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Not a radiological finding of papillary necrosis on excretory urogram is | [
"Tracks and horns from calyces",
"Ring shadow",
"Increased dense nephrogram",
"Egg in cup appearance"
] | C | Ans is 'c'. i.e. Increased dense nephrogramThe diagnosis of papillary necrosis depends on the demonstration of calyceal and papillary abnormalities without associated parenchymal loss. The calyceal and papillary abnormalities fall into two groups:Those that are characteristic of papillary necrosisTracks and horns of contrast medium arising from the calyceal Fornices (representing necrosis around the papillary margin.)Egg in a cup appearance (due to central necrosis producing central pool of contrast within the papillae)Ring shadow (Papillary sloughing produces a central lucent filling defect with a surrounding ring of contrast medium)Those that are non-specificThe end result of papillary sloughing is clubbed, blunt or truncated calyces.Renal papillary necrosis refers to coagulative necrosis of the renal medullary pyramids and papillae brought on by several associated conditions and toxins that exhibit synergism toward the development of ischemia. Renal papillary necrosis may be localized or diffuse and unilateral or bilateral.Renal papillary necrosis can lead to secondary infection of desquamated necrotic foci, deposition of calculi, and/or separation and eventual sloughing of papillae, with impending acute urinary tract obstruction. Sinus like tracts and cavitation's may be seen surrounding the sloughed papilla. Multiple sloughed papillae can obstruct their respective calyces or can congregate and embolize to more distal sites (eg, ureteropelvic junction, ureter, ureterovesical junction)Renal papillary necrosis is potentially disastrous and, in the presence of bilateral involvement or an obstructed solitary kidney, may lead to renal failure.Certain conditions have a known association with renal papillary necrosis, and the underlying mechanism of these conditions is ischemia, which ultimately leads to renal papillary necrosis.Analgesic abuseObstruction of the urinary tract with infectionSickle cell diseaseDiabetes mellitus | train | med_mcqa | null |
Structures lying within the spermatic cord include all except: | [
"Direct hernia sac",
"Indirect hernia sac",
"Properitoneal fat",
"Vas deferens"
] | A | A direct hernia protrudes through the medial inguinal canal floor behind the spermatic cord. A femoral hernia also protrudes through a medial inguinal canal floor defect and passes beneath the inguinal ligament into the thigh. An indirect hernia sac passes through the internal inguinal ring within the structures of the cord and ,in male patients , may extend all the way into the scrotum. A mass of properitoneal fat frequently extends through the internal ring aloll;g with the indirect sac. This mass is frequently referred to as a lipoma of the cord, but the term is incorrect since it is not a tumor. The vas deferens carries sperm from the testicle to join the urethra. | train | med_mcqa | null |
Priscilla White classification is used in :-- | [
"Gestational hypertension",
"Cardiac disorders in pregnancy",
"Gestational diabetes mellitus",
"Thyroid disorders of pregnancy"
] | C | Lady Priscilla White pioneered research into diabetic woman during pregnancy.The classification is based on age at onset of diabetes, duration of disease and the presence of atherosclerotic vascular disease and renal complications. | train | med_mcqa | null |
Inlay is | [
"Cast gold",
"Direct gold",
"Both",
"None of the above"
] | A | null | train | med_mcqa | null |
A 26-year-old male presented with 4 day history of pain in the right sided lower abdomen with frequent vomiting. Patient's general condition is fair and clinically a tender lump was felt in the right iliac fossa. Most appropriate management for this case would be: | [
"Exploratory laparotomy",
"Immediate appendectomy",
"Ochsner-Sherren regimen",
"External drainage"
] | C | Ans. (c) Ochsner-Sherren regimenOchsner-Sherren regimen:* Advised in appendicular mass -- as the inflammatory process is localized with full of adhesions and if we try to remove appendix, we will cause bowel injury and result in enterocutaneous fistula.* This management includes -- nil oral, IV fluids, antibiotics and observation of input, output and abdominal girth chart.* Clinical improvement seen in 24-48 hours.* If there is no improvement take CECT abdomen and if there is abscess drain it radiologically.* Interval appendectomy done after 6 weeks* Criteria to stop Ochsner regimen:* Increasing pulse rate* Increasing abdominal girth chart* Increasing mass size | train | med_mcqa | null |
Which of the following is false about disadvantage of Sod hypochlorite | [
"Cannot remove smear layer alone",
"Precipitates on combination with chlorhexidine",
"Should not be used in acute pulpal abscess",
"None of the above"
] | D | null | train | med_mcqa | null |
Noma is | [
"pyogenic granuloma",
"fibrous dysplasia",
"Vincent's disease",
"cancrum oris"
] | D | null | train | med_mcqa | null |
Nerve to pterygoid canal is formed from - | [
"Deep petrosal nerve + greater petrosal nerve",
"Facial nerve",
"Lesser superficial petrosal nerve",
"Lesser petrosal nerve"
] | A | Ans. is 'a' i.e., Deep petrosal nerve + greater petrosal nerve o The deep petrosal nerve joins the greater petrosal nerve to form the nerve of the pterygoid canalo Greater petrosal nerve proceeds towards the foramen lacerum, where it joins the deep petrosal nerve which carries sympathetic fibres to form the nerve of pterygoid canal. This passes through the pterygoid canal to reach the pterygopalatine ganglion.o Postganglionic parasympathetic fibres arising in the ganglion supply the lacrimal gland and the mucosal glands of the nose, palate and pharynx. The gustatory fibres do not relay in the ganglion and are distributed to the palate.Petrosal nervesGreater petorsai nerveo First branch of facial nerveo Arises from geniculate gangliono In foramen lacerum it joins deep petorsai nerve and forms the nerve to pterygoid canalo Supplies lacrimal glands, nose, mucosal glands of pharynx, palate.Lesser petorsai nerveo Branch of 9th cranial nerve through tympanic plexus (passes via otic ganglion)o It suplies parotid gland.Deep petorsai nerveo it is a branch of sympathetic plexus around internal carotid artery.o It contains cervical sympathetic fibers.External petorsai nerveo It is an inconsistant branch of sympathetic plexus around middle meningeal artery. | train | med_mcqa | null |
The development of the respiratory system begins during the fourth week of development as an evagination of the | [
"First branchial pouch",
"First branchial cleft",
"Vental wall of the foregut",
"Dorsal wall of the midgut"
] | C | The respiratory diverticulum is an evagination of the endodermal floor of the foregut. All of the epithelial surfaces of the respiratory system are derived from this evagination.
The first branchial pouch is the endodermal imagination that forms the eustachian tube and the middle ear linings.
The first branchial cleft is an ectodermal imagination that forms the external ear canal.
The sixth branchial arch contributes to the cartilage of the larynx. | train | med_mcqa | null |
The 7-year-old boy now in your office was last seen 2 weeks ago with a mild viral upper respiratory tract infection. Today, however, he presents with fever, ataxia, weakness, headache, and emesis. In the office, he has a 3-minute left-sided tonic-clonic seizure. You send him to the hospital and order a magnetic resonance imaging (MRI) with contrast of the brain, the results of which are shown. This boy's likely diagnosis is which of the following? | [
"Multiple sclerosis",
"Acute disseminated encephalomyelitis (ADEM)",
"Malignant astrocytoma",
"Bacterial meningitis"
] | B | (b) Source: (Hay et al, p 755. Kliegman et al, pp 2079-2080. McMilla et al, p 2263. Rudolph et al, p 920.) ADEM is an autoimmune demy-elinating disease seen in children less than 10 years of age. It may follow many different types of infections, including upper respiratory tract infections, varicella, mycoplasma, herpes simplex virus, rubella, rubeola, and mumps; it may also follow immunizations. The MRI presented in the question shows multiple "white" plaques scattered across the brain representing areas of demyelination. The history and physical examination findings of ADEM are similar to multiple sclerosis; differences include age of onset (ADEM is usually seen in < 10-year olds), the presence of systemic findings like fever and emesis, and the lack of progression in the lesions once identified. Mortality is high, with 10% to 30% of affected patients dying. Treatment is high-dose corticosteroids. Meningitis is not usually diagnosed with MRI, but rather a lumbar puncture. Malignancies and neurocysticer-cosis (CNS infection by the tapeworm Taenia solium) do not present with the MRI findings described. | train | med_mcqa | null |
All of the following statements about Universal Definition of Myocardial Infarction are true, Except: | [
"Sudden, unexpected Cardiac death with symptoms of Ischemia.",
"Elevation of cardiac biomarkers with new regional wall motion abnormality",
"Three times increase in Troponin levels after Percutaneous Coronary Intervention (PCI)",
"Three times increase in Troponin levels after Coronary Aery Bypass Grafting (CA... | D | Answer is D (Three times increase in Troponin levels after Coronary Aery Bypass Grafting (CABG) Myocardial Infarction associated with CABG is defined by an increase in cardiac biomarkers to more than 5 times normal (> 5 times above the 99th percentile). Universal Defination of Myocardial infarction Myocardial infarction related to ischemia due to primary coronary event (plaque rupture) or imbalace between oxygen demand and supply (coronary spasm, hypotension etc) . Myocardial Infarction related Sudden Cardiac Death (Death occuring before blood samples could be obtained, or at a time before the appearance of cardiac biomarkers in the blood.) Myocardial Infarction associated with PCI (in patients with normal baseline troponin values) Myocardial infarction associated with CABG (in patients with normal baseline troponin values,) Detection of rise and/or fall of cardiac biomarkers (preferably troponin) with at least one value * By convention, increases of biomarkers greater than 5 x 99'h Sudden, unexpected cardiac death, involving cardiac arrest, often with : * By convention, increases of biomarkers greater above the 99th percentile of the * Symptoms suggestive of than 3 x 99th percentile URL plus upper reference limit (URL) myocardial ischaemia, and percentile URL either new pathological together with evidence of myocardial ischaemia with at least accompanied by * New ST elevation, or new have been designated as Q waves or new LBBB, or angiographically one of the following: LBBB, and/or defining PCI- documented new graft * Symptoms of ischaemia * Evidence of fresh thrombus by related myocardial or native aery * ECG changes indicative of new coronary angiography and/or infarction. occlusion, or imaging ischaemia * Development of pathological Q waves in the ECG at autopsy, evidence of new loss of ble myocardium have been designated as defining CABG-related myocardial infarction. * Imaging evidence of new loss of ble myocardium or new regional wall motion abnormality. | train | med_mcqa | null |
Which one of the following is an Aldosterone antagonist? | [
"Spironolactone",
"Amiloride",
"Triameterine",
"Acetazolamide"
] | A | (A) Spironolactone > Spironolactone is a steroid chemically related to the mineralocorticoid aldosterone> Spironolactone is an aldosterone antagonist. | train | med_mcqa | null |
A child with large perimembranous VSD has congestive hea failure. What may be the cause of improvement of failure in this patient | [
"Aoic regurgitation",
"Vascular changes in pulmonary circulation",
"Infective endocarditis",
"Closure of VSD spontaneously"
] | B | Patients born With uncomplicated VSD may develop pulmonary stenosis due to hyperophy of right ventricular infundibulum ,develop pulmonary aerial hypeension or rarely develop aoic regurgitation. Development of pulmonary aerial hypeension is dreaded complication since if it is of obstructive type the patient becomes inoperable. Ref Ghai pediatrics eighth edition pg no 417 | train | med_mcqa | null |
Vitamin E prevents rancidity by virtue of its---------property: | [
"Antioxidant",
"Oxidant",
"Sulfuration",
"Hydrogenation"
] | A | A Harper, 26th ed, p. 486 & 25th ed. p. 647 | train | med_mcqa | null |
At the end of 1 year of age, the number of carpal bones seen in the skiagram of the hand is – | [
"Nil",
"1",
"2",
"3"
] | C | null | train | med_mcqa | null |
Point shource epidemic is - | [
"Short term fluctuation",
"Periodic fluctuation",
"Long term fluctuation",
"Secular trend"
] | A | Ans. is 'a' i.e., Short term fluctuation * Point source (single exposure) epidemic is short term fluctuation.* There are three kinds of time trends or fluctuations in disease occurenceA. Short term fluctuations - epidemics.B. Secular trends or long term fluctuations.C. Periodic fluctuation. | train | med_mcqa | null |
Which of the following is true about diazoxide except | [
"K+ channel opener",
">Can be used as antihypeensive agent",
">Causes severe hypoglycemia",
">Used in insulinoma"
] | C | Causes severe hypoglycemia Diazoxide Diazoxide is a direct acting aeriolar dilator. Diazoxide causes aeriolar dilatation with little effect on veins. Diazoxide prevents smooth muscle contraction and relaxes the aerioles Diazoxide is a potassium channel activator which causes local relaxation in smooth muscle by increasing membrane permeability to potassium ions. This switches off voltage gated calcium ion channel which inhibits the generation of action potential. When used as an intravenous antihypeensive agent diazoxide causes excessive hypotension. Diazoxide was formerlyused as an intravenous bolus dose for the at of hypeensive emergencies. But the dangers of excessive hypotension are now recognized to outweigh the benefit, and its emergency use is obsolete. Hypotension due to diazoxide has resulted in stroke and myocardial infarction. - The reflex sympathetic response due to hypotension can provoke angina, electrocardiographic evidence of ischemia and cardiac failure in patients with ischemic hea disease and diazoxide should be avoided in this situation. Diazoxide produces hyperglycemia by increasing insulin secretion, therefore it is used to treat various forms of hypoglycemia Diazoxide activates the same potassium channel in the pancreatic islet cells that is blocked by sulfonylureas. SullOnylureas close the potassium channels and increase insulin secretion whereas diazoxide opens the potassium channel in pancreatic islet cells and decrease insulin secretion. Due to its hyperglycemic action it is a useful drug for patients with chronic hypoglycemia from excess endogenous insulin secretion, either from an iselt cell tumour (insulinoma) or islet cell hyperplasia. According to Lawerence Diazoxide stimulates the ATP dependent r channel that is blocked by the sulphonylureas. Therefore its chronic use as an antihypeensive agent is precluded by the development of diabetes. Indeed its use in therapeutics should now be confined to rare indication of treating hypoglycemia due to islet cell tumour (insulinoma). Diazoxide is chemically related to thiazide diuretics. But in contrast to the structurally related thiazide diuretics, diazoxide causes renal salt and water retention. | train | med_mcqa | null |
Drug of choice for rapid cyclers is | [
"Lithium",
"Sodium valproate",
"Carbamazepine",
"Amitryptaline"
] | B | Sodium valproate is the drug of choice for rapid cyclers.
Rapid cyclers has 4 or more than 4 episodes of mania, depression or hypomania in 1 year. | train | med_mcqa | null |
A 5-year-old boy told his mother that he had an accident with his bicycle because he was thinking of taking some money from his mother. This type of reasoning is known as | [
"Adaptive reasoning",
"Magical thinking",
"Concrete operation",
"Abstract reasoning"
] | B | The type of reasoning used by this 5-year-old boy, who believed that something bad he was thinking caused a bad event to occur (i.e., the bicycle accident), is called magical thinking. This type of reasoning is typical of children in Piaget's preoperational stage (age 2-7 years). | train | med_mcqa | null |
A patient repoed with a history of fall on an outstretched hand, complains of pain in the anatomical snuffbox and clinically no deformities visible. The diagnosis is: | [
"Colles' fracture",
"Lunate dislocation",
"Baon's fracture",
"Scaphoid fracture"
] | D | D i.e. Scaphoid | train | med_mcqa | null |
In hypoxic injury, cornea becomes edematous because of accumulation of: | [
"Carbon dioxide",
"Lactate",
"Pyruvate",
"Glycogen"
] | B | Ans. b. Lactate (Ref: Yanoff and Duker 4/e p280)In hypoxic injury, cornea becomes edematous because of accumulation of lactate.'Contact lenses are generally very well tolerated, but they induce numerous changes in corneal physiology and the tear film. Decreased oxygen tension occurs with contact lens wear, especially when conventional lenses are worn overnight. Hypoxic stromal edema results from the osmotic changes produced by lactate accumulation. - Yanoff and Duker 4/e p280CorneaCornea (the anterior surface) is the most important refractive surface of the eye, and have power of 45 diopter (3/4th of total power of eye). The refractive index is 1.376Q The critical angle is 46" at cornea tear interfaceThe healthy cornea is avascular and devoid of lymphatic channelsQ.Corneal cell derives nourishment by diffusion from the aqueous, the capillaries at the limbus and oxygen dissolved in the tear himQ.The metabolism of cornea is preferentially aerobicQ and it can function only up to 6-7 hours anaerobically under normal conditions.Hypoxic corneal stromal edema results from the osmotic changes produced by lactate accumulationQ.The metabolic active cells are endothelium, epithelium and stromal keratocytesQOxygen is mostly derived from tear filmQ with a small contribution from timbal capillaries.Glucose supply from cornea metabolism is mainly (90%) derived from aqueousQ and supplemented (10%) by limbal capillaries.Cornea is richly supplied by nervesQ (without myelin sheaths and Schwann cell sheath) which originate from small ophthalmic division of trigeminal nerve, mainly by long ciliary nerveQ Due to its dense nerve supply, the cornea is extremely sensitive structure. | train | med_mcqa | null |
All of the following signs confirm the brain death except | [
"Hypothermia",
"Absent corneal reflex",
"Dilated & fixed pupils",
"No heart movements"
] | A | (A) Hypothermia > Brain death is present when there is irreversible loss of all brain function, both brain-stem function and cortical (hemisphere) function.> Brain death criteria -- Loss of brainstem function & Absent cranial nerve reflexes - Pupillary light reflex; Corneal reflex; Oculo vestibular reflex (cold caloric test; No gag reflex)> Absent respiratory brain stem reflexes is done by Apnea test: Loss of cortical function (No spontaneous movement; no response to external stimuli); Irreversibility> Brain death is present when there is irreversible loss of brain function (criteria ? loss of brainstem function) absent cranial nerve reflexes, pupillary light reflex, corneal reflex, oculo vestibular reflex. | train | med_mcqa | null |
Abnormality seen in ADHD is - | [
"Hyperactivity",
"Hallucinations",
"Delusion",
"All of the above"
] | A | Ans is 'a' i.e. Hyperactivity o Characteristic triad of Attention deficit hyperactivity disorder includei. Hyperactivity,ii. Impulsiveness andiii. Inattention (distractibility or lack of concentration). | train | med_mcqa | null |
Which reaction uses propionic acid? | [
"Glycolysis",
"Glyconeogenesis",
"Glycogenolysis",
"None"
] | B | The major non-carbohydrate precursors of glucose are lactate, glucogenic amino acids (all except leucine), glycerol and propionyl CoARef: DM Vasudevan, 7th edition, page no: 117 | train | med_mcqa | null |
The most common glomerulonephritis is...... | [
"Membranous GN",
"IgA nephropathy",
"PSGN",
"RPGN"
] | B | Ans: b (IgA nephropathy) Ref: Robbins, 7th ed, p. 986* IgA nephropathy is the most common cause of GN worldwide* Also called Bergers disease* IgA deposits in mesangium along with IgQ IgM, C3. properdin* C/F: Hematuria after a respiratory/urinary/GIT infection* Rx: Steroids (high dose).Remember...* Most common glomerulonephritis is IgA nephropathy* Most common nephrotic syndrome is membranous glomerulonephropathy. | train | med_mcqa | null |
A newborn baby is readmitted to the hospital with hypoxia and upon testing is found to have pulmonary stenosis, dextraposition of the aoa, interventricular septal defect, and hyperophy of the right ventricle. Which of the following is best described by these symptoms? | [
"ASD",
"Patent ductus aeriosus",
"Tetralogy of Fallot",
"Aoic stenosis"
] | C | Tetralogy of Fallot is a combination of congenital cardiac defects consisting of- (a) pulmonary stenosis, (b) dextraposition of the aoa (so that it overrides the ventricular septum and receives blood from the right ventricle), (c) ventricular septal defect (VSD), (d) right ventricular hyperophy. | train | med_mcqa | null |
For survey of immunization by WHO age group selected is ? | [
"12 - 23 months",
"0 - 6 months",
"6 - 12 months",
"2 - 5 years"
] | A | Ans. is 'a' i.e., 12 - 23 months In the Expanded programme on Immunization (EPI) cluster technique, a simplified cluster sampling method is used. It is based on ranodm selection of 210 children who are 12-23 months of age. These patients are selected in 30 clusters of 7 children each to estimate immunization coverage levels. | train | med_mcqa | null |
100 Core Health Indicators refers to | [
"Sustainable Developmental Goals",
"Millennium Developmental Goals",
"Global Reference List",
"Health for all"
] | C | Global Reference list is a standard set of 100 core indicators prioritized by global community to provide concise information on the health situation and trends, including responses at National and Global levels. | train | med_mcqa | null |
Time interval between acute and persistent psychotic disease is - | [
"1 week",
"2 week",
"3 week",
"1 months"
] | D | Ans. is 'd' i.e., 1 monthso If symtoms are for less than 1 months, it is transient psychotic disorder and if there are for more than 1 months, it is persistent psychotic disorder (persistent delusional disorder).Note:- Diagnosic criteria for delusional disorder (Persistent delusion disorder) has different durations in DSM IV and ICD-10 :-According to DSM IV, symptoms (Non bizzare delusion) should be for > 1 months.According to ICD-10, Symptoms should be for > 3 months. | train | med_mcqa | null |
Glutathione is a protein which contain how many amino acids | [
"2",
"3",
"4",
"5"
] | B | Glutathione is gamma glutamyl cysteinyl glycine (contain 3 amino acid derivaties) | train | med_mcqa | null |
Which of the following techniques would be the best preventive measure for dental caries? | [
"Elimination of sugars from the diet",
"Reduce frequency of intake of cariogenic food stuffs",
"Rinse and swish with water after each meal and snacks",
"Substitution of alcohol-based sugar for sucrose"
] | D | null | train | med_mcqa | null |
Phossy jaw is seen in which poisoning? | [
"Mercury",
"Yellow phosphorous",
"Red phosphorous",
"Tetanus"
] | B | ANSWER: (B) Yellow phosphorousREF: Textbook of Forensic Medicine and Toxicology by Nagesh Kumar Rao - Page 371Phossy jaw is a type of osteomyelitis of jaws observed in chronic cases of phosphorus poisoning. Incidence is common among the workers of phosphorus industries linked to "yellow phosphorous," the key ingredient in "strike-anywhere" matches, who are exposed to phosphorus fumes. The process starts in a carious tooth and then spreads, causing severe necrosis of the lower jawNote: Yellow phosphorous is also known as white phosphorous | train | med_mcqa | null |
Which of the following increases uric acid excretion | [
"Allopurinol",
"Aspirin",
"Colchicine",
"Probenecid"
] | D | Probenecid is a uricosuric agent used in the treatment of chronic gout / hyperuricaemia . ref - Davidsons 23e pg1015-1016 | train | med_mcqa | null |
Which one of the following is most suggestive of neonatal small bowel obstruction – | [
"Generalized abdominal distension",
"Failure to pass meconeum in the first 24 hours",
"Bilious vomiting",
"Refusal of feeds"
] | C | "Bilious vomiting is the most common symptom". — Internet
Intestinal obstruction in the newborn
Presentation depends on the site of obstruction.
1. Proximal obstruction
A history of polyhydramnios is common.
The higher the obstruction in the intestine the earlier the infant will develop vomiting which may be bile stained.
Abdominal distension will be less prominent.
Obstipation is less common.
2. Distal obstruction
Abdominal distension and obstipation are more common.
Vomiting is less common.
Note -
In neonates proximal intestinal obstruction is much more common than distal. So, bilious vomiting is the most common presentation of neonatal intestinal obstruction. | train | med_mcqa | null |
Oral and topical drug for nasal decongestion is - | [
"Phenylephrine",
"Histamine",
"Methoxamine",
"Dopamine"
] | A | Ans. is 'a' i.e., Phenylephrine Phenytephrineo It is selective alpha 1 agonist.o Topically it is used as nasal decongestant and in eye for producing mydriasis when cycloplegia is not required,o It is also a part of oral nasal decongestant preparations. | train | med_mcqa | null |
A patient presented with a vesicle on shin. Microscopy of Tzanck smear showed giant cells. Causative agent is: | [
"Vaccinia virus",
"Varicella zoster",
"Mycobacterium",
"Molluscum contagiosum"
] | B | Ans. b. Varicella zoster (Ref: Fitzpatrick 7/e p490-493 1873-1898; Rooks 8/e p33 14-33.22; Roxburgh 18/52-54) Vesicles on shin and giant cell on Tzanck smear suggest the diagnosis of Herpes Zoster.Tzanck SmearCytological examination of skin blistersAlter rupturing roof of the blister, the floor is scraped with a surgical blade and material is transferred on to a microscopic slide and fixed.Slides are stained with Giemsa stain. Wright's stain or toluidine blue and examined under the microscope.DisorderFindingPemphigusAcantholytic cellsQBullous pemphigoidPredominantly eosinophilQChronic bullous disease of childhoodPredominantly neutrophilsQVaricella zosterMulti nucleated giant cellsQHerpes simplex infectionMultinucleated giant cellsQToxic epidermal necrolysisNecrotic cellsHerpes ZosterCaused by Varicella Zoster (chicken pox) virusQ, one attack gives life long immunityThoracic nerves (intercostal nerves)Q, ophthalmic division of trigeminal nerve and other spinal nerves are most commonly affectedPathology:Ballooning is characteristicQTzanck smear: Multinucleated giant cellsQClinical Features:Prodrome of segmental pain begins 1-4 days before the eruptionQ, erythema and edema is rapidly followed by appearance of grouped vesicles unilateral and in a segmental distribution (MC thoracic dermatome)Q, mucous membrane within the affected dermatome may be involvedUnilateral vesicular eruption within a dermatome associated with severe painThe dermatome from T3 to L3 are most frequently involveComplications:Post-herpetic neuralgiaQ (persistent neuralgic pain)Corneal ulcer and scarring (zoster of ophthalmic division of trigeminal nerve), eye involvement is indicated when vesicles are present on the side of nose- Hutchinson's signQVariants:Ramsay Hunt Syndrome: H. zoster involving sensory branch of facial nerveQZoster opthalmicus: H. zoster involving ophthalmic division of trigeminal nerve.Q | train | med_mcqa | null |
Anterior ethmoidal aery arises from: | [
"Maxillary aery",
"Mandibular aery",
"Superficial temporal aery",
"Ophthalmic aery"
] | D | Anterior and posterior ethmoidal aeries are branches of ophthalmic aery which is a branch of Internal carotid aery. | train | med_mcqa | null |
Which of the following is NOT a motile organism: September 2004 | [
"Shigella",
"Treponema",
"Listeria",
"Pseudomonas"
] | A | Ans. A i.e. Shigella Shigellae are sho, Gram negative bacilli. They are non-motile, non-capsulated and non-sporing. | train | med_mcqa | null |
Highest biological value of protein is seen in ? | [
"Eggs",
"Fish",
"Soyabean",
"Gram"
] | A | Ans. is 'a' i.e., Egg Egg protein is considered to be the best food protein by nutritionists. Net protein utilization, which combines in a single value, the biological value and digestibility is 100 for egg compared to 80 for meat and 75 for milk. Egg protein therefore is used as a reference protein. It is taken as the standard protein, against which the quality of other proteins is compared. | train | med_mcqa | null |
Which of the following condition is associated with a loss of attenuation reflex? | [
"Stapedial palsy",
"Glomus tumor",
"Internal ear pathology",
"Malingerers"
] | A | In stapedial palsy, damage to the nerve result in a reduction in sound attenuation reflex resulting in sound being heard excessively loud in the affected ear (hyperacusis). Attenuation reflex: When very loud sound is transmitted through the ossicular system to CNS a reflex is initiated with a latent period of 40 to 80ms. This reflex causes contraction of tensor tympani and stapedius muscle. Contraction of these two muscles make the ossicular system rigid and therefore it fails to vibrate with the sound wave. Thus sound is not allowed to enter inner ear or its intensity is reduced by 30 to 40 decibels. | train | med_mcqa | null |
Incubation period of gonorrhoea is - | [
"Less than 24 hrs",
"1 to 2 days",
"2 to 15 days",
"12 to 25 days"
] | C | Ans. is 'c' i.e., 2 to 15 days Incubation period of gonorrhea is 2 - 8 days. | train | med_mcqa | null |
A 42-year-old man presents with central, crushing chest pain that radiates to the jaw. The pain occurred while jogging around the local park. The pain was alleviated with rest. The ECG is normal. Diagnosis is? | [
"Angina pectoris",
"Acute Pericarditis",
"STEMI",
"NSTEMI"
] | A | Ans. A Angina pectorisRef CMDT 2019 pg. 369The patient is having chest pain on jogging which is a presentation of chronic stable Angina. It is aggravated by cold, by anxiety, and by exercise. In the case of a normal resting ECG, an exercise ECG should be obtained. All other choices present with chest pain on rest. | train | med_mcqa | null |
What is the indication for surgery in asymptomatic patients with the abdominal aoic aneurysm? | [
"Transverse diameter > 3 cm",
"Transverse diameter > 5.5 cm",
"Transverse diameter > 7.5 cm",
"No need for surgery unless symptomatic"
] | B | Most precise test for imaging aoic aneurysm: CT scan5-year risk of rupture for an aneurysm : <5cm - 1 to 2% and > 5 cm-20 to 40%For asymptomatic abdominal aoic aneurysms, an operation is indicated if the diameter is > 5.5 cmIn elective surgery of AAA, the operative moality rate is 1 to 2% whereas after acute rupture the moality of emergency operation is >50%MC complications after repair are Cardiac (ischemia and infarction) & Respiratory (atelectasis & lower lobe consolidation)MC non-cardiac complication after repair of AAA is the Renal failure. | train | med_mcqa | null |
The presence of Heinz bodies in erythrocytes indicates: | [
"Malarial infection",
"Hemoglobin abnormalities",
"Oxidative stress",
"Degraded bacterial forms"
] | C | Individuals with inherited deficiency of G6PD, an enzyme required for hexose monophosphate shunt for glucose metabolism, fail to develop adequate levels of reduced glutathione in their red cells.
This results in oxidation and precipitation of hemoglobin within the red cells forming Heinz bodies.
Mohan H. Textbook of pathology. Jaypee Brothers Medical Publishers; 2015. Edition 7. Page 293 | train | med_mcqa | null |
All of the following are topically used sulfonamides EXCEPT: | [
"Sulfacetamide",
"Sulfasalazine",
"Silver sulfadiazine",
"Mafenide"
] | B | SULFONAMIDES: 1 . Sho acting ( 4-8 hr ): Sulfadiazine 2. Intermediate acting (8-12 hr ): Sulfamethm,azole 3. Long acting ( -7 days): Sulfadoxine, Sulfamethopyrazine 4. Special purpose sulfonamides: Sulfacetamide sod, Mafenide, Silver sulfadiazine, Sulfasalazine. Sulfasalazine (Salicylazosulfapyridine) It is a compound of 5-aminosalicylic acid (5-ASA) with sulfapyridine linked through an azo bond that has a specific therapeutic effect in inflammatory bowel diseases (IBDs) like ulcerative colitis and Crohn&;s disease.They are both locally and systemically acting agents. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:661 | train | med_mcqa | null |
Negative intrapleural pressure is due to - | [
"Uniform distribution of surfactant over alveoli",
"Negative intraalveolar pressure",
"Absorption by lymphatics",
"Presence of cartilage in the upper airway"
] | C | The intrapleural pressure becomes more negative at the end of inspiration and less negative at expiration. It ranges between -3 and -6 mmHg.
The elasticity of lung and rib cage causes it to recoil and thus creating the negative pressure.
The lymphatic drainage of the pleural fluid also creates a negative pressure. | train | med_mcqa | null |
Indicator of Remote contamination of water | [
"Fecal Streptococci",
"Clostridium Perfirengens",
"E. Coli",
"Salmonella Typhi"
] | B | Bacteriological Indicators of Water Quality E Coli: Best indicator. Ideally water should be coliform free except large urban water supplies where up to 5% contamination is acceptable if samples are taken up to 1year. For this screening test used is presumptive coliform count, MPN (Most Probable Number) and multiple tube test. Diagnostic test is EIJKMAN'S test. Faecal streptococci: Best tells recent contamination Clostridium perfringens: Best tells remote contamination | train | med_mcqa | null |
Which is the MOST common species of pseudomonas causing intravascular catheter related infection? | [
"P. cepacia",
"P. aeruginosa",
"P. maltophilia",
"P. mallei"
] | B | P. aeruginosa is the most common species of pseudomonas which causes intravascular catheter related infection. Commonly associated with plastic catheters and selected for by surgical tissue breakage, Pseudomonas aeruginosa is a frequent nosocomial organism. P.aeruginosa is an aerobic gram negative bacillus which is not normally a pa of the endogenous flora of the human host. It possesses endotoxin and a series of exotoxins. It causes local infection of paranasal sinuses of non compromised host and cause severe infection in patients compromised by the obstruction of nasotracheal tubes, impaired mucous membrane clearance and neutropenia. It is also known to cause malignant otitis externa in elderly diabetic patients. Ref: Otolaryngology: Basic Science and Clinical Review edited by Thomas Van De Water, page 88. | train | med_mcqa | null |
Thiazides and loop diuretics both have opposite action on which of the following ions ? | [
"Sodium",
"Potassium",
"Calcium",
"Chloride"
] | C | Ans. is'c'i.e., Calcium(Ref: KDT 7/e p. 5S2l)Furosemide action on calciumFurosemide increases Ca2+ excretion (contrast thiazides which reduce it) | train | med_mcqa | null |
The major neurotransmitter released at end organ effectors of the sympathetic division of the autonomic nervous system is: | [
"Adrenaline",
"Nor–adrenaline",
"Dopamine",
"Acetylcholine"
] | B | - Neurotransmitters at end organ.
Sympathetic
All organs except sweat glands and hair follicle - Noradrenaline/Norepinephrine
Sweat gland and hair follicle- Acetylcholine
Parasympathetic
Acetylcholine | train | med_mcqa | null |
The most common cause of delayed umbilical cord separation is | [
"Raspbery tumour",
"Leukocyte adhesion deficiency",
"Patent urachus",
"Umbilical granuloma"
] | B | Leukocyte adhesion deficiency may present with recurrent bacterial infections, defects in neutrophil adhesion, and a delay in umbilical cord sloughing. All other options given are various umbilical pathologies, but not related to delayed sloughing of cord | train | med_mcqa | null |
All of the following cause hyperventilation except | [
"Decreased pH in CSF",
"Decreased plasma HCO3",
"CO poisoning",
"Increased adrenergic levels"
] | C | Arterial hypoxemia is defined as an arterial P02 (partial pressure of oxygen) less than 80 mmHg, who is breathing room air at sea level. And because the partial pressure of a gas is determined by the soluble fraction of gas and not by the amount carried chemically bound to hemoglobin - the Hb does not determine P02 and hypoxemia does not depend on Hb level.
In CO poisoning effective hemoglobin that can carry O2 decreases (because CO occupies Hb binding site) since P02 or arterial blood O2 remains normal, peripheral chemoreceptors are not stimulated and hyperventilation is not seen.
In hypoxia, with the reduction of PO2 cerebral blood flow increases (d/t vaso dilatation)to maintain O2 delivery in the brain.
The cerebral cortex can tolerate acute hypoxia for 5-10 min at 28°C, 20 min at 20°C, and 50 min at 50°C.
Hypoxic ischemia almost invariably involve hippocampus. The hippocampal CA1 neurons are vulnerable to even brief episodes of hypoxic ischemia. | train | med_mcqa | null |
In the histology section given, which marked area is involved in relieving pain in response to massage: | [
"A",
"B",
"C",
"D"
] | A | Gate control theory of pain states that innocuous stimuli, such as rubbing a hu area (massage), can block or reduce painful sensations. Such stimulation inhibits C fibres and A delta fibres and activates the large-diameter (Ab) fibersand their activity leads to release of GABA and other inhibitory neurotransmitters by interneurons within the dorsal horn. Transcutaneous electrical nerve stimulation (TENS) of pain relief is also based on gate control theory of pain. Lamina II or substantia gelatinosa acts as the gate where pain modulation occurs. A: Dorsal or posterior horn B: Lateral horn: From T1 to L2, the lateral horn contains the visceral motor efferent cell bodies of the sympathetic system, and From S2 to S4, it contains the visceral motor efferent cell bodies of the parasympathetic system. These cell bodies are collectively referred to as the intermediolateral nucleus. C: Ventral or anterior horn D: Anterolateral tract (spinothalamic tract) | train | med_mcqa | null |
A woman has mild depressive symptoms after few days of delivery which disappears within 2 weeks of the postpaum period. The most likely cause is ______ | [
"Post-paum blues",
"Mania",
"Post-paum psychosis",
"Major depression"
] | A | The patient has mild depressive symptoms after a few days of delivery which resolved spontaneously; this is characteristic of postpaum blues. During this period the patient may experience mood lability, sadness, dysphoria, subjective confusion, and tearfulness. These feelings have been ascribed to rapid changes in women's hormonal levels, the stress of childbih, and the awareness of the increased responsibility that motherhood brings. This usually resolve spontaneously. | train | med_mcqa | null |
In alkaptonuria the urine contains | [
"Hemogentisic acid",
"Phenylalanine",
"Ketonis",
"Acetates"
] | A | Alkaptonuria is an autosomal recessive Condition. The metabolic defect is deficiency of homogentisate oxidase. this results in excretion of homogentisic acid in urine.Ref: DM Vasudevan - Textbook of Biochemistry for Medical Students, 7th edition, page no: 237 | train | med_mcqa | null |
Which of the following injuries can be classified as Gustilo Anderson Grade III injuries? | [
"Open fracture with clean wounds less than 1 cm long",
"Open fractures with a laceration more than 1 cm long usually up to 10 cms, without extensive soft tissue damage, flaps or avulsions",
"Open segmental fractures, open fractures with extensive soft tissue damage,traumatic amputation",
"Compartment syndrome... | C | Ans- C Ref- Complete version Gustilo Type I II IIIA IIIB IIIC Images Energy Low energy Moderate High High High Wound Size < 1 cm > 1cm >10cm >10cm >10cm Soft Tissue Minimal Moderate Extensive Extensive Extensive Contamination Clean Moderate contamination Extensive Extensive Extensive Fracture Pattern Simple fx pattern with minimal comminution Moderate comminution Severe comminution or segmental fractures Severe comminution or segmental fractures Severe comminution or segmental fractures Periosteal Stripping No No Yes Yes Yes Skin Coverage Local coverage Local coverage Local coverage including Requires free tissue flap or rotational flap coverage Typically requires flap coverage Neurovascular Injury Normal Normal Normal Normal Exposed fracture with arterial damage that requires repair Antibiotics 1st generation cephalosporin for 24 hours after closure 1st generation cephalosporin for gram positive coverage. Aminoglycoside (such as gentamicin) for gram negative coverage in type III injuries the cephalosporin/aminoglycoside should be continued for 24-72 hours after the last debridement procedure Penicillin should be added if concern for anaerobic organism (farm injury) aminoglycoside (such as gentamicin) for gram negative coverage 1st cephalosporin (ancef) for gram positive coverage. the cephalosporin/aminoglycoside should be continued for 72 hours after the last debridment procedure penicillin should be added if concern for anaerobic organism (farm injury Antibiotics (other considerations) Flouroquinolones should be used for fresh water wounds or salt water wounds can be used if allergic to cephalosporins or clindamycin Doxycycline and ceftazidime can be used for salt water wounds Antibiotic Indications for Open Fractures Gustillo Grade I and II 1st generation cephalosporin Gustillo Grade III 1st generation cephalosporin + aminoglycoside traditionally recommended, but there is no evidence in the literature to support its use With farm injury / bowel contamination 1st generation cephalosporin + aminoglycoside + PCN add PCN for clostridia Duration initiate as soon as possible increased infection rate when antibiotics are delayed > 3 hours from time of injury continue for 72 hours after I&D 48 hours after each procedure Tetanus booster if not up to date | train | med_mcqa | null |
Interferon interferes with replication of virus at the time of: | [
"Protein synthesis",
"DNA/RNA replication",
"When virus enters the cell",
"Uncoating of the virus protein capsule"
] | A | Interferons are proteins that can induce a nonspecific resistance to viral infection by several mechanisms, including the inhibition of protein synthesis, inactivation of viral RNA, and enhancement of phagocytic and cytotoxic mechanisms. | train | med_mcqa | null |
Ehrlich phenomenon is seen in | [
"Myobacterium Tuberculosis",
"Proteus",
"Staphylococcus",
"Corynebacterium"
] | D | The difference between the amount of diphtheria toxin that will exactly neutralize one unit of antitoxin and that which, added to one unit of antitoxin, will leave one lethal dose free is greater than one lethal dose of toxin; i.e., it is necessary to add more than one lethal dose of toxin to a neutral mixture of toxin and antitoxin to make the mixture lethal (the basis of the L+ dose). Reference: Textbook of Microbiology; Anathanarayan and panicker's; 9th edition | train | med_mcqa | null |
Which of the following is purification of water at large scale - a) Disinfection of well b) Rapid sand filterc) Slow sand filterd) Household purification | [
"bc",
"c",
"ac",
"ad"
] | A | Purification of water
Purification of water is of great importance in community.
The method of treatment to be employed depends upon the nature of raw water, and the desired standards of water quality.
For example ground water (deep well, tube well and springs) may need no treatment. On the other hand surface water (river) requires extensive treatment.
Purification of water may be : -
Purification on large scale
Storage
Filtration
Slow sand (Biological filter)
Rapid sand (mechanical filter)
3. Disinfection
Chlorination
Ozonation
UV irradiation
Purification on small scale
Household purification
Boiling
Chemical disinfection
2. Disinfection of wells | train | med_mcqa | null |
In a patient with acute leukaemia, immunophenotype pattern is CD 19+ve, CD 10+ve, CD33+ve, CD 13+ve. He may probably have - | [
"Biphenotypic leukemia",
"ALL",
"AML- M2",
"AML-M0"
] | A | null | train | med_mcqa | null |
Which of the following may not seasonal may not cause microvesicular steatosis | [
"Alcoholic fatty liver",
"Tetracycline toxicity",
"Acute fatty liver of pregnancy",
"Reyes syndrome"
] | A | Refer Robbins page no 830 | train | med_mcqa | null |
A 20-year-old male patient presents to the OPD with complaints of fever, intermittent abdominal pain, and dysuria. He gives a history of swimming in the freshwater lake 10 days back. Urine microscopy shows the following. Which of the following is the causative agent? | [
"Schistosoma mansoni",
"Schistosoma hematobium",
"Schistosoma japonicum",
"Schistosoma mekongi"
] | B | The given clinical picture along with the history of swimming and the image showing egg which is non-operculated with the terminal spine at one pole are suggestive of infection with Schistosoma hematobium. The eggs of Schistosoma hematobium are ovoid, non-operculated, with a brownish-yellow transparent shell, carrying a terminal spine at one pole. Species differentiation of Schistosoma can be done based on the location of the spine as follows: Terminal spine: Schistosoma hematobium Lateral spine: Schistosoma mansoni Rudimentary lateral spine: Schistosoma japonicum Reference: Paniker&;s Textbook of Medical Parasitology 8th edition | train | med_mcqa | null |
The most common cause of trismus is due to infection in muscle: | [
"Masseter",
"Medial pterygoid",
"Temporalis",
"All of the above"
] | B | The most common cause of trismus is due to infection adjacent to muscles of jaw closure i.e., masseter, medial pterygoid, temporalis mostly due to involvement of pericoronal, submasseteric, and pterygo mandibular spaces. | train | med_mcqa | null |
Most common enzyme deficiency responsible for Galactosemia is? | [
"UDP galactose epimerase",
"Galaktokinase",
"Galactosidase",
"Galactose-l-phosphate uridyl transferase"
] | D | ANSWER: (D) Galactose-1-phosphate uridyl transferaseREF: Textbook of Biochemistry and Human Biology by L. M. Srivastava Page 353, Saunders manual of pediatric practice by Laurence Finberg, Ronald E. Kleinman Page 238The Galactosemias are three inherited disorders of the catabolic pathway of Galactose (all autosomal recessive). HowTever the term usually denotes the most common (Classical) of these diseases, Galactose-1-phosphate uridyl transferase (GALT) deficiency"TyPeGeneEnzymeSigns/SymptomsCommentType 1 (CLASSICAL)GALTGalactose-1- phosphate uridyl transferaseGrowth & mental retardation, failure to thrive, refuses to feed milk, diarrhea/ vomiting on feeding, Hepatomegaly/ jaundice, cataractMost common & most severeType 2GALK1GalactokinaseMild form, Only known symptom is cataracts, due to production of galactitol in the lens. Type 3GALEUDP galactose epimeraseVaries from mild to severe. Severe form is similar to classical GalactosemiaRarest, Mild form is Most benign | train | med_mcqa | null |
Bloomers shelf is: | [
"Peritoneal mets palpable per rectal",
"Supraclavicular lymph nodes",
"Axillary lymphnodes",
"Ovarian mass"
] | A | Ans) a (Peritoneal mets...) Ref: Bailey 25thThe anterior surface of proximal 1 /3rd of rectum is covered by visceral peritoneum. The peritoneal reflection is 7 to 9 cm from the anal verge in men and 5 to 7.5 cm in women. This anterior peritonealised space is so called the pouch of douglas or the pelvic cul de sac & may serve as the site of so called drop metastasis from visceral tumors. These peritoneal metastasis can form a mass in the cu led sac called Bloomers shelf & can be detected by per rectal examination.Sister Mary Joseph's nodules- Umblical deposits in visceral tumors. | train | med_mcqa | null |
Vision loss in HIV is commonly due to infection with: March 2005 March 2013 (h) | [
"Herpes virus",
"Toxocara",
"Toxoplasma",
"Cytomegalovirus"
] | D | Ans. D: Cytomegalovirus Cytomegalovirus (CMV) retinitis is a sight-threatening disease frequently associated with Acquired Immunodeficiency Syndrome (AIDS). Patients with retinitis caused by CMV infection may be asymptomatic or may experience blurred vision, floaters, scotomata, or central or peripheral vision loss or distoion. Retinal examination shows creamy to yellowish lesions, white granular areas with perivascular exudates, and hemorrhages ("cottage cheese and ketchup"). The abnormalities initially appear in the periphery, but progress if untreated to involve the macula and optic disc. Vision loss is usually permanent. | train | med_mcqa | null |
Which of the following statements regarding liver enzymes is true | [
"ALT is less specific indicator of liver injury than AST",
"Absolute levels of aminotransferase correlate with outcome",
"Glutathione-S- Transferase is used as a hepatic prognostic marker after surgery",
"None of the above"
] | C | Answer is C (Glutathione-S- Transferase is used as a hepatic prognostic marker after surgery) Glutathione - S - Transferase is an emerging enzyme marker for post-transplant monitoring (surgery) as an aid to the diagnosis of acute allagraft rejection ALT is a more specific indicator of liver injury than AST and absolute levels of aminotransferase do not correlate with outcome. ALT is a more specific indicator of Liver injury than AST AST (Aspaate Aminotransferase) is found in the liver, cardiac muscle, skeletal muscle, kidneys, brain, pancreas, lung, leukocytes and erythrocytes in decreasing order of concentration. ALT is found primarily in the liver and is therefore a more specific indicator of Liver injury - Harrison's 186/2528 Absolute level of Aminotransferase elevation do not correlate with outcome `There is poor correlatation between extent of Liver cell Necrosis and the elevation of serum aminotransferase levels in chronic liver diseases. Similarly, absolute elevation of aminotransferase levels is of little value in predicting the outcome of acute hepatocellular disorders' - Schiff's Deseases of the Liver Serum Glutathione - S- Transferase may be used as a prognostic marker after transplant surgery 'Serum Alpha - Glutathione - S - Transferase is an emerging static test indicating hepatocellular damage. As in vivo plasma half life of this enzyme is less than 60-90 minutes, this enzyme offer advantages in post-transplant monitoring as an aid to the diagnosis of acute allagraft rejection. Recent investigations have indicated that monitoring of GST reduced both moality and morbidity in liver transplant recipients. GST showed a distinct higher sensitivity (81%) for acute rejection than conventional liver function tests (the specificity however was relatively low (45%). Glutathione - S-Transferase (GST) - Miller's Anesthesia (Elsevier) 2010/426 Glittathione-S-Transferase is a sensitive and specific test for some patterns of Liver injury. The enzyme has a brief plasma half life (90 minutes) and is released rapidly into circulation following hpatocellular injury. Thus serial GST measurements can reveal time course of hepatic injury from its onset to its resolution. In contrast to AST and ALT which reside in Acinar Zone I, GST localizes in Acinar Zone III (centrilobular region). This zone contains the hepatacyte population with highest susceptibility to injury from hypoxia or reactive drug metabolites. Accordingly GST would be more sensitive than AST or ALT as a marker of contrilobular necrosis in its incipient stage. | train | med_mcqa | null |
Sternal puncture is done at which site | [
"Junction of upper and lower half of body",
"Upper pa of manubrium",
"Lower pa of manubrium",
"Just above xiphisternum"
] | B | Answer-B. Upper pa of manubriumSternal punctureManubrium sterni is the preferred site for bone marrow aspiration because it is subcutaneous and readily accessible.The bone marrow sample is required for haematological examination. A thick needle is inseed into the upper pa of the manibrium to avoid injury to arch of aoa, which lies behind the lower pa. | train | med_mcqa | null |
Asteroid bodies are seen in: | [
"Sarcoidosis",
"Syphilis",
"Chromoblastomycosis",
"Sporotrichosis"
] | A | Asteroid bodies may be seen in the cytoplasm of epithelioid or giant cells in sarcoidosis as eosinophilic, stellate or spider-like inclusions. The radiating filamentous arms contain complex lipoproteins, calcium, phosphorus, silicon, and aluminum. | train | med_mcqa | null |
Sulfa drug used in inflammatory bowel disease includes: | [
"Sulfasalazine",
"Sulfamethoxazole",
"Sulfinpyrazone",
"Sulphadoxine"
] | A | the azo bond is split by colonic bacteria to release 5ASA and sulfa pyridine .the former exes a local antiinflammatory effect ESSENTIALS OF MEDICAL PHARMACOLOGY SEVENTH EDITIION KD TRIPATHI PG NO 683 | train | med_mcqa | null |
Ford foundation established by | [
"National institute of health administration",
"National institute of virology",
"All India institute of hygiene and public health",
"RHC at AIIMS"
] | A | Ford Foundation has suppoed the establishment of NIHAE (National Institute of Health Administration and Education) at Delhi. The institute provides a senior staff, college type training for health administrators.Park 23e pg: 924 | train | med_mcqa | null |
Which of the following belong to special visceral efferent column | [
"Nucleus tractus solitarius",
"Nucleus ambigus",
"Dorsal nucleus of vagus",
"Mesencephalic nucleus of trigeminal"
] | B | NUCLEI OF THE NEURAL COLUMNS IN BRAINSTEM - SSA Vision (CN II) Hearing & balance Vestibulocochlear nuclei (CN VIII) Pontomedullary junction - GSA Trigeminal nerve (CN V) Nuclei of trigeminal nerve : Main sensory - Pons mesencephalic nucleus - midbrain Spinal sensory - lateral medulla - SVA Smell (CN I) taste Chemo/ presso-reception Nucleus tractussolilarius (tip) Bottom of nucleus tractus solitarius - GVA Same as SVA - GSE Skeletal Muscle eye CN III, IV, VI tongue CN XII Oculomotor (pons), trochlear nuclei, abducent Hypoglossal nucleus (midbrain) - SVE 1st arch 2nd arch 4h & 6th arch Muscles of pharyngeal arches Trigeminal nerve Facial nerve muscles of palate pharynx & larynx Trigeminal &facial nuclei in pons Nucleus ambiguous Nucleus ambiguous CN IX, X, XI, Muscles of palate Pharynx, larynx SVA Glossal nucleus of vagus Parasympathetic to cardiac & smooth muscles GVE Mesencephalic nucleus of CN V GSA SENSORY -Spinothalamic tract Sums contralateral after ascending 1-2 segments ipsilaterally Contralateral loss of pain and temperature 1-2 segments below lesion -MOTOR coicospinal tract Motor control contralateral from the coex Ipsilateral spastic paralysis below the lesion (UMN lesion) At the level of lesion flaccid paralysis (LMN lesion) | train | med_mcqa | null |
If the mean cholesterol value of a group of normal subjects is 230mg% with standard error of 10. The 95% confidence limits for the population: | [
"220 & 240",
"210 & 250",
"200 & 260",
"210 & 240"
] | B | null | train | med_mcqa | null |
X-ray abdomen of a 30-year-old SLE patient who cannot feel her baby moving for past 7 days. All can be seen except: | [
"Hyper-flexion of spine",
"Single fetus",
"Anti-Beta 2 glycoprotein antibody",
"Elevated fibrinogen"
] | D | Ans. (d) Elevated fibrinogen.* When a dead fetus has been in utero for 3-4 weeks, fibrinogen levels may drop, leading to a coagulopathy. This is rarely a problem because of earlier recognition and induction. In some cases of twin pregnancies, induction after the death of a twin may be delayed to allow the viable twin to mature.* Anti-phospholipid antibody syndrome explains the I.U.D* The irregular overlapping of the cranial bones on one another is due to liquefaction of the brain matter and softening of the ligamentous structures supporting the vault. It usually appears 7 days after death. Similar features may be found in extra-uterine pregnancy with the foetus alive. | train | med_mcqa | null |
Following are examples of privileged communication except | [
"Veneral diseases",
"Infections diseases",
"Notifiable disease",
"Non communicable disease"
] | D | Privileged communication veneral disease Infectious diseases Notifiable disease In patient's interest Suspected crime Cous of law Insurance repos Ref: FORENSIC MEDICINE AND TOXICOLOGY Dr PC IGNATIUS THIRD EDITION PAGE 384 | train | med_mcqa | null |
A woman complains of discharge and soreness in the vulval region at a POA of 36 weeks. Examination reveals small discreet, tender ulcers in the labia majora, minora and perineum. She has not had a similar episode previously. On viral culture and serological testing she did not have antibodies against the infecting strain.What is the best treatment option? | [
"Perform a cesarean section immediately",
"Treat with oral acyclovir and induced labour as soon as the ulcers heal",
"Treat with oral acyclovir and await spontaneous onset of labour",
"Treat with oral acyclovir and perform an elective cesarean section at 38 weeks"
] | D | Ans. is d, i.e. Treat with oral acyclovir and perform an elective cesarean section at 38 weeksThis is a case of primary herpes because she does not have type-specific antibodies. The best management option is to deliver by cesarean section at 38 weeks, if primary herpes occurs in the third trimester, especially during the last 6 weeks, as there is no time for the mother to develop antibodies. It is not necessary to perform a cesarean section immediately as transplacental transmission does not occur. Treatment with acyclovir is indicated in primary herpes as it reduces the severity and the duration of the maternal disease. | train | med_mcqa | null |
Nerve supply of tip of nose is | [
"Maxillary nerve",
"Ophthalmic nerve",
"Facial nerve",
"Mandibular branch of Vth nerve"
] | B | The afferent component of corneal reflex is mediated through the ophthalmic branch of the trigeminal nerve. (V1 nerve).
The efferent component is mediate through the facial nerve (VIIth nerve). | train | med_mcqa | null |
A 52-year-old man complains of episodes of severe unilateral, stabbing facial pain that is intermittent for several hours, and then disappears for several days. The pain is described as "electric shock-like" and only lasts a few seconds. Physical examination of the face and mouth is entirely normal. Which of the following treatments is most effective for this condition? | [
"morphine",
"indomethacin",
"cimetidine",
"carbamazepine"
] | D | This patient has trigeminal neuralgia. Carbamazepine (an anticonvulsant drug) is given in doses varying from 600 to 1200 mg/day. Phenytoin has also been used. The two drugs can also be used in combination. Operative procedures include alcohol injection of the nerve or ganglion, partial section of the nerve in the middle or posterior fossa, decompression of the root, and medullary tractotomy. Radiofrequency surgery can destroy pain fibers but spare motor fibers. | train | med_mcqa | null |
A 5 year old Child is suffering from patent ductus aeriosus (PDA) with congestive cardiac failure.Ligatio of ductus aeriosus was decided for surgical management.The most apropriate inhalation anaesthetic agent of the choice with minimal haemodynamic alteration for induction of anaethesia is | [
"Sevoflurane",
"Isoflurane",
"Enflurane",
"Halothen"
] | A | Sevoflurane is the inducing agent of choice in children . Cardiovascular stability in decreasing order : Isoflurane(nost stable)>desflurane>Sevoflurane>Halothane>Enflurane. Halothane suppresses baroreceptor reflex and causes tachycardia (Arrythmogenic -by sensitising the hea to catecholamines) Enflurane is most cardiovascular unstable agent Isoflurane is the most cardiostable inhalational agent as cardiac output is best maintained by reflex tachycardia as protective baroreceptor reflex is minimally inhibited. Among Isoflurane and sevoflurane, sevoflurane is the agent of choice in children. Ref.:Morgan 4th/e p 929 | train | med_mcqa | null |
Major source of cyanocobalamin vitamin is:- | [
"Animal only diet",
"Plant only diet",
"Sunlight",
"None"
] | A | Vitamin B12 Synthesized exclusively by microbes. Dietary source is exclusively of animal origin Vitamin B12 deficiency clinical manifestations: Haematological: Megaloblastic anemia, Hypersegmentation of neutrophils. Neurological: Demyelination in peripheral nerves and spinal cord | train | med_mcqa | null |
Nerve injured in fracture of medial epicondyle of humerus | [
"Anterior interosseous nerve",
"Median nerve",
"Ulnar nerve",
"Radial nerve"
] | C | It is more commonly injured than the lateral epicondyle, because the epiphysis of the medial epicondyle appears early and fuses late with the main epiphysis of the lower humerus. This fracture is commonly associated with posterior dislocation of the elbow. It may be associated with an ulnar nerve injury. Ref essential ohopaedic, maheshwari and mhaskar 9th ed p 105 | train | med_mcqa | null |
Case of 30 year chronic smoker male, visited your clinic with this consdition Diognosis: | [
"Diabetic gangrene",
"Buerger's disease",
"Atherosclerotic plaque",
"Septic foot"
] | B | Ans. (b) Buerger's diseaseRef: Vascular intervention: A Clinical approach, P 219- 221* Buergers disease (NOT berger disease) is also known as thrombo angitis obliterans. An inflammatory and obliterative disease of blood vessels of the extremities, mainly lower extremities. Occurring chiefly in smoker young men and leading to ischemia of the tissues and gangrene.* Involvement of artery vein and nerve, most commonly involved is tibial artery. Intermittent claudication, pain at rest relieved by dangling legs. Dry gangrene in toes shows shriveled woody induration.* IOC: duplex USG (ankle brachial index: 0.5 to 0.9)* Treatment: for Claudication pain, reducing the viscosity of blood pentoxyphylline is used. For resting pain, lumbar sympathectomy If gangrene a Amputation done. | train | med_mcqa | null |
Not a component of tetralogy of fallot - | [
"Pulmonary stenosis",
"Ventricular septal defect",
"Overriding aorta",
"Patent ductus arteriosus"
] | D | Ans. is 'd' i.e., Patent ductus arteriosus Tetralogy of falloto TOF is the commonest cyanotic congenital heart disease.o It has four componentsi) VSDii) Pulmonic stenosisiii) Overriding or dextroposed aortaiv) Right ventricular hypertrophyo Pulmonic stenosis (right ventricular outflow obstruction) is mainly due to infundibular stenosis. Obstruction at pulmonary valve level (valvular stenosis) is very uncommon (only 10%)."Pentology of fallot consists of components of TOF plus atrial septal defect" | train | med_mcqa | null |
Which of the following vaccine should not be given during pregnancy ?- | [
"HBV",
"Measles, mumps, rubella",
"Typhoid",
"Cholera"
] | B | null | train | med_mcqa | null |
Consistent change in particular direction over a period of time | [
"Sporadic",
"Endemic",
"Secular trend",
"Pandemic"
] | C | null | train | med_mcqa | null |
Rib ossification center first appears in which rib ? | [
"1st",
"12th",
"6th",
"3rd"
] | C | Ans. is 'c' i.e., 6thEach rib (except for 11th& 12th) is ossified from four centres :-One primary centre-->for bodyThree epiphyseal (secondary )centres for :-HeadAicular pa of tubercleNon aicular pa of tubercleOssification begins near the angle toward the end of 2" month (around 8th week) of fetal life, and is seen first in 6th and 7th ribs.The epiphyses for the head and tubercle make their appearance between 16th and 20th years, and are united to the body about the 25th year. | train | med_mcqa | null |
Which group of streptococcus grow at > 60degC | [
"A",
"B",
"C",
"D"
] | D | Ans. is 'd' i.e., D Among streptococci, enterococcus (group D streptococcus) is heat resistant. | train | med_mcqa | null |
The regeneration of nerve fibres is possible in the
peripheral nervous system than the central nervous system because | [
"Presence of neurilemmal sheath in peripheral nerve",
"Presence of neurilemmal sheath in central nervous system",
"The absence of myelin sheath in the central nervous system",
"Disturbed vascular supply"
] | A | null | train | med_mcqa | null |
The key to the root of the neck is the scalenus anterior muscle. Which among the following is TRUE about scalenus anterior? | [
"Not Pierced by phrenic nerve",
"Attached to scalene tubercle on 2nd rib",
"Separates subclan aery from subclan vein",
"Pierced by phrenic nerve"
] | B | The subclan vein forms an arch across the pleura at a level below the arch of subclan aery. The two arches are separated from each other by scalenus anterior muscle.Scalenus anterior arises from the anterior tubercles of C3-C6 and attaches to the scalene tubercle and adjacent ridge on the inner border and upper surface of the first rib.Phrenic nerve passes veically down across the obliquity of the muscle, plastered there to by the preveebral fascia.Transcervical and suprascapular aeries lie between the scalenus anterior and the carotid sheath. | train | med_mcqa | null |
Dobutamine acts on all of the following receptors except | [
"β1",
"β2",
"D1",
"α1"
] | C | Dobutamine has no action on Dopamine receptors. | train | med_mcqa | null |
True about Vossius' s ring is | [
"It is the ring around optic nerve",
"Synonymous with Soemmering's ring",
"Impression of miotic pupil on lens",
"Impression of dilated pupil on lens"
] | C | During injury to eye a circular ring of faint or stippled opacity is seen on the anterior surface of lens due to brown amorphous granules of pigment lying on the capsule. This is known as Vossius&;s ring. It has the same diameter as that of contracted pupil and is due to impression of Iris on the lens produced by force of concussion injury which drives the cornea and iris backwards. | train | med_mcqa | null |
A 4-year-old boy had a history of intellectual disability and seizure is brought to doctor with a month of history of shoness of breath. On physical examination, doctor notices numerous papule on boy face. Echocardiography shows tumor like growth in left ventricle. Which of the following is the most likely diagnosis for this patient hea condition? | [
"Lipoma",
"Myxoma",
"Rhabdomyoma",
"Dilated cardiomyopathy"
] | C | Tuberous sclerosis is a autosomal dominant condition characterized by development of hamaomas and benign neoplasms involving the brain and other tissues. The most frequent clinical manifestations are seizures, autism,and mental retardation. Hamaomas within the CNS take the form of coical tubers and subependymal nodules; subependymalgiant-cell astrocytoma's. Half of patient with tuberous sclerosis develop rhabdomyomas, primary tumors of cardiac muscle that, although benign, may compromise cardiac function. They may be found on atrioventricular valves or on ventricle walls, causing outflow obstruction. The nuclei of the rhabdomyoma cells are central or eccentrically located. In some cells, eosinophilic septa stretch from the cell membrane to a centrally placed nucleus, impaing a spiderlike appearance to the cell known as 'spider cells' Spider cells are pathognomonic for cardiac rhabdomyomas and they represent degenerating rhabdomyocytes. image showing spider cells Myxoma are almost exclusively seen in adults and usually located in the atria, making this a less likely diagnosis. Dilated cardiomyopathy involves hyperophy and dilation and eventually hea failure and is not associated with tuberous sclerosis. Lipoma can create ball valve obstruction and with history suggesting tuberous sclerosis, lipoma is less likely. | train | med_mcqa | null |
True about Metaiodobenzylguanidine (MIBG) scan:
(A)Concentrates in catecholamine producing tumor cells
(B)Used in Pheochromocytoma
(C)Used in Neuroblastoma
(D)Used in Paraganglioma
(E)Used in Carcinoids | [
"CABDA",
"CABED",
"ABCDE",
"BACED"
] | C | null | train | med_mcqa | null |
Antidote for ethylene glycol poisoning is/are: a) Methyl violet b) Fluconazole c) Fomepizole d) Ethyl alcohol | [
"ac",
"cd",
"ad",
"bc"
] | B | null | train | med_mcqa | null |
Basophilic stippling is seen which of the following cells | [
"Eosinophils",
"RBC's",
"Basophils",
"Neutrophils"
] | B | LEAD Chronic Poisoning (plumbism; saturnism) Signs and Symptoms :- (1) Facial Pallor : The facial pallor paicularly about the mouth is one of the earliest and most consistent sign. It seems to be due to vasospasm. (2) Anaemia : There may be polycythaemia with polychromatophilia in early stages, but later there is anaemia which is associated with polychromasia, punctate basophilia, reticulocytosis, poikilocytosis, anisocytosis, nucleated red cells (sideroblasts) and an increase in mononuclear cells, whereas polymorphonuclear cells and platelets are decreased. The anaemia is probably due to decreased survival time of red blood cells and inhibition of haeme synthesis by interference with the incorporation of iron into protoporphyrin. Punctate basophilia or basophilic stippling means the presence of many dark blue-coloured pinhead- sized spots in the cytoplasm of red blood cells, due to toxic action of lead on porphyrin metabolism. Reticulocytes and basophilic stippled cells result from the inhibition of 5 pyrimidine nucleotidase, an impaired ability to rid the cell of RNA degradation products and the aggregation of ribosome. (3) Line : A stippled blue line, called Buonian line, is seen on the gums. It appears due to subepithelial deposit of granules at the junction with teeth, only near diy or carious teeth, within a week of exposure, especially on upper jaw. It is due to formation of lead sulphide by the action of hydrogen sulphide formed by decomposed food in the mouth. (4) Colic and Constipation : It is usually later symptom. Colic of intestines, ureters, uterus and blood vessels occur in 85% of cases. The colic occurs at night and the pain may be very severe. Constipation is usual but diarrhoea or vomiting may occur. (5) Lead Palsy: It usually occurs late, and is seen in less than 10% of cases. There may be tremors, numbness, hyperaesthesia, and cramps before the actual muscle weakness. It is commoner in adults than in children, and men are paicularly affected. The muscle groups affected are those most prone to fatigue. Usually the extensor muscles of the wrist (wrist drop; radial nerve is affected) are affected, but the deltoid, biceps, anterior tibial (foot drop), and rarely muscles of eye or intrinsic muscles of hand or foot are affected. The paralysis is associated with degeneration of the nerve and atrophy of the muscles. Recovery may be complete but is usually slow. ( 6) Encephalopathy : It is common in children often associated with tetraethyl lead. The symptoms are vomiting, headache, insomnia, visual disturbances, irritability, restlessness, delirium, hallucinations, convulsions, coma and death. Lead encephalopathy is usually irreversible and about 85% have permanent brain damage. Death occurs in about 25% cases. Ref:- k s narayan reddy; pg num:-544,545 | train | med_mcqa | null |
Neuroblastomas - good prognositc factor is | [
"N-myc amplification",
"RAS oncogene",
"Hyperdiploidy",
"Translocations"
] | C | Ref : Sabiston 20th edition Pgno : 1887-1888 Neuroblastoma prognostic factors Favorable prognosis Unourable Prognosis Age <1 year Thoracic primary lesion Shimada index showing well differentiated stromal rich tumor Increased ratio of VMA/HVA Normal serum ferritin Hyperdiploid or near triploid High level of expression of Trk-A gene N-myc amplification (>10) Deletion of 1p(most characteristic cytogenetics abnormality) and gain of 17q Expression of multidrug resistance protein Over expression of telomerase Increased serum ferritin Diploid Older patients of stages III and IV | train | med_mcqa | null |
Lambda is represented by which of the following? | [
"A",
"B",
"C",
"None of the above"
] | C | The lambda is the meeting point between the sagittal and lambdoid sutures. In the foetal skull, this is the site of the posterior fontanelle, which closes at two to three months of age. | train | med_mcqa | null |
Which of the following procedure is NOT done in a case of Hirschsprung's disease? | [
"Swenson's operation",
"Duhamel's operation",
"Fasanella -servat procedure",
"Soave's operation"
] | C | Fasanella - servat procedure is done in cases of mild congeital ptosis, mild ptosis associated with horner's syndrome and selected cases of mild acquired involutional ptosis, in which the upper lid is elevated by removing a block of tissue from the underside of the lid. This tissue includes the tarsus, conjunctiva, and Muller muscle. Note: Treatment of hirschsprung's disease: Colostomy- prompt colostomy should be performed in neonate with the disease. "Definitive operation is postponed till the child become at least 1 year of age and normal weight. It includes- Swenson's operation, Duhamel's operation, Soave's operation, colonic anastomosis etc" Ref: Love & bailey 25/e, page 86-87 ; S. Dass Textbook of Surgery 5/e, page 1035-36 ; Comprehensive Opthalmology by AK Khurana, 4/e, page 358 ; Opthalmic Surgical Procedures by Petre Hersh, 2/e, page 281 | train | med_mcqa | null |
An increase in the concentration of 2-3 Biphosphoglycerate (2, 3 DPG) may be seen in all of the following except. | [
"Anemia",
"Hypoxia",
"Inosine",
"Hvpoxanthine"
] | D | D i.e. Hyoxanthine2, 3 Bisphosphoglycerate (2, 3- BPG) or 2, 3 Diphosphoglycerate 2, 3- DPG)It is most abundant organic phosphate in RBC5 where its concentration is approximately that of hemoglobin. It is synthesized from glycolytic intermediates 3-phosplzoglyceraldehyde by means of Rapopo- leubering shunt.It is highly charged anion that binds to the /3 chains of deoxy hemoglobin. One mole of deoxyhemoglobin binds to one mole of 2, 3 BPG. A single molecule of 2, 3 - BPG binds to a positively charged pocket (cavity) formed by two 13-chains, in the centre of deoxyhemoglobin. Positively charged aminoacids of pocket form ionic bonds with negatively charged phosphate group of 2, 3- BPG.It decreases 02 affinity of hemoglobin by binding to deoxyhemoglobin but not to oxyhemoglobin and stabilizing the taut conformation of deoxy hemoglobin.Oxyhemoglobin + 2, 3 - BPG ____________ Deoxyhemoglobin + 02(HbO2) (Hb - 2, 3 - BPG)In this equilibrium, an increase in the concentration of 2, 3 - BPG shifts the reaction to right causing more oxygen to be released.Hemoglobin from which 2, 3 - BPG is removed has a high affinity for oxygen. However, the presence of 2, 3 - BPG significantly reduces the affinity of hemoglobin for oxygen, shifting the oxygen dissociation curve to right. This reduced affinity enable hemoglobin to releases oxygen efficiently at the paial pressure found in tissues.Role of 2, 3 - BPG in stored & transfused blood: ?Storing blood in acid- citrate - dextrose leads to a decrease of 2, 3- BPG in RBC. Hemoglobin deficient in 2, 3 - BPG displays an abnormally high 02 affinity & fails to unload its bound 02 in tissues properly and thus acts as an oxygen trap rather than as oxygen transpo system. However, transfused RBCs are able to restore their depleted supplies of 2, 3BPG in 24-48 hours; this may be a serius issue in critically ill patiens. This decrease in 2, 3 - BPG can be prevented by adding inosine (hypoxanthine - ribose) to the storage mediumQ. Uncharged inosine molecule enters RBC, releases its ribose moiety, gets phosphorylated and enters HMP pathway to become 2, 3-BPG. Hypoxanthine is formed during utilization of inosine to maintain or increase 2, 3 - BPG content. Thus while inosine increase/ maintain 2, 3 - BPG content, hypoxanthine does notQ.In chronic hypoxia & anemia the concentration of 2, 3- BPG increases whereas, when pH falls (or is low), 2 3- BPG concentration falls because acidosis inhibits red cell glycolysis.Increasing 2, 3 - BPGChronic hypoxia eg- Obstructive pulmonary emphysema- High altitudes- Cyanotic congenital hea diseaseAnemia eg sickle cell HbAcidosis (1- pH)Exercise (in non athletes)Harmones- Thyroid hormone- Growth hormone- AndrogensPregnancyRejuvenating chemical agentsInosineQDihydroxyacetonePyruvatePhosphatePhosphoenol, pyruvate | train | med_mcqa | null |
Number of vitamins required in citric acid cycle is: | [
"2",
"3",
"4",
"5"
] | C | Four of the B vitamins are essential in the citric acid cycle and hence energy-yielding metabolism: (1) riboflavin, in the form of flavin adenine dinucleotide (FAD), a cofactor for succinate dehydrogenase; (2) niacin, in the form of nicotinamide adenine dinucleotide (NAD), the electron acceptor for isocitrate dehydrogenase, a-ketoglutarate dehydrogenase, and malate dehydrogenase; (3) thiamin (vitamin B1), as thiamin diphosphate, the coenzyme for decarboxylation in the a-ketoglutarate dehydrogenase reaction; and (4) pantothenic acid, as pa of coenzyme A, the cofactor attached to "active" carboxylic acid residues such as acetyl-CoA and succinyl-CoA Ref: Harper 28th edition, chapter 17. | train | med_mcqa | null |
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