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Which among the following is NOT a second messenger? | [
"cAMP",
"cGMP",
"Ca",
"G- Protein"
] | D | Calcium is used as second messenger in systems involving G proteins and inositol triphosphate. Second messengers include 3', 5'-cAMP, synthesized from ATP by the enzyme adenylyl cyclase in response to the hormone epinephrine, and Ca2+, which is stored inside the endoplasmic reticulum of most cells. Other second messengers include 3',5'-cGMP, nitric oxide, and the polyphosphoinositols produced by the hydrolysis of inositol phospholipids by hormone-regulated phospholipases. Ref: Kennelly P.J., Rodwell V.W. (2011). Chapter 9. Enzymes: Regulation of Activities. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | train | med_mcqa | null |
Neuromuscular blocker of choice in real failure: | [
"Atracurium",
"Pancuronium",
"Rocuronium",
"Tubocurare"
] | A | Ans: A (Atracurium) Ref: Ajay Yadav's Short Textbook of Anaesthesia, 1st ed. Pg 89.Explanation:AtracuriumIt has a unique method of degradationIts metabolism is independent of hepatic and renal functionsIt undergoes HOFFMAN DEGREDATION (95%) and ester hydrolysis (5%) in plasmaSystemic effects,CVS: Can cause hypotension because of histamine releaseResp: Can cause Bronchospasm due to histamine releaseCNS: At higher doses, its metabolic product Laudanosine can precipitate convulsionsAllergic reactions from pruritic rash to angioedema can occurUsesAtracurium is relaxant of choice inHepatic failureRenal failureMyasthenia gravis | train | med_mcqa | null |
All are true regarding fetal RBC&;s Except - | [
"Elevated 2,3 DPG",
"Decreased carbonic anhydrase activity",
"Decreased life span",
"High RBC volume"
] | A | <p>The difference in physiochemical propeies when compared with Hb A are: increased solubility of deoxy HbF,slower electrophoretic mobility for HbF,increased resistance of UnFounately to alkali denaturation,HbF has decreased interaction with 2,3-BPG.Thus increase in oxygen affinity is physiologically advantageous in facilitating transplacental oxygen transpo due to diminished binding of 2,3-BPG.</p><p>Reference :DM Vasudevan textbook of biochemistry sixth edition pg no 259</p> | train | med_mcqa | null |
Ohobaric oxygen is used in:- | [
"CO poisoning",
"Ventilation failure",
"Anerobic infection",
"Gangrene"
] | A | Ans is 'a' i.e., CO Poisoning Ohobaric Oxygen - 100% oxygen at atmospheric pressure. Ohobaric oxygen is used in CO poisoning. It reduces the half life of carboxyhemoglobin complex. About use of hyperbaric oxygen in CO poisoning. - Although hyperbaric oxygen therapy is often recommended for patients with coma, syncope, seizures, and cardiovascular instability, for those who do not respond to ohobaric oxygen therapy, recent data suggest that it is no more effective than ohobaric oxygen therapy - | train | med_mcqa | null |
Thumb printing sign is seen in | [
"Acute epiglotitis",
"Acute largnotracheobronchitis",
"Acute Laryngitis",
"Carcinoma vocal cords"
] | A | (Acute epiglottitis): (309-Dhingra 5th; 599-P-Hazarika 3rd/edition)ACUTE EPIGLOTTITIS(Syn - Acute supraglottic laryngitis)* Caused by Hemophilus influenza type BClinical FeaturesSymptomsSignsGeneral - usually starts as URTISigns* High grade fever* General - fever, toxic appearance and flushed skin, lethargic* Dribbling saliva* On auscultation decreased air entry Local* Sore throad* Dysphagia/odynophagia* Muffled (Hot potato) voice* F B sensation in the throat* Breathing difficulty -Inspiratory stridor is variably present and may be associated with expiratory rottles ORAL* Pharynx is usually congested and pooling of saliva* Red and edematous epiglottis popping up "Cherry red epiglottis"* Stridor is inspiratory and increases on supine position. Patient tends it sit up leaning forward supporting on upper limbs (Tripod sign) which relieves stridor to some extent* Inspiratory stritor if severe causes intermittent retraction, active accessory respiratory muscles and perioral cyanosis Differences between acute epiglottis and acute laryngo-tracheo-bronchitis in children Acute epiglottisAcute laryngo-tracheo-bronchitis (or group)* Causative organismHaemophilus influenza type BParainfluenza virus type I and II* Age2-7 years3 months to 3 years* PathologySupraglottic larynxSubglottic area* Prodromal symptomsAbsentPresent* OnsetSuddenSlow* FeverHighLow grade or no fever* Patient's lookToxicNon-toxic* CoughUsually absentPresent, (Barking seal-like)* StridorPresent and may be markedPresent* OdynophagiaPresent with drooling of secretionsUsually absent* RadiologyThumb sign on lateral viewSteeple sign on anteroposterior view of neck* TreatmentHumidified oxygen, third generation cephalosporin (ceftriaxone) or amoxicillinHumidified 02 tent, steroids | train | med_mcqa | null |
Which of the following statement is true regarding Atazanavir:- | [
"Effective against only HIV-1",
"Resistance is due to mutation in codon 50 isoleucine to valine substitution",
"Decrease cholesterol and triglyceride levels",
"Combination with ritonavir do not have any advantage"
] | B | Atazanavir is effective against both against HIV 1 and HIV 2 but NNI are effective only against HIV 1. They do not decrease cholesterol and triglyceride levels. Combination with ritonavir have an advantage due to the phenomenon of Ritonavir boosting. The resistance is due to mutation in codon 50 isoleucine to valine substitution. | train | med_mcqa | null |
Telomerase- | [
"RNA polymerase",
"Causes carcinogenesis",
"Present in somatic cells",
"Absent in germ cells"
] | B | By using TERC, TE can add a six-nucleotide repeating sequence, 5'-TTAGGG (in veebrates, the sequence differs in other organisms) to the 3' strand of chromosomes. These TTAGGG repeats (with their various protein binding paners) are called telomeres. The template region of TERC is 3'-CAAUCCCAAUC-5'. Telomerase can bind the first few nucleotides of the template to the last telomere sequence on the chromosome, add a new telomere repeat (5'-GGTTAG-3') sequence, let go, realign the new 3'-end of telomere to the template, and repeat the process. Telomerase reverses telomere shoening. | train | med_mcqa | null |
The patient is suffering from which stage of trachoma? | [
"Trachomatous inflammation intense",
"Trachomatous scarring",
"Trachomatous corneal opacity",
"Trachomatous trichiasis"
] | D | Ans. (d) Trachomatous trichiasisGoing by the FISTO classification of WHO, active inflammation signs and Arlt's line cannot be seen, so the above case cannot be TF, TI, TS.Corneal epithelial defects can be seen, but corneal opacity has still not developed, thus the above patient can be graded as a case of TT. | train | med_mcqa | null |
After cataract is best treated with | [
"ARGON LASER",
"Nd-YAG LASER",
"EXIMER LASER",
"Holmium LASER"
] | B | . | train | med_mcqa | null |
Which of the following is not associated with hypothyroidism | [
"Low T3",
"High TSH",
"High Triglycerides",
"Low cholesterol"
] | D | Answer is D (Low cholesterol): Hypothyroidism is associated with increased cholesterol (Hypercholesterolemia) and not with low cholesterol (Hypocholesterolemia). A normal TSH excludes primary (but not secondary) hypothyroidism. If the TSH is elevated an unbound T4 level is needed to confirm the presence of clinical hypothyroidism but T4 is inferior to TSH where used as a screening test. *Circulating unbound T3 (Free T3) levels may be normal in about 25% of patients reflecting adaptive diodinase responses to hypothyroidism. Free T3 measurements are therefore not indicated. | train | med_mcqa | null |
Lamina papyracea is between ? | [
"Optic nerve and orbit",
"Maxillary sinus and orbit",
"Ethmoid sinus and orbit",
"Cranial cavity and orbit"
] | C | The thinnest poion of medial wall of orbit is the lamina papyracea which separates ethmoid sinuses from orbit. o Infection from ethmoidal sinus can easily breach this paper thin bone and affect the orbital contents. | train | med_mcqa | null |
Dermatophytes involve- | [
"Stratum corneum",
"Stratum lucidum",
"Stratum malpighian",
"Stratum basale"
] | A | DERMATOPHYTOSIS Infection caused by dermatophytes. Superficial cutaneous infection. Affects stratum corneum layer of skin , hair and nails Trichophoton species affects skin , hair and nails Epidermophyton Affects skin and nails Microsporum Affects skin and hair Iadvl textbook of dermatology page page 253 | train | med_mcqa | null |
Which index uses calibrated probe for calculus? | [
"OHI",
"Marginal line calculus index",
"Calculus severity index",
"Volpe Manhold Index"
] | D | null | train | med_mcqa | null |
The most common site of leak in CSF rhinorrhoea is: | [
"Sphenoid sinus",
"Frontal sinus",
"Cribriform plate",
"Tegmen tympani"
] | C | CSF rhinorrhoea is most commonly iatrogenic, following endoscopic sinus surgery. It can occur in surgery of frontal, sphenoid or ethmoid sinus. Injury to cribriform plate and ethmoid roof is the most common cause. | train | med_mcqa | null |
The maximum age for growth of lymphoid tissue ? | [
"3-4 years",
"5-7 years",
"7-11 years",
"11-14 years"
] | B | Ans. is 'b i.e., 5-7 years o The growth of lymphoid tissue is most notable during mid-childhood. o Children between 4 and 8 years of age often have hyperophied tonsils and large lymph nodes, which is infact a sign of lymphoid hyperplasia. | train | med_mcqa | null |
For renal stone, diagnosis is not done by – a) IVPb) MRIc) PET-Scand) USGe) CT scan | [
"a",
"c",
"bc",
"ad"
] | C | Radiological investigations used for urinary stones are : -
i) Plane abdominal x-ray (KUB film) → First radiological test.
ii) Intravenous pyelogram (IVP).
iii) Non-contrast helical CT → Investigation of choice.
iv) USG | train | med_mcqa | null |
Investigation of choice for posterior chethral stricture is | [
"Retrograde Urethrogram",
"Anterograde Urethrogram",
"IV Pydogram",
"Ascending Urethrogram"
] | B | Investigation of choice :
a) Anterior Urethral stricture ⇒ Retrograde Urethrogram.
b) Posterior Urethral stricture ⇒ Anterograde urethrogram. | train | med_mcqa | null |
Expansile lytic osseous metastases are characteristic of primary malignancy of | [
"Kidney",
"Bronchus",
"Breast",
"Prostate"
] | A | Ans. is 'a' i.e. Kidney | train | med_mcqa | null |
The definition of hypeension in children is | [
"Average systolic blood pressure (SBP) and/or diastolic BP that is >=95th percentile for age, sex, and height on >=2 occasions",
"Average systolic blood pressure (SBP) and/or diastolic BP that is >=95th percentile for age, sex, and height on >=3 occasions",
"Average systolic blood pressure (SBP) and/or diastoli... | B | The definition of hypeension in adults is BP >=140/90 mm Hg, regardless of body size, sex, or age. This is a functional definition that relates level of BP elevation with the likelihood of subsequent cardiovascular events. Because hypeension-associated cardiovascular events, such as myocardial infarction or stroke, usually do not occur in childhood, the definition of hypeension in children is statistical rather than functional. The National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents published the Fouh Repo on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents (Fouh Repo) in 2004. This repo established normal values based on the normative distribution of BP in healthy children and included tables with systolic and diastolic values for the 50th, 90th, 95th, and 99th percentile by age, sex, and height percentile. The Fouh Repo defined hypeension as average systolic blood pressure (SBP) and/or diastolic BP that is >=95th percentile for age, sex, and height on >=3 occasions. Prehypeension was defined as average SBP or diastolic BP that is >=90th percentile but <95th percentile. In adolescents beginning at age 12 yr, prehypeension is defined as BP between 120/80 mm Hg and the 95th percentile. A child with BP levels >=95th percentile in a medical setting but normal BP outside of the office has white coat hypeension. The Fouh Repo fuher recommended that if BP is >=95th percentile, then hypeension should be staged. Children with BP between the 95th and 99th percentile plus 5 mm Hg are categorized as stage 1 hypeension, and children with BP above the 99th percentile plus 5 mm Hg have stage 2 hypeension. Stage 1 hypeension, if asymptomatic and without target organ damage, allows time for evaluation before staing treatment, whereas stage 2 hypeension calls for more prompt evaluation and pharmacologic therapy. Reference: Nelson; 20th edition; Page no: 2294 | train | med_mcqa | null |
Which complex in mitochondrial ETC does not pump out H ions - | [
"Complex I",
"Complex II",
"Complex III",
"Complex IV"
] | B | Ans. is 'b' i.e., Complex II | train | med_mcqa | null |
Abductors of vocal cord is | [
"Lateral cricoarytenoids",
"Posterior cricoarytenoids",
"Thyro arytenoids",
"Cricothyroids"
] | B | i.e. (Posterior cricoarytenoids): (243-BDC-3-5th ed)Muscles acting on the Larynx|| |Movements Muscles1. Elevation of larynx Thyrohyoid, mylohyoid2. Depression of larynx Sternothyroid, sternohyoid3. Opening of larynx Thyroepiglotticus4. Closing inlet of larynx Aryepiglotticus5. Abductor of vocal cords Posterior cricoaryteroids only6. Adductor of vocal cords Lateral cricoarytenoids, transverse oblique arytenoids7. Tensor of vocal cords Cricothyroids8. Relaxor of vocal cords Thyroarytenoids(i) Cricothyroid is supplied by external laryngeal nerve(ii) Rest of the intrinsic muscle - recurrent laryngeal nerve | train | med_mcqa | null |
Which is not a feature of pancreatic ascites ? | [
"Low protein",
"Somatostatin is the drug of choice",
"Communication with pancreatic duct in 80%",
"Raised amylase levels"
] | A | Answer is 'a' i.e. Low protein Pancreatic ascitic fluid, contains elevated protein (> 2.9 g/dI) and amylase levels. Pancreatic ascites occurs - when pancreatic juice gains entry into the peritoneal cavity either from a pancreatic duct disruption or - from a leaking pseudocyst The principal causative factors are alcoholic pancreatitis in adults and traumatic pancreatitis in children. The diagnosis can usually be made when high amylase levels are found in the ascitic fluid. Definitive diagnosis is made by ERCP. Management The initial treatment usually is nonoperative and involves attempts to decrease pancreatic secretion by - elimination of enteral feeding - nasogastric drainage and - use of antisecretory hormone somatostatin About 50 to 60 % pts. respond to this tit. If considerably improvement does not occur within 2-3 weeks then these patients are treated either endoscopically or surgically. - Endoscopic tit involves endoscopic pancreatic sphincterotomy with or without placement of transpapillary pancreatic duct stent. By reducing the resistance to drainage into the duodenum, and by bridging the site of duct disruption, this approach is designed to allow the site of leakage to seal. Surgical treatment is usually preceded by ERCP to identify the site of duct disruption. Surgery involves resection (for leaks in the pancreatic tail) internal Roux-en- Y drainage (for leaks in the pancreatic head & neck region) | train | med_mcqa | null |
Schizophrenia with early onset and poor prognosis is | [
"Catatonic",
"Hebephrenic",
"Paranoid",
"Schizoaffective"
] | B | B i.e. Hebephrenic | train | med_mcqa | null |
A client comes into the ER after hitting his head in an MVA. He’s alert and oriented. Which of the following nursing interventions should be done first? | [
"Assess full ROM to determine extent of injuries",
"Call for an immediate chest x-ray",
"Immobilize the client’s head and neck",
"Open the airway with the head-tilt-chin-lift maneuver"
] | C | All clients with a head injury are treated as if a cervical spine injury is present until x-rays confirm their absence. The airway doesn’t need to be opened since the client appears alert and not in respiratory distress.
Option A: ROM would be contraindicated at this time.
Option B: There is no indication that the client needs a chest x-ray.
Option D: In addition, the head-tilt-chin-lift manoeuvre wouldn’t be used until the cervical spine injury is ruled out. | train | med_mcqa | null |
A scatter diagram was plotted as shown below to study the relationship between two variables. This is an example of: | [
"High positive correlation",
"High negative correlation",
"Low positive correlation",
"Low negative correlation"
] | D | null | train | med_mcqa | null |
Which of the following tests is to be done to screen a lady with family history of thalassemia? | [
"Hb A2 Levels",
"NESTROFT",
"High performance liquid chromatography",
"P. smear and reticulocyte count"
] | B | Ref: Textbook of hematology Dr. Tejender sittgh 2nd ed. P 90-92, Hemoglobinopathies by Atiupam sachdev 1st ed. P 100Initial screening test for diagnosis of b-thalassemia carriers is NESTROFT. The naked eye single tube osmotic fragility test is based on osmotic fragility using 0.36% buffered saline.Procedure* Two test tubes labeled as Buffered saline (2mL) and distilled water 2mL) are taken and a drop of water is added to each of tubes, which is left undisturbed for hall an hour at room temperature. Following this contents ol the tube are shaken and held against a white paper on which a thin black line is drawn.Interpretation* The line is clearly visible through the DW tube and if the same is seen in Buffered saline tube, it indicates that the test is negative.* Thalassemia syndrome is the most common genetic syndrome worldwide.* IOC for thalassemia is HPLC [?] Hb electrophoresis. | train | med_mcqa | null |
In blood culture the ratio of blood to reagent is - | [
"1:05",
"1:20",
"1:10",
":100"
] | C | Specifics for <a href=" and panels</a> are as follows: Specimen type - Whole blood Container - Culture bottles (one aerobic and one anaerobic) for blood and green-top tube (heparin) for fungus and mycobacteria (if warranted by clinical suspicion) Collection method - Venipuncture Specimen volume - Adults: 10-20 mL per culture set; Pediatric patients: 1.0-3.0 m The blood is inoculated into the bottle containing blood culture medium in the blood to the broth ratio of 1:10 .but in children where the amount of blood drawn is little a ratio of 1:5 may be achieved REF: MEDSCAPE | train | med_mcqa | null |
If full coronal restoration of mandibular incisors is necessary, it requires the use of a: | [
"Maxillary central crown form",
"Maxillary lateral crown form",
"Maxillary canine crown form",
"Mandibular lateral crown form"
] | B | No crown forms are available that are made specifically for mandibular incisors.
If full coronal restoration of mandibular incisors is necessary, it requires the use of a maxillary lateral crown form. | train | med_mcqa | null |
A patient had undergo suction evacuation for 10 weeks pregnancy. Three days later she came back with profuse vaginal bleeding and abdominal pain. The most likely diagnosis is : | [
"Uterine atony",
"Cervical injury",
"Retained products",
"Uterine perforation"
] | C | Retained products | train | med_mcqa | null |
Angiographically,the typical "beaded" or "pile of plates"appearance involving the internal carotid acry is seen In - | [
"Takayasu's Disease",
"Non-specific aoo-aeritts",
"Fibromuscular dysplasia",
"Rendu-Osler-Weber Disease"
] | C | Fibromuscular dysplasia is a hyperplastic disorder that affects medium-size and small aeries. It occurs predominantly in females and usually involves the renal and carotid aeries but can affect extremity vessels such as the iliac and subclan aeries. The histologic classification includes intimal fibroplasia, medial dysplasia, and adventitial hyperplasia. Medial dysplasia is subdivided into medial fibroplasia, perimedial fibroplasia, and medial hyperplasia.fibroplasia is the most common type and is characterized by alternating areas of thinned media and fibromuscular ridges. The internal elastic lamina usually is preserved. The iliac aeries are the limb aeries most likely to be affected by fibromuscular dysplasia.It is identified angiographically by a "STRING OF BEADS" appearance caused by thickened fibromuscular ridges contiguous with thin, less-involved poions of the aerial wall. When limb vessels are involved, clinical manifestations are similar to those for atherosclerosis, including claudication and rest pain. PTA and surgical reconstruction have been beneficial in patients with debilitating symptoms or threatened limbs. ref:Harrison&;s principles of internal medicine,ed 18,pg no 2069 | train | med_mcqa | null |
A 40 year old woman has severe, disabling rheumatoid ahritis. Rheumatoid factor is positive. What would a biopsy of the synovium of her knee most likely reveal? | [
"A nearly normal synovium with scattered inflammatory cells",
"A non-proliferative synovitis with abscess formation",
"A non-proliferative synovitis with many neutrophils",
"A proliferative synovitis with many lymphocytes, macrophages, and plasma cells"
] | D | Severe rheumatoid ahritis causes a proliferative synovitis with extensive damage to the synovium of the joint. The synol membrane becomes markedly thickened (pannus formation), with edematous villous projections that extend into the joint space. The intense inflammatory infiltrate that is present is typically composed of plasma cells, lymphocytes, and macrophages. Ref: Bednar M.S., Light T.R. (2006). Chapter 10. Hand Surgery. In H.B. Skinner (Ed), CURRENT Diagnosis & Treatment in Ohopedics, 4e. | train | med_mcqa | null |
A 62-year-old alcoholic presents with an indurated ulcer, 1.5 cm in length, in the left lateral aspect of her tongue (not fixed to the alveolar ridge). There are no clinically abnormal glands palpable in the neck, and a biopsy of the tongue lesion reveals squamous cell carcinoma What should she undergo?Oral tongue squamous cell carcinoma | [
"Chemotherapy",
"Local excision of the ulcer",
"Wide excision and left radical neck dissection",
"Antibiotic therapy and should be encouraged to stop smoking"
] | C | Squamous cell carcinoma of the tongue frequently (40-60%) metastasizes to the lymph glands. Carcinoma of the tongue usually commences at the tip or side. The 5-year survival rate for carcinoma of the tongue is 40%, but it improves to 55% if lymph nodes are not involved. | train | med_mcqa | null |
The most common pre-malignant condition of oral carcinoma is: | [
"Leukoplakia",
"Erythroplakia",
"Lichen planus",
"Submucous Fibrosis"
] | A | (a) Leukoplakia(Ref. Cummings, 6th ed., 1299)All the other choices also are pre-malignant but leukoplakia is the most common premalignant condition. | train | med_mcqa | null |
ALL of the following statement regarding the ECG in acute pericarditis are true except - | [
"T wave inversions develop before ST elevation retur to baseline",
"Global ST segment elevation is seen in early pericarditis",
"Sinus tachycardia is a common finding.",
"PR segment depression is present in majority of patients"
] | A | Ref: R.Alagappan Manual for Medicine 4th Edition pg no:112 Acute Pericarditis ECG shows * Sinus tachycardia * An elevated, concave upwards S-T segment * Upright, tall, peaked T-waves (earliest change) * No reciprocal changes in the opposite leads. | train | med_mcqa | null |
Which category of ICD is associated with schizophrenia | [
"F0",
"F1",
"F2",
"F3"
] | C | ICD ICD mentions International classification of mental and behavioural disorders this was given by WHO( World health Organisation) ICD is used all over the world except America latest edition of ICD is ICD11 ICD 11 was released in 2018 DSM DSM mentions Diagnostic and Statistical manual of mental disorders this was given by APA( American Psychiatric Assosiation) DSM is used in America latest edition of DSM is DSM 5 ICD 11 was released in 2018 categorisation ofmental disorders in ICD 10 is mentioned below F00-F09 Organic, including symptomatic, mental disorders F10-F19 Mental and behavioural disorders due to psychoactive substance use F20-F29 Schizophrenia, schizotypal and delusional disorders F30-F39 Mood disorders ICD-10 Classification of Mental and Behavioural Disorders, World Health Organization, Geneva, 1992 | train | med_mcqa | null |
1CD 10 has..............chapters: | [
"2",
"12",
"22",
"32"
] | C | 22 | train | med_mcqa | null |
In hepatic metabolism, phase II reactions are: | [
"Sulfation",
"Methylation",
"Glucuronidation",
"All of these"
] | D | - Metabolic Reactions
Phase 1 (non-synthetic) - Functional group is attached to the drug molecule.
§ Oxidation
§ Reduction
§ Hydrolysis
§ Cyclization
§ Decyclization
Phase 2 (synthetic) - Conjugate is attached to the drug molecule.
§ Glucuronidation
§ Acetylation
§ Methylation
§ Sulfation
§ Glycine conjugation | train | med_mcqa | null |
50 year old male with positive family history of prostate cancer has come to you for a screening test. The screening test done to pickup prostate cancer is | [
"DRE",
"PSA",
"DRE + PSA",
"Endorectal coil MRI with T1 and T2 W images"
] | C | Prostate-specific antigen (PSA) and Digital rectal examination (DRE) Age 50 for men who are at average risk of prostate cancer and are expected to live at least 10 more years. Age 45 for men at high risk of developing prostate cancer. This includes African Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65). Age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age). | train | med_mcqa | null |
A 30 year old male is having attic cholesteatoma of left ear with lateral sinus thrombophlebitis. Which of the following would be the operation of choice? | [
"Intact canal wall mastoidectomy",
"Canal wall down mastoidectomy",
"Mastoidectomy with cavity obliteration",
"Simple mastoidectomy with Tympanoplasty"
] | B | Canal wall down mastoidectomy is done in cases of attic cholesteatoma. In this procedure mastoid cavity is left open into the external auditory canal. Since the patient in the question is suffering from attic cholesteatoma and secondary complications canal wall down mastoidectomy would be the treatment of choice. Other indications of this procedure includes extensive chronic otits media, formation of a new attic retraction pocket with disease following a previously performed canal wall up procedure, lateral semicircular canal fistula in the only hearing ear. | train | med_mcqa | null |
'Peg cells' are seen in which of the following pa of the female genital tract? | [
"Vagina",
"Vulva",
"Ovary",
"Fallopian Tubes"
] | D | There are three types of cells present in the epithelium of fallopian tubes, they are ciliated epithelial cells, nonciliated secretory cells and intercalated or peg cells called stem cells. Peg cells can differentiate into either of the other two types of cells. Peg cells: They are abundant during the premenstrual and menstrual periods. They have long slender, rod like nuclei and small amount of cytoplasm squeezed by adjoining cells. They represent secretory cells in transitional stages. Fallopian tubes usually measures between 8-14cm and is divided into an interstitial poion, isthmus, ampulla and infundibulum. Ref: Textbook of Pathology By V. Krishna page 930, Syllabus of Gynecologic Pathology with Clinical Correlations By Tung Van Dinh page 82 | train | med_mcqa | null |
A 5 year old male child has multiple hyper pigmented macules over the trunk, on rubbing the lesion with the rounded end of a pen. He developed uicarial wheal, confined to the border of the lesion. The most likely diagnosis is | [
"Fixed drug eruption",
"Licken planus",
"Uicaria pigmentosa",
"Uicarial vasculitis"
] | C | Uicaria pigmentosa Uicaria is characterized by large, irregularly shaped pruritic, erythematous wheels Special forms of uicaria have special features (Dermographism, cholinergic uicaria, solar uicaria, or cold uritcaria) Most incidents are acute and self-limited over a period of 1-2 weeks Chronic uicaria (episodes lasting> 6 weeks) may have an autoimmune basis The most common immunologic mechanism is hypersensitivity mediated by IgE, seen for most patients with acute uicaria The morphology of the lesions may vary over a period of minutes to hours, resulting in geographic or bizarre, pattern, true uicaria last less than 24 hours and often only 2-4 hours. The most common cause of acute uicaria are foods, viral infections and medications Diagnosis - In vivo allergy skin testing and in vitro RAST testing Determination of serum tryptase (Increased in anaphylaxis, systemic mastocytosis, non IgE mediated disease ("anaphylactoid reaction") ACE inhibitors and Angiotensin II receptors antagonist therapy is contraindicated. Uicaria pigmentosa (mastocytosis) - consists of multiple irregularly shaped hyperpigmented muscle which may present on the trunk and extremities. Stroking the skin through the lesion with a blunt instrument elicits the classical "triple response of Lewis" called | train | med_mcqa | null |
Hypoxia causes vasoconstriction in | [
"Muscle",
"Lungs",
"Liver",
"Spleen"
] | B | "O2 deficiency (Hypoxia), Accumulation of CO2,| PH produce vasoconstriction in the lungs. While these in the other tissues produce vasodilatation.Ref: Guyton; 13th edition | train | med_mcqa | null |
Which one of the following drugs is used to treat status epilepticus ? | [
"Primidone",
"Carbamazepine",
"Diazepam",
"Sodium valproate"
] | C | null | train | med_mcqa | null |
Which of the following is not true about expected date of delivery (EDD)? | [
"Less than 5% deliver on the expected date of delivery",
"50% deliver within one week",
"80% deliver within two weeks",
"Standard deviation around EDD is 3 weeks"
] | D | Ans. d. Standard deviation around EDD is 3 weeks (Ref Dutta's (Jaypee) / 73)Expected Date of Delivery (EDD)Only 4% of births take place on EDDAbout 50% deliver within 1 week on either side of EDD80% deliver about 2 weeks before to 1 week after EDDStandard deviation is of 13 days(90% of babies will be born within three weeks of their EDD. and 21% will be born within three days of it) | train | med_mcqa | null |
Root value of thoracodorsal nerve | [
"C5,C6,C7",
"C6,T1",
"C6,C7,C8",
"T1,T2"
] | A | Thoracodorsal nerve or long thoracic nerve arises from brachial plexus. Its nerve value is C5, C6 and C7. REF:BDChaurasia 7th edition Page no: 57. | train | med_mcqa | null |
After postmortem exam, body has to be handed over to | [
"Investigating police officer",
"Relative of victim",
"Magistrate",
"The civil authorities"
] | A | null | train | med_mcqa | null |
A nerve injured in radical neck dissection leads to loss of sensation in medial side of the arm, nerve injured is:- | [
"Long thoracic nerve",
"Thoracodorsal nerve",
"Dorsal scapular nerve",
"Medial cutaneous nerve of arm"
] | D | Nerve injured in radical neck dissection leads to loss of sensation in medial side of the arm, nerve injured is medial cutaneous nerve of arm. The medial cutaneous nerve of arm supplies the skin of the medial aspect of the arm. It is the smallest branch of the brachial plexus, and arises from the medial cord and contains fibres from the eighth cervical and first thoracic ventral rami. | train | med_mcqa | null |
Extensive involvement of deep white matter with bilateral hyperdense thalami on non-contrast CT scan of the brain is virtually diagnostic of - | [
"Alexander's disease",
"Krabbe's disease",
"Canavan's disease",
"Metachromatic leukodystrophy"
] | B | Extensive involvement of deep white matter with bilateral hyperdense thalami on CT scan suggests the diagnosis of Krabbe's disease. | train | med_mcqa | null |
In autopsy, preservative used for vitreous is | [
"Phenol",
"Xylol",
"Flouride",
"HCL"
] | C | Vitreous humor is the preferred specimen for postmoem confirmation of alcohol ingestion, since postmoem formation of ethanol does not occur to significant extent in vitreous, and hence useful even in decomposing bodies. It is recommended that this specimen is included routinely in sudden death investigations. In known diabetics, it is always wise to check the postmoem vitreous glucose level, even when there seems to be some other plausible cause of death. A high vitreous glucose level (> 200 mg/dl or so) is likely reflective of hyperglycaemia. Vitreous humor is preserved using sodium fluoride (10 mg/ml). Ref - Krishan Vij textbook of forensic medicine and toxicology 5e pg : 107 ,445 | train | med_mcqa | null |
Acrodermatitis continua of Hallopeau is due to | [
"Pustular psoriasis",
"Zinc toxicity",
"Zinc deficiency",
"Colloidion baby"
] | A | Acrodermatitis continua of Hallopeau (ACH) is a rare inflammatory disease characterised by pustular eruptionsbeginning in the tips of fingers and toes (digits). The pustules may vary in extent over a chronic, recurrent course Acrodermatitis continua of Hallopeau is often triggered by localised trauma or infection at the distal phalanx(the tip of the digit). 80% begin in only one digit, most commonly the thumb. During acute flare-ups, the skin of the distal phalanx becomes red and scaly and develops small pustules. The pustules often join together and on bursting, reveal a painful, red and glazed area where new pustules then develop. Pustulation of the nail bed and its growth site (matrix) can result in onychodystrophy (malformation) and anonychia (loss of nail). Slowly, the disease can rarely spread proximally to affect the hand, forearm and/or foot. There may be osteolysis (destruction of bone) resulting in a wasted and tapered tip of finger or toe. In adults, acrodermatitis continua of Hallopeau may evolve into generalised Reference: GHAI Essential pediatrics, 8th edition | train | med_mcqa | null |
V/Q ratio at the base of lung? | [
"1",
"3",
"0.6",
"1.8"
] | C | Ans. is 'c' i.e., 0.6(Ref: Ganong 24hle P.636-637OverallV/Qratio of lung 0.8V/Qratio at aPex 3.0 (maximum)V/Q ratio at base - 0.6 (Least) | train | med_mcqa | null |
Universal finding is asthma is - | [
"Hypoxia",
"Hypercarbia",
"Respiratory acidosis",
"Metabolic acidosis"
] | A | null | train | med_mcqa | null |
True in Pancreas traumaa) Solitary involvement commonb) Blunt injury usual causec) Always surgery neededd) Amylase - in 90% casese) HRCT is investigation of choice | [
"ab",
"bc",
"cd",
"de"
] | D | null | train | med_mcqa | null |
Function of Larynx is A/E | [
"Phonation",
"Protect lower respiratory tract from infection",
"Prevent food regurgitation",
"Immunity enhancement"
] | D | (Immunity enhancement): (303-4- Dhingra 5th edition; 577-P Hazarika 3rd)Function of the Larynx1. Primary function is to protect lower respiratory tractProtection of tracheobronchial tree is fascilitated by'Three - tier' sphincter action- Laryngeal elevation - Mylohyoid- Laryngeal tilting - Stylopharyngeous- Cricopharyngeal sphincter relaxes- Cough reflex- Cessation of respirationLarynx is aptly, called the watch-dog of lungs as it immediately barks' at the entry of any foreign intruder2. Phonation - is also an important function of the lung which facilitates communication3. Respiration: Reflex adjustments of the glottis apparatus plays a role in the mechanism of respiration Larynx regulates flow of air into the lungs.Vocal cords abduct during inspiration and adduct during expiration4. Fixation of the chest - To increase intrathoracic pressure when larynx is closed, chest wall gets fixed and various thoracic and abdominal muscles can then act best. This function is important in digging, pulling and climbing. Coughing, vomiting, defaecation, micturition and childbirth (Straining) also require a fixed thoracic cage against a closed glottis. | train | med_mcqa | null |
Following are features of Barrett&;s oesophagus | [
"Intestinal Metaplasia",
"Always gastric type of epithelium",
"Squamous carcinoma more common",
"Present as patchy or ring involvement"
] | A | Histologic changes of the distal oesophagal mucosa from its normal squamous epithelium to a columnar configuration (intestinal metaplasia). Barrett oesophagus in endoscopy appears as velvety-red "tongues" of mucosa that extend cephalad from the GEJ. These patients carry a higher risk to Adenocarcinoma oesophagus compared to normal population. Reference: Sabiston 20th edition page: 1074 | train | med_mcqa | null |
Best way to differentiate a periapical cyst and a perapical granuloma is | [
"Radiographically",
"Histologically",
"Clinically",
"None of the above"
] | B | null | train | med_mcqa | null |
Which of the following structures is derived from the diencephalon? | [
"Caudate nucleus",
"Cerebellum",
"Olfactory bulbs",
"Neurohypophysis"
] | D | Neurohypophysis develops from the diencephalon. Adenohypophysis (pars distalis, pars tuberalis, and pars intermedia) develops from Rathke's pouch, ectodermal diveiculum of the stomodeum. Caudate nucleus & olfactory bulbs develop from the telencephalon. Cerebellum develops from the metencephalon | train | med_mcqa | null |
Dose of Human Rabies Immunoglobulin is: | [
"10 IU/kg",
"20 IU/kg",
"30 IU/kg",
"40 IU/kg"
] | B | b. 20IU/kg(Ref: Nelson's 20/e p 3450, 1642-1644, Ghai 8/e p 202-203)Human rabies immunoglobulin (HRIG--dose is 20U/kg body weight, maximum dose 1500IU); andEquine rabies immunoglobulin (ERIG--dose is 40U/kg, maximum dose 3000IU) | train | med_mcqa | null |
While performing embalming, difficulty encountered due to aerial system problem. How should the embalming fluid be introduced to overcome this problem? | [
"Low pressure high velocity",
"Low pressure low velocity",
"High pressure high velocity",
"High pressure low velocity"
] | D | In jaundice embalming, the use of formaldehyde as the primary preservative initiates a chain of events that causes the unwanted yellow-green color reaction to occur in most cases. In embalming of jaundice cases, the formaldehyde based solutions convers the bilirubin in the body into biliverdin and the colour changes into green. EMBALMING: THANATOPRAXIA * It is the treatment of the dead body with antiseptics and preservatives to stop putrefaction and preserve the body. * Embalming a body within 6 hoursQ - satisfactory result. * It produces a chemical stiffeningQ similar to rigor mois. * Embalming rigidity is permanent and Normal rigor does not occurQ. Constituents of a typical embalming fluid * Preservative - Commonly a mixture of formaldehyde, glu!taraldehyde. Methanol is used to hold the formaldehyde in solution. * Germicide - Phenol * Humectant (to preserve the moisture) - Glycerine * Buffer (to maintain the pH) - Sodium borate/sodium bicar!bonate. * Anticoagulants-Sodium citrate/sodium oxalate * Dyes (to restore the body's natural colouration) - eosin * + Perfume - wintergreen * Vehicle - water upto 10 L Note: Ethanol is not a constituent of embalming fluid. Injection types: * Aerial injection is preferred* It is forcing of fluid in an aery to reach the tissues through the aerioles and capillaries. * Diffusion occurs into the cells and ti sues for preservation at the capillary level.* For overcoming the clots & better perfusion in aerial injection, High pressure with low flow is preffered. Methods of Injection * Continuous injection & drainage * Continuous injection and disrupted drainage * Alternate injection and drainage * Discontinuous injection and drainage - Best method of injection | train | med_mcqa | null |
Wide QRS duration is- | [
">0.8sec",
">0.9sec Pattern)",
">.12sec",
"All the above"
] | C | a wide qrs complex by definiton is more than 120 ms The QRS complex duration is wide (>0.12 seconds or 3 small boxes) in every lead. Causes of a widened QRS complex include right or left BBB, pacemaker, hyperkalemia, ventricular preexcitation as is seen in Wolf-Parkinson-White pattern, and a ventricular rhythm. Ref Harrison 20th edition pg 1576 | train | med_mcqa | null |
Large warty vegetation are characteristic of- | [
"SLE",
"SABE",
"Both",
"None"
] | B | null | train | med_mcqa | null |
Investigation of choice for nasopharyngeal angiofibroma? | [
"X-ray",
"MRI",
"Plane-CT",
"CT- contrast"
] | D | Ans. is'd'i.e., CT contrastRef: Dhingra Sth/e p. 262CT scan of head with contrast enhancement is the investigation of choice for JNA. | train | med_mcqa | null |
Supratemporal lental subluxation is seen in | [
"Weil's marchasani syndrome",
"Marfans",
"Hunters",
"Homocystinuria"
] | B | Ans. is 'b' i.e., Marfans | train | med_mcqa | null |
Which of the following is the best technique to screen neonates for inherited metabolic disorders | [
"Tandem mass spectrometry",
"Northern Blotting",
"PCR",
"ChIP technique"
] | A | Tandem mass spectrometry is a technique in which compounds are separated by molecular weight by one mass spectrometer, fragmented as they exit, and identified on the basis of their fragments by a second mass spectrometer. | train | med_mcqa | null |
Surface marking of the mitral valve is | [
"Behind sternal end of left 4th costal cailage",
"Behind sternal end of right 4th costal cailage",
"Left 4th intercostal space in the midclavicular line",
"Left 3rd intercostal space in the midclavicular line"
] | A | Surface marking of mitral value is an oblique line 3 cm behind the left half of sternum opposite left 4th coastal cailage. <img src=" /> BD CHAURASIA'S HUMAN ANATOMY.VOLUME 1.6TH EDITION.PAGE NO 291.TABLE 21.1:SURAFACE MARKING OF CARDIAC VALVE | train | med_mcqa | null |
Alvarado score is used for | [
"Acute cholecystitis",
"Acute appendicitis",
"Acute apncreatitis",
"Acute epidydimitis"
] | B | Answer- B. Acute appendicitisScoring system for Acute Appendicitis: Alvarado Score:The diagnosis of appendicitis is based primarily on clinical history and physical examination assisted by blood counts. A number of clinical and laboratory based scoring systems have been devised to assist diagnosis.The most widely used scoring system is Alvarado score. | train | med_mcqa | null |
Coarctation of Aoa is most commonly associated with which of the following structural defects? | [
"Patent Ductus Aeriosus (PDA)",
"Ventricular Septal Defect (VSD)",
"Atrial Septal Defect (ASD)",
"Bicuspid Aoic valve"
] | D | Coarctation of Aoa is associated with Bicuspid Aoic Valve in 40% of patients. Clinical manifestations of coarctation depend on site & extent of obstruction and the presence of associated cardiac anomalies, most commonly a bicuspid aoic valve. Ref: Current Surgical 12th Edition, Page 426; Harrison's 16th Edition, Page 1387. | train | med_mcqa | null |
Parathormone has all of the following effects, except | [
"Increased bone resorption",
"Increased Ca+2 reabsorption in kidney",
"Increased phosphate reabsorption in kidney J",
"Increased calcitriol synthesis"
] | C | Parathyroid hormone (PTH), also called parathormone or parathyrin, is a hormone secreted by the parathyroid glands that is impoant in bone remodeling, which is an ongoing process in which bone tissue is alternately resorbed and rebuilt over time.Parathyroid hormone regulates serum calcium through its effects on bone, kidney, and the intestine:In bone, PTH enhances the release of calcium from the large reservoir contained in the bones. Bone resorption is the normal destruction of bone by osteoclasts, which are indirectly stimulated by PTH.In the kidney, Circulating parathyroid hormone influences the reabsorption that occurs in the distal tubules and the renal collecting ducts.PTH reduces the reabsorption of phosphate from the proximal tubule of the kidney.PTH increases the activity of 1-a-hydroxylase enzyme, which conves 25-hydroxycholecalciferol, the major circulating form of inactive vitamin D, into 1,25-dihydroxycholecalciferol, the active form of vitamin D, in the kidney.Ref: Ganong&;s review of medical physiology;24th edition; page no-377 | train | med_mcqa | null |
False regarding complete feminization is: | [
"Pre lobular bulb",
"Presence of feminine breast",
"Primary amenorrhea",
"Blind vagina"
] | A | Complete testicular feminization is a common form of male pseudohermaphroditism. It is the 3rd most
common cause of primary amenorrhea after gonadal dysgenesis and congenital absence of the vagina. The
features are characteristic. Namely, a "woman" is ascertained either because of inguinal hernia (prepubertal) or
primary amenorrhea (postpubertal). | train | med_mcqa | null |
Which of the following can be used for obtaining specimen for isolation of microorganism in laboratory diagnosis: | [
"Meningococcal rash",
"Blood in staphylococcal food poisoning",
"Throat swab in Rheumatic fever",
"Blood in post-streptococcal GN"
] | A | Ans. is. a' i.e. Meningococcal rash | train | med_mcqa | null |
Post - Menopausal bleeding is associated with all except : | [
"Ca cervix",
"CIN",
"Ca ovary",
"Endometrial Ca"
] | B | Ans. is b i.e. CIN | train | med_mcqa | null |
Most impoant stimulus to peripheral chemoreceptors | [
"PO2",
"CO2",
"pH",
"HCO3"
] | A | Peripheral chemoreceptors are activated by changes in the paial pressure of oxygen and trigger respiratory drive changes aimed at maintaining normal paial pressure levels.Ref: Ganong review of medical physiology 23rd edition Page no: 562 | train | med_mcqa | null |
Causative agent of rhinosporidiosis is ? | [
"Bacteria",
"Fungus",
"Protozoa",
"Virus"
] | A | Ans: is. 'a' i.e., Bacteria "Molecular studies have shown that the organism is not a fungus, but a primitive aquatic bacterium". "By using molecular tools, recently it has been found that R. seeberi is not a fungus but an unusual protist that shares phylogenetic features with microbes that cause infection in fish" "The etiological agent, Rhinosporidium seeberi, has never been successfully propagated in vitro. Initially thought to be a parasite for more than 50 years, R seeberi had been considered a water mould. Molecular biological techniques have recently demonstrated that this organism is an aquatic protistan parasite. It is currently included in a new class, the mesomycetozoea, along with organisms that cause similar infections in amphibians and fish". | train | med_mcqa | null |
A patient presented with oral mucosal lesions and flaccid blisters Over skin. It detects what and which pattern under microscopic examination? | [
"Fishnet pattern IgG in epidermis",
"IgG at Dermo-epiderrnal juction",
"IgA at Dermo-epidermal junction",
"IgG in dermis"
] | A | In pemphigus vulgaris skin involvement stas in the form of flaccid blisters. Cutaneous lesions are usually preceded by blisters and erosions of oral mucosa In Direct immunofluorescence intercellular IgG -fishnet pattern throughout the epidermis is seen in pemphigus vulgaris. page no.280,287 Reference IADVL's concise textbook of dermatology | train | med_mcqa | null |
A 5-year-old boy is being evaluated for recurrent epistaxis and other abnormal bleeding episodes, including excessive bleeding from the umbilical cord at bih. Laboratory studies reveal the following: decreased hemoglobin (with microcytic hypochromic red cell indices), normal platelet count, markedly prolonged prothrombin time (PT) and paial thromboplastin time (PTT), and unmeasurable thrombin time (TT). Platelet aggregation studies reveal a normal platelet response to ristocetin, but with other substances (including collagen, ADP, and epinephrine), this patient's platelets exhibit a primary wave defect. Based on these findings, this patient most likely has | [
"Afibrinogenemia",
"Bernard-Soulier syndrome",
"Glanzmann's thrombasthenia",
"Wiskott-Aldrich syndrome"
] | A | Platelet aggregation refers to platelets binding to other platelets. One mechanism for this involves fibrinogen, which can act as a molecular bridge between adjacent platelets by binding to GpIIb and GpIIIa receptors on the surface of platelets. Abnormalities of platelet aggregation (aggregation defects or primary wave defects) include Glanzmann's thrombasthenia and afibrinogenemia. Patients with Glanzmann's thrombasthenia have a deficiency of GpIIb-IIIa and defective platelet aggregation. Patients with low or no fibrinogen levels characteristically have prolonged PT, PTT, and TT values: in fact, they are so prolonged they are unmeasurable. In contrast to platelet aggregation, platelet secretion refers to the secretion of the contents of two types of granules within the platelet cytoplasm. a granules contain fibrinogen, fibronectin, and platelet-derived growth factor, while dense bodies contain ADP, ionized calcium, histamine, epinephrine, and serotonin. Decreased platelet secretion (activation defects) is seen with deficiencies of these granules; these diseases are called storage pool defects. They can involve either a granules (gray platelet syndrome) or dense bodies (Chediak-Higashi syndrome, Wiskott-Aldrich syndrome, or TAR). Wiskott-Aldrich syndrome is an X-linked disorder that is characterized by eczema, thrombocytopenia (small platelets), and immunodeficiency consisting of decreased levels of IgM and progressive loss of T cell function.These patients have recurrent infections with bacteria, viruses, and fungi. TAR refers to the combination of thrombocytopenia and absent radii. Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition. | train | med_mcqa | null |
Closure of coronal sutures starts at age of - | [
"20 years",
"25 years",
"30-35 years",
"50-60 years"
] | B | This question is tricky one. Most of the guides have given option c is the answer. Which is incorrect.
Coronal suture is completely obliterated at 35-40 years. But, read the question carefully, examiner is asking when the closure starts (not completes).
Closure of coronal, lambdoid and sagittal sutures starts at inner side at 25 years. And it is complete on outer side :-
Sagittal suture → 30-35 years.
Coronal suture → 35-40 years.
Lambdoid suture → 45-50 years. | train | med_mcqa | null |
Most common presentation of neuroblastoma is ? | [
"Lytic lesion in skull with suture diasthesis",
"Lung metastasis",
"Renal invasion",
"Secondaries in brain"
] | A | Ans. is 'a' i.e., Lytic lesions in skull, with sutural diastasis Most frequent site of metastasis from nueroblastoma is bone : where metastasis occurs very early. Lytic lesions in skull and sutural diastasis are manifestations of bony metastasis to skull, and hence the earliest feature, amongst the options in the questions. | train | med_mcqa | null |
Alkylating agent used in chemotherapy: | [
"Mechlorethamine",
"Procarbazine",
"Cyclophosphamide",
"All of the above"
] | D | Ref: KDT pg. 819-20; Katzung, 11th ed. pg. 1280* Bleomycin: This is a mixture of closely related glycopep- tides antibiotics having potent antitumour activity.* It is highly effective in testicular tumour and squamous cell carcinoma of skin, oral cavity, head and neck, genitourinary tract and esophagus.* Side effect: pulmonary fibrosis and myelosuppression.Alkylating agents have cytotoxic and radiomimetic actions. They are mainly cell cycle non-specific, i.e. act on dividing as well as resting cells.* Cross-linking of DNA appears to be of major importance to the cytotoxic action of alkylating agents, and replicating cells are most susceptible to these drugs.* Drugs are:Alkylating agents- cell cycle- nonspecific agentsAntimetabolites- cell cycle- specific agentsNitrogen mustard* Cyclophosphamide* Ifosfamide* Mechlorethamine* Melphalan* ChlorambucilFolic acid antagonist:MethotrexatePurine analogues* 6 Mercaptopurine* 6thioguanine* Cladribine* FludarabineDrugs acting by Methylation* Procarbazine* Dacarbazine* TemozolomidePyrimidine analogues* Capecitabin* Gemcitabin* Cyatarabine and 5 FUNitrosoureas* Carmustine* Lomustine* Semustine* StreptozocinMiscellaneous* Busulfan* Altretamine* Thiotepa* Trabectadin | train | med_mcqa | null |
A middle aged female presents with increasing visual loss, breast enlargement and irregular menses. Investigation of choice would be: | [
"S. calcitonin",
"S. prolactin",
"S. hemoglobin concentration",
"S. calcium"
] | B | A middle aged female is presenting with:
Increasing visual loss
Breast enlargement
Irregular menses
All these features can be explained by pituitary adenoma.
Most common type of pituitary adenomas prolactinomas
Prolactinomas can be diagnosed by raised serum prolactin levels so, the investigation of choice here is serum prolactin level
Also Known: Work up of patient with amenorrhea, galactorrhea, and hyperprolactinemia | train | med_mcqa | null |
Bacteriostatic anti - TB drug is | [
"Pyrazinamide",
"INH",
"Rifampin",
"Ethambutol"
] | D | Ans. is 'd' i.e., Ethambutol All first line drugs are tuberculocidal except ethambutol which is tuberculostatic:* Tuberculocidal: Rifampin, INH, streptomycin, pyrazinamide.* Tuberculostatic : Ethambutol, PAS, cycloserine, thioacetazone. | train | med_mcqa | null |
A patient with chronic kidney disease on dialysis is posted for emergency laparotomy. Which of the following anaesthetic agent is contraindicated in this patient? | [
"d-Tubocurarine",
"Scoline",
"Halothane",
"Gallamine"
] | D | Gallamine is one of a series of synthetic substitutes for curare. Gallamine has the most potent vagolytic propeies of any relaxant, and it is entirely dependent on renal function for elimination. In renal insufficiency the neuromuscular blockade that it causes is considerably prolonged and gallamine is contraindicated. Ref: Butterwoh IV J.F., Butterwoh IV J.F., Mackey D.C., Wasnick J.D., Mackey D.C., Wasnick J.D. (2013). Chapter 11. Neuromuscular Blocking Agents. In J.F. Butterwoh IV, J.F. Butterwoh IV, D.C. Mackey, J.D. Wasnick, D.C. Mackey, J.D. Wasnick (Eds), Morgan & Mikhail's Clinical Anesthesiology, 5e. | train | med_mcqa | null |
Which among the following is a typical intercostal nerve? | [
"First",
"Second",
"Third",
"Seventh"
] | C | Typical intercostal nerves are the ones that are confined to their own intercostal spaces in the thoracic wall. The course of the third, fouh, fifth, and sixth intercostal nerves can be regarded as typical. They run forwards in the intercostal spaces lying between the second and third layers of the muscles. A typical intercostal nerve has four major branches. The first branch is made up of the unmyelinated postganglionic fibers of the gray rami communicantes, which interfaces with the sympathetic chain. The second branch is the posterior cutaneous branch, which innervates the muscles and skin of the paraspinal area. The third branch is the lateral cutaneous division, which arises in the anterior axillary line. It provides most of the cutaneous innervation of the chest and abdominal wall. The fouh branch is the anterior cutaneous branch supplying innervation to the midline of the chest and abdominal wall. | train | med_mcqa | null |
Nullity of marriage is considered when - | [
"Adultery in first 7 years",
"Infeility of husband",
"Assault in first 7 yrs",
"Age >55 years"
] | B | Ref:The essential of forensic medicine and toxicology Dr.K.S NARAYAN REDDY 32nd edition pg no 371 Nullity of marriage (S.12 Hindhu marriage Act) that is marriage never to have existed in law. A marriage can be nullified 1. when either pay was under the age of marriage contract 2. when one pay was of unsound mind or a mental defective at the time of marriage 3.when one person was already validly married 4. where the marriage has not been consummated due to impotence or wilful refusal 5.where the woman was pregnant by another man at the time of marriage | train | med_mcqa | null |
A my I nitrite is u sed as antidote in which poisoning- | [
"Cyanide",
"Cholinesterase",
"Benzodiazepine",
"Barbiturate"
] | A | Ans. is 'a' i.e., Cyanide PoisonAntidotesAcetominaphen (paracetamol)N-Acetyl cysteineNitrites, cyanidesAmyl nitrite + sodium nitrite + sodium thiosulphateOrganophosphates (antichol inesterase)Atropine and oximesDigoxinDizibind or digoxin immune FabEthylene glycol, methanol, ethanolFomipizoleHeroin (opioids)Naloxone or nalmefene or naltrexoneBenzodiazepineFlumazenilDhatura / atropine i antihistaminicsPhysostigmineActue iron poisoningDeferoxamineAcute arsenic poisoningDimercaprol / B ALOxalic acidCalcium gluconateStrychinineShort acting barbituratesNote: Cooper sulphate is a poison itself, but it is used as an antidote in phosphorus poisoning. | train | med_mcqa | null |
In pulmonary embolism , fibrinolytic therapy is responsible for | [
"Massive emboli",
"Risk of hemorrhage",
"All the above",
"None of the above"
] | B | Hemorrhage is the main complication of fibrinolytic therapy, so it is contraindicated in all situations where the risk of bleeding is increased - recent trauma, surgery, biopsies, stroke, peptic ulcer, aneurysms, bleeding disorders, diabetes, acute pancreatitis etc.) | train | med_mcqa | null |
Schwartz operation is done in - | [
"CSOM",
"Serous otitis media",
"Otosclerosis",
"Acute mastoiditis"
] | D | Indications of simple / cortical mastoidectomy (Schwartz operation)
Acute coalescent mastoiditis.
Incompletely resolved acute otitis media with reservoir sign.
Masked mastoiditis.
As a initial step to perform:
Endolymphatic sac surgery
Decompression of facial nerve
Translabyrinthine or retrolabyrinthine procedures for acoustic neuroma. | train | med_mcqa | null |
Which of the following drugs produces dissociative anaesthesia: March 2013 (g) | [
"Ketamine",
"Propofol",
"Thiopentone",
"Enflurane"
] | A | Ans. A i.e. Ketamine Ketamine Is a phencyclidine, Causes dissociative anaesthesia, Causes - Hallucination, - Delusion and - Illusion Causes profound analgesia Increases all pressures: - Intracranial Tension, - Intraocular pressure, - BP C/I in: Intracerebral mass/hemorrhage etc | train | med_mcqa | null |
A man presents with fever and chills 2 weeks after a louse bite. There was a maculo-papular rash on the trunk, which spread peripherally. The cause of this infection can be:- | [
"Scrub typhus",
"Endemic typhus",
"Rickettsial pox",
"Epidemic typhus"
] | D | Epidemic typhus is transmitted by louse. Scrub typhus and Rickettsial pox are transmitted by mites Endemic typhus is transmitted by rat flea. | train | med_mcqa | null |
The hygroscopic technique is associated with: | [
"Investment",
"Hydrocolloids",
"Amalgam",
"Silicate"
] | A | null | train | med_mcqa | null |
Digoxin action is not affected in: | [
"Hepatic disease",
"Electrolyte disturbances",
"Renal failure",
"MI"
] | A | Digoxin is eliminated mainly via excretion through kidney whereas digitoxin is metabolized by the liver. The dose of digoxin, therefore, does not require an adjustment in hepatic failure whereas it has to be reduced in renal failure. The arrhythmogenic dose of digitalis is reduced in MI. It should be used after MI only when CHF is accompanied with AF and rapid ventricular rate.
Hypokalemia, hypomagnesemia and hypercalcemia predisposes to digitalis toxicity. | train | med_mcqa | null |
In vitro coagulation is initiated by factor: | [
"XII.",
"XI.",
"X.",
"VII."
] | A | The conversion of fibrinogen to fibrin is catalyzed by thrombin. Thrombin is a serine protease that is formed from its circulating precursor, prothrombin, by the action of activated factor X.
Factor X can be activated by reactions in either of two systems, an intrinsic and extrinsic system. The initial reaction in the intrinsic system is conversion of inactive factor XII to active factor XII (XIIa). This activation, which is catalyzed by high molecular weight kininogen and kallikrein can be brought about in vitro by exposing the blood to electro negatively charged wettable surfaces such as glass and collagen fibers. Activation in vivo occurs when blood is exposed to the collagen fibers underlying the endothelium in the blood vessels. Active factor XII than activates factor Xi, and active factor XI activates factor IX. Activated factor IX forms a complex with active factor VIII, which is activated when it is separated from Von Willibrand’s factor. The complex of IXa and VIIIa active factor X. phospholipids from aggregated platelets (PL) and Ca are necessary for full activation of factor X. | train | med_mcqa | null |
Gene involved in rett syndrome- | [
"P53",
"MECP2",
"RB",
"BRCA"
] | B | Ans. is 'b' i.e., MECP2o RETT syndrome is a neurodevelopment disorder.o Genes involve most commonly in RETT syndrome is MECP2 (methyl CpG binding protein-2) o Other genes which may also be involved are FOXG1 and CDKL5. | train | med_mcqa | null |
Most common breech presentation is? | [
"Right sacroanterior",
"Left sacroanterior",
"Right sacroposterior",
"Left sacroposterior"
] | B | Left sacroanterior REF: Dutta 6th ed p. 376 Most common position in breech presentation is left sacroanterior > right sacroanterior. | train | med_mcqa | null |
A 35-year-old patient on USG shows 3x4 cm clear ovarian cyst on right side. Next line of management is: | [
"Laparoscopy",
"OC pills",
"Wait and watch",
"Ca-125 estimation"
] | C | Ans. is c, i.e. Wait and watchRef: Novak 14th/ed, p472The patient is premenopausal and has a 3x4cm clear ovarian cyst, so she is best managed by giving OC pills for 1-2 cycles and then repeating the USG.Note: OCP's are not given routinely for ovarian masses as trey decrease the risk of developing new cysts but do not hasten the resolution of existing cyst | train | med_mcqa | null |
Median nerve injury at wrist, is commonly tested by:- | [
"Contraction of abductor pollicis brevis",
"Contraction flexor pollicis brevis",
"Contraction opponens pollicis",
"Loss of sensation on palm"
] | A | Median nerve injury at wrist is commonly subjected to pen test. This test is for the function of abductor pollicis brevis (Draw thumb forwards at right angle to palm) supplied by median nerve. Pen test A pen is kept at a level higher than the thumb and the pt is asked to touch the tip of the pen | train | med_mcqa | null |
The immediate precursor in the formation of acetoacetate from acetyl CoA in the liver is | [
"Mevalonate",
"HMG CoA",
"Acetoacetyl CoA",
"3-Hydroxybutyryl"
] | B | HMG CoA
Acetoacetyl-CoA is the starting material for ketogenesis.
However, it is HMG-CoA from which acetoacetate arises. | train | med_mcqa | null |
Which of the following is not a common manifestation of congenital Rubella - | [
"Deafness",
"PDA",
"Aoic stenosis",
"Mental retardation"
] | C | Ans. is 'c' i.e., Aoic Stenosis o Nerve deafness is the single most common clinical finding among infant with congenital Rubella syndrome. o PDA is the most common CHD in congenital rubella syndrome. o Classical triad of congenital rubella consists of -3 Cataract, Deafness, CHD o Mental retardation is also common. | train | med_mcqa | null |
A 50 yr old male presented with history of hematemesis - 500 ml of blood and on examination shows BP - 90/60, PR -110/min and splenomegaly 5 cm below lower costal margin. Most probable diagnosis is | [
"Mallory Weiss tear",
"Duodenal ulcer",
"Gastritis",
"Portal hypertension"
] | D | Ans. is 'd' i.e. Portal hypertension Causes of Hematemesis (in decreasing order)Peptic ulcerDuodenal ulcer (Most common cause)Gastric ulcerEsophageal varices (portal hypertension)Mallory Weiss tearGastroduodenal erosionsErosive esophagitisNeoplasm of esophagus, stomach & duodenum.Vascular ectasias Here in this patient, splenomegaly is suggestive of portal hypertension.Mallory-Weiss tear is suggested if the patient presents in the classic pattern - initially vomiting is without blood, after retching and vomiting with epigastric pain, hematemesis occurs.Gastritis is usually associated with history of intake of NSAIDS, alcohol, corticosteroids and oral potassium supplements. | train | med_mcqa | null |
Hysterosalphingography is performed in which phase of mentrual cycle? | [
"During menstruation",
"Luteal phase",
"Follicular phase",
"Secretory phase"
] | C | A hysterosalpingography should be performed only in the follicular phase of the menstrual cycle after cessation of menstrual bleeding till ovulation (days 6-12 of the menstrual cycle) to avoid X-ray radiation during undiagnosed early pregnancy. | train | med_mcqa | null |
Thurston Holland sign is seen in ? | [
"Type I",
"Type II",
"Type III",
"Type IV"
] | B | Ans. is 'b' i.e., Type II Epiphyseal (Physeall Injuries o The junction between the metaphysis and epiphysis, i.e. physeal plate/growth plate, is the weakest point of a long bone in children and is, therefore, most vulnerable to shearing forces. o Salter and Harris have classified epiphyseal injuries into five types ? Type I : Complete separation of epiphysis from the metaphysis without fracture. Common in rickets, scurvy and osteomyelitis. Type II: The fracture involves the physis and a triangle of metaphyseal bone (Thurston Holland sign).This is the commonest type of epiphyseal injury accounting for 73 percent of cases over 10 years of age. Type III: The fracture is intra- aicular and extends along the physis and then along the growth plate. This injury is relatively uncommon. Type IV: The fracture is intra- aicular and extends through the epiphysis, physis and metaphysis. Perfect reduction is necessary and open reduction is more often necessary to prevent growth arrest. Type V : Crushing of epiphysis. Growth arrest usually follows. Type VI (Rang's type) : There is a peripheral physis (perichondrial ring) injury. | train | med_mcqa | null |
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