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jipmer > jipmer 2013 paper > Flashcards

jipmer 2013 paper Flashcards

1
Q

giant a wave s seen in

A

pulmonary ht , tricuspid stenosis , right atrial myxoma

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2
Q

tricuspid regurgitation

A

reversal of x descent and accentuated v-y descent

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3
Q

accentuated a-x descent

A

constrictive pericarditis , cardiac tamponade , restrictive cardiomyopathy

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4
Q

accentuated v y descent

A

constrictive pericarditis , tricuspid regurgitation

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5
Q

exercise stress test is stopped when

A

st depression >2 mm or fall in systolic BP > 10 mm hg

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6
Q

exercise stress test ci

A

when there s rest angina within 48 hrs, sever AS , Severe PHT, active infective endocarditis

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7
Q

when in MI can stress test be done

A

when it s heart rate controlled and after 6 days of MI

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8
Q

senstivity of exercise stress test

A

75%

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9
Q

loeys-dietz syndrome

A

mutation in TGF b receptor leads to abnormalities in elastin and collagen 1 and 3 and rupture fairly easily

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10
Q

all connective tissue disorders cause

A

dilatation of ascending aorta

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11
Q

mc condition ass with anuerysms of the ascending aorta

A

hypertension

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12
Q

arteries spared in atherosclerosis

A

upper limb , mesenteric and internal mammary arteries

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13
Q

most common predisposing factor for aortic dissection

A

hypertension

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14
Q

ischemia modified albumin test s

A

more sensitive than d dimer test for PE

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15
Q

indications for IVC filter

A

active bleeding and recurrent venous thrombosis

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16
Q

other ECG findings in PE

A

T wave inversion inv in V1-4 , slow R wave progression

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17
Q

acute stage of UC can be associated with which cvs condition

A

Pulmonary embolism

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18
Q

functional residual capacity in restrictive lung disease

A

increased

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19
Q

drugs causing ARDS

A

heroin , barbiturates , thiazides

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20
Q

rbc wbc count, specific gravity to say plueral effusion is exudate

A

> 10000 , > 1000 , >1.12

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21
Q

anti cancer drugs causing exudative plueral effusion

A

procarbazine and dazatinib

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22
Q

examples of plueral exudate

A

hemothorax , chylothorax , ovarian hyperstimualtion

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23
Q

urinothorax , myxoedema lead to what type of plueral effusion

A

transudate

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24
Q

opthal manifestations in thalamic hemorrhage

A

vertical gaze palsy , miosis , no light reflex , eye downward and inward , retraction nystagmus

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25
Q

high carotenoid ingestion ;: CSF

A

xanthochromia

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26
Q

causes for dropped head

A

amyotrophic lateral sclerosis , hyperparathyroidism , polymyositis , myasthenia gravis

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27
Q

mc tumour ass with production of cushings syndrome

A

carcinoid tumour lung

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28
Q

not seen in SLE

A

uveitis , parotid enlargement , joint deformity , lung cavitations

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29
Q

mc pulmonary manifestation of RA

A

pulmonary nodules

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30
Q

multicentric reticular histiocytosis

A

destructive symmetric polyarthritis inv DIP

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31
Q

skin kesions in multicentric reticular histiocytosis

A

multiple nodules at the base of the nail :: coral bead appearance

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32
Q

x - ray finding in above condition

A

loss of bone dispropotionate to the cartilage loss similar to gout

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33
Q

aldolase enzyme and gout

A

its deficiency can cause gout

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34
Q

serum uric acid levels and gout

A

> 7 predispose to gout

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35
Q

martels or g sign seen in

A

gout

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36
Q

factors predisposing to gout

A

excessive ethanol , steroid withdrawal , uncontrolled diuretics or aspirin ,mi , stroke , surgery , trauma

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37
Q

psuedo gout commonly involves which jt

A

knee

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38
Q

microbe ass with kawasaki disease

A

staph aureus

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39
Q

mc causes of metabolic alkolosis

A

diuretic use , gastric secretion loss

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40
Q

LOS tone increased by

A

antacids , domperidone , pgf2 , metaclopromide , cholinergics , supine posrue

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41
Q

most important factor contributing to high intraluminal pressure in LOS

A

intra abdominal pressure

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42
Q

surveillance in baretts eosophagus

A

every 2 yrs with biopsy endoscopically

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43
Q

neoadjuvant chemotherapy in oesophageal ca

A

cisplatin

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44
Q

drug which increases the risk in baretts oesophagus

A

bisphosphonates

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45
Q

how much % of oesophageal narrowing occured before dysphagia

A

60%

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46
Q

caeliac or supraclavicular node involvement in oesophagus

A

indicates metastasis

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47
Q

radiotherapy in oesophageal ca

A

upper 1/3 rd or post cricoid growth

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48
Q

most common benign small bowel tumours

A

adenoma

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49
Q

most common symptomatic benign small bowel tumours

A

leiomyomas

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50
Q

benign small bowel tumors most commonly present as

A

incidental finding

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51
Q

most common cause of intusussuception in adults

A

small bowel benign tumours

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52
Q

the layer responsible for strength of intestinal anastomosis

A

submucosa

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53
Q

whirl pattern on CT scan

A

volvulus

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54
Q

gastric volvulus in children

A

mesentricoaxial or vertical

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55
Q

mc cause of large bowel obstruction in pregnancy

A

caecal vovulus

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56
Q

paul miculicz procedure

A

sigmoid colectomy for volvulus

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57
Q

hla association in chrons disease , UC

A

hla dr 1 , hla dqw5 :::::: hla dr 2 , dr103

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58
Q

appendicectomy and IBD

A

appendicectomy inc CD but protects against UC

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59
Q

earliest lesions in CD

A

apthoid ulcers

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60
Q

recurrence after surgery and antibiotics

A

recurrence more and not responsive in CD , opp in UC

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61
Q

extraintestinal features more in UC

A

pyoderma gangrenosum , osteoporotic fractures , PSC

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62
Q

extraintestinal features equal in UC and CD

A

sacroilietis , uveitis

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63
Q

collar button ulcers occur in

A

UC

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64
Q

Earliest radiological feature in UC

A

fine mucosal granularity

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65
Q

other serological markers in CD

A

anti e.coli OMPc , anti I2 , anti flagellin

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66
Q

GRAVES disease

A

primary thyrotoxicosis so cardiac symptoms rare

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67
Q

in graves when does hyperthyroidism occur

A

same time as goitre

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68
Q

medullary ca thyroid - % familial

A

only 10-20%

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69
Q

hurthle cell ca secretes

A

thyroglobulin

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70
Q

recurrence rate after incisional hernia repair

A

25-50%

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71
Q

laproscopic usg

A

to detect superficial liver and peritoneal metastasis

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72
Q

colovesical fistula mc cause

A

diverticular disease

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73
Q

colovesical fistula

A

most commonly presents as pnuematuria

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74
Q

follicular ca thyroid

A

macroscopically capsulated microscopically invasive , multiple foci seldom seen

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75
Q

curling ulcer at what % of burns

A

35%

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76
Q

shone complex

A

parachute mv , subaortic stenosis , COA

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77
Q

vein of markowski

A

drains into vein of galen

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78
Q

absent distal femoral epiphysis at birth

A

congenital hypothyroidism

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79
Q

urine iodine levels in i2 def in goitre

A

low

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80
Q

is there goitre in thyroid dysgenesis

A

no

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81
Q

non immune fetal hydrops and placenat size

A

thickened , >6cm

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82
Q

non immune fetal hydrops mc cause

A

cvs anomolies

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83
Q

barlows disease

A

scurvy

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84
Q

which radiological sign confirms scurvy

A

metaphyseal lucency under the while line of frenkel

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85
Q

13 th day after fertilization

A

villi formation

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86
Q

22-23 days

A

fetoplacental circulation and fetal heart

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87
Q

10-12 weeks

A

swallowing

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88
Q

11 weeks

A

fetal breathing movements

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89
Q

12 weeks

A

urine formation

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90
Q

mentovertical engaging diameter presenting part

A

brow

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91
Q

submentovertical submentobregmatic

A

face

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92
Q

anthropoid pelvis

A

all ap diameters long , transverse diameters short

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93
Q

platypoid pelvis is opp

A

of anthropoid , all ap diameters are short

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94
Q

rachitic pelvis

A

reniform inlet

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95
Q

osteomalacia pelvis

A

triradiate pelvis

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96
Q

naegles pelvis

A

arrested dev of one ala of sacrum

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97
Q

roberts pelvis

A

arrested dev of both ala of sacrum

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98
Q

fetal serum and Amniotic fluid AFP levels in first trimester pregnancy

A

reaches peak by 13 weeks ,

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99
Q

maternal serum AFP levels

A

reaches peak by 32 weeks

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100
Q

barts test / ketterings test

A

other name for triple test

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101
Q

papp a in downs

A

reduced levels , done in first trimester

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102
Q

for early detection of downs most specific and sensitive

A

b hcg , ms afp

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103
Q

double marker test

A

b hcg and papp a

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104
Q

maternal hypoglycemia

A

increased fetal movements

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105
Q

single measurement which best reflects fetal nutrition

A

us - abdominal circumference

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106
Q

doc for chlamydiae in pregnancy

A

erythromycin

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107
Q

hellin rule

A

mathematical frequency of multiple births

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108
Q

lambda or twin peak sign

A

dichorionic twins

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109
Q

t sign

A

monochorionic twins

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110
Q

least chance for cord prolapse is for

A

frank breech

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111
Q

commonest cause for cord prolapse

A

transverse lie

112
Q

pretreatment b hcg levels serum before treatment of mole poor prognosis

A

serum hcg level >50,000 miu/ml

113
Q

time by which b hcg falls to normal post mole rx

A

4-6 weeks

114
Q

shone complex

A

parachute mv , subaortic stenosis , COA

115
Q

vein of markowski

A

drains into vein of galen

116
Q

absent distal femoral epiphysis at birth

A

congenital hypothyroidism

117
Q

urine iodine levels in i2 def in goitre

A

low

118
Q

is there goitre in thyroid dysgenesis

A

no

119
Q

non immune fetal hydrops and placenat size

A

thickened , >6cm

120
Q

non immune fetal hydrops mc cause

A

cvs anomolies

121
Q

barlows disease

A

scurvy

122
Q

which radiological sign confirms scurvy

A

metaphyseal lucency under the while line of frenkel

123
Q

13 th day after fertilization

A

villi formation

124
Q

22-23 days

A

fetoplacental circulation and fetal heart

125
Q

10-12 weeks

A

swallowing

126
Q

11 weeks

A

fetal breathing movements

127
Q

12 weeks

A

urine formation

128
Q

mentovertical engaging diameter presenting part

A

brow

129
Q

submentovertical submentobregmatic

A

face

130
Q

anthropoid pelvis

A

all ap diameters long , transverse diameters short

131
Q

platypoid pelvis is opp

A

of anthropoid , all ap diameters are short

132
Q

rachitic pelvis

A

reniform inlet

133
Q

osteomalacia pelvis

A

triradiate pelvis

134
Q

naegles pelvis

A

arrested dev of one ala of sacrum

135
Q

roberts pelvis

A

arrested dev of both ala of sacrum

136
Q

fetal serum and Amniotic fluid AFP levels in first trimester pregnancy

A

reaches peak by 13 weeks ,

137
Q

maternal serum AFP levels

A

reaches peak by 32 weeks

138
Q

barts test / ketterings test

A

other name for triple test

139
Q

papp a in downs

A

reduced levels , done in first trimester

140
Q

for early detection of downs most specific and sensitive

A

b hcg , ms afp

141
Q

double marker test

A

b hcg and papp a

142
Q

maternal hypoglycemia

A

increased fetal movements

143
Q

single measurement which best reflects fetal nutrition

A

us - abdominal circumference

144
Q

doc for chlamydiae in pregnancy

A

erythromycin

145
Q

hellin rule

A

mathematical frequency of multiple births

146
Q

lambda or twin peak sign

A

dichorionic twins

147
Q

t sign

A

monochorionic twins

148
Q

least chance for cord prolapse is for

A

frank breech

149
Q

commonest cause for cord prolapse

A

transverse lie

150
Q

pretreatment b hcg levels serum before treatment of mole poor prognosis

A

serum hcg level >50,000 miu/ml

151
Q

time by which b hcg falls to normal post mole rx

A

4-6 weeks

152
Q

pg e2 predominates in the

A

proliferative phase

153
Q

pgf2

A

luteal phase

154
Q

swiss cheese pattern of the endometrium is seen in

A

metropathia hemorrhagia

155
Q

duphaston

A

given for medical management of DUB , does not suppress ovulation

156
Q

contraindications to TCRE

A

uterine size > 12 weeks , adenomyosis , uterine malignancy , genital infection

157
Q

tcre removes how much of the endometrium

A

5 mm

158
Q

RITEA

A

66 DEGREE C

159
Q

MICROWAVE

A

9.2GHZ , 80 .c for 3 min

160
Q

cerozette advantages

A

75 ug desogestrol , stringent time complication not necessary , no androgenic effects , no effect on carbohydrate or lipid metabolism , binds to progesterone receptors

161
Q

most common cause of death in complications related to ca cervix

A

uremia

162
Q

simpsons pain

A

endometrial ca

163
Q

cystoscopy of endometrial ca

A

snow hill pattern , von epethelial islets

164
Q

mc germ cell tumour

A

mature teratoma

165
Q

mc malignant GCT

A

DYSGERMINOMA

166
Q

largest benign ovarian tumour

A

mucinous cystadenoma

167
Q

mc benign tumour ovary

A

dermoid cyst

168
Q

most common tumour of the ovary

A

serous cystadenoma

169
Q

mc ovarian tumour to involve the opposite side

A

granulosa cell tumour

170
Q

papillary cystadenoma becomes malignant in

A

50%

171
Q

meigs syndrome

A

ovarian fibroma

172
Q

psuedomeigs syndrome

A

thecoma , brunners , granulosa cell tumour

173
Q

ovarian tumours ass with calcification

A

teratoma , gonadoblastoma , fibroma

174
Q

coffee bean nuclei

A

granulosa cell tumour

175
Q

bryants test , regiment badge sign

A

anterior dislocation

176
Q

puttiplat , bristow procedure

A

done for anterior dislocation of shoulder

177
Q

monteggia fracture dislocation nerve involved

A

posterior interosseus nerve

178
Q

volkmann ischemic and lunate dislocation nerve involved

A

median nerve

179
Q

phalen sign is seen in

A

carpel tunnel syndrome

180
Q

siffer kart sign

A

blounts disease

181
Q

local anaesthetics are

A

weak bases and become more potent with bicarbonate addition

182
Q

prilocaine characteristics

A

safest , maximum methhemoglobinemia, most suitable for biers block

183
Q

bupivacaine characteristics

A

most suited and best for isobaric , ci in iv regional anaesthesia

184
Q

first synthetic la

A

procaine

185
Q

la of choice in malignant hyperthermia

A

procaine

186
Q

la ci in neonates and labour

A

mepivacaine

187
Q

la whose intradural injection is ci as it can cause paraplegia

A

chlorprocaine

188
Q

lowest potency la

A

procaine

189
Q

shortest la

A

chlorprocaine

190
Q

longest acting la

A

dibucaine

191
Q

la ci for surface anaesthesia

A

procaine , benzocaine , mepivacaine

192
Q

intermediate acting amides

A

lignocaine , mepivacaine , prilocaine

193
Q

articaine

A

recently introduced aminoamide for dental and periodantal procedures

194
Q

most commmon ecg finding with bupivacaine

A

idioventricular rythm and qrs broadening

195
Q

differential blockade caused by which LA

A

bupivacaine

196
Q

the concentration of adrenaline use along with lidocaine

A

1:200000

197
Q

muscle relaxants with minimum histamine release , used in asthma

A

vecuronium

198
Q

muscle relaxant of choice to inc BP

A

pancuronium

199
Q

muscle relaxant with ganglion block

A

curare , galamine , trimethaphan , pancuronium

200
Q

above what dose does succinyl choline cause biphasic block

A

500 ml

201
Q

inc order of potency of inhalational anaesthetics , dec order of mac

A

DSEIM , before d N2O, before E ether , before M halothane

202
Q

inc order of faster induction , recovery , dec order of blood gas partition coefficient

A

HEISDX , before h ether , before d N2O

203
Q

density of xenon

A

5.887 g/dl

204
Q

disadv of xenon

A

because of high density causes inc resistance should be used with caution in copd , morbidly obese , premature infants

205
Q

ether adv

A

produces excellent muscle relaxation

206
Q

drager barko test is used for

A

halothane

207
Q

halothane and analgesia

A

no analgesia

208
Q

best muscle relaxants

A

ether followed by halothane

209
Q

order of CO production by inhalational anaesthetics

A

desflurane > enflurane> isoflurane >halothane =sevoflurane

210
Q

inhalational agent of choice for controlled hypotension and hepatic disease

A

sevoflurane

211
Q

halothane and enflurane - heart

A

derpressants cardiac

212
Q

halothane and isoflurane - heart

A

sensitize to cathecolamines

213
Q

which mineral levels to be measured during continous propofol infusion

A

zinc

214
Q

diprivan

A

1 % formulation of propofol contains 10 %soya oil , 1.25% egg phosphatide and 2.25% glycerol

215
Q

propofol infusion syndrome

A

> 4 mg/kg / hr for 48 hrs

216
Q

iv anaesthetic with both analgesic ans anaesthetic activity

A

ketamine

217
Q

drugs dec icp but inc iot

A

barbiturates , etomidate , cyclopropane

218
Q

inhalational anaesthetics minimally metabolized

A

xenon fol by n2o followed by des

219
Q

aoc for right to left shunt

A

ketamine

220
Q

aoc for left to right shunt

A

isoflurane

221
Q

aoc for electroconvulsive therapy

A

methohexitone

222
Q

aoc for thyrotoxicosis

A

thiopentone

223
Q

earliest radiological feature of AS

A

romana sign

224
Q

radiological features of psoriatic arthritis

A

opera glass deformity , mouse ear appearance

225
Q

joint not involved in psoriatic arthritis

A

first MCP of thumb

226
Q

joints of wrist inv in hemochromatosis , psuedogout

A

MCP

227
Q

calcification of menisci and hyaline cartilage

A

CPPD

228
Q

osteonecrosis x ray finding

A

crescent sign , spotty calcification

229
Q

gauchers disease x ray finding

A

erlenmayer flask deformity

230
Q

walderstrom sign

A

non specific sign of hip effusion

231
Q

licked candle stick appearance

A

atrophic nueropathic arthritis

232
Q

apple core defromity , migrating mouse sign

A

synovio chondro metaplasia

233
Q

osteopetrosis x ray appearance

A

bone in bone appearance , sandwich vertebra , rugger jersey spine

234
Q

flowing cadle wax appearance

A

melorrhosteosis

235
Q

hook shaped vertebral bodies , cut corner sign

A

mps 1 / hurler

236
Q

central beaking of vertebra / ape like pelvis

A

mps 4 / morquio

237
Q

steinberg sign

A

marfans

238
Q

hyperparathyroidism features

A

rugger jersey spine / pepper pot skull / subperiosteal resorption of phalanges

239
Q

histiocytosis x features

A

button hole sequestrum , floating tooth sign , hole with hole appearance

240
Q

h shaped vertebrae , cup shaped ribs , curved telephone recievers,

A

thanotrophic dwarfism

241
Q

cold lesion in bone scan is

A

purely lytic metastasis

242
Q

which type of osteogenesis imperfecta has 100 % fractures in utero

A

type 2

243
Q

which type of osteogenesis imperfecta has blue sclera

A

type 1

244
Q

which type of OI has limb shortening and pulmonary ht

A

type 3

245
Q

which type of OI has short trunk

A

type 2

246
Q

which type of OI has no bleeding problems

A

type 4

247
Q

hemangiomas of bone : appearance in bone scan

A

normal or decreased activity

248
Q

superscan s produced by

A

metastatic prostatic cancer

249
Q

drooping water lily sign

A

duplicated renal collecting systems

250
Q

renal fascia sign

A

acute renal artery occlusion

251
Q

rim crescent sign and soap bubble appearance

A

hydronephrosis

252
Q

golf hole ureter

A

tb bladder

253
Q

moth eaten appearance

A

tb kidney

254
Q

fish hook bladder

A

BPH

255
Q

sunburst nephrogram , patchy chaotic nephrogram

A

autosomal recessive polycystic kidney

256
Q

medullary sponge kidney radiographic appearance

A

paintbrush / bouquet of flowers appearance

257
Q

wind in sail /keyhole appearance

A

posterior urethral valve

258
Q

edling sign

A

psuedoureterocoele

259
Q

weigert meyer rule

A

insertion of upper pole is inferior and medial than lower pole in complete ureteric dilatation

260
Q

earliest sign of inc ICT

A

Erosion of dorsal sella

261
Q

chicken wire calcification

A

codmans tumour / chondroblastoma

262
Q

geographical lytic skull / vertebra plana

A

eosinophilic granuloma/ hans schuller christian disease / histiocystosis

263
Q

vertebra plana also seen in

A

ewings sasrcoma , metastasis , luekemia , tb , osteochondritis of vertebral body called calve’s disease

264
Q

ortho tumour x ray : whisps or flecks of calcification

A

chondroma

265
Q

chondrosarcoma x ray appearance

A

mottled / punctuate calicification/ popcorn balls / endosteal scalloping , cortical expansion

266
Q

most common bone affected in chondrosarcoma

A

pelvis

267
Q

dysprosium isotope use

A

aggregated hydroxide for synovectomy treatment in arthritis

268
Q

erbium

A

relieving arthritis pain in synovial joints

269
Q

holmium

A

diagnosis and treatment of liver tumours

270
Q

Gold standard for assessing myocardial viability

A

18 FDG pet

271
Q

most common type of lichen planus

A

hypertrophic type

272
Q

characteristic features of lichen planus

A

lacey mucosal pattern , scarring alopecia , max joseph histological cleft

273
Q

left horn of sinus venosus

A

coronary sinus

274
Q

right horn of sinus venosus

A

smooth part of right atrium

275
Q

superior vena cava is formed from

A

right anterior cardinal vein and common cardinal vein

jipmer (5 decks)

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