant women3. Newborn infants whose mother had onset of chickenpox within 5 days before or within 48 h after delivery4. Hospitalized premature infant (>28 weeks of gestation) whose mother lacks a reliable history of chickenpox or serologic evidence of protection against varicella5. Hospitalized premature infant (<28 weeks of gestation or <1000-g birth weight), regardless of maternal history of varicella or varicella-zoster virus serologic status.", "explanation_word_count": 314, "prompt": "Chickenpox is caused by\nA. Varicella-zoster virus\nB. Epstein-barr virus\nC. Pox virus\nD. Herpes simplex virus\nReturn the correct option letter.", "reference": "Ans. A. Varicella-zoster virus. (Ref. Harrison's medicine 17th ed. Chapter 173)Varicella-zoster virus# Varicella-zoster virus (VZV) causes two distinct clinical entities:- varicella (chickenpox) and- herpes zoster (shingles).# Chickenpox, a ubiquitous and extremely contagious infection, is usually a benign illness of childhood characterized by an exanthematous vesicular rash.# With reactivation of latent VZV (which is most common after the sixth decade of life), herpes zoster presents as a dermatomal vesicular rash, usually associated with severe pain.# Children between 5-9 yr age are most commonly affected.# Incubation period 14-17 days.# Secondary attack rate 72-90%.# Patients are infectious prior to onset of rash, during period of vesicle formation (4-5days) & until all vesicles are crusted.# Hallmark of infection is maculopapules, vesicles escabs in various stages.# Most common infectious complication of varicella is superficial bacterial infection of skin by Staph.# Most common extracutaneous site of affection by VZV is CNS.Recommendations for VZIG AdministrationExposure Criteria1. Exposure to person with chickenpox or zostera. Household: residence in the same householdb. Playmate: face-to-face indoor playc. HospitalVaricella: same 2- to 4-bed room or adjacent beds in large ward, face-to-face contact with infectious staff member or patient, visit by a person deemed contagiousZoster: intimate contact (e.g., touching or hugging) with a person deemed contagiousd. Newborn infant: onset of varicella in the mother <5 days before delivery or <48 h after delivery; VZIG not indicated if the mother has zoster2. Patient should receive VZIG as soon as possible but not >96 h after exposureCandidates (Provided They Have Significant Exposure) Include:1. Immunocompromised susceptible children without a history of varicella or varicella immunization2. Susceptible pregnant women3. Newborn infants whose mother had onset of chickenpox within 5 days before or within 48 h after delivery4. Hospitalized premature infant (>28 weeks of gestation) whose mother lacks a reliable history of chickenpox or serologic evidence of protection against varicella5. Hospitalized premature infant (<28 weeks of gestation or <1000-g birth weight), regardless of maternal history of varicella or varicella-zoster virus serologic status.\nA", "question_key": "chickenpox is caused by", "split": "validation", "is_mia_member": false} | |
| {"id": "9a969791-6e1a-4fc7-90c3-12824f1cb309", "question": "A bactericidal drug would be preferred over a bacteriostatic drug in a patient with:", "opa": "Neutropenia", "opb": "Cirrhosis", "opc": "Pneumonia", "opd": "Hea disease", "cop": 0, "answer": "A", "exp": "Primarily bacteriostatic:Sulfonamides ,Erythromycin Tetracyclines, Ethambutol Chloramphenicol ,Clindamycin Linezolid. Primarily bactericidal Penicillins Cephalosporins Aminoglycosides Vancomycin Polypeptides Nalidixic acid Rifampin Ciprofloxacin Isoniazid Metronidazole Pyrazinamide Cotrimoxazole Many infections in patients with normal host defence respond equally well to bacteriostatic and bactericidal AMAs. But several acute infections resolve faster with a cidal than a static drug, because the cidal drug directly reduces the number of bacteria at the site of infection, while the static drug only prevents increase in their number. Many bactericidal drugs exe prolonged postantibiotic effect so that maintenance of drug level continuously above the MIC is not essential. With bacteriostatic AMAs the bacteria sta multiplying quickly when drug level falls below the MIC, resulting in relapse of infection. A bactericidal antibiotic is clearly superior to bacteriostatic one in treating patients with impaired host defence, life-threatening infections, infections at less accessible sites (SABE) or when carrier state is possible (typhoid) . ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:676", "explanation_word_count": 160, "prompt": "A bactericidal drug would be preferred over a bacteriostatic drug in a patient with:\nA. Neutropenia\nB. Cirrhosis\nC. Pneumonia\nD. Hea disease\nReturn the correct option letter.", "reference": "Primarily bacteriostatic:Sulfonamides ,Erythromycin Tetracyclines, Ethambutol Chloramphenicol ,Clindamycin Linezolid. Primarily bactericidal Penicillins Cephalosporins Aminoglycosides Vancomycin Polypeptides Nalidixic acid Rifampin Ciprofloxacin Isoniazid Metronidazole Pyrazinamide Cotrimoxazole Many infections in patients with normal host defence respond equally well to bacteriostatic and bactericidal AMAs. But several acute infections resolve faster with a cidal than a static drug, because the cidal drug directly reduces the number of bacteria at the site of infection, while the static drug only prevents increase in their number. Many bactericidal drugs exe prolonged postantibiotic effect so that maintenance of drug level continuously above the MIC is not essential. With bacteriostatic AMAs the bacteria sta multiplying quickly when drug level falls below the MIC, resulting in relapse of infection. A bactericidal antibiotic is clearly superior to bacteriostatic one in treating patients with impaired host defence, life-threatening infections, infections at less accessible sites (SABE) or when carrier state is possible (typhoid) . ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:676\nA", "question_key": "a bactericidal drug would be preferred over a bacteriostatic drug in a patient with:", "split": "validation", "is_mia_member": false} | |
| {"id": "16d5a54e-fb3a-4453-8caa-f6ec9a909d62", "question": "Treatment of choice for annular pancreas is -", "opa": "Division of pancreas", "opb": "Duodeno-duodenostomy", "opc": "Duodeno-jejunostomy", "opd": "Roux-en-Y loop", "cop": 1, "answer": "B", "exp": "Ans B Reference Sabiston Textbook of Surgery. 20th edition. Annular pancreas results from aberrant migration of the ventral pancreas bud which leads to circumferential or near-circumferential pancreas tissue surrounding the second portion of the duodenum This abnormality may be associated with other congenital defects, including Down syndrome, malrotation, intestinal atresia, and cardiac malformations If symptoms of obstruction occur surgical bypass through duodenojejunostomy is performed Axial image from an abdominal CT scan showing the annulus encircling the duodenum (arrow). Courtesy-", "explanation_word_count": 79, "prompt": "Treatment of choice for annular pancreas is -\nA. Division of pancreas\nB. Duodeno-duodenostomy\nC. Duodeno-jejunostomy\nD. Roux-en-Y loop\nReturn the correct option letter.", "reference": "Ans B Reference Sabiston Textbook of Surgery. 20th edition. Annular pancreas results from aberrant migration of the ventral pancreas bud which leads to circumferential or near-circumferential pancreas tissue surrounding the second portion of the duodenum This abnormality may be associated with other congenital defects, including Down syndrome, malrotation, intestinal atresia, and cardiac malformations If symptoms of obstruction occur surgical bypass through duodenojejunostomy is performed Axial image from an abdominal CT scan showing the annulus encircling the duodenum (arrow). Courtesy-\nB", "question_key": "treatment of choice for annular pancreas is -", "split": "validation", "is_mia_member": false} | |
| {"id": "a6633cde-2b8a-4344-a05f-5a8a6ec176ec", "question": "Most common cause of obstructive jaundice in children?", "opa": "Biliary atresia", "opb": "Criggler najjar syndrome", "opc": "Byler disease", "opd": "Caroli cyst", "cop": 0, "answer": "A", "exp": "Biliary atresia: Biliary atresia is characterized by obliteration or discontinuity of the extrahepatic biliary system. The disorder represents the most common surgically treatable cause of cholestasis seen during the newborn period", "explanation_word_count": 31, "prompt": "Most common cause of obstructive jaundice in children?\nA. Biliary atresia\nB. Criggler najjar syndrome\nC. Byler disease\nD. Caroli cyst\nReturn the correct option letter.", "reference": "Biliary atresia: Biliary atresia is characterized by obliteration or discontinuity of the extrahepatic biliary system. The disorder represents the most common surgically treatable cause of cholestasis seen during the newborn period\nA", "question_key": "most common cause of obstructive jaundice in children?", "split": "validation", "is_mia_member": false} | |
| {"id": "f6648b1d-d7b0-43de-b8a5-e1685c6e47bc", "question": "Division of zygote took place on 5th day after fertilization. What is the type of twinning:", "opa": "Monochorionic, Monoamniotic", "opb": "Monochorionic, Diamniotic", "opc": "Dichorionic, Diamniotic", "opd": "Dichorionic, Monoamniotic", "cop": 1, "answer": "B", "exp": "Ans. (b) Monochorionic, DiamnioticRef: Dutta 8th ed. 233Division of zygote and types of TwinningDivision of Zygote on/ afterTypes of Twining72 hours/3 daysDichorionic, DiamnioticBetween 4-8 daysMonochorionic, DiamnioticBetween 8-12 daysMonochorionic, Monoamniotic> DaysSiamese, Conjoined TwinsAlso Know* Most common type of twinning is dizygotic twins: 69%* Monozygotic twins in: 31%* MC TYPE OF TWIN GESTATION: Diamniotic Monochorionic (70-75%)* Least common type of twin gestation: Conjoined twins (<1%)* Hellin rule is associated with multiple pregnancyas per which chance of twins is al in 80 pregnancies, triplets 1 in 802 and so on. It can result in complications;* Prematurity is the commonest fetal complication* Post partumhemorrhage is the commonest maternal complication.", "explanation_word_count": 96, "prompt": "Division of zygote took place on 5th day after fertilization. What is the type of twinning:\nA. Monochorionic, Monoamniotic\nB. Monochorionic, Diamniotic\nC. Dichorionic, Diamniotic\nD. Dichorionic, Monoamniotic\nReturn the correct option letter.", "reference": "Ans. (b) Monochorionic, DiamnioticRef: Dutta 8th ed. 233Division of zygote and types of TwinningDivision of Zygote on/ afterTypes of Twining72 hours/3 daysDichorionic, DiamnioticBetween 4-8 daysMonochorionic, DiamnioticBetween 8-12 daysMonochorionic, Monoamniotic> DaysSiamese, Conjoined TwinsAlso Know* Most common type of twinning is dizygotic twins: 69%* Monozygotic twins in: 31%* MC TYPE OF TWIN GESTATION: Diamniotic Monochorionic (70-75%)* Least common type of twin gestation: Conjoined twins (<1%)* Hellin rule is associated with multiple pregnancyas per which chance of twins is al in 80 pregnancies, triplets 1 in 802 and so on. It can result in complications;* Prematurity is the commonest fetal complication* Post partumhemorrhage is the commonest maternal complication.\nB", "question_key": "division of zygote took place on 5th day after fertilization. what is the type of twinning:", "split": "validation", "is_mia_member": false} | |
| {"id": "996f63a9-73de-449b-a4d5-21f9e9dc086b", "question": "Most vascular zone of the bone is", "opa": "Metaphysis", "opb": "Diaphysis", "opc": "Epiphysis", "opd": "Medullary Cavity", "cop": 0, "answer": "A", "exp": "Metaphysis is the most vascular zone of the bone especially in children as it has long hairpin loop arranged aerioles and venules running through it.(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 9)", "explanation_word_count": 34, "prompt": "Most vascular zone of the bone is\nA. Metaphysis\nB. Diaphysis\nC. Epiphysis\nD. Medullary Cavity\nReturn the correct option letter.", "reference": "Metaphysis is the most vascular zone of the bone especially in children as it has long hairpin loop arranged aerioles and venules running through it.(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 9)\nA", "question_key": "most vascular zone of the bone is", "split": "validation", "is_mia_member": false} | |
| {"id": "05a8b60e-7619-4b98-bbab-9ad7883ab979", "question": "A young male presents with fever, followed by headache, confusion, focal seizures and right hemiparesis. MRI shows bilateral frontotemporal hyperintense lesion. Which of the following is the most likely diagnosis?", "opa": "Acute pyogenic meningitis", "opb": "Herpes simplex encephalitis", "opc": "Neurocysticercosis", "opd": "Carcinomatous meningitis", "cop": 1, "answer": "B", "exp": "Patient is showing features suggestive of herpes simplex encephalitis. Clinical manifestations in viral encephalitis includes altered level of consiousness (confusion, behavioral abnormalities), mild lethargy to coma, evidence of both focal or diffuse neurologic signs and symptoms and focal or generalized seizures. Investigations: CSF shows lymphocytic leukocytosis, red blood cells due to hemorrhagic necrosis and elevated cerebrospinal fluid (CSF) protein levels. In HSV encephalitis80% will have abnormalities in temporal lobe and 10% have extra temporal abnormalities. The lesions are typically hyper intense on T2-weighted images. Brain biopsy has been the gold standard for defining HSV encephalitis, but now PCR for detection of HSV DNA in CSF has largely replaced biopsy for defining CNS infection. Acyclovir is used in the treatment. Ref: Harrison's Internal Medicine, 18th Edition, Pages 3421, 3437, Chapters 179, 379, 381.", "explanation_word_count": 127, "prompt": "A young male presents with fever, followed by headache, confusion, focal seizures and right hemiparesis. MRI shows bilateral frontotemporal hyperintense lesion. Which of the following is the most likely diagnosis?\nA. Acute pyogenic meningitis\nB. Herpes simplex encephalitis\nC. Neurocysticercosis\nD. Carcinomatous meningitis\nReturn the correct option letter.", "reference": "Patient is showing features suggestive of herpes simplex encephalitis. Clinical manifestations in viral encephalitis includes altered level of consiousness (confusion, behavioral abnormalities), mild lethargy to coma, evidence of both focal or diffuse neurologic signs and symptoms and focal or generalized seizures. Investigations: CSF shows lymphocytic leukocytosis, red blood cells due to hemorrhagic necrosis and elevated cerebrospinal fluid (CSF) protein levels. In HSV encephalitis80% will have abnormalities in temporal lobe and 10% have extra temporal abnormalities. The lesions are typically hyper intense on T2-weighted images. Brain biopsy has been the gold standard for defining HSV encephalitis, but now PCR for detection of HSV DNA in CSF has largely replaced biopsy for defining CNS infection. Acyclovir is used in the treatment. Ref: Harrison's Internal Medicine, 18th Edition, Pages 3421, 3437, Chapters 179, 379, 381.\nB", "question_key": "a young male presents with fever, followed by headache, confusion, focal seizures and right hemiparesis. mri shows bilateral frontotemporal hyperintense lesion. which of the following is the most likely diagnosis?", "split": "validation", "is_mia_member": false} | |
| {"id": "1e238c55-0e8f-4ec3-b4b8-bf4e6d12b80b", "question": "A pregnant lady complaints of headache, feeling of excessive tiredness and drowsiness whenever she lies down in supine position. Her symptoms are relieved on sitting up and while lying on her side. What is the most likely diagnosis?", "opa": "IVC compression", "opb": "Compression on sympathetic chain", "opc": "Raised intra abdominal pressure", "opd": "Decreased blood supply to placenta", "cop": 0, "answer": "A", "exp": "Patient is showing features of supine hypotensive syndrome caused by the compression of inferior vena cava by the weight of a pregnant female's uterus, fetus, placenta and amniotic fluids while lying in the supine position. This condition can develop as early as the second trimester but is maximal during the third trimester, 36 to 38 weeks. When the pregnant female in these stages lies in the supine position, the added weight of the enlarged uterus and its contents will press down on the inferior vena cava. When the IVC is compressed it reduces the amount of blood that returns to the hea and reduces cardiac output, this can result in a loss of 30% of the effective circulating blood volume. It can take 3-7 minutes for significant hypotension to manifest.", "explanation_word_count": 126, "prompt": "A pregnant lady complaints of headache, feeling of excessive tiredness and drowsiness whenever she lies down in supine position. Her symptoms are relieved on sitting up and while lying on her side. What is the most likely diagnosis?\nA. IVC compression\nB. Compression on sympathetic chain\nC. Raised intra abdominal pressure\nD. Decreased blood supply to placenta\nReturn the correct option letter.", "reference": "Patient is showing features of supine hypotensive syndrome caused by the compression of inferior vena cava by the weight of a pregnant female's uterus, fetus, placenta and amniotic fluids while lying in the supine position. This condition can develop as early as the second trimester but is maximal during the third trimester, 36 to 38 weeks. When the pregnant female in these stages lies in the supine position, the added weight of the enlarged uterus and its contents will press down on the inferior vena cava. When the IVC is compressed it reduces the amount of blood that returns to the hea and reduces cardiac output, this can result in a loss of 30% of the effective circulating blood volume. It can take 3-7 minutes for significant hypotension to manifest.\nA", "question_key": "a pregnant lady complaints of headache, feeling of excessive tiredness and drowsiness whenever she lies down in supine position. her symptoms are relieved on sitting up and while lying on her side. what is the most likely diagnosis?", "split": "validation", "is_mia_member": false} | |
| {"id": "e537c061-52ef-4f00-a80e-86ffaee2af86", "question": "A patient with H. Pylori infection is treated with drugs. The best method to detect presence of residual H.Pylori infection in this person is :", "opa": "Rapid unrease test", "opb": "Urea breath test", "opc": "Endoscopy and biopsy", "opd": "Serum anti H.Pylori titre", "cop": 1, "answer": "B", "exp": "Answer is B (Urea breath test) : The test of choice for documenting eradication is urea breath test. Assessing success of Treatment / Eradicatiion of H. Pyrlori : Assessment should be done atleast 4 weeks after completin of anti H. Pylori therapy. In the assessment of treatment success non invasive tests are normally preferred. Assessment of success of treatment Non invasive tests are preferred Inasive tests are not preferred Urea breath test : Test of choice for documenting eradication. Stool antigen test :If UBT is not available a stool antigen test should be considered for documenting eradication Biopsy based tests (Biopsy Urease test, Histology / Culture) are invasive tests based on Endoscopic biopsy. Serological testing :Is not useful for purpose of documentation of eradication as antibody titres fall slowly and often do not become undetectable These may be used to document eradication but are not preferred for this purpose.", "explanation_word_count": 143, "prompt": "A patient with H. Pylori infection is treated with drugs. The best method to detect presence of residual H.Pylori infection in this person is :\nA. Rapid unrease test\nB. Urea breath test\nC. Endoscopy and biopsy\nD. Serum anti H.Pylori titre\nReturn the correct option letter.", "reference": "Answer is B (Urea breath test) : The test of choice for documenting eradication is urea breath test. Assessing success of Treatment / Eradicatiion of H. Pyrlori : Assessment should be done atleast 4 weeks after completin of anti H. Pylori therapy. In the assessment of treatment success non invasive tests are normally preferred. Assessment of success of treatment Non invasive tests are preferred Inasive tests are not preferred Urea breath test : Test of choice for documenting eradication. Stool antigen test :If UBT is not available a stool antigen test should be considered for documenting eradication Biopsy based tests (Biopsy Urease test, Histology / Culture) are invasive tests based on Endoscopic biopsy. Serological testing :Is not useful for purpose of documentation of eradication as antibody titres fall slowly and often do not become undetectable These may be used to document eradication but are not preferred for this purpose.\nB", "question_key": "a patient with h. pylori infection is treated with drugs. the best method to detect presence of residual h.pylori infection in this person is :", "split": "validation", "is_mia_member": false} | |
| {"id": "4665c308-c0dd-43da-9ba3-e2e7878e8bdc", "question": "Digoxin increases cardiac contractility by directly engaging in wof", "opa": "Inhibiting myocardial Na + /Ca 2+ -ATPase", "opb": "Activating L-type Ca 2+ channels", "opc": "Inhibiting cardiac phosphodiesterase", "opd": "Inhibiting myocardial Na + /K + -ATPase", "cop": 3, "answer": "D", "exp": "Mechanism of action:- Digoxin increases force of cardiac contraction by a direct action independent of innervation. It selectively binds to extracellular face of the membrane associated Na+K+ ATPase of myocardial fibres and inhibitis this enzyme. Inhibition of this cation pump results in progressive accumulation of Na+ intracellularly. This indirectly results in intracellular Ca2+ accumulation. During depolarization Ca2+ ions enter the cell driven by the steep Ca2+ gradient through voltage sensitive L type Ca2+ channels. This triggers release of larger amount of Ca2+ stored in sarcoplasmic reticulum (SR) through Ryanodine calcium channel 2 (RYR2) - cytosolic Ca2+ increases transiently (calcium transients) - triggers contraction by activating troponin C on myofibrils. Ref:- kd tripathi; pg num:-514", "explanation_word_count": 112, "prompt": "Digoxin increases cardiac contractility by directly engaging in wof\nA. Inhibiting myocardial Na + /Ca 2+ -ATPase\nB. Activating L-type Ca 2+ channels\nC. Inhibiting cardiac phosphodiesterase\nD. Inhibiting myocardial Na + /K + -ATPase\nReturn the correct option letter.", "reference": "Mechanism of action:- Digoxin increases force of cardiac contraction by a direct action independent of innervation. It selectively binds to extracellular face of the membrane associated Na+K+ ATPase of myocardial fibres and inhibitis this enzyme. Inhibition of this cation pump results in progressive accumulation of Na+ intracellularly. This indirectly results in intracellular Ca2+ accumulation. During depolarization Ca2+ ions enter the cell driven by the steep Ca2+ gradient through voltage sensitive L type Ca2+ channels. This triggers release of larger amount of Ca2+ stored in sarcoplasmic reticulum (SR) through Ryanodine calcium channel 2 (RYR2) - cytosolic Ca2+ increases transiently (calcium transients) - triggers contraction by activating troponin C on myofibrils. Ref:- kd tripathi; pg num:-514\nD", "question_key": "digoxin increases cardiac contractility by directly engaging in wof", "split": "validation", "is_mia_member": false} | |
| {"id": "9ac791bf-d8b6-4e82-9912-dd5df2d2cad4", "question": "Wof bones is affected more with glucocoicoid induced osteoporosis", "opa": "Humerus", "opb": "Femur", "opc": "Radius", "opd": "veebra", "cop": 3, "answer": "D", "exp": "Adverse effects:- Osteoporosis Especially involving veebrae and other flat spongy bones. Compression fractures of veebrae and spontaneous fracture of long bones can occur, especially in the elderly. Radiological evidence of osteoporosis is an indication for withdrawal of coicoid therapy. Coicosteroid induced osteoporosis can be prevented/arrested by calcium supplements + vit D, and by estrogen/raloxifene or androgen replacement therapy in females and males respectively. However, bisphosphonates are the most effective drugs. Avascular necrosis of head of femur, humerus, or knee joint is an occasional abrupt onset complication of high dose coicosteroid therapy. Ref:- kd tripathi; pg num:-293", "explanation_word_count": 97, "prompt": "Wof bones is affected more with glucocoicoid induced osteoporosis\nA. Humerus\nB. Femur\nC. Radius\nD. veebra\nReturn the correct option letter.", "reference": "Adverse effects:- Osteoporosis Especially involving veebrae and other flat spongy bones. Compression fractures of veebrae and spontaneous fracture of long bones can occur, especially in the elderly. Radiological evidence of osteoporosis is an indication for withdrawal of coicoid therapy. Coicosteroid induced osteoporosis can be prevented/arrested by calcium supplements + vit D, and by estrogen/raloxifene or androgen replacement therapy in females and males respectively. However, bisphosphonates are the most effective drugs. Avascular necrosis of head of femur, humerus, or knee joint is an occasional abrupt onset complication of high dose coicosteroid therapy. Ref:- kd tripathi; pg num:-293\nD", "question_key": "wof bones is affected more with glucocoicoid induced osteoporosis", "split": "validation", "is_mia_member": false} | |
| {"id": "5df38361-b59f-41c9-9f8b-649a606b0c50", "question": "Resting membrane potential in ventricular myocardium", "opa": "-50mV", "opb": ">70mV", "opc": "+70mV", "opd": "-90mV", "cop": 3, "answer": "D", "exp": "Ventricular cardiomyocyte membrane potential is about -90 mV at rest, which is close to the potassium reversal potential. When an action potential is generated, the membrane potential rises above this level in four distinct phases.", "explanation_word_count": 34, "prompt": "Resting membrane potential in ventricular myocardium\nA. -50mV\nB. >70mV\nC. +70mV\nD. -90mV\nReturn the correct option letter.", "reference": "Ventricular cardiomyocyte membrane potential is about -90 mV at rest, which is close to the potassium reversal potential. When an action potential is generated, the membrane potential rises above this level in four distinct phases.\nD", "question_key": "resting membrane potential in ventricular myocardium", "split": "validation", "is_mia_member": false} | |
| {"id": "b9b7ba1d-e27e-484b-8081-6deb40e2092f", "question": "A middle-aged woman suffers from weakness of her ocular and facial muscles, which worsens with repeated use. She has antibodies to acetylcholine receptors in her serum. The likely diagnosis is:", "opa": "Lymphangioma", "opb": "Parkinson's Disease", "opc": "Osteoid Osteoma", "opd": "Myasthenia gravis", "cop": 3, "answer": "D", "exp": "Myasthenia gravis is an autoimmune disease caused by the product of antibodies against acetylcholine receptors. The ocular and facial muscles are usually weakened. The weakness worsens with repeated contractions of the muscles. Treatment with anticholinesterase agents can improve the weakness and fatigability by increasing the quantity of acetylcholine available at the motor. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 53. Myasthenia Gravis and Related Disorders of the Neuromuscular Junction. In A.H. Ropper, M.A. Samuels (Eds),Adams and Victor's Principles of Neurology, 9e.", "explanation_word_count": 84, "prompt": "A middle-aged woman suffers from weakness of her ocular and facial muscles, which worsens with repeated use. She has antibodies to acetylcholine receptors in her serum. The likely diagnosis is:\nA. Lymphangioma\nB. Parkinson's Disease\nC. Osteoid Osteoma\nD. Myasthenia gravis\nReturn the correct option letter.", "reference": "Myasthenia gravis is an autoimmune disease caused by the product of antibodies against acetylcholine receptors. The ocular and facial muscles are usually weakened. The weakness worsens with repeated contractions of the muscles. Treatment with anticholinesterase agents can improve the weakness and fatigability by increasing the quantity of acetylcholine available at the motor. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 53. Myasthenia Gravis and Related Disorders of the Neuromuscular Junction. In A.H. Ropper, M.A. Samuels (Eds),Adams and Victor's Principles of Neurology, 9e.\nD", "question_key": "a middle-aged woman suffers from weakness of her ocular and facial muscles, which worsens with repeated use. she has antibodies to acetylcholine receptors in her serum. the likely diagnosis is:", "split": "validation", "is_mia_member": false} | |
| {"id": "480b3d47-b525-4e7a-ad88-f32ac4659698", "question": "Phrynoderma is NOT due to deficiency of", "opa": "Essential fatty acids", "opb": "Vit A", "opc": "Vit D", "opd": "Vit B", "cop": 2, "answer": "C", "exp": "PHRYNODERMA(toad-skin disease):- May be a manifestation of vitamin A deficiency, though it may also be due to deficiency of essential fatty acids and even vitamin B. Manifests as rough, hyperkeratotic follicular papules around elbows and knees. Ref:- NEENA KHANNA; pg num:- 391", "explanation_word_count": 42, "prompt": "Phrynoderma is NOT due to deficiency of\nA. Essential fatty acids\nB. Vit A\nC. Vit D\nD. Vit B\nReturn the correct option letter.", "reference": "PHRYNODERMA(toad-skin disease):- May be a manifestation of vitamin A deficiency, though it may also be due to deficiency of essential fatty acids and even vitamin B. Manifests as rough, hyperkeratotic follicular papules around elbows and knees. Ref:- NEENA KHANNA; pg num:- 391\nC", "question_key": "phrynoderma is not due to deficiency of", "split": "validation", "is_mia_member": false} | |
| {"id": "dfaab0c0-a89f-4502-ab7d-c2f829a85da8", "question": "Which of the following structure forms the medial border of Hesselbach's triangle?", "opa": "Linea alba", "opb": "Linea semilunaris", "opc": "Inferior epigastric aery", "opd": "Conjoint tendon", "cop": 1, "answer": "B", "exp": "Boundaries of Hasselbach's triangle:Medial border: Lateral margin the rectus sheath, also called linea semilunaris.Superolateral border: Inferior epigastric aery.Inferior border: Inguinal ligament, sometimes Referred to as Poupa's ligament.", "explanation_word_count": 30, "prompt": "Which of the following structure forms the medial border of Hesselbach's triangle?\nA. Linea alba\nB. Linea semilunaris\nC. Inferior epigastric aery\nD. Conjoint tendon\nReturn the correct option letter.", "reference": "Boundaries of Hasselbach's triangle:Medial border: Lateral margin the rectus sheath, also called linea semilunaris.Superolateral border: Inferior epigastric aery.Inferior border: Inguinal ligament, sometimes Referred to as Poupa's ligament.\nB", "question_key": "which of the following structure forms the medial border of hesselbach's triangle?", "split": "validation", "is_mia_member": false} | |
| {"id": "0268a833-6d2d-45c8-9100-d5a690caf802", "question": "A newborn has multiple congenital defects owing to dysgenesis of the neural crest. Which of the following cells is most likely to be spared?", "opa": "Geniculate ganglion cells", "opb": "Melanocytes", "opc": "Motor neurons", "opd": "Parafollicular cells", "cop": 2, "answer": "C", "exp": "Motor neurons develop from the neural tube, more specifically from the basal plate. Other options (Geniculate ganglion cells,Melanocytes and Parafollicular cells) are derivatives of the neural crest. Derrvatives of the neural crest:", "explanation_word_count": 33, "prompt": "A newborn has multiple congenital defects owing to dysgenesis of the neural crest. Which of the following cells is most likely to be spared?\nA. Geniculate ganglion cells\nB. Melanocytes\nC. Motor neurons\nD. Parafollicular cells\nReturn the correct option letter.", "reference": "Motor neurons develop from the neural tube, more specifically from the basal plate. Other options (Geniculate ganglion cells,Melanocytes and Parafollicular cells) are derivatives of the neural crest. Derrvatives of the neural crest:\nC", "question_key": "a newborn has multiple congenital defects owing to dysgenesis of the neural crest. which of the following cells is most likely to be spared?", "split": "validation", "is_mia_member": false} | |
| {"id": "4fb19f04-e93b-4961-9a9c-e20fcbdb194f", "question": "Disulfiram like reaction is commonly caused by which of the following: March 2005", "opa": "Penicillin", "opb": "metronidazole", "opc": "Tetracycline", "opd": "erythromycin", "cop": 1, "answer": "B", "exp": "Ans. B: Metronidazole Drugs causing Disulfiram like reaction Metronidazole Cefamandole Cefoperazone Chlorpropamide Sulfonylureas Quinacrine Griseofuvin Chloramphenicol Tinidazole Procarbazine Ritonavir Nitrofurantoin Chloramphenicol Chloral hydrate", "explanation_word_count": 23, "prompt": "Disulfiram like reaction is commonly caused by which of the following: March 2005\nA. Penicillin\nB. metronidazole\nC. Tetracycline\nD. erythromycin\nReturn the correct option letter.", "reference": "Ans. B: Metronidazole Drugs causing Disulfiram like reaction Metronidazole Cefamandole Cefoperazone Chlorpropamide Sulfonylureas Quinacrine Griseofuvin Chloramphenicol Tinidazole Procarbazine Ritonavir Nitrofurantoin Chloramphenicol Chloral hydrate\nB", "question_key": "disulfiram like reaction is commonly caused by which of the following: march 2005", "split": "validation", "is_mia_member": false} | |
| {"id": "3bc545fe-6703-40ad-b463-21bd86431036", "question": "Which of the following among axillary lymphnodes, is a terminal group of lymph nodes", "opa": "Pectoral", "opb": "Central", "opc": "Lateral", "opd": "Apical", "cop": 3, "answer": "D", "exp": "Level III axillary lymph nodes are part of Apical axilla. They include the nodes which lies medial to medial margin of pectoralis minor, namely, subclavicular, infraclavicular or apical. The apical lymph nodes drain lymph from anterior, posterior, central and lateral group of axillary lymph nodes. So they are the terminal group of axillary lymph nodes.", "explanation_word_count": 55, "prompt": "Which of the following among axillary lymphnodes, is a terminal group of lymph nodes\nA. Pectoral\nB. Central\nC. Lateral\nD. Apical\nReturn the correct option letter.", "reference": "Level III axillary lymph nodes are part of Apical axilla. They include the nodes which lies medial to medial margin of pectoralis minor, namely, subclavicular, infraclavicular or apical. The apical lymph nodes drain lymph from anterior, posterior, central and lateral group of axillary lymph nodes. So they are the terminal group of axillary lymph nodes.\nD", "question_key": "which of the following among axillary lymphnodes, is a terminal group of lymph nodes", "split": "validation", "is_mia_member": false} | |
| {"id": "eef73746-8a75-4d05-befb-67d65f405a3f", "question": "Which structure(s) passes behind the inguinal ligament -a) Femoral branch of genitofemoral nerveb) Superficial epigastric arteryc) Psoas majord) Femoral veine) Saphenous vein", "opa": "abc", "opb": "ad", "opc": "bc", "opd": "acd", "cop": 3, "answer": "D", "exp": "Structures passing deep to inguinal ligament.\n- Psoas major, Iliacus, pectineus\n- Femoral nerve and vessels\n- Lateral cutaneous nerve of thigh\n- Femoral branch of genitofemoral nerve\n- Lymphatics", "explanation_word_count": 25, "prompt": "Which structure(s) passes behind the inguinal ligament -a) Femoral branch of genitofemoral nerveb) Superficial epigastric arteryc) Psoas majord) Femoral veine) Saphenous vein\nA. abc\nB. ad\nC. bc\nD. acd\nReturn the correct option letter.", "reference": "Structures passing deep to inguinal ligament.\n- Psoas major, Iliacus, pectineus\n- Femoral nerve and vessels\n- Lateral cutaneous nerve of thigh\n- Femoral branch of genitofemoral nerve\n- Lymphatics\nD", "question_key": "which structure(s) passes behind the inguinal ligament -a) femoral branch of genitofemoral nerveb) superficial epigastric arteryc) psoas majord) femoral veine) saphenous vein", "split": "validation", "is_mia_member": false} | |
| {"id": "a2f81f12-c510-45b2-b2b2-5de7c4116a99", "question": "After ovulation the discharged oocytes and surrounding layer of granulosa cells are known as", "opa": "Corpus luteum", "opb": "Corona radiata", "opc": "Stigma", "opd": "Zona pellucida", "cop": 1, "answer": "B", "exp": "The corona radiata is the innermost layer of the cells of the cumulus oophorus and is directly adjacent to the zona pellucida, the inner protective glycoprotein layer of the ovum . Its main purpose in many animals is to supply vital proteins to the cell. It is formed by follicle cells adhering to the oocyte before it leaves the ovarian follicle, and originates from the squamous granulosa cells present at the primordial stage of follicular development. The corona radiata is formed when the granulosa cells enlarge and become cuboidal, which occurs during the transition from the primordia to primary stage . These cuboidal granulosa cells, also known as the granulosa radiata, form more layers throughout the maturation process, and remain attached to the zona pellucida after the ovulation of the graafian follicle . For feilization to occur, sperm cells rely on hyaluronidase (an enzyme found in the acrosome of spermatozoa) to disperse the corona radiata from the zona pellucida of the secondary (ovulated) oocyte, thus permitting entry into the perivitelline space and allowing contact between the sperm cell and the nucleus of the oocyte. Ref - Wikipedia.org", "explanation_word_count": 184, "prompt": "After ovulation the discharged oocytes and surrounding layer of granulosa cells are known as\nA. Corpus luteum\nB. Corona radiata\nC. Stigma\nD. Zona pellucida\nReturn the correct option letter.", "reference": "The corona radiata is the innermost layer of the cells of the cumulus oophorus and is directly adjacent to the zona pellucida, the inner protective glycoprotein layer of the ovum . Its main purpose in many animals is to supply vital proteins to the cell. It is formed by follicle cells adhering to the oocyte before it leaves the ovarian follicle, and originates from the squamous granulosa cells present at the primordial stage of follicular development. The corona radiata is formed when the granulosa cells enlarge and become cuboidal, which occurs during the transition from the primordia to primary stage . These cuboidal granulosa cells, also known as the granulosa radiata, form more layers throughout the maturation process, and remain attached to the zona pellucida after the ovulation of the graafian follicle . For feilization to occur, sperm cells rely on hyaluronidase (an enzyme found in the acrosome of spermatozoa) to disperse the corona radiata from the zona pellucida of the secondary (ovulated) oocyte, thus permitting entry into the perivitelline space and allowing contact between the sperm cell and the nucleus of the oocyte. Ref - Wikipedia.org\nB", "question_key": "after ovulation the discharged oocytes and surrounding layer of granulosa cells are known as", "split": "validation", "is_mia_member": false} | |
| {"id": "9ab095cb-17cb-4483-91cf-a454db77eee0", "question": "which of the following is a NaSSa", "opa": "miazapine", "opb": "clozapine", "opc": "nefazadone", "opd": "sealine", "cop": 0, "answer": "A", "exp": "NaSSA * IMPOANCE Nor adrenergic and specific serotonergic antidepressant * MECHANISM * Alpha 2 adrenergic receptor antagonism=== increase serotonin and NA * 5HT2,3 antagonist============increase sleep and appetite * DRUGS miazapine * USE Elderly with depression * SIDE EFFECTS hyperlipidemia ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955", "explanation_word_count": 43, "prompt": "which of the following is a NaSSa\nA. miazapine\nB. clozapine\nC. nefazadone\nD. sealine\nReturn the correct option letter.", "reference": "NaSSA * IMPOANCE Nor adrenergic and specific serotonergic antidepressant * MECHANISM * Alpha 2 adrenergic receptor antagonism=== increase serotonin and NA * 5HT2,3 antagonist============increase sleep and appetite * DRUGS miazapine * USE Elderly with depression * SIDE EFFECTS hyperlipidemia ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955\nA", "question_key": "which of the following is a nassa", "split": "validation", "is_mia_member": false} | |
| {"id": "65f33222-8ead-41f2-8166-26518039e316", "question": "The inheritance pattern of Familial hypercholesterolemia is", "opa": "Autosomal recessive", "opb": "Autosomal dominant", "opc": "X-linked dominant", "opd": "X-linked recessive", "cop": 1, "answer": "B", "exp": "Mutations involving single genes follow one of three patterns of inheritance: autosomal dominant, autosomal recessive, or X-linked. Autosomal Dominant Inheritance Familial hypercholesterolemia Huntington disease Marfan syndrome Ehlers-Danlos syndrome Hereditary spherocytosis Neurofibromatosis, type 1 Adult polycystic kidney disease Familial Hypercholesterolemia Familial hypercholesterolemia is among the most common mendelian disorders; the frequency of the heterozygous condition is 1 in 500 in the general population. It is caused by a mutation in the LDLR gene that encodes the receptor for low-density lipoprotein (LDL), the form in which 70% of total plasma cholesterol is transpoed. A brief review of the synthesis and transpo of cholesterol follows. Normal Cholesterol Metabolism. Cholesterol may be derived from the diet or from endogenous synthesis. Dietary triglycerides and cholesterol are incorporated into chylomicrons in the intestinal mucosa, which drain by way of the gut lymphatics into the blood. These chylomicrons are hydrolyzed by an endothelial lipoprotein lipase in the capillaries of muscle and fat. The chylomicron remnants, rich in cholesterol, are then delivered to the liver. Some of the cholesterol enters the metabolic pool (to be described), and some is excreted as free cholesterol or bile acids into the biliary tract. The endogenous synthesis of cholesterol and LDL begins in the liver (Fig. 6-2). The first step in the synthesis of LDL is the secretion of triglyceride-rich very- low-density lipoprotein (VLDL) by the liver into the blood. In the capillaries of adipose tissue and muscle, the VLDL paicle undergoes lipolysis and is conveed to intermediate- density lipoprotein (IDL). In comparison with VLDL, the content of triglyceride is reduced and that of cholesteryl esters enriched in intermediate-density lipoprotein (IDL), but IDL retains on its surface two of the three VLDL- associated apolipoproteins B-100 and E. Fuher metabo- lism of IDL occurs along two pathways: Most of the IDL paicles are directly taken up by the liver through the LDL receptor described later; others are conveed to cholesterol- rich LDL by a fuher loss of triglycerides and apolipopro- tein E. In the liver cells, IDL is recycled to generate VLDL. Two thirds of the resultant LDL paicles are metabo- lized by the LDL receptor pathway, and the rest is metabo- lized by a receptor for oxidized LDL (scavenger receptor), to be described later. The LDL receptor binds to apolipo- proteins B-100 and E and thus is involved in the transpo of both LDL and IDL. Although the LDL receptors are widely distributed, approximately 75% are located on hepatocytes, so the liver plays an extremely impoant role in LDL metabolism. The first step in the receptor-mediated transpo of LDL involves binding to the cell surface receptor, followed by endocy- totic internalization inside so-called \"clathrin-coated pits\" (Fig. 6-3). Within the cell, the endocytic vesicles fuse with the lysosomes, and the LDL molecule is enzymatically degraded, resulting ultimately in the release of free cholesterol into the cytoplasm. The cholesterol not only is used by the cell for membrane synthesis but also takes pa in intracel- lular cholesterol homeostasis by a sophisticated system of feed- back control: * It suppresses cholesterol synthesis by inhibiting the activity of the enzyme 3-hydroxy-3-methylglutaryl- coenzyme A reductase (HMG-CoA reductase), which is the rate-limiting enzyme in the synthetic pathway. * It stimulates the formation of cholesterol esters for storage of excess cholesterol. * It downregulates the synthesis of cell surface LDL recep- tors, thus protecting cells from excessive accumulation of cholesterol. The transpo of LDL by the scavenger receptors, alluded to earlier, seems to take place in cells of the mononuclear- phagocyte system and possibly in other cells as well. Monocytes and macrophages have receptors for chemically modified (e.g., acetylated or oxidized) LDLs. The amount catabolized by this \"scavenger receptor\" pathway is directly related to the plasma cholesterol level. (Robbins Basic Pathology,9th edition,pg no. 219)", "explanation_word_count": 618, "prompt": "The inheritance pattern of Familial hypercholesterolemia is\nA. Autosomal recessive\nB. Autosomal dominant\nC. X-linked dominant\nD. X-linked recessive\nReturn the correct option letter.", "reference": "Mutations involving single genes follow one of three patterns of inheritance: autosomal dominant, autosomal recessive, or X-linked. Autosomal Dominant Inheritance Familial hypercholesterolemia Huntington disease Marfan syndrome Ehlers-Danlos syndrome Hereditary spherocytosis Neurofibromatosis, type 1 Adult polycystic kidney disease Familial Hypercholesterolemia Familial hypercholesterolemia is among the most common mendelian disorders; the frequency of the heterozygous condition is 1 in 500 in the general population. It is caused by a mutation in the LDLR gene that encodes the receptor for low-density lipoprotein (LDL), the form in which 70% of total plasma cholesterol is transpoed. A brief review of the synthesis and transpo of cholesterol follows. Normal Cholesterol Metabolism. Cholesterol may be derived from the diet or from endogenous synthesis. Dietary triglycerides and cholesterol are incorporated into chylomicrons in the intestinal mucosa, which drain by way of the gut lymphatics into the blood. These chylomicrons are hydrolyzed by an endothelial lipoprotein lipase in the capillaries of muscle and fat. The chylomicron remnants, rich in cholesterol, are then delivered to the liver. Some of the cholesterol enters the metabolic pool (to be described), and some is excreted as free cholesterol or bile acids into the biliary tract. The endogenous synthesis of cholesterol and LDL begins in the liver (Fig. 6-2). The first step in the synthesis of LDL is the secretion of triglyceride-rich very- low-density lipoprotein (VLDL) by the liver into the blood. In the capillaries of adipose tissue and muscle, the VLDL paicle undergoes lipolysis and is conveed to intermediate- density lipoprotein (IDL). In comparison with VLDL, the content of triglyceride is reduced and that of cholesteryl esters enriched in intermediate-density lipoprotein (IDL), but IDL retains on its surface two of the three VLDL- associated apolipoproteins B-100 and E. Fuher metabo- lism of IDL occurs along two pathways: Most of the IDL paicles are directly taken up by the liver through the LDL receptor described later; others are conveed to cholesterol- rich LDL by a fuher loss of triglycerides and apolipopro- tein E. In the liver cells, IDL is recycled to generate VLDL. Two thirds of the resultant LDL paicles are metabo- lized by the LDL receptor pathway, and the rest is metabo- lized by a receptor for oxidized LDL (scavenger receptor), to be described later. The LDL receptor binds to apolipo- proteins B-100 and E and thus is involved in the transpo of both LDL and IDL. Although the LDL receptors are widely distributed, approximately 75% are located on hepatocytes, so the liver plays an extremely impoant role in LDL metabolism. The first step in the receptor-mediated transpo of LDL involves binding to the cell surface receptor, followed by endocy- totic internalization inside so-called \"clathrin-coated pits\" (Fig. 6-3). Within the cell, the endocytic vesicles fuse with the lysosomes, and the LDL molecule is enzymatically degraded, resulting ultimately in the release of free cholesterol into the cytoplasm. The cholesterol not only is used by the cell for membrane synthesis but also takes pa in intracel- lular cholesterol homeostasis by a sophisticated system of feed- back control: * It suppresses cholesterol synthesis by inhibiting the activity of the enzyme 3-hydroxy-3-methylglutaryl- coenzyme A reductase (HMG-CoA reductase), which is the rate-limiting enzyme in the synthetic pathway. * It stimulates the formation of cholesterol esters for storage of excess cholesterol. * It downregulates the synthesis of cell surface LDL recep- tors, thus protecting cells from excessive accumulation of cholesterol. The transpo of LDL by the scavenger receptors, alluded to earlier, seems to take place in cells of the mononuclear- phagocyte system and possibly in other cells as well. Monocytes and macrophages have receptors for chemically modified (e.g., acetylated or oxidized) LDLs. The amount catabolized by this \"scavenger receptor\" pathway is directly related to the plasma cholesterol level. (Robbins Basic Pathology,9th edition,pg no. 219)\nB", "question_key": "the inheritance pattern of familial hypercholesterolemia is", "split": "validation", "is_mia_member": false} | |
| {"id": "8667d1a3-bee7-450c-9897-d44d2b2992a9", "question": "Diagnostic power of a test is reflected by", "opa": "image_question", "opb": "image_question", "opc": "image_question", "opd": "image_question", "cop": 2, "answer": "C", "exp": "Diagnostic power of Screening test: Predictive accuracy (it tells the actual no.of people having the disease or not having the disease out of those shown positive or negative by a screening test, respectively) Diagnostic power of a screening test to correctly identify a disease: Positive predictive value(PPV). Diagnostic power of a screening test to correctly exclude a disease: Negative predictive value (NPV) Ref: Parl 25th edition Pgno: 153", "explanation_word_count": 69, "prompt": "Diagnostic power of a test is reflected by\nA. image_question\nB. image_question\nC. image_question\nD. image_question\nReturn the correct option letter.", "reference": "Diagnostic power of Screening test: Predictive accuracy (it tells the actual no.of people having the disease or not having the disease out of those shown positive or negative by a screening test, respectively) Diagnostic power of a screening test to correctly identify a disease: Positive predictive value(PPV). Diagnostic power of a screening test to correctly exclude a disease: Negative predictive value (NPV) Ref: Parl 25th edition Pgno: 153\nC", "question_key": "diagnostic power of a test is reflected by", "split": "validation", "is_mia_member": false} | |
| {"id": "e9cc12ec-98f6-4fa0-9cbb-ef636489cd7a", "question": "Which one of the following is not an aetiology of transudative pleural effusion?", "opa": "Mesothelioma", "opb": "Congestive hea failure", "opc": "Cirrhosis", "opd": "Nephrotic syndrome", "cop": 0, "answer": "A", "exp": "Malignant mesothelioma produces exudative pleural effusion.The chest radiograph reveals a pleural effusion,generalized pleural thickening,and a shrunken hemithorax.Mesothelioma arise from the mesothelial cells,and most are related to asbestos exposure. Reference:Harrison's medicine-18th edition,page no:2179.", "explanation_word_count": 40, "prompt": "Which one of the following is not an aetiology of transudative pleural effusion?\nA. Mesothelioma\nB. Congestive hea failure\nC. Cirrhosis\nD. Nephrotic syndrome\nReturn the correct option letter.", "reference": "Malignant mesothelioma produces exudative pleural effusion.The chest radiograph reveals a pleural effusion,generalized pleural thickening,and a shrunken hemithorax.Mesothelioma arise from the mesothelial cells,and most are related to asbestos exposure. Reference:Harrison's medicine-18th edition,page no:2179.\nA", "question_key": "which one of the following is not an aetiology of transudative pleural effusion?", "split": "validation", "is_mia_member": false} | |
| {"id": "417e4104-370f-4905-b3f8-ef4fc6fa06c6", "question": "Rupture of the carotid artery in the neck region. Which of the following site pressure is applied", "opa": "C3 vertebra", "opb": "C4vertebr", "opc": "C5 vertebra", "opd": "C6 vertebra", "cop": 3, "answer": "D", "exp": "D. i.e. (C6 - vertebra ) (444 - Grey 14th)The bifurcation of the common carotid artery in to the internal and external carotid arteries can be palpated just beneath the anterior border of sterno cleidomastoid muscle at the level of the superior border of the thyroid cartilage. This is a convenient site to take the carotid pulse (748- Snell 8th) (C3 - C4 junction)The artery may be compressed against the prominent transverse process of the sixth cervical vertebra (chassaignac's tubercle) and above this level it is superficial and its pulsation can be easily fet (444 - Gray - anatomy 14th)* Best radiographic view for fracture of Cl C2 vertebra is odontoid view*** C7 has longest spinous process*** Subclavian Artery in patients with upper limb hemorrhage - compressed against the upper surface of the fist rib (third part of subclavian artery", "explanation_word_count": 133, "prompt": "Rupture of the carotid artery in the neck region. Which of the following site pressure is applied\nA. C3 vertebra\nB. C4vertebr\nC. C5 vertebra\nD. C6 vertebra\nReturn the correct option letter.", "reference": "D. i.e. (C6 - vertebra ) (444 - Grey 14th)The bifurcation of the common carotid artery in to the internal and external carotid arteries can be palpated just beneath the anterior border of sterno cleidomastoid muscle at the level of the superior border of the thyroid cartilage. This is a convenient site to take the carotid pulse (748- Snell 8th) (C3 - C4 junction)The artery may be compressed against the prominent transverse process of the sixth cervical vertebra (chassaignac's tubercle) and above this level it is superficial and its pulsation can be easily fet (444 - Gray - anatomy 14th)* Best radiographic view for fracture of Cl C2 vertebra is odontoid view*** C7 has longest spinous process*** Subclavian Artery in patients with upper limb hemorrhage - compressed against the upper surface of the fist rib (third part of subclavian artery\nD", "question_key": "rupture of the carotid artery in the neck region. which of the following site pressure is applied", "split": "validation", "is_mia_member": false} | |
| {"id": "67c333fb-0b37-4a45-8dc7-bf0053de2145", "question": "In a patient with a transplanted heart which of these are the reasons for increased cardiac output during exercise", "opa": "Reinnervation of transplanted heart by vagus", "opb": "Intrinsic mechanism.", "opc": "Epinephrine from medulla", "opd": "Bainbridge reflex", "cop": 2, "answer": "C", "exp": "Cardiac transplantation results in total denervation of the donor's heart, including the donor sinus node, which usually controls heart rate after transplantation.\nDenervation causes an increase in basal heart rate due to parasympathetic sectioning (normally parasympathetic tone is greater than sympathetic tone on the heart).\n\nFurther increase in heart rate during exercise is dependent primarily on increase in plasma catecholamine concentration, e.g. from the adrenal medulla.", "explanation_word_count": 67, "prompt": "In a patient with a transplanted heart which of these are the reasons for increased cardiac output during exercise\nA. Reinnervation of transplanted heart by vagus\nB. Intrinsic mechanism.\nC. Epinephrine from medulla\nD. Bainbridge reflex\nReturn the correct option letter.", "reference": "Cardiac transplantation results in total denervation of the donor's heart, including the donor sinus node, which usually controls heart rate after transplantation.\nDenervation causes an increase in basal heart rate due to parasympathetic sectioning (normally parasympathetic tone is greater than sympathetic tone on the heart).\n\nFurther increase in heart rate during exercise is dependent primarily on increase in plasma catecholamine concentration, e.g. from the adrenal medulla.\nC", "question_key": "in a patient with a transplanted heart which of these are the reasons for increased cardiac output during exercise", "split": "validation", "is_mia_member": false} | |
| {"id": "ac0db10d-6cd8-4ef2-9de8-22577d1b8c18", "question": "Agent causing hemorrhagic cystitis", "opa": "Cyclophosphamide", "opb": "Vincristine", "opc": "Cisplatin", "opd": "5 Fluorouracil", "cop": 0, "answer": "A", "exp": "Ans: a (Cyclophosphamide)Ref: KD Tripathi, 6th ed. Pg. 822Haemorrhagic cystitis is caused by a metabolite of cyclophosphamide - acrolein If severe, the cystitis may be effectively treated by mesna.Drugs causing Haemorrhagic cystitisIfosfamide Cyclophosphamide Aniline or toluidine derivatives Penicillins - rare Danazol - rare Ifosfamide is the most common cause of haemorrhagic cystitis.", "explanation_word_count": 51, "prompt": "Agent causing hemorrhagic cystitis\nA. Cyclophosphamide\nB. Vincristine\nC. Cisplatin\nD. 5 Fluorouracil\nReturn the correct option letter.", "reference": "Ans: a (Cyclophosphamide)Ref: KD Tripathi, 6th ed. Pg. 822Haemorrhagic cystitis is caused by a metabolite of cyclophosphamide - acrolein If severe, the cystitis may be effectively treated by mesna.Drugs causing Haemorrhagic cystitisIfosfamide Cyclophosphamide Aniline or toluidine derivatives Penicillins - rare Danazol - rare Ifosfamide is the most common cause of haemorrhagic cystitis.\nA", "question_key": "agent causing hemorrhagic cystitis", "split": "validation", "is_mia_member": false} | |
| {"id": "6380a5dd-9aa6-4162-b75d-a1a11364b8a6", "question": "Meig's syndrome is associated with ovarian: September 2006", "opa": "Teratoma", "opb": "Brenner tumour", "opc": "Fibroma", "opd": "Theca cell tumour", "cop": 2, "answer": "C", "exp": "Ans. C: Fibroma Meigs' syndrome, is the triad of ascites, pleural effusiion and benign ovarian fibroma. It resolves after the resection of the tumour. For reasons unknown, the pleural effusion is classically on the right side", "explanation_word_count": 36, "prompt": "Meig's syndrome is associated with ovarian: September 2006\nA. Teratoma\nB. Brenner tumour\nC. Fibroma\nD. Theca cell tumour\nReturn the correct option letter.", "reference": "Ans. C: Fibroma Meigs' syndrome, is the triad of ascites, pleural effusiion and benign ovarian fibroma. It resolves after the resection of the tumour. For reasons unknown, the pleural effusion is classically on the right side\nC", "question_key": "meig's syndrome is associated with ovarian: september 2006", "split": "validation", "is_mia_member": false} | |
| {"id": "34524ef4-95a0-49e2-9107-ab204ae1eab5", "question": "Which of the milestones develop first", "opa": "Mirror play", "opb": "Crawling", "opc": "Creeping", "opd": "Pincer grasp", "cop": 0, "answer": "A", "exp": "*Mirror play is attained by 6 months *Crawling by 8 months *Creeps by 10 months and creeps well by 12 months *Immature pincer grasp by 10 months *Mature pincer grasp by 12 months Ref : OP GHAI - ESSENTIAL PEDIATRICS - 8 TH edition page no 4 and 52", "explanation_word_count": 37, "prompt": "Which of the milestones develop first\nA. Mirror play\nB. Crawling\nC. Creeping\nD. Pincer grasp\nReturn the correct option letter.", "reference": "*Mirror play is attained by 6 months *Crawling by 8 months *Creeps by 10 months and creeps well by 12 months *Immature pincer grasp by 10 months *Mature pincer grasp by 12 months Ref : OP GHAI - ESSENTIAL PEDIATRICS - 8 TH edition page no 4 and 52\nA", "question_key": "which of the milestones develop first", "split": "validation", "is_mia_member": false} | |
| {"id": "0b7bd8f1-6303-4933-9f6a-657abe3eb0b8", "question": "Which of the following has life span of upto 10 years?", "opa": "Progestasert", "opb": "CuT 380A", "opc": "LNG-IUD", "opd": "CuT 250", "cop": 1, "answer": "B", "exp": "Ans. B. CuT 380A. (Ref. Obstetrics D.C. Dutta 6th Ed. - 483).The TCu380A IUD (ParaGard) is a T-shaped polyethylene rod, wrapped with copper around the arms and stem. It is approved for 10 years of continuous use.Good Candidates for TCu380A# Postpartum women, breastfeeding or not, after 4 weeks.# Women with liver disease, hepatitis.# Women with breast cancer.# Women with hypertension, hyperlipidemia.# Women with current or history of ischemic heart disease, stroke.# Women with multiple risk factors for cardiovascular disease. Women with uncomplicated valvular heart disease.# Women with current deep vein thrombosis/pulmonary embolism.# Women who have had major surgery.# Women with migraines with or without focal neurological symptoms.# Women with gall bladder disease or history of pregnancy-related cholestasis.The LNG-IUS (Mirena). is a T-shaped polydimethylsiloxane rod con- taining 52 mg LNG. The LNG-IUS is approved for 5 years of use. The LNG-IUS adds an important non-contra- ceptive advantage for this age group: it decreases menstrual blood loss and dysmenorrhea and may avoid the need for hysterectomy or endometrial ablation. The copper IUD is generally associated with heavier menses.In addition to decreasing menstrual blood loss, the local administration of LNG to the endometrium protects it from development of estrogen-induced endometrial hyperplasia. This is of benefit for transitional women with irregular bleeding and for women on tamoxifen therapy following breast cancer. Use of the LNG-IUS is reported to reduce the risk of endometrial cancer by 40-60%.GOOD CANDIDATES FOR LNG-IUS# Women with menorrhagia, dysmenorrhea, or endometriosis.# Women with bleeding disorders or on anticoagulation therapy.Women with thalassemia, sickle cell disease, or iron- deficiency anemia.# Breastfeeding women after 4-6 weeks postpartum.Generation of IUCDCoilFailure rateLasts for (years)FirstCuT (200)>2/1003-5 CuT (200)>2/100 SecondMultiload Cu 2501-2 /1003-5 NovaT1-2 /1001-2/100ThirdMultiload Cu 3750.5-111005+ Copper Cu 380A0.3-1/100 Hormone releasingProgestasert (no more manufactured)1lyr LNG-IUCD(52mg Levenorgestrel impregnated; releases at arte of 20?g/day)0.5/100 at 1 yr5 yrs 0.7/100 at 3 yr 1/100 at 5 yr Marina (Latest)Least5 yrsMore Educational points:# Cu T 380A and Levenorgestrel have got lowest rate, whereas progestasert has got highest rate of ectopic pregnancy.# The Mirena IUD works by killing or irreparably damaging sperm and obstructing it's ability to fertilize an egg. It does this by releasing levonorgestrel, also known as progestin.# Progestin is a synthetic substance which imitates the biological activity of the natural hormone progesterone.# Progesterone can inhibit ovulation during pregnancy. Progestin was synthesized for, among reasons, suppresing ovulation for birth control.- Mirena reduces the frequency of ovulation. Ovulation occurs during the menstrual cycle where the ovarian follicle releases an egg. Reduction of the times in which an egg is available to fertilize handicaps the sperm's opportunity for reproduction.- Mirena changes the consistency of cervical mucus. This change thickens the cervical mucus making the passage of sperm through the cervix much more difficult.- Mirena thins the endometrium, the lining of the walls of the uterus. It is thought that this reduces the chances of embryo implantation to the endometrium.LNG-IUCD:# A new device, levonova (LNG IUD) contains 60mg of levonorgestrel and releases the hormone in very low doses i.e. 20 microgram/ day (versus Progestasert which carries 38mg of progesterone and releases 65microgram of the hormone per day).# It is thus longacting (5 years) and has low pregnancy rate of 0-3 per 100 woman years, n However, risk of ectopic pregnancy is higher.# Mechanism of action: - Strong and uniform endometrial suppression - Scanty cervical mucus - Anovulation and insufficient luteal phase and normal progesterone levels, n It can be used as hormone replacing therapy.# It is useful for the treatment of endometrial hyperplasia, n Irregular uterine bleeding can be a problem initially.# MIRENA contains 52mg levonorgestrel, eluting 20 microgram daily. It can be retained for 5 years, with failure rate of 0 to 3 per 100 woman years.EMERGENCY CONTRACEPTION (Postcoital contraception)Mechanism of action1. Delaying /inhibiting ovulation2. Inhibiting fertilization3. Preventing implantation of fertilized eggIndications1. Unprotected intercourse2. Condom rupture3. Missed pills4. Sexual assault or rape5. First time intercourse.Methods1. Morning after pills (Conjugated estrogen and ethnyl estradiol)--use in 72 hr.2. Combined hormonal regimen (YUZPE method)Q3. POP (very successful)4. IUCD (should be inserted within5 days)5. RU486 (Mifepristone)-single dose 600 mg irrespective of day and number of intercourse.", "explanation_word_count": 673, "prompt": "Which of the following has life span of upto 10 years?\nA. Progestasert\nB. CuT 380A\nC. LNG-IUD\nD. CuT 250\nReturn the correct option letter.", "reference": "Ans. B. CuT 380A. (Ref. Obstetrics D.C. Dutta 6th Ed. - 483).The TCu380A IUD (ParaGard) is a T-shaped polyethylene rod, wrapped with copper around the arms and stem. It is approved for 10 years of continuous use.Good Candidates for TCu380A# Postpartum women, breastfeeding or not, after 4 weeks.# Women with liver disease, hepatitis.# Women with breast cancer.# Women with hypertension, hyperlipidemia.# Women with current or history of ischemic heart disease, stroke.# Women with multiple risk factors for cardiovascular disease. Women with uncomplicated valvular heart disease.# Women with current deep vein thrombosis/pulmonary embolism.# Women who have had major surgery.# Women with migraines with or without focal neurological symptoms.# Women with gall bladder disease or history of pregnancy-related cholestasis.The LNG-IUS (Mirena). is a T-shaped polydimethylsiloxane rod con- taining 52 mg LNG. The LNG-IUS is approved for 5 years of use. The LNG-IUS adds an important non-contra- ceptive advantage for this age group: it decreases menstrual blood loss and dysmenorrhea and may avoid the need for hysterectomy or endometrial ablation. The copper IUD is generally associated with heavier menses.In addition to decreasing menstrual blood loss, the local administration of LNG to the endometrium protects it from development of estrogen-induced endometrial hyperplasia. This is of benefit for transitional women with irregular bleeding and for women on tamoxifen therapy following breast cancer. Use of the LNG-IUS is reported to reduce the risk of endometrial cancer by 40-60%.GOOD CANDIDATES FOR LNG-IUS# Women with menorrhagia, dysmenorrhea, or endometriosis.# Women with bleeding disorders or on anticoagulation therapy.Women with thalassemia, sickle cell disease, or iron- deficiency anemia.# Breastfeeding women after 4-6 weeks postpartum.Generation of IUCDCoilFailure rateLasts for (years)FirstCuT (200)>2/1003-5 CuT (200)>2/100 SecondMultiload Cu 2501-2 /1003-5 NovaT1-2 /1001-2/100ThirdMultiload Cu 3750.5-111005+ Copper Cu 380A0.3-1/100 Hormone releasingProgestasert (no more manufactured)1lyr LNG-IUCD(52mg Levenorgestrel impregnated; releases at arte of 20?g/day)0.5/100 at 1 yr5 yrs 0.7/100 at 3 yr 1/100 at 5 yr Marina (Latest)Least5 yrsMore Educational points:# Cu T 380A and Levenorgestrel have got lowest rate, whereas progestasert has got highest rate of ectopic pregnancy.# The Mirena IUD works by killing or irreparably damaging sperm and obstructing it's ability to fertilize an egg. It does this by releasing levonorgestrel, also known as progestin.# Progestin is a synthetic substance which imitates the biological activity of the natural hormone progesterone.# Progesterone can inhibit ovulation during pregnancy. Progestin was synthesized for, among reasons, suppresing ovulation for birth control.- Mirena reduces the frequency of ovulation. Ovulation occurs during the menstrual cycle where the ovarian follicle releases an egg. Reduction of the times in which an egg is available to fertilize handicaps the sperm's opportunity for reproduction.- Mirena changes the consistency of cervical mucus. This change thickens the cervical mucus making the passage of sperm through the cervix much more difficult.- Mirena thins the endometrium, the lining of the walls of the uterus. It is thought that this reduces the chances of embryo implantation to the endometrium.LNG-IUCD:# A new device, levonova (LNG IUD) contains 60mg of levonorgestrel and releases the hormone in very low doses i.e. 20 microgram/ day (versus Progestasert which carries 38mg of progesterone and releases 65microgram of the hormone per day).# It is thus longacting (5 years) and has low pregnancy rate of 0-3 per 100 woman years, n However, risk of ectopic pregnancy is higher.# Mechanism of action: - Strong and uniform endometrial suppression - Scanty cervical mucus - Anovulation and insufficient luteal phase and normal progesterone levels, n It can be used as hormone replacing therapy.# It is useful for the treatment of endometrial hyperplasia, n Irregular uterine bleeding can be a problem initially.# MIRENA contains 52mg levonorgestrel, eluting 20 microgram daily. It can be retained for 5 years, with failure rate of 0 to 3 per 100 woman years.EMERGENCY CONTRACEPTION (Postcoital contraception)Mechanism of action1. Delaying /inhibiting ovulation2. Inhibiting fertilization3. Preventing implantation of fertilized eggIndications1. Unprotected intercourse2. Condom rupture3. Missed pills4. Sexual assault or rape5. First time intercourse.Methods1. Morning after pills (Conjugated estrogen and ethnyl estradiol)--use in 72 hr.2. Combined hormonal regimen (YUZPE method)Q3. POP (very successful)4. IUCD (should be inserted within5 days)5. RU486 (Mifepristone)-single dose 600 mg irrespective of day and number of intercourse.\nB", "question_key": "which of the following has life span of upto 10 years?", "split": "validation", "is_mia_member": false} | |
| {"id": "2accf933-b8a2-4d59-a0f4-7f8fce4e1d10", "question": "Which of the following is a long acting bronchodilator?", "opa": "Salbutamol", "opb": "Terbutaline", "opc": "Adrenaline", "opd": "Formoterol", "cop": 3, "answer": "D", "exp": "Beta-2 agonists are well known bronchodilators. This includes:#Salbutamol, Terbutaline, Formoterol, Salmeterol, Indacaterol, Albuterol etc.Among these agents, formoterol, salmeterol, Indacaterol are longer acting analogue and are preferred in prophylactic therapy of bronchial asthma and COPD.", "explanation_word_count": 36, "prompt": "Which of the following is a long acting bronchodilator?\nA. Salbutamol\nB. Terbutaline\nC. Adrenaline\nD. Formoterol\nReturn the correct option letter.", "reference": "Beta-2 agonists are well known bronchodilators. This includes:#Salbutamol, Terbutaline, Formoterol, Salmeterol, Indacaterol, Albuterol etc.Among these agents, formoterol, salmeterol, Indacaterol are longer acting analogue and are preferred in prophylactic therapy of bronchial asthma and COPD.\nD", "question_key": "which of the following is a long acting bronchodilator?", "split": "validation", "is_mia_member": false} | |
| {"id": "3a569115-592c-4c84-b164-92ff4c41439f", "question": "Half-life of insulin receptor is", "opa": "3 hr", "opb": "7 hr", "opc": "12 hr", "opd": "24 hr", "cop": 1, "answer": "B", "exp": "The insulin receptor (IR) is a transmembrane receptor that is activated by insulin, IGF-I, IGF-II and belongs to the large class of tyrosine kinase receptors. Metabolically, the insulin receptor plays a key role in the regulation of glucose homeostasis, a functional process that under degenerate conditions may result in a range of clinical manifestations including diabetes and cancer. The half-life of insulin receptor is about 7 hrs.Ref: Ganong&;s review of medical physiology;24th edition; page no-437", "explanation_word_count": 77, "prompt": "Half-life of insulin receptor is\nA. 3 hr\nB. 7 hr\nC. 12 hr\nD. 24 hr\nReturn the correct option letter.", "reference": "The insulin receptor (IR) is a transmembrane receptor that is activated by insulin, IGF-I, IGF-II and belongs to the large class of tyrosine kinase receptors. Metabolically, the insulin receptor plays a key role in the regulation of glucose homeostasis, a functional process that under degenerate conditions may result in a range of clinical manifestations including diabetes and cancer. The half-life of insulin receptor is about 7 hrs.Ref: Ganong&;s review of medical physiology;24th edition; page no-437\nB", "question_key": "half-life of insulin receptor is", "split": "validation", "is_mia_member": false} | |
| {"id": "ec127d31-c43f-4034-b0c2-fb8bad817ff7", "question": "Urease test is positive for: March 2013", "opa": "E. coli", "opb": "Klebsiella", "opc": "V. cholerae", "opd": "Filaria", "cop": 1, "answer": "B", "exp": "Ans. B i.e. Klebsiella Urease It catalyzes the hydrolysis of urea to produce ammonia and carbamate, the carbamate produced is subsequently degraded by spontaneous hydrolysis to produce another ammonia and carbonic acid. Urease activity tends to increase the pH of the environment in which it is as it produces ammonia, as it is a basic molecule. Ureases are found in numerous bacteria, fungi, algae, plants and some inveebrates, as well as in soils, as a soil enzyme. They are nickel-containing metalloenzymes of high molecular weight. Mnemonic (PUNCH-K): P-Proteus; U-Ureaplasma; N-Nocardia; C-Cryptococcus; H-Helicobacter; K: Klebsiella", "explanation_word_count": 95, "prompt": "Urease test is positive for: March 2013\nA. E. coli\nB. Klebsiella\nC. V. cholerae\nD. Filaria\nReturn the correct option letter.", "reference": "Ans. B i.e. Klebsiella Urease It catalyzes the hydrolysis of urea to produce ammonia and carbamate, the carbamate produced is subsequently degraded by spontaneous hydrolysis to produce another ammonia and carbonic acid. Urease activity tends to increase the pH of the environment in which it is as it produces ammonia, as it is a basic molecule. Ureases are found in numerous bacteria, fungi, algae, plants and some inveebrates, as well as in soils, as a soil enzyme. They are nickel-containing metalloenzymes of high molecular weight. Mnemonic (PUNCH-K): P-Proteus; U-Ureaplasma; N-Nocardia; C-Cryptococcus; H-Helicobacter; K: Klebsiella\nB", "question_key": "urease test is positive for: march 2013", "split": "validation", "is_mia_member": false} | |
| {"id": "2ed70b51-8874-4365-8ab3-9f648e440e6a", "question": "A child comes with a circular 3cm x 3cm scaly patchy hair loss with itching in the lesions. The investigation of choice is", "opa": "Split skin smear", "opb": "KOH mount", "opc": "Gram stain", "opd": "Tzanck smear", "cop": 1, "answer": "B", "exp": "Itchy lesions over head with hair loss likely suggestive of Tinea capitis and KOH mount of hairs is the investigation of choice.", "explanation_word_count": 22, "prompt": "A child comes with a circular 3cm x 3cm scaly patchy hair loss with itching in the lesions. The investigation of choice is\nA. Split skin smear\nB. KOH mount\nC. Gram stain\nD. Tzanck smear\nReturn the correct option letter.", "reference": "Itchy lesions over head with hair loss likely suggestive of Tinea capitis and KOH mount of hairs is the investigation of choice.\nB", "question_key": "a child comes with a circular 3cm x 3cm scaly patchy hair loss with itching in the lesions. the investigation of choice is", "split": "validation", "is_mia_member": false} | |
| {"id": "d97e0fca-3912-4e00-96cc-2acf542d2dd8", "question": "Micronutrient associated with rash and diarrhea is:", "opa": "Manganese", "opb": "Copper", "opc": "Zinc", "opd": "Iron", "cop": 2, "answer": "C", "exp": "Acrodermatitis enteropathica is a rare autosomal recessive disorder caused by an inability to absorb sufficient zinc from diet. The cutaneous eruption consists of vesicio-bullous, eczematous, dry scaly or psoriasisiform skin lesions symmetrically distributed in body. Associated manifestations include chronic, stomatitis, glossitis, paronychia and superinfection with candida albicans. Ref: Park 21st edition: page 577.", "explanation_word_count": 52, "prompt": "Micronutrient associated with rash and diarrhea is:\nA. Manganese\nB. Copper\nC. Zinc\nD. Iron\nReturn the correct option letter.", "reference": "Acrodermatitis enteropathica is a rare autosomal recessive disorder caused by an inability to absorb sufficient zinc from diet. The cutaneous eruption consists of vesicio-bullous, eczematous, dry scaly or psoriasisiform skin lesions symmetrically distributed in body. Associated manifestations include chronic, stomatitis, glossitis, paronychia and superinfection with candida albicans. Ref: Park 21st edition: page 577.\nC", "question_key": "micronutrient associated with rash and diarrhea is:", "split": "validation", "is_mia_member": false} | |
| {"id": "b9f6c3a3-bc00-4059-b9c6-ff8da9780ac4", "question": "Dakin's solution is", "opa": "0.5% NaOCl", "opb": "2.5% NaOCl", "opc": "1.25% NaOCl", "opd": "5.2% NaOCl", "cop": 0, "answer": "A", "exp": "NaOCl as a buffered 0.5% solution was recommended for irrigation of wound during world war I by Dakin. Coolidge introduced NaoCl to endodontics.", "explanation_word_count": 22, "prompt": "Dakin's solution is\nA. 0.5% NaOCl\nB. 2.5% NaOCl\nC. 1.25% NaOCl\nD. 5.2% NaOCl\nReturn the correct option letter.", "reference": "NaOCl as a buffered 0.5% solution was recommended for irrigation of wound during world war I by Dakin. Coolidge introduced NaoCl to endodontics.\nA", "question_key": "dakin's solution is", "split": "validation", "is_mia_member": false} | |
| {"id": "9e756e0b-9bf4-45a1-9bf4-976ba762f958", "question": "Buerger waves (alpha waves) of EEG have the rhythm per sec of", "opa": "0-4", "opb": "7-Apr", "opc": "13-Aug", "opd": "13-30", "cop": 2, "answer": "C", "exp": "Stages of sleep and rhythm\n- Beta rhythm- Alert, awake, maximum concentration- 13-30Hz\n- Alpha rhythm- Eyes closed, mind wandering, less attentiveness- 8-13Hz\n- Theta rhythm- Stage 1 NREM- 4-7 Hz\n- Sleep spindles, K complex- Stage 2 NREM\n- Delta rhythm- Deep sleep (Stage 3 & 4 NREM)- 3-5 Hz\n- Beta Rhythm and occasional alpha rhythm- REM", "explanation_word_count": 46, "prompt": "Buerger waves (alpha waves) of EEG have the rhythm per sec of\nA. 0-4\nB. 7-Apr\nC. 13-Aug\nD. 13-30\nReturn the correct option letter.", "reference": "Stages of sleep and rhythm\n- Beta rhythm- Alert, awake, maximum concentration- 13-30Hz\n- Alpha rhythm- Eyes closed, mind wandering, less attentiveness- 8-13Hz\n- Theta rhythm- Stage 1 NREM- 4-7 Hz\n- Sleep spindles, K complex- Stage 2 NREM\n- Delta rhythm- Deep sleep (Stage 3 & 4 NREM)- 3-5 Hz\n- Beta Rhythm and occasional alpha rhythm- REM\nC", "question_key": "buerger waves (alpha waves) of eeg have the rhythm per sec of", "split": "validation", "is_mia_member": false} | |
| {"id": "a83e0975-7442-40dc-ae3e-a36655631a13", "question": "Most prominent spinous process is of which vertebra?", "opa": "C6", "opb": "C7", "opc": "L1", "opd": "T12", "cop": 1, "answer": "B", "exp": "Ans. b (C7). (Ref. BD Chaurasia, Anatomy, Vol 3, 2nd/pg.35)Importance of certain cervical vertebral levelCs-C6Most common disc space reduced in cervical spondylosis.C6has prominent bony tubercle called Chassaignae's tubercle at the level of cricoid cartilage (a level where trachea ends).C7is also known as vertebra prominence as it has most prominent and long spinous process among the all-cervical vertebrae, and the tip of which can be felt on palpation just below the nape of the neck.C7 spinous process tip give attachment to following structures:- Ligamentum nuchae- Rhomboidus minor- Serratus posterior- Semispinalis, and- Trapezius- Interspinalis- Splenius capitis- Spinalis cervicis", "explanation_word_count": 103, "prompt": "Most prominent spinous process is of which vertebra?\nA. C6\nB. C7\nC. L1\nD. T12\nReturn the correct option letter.", "reference": "Ans. b (C7). (Ref. BD Chaurasia, Anatomy, Vol 3, 2nd/pg.35)Importance of certain cervical vertebral levelCs-C6Most common disc space reduced in cervical spondylosis.C6has prominent bony tubercle called Chassaignae's tubercle at the level of cricoid cartilage (a level where trachea ends).C7is also known as vertebra prominence as it has most prominent and long spinous process among the all-cervical vertebrae, and the tip of which can be felt on palpation just below the nape of the neck.C7 spinous process tip give attachment to following structures:- Ligamentum nuchae- Rhomboidus minor- Serratus posterior- Semispinalis, and- Trapezius- Interspinalis- Splenius capitis- Spinalis cervicis\nB", "question_key": "most prominent spinous process is of which vertebra?", "split": "validation", "is_mia_member": false} | |
| {"id": "fdd3dd9d-2385-4ab0-82ec-78e9eeef6866", "question": "Polycythemia vera is absolute venous hematocrit of > -", "opa": "45%", "opb": "55%", "opc": "65%", "opd": "70%", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e., 55% Diagnosis of polycythemiaHematocrito The hematocrit (HCT) is expressed as the percent of a blood occupied by intact RBC's.o Polycy'themia in the adult patient is suspected when the hematocrit is> 48% in women> 52% in menHemoeiobin concentrationo The hemoglobin concentration (HGB) is its content in grams/100 ml of whole blood. Polycythemia in the adult is suspected when the hemoglobin is>16.5% in women> 18.5% in menRed blood cell counto The red blood cell count is expressed as the number of RBC per microl or L of whole blood,o It is least often used to suggest polycythemia since patients with thalassemia minor may have an elevated RBC count but a normal or reduced hematocrit or hemoglobin due to presence of small (microcytic) poorly hemoglobinized (hypochromid red cells).o Once a high value has been reported it should be confirmed by repeat testing to rule out lab error.o An accurate history and physical examination is critical in order to determine the etiology of polycythemia.o The most common cause of polycythemia is hypoxia secondary to pulmonary disease as a result pertaining eliciting symptoms pertaining to altered lung function.The 2008 WHO diagnostic criteria for polycythemia vera: -MAJOR CRITERIAo Hb > 18.59/dl (men) > 16.5 g/'dl (women)oro Hb or Hct > 99,h percentile of reference for age, sex or altitude of residenceoro Hb> 17g/dl (men)o Hb > 15g;dl (women)If associated with a sustained increase of 129 gdl fronts baseline that cannot be attributed to correction of iron defic iencyoro Elevated red cell mass > 25% above mean normal predicted valueo Presence of JAK 2V617F or similar mutationMINOR CRITERIAo Bone marrow biopsy showing trilineage myeloproliferationo Subnormal serum ervthropoieten level EFC growth", "explanation_word_count": 278, "prompt": "Polycythemia vera is absolute venous hematocrit of > -\nA. 45%\nB. 55%\nC. 65%\nD. 70%\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e., 55% Diagnosis of polycythemiaHematocrito The hematocrit (HCT) is expressed as the percent of a blood occupied by intact RBC's.o Polycy'themia in the adult patient is suspected when the hematocrit is> 48% in women> 52% in menHemoeiobin concentrationo The hemoglobin concentration (HGB) is its content in grams/100 ml of whole blood. Polycythemia in the adult is suspected when the hemoglobin is>16.5% in women> 18.5% in menRed blood cell counto The red blood cell count is expressed as the number of RBC per microl or L of whole blood,o It is least often used to suggest polycythemia since patients with thalassemia minor may have an elevated RBC count but a normal or reduced hematocrit or hemoglobin due to presence of small (microcytic) poorly hemoglobinized (hypochromid red cells).o Once a high value has been reported it should be confirmed by repeat testing to rule out lab error.o An accurate history and physical examination is critical in order to determine the etiology of polycythemia.o The most common cause of polycythemia is hypoxia secondary to pulmonary disease as a result pertaining eliciting symptoms pertaining to altered lung function.The 2008 WHO diagnostic criteria for polycythemia vera: -MAJOR CRITERIAo Hb > 18.59/dl (men) > 16.5 g/'dl (women)oro Hb or Hct > 99,h percentile of reference for age, sex or altitude of residenceoro Hb> 17g/dl (men)o Hb > 15g;dl (women)If associated with a sustained increase of 129 gdl fronts baseline that cannot be attributed to correction of iron defic iencyoro Elevated red cell mass > 25% above mean normal predicted valueo Presence of JAK 2V617F or similar mutationMINOR CRITERIAo Bone marrow biopsy showing trilineage myeloproliferationo Subnormal serum ervthropoieten level EFC growth\nB", "question_key": "polycythemia vera is absolute venous hematocrit of > -", "split": "validation", "is_mia_member": false} | |
| {"id": "7658059f-9d3f-4fc0-8f5f-c7c46387d28e", "question": "Which is not transmitted by arthropod :", "opa": "Rickettsia prowazaki", "opb": "Coxiella burneti", "opc": "Rickettsia akasi", "opd": "Rickettsia rickettsi", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e. Coxiella Burnetti \"Rickettsia is a small obligate intracellular parasite and except for Q fever (caused by Coxiella burnetti) are transmitted to human by Arthropod\"Human Diseases Caused By RickettsiaOrganism Disease Vector* Rickettsia prowazekii Epidemic Typhus* louse** Rickettsia typhi Endemic Typhus* Flea** Orientia Tsutsugamushi Scrub Typhus* Mite** Rickettsia Ricketsei Rocky mountain* spotted fever* Tick** Rickettsia Akari Rickettsialpox* Mite** Coxiella Burnetti Q fever * Airborne fomites*", "explanation_word_count": 68, "prompt": "Which is not transmitted by arthropod :\nA. Rickettsia prowazaki\nB. Coxiella burneti\nC. Rickettsia akasi\nD. Rickettsia rickettsi\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e. Coxiella Burnetti \"Rickettsia is a small obligate intracellular parasite and except for Q fever (caused by Coxiella burnetti) are transmitted to human by Arthropod\"Human Diseases Caused By RickettsiaOrganism Disease Vector* Rickettsia prowazekii Epidemic Typhus* louse** Rickettsia typhi Endemic Typhus* Flea** Orientia Tsutsugamushi Scrub Typhus* Mite** Rickettsia Ricketsei Rocky mountain* spotted fever* Tick** Rickettsia Akari Rickettsialpox* Mite** Coxiella Burnetti Q fever * Airborne fomites*\nB", "question_key": "which is not transmitted by arthropod :", "split": "validation", "is_mia_member": false} | |
| {"id": "bcd242da-73fe-4954-abec-179d85a8af91", "question": "What is the daily requirement of potassium in a healthy adult?", "opa": "2-3 g/day", "opb": "3-4 g/day", "opc": "4-5 g/day", "opd": "5-7 g/day", "cop": 0, "answer": "A", "exp": "Minimum daily requirement for potassium in healthy adults is estimated to be 2g. The average intake of potassium among the adult population of industrialized world is approximately is 2-3 per day. Recommended daily intake of potassium to reduce risk of high blood pressure, stroke, and hea disease is 4-5g/d.", "explanation_word_count": 49, "prompt": "What is the daily requirement of potassium in a healthy adult?\nA. 2-3 g/day\nB. 3-4 g/day\nC. 4-5 g/day\nD. 5-7 g/day\nReturn the correct option letter.", "reference": "Minimum daily requirement for potassium in healthy adults is estimated to be 2g. The average intake of potassium among the adult population of industrialized world is approximately is 2-3 per day. Recommended daily intake of potassium to reduce risk of high blood pressure, stroke, and hea disease is 4-5g/d.\nA", "question_key": "what is the daily requirement of potassium in a healthy adult?", "split": "validation", "is_mia_member": false} | |
| {"id": "98962868-b39b-4f72-8a54-79cce3221fba", "question": "The patient with least risk of pulmonary aspiration of gastric contents during induction of anesthesia is:-", "opa": "Markedly obese and NPO for eight hours", "opb": "Fed coffee four hours before elective surgery", "opc": "Scheduled for elective cesarean delivery and NPO for 20 hours", "opd": "NPO for four hours after a full meal", "cop": 0, "answer": "A", "exp": "NPO is same for obese and normal. NPO guidelines - 6hrs for liquid and semisolid, 2 hours NPO for clear fluids. Subset of patients who are at high risk for aspiration - pregnant women, morbidly obese (rapid sequence induction), full fatty meal - 8 hours NPO.", "explanation_word_count": 41, "prompt": "The patient with least risk of pulmonary aspiration of gastric contents during induction of anesthesia is:-\nA. Markedly obese and NPO for eight hours\nB. Fed coffee four hours before elective surgery\nC. Scheduled for elective cesarean delivery and NPO for 20 hours\nD. NPO for four hours after a full meal\nReturn the correct option letter.", "reference": "NPO is same for obese and normal. NPO guidelines - 6hrs for liquid and semisolid, 2 hours NPO for clear fluids. Subset of patients who are at high risk for aspiration - pregnant women, morbidly obese (rapid sequence induction), full fatty meal - 8 hours NPO.\nA", "question_key": "the patient with least risk of pulmonary aspiration of gastric contents during induction of anesthesia is:-", "split": "validation", "is_mia_member": false} | |
| {"id": "693f42bd-2c7e-4707-8896-ccb772b7ac3a", "question": "Chemical use in vaginal sponge is -", "opa": "Ethynil estradiol", "opb": "Progesterone", "opc": "Mifepristone", "opd": "Nonoxynol-9", "cop": 3, "answer": "D", "exp": "Ans. is `d' i.e., Non - oxynol - 9 Vaginal sponge It is marketed in USA under the trade name TODAY. o It is small polyurethane foam sponge saturated with spermicide, nanoxynol-9. o The failure rate :- i) Parous women --> 20 to 40 per 100 women years. ii) Nulliparous women --> 9 to 20 per 100 women years.", "explanation_word_count": 48, "prompt": "Chemical use in vaginal sponge is -\nA. Ethynil estradiol\nB. Progesterone\nC. Mifepristone\nD. Nonoxynol-9\nReturn the correct option letter.", "reference": "Ans. is `d' i.e., Non - oxynol - 9 Vaginal sponge It is marketed in USA under the trade name TODAY. o It is small polyurethane foam sponge saturated with spermicide, nanoxynol-9. o The failure rate :- i) Parous women --> 20 to 40 per 100 women years. ii) Nulliparous women --> 9 to 20 per 100 women years.\nD", "question_key": "chemical use in vaginal sponge is -", "split": "validation", "is_mia_member": false} | |
| {"id": "bb815f55-5fb4-412b-95a6-8c5a3b8e8747", "question": "Which of the following is a high pitched sound: March 2011", "opa": "1st hea sound", "opb": "Tumour plop", "opc": "Opening Snap", "opd": "4th hea sound", "cop": 2, "answer": "C", "exp": "Ans. C: Opening snap The opening snap (OS) is a brief, high-pitched, early diastolic sound, which is usually due to stenosis of an AV valve, most often the mitral valve First hea sound (S1): Due to closure of AV valves (mitral and tricuspid) Low pitched Duration: 0.14 seconds Soft 51: Mitral stenosis (long standing, calcified), mitral regurgitation Loud Si: Mitral stenosis (prolonged flow through AV valve), anemia, fever, thryotoxicosis Second hea sound (S2): Due to closure of semilunar valves (aoic, pulmonary) High pitched Wide split of S2: Atrial septal defect, mitral regurgitation, pulmonary stenosis Reverse splitting of S2: LBBB, hypeension, aoic stenosis Third hea sound (S3): Due to ventricular filling Low pitched Diastolic, occurring after S2 Best heard at apex with the bell of stethoscope Causes: Children, hyperdynamic states, left ventricular failure, right ventricular failure Fouh hea sounds (S4): Low pitched Pre-systolic, produced during second rapid filling phase (before S1) Best heard with bell of stethoscope Seen in: Hypeension, aoic stenosis, HOCM, acute mitral regurgitation", "explanation_word_count": 163, "prompt": "Which of the following is a high pitched sound: March 2011\nA. 1st hea sound\nB. Tumour plop\nC. Opening Snap\nD. 4th hea sound\nReturn the correct option letter.", "reference": "Ans. C: Opening snap The opening snap (OS) is a brief, high-pitched, early diastolic sound, which is usually due to stenosis of an AV valve, most often the mitral valve First hea sound (S1): Due to closure of AV valves (mitral and tricuspid) Low pitched Duration: 0.14 seconds Soft 51: Mitral stenosis (long standing, calcified), mitral regurgitation Loud Si: Mitral stenosis (prolonged flow through AV valve), anemia, fever, thryotoxicosis Second hea sound (S2): Due to closure of semilunar valves (aoic, pulmonary) High pitched Wide split of S2: Atrial septal defect, mitral regurgitation, pulmonary stenosis Reverse splitting of S2: LBBB, hypeension, aoic stenosis Third hea sound (S3): Due to ventricular filling Low pitched Diastolic, occurring after S2 Best heard at apex with the bell of stethoscope Causes: Children, hyperdynamic states, left ventricular failure, right ventricular failure Fouh hea sounds (S4): Low pitched Pre-systolic, produced during second rapid filling phase (before S1) Best heard with bell of stethoscope Seen in: Hypeension, aoic stenosis, HOCM, acute mitral regurgitation\nC", "question_key": "which of the following is a high pitched sound: march 2011", "split": "validation", "is_mia_member": false} | |
| {"id": "a5aefc13-e516-4edb-9531-ae2c91b9f6dc", "question": "Stimulation of which of the following nerves cause improvement in mood?", "opa": "Olfactory Nerve", "opb": "Optic Nerve", "opc": "Trigeminal Nerve", "opd": "Vagus Nerve", "cop": 3, "answer": "D", "exp": "2 Advanced treatment options for depression: Vagus Nerve Stimulation: A number of clinical studies have shown that vagus nerve stimulation (VNS) has antidepressant effects in patients with depression resistant to four or more treatments. Improvement with VNS result in enhanced neurocognitive function in many patients. VNS appears to be most effective in patients with low to moderate antidepressant resistance. Response rates usually range from 30-40%, and long-term VNS treatment appears to be associated with sustained symptomatic improvement. VNS is also known to improve mood in depressed patients with epilepsy. Transcranial Magnetic Stimulation: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive and easily tolerated method of altering coical physiology. Clinical studies suppo an antidepressant effect of high-frequency rTMS administered to the left PFC; however, antidepressive efficacy is not consistent, and where efficacy is demonstrated, degree of clinical improvement appears to be small. The absence of psychosis, and younger age may be predictors of treatment success. Low frequency TMS to the right PFC also has shown promise. Repetitive TMS may be useful in augmenting or hastening the response of antidepressant drugs in patients with major depressive disorder. Ref: Loosen P.T., Shelton R.C. (2008). Chapter 18. Mood Disorders. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e.", "explanation_word_count": 211, "prompt": "Stimulation of which of the following nerves cause improvement in mood?\nA. Olfactory Nerve\nB. Optic Nerve\nC. Trigeminal Nerve\nD. Vagus Nerve\nReturn the correct option letter.", "reference": "2 Advanced treatment options for depression: Vagus Nerve Stimulation: A number of clinical studies have shown that vagus nerve stimulation (VNS) has antidepressant effects in patients with depression resistant to four or more treatments. Improvement with VNS result in enhanced neurocognitive function in many patients. VNS appears to be most effective in patients with low to moderate antidepressant resistance. Response rates usually range from 30-40%, and long-term VNS treatment appears to be associated with sustained symptomatic improvement. VNS is also known to improve mood in depressed patients with epilepsy. Transcranial Magnetic Stimulation: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive and easily tolerated method of altering coical physiology. Clinical studies suppo an antidepressant effect of high-frequency rTMS administered to the left PFC; however, antidepressive efficacy is not consistent, and where efficacy is demonstrated, degree of clinical improvement appears to be small. The absence of psychosis, and younger age may be predictors of treatment success. Low frequency TMS to the right PFC also has shown promise. Repetitive TMS may be useful in augmenting or hastening the response of antidepressant drugs in patients with major depressive disorder. Ref: Loosen P.T., Shelton R.C. (2008). Chapter 18. Mood Disorders. In M.H. Ebe, P.T. Loosen, B. Nurcombe, J.F. Leckman (Eds), CURRENT Diagnosis & Treatment: Psychiatry, 2e.\nD", "question_key": "stimulation of which of the following nerves cause improvement in mood?", "split": "validation", "is_mia_member": false} | |
| {"id": "be53122a-0e83-41b6-95ba-227677365c4b", "question": "Pleural mesothelioma is associated with", "opa": "Asbestosis", "opb": "Berylliosis", "opc": "Silicosis", "opd": "Beryliosis", "cop": 0, "answer": "A", "exp": "Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.493 Asbestos exposure predisposes to a number of cancers, most impoantly bronchogenic carcinoma andmalignant mesothelioma . A few others are: carcinomas of oesophagus, stomach, colon, kidneys and larynx and various lymphoid malignancies. 1. Bronchogenic carcinoma is the most common malignancy in asbestos workers. Its incidence is 5 times higher in non-smoker asbestos workers than the nonsmoker general population and 10 times higher in smoker asbestos workers than the other smokers. 2. pleural mesothelioma is an uncommon tumour but association with asbestos exposure is present in 30 to 80% of cases with mesothelioma. The exposure need not be heavy because mesothelioma is known to develop in people living near asbestos plants or in wives of asbestos workers.", "explanation_word_count": 118, "prompt": "Pleural mesothelioma is associated with\nA. Asbestosis\nB. Berylliosis\nC. Silicosis\nD. Beryliosis\nReturn the correct option letter.", "reference": "Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.493 Asbestos exposure predisposes to a number of cancers, most impoantly bronchogenic carcinoma andmalignant mesothelioma . A few others are: carcinomas of oesophagus, stomach, colon, kidneys and larynx and various lymphoid malignancies. 1. Bronchogenic carcinoma is the most common malignancy in asbestos workers. Its incidence is 5 times higher in non-smoker asbestos workers than the nonsmoker general population and 10 times higher in smoker asbestos workers than the other smokers. 2. pleural mesothelioma is an uncommon tumour but association with asbestos exposure is present in 30 to 80% of cases with mesothelioma. The exposure need not be heavy because mesothelioma is known to develop in people living near asbestos plants or in wives of asbestos workers.\nA", "question_key": "pleural mesothelioma is associated with", "split": "validation", "is_mia_member": false} | |
| {"id": "a3f30830-41ca-4308-b6fc-b7e281e02b93", "question": "Hypocalcemia with hypophosphatemia is seen in:September 2006", "opa": "Crush injury", "opb": "Rhabdomyolysis", "opc": "Vitamin D dependent rickets-II", "opd": "Renal failure", "cop": 2, "answer": "C", "exp": "Ans. C: Vitamin D dependent rickets-IIIn rhabdomyolysis due to crush injury, hypocalcemia and hyperphosphatemia may occur. Severe intravascular hemolysis may lead to a similar syndrome.Hyperphosphatemia alters calcium and phosphate ion solubility products, and calcium deposition in soft tissue may occur. The lower circulating concentrations of 1, 25 (OH)2D may fuher aggravate the hypocalcemia by impairing intestinal absorption of calcium.Hyperphosphatemic-induced hypocalcemia inhibits vitamin D synthesis and results in an increase in PTH secretion. Secondary hyperparathyroidism from long-term hyperphosphatemia is usually associated with renal insufficiency. Treatment should be directed towards the hyperphosphatemia in order to correct the hypocalcemia.Hypophosphatemia is more severe than hypocalcemia in vitamin D deficiency states because of the increased secretion of PTH, which is only paly active in elevating blood calcium but is capable of phosphaturia.", "explanation_word_count": 129, "prompt": "Hypocalcemia with hypophosphatemia is seen in:September 2006\nA. Crush injury\nB. Rhabdomyolysis\nC. Vitamin D dependent rickets-II\nD. Renal failure\nReturn the correct option letter.", "reference": "Ans. C: Vitamin D dependent rickets-IIIn rhabdomyolysis due to crush injury, hypocalcemia and hyperphosphatemia may occur. Severe intravascular hemolysis may lead to a similar syndrome.Hyperphosphatemia alters calcium and phosphate ion solubility products, and calcium deposition in soft tissue may occur. The lower circulating concentrations of 1, 25 (OH)2D may fuher aggravate the hypocalcemia by impairing intestinal absorption of calcium.Hyperphosphatemic-induced hypocalcemia inhibits vitamin D synthesis and results in an increase in PTH secretion. Secondary hyperparathyroidism from long-term hyperphosphatemia is usually associated with renal insufficiency. Treatment should be directed towards the hyperphosphatemia in order to correct the hypocalcemia.Hypophosphatemia is more severe than hypocalcemia in vitamin D deficiency states because of the increased secretion of PTH, which is only paly active in elevating blood calcium but is capable of phosphaturia.\nC", "question_key": "hypocalcemia with hypophosphatemia is seen in:september 2006", "split": "validation", "is_mia_member": false} | |
| {"id": "88f79590-56c9-41b7-82f2-38a66caecd6b", "question": "A nullipara is on investigations for her infeility. She had a history of pulmonary tuberculosis which was treated effectively. If genital tuberculosis is the reason for her infeility, which organ can be affected the most?", "opa": "Tubes", "opb": "Uterus", "opc": "Cervix", "opd": "Vagina", "cop": 0, "answer": "A", "exp": "Genitourinary TB includes renal, ureteral, bladder, uterine-fallopian, prostatic, and epididymal disease. It is slightly more common in women than men and tends to involve older populations. The commonest site of affection is the Fallopian tubes. Both the tubes are affected simultaneously. The initial site of infection is in the submucosal layer (interstitial salpingitis) of the ampullary pa of the tube. The fimbriae are eveed and the abdominal ostium usually remains patent. The elongated and distended distal tube with the patent abdominal ostium gives the appearance of 'tobacco pouch'. Ref: Textbook of Gynaecology edited by D C Dutta, 4th edition, Page 129-130.", "explanation_word_count": 100, "prompt": "A nullipara is on investigations for her infeility. She had a history of pulmonary tuberculosis which was treated effectively. If genital tuberculosis is the reason for her infeility, which organ can be affected the most?\nA. Tubes\nB. Uterus\nC. Cervix\nD. Vagina\nReturn the correct option letter.", "reference": "Genitourinary TB includes renal, ureteral, bladder, uterine-fallopian, prostatic, and epididymal disease. It is slightly more common in women than men and tends to involve older populations. The commonest site of affection is the Fallopian tubes. Both the tubes are affected simultaneously. The initial site of infection is in the submucosal layer (interstitial salpingitis) of the ampullary pa of the tube. The fimbriae are eveed and the abdominal ostium usually remains patent. The elongated and distended distal tube with the patent abdominal ostium gives the appearance of 'tobacco pouch'. Ref: Textbook of Gynaecology edited by D C Dutta, 4th edition, Page 129-130.\nA", "question_key": "a nullipara is on investigations for her infeility. she had a history of pulmonary tuberculosis which was treated effectively. if genital tuberculosis is the reason for her infeility, which organ can be affected the most?", "split": "validation", "is_mia_member": false} | |
| {"id": "ec73670d-f78f-467c-aabb-770f5958c303", "question": "Most dangerous type of diptheria -", "opa": "Facial", "opb": "Laryngeal", "opc": "Nasal", "opd": "Cutaneous", "cop": 1, "answer": "B", "exp": "Ans. is 'b' i.e., Laryngealo Clinically diphtheria is divided into :-1) Facial (tonsillo-pharyngeal) diphtheria# It is the commonest type with incubation period of 2-5 days. There is thick adherent pseudomembrane (grey or white) on one or both tonsils or adjacent pharynx. Dislodging of membrane is likely to cause bleeding. A small perecentage of patient present with massive swelling of tonsils and uvula with cervical lymphadenopathy (bull neck) and severe toxemia, called malignant diphtheria.2) Laryngeal diphtheria# It is the most severe form of diphtheria.3) Nasal diphtheria# It is the mildest form.4) Cutaneous diphtheria# It is caused by nontoxigenic strain and patient presents with \"punched out\" ulcer.5) Other forms# These are conjunctival, otitic, genital (vulval, vaginal or prepucial), and gastrointestinal.", "explanation_word_count": 117, "prompt": "Most dangerous type of diptheria -\nA. Facial\nB. Laryngeal\nC. Nasal\nD. Cutaneous\nReturn the correct option letter.", "reference": "Ans. is 'b' i.e., Laryngealo Clinically diphtheria is divided into :-1) Facial (tonsillo-pharyngeal) diphtheria# It is the commonest type with incubation period of 2-5 days. There is thick adherent pseudomembrane (grey or white) on one or both tonsils or adjacent pharynx. Dislodging of membrane is likely to cause bleeding. A small perecentage of patient present with massive swelling of tonsils and uvula with cervical lymphadenopathy (bull neck) and severe toxemia, called malignant diphtheria.2) Laryngeal diphtheria# It is the most severe form of diphtheria.3) Nasal diphtheria# It is the mildest form.4) Cutaneous diphtheria# It is caused by nontoxigenic strain and patient presents with \"punched out\" ulcer.5) Other forms# These are conjunctival, otitic, genital (vulval, vaginal or prepucial), and gastrointestinal.\nB", "question_key": "most dangerous type of diptheria -", "split": "validation", "is_mia_member": false} | |
| {"id": "8992097b-5a22-4124-ba46-46335ba97db5", "question": "Which of the following is not a component of Jones criteria for diagnosing acute rheumatic fever?", "opa": "Pancarditis", "opb": "Migratory polyhritis", "opc": "Erythema nodosum", "opd": "Sydenham chorea", "cop": 2, "answer": "C", "exp": "Major criteria (Jones criteria for Acute Rheumatic fever) Carditis Clinical and/or subclinical Ahritis Polyahritis only Monoahritis or polyahritis or polyahralgia in moderate to high-risk populations Chorea Erythema marginatum Subcutaneous nodules There is a latent period of ~3 weeks (1-5 weeks) between the precipitating group A streptococcal infection and the appearance of the clinical features of ARF. The exceptions are chorea and indolent carditis, which may follow prolonged latent periods lasting up to 6 months. Syndenham's Chorea - commonly occurs in the absence of other manifestations, follows a prolonged latent period after group A streptococcal infection, and is found mainly in females. ARF almost always affects the large joints--most commonly the knees, ankles, hips, and elbows--and is asymmetric Subcutaneous nodules occur as painless, small (0.5-2 cm), mobile lumps beneath the skin overlying bony prominences (extensor surfaces).", "explanation_word_count": 133, "prompt": "Which of the following is not a component of Jones criteria for diagnosing acute rheumatic fever?\nA. Pancarditis\nB. Migratory polyhritis\nC. Erythema nodosum\nD. Sydenham chorea\nReturn the correct option letter.", "reference": "Major criteria (Jones criteria for Acute Rheumatic fever) Carditis Clinical and/or subclinical Ahritis Polyahritis only Monoahritis or polyahritis or polyahralgia in moderate to high-risk populations Chorea Erythema marginatum Subcutaneous nodules There is a latent period of ~3 weeks (1-5 weeks) between the precipitating group A streptococcal infection and the appearance of the clinical features of ARF. The exceptions are chorea and indolent carditis, which may follow prolonged latent periods lasting up to 6 months. Syndenham's Chorea - commonly occurs in the absence of other manifestations, follows a prolonged latent period after group A streptococcal infection, and is found mainly in females. ARF almost always affects the large joints--most commonly the knees, ankles, hips, and elbows--and is asymmetric Subcutaneous nodules occur as painless, small (0.5-2 cm), mobile lumps beneath the skin overlying bony prominences (extensor surfaces).\nC", "question_key": "which of the following is not a component of jones criteria for diagnosing acute rheumatic fever?", "split": "validation", "is_mia_member": false} | |
| {"id": "3b2ec133-11fd-474d-8918-61b299823c52", "question": "Which one of the following is not a diagnostic criterion for rheumatoid arthritis according to the American Rheumatism Association?", "opa": "Raised rheumatoid factor.", "opb": "Symmetric swelling (arthritis) for at least 6 weeks.", "opc": "Symmetrical muscle weakness.", "opd": "Rheumatoid nodules.", "cop": 2, "answer": "C", "exp": "Ans. C. Symmetrical muscle weakness.Rheumatoid arthritis is defined by the presence of four or more of the following criteria according to the American Rheumatism Association:a. Morning stiffness in and around joints lasting at least 1 hour before maximal improvement, present for at least 6 weeksb. Soft tissue swelling (arthritis) of three or more joint areas observed by a physician, present for at least 6 weeksc. Swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal or wrist joints for at least 6 weeksd. Symmetric swelling (arthritis) for at least 6 weekse. Rheumatoid nodulesf. The presence of rheumatoid factorg. Radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints", "explanation_word_count": 104, "prompt": "Which one of the following is not a diagnostic criterion for rheumatoid arthritis according to the American Rheumatism Association?\nA. Raised rheumatoid factor.\nB. Symmetric swelling (arthritis) for at least 6 weeks.\nC. Symmetrical muscle weakness.\nD. Rheumatoid nodules.\nReturn the correct option letter.", "reference": "Ans. C. Symmetrical muscle weakness.Rheumatoid arthritis is defined by the presence of four or more of the following criteria according to the American Rheumatism Association:a. Morning stiffness in and around joints lasting at least 1 hour before maximal improvement, present for at least 6 weeksb. Soft tissue swelling (arthritis) of three or more joint areas observed by a physician, present for at least 6 weeksc. Swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal or wrist joints for at least 6 weeksd. Symmetric swelling (arthritis) for at least 6 weekse. Rheumatoid nodulesf. The presence of rheumatoid factorg. Radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints\nC", "question_key": "which one of the following is not a diagnostic criterion for rheumatoid arthritis according to the american rheumatism association?", "split": "validation", "is_mia_member": false} | |
| {"id": "09a64b04-343b-4045-aee2-3c4047bbe373", "question": "Unfamiliarity of familiar things is seen in:", "opa": "Deja vu", "opb": "Jamais vu", "opc": "Deja entendu", "opd": "Deja pence", "cop": 1, "answer": "B", "exp": "Jamais vu refers to the feeling of unfamiliarity for familiar things. Deja vu refers to the feeling that an event which is being currently experienced has also happened in the past.", "explanation_word_count": 31, "prompt": "Unfamiliarity of familiar things is seen in:\nA. Deja vu\nB. Jamais vu\nC. Deja entendu\nD. Deja pence\nReturn the correct option letter.", "reference": "Jamais vu refers to the feeling of unfamiliarity for familiar things. Deja vu refers to the feeling that an event which is being currently experienced has also happened in the past.\nB", "question_key": "unfamiliarity of familiar things is seen in:", "split": "validation", "is_mia_member": false} | |
| {"id": "d7a74861-ac93-428c-b719-594ef44da167", "question": "Site of lesion in Bitemporal hemianopia is -", "opa": "Optic nerve", "opb": "Optic tract", "opc": "Optic chiasma", "opd": "Optic radiation", "cop": 2, "answer": "C", "exp": "Sagittal (central) lesions of the chiasma. These are characterised by bitemporal hemianopia and bitemporal hemianopic paralysis of pupillary reflexes. These usually lead to paial descending optic atrophy. Common causes of central chiasmal lesion are: suprasellar aneurysms, tumours of pituitary gland, craniopharyngioma, suprasellar meningioma and glioma of third ventricle, third ventricular dilatation due to obstructive hydrocephalus and chronic chiasmal arachnoiditis. Ref:AK Khurana 4thE pg 290", "explanation_word_count": 64, "prompt": "Site of lesion in Bitemporal hemianopia is -\nA. Optic nerve\nB. Optic tract\nC. Optic chiasma\nD. Optic radiation\nReturn the correct option letter.", "reference": "Sagittal (central) lesions of the chiasma. These are characterised by bitemporal hemianopia and bitemporal hemianopic paralysis of pupillary reflexes. These usually lead to paial descending optic atrophy. Common causes of central chiasmal lesion are: suprasellar aneurysms, tumours of pituitary gland, craniopharyngioma, suprasellar meningioma and glioma of third ventricle, third ventricular dilatation due to obstructive hydrocephalus and chronic chiasmal arachnoiditis. Ref:AK Khurana 4thE pg 290\nC", "question_key": "site of lesion in bitemporal hemianopia is -", "split": "validation", "is_mia_member": false} | |
| {"id": "6f51b258-3ea2-40a8-a894-11cb5c209170", "question": "A 29-year-old man complains of back pain for several months. It takes him over 2 hours to limber up in the morning. His x-ray is shown in Figure given below. Which of the following is the most likely diagnosis?", "opa": "RA", "opb": "spondylolisthesis", "opc": "osteomalacia", "opd": "ankylosing spondylitis", "cop": 3, "answer": "D", "exp": "The x-ray reveals typical evidence of sacroiliitis, with widening of the joints, sclerosis, and evasions. Similar findings can be seen in psoriatic and enteropathic spondyloarthropathy.", "explanation_word_count": 25, "prompt": "A 29-year-old man complains of back pain for several months. It takes him over 2 hours to limber up in the morning. His x-ray is shown in Figure given below. Which of the following is the most likely diagnosis?\nA. RA\nB. spondylolisthesis\nC. osteomalacia\nD. ankylosing spondylitis\nReturn the correct option letter.", "reference": "The x-ray reveals typical evidence of sacroiliitis, with widening of the joints, sclerosis, and evasions. Similar findings can be seen in psoriatic and enteropathic spondyloarthropathy.\nD", "question_key": "a 29-year-old man complains of back pain for several months. it takes him over 2 hours to limber up in the morning. his x-ray is shown in figure given below. which of the following is the most likely diagnosis?", "split": "validation", "is_mia_member": false} | |
| {"id": "4126ebd8-11d1-4cb5-bb67-b7213edf14d0", "question": "Following strain used is ?", "opa": "Methyl violet", "opb": "Brilliant cresyl blue", "opc": "Sudan black", "opd": "Indigo carmine", "cop": 1, "answer": "B", "exp": "This is a form of supravital staining in which cells are stained while living. It takes two days from reticulocytes to become RBC", "explanation_word_count": 23, "prompt": "Following strain used is ?\nA. Methyl violet\nB. Brilliant cresyl blue\nC. Sudan black\nD. Indigo carmine\nReturn the correct option letter.", "reference": "This is a form of supravital staining in which cells are stained while living. It takes two days from reticulocytes to become RBC\nB", "question_key": "following strain used is ?", "split": "validation", "is_mia_member": false} | |
| {"id": "bf0d4260-f084-4e46-82ca-ea1c7bdab0a3", "question": "What is the role of Weiger's ligament?", "opa": "Attachment of vitreous to the retina", "opb": "Attachment of vitreous to orra serrata", "opc": "Attachment of vitreous to optic disc", "opd": "Attachment of vitreous to posterior surface of lens", "cop": 3, "answer": "D", "exp": "During childhood, Weiger's ligament (hyaloido capsular ligament) helps in the attachment of vitreous to the posterior surface of the lens. Vitreous is attached to the internal limiting membrane of retina from 2mm anterior to the ora serrata to the edges of the optic disk. The attachment is quite firm at the macula and vitreous base and in peripapillary region. A hyaloid canal (Cloquet's canal) runs down the the centre of the vitreous body from the optic disc to the posterior pole of the lens. Ref: Comprehensive Ophthalmology by AK Khurana, 4th edn, page 243", "explanation_word_count": 93, "prompt": "What is the role of Weiger's ligament?\nA. Attachment of vitreous to the retina\nB. Attachment of vitreous to orra serrata\nC. Attachment of vitreous to optic disc\nD. Attachment of vitreous to posterior surface of lens\nReturn the correct option letter.", "reference": "During childhood, Weiger's ligament (hyaloido capsular ligament) helps in the attachment of vitreous to the posterior surface of the lens. Vitreous is attached to the internal limiting membrane of retina from 2mm anterior to the ora serrata to the edges of the optic disk. The attachment is quite firm at the macula and vitreous base and in peripapillary region. A hyaloid canal (Cloquet's canal) runs down the the centre of the vitreous body from the optic disc to the posterior pole of the lens. Ref: Comprehensive Ophthalmology by AK Khurana, 4th edn, page 243\nD", "question_key": "what is the role of weiger's ligament?", "split": "validation", "is_mia_member": false} | |
| {"id": "4caeeb14-fcd2-446e-a0ca-87e57434d1d3", "question": "Best indicator for monitoring of syphilis treatment", "opa": "VDRL", "opb": "FTA-ABS", "opc": "TPI", "opd": "TPHACovered with exudate", "cop": 0, "answer": "A", "exp": "Ans. (a) VDRL Serological test of syphilis Most sensitive test FTA-ABS Most specific test TPI (not used now) Test of choice for rapid diagnosis RPR Test of choice for evaluation of therapy VDRL Test of choice for diagnosis of congenital syphilis IgM FTA-ABS Now, TPPA has supplanted FTA-ABS as definitive diagnosis test for syphilis.", "explanation_word_count": 54, "prompt": "Best indicator for monitoring of syphilis treatment\nA. VDRL\nB. FTA-ABS\nC. TPI\nD. TPHACovered with exudate\nReturn the correct option letter.", "reference": "Ans. (a) VDRL Serological test of syphilis Most sensitive test FTA-ABS Most specific test TPI (not used now) Test of choice for rapid diagnosis RPR Test of choice for evaluation of therapy VDRL Test of choice for diagnosis of congenital syphilis IgM FTA-ABS Now, TPPA has supplanted FTA-ABS as definitive diagnosis test for syphilis.\nA", "question_key": "best indicator for monitoring of syphilis treatment", "split": "validation", "is_mia_member": false} | |
| {"id": "0d016065-bf04-4122-8243-6d2be310c274", "question": "Nucleus accumbens is related to which of the following?", "opa": "Basal ganglia", "opb": "Brain stem", "opc": "Thalamus", "opd": "Cerebellum", "cop": 0, "answer": "A", "exp": "Ans. a (Basal ganglia). (Ref. Ganong, Physiology 21st ed., 265)NUCLEUS ACCUMBENS# Nucleus accumbens is located at the base of the striatum, and is a part of basal ganglia.# Addiction is associated with the reward system, particularly with nucleus accumbens.# The medial frontal cortex, the hippocampus, and the amygdala are concerned with memory, and they all project to the nucleus accumbens.# Drugs that block the postsynaptic D3 receptors reduce the rate of self-stimulation and these receptors are mainly located at nucleus accumbens.", "explanation_word_count": 81, "prompt": "Nucleus accumbens is related to which of the following?\nA. Basal ganglia\nB. Brain stem\nC. Thalamus\nD. Cerebellum\nReturn the correct option letter.", "reference": "Ans. a (Basal ganglia). (Ref. Ganong, Physiology 21st ed., 265)NUCLEUS ACCUMBENS# Nucleus accumbens is located at the base of the striatum, and is a part of basal ganglia.# Addiction is associated with the reward system, particularly with nucleus accumbens.# The medial frontal cortex, the hippocampus, and the amygdala are concerned with memory, and they all project to the nucleus accumbens.# Drugs that block the postsynaptic D3 receptors reduce the rate of self-stimulation and these receptors are mainly located at nucleus accumbens.\nA", "question_key": "nucleus accumbens is related to which of the following?", "split": "validation", "is_mia_member": false} | |
| {"id": "8c17c2e4-c3a7-44d1-b2c3-5fb37abf0799", "question": "Primary site of involvement in congenital TB:", "opa": "Lungs", "opb": "Liver", "opc": "Lymph nodes", "opd": "Stomach", "cop": 1, "answer": "B", "exp": "Ans. (b) Liver(Ref: Nelson 19 ed Chap 212)In congenital TB, primary organ involved is liver.Congenital tuberculosis is rare because the most common result of female genital tract tuberculosis is infertility.Congenital transmission usually occurs from a lesion in the placenta through the umbilical vein.Primary infection in the mother just before or during pregnancy is more likely to cause congenital infection than is reactivation of a previous infection.The tubercle bacilli first reach the fetal liver, where a primary focus with periportal lymph node involvement may occur.Organisms pass through the liver into the main fetal circulation and infect many organs.", "explanation_word_count": 102, "prompt": "Primary site of involvement in congenital TB:\nA. Lungs\nB. Liver\nC. Lymph nodes\nD. Stomach\nReturn the correct option letter.", "reference": "Ans. (b) Liver(Ref: Nelson 19 ed Chap 212)In congenital TB, primary organ involved is liver.Congenital tuberculosis is rare because the most common result of female genital tract tuberculosis is infertility.Congenital transmission usually occurs from a lesion in the placenta through the umbilical vein.Primary infection in the mother just before or during pregnancy is more likely to cause congenital infection than is reactivation of a previous infection.The tubercle bacilli first reach the fetal liver, where a primary focus with periportal lymph node involvement may occur.Organisms pass through the liver into the main fetal circulation and infect many organs.\nB", "question_key": "primary site of involvement in congenital tb:", "split": "validation", "is_mia_member": false} | |
| {"id": "92fe381e-4631-45f9-9235-dd669276b4dd", "question": "Linear lesion is seen in -", "opa": "Sporotrichosis", "opb": "Lichen planus", "opc": "Psoriasis", "opd": "Pemphigus", "cop": 0, "answer": "A", "exp": "Sporotrichosis : Is a subacute or chronic infection caused by sporothrix scheinkii characterised by nodular lesions and ulcers in the skin and subcutaneous tissue and lymph nodes with occasional involvement of internal organs. Etiology : Causative organism:sporothrix scheinkii Dimorphic fungus Mycelia at 26c- bearing flower head endings of mycelia Yeast at 37c Saprophyte in soil and dead plants Route of entry scratches thorn prick Histopathology: Asteroid bodies basphilic yeast like body surrounded by radiating homogeneous eosinophilic material surrounded by granulomatous reaction. Clinical features Lymphocutaneous sporotrichosis =Trauma followed by development of nodules and ulcers along the line of lymphatic stocks Mucocutaneous sporotrichosis Fixed cutaneous sporotrichosis Pulmonary sporotrichosis Disseminated sporotrichosis Laboratory diagnosis. Sabourauds dextrose agar culture Animal inoculation cigar bodies in pus from lesions Sporotrichin skin test Treatment: Treatment of choice for lymphocutaneous lesion: saturated solution of potassium iodide three drops tid Itraconazole Terbinafine Voriconazole Iadvl textbook of dermatology page 306 PSORIASIS:-Inflammatory skin disease.Genetic predisposition. Psoriasis susceptibility 1 (PSORS1) is the most impoant susceptibility locus. 1. Classic lesion-Well defined erythematous plaque with a silvery white scales.2. Size varies from pin point papules to plaques. LICHEN PLANUS:- Inflammatory T cell mediated auto immune disorder affecting skin, hair,nails and mucous membranes. Four Ps- purple , polygonal and pruritic papule. Classic lesion- small polygonal shaped, and red/ violet, flat topped papule. Surface is slightly shiny/ transparent,and a network of fine,white lines called 'Wickhams striae' or small grey white puncta is also seen.", "explanation_word_count": 237, "prompt": "Linear lesion is seen in -\nA. Sporotrichosis\nB. Lichen planus\nC. Psoriasis\nD. Pemphigus\nReturn the correct option letter.", "reference": "Sporotrichosis : Is a subacute or chronic infection caused by sporothrix scheinkii characterised by nodular lesions and ulcers in the skin and subcutaneous tissue and lymph nodes with occasional involvement of internal organs. Etiology : Causative organism:sporothrix scheinkii Dimorphic fungus Mycelia at 26c- bearing flower head endings of mycelia Yeast at 37c Saprophyte in soil and dead plants Route of entry scratches thorn prick Histopathology: Asteroid bodies basphilic yeast like body surrounded by radiating homogeneous eosinophilic material surrounded by granulomatous reaction. Clinical features Lymphocutaneous sporotrichosis =Trauma followed by development of nodules and ulcers along the line of lymphatic stocks Mucocutaneous sporotrichosis Fixed cutaneous sporotrichosis Pulmonary sporotrichosis Disseminated sporotrichosis Laboratory diagnosis. Sabourauds dextrose agar culture Animal inoculation cigar bodies in pus from lesions Sporotrichin skin test Treatment: Treatment of choice for lymphocutaneous lesion: saturated solution of potassium iodide three drops tid Itraconazole Terbinafine Voriconazole Iadvl textbook of dermatology page 306 PSORIASIS:-Inflammatory skin disease.Genetic predisposition. Psoriasis susceptibility 1 (PSORS1) is the most impoant susceptibility locus. 1. Classic lesion-Well defined erythematous plaque with a silvery white scales.2. Size varies from pin point papules to plaques. LICHEN PLANUS:- Inflammatory T cell mediated auto immune disorder affecting skin, hair,nails and mucous membranes. Four Ps- purple , polygonal and pruritic papule. Classic lesion- small polygonal shaped, and red/ violet, flat topped papule. Surface is slightly shiny/ transparent,and a network of fine,white lines called 'Wickhams striae' or small grey white puncta is also seen.\nA", "question_key": "linear lesion is seen in -", "split": "validation", "is_mia_member": false} | |
| {"id": "a91f5e09-0811-4845-87cd-d766ab11195f", "question": "In Peripaum cardiomyopathy, cardiac failure occurs at:-", "opa": "Within 7 days after delivery.", "opb": "Within 6 weeks after delivery.", "opc": "Within 24 months after delivery.", "opd": "Within 5 months after delivery.", "cop": 3, "answer": "D", "exp": "Diagnostic criteria for Peripaum cardiomyopathy - A) Development of cardiac failure in the last month of pregnancy or within 5 months after delivery. B) Absence of an identifiable cause for the cardiac failure. C) Absence of recognizable hea disease prior to the last month pf pregnancy D) Left ventricular systolic dysfunction demonstrated by classic echocardiographic criteria, such as depressed ejection fraction along with a dilated left ventricle", "explanation_word_count": 65, "prompt": "In Peripaum cardiomyopathy, cardiac failure occurs at:-\nA. Within 7 days after delivery.\nB. Within 6 weeks after delivery.\nC. Within 24 months after delivery.\nD. Within 5 months after delivery.\nReturn the correct option letter.", "reference": "Diagnostic criteria for Peripaum cardiomyopathy - A) Development of cardiac failure in the last month of pregnancy or within 5 months after delivery. B) Absence of an identifiable cause for the cardiac failure. C) Absence of recognizable hea disease prior to the last month pf pregnancy D) Left ventricular systolic dysfunction demonstrated by classic echocardiographic criteria, such as depressed ejection fraction along with a dilated left ventricle\nD", "question_key": "in peripaum cardiomyopathy, cardiac failure occurs at:-", "split": "validation", "is_mia_member": false} | |
| {"id": "cd871163-2422-4a8d-a943-df37925c8378", "question": "Fetal Hb shows high pO2 saturation compared to adult Hb because -", "opa": "Affinity' to binding to DPG is different in fetal Hb", "opb": "Right shift to Oxygen dissociation curve", "opc": "Acidic environment", "opd": "Cooperative binding", "cop": 0, "answer": "A", "exp": "Ans. is 'a' i.e., Affinity to binding to DPG is different in fetal Hb o Make it very clear in mind that higher affinity' of fetal hemoglobin for oxygen is due to low affinity of HbF for 2,3- DPG (not due to decreased 2, 3-DPG concentration). HbF does not combines to 2, 3-DPG as avidly as adult hemoglobin.\"Fetal hemoglobin is left - shifted because it has a low affinity' for DPG\", --Principles of medical physiology'\"It is worth noting that DPG does not combine with fetal hemoglobin. That is perhaps one reason why HbF has greater affin ity for oxygen than adult hemoglobin (HbF) \".-- Understanding of medical physiology\"Fetal hemoglobin binds less 2-3 DPG it has consequently a greater affinity for O2\" -- Pediatric physiologyo All other textbooks have mentioned the same thing.o So, high affinity of HbF to O2 is due to low affinity of HbF for 2,3 DPG (and not due to decreased 2,3-DPG concentration).Effect of 2-3 diphosphoglvcerete (2.3 PPG)o Another important factor which influences oxygen-hemoglobin dissociation curve is 2,3 DPG in RBC. DPG is an optional by-product of the glycolytic pathway. DPG binds with deoxygenated hemoglobin but not with oxygenated hemoglobin. Therefore raised DPG concentration releases oxygen from oxyhemoglobin by shifting the following reversible reaction to the right: -HbO2 + DPG - Hb - DPG + O2o One molecule of DPG binds with one mole of deoxyhemoglobin.o That is why in the presence of raised DPG concentration, less oxygen can combine with hemoglobin at a given PO2. Hence an increase in DPG concentration shifts the oxygen-hemoglobin dissociation curve to the right. Thus 2,3 DPG causes delivery (unloading) of O2 to the tissues.o Factors which increases 2,3 DPG level and therefore lower the oxygen affinity of hemoglobin (right shift of O2 dissociation curve and increased delivery of oxygen to tissues) are : -# Hypoxia# High altitude# Alkalosis# Exercise# Pregnancy# Anemia# Hormones (thyroid, GH, androgen)# Cyanotic congenital heart disease# Chemical agents (Inosine, Pyruvate, PEP, phosphate, dihydroxyacetone)o Factors which decrease 2,3 DPG levels and therefore increase oxygen a ffinity of hemoglobin (left shift of O2 dissociation curve and decreased delivery' of O2 to the tissues) are : - Stored blood, and fetal hemoglobin (HbF).o Fetal hemoglobin has considerably less afinity for 2,3 - DPG than does adult hemoglobin therefore fetal hemoglobin has greater affinity for oxygen than adult hemoglobin. In human blood, the affinity of fetal hemoglobin for 2,3-DPG is only about 40% that of adult hemoglobin. This makes fetal hemoglobin behave as if 2,3-DPG levels are low. Therefore, the oxygen dissociation curve is shifted to the left. Although fetal red cells do contain 2,3 DPG, the poor binding of 2,3-DPG by fetal hemoglobin is an important factor in facilitating transport of oxygen across the placenta from mother to fetus. On the maternal side of the placenta, the reduction of hemoglobin effectively shifts the curve to the right, increasing oxygen release. On the fetal side, 2,3-DPG does not interfere with the affinity' of fetal hemoglobin for oxygen and thus the uptake of oxygen by fetal erythrocytes.", "explanation_word_count": 491, "prompt": "Fetal Hb shows high pO2 saturation compared to adult Hb because -\nA. Affinity' to binding to DPG is different in fetal Hb\nB. Right shift to Oxygen dissociation curve\nC. Acidic environment\nD. Cooperative binding\nReturn the correct option letter.", "reference": "Ans. is 'a' i.e., Affinity to binding to DPG is different in fetal Hb o Make it very clear in mind that higher affinity' of fetal hemoglobin for oxygen is due to low affinity of HbF for 2,3- DPG (not due to decreased 2, 3-DPG concentration). HbF does not combines to 2, 3-DPG as avidly as adult hemoglobin.\"Fetal hemoglobin is left - shifted because it has a low affinity' for DPG\", --Principles of medical physiology'\"It is worth noting that DPG does not combine with fetal hemoglobin. That is perhaps one reason why HbF has greater affin ity for oxygen than adult hemoglobin (HbF) \".-- Understanding of medical physiology\"Fetal hemoglobin binds less 2-3 DPG it has consequently a greater affinity for O2\" -- Pediatric physiologyo All other textbooks have mentioned the same thing.o So, high affinity of HbF to O2 is due to low affinity of HbF for 2,3 DPG (and not due to decreased 2,3-DPG concentration).Effect of 2-3 diphosphoglvcerete (2.3 PPG)o Another important factor which influences oxygen-hemoglobin dissociation curve is 2,3 DPG in RBC. DPG is an optional by-product of the glycolytic pathway. DPG binds with deoxygenated hemoglobin but not with oxygenated hemoglobin. Therefore raised DPG concentration releases oxygen from oxyhemoglobin by shifting the following reversible reaction to the right: -HbO2 + DPG - Hb - DPG + O2o One molecule of DPG binds with one mole of deoxyhemoglobin.o That is why in the presence of raised DPG concentration, less oxygen can combine with hemoglobin at a given PO2. Hence an increase in DPG concentration shifts the oxygen-hemoglobin dissociation curve to the right. Thus 2,3 DPG causes delivery (unloading) of O2 to the tissues.o Factors which increases 2,3 DPG level and therefore lower the oxygen affinity of hemoglobin (right shift of O2 dissociation curve and increased delivery of oxygen to tissues) are : -# Hypoxia# High altitude# Alkalosis# Exercise# Pregnancy# Anemia# Hormones (thyroid, GH, androgen)# Cyanotic congenital heart disease# Chemical agents (Inosine, Pyruvate, PEP, phosphate, dihydroxyacetone)o Factors which decrease 2,3 DPG levels and therefore increase oxygen a ffinity of hemoglobin (left shift of O2 dissociation curve and decreased delivery' of O2 to the tissues) are : - Stored blood, and fetal hemoglobin (HbF).o Fetal hemoglobin has considerably less afinity for 2,3 - DPG than does adult hemoglobin therefore fetal hemoglobin has greater affinity for oxygen than adult hemoglobin. In human blood, the affinity of fetal hemoglobin for 2,3-DPG is only about 40% that of adult hemoglobin. This makes fetal hemoglobin behave as if 2,3-DPG levels are low. Therefore, the oxygen dissociation curve is shifted to the left. Although fetal red cells do contain 2,3 DPG, the poor binding of 2,3-DPG by fetal hemoglobin is an important factor in facilitating transport of oxygen across the placenta from mother to fetus. On the maternal side of the placenta, the reduction of hemoglobin effectively shifts the curve to the right, increasing oxygen release. On the fetal side, 2,3-DPG does not interfere with the affinity' of fetal hemoglobin for oxygen and thus the uptake of oxygen by fetal erythrocytes.\nA", "question_key": "fetal hb shows high po2 saturation compared to adult hb because -", "split": "validation", "is_mia_member": false} | |
| {"id": "2ff1cede-b2a0-4b34-b126-37f3c5cbe028", "question": "A 16-year-old boy lost his sight in one eye after a fight. Under which section of IPC is grievous injury included?", "opa": "Section 319", "opb": "Section 320", "opc": "Section 324", "opd": "Section 326", "cop": 1, "answer": "B", "exp": "Grievous injury is included under section 320. The following kinds of hu only are designated as \"grievous\": ? Emasculation ? Permanent privation of the sight of either eye ? Permanent privation of the hearing of either ear ? Privation of any member or joint ? Destruction or permanent impairing of the powers of any member or joint ? Permanent disfiguration of the head or face ? Fracture or dislocation of a bone or tooth ? Any hu which endangers life or which causes the victim to be in severe bodily pain or unable to follow his ordinary pursuits for a period of 20 days.", "explanation_word_count": 94, "prompt": "A 16-year-old boy lost his sight in one eye after a fight. Under which section of IPC is grievous injury included?\nA. Section 319\nB. Section 320\nC. Section 324\nD. Section 326\nReturn the correct option letter.", "reference": "Grievous injury is included under section 320. The following kinds of hu only are designated as \"grievous\": ? Emasculation ? Permanent privation of the sight of either eye ? Permanent privation of the hearing of either ear ? Privation of any member or joint ? Destruction or permanent impairing of the powers of any member or joint ? Permanent disfiguration of the head or face ? Fracture or dislocation of a bone or tooth ? Any hu which endangers life or which causes the victim to be in severe bodily pain or unable to follow his ordinary pursuits for a period of 20 days.\nB", "question_key": "a 16-year-old boy lost his sight in one eye after a fight. under which section of ipc is grievous injury included?", "split": "validation", "is_mia_member": false} | |
| {"id": "80b765bf-58b1-467b-8503-18077dfd36cb", "question": "How to differentiate staphylococci and micrococci", "opa": "Catalase test", "opb": "Hugh and Leifson's oxidation-fermentation test", "opc": "Gram staining", "opd": "AFS", "cop": 1, "answer": "B", "exp": "Micrococci are gram-positive cocci which can be mistaken for S.aureus in culture but are larger and mostly in pairs, tetrads or irregular clusters. Micrococci is catalase and modified oxidase positive and oxidative in Hugh and Leifson's oxidation-fermentation test. Ref: Textbook of Ananthanarayan and paniker's; 10th Edition; Pg:209", "explanation_word_count": 48, "prompt": "How to differentiate staphylococci and micrococci\nA. Catalase test\nB. Hugh and Leifson's oxidation-fermentation test\nC. Gram staining\nD. AFS\nReturn the correct option letter.", "reference": "Micrococci are gram-positive cocci which can be mistaken for S.aureus in culture but are larger and mostly in pairs, tetrads or irregular clusters. Micrococci is catalase and modified oxidase positive and oxidative in Hugh and Leifson's oxidation-fermentation test. Ref: Textbook of Ananthanarayan and paniker's; 10th Edition; Pg:209\nB", "question_key": "how to differentiate staphylococci and micrococci", "split": "validation", "is_mia_member": false} | |
| {"id": "15ee4034-c6b1-4f2d-93c3-e9fa2d2ef70f", "question": "The longest acting local anesthetics -", "opa": "Bupivacaine", "opb": "Ropivacaine", "opc": "Dibucaine", "opd": "Tetracaine", "cop": 2, "answer": "C", "exp": "long acting ester local anesthetic -Benzocaine . tetracaine long acting amide local anesthetic- bupivacaine, ropivacaine , levobupivacaine , dibucaine overall longest acting local anesthetic- Dibucaine- Tetracaine- Bupivacaine", "explanation_word_count": 24, "prompt": "The longest acting local anesthetics -\nA. Bupivacaine\nB. Ropivacaine\nC. Dibucaine\nD. Tetracaine\nReturn the correct option letter.", "reference": "long acting ester local anesthetic -Benzocaine . tetracaine long acting amide local anesthetic- bupivacaine, ropivacaine , levobupivacaine , dibucaine overall longest acting local anesthetic- Dibucaine- Tetracaine- Bupivacaine\nC", "question_key": "the longest acting local anesthetics -", "split": "validation", "is_mia_member": false} | |
| {"id": "228a9c90-d6e9-4c90-ad11-b2c70b74d43b", "question": "Least soluble anaesthetic agent is", "opa": "Desflurane", "opb": "Sevoflurane", "opc": "Halothane", "opd": "Methoxyflurane", "cop": 0, "answer": "A", "exp": "Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, is a term used in pharmacology to describe the solubility of inhaled general anesthetics in blood. The coefficient is defined as the ratio of the concentration in blood to the concentration in gas that is in contact with that blood when the paial pressure in both compaments is equal. Newer anesthetics (such as desflurane) typically have smaller blood-gas paition coefficients than older ones (such as ether); these are preferred because they lead to faster onset of anesthesia and faster emergence from anesthesia once application of the anesthetic is stopped. If an anesthetic has a high coefficient, then a large amount of it will have to be taken up in the body's blood before being passed on to the fatty (lipid) tissues of the brain where it can exe its effect. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e", "explanation_word_count": 151, "prompt": "Least soluble anaesthetic agent is\nA. Desflurane\nB. Sevoflurane\nC. Halothane\nD. Methoxyflurane\nReturn the correct option letter.", "reference": "Blood-gas paition coefficient, also known as Ostwald coefficient for blood-gas, is a term used in pharmacology to describe the solubility of inhaled general anesthetics in blood. The coefficient is defined as the ratio of the concentration in blood to the concentration in gas that is in contact with that blood when the paial pressure in both compaments is equal. Newer anesthetics (such as desflurane) typically have smaller blood-gas paition coefficients than older ones (such as ether); these are preferred because they lead to faster onset of anesthesia and faster emergence from anesthesia once application of the anesthetic is stopped. If an anesthetic has a high coefficient, then a large amount of it will have to be taken up in the body's blood before being passed on to the fatty (lipid) tissues of the brain where it can exe its effect. Ref: Miller's anesthesia 8th edition Ref: Morgan & Mikhail's clinical anesthesiology 6e\nA", "question_key": "least soluble anaesthetic agent is", "split": "validation", "is_mia_member": false} | |
| {"id": "5306e15c-f63f-4363-adc6-09351ca05cd5", "question": "Which of the following aminoacids is a component of Thioredoxin reductase-", "opa": "Selenocysteine", "opb": "Cysteine", "opc": "Methionine", "opd": "Homocysteine", "cop": 0, "answer": "A", "exp": "Ans. is 'a' i.e., Selenocysteine* The 21st proteinogenic aminoacid is selenocysteine (It is represented as sec or as U).* Selenocysteine is a component of:# Thioredoxin reductase# 5' deiodinase# Glutathione peroxidase* Selenocysteine is coded by one of the stop codons UGA, if it is followed by selenocysteine insertion element in the 3' untranslated region of mRNA* tRNAsec (tRNA which is charged with selenocysteine) is first attached to serine by seryl tRNA synthetase or seryl tRNA ligase. But this tRNA is not identified by EF1A (the translation factor which attaches every aminoacyltRNA to A site of ribosome during chain elongation of protein synthesis).* Serine attached tRNAsec is converted into selenocysteine attached tRNAsec by selenocysteine synthetase (Pyridoxal phosphate dependent enzyme) and is guided by EFsec to A site of 60 s ribosome* Please note the 22nd aminoacid is pyrrolysine (represented as pyl or O) is also coded by amber codon UAG. It is not found in human proteins.", "explanation_word_count": 154, "prompt": "Which of the following aminoacids is a component of Thioredoxin reductase-\nA. Selenocysteine\nB. Cysteine\nC. Methionine\nD. Homocysteine\nReturn the correct option letter.", "reference": "Ans. is 'a' i.e., Selenocysteine* The 21st proteinogenic aminoacid is selenocysteine (It is represented as sec or as U).* Selenocysteine is a component of:# Thioredoxin reductase# 5' deiodinase# Glutathione peroxidase* Selenocysteine is coded by one of the stop codons UGA, if it is followed by selenocysteine insertion element in the 3' untranslated region of mRNA* tRNAsec (tRNA which is charged with selenocysteine) is first attached to serine by seryl tRNA synthetase or seryl tRNA ligase. But this tRNA is not identified by EF1A (the translation factor which attaches every aminoacyltRNA to A site of ribosome during chain elongation of protein synthesis).* Serine attached tRNAsec is converted into selenocysteine attached tRNAsec by selenocysteine synthetase (Pyridoxal phosphate dependent enzyme) and is guided by EFsec to A site of 60 s ribosome* Please note the 22nd aminoacid is pyrrolysine (represented as pyl or O) is also coded by amber codon UAG. It is not found in human proteins.\nA", "question_key": "which of the following aminoacids is a component of thioredoxin reductase-", "split": "validation", "is_mia_member": false} | |