Can You Pass This Hardest Medical Test?

Measles vaccine is a part of EPI schedule, not MMR.

Montelukast and Zafirlukast are leukotriene antagonists.

The presence of acetyl cholinesterase enzyme in the amniotic fluid suggests a diagnosis of open spina bifida. Open spina bifida is a neural tube defect where the spinal column does not close completely during fetal development. The enzyme acetyl cholinesterase is found in high levels in the spinal cord, and its presence in the amniotic fluid indicates a leakage of spinal fluid, which is characteristic of open spina bifida.

Codman’s triangle and Sunray appearance are seen in osteosarcoma.

Acrodynia, also known as Pink's disease is caused by chronic mercury poisoning in children.

Previously zidovudine was given. Presently nevirapine is used as it is cheaper and more effective.

85% of lung cancer among smokers is attributed to smoking.

Herd structure is not constant.

Granular endoplasmic reticulum synthesises proteins and agranular endoplasmic reticulum synthesises lipids.

It is a case of TURP syndrome due to entry of irrigation fluid (with low sodium content) into the bloodstream.

Octreotide is given IM / IV / subcutaneously.

Papez circuit of the brain is one of the major pathways of the limbic system and is chiefly involved in the cortical control of emotion. The Papez circuit plays a role in storing memory.

Mnemonc for components of Papez circuit: MACEH

Mamillary body - Anterior thalamic nucleus - Cingulated gyrus - Entorhinal cortex - Hpppocampus

Older antiobesity drugs act by inhibiting noradrenaline or serotonin reuptake. Newer ones have various mechanisms.
Older generation agents:
-Noradrenergic agents (influence appetite center) - Phentermine, Mazindol
-Serotonergic agents (influence satiety center) - Fenfluramine, Dexenfluramine
-Noradrenergic / Serotonergic agents (combined action) - Sibutramine
Newer agents
-Orlistat - Inhibits gastric and pancreatic lipase - digestion and absorption of triglycerides is impaired
-Olestra - Suprose polyester which can replace fat as a cooking medium
-Leptin analogues
-Neuropeptide Y antagonist
-Beta 3 adrenergic agonists

Aspirin is an antiplatelet agent, hence the bleeding time is prolonged.

CHPS results in loss of acidic gastric fluid. Hence the metabolic abnormality is Hypochloremic hypokalemic metabolic alkalosis

Rapid acting insulins - Lispro, Aspart, Glulisine
Short acting insulin - Regular insulin
Intermediate acting insulin - NPH
Long acting insulin - Glargine, Determir

Tube cast (cylinder cast) is applied for knee fractures.

It is probably a case of digitalis toxicity resulting in complete heart block.

In simple random sampling, the samples consist of randomly selected individuals. Whereas in cluster sampling, the samples consist of randomly selected groups.

Presence of pus cells without any organisms indicates non gonoccal urethritis. So we need to test for chlamydia. Mc Coy and HeLa cell culture is used for isolation of chlamydia.

Features of DIC - Increased FDP, prolonged PT, reduced platelets

Most common congenital anomaly - Cardiovascular
Most specific - Caudal regression syndrome

Mouthing appears at 4 months. Stranger anxiety appears at 7 months. Hence the developmental age is between 4 and 7 months. Among the options given, 5 months fits into this period.

Palatal paralysis causes rhinolalia aperta

K nail is a clover shaped ( in cross section ) intramedullary rod used for internal fixation of long bone fractures. K wire is a thin wire used in fixing bone fragments and for skeletal traction. Interlocking nails (shown here) are also used in long bone fractures as intramedullary fixation. But they have screws at the ends to hold them in position (unlike k nail, which does not have any screws). DCP (Dynamic compression plates) are a type of plate fixation. They are seen outside the medullary cavity.

C terminal is concerned with ligand binding.

Insulin receptors are enzymes, not transcription factors.

Acute pancreatitis is the most common complication after ERCP (Endoscopic Retrograde Cholangiopancreatography). During an ERCP procedure, the pancreas can become inflamed due to the insertion of instruments and contrast dye, leading to acute pancreatitis. This can cause symptoms such as severe abdominal pain, nausea, and vomiting. Prompt medical intervention is required to manage this complication.

Methionine tRNA will the first tRNA to come into action in cytosolic eukaryotic gene expression.

Symmetric tonic neck reflex is present in an infant between 2 and 12 months of age. It is not present at birth.

The cervical and lumbar regions of the vertebral canal show secondary curves, also known as lordotic curves, with concavity backwards. These curves develop after birth and are associated with the body's adaptation to upright posture and bipedal locomotion. The thoracic and sacral regions, on the other hand, exhibit primary curves (kyphotic curves) with concavity forwards.

Bacitracin sensitivity is used to differentiate Streptococcus pyogenes from other hemolytic streptococci.

Management of postoperative shivering:
Drug of choice – Tramadol
Alternate drugs – pethidine, pentazocine
Supportive treatment – oxygen inhalation (there is increased oxygen consumption during shivering)

Mephentermine is acts as an agonist on alpha and beta adrenergic receptors. This causes increased in cardiac output and blood pressure. Hence it cannot be used to induce hypotension.

Infrared therapy is a surface heat therapy.

Most important source of infection is the patient’s own lid and conjunctival flora. Topical povidone iodine helps prevent this.

Bernard Soulier platelets react normally to all stimuli except Ristocetin.

Orchidopexy in a case of cryptorchidism should be done before the age of 1 year.

Osteoblastic activity is suppressed by myeloma cells. (through secretion of cytokines). Hence these site show no increased uptake during bone scan.

Difficulty in delivery of aftercoming head in case of breech delivery can be due to :
-Contracted pelvis
-Extension of head
-Hydrocephalus
-Rigid perineum

Integrins are transmembrane proteins that act as membrane receptors for extracellular matrix components. Eg: Fibronectin receptor, Laminin receptor

The correct answer is Mature B cell. This is because ALL L3 morphology refers to acute lymphoblastic leukemia with L3 morphology, which is a type of blood cancer. In this type of leukemia, the cancer cells resemble mature B cells, which are a type of white blood cell. Therefore, the malignancy arises from the cell lineage of mature B cells.

Hyponatremia is seen in CCF

ECG changes in hypokalemia - ST depression, prolonged PR interval, T inversion / flattening, Prominent U waves, Sinoatrial block (rare)

Hereditary spherocytosis is caused by a variety of molecular defects in the genes that code for spectrin (alpha and beta), ankyrin, band 3 protein (anion transport protein), protein 4.2 (palladin) and other erythrocyte membrane proteins.

Pre B cell ALL often has a bad prognosis.

Myopathy refers to muscle weakness or dysfunction. X-linked hypophosphatemic rickets is a genetic disorder that affects the bones and teeth, causing softening and weakness. However, it does not typically cause myopathy. On the other hand, oncogenic osteomalacia and nutritional osteomalacia are both conditions that result in bone softening and can cause myopathy. Cushing syndrome, which is caused by excessive cortisol production, can also lead to muscle weakness and myopathy. Therefore, the correct answer is X-linked hypophosphatemic rickets.

Intracardiac implants can be identified in an xray based on the position and the morphology of the implant.
Prosthetic Mitral valve - Ball and cage (with 4 struts) is visualised, directed towards apex. Located at the region of mitral valve
Prosthetic aortic valve - Ball and cage (with 3 struts) is visualised, directed upwards, located at region of aortic valve.
Device closure of ASD - Dumb bell shaped, located at site of interatrial septum
Device closure of PDA - Ring shaped, located between aorta and pulmonary artery

Enteroendocrine cells are specialized endocrine cells of the gastrointestinal tract. They produce hormones such as serotonin, somatostatin, motilin, cholecystokinin, gastric inhibitory peptide, neurotensin, vasoactive intestinal peptide, and enteroglucagon. They release their products from their basal surface.

Goblet cells release mucus from their apical surface.