Patient during surgery tr fused with blood… she develops high grade fever,

Một phần của tài liệu MediCall book series (Trang 574 - 600)

 Graft versus host reaction

 Febrile non hemolytic reaction

 Anaphylactic shock

 Bacterial contaminated blood

Severe sepsis plus refractory hypotension (refractory to fluid resuscitation) is consistent with septic shock

4. Breast lies in

 deep facia

 superficial pectoral fascia

The superficial fascia has two layers, a fatty layer (Camper"s fascia) .A superficial pectoral fascia envelops the breast the undersurface of the breast lies on the deep pectoral fascia.

 thoracic facia

 pectoral fascia

5. Inheritance pattern of polycystic kidney disease

 Autosomal dominant

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by the growth of numerous cysts in the kidneys. ... About 90 percent of all cases of

polycystic kidney disease (PKD) are inherited in an autosomal dominant fashion. ADPKD is caused by mutations in the PKD1 and PKD2 gene

 autosomal recessive

 X kinked recessive

 X kinked dominant

6. Hypercalcemia is seen in which malignancy

 BCC

 SCC

Humoral hypercalcemia of malignancy (HHM) is one of the most common metabolic complications associated with cancer. A retrospective study of hypercalcemia in patients with squamous cell carcinoma of the oral cavity was undertaken.

 choreoCA

 hamartoma

7. Female have labia majora and minora infection

 .Greater vestibular gland

The Bartholin"s glands (also calledBartholin glands or greater vestibular glands) are two pea sized compound racemose glands located slightly posterior and to the left and right of the opening of the vagina. They secrete mucus to lubricate the vaginaand are homologous to bulbourethral glands in males.

 lesser vestibular gland

 bartholin gland

 vulval gland

8. Active Programmed cell death is called

 necrosis

 Apoptosis

If cells are no longer needed, they commit suicide by activating an intracellular death program. This process is therefore called programmed cell death, although it is more

commonly called apoptosis (from a Greek word meaning “falling off,” as leaves from a tree).

 atrophy

 hypoplasia

9. Major source of urea is

 nitrogeneous bases

 nucleic acid

 cell membrane

 ammonia

Urea is naturally produced when the liver breaks down protein or amino acids, and ammonia. The kidneys then tr fer the urea from the blood to the urine. Extra nitrogen is expelled from the body through urea, and because it is extremely soluble, it is a very efficient process.

10. which of two bronchi is longer. Left bronchi as compared to right bronchi?

 short than right

 less sharp

 more vertical

 longer than right

The right main bronchus is wider, shorter, and more vertical than the left main bronchus. It enters the right lung at approximately the fifth thoracic vertebra. ... The left main bronchus is smaller in caliber but longer than the right, being 5 cm long.

11. Posterolateral of thyroid is

 carotid artery

 carotid sinus

 .carotid sheath

Psterolateral to thyroid is carotid sheath. The four major structures contained in the carotid sheath are: the commoncarotid artery as well as the internalcarotid artery (medial) internal jugular vein (lateral) the vagus nerve (CN X) (posterior) the deep cervical lymph nodes.

 carotid body

12. During last trimestr endometruim is sensitive to

 progesterone

 LH

 Prolactin

 Oxytocin

Blood samples were drawn during the first trimester and third trimester of pregnancy and at 8 weeks postpartum. ... Parity was the main predictor of oxytocin levels in the thirdtrimester of pregnancy and ofoxytocin level changes from the first to the third trimester of pregnancy.

13. Pancreatic head CA compress which structure

 common bile duct

Carcinoma of the head of the pancreas leads to jaundice caused by biliary obstruction. The gallbladder is usually distended (Courvoisier sign). Carcinomas of the body and tail are accompanied by severe pain resulting from retroperitoneal invasion and infiltration of the celiac ganglia and splanchnic nerves

 bile duct

 dudenum

 ileum

14. .Respiratory acidosis is associated with

 CO2 wash out

 CO2 retention

Respiratory acidosis is a condition that occurs when the lungs can"t remove enough of the carbon dioxide (CO2) produced by the body. Excess CO2 causes the pH of blood and other bodily fluids to decrease, making them too acidic. ... This is also called respiratory failure or ventilatory failure.

 dirrohea

 hyperventilation

15. Diatbetic patient with wound infection, fruity odour and greenish discharge, causative organism is

 strep pyogenase

 Actinomycetes

 staph epidermis

 Pseudomonas

Pseudomonas skin infections include: Puncture wounds of the foot. These can frequently become infected with Pseudomonas species and the patient will present with drainage with a sweet, fruity-smelling discharge. ... Colonisation with Pseudomonas is recognised by malodorous greenish superficial crust.

16. .Natural occuring opiods...

 Morphine and codein

Morphine and codeine are all-natural opioids, made by the opium poppy. Opioids are psychoactive chemicals that occur naturally.

 endomethacin

 aspirin

 Tramadal

17. Third degree AV block on ECG

 mobitz type 1

 mobitz type 2

 complete heart block

Third-degree atrioventricular block (AV block), also known as complete heart block, is a medical condition in which the nerve impulse generated in the sinoatrial node (SA node) in the atrium of the heart does not propagate to the ventricles.

 2nd degree block

18. Circumflex artery supplies blood to

 left atrium and left ventricle

The circumflex artery branches off of the left coronary artery and supplies most of the left atrium: the posterior and lateral free walls of the left ventricle, and part of the anterior papillary muscle. The circumflex artery may give off a variable number of left marginal branches to supply the left ventricle

 left atrium

 left ventricle

 right atrium

19. To diagnose asthma ratio used is

 V/Q

 Q/V

 FEC/FEV

 FEV1/FEC

FEV1/FVC ratio of less than 70% increases the probability of asthma in an elderly patient with asthma symptoms. To diagnose asthma: Having a lowFEV1 and low FEV1/FVC me that the air has a hard time leaving the lungs, which indicates airway obstruction. Obstructive lung diseases include asthma and COPD (chronic obstructive pulmonary disease)

20. Cell of gray matter wth short cytoplasmic process.

 protoplasmic astrocytes

Unlike fibrous astrocytes, protoplasmic astrocytes occur in the gray matter of the central nervous system. They have fewer fibrils within their cytoplasm, and cytoplasmic organelles are sparse, so that the somata are shaped by surrounding neurons and fibres.

 oligodendrocytes

 shwan cells

 axon

21. Fracture followed by swelling then regress which change is it

 metaplasia

Metaplasia (Greek: "change in form") is the reversible tr formation of one differentiated cell type to another differentiated cell type. The change from one type of cell to another may be part of a normal maturation process, or caused by some sort of abnormal stimulus.

 atrophy

 dysplasia

 hypertrophy

22. Long acting local anaesthetics are

 prilocaine

 lidocain

 Bupivicaine and adrenaline

In general, LAs can be divided into three categories: short acting (e.g., 2-chloroprocaine, 45- 90 minutes), intermediate duration (e.g., lidocaine, mepivacaine, 90-180 minutes), and long acting (e.g., bupivacaine, levobupivacaine, ropivacaine, 4-18 hours

 ropivacain

23. HIV infected patients can be affected by

 candida

 Pneumocystis carini

Pneumocystis jirovecii (previously P. carinii) is a yeast-like fungus of the genus

Pneumocystis. The causative organism of Pneumocystis pneumonia, it is an important human pathogen, particularly among immunocompromised hosts.

 staph aureus

 Pseudomonas

24. Aspirin mechanism of action

 inhibits COX 1

 inhibits COX 2

 activate phospholipase A2

 Irreversible inactivation of Cylooxygenase

Aspirin"s ability to suppress the production of prostaglandins and thromboxanes is due to its irreversible inactivation of the cyclooxygenase (COX) enzyme. Cyclooxygenase is required for prostaglandin and thromboxane synthesis.

25. Stroke volume is greater in

 CHF

 normal

 pregnant

 Atheletes

The resting stroke volume of an athlete is greater than that of a sedentary individual because of hypertrophy of the cardiac muscle in the athlete, which results in an increase in contractility and an increase in venous tone that lead to more blood being returned to the heart.

26. Predominant kidney buffer is

 HCO

 NH4OH

 proteins

 Phosphate

Excretion of acid (or generation of bicarbonate) by the kidneys is necessary for acid-base homeostasis.Phosphate is the most predominant urine buffer,its urinary excretion increases with acidosis

27. Function of tibialis anterior and posterior

 extend

 abduction

 dorxiflex & invert foot

The tibialis posterior has a major role in supporting the medial arch of the foot. Dysfunction of the tibialis posterior, including rupture of the tibialis posterior tendon, can lead to flat feet in adults, as well as a valgus deformity due to unopposed eversion when inversion is lost. The tibialis anterior is a muscle in hum that originates in the upper two-thirds of the lateral (outside) surface of the tibia and inserts into the medial cuneiform and first

metatarsal bones of the foot. It acts to dorsiflex and invert the foot.

 evert foot

28. Laboratory tests used to determine the cause of splinter hemorrhages include:

 Complete blood count

If your doctor suspects infective endocarditis, your blood will be tested for bacteria. A complete blood count (CBC) may also be used to check for anemia. A shortage of red blood

cells can occur with infective endocarditis. Your doctor may order an echocardiogram, or an ultrasound of the heart

 IgM

 CBC

 ELIZA

29. Characteristic of right ventricle.

 thick wall

 more pressure

 pulmonary trunk

Excretion of acid (or generation of bicarbonate) by the kidneys is necessary for acid-base homeostasis. … Phosphate is the most predominant urine buffer, its urinary excretion increases with acidosis

 more flow

30. Propylthyouracil inhibit

 methyalase

 reductase

 oxidase

 Iodide

Propylthiouracil (PTU), carbimazole, and thiamazole (methimazole) (an active metabolite of carbimazole) are drugs with antithyroid (thyrostatic) activity. They inhibit the synthesis of T3 and T4 by blocking the organification of iodine and the coupling of iodothyronine residues.

31. Diphylobothrum latum cause

 iron deficiency anemia

 sideroblastic anemia

 megalobastic anemia

In a small number of cases, this leads to severe vitamin B12 deficiency due to the parasite absorbing 80% or more of the host’s B12 intake, and a megaloblastic anemia

indistinguishable from pernicious anemia.[9] The anemia can also lead to subtle

demyelinative neurological symptoms (subacute combined degeneration of spinal cord).

Infection for many years is ordinarily required to deplete the human body of vitamin B-12 to the point that neurological symptoms appear.

 Aplastic anemia

32. Antibiotic associated diarhea cause which vitamin deficiency

 B1

 B2

 Vitamin K

Vitamin K deficiency is an important cause of acquired bleeding diathesis in neonates and infants and its deficiency does not develop in healthy infants receiving a normal diet.

However, in the presence of diarrhea and/or antibiotic usage leading to suppression of intestinal bacteria, and consequently VKD may occur.

 vit D

33. In hospitalized patients Parenteral administeration of nutrition cause which complication

 Hyperglycemia

Hyperglycemia is a frequent complication of enteral and parenteral nutrition in hospitalized patients. Extensive evidence from observational studies indicates that the development of hyperglycemia during parenteral and enteral nutrition is associated with an increased risk of death and infectious complications.

 hyponatremia

 hypercalcemia

 hypertension

34. 5 years after gastrectomy which complication occurs

 folate deficiency

 iron deficiency

 Vitamin B12 deficiency

Complications of post-gastrectomy syndrome include anemia as a result of vitamin B12 or iron malabsorption and osteoporosis. These problems generally occur months or even years after gastric surgery. ... In either case, that absence of intrinsic factor leads to the poor absorption of vitamin B12

 Thalasemia

35. In down syndrome what is genetic abnormality in this syndrome

 .trisomy 21

Down syndrome (DS or DNS), also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is typically associated with physical growth delays, characteristic facial features, and mild to moderate intellectual disability.

 trisomy 18

 trisomy 22

 trisomy 13

36. which Mutation in gene cause colon cancer

 ROS

 KRAS

A number of clinical trials have shown that KRAS mutations of colorectal cancer (CRC) can predict a lack of responses to anti-epidermal growth factor receptor–based therapy. ... KRAS mutation causes a marked decrease in aspartate level and an increase in asparagine level in CRC.

 ACE

 NHPPC

37. cartilage is covered by

 epichondrium

 perichondrium

 endochondrium

 perichondrium

The perichondrium (from Greek περί (peri "around") and χόνδρος (chondros "cartilage")) is a layer of dense irregular connective tissue that surrounds the cartilage of developing bone.

It consists of two separate layers: an outer fibrous layer and inner chondrogenic layer.

38. Bicep reflex lost ,which spinal nerves are involved

 C5 C6

Biceps reflex is a reflex test that examines the function of the C5 reflex arc and the C6 reflex arc.[1] The test is performed by using a tendon hammer to quickly depress the biceps brachii tendon[2] as it passes through the cubital fossa. Specifically, the test activates the stretch receptors inside the biceps brachii muscle which communicates mainly with the C5 spinal nerve and partially with the C6 spinal nerve to induce a reflex contraction of the biceps muscle and jerk of the forearm. A change to the biceps reflex indicates pathology at the level of musculocutaneous nerve, segment C5/6 or at some point above it in the spinal cord or brain.

 C5

 C6

 C6 & C7

39. Terminal branch of facial artery

 angular artery.

The angular artery is the terminal part of the facial artery, it ascends to the medial angle of the eye"s orbit, imbedded in the fibers of the angular head of the Quadratus labii superioris, and accompanied by the angular vein.

 buccal

 auriculotemporal

 mandibular

40. Rupture of middle meningeal artery with intact meninges occurs in

 sub Arachnoid

 sudural hematoma

 intracrnial hematoma

 Epidural Haemorrhage

It is vulnerable to injury at this point, where the skull is thin. Rupture of the artery may give rise to an epidural hematoma. In the dry cranium, the middle meningeal, which runs within the dura mater surrounding the brain, makes a deep indention in the calvarium.

41. Child with consation and absence of ganglion

 atonic colon

 Hirschsprung Disease

Hirschsprung disease is a congenital disease where the large intestine does not have nerve cells needed to expel stools (feces) normally from the body. About one in 5000 newborns have Hirschsprung disease. Symptoms in newborns include: No bowel movement within 48 hours after birth.

 dudenal atresia

 Hypertrophic outlet

42. herpes zoster opthalmicus VZV is present in which nerve

 Opthalmic nerve

Herpes zoster ophthalmicus (HZO) and also known as ophthalmic zoster is a disease characterised by reactivation of dormant varicella zoster virus residing within the

ophthalmic nerve (the first division of the trigeminal nerve). This condition is an important subtype of shingles, representing 15% of all cases.

 maxillary

 fascial

 Trigeminal

43. Pseudomembranous colitis is caused by

 Pseudomonas

 staph aureus

 Clostridium difficle

Pseudomembranous colitis refers to swelling or inflammation of the large intestine (colon) due to an overgrowth of Clostridium difficile (C difficile) bacteria. This infection is a common cause of diarrhea after antibiotic use.

 C. tetni

44. Shistostoma hematobium cause

 bladder cancer

Bladder cancer is estimated to have an annual incidence in the United States. Schistosoma haematobium is presumed to be the primary cause of endemic squamous cell carcinoma in bladder.

 bladder atrophy

 renal cell CA

 adeno CA

45. Human act as intermediate host

 Hydatid cyst

Echinococcus granulosus, also called the hydatid worm, hyper tape-worm or dog tapeworm, is a cyclophyllid cestode that dwells in the small intestine of canids as an adult, but which has important intermediate hosts such as livestock and hum , where it causes cystic echinococcosis, also known as hydatid disease

 H m oni

 S. hematobium

 A.Dudenale

46. extensor of back are supplied by which rami of spinal nerve

 anterior rami

 dorsal root

 lateral root

 dorsal rami

The dorsal ramus of spinal nerve is the posterior division of a spinal nerve. ... skin and muscle along the back, more or less at the level from which the ramus leaves the spinal nerve

47. Role of chemotherapy drugs in cancer treatment

 Apoptosis of cancer cells

Usually, cancer drugs work by damaging the RNA or DNA that tells the cell how to copy itself in division. ... The faster that cancer cells divide, the more likely it is that chemotherapy will

kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

 necrosis

 hyoxia

 sec. blood flow

48. What can cause blood in csf

 subdural hematoma

 Arachnoid hematoma

 spinal hematoma

 subarachnoid haemorrhage

Red blood cells in CSF caused by a traumatic tap or a subarachnoid hemorrhage artificially increase the white blood cell count and protein level, thereby confounding the diagnosis.

49. Carpal tunnel syndrome sensory impairment occur in which area

 Lateral third half

Carpal tunnel syndrome (CTS) involves compression of median nerve within carpal tunnel.

Sensory impairment occurs in the first three digits and the lateral half of the fourth digit.

Pain may be felt in the palm, anterior wrist, and forearm and proximally to the shoulder.

 fore arm

 medial third

 upper third

50. Person is unable to flex elbow which nerve is involved

 radial

 ulnar

 median

 Musculocutaneous

The musculocutaneous nerve innervates the muscles in the anterior compartment of the arm – the biceps brachii, brachialis and coracobrachialis. These muscles flex the upper arm at the shoulder and the elbow. In addition, the biceps brachii also performs supination of the forearm.

51. In horizontal rotation of neck. Muscles involved are

 serratus anterior

 serratus posterior

 both sternocleidomastoid

The sternocleidomastoid muscle (also known as sternomastoid, commonly abbreviated as SCM , is a paired muscle in the superficial layers of the side of the neck. It is one of the largest and most superficial cervical muscles. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is

innervated by the accessory nerve.

 ipsilatral SCM

52. ptosis ,meiosis ,anhydrosis are signs of

 horner syndrome

Horner syndrome is a relatively rare disorder characterized by a constricted pupil (miosis), drooping of the upper eyelid (ptosis), absence of sweating of the face (anhidrosis), and sinking of the eyeball into the bony cavity that protects the eye (enophthalmos). These are the four classic signs of the disorder.

 CN III lesion

 facial palsy

 Midbrain lesion

53. 53 year old female have rectal carcinoma which of following is is best prognostic factor

 grade

 Stage of Carcinoma

patients with adenocarcinoma or mucinous adenocarcinoma of the rectum, the prognosis after radical resection for cure was investigated. Staging according to the fourth edition of the UICC TNM classification showed a good correlation to prognosis. By multivariate analysis, various additional independent prognostic factors could be demonstrated. The individual additional prognostic factors are partly of significance in some pTNM defined stages and substages

 LNs

 adjuvant therapy

54. A person who is hypertensive and diabetic is prescribed

 tenolol

 amlodipine

 furosemide

 captopril

Captopril is an ACE inhibitor. ACE stands for angiotensin converting enzyme. Captopril is used to treat high blood pressure (hypertension), congestive heart failure, kidney problems caused by diabetes, and to improve survival after a heart attack.

55. Urinary incontinence is associated with

 pelvic nerve

 sciatic nerve

 Pudendal nerve (S2,S3,S4)

Stress urinary incontinence, pelvic floor prolapse, and fecal incontinence are associated with pudendal neuropathy). Pudendal nerve(S2,S3,S4) functions to innervate the external

urethral sphincter it is responsible for the tone of the sphincter mediated via acetylcholine release. This me that during periods of increased acetylcholine release the skeletal muscle in the external urethral sphincter contracts, causing urinary retention. Whereas in periods of decreased acetylcholine release the skeletal muscle in the external urethral sphincter

relaxes,

 internal pudendal

56. Keratinized structure is seen in which carcinoma

 BCC

 squamous cell carcinoma

A keratin pearl is a keratinized structure found in regions where abnormal squamous cells form concentric layers. Also called an epithelial pearl, due to a location among squamous cells of the epithelium, this type of structure is sometimes seen with squamous cell carcinoma

 adeno CA

 Craniopharryngoma

57. Most common nerve demage in humerous shaft fracture

 ulnar

 Musculocutaneous

 median

 radial

Neurovascular injury: about a third of proximal humeral fractures produce neurovascular injury. Axillary nerve damage is most common. Suprascapular, radial and musculocutaneous nerves can also be affected. Axillary artery injury may (rarely) occur (look for expanding mass over the proximal shoulder girdle).

58. Condition unlikly with high PTH levels

 Hyperphosphatemia

PTH reduces the reabsorption of phosphate from the proximal tubule of the kidney, which me more phosphate is excreted through the urine. However, PTH enhances the uptake of phosphate from the intestine and bones into the blood. In the bone, slightly more calcium than phosphate is released from the breakdown of bone.

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