Answers for Questions in AIIMS Nov 2011 from Operation Harri – A Book for AIIMS and AIPG from Positive Coaching

60 out of 200 Questions in AIIMS Nov 2001 were from Operation Harri – A Book for AIIMS and AIPG from Positive Coaching

The highlight of this book is that, in between chapters Questions have been sandwiched [AIIMS, ALL Indian Questions and mock Questions], So that both theory and MCQs are judiciously covered. It will be useful for medical students to get oriented with P.G. Medical entrance exam preperations.

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Pozitive : AIIMS : May 2013 : Discussion

AIIMS November 2013 Q & A by Pozitive

-oOo-

• For OPERATION HARRI BOOK-KINDLY CONTACT : 9715610411

• Complete Discussion of AIIMS NOV 2011 will be hosted here shortly

• 160/200 Questions from 2011 has been discussed at POSITIVE-P.G. Medical Entrance Exam Training Centre

• 50 Fresh Questions from AIIMS NOV 2011 were answered from OPERATION HARRI text book

• 100 Questions from ALL INDIA 2012 in OPERATION HARRI Book

• 220 Questions from ALL INDIA 2012 discussed at various programme of POSITIVE, P.G. Medical Entrance Exam Training Centre.

-oOo-

About Operation Harri . . .

Dr. Krithiga Rajan, M.D (Peds) Rank 4-TN 2008 says

I am proud to say that i am one of those who reaped the benefits of the programme “OPERATION HARRI” when it was introduced in the year 207. The important facts from each page of Harrison were discussed, reinforced and carved in our brain. It helped a lot to get through the entrance exam successfully. Being condensed as a book now, it would be still more useful to come out with flying colours in your entrance exams

Dr. Ilavarsi M.D (Int.Med) Rank 3-AIIMS Nov 2010 says

OPERATION HARRI is one of the brain children and a powerful weapon of POSITIVE… I did not understand its importance fully well when I was preparing for pg entrance… only after entering AIIMS, I came to know that most of the PG students text book for the purpose of their university examinations… but OPEARATION HARRI is a boon in disguise for those who have not read Harrison during their UG days… it gives you extra force in the exams…

Dr. R. Priyadharsini. M.D (OG), Rank-55, TN-2008 says

Operation Harri is an unique programme for PG aspirants. It is brought out in a concised, readable and all the more remembrable manner. Apart from Medicine, it coverss Pharm, Path, Micro, Physio. It will be useful to laborious task of reading the massive volumes of Harrison books is much simplified and is neatly encapsulated as a tablet format. More than 50% of the questions in the All India exams can be answered by just reading this book. The reciepse is ready for you. Choice is yours.

Dr. V. Palani Kumaran M.D, Rank-9-TN-2011 says

I am the one of the greatest fan of OPEARTION HARRI. The collection of OPERATION HARRI will be very much useful not only for MCQ preparation but also useful in having academic knowledge in Medicine for further carrier. Really it is a boon to have OPERATION HARRI in text which, I am sure is going to make a lot of true POSITIVIANS Succeed in Entrance Exams and also to acquire good basic knowledge thoroughly in Medicine. I wish the Almighty for all success

-oOo-

Neither this question:

 

11. Karyotyping of fetus can be done frm a/e?(AIIMS-NOV-2011)

a.Chorionic villlus sampling

b.cordocentesis
c.amniocentesis           d.fetal skin

Ans: ?D

REF – OPERATION HARRI -PAGE289

Prenatal diagnosis

–     Amniocentesis involves the removal of a small amount of amniotic fluid, usually at 16 weeks of gestation. The main indications for amniocentesis include advanced maternal age above age 35, abnormal serum triple marker test (alfa-fetoprotein, beta human chorionic gonadotropin, pregnancy-associated plasma protein A, or unconjugated estriol), a family history of chromosomal abnormalities, or a Mendelian disorder amenable to genetic testing.

–     Chorionic villus sampling (CVS), in which a small amount of the chorion is removed by a transcervical or transabdominal biopsy. Chromosomes and DNA obtained from these cells can be submitted for cytogenetic and mutational analyses. CVS can be performed earlier in gestation (weeks 9–12) than amniocentesis.

–     Later in pregnancy, beginning at about 18 weeks of gestation,(AI-2006***) percutaneous umbilical blood sampling (PUBS) permits collection of fetal blood for lymphocyte culture and analysis.

12. TB meningitis features, blood picture will show which of the following-?(AIIMS-NOV-2011)

a.lymphocytosis ,low glucose ,high protein
b. lymphocytosis ,normal glucose ,high protein
c.                                       d.

ANS-A

POSIGOLD ALL INDIA 2007, QUES: 36, PAGE 36

REF-CONSULTANT, OPERATION HARRI-PAGE-711

Tuberculous Meningitis and Tuberculoma

  –   Seen most often in young children.

  –   In more than half of cases, evidence of old pulmonary lesions or a miliary pattern is found on chest radiography.

 –    Cerebrospinal fluid (CSF)- high leukocyte count (up to 1000/microL), usually with a predominance of lymphocytes, a protein content of 1–8 g/L, low glucose concentration.

–     AFB are seen on direct smear of CSF sediment in up to one-third of cases.

–     Culture of CSF is diagnostic in up to 80% of cases and remains the gold standard.

–     Polymerase chain reaction (PCR) has a sensitivity of up to 80%, but rates of false-positivity reach 10%.

–     The ADA concentration may be a sensitive test but has low specificity.

–     Tuberculoma-CT or MRI reveals contrast-enhanced ring lesions.

13. Preleukemic conditions all except?(AIIMS-NOV-2011)

a.pnh
b.paraoxysmal cold hemoglobinuria
c.myelodysplasia        d.aplastic leukemia

ANS-B

REF-OPERATION HARRI-PAGE-480

Paroxysmal Cold Hemoglobinuria (PCH)

*    Mostly in children, usually triggered by a viral infection, usually self-limited.

*    Donath-Landsteiner antibody.

*    Antibody-anti-P specificity and binds to red cells only at a low temperature (optimally at 4°C), but when the temperature is shifted to 37°C, lysis of red cells takes place in the presence of complement.

Paroxysmal Nocturnal Hemoglobinuria (PNH)

*    Intracorpuscular defect acquired at the stem cell level.

*    Clinical – Triad

   – Hemolytic anemia.

   – Venous thrombosis.

   – Deficient hematopoeisis(Pancytopenia).

*    RBC – ­ sensitivity to hemolytic action of complement .

*    ­ platelet aggregation (due to complement)   ® thrombosis.

* Platelet – normal life span.

* Venous thrombosis

   – 40%.

   – Budd. Chiari.

   – CVT – common cause of death.

* Bone marrow – normocellular.*

*    15 – 30% ® Aplastic anemia.

*    Commonest cause of death has been venous thrombosis followed by infection.

*    1–2% of all cases PNH may terminate in acute myeloid leukemia.

*    Spontaneous recovery from PNH has been well documented.

Pathogenesis

14. A patiemt has normal PT,Plat count and inc aPTT,factor 8 levels given as 60 iu/ml, no bleeding history, diagnosis? ?(AIIMS-NOV-2011)

a.Factor IX def.                 b.Thalassemia
c.Factor VIII inhibitors     d.Lupus anticoagulant

ANS-?A

REF-OPERATION HARRI-PAGE 538

Acquired Inhibitors of Coagulation Factors

* FVIII is the most common target of antibody formation.

*    Occurs predominantly in older adults.

*    Autoimmune diseases, malignancies (lymphomas, prostate cancer), dermatologic diseases, and pregnancy.

*    In contrast to hemophilia, hemarthrosis is rare.

*    The diagnosis is based on the prolonged aPTT with normal PT and TT.*

The aPTT remains prolonged after mixture of the test plasma with equal amounts of pooled normal plasma for 2 h at 37°C.

*    Major bleeding is treated with high doses of human or porcine FVIII, PCC/PCCa, or recombinant FVIIa.

*    Anti-CD20 monoclonal antibody (rituximab) – effective in patients with autoantibodies to FVIII.

*    Lupus anticoagulant can be associated with venous or arterial thrombotic disease- a prolonged PTT that does not correct on mixing.

* To distinguish acquired inhibitors from lupus anticoagulants- the dilute Russell’s viper venom test and the hexagonal-phase phospholipids test will be negative in patients with an acquired inhibitor and positive in patients with lupus anticoagulants

15. Which of the following does not present with eosiniphilia and ARF.. ?(AIIMS-NOV-2011)

a.drug induced interstitial nephritis
b.atheroembolic phenomena
c.contrast nephropathy    d.PAN

ANS-D.?C

REF-OPERATION HARRI-PAGE 182,274

Intrinsic Renal Disease

*    Ischemic and toxic ATN account for ~90% of acute intrinsic renal failure.

*    ATN can often be distinguished from prerenal azotemia by urinalysis and urine electrolyte composition.

*    The kidney is vulnerable to toxic injury by virtue of its rich blood supply (25% of cardiac output) .

*    Eosinophiluria – suggestive of allergic interstitial nephritis or atheroembolic renal disease and is observed by using a Hansel stain.

*    Stigmata of atheroemboli (livedo reticularis, distal peripheral infarcts, eosinophilia).

Eosinophilia -1) drugs (iodides, aspirin, sulfonamides, nitrofurantoin, penicillins, and cephalosporins). 2)Allergies such as hay fever, asthma, eczema, serum sickness, allergic vasculitis, and 3)collagen vascular diseases (e.g., rheumatoid arthritis, eosinophilic fasciitis, allergic angiitis, and periarteritis nodosa) and 4)malignancies (e.g., Hodgkin’s disease; mycosis fungoides; chronic myeloid leukemia; and cancer of the lung, stomach, pancreas, ovary, or uterus), as well as in Job’s syndrome and CGD.

16. prothrombin time measurement –?(AIIMS-NOV-2011)

a.within 2 hr should be measured
b.immediately refrigerate to preserve coagulant factor function
c. platelet rich plasma is required
d. activate with kaolin

REF-PARTIAL HELP-OPERAATION HARRI-PAGE: 544

Monitored by prothrombin time- performed by adding thromboplastin, a reagent that contains tissue factor, phospholipid, and calcium, to citrated plasma and determining the time to clot formation.

17. 1 6 year old girl wth primary amenorrhea attends OPD. She has normal sexual development and normal breast but with absent public and axillary hair. Examination shows B/L inguinal hernias.USG shows absent uterus and blind vagina. Diagnosis will be?(AIIMS-NOV-2011)

a.Turner syndrome     b.Mullerian agenesis
c.Star syndrome
d.Androgen insensitivity syndrome

REF-POSITIVE GENETICS, POSIGOLD, AIIMS NOV 2006, Quest: 88, Page 197

OPERATION HARRI–PAGE-213, CONSULTANT

OPERATION HARRI-DICSUSSION

*    Abnormalities of the uterus and outflow tract typically present as primary amenorrhea.

*    Patients with normal pubertal development and a blind vagina- the differential diagnosis includes obstruction by a transverse vaginal septum or imperforate hymen; müllerian agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome), which has been associated with mutations in the WNT4 gene(AI-2010***); and androgen insensitivity syndrome (AIS), which is an X-linked recessive disorder that accounts for ~10% of all cases of primary amenorrhea.

*    Patients with AIS have a 46, XY karyotype, but because of the lack of androgen receptor responsiveness, they have severe underandrogenization and female external genitalia. The absence of pubic and axillary hair (AIIMS-NOV-2010***)distinguishes them clinically from patients with müllerian agenesis.

*    Asherman syndrome presents as secondary amenorrhea or hypomenorrhea and results from partial or complete obliteration of the uterine cavity by adhesions that prevent normal growth and shedding of the endometrium. Curettage performed for pregnancy complications accounts for >90% of cases(AI-2006***)

* Müllerian agenesis may also require surgical intervention, although vaginal dilatation is adequate in some patients. Because ovarian function is normal, assisted reproductive techniques can be used with a surrogate carrier.

18. An elderly male presented with fever, chest pain and dry cough, sputum cultured on charcoal yeast medium, the organism is (AIIMS-NOV-2011)

a.H.influenza               b.Moraxella catarrhalis

c.Legionella                 d.Burkholderia cepacia

ANS-C

REF-POSIGOLD, OPERATION HARRI – PAGE660

Culture

*    Multiple selective BCYE media- grow slowly, requiring 3–5 days.

*    L. pneumophila is often isolated from sputum that is not grossly or microscopically purulent.

*    Sputum containing more than 25 epithelial cells per high-power field (a finding that classically suggests contamination).

Antibody detection

*    A fourfold rise in titer is diagnostic.

 * 12 weeks are often required for the detection of an antibody response.

 *   Used primarily in epidemiologic studies.

 *   Cross-reactivity with Legionella spp. and some gram-negative bacilli.

19. Oculomotor nerve palsy causes all except?(AIIMS-NOV-2011)

a.Miosis                     b.Ptosis
c.Outward eye deviation   d.Diplopia

REF-POSIGOLD

OPERATION HARRI-PAGE-107

Total palsy of the oculomotor nerve causes ptosis, a dilated pupil, and leaves the eye “down and out” because of the unopposed action of the lateral rectus and superior oblique.

20.In herpes zoster all are seen commonly except? (AIIMS-NOV-2011)

a. Pseudo dendritic

b. Anterior stromal keratitis
c. Endothelitis              d. Sclerokeratitis

ans-a

REF-POSITIVE PEARL-OPHTHAL,OPERATION HARRI-PAGE-97

H. Zoster

–  Usually in nasocilliary nerve involvement (Hutchinson’s sign).

–     Stromal keratitis, anterior uveitis, raised intraocular pressure, ocular motor nerve palsies, acute retinal necrosis, and postherpetic scarring and neuralgia are common sequelae.

–     antiviral agents and cycloplegics. In severe cases, glucocorticoids.

POSITIVE PEARL-OPHTHAL HANDOUT

Herpes Zoster Ophthalmicus

21. Increased level of alanine in serum after fasting suggests? ?(AIIMS-NOV-2011)

A. Increased muscle breakdown
B. Reduced amino acid utilisation from gluconeogenesis
C. Break in continuity of plasma membrane resulting in leakage of amino acids
D.

ANS-A

REF-CONSULTANT,OPERATION HARRI-PAGE-PAGE-322

Gluconeogenesis

*    The major aim of protein catabolism during a state of starvation is to provide the glucogenic amino acids (especially alanine and glutamine)

*    In the hypometabolic/starved state, protein breakdown for gluconeogenesis is minimized, especially as ketones derived from fatty acids become the substrate preferred by certain tissues.

*      In the hypermetabolic/stress state, gluconeogenesis increases dramatically

22. Same aminoacid is coded by multiple codons due to following : ?(AIIMS-NOV-2011)

a.Degeneracy            b.Frame shift mutation
c.Transcription           d.Mutation

ANS-A

REF-OPERATION HARRI PAGE-PAGE-277,

POSIGOLD-AI-2007, AI-2006, AIIMS NOV 2006, Ques: 189, Page 204,CONSULTANT-

What is degeneracy of codon?

There are three nucleotides which make combinations of three to form a codon. So 4C3 i.e., 4^3 = 64 combinations or codons are possible, we know three of them are stop codons, so 61 code for 20 aminoacids i.e., more than one codon code for a single aminoacid, this is Known as degeneracy of codon.

OPERATION HARRI-DISCUSSION

Structure of DNA

*    DNA is a double-stranded helix composed of four different bases: adenine (A), thymidine (T), guanine (G), and cytosine (C). Adenine is paired to thymidine, and guanine is paired to cytosine, by hydrogen bond interactions.

*    Messenger RNA (mRNA) is encoded by  sense or coding strand of the DNA double helix and is translated into proteins by ribosomes.

*    Codons, a triplet of bases that specifies a particular amino acid. It is possible to arrange the four bases into 64 different triplet codons (4³). Each codon specifies 1 of the 20 different amino acids.

*    More codons than amino acids, the genetic code is degenerate.

23. Systemic steroids are indicated in? ?(AIIMS-NOV-2011)

A. Pustular psoriasis  B. Impetigo herpetiformis
C. Psoriatic arthropathy
D. Psoaritic erythroderma

ANS-C

PARTIAL HELP FROM OPERATION HARRI-page-231

psoriasis –

*    Most patients with localized, plaque-type psoriasis can be managed with midpotency topical glucocorticoids.

*    A topical vitamin D analogue (calcipotriene) and a retinoid (tazarotene) are efficacious in the treatment of limited psoriasis and have  replaced other topical agents such as coal tar, salicylic acid, and anthralin.

*    Ultraviolet B (UV-B) light, narrowband UV-B, and ultraviolet A (UV-A) spectrum with either oral or topical psoralens (PUVA) are  effective.

*    The long-term use of UV light is associated with an increased incidence of non-melanoma and melanoma skin cancer.

*    UV light therapy is contraindicated in patients receiving cyclosporine.

*    Oral glucocorticoids should not be used for the treatment of psoriasis due to the potential for developing life-threatening pustular psoriasis when therapy is discontinued.

*    Methotrexate is an effective agent, especially in patients with psoriatic arthritis.

24. Intra-epidermal IgG is associated with? (AIIMS-NOV-2011)

A. Pemphigus             B. Bullous pemphigoid
C. ?                              D. ?

ANS-A

REF-OPERATION HARRI-PAGE238, CONSULTANT

Pemphigus Vulgaris

*    Intraepidermal blistering diseases characterized by loss of cohesion between epidermal cells (a process termed acantholysis).

*    Manual pressure to the skin of these patients may elicit the separation of the epidermis (Nikolsky’s sign)-also seen in toxic epidermal necrolysis, Stevens-Johnson syndrome.

*    Predominates in patients >40 years.

*    PV typically begins on mucosal surfaces.

*    PV may be associated with severe skin pain.

*   Lesions  heal without scarring.

*    Postinflammatory hyperpigmentation is usually present at sites of healed lesions.

*    Biopsies – intraepidermal vesicle formation secondary to loss of cohesion between epidermal cells (i.e., acantholytic blisters).

*    Blister formation is within the suprabasal portion of the epidermis.

*    Direct immunofluorescence microscopy of lesional or intact patient skin shows deposits of IgG on the surface of keratinocytes.

25. A man presents with a 6 month history of recurrent oral ulceration. He has yellowish ulcerations on his lip which are erythematous, with a central halo and nodular lesions on his shin. Diagnosis is : (AIIMS-NOV-2011)

A. Behcet’s syndrome                  B. Herpes labialis
C. Fixed drug eruption  D. Pemphigus vulgaris

ANS-A

REF-OPERATION HARRI-PAGE-128,MKT

26. IgA deposits in dermal papilla. Diagnosis? (AIIMS-NOV-2011)

a.Dermatitits herpetiformis
b.pemphigus
c.Bullous pemphigoid
d.IgA dermatosis of childhood

ans-a

REF-OPERATION HARRI PAGE 238

27. HRT is useful in all except?(AIIMS-NOV-2011)

a.Flushing                    b.Osteoporosis
c.Vaginal atrophy

d.Coronary heart disease

ANS-D

REF-POSIGOLD

OPERATION HARRI-PAGE-15

Hormone therapy – no cardioprotective effect

28. Which of the following is the least likely physiological change in pregnancy?(AIIMS-NOV-2011)

a) Increase in intravascular volume
b) Increase in cardiac output
c) Increase in stroke volume
d) Increase in peripheral vascular resistance

ANS-D
REF – OPERATION HARRI – PAGE 18,

OPERATION HARRI -DISCUSSION

MEDICAL DISORDERS DURING PREGNANCY

a) Introduction

*    Cardiac output increase by 40%.

*    Heart rate – increases by 10/mt in 3^rd Trimester.

*    2^nd Trimester –decrease systemic vascular resistance.

*    B.P – measured in the sitting position(lateral recumbent position is associated with a lower blood pressure).

*    HT – more than 2 readings elevated at 6 hrs apart.

CONSULTANT DISCUSSION

Cardiovascular changes in pregnancy

Cardiac output              increased 40%

        Increase in pulse rate

        Increase in stroke volume

        Increase in contractility

        Peripheral resistance diminished

29. Granulosa cell tumor marker?(AIIMS-NOV-2011)

a.inhibin                      b.CA-19-9
c.CA 5                         d.CA-125

ANS-A

REF-CONSULTANT,OPERATION HARRI-PAGE429

OPERATION HARRI –DISCUSSION

Granulosa cell tumors -secrete estrogen and cause menstrual abnormalities, bleeding, and precocious puberty-Endometrial carcinoma can be seen in 5%.

*    Sertoli and Leydig cell tumors-produce androgens with resultant virilization or hirsutism.

*    Can be cured with total abdominal hysterectomy and bilateral salpingo-oophorectomy. – grow slowly.

*    Serum markers – estradiol, inhibin, and müllerian inhibitory substance.

*    Neither radiation therapy nor chemotherapy.

30. With reference to Bacteroides fragilis, the following statements are true except?(AIIMS-NOV-2011)

a.B.fragilis is the same frequent anaerobe isolated from clinical samples
b.B.fragilis is not uniformly sensitive to metronidazole
c.The lipopolysaccaride formed by B.fragilis is structurally and functionally different from the conventional endotoxin
d.Shock and disseminated intravascular coagulation are common in Bacteroides bacteremia

REF-POSIGOLD,OPERATION HARRI-PAGE 699

Pathogenesis

*    Occur when an anatomic barrier becomes disrupted and constituents of the local flora enter a site that was previously sterile.

*    Prevotella melaninogenica attaches to other microorganisms- fimbriae that facilitate attachment.

*    Some Bacteroides strains have pili.

*    Virulence factor-polysaccharide complex of B. fragilis.

*    Interleukin (IL) 8, IL-17, and tumor necrosis factor (TNF)alfa-stimulate abscess formation.

*    IL-10- the cytokine inhibits of abscess formation.**

*    The collagenase produced by P. gingivalis may enhance tissue destruction.

*    An enterotoxin has been identified in B. fragilis strains associated with diarrheal disease.

*    B. fragilis possess lipopolysaccharides (LPSs, endotoxins) that are 100–1000 times less biologically potent than endotoxins associated with aerobic gram-negative bacteria-lower frequency of DIC and purpura in Bacteroides bacteremia (AIIMS-NOV-06***,AIIMS-N0V-2011).

31. A patient admitted to an ICU is on central venous line for the last one week. He is on ceftazidime and amikacin. After 7 days of antibiotics he develops a spike of fever and his blood culture is positive for gram positive cocci in chains, which are catalase negative. Following this, vancomycin was started but the culture remained positive for the same organism even after 2weeks of therapy. The most likely organism causing infection is?(AIIMS-NOV-2011)

a.Staphylococcus aureus
b.Viridans streptococci
c.Enterococcus faecalis
d.Coagulase negative staphylococcus

ANS-C

REF-OPERATION HARRI-623,POSIGOLD

OPERATION HARRI DISCUSSION

Enterococci and Nonenterococcal Group D Streptococci

*    Gram positive -Cocci  -Nonmotile -Predominately inhabit human intestines.

*   Facultative anaerobes (prefer anaerobic) -Used as indicators of fecal pollution.

*    Belong to Lancefield’s serologic group D -Catalase negative.

*    Can grow in 6.5% NaCl.

*    Can grow at a pH range of 9.6 to 4.6 .

*    Can grow at temperatures ranging from 10 to 45°C .

*    Sensitive to chlorination.

*    A common cause of nosocomial bacteremia in patients with intravascular catheters and account for 10–20% of cases of bacterial endocarditis.

*    Enterococci are frequently cultured from bile and are involved in infectious complications of biliary surgery.

*    Treatment-resistant to all cephalosporins*- enterococcal endocarditis and meningitis-penicillin or ampicillin plus gentamicin.

*    Penicillin Resistance – 2 methods.

1) b lactamase- E. faecalis-Trt- vancomycin, ampicillin/sulbactam, amoxicillin/clavulanate, imipenem, or meropenem may be used in combination with gentamicin.

2)   Altered penicillin binding protein- common among E. faecium isolates.

32. The following drug is not useful for MRSA?(AIIMS-NOV-2011)

a.Cefaclor                  b.Cotrimoxazole
c.Ciprofloxacin            d.???????

ANS-A

Ref-OPERATION HARRI-PAGE-60, CONSLUTANT

OPERATION HARRI DISCUSSION

MRSA

*    Vancomycin – Vancoresistance – Van A gene

Drugs used

*    Chloramphenicol

*    Linezolid

*    Minocycline

*    Quinupristin/Dalfopristin

*    Septran

*    Quinolones

*    Tigecycline

*    Dalbavancin, oritavancin, and ceftobiprole

*    Oral agents -clindamycin, TMP-SMX, doxycycline, telavancin and linezolid.

*    New – Daptomycin – (Parentral, cidal) – is approved for the treatment of bacteremias and complicated skin infections. It is not effective in respiratory infections- has a novel mechanism of action: it disrupts the cytoplasmic membrane Ortivancin – a new Glycopeptide

SIMILAIR QUESTION IN SURGERY DICSUSSION

Not useful against MRSA

a) Cefaclor                

b) Cotrimoxazole

c) Ciprofloxacin

d) Vancomycin         

e) Linezolid

ANS-A

33. Efavirenz acts through the following mechanism(AIIMS-NOV-2011)

a.Protease inhibitor
b.Preventing HIV entry into cell
c.Reverse transcriptase inhibitor
d.Integrase inhibitor

ANS-C

REF-CONSULTANT,OPERATION HARRI-PAGE-830

Reverse Transcriptase Inhibitors

Nucleoside	Nucleotide
Zidovidine Didanosine Zalcitabine Stavudine Lamivudine Abacavir Emtricitabine	Tenofovir

NNRTI

*    Nelvirapine

*    Delaviridine

*    Efavirnez

Protease Inhibitor

*    Saquinavir

*    Ritonavir

*    Indinavir

*    Nelfinavir

*    Amprenavir

*    Fosamprenavir

*    Lopinavir

*    Atazanavir

Fusion Inhibitor
–  Enfuvirtide

ANS-

Disease	Protein featured	Official abbreviation
Alzheimer’s disease	Beta amyloid[6][7][8]	Aβ
Diabetes mellitus type 2	IAPP (Amylin)[9][10]	AIAPP
Parkinson’s disease	Alpha-synuclein[7]	none
Transmissible spongiform encephalopathy e.g. Bovine spongiform encephalopathy	PrPSc[11]	APrP
Huntington’s Disease	Huntingtin[12][13]	none
Medullary carcinoma of the thyroid	Calcitonin[14]	ACal
Cardiac arrhythmias, Isolated atrial amyloidosis	Atrial natriuretic factor	AANF
Atherosclerosis	Apolipoprotein AI	AApoA1
Rheumatoid arthritis	Serum amyloid A	AA
Aortic medial amyloid	Medin	AMed
Prolactinomas	Prolactin	APro
Familial amyloid polyneuropathy	Transthyretin	ATTR
Hereditary non-neuropathic systemic amyloidosis	Lysozyme	ALys
Dialysis related amyloidosis	Beta 2 microglobulin	Aβ2M
Finnish amyloidosis	Gelsolin	AGel
Lattice corneal dystrophy	Keratoepithelin	AKer
Cerebral amyloid angiopathy	Beta amyloid[15]	Aβ
Cerebral amyloid angiopathy (Icelandic type)	Cystatin	ACys
systemic AL amyloidosis	Immunoglobulin light chain AL[14]	AL
Sporadic Inclusion Body Myositis	S-IBM	none

 

Official abb.	Amyloid type/Gene	Description
AL	amyloid light chain	AL amyloidosis / multiple myeloma. Contains immunoglobulin light-chains (λ,κ) derived from plasma cells.
AA	SAA	AA amyloidosis
Aβ	β amyloid/APP	Found in Alzheimer disease brain lesions.
ATTR	transthyretin	A mutant form of a normal serum protein that is deposited in the genetically determined familial amyloid polyneuropathies. TTR is also deposited in the heart in senile systemic amyloidosis.[6] Also found in Leptomeningeal amyloidosis.
Aβ2M	β2 microglobulin	Not to be confused with Aβ, β2m is a normal serum protein, part of major histocompatibility complex (MHC) Class 1 molecules. Haemodialysis-associated amyloidosis
AIAPP	amylin	Found in the pancreas of patients with type 2 diabetes.
APrP	prion protein	In prion diseases, misfolded prion proteins deposit in tissues and resemble amyloid proteins. Some examples are Creutzfeldt–Jakob disease (humans), BSE or “mad cow disease” (cattle), and scrapie (sheep and goats).
AGel	GSN	Finnish type amyloidosis
ACys	CST3	Cerebral amyloid angiopathy, Icelandic-type
AApoA1	APOA1	Familial visceral amyloidosis
AFib	FGA	Familial visceral amyloidosis
ALys	LYZ	Familial visceral amyloidosis
?	OSMR	Primary cutaneous amyloidosis
ABriADan	ITM2B	Cerebral amyloid angiopathy, British-type Danish-type
Pro	prolactin	Prolactinoma
AKer	keratoepithelin	Familial corneal amyloidosis
AANF	atrial natriuretic factor	Senile amyloid of atria of heart
ACal	calcitonin	Medullary carcinoma of the thyroid

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• Online and Classroom Model Exams for AIPG and State PG TNPG Tamil Nadu Post Graduate Entrance. Click here to know the details

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• Face your exams with confidence with PRC – Positive Residential Care : Individual -need based – Entrance Exam oriented care

• Answers for 100 Questions in AIPG 2012 ( All India PG / AIPPG / AIPGME / AIPGMEE 2012 ) from Operation Harri – A Book for AIIMS and AIPG from Positive Coaching