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Stability of knee joint depends mainly on? | [
"Bony configuration",
"Muscles",
"Ligaments",
"Tendons"
] | C | In knee as well as other joints like interphalangeal, wrist and intervertebral joint stability mainly depends on ligaments. In ball and socket joint like hip, stability is provided by bony configuration. In very mobile shoulder joint main stabilizing structures are muscles. Menisci and tendons do not contribute significantly to stability. | train | med_mcqa | null |
Which of the following is a DNA virus? | [
"Hepatitis A virus",
"Hepatitis B virus",
"Hepatitis C virus",
"Hepatitis D virus"
] | B | Ans. b (Hepatitis B virus). (Ref. Harrison's medicine 17th/Table 16-4; Anantanarayan, 6th/511)Clinical situationLab findingProtective antibody against HBVHBsAgAcute HBV infection, highly infectiousHBsAg, HBeAg, IgM anti-HBC absChronic HBV infection or carrier state, highly infectiousHBsAg, HBeAg, IgG anti-HBC absChronic HBV infection, low infectivityHBsAg, IgM anti-HBC abs, anti-HBe +/-Remote HBV infection, infectivity very low or nilIgG anti-HBC abs, anti HBs +/-, anti-HBe +/-Viral HepatitisVirusHepatitis AHepatitis BHepatitis CHepatitis DHepatitis EType of virusViral familyssRNAHepatovirus; related to picornavirusPartially dsDNAHepadnavirusssRNAFlaviviridaeCircular defective ssRNA Subviral particle in Deltaviridae familyssRNA CalicivirusRoute of transmissionFecal-oral (contaminated food or water)Parenteral, sexual contact, perinatalParenteral; intranasal cocaine use is a risk factorParenteralFecal-oralMean incubation period2-4 weeks1-4 months7-8 weeksSame as HBV4-5 weeksFrequency of chronic liver diseaseNever10%>80%5% (coinfection); >70% for superinfectionNeverDiagnosisDetection of serum IgM antibodiesDetection of HBsAg or antibody to HBcAgPCR for HCV RNA; 3rd-generation ELISA for antibody detectionDetection of IgM and IgG antibodies; HDV RNA serum; HDAg in liverPCR for HEV RNA; detection of serum IgM and IgG antibodiesCarrier-++--Oncogenicity-++-- | train | med_mcqa | null |
All are TRUE about CA breast, EXCEPT - | [
"Affected sibling is a risk factor",
"Paget's disease of nipple is intraductal type of CA",
"Common in aged nulliparous",
"Increased incidence with prolonged breast feeding"
] | D | Ans. is 'd' i.e., Increased incidence with prolonged breast feeding Prolonged breast feeding has a protective effect. Earlier it was controversial whether breast feeding had any beneficial effect or not. But many trials have now proved that longer durations of breast feeding have a protective effect. [Ref: Robbins 8/e p1077(7/e, p 1132); Cancer of Breast by Donegan & Spratt, 5/e, p 117; Bailey & Love 25/e p837 (24/e, p 835); NMS 4/e, p 449; Washington Manual of Surgery 4/e, p 525; Schwaz 8/e, p 466J Paget's disease of nipple -Paget's disease of the breast is a superficial manifestation of an underlying breast carcinoma. The underlying breast carcinoma is intraductal carcinoma. - it presents clinically as a chronic eczematous eruption of nipple, which may be subtle but may progress to an ulcerated, weeping lesion. - Paget's disease usually is associated with extensive DCIS and may be associated with an invasive cancer." The carcinoma may or may not be palpable. - Pathognomonic histological feature is presence of Paget's cells in the epithelium. Paget's cells are large pale vacuolated cells. Treatment is described ahead. | train | med_mcqa | null |
d–Tubocurarine acts by : | [
"Inhibiting nicotinic receptors at myoneural junction",
"Inhibiting nicotinic receptors at autonomic ganglion",
"Producing depolarizing block",
"By inhibiting reuptake of acetylcholine"
] | A | null | train | med_mcqa | null |
Which of the following is true regarding essential medicines | [
"Drugs for emergency conditions",
"Drugs for serious disorders",
"Drugs to satisfy priority needs of the populations",
"Newer orphan drugs"
] | C | essential drugs- needed to satisfy primary health care needs of the society regularly indian govt will release national list of essential medicines - these drugs should be available in all PHCs and in government hospitals orphan drugs - for rare diseases Ref KD tripathi 8th ed. | train | med_mcqa | null |
How does wilms tumor commonly present in children | [
"Hematuria",
"Abdominal pain",
"Abdominas mass",
"Fever"
] | C | Asymptomatic abdominal mass is the most common presentation of wilms tumor. | train | med_mcqa | null |
Drugs undergoing acetylation include all except: | [
"Dapsone",
"Metoclopramide",
"Procainamide",
"INH"
] | B | Ans. B. MetoclopramideAcetylation by N-acetyl transferases (NAT)e.g, S - SulfonamidesH - HydralazineI - IsoniazidP - Procainamide, PASD - DapsoneC - Clonazepam, Caffeine | train | med_mcqa | null |
Professional misconduct - | [
"Association with non medical persons in medical procedures",
"Dichotomy",
"Issuing false ceificate",
"All of the above"
] | D | Professional misconduct is any conduct of the doctor which might reasonably be regarded as disgraceful or dishonorable. Conduct is judged by professional men of good repute and competence. The doctor may get a warning notice and his name can be erased from Medical Register if guilty. These offenses include mnemonic 6 A's 1 D. Adultery, unlawful Aboion, Adveising, Association with unqualified persons in professional matters, Addiction, Alcohol, and Dichotomy or fee splitting. REF: Dr.K.S.Narayana Reddys Synopsis of Forensic Medicine & Toxicology 29th edition Pg.15. | train | med_mcqa | null |
A fracture of eye by a ping pong bolt is: | [
"Blow out fracture",
"Orbital fracture",
"Blow in fracture",
"Compound fracture"
] | A | null | train | med_mcqa | null |
In Intrapaum Fetal Monitoring of women with pregnancies at risk, fetal hea auscultation is performed at least every --- minutes during first-stage labor and every --- minutes during the second stage | [
"60min and 30min",
"30min and 15min",
"15min and 5min",
"5min and 1min"
] | C | Intrapaum fetal monitoring:Briefly, the American Academy of Pediatrics and American College of Obstetricians and Gynecologists (2012) recommend that during first-stage labor, in the absence of any abnormalities, the fetal hea rate should be checked immediately after a contraction at least every 30 minutes and then every 15 minutes during the second stage. If continuous electronic monitoring is used, the tracing is evaluated at least every 30 minutes during the first stage and at least every 15 minutes during second-stage labor. For women with pregnancies at risk, fetal hea auscultation is performed at least every 15 minutes during first-stage labor and every 5 minutes during the second stage. Continuous electronic monitoring may be used with evaluation of the tracing every 15 minutes during the first stage of labor, and every 5 minutes during the second stage.(Ref: William's Obstetrics; 25th edition) | train | med_mcqa | null |
True statement: | [
"Half life of I125 is 60 days",
"Half life of I131 is 12 days",
"I131 is used in RIA for thyroid hormones",
"I125 is preferred over 123 for thyroid scan"
] | A | Other high yielding points
I127 is stable iodine isotope
I-131 Has half life of 8 days
The gamma-emitting isotopes iodine-123 (half-life 13 hours) used as nuclear imaging tracers to evaluate the anatomic and physiologic function of the thyroid.
Iodine-125 is commonly used by radiation oncologists in low dose rate brachytherapy in the treatment of cancer at sites other than the thyroid, especially in prostate cancer. When I-125 is used therapeutically, it is encapsulated in titanium seeds and implanted in the area of the tumor, where it remains. The low energy of the gamma spectrum in this case limits radiation damage to tissues far from the implanted capsule. Iodine-125, due to its suitable longer half-life and less penetrating gamma spectrum, is also often preferred for laboratory tests that rely on iodine as a tracer that is counted by a gamma counter, such as in radioimmunoassaying | train | med_mcqa | null |
Which of the following is not a characteristic feature of Kala-azar ? | [
"Splenomegaly",
"Leukocytosis",
"Anemia",
"Hypoalbuminemia"
] | B | VL is caused by the protozoon Leishmania donovani complex (comprising L. donovani, L. infantum and L. chagasi). India, Sudan, Bangladesh and Brazil account for 90% of cases of VL. Other affected regions include the Mediterranean, East Africa, China, Arabia, Israel and other South American countries . In addition to sandfly transmission, VL has also been repoed to follow blood transfusion, and disease can present unexpectedly in immunosuppressed patients - for example, after renal transplantation and in HIV infection. The majority of people infected remain asymptomatic. In visceral disease, the spleen, liver, bone marrow and lymph nodes are primarily involved. Clinical features In the Indian subcontinent, adults and children are equally affected; elsewhere, VL is mainly a disease of small children and infants, except in adults with HIV co-infection. The incubation period ranges from weeks to months (occasionally, several years). The first sign of infection is high fever, usually accompanied by rigor and chills. Fever intensity decreases over time and patients may become afebrile for intervening periods ranging from weeks to months. This is followed by a relapse of fever, often of lesser intensity. Splenomegaly develops quickly in the first few weeks and becomes massive as the disease progresses. Moderate hepatomegaly occurs later. Lymphadenopathy is common in Africa, the Mediterranean and South America but is rare in the Indian subcontinent. Blackish discoloration of the skin, from which the disease derived its name, kala-azar (the Hindi word for 'black fever'), is a feature of advanced illness but is now rarely seen. Pancytopenia is common. Moderate to severe anaemia develops rapidly and can cause cardiac failure. Thrombocytopenia, often compounded by hepatic dysfunction, may result in bleeding from the retina, gastrointestinal tract and nose. In advanced illness, hypoalbuminaemia may manifest as pedal oedema, ascites and anasarca (gross generalised oedema and swelling). As disease progresses, there is profound immunosuppression and secondary infections are very common. These include tuberculosis, pneumonia, gastroenteritis, severe amoebic or bacillary dysentery, boils, cellulitis, chickenpox, shingles and scabies. Without adequate treatment, most patients with clinical VL die. Ref Harrison20th edition pg 1077 | train | med_mcqa | null |
A three days old infant develops jaundice upto thigh. " Mother's blood group O '–ve' and baby is A `+ve' probable causes – | [
"Physiological jaundice",
"Rh incompatibility",
"Septicemia",
"Extrahepatic biliary atresia"
] | A | null | train | med_mcqa | null |
Yellow or green pigmentation of teeth is seen in: | [
"Erythroblastosis fetalis",
"Porphyria",
"Internal resorption",
"Nasmyth membrane"
] | A | null | train | med_mcqa | null |
Antihypeensive of choice in a pregnant lady is: September 2011 | [
"Methyldopa",
"Frusemide",
"Nitroprusside",
"ACE inhibitors"
] | A | Ans. A: Methyldopa Methyldopa is usually safe and preferred as an antihypeensive agent in pregnancy Methyldopa/ L-alpha-Methyl-3, 4-DihydrOxyPhenylAlanine It is an alpha-adrenergic agonist (selective for alpha-2-adrenergic receptors) psychoactive drug used as a sympatholytic or antihypeensive. It continues to have a role in otherwise difficult to treat hypeension and gestational hypeension (also known as pregnancy-induced hypeension (PIH)). Methyldopa is used in the clinical treatment of the following disorders: - Hypeension - Gestational hypeension (or pregnancy-induced hypeension) and pre-eclampsia Methyldopa has a dual mechanism of action: - It is a competitive inhibitor of the enzyme DOPA decarboxylase, also known as aromatic L-amino acid decarboxylase, which conves L-DOPA into dopamine. - Dopamine is a precursor for norepinephrine (noradrenaline) and subsequently epinephrine (adrenaline). - This inhibition results in reduced dopaminergic and adrenergic neurotransmission in the peripheral nervous system. - This effect may lower blood pressure and cause central nervous system effects such as depression, anxiety, apathy, anhedonia, and parkinsonism. - It is conveed to alpha-methylnorepinephrine by dopamine beta-hydroxylase (DBH). - Alpha-methylnorepinephrine is an agonist of presynaptic central nervous system alpha-2-adrenergic receptors. - Activation of these receptors in the brainstem appears to inhibit sympathetic nervous system output and lower blood pressure. This is also the mechanism of action of clonidine. Methyldopa exhibits variable absorption from the gastrointestinal tract. It is metabolized in the liver and intestines and is excreted in urine. Side effects may include: - Psychological Depression and/or even suicidal ideation, as well as nightmares Decreased aleness, awareness, and wakefulness Cognitive and memory impairment Derealization and/or depersonalization, as well as mild psychosis Physiological Miosis Xerostomia Gastrointestinal disturbances such as diarrhea and/or constipation Myalgia or muscle aches, ahralgia or joint pain, and/or paresthesia ("pins and needles") Restless legs syndrome (RLS) Parkinsonian symptoms such as muscle tremors, rigidity, hypokinesia, and/or balance or postural instability Akathisia, ataxia, dyskinesia as well as even tardive dyskinesia, and/or dystonia Bell's palsy or facial paralysis Sexual dysfunction consisting of impaired erectile dysfunction and/or anorgasmia Hyperprolactinemia or excess prolactin, gynecomastia/breast enlargement in males, and/or amenorrhoea or absence of menstrual cycles in females Bradycardia Ohostatic hypotension (also known as postural hypotension) Hepatitis, hepatotoxicity Pancreatitis Haemolytic anaemia Myelotoxicity or bone marrow suppression Lichenoid reactions such as skin lesions and/or rashes | train | med_mcqa | null |
Which of the following is active in dephosphorylated state? | [
"Glycogen Synthase",
"Pyruvate Carboxylase",
"Glycogen Phosphorylase",
"PEPCK"
] | A | Glycogen Synthase is enzyme of Glycogen Synthesis, which is an Anabolic pathway. So this enzyme is active in Dephosphorylated state. Rest all enzymes are involved in Catabolic pathways, so they are active in Phosphorylated state. Pyruvate Carboxylase is involved in Gluconeogenesis, which is a Catabolic pathway. Glycogen Phosphorylase is involved in Glycogenolysis, which is a Catabolic pathway. PEPCK- Phospho Enol Pyruvate Carboxy Kinase, is also involved in Gluconeogenesis, which is a Catabolic pathway. Extra Information: Enzyme Active in Dephosphorylated state Enzyme Active in Phosphorylated state Glycogen Synthase Glycogen Phosphorylase Acetyl CoA Carboxylase Phosphorylase Kinase Pyruvate Dehydrogenase Key enzymes of Gluconeogenesis HMG CoA Reductase HMG CoA Reductase Kinase PFK-II (Phosphofructokinase-II) Citrate Lyase | train | med_mcqa | null |
A 14 year old girl on exposure to cold has pallor of extremities followed by pain and cyanosis. In later stages of life she is most prone to develop: | [
"SLE",
"Scleroderma",
"Rheumatoid Ahritis",
"Dermatomyositis"
] | B | Answer is B i.e. (Scleroderma): Pallor of extremities, followed by pain and cyanosis suggests a diagnosis of Reynaud's Phenomenon. Reynaud's phenomenon as the presenting manifestation is most strongly associated with scleroderma or systemic sclerosis. Reynaud's Phenomenon and Scleroderma Reynaud's phenomenon (RP) is the clinical syndrome of episodic color change of the digits in response to cold and in some patients, emotional stress. The typical sequence is pallor (aerial constriction) followed by cyanosis (vasospasm and desaturation) of hemoglobin. Reynaud's Phenomenon is may be associated with a variety of connective tissue disorders including SLE, Rheumatoid ahritis, scleroderma and dermatomyositis (all options provided in question), however its association with scleroderma is exceptionally strong. Secondary causes of Raynaud Phenomenon: Rheumatologic Hematologic disorders Systemic sclerosis (scleroderma) Cryoglobulinemia Systemic lupus erythematosus Paraproteinemia Rheumatoid ahritis Polycythemia Sjogren syndrome Cold agglutinins Dermatomyositis Polymyositis Vasculitis Mechanical Endocrine disorders Vibration injury Hypothyroidism Frostbite Carcinoid syndrome Thoracic outlet syndrome Pheochromocytoma Vascular embolus or occlusion Vasospasm Drugs Migraine headaches Sympathomimetics drugs (decongestants, diet pills) Serotonin agonists (sumatriptan) Chemotherapeutic agents (bleomycin, cisplatin, carboplatin, vinvlastine) Ergotamine tarate Caffeine Nicotine | train | med_mcqa | null |
In Duchennes muscular dystrophy, calf muscle is: September 2009 | [
"Hyperophied",
"Atrophied",
"Pseudoatrophied",
"Pseudohyperophied"
] | D | Ans. D: Pseudohyperophied Duchenne muscular dystrophy is by far the most common childhood-onset muscular dystrophy, afflicting 1 in 3300 boys with an overall prevalence of 63 cases per million. One third of these cases are due to spontaneous mutations, while the rest are inherited in an X-linked dominant manner. Duchenne muscular dystrophy clinically manifests in patients aged 3-7 years, with development of lordosis, a waddling gait, and the Cowers sign. Calf pseudohyperophy follows 1-2 years later. Most patients are wheelchair bound by age 12 years. Diagnostic criteria include: Weakness with onset in the legs; Hyperlordosis with wide-based gait; Hyperophy of weak muscles; Progressive course over time; Reduced muscle contractility on electrical stimulation in advanced stages of the disease; and (6) absence of bladder or bowel dysfunction, sensory disturbance, or febrile illness. Duchenne muscular dystrophy is much more than a disease of skeletal muscles. Dystrophin is also found in the hea, brain, and smooth muscle. Late-stage cardiac fibrosis can lead to output failure and pulmonary congestion, a common cause of death. Additionally, cardiac fibrosis can include cardiomyopathy and conduction abnormalities, which can induce fatal arrhythmias. | train | med_mcqa | null |
Most common cause of nephrotic range proteinuria in an adult is- | [
"Diabetes Mellitus",
"Amyloidosis",
"Hypeensive nephropathy",
"Wegner'sGranulomatosis"
] | A | Most common cause of nephrotic syndrome in Elderly people -membranous glomerulonephritis(membranous nephropathy). Children-minimal change disease Most common cause of chronic renal failure is DIABETIC NEPHROPATHY . Pathological changes seen -mesangial sclerosis ,eosinophilic PAS +nodules called -kimmelsteil wilson nodules Immunofluorescence-non specific deposition of IgG and complement. On Electron microscopy-no immune deposits are seen. Earliest manifestation of DN-microalbuminuria(30-300 mg/24 hrs) In advanced DN, kidneys are enlarged in contrast to many other Glomerular diseases where kidneys decrease in size. Ref:Harrison 20 th edition pg no. 2144 | train | med_mcqa | null |
Hydatid sand is made of: | [
"Scolex",
"Cyst",
"Protscolex",
"Brood capsule"
] | C | * On USG, the hydatid sand looks like an echogenic material floating inside the cystic fluid. Its major component is Protoscolex. | train | med_mcqa | null |
Which pigment accumulates in brown atrophy of hea? | [
"Melanin",
"Lipofuscin",
"Hemosiderin",
"Hemozoin"
] | B | Lipofuscin, or "wear-and-tear pigment," is an insoluble brownish-yellow granular intracellular material that accumulates in a variety of tissues (paicularly the hea, liver, and brain) as a function of age or atrophy.Lipofuscin represents complexes of lipid and protein that derive from the free radical-catalyzed peroxidation of polyunsaturated lipids of subcellular membranes. It is not injurious to the cell but is a marker of past free radical injury. The brown pigment, when present in large amounts, impas an appearance to the tissue that is called brown atrophy. Melanin is an endogenous, brown-black pigment that is synthesized by melanocytes and acts as a screen against harmful ultraviolet radiation.Hemosiderin is a hemoglobin-derived granular pigment that is golden yellow to brown and accumulates in tissues when there is a local or systemic excess of iron.( Robbins Basic Pathology, 9th edition, page 24 ) | train | med_mcqa | null |
A rapid method of chromosome identification in interphase is - | [
"FISH",
"PCR",
"SSCP",
"Karyotyping"
] | A | "FISH can be used in interphase cells to determine the chromosome number of one or more chromosomes as well as to detect some specific chromosome rearrangements that are characteristic for certain cancers. The primary advantage of interphase FISH is that it can be performed very rapidly if necessary, usually within 24 hours, because cell growth is not required.
A good example is the Aneuploid Screen test which is performed on amniotic fluid cells when there is a strong clinical indication for one of the common trisomies. The sample nuclei are denatured and hybridized with DNA probes for chromosomes 13, 18, 21, X, and Y and results usually obtained within 24 hours. Routine Cytogenetics is included with an Aneuploid Screen to confirm the results or detect any abnormalities not detected by interphase FISH". | train | med_mcqa | null |
Prolonged blockade of Eustachian tube leads to - | [
"Atelectatic ear",
"Cholesteatoma",
"Perforation",
"All of the above"
] | D | Ans. is 'd' i.e., All of the above Effects of acute and prolonged tubal blockageAcute tubal blockage|Absorption of ME gases|Negative pressure in ME|Retraction of TM|Transudate in ME/haemorrhage (acute OME)Prolonged tubal blockage/dysfunction|OME (thin watery or mucoid discharge)|Atelectatic ear/ perforation|Retraction pocket/ cholesteatoma|Erosion of incudostapedial jointME, middle ear; TM, tympanic membrane; OME, otitis media with effusion. | train | med_mcqa | null |
All of the following are indication of TIPSS except | [
"Prevention of acute variceal bleed .",
"Hepato Renal Syndrome",
"Refractory Ascites",
"Hepato Pulmonary Syndrome"
] | D | Hepato Pulmonary Syndrome is a Contra Indication of TIPSS . Indications of TIPSS:- 1.Prevention of acute variceal bleeding (MC) 2.Refractory variceal bleeding 3.Refractory ascites 4.Refractory hepatic hydrothorax 5.Hepatorenal syndrome 6.Budd Chiari syndrome 7.Veno-occlusive disease 8.Poal hypeensive gastropathy | train | med_mcqa | null |
When information memorized afterwards is interfered by the information learnt earlier, it is called: | [
"Retroactive inhibition",
"Proactive inhibition",
"Simple inhibition",
"Inhibition"
] | A | The tendency of previously learned information to hinder subsequent learning is known as retroactive inhibition. If an information, hinders previously learned information, it is called as proactive inhibition | train | med_mcqa | null |
Which of the following is the IOC to detect abnormally located placenta? | [
"TVS",
"MRI",
"Doppler",
"TAS"
] | A | Transvaginal sonography (TVS) is the investigation of choice and is superior to Transabdominal sonography(TAS) for detecting placental abnormalities. Approach to placenta pre after confirmation by TVS at anomaly scan. Bleeding present: Individual management. No Bleeding/Minor Pre: Repeat USG at 36 weeks No bleeding/Major Pre or accreta: USG at 32 weeks followed by elective CS at 37 to 38 weeks. Note: Transabdominal sonographic assessment (TAS) of placental location is one of the standard components of the basic obstetrical ultrasound examination, and thus can be considered a screening test for placenta pre, however according to recent studies TVS generally provides a clearer image of the relationship between the edge of the placenta and the internal cervical os than transabdominal ultrasound. Randomized trials and prospective comparative studies have established the superior performance of TVS over transabdominal sonography for diagnosis of placenta pre. Ref: Williams Obstetrics 24th edition Pgno: 802 | train | med_mcqa | null |
The symptoms of hyperparathyroidism include | [
"Constipation and muscle weakness",
"Anorexia and weight loss",
"Polydipsia and polyuria",
"All of the above"
] | B | Symptoms depend on whether the hyperparathyroidism is the result of parathyroid overactivity or secondary. In primary hyperparathyroidism, about 75% of people have no symptoms. The problem is often picked up incidentally during blood work for other reasons, and the test results show a higher amount of calcium in the blood than normal.Many other people only have non-specific symptoms. Symptoms directly due to hypercalcemia are relatively rare, being more common in patients with malignant hypercalcemia. If present, common manifestations of hypercalcemia include weakness and fatigue, depression, bone pain, muscle soreness (myalgias), decreased appetite, feelings of nausea and vomiting, constipation, polyuria, polydipsia, cognitive impairment, kidney stones and osteopenia or osteoporosis. A history of acquired racquet nails (brachyonychia) may be indicative of bone resorption.Parathyroid adenomas are very rarely detectable on clinical examination. Surgical removal of a parathyroid tumor eliminates the symptoms in most patients. In secondary hyperparathyroidism, the parathyroid gland is behaving normally; clinical problems are due to bone resorption and manifest as bone syndromes such as rickets, osteomalacia, and renal osteodystrophy. Ref ganong's review of medical physiology 25e | train | med_mcqa | null |
Duke's stage C2 refers to carcinoma - | [
"Bladder penetrating the extravesical fat",
"Bladder with metastasis to internal iliac lymph nodes",
"With histological features of 75% anaplastic cells",
"Rectum with metastasis to inferior mesentric lymph nodes"
] | D | Duke's staging is used for colorectal cancer.
In Dukes 'C' stage, there is involvement of regional lymphnodes.
Duke's staging has been explained earlier. | train | med_mcqa | null |
The vein formed by union of posterior division of retromandibular vein and posterior auricular vein is | [
"Common facial vein",
"Anterior jugular vein",
"External jugular vein",
"Interior jugular vein"
] | C | External jugular vein is formed by posterior auricular vein and posterior division of retromandibular vein. | train | med_mcqa | null |
Distal renal tubular acidosis is associated with | [
"Oxalate stones",
"Citrate",
"Calcium stones",
"Uric acid"
] | C | null | train | med_mcqa | null |
Which among the following are a cause of posterior mediastinal opacity on Posterior-Anterior (PA) and lateral view of chest radiograph? | [
"Tortuous innominate artery",
"Bochdalek's Hernia",
"Enlarged pulmonary artery",
"Thymoma"
] | B | Amongst the given options Bochdalek hernia is the posterior mediastinal mass.
Tortuous innominate artery and enlarged pulmonary artery (e.g. aneurysm) are middle mediastinal mass, and thymoma is anterior mediastinal mass. | train | med_mcqa | null |
Child's criteria is used in Cirrhosis | [
"Pancreatitis",
"Cirrhosis",
"Multiple myeloma",
"AIDS"
] | B | Variables of CTP score Serum albumin Serum bilirubin Prothrombin time Ascites Encephalopathy Ref: Sabiston 20th edition Pgno : 1436 | train | med_mcqa | null |
Degloving injury involve: | [
"Avulsion of subcutaneous layer with fat",
"Erosion of skin with muscle",
"Peeling of the skin",
"d. Necrosis of muscle"
] | C | Ans. (c) Peeling of the skinRef: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. / 296-98; Internet sourceAn injury most commonly to an extremity or digit in which the skin and subcutaneous tissue are separated from the deeper tissue layers thereby depleting its blood supply and increasing the risk of tissue necrosis. | train | med_mcqa | null |
Which of the following has antioxidant propey? | [
"Selenium",
"Copper",
"Zinc",
"All"
] | D | The activity of the antioxidant enzymes depends on supply of minerals : Manganese Copper Zinc Selenium Manganese, copper and zinc are required for the activity of superoxide dismutase. Selenium is required for the activity of glutathione peroxidase. REF: ROBBINS pathology 10th edition | train | med_mcqa | null |
All of the following may cause Traumatic Asphyxia, except | [
"Railway Accident",
"Road Traffic Accident",
"Accidental strangulation",
"Stampede in crowd"
] | C | Traumatic asphyxia results from respiratory arrest due to mechanical fixation of the chest so that the normal movements of the chest wall are prevented. Here all options other than accidental strangulation can result in fixation or compression of chest wall. But in accidental strangulation there will be compression of the neck by a ligature without suspending the body i.e. there is no fixation of the chest wall. Hence it is not a type of traumatic asphyxia. Ref: The synopsis of forensic medicine & Toxicology 28th edition pg: 190 | train | med_mcqa | null |
Bisacodyl is: | [
"Bulk forming",
"Stool softner",
"Stimulant purgative",
"Osmotic purgative"
] | C | stimulant purgatives 1.diphenylmethane( bisacodyl,sodium picosulfate) 2. Anthraquinones(senna) 3.5HT4 antagonisr(prucalopride) 4.fixed oil(castor oil) ESSENTIALS OF MEDICAL PHARMACOLOGY SEVENTH EDITION KD TRIPATHI PG NO .672 | train | med_mcqa | null |
Which of the following statements about cerebellar astrocytomas in pediatric age group is false | [
"These are usually low grade tumors",
"These tumors have a good prognosis",
"These are more commonly seen in the 1st and 2nd decades",
"These tumors are more common in females"
] | D | Cerebellar astrocytoma is a low grade tumours and have good prognosis and is most commonly seen in first and second decades . These tumours are most commonly seen in males. Reference: GHAI Essential pediatrics, 8th edition. | train | med_mcqa | null |
Enzyme associated with hyperuricemia: | [
"Glucose-6-phosphatase",
"PRPP (PhosphoRibosyl PyroPhosphate) glutamylamidotransferase",
"Xanthine oxidase",
"All of the above"
] | D | Uric acid is the end product of purine metabolismHyperuricemia refers to an elevation in the serum uric acid concentration.In type I glycogen storage disease (von Gierke's), glucose 6-phosphate can Not be conveed to glucose due to the deficiency of glucose-6-phosphatase.This leads to increased utilization of glucose-6-phosphate by hexose monophospahet shunt (HMP shunt), resulting in increased levels of ribose-5-phosphate and PRPP, and ultimately purine overproduction.Von-Gierkes disease is also associated with increased activity of glycolysis. Due to this, lactic acid accumulates in the body which interferes with the uric acid excretion through renal tubulesThe lack of feedback control by PRPP glutamylamidotransferase by purine nucleotides also leads to their elevated synthesisXanthine oxidase is an impoant enzyme that conves hypoxanthine to xanthine, and xanthine to uric acid. | train | med_mcqa | null |
Antisocial personality is seen with - | [
"Drug abuse",
"Paranoid schizophrenia",
"OCN",
"None"
] | A | Patient with antisocial personality disorder may have criminal behavior, homicide, sexual offence and drug abuse. | train | med_mcqa | null |
A 25 year old university student had a fight with the neighboring boy. On the next day while out, he staed feeling that two men in police uniform were observing this movements. When he reached home in the evening he was frightened. He expressed that police was after him and would arrest him. His symptoms represent: | [
"Delusion of persecution",
"Ideas of reference",
"Passivity",
"Thought inseion"
] | A | A i.e. Delusion of persecution | train | med_mcqa | null |
The Non- REM (NREM) sleep is commonly associated with:- | [
"Frequent dreaming",
"Frequent penile erections",
"Increased blood pressure",
"Night terrors"
] | D | Night terrors are seen in NREM Stage 4. * Individuals have very little or no recall of thought content that might be present during their non-REM sleep. Remaining options are features of REM sleep. Features of REM sleep: Rapid eye movement Generalized muscle atony Penile erections Autonomic hyperactivity | train | med_mcqa | null |
Alport syndrome is characterized by antibodies act against? | [
"Laminin",
"Fibronectin",
"Collagen IV",
"Heparan sulphate"
] | C | Ans is 'c' i.e. Collagen IV o Alport syndrome is a type hereditary nephritis characterized by glomerulonephritis, sensorineural hearing loss and eye defects. It is due to defect in a -5 chain of collagen IV (COL4 A5).o The most common inheritence is X-linked which causes defect in a -5 chain of collagen IV. Very rare autosomal forms (dominant and recessive) also exist, which affect a-3 or a-4 chains of collagen 4 (COL 4 A3 or COL 4 A4). | train | med_mcqa | null |
Preparation of shoulder in anterior tooth is done with: | [
"Invested cone bur",
"Plain fissure bur",
"Cross cut fissure bur",
"End cutting bur"
] | D | null | train | med_mcqa | null |
After PD Surgery patient immediate recall is done after | [
"1 week",
"2 weeks",
"3 weeks",
"4 weeks"
] | A | null | train | med_mcqa | null |
A midline cleft lip is present when there is failure of fusion between the following structure? | [
"Mandibular processes",
"Medial nasal processes",
"Medial and lateral nasal process",
"Medial nasal and maxillary process."
] | B | Clefting of the lip and/or palate is felt to occur around the eighth week of embryogenesis, either by failure of fusion of the medial nasal process and the maxillary prominence or by failure of mesodermal migration and penetration between the epithelial bilayer of the face. The cause of orofacial clefting is felt to be multifactorial. Factors that likely increase the incidence of clefting include,Increased parental ageDrug useInfections during pregnancySmoking during pregnancyFamily history of orofacial clefting. | train | med_mcqa | null |
Which of the following Natural method of contraception is most effective? | [
"Calendar method",
"Billing method",
"Symptothermic method",
"Basal body temperature method"
] | C | Ans. c (Symptothermic method) (Ref. Park's textbook of PSM 22nd/403, 404)CONTRACEPTIVE METHODS# SPACING : Barrier methods, -Intrauterine devices, -Hormonal, -Postconceptional, Miscellaneous# Abstinence# Coitus interruptus# Safe period/Rhythm method/Calendar method/Ogino method# Natural family planning- Basal body temperature- Cervical mucus (Billing's method/ovulation method)- Symptothermic (combination of temperature, cervical mucus, and calendar technique)# TERMINAL: -Male sterilization and -Female sterilizationDrawbacks of the Calendar Method of Contraception# If cycle is irregular, it is difficult to predict the safe period.# It is possible only for use by educated and responsible couples with high motivation and cooperation.# Compulsory abstinence of sexual intercourse for nearly 1/2 of every month is required (programmed sex).# It has high failure rate up to 10 per 100 woman years.# It is applicable during the postnatal period.# Ectopic pregnancies and embryonic abnormalities have been reported as result of safe period method use. | train | med_mcqa | null |
Cardiac tamponade causes pulsus: | [
"Alternans",
"Bigemini",
"Paradoxus",
"Parvus"
] | C | Ans: c (Paradoxus) Ref: Harrisons, 16th ed, p. 1416; 17th ed, p. 1491Clinical signs in cardiac tamponade - pulsus paradoxus, prominent x descent in JVPECG changes - low ECG voltage, electrical alternans. RVDC feature in echoNotesFreidrichs sign - Rapid fall (steep Y descent) and rise of JVP seen in constrictive pericarditis and tricuspid regurgitation. | train | med_mcqa | null |
Which of the following is not a criteria suggesting casuality in non communicable diseases? | [
"Strength of association",
"Dose response relationship",
"Specificity of association",
"Lack of temporal association"
] | D | The presence of temporal association is included among the criteria designed by Sir Austin Bradford Hill in order to suggest causality in non-communicable diseases. Thus this criteria can distinguish between casual and non casual associations. Temporal association is based on the fact that the suspected cause should precede the observed effect. Ref: Park's Textbook of Preventive and Social Medicine By K. Park, 19th Edition, Pages 83-4; Encyclopedia of Epidemiologic Methods By Mitchell H. Gail, Jacques Benichou, Pages 428-430 | train | med_mcqa | null |
Graft from identical twin is defined as: | [
"Allograft",
"Isograft",
"Xenograft",
"Autograft"
] | B | Ans. (b) Isograft(Ref: Robbins 9th/pg 231-234)Types of grafts QAutografts Q: transplant of individual own organIsograft: Graft from identical twinAllografts Q: between individuals of the same speciesXenografts Q: grafts from one species to another species | train | med_mcqa | null |
The following are small residual insecticides EXCEPT - | [
"Pyrethrum",
"DDT",
"Gamma BHC",
"Malathion"
] | A | Anti-adult measures: Residual sprays (DDT, Lindane, Malathion, OMS-33) Space sprays (Pyrethrum extract, residual space insecticide - Malathion and fenitrothion fogging) Park's Textbook of Preventive and Social Medicine, 25th Edition, Pg 833 | train | med_mcqa | null |
Following is true about medullobastoma: | [
"It is seen mainly in over 50 age group",
"It is radiosensitive tumour",
"Only treatment is surgery",
"Seen in anterior cranial fossa"
] | B | Ans. (b) It is radiosensitive tumour(Ref: R 9th/pg 1312)Medulloblastoma is exquisitely radiosensitive Q; Predominantly seen in children & exclusively in cerebellum Q | train | med_mcqa | null |
Latex agglutination test in CSF is done for detection of: | [
"Cryptococcus",
"E.Coli",
"Tuberculosis",
"Coxsackie"
] | A | Latex agglutination tests can detect antigens of encapsulated organisms (S. pneumoniae, H. influenzae, N. meningitidis, and Cryptococcus neoformans) but are rarely used Except for detection of Cryptococcus or in paially treated patients. PCR of CSF has been used to detect bacteria (S. pneumoniae, H. influenzae, N. meningitidis, M. tuberculosis) and viruses (HSV, VZV, CMV, EBV, and enteroviruses) in patients with meningitis. | train | med_mcqa | null |
The most common condition of inherited blindness due to mitochondrial chromosomal anomaly is : | [
"Retinopathy of prematurity",
"Leber's Hereditary Optic neuropathy",
"Retinitis pigmentosa",
"Retinal detachment"
] | B | B i.e. Leber's hereditary optic neuropathy - Leber's hereditary optic neuropathy (WON) is a rare cause of bilateral optic neuritis Q which results from maternal mitochondrial DNA mutationsQ - Young male (15-35 years) presenting with bilateral sequential acute or subacute, severe, painless loss of vision with in weeks or months of first) in both eyes with normal (or brisk) papillary response, centrocecal scotoma and disc findings (hyperemia, edema, and talengiectatic microangiopathy) in acute phaseQ are diagnostic of leber's hereditary optic neuropathy. | train | med_mcqa | null |
Which of the following is false about gingival index? | [
"It can be used for all teeth or selected teeth",
"it uses a scoring system of 0- 3",
"it requires the use of a periodontal probe",
"it requires the measurement of the pocket depth"
] | D | null | train | med_mcqa | null |
Which of the following develops from an unerupted tooth? | [
"Dental cyst",
"Dentigerous cyst",
"Both of the above",
"None of the above"
] | B | Dentigerous (follicular) cysts are epithelial-lined, developmental, odontogenic cysts. Fifteen to eighteen percent of jaws cysts are dentigerous, surround the crowns, and attach at the cementoenamel junction of unerupted teeth. The lower third molars and the upper canines are the most commonly involved teeth. The cyst develops subsequent to an accumulation of fluid between the remnants of the enamel organ and the contiguous tooth crown. Ref: Smith R.A. (2012). Chapter 25. Jaw Cysts. In A.K. Lalwani (Ed), CURRENT Diagnosis & Treatment in Otolaryngology--Head & Neck Surgery, 3e. | train | med_mcqa | null |
HIV mostly affects which cells? | [
"CD4 cells",
"CD 8 cells",
"T cells",
"Plasma cells"
] | A | harshmohan textbook of pathology 7th edition. *the pathogenesis of HIV infection is largely related to the depletion of CD4 + T cells resulting in preformed immunosuppression .Selective tropism for CD4+ molecule receptors, gp 120 envelope glycoprotein of HIV has selective tropism for the cells containing CD 4 molecules on their surface,most impoantly CD4+T cells | train | med_mcqa | null |
Hyperparathyroidism causes - | [
"Multiple bone cysts",
"Subperiosteal bone resorption",
"Brown's tumor",
"All of the above"
] | D | Radiological features of bone are : Rarefaction of bones, salt pepper skull, loss of lamina dura, sub-periosteal resorption of bone, multiple cysts, Brown's tumor, and collapse of vertebrae with biconvex disc. | train | med_mcqa | null |
Which of the statements is not true regarding Macleod's Syndrome ? | [
"It is not a true emphysema",
"Occurs before 8 years of age",
"It is unilateral emphysema",
"The pulmonary aery on the affected side is hyperplastic"
] | C | Ans. is 'c' i.e., The pulmonary aery on the affected side is hyperplastic Macleod syndrome o It is also known as Swyer - Janes syndrome o It is a cause of unilateral hyperlucent lung. o It may present as acute pneumonia, but most patients are discovered when a chest X-ray is obtained for an unrelated reason. o This not a true emphysema. o On examination there is hyperresonance and a small lung with mediastinum shifted towards the more abnormal lune. There is no vascular abnormality. o No specific treatment is required, it may become less symptomatic with time. | train | med_mcqa | null |
Dent disease is due to defect of? | [
"Sodium channel",
"Potassium channel",
"Chloride channel",
"Calcium channel"
] | C | Dent's disease (or Dent disease) is a rare X-linked recessive inherited condition that affects the proximal renal tubules of the kidney. It is one cause of Fanconi syndrome and is characterized by tubular proteinuria, excess calcium in the urine, the formation of calcium kidney stones, nephrocalcinosis, and chronic kidney failure. About 60% of patients have mutations in the CLCN5 gene (Dent 1), which encodes a kidney-specific chloride/proton antipoer, and 15% of patients have mutations in the OCRL1 gene (Dent 2). Dent's disease often produces the following signs and symptoms: Rickets Extreme thirst combined with dehydration Nephrolithiasis (kidney stones) Hypercalciuria (high urine calcium - >300 mg/d or >4 mg/kg per d) with normal levels blood/serum calcium) Aminoaciduria (amino acids in urine) Phosphaturia (phosphate in urine) Diagnosis is based on a genetic study of CNCL5 gene Ref: wikipedia | train | med_mcqa | null |
Most commonly utilized Intercostal Space for Pericardiocentesis is: | [
"Left 5th Intercostal Space",
"Left 6th Intercostal Space",
"Right 5th Intercostal Space",
"Right 6th Intercostal Space"
] | A | Answer is A (Left 5th Intercostal Space) Left Fifth Intercostal Space is the most commonly utilized space fir Parasternal Pericardiocentesis `There are various sites for aspiration but the two commonest sites used are the sub-xiphoid and the left fifth intercostal space. The sub-xiphoid approach is the much preferred route, as one can aspirate fluid even in the case of small effusions. This route is extra-pleural and avoids the coronary, pericardial, and internal mammary aeries. | train | med_mcqa | null |
In burns least useful is | [
"Normal saline",
"Blood",
"Dextran",
"Ringer lactate"
] | B | We know that Ringer's lactate is the preferred agent during initial 24 hrs. Nasogastric intubation is done to decrease the risk of emesis and possible aspiration (as parlytic ileus develops in a pt. with significant burn) Dextran is a colloid and can be used in 2nd 24 hrs., however albumin is the preferred and most widely used colloid. Blood has also role in burn patient. The need for Blood replacement is significant in extensive burns. Besides injury to red blood cells and their decreased half-life resulting in their early destruction, many patients may be anaemic. Hence, repeated and frequent transmission to maintain a hematocrit around 35% is necessary. Ref Bailey and love 27e p625 , Srb`s manual of surgery p133 | train | med_mcqa | null |
Vitamin which is excreted in urine is : | [
"Vitamin A",
"Vitamin C",
"Vitamin D",
"Vitamin K"
] | B | B i.e. Vitamin CVitamin C is a water soluble vitamin, which is mainly excreted in urineQ. Its intake above 100 mg/day results in saturation of its metabolic capacity and excretion into urine. So large doses (1 gm TDS/81p) are used to acidify urine in preventing and treating UTI as some drugs act better in acidic urine.Vitamin A, D, E, K are fat soluble and so excreted mainly in bile and very minimally in urine. | train | med_mcqa | null |
Peak growth velocity in adolescent girl is indicated by? | [
"Breast enlargment",
"Axillary hair",
"Public hair",
"Just before commensement of menarche"
] | D | Ans. is 'd' i.e., Just before commincement of menarche Mensus typically appears around the peak in height velocity -Nelson Menarche usually occurs after peak velocity has been attained and as the growth rate begins to decline. Remember o Growth acceleration begins in early adolescence, but peak growth velocities are not reached until middle adolescence. | train | med_mcqa | null |
For karyotyping, the dividing cells are arrested by the addition of colchicines in the following mitotic phase | [
"Prophase",
"Metaphase",
"Anaphase",
"Telophase"
] | B | b. Metaphase(Ref: Nelson's 20/e p 605-606, Ghai 8/e p 645)Chromosomes are examined after arresting dividing cells in metaphase with mitotic spindle inhibitors (e.g., N-diacetyl- N-methylcolchicine), followed by staining. | train | med_mcqa | null |
Test for quantification of viral infectivity is | [
"Cytopathic effect",
"Plaque assay",
"Electron microscopy",
"Haemagglutination"
] | B | Viral assays
Virus content of a specimen can be assayed in two ways
1. With reference to total virus particles-
Electron microscopy
Hemagglutination
2. With reference to the infectious virions only
A. Quantal Assays
→ Indicates the presence or absence of infectious virus e.g
Death of the experimental animal.
Production of haemagglutinin in allantoic fluid.
Appearance of cytopathological effects on cell cultures.
B. Quantitative infective assay
It measures the exact number of infectious particles. Eg:
Plaque assay (monolayer cell culture) (CAM).
Pock assay on chick embryo chorioallantoic membrane.
→ Viruses producing pocks on chorioallantoic membrane are HSV, vaccinia, smallpox (variola), monkey pox, cowpox and camel pox. | train | med_mcqa | null |
Amino acid which is optically ine ? | [
"Valine",
"Alanine",
"Glycine",
"Threonine"
] | C | The a-carbon of amino acids has four different groups attached to it and so is a chiral or asymmetric carbon. Hence, there are two possible enantiomers, L and D, i.e., mirror image with refrence to a-carbon. The chiral carbon is also responsible for optical activity and stereoisomerism. Only exception is glycine, which is the simplest amino acid. Glycine has no chiral carbon (chirality) because a-carbon of glycine does not have four different groups attached to it. Therefore glycine does not have optical activity or D and L forms (enantiomers). | train | med_mcqa | null |
Bradykinin is for | [
"Pain",
"Vasodilation",
"Vasoconstriction",
"Increase in vascular permeability"
] | A | Ref Robbins 8/e p65; 7/e p45,9/e p89 Bradykinin is a potent endothelium-dependent vasodilator and mild diuretic, which may cause a lowering of the blood pressure. It also causes contraction of non-vascular smooth muscle in the bronchus and gut, increases vascular permeability and is also involved in the mechanism of pain. | train | med_mcqa | null |
A scientist has developed an adipocyte cell line that, at 42degC, cannot degrade triglycerides to glycerol and free fatty acids. At 25degC, the triglyceride degradation is normal. Which one of the following best reflects enzymes in which a temperature-sensitive mutation may lead to this phenotype? | [
"Protein Kinase A - yes; Adenylate Kinase - no; Insulin Receptor - no; Glucagon Receptor - yes; Glycerol Kinase - yes",
"Protein Kinase A - no; Adenylate Kinase - no; Insulin Receptor - yes; Glucagon Receptor - no; Glycerol Kinase - yes",
"Protein Kinase A - yes; Adenylate Kinase - no; Insulin Receptor - no; Gl... | C | Insulin levels decrease, and glucagon levels rise, stimulating lipolysis. (Epinephrine and other hormones promote lipolysis by the same mechanism.)a. cAMP levels rise, and PKA is activated.b. PKA phosphorylates perilipin-1, which then dissociates from the enzyme ATGL.c. When free of perilipin-1, ATGL is active and converts triacylglycerol to a free fatty acid and DAG.d. PKA directly phosphorylates and activates hormone sensitive lipase, which converts DAG to a free fatty acid and monoacylglycerol.e. Monoglyceride lipase then converts the monoacylglycerol to a free fatty acid and glycerol.The hormone-sensitive lipase of adipose tissue is responsible for degrading diacylglycerol to a free fatty acid and monoacylglycerol. The enzyme is activated by glucagon via a cAMP-mediated process (the activation of protein kinase A). Thus, mutations in PKA or the glucagon receptor may interfere with the eventual phosphorylation and activation of the hormone-sensitive lipase. Adenylate kinase is not involved in this cascade (although a mutation in adenylate cyclase would be involved, as that is the enzyme that produces cAMP). The insulin receptor promotes triglyceride synthesis and storage in the adipocyte, so a mutation in the insulin receptor would not promote triglyceride degradation. Glycerol kinase is only expressed in the liver and is not present in adipose cells. | train | med_mcqa | null |
Most common site of aoic aneurysm rupture is | [
"Descending thoracic aoa",
"Arch of aoa",
"Aoic Root",
"Infrarenal aoa"
] | D | Answer- D. Infrarenal aoaRuptured aneurysm is the most common cause of aoic rupture and they are most common in the abdomen. | train | med_mcqa | null |
NO is secreted by | [
"Endothelium",
"Endoderm",
"Ectoderm",
"Bones"
] | A | Nitric oxide, known as an endothelium-derived relaxing factor (EDRF), is biosynthesized endogenously from L-arginine, oxygen, and NADPH by various nitric oxide synthase (NOS) enzymes. Reduction of inorganic nitrate may also serve to make nitric oxide. The endothelium (inner lining) of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax, thus resulting in vasodilation and increasing blood flow. Nitric oxide is highly reactive (having a lifetime of a few seconds), yet diffuses freely across membranes. These attributes make nitric oxide ideal for a transient paracrine (between adjacent cells) and autocrine (within a single cell) signaling molecule.(Ref: Ganong&;s review of medical physiology 23rd edition Page no: 405) | train | med_mcqa | null |
Boot shaped heart on chest X - ray is seen in- | [
"Tetrofogy of fallot",
"TGA",
"TAPVC",
"PAPVC"
] | A | Ans. is 'a' i.e., Tetrology of fallot Radiological findings of TQFi) Boot shaped heart (Coeur en Sabot)ii) Normal sized heart (no cardiomegaly)iii) Pulmonary oligemiaiv)Right aortic arch (in 25% cases). | train | med_mcqa | null |
Ocular muscle involved in Marcus Gun jaw winking phenomenon is - | [
"Orbicularis oculi",
"Levator palpebrae",
"Medial rectus",
"Lateral rectus"
] | B | Congenital synkinetic ptosis (Marcus Gunn jaw winking ptosis). In this condition there occurs retraction of the ptotic lid with jaw movements i.e., with stimulation of ipsilateral pterygoid muscle. It is due to the mixing of the fibres of 5th and 3rd cranial nerves. Ref:AK Khurana 4thE pg356 | train | med_mcqa | null |
Which of the following is a modified amino acid? | [
"Arginine",
"Cysteine",
"Asparagine",
"Threonine"
] | B | Two molecules of cysteine make cysteine (cys-cys) or dithio b, b-a amino propionic acid. The SS linkage is called as disulfide bridge. Ref: Textbook of medical biochemistry, MN Chatterji, 8th edition, page no: 78 | train | med_mcqa | null |
Hepatotoxic drugs are | [
"Chloroform",
"Halothane",
"Both are above",
"None"
] | C | Refer KDT 6/e p372 Massive liver necrosis following Halothane anaesthesia is seen in some cases If chloroform cos given for long period liver damage occurs | train | med_mcqa | null |
A 50 years old male with type 2 diabetes mellitus is found to have 24-hour urinary albumin of 250 mg. Which of the following drugs may be used to retard progression of the renal disease? | [
"Hydrochlorothiazide",
"Enalapril",
"Amiloride",
"Aspirin"
] | B | Antihypeensive drugs in Diabetes MellitusACE inhibitors (enalapril) or angiotensin receptor blockers are the first line of therapy in hypeensive individuals with type 2 DM.They have no known adverse action on glucose or lipid metabolism.Minimize the development of diabetic nephropathy (by reducing renal vascular resistance and renal perfusion pressure-the primary factor underlying renal deterioration in these patients).(Refer: Harrison's Principles of Internal Medicine, 18th edition, pg no: 2054-2058) | train | med_mcqa | null |
Kayser- Fleischer rings (KF rings) are seen in: | [
"Pterygium",
"Hematochromatosis",
"Wilson's disease",
"Menke's kinked hair syndrome"
] | B | Wilson&;s disease * Wilsons disease is a rare genetic disease that requires the-- patient to inherit two abnormal copies of the gene ATP7B. In other words both parents most be carriers (have one abnormal copy of this gene). * The chances of getting this disease is about 1 in 40,000 people world wide. The chances of being a carrier is about 1 in 90. * It affects men, women and all races equally. * Wilson disease Is a genetic disorder that prevents the body from expelling excess copper. * Copper builds up in the liver, brain, kidneys, and eyes. Over time the copper causes irreversible organ damage. * If left untreated this Ref: AK khurana 7th ed. | train | med_mcqa | null |
All can cause high anion gap acidosis except | [
"Ethylene glycol",
"Starvation",
"Diabetic ketoacidosis",
"Glue-sniffing"
] | D | . | train | med_mcqa | null |
True about exotoxin - | [
"Non-antigenic",
"Enzymatic",
"Non-protein",
"Heat stable"
] | B | Ans. is 'b' i.e., Enzymatic Distinguishing feature of Exotoxins and endotoxinsExotoxinsEndotoxinso Proteinso Heat labileo Secreted by cellso Action enzymico Active in minute doseo Highly antigenico Action specifically neutralised by antibodyo Specific pharmacologic effect for each toxino Can be toxoidedo Upopolysaccharideo Heat stableo Forms part of cell wrallo No enzy mic actiono Active only in large doseo Weakly antigenico Neutralisation of antibody ineffectiveo Effect nonspecifico Cannot be toxoided | train | med_mcqa | null |
All of the following antibacterial agents act by inhibiting cell wall synthesis, except : | [
"Carbapenems",
"Monobactams",
"Cephalosporins",
"Nitrofurantoin"
] | D | null | train | med_mcqa | null |
In salmonella infection, true statement is: | [
"Flagellar antigen forms chalky granular clumps",
"Somatic antigen is a protein",
"Absence of Vi antibody indicate poor prognosis",
"Serological classification is by Craige's scheme"
] | C | Absence of Vi antibody indicate poor prognosis in salmonella infection is the true statement among the options given above. Option 1 Option 2 Somatic antigen (O Ag): Pa of cell wall lipopolysaccharide (LPS). Flagellar antigen (H Ag): Made-up of proteins: flagellin, confers motility. Option 3 The complete absence of the Vi antibody in a proven case of typhoid fever indicates poor prognosis Option 4 Phase variation: Conversion of isolates from one phase to another is achieved by using Craigie's tube method. Note: Vi Antibodies are not seen in normal population. | train | med_mcqa | null |
The MOST severe complication of idiopathic hyper-eosinophilic syndrome is: | [
"Endocardial fibrosis",
"Eosinophilic gastroenteritis",
"Interstitial pneumonia",
"Bone marrow failure"
] | A | The most severe complicaions are involving hea and CNS. In the hea pathologic changes leads to thrombosis, endocardial fibrosis and restricve cardiomyopathy. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 481 | train | med_mcqa | null |
An early systolic murmur may be caused by all the following except | [
"Small ventricular septal defect",
"Papillary muscle dysfunction",
"Tricuspid regurgitation",
"Aoic stenosis"
] | D | Ref Harrison 19 th ed pg 1447 Acute severe MR results in a decrescendo early systolic murmur, the characteristics of which are related to the progressive attenuation of the left ventricular to left atrial pressure gradient dur- ing systole because of the steep and rapid rise in left atrial pressure in this context. Severe MR associated with posterior leaflet prolapse or flail radiates anteriorly and to the base, where it can be confused with the murmur of AS. MR that is due to anterior leaflet involvement radiates posteriorly and to the axilla. With acute TR in patients with normal pulmonary aery pressures, an early systolic murmur that may increase in intensity with inspiration may be heard at the left lower sternal border, with regurgitant cv waves visible in the jugular venous pulse. | train | med_mcqa | null |
Which of the following is associated with 'All-or-none' law? | [
"Action potential",
"Resting potential",
"Membrane potential",
"None of the above"
] | A | Once threshold intensity is reached, a full-fledged action potential is produced. Fuher increases in the intensity of a stimulus produce no increment or other change in the action potential as long as the other experimental conditions remain constant. The action potential fails to occur if the stimulus is subthreshold in magnitude, and it occurs with constant amplitude and form regardless of the strength of the stimulus if the stimulus is at or above threshold intensity. The action potential is therefore all-or-none in character. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 4. Excitable Tissue: Nerve. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | train | med_mcqa | null |
A patient presents with endocrinopathy. fibrous dysplasia of bone and hyperpigmentation. What should be the possible diagnosis? | [
"Ollier's syndrome",
"Mazabraud syndrome",
"Mc Cune-Albright syndrome",
"Maffucci's syndrome"
] | C | Mc Cune Albright syndrome is a triad of Precocious puberty (endocrinopathies) fibrous dysplasia, cafe-au-lait spots. | train | med_mcqa | null |
Depth of anaesthesia by inhalation anaesthetics depends upon | [
"Respiratory minute volume",
"Solubility of anaesthetic agent in blood",
"Blood concentration of anaesthetic agent",
"All of the above"
] | D | (D) All of the above # Depth of anaesthesia depends on the potency of the agent (MAC is an index of potency) and its partial pressure (PP) in the brain, while induction and recovery depend on the rate of change of PP in the brain.> Factors affecting PP of anaesthetic attained in brain are: PP of anaesthetic in the inspired gas Pulmonary ventilation Alveolar exchange Solubility of anaesthetic in blood Solubility of anaesthetic in tissue Cerebral blood flow | train | med_mcqa | null |
The commonest site for extragonadal germ cell tumour is- | [
"Retroperitoneum",
"Sacrococcygeal region",
"Pineal gland",
"Mediastinum"
] | D | Extragonadal germinal cell syndromes are rare tumors that predominantly affect young males. Literature suggests that the only known risk factor for extragonadal germ cell tumors (EGCTs) is Klinefelter syndrome (47XXY), which is associated with mediastinal nonseminomatous germ cell tumors. They are characterized by their location on the midline from the pineal gland to the coccyx. In extragonadal germ cell tumors, no evidence of a primary malignancy is present in either the testes or ovaries by radiologic imaging or physical examination. Extragonadal germ cell tumors produce a rich symptomatology and may reach large volumes if they arise in silent areas. Histologically, they mirror their gonadal counterpas with which they share the same chemosensitivity and radiosensitivity. Modern approaches to diagnosis and treatment can result in high rates of long-term survival and even cureA number of different types of germ cell tumours can develop in the mediastinum. These are much more common in males than females. They are generally put into 2 main groups Non seminoma germ cell tumours (in females these are called non dysgerminomas) - including teratomas, choriocarcinomas, embryonal carcinomas and yolk sac tumours Seminomas (in females these are called dysgerminomas) Some teratomas can be non cancerous (benign).Many people with a tumour in the mediastinum don't have any symptoms. The doctor might spot the tumour on a chest X-ray you had for another reason. If symptoms are present they might include Shoness of breath Pain in the chest A cough Raised temperature Weight loss Night sweats | train | med_mcqa | null |
ICD - 10 chapter 1 describes ? | [
"Poisoning and consequences",
"Diseases of the nervous system",
"Infectious and parasitic diseases",
"Psychiatric diseases"
] | C | Ans. is 'c' i.e., Infectious and parasitic diseases The ICD-10 is arranged in 21 major chaptors.21 Chapters and their contentsChapter I includes 'Infectious and parasitic diseases'Chapter II includes Weoplams'Chapter III includes 'Diseases of blood & immune system'Chapter IV includes 'Endocrine, nutritional and metabolic disorders'Chapter V includes 'Mental & behavioral disorders'Chapter VI includes 'Diseases of nervous system'Chapter VII includes 'Diseases of eye'Chapter VIII includes 'Diseases of ear and mastoid'Chapter IX includes 'Diseases of CVS'Chapter X includes 'Diseases of respiratory system'Chapter XI includes 'Diseases of digestive system'Chapter XII includes 'Diseases of skin & subcutaneous tissue'Chapter XIII includes 'Diseases of musculoskeletal system'Chapter XIV includes 'Diseases of genitourinary system'Chapter XV includes 'Pregnancy childbih and perperium'Chapter XVI includes 'Conditions of perinatal period'Chapter XVII includes 'Congenital malformation and genetic disorders'Chapter XVIII includes 'Clinical and laboratory findings not included elsewhere'Chapter XIX includes Injury, poisoning and other consequences of external causes.Chapter XX includes 'External causes of morbidity and moility'Chapter XXI (21) includes Factors influencing health status and contact with health services | train | med_mcqa | null |
ICDS package does not include - | [
"Nutrition",
"Immunisation",
"Health check up",
"Formal education"
] | D | ICDS include supplementary nutrition nutrition and health education,immunisation,health checkup.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-545 | train | med_mcqa | null |
Which of the following is false regarding Cholestasis of pregnancy ? | [
"Serum bilirubin >5 mg/dl",
"Alanine amino transferase (ALT) <250 IU/L",
"Pruritus preceeds abnormal lab values by weeks",
"Dyslipidemia"
] | A | Hyperbilirubinemia results from retention of conjugated pigment, but total plasma concentrations rarely exceeds 4 to 5 mg/dl. Serum transaminase levels are normal to moderately elevated but seldom exceed 250 U/L Disorder AST (SGOT) U/L Biliirubin (mg/dl) Cholestasis of pregnancy Upto 200 1-5 Acute fatty liver of pregnancy 200-800 4-10 Hepatitis 2000+ 5-20 Ref: Williams Obstetrics 25th edition Pgno: 1059 | train | med_mcqa | null |
Which of the following is not a legal ground for divorce? | [
"Adultery",
"Forced conversion to another religion",
"Either pay was mentally unsound from the time of marriage",
"Either spouse not being heard from for 7 years or more"
] | C | If either pay is mentally unsound from the time of marriage the marriage is void and hence no divorce is possible. Divorce is only applicable for the dissolution of a previously valid marriage. Grounds for divorce also includes: Cruelty, deseion, mental unsoundness developing after marriage, communicable venereal diseases, renunciation, mutual consent and husband found guilty of rape, sodomy or bestiality. Ref: Textbook of Forensic Medicine and Toxicology By V.V Pillay, 15th Edition, Page 317 | train | med_mcqa | null |
False about short bowel svndrome- | [
"Hypergastrinemia & high gastric secretion is seen",
"Diarrhea, dehydration and malnutrition",
"Hirsutism",
"Chronic TPN dependence"
] | C | Ans. is 'c' i.e., Hirsutism Short bowel syndrome -o Presence of less than 200 cm of residual small bowrel in adult patients.o Insufficient absorptive capacity of small intestine results in diarrhea, dehydration and malnutition.Causes - Small intestine resection (massive) due toMassive resection in singleCumutative effect of multipleoperation as in acute mesentericoperations of small intestineischemia, malignancyresected as in Crohn's diseaseo In pediatric patients, MC etiologies are intestinal atresia, volvulus and necrotizing enterocolitis. Resection of less than 50% of small intestine is generally well tolerated.o Clinically significant malabsorption occurs when more than 50 to 80% of small intestine has been resected.o Resection ofjejunum is better tolerated than resection of ileum.o Presence of healthy colon, intact ileocecal valve and healthy residual small bowel are factors associated with decreased severity of malabsorption.o Malabsorption in short bowel syndrome is exacerbated by a characteristic hypergastrinemia associated gastric acid hypersecretion which persists for 1 to 2 years post operatively.Management -1. Medical- a)TPNHigh dose H-, reseptor antagonist/PPLAntimotility agents - Loperamide.Octreotide - reduces volume of GI secretions.o Levels of Iron, Magnesium, Zinc, Copper and vitamins must be monitored closely and deficienc ies prevented.1 Surgery -Non transplant surgery : Goal is to increase nutrient and fluid absorption by slowing intestinal transit or increasing intestinal length.Segmental reversal of small bowel.Colon interpositionSmall intestinal valves construction.Electrical pacing of small intestine.Bianchi's Intestinal lengthening operation (generally used in pediatric patients with dilated small bowel).Serial transverse enteroplasty (2003).Intestinal transplantation : Indicated for life threatening complications of intestinal failure or chronic TPN therapy -Impending/overt liver failure.Thrombosis of major central veins.Frequent cathater related sepsis.Frequent episodes of severe dehydration. | train | med_mcqa | null |
Features of pyloric stenosis | [
"Hypokalemic alkalosis",
"Peristalsis right to left",
"Commonly caused by carcinoma stomach",
"Retention vomiting present"
] | A | Because of vomiting-hypochloremia hyponatremia, hypocalcemia, hypomagnesemia alkalosis occurs. Reference: SRB edition:5th page no: 829 | train | med_mcqa | null |
The following statements are true for the therapy with lithium except: | [
"It is used in bipolar disorder",
"Amiloride is useful in treating lithium induced diabetes insipidus",
"Regular measurements of blood concentration of lithium is necessary",
"Sodium ion is a specific antidote for lithium clearance"
] | D | Ans. (D) Sodium ion is an specific antidote for lithium clearance(Ref: KDT 8/e p476-477)There is no specific antidote for lithium.Lithium is the drug of choice for the treatment of bipolar disorder and prophylaxis of acute mania.It is a narrow therapeutic index drug and requires therapeutic drug monitoring.Amiloride is the drug of choice for lithium induced diabetes insipidus. | train | med_mcqa | null |
Most common site of TB - | [
"Spine",
"Knee",
"Hip",
"Shoulder"
] | A | Ans. is 'a' i.e., Spine Skeletal tuberculosiso Tuberculous infection of bone (osteomyelitis) is a form of secondary osteomyelitis caused by hematogenous dissemination from a primary' infected visceral focus. The primary-focus may be active or quiescent, apparent or latent; either in the lungs, lymph glands or other viscera.Tuberculous infection of bone (Tubercular Osteomyelitis) vs Bacterial infection (Bacterial Osteomyelitis)Acute bacterial InfectionTuberculous Infectiono Perisoteal Reaction is marked\o Sequestra are commono Perifocal Reactive bone formation (involucrum) is prominento Involvement of adjacent tissues may result in abscess formationo Abscess wall shows characteristic signs of inflammationo Periosteal Reaction is minimal (limited)o Sequestra are very uncommono Very little Perifocal Reactive bone formation is seen (lesion is primarily a lytic process)o Involvement of adjacent tissues may result in abscess formationo Abscess wall does not show characteristic signs of inflammation (cold abscess)o The spine is the commonest site of bone and joint tuberculosis, about 50 percent of the total number of cases,o Next in order of frequency are the hip. the knee and the elbow.TissueDiseaseRemarksBoneo Long boneo Short bone (phalanges)o SpineTB osteomyelitisTubercular dactylitisTB spondylitisTibia commonly affectedAlso called spina ventosaAlso called Pott's diseaseJointo Arthritiso SynoviumTB arthritisSynovial TBHip joint commonly affeetedKnee-commonest siteOtherso Tendon (synovium)o BursaeTB tensosynovitis of flexor tendons at wristTB bursitis of trochantericCompound palmar ganglionTrochanteric bursitis | train | med_mcqa | null |
Left Umbilical vein becomes: | [
"Ligamentum teres",
"Ligamentum venosum",
"Medial umbilical ligament",
"Ligamentum aeriosum"
] | A | Ligamentum teres | train | med_mcqa | null |
All are true regarding Prostaglandins except: | [
"LT cause vasoconstriction and decreased vascular permeability",
"20 carbon unsaturated fats",
"Prostacyclin inhibits platelet aggregation",
"Prostaglandins cause uterine muscle contraction & induce labor"
] | A | Ans-ARef: Harpers illustrated Biochemistry,28th editionExplanation:Synthesis from arachidonate (See figure on the next page)FUNCTIONSProstacyclin (PGI2)Inhibit platelet aggregationVasodilatationPGF:Uterine muscle contractionInduce laborBronchoconstrictorPGE:BronchodilatorCauses inflammationThromboxaneSynthesis: plateletFunction: platelet aggregationAspirin - Inhibits TXA2 - | Platelet aggregationAspirin is used in the treatment of myocardial infarctionLeukotrienesThe site of synthesis: leukocytes, platelets, macrophagesSlow reacting substance (SRS-A)Leukotrienes-C, D, EFunctions: InflammationVasoconstrictionBronchoconstriction | train | med_mcqa | null |
2,3-BPG binds to sit, itaemogitiniti and the affinit\es gen | [
"4, decreases",
"1, decreases",
"4, increases",
"1, increases"
] | B | Ans. b. 1, decreases | train | med_mcqa | null |
Spot map is used for - | [
"Local distribution of disease",
"Rural urban variation",
"National variation",
"None"
] | A | Studies of the geographical distribution of disease is one of the impoant dimensions of descriptive epidemiology. These variations include International variations, National variations, Rural-urban variation and Local distribution. These variations are best studied with the aid of 'spot maps' or shaded maps. these maps show glance areas of high or low frequency, the boundaries and pattern of disease distribution. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 74 | train | med_mcqa | null |
. Bacteria is not shed in - | [
"Carrier state",
"Latent infection",
"Incubation period",
"Subclinical infection"
] | B | null | train | med_mcqa | null |
The characteristic burnt rope odour is caused by toxin of: | [
"Cannabis",
"Tobacco",
"Strychnine",
"Chloral hydrate"
] | A | Ans. a. Cannabis | train | med_mcqa | null |
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