126 gas bloat syndrome is acomplication of nissen fundoplication
127 commest graft used for cabg=long saphenous vein
128 giant cell reparative granuloma of jaw is treated by curretage
129 commonest cause of esophageal perforation is iatrogenic
130 chromic cat gut is delayed absorbable synthethic suture material
131. All are primary causes of nephrotic syndrome in infants younger than one year, EXCEPT
A. Congenital nephrotic syndrome
B. Minimal change disease
C. Membranous nephropathy.
D. Systemic lupus erythematosus
Ans d
. Congenital nephrotic syndrome is defined as nephrotic syndrome manifesting at birth or within the first 3 mo of life. Congenital nephrotic syndrome may be classified as primary or as secondary to a number of etiologies such as in-utero infections (cytomegalovirus, toxoplasmosis, syphilis, hepatitis B and C, HIV), infantile systemic lupus erythematosus, or mercury exposure.
132. Regarding Reye syndrome, all of the following statements are TRUE, EXCEPT
A. The white liver disease and encephalopathy with fatty degeneration of the viscera are its other nomenclatures
B.Sporadic Reye syndrome can occur in the context of varicella or influenza B virus infection
C. The condition is usually observed in children below 3 years of age
D. Mitochondrial dysfunction of fatty acid oxidation is significant
Ans c
Reye syndrome is most often seen in children ages 4 - 12. Most cases that occur with chickenpox are in children ages 5 - 9
Reye syndrome typically occurs after a viral illness, particularly an upper respiratory tract infection, influenza, varicella, or gastroenteritis, and is associated with the use of aspirin during the illness. A dramatic decrease in the use of aspirin among children, in combination with the identification of medication reactions, toxins, and inborn errors of metabolism (IEMs) that present with Reye syndrome–like manifestations, have made the diagnosis of Reye syndrome exceedingly rar
he pathogenesis of Reye syndrome, while not precisely elucidated, appears to involve mitochondrial injury resulting in dysfunction that inhibits oxidative phosphorylation and fatty-acid beta-oxidation in a virus-infected, sensitized host. The host has usually been exposed to mitochondrial toxins, most commonly salicylates (>80% of cases).
133. Hemorrhagic cystitis is a dreaded complication associated with use of
A. Clobazam
B. Cyclosporin
C. Cycloserine
D. Cyclophosphamide
Ans d
134. An 18 month old boy presents with prominent eyeballs and periorbital ecchymosis and an enlarging swelling on the left upper abdomen. He is markedly pale. A large left sided mass distinct from the spleen was palpable. The most likely diagnosis is
A. Wilm's tumor
B. Osteopetrosis
C. Neuroblastoma
D. Gauchers Disease
Ans C
Wilms' tumor occurs in children up to about age 8. About 75 percent of cases occur before age 5, and the average age of children with Wilms' tumor is 2 - 3 years
Neuroblastoma is typically diagnosed in babies or young children. The average age for neuroblastoma is about 18 months of age
The characteristic “raccoon eyes” appearance associated with neuroblastoma and metastasis to the skull is probably related to obstruction of the palpebral vessels (branches of the ophthalmic and facial vessels) by tumor tissue in and around the orbits
135. One of the following intrauterine infections has characteristically the following triad of chorioretinitis, microcephaly and intraceiebral calcifications.
A. Cytomegalovirus
B. Toxoplasmosis ,
C. Rubella
D. Herpes simplex
Ans A
In congenital CMV infections, over 90% of the newborns are asymptomatic at the time of birth but the consequences of in utero CMV infection such as hearing loss will show up as the infant gets older. The most morphological abnormalities is microcephaly and periventricular calcification. Death that occurs shortly after birth tends to be resulted from hepatic failure. CMV infections due to primary infections produce more severe damage than those resulted from reactivation of latent infection.
136. A 5 year old girl has 3 months history of joint pains and morning stiffness. Knees and ankles are involved with mild swelling and tenderness. Slit lamp examination reveals IRIDOCYCLITIS. The diagnosis is
A. Juvenile Rheumatoid Arthritis (JRA)
B. Systemic Lupus Erythematosus (SLE)
C. Henoch — Schonlein Purpura (HSP)
D. Rheumatic Arthritis
Ans A
137. A 7 year old/ boy has short stature, large skull, prominent forehead, saddle shaped nose, exaggerated lordosis and normal intelligence and development, the diagnosis is
A. Noonan syndrome
B. Hypopituitarism
C. Isolated Growth Hormone V Deficiency
D. Achondroplasia
Ans D
138. Immediately after birth, the preventable causes of mental retardation include all of the following, EXCEPT
A. Hypothyroidism
B. Phenylketonuria.
C. Kernicterus
D. Hurlers disease
Ans c
139. Which of the following is associated with large anterior fontanel ?
A. Achondroplasia
B. Apert syndrome
C. Cleidocranial Dysostosis
D. All of the above
Ans D
Apert's syndrome (craniosynostosis, proptosis, hypertension)
140. An aggressive looking, thin and tall adolescent boy aged 15 years is noted to have prominent long limbs and small testes. What is the most relevant investigation ?
A. Hormonal assays
B. Chromosomal analysis
C. Skeletal survey
D. Ultrasound evaluation
Ans b
141. Relative humidity of alveolar air is
A. 50%
B. 30%
C. 75%
D. 100%
Ans D
In the nose, warmed air reaches 32°C with humidification of 80 to 90%. At the carina, temperature is elevated to 37°C with humidity of 100%. The same air breathed through the mouth reaches temperatures of 22°C with relative humidity of 60 %. Heating and humidification occur through the mucosa of the trachebroncheal tree. Alveolar air has a temperature of 37°C and the humidity is 100%. At this point the air contains 44 mg water/litre gas. In normal climatological conditions the breathed air contains less then 44 mg water/litre gas. Air at room temperature of 22°C with 50% humidity contains 10 mg water/litre of gas.
142. Emergence reactions is found with
A. propofol
B. sevoflurane
C. ketamine -
D. thiopental
Ans C
143. The following are signs and ymptoms of local anaesthetic toxicity EXCEPT
A. Perioral tingling
B. Convulsions
C. Arrhythmia
D. Diarrhoea
Ans D
Toxicity
Local anaesthetic toxicity starts with perioral tingling and paraesthesiae, progressing to drowsiness, seizures, coma and cardiorespiratory arres
Localized
A cause of local toxicity is allergic reaction to para-aminobenzoic acid (PABA). These reactions range from urticaria to anaphylaxis.
PABA is a metabolic product of the degradation of Ester class of local anesthetics, such as procaine (Novocaine), benzocaine, and, to a lesser degree, amide class anesthetics such as lidocaine, and prilocaine. It is also a metabolic by-product of pramod methylparaben, a preservative in multi-dose vials of lidocaine. When allergic response to injected anesthetics does occur, it is most likely due to the ester class local anesthetics. The amide class of local anesthetics is far less likely to produce allergic reaction.[2][3]
Use of topical anesthetics for relief of eye pain can result in severe corneal damage. See abuse of anesthetics for ocular pain relief page.
[edit]Systemic
Systemic toxicity of local anesthetics can be described by the direct effects on the immune system, blood (hematologic), central nervous system, and cardiovascular system.
Immune system
As noted previously, allergic reaction to metabolic break-down of anesthetic agents and preservatives (PABA) can cause anaphylaxis.
Hematologic
Methemoglobinemia is a process where iron in hemoglobin is altered, reducing its oxygen-carrying capability, which produces cyanosis and symptoms of hypoxia. Benzocaine, lidocaine, and prilocaine all produce this effect, especially benzocaine.[2]
Central Nervous System
Systemic toxic reactions to locally administered anesthetics are progressive as the level of the anesthetic agent in the blood rises. Initial symptoms suggest some form of central nervous system excitation such as a ringing in the ears (tinnitus), a metallic taste in the mouth, or tingling or numbness of the mouth. Advanced symptoms include motor twitching in the periphery followed by grand mal seizures, coma, and eventually respiratory arrest.[4]
Cardiovascular
Cardiovascular effects are primarily those of direct myocardial depression and bradycardia, which may lead to cardiovascular collapse.[1] At extremely high levels, cardiac arrhythmia or hypotension and cardiovascular collapse occu
144. One bar equals
A. 15 psi
B. 100 cm water
C. 30 psi
D. 100 mm Hg
Ans A
Bar is a measure of pressure. 1bar = approx 14.5 psi, this equates to the average atmospheric pressure at sea level.
145. One of the following drugs is used commonly in the prophylaxis of tuberculous infection
A. Rifampicin
B. lsoniazid
C. Ciprofloxacin
D. Pyrazinamide
Ans b
146. In tuberculosis, for sputum to be positive for AFB, the number of the bacilli should
be at least ------ organisms per ml of sputum.
A. 100
B. 1,000
C. 10,000
D. 100,000
Ans C
It has been recommended that a minimum of 100 high-power fields of microscope should be examined for maximum yield5,6. A minimum of 10 acid fast bacilli (AFB) per 100 fields is taken as the threshold for considering a result as positive,
Sputum microscopy is likely to be positive when there are at least 10,000 organisms per milliliter of sputum
147. Most common cause of hemothorax is
A. trauma
B. iatrogenic injury
C. pleural malignancy
D. postoperative haemorrhage
Ans A
148. Hypercalcemia in sarcoidosis is the result of
A. decreased renal excretion of calcium
B. increased serum parathyroid hormone production
C. increased production of 1,25-dihydroxyvitamin D
D. increased production of /25-dihydroxyvitamin D
Ans C
Hypercalcemia in sarcoidosis is the result of elevated levels of 1-25 hydroxyvitamin D that comes from the conversion of 25 hydroxyvit- amin D by these granuloma
149. In the pathogenesis of sycosis barbae the most commonly involved organism is
A. Bacteria
B. Fungi
C. Ingrown hair
D. Virus
Ans A
Sycosis vulgaris (also known as "Barber's itch," and "Sycosis barbae") is a cutaneous condition characterized by a chronic infection of the chin or bearded region.[1]:252[2] The irritation is caused by a deep infection of hair follicles, often by species of Staphylococcus or Propionibacterium bacteria. [3] Asymptomatic or painful and tender erythematous papules and pustules may form around coarse hairs in the beard (sycosis barbae) or the back of the neck (sycosis nuchae)
150. On Wood's lamp examination of tinea versicolor fluorescence seen is
A. golden yellow
B. green
C. coral red
D. pink
Ans A
A golden yellow fluorescence shows Tinea versicolor infection, a bright yellowish green color indicates Trichophyton schoenleini infection, a Pink or Pinkish orange fluorescence shows infection by Porphyries Cutanea Tarda, a pale green color indicates Trichophyton Schoenleini infection, an aqua green or blue fluorescence indicates infection by the bacteria Pseudomonas aeruginosa, a bright yellowish green fluorescence shows infection by Microsporum canis, a bluish white color indicates leprosy, a pale white color indicates hypo pigmentation, a purplish brown fluorescence shows hyper pigmentation, a bright white color shows albinism, presence of ash leaf shaped patches shows tuberous sclerosis
127 commest graft used for cabg=long saphenous vein
128 giant cell reparative granuloma of jaw is treated by curretage
129 commonest cause of esophageal perforation is iatrogenic
130 chromic cat gut is delayed absorbable synthethic suture material
131. All are primary causes of nephrotic syndrome in infants younger than one year, EXCEPT
A. Congenital nephrotic syndrome
B. Minimal change disease
C. Membranous nephropathy.
D. Systemic lupus erythematosus
Ans d
. Congenital nephrotic syndrome is defined as nephrotic syndrome manifesting at birth or within the first 3 mo of life. Congenital nephrotic syndrome may be classified as primary or as secondary to a number of etiologies such as in-utero infections (cytomegalovirus, toxoplasmosis, syphilis, hepatitis B and C, HIV), infantile systemic lupus erythematosus, or mercury exposure.
132. Regarding Reye syndrome, all of the following statements are TRUE, EXCEPT
A. The white liver disease and encephalopathy with fatty degeneration of the viscera are its other nomenclatures
B.Sporadic Reye syndrome can occur in the context of varicella or influenza B virus infection
C. The condition is usually observed in children below 3 years of age
D. Mitochondrial dysfunction of fatty acid oxidation is significant
Ans c
Reye syndrome is most often seen in children ages 4 - 12. Most cases that occur with chickenpox are in children ages 5 - 9
Reye syndrome typically occurs after a viral illness, particularly an upper respiratory tract infection, influenza, varicella, or gastroenteritis, and is associated with the use of aspirin during the illness. A dramatic decrease in the use of aspirin among children, in combination with the identification of medication reactions, toxins, and inborn errors of metabolism (IEMs) that present with Reye syndrome–like manifestations, have made the diagnosis of Reye syndrome exceedingly rar
he pathogenesis of Reye syndrome, while not precisely elucidated, appears to involve mitochondrial injury resulting in dysfunction that inhibits oxidative phosphorylation and fatty-acid beta-oxidation in a virus-infected, sensitized host. The host has usually been exposed to mitochondrial toxins, most commonly salicylates (>80% of cases).
133. Hemorrhagic cystitis is a dreaded complication associated with use of
A. Clobazam
B. Cyclosporin
C. Cycloserine
D. Cyclophosphamide
Ans d
134. An 18 month old boy presents with prominent eyeballs and periorbital ecchymosis and an enlarging swelling on the left upper abdomen. He is markedly pale. A large left sided mass distinct from the spleen was palpable. The most likely diagnosis is
A. Wilm's tumor
B. Osteopetrosis
C. Neuroblastoma
D. Gauchers Disease
Ans C
Wilms' tumor occurs in children up to about age 8. About 75 percent of cases occur before age 5, and the average age of children with Wilms' tumor is 2 - 3 years
Neuroblastoma is typically diagnosed in babies or young children. The average age for neuroblastoma is about 18 months of age
The characteristic “raccoon eyes” appearance associated with neuroblastoma and metastasis to the skull is probably related to obstruction of the palpebral vessels (branches of the ophthalmic and facial vessels) by tumor tissue in and around the orbits
135. One of the following intrauterine infections has characteristically the following triad of chorioretinitis, microcephaly and intraceiebral calcifications.
A. Cytomegalovirus
B. Toxoplasmosis ,
C. Rubella
D. Herpes simplex
Ans A
In congenital CMV infections, over 90% of the newborns are asymptomatic at the time of birth but the consequences of in utero CMV infection such as hearing loss will show up as the infant gets older. The most morphological abnormalities is microcephaly and periventricular calcification. Death that occurs shortly after birth tends to be resulted from hepatic failure. CMV infections due to primary infections produce more severe damage than those resulted from reactivation of latent infection.
136. A 5 year old girl has 3 months history of joint pains and morning stiffness. Knees and ankles are involved with mild swelling and tenderness. Slit lamp examination reveals IRIDOCYCLITIS. The diagnosis is
A. Juvenile Rheumatoid Arthritis (JRA)
B. Systemic Lupus Erythematosus (SLE)
C. Henoch — Schonlein Purpura (HSP)
D. Rheumatic Arthritis
Ans A
137. A 7 year old/ boy has short stature, large skull, prominent forehead, saddle shaped nose, exaggerated lordosis and normal intelligence and development, the diagnosis is
A. Noonan syndrome
B. Hypopituitarism
C. Isolated Growth Hormone V Deficiency
D. Achondroplasia
Ans D
138. Immediately after birth, the preventable causes of mental retardation include all of the following, EXCEPT
A. Hypothyroidism
B. Phenylketonuria.
C. Kernicterus
D. Hurlers disease
Ans c
139. Which of the following is associated with large anterior fontanel ?
A. Achondroplasia
B. Apert syndrome
C. Cleidocranial Dysostosis
D. All of the above
Ans D
Apert's syndrome (craniosynostosis, proptosis, hypertension)
140. An aggressive looking, thin and tall adolescent boy aged 15 years is noted to have prominent long limbs and small testes. What is the most relevant investigation ?
A. Hormonal assays
B. Chromosomal analysis
C. Skeletal survey
D. Ultrasound evaluation
Ans b
141. Relative humidity of alveolar air is
A. 50%
B. 30%
C. 75%
D. 100%
Ans D
In the nose, warmed air reaches 32°C with humidification of 80 to 90%. At the carina, temperature is elevated to 37°C with humidity of 100%. The same air breathed through the mouth reaches temperatures of 22°C with relative humidity of 60 %. Heating and humidification occur through the mucosa of the trachebroncheal tree. Alveolar air has a temperature of 37°C and the humidity is 100%. At this point the air contains 44 mg water/litre gas. In normal climatological conditions the breathed air contains less then 44 mg water/litre gas. Air at room temperature of 22°C with 50% humidity contains 10 mg water/litre of gas.
142. Emergence reactions is found with
A. propofol
B. sevoflurane
C. ketamine -
D. thiopental
Ans C
143. The following are signs and ymptoms of local anaesthetic toxicity EXCEPT
A. Perioral tingling
B. Convulsions
C. Arrhythmia
D. Diarrhoea
Ans D
Toxicity
Local anaesthetic toxicity starts with perioral tingling and paraesthesiae, progressing to drowsiness, seizures, coma and cardiorespiratory arres
Localized
A cause of local toxicity is allergic reaction to para-aminobenzoic acid (PABA). These reactions range from urticaria to anaphylaxis.
PABA is a metabolic product of the degradation of Ester class of local anesthetics, such as procaine (Novocaine), benzocaine, and, to a lesser degree, amide class anesthetics such as lidocaine, and prilocaine. It is also a metabolic by-product of pramod methylparaben, a preservative in multi-dose vials of lidocaine. When allergic response to injected anesthetics does occur, it is most likely due to the ester class local anesthetics. The amide class of local anesthetics is far less likely to produce allergic reaction.[2][3]
Use of topical anesthetics for relief of eye pain can result in severe corneal damage. See abuse of anesthetics for ocular pain relief page.
[edit]Systemic
Systemic toxicity of local anesthetics can be described by the direct effects on the immune system, blood (hematologic), central nervous system, and cardiovascular system.
Immune system
As noted previously, allergic reaction to metabolic break-down of anesthetic agents and preservatives (PABA) can cause anaphylaxis.
Hematologic
Methemoglobinemia is a process where iron in hemoglobin is altered, reducing its oxygen-carrying capability, which produces cyanosis and symptoms of hypoxia. Benzocaine, lidocaine, and prilocaine all produce this effect, especially benzocaine.[2]
Central Nervous System
Systemic toxic reactions to locally administered anesthetics are progressive as the level of the anesthetic agent in the blood rises. Initial symptoms suggest some form of central nervous system excitation such as a ringing in the ears (tinnitus), a metallic taste in the mouth, or tingling or numbness of the mouth. Advanced symptoms include motor twitching in the periphery followed by grand mal seizures, coma, and eventually respiratory arrest.[4]
Cardiovascular
Cardiovascular effects are primarily those of direct myocardial depression and bradycardia, which may lead to cardiovascular collapse.[1] At extremely high levels, cardiac arrhythmia or hypotension and cardiovascular collapse occu
144. One bar equals
A. 15 psi
B. 100 cm water
C. 30 psi
D. 100 mm Hg
Ans A
Bar is a measure of pressure. 1bar = approx 14.5 psi, this equates to the average atmospheric pressure at sea level.
145. One of the following drugs is used commonly in the prophylaxis of tuberculous infection
A. Rifampicin
B. lsoniazid
C. Ciprofloxacin
D. Pyrazinamide
Ans b
146. In tuberculosis, for sputum to be positive for AFB, the number of the bacilli should
be at least ------ organisms per ml of sputum.
A. 100
B. 1,000
C. 10,000
D. 100,000
Ans C
It has been recommended that a minimum of 100 high-power fields of microscope should be examined for maximum yield5,6. A minimum of 10 acid fast bacilli (AFB) per 100 fields is taken as the threshold for considering a result as positive,
Sputum microscopy is likely to be positive when there are at least 10,000 organisms per milliliter of sputum
147. Most common cause of hemothorax is
A. trauma
B. iatrogenic injury
C. pleural malignancy
D. postoperative haemorrhage
Ans A
148. Hypercalcemia in sarcoidosis is the result of
A. decreased renal excretion of calcium
B. increased serum parathyroid hormone production
C. increased production of 1,25-dihydroxyvitamin D
D. increased production of /25-dihydroxyvitamin D
Ans C
Hypercalcemia in sarcoidosis is the result of elevated levels of 1-25 hydroxyvitamin D that comes from the conversion of 25 hydroxyvit- amin D by these granuloma
149. In the pathogenesis of sycosis barbae the most commonly involved organism is
A. Bacteria
B. Fungi
C. Ingrown hair
D. Virus
Ans A
Sycosis vulgaris (also known as "Barber's itch," and "Sycosis barbae") is a cutaneous condition characterized by a chronic infection of the chin or bearded region.[1]:252[2] The irritation is caused by a deep infection of hair follicles, often by species of Staphylococcus or Propionibacterium bacteria. [3] Asymptomatic or painful and tender erythematous papules and pustules may form around coarse hairs in the beard (sycosis barbae) or the back of the neck (sycosis nuchae)
150. On Wood's lamp examination of tinea versicolor fluorescence seen is
A. golden yellow
B. green
C. coral red
D. pink
Ans A
A golden yellow fluorescence shows Tinea versicolor infection, a bright yellowish green color indicates Trichophyton schoenleini infection, a Pink or Pinkish orange fluorescence shows infection by Porphyries Cutanea Tarda, a pale green color indicates Trichophyton Schoenleini infection, an aqua green or blue fluorescence indicates infection by the bacteria Pseudomonas aeruginosa, a bright yellowish green fluorescence shows infection by Microsporum canis, a bluish white color indicates leprosy, a pale white color indicates hypo pigmentation, a purplish brown fluorescence shows hyper pigmentation, a bright white color shows albinism, presence of ash leaf shaped patches shows tuberous sclerosis
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