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An, 8 year old boy, weighing 30kg is undergoing resection of wilms tumor. His hemoglobin is 12g/dL. If the threshold for transfusion is 8g/dL, the allowable blood loss is | [
"820ml",
"840ml",
"860ml",
"880ml"
] | B | null | train | med_mcqa | null |
Glucose reabsorption occurs in the | [
"Proximal tubule.",
"Loop of Henle.",
"Distal tubule.",
"Cortical collecting duct."
] | A | Glucose, amino acids, and bicarbonate are reabsorbed along with Na+ in the early portion of the proximal tubule. | train | med_mcqa | null |
Which of the following is the most common cause of midsystolic murmur in adults? | [
"Aortic stenosis",
"Aortic regurgitation",
"Hypertrophic obstructive cardiac myopathy",
"All of the above"
] | A | AS is the most common cause of a midsystolic murmur in an adult. | train | med_mcqa | null |
A 60-year-old alcoholic who sustained blunt trauma to his head due to assault is brought to the ER. HE opens his eyes to pain and speaks incomprehensible words when his sternum is pressed. He withdraws his hand to pain. His Glasgow Coma Score is- | [
"6",
"8",
"10",
"12"
] | B | Ans. is 'b' i.e., 8 E-To pain +V- incomprehensible words + M- Withdraws to pain 2+2+4 A) Eye opening B) Verbal response C) Motor response Spontaneous 4 Oriented 5 Obeys commands 6 To Voice 3 Confused 4 Localises pain 5 To pain 2 Inappropriate words 3 Withdraws (pain) 4 None 1 Incomprehensible words 2 Flexion (pain) 3 None 1 Extension (pain) None 2 1 o A score of 7 or less is classed as coma o A score of 9 or more excludes coma | train | med_mcqa | null |
Glycogen phosphorylase requires - | [
"Thiamine pyrophosphate",
"Pyridoxal phosphate",
"Citrate",
"FAD"
] | B | Ans. is 4b' i.e., Pvridoxal phosphate o Glycogenolysis occurs primarily by phosphorolytic breaking of a-l,4-glycosidic bonds of glycogen. The key enzyme responsible for glycogenolysis is glycogen phosphorylase which catalyses stepwize phosphorolytic removal of glucose as glucose-1-phosphate, from glycogen.o Pvridoxal phosphate is essential cofactor in this reaction; it is covalently bound to glycogen phosphorylase. | train | med_mcqa | null |
Which drug has more analgesic effects than morphine? | [
"Heroin",
"Apomorphine",
"Codeine",
"Pethidine"
] | A | Codeine is less potent than morphine as an analgesic(60mg codeine=10 mg morphine). 100 mg pethidine= 10 mg morphine.Heroin is conveed to morphine in the body and has higher lipid solubility than morphine. Ref KD Tripathi 8th ed. | train | med_mcqa | null |
Uncontrolled hypeension may cause which of the following complication in cataract surgery: | [
"Glaucoma",
"Retinal detachment",
"Endophthalmitis",
"Suprachoroidal hemorrhage"
] | D | Uncontrolled hypeension is a r/f for suprachoroidal hemorrhage. Impoant Pre-op evaluation points for ocular surgeries Diabetes: Uncontrolled DM is a r/f for Endophthalmitis. Hypeension: R/f for suprachoroidal hemorrhage. Stroke: positional problem for the patient. HIV: Universal precautions to be taken. Epilepsy: General anesthesia may be preferred. | train | med_mcqa | null |
Which of the following is associated with secondary hyperparathyroidism - | [
"Parathyroid adenoma",
"Marked hypercalcemia",
"Chronic renal failure",
"Parathyroidectomy relieves the symptoms"
] | C | severe secondary hyperparathyroidism occurs due to hypercalcemia associated with renal failure (Harrison 17 pg 2387) | train | med_mcqa | null |
Cushing Ulcer seen in | [
"Stress ulcer in Head injury",
"Stress ulcer in Burns",
"Ulcer in Crohn's disease",
"Ulcer in Hiatus hernia"
] | A | * Cushing ulcer: Ulcer in stomach in stress and head injury (Most common site is body and fundus) * Curling ulcer: Ulcer in duodenum > Stomach in burns * Cameron ulcer: Ulcer in proximal stomach in hiatus hernia (veical ulcers also known as riding ulcers) Ref:- Surgery Sixer 3rd Edition; Pg num:- 364 | train | med_mcqa | null |
The "rotator cuff' muscle includes all EXCEPT | [
"Supraspinatus",
"Infraspinatus",
"Teres major",
"Subscapularis"
] | C | (Teres Major) (489 - Snell 7th)ROTATOR CUFF - Four muscle - Supraspinatus, Infraspinatus Teres minor and the subscapularis - Form what is termed the "rotator cuff '. The tone of these muscles assists in holding the head of the humerus in the glenoid cavity of the scapula during movements at the shoulder joint. Therefore they assist in stabilizing the shoulder joint. The cuff lies on the anterior, superior and posterior aspects of the joint. The cuff is deficient inferiorly, and this is a site of potential weakness.* The commonest cause of pain around the shoulder is a disorder of the rototor cuff' (Rotator cuff syndrome) | train | med_mcqa | null |
Positive hepatojugular reflux is found in all of the following conditions except - | [
"Tricuspid regurgitation",
"Right heart failure",
"Decreased after load",
"Increased capillary bed pressure"
] | C | Ans. is 'c' i.e., Associated with decreased afterload [Ref: CMDT 2007p. 318; British Medical Journal May 1999\ Hepatojugular refluxThis is done by applying firm pressure with the palm of the hand to the right upper quadrant of the abdomen for 10- 30 seconds with the patients breathing quietly while the jugular vein is observed.In normal subjects (Negative hepatojugular reflux)Jugular venous pressure rises only transiently with rapid return to the baseline.Positive hepatojugular reflux (Left ventricular failure Q)A positive abdominojugular reflux sign is defined by an increase in the jugular venous pressure of greater than 3 cm, sustained for greater than 15 seconds.ExplanationPushing on the liver (or even midabdomen) for about 15 seconds increases the amount of blood returned to the right atrium and right ventricle (increased preload).Concurrently, there is increase in right ventricle afterload, owing to upward movement of the diaphragm which reduces intrathoracic volumes. (Pulmonary artery pressure is increased due to reduced intrathoracic volumes). (Leading to increased right ventricle afterload)In a normal person the jugular venous pressure would rise temporarily and then normalize quickly as the healthy right ventricle pumps out the additional blood i.e. it handles the increase in preload and afterload quite well.A dysfunctioning right ventricle however fails to accept this increase in preload and afterload and therefore there is persistent elevation of systemic venous pressure.The abdominojugular reflux is not specific to any disorder but rather is a reflection of the inability of the right ventricle to accept or reject the transiently increased venous return."Positive abdominojugular reflux is most commonly associated with left ventricular failure".In the absence of left heart failure a positive abdominal jugular reflex sign should prompt consideration of :-Impaired right ventricular preloadA Decrease in right ventricular compliance.A decrease in right ventricular systolic function orAn elevation in right ventricular afterload.Conditions associated with abdominojugular reflux -Left ventricular failure Q (MC)Right heart failure QConstrictive pericarditis QRight ventricular infarction QRestrictive cardiomyopathy QNote - Both pulmonary stenosis and tricuspid regurgitation cause right heart failure. | train | med_mcqa | null |
Test to differentiate between psychological and organic erectile dysfunction: NEET 13 | [
"Pharmacologically induced penile erection therapy",
"Nocturnal penile tumescence",
"Sildenafil induced erection",
"Squeeze technique"
] | B | Ans. Nocturnal penile tumescence | train | med_mcqa | null |
In Maple syrup urine disease, which of the following compounds is accumulated: | [
"Homogentisic acid oxidase",
"Methyl malonyl CoA",
"a-keto acid decarboxylase",
"Transaminase"
] | C | Ans. C. a-keto acid decarboxylaseValine, Leucine and Iso leucine are branched chain amino acids which undergo degradation to form various products. Valine is glucogenic and forms Succinyl CoA. Leucine is ketogenic and forms Acetoacetate and Acetyl CoA. Isoleucine is ketogenic (Acetyl CoA) and Glucogenic (Succinyl CoA). Absence of a-keto acid decarboxylase leads to an inherited disorder Maple Syrup Urine Disease. In this urine gives the smell of burnt sugar. | train | med_mcqa | null |
Temporal association of a disease is best established by | [
"Case-Control study",
"Cross-section study",
"Coho study",
"Descriptive study"
] | C | Temporal relationship: Exposure must precede disease"A well-designed coho study is considered the most reliable means of showing an association between a suspected risk factor and subsequent disease"Park 23e pg:76 | train | med_mcqa | null |
Best fixative for Pap smear: | [
"95% ethanol + 5% ether",
"10% formaldehyde",
"80% isopropyl alcohol",
"90% ether + alcohol"
] | A | ANS. AFixatives:* Pap smear: 95% ethanol + 5% ether* Light microscopy: 10% formaldehyde* Electric microscopy: 2% glutaraldehyde* For liquid-based cytology: Methanol* For bone marrow biopsy: Zenker's fluid* For bone marrow aspirate: Helly's fluid* Cell block: Bouin's fluid* Karyotyping fixatives: Carnoy's fixative (3:1 methanol to glacial acetic acid)* Gastrointestinal biopsies: Bouin's fluid. | train | med_mcqa | null |
A patient presented with scarring alopecia, thinned nails, hyperpigmented macular lesions over the trunk and oral mucosa. Diagnosis is: | [
"Psoriasis",
"Leprosy",
"Lichen planus",
"Pemphigus"
] | C | Scarring alopecia is found in LP and Leprosy both. But oral mucosal involvement and thinning of nails or the diagnosis of LP. | train | med_mcqa | null |
All except one are true about cocaine | [
"Is ester of benzoic acid",
"Produces para aminobenzoic acid as metabolite",
"Metabolised by liver",
"Vasoconstrictor"
] | B | Cocaine being metabolisd by liver, does not produce PABA. | train | med_mcqa | null |
Synkinesis is a sequel of | [
"Facial nerve paralysis",
"Trigeminal nerve paralysis",
"Superficial temporal nerve paralysis",
"Greater petrosal nerve paralysis"
] | A | Synkinesis or mass movement is a complication of peripheral facial nerve paralysis which occurs due to cross-innervation of fibres. Ref: Dhingra 6th edition pg. 98 | train | med_mcqa | null |
True about cryptococcus are all except | [
"Primarily infects lung",
"Urease negative",
"India-ink is used",
"All are true"
] | B | Ans. is `b i.e., Urease negative CRYPTOCOCCUS NEOFORMANS The only pathogenic yeast Four capsular serotypes - A, B, C and D It has polysaccharide capsule Most infections in immunocompromized patients are caused by serotype A. Pigeon droppings commonly contains serotype A and D. Eucalyptus tree contain serotype B. It is urease positive. Mode of transmission By inhalation of the fungus into the lung (most common) Through skin or mucosa (some times). | train | med_mcqa | null |
Which of the following statments is not true of McBurney's incsion - | [
"Most suitable if the diagnosis of appendicitis is definite",
"If it is converted into a muscle cutting incision it is called Rutherford Morison's incision",
"Inguinal hernia is a sequlae of the incision",
"The incision can be extended upwards or downwards"
] | D | Incision is extended upwards and laterally not downwards. | train | med_mcqa | null |
Chorea is NOT seen in | [
"Huntington's disease",
"Creutzfeldt-Jakob disease",
"Rheumatic fever",
"Tourette syndrome"
] | D | (D) Tourette Syndrome # TOURETTE SYNDROME is a neurological disorder characterised by sudden rapid, involuntary movements called tics, which occur repeatedly. Tourette Syndrome is also linked to other behaviours, most often OCD and Attention Deficit Disorder (ADHD).> Symptoms can include bouts of motor and vocal tics and the focus of these tics tends to wax and wane over time.> Typically tics increase as a result of stress or tension, and may decrease when relaxed or absorbed in a task.> Chorea is seen with: Huntington's disease, a group of neurodegenerative diseases such as Creutzfeldt-Jakob disease and Kuru, children and adolescents with rheumatic fever develop Sydenham's chorea as a complication, drugs like levodopa, anti-convulsants, anti-psychotics, Wilsond disease and Chorea gravidarum is rare type of chorea which is a complication of pregnancy. | train | med_mcqa | null |
Eye examination of a patient revealed lack of upward gaze and dilated pupils fixed to light. What is the MOST probable location of the lesion? | [
"Optic chiasm",
"Inferior colliculus",
"Superior colliculus",
"Edinger Westphal nucleus"
] | C | In a patient with lesion of the superior colliculus, there is loss of upward gaze associated with dilated pupils that are fixed to light. Lesions in the collicular region is caused by pressure and distoion of underlying structures in the midbrain and not by damaged to specific pathways traversing the colliculi. It can produce any combination of impaired upward gaze, impaired downward gaze, pupillary abnormalities or loss accommodation reflex can occur. The general name for the clinical picture produced is called Perinaud's syndrome. Ref: Textbook of Ophthalmology edited by Sunita Agarwal, page 284. | train | med_mcqa | null |
Which is the pathognomic feature of Alzheimer's disease? | [
"Lewy bodies",
"Pick bodies",
"Ballooned neurons",
"Plaque and tangles"
] | D | Ans. d. Plaque and tanglesRef: Robbins and Cotran Pathologic Basis of Disease 9th Ed; Page No-1290Alzheimer disease is the most important cause of dementia in elderly.It usually begins after age of 50 years.Most cases are sporadic; only 5-10 of cases are familial.Pneumonia is the most common cause of death.Grossly:Cortical atrophy with narrowed gyri and widened sulci especially in the frontal, temporal, and parietal lobes.Hydrocephalus ex vacuo also occurs due to cortical atrophy.Earliest sites involved are medial temporal lobe structure.Morphologic AbnormalitiesNeurofibrillary tangles (NFT):NFT are bundles of helical filaments in neural cytoplasm.It is hypo phosphorylated tau protein.Especially seen in the cerebral cortex.It is clearly visible by sliver (Bielschowsky) staining.Neuritic (senile) plaques:They are spherical collections of dilated, tortuous, neuritic processes (dystrophic neutrites) within the cerebral cortex, hippocampus, and amygdala.A distinctive peptide structure is present around central amyloid core.Non-specific findings.Increased number of neuritic plaque correlates advanced age and severity of dementia.Granulovacuolar degeneration: is the intraneuronal cytoplasmic granule-containing small and clear vacuoles occurring within the pyramidal cells of the hippocampusAmyloid angiopathy: Almost Invariably accompanies Alzheimer disease. There is vascular p-amyloid deposition.Hirano bodies: Are the intracytoplasmic proximal dendritic eosinophilic inclusions containing actin protein.EtiologyAbnormal amyloid gene expression is the most favored etiologic concept today.Ap40 Aggregates are directly neurotoxic and it will induce synaptic damage of nucleus basalis of mayernet. This will decreases the brain content of the enzyme and its product acetylcholine, especially in the cerebral cortex and hippocampus. Acetylcholine plays a role in learning, and drugs that block its action adversely affect short-term memory.The APP gene located on chromosome 21; it encoded for amyloid precursor protein, a precursor to the Ab peptide. Mutations in the APP gene have been linked to familial Alzheimer disease.Down syndrome patients (trisomy 21) experience early onset Alzheimer disease secondary to gene dosage effect.Other genetic abnormalitiesInheritance of the[?]4 allele of apoprotein E is located in chromosome 19; is associated with greater frequency in patients with Alzheimer disease.Mutations in genes coding for presenilins. Presenilin-1 located in chromosome 14 and presenilin-2 located in chromosome 1 have been associated with many kindreds with familial early onset Alzheimer disease. | train | med_mcqa | null |
What is the MOST suitable management for a 2 year old child presenting with complaints of cough for 5 days. On examination his respiratory rate is 40/ minute. He is well nourished, ale and feeding well: | [
"Advise mother to give home care",
"Sta cotrimoxazole in age appropriate doses",
"Sta with first dose intramuscular ampicillin",
"None of the above"
] | A | As per IMNCI classification, child has no pneumonia. Antibiotics are not recommended in the management. The child is given symptomatic management. The mother is advised to give home care. Ref: Park 21st edition, page 160-161. | train | med_mcqa | null |
A 2 years old child presents with cleft of the hard and soft palate which extends till the incisive foramen. According to Veau's classification this case comes under | [
"Group I",
"Group II",
"Group III",
"Group IV"
] | B | null | train | med_mcqa | null |
'Boari's Operation' is | [
"Renal pelvic flap",
"Urinary diversion",
"Bladder flap",
"None"
] | C | Bladder flap | train | med_mcqa | null |
Calcific hepatic metastases are seen in – | [
"Adenocarcinoma of the colon",
"Carcinoid tumours",
"Renal cell carcinoma",
"Lymphoma"
] | A | A calcified pattern in hepatic metastasis is commonly due to mutinous adenocarcinoina of colon or ovary. | train | med_mcqa | null |
Which of the following conditions may lead to exudative pleural effusion | [
"Cirrhosis",
"Nephrotic syndrome",
"Congestive hea failure",
"Bronchiogenic carcinoma"
] | D | Ref Harrison Malignant pleural effusions secondary to metastatic disease are the second most common type of exudative pleural effusion. The three tumors that cause ~75% of all malignant pleural effusions are lung carcinoma, breast carcinoma, and lymphoma. Ref Davidson edition23rd pg 626 | train | med_mcqa | null |
A 75-year-old woman is admitted to the hospital after falling in her bathroom. Radiographic examination reveals an extracapsular fracture of the femoral neck. Which artery is most likely at risk for injury? | [
"Inferior gluteal",
"First perforating branch of deep femoral",
"Medial circumflex femoral",
"Obturator"
] | C | The medial circumflex femoral artery is responsible for supplying blood to the head and neck of the femur by a number of branches that pass under the edge of the ischiofemoral ligament. This artery is most likely at risk for injury in an extracapsular fracture of the femoral neck. The inferior gluteal artery arises from the internal iliac and enters the gluteal region through the greater sciatic foramen, below the piriformis. The first perforating artery sends an ascending branch that anastomoses with the inferior gluteal artery in the buttock. The obturator artery arises from the internal iliac artery and passes through the obturator foramen. It commonly supplies the artery within the ligament of the head of the femur. The superior gluteal artery arises from the internal iliac artery and enters through the greater sciatic foramen above the piriformis. | train | med_mcqa | null |
Sine wave in ECG is seen in? | [
"Hyperkalemia",
"Hypokalemia",
"Hypercalcemia",
"Hypocalcemia"
] | A | a. Hyperkalemia(Ref: Nelson's 20/e p 357-360)Hyperkalemia produces a sequence of changes in ECG:1st ECG finding: Narrowing and peaking (tenting) of the T wavesQFurther elevation of K+ leads to AV conduction disturbances, | P-wave amplitude & widening of QRS intervalSevere hyperkalemia eventually causes with a slow sinusoidal "sine-wave" pattern followed by asystole. | train | med_mcqa | null |
True about GVHD is? | [
"Occurs when host is immunocompetent",
"Most common organ involved is lung",
"Most common in renal transplant",
"Occurs when donor cells are immunocompetent"
] | D | Graft versus host (GVH) Disease:
Graft versus host disease occurs in any situation in which immunologically competent cells or their precursors are transplanted into immunologically crippled patients and the transferred cells recognize alloantigens in the host.
Graft versus host disease occurs most commonly in the setting of allogeneic bone marrow transplantation but may also follow transplantation of solid organs rich in lymphoid cells (e.g. the liver) or transfusion of un-irradiated blood.
Recipients of bone marrow transplants are immunodeficient because of either their primary disease or prior treatment of the disease with drugs or irradiation.
When such recipients receive normal bone marrow cells from allogeneic donors, the immunocompetent, T cells present in the donor marrow recognizes the recipient's HLA antigen as foreign antigen and react against them. Both CD4+ and CD8+T cells recognize and attack host tissues
In clinical practice, GVH can be so severe that bone marrow transplants are done only between HLA matched donor and recipient
There are three principal target tissues affected in GVHD : Skin, liver, and gut | train | med_mcqa | null |
A person has to go to Shimla next morning. What drug should be given to prevent motion sickness in this person? | [
"Scopolamine patch a night before",
"Ranitidine one night before and then before the trip",
"Dimenhydrinate 1 hour before journey",
"Omeprazole half an hour before the trip"
] | A | Ans. (A) Scopolamine patch a night before(Ref: KDT 7/e p120)Scopolamine (hyoscine) is drug of choice for motion sickness. It should be given as transdermal patch (a night before) or orally (half an hour before journey). | train | med_mcqa | null |
Urine cytology is used for the screening of: | [
"Wilms tumor",
"Renal cell carcinoma",
"Urothelial carcinoma",
"Carcinoma prostate"
] | C | Ans. (c) Urothelial carcinomaRef: Campbell Urology 11th Edition, Page 2197* Urinary cytology is used for screening of urothelial cancer.* AUA guidelines for evaluation include cystoscopy, upper; tract imaging and urine cytology. | train | med_mcqa | null |
Hypokalemic Hypeension is a feature of? | [
"Bater syndrome",
"Gitelman syndrome",
"Grave's disease",
"Liddle syndrome"
] | D | Liddle syndrome: Is a defect in aldosterone receptor ENaC which exhibits a reduced degradation and results in channel being in open configuration for a longer duration. This enhances mineralocoicoid action and leads to enhanced urinary loss of potassium. Choice A and B have normal to low BP since both have salt wasting. Grave's will cause hypeension due to intrinsic sympathomimetic action of thyroid hormones. However there is no electrolyte imbalance. | train | med_mcqa | null |
Steroid hormone receptors have attachment site for all except: | [
"Steroid hormone",
"Transcription repressors",
"Hormone responsive element",
"Transcription activators"
] | B | Ans. is 'b' i.e. Transcription repressors Steroid hormone receptors are intracellular receptors that perform signal transduction for steroid hormones. Steroid hormone receptors are part of the nuclear receptor family that also includes a group of homologous structured receptors that bind to non-steroid ligands such as thyroid hormones and vitamin A, as well as to vitamin D. All these receptors are transcription factors. They act on nuclear DNA to regulate gene transcription.The steroid hormones, thyroid hormones, retinoic acid form part of Group I hormones. Group I hormones are those which act on intracellular receptors whereas Group II hormones act on receptors located on the extracellular surface of the plasma membrane.Group I hormones activate gene transcription by 2 different mechanisms.Steroid hormone receptors are located within cytoplasm, in complex with heat shock protein (HSP). The steroid hormones being lipophilic readily diffuse through the plasma membrane and bind to the steroid receptors. Ligand binding causes dissociation of the heat shock protein from the receptor.The receptor ligand complex then moves into the nucleus and bind with high affinity to a specific DNA sequence called the hormone response element (HRE). This DNA-bound, liganded receptor serves as a high-affinity binding site for one or more transcription activator proteins. This complex then activates gene transcription.In contrast to steroid receptors, receptors for thyroid hormones and retinoids lie within the nucleus already bound to the Hormone response element. However this DNA-bound receptor fails to activate transcription because it's Complexed with a transcription repressor. This receptor-corepressor complex serves as an active repressor of gene transcription. Binding of thyroid or retinoid hormone results in dissociation of the transcription repressor from the receptor. Receptor activators then bind to the DNA bound liganded receptor complex to activate gene transcription. | train | med_mcqa | null |
Bacterial Index deals with | [
"Tuberculosis",
"Leprosy",
"Syphilis",
"Gonorrhea"
] | B | In leprosy, Bacterial Index is the only objective way of monitoring the benefit of treatment. 0 No bacilli in any of 100 oil immersion fields1+ 1-10 in 1002+ 1-10 in 103+ 1-10 in each field4+ 10-1005+ 100-10006+ more than 1000It is calculated for each site examined an average is taken.Park 23e pg: 314 | train | med_mcqa | null |
Drug of choice for obsessive-compulsive disorder is:March, 2005, September 2009 | [
"Seraline",
"Alprazolam",
"Chlorpromazine",
"Fluoxetine"
] | D | Ans. D: FluoxetineThe two medications proven to be most effective in the treatment of OCD are tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).Serotonin is a chemical in the brain called a neurotransmitter that may be imbalanced in people with OCD.While both drugs are very effective, SSRIs have generally become the preferred medication for anxiety disorders including OCD.SSRIs have less side effects than other forms of antidepressants, less withdrawal symptoms, less danger in the event of an overdose and overall are considered safer that other types of drugs (TCAs and SSRIs are both very safe drugs, however). Common SSRIs include fluoxetine, fluvoxamine, seraline, paroxetine, citalopram, and escitalopram. | train | med_mcqa | null |
Enteric cycle of Toxoplasma gondii occurs in: March 2013 (d, f) | [
"Rat",
"Cat",
"Cow",
"Sheep"
] | B | Ans. B i.e. Cat The lifecycle of T. gondii It can be broadly summarized into two components: - A sexual component that occurs only within cats (felids, wild or domestic), and - An asexual component that can occur within viually all warm-blooded animals, including humans, cats, and birds. Because T. gondii can sexually reproduce only within cats, they are defined as the definitive host of T. gondii. All other hosts - hosts in which only asexual reproduction can occur - are defined as intermediate hosts. | train | med_mcqa | null |
Parboiling is done for- | [
"Milling process",
"Polishing of rice",
"Preservation of nutrition",
"Storage of rice"
] | C | Ans. is 'c' i.e., Preservation of nutrition o Parboiling (partial cooking in steam) is technique of preserving the nutritive value of rice. In parboiling, greater parts of vitamins and minerals present in outer layer of the rice grain are driven into the deepar layers. With subsequent milling the nutrient are not removed. | train | med_mcqa | null |
Isolated deletion of which chromosome causes myelodysplastic syndrome - | [
"2q",
"5q",
"8q",
"11q"
] | B | null | train | med_mcqa | null |
All are symptoms of hyperglycaemia in a diabetic patient except | [
"Polyuria",
"Weight gain",
"Fatigue",
"Recurrent skin infections"
] | B | Symptoms of hyperglycemia include polyuria, polydipsia, weight loss, fatigue, weakness, blurry vision, frequent superficial infections (vaginitis, fungal skin infections), and slow healing of skin lesions after minor trauma. Metabolic derangements relate mostly to hyperglycemia (osmotic diuresis) and to the catabolic state of the patient (urinary loss of glucose and calories, muscle breakdown due to protein degradation and decreased protein synthesis). Blurred vision results from changes in the water content of the lens and resolves as the hyperglycemia is controlled.Ref: Harrison 19e pg: 2406 | train | med_mcqa | null |
First enzyme to be raised in MI is | [
"CPK-MB",
"LDH",
"Myoglobin",
"Troponin-I"
] | C | The laboratory evaluation of MI is based on measuring blood levels of macromolecules that leak out of injured myocardial cells through damaged cell membranes these molecules include myoglobin, cardiac troponins T and I (TnT, TnI), creatine kinase (CK) (specifically the myocardial isoform, CK-MB), and lactate dehydrogenase. Troponins and CK-MB have high specificity and sensitivity for myocardial damage. (Robbins Basic pathology,9th edition.pg no.382) | train | med_mcqa | null |
Which one of the following preferentially activates plasminogen bound to fibrin and avoids the systemic lytic state : | [
"Streptokinase",
"Aminocaproic acid",
"Tranexamic acid",
"Alteplase"
] | D | null | train | med_mcqa | null |
Oil red o staining used for | [
"Frozen section",
"Glutaraldehyde fixed specimen",
"Alcohol fixed specimen",
"Formalin fixed specimen"
] | A | Ref Bancroft histology 7/e p 83 Air dry frozen sections on slides for 30 minutes minimum 2. Fix in 10% neutral buffered formalin for 10 minutes 3. Dip in 60% isopropanol 1 time quickly 4. Stain in working Oil Red O solution for 15 minutes 5. | train | med_mcqa | null |
Most common site of rupture of esophagus during rigid esophagoscopy is at | [
"Above cricopharynx",
"Near vocal cord",
"GE junction",
"At killian's dehiscence"
] | D | Complications of Rigid esophagoscopv Injury to lips and teeth. Injury to arytenoids. Injury to pharyngeal mucosa. Perforation of esophagus; most often it occurs at the site of killians dehiscence (near the cricopharyngeal sphincter). Compression of trachea. | train | med_mcqa | null |
The most effective antitubercular drug against slow multiplying intracellular mycobacteria is : | [
"Rifampicin",
"Isoniazid",
"Pyrazinamide",
"Ethambutol"
] | C | null | train | med_mcqa | null |
VDRL reactive mother gave birth to an infant. All of the following would help in determining the risk of transmission to the infant except: | [
"TPHA test on the serum sample of the mother",
"TPHA test on the serum sample of the infant",
"VDRL on the paired serum sample of the infant and mother",
"Time interval between the treatment of the mother and her delivery"
] | B | Ans. is 'b' i.e., TPHA test on the serum sample of the infant(Ref: Harrison, 19th/e, p. 1132; Ananthanarayan, 9th/e, p. 370)Tests for antibodies in the newborn's blood are not always positive at first, even when infection is present in the infant, possibly because if the infection is acquired late in pregnancy, specific antibody have not had time to form.ABOUT OTHER OPTIONSOption 'a' - A positive TPHA on maternal serum confirms the diagnosis of maternal syphilis and depending on the age of gestation indicate the risk of transmission.Option 'c' - Infant should be evaluated for congenital syphilis if the newborn has a titre four-fold greater than mother (Examination of paired serum example of the infant and mother).Option 'd' - Early and adequate treatment of mother decreases the risk of transmission. | train | med_mcqa | null |
Purpose of tilting the cast, while surveying is to: | [
"Achieve maximum guiding planes",
"Create undercuts",
"Obtain a favorable path of insertion",
"Obtain retention"
] | C | null | train | med_mcqa | null |
Buspirone acts on | [
"5HT1A",
"5HT1B",
"5HT2",
"5HT3"
] | A | Buspirone:- * Buspirone is a 5HT1A paial agonist used as an anxiolytic. * It is also used in relief of pain and related anxiety of functional dyspepsia associated with Irritable Bowel Syndrome. * Buspirone (atypical anxiolytic), in contrast to conventional Benzodiazepine anti-anxiety drugs: [?] Have minimal abuse liability [?] No withdrawal reactions on abrupt discontinuation [?] Lesser impairment of psychomotor skills and function Adverse effects of Buspirone:- Tachycardia, nervousness, GI distress, parasthesias and dose dependent miosis. Ref:- Goodman & Gilman Pharmacological Basis of Therapeutics 13th Ed; Pg num:- 230 | train | med_mcqa | null |
A patient sustained injury to the upper limb 3 yrs back; he now presents with valgus deformity in the elbow and paresthesias over the medial border of the hand. The injury is likely to have been - | [
"Supracondylar # humerus",
"Lateral condyle # humerus",
"Medial condyle # humerus",
"Posterior dislocation of the humerus"
] | B | There is no confusion for this one as patient has developed tardy ulnar nerve palsy with valgus deformity.
Cubitus vulgus occurs with fracture lateral condyle. | train | med_mcqa | null |
Glycogen phosphorylase is active in | [
"Phosphorylated form",
"Dephosphorylated form",
"Both phosphorylated & dephosphorylated form",
"No rate of phosphorylation"
] | A | The phosphorylase -b is the inactive form. It becomes active on phosphorylation. The active enzyme denoted as phosphorylase -aRef: DM Vasudevan, 7th edition, page no: 127 | train | med_mcqa | null |
An 17-year-old patient presents to you for evaluation because she has not yet staed her period. On physical examination, she is 5ft 8 in tall. She has no breast development and no axillary or pubic hair. On pelvic examination, she has a normally developed vagina. A cervix is visible. The uterus is palpable, as are normal ovaries. physician decides to test her sense of smell . what is the physician suspecting ? | [
"Asherman's syndrome",
"Kallman's syndrome",
"Stein-Leventhal syndrome",
"Sheehan's syndrome"
] | B | Diagnosis is Kallman's syndrome 46 XX Hypogonadotropic hypogonadism Low LH & FSH as no GnRH Anosmia Amenorrhoea Either normal or taller Ovaries normal but dont get stimulated in the absence of gonadotropins Uterus present and thelarche absent External genitalia female like Pubic hair Present | train | med_mcqa | null |
Call-Exner bodies are seen in: | [
"Granulosa cell tumor",
"Yolk Sac tumor",
"Choriocarcinoma",
"Dysgerminoma"
] | A | Ans. is 'a' i.e. Granulosa cell tumor Call Exner bodies are feature of Granulosa cell tumour.Call Exner bodies:The formation of call Exner bodies is a distinct feature of granulosa cells and can be readily recognized in certain types of granulosa cell tumours.These are composed of small spherical globules around which the granulosa cells are arranged radially. These structures form call Exner bodies.Also Know:* Schiller Duval body- Endodermal sinus tumour (yolk sac tumour)* Hobnail cells- Clear cell carcinoma* Reinke crystals- Hilus cell tumour* Walthard cell and puffed wheat cell- Brenner tumour* Rokitansky body- Teratoma | train | med_mcqa | null |
Which of the following is most potent vasodilator: | [
"Serotonin",
"Bradykinin",
"Histamine",
"Prostaglandin"
] | C | null | train | med_mcqa | null |
A Patient with increased BP and decreased hea rate is likely to have | [
"Increased ICT",
"Deep sea diving",
"Brain tumor",
"Head tumor"
] | A | Cushing's reflex , is a physiological nervous system response to increased intra cranial pressure.Results in cushings triad - increased BP, irregular breathing and bradycardia. Usually seen in terminal stages of head injury . It can also be seen after iv administration of epinephrine. In head injury- CPP=MAP-ICP. CPP- cerebral perfusion pressure. MAP- Mean aerial pressure. ICP- intra cranial pressure Head injury causes increased ICP thus lowering CPP causing ischemia. When ICP approaches the level of mean systemic pressure , cerebral perfusion falls . Bodys response to fall in cerebral perfusion is raise systemic blood pressure and dialate cerebral vessels which increases cerebral blood volume and increases ICP followed by lowering CPP.And causes a vicious cycle. When aerial pressure lowers , a reflex called CNS ischaemic response is initiated by the hypothalamus . Hypothalamus activates sympathetic nervous system causing peripheral vasoconstriction and increased cardiac output. This increases aerial pressure and cerebral blood flow is restored. This response stimulates the baroreceptors in the carotid bodies thus slowing the hea rate drastically- bradycardia(baroreceptor reflex -refer image) 2) Marey's law- Explained by barereceptor reflex States that' hea rate is inversely propoional to blood pressue '(but not the vice versa) . Bainbridge reflex- infusion of saline or blood --- increased venous filling of atria--- stimulation of tachycardia producing atrial receptor(TPAR)---tachycardia | train | med_mcqa | null |
Which of the following drug inhibits the enzyme 11-beta- hydroxylase responsible for coisol synthesis:- | [
"Thiopentone",
"Propofol",
"Etomidate",
"Ketamine"
] | C | Etomidate Inhibits the activity of II-B- hydroxylase an enzyme necessary for the synthesis of coisol, aldosterone ,17- hydroxyl-progesterone and coicosterone. Associated with adrenocoical suppressionwhich canlast for 72 hours. Inhibits the enzyme 11b-hydroxylase, - decreased biosynthesis of coisol and mineralocoicoid and increases the formation 11-deoxycoicosterone. More potent inhibitor of steroid synthesis than as a sedative-hypnotic as the concentration which produces adrenocoical suppression(10 ng/mL)is much lower than that needed for hypnosis (>200 ng/mL). | train | med_mcqa | null |
Indication for relining of complete denture include alt, expect | [
"Immediate denture at 3-6 months after their original construction",
"Patient cannot afford new denture",
"Abuse soft tissues are present",
"When the construction of new dentures with the multiple appointment cause physical and mental stress"
] | C | null | train | med_mcqa | null |
If coefficient of correlation between height and weight is 2.6, TRUE is - | [
"Positive correlation",
"No association",
"Negative correlation",
"Calculation of coeffecient is wrong"
] | D | Ans. is 'd' i.e., Calculation of coefficient is wrong o Coefficient of correlation lies between -1 and +1. It never occurs outside this range. So if the coefficient of correlation is 2.6 then there is some mistake in calculation. | train | med_mcqa | null |
Regarding carcinoma Gallbladder true statement | [
"Squamous cell carcinoma is the most common",
"Present with jaundice",
"Good prognosis",
"65% survival after surgery"
] | B | Clinical features Most commonly presents with right upper quadrant pain often mimicking cholecystitis and cholelithiasis Weight loss, jaundice and abdominal pain are less common presenting symptoms Chronic cholecystitis with a recent change in quality or frequency of the painful episodes in 40% patients Malignant biliary obstruction with jaundice, weight loss and RUQ pain Ref: Sabiston 20th edition Pgno : 1512-1514 | train | med_mcqa | null |
Color doppler TVS of Endometrioma demonstrates | [
"Intracystic flow",
"Pericystic flow",
"Diffuse blood flow",
"None of above"
] | B | Endometrioma demonstrates pericystic flow. | train | med_mcqa | null |
Pleomorphism is seen in | [
"Toxocara",
"Chickenpox",
"Rubella",
"Smallpox"
] | B | null | train | med_mcqa | null |
Doubling of Beta HCG levels is seen in? | [
"24 hours",
"48 hours",
"72 hours",
"96 hours"
] | B | Ans. (b) 48 hoursRef.: D.C. Dutta 8th ed. /23, 8th ed. / 66, 7h ed./58-59HCG* HCG is a glycoprotein which is synthesized by syncytiotrophoblast of the placenta.* The half-life of HCG is 36 hours.* In early pregnancy the doubling time of HCG is 1.4 -2days.* It has 2 subunits:# a-biologically similar in LH, FSH and TSH. (i.e. nonspecific)# b-subunit-unique to HCG. (i.e. specific)* Structurally it is similar to- FSH, LH, TSH but functionally it is similar to LH (i.e. luteotropic), i.e. helps in maintaining corpus luteum. So, the main hormone which maintains activity of corpus luteum during pregnancy is HCG and in non-pregnant state is LH.* It can be detected in material serum as early as 8 days following fertilization/day 22 of menstrual cycle/5 days before missed period by immuno assay.0* The level is 100 IU/L or mlU/mL around the time of the expected menses.* The level progressively rise and reach maximum levels by about 8-10 weeks/70days/lst trimester. It then falls until about 16 weeks and remains at low level up to term.* HCG disappears from circulation by 2 weeks following delivery.Action* Sustains the corpus luteum and thereby maintains the hormonal support to the pregnancy in early weeks.* Stimulates the leydig cells of the male fetus to produce testosterone and thereby induces development of the male external genitalia | train | med_mcqa | null |
True about Wilson's disease is ? | [
"Increased serum ceruloplasmin",
"Decreased liver copper",
"Increased urinary copper excretion",
"Decreased urine copper excretion"
] | C | null | train | med_mcqa | null |
What is not done in third stage of labour as pa of 'Active management of third stage' protocol ? | [
"Oxytocin injection",
"Gentle massage of uterus",
"Controlled cord traction",
"Ergometrine injection"
] | D | Third stage of labor The placenta usually is delivered within 5 minutes of the delivery of the infant. - Signs of placental separation o The uterus becomes globular and firm. o There often is a sudden gush of blood. o The uterus rises in the abdomen because the placenta, having separated, passes down into the lower uterine segment and vagina, where its bulk pushes the uterus upward. o The umbilical cord protrudes faher out of the vagina, indicating that the placenta has descended. - Uterine hemostasis. The mechanism by which hemostasis is achieved at the placental site is vasoconstriction, produced by a well contracted myometrium. Intravenous or intramuscular oxytocin (10 U intramuscularly or 20 U in a 1000-mL intravenous bottle), ergonovine (0.2 mg intramuscularly or intravenously), or prostaglandin F2I+- (0.25 mg intramuscularly and repeated if necessary at 15- to 90-minute intervals up to a maximum of eight doses) helps the uterus contract and decreases blood loss. But the drug which is preferred across all the condition presenting in pregnancy, without many complications, is Oxytocin. Hence the drug of choice in this 'Active management of third stage of labour' is Oxytocin. These medications are administered after the placenta has been delivered. | train | med_mcqa | null |
Mass chemoprophylaxis in endemic area is recommended for all of the following, except ? | [
"Yaws",
"Leprosy",
"Trachoma",
"Filaria"
] | B | Ans. is 'b' i.e., Leprosy Mass chemoprophylaxis is recommended in yaws, pinta, bejel, trachoma, filaria and malaria. Mass chemoprophylaxis is not recommended for the control of leprosy in endemic area. | train | med_mcqa | null |
All of the following are efective topically exxcept- | [
"Procaine",
"Cocaine",
"Lidocaine",
"Amethocaine"
] | A | Procaine is not effective topically because of poor penetration | train | med_mcqa | null |
Specific treatment of severe pre-eclampsia is: | [
"Magnesium sulphate",
"Termination of pregnancy",
"Clonidine",
"Hydralazine"
] | B | Ans. B. Termination of pregnancyManagement includes termination of pregnancy as only this followed by placental delivery will revert the maternal physiology to normal. Magnesium sulphate is a very toxic drug that is not to be given in patients with severe preeclampsia prophylactically as it not an antihypertensive. Magnesium sulphate is reserved for impending or established eclampsia.Clonidine and hydralazine are antihypertensives to be used in mild preeclampsia. | train | med_mcqa | null |
The suppoing cells of the testes are the following? | [
"Spermatogonia",
"Leydig cells of testes",
"Cells of Seoli",
"Spermatids"
] | C | All cells of the spermatogenic lineage are closely associated with the extended surfaces of Seoli cells and depend on them for metabolic and physical suppo. Each Seoli cell suppos 30 to 50 developing germ cells. Impoant in Seoli cell function are elaborate tight occluding junctions between their basolateral membranes that form a blood-testis barrier within the seminiferous epithelium. | train | med_mcqa | null |
Aflatoxin is produced by ? | [
"Aspergillus niger",
"Aspergilus flavus",
"Candida albicans",
"Actinomycetes"
] | B | Aflatoxins are a group of mycotoxins produced by ceain fungi,Aspergillus flavusREF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-608 | train | med_mcqa | null |
True about normal sperm count: | [
"60-100 lakh/mm3",
"4-5 million/mm3",
"60-120 lakh/mm3",
"60-120 million/mL"
] | D | Ans. is d, i.e. 60-120million/mL.Normal values are:Volume 2-6mLpH = Alkaline =7.2-7.8Liquefaction within half an hourCount: 15-200millionpermLMobility and motility 60% progressive forward motilityMorphology 60% normal forms | train | med_mcqa | null |
The gradient of alveolar aerial oxygen tension increases in A/E: | [
"Diffusion defect",
"Right - Left shunt",
"Hypoventilation",
"Ventilation perfusion abnormality"
] | C | C i.e Hypoventilation | train | med_mcqa | null |
Tobe Ayer's Test is seen in ? | [
"Acute mastoiditis with lateral sinus thrombosis",
"Maxillary cancer with spread to nasal cavity",
"Rhinosporidiosis",
"Jugular vein thrombosis"
] | A | Ans' is'a'i.e., Acute mastoiditis with lateral sinus thrombosis | train | med_mcqa | null |
This patient presented with jaw pain and was found to have an elevated alkaline phosphatase and a normal serum creatinine. Which one of the following tests would confirm the diagnosis? | [
"Bone scan",
"Insulin-like growth factor-1 level",
"Serum calcium",
"Abdominal ultrasound"
] | A | Answer A. Bone scanPaget's disease, acromegaly, and renal osteodystrophy are among the causes of jaw enlargement, visible in this image. An elevated alkaline phosphatase makes Paget's disease the most likely diagnosis; the diagnosis can be confirmed with a bone scan. | train | med_mcqa | null |
Disability ceificate for poor vision if 4/60, is impairment percentage of: | [
"100",
"75",
"40",
"30"
] | B | Disability ceificate for poor vision if 4/60, is impairment percentage of: 75% All with correction Category Better Eye Worse Eye % Age Impairment Category 0 6/9-6/18 6/24 to 6/36 20% Category I 6/18-6/36 6/60 to Nil 40% Category II 6/40-4/60 or field of vision 10-20 3/60 to Nil 75% Category III 3/60 to 1/60 or field of vision 10 F.C. at 1 ft. to Nil 100% Category IV F.C. at 1 ft. to Nil or field of viosion 10 F.C. at 1 ft. to Nil 100% One eyed persons 6/6 F.C. at 1 ft. to Nil or field of vision 10 30% Note: F.C. means finger count Ref: OFFICE OF THE CHIEF COMMISSIONER FOR PERSONS WITH DISABILITIES DISABILITY GUIDELINES : Categories of visual Disability: | train | med_mcqa | null |
By 2022, every rural person in the country will have access to ___ lpcd within their household premises or at a horizontal or veical distance of not more than ___ meters from their household without barriers of social or financial discrimination:- | [
"100 and 100",
"50 and 50",
"50 and 70",
"70 and 50"
] | D | Ministry of Drinking water and Sanitation Government of India. The Ministry has prepared a Strategic Plan for the rural drinking water sector for the period 2011 to 2022. The Goal of the Strategic Plan is: To ensure, that every rural person has enough safe water for drinking, cooking and other domestic needs as well as livestock throughout the year including during natural disasters and by 2022, every rural person in the country will have access to 70 lpcd within their household premises or at a horizontal or veical distance of not more than 50 meters from their household without barriers of social financial discrimination. Individual States can adopt higher quantity norms, such as 100 lpcd. | train | med_mcqa | null |
A 30-year-old patient presents with loose stools, lower abdominal pain, weight loss, diarrhea and passage of blood and mucus. On sigmoidoscopy this is the presentation of the patient, all of the following statements regarding this condition are true except? | [
"More than 100 colonic adenomas are diagnostic of this condition",
"Polyps and malignant tumors can develop in the duodenum and small bowel",
"Ibis condition is associated with benign meso- dermal tumors such as desmoid tumors and osteomas",
"This condition is associated with APC gene of chromosome 4"
] | D | Ans. (d) This condition is associated with APC gene of chromosome 4.Features of familial adenomatous polyposis* Autosomal dominant inherited disease due to mutation of the APC gene on the short arm of chromosome 5.* More than 100 colonic adenomas are diagnostic* Prophylactic surgery is indicated to prevent colorectal cancer* Polyps and malignant tumors can develop in the duodenum and small bowel* FAP can also be associated with benign mesodermal* Tumors such as desmoid tumors and osteomas. Epidermoid cysts can also occur (Gardner's syndrome)Image source- style="font-family: Times New Roman, Times, serif"> | train | med_mcqa | null |
Implantation occurs at | [
"2-3 days",
"6-7 days",
"15-20 days",
"20-25 days"
] | B | HUMAN EMBRYOLOGY-INDERBIR SINGH TENTH EDITION-PAGE NO:72In humans implantation begins on the 6th day after feilization | train | med_mcqa | null |
Which of the following is not an oxidoreductase - | [
"Catalase",
"Glucokinase",
"Alcohol dehydrogenase",
"Peroxidase"
] | B | Ans. is 'b' i.e., Glucokinase Oxidoreductases are oxidases, dehydrogenases, hydroperoxidases (Catalase, peroxidase), oxygenases.Glucokinase is a transferase. | train | med_mcqa | null |
A 65 yrs old man with H/O back pain since 3 months. ESR is raised. On examination marked stiffness and mild restriction of chest movements is found. On x-ray, syndesmophytes are present in veebrae. Diagnosis is | [
"Ankylosing spondylitis",
"Degenerative osteoahritis of spine",
"Ankylosing hyperosteosis",
"Lumbar canal stenosis"
] | A | Ankylosing spondylitis (Ref: Apley's 9/e, p 66-70, 477; Harrison 17/e, p 2109-2112, 1 1 1 Turek's ohopedics 6/e ,p158, 168] The clinical profile of the given case fits into Ankylosing spondylitis (A.S.) except, for the age. A.S. is usually seen in 2nd or 3rd decades of age with a median age of 23. However "in 5% of patients, symptoms begin after 40" - Harrison All other features, i.e. raised ESR, marked stiffness, restriction of chest movements & syndesmophytes are seen in A.S. Syndesmophvtes Syndesmophytes are thin, slender veical radiodense spicules bridging the veebral bodies, giving the spine `bamboo' appearance. They are actually ossification of outer. fibres of annulus fibroses. Syndesmophytes are seen in: - Ankylosing spondylitis - Psoriatic ahritis - Reiter's disease - Ahritis assoc. with Inflammatory bowel disease Before discussing A.S. lets see other options: Diffuse idiopathic skeletal hyperostosis (DISH): Also k/a Forestier's disease, ankylosing hyperostosis DISH is a syndrome of excessive calcification and ossification of soft tissues. mainly ligaments and entheses, that develops with aging. There is a marked predilection to the axial skeleton, paicularly the thoracic spine. It may also involve the peripheral joints. The most characteristic radiographic abnormality of DISH is calcification and ossification of the anterior longitudinal ligament of the spine. The diagnosis is made by, spinal radiographs that show "flowing" calcifications along the anterior and lateral poion of at least four contiguous veebral bodies without loss of disc height and without typical radiographic findings of ankylosing spondylitis. (no syndesmophytes). DISH commonly occurs in men in their fifth to sixth decade of life. Patients are often asymptomatic but may have spinal pain or limited spinal motion. DISH can be ruled out as in DISH there is no raised ESR and syndesmophytes. (ESR is raised in inflammatory spondyloahropathies like Ankylosing spondylitis. But DISH and degenerative osteoahritis are non-inflammatory conditions, so ESR would be normal.) Apley's writes- "Although DISH bears a superficial resemblance to AS, it is not an inflammatory disease; spinal pain and stiffness are seldom severe, the sacroilitis joints are not eroded and the ESR is normal." Harrison writes- "Diffuse idiopathic skeletal hyperostosis which occurs in middle aged and elderly is usually not symptomatic." Degenerative osteoahritis of spine: It is a disease of elderly characterised by formation of large osteophytes along the anterior and lateral aspects of spine with decreased interveebral disc spaces. Lumbar canal stenosis: It is ruled out as - Neurogenic claudication or pseudoclaudication is the usual symptom, consisting of back and buttock or leg pain induced by walking or standing and relieved by sitting. It can be congenital (achondroplasia) or acquired in degenerative diseases, trauma, spine surgery, metabolic or endocrine disorders and Paget's disease. S/s of the case Ankylosing spondylitis (AS) . Ankylosing hyperosteosis/Diffuse idiopathic skeletal hyperosteosis (DISH) Degenerative osteoahritis of spinelspondylosis deformation 65 yrs age in 5% common common 3 months history + insidious long duration insidious long , ,,, duration Back pain ++ +/- (may be asymptomatic) - +/ (may be asymptomatic) Marked stiffness ++ - (Stiffness is mild) TESR + inflammatory - non-inflammatory - non-inflammatory Restriction of chest movements + _ ? Syndesmo phytes + "flowing wax" like calcification or hyperostoses, no 1 of interveebral disc space Osteophytes 1 of interveebral disc space * No raised ESR or syndesmophytes are seen. Ankylosing spondylitis Introduction Prototype of seronegative (absence of rheumatoid factor) spondyloahropathies. Inflammatory disorder of unknown cause. Usually begins in the second or third decade with a median age of 23, in 5% symptoms begin after 40. Male to female ratio is 2-3 : 1 Strong correlation with HLA-B27 Pathology Enthesitis i.e. inflammation of the inseion points of tendons, ligaments or joint capsule on hone is one of the hallmarks of this entity of disease. Primarily affects axial (spinal) skeleton and sacroiliitis is often the earliest manifestation of A.S.. Involvement of costoveebral joints frequently occur, leading to diminished chest expansion (normal 5 cm) Peripheral joints for e.g. shoulders, and hips (root joints) are also involved in 1/3rd patients. Extraaicular manifestations like acute anterior uveitis (in 5%); rarely aoic valve disease, carditis and pulmonary fibrosis. Pathological changes proceed in three stages? 1)Inflammation with granulation tissue formation and erosion of adjacent bone. 2)Fibrosis of granulation tissue 3)Ossification of the fibrous tissue, leading to ankylosis of the joint. Clinical features Low back pain of insidious onset Duration usually less than 3 months Significant morning stiffness and improvement with exercise Limited chest expansion Diffuse tenderness over the spine and sacroiliac joints Loss of lambar lordosis, increased thoracic kyphosis Decreased spinal movements (especially extension) in all directions. Radiological features Cardinal and earliest sign is erosion and fuzziness of the sacroiliac joints Squaring of veebral bodies Syndesmophytes (described earlier) giving the appearance of a "bamboo spine". Other investigations ESR and CRP are usually elevated HLA-B27 is present in 95% of cases. Treatment General measures to maintain satisfactory posture and preserve movement. NSAIDs TNF inhibitors for severe disease Operations to correct deformities Complications Spinal fractures Hyperkyphosis Spinal cord compression Lumbosacral nerve root compression | train | med_mcqa | null |
All of the following can cause SLE like syndrome EXCEPT | [
"INH",
"Penicillin",
"Hydralazine",
"Sulphonamide"
] | B | Ref - researchgate.net | train | med_mcqa | null |
Length of Umbilical cord is | [
"10-20 cm",
"20-40 cm",
"40-70 cm",
"80-100 cm"
] | C | Umbilical cord - Normal length- 40-70 cm long- Cord has three vessels : 1 vein(left) and 2 aeries - Length is influenced by amniotic fluid volume and fetal mobility. | train | med_mcqa | null |
The following local anesthetic raises BP instead of tending to cause a fall | [
"Cocaine",
"Dibucaine",
"Lignocaine",
"Procaine"
] | A | All LA’s cause hypotension except cocaine.
Cocaine increases blood pressure by inhibiting the reuptake of catecholamines. | train | med_mcqa | null |
A 9 year old boy is admitted with acute abdominal pain localized in the right iliac fossa. He is pyrexial with localized peritonism in RIF. The causative cell involved here | [
"Lymphocytes",
"Neutrophil",
"Macrophages",
"Monocytes"
] | B | Ans. (b) Neutrophil(Ref: Robbins 9th/pg 71; 8th/pg 44)This is a case of acute appendicitisThe principal inflammatory cell in this case of acute appendicitis is the neutrophil. | train | med_mcqa | null |
Antihypertensive not contraindicated in pregnancy | [
"Spironolactone",
"Labetalol",
"Sodium Nitroprusside",
"ACE inhibitor"
] | B | Ans. is 'b' i.e. Labetalol Drugs used for the t/t of Hypertensive pregnancy B etter M other C are D uring H ypertensive P regnancy Beta blockers (labetalol, atenolol) Methyl dopa (.D.O.C. in pregnancy) Clonidine Dihydropyridine CCB's (discontinue before labour as they weaken uterine contractions) Hydralazine (D.O.C in hypertensive emergency) Prazosin Antihypertensives to be avoided during pregnancy Diuretics Tends to reduce blood volume - accentuate uteroplacental perfusion deficit (of toxemia) - increased risk of foetal wastage, placental infarcts, miscarriage, still birth. ACE inhibitors, AT1 antagonists Risk of foetal damage, growth retardation. Reserpine Suicidal depression in mother, nasal obstruction, deranged respiratory and temperature control in the new bom. Nonselective b blockers Propranolol has been implicated to cause low birth weight decreased placental size, neonatal bradycardia and hypoglycemia. Sodium Nitroprusside Contraindicated in eclampsia Pregnancy hypertension There is a lack of good clinical trial evidence, on which to base recommendations of one agent over another. Instead, drug usage reflects longevity of use without obvious harm to the fetus. Hence methyldopa is still the drug of choice for many obstetricians. Calcium channel blockers (especially nifedipine) are common second line drugs. Parenteral hydralazine is reserved for emergency reduction of blood pressure in late pregnancy, preferably in combination a b blocker to avoid unpleasant tachycardia (labetalol and atenolol) are often effective and probably the drug of choice in the third trimester. There is anecdotal evidence to suggest growth retardation with b blockade used in first and second trimester. Diuretics reduce the chance of developing preeclampsia but are avoided in pre-eclampsia itself because these patients, already have a contracted circulatory volume. Spironolactone is a diuretic which is avoided in pregnancy because of its antiandrogenic effect on fetus. ACE inhibitors (and by implication angiotensin AT1receptor antagonist) are absolutely contraindicated during pregnancy where they cause fetal death, typically midtrimester (they can be prescribed during first trimester) Note : There is no evidence that ACE inhibitors - or any of the commonly used antihypertensive drugs are teratogenic and women who become pregnant while receiving these should be reassured but should, of course, then discontinue the ACE inhibitor or AT1receptor antagonist. | train | med_mcqa | null |
In modified Pugh's classification score of 8, what shall be the line of management ? | [
"Conservative management",
"Ohotopic liver transplant",
"Sclerotherapy",
"Shunt surgery"
] | B | Child-Pugh score is calculated by adding the scores of the five factors and can range from 5 to 15. Decompensation indicates cirrhosis with a Child-Pugh score of >7 (class B). This level has been the accepted criterion for listing liver transplantation. Parameters: Bilirubin INR Albumin Ascites Asterixis Grade Points One-year Patient Survival (%) A: well-compensated disease 5-6 100 B: significant function compromise 7-9 80 C: decompensated disease 10-15 45 | train | med_mcqa | null |
The most common finding associated With fibromyalgia syndrome is- | [
"High ESR",
"Musculoskeletal pain without local tenderness",
"Spontaneous resolution of symptoms",
"Tiredness and insomnia"
] | B | The defining symptoms of fibromyalgia are chronic widespread pain, fatigue, sleep disturbance, and heightened pain in response to tactile pressure (allodynia). Other symptoms may include tingling of the skin (paresthesias),prolonged muscle spasms without muscle tenderness weaknessin the limbs, nerve pain, muscle twitching, palpitations,and functional bowel disturbances. Ref Davidson 23rd edition pg 629 | train | med_mcqa | null |
A neurodevelopmental disorder which is characterized by impaired social interaction, impaired verbal and nonverbal communication, and restricted and repetitive behavior is description for: | [
"Autism",
"Anxiety disorder",
"Antisocial personality disorder",
"Paranoid schizophrenia"
] | A | Autistic disorder (childhood autism) Social deficits. Examples include babies who don't like being held, and also reduced eye contact, unusual facial expressions, lack of gestures, poor understanding of others' feelings, lack of empathy, and few peer relationships. Communication deficits. Speech in autistic children shows wide variety; it may be completely absent (30 per cent), or merely show unusual or asocial qualities. Common abnormalities of speech include echolalia, odd prosody and pronoun reversal. These children have difficulty in two-way conversations, and some ask a string of questions instead. Restricted/repetitive interests and behaviors. Autistic children often show a deep interest in things others regard as very mundane; for example, washing machines or license plates. | train | med_mcqa | null |
Intrapulmonary shunting refers to | [
"Anatomical dead space",
"Alveolar dead space",
"Wasted ventilation",
"Perfusion in excess of ventilation"
] | D | A pulmonary shunt often occurs when the alveoli fill with fluid, causing pas of the lung to be unventilated although they are still perfused. Intrapulmonary shunting is the main cause of hypoxemia (inadequate blood oxygen) in pulmonary edema and conditions such as pneumonia in which the lungs become consolidated Ref: guyton and hall textbook of medical physiology 12 edition page number:333,334,335 | train | med_mcqa | null |
Damage to categorical hemisphere usually leads to | [
"Normal speech",
"Increased speech",
"Decreased speech",
"Senseless, fluent speech"
] | D | . *categorical hemisphere is for sequential analytic processes and concerned with language function. *lesion in it produce language disorders and it can be fluent,nonfluent and anomic aphasias.ASSOCIATION AREAS Association areas form the "Inter-junction" for various cerebral coex pas. They paicularly connect motor & sensory areas. Mainly are associated with higher mental functions. Higher mental functions include speech, learning & memory and intellectual functions (insight, imagination etc.,) SENSORY ASSOCIATION AREA: This area provides primary interpretation of perceived sensation. Area included: 1. Brodmann's area 3,1,2 - Includes somatosensory coex. Perceives sensation of an object. 2. Brodmann's area 5 - Referred as "Somatosensory association area". Interprets the shape, size, & texture of sensation. 3. Brodmann's area 17 & 18 - Includes primary visual coex. Colors are perceived. 4. Brodmann's area 19 - Referred as "Visual association area" Identification of visual objects. 5. Brodmann's area 42 - Referred as "Auditory association area". Interprets the meaning of heard sound. MOTOR ASSOCIATION AREA: Includes, Premotor area (premotor coex & supplementary motor area). INTERHEMISPHERICAL DIFFERENCES: Right & left hemispheres are homologous & symmetrical regions of cerebral coex on either side of brain. They are connected together by long association fibers carried by corpus callosum. FUNCTIONS OF HEMISPHERES: Functional asymmetry usually exists between hemispheres. Most impoant functional asymmetry is exhibited by "Language". 1. Left hemisphere: Referred as "Dominant/Categorical hemisphere" Functions: Mainly represents language areas (Wernicke's area & Broca's area) - Both spoken & written language. Visual processing of written language. Auditory processing of spoken language. Language-related motor functions like speech, reading & writing. Detailed analytical abilities. Mathematical & scientific skills with reasoning. Complex motor planning activities. Mainly involves sequential analytical process & language. 2. Right hemisphere: Referred as "Non-dominant/Representation hemisphere" Ref Harrison20th edition pg 2367 | train | med_mcqa | null |
Which among the following parotid tumor spreads through neural sheath - | [
"Mixed parolid tumor",
"Adenocystic Ca",
"Sq. Cell Ca",
"Oxyphillic lymphoma"
] | B | "Adenoid cystic carcinoma, which has a propensity for neural invasion, is the second most common malignancy in adults. Skip lesions along nerves are common and can lead to treatment failures because of the difficulty in treating the full extent of invasion. Adenoid cystic carcinomas have a high incidence of distant metastasis but display indolent growth. It is not uncommon for patients to experience lengthy survival despite the presence of disseminated disease." - Schwartz 8/e
"Treatment consists of removal of the gross tumor with radiation therapy for the microscopic disease that is assumed to exist at the periphery of the tumor."- Sabiston 18/e p836 | train | med_mcqa | null |
A 12 year old boy had severe vomiting and diarrhoea. He was brought to the hospital bacause of severe oliguria. He was given IV fluids and furosemide without any diuresis. Blood beichemistry revealed : Urea 120 mg% and serum creatinine 4 mg%. The most likely diagnosis is - | [
"Preneal azotemia",
"Haemolytic uraemic syndrome",
"Acute glomerulonephritis",
"Acute tubular necrosis"
] | B | Ans. is 'b' i.e., Hemolytic uremic syndrome | train | med_mcqa | null |
Most common indication for Liver Transplant in paediatric Patients: | [
"Biliary Atresia",
"Cirrhosis",
"Hepatitis",
"Fulminant liver failure"
] | A | Ans. (a) Biliary AtresiaRef: Surgery Sixer 3rd Edition Page 153* MC indication for Liver transplant in Children - Biliary tresia* MC indication for Liver transplant in Adults - HCV induced cirrhosis* MC metabolic indication for Liver transplant - Alpha 1 AT deficiency | train | med_mcqa | null |
Indication of fetal distress is : | [
"Decrease in fetal scalp blood pH",
"Meconium staining",
"Late deceleration of hea rate",
"All of the above"
] | D | All of the above | train | med_mcqa | null |
Which of the following is the treatment of choice for Stage – I Wilm's Tumor : | [
"Laparoscopic Nepluoectomy",
"Open Nephroureterectomy",
"Chemotherapy",
"Observation"
] | B | The treatment of choice for Stage I Film's tumor is Transperitoneal Radical Nephrectomy (Radical Nephroureterectomy) followed by chemotherapy with or without radiotherapy depending on tumor histology.
Treatment of Wilms tumor :
Treatment of wilm's tumor consists surgical resection followed by chemo and ratiotherapy. | train | med_mcqa | null |
Most commonly used immunosuppressants are : | [
"Glucocorticoids",
"Cyclosporine",
"Tacrolimus",
"Methotrexate"
] | A | null | train | med_mcqa | null |
A 30 year old male present with pruritic flat-topped polygonal, shiny violaceous papules with flexural distribution. the most likely diagnosis is? | [
"Psoriasis",
"Pityriasis",
"Lichen planus",
"Lichenoid dermatitis"
] | C | C. i.e. Lichen planus | train | med_mcqa | null |
In neonatal resuscitation, which of the following drug is used? | [
"Dopamine",
"Sodium Bicarbonate",
"Noradrenaline",
"Dobutamine"
] | B | Impoant drugs used for neonatal resuscitation areEpinephrine (adrenaline)Normal saline or ringer lactateNaloxone and sodium bicarbonateAlso, knowDose of adrenaline in neonatal resuscitation: 0.1 to 0.3 mg/kg diluted 1:10,000.(Ref: NRP guidelines 2015) | train | med_mcqa | null |
Anion gap is mostly due to: | [
"Proteins",
"Sulphates",
"Phosphates",
"Nitrates"
] | A | A i.e. Proteins Anion gap (AG) -Represents unmeasured anions in plasmaQ - AG is mostly due to proteinsQ - Normal AG is 10 -12 mmol/LQ. - Decrease in serum albumin by 1g/di decreases AG by 2.5meq/LQ - 0 O_ " align="left" height="183" width="53">The concentration of anions and cations in plasma must be equal to maintain electrical neutrality. However, only ceain cations (Nat) and anions (C1-, HCO3- ) are routinely measured in clinical laboratory. Anion gap (AG) represents the unmeasured anions in the plasma. (difference between 'unmeasured cations & unmeasured anions') It is calculatedQ as follows: AG = The most impoant unmeasured cations: Ca2+, Mg2+, K+ The most impoant unmeasured anions: Proteins (Albumin), sulphate, phosphates Proteins are present in our body in much more quantities as compared to other unmeasured anions. | train | med_mcqa | null |
Radioisotope of choice for Triple phase Bone scan NOT RELATED- RADIOLOGY | [
"Tc99m-Sestamibi",
"Tc99m-Peectinate",
"Tc99m-Methyl diphosphonate",
"Tc99m-Thallium201 subtraction"
] | C | Tc99m-Sestamibi: Parathyroid scanTc99m-Peectinate: Meckle's diveiculum, Salivary gland scintigraphyand Thyroid scan.Tc99m-Methyl diphosphonate: Bone scanTc99m-Thallium201 subtraction: Second choice for detecting parathyroidadenomas. | train | med_mcqa | null |
Which of the ollowing is an antiapoptotic 'gene ? | [
"C-myc",
"P53",
"bc1-2",
"bax"
] | C | Ans. is 'c' i.e., bcl - 2 | train | med_mcqa | null |
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