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All of the following are associated with Secondary Hemochromatosis except - | [
"Thalassemia Major",
"Sideroblastic Anemia",
"Hereditary Spherocytosis",
"Paroxysmal Nocturnal Haemoglobinuria (PNH)"
] | D | null | train | med_mcqa | null |
Throat pack true is: | [
"Not used with cuffed endotracheal tubes",
"Removed prior to extubation",
"Well tolerated by awake patient",
"Should be used even after surgery"
] | B | It is imperative that the pack be removed prior to extubation. No throat pack can be kept in place after extubation, as it can cause choking and respiratory collapse. | train | med_mcqa | null |
Negri bodies are seen in infections due to | [
"Poliovirus",
"Rabies virus",
"Herpes virus",
"Adenovirus"
] | B | (B) Rabies virus # Negri Bodies:> Most characteristic pathologic finding of rabies in the CNS is the formation of cytoplasmic inclusions called Negri bodies within neurons.> Each eosinophilic mass measures 10 mm and is made up of a finely fibrillar matrix and rabies virus particles.> Negri bodies are distributed throughout the brain, particularly in Ammon's horn, the cerebral cortex, the brainstem, the hypothalamus, the Purkinje cells of the cerebellum, and the dorsal spinal ganglia.> Negri bodies are not demonstrated in at least 20% of cases of rabies, and their absence from brain material does not rule out the diagnosis. | train | med_mcqa | null |
Lysosomal transpo defect is seen in | [
"Cystinosis",
"Goucher's disease",
"Metachromatic leukosytrophy",
"Tay Sach's disease"
] | A | Answer- A. CystinosisTwo disorders are caused by a proven defect in carrier-mediated transpo of metabolites: cystinosis end the group of sialic acid storage disorders (SASD). | train | med_mcqa | null |
Fever increase w ater losses by ______ ml/day per degree Celsius - | [
"100",
"200",
"400",
"800"
] | B | Ans. is 'b' i.e., 200 ml/day per degree Celsius \ | train | med_mcqa | null |
Radiograph of the ankle of a diabetic patient with painless, swollen joint shows destroyed joint with large number of loose bodies. The most probable diagnosis is: | [
"Charcot's joint",
"Clutton's joint",
"Osteoahritis",
"Rheumatoid ahritis"
] | A | Neuropathic ahritis (Charcot's joint) is encountered most often in patients with diabetes mellitus. It is a progressive destructive ahritis associated with loss of pain sensation, proprioception, or both. Without these protective mechanisms, joints are subjected to repeated trauma, resulting in progressive cailage and bone damage. There is fragmentation and eventual loss of aicular cailage with eburnation of the underlying bone resulting in the formation of loose bodies. Clutton's joints is a term describing the finding of symmetrical joint swelling seen in patients with congenital syphilis. It is most commonly affects the knees presenting with synovitis and joint effusions. Ref: Harrisons principles of internal medicine, 18th edition, chapter: 336 | train | med_mcqa | null |
True about Crohn disease are all EXCEPT? | [
"Loss of haustration",
"Growth failure",
"Cobblestone colon",
"Perianal fistula formation"
] | A | Discussing about the options one by one, a. Loss of haustrations is a feature of ulcerative colitis b. Growth failure can even be the only manifestation of Crohn disease. c. Linear ulcers can give a cobblestone appearance to the mucosal surface in Crohn disease d. Perianal disease is common (tag, fistula, deep fissure, abscess) in Crohn disease | train | med_mcqa | null |
Which of the following is true about Secular trend - | [
"Road side accident is a good example",
"Due to environmental factors",
"Is due to normally occuring variation in herd immunity",
"Consistent change in a paicular direction over a period of time"
] | D | Ans. is 'd' i.e., Consistent change in a paicular direction over a period of time The term 'Secular trend' implies changes in the occurrence of disease i.e. a progressive increase or decrease in incidence over a long period of time, such as several years or decades. | train | med_mcqa | null |
If land is available the best method of sewage disposal is - | [
"Dumping",
"Composting",
"Trickling filter",
"Activated sludge process"
] | B | Park's textbook of preventive and social medicine 23rd edition. Park's textbook of preventive and social medicine 23rd edition. * Composting is a method of combined disposal of refuse and night soil or sludge where suitable land is available. | train | med_mcqa | null |
Anemia of chronic disease is characterized by | [
"Increased sideroblasts",
"Increased TIBC",
"Increased bone marrow iron",
"Increased protoporphyrin"
] | C | *Anemia of chronic disease- Impaired red cell production associated with any chronic diseases that would be infectious/inflammatory/neoplastic.*Chronic diseases produce a cytokine "IL-6" that increases the production of hepcidin from the liver. Hepcidin inhibits ferropoin function in macrophages and reduces the transfer of iron from the storage pool to developing erythroid precursors in bone marrow. *So the patient develops anemia irrespective of an increased amount of iron in macrophages.*Laboratory findings- Increased ferritin (storage iron), Low serum iron and reduced total iron binding capacity.-progenitors do not proliferate adequately because erythropoietin levels are inappropriately low for the degree of anemia.Whereas in iron deficiency anemia, the patient will have decreased ferritin, low serum iron, and high iron binding capacity. (Ref: Robbins 8/e p662) | train | med_mcqa | null |
All of the following support uterus except | [
"Cardinal ligament",
"Round ligament",
"Pubocervical ligament",
"Mackenrodt's ligament"
] | B | Ans. is b, i.e. Round ligamentRemember* Most important support of uterus is levator ani muscle* Most important ligament supporting the uterus--Cardinal ligament/Mackenrodt's ligament* Round ligament is a secondary support of the uterus as it does not support it directly but helps to keep it in anteverted position* Broad ligament is a fold of peritoneum and does not support the uterus at all.Note: Hence answer to question no. N2 is 'Broad Ligament' and question no. N3 where all other supports are primary supports, the answer is 'round ligament' which is only a secondary support. | train | med_mcqa | null |
Which of the following drug decreases plasma renin activity ? | [
"Enalapril",
"Nifedipine",
"Hydralazine",
"Clonidine"
] | D | null | train | med_mcqa | null |
All the following conditons cause thrombocytopenia EXCEPT- | [
"Giant hemangioma",
"Infectious mononucleosis",
"HIV infection",
"Iron deficiency anemia"
] | D | TEXTBOOK OF PATHOLOGY HARSHMOHAN 6TH EDITION PG NO 332&333 THROMBOCYTOPENIAS Thrombocytopenia is defined as a reduction in the peripheral blood platelet count below the lower limit of normal i.e. below 150,000/ml. Thrombocytopenia is associated with abnormal bleeding that includes spontaneous skin purpura and mucosal haemorrhages as well as prolonged bleeding after trauma. However, spontaneous haemorrhagic tendency becomes clinically evident only after severe depletion of the platelet count to level below 20,000/ml. SECTION II Haematology and Lymphoreticular Tissues Thrombocytopenia may result from 4 main groups of causes: 1. Impaired platelet production. 2. Accelerated platelet destruction. 3. Splenic sequestration. 4. Dilutional loss. A list of causes of thrombocytopenia is given in Table 13.2. Three of the common and impoant causes-- drug-induced thrombocytopenia, idiopathic thrombocytopenic purpura (ITP), and thrombotic thrombocytopenic purpura (TTP), are discussed below. Drug-induced Thrombocytopenia Many commonly used drugs cause thrombocytopenia by depressing megakaryocyte production. In most cases, an immune mechanism by formation of drug-antibody complexes is implicated in which the platelet is damaged as an 'innocent bystander'. Drug-induced thrombocytopenia is associated with many commonly used drugs and includes: chemotherapeutic agents (alkylating agents, anthracyclines, TABLE 13.2: Causes of Thrombocytopenia. I. II. IMPAIRED PLATELET PRODUCTION 1. Generalised bone marrow failure e.g. Aplastic anaemia, leukaemia, myelofibrosis, megaloblastic anaemia, marrow infiltrations (carcinomas, lymphomas, multiple myeloma, storage diseases). 2. Selective suppression of platelet production e.g. Drugs (quinine, quinidine, sulfonamides, PAS, rifampicin, anticancer drugs, thiazide diuretics), (heparin, diclofenac, acyclovir), alcohol intake. ACCELERATED PLATELET DESTRUCTION 1. Immunologic thrombocytopenias e.g. ITP (acute and chronic), neonatal and post-transfusion (isoimmune), drug-induced, secondary immune 'thrombocytopenia (post-infection, SLE, AIDS, CLL, lymphoma). 2. Increased consumption e.g. DIC, TTP, giant haemangiomas, microangiopathic haemolytic anaemia. III. SPLENIC SEQUESTRATION Splenomegaly IV. DILUTIONAL LOSS Massive transfusion of old stored blood to bleeding patients. antimetabolites), ceain antibiotics (sulfonamides, PAS, rifampicin, penicillins), drugs used in cardiovascular diseases (digitoxin, thiazide diuretics), diclofenac, acyclovir, heparin and excessive consumption of ethanol. Clinically, the patient presents with acute purpura. The platelet count is markedly lowered, often below 10,000/ml and the bone marrow shows normal or increased number of megakaryocytes. The immediate treatment is to stop or replace the suspected drug with instruction to the patient to avoid taking the offending drug in future. Occasional patients may require temporary suppo with glucocoicoids, plasmapheresis or platelet transfusions. Heparin-induced Thrombocytopenia Thrombocytopenia due to administration of heparin is distinct from that caused by other drugs in following ways: i) Thrombocytopenia is generally not so severe to fall to level below 20,000/ml. ii) Unlike drug-induced thrombocytopenia, heparin-induced thrombocytopenia is not associated with bleeding but instead these patients are more prone to develop thrombosis. The underlying mechanism of heparin-induced thrombocytopenia is formation of antibody against platelet factor 4 (PF-4)-heparin complex. This specific antibody activates the endothelial cells and initiates thrombus formation. It occurs in a small propoion of cases after the patient has received heparin for 5-10 days. Diagnosis is made by a combination of laboratory and clinical features with 4 Ts: thrombocytopenia, thrombosis, time of fall of platelet count, absence of other causes of thrombocytopenia. Immune Thrombocytopenic Purpura (ITP) Idiopathic thrombocytopenic purpura or immune thrombocytopenic purpura (ITP), is characterised by immunologic destruction of platelets and normal or increased megakaryocytes in the bone marrow. PATHOGENESIS. On the basis of duration of illness, ITP is classified into acute and chronic forms, both of which have different pathogenesis. Acute ITP. This is a self-limited disorder, seen most frequently in children following recovery from a viral illness (e.g. hepatitis C, infectious mononucleosis, CMV infection, HIV infection) or an upper respiratory illness. The onset of acute ITP is sudden and severe thrombocytopenia but recovery occurs within a few weeks to 6 months. The mechanism of acute ITP is by formation of immune complexes containing viral antigens, and by formation of antibodies against viral antigens which crossreact with platelets and lead to their immunologic destruction. Chronic ITP. Chronic ITP occurs more commonly in adults, paicularly in women of child-bearing age (20-40 years). The disorder develops insidiously and persists for several years. Though chronic ITP is idiopathic, similar immunologic thrombocytopenia may be seen in association with SLE, AIDS and autoimmune thyroiditis. The pathogenesis of chronic ITPis explained by formation of anti-platelet autoantibodies, usually by platelet-associated IgG humoral antibodies synthesised mainly in the spleen. These antibodies are directed against target antigens on the platelet glycoproteins, Gp IIb-IIIa and Gp Ib-IX complex. Some of the antibodies directed against platelet surface also interfere in their function. The mechanism of platelet destruction is similar to that seen in autoimmune haemolytic anaemias. Sensitised platelets are destroyed mainly in the spleen and rendered susceptible to phagocytosis by cells of the reticuloendothelial system.<\p> | train | med_mcqa | null |
Inhalational anesthetic with highest respiratory irritation is:- | [
"Desflurane",
"Nitrous oxide",
"Sevoflurane",
"Halothane"
] | A | Max respiratory irritation:- Desflurane MAC of Nitrous Oxide: >104% Smooth inducing agent, preferred in children : Sevoflurane Halothane:- Sensitize hea to arrythmogenic agent( Eg:- Ardenaline). Therefore contraindicated in pheochromocytoma | train | med_mcqa | null |
All of the following aeries are common sites of occlusion by a thrombus except: | [
"Anterior intervetricular",
"Posterior interventricular",
"Cirucumflex",
"Marginal"
] | D | D i.e. Marginal Nodal, Acute Marginal & Posterior Descending (interventricular) aeryQ are branches of Right Coronary aery; whereas Circumflex, Diagonal, Obtuse Marginal & Anterior Descending (interventricular) aeryQ are branches of Left Coronary Aery. LAD, RCA and LCX are common whereas as marginal branches are uncommon site of thrombosis. | train | med_mcqa | null |
Incidence is defined as - | [
"Number of new cases occurring in a defined population",
"Total cases (new+old) occurring in a defined population",
"Number of exposed developing the disease in a defined population",
"None of the above"
] | A | null | train | med_mcqa | null |
In which case Anterior resection is the method of t/t - | [
"Ca sigmoid colon",
"Ca rectum",
"Ca colon",
"Ca anal canal"
] | B | Anterior resection is the general term used to describe operations in which rectosigmoid part is resected from an abdominal approach with no need for perineal, sacral or other incision.
Resection of the rectosigmoid colon performed above the pelvic peritoneum is called high anterior resection, whereas an operation in which it is necessary to open the pelvic peritoneum to approach the lesion in upper 2/3 of rectum is called as Low anterior resection. | train | med_mcqa | null |
All of the following statements about staphylococcus aureus are true, Except - | [
"Most common source of infection is cross infection from infected people",
"About 30% of general population is healthy nasal carriers",
"Epidermolysis and TSS toxin are superantigens",
"Methicillin resistance is chromosomally mediated"
] | A | Most common source of infection of staph. aureus is an endogenous infection from individuals own colonizing strains. Most individuals who develop staph. aureus infections do so with their own colonizing strains. Most common route of infection is skin.
In hospital infections (nosocomial infections), transmission of staphylococci results most frequently from transient colonization of hands of hospital personnel, who then transfer strains from one patient to another.
Staphylococci are part of normal human bacterial flora with about 30% of the general population being nasal carriers and another 10% carrying it on the perineal skin.
Option 'c' is partially correct as TSS toxin (TSST) is a superantigen, but Epidermolysis is not a superatigen.
Methicillin resistance of staphylococcus aureus is chromosomally mediated and is due to the production of PBP2a. | train | med_mcqa | null |
Which of the following amino acid is required for synthesis of hemoglobin? | [
"Alanine",
"Glycine",
"Arginine",
"Histidine"
] | B | Synthesis of Heme The enzyme ALA synthase condenses glycine with succinyl CoA to form delta-aminolevulinic acid (ALA) (Chapter 21). It is the key enzyme of heme synthesis.Ref: DM Vasudevan - Textbook of Biochemistry, 6th edition, page no: 185 | train | med_mcqa | null |
Most abundant type of Crystalline protein in Lens is | [
"α Crystallin",
"β Crystallin",
"γ Crystallin",
"δ Crystallin"
] | B | Among the Crystalline proteins, β Crystallin protein forms 55% of the total proteins. | train | med_mcqa | null |
The Child-Turcotte-Pugh (CTP) score is used for: | [
"Cirrhosis",
"Hepatocellular carcinoma",
"Biliary atresia",
"None of the above"
] | A | The Child-Turcotte-Pugh (CTP) score was originally developed to evaluate the risk of poocaval shunt procedures secondary to poal hypeension and subsequently has been shown to be useful in predicting surgical risks of other intra-abdominal operations performed on cirrhotic patients. Ref: Schwaz's principle of surgery 9th edition, chapter 31. | train | med_mcqa | null |
Bacteria can transfer genetic information through all of the following methods except: | [
"Through conjugation",
"Through bacteriophages",
"Through incorporation of pa of host DNA",
"By taking up soluble DNA fragments across their cell wall from other species"
] | C | Genetic information can be transferred from one bacterium to another through three methods transformation, transduction and conjugation. Methods of transfer Mechanism Nature of DNA transferred Transformation Transfer of DNA from one bacterium to another Any gene Transduction Transfer of DNA from one bacterium to another by bacteriophage Any gene in generalized transduction, only selected genes in specialized transduction Conjugation Transfer of DNA from one bacterium to another through sex pilus Chromosomal or plasmid DNA Ref: Textbook of Microbiology By Ananthanarayan and Panicker, 6th Edition, Page 53 ; Textbook of Microbiology and Immunology By Parija, Pages 54-7 | train | med_mcqa | null |
A young man presents to the emergency depament with a maculopapular rash 2 weeks after healing of a painless genital ulcer. The most likely etiological agent is: | [
"Treponema Pallidum",
"Treponema Peunae",
"Chlamydia Trachomatis",
"Calymmatobacter granulomatis"
] | A | Humans are the only natural reservoir of Treponema pallidum. It readily penetrates abraded skin and mucous membranes to multiply locally and spread through the blood stream or lymphatics. A developing maculopapular rash two weeks after a painless genital ulcer indicates a diagnosis of secondary syphillis. Ref: Primary care medicine: Office evaluation and management of the adult patient, by Allan H.Goroll,Albe G.Mulley, Page 989. | train | med_mcqa | null |
True about narcolepsy: | [
"Sleep sudden",
"Presents in Ilnd decade",
"Cataplexy",
"All"
] | D | A i.e. Sleep sudden; C i.e. Cataplexy; B i.e. Presents in IInd decadeNacrolepsyIt is a disorder most commonly present with uncontrollable sleep attacksQ in which patient abruptly falls asleep in inappropriate (eg while eating), embarrassing (eg during intercourse), and even dangerous (eg while driving) situations.Although sleep attacks have been described as brief (eg. lasting 15-20 minutes) and refreshing, this is not always true.The key features are?CataplexyQ (sudden, brief episodes of paralysis with loss of muscle tone) which occurs in most cases. Sleep paralysisQ (brief paralysis associated with onset of sleep or wakefulness)Hypnagogic hallucinationsQ (dream like experience while falling asleep but not yet asleep).It usually begins in second decade (10-20 years) Q i.e. adolescence & occurs equally in males and females.The strong genetic association with HLA DR2, specifically HLA DQB1 * 602 (>85%) suggests an autoimmune mechanism.In narcolepsy (esp. with cataplexy), Hypocretins (Orexins), the hypothalamic neuropeptide transmitter, regulating sleep-wake cycle, is decreased in brain and CSF along with the decrease in number of hypocretin-positive cells in hypothalamus.It results from defective REM sleep regulationQ. Sleep attacks & hypnagogic hallucinations are d/t REM intrusion, whereas cataplexy and sleep paralysis is atonia without REM.Diagnosis is confirmed by a sleep onset REM period (on all night PSG) or a positive MSLT in the sleep laboratory.Treatment includes:Stimulant drug eg. dexamfetamine to decrease sleepiness & frequency of sleep attacks.- Modafinil, a non amfetamine stimulant to decrease day time sleepiness with less side effects. - Clomipramine & other antidepressants to decrease cataplexy. | train | med_mcqa | null |
All of the following statements about El-Tor vibrios are true, Except - | [
"Humans are the only reservoir",
"Can survive in ice cold water for 2-4 weeks",
"Killed by boiling for 30 seconds",
"Enterotoxin can have direct effects on other tissues besides intestinal epithelial cells"
] | D | Ans. is 'd' i.e., Enterotoxin can have direct effect on other tissues besides intestinal epithelial cells Cholera exotoxin (enterotoxin) affects only intestinal epithelial cells. Cholera exotoxin has no effects on any other tissues except intestinal epithelial cells. There is no evidence the V. cholerae invades any tissue nor the enterotoxin to have any direct effect on any organ other than the small intestine. The human is the only reservoir of cholera infection, which may be a case or carrier. There is no known animal reservoir. V. cholerae are killed within a few seconds by boiling. cholerae can survive in ice cold water for 2 - 4 weeks. They remain in ice for 4 - 6 weeks or longer. | train | med_mcqa | null |
320 IPC is for – | [
"Defines hurt",
"Defines murder",
"Attempt to murder",
"Defines grievous hurt"
] | D | According to sec. 320 IPC any of following injuries are grievous. Emasculation Permanent privation of sight of either eye Permanent privation of hearing of either ear Privation of any member or joint Destruction or permanent impairing of power of any member or joint Permanent disfiguration of head or face Fracture or dislocation of bone or tooth Any hurt which endangers life or which causes the victim to be in severe bodily pain or unable to follow his ordinary pursuits for a period of twenty days. | train | med_mcqa | null |
The following protein acts cGMP | [
"Atrial natriuretic peptide",
"G-protein",
"Glycoprotein",
"Mucoprotein"
] | A | Atrial natriuritic peptide is produced by hea due to increased blood pressure, it acts enzyme guanylyl cyclase and produces cGMP Ref:Guyton and Hall textbook of medical physiology 12th edition,page number: 489,490 | train | med_mcqa | null |
Neutrophilic leucocytosis is seen in all except | [
"Sepsis",
"Myocardial infarction",
"Pyogenic osteomyelitis",
"Hay fever"
] | D | Acute myocardial infarction ST-elevation (STEMI) is frequently associated with leukocytosis and relative increased in neutrophil count. It is believed that the peripheral leukocyte count have impoant prognostic implication in AMI. In patients with leukocytosis, the possibility of infection always exists, especially with neutrophilia and no prior documentation of leukocytosis. However, the risk of aggressive and overwhelming infection and sepsis is increased due to the paucity of neutrophils Background. Spinal infection may be defined as an infectious disease that affects the veebral body, the interveebral disk, or adjacent paraspinal tissue. It accounts for 2-7% of all musculoskeletal infections. Pyogenic veebral osteomyelitis is the most commonly encountered form of veebral infection Ref Davidson 23rd edition pg 225 , harriosns 203 p328 | train | med_mcqa | null |
Retienloeyte level in newborn's ? | [
"0.2–1.5%",
"1–1.6%",
"2.5–6%",
"6–10.2%"
] | C | Reticulocyte count is the percentage of reticulocytes in total red blood cells. | train | med_mcqa | null |
Most common site of intracranial hemorrhage in hepertensive hemorrhage is - | [
"Basal ganglia",
"Brainstem",
"Cerebellum",
"Hippocampus"
] | A | null | train | med_mcqa | null |
Lymphatic filariasis is not caused by- | [
"Brugia malayi",
"Brugia timori",
"Loa loa",
"Wuchereria bancrofti"
] | C | Lymphatic filariasis- infection with the filarial worms Wuchereria bancrofti & Brugia malayi is associated with clinical outcomes ranging from subclinical infection to hydrocele & elephantiasis. Loiasis is caused by Loa loa ,which is characterised by calabar swelling,an intense,tense,localised swelling that may be painful ,especially if it is near a joint. Reference Harrison20th edition pg 1123 | train | med_mcqa | null |
Dryness of eye is caused by injury to the facial nerve at- | [
"Chorda tympani",
"Cerebellopontine angle",
"Tympanic canal",
"Geniculate ganglion"
] | D | Dryness in the eye (loss of lacrimation) occurs if the injury is at or proximal to geniculate ganglion.
First, see the major symptoms of facial nerve palsy : -
Loss of lacrimation: - Due to the involvement of greater superficial petrosal nerve.
Loss of stapedial reflex: - Due to the involvement of nerve to stapedius.
Lack of salivation: - Due to chorda tympani.
Loss of taste sensation from Anterior 2/3 of the tongue: - due to chorda tympani.
Paralysis of the muscle of facial expression: - Due to terminal (peripheral) branches.
Now you can make out the site of injury : -
All the 5 symptoms (i to v) are present → Injury is at or proximal to geniculate ganglion (as all the branches of the facial nerve are involved).
There is no loss of lacrimation (greater superficial petrosal nerve is spared) but symptoms (ii) to (v) occur → Injury is distal to geniculate ganglion but proximal to or at the level of the second genu from where the nerve to stapedius arises.
Only symptoms (iii) to (v) are present (greater petrosal and nerve to stapedius are spared) → Injury is distal to the second genu but proximal to the origin of chorda tympani, i.e., Injury is between Second genu and mid portion of verticle segment.
Only (Vth) symptom is present → Injury is distal to the origin of chorda tympani, which may be at the level of the stylomastoid foramen. | train | med_mcqa | null |
Function of sodium borate in embalming fluid is | [
"Anticoagulant",
"Preservative",
"Buffer",
"Vechile"
] | C | Buffer | train | med_mcqa | null |
A one-and-a-half-year-old child holding her father's hand slipped and fell but did not let go of her father's hand. After that she continued to cry and hold the forearm in pronated position and refused to move the affected extremity. Which of the following management at this stage is most appropriate? | [
"Supinate the forearm",
"Examine the child under GA",
"Elevate the limb and observe",
"Investigate for osteomyelitis"
] | A | (a) Supinate the forearm- This is a case of pulled elbow.- Treatment is simple. The child's attention is diverted, the elbow is quickly supinated and then slightly flexed. | train | med_mcqa | null |
A child with acute respiratory distress showing hyperinflation of unilateral lung in X-ray is due to- | [
"Staphylococcal bronchopneumonia",
"Aspiration pneumonia",
"Congenital lobar emphysema",
"Foreign body aspiration"
] | D | D i.e. Foreign body aspiration Guys if you go through this cha you can easily rule out first two options of pneumonia & now you are left with other two; in which you need a little bit of knowledge about congenital lobar emphysema Congenital Lobar Emphysema Due to dysplastic or deficient bronchial cailage or/ & bronchial compression d/ t aberrant pulmonary aery 1/ t distal lobe go into emphysematous condition. Most commonly found in infants and presents with progressive respiratory distress + progressive cynosis within first 6 months of lifeQ. Radiological - Left upper lobe > Right middle lobe involvement Hazy mass like opacity immediately after bih (d/t delayed clearance of lung fluid in affected lobe) Air trapping and hyperlucent expanded lobeQ (after clearing of fluid) which will later on cause compression collapse of adjacent lobe & opposite mediastinal shift. | train | med_mcqa | null |
Penetrating injury to NECK is defined as - | [
"More than 2 cm deep injury",
"Injury to any internal neck organ",
"Violation of platysma",
"Sharp Instrument"
] | C | The synopsis of forensic medicine & toxicology;Dr k.s narayan reddy; 28th edition ; pg.no. 114; A penetration wound is produced when the weapon enters a cavity of body . In penetrating injury to neck there is violation of platysma . | train | med_mcqa | null |
The Anaesthesia technique of choice in severely preeclamptic women for cesarean delivery - | [
"Spinal Anaesthesia",
"Epidural Anaesthesia",
"General Anaesthesia",
"Pudendal shock"
] | B | The use of spinal anesthesia is discouraged in severe preeclampsia. Epidural anaesthesia is preferred since it has more hemodynamic stability. Regional anaesthesia spinal /epidural preferred over general anaesthesia for cesarean delivery since in pregnant female there are many risk associated with general anaesthesia. | train | med_mcqa | null |
Acute angle closure glaucoma | [
"Colored haloes present",
"Flashes of light seen",
"Deep anterior chamber",
"All"
] | A | A i.e. Colored haloes present | train | med_mcqa | null |
Synol sarcoma cellular markers are | [
"Cytokeratin",
"S-100",
"Vimenitin",
"All"
] | D | Cytoplasmic structural proteins termed cytokeratins (CKs) have been described in normal human epithelium and a wide array of epithelial neoplasms.14 To date, 20 different CK subsets have been identified, and most recent studies have evaluated the usefulness of antibodies to specific CK subsets for determining the origin of a metastatic carcinoma. Antibodies to cytokeratins 7 and 19 are useful adjuncts for the separation of Monophasic synol sarcoma from malignant peripheral nerve sheath tumor (MPNST). The majority of MSSs stain for one or both of these antigens, whereas most MPNSTs, including those that are EMA- or AEl/AE3-positive, do not express these cytokeratin subsets. S-100 protein in a spindle cell sarcoma is often considered evidence of a neurogenic tumor, it has become increasingly recognized that MSSs stain for this antigen in up to 40% of cases.1 In addition, only 50% to 60% of MPNSTs stain for S-100 protein,2 - 3 and usually only in a focal pattern. | train | med_mcqa | null |
Which one of the following is NOT true about chemical mediators: | [
"Leukotrienes are formed by lipo-oxygenase pathway",
"Histamine is a preformed chemical mediator",
"Prostaglandin causes vasoconstriction at the site of inflammation",
"Thromboxane A2 is associated with platelet aggregation"
] | C | Leukotrienes are formed by Lipo-oxygenase , Whereas, prostaglandins are formed by cyclo-oxygenase. PGs causes vasodilation. | train | med_mcqa | null |
Interferon gamma release assay measures IFN release against which M. TB antigen | [
"ESAT-6",
"E SAT-7",
"CF-11",
"CF-12"
] | A | Ans. is 'a' i.e., ESAT-6 3 Interferon-gamma release assays (IGRAs) are diagnostic tools for latent tuberculosis infection (LTBI). They are surrogate markers of Mycobacterium tuberculosis infection and indicate a cellular immune response to M. tuberculosis. a IGRAs cannot distinguish between latent infection and active tuberculosis (TB) disease and should not be used for diagnosis of active TB, which is a microbiological diagnosis. A positive IGRA result may not necessarily indicate active TB, and a negative IGRA result may not rule out active TB . 3 Because IGRAs are not affected by Bacille Calmette-Guerin (BCG) vaccination status, IGRAs are useful for evaluation of LTBI in BCG-vaccinated individuals, paicularly in settings where BCG vaccination is administered after infancy or multiple (booster) BCG vaccinations are given. Assay antigens M. tuberculosis-specific antigens include :- Early secreted antigenic target 6 (ESAT-6) and Culture filtrate protein 10 (CFP-10). These are encoded by genes located within the region of difference 1 (RD1) segment of the M. tuberculosis genome. They are more specific for M. tuberculosis than purified protein derivative (PPD) because they are not shared with any BCG vaccine strains or most species of NTM other than M marinum, M. kansasii, M szulgai, and M. flavescens. Types of assays Two IGRAs are available in many countries :- The QuantiFERON-TB Gold In-Tube (QFT-GIT) assay, which has replaced the second-generation QuantiferonTB Gold (QFT-G) assay, and the T-SPOTTB assay. The QFT-GIT assay is an enzyme-linked immunosorbent assay (ELISA)-based, whole-blood test that uses peptides from three TB antigens i.e., CFP-10, and TB7.7) in an in-tube format The result is repoed as quantification of interferon (IFN)-gamma in international units (IU) per mL. A newer assay, the QuantiFERON-TB Gold Plus (QFT-Plus), became available in 2015. This test is available in Europe but not in Noh America. The QFT-Plus assay has two TB antigen tubes, unlike the QFT assay (which has a single TB antigen tube). Sensitivity and specificity IGRAs have specificity >95 percent for diagnosis of latent TB infection. The sensitivity for T-SPOTTB appears to be higher than for QFT-GIT or TST (approximately 90, 80, and 80 percent, respectively) . The higher sensitivity of T-SPOTTB may be useful for evaluating individuals with immunosuppressive conditions. TST specificity is high in populations not vaccinated with BCG (97 percent). Among populations where BCG is administered, it is much lower although variable (approximately 60 percent). | train | med_mcqa | null |
The most common inherited disorder of cholangiocyte injury is: | [
"Cystic fibrosis",
"Dubin johnson",
"Crigler najjar type II",
"Wilson disease"
] | A | The most common inherited disorder of cholangiocyte injury is cystic fibrosis. It affects secretory epithelia and is linked to mutations in the CFTR gene, which encodes the cystic fibrosis transmembrane conductance regulator ion channel protein. Cholestatic disease occurs in 30% of adults with this disorder. Ref:Sleisenger and Fordtran's,E-9,P-329 | train | med_mcqa | null |
Most common Paraneoplastic syndrome of HCC | [
"Hypoglycemia",
"Hypeension",
"Hypercalcaemia",
"Erythrocytosis"
] | A | Para neoplastic syndromes in HCC Hypocholesterolemia(most common) Hypoglycemia Erythrocytosis Hypercalcemia Ref:Sabiston 20th edition Pgno : 1458-1463 | train | med_mcqa | null |
Type of inheritance in Tuberous sclerosis - | [
"Autosomal dominant",
"Autosomal recessive",
"X-linked dominant",
"X-linked recessive"
] | A | Ans. is 'a' i.e., Autosomal dominant | train | med_mcqa | null |
MELAS inhibit all ETC Complexes EXCEPT: | [
"I",
"II",
"III",
"IV"
] | B | MELAS (mitochondrial encephalopathy, lactic acidosis, and stroke) MELAS inhibits complex I, III & IV of ETC. It is an inherited condition due to NADH-Q oxidoreductase, Caused by a mutation in mitochondrial DNA Involved in Alzheimer disease and diabetes mellitus. ETC is affected, brain is affected and due to anaerobic metabolism, lactic acidosis occurs. | train | med_mcqa | null |
An young boy presents to you with history of breathlessness on exertion .You being an intern proceed with auscultation of the patient's chest. Your findings are ejection systolic murmur in the left 2nd intercostal space , S1 is normal and has wide and fixed split S2. You then send the patient for an ECG , what would be the most likely finding in the ECG report? | [
"Right axis deviation",
"Left axis deviation",
"Large p waves",
"Absent p waves"
] | A | The history given is typical of ASD . It is characterized by right axis deviation and right bundle branch block pattern.
Left axis deviation can happen if it is osmium primum ASD | train | med_mcqa | null |
WHO guidelines for minimal sperm count is:September 2007 | [
"10 million/ ml",
"20 million/ml",
"50 million/ ml",
"60 million/ ml"
] | B | Ans. B: 20 million/mlAccording to WHO guidelines, minimum sperm values of normal sperm areVolume: 2 mlConcentration:20 million/ mlMotility: 50%Normal morphology: 30% | train | med_mcqa | null |
The fastest dental film currently available has the speed
rating of | [
"\"D\" speed",
"\"C\" speed",
"\"F\" speed",
"\"E\" speed"
] | C | null | train | med_mcqa | null |
Coccidioides immitis is identified in tissues on the basis of which of the following- | [
"Budding yeast cells with pseudohyphae",
"Yeaslike forms with very large capsules",
"Ahrospores",
"None"
] | C | Ans. is 'c' i.e., Ahrospores . C. immitis is identified by its appearance (endosporulating spherules) and by the formation of thick walled, barrel-shaped spores, called ahrospores. Remember . Blastomyces dermatitidis --> Yeast phase has spherical or oval double walled cells with single broad based bud. Paracoccidioides brasiliensis --> Yeast phase has spherical thick walled cells with multiple buds. Coccidioides immitis --> Tissue phase has spherule with numerous endospores. | train | med_mcqa | null |
Which of the following is the principal function of the bones (ossicles) of the middle ear? | [
"They provide mechanical support for the flexible membranes to which they are attached (i.e., the eardrum and the oval window)",
"They reduce the amplitude of the vibrations reaching the oval window, protecting it from mechanical damage",
"They increase the efficiency of vibration transfer through the middle ea... | C | Ans. C. They increase the efficiency of vibration transfer through the middle earThe transfer of energy through the middle ear from the relatively large eardrum to the smaller oval window by the ossicular chain increases the efficiency of the mechanical transduction process. The bones do not support the membrane structures but allow them to move relatively freely. Interference with the ossicular transmission process by external influences (as by the stapedius and tensor tympani muscles) or by disease processes, acts to reduce the vibration transfer efficiency, a change that can be either protective or harmful. The function of the eustachian tube is independent of the ossicles. While the bones themselves are passive, they are essential to the process of sound conduction. | train | med_mcqa | null |
Thrombocytopenia is not seen in: | [
"H.S. purpura",
"DIC",
"Leukemia",
"Metastasis"
] | A | Answer is A (H. S. Purpura) | train | med_mcqa | null |
Parasympathetic system originates from all of the following cranial nerves except | [
"Oculomotor (III)",
"Facial (VII)",
"Trigeminal (V)",
"Vagus (X)"
] | C | Trigeminal nerve does not give rise to any parasympathetic system Ref: guyton and hall textbook of medical physiology 12 edition page number:673,674,675 | train | med_mcqa | null |
Counter-transference is - | [
"Patient's feeling towards therapist",
"Doctor's feeling towards the patient",
"Psychic connection between patient and disease",
"Type of defence mechanism"
] | B | Transference → Patient's feeling for a therapist.
Counter-transference → Therapist's feeling for the patient. | train | med_mcqa | null |
The commonest nerve injury associated with the shown fracture is | [
"Median nerve",
"Ulnar nerve",
"Radial nerve",
"Musculocutaneous nerve"
] | B | will perform a physical assessment. They will move each joint in the upper arm and ask the person to repo any sensation of stretching, tingling, or pain Ref ganong's review of medical physiology 25e p783 | train | med_mcqa | null |
BMI is measured in children by: | [
"Wt.kg/Ht.m2",
"Wt.kg/Ht.cm2",
"Wt.gm/Ht.cm2",
"Wt.gm/Ht.m2"
] | A | Ans. (a) Wt.kg/Ht.m2Ref.-.Nelson 18th ed., chapter 44Also note that the way we diagnose obesity in children is different from adultsBMI PERCENTILE FOR AGEWEIGHT STATUS<5th percentileUnderweight5th-84th percentileNormal weight85th-94th percentileAt risk for overweight>95th percentileOverweightThe obesity guidelines for adults areBMI (kg/m2)WEIGHT STATUS<18.5Underweight18.5-24.9Normal weight25-29.9Overweight30-34.9Obese35-39.9Moderately obese40-49.9Morbid obesity>50Super morbid obesity | train | med_mcqa | null |
Cyclosporine acts by decreasing the production of: | [
"IL-1",
"IL-2",
"IL-6",
"IL-8"
] | B | Cyclosporine -It profoundly and selectively inhibits T lymphocyte proliferation, IL-2 and other cytokine production and response of inducer T cells to IL-l, without any effect on suppressor T-cells. Stimulation of T cell receptor produces a cascade of Ca2+ dependent events and protein kinase C (PKC) activation. The Ca2+ ions after binding to calmodulin activate a membrane-associated serine/ threonine phosphatase called calcineurin which dephosphorylates regulatory protein 'nuclear factor of activated T-cell' (NFAT), permitting its intranuclear migration and transcription of cytokine genes leading to the production of IL-2 along with other interleukins, GM-CSF, TNFa, interferon, etc. Cyclosporine enters target cells and binds to cyclophilin, an immunophilin class of protein. The complex then binds to and inactivates calcineurin response of the helper T cell to antigenic stimulation fails. Cyclosporine also enhances expression of an inhibitor of IL-2 which attenuates IL-2 stimulated T -cell proliferation and production of killer lymphocytes. ESSENTIALS of MEDICAL PHARMACOLOGY SIXTH EDITION -KD TRIPATHI Page:851 | train | med_mcqa | null |
In a family, the father has fidely spaced eyes, increased facial hair and deafness. One of the three children has deafness with similar facial features. The mother is normal. Which one of the following is least likely pattern of inheritance in this case | [
"Autosomal dominant",
"Autosomal recessive",
"X-linked dominant",
"X-linked recessive"
] | A | Autosomal dominance is a pattern of inheritance characteristic of some genetic diseases. "Autosomal" means that the gene in question is located on one of the numbered, or non-sex, chromosomes. "Dominant" means that a single copy of the disease-associated mutation is enough to cause the disease. This is in contrast to a recessive disorder, where two copies of the mutation are needed to cause the disease. Huntington&;s disease is a common example of an autosomal dominant genetic disorder. Reference: GHAI Essential pediatrics, 8th edition | train | med_mcqa | null |
Most common gene associated with renal cell carcinoma | [
"WT1",
"BRCA 1",
"VHL",
"PATCH"
] | C | Both sporadic and familial RCC is associated with: Loss of sequence on chromosome 3 either by translocation (3:6, 3:8, 3:11) or deletion. This region harbours the VHL gene. Familial RCC is associated with:- Von Hippel-Lindau syndrome Ref: RAM DAS NAYAK EXAM PREPARATORY MANUAL FOR UNDERGRADUATES 2nd ed. pg no: 633 | train | med_mcqa | null |
In lateral medullary syndrome (Wallenberg) the lesion is in | [
"Trigeminal motor nucleus",
"Spinal tract of trigeminal",
"Medial lemniscus",
"Pyramidal tract"
] | B | (B) Spinal tract of trigeminal # LATERAL MEDULLARY SYNDROME (also called Wallenberg's syndrome and posterior inferior cerebellar artery syndrome) is a disease in which the patient has difficulty with swallowing or speaking or both owing to one or more patches of dead tissue (known as an infarct) caused by interrupted blood supply to parts of the brain.> Cause: It is the clinical manifestation resulting from occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches or of the vertebral artery, in which the lateral part of the medulla oblongata infarcts, resulting in a typical pattern. PATIENT'S SIGNS & SYMPTOMS COMPARING WITH KNOWN NEUROVASCULAR SYNDROMES Patient's signs/symptomsAffected structureMedial medullary syndromeHemiplegia sparing the facePyramidal tractLoss of tactile and proprioceptive sensitivityMedial lemniscusAtaxia with a tendency to fall towards the lesion (ipsilateral)Uncertain: can involve restiform body, cerebellar hemispheres, olivocerebellar fibers & spinocerebellar tractsLateral medullary syndromeVertigo, nausea and vomitingVestibular nucleus and its connectionsDysphagia, hoarseness, loss of vomiting reflex, bradycardiaCranial nerves IX and XIpsilateral loss of pain and temperature sensitivity, sometimes involving the faceSpinothalamic tractBasilar artery syndromeA combination of various brainstem syndromes combined with those related to occlusion of posterior cerebral artery branches. Intact sensitivity in the presence of near-complete paralysis (as in the TIA) presented by the patient.Same as above + thalamic nuclei. | train | med_mcqa | null |
Which of the following carcinomas commonly presents with neck nodes - | [
"Cricoid",
"Glottic",
"Epiglottis",
"Anterior commissure"
] | C | null | train | med_mcqa | null |
A patient meets with an accident with resultant transection of the pituitary stalk; what will NOT Occur - | [
"Diabetes mellitus",
"Diabetes insipidus",
"Hyperprolactinemia",
"Hypothyroidism"
] | A | null | train | med_mcqa | null |
Umbrella configration on fluorescein angiogrphyis seen in ? | [
"Retinitis pigmentosa",
"Rheugmatous retinal detachment",
"Central serous retinopathy",
"Eale's disease"
] | C | Ans. is 'c' i.e., Central serous retinopathy Central serous retinopathy Central serous retinopathy is caused by an accumulation of transparent fluid at the posterior pole especially at macula causing a circumscribed area retinal detachment in the macular region. There is detachment of neurosensory retina (layers of rods and cones) with or without retinal pigment epithelium detachment. The condition affects males between 20-40 years of age. Patient presents with a sudden onset of painless loss of vision associated with relative positive scotoma, micropsia and metamorphosia. Ophthalmoscopic findings include mild elevation of macular area demarcated by a circular ring reflex and foveal reflex is distoed or absent. The diagnosis is confirmed by fluorescein angiography. It shows focal leakage of fluorescein in following two patterns : ? Ink-blot pattern or enlarging dot sign :- A small hyperfluorescent spot which gradually increases in size. Smoke-stack pattern :- Small hyperfluorescent spot which ascends veically like a smoke stack and gradually spreads laterally to take a mushroom or umbrella configration | train | med_mcqa | null |
One bacterium receives a gene for restriction endonuclease from another by horizontal transduction. What is the likely outcome? | [
"The proof-reading activity of the bacteria is increased",
"The bacterium will die as it does not have the protective methylase enzyme",
"The bacterium will cause digestion of host DNA on infection",
"The mechanism of repair is excellent"
] | B | The DNA methylase offers protection from endonucleolytic attack by the separate restriction enzyme. The descendants of cells that had lost the genes encoding DNA restriction endonucleases appeared unable to modify a sufficient number of recognition sites in their chromosomes to protect them from lethal attack by the remaining restriction enzymes, and consequently died. Hence, the fate of this bacterium which received a gene for for restriction endonuclease will be the same as given above. Restriction endonuclease: Restriction endonucleases cut DNA at specific sites when the bases are not protected (modified, usually, methylation). Bacteria synthesize restriction enzymes as a defense against invading foreign DNAs such as phages and foreign plasmids. Three major types have been recognized. Type I enzymes are single multifunctional proteins of three subunits. Type II enzymes are used most widely for genetic engineering. Type II enzymes have separate endonuclease and methylase proteins. Type III enzymes carry out restriction and modification by two proteins with a shared polypeptide. Ref: Advances in Biochemistry and Biotechnology By Chiranjin Chakraboy, Volume 1, 2005, Page 128; Genetics Manual : Current Theory, Concepts, Terms By G. P. Redei, 1998, Page 885; Biochemistry By Pankaja Naik, 3rd Edition, Page 535 | train | med_mcqa | null |
Unilateral proptosis and bilateral 6th nerve palsy are seen in? | [
"Cavernous sinus thrombosis",
"Meningitis",
"Hydrocephalus",
"None"
] | A | Cavernous sinus thrombosis is usually a unilateral condition which caused rapid unilateral proptosis. The 6th nerve passes through the cavernous sinus, So bilateral 6th nerve palsy is seen. Later 3rd and 4th nerves are also involved. Clinical features of cavernous sinus thrombosis: Onset of cavernous sinus thrombosis is abrupt with chills and rigors. The patient is acutely ill. Eyelids get swollen with chemosis and proptosis of the eyeball. Cranial nerves 3,4 and 6 which are related to the sinus get involved individually and sequentially causing total ophthalmoplegia. The pupil becomes dilated and fixed, optic disc shows congestion and oedema with diminution of vision. Sensation in the distribution of ophthalmic division of trigeminal nerve is diminished. (Ref: Textbook of diseases of ENT, PL Dhingra, 7th edition, pg no. 226) | train | med_mcqa | null |
Maxillary posteriors Buccolingually are | [
"Trapezoid",
"Rhomboid",
"Pentagonal",
"Triangular"
] | A | null | train | med_mcqa | null |
A 30-year-old man presents with recurrent flushing, diarrhea, and weight loss. His examination is normal. Lab investigations reveal an elevated urinary 5-hydroxyindoleacetic acid. Which of the following is the most likely diagnosis? | [
"phenylketonuria",
"alkaptonuria",
"malignant melanoma",
"carcinoid syndrome"
] | D | Carcinoid syndrome is characterized by increased levels of 5-hydroxyindolacetic acid. The syndrome occurs in relation to malignant tumors that have metastasized, usually with hepatic implants. Gastrointestinal carcinoids are most commonly found in the appendix. These are very slow growing, thus the 5-year survival rate is 99%. Many carcinoids are discovered as incidental findings on autopsy. | train | med_mcqa | null |
Bacteria found in gingivitis are localized in | [
"Connective tissue fibres",
"Gingival sulcus",
"Alveolar bone",
"Periodontal ligament"
] | B | null | train | med_mcqa | null |
Free water clearance is decreased by? | [
"Vincristine",
"Vinblastine",
"Chlorpropamide",
"Furosemide"
] | D | Free water clearance is the volume of blood plasma that is cleared of solute-free water per unit time. Diuretics usually decrease free water clearance by excreting more solutes in the urine free water clearance of zero means the kidney is producing urine isosmotic with respect to the plasma. REF Essentials of Medical Pharmacology, K.D Tripathi,6 th edition, page 564 | train | med_mcqa | null |
All of the following are effective in giardiasis except | [
"Co-trimoxazole",
"Furazolidine",
"Metronidazole",
"Tinidazole"
] | A | null | train | med_mcqa | null |
Mitochondiral DNA is | [
"Closed circular",
"Nicked circular",
"Linear",
"Open circular"
] | A | null | train | med_mcqa | null |
Route of administration of vancomycin in pseudomembranous colitis is: | [
"i.m.",
"oral",
"i.v.",
"s.c"
] | B | null | train | med_mcqa | null |
What is the recommended level of chlorine in Swimming pool? | [
">0.5 mg/L",
">0.8 mg/L",
">1 mg/L",
">5 mg/L"
] | C | Residual chloride levels in: (i.e. after the contact period of one hour) Drinking water- >/= 0.5 mg/L or ppm Swimming pools- >/= 1.0 mg/L To kill Cyclops in Drinking water - >/= 2.0 mg/L Residual chlorine level can be measured using chloroscope/ Ohotoluidine test. | train | med_mcqa | null |
A 6 year old female child presented with a valgus deformity of right elbow since 2 years which is gradually progressive and she is feeling tingling in ulnar one and half fingers as well. She had a history of cast applied for 6 weeks after fall on outstretched hand 2 years back. The probable fracture was: | [
"Supracondylar humerus fracture",
"Posterior dislocation of elbow",
"Lateral condyle humerus fracture",
"Fracture medial condyle humerus"
] | C | Ans. C. Lateral condyle humerus fracturea. Lateral condyle of humerus fracture are fracture of necessity as chances of nonunion are very common. In the above scenario, valgus deformity is progressive, which usually results from non-union of lateral condyle. As the Valgus keeps on increasing, it will stretch the ulnar nerve resulting in tardy ulnar nerve palsy.b. Medial condyle of humerus fracture and supracondylar humerus fractures are known to cause Varus deformity.c. Posterior dislocation of elbow will lead to extension deformity. | train | med_mcqa | null |
Which of the following carries higher risk of DVT and pulmonary thromboembolsim: March 2013 | [
"Hand surgery",
"Breast surgery",
"Hip surgeries",
"Obesity"
] | C | Ans. C i.e. Hip surgeriesAcquired risk factors for DVTIt include the strong risk factor of older age, which alters blood composition to or clotting.Other impoant acquired risk factors include major surgery and trauma, both of which may increase the risk because of tissue factor from outside the vascular system entering the bloodIn ohopedic surgery, venous stasis may be temporarily provoked by a cessation of blood flow as pa of the procedure.Cancer can grow in and around veins, causing venous stasis, and can also stimulate increased levels of tissue factor.Pregnancy causes blood to or clotting, and in the postpaum, placental tearing releases substances that or clotting.Oral contraceptives and hormonal replacement therapy increase the risk through a variety of mechanisms, including altered blood coagulation protein levels and reduced fibrinolysis | train | med_mcqa | null |
The length of junctional epithelium is: | [
"0.25 - 1.35 mm",
"0.5 - .75 mm",
"1.0 - 2.0 mm",
"1.0 - 1.5 mm"
] | A | null | train | med_mcqa | null |
The pa of the male urethra where the urethral crest is situated in is: | [
"Penile urethra",
"Pre-prostatic urethra",
"Prostatic urethra",
"Membranous urethra"
] | C | The Urethral Crest is a midline, longitudinal, ridge like projection of mucosa which lies on the posterior wall of prostatic urethra.Ref: Clinical Anatomy By Richard S. Snell, 6th edition, Pages 327, 370; Clinical Anatomy (A Problem Solving Approach) By Neeta V Kulkarni, 2nd edition, Pages 791, 792. | train | med_mcqa | null |
Which of the following fractures of femoral shaft are most suitable to internal fixation by Kuntscher nail | [
"Transverse fracture of mid shaft",
"Spiral fracture of mid shaft",
"Oblique fracture of distal third of shaft",
"Subtrochanteric fracture"
] | A | Management plan of Fracture shaft of Femur in adultsExternal fixatorPlatingIntramedullary nailingExcessive soft tissue injuries with extensive contamination Medullary contamination Vascular injuryExtremely narrow marrow canal Fractures with previous malunion Fractures extending into perochanteric and metaphyseal region Ipsilateral fracture of neck and shaft of femurKuntscher'snailingInterlocking nailingTransverse fracture at isthmus Segmental transverse fracture of mid third of femurDiaphyseal fractures Severe comminution Oblique fractureSpiral fracture Segmental fracture with obliquity (Refer: Campbell's operative Ohopedics, 10th edition,pg no:2825-2854) | train | med_mcqa | null |
Dextromethorphan is an : | [
"Antihistaminic",
"Antitussive",
"Expectorant",
"Antiallergic"
] | B | null | train | med_mcqa | null |
The most stabilising force for nucleic acids is? | [
"Hydrogen bonds",
"Covalent bond",
"Vanderwaals interaction",
"Conformational entropy"
] | C | A non-covalent interaction differs from a covalent bond in that it does not involve the sharing of electrons, but rather involves more dispersed variations of electromagnetic interactions between molecules Non-covalent interactions can be classified into different categories, such as electrostatic, p-effects, van der Waals forces, and hydrophobic effects. Non-covalent interactions are critical in maintaining the three-dimensional structure of large molecules, such as proteins and nucleic acids Nucleic Acids are also Stabilized by Base Pairing & Stacking. Ref: Biochemistry by U. Satyanarayana 3rd edition Pgno : 69 | train | med_mcqa | null |
Cotton fever is due to the abuse of: | [
"Amphetamine",
"Heroin",
"Phencylidine",
"Cocaine"
] | B | COTTON FEVER : Fever developing due to injection of a water extract of the cotton remaining after the heroin supply is used in a "bag" | train | med_mcqa | null |
The inheritance pattern of dentinogenesis imperfecta is | [
"Homozygous",
"Autosomal dominant",
"Recessive",
"X-linked recessive"
] | B | null | train | med_mcqa | null |
A patient with Hodgkin&;s lymphoma is having a single cervical lymphnode. Biopsy showed lymphocyte: predominant variant Which of the following is the treatment of eboke - | [
"Chemotherapy with Radiotherapy",
"Chemotherapy only",
"Radiotherapy only",
"No treatment needed"
] | C | Historically ,radiotherapy to lymph nodes is used to treat localised stage 1A(involvement of a single lymph node region) or stage 2 A(involvement of two or more lymph node regions) effectively , with no adverse prognostic features . Reference :Davidson &;s principles & practice of medicine 22nd edition pg no1043 | train | med_mcqa | null |
Hallucination is a disorder of | [
"Thought",
"Perception",
"Memory",
"Intelligence"
] | B | Hallucination A hallucination is a perception experienced in the absence of an external stimulus. The hallucinations can be in the auditory, visual, olfactory, gustatory oactile domains. Auditory hallucinations are commonest types of hallucinations in non-organic psychiatric disorders like schizophrenia. visual hallucinations are comonest type of hallucinations in organic brain syndrome like delirium tactile hallucinations are comonest type of hallucinations in substance use like cocaine commonly called as cocaine bugs olfactory and gustatory hallucinations are commonest type of hallucinations in temporal lobe epilepsy Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no. 13 kaplon and sadock synopsis of psychiatry, 11 the edition, pg no.307 | train | med_mcqa | null |
Which one of the following is not a feature of Turner&;s syndrome | [
"Sho stature",
"Mental retardation",
"Coarctation of aoa",
"Lymphedema"
] | B | Key clinical features of Turner syndrome are a lack of breast development or amenorrhea, with elevated follicle-stimulating hormone levels by 14 years of age; and infeility in women. Other characteristics of Turner syndrome include sho stature, a webbed neck, a low posterior hairline, misshapen or rotated ears, a narrow palate with crowded teeth, a broad chest with widely spaced nipples, cubitus valgus, hyperconvex nails, multipigmented nevi, pubeal delay, and cardiac malformation. <img src=" /> Figure 1. A 12-year-old girl with Turner syndrome. Note the subtle, distinctive facial features including prominent, posteriorly rotated auricles with looped helices and attenuated tragi; infraorbital skin creases; and mildly foreshoened mandible. One third of patients with Turner syndrome have a cardiac malformation; 75 percent of these patients have coarctation of aoa or a bicuspid aoic valve. Progressive aoic root dilatation or dissection can also occur, paicularly in patients with a bicuspid valve, coarctation, or untreated hypeension.Patients with Turner syndrome often have an atherogenic cardiovascular risk factor profile. Other potential complications of Turner syndrome include strabismus, sensorineural hearing loss, recurrent otitis media, ohodontic anomalies, renal malformation (e.g., horseshoe kidney, duplicated or cleft renal pelvis), autoimmune thyroiditis, celiac disease, congenital hip dysplasia, and scoliosis. Girls with Turner syndrome typically have normal intelligence. Reference: GHAI Essential pediatrics, 8th edition | train | med_mcqa | null |
Criminal nerve of Grassi: | [
"Anterior branch of vagus at pylorus",
"Anterior branch of vagus at Cardia",
"Proximal branch of posterior vagus",
"Distal branch of posterior vagus"
] | C | Stomach Innervation The extrinsic innervation of the stomach is both parasympathetic through the vagus and sympathetic through the celiac plexus The vagus nerve originates in the vagal nucleus in the floor of the fouh ventricle and traverses the neck in the carotid sheath to enter the mediastinum, where it divides into several branches around the esophagus. These branches coalesce above the esophageal hiatus to form the left and right vagus nerves. At the GE junction, the left vagus is anterior, and the right vagus is posterior Left Vagus Right vagus At the GE junction, left vagus is anterior Left vagus gives off the hepatic branch to the liver and then continues along the lesser curvature as the anterior nerve of Latarjet At the GE junction, right vagus is posterior Criminal nerve of Grassi is the first branch of the right or posterior vagus nerve and is recognized as a potential as a potential etiology of recurrent ulcers when left undivided Right vagus also gives a branch off to celiac plexus and then continues posteriorly along the lesser curvature Ref: Sabiston 20th edition Pgno: 1188 | train | med_mcqa | null |
Horner's syndrome is characterised by all of the following except: | [
"Contralateral enophthalmos",
"Ipsilateral miosis",
"Ipsilateral ptosis",
"Anhydrosis of the affected side of face"
] | A | Ans. Contralateral enophthalmos | train | med_mcqa | null |
Disecting hematoma is a clinical complication occurring in | [
"Turner's syndrome",
"Klinefelter's syndrome",
"Down syndrome",
"Marfan syndrome"
] | D | Marfan Syndrome Marfan syndrome is a disorder of connective tissues, manifested principally by changes in the skeleton, eyes, and cardiovascular system. Its prevalence is estimated to be 1 in 5000. Approximately 70% to 85% of cases are familial and transmitted by autosomal dominant inheritance. The remainder are sporadic and arise from new mutations. Pathogenesis. Marfan syndrome results from an inherited defect in an extracellular glycoprotein called fibrillin- 1. There are two fundamental mechanisms by which loss of fibrillin leads to the clinical manifestations of Marfan syndrome: loss of structural suppo in microfibril rich connective tissue and excessive activation of TGF-b signaling. Each of these is discussed below. * Fibrillin is the major component of microfibrils found in the extracellular matrix. These fibrils provide a scaffolding on which tropoelastin is deposited to form elastic fibers. Although microfibrils are widely distributed in the body, they are paicularly abundant in the aoa, ligaments, and the ciliary zonules that suppo the lens; these tissues are prominently affected in Marfan syndrome. Fibrillin occurs in two homologous forms, fibrillin-1 and fibrillin-2, encoded by two separate genes, FBN1 and FBN2, mapped on chromosomes 15q21.1 and 5q23.31, respectively. Mutations of FBN1 underlie Marfan syndrome; mutations of the related FBN2 gene are less common, and they give rise to congenital contractural arachnodactyly, an autosomal dominant disorder characterized by skeletal abnormalities. Mutational analysis has revealed more than 600 distinct mutations of the FBN1 gene in individuals with Marfan syndrome. Most of these are missense mutations that give rise to abnormal fibrillin-1. These can inhibit polymerization of fibrillin fibers (dominant negative effect). Alternatively, the reduction of fibrillin content below a ceain threshold weakens the connective tissue (haploinsufficiency). * While many clinical manifestations of Marfan syndrome can be explained by changes in the mechanical propeies of the extracellular matrix resulting from abnormalities of fibrillin, several others such as bone overgrowth and myxoid changes in mitral valves cannot be attributed to changes in tissue elasticity. Recent studies indicate that loss of microfibrils gives rise to abnormal and excessive activation of transforming growth factor-b (TGF-b), since normal microfibrils sequester TGF-b and thus control the bioavailability of this cytokine. Excessive TGF-b signaling has deleterious effects on vascular smooth muscle development and it also increases the activity of metalloproteases, causing loss of extracellular matrix. This schema is suppoed by two sets of observations. First, in a small number of individuals with clinical features of Marfan syndrome (MFS2), there are no mutations in FBN1 but instead gain-of-function mutations in genes that encode TGF-b receptors. Second, in mouse models of Marfan syndrome generated by mutations in Fbn1, administration of antibodies to TGF-b prevents alterations in the aoa and mitral valves. Ref Robbins 9/e pg 144 | train | med_mcqa | null |
Which of the following feature may be used to differentiate hemophilia A from von Willebrand disease | [
"Bleeding time",
"Prothrombin time",
"Paial thromboplastin time",
"Factor VIII levels"
] | A | Answer is A (Bleeding time) : Bleeding time is prolonged in von Willebrand disease, but normal in Hemophilia A Both conditions present with decreased levels of factor VIII normal PT and elevated PTT and hence these features cannot be used to differentiate between hemophilia A and von Willebrand disease. Features of VWF and differences with Haemophilia A Feature Hemophilia A Von Willebrand Disease Inheritance Sex linked Autosomal (Most common is A.dominant) Factor VIIIc Decreased Decreased VWF Normal Decreased Ristocetin cofactor Normal Decreased Common Presentation Features of clotting disorder Skin/Mucosal bleeding -- Hemahrosis ++ Features of bleeding disorder +- clotting disorder Skin/Mucosal bleeding + Hemohrosis+ Bleeding Time Normal Prolonged APTT Prolonged Prolonged (may be normal) PT Normal Normal Thrombin Time Normal Normal Fibrinogen Normal Normal Platelet aggregation in Response to Ristocetin Normal Decreased | train | med_mcqa | null |
The indications of cast metal inlay are all except | [
"The cavity’s width exceeds ⅓ the intercuspal distance",
"Strong, self-resistant cusps present",
"Occlusal surfaces are not to be changed",
"The tooth is not to be used as an abutment"
] | A | Inlays
An inlay can be defined as a restoration which has been constructed out of mouth from gold, porcelain or other materials and then cemented into the prepared cavity of a tooth.
Indications
The cavity's width does not exceed one-third the intercuspal distance.
Strong, self-resistant cusps are there.
Minimum or no occlusal facets present and if present, are confined to the occlusal surfaces only.
The tooth is not to be used as an abutment for a fixed or removable prosthesis.
Occlusal or occluding surfaces are not to be changed by the restorative procedure.
MDS Prep Bytes (Cast Restoration – Inlay) | train | med_mcqa | null |
Which of the following is done for the quick diagnosis of Erythrasma- | [
"Biopsy",
"KOH examination",
"Culture and sensitivity",
"Wood's lamp examination"
] | D | Ans is 'd' i.e. Wood's lamp examination o Erythrasma is caused by infection by Coryneform bacteria. Wood's lamp examination is a commonly used test to diagnose Erythrasma. Lesion shows coral red fluorescence due to coproporphyrin III production by the bacteria.ConditionFluorescent coloursTinea capitisBright yellow greenErythrasmaCoral red or pinkVitiligoMilky whiteAlbinismBlue whiteLeprosyBlue whiteTuberous sclerosisBlue whitePseudomonas infectionGreenish whitePorphyriaPink/orangeTinea versicolorGolden yellow | train | med_mcqa | null |
Inferior scapular angle is at which level? | [
"T4",
"T6",
"T8",
"T2"
] | C | Ans, C T8* Inferior scapular angle lies at the anatomical level of T8SP: Spinous process, TP: Thoracic process | train | med_mcqa | null |
In maturity onset diabetes mellitus, ophthalmoscopy should be done at | [
"Immediately",
"After 5 years",
"After 10 years",
"After 15 years"
] | A | Ans. is 'a' i.e immediately Ophthalmological examination is done inType II diabetese mellitus - at the time of diagnosis and reexamined at least annually*Type I DM - Within 3 yrs after diagnosis and reexamined on at least on annual basis*Diabetic women who becomes pregnant - should be examined in the 1st trimester and at least every 3 months thereafter until parturition. *Explanation :Diabetic retinopathy depends on the length of time the patient has had diabetes, even though his sugar level may be well controlled.Both in Type I and Type II DM, retinopathy occurs at least 3 to 5 years after the onset of diseaseBut type I DM can be diagnosed at the time of onset because of specific symptoms, such as polyuria, nocturnal enuresis, polydipsia, polyphagia.Type II DM is usually diagnosed many years after the onset of disease. Type II remains occult for many yrs and usually presents as a neurological or cardiological complication or may be diagnosed accidently during routine laboratory studies. | train | med_mcqa | null |
This defect most commonly involves which region of the spine? | [
"Cervico-dorsal",
"Dorso-lumbar",
"Lumbo-sacral",
"Atlanto-occipital"
] | C | - The given image is showing a sac of meninges with some neural component inside it. So it is a meningomyelocele. - Most common location of a meningomyelocele is lumbo-sacral region. | train | med_mcqa | null |
A chest physician performs bronchoscopy in the procedure room of the out patient depament. To make the instrument safe for use in the next patient waiting outside, the most appropriate method to disinfect the endoscope is by - | [
"70 % alcohol for 5 min",
"2% glutaraldehyde for 20 min",
"2% formaldehyde for 10 min",
"1% sodium hypochlorite for 15 min"
] | B | Glutaraldehyde is especially effective against the tubercle bacilli, fungi, and viruses. It is less toxic and irritant to eyes and skin than formaldehyde. It has no deleterious effects on the cement or lenses of instruments such as cystoscope and bronchoscopy It can be safely used to treat corrugated rubber,nanestheticubes, face masks, plastic endotracheal tubes, metal instruments a, d polythene tubings REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8th Edition pg no:36 | train | med_mcqa | null |
Which IV fluid should not be used in a patient with head injury - | [
"5% Dextrose",
"Normal saline",
"Dextrose normal saline",
"All of the above"
] | A | null | train | med_mcqa | null |
Angiotensin II causes A/E: | [
"Stimulates release of ADH",
"Increases thirst",
"Vasodilation",
"Stimulates aldosterone release"
] | C | Ans. C. VasodilationActions of Angiotensin IIa. Angiotensin II binds to AT1 receptors in the zona glomerulosa which act via a G protein to activate phospholipase C. The resulting increase in protein kinase C fosters the conversion of cholesterol to pregnenolone and facilitates the action of aldosterone synthase, resulting in increased secretion of aldosterone. Angiotensin II is one of the most potent vasoconstrictors in body.b. Angiotensin II increases thirst sensation through the subfornical organ (SFO) of the brain, decreases the response of the baroreceptor reflex, and increases the desire for salt.c. It increases secretion of ADH in the posterior pituitary and secretion of ACTH in the anterior pituitary.d. It also potentiates the release of norepinephrine by direct action on postganglionic sympathetic fibers. | train | med_mcqa | null |
Whenever the caries cone in enamel is larger or at least the same size as that in dentin, it is called as | [
"Residual caries",
"Recurrent caries",
"Forward caries",
"Backward caries"
] | C | null | train | med_mcqa | null |
HIV targeted intervention not done in | [
"Migrant labourers",
"Street children",
"Long distance truckers",
"Doctors and nursing professionals"
] | D | Targeted intervention - It is a specific package of intervention & services which are given to population those who have either high risk of HIV or those who have repoed high risk of HIV. Groups with high risk of HIV are: Commercial sex workers Injecting Drug Users Truck Drivers Migrant Labour Street children Transgender Adolescents - Hence, option-4 is the answer. | train | med_mcqa | null |
In haemolytic glaucoma the mechanisms are all except – | [
"Siderosis of trabeculae",
"Deposition of haemosiderin",
"RBC clogging the trabeculae",
"Inflammation"
] | D | There is no inflammation. The mechanism of IOP elevation is an obstruction of the trabecular meshwork by macrophages laden with pigment, erythrocytes and debris. | train | med_mcqa | null |
A patient presents in emergency in shock, with a history off fleshy mass protruding from vagina with heavy bleeding PV. She had history of delivery at home 1 hour back by a health worker with a history of difficulty in placental removal and 'Uterine handling'. Most probable diagnosis is? | [
"Atonic PPH",
"Uterine inversion",
"Fibroid polyp",
"Cervical tear"
] | B | Uterine inversion presents after excessive traction on cord for pulling out the placenta, which leads to paial or complete inversion of uterus. It is usually associated with PPH and may result in shock (hemorrhagic and neurogenic. However more common cause of moality is hemorrhagic) if treatment is delayed. | train | med_mcqa | null |
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