CHANGE ANS IS B Q-35: - Regarding the use of the D-dimer test in the evaluation of pulmonary embolism, which of the following is true?
a. Semiquantitative latex assays are very sensitive but impractical because of long laboratory turnaround times.
b. False negatives are more likely if the patient has had symptoms for more than a week.
c. The SimpliRED assay is accurate enough to initiate treatment of pulmonary embolism with a positive test.
d. The patient must have symptoms for at least 6 hours for the D-dimer test to be clinically useful.
Ans 35: (b) False negatives are more likely if the patient has had symptoms for more than a week.
Reference – Read the text below
· D-dimers are fibrin split products released into the circulation by plasmin during fibrinolyisis.
· This typically occurs within 1 hour of thrombus formation. The continued fibrinolysis initiated after a thrombus formation will continue to elevate D-dimer levels for a week. A false-negative result is more likely after this time frame.
· Semiquantitative latex assay tests are performed rapidly but have been criticized for low sensitivity.
· The SimpliRED assay, the prototypical second-generation test, is highly sensitive, and a negative test can be used to exclude a pulmonary embolism in the low-risk patient.
· However, the test has a low specificity, and further testing is necessary in the presence of a positive test before the diagnosis of pulmonary embolism can be made.
CHANGE ANS IS C Q-272 Which of the following disorders is thought by many to be strongly influenced by cultural roles?
- Avoidant personality
- Antisocial personality
- Dependent personality
- Borderline personality.
Ans 272: (c) Dependent personality
Reference – Read the text below
- Some researchers in psychiatry feel that dependent personality disorder depends to a large degree on cultural roles (i.e., certain individuals or groups are expected to assume dependent roles in the culture based on their gender or ethnic background).
- To some extent, this may be changing, but it can still be observed.
NO CHANGE Q-59 Neurogenic tumors of the mediastinum occur in :
- Anterior mediastinum
- Posterior mediastium
- Middle mediastinum
- Anywhere in the mediastinum
Ans-59: (d) Anywhere in the mediastinum
Ref: Read the text below
NO CHANGE Q-96: - Orexinergic neuron secrete nueropeptide Y . which of the following is the true statement
a. Its secretion controlled by melotonic receptor
b. Constitutes 32 aminoacid
c. Increases in starvation
d. Decreases thermogenesis
Ans 96: (c) Increases in starvation
Ref:Read the text below
Kaye et al. conducted a study to demonstrate the role of NPY in anorexia nervosa. In this post mortem study, high levels of NPY were found in the cerebrospinal fluid of patients with anorexia nervosa.
Subsequently, high concentrations of adrenocorticotropic hormone (ACTH) and cortisol in the plasma were also found in patients with anorexia nervosa
Q-269 Potentiation of neuromuscular block by neomycin is
a. Less likely with a non-depolarising block than with a depolarising block
b. Decreased by enflurane
c. Intensified by the administration of calcium
d. Antagonised by the administration of neostigmine
Ans 269: (d) Antagonised by the administration of neostigmine
Ref– Read the text below
Neostigmine is used to improve muscle tone in people with myasthenia gravis and routinely, in anesthesia at the end of an operation, to reverse the effects of non-depolarizing muscle relaxants such as rocuronium and vecuronium so option d is only true.
POTENTIATION OF NEUROMUSCULAR BLOCK
(a) Volatile anaesthetic agents
- Enflurane > isoflurane > desflurane > sevoflurane > halothane
- CNS depression
- Decreased skeletal muscle tone
(b) Aminoglycoside antibiotics
- Especially streptomycin and neomycin
(c) Local anaesthetics
- Decreased prejunctional (acetylcholine) release
- Stabilise postsynaptic membrane
- Direct depolarisation of skeletal muscles
(d) Anti-arrhythmic drugs
(e) Diuretics (Frusemide)
(a) Slows the enzymatic activity in the liver
(b) Decreases clearance