Q1318. of life. Laboratory investigations reveal severe hyperammonemia, low citrulline levels, elevated plasma glutamine, and normal orotic acid levels in urine. There is no evidence of metabolic acidosis or hypoglycemia. What is the most likely diagnosis?

Q1327. A 7-year-old child presents with a rapidly enlarging jaw mass. The lymphoma is known to have a strong association with Epstein–Barr virus infection. Which of the following chromosomal translocations is most characteristic of this condition?

Q1350. The primary mechanism of action of botulinum toxin is?

Q1352. vomiting, or vaginal discharge. Her vitals are stable, and there is no history of recent antibiotic use or urinary tract abnormalities. Empirical therapy is being considered. Which of the following drugs should NOT be preferred as first-line empirical treatment in this case?

Q1355. confused, febrile (39.5°C), with a positive Kernig’s sign and neck rigidity. On CSF analysis show low glucose. Fundoscopy shows no papilledema. The physician decides to start empirical antibiotics immediately. Which of the following is the most appropriate empirical therapy?

Q1361. A 48-hour culture on the PPLO agar shows small colonies showing fried egg colonies. Which organism is most likely?

Q1362. A patient from an endemic area presents with chronic respiratory symptoms. Microscopy shows small oval yeast forms with narrow-based budding, seen inside macrophages. Which of the following organisms is most likely responsible?

Q1364. An HIV-positive patient presents with curdy white vaginal discharge. Microscopic examination of the discharge on KOH mount shows oval, narrow-based budding yeast cells measuring 4–6 μm. The organism causing this infection is an opportunistic pathogen. Which of the following is the correct characteristic of this organism?

Q1366. A 4-year-old child presents with fever, cough, and signs of lower respiratory tract infection. Sputum culture shows no growth on blood agar but grows on chocolate agar. The organism is a fastidious gram-negative bacillus requiring Factor X and Factor V for growth. The most likely causative organism is:

Q1367. A young man gives a history of bathing in pond water. He develops a rapidly moving, serpiginous, pruritic rash over the body. A stool examination shows no ova and no cysts, but larvae are identified. Routine bacterial culture is negative. What is the most likely causative organism?

Q1369. A 30-year-old foreign traveler presents with acute onset profuse watery diarrhea for 12 hours. The stools are colorless and rice-water–like, with no blood or pus. He has signs of severe dehydration. Which toxin is responsible for this illness?

Q1370. Patient with history of consuming home-canned vegetables at a family gathering presents with acute flaccid paralysis. The clinical picture is attributed to botulinum toxin produced by Clostridium botulinum. What is the most likely mode of transmission in this case?

Q1418. Under the Integrated Child Development Services (ICDS) program in India, children aged 6 months to 6 years (6–72 months) receive supplementary nutrition at the Anganwadi center. What is the minimum calorie and protein provided per day under the program?

Q1420. A healthcare facility has a stock of expired antibiotics. What is the correct method for their disposal according to biomedical waste and environmental guidelines?

Q1422. Two ANMs are available, and the session has 2 hours left. They have a single vaccine vial carrier. To optimize session management, maximize vaccination coverage, minimize vaccine wastage, and ensure effective cold chain utilization, which strategy would be most appropriate?

Q1429. The “Health for All (HFA)” initiative launched after the Alma-Ata Declaration, 1978, aimed to achieve universal health coverage. Later, global focus shifted to Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs). Which of the following is the primary reason for this shift?

Q1436. A patient is brought to the emergency department in a state of shock. A laboratory evaluation is performed, revealing the following biochemical profile: pH = 4.5, HCO3- = 20 mEq/L, and pCO2 = 25 mmHg. Which of the following best describes this patient's acid-base status?

Q1529. A 22-year-old Kabaddi player sustains a twisting injury to the knee while playing. He complains of immediate pain and instability. The injury occurred when the knee was partially flexed and the foot was planted on the ground. Which structure is most likely injured?

Q1565. A patient presents with a painful genital ulcer of acute onset. On examination, the ulcer has ragged, undermined edges with a purulent base. He also has tender, unilateral inguinal lymphadenopathy. What is the most likely causative organism