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Which of the following is the synthetic vitamer of vitamin K? | [
"Phylloquinone",
"Menaquinone",
"Menadione",
"All of the above"
] | C | Vitamers are different forms of vitamins. Vitamin K has three different vitamers as: | train | med_mcqa | null |
A 52-year-old woman undergoes a sigmoid resection with primary anastomosis for recurrent diveiculitis. She returns to the emergency room 10 days later with left flank pain and decreased urine output; laboratory examination is significant for a white blood cell (WBC) count of 20,000/mm3 . She undergoes a CT scan that demonstrates new left hydronephrosis, but no evidence of an intraabdominal abscess. Which of the following is the most appropriate next step in management? | [
"Intravenous pyelogram",
"Intravenous antibiotics and repeat CT in 1 week",
"Administration of intravenous methylene blue",
"No fuher management if urinalysis is negative for hematuria"
] | A | The patient should undergo an intravenous pyelogram for a suspected ureteral injury. After gynecologic surgeries, colorectal surgery is the most common cause of iatrogenic ureteral injuries. Intraoperatively, intravenous administration of methylene blue or indigocyanine green may facilitate identification of an injury. However, delay in diagnosis is common, and patients may present with flank pain, fevers, and signs of sepsis, ileus, or decreased urine output. CT scan may demonstrate hydronephrosis or a fluid collection (urinoma). Initial diagnosis and management should include urinalysis, although hematuria may not always be present; percutaneous nephrostomy tube or retrograde ureteral catheterization; percutaneous drainage of fluid collections; and identification of the location of ureteral injury. Surgical management should be delayed if diagnosis is late (10-14 days), and operative strategy is dependent on the location of the injury. Diagnostic imaging such as a pyelogram or nuclear medicine scan may be helpful to identify the site of the injury. | train | med_mcqa | null |
Infective endocarditis after tooth extraction is probably due to ? | [
"Streptococcus viridans",
"Streptococcus pneumoniae",
"Streptococcus pyogenes",
"Staphylococcus aureus"
] | A | Ans. is 'a' i.e., Streptococcus viridans Viridans streptococci are normally resident in the mouth and upper respiratory tract. They cause transient bacteremia following tooth extraction or other dental procedures; and get implanted on damaged or prosthetic valves or in a congenitally diseased hea, and grow to form vegetations. They are ordinarily nonpathogenic but can on occasion cause disease. In persons with preexisting cardiac lesions, they may cause bacterial endocarditis, Str. sanguis being most often responsible. Str. mutans is impoant in causation of dental caries. The transient viridans streptococcal bacteremia induced by eating, tooth-brushing, flossing and other source of minor trauma, together with adherence to biological surfaces, is thought to account for the predilection of these organisms to cause endocarditis. Viridans streptococci are also isolated, often as a pa of a mixed flora, from sites of sinusitis, brain abscess and liver abscess. Viridans streptococcal bacteremia occurs relatively frequently in neutropenic patients, paicularly after bone marrow transplantation or high dose chemotherapy for cancer. Treatment of varidans streptococcal infections include :- Bacteremia in neutropenic patients - Vancomycin. Other infection - Penicillin. | train | med_mcqa | null |
Most common aery involved in pancreatic pseudoaneurysm | [
"Gastroduodenal aery",
"Inferior pancreaticoduodenal aery",
"Gastric aery",
"Splenic aery"
] | D | Aeries involved in pseudoaneurysm associated with pancreatic pseudocyst Splenic Aery (30-50%):Most common Gastroduodenal aery : (10-15%) Inferior and superior pancreaticoduodenal aery (10%) Ref: Maingot 11th edition Pgno :977 | train | med_mcqa | null |
Choanal atresia is due to persistence of ? | [
"Bucconasal membrane",
"Oropharyngeal membrane",
"Laryngo tracheal fold",
"Tracheoesophageal fold"
] | A | Choanal atresia is an abnormality of canalization during development of the nasal passages. It involves bone and/or soft tissue and may result in either paial (choanal stenosis) or complete obstruction of the posterior nasal airway. The most widely accepted mechanism for the development of choanal atresia is the persistence of the bucconasal membrane beyond the sixth week of gestation, but abnormal migration of cephalic neural crest cells following neural tube closure also has been implicated. The incidence of choanal atresia is 1 in 7000 to 8000 live bihs. It is more common in females (2:1), more likely to be bony or cailaginous than membranous (9:1), and more commonly unilateral and right-sided (2:1). | train | med_mcqa | null |
First to be blocked by muscle relaxants | [
"Laryngeal muscles",
"Diaphragm",
"Thenar muscles",
"Intercostals"
] | A | First muscles to be blocked by muscle relaxants (both depolarizing and non-depolarizing type) are central muscles i.e., muscles of head and neck (face, jaw, pharynx, larynx), respiratory, abdominal muscles and muscles of trunk. After the central muscles, muscles of limbs (peripheral muscles) are blocked.muscle relaxant is a drug that affects skeletal muscle function and decreases the muscle tone. It may be used to allete symptoms such as muscle spasms, Ref Robbins 9/e 456 | train | med_mcqa | null |
Aldosterone secretion is stimulated by which of the following? | [
"Hyperkalemia",
"Dopamine",
"Somatostatin",
"Atrial Natri uretic peptide (ANP)"
] | A | Hyperkalemia stimulates aldosterone secretion and hypokalemia suppress aldosterone secretion. The serum potassium is an impoant independent regulator of plasma aldosterone levels (Independent of Renin and ACTH). Increased plasma K+ concentration causes direct stimulation of aldosterone by. Major Direct Stimulants for Aldosterone Secretion Angiotensin II (RAAS) (RAAS is the major regulator) Serum Potassium (Hyperkalemia stimulates and hypokalemia suppresses aldosterone secretion) ACTH (Acute) Factors Regulating Aldosterone secretion Factor Stimulatory Inhibitory Peptides Angiotensin ACTH Angiotensin III Vasopressin Endothelin Atrial natriuretic peptide Somatostatin Ions Plasma potassium Other Serotonin Dopamine Ref: Harrison 19th edition Pgno: 310 | train | med_mcqa | null |
Decreased mineralization of Epiphyseal plate in a growing child is seen in - | [
"Rickets",
"Osteomalacia",
"Scurvy",
"Osteoporosis"
] | A | Defective mineralization is seen in both rickets and osteomalacia.
However, the question is about defective mineralization in the Epiphyseal plate (growth plate/physics) in a growing child, which is seen in rickets.
Osteomalacia is a disease of the mature skeleton when physis (epiphyseal plate) has already been fused. There is no physics (epiphyseal plate) in a mature bone. | train | med_mcqa | null |
A 60 year male is brought by his wife. He thinks that he had committed sins all through his life. He is very much depressed and has considered committing suicide but has not through hot do go about it. He had also attached sessions with a spiritual guru. He is not convinced by his wife that he has lead a pious life. He does not want to hear anything on the contrary. How will you treat him? | [
"Antipsychotic + Anti depressant",
"Antidepressant with cognitive behavioural therapy",
"Guidance & recounselling with guru+Anti depressant",
"Anti depressant alone"
] | A | A i.e. Antipsychotic + Anti depressant The patient is presenting with features of depression, hypochondrial preoccupation & delusional guilt suggesting the diagnosis of depression with psychotic features (i.e. psychotic depression). It should be managed with a combination of antipsychotic (SNRIs or TCA rather than SSRI) and antidepressantQ. ECT is an alternative perhaps more effective than pharmacotherapy. | train | med_mcqa | null |
After hyperventilating for sometime, holding the breath is dangerous, since: | [
"It can lead to CO2 necrosis",
"Due to lack of stimulation by CO2 anoxia can go into dangerous levels",
"Decreased CO2 shift the oxygen dissociation curve to the left",
"Alkalosis can lead to tetany"
] | D | In respiratoy alkalosis, there is an increase in extracellular fluid pH and a decrease in H+ concentration. The cause of the alkalosis is a decrease in plasma pCO2, caused by hyperventilation. The reduction in pCO2, then leads to a decrease in the rate of H+ secretion by the renal tubules. The decrease in H+ secretion reduces the amount of H+ in the renal tubular fluid. Consequently, there is not enough H+ to react with all the HCO3- that is filtered. Therefore, the HCO3- that cannot react with H+ is not reabsorbed and is exreted in the urine. This results in a decrease in plasma HCO3- concentration and correction of the alkalosis. Therefore, the compensatory response to a primary reduction in pCO2 in respiratory alkalosis is a reduction in plasma HCO3- concentration, caused by increased renal exretion of HCO3-
Changes in plasma hydrogen ion concentration can influence the degree of calcium binding to plasma proteins. With acidosis, less calcium is bound to the plasma proteins. Conversely, in alkalosis, a greater amount of calcium is bound to the plasma proteins. Therefore, patients with alkalosis are more susceptible to hypocalcemic tetany. | train | med_mcqa | null |
Xeroderma pigmentosum is caused due to group of closely related abnormalities in | [
"Mismatch repair",
"Base excision repair",
"Nucleotide excision repair",
"SOS repair"
] | C | Ref Harrison 17/e p387; Robbins 7/e p287; 9/e 314 Xeroderma Pigmentosum. Xeroderma pigmentosum (XP) is the classical human recessive disorder caused by defective nucleotide excision repair of DNA damage, including pyrimidine dimers induced by UV radiation. Symptoms may include a severe sunburnafter only a few minutes in the sun, freckling in sun exposed areas, dry skin and changes in skin pigmentation. Nervous system problems, such as hearing loss, poor coordination, loss of intellectual function and seizures, may also occur.Complications include a high risk of skin cancer, with about half having skin cancer by age 10 without preventive effos, and cataracts. There may be a higher risk of other cancers such as brain cancers.[ | train | med_mcqa | null |
Which one of the following human tissues contains the greatest amount of body glycogen? | [
"Liver",
"Kidney",
"Skeletal muscle",
"Cardiac muscle"
] | C | null | train | med_mcqa | null |
Pegylated Filgrastim is used for treatment of: | [
"Anaemia",
"Neutropenia",
"Thrombocytopenia",
"Pancytopenia"
] | B | Drugs Affecting Cells Of Blood i) RBC Growth factor for RBC is erythropoietin If we give erythropoietin from outside in form of darbopoetin, it will increase the formation of RBC Darbopoetin Uses Anemia due to chronic renal failure Bone marrow suppression ii) WBC Growth factor: G-CSF & GM-CSF G-CSF Drug GM-CSF Drug FILGRASTIM PEGFILGRASTIM SARGRAMOSTIM MOLGRAMOSTIM These drugs are used for anti-cancer drug induced neutropenia iii) Platelet Major growth factor in platelet is IL-11 OPRELVEKIN (injectable) Recombinant IL-11 All these drugs are given by subcutaneous routes. | train | med_mcqa | null |
Sphincter of Lutkans seen in | [
"Cystic duct",
"Common bile duct",
"Pancreatic duct",
"Ampulla of vater"
] | A | The mucosa of the cystic duct is arranged in spiral folds known as the valves of Heister and the wall is surrounded by a sphincteric structure called the sphincter of Lutkens.The mucous membrane contains indentations of the mucosa that sink into the muscle coat; these are the crypts of Luschka.Ref: Bailey and Love 27th edition Pg: 1188 | train | med_mcqa | null |
An elderly male on ventilator has received atracurium infusion for 3 days. He now develops epileptic fits. Probable cause for his epilepsy is: | [
"Allergy to drug",
"Accumulation of Atracurium",
"Accumulation of Laudanosine",
"Ventilator failure"
] | C | (C) Accumulation of Laudanosine [Lee13-191; Wuer-b09, 831# Laudanosine is a metabolite of Atracurium and has CNS stimulating properties.> Laudanosine may produce convulsions from its CNS stimulating action, when high plasma concentration of Laudanosine are reached. In clinical practice, in the operating room and ICV setting, such high concentrations are usually not reached, out the patient in question has been on atracurium for 3 consecutive days before he develops epilepsy and hence high plasma concentration of Laudanosine could well be a probable cause for epilepsy.# Use Of Muscle Relaxants In The Intensive Care Unit:> Canadian Journal Of Anaesthesia : Laudanosine is a metabolite of Atracurium. Hofmann elimination of each molecule of Atracurium releases two molecules of laudanosine. Laudanosine is a central system stimulant and has caused seizures in dogs following large intravenous boluses The seizure threshold level in humans is not known but case reports suggest that clinical doses are unlikely to result in important central effects in humans. Hepatic clearance and elimination half- life are prolonged in patients with liver failure. (Renal elimination accounts for only 4-9% while the remaining portion is dependent upon hepatic metabolism). | train | med_mcqa | null |
The pain around the hip with flexion, adduction & internal rotation of lower limb in a young adult after a road traffic accident is suggestive of | [
"Intracapsular fracture of the femoral neck",
"Extracapsular fracture of the femoral neck",
"Posterior dislocation of hip",
"Anterior dislocation of hip"
] | C | REF : MAHESWARI 9TH ED | train | med_mcqa | null |
Histopathologicali osett een in | [
"Retinoblastoma",
"Neurocysticercosis",
"PNET",
"Medulloblastoma"
] | B | Ans. b. Neurocysticercosis | train | med_mcqa | null |
Selective medium for Gonococci is | [
"Thayer - main medium",
"LJ medium",
"DCA medium",
"Macconkey's medium"
] | A | Selective media for gonococci is Thayer - Main media. It contains vancomycin, colistin and nystatin. These antimicrobials will suppress the growth of other organisms which inhibits the growth of Meningococci. Reference: Textbook of Microbiology; Anathanarayan and panicker's; 10th edition; Page no: 231 | train | med_mcqa | null |
Sodium content in mmol/L in WHO oral rehydration solution is- | [
"20",
"80",
"90",
"111"
] | B | Reduced osmolarity ORS grams/litre Reduced osmolarity ORS mmol/litre Sodium chloride 2.6 Sodium 75 Glucose, anhydrous 13.5 Chloride 65 Potassium chloride 1.5 Glucose, anhydrous 75 Trisodium citrate, dihydrate 2.9 Potassium 20 Citrate 10 Total Osmolarity 245 | train | med_mcqa | null |
Macrophage activation syndrome characterized by all except ? | [
"Activation of CD 8 + T cells",
"Presence of cytokine storm",
"It is the other name for hemophagocytic lymphohistiocytosis",
"Low levels of plasma ferretin"
] | D | Ans. is 'd' i.e., Low levels of plasma ferretin Hemophagocytic Lymphohistiocytosis Hemophagocytic lymphohistiocytosis (HLH) is a reactive condition marked by cytopenias and signs and symptoms of systemic inflammation related to macrophage activation. For this reason, it is also sometimes referred to as macrophage activation syndrome. Pathogenesis The common feature of all forms of HLH is systemic activation of macrophages and CD8+ cytotoxic T cells. The activated macrophages phagocytose blood cell progenitors in the marrow and formed elements in the peripheral tissues, while the "stew"of mediators released from macrophages and lymphocytes suppress hematopoiesis and produce symptoms of systemic inflammation. These effects lead to cytopenias and a shock-like picture, sometimes referred to as "cytokine storm" or the systemic inflammatory response syndrome. Familial forms of HLH are associated with several different mutations, all of which impact the ability of cytotoxic T cells and NK to properly form or deploy cytotoxic granules. The most common trigger for HLH is infection, paicularly with Epstein-Barr virus (EBV). Clinical Features Most patients present with an acute febrile illness associated with splenomegaly and hepatomegaly. Hemophagocytosis is usually seen on bone marrow examination, but is neither sufficient nor required to make the diagnosis. Laboratory studies typically reveal anemia, thrombocytopenia, and very high levels of plasma ferritin and soluble IL-2 receptor, both indicative of severe inflammation, as well as elevated liver function tests and triglyceride levels, both related to hepatitis. Coagulation studies may show evidence of disseminated intravascular coagulation. If untreated, this picture can progress rapidly to multiorgan failure, shock, and death. Treatment Involves the use of immunosuppressive drugs and "mild" chemotherapy. Patients with germline mutations that cause HLH or who have persistent/resistant disease are candidates for hematopoietic stem cell transplantation. Without treatment, the prognosis is grim, paicularly in those with familial forms of the disease, who typically survive for less than 2 months. | train | med_mcqa | null |
A young lady was admitted with h/o taking over dose of diazepam after broken affair. She has history of slitting her wrist previously. Most likely diagnosis is: | [
"Narcissistic PD",
"Dependent PD",
"Borderline PD",
"Histrionic PD"
] | C | The repetitive episodes of self - harming behavior after stressors is suggestive of borderline personality disorder. It comes under Cluster B Personality disorder . In this person is Emotionally unstable and have impulsive nature with history of unstable relationships. These person use mechanism of splitting (eg. think person is either good/ devil). Splitting is an unconscious tendency to categorize people as either overly idealized or denigrated, often out of intolerance of ambiguity Other types of cluster B PD are Histrionic PD, Narcissistic PD and Antisocial PD. | train | med_mcqa | null |
In the early postoperative period after excision of a pheochromocytoma, which complication is least likely? | [
"Infection",
"Hypeension",
"Atelectasis",
"Bleeding"
] | B | Hypeension is least likely to occur postoperatively because the source of catecholamines (ad.medulla) is removed so low BP is seen and therefore Hydrocoisone should be given to maintain BP & sugar Rest all options are common to occur post operatively. | train | med_mcqa | null |
Most common benign hepatic tumor is? | [
"Hemangioma",
"Hepatocellular carcinoma",
"Hepatoma",
"Secondaries"
] | A | Ans. (a) HemangiomaRef.: Bailey & Love 26th ed. /1083BENIGN TUMOURS OF LIVER* Hemangiomas: These are the most common type of benign liver tumor. Most of these tumors do not cause symptoms and do not need treatment.* Hepatic adenomas: These are benign epithelial liver tumors that develop in the liver and are found mainly in women that using estrogens as contraceptives. Symptoms associated with hepatic adenomas are all associated with large lesions which can cause intense abdominal pain.* Focal nodular hyperplasia (FNH) is the second most common tumor of the liver. This tumor is the result of a congenital arteriovenous malformation hepatocyte response. | train | med_mcqa | null |
The sandwich technique is recommended for: | [
"Class II composite restorations",
"Class V composite restoration",
"Class III composite restoration",
"Both 1 and 2"
] | D | This sandwich technique is recommended for Class II and V composite restorations when individual patients are at a moderate to high risk for caries.
Ref: Phillip’s Science of Dental Materials ed 12 pg 327 | train | med_mcqa | null |
In a patient who is an alcoholic, which of the following causes delirium tremens? | [
"Small consumption of alcohol",
"Gradual withdrawal from alcohol",
"Fatty liver",
"Acute infection"
] | D | Ans: D. Acute infectionThe essential feature of the syndrome is delirium occurring within 1 week after a person stops drinking or reduces intake of alcohol.Physical illness (Eg: hepatitis or pancreatitis) predisposes to the syndrome. | train | med_mcqa | null |
The following adverse effect of Penicillin is dose related: | [
"Skin rash",
"Interstitial Nephritis",
"Drug fever",
"Encephalopathy"
] | D | null | train | med_mcqa | null |
Which of the following streptococcal antigen cross reacts with synol fluid? | [
"Carbohydrate (group A)",
"Cell wall protein",
"Capsular hyaluronic acid",
"Peptidoglycan"
] | C | Antigens cross reactivity between Streptococcus antigens and the corresponding human antigen Streptococcal component Human tissue Capsular hyaluronic acid Synol fluid Cell wall protein Myocardium Group A carbohydrate Cardiac valves Cytoplasmic membrane antigen Vascular intima Peptidoglycans Skin antigens | train | med_mcqa | null |
When performing endodontic surgery on anterior crowned teeth, the ideal surgical flap design is a | [
"Full thickness rectangular flap",
"Full thickness triangular flap",
"Submarginal Leubke-Ochsenbein flap",
"Submarginal semilunar flap"
] | C | null | train | med_mcqa | null |
Most common cause of acute parotitis - | [
"S. Aureus",
"S. Pneumonia",
"Klebsiella",
"S.Viridans"
] | A | Ans. is 'a' i.e., Staph Aureus o MC organism is staph aureus >> str. viridans >> pneumococcus. | train | med_mcqa | null |
All are recognized causes of adult respiratory disress syndrome except: | [
"Smoke inhalation",
"Malignant hypeension",
"Gastric aspiration",
"Viral pnemonia"
] | B | ARDS is associated with non cardiogenic pulmoanary edema.Malignant hypeension will cause development of cardiogenic pulmonary edema. The four most impoant causes of ARDS: Sepsis,diffuse pulmonary infections,gastric aspiration and head injuries. | train | med_mcqa | null |
A known case of Lepromatous Leprosy was initiated on treatment.He developed new painful,erythematous papules over the body along with fever and lymphadenopathy. What is the likely diagnosis? | [
"Type I lepra reaction",
"Type II lepra reaction",
"Fernandez reaction",
"Mitsuda response"
] | B | Fever,Lymphadenopathy appearance of new skin lesions are suggestive of Type II Lepra reaction (or down grading reaction) which is caused by Type III hypersensitivity. | train | med_mcqa | null |
Type D personality has been recently found to be a risk factor for - | [
"Coronary artery disease",
"Depression",
"Personality disorder",
"Schizophrenia"
] | A | Type C personality → Increased risk of cancer
Type D personality → Increased risk of Cardiovascular problems:- increased mortality, MI, Sudden Cardiac death. | train | med_mcqa | null |
Cardiac marker diagnostic on 10th day of MI- | [
"CPKMB",
"LDH",
"Troponin",
"Myoglobin"
] | C | null | train | med_mcqa | null |
Which of the following is a derivative of Reichert's Cartilage? | [
"Stapes",
"malleus",
"Incus",
"Sphenomandibular joint"
] | A | Ans. is 'a' i.e., Stapes * Carilage of the second pharyngeal arch is called Reichert's Cartilage.* Derivatives of the Reichert's Cartilage includei) Stapesii) Styloid processiii) Stylohyoid ligamentiv) Small cornua of hyoidv) Superior part of the body of hyoid | train | med_mcqa | null |
Esophageal manometry is useful all this conditions EXCEPT: | [
"Achalasia",
"Diffuse esophageal spasm",
"To assess the peristaltic integrity prior to the surgery for GERD",
"Malignancy"
] | D | Esophageal manometry, or motility testing, entails positioning a pressure sensing catheter within the esophagus. Manometry is used to diagnose 1. Motility disorders (achalasia, diffuse esophageal spasm) 2.To assess peristaltic integrity prior to the surgery for reflux disease. Esophageal malignancy is not diagnosed with esophageal manometry. Upper GI endoscopy is the effective method for malignancy and biopsy can be taken. Ref: Harrison, Edition-18,Page-2430 | train | med_mcqa | null |
The loading dose of Aminophylline is- | [
"50-75 mg/kg",
"0.5-1.0 mg/kg",
"2.0-3.5 mg/kg",
"5-6 mg/kg"
] | D | Ans. is 'd' i.e. 5-6 mg/kg o Aminophylline is a preparation of theophylline, where theophylline is complexed with EDTA. o The i.v. injection must be slow (loading dose of 5 mg/kg over 20 min followed by an infusion of 9 mg/kg/h, adjusted according to subsequent plasma theophylline concentrations). | train | med_mcqa | null |
Which of the following pigments are involved in free radical injury? | [
"Lipofuscin",
"Melanin",
"Bilirubin",
"Hematin"
] | A | In aging or debilitating diseases the phospholipid end-products of membrane damage mediated by oxygen free radicals to get eliminated by intracellular lipid peroxidation. These, therefore, persist as collections of indigestible material in the lysosomes; thus lipofuscin is an example of residual bodies. Ref: Textbook of Pathology HARSH MOHAN 7th Edition page no.25 | train | med_mcqa | null |
Disulphiram acts by competitive inhibition of which enzyme? | [
"Alcohol dehydrogenase",
"Aldehyde dehydrogenase",
"Alcohol carboxylase",
"Aldyhyde carboxylase"
] | B | Ans. (b) Aldehyde dehydrogenaseRef KDT 6th ed. / 386EthanolAlcohol Dehydrogenase-------------------Acetaldehyde Aldehyde Dehydrogenase---------------------Acetate* Disulfiram is an anti-craving agent for alcoholics. It has been used as an aversion technique in alcoholics.* Disulfiram acts by inhibiting aldehyde dehydrogenase. If a person still takes alcohol while on disulfiram treatment, alcohol is metabolized as usual, but acetaldehyde accumulates.* This accumulation of acetaldehyde gives some distressing symptoms like flushing, burning sensation, throbbing headache, perspiration, dizziness, vomiting, confusion and circulatory collapse.* Therefore, it is recommended only for those alcoholics who are motivated and sincerely desire to leave the habit.* Drugs causing Disulfiram like reaction:# Metronidazole# Chlorpropamide# Cefoperazone# Cefotetan# Trimethorprim* Other drugs that decrease craving for alcohol and smoking: (remembered as NATO)# NALTREXONE# ACAMPROSATE# TOPIRAMATE# ONDANSETRONAlso Know* Drug which inhibit alcohol dehydrogenase - FOMEPIZOLE* Antidote for methanol poisoning: FOMEPIZOLE > ETHANOL* Antidote for ethelene glycol poisoning: FOMEPIZOLE | train | med_mcqa | null |
About scurvy true A/E – | [
"Subperiosteal haematoma with tenderness",
"Separation of epiphysis",
"↑ S. alkaline phosphatase",
"Gingival bleeding"
] | C | SCURVY
Scurvy is a disease resulting from deficiency of Vitamin 'C', which is required for collegen synthesis.
Function of Vit C and pathophvsiologv of scurvy
1. Collegeiz synthesis
Vitamin C is essential for the hydroxylation of lysine and proline in collegen formation.
Collegen is a component of intracellular matrix of capillaries, bone & teeth. | train | med_mcqa | null |
Keratoderma is a feature of - | [
"Pityriasis rubra pilaris",
"Pemphigus",
"Pityriasis rosea",
"Psoriasis"
] | A | pityriasis rubra pilaris: progress to erythroderma- with islands of sparing skin-nappies claires Fitzpatrick texbook of dermatology, page 532 | train | med_mcqa | null |
Omalizumab is ? | [
"Anti IgM antibody",
"AntilgG antibody",
"Anti IgE antibody",
"Anti IgD antibody"
] | C | Ans. is 'c' i.e., Anti IgE antibody | train | med_mcqa | null |
The following statements are true regarding leptospirosis, except - | [
"It is zoonosis",
"Man is the dead end host",
"Man is an accidental host",
"Lice acts as reservoirs of infection"
] | D | <p> Rats and small rodents- paicularly R.norvegicus and Mus musculoskeletal are the most impoant vectors. Reference:Park&;s textbook of preventive and social medicine,K.Park,23rd edition,page no:292. <\p> | train | med_mcqa | null |
A young child with recurrent bacterial meningitis should be clinically evaluated for the presence of | [
"Holoprosencephaly",
"Hypoplastic left hea syndrome",
"Spina bifida occulta with a dermal sinus tract",
"Syringomyelia of the lower cervical cord"
] | C | Spina bifida is a general term that refers to the abnormal fusion of the veebral arches of the lowest veebrae, usually in the sacrolumbar region. There are several disorders in this group of developmental abnormalities that have varying degrees of severity. Spina bifida occult is the mildest form and is characterized by failure of veebral fusion only. The spinal cord and meninges are normal. In spina bifida occult the defect in the closure of the neural tube is covered by skin and dermis, with only a pinpoint sinus or hair-covered depression marking the site. Bacterial meningitis, or meningomyelitis, is the major potential risk in these patients. The remaining types of spina bifida are classified as spina bifida cystic. Spina bifida with a meningocele is characterized by protrusion through the veebral defect of a meningeal sac filled with cerebrospinal fluid (CSF). Because the cord is in its normal location, there are minimal neurologic deficits. Next in severity is spina bifida with a myelomeningocele, which is characterized by herniation of the cord and a meningeal sac through the veebral defect. This abnormality is often associated with severe neurologic defects in the lower extremities, bladder, and rectum. The most severe form of spina bifida, spina bifida apea or myeloschisis, results from complete failure of fusion of the caudal end of the neural plate, which lies open on the skin surface. This abnormality also results in severe neurologic defects in the legs, bladder, and rectum. Reference: GHAI Essential pediatrics, 8th edition | train | med_mcqa | null |
The causative agent of Favus is | [
"Microsporum audounii",
"Microsporum canis",
"Trichophyton mentagrophyte",
"Trichophyton schoenleinii"
] | D | Favus is caused by Trichophyton schoenleinii and Trichophyton violaceum. Trichophyton mentagrophyte causes Tinea barbie and ectothrix hair infection. Microsporum audouinii - Tinea capitis and ectothrix hair infection. Microsporum canis infects dogs and cats. Reference: Textbook of Microbiology; Baveja; 4th edition | train | med_mcqa | null |
Features in our of ventricular tachycardia are all the following except | [
"AV dissociation",
"Capture/fusion beat",
"Good response to carotid sinus massage",
"A history of myocardial infarction"
] | C | Features in our of ventricular tachycardia are the D/D of broad complex tachycardia : History of Myocardial Infarction AV dissociation (pathognomonic) Capture/fusion beats (pathognomonic) Extreme left axis detion Very broad QRS complexes No response to carotid sinus massage or IV adenosine Ref - Harrison&;s internal medicine 20e pg1750 | train | med_mcqa | null |
Which of the following statements about cerebellar astrocytomas in paediatric age group is False: | [
"These are usually Low grade tumors",
"These tumors have a good prognosis",
"These are more commonly seen in the 1' and 2'd decades",
"These tumours are more common in females"
] | D | Answer is D (These tumors are more common in females) Cerebellar Astrocytomas do not show any clear gender predilection and are equally common in both males & females. The predominant group of astrocytomas in childhood are low grade astrocytomas (Nelsons ) Juvenile Pilocytic Astrocytoma (JPA) is the most common astrocytoma in children') Juvenile Pilocytic Astrocytoma is a low grade tumor and is classified as a WHO grade I tumor Cerebellar Astrocytomas (JPA) do not show any clear gender predelictionQ (i.e, Equally common in males and females) (From WHO classification of tumors of CNS) Cerebellar Astrocytomas (Juvenile JPA) most commonly develop during the first two decades of lifedeg (WHO classification of Tumors of CNS) Cerebellar Astrocytomas have a good prognosis With complete surgical resection the overall survival for Juvenile Pilocytic Astrocytomas approaches 80% - 100% Facts to Remember : * The most common tumors in children are : Leukaemia * The most common solid tumours in children are: CNS tumors * The most common site of brain tumors in children is Infratentorial (cerebellar) * The most common site of brain tumors in neonates is supratentorial * The most common CNS tumors in children are Glial tumors Choi tumors * Astrocytomas * Oligodindrogliomas * Ependymomas Note * Glial tumors as a group are more common than medulloblastomas * If a question asks about the most common brain tumor in children, and it does not have astrocytoma as an option, but it has 'glioma' as an option, mark Glioma in preferance to Medulloblastoma. (Astrocytoma is also a' glioma'). * When based on histology the prevalence of Medulloblastomas and Juvenile Pilocytic astrocytoma / cerebellar astrocytomas has been mentioned as equal in most textbooks Yet Cerebellar astrocytomas are accepted as the most common posterior fossa tumors in children * Astrocytoma (Cerebellar) - Most common posterior fossa tumor in children is Cerebellar Astrocytoma.Q - Therefore most common brain tumor in children is also Cerebellar Astrocytoma. Q - Astrocytoma also has the best prognosis in children.Q - Therefore tumor with best prognosis in children is also Astrocytoma.Q * Medulloblastoma - The second most common posterior fossa tumor in children. Q - Tumor which spreads along CSF pathways is medulloblastoma.Q - Tumor which is capable of metastasising to extracranial sites is medulloblastoma. Q - Medulloblostoma is highly radiosensitive.Q * Brain Stem Gliomas : - These are the third most frequent post. fossa tumors in childrenQ * Craniophatyngioma : - These are the most common supratentorial tumor in children.Q | train | med_mcqa | null |
Which of the following malignancies is not associated with cigarette smoking? | [
"Acute myeloid leukemia",
"Cervix",
"Pancreas",
"Postmenopausal breast cancer"
] | D | Tobacco smoking associated cancers: Lung, oral cavity, naso-, oro-, and hypopharynx, nasal cavity and paranasal sinuses, larynx; esophagus, stomach, pancreas, liver, kidney (body and pelvis), ureter, urinary bladder, and uterine cervix and also causes myeloid leukemia. Play a role in increasing the risk of colorectal, hepatocellular, and possibly premenopausal breast cancer. There is no association with postmenopausal breast cancer. Ref: Burns D.M. (2012). Chapter 395. Nicotine Addiction. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | train | med_mcqa | null |
ECT is contraindicated in | [
"Pregnancy",
"Seizure disorder",
"Mania",
"Raised Intracranial pressure"
] | D | Raised intracranial pressure is the only absolute contraindication for ECT | train | med_mcqa | null |
All of the following statements about Sibson&;s fascia are true, except: | [
"It is attached to transverse process of C7",
"Subclan aery arches over it",
"Attached to the cervical pleura",
"Develops from the Scalenous Anterior"
] | D | Sibson&;s fascia morphologically represents degenerated Scalenous Minimus muscle Sibson&;s fascia or Suprapleural membrane: Sibson Fascia is a strong fascial connective tissue layer above the superior thoracic inlet on each side, covering the apex of the lung. It serves as a plane of seperation between the lower neck and the thorax. It is placed over the cervical pleura and hence also named as Suprapleural membrane. Sibson&;s fascia, morphologically represents the degenarated Scalenus Minimus muscle. Attachements and relations of Sibson&;s fascia: Attachments Relations Posteriorly: Transverse process of the C7 Anteriorly and laterally: medial margin of the first rib Superiorly: Subclan aery and Vein Inferiorly: Cervical pleura (cervical dome of pleura is attached to its undersurface) Functions: It protects the underlying cervical pleura, beneath which is located the apex of the lung It provides rigidity to the thoracic inlet that prevents distoion due to changes in intrathoracic pressure during respiration. Consequently, the root of neck is not puffed up and down during respiration. Ref: Gray&;s Anatomy 41st edition Pgno: 446 | train | med_mcqa | null |
Largest tooth in the mandibular arch is: | [
"Canine",
"Deciduous first molar",
"Permanent first molar",
"Third molar"
] | C | null | train | med_mcqa | null |
Bone within bone appearance is seen in – | [
"CML",
"Osteoporosis",
"Osteopetrosis",
"Bone infarct"
] | C | Bone within a bone appearance may be seen in osteopetrosis. | train | med_mcqa | null |
All are true about acromegaly except : | [
"Increased IGF-1 levels",
"Excessive growth occurs before fusion of the epiphyses of the long bones",
"Somatostatin analogues can be used",
"Growth hormone levels increased"
] | B | Ans. B. Excessive growth occurs before fusion of the epiphyses of the long bonesIn acromegaly, IGF-I levels are invariably high and reflect a Log-Linear relationship with clrculatlng GH concentrations.For acromegaly, somatostatin analogues and GH receptor antagonists are indicatedAge-matched serum IGF-I levels are elevated in acromegaly.Somatostatin analogues are used as adjuvant treatment for preoperative shrinkage of large invasive macroadenomas.Transsphenoidal surgical resection by an experienced. surgeon is the preferred primary treatment.Tumors of the somatotrophs of the anterior pituitary (pituitary adenomas) secrete large amounts of growth hormone, leading to glgantbm ln chlUren and acromegaly in adults.Hypersecretion of growth hormone is accompanied by hypersecretion of prolactin in 20-40% of patients with acromegaly. | train | med_mcqa | null |
Hyperkalemia presents with all except? | [
"Periodic paralysis",
"Hemodynamic collapse",
"Ileus",
"Slow idioventricular rhythms"
] | C | Hyperkalemia from a variety of causes can also present with ascending paralysis this is known as secondary hyperkalemic paralysis to differentiate it from familial hyperkalemic periodic paralysis (HYPP). The presentation may include diaphragmatic paralysis and respiratory failure. Cardiac rhythm disorder with hyperkalemia includes slow indioventricular rhythm. Hypokalemia results in slow repolarization of skeletal muscle, impairing the capacity to contract: weakness and even paralysis may ensue. The paralytic effects of hypokalemia on intestinal smooth muscle may cause intestinal ileus. | train | med_mcqa | null |
A 74-year-old woman is admitted to the hospital in an obtunded condition. Her temperature is 37deg C, pulse is 95/ min, respirations are 22/min, and blood pressure is 90/60 mm Hg. She appears dehydrated and has poor skin turgor. Her serum glucose level is 872 mg/dL. Urinalysis shows 4+ glucosuria, but no ketones, protein, or blood. Which of the following factors is most important in the pathogenesis of this patient's condition? | [
"Autoimmune insulitis",
"Glucokinase gene mutation",
"HLA-DR3/HLA-DR4 genotype",
"Peripheral insulin resistance"
] | D | A complication of type 2 diabetes mellitus is hyperosmolar, nonketotic coma. In type 2 diabetes mellitus, the fundamental defect is insulin resistance, leading to an eventual decrease in plasma insulin or a relative lack of insulin, but there is still enough insulin to prevent ketosis. The resulting hyperglycemia tends to produce polyuria, leading to dehydration, which increases the serum glucose level further. If not enough fluids are ingested, dehydration drives the serum glucose to very high levels. Glucokinase gene mutations can be present with maturity-onset diabetes of the young (MODY). The HLA-DR3/HLA-DR4 genotype is a predisposing factor for type 1 diabetes mellitus. Severe loss of beta cells with insulitis, which may be triggered by a viral infection, is a feature of autoimmune, or type 1, diabetes mellitus. | train | med_mcqa | null |
Brunner glands are seen in | [
"Stomach",
"Duodenum",
"Ileum",
"Appendix"
] | B | INDERBIR SINGH&;S TEXTBOOK OF HUMAN HISTOLOGY-PAGE NO:272 The wall of the small intestine is made up of the four layers: mucous,submucous,muscularis and serous.the serous and muscular layers correspond exactly to the general structure of the alimentary canal.the sub mucosa is also typical except in the duodenum,where it contains the glands of brunner | train | med_mcqa | null |
Human Development Index (HDI) does not include:- | [
"Mean years of schooling",
"Life expectancy at age 1",
"Real GDP per capita",
"Life expectancy at bih"
] | B | Human Development Index Have 3 dimensions: Literacy rate aka Knowledge/ Mean years of schooling / Education index/ Enrolment ratio. Income aka income per capita/ US $ PPP Life expectancy at bih aka LE0/ Longevity at bih. | train | med_mcqa | null |
Xenon anesthesia all are true except | [
"Slow induction and recovery",
"Non explosive",
"Minimal cardiovascular side effect",
"Low blood solubility"
] | A | Advantages of Xenon anesthesia Ine Minimal effect on CVS function Lowest blood solubility Does not trigger malignant hypothermia Environmental friendly Non explosive Refer Goodman Gilman 12/e p 547 | train | med_mcqa | null |
A middle-aged woman comes to her physician's office with complaints of visual difficulties. A review of systems and physical examination are unremarkable except for her eye exam. When a light is shined in her right eye, there is no pupillary response in either eye. However, upon shining a light in her left eye, both ipsilateral and contralateral pupillary responses are apparent. Her extraocular movements are intact. What is the MOST likely location of her lesion? | [
"Oculomotor nerve, left side",
"Oculomotor nerve, right side",
"Optic nerve, left side",
"Optic nerve, right side"
] | D | This woman has a "Marcus-Gunn pupil," with a defect in the afferent pathway of the optic nerve (in this case on the right side). Recall that the afferent limb of the pupillary light reflex is the optic nerve (CN II); the efferent limb is the oculomotor nerve (CN III; parasympathetic fibers). When light is shined into her right eye, because her right optic nerve is not functioning properly, the light signal is not transmitted to the CNS, resulting in no pupillary response. As light is shined into her left eye, the left optic nerve transmits the signal to the CNS, which then sends an outbound signal through both the right and left oculomotor nerves to cause pupillary constriction in both eyes. Must know: The occulomotor nerve innervates all extraocular muscles except the lateral rectus (innervated by the abducens nerve), and the superior oblique (innervated by the trochlear nerve). The oculomotor nerve also mediates pupillary constriction (parasympathetic fibers), eyelid opening (levator palpebrae), and innervates the ciliary muscle (allowing accommodation). A patient with a lesion of the left optic nerve would have no pupillary responses in either eye when shining a light in the left eye; pupillary responses would be present in both eyes when shining a light in the right eye. Ref: Greenberg D.A., Aminoff M.J., Simon R.P. (2012). Chapter 7. Neuro-Ophthalmic Disorders. In D.A. Greenberg, M.J. Aminoff, R.P. Simon (Eds), Clinical Neurology, 8e. | train | med_mcqa | null |
The most impoant channel of elimination of digoxin is: | [
"Glomerular filtration",
"Tubular secretion",
"Hepatic metabolism",
"Excretion in bile"
] | A | Digoxin is primarily eliminated unchanged by glomerular filtration Digitoxin is eliminated by hepatic metabolism. | train | med_mcqa | null |
Radioiodine ablation is preferred in | [
"Pregnancy",
"Graves disease",
"Young patients",
"Post surgery papillary carcinoma"
] | D | Surgery is followed by RIA if thyroid tissue is left.
I131 is used which has a half life of 8 days. | train | med_mcqa | null |
The highest ESR is seen in following conditions, except: | [
"Polymyositis rheumatica",
"Multiple myeloma",
"Temporal Aeritis",
"Polycythemia rubra"
] | D | Polycythemia rubra | train | med_mcqa | null |
At what level of b-HCG is it that normal pregnancy can be earliest detected by TVS: | [
"500 IU/m1",
"1000 IU/m1",
"1500 IU/m1",
"2000 IU/m1"
] | B | Ans. is b i.e. 1000 IU/m1 PhCG level (MiU/mi) Structure visible TVS/TAS * 1000 - 1200 Gestational sac TVS * 6000 Gestational Sac TAS * 7000 Yolk sac TAS * 11000 Embryo TAS | train | med_mcqa | null |
In severe injury, first to be maintained is ? | [
"Hypotension",
"Dehydration",
"Airway",
"Cardiac status"
] | C | Answer is 'c' i.e. Airway ABC is followed i.e. Airway Breathing then Circulation is evaluated in order. | train | med_mcqa | null |
In action potential of nerve the overshoot is | [
"Above Iso-potential",
"Below Iso-potential",
"Below resting membrane potential",
"Above resting membrane potential"
] | A | Over shoot is produced due to opening of sodium channals and depolarization It is about the threshold level Ref:Guyton and Hall textbook of medical physiology 12th edition,page number: 66 | train | med_mcqa | null |
Bacitracin acts on | [
"Cell wall",
"Cell membrane",
"Nucleic acid",
"Ribosome"
] | A | Ref Katzung 10/e p 741 Bacitracin acts by inhibiting the synthesis of cell wall Other polypeptide antibiotics like Polymyxin B, colistin and tyrothricin act by affecting membranes | train | med_mcqa | null |
Common precursor of mineralocorticoid, glucocorticoids and sex steroids: | [
"Pregnenolone",
"a- hydroxyprogesterone",
"Dehydrotesterone",
"Deoxycorticoid"
] | A | Ans. (a) Pregnenolone(Ref: Ganong, 25th ed/p.362)Adrenal steroid hormones are derived from cholesterolIn the mitochondria, cholesterol is converted to pregnenolone by cholesterol desmolase, also called as side- chain cleavage enzyme | train | med_mcqa | null |
All are true regarding diphtheria toxin except ? | [
"Toxin blocks elongation of protein",
"Beta lysogenic strain produces toxin",
"Iron is critical for toxin production",
"Toxin is necessary for local wound production"
] | D | Option 4 Corynebacteriam diphtheriae does not need to be toxigenic to establish localized infection. Option 1, 2, 3 Mechanism of Action of diphtheria toxin Has 2 fragments: Fragment A (active unit) Fragment A is internalized into the host cells and then causes- ADP ribosylation of elongation factor 2(EF2) - inhibition of EF2- irreversible inhibition of translation step of protein synthesis- cell death. Fragment B (binding unit) Binds to the host cell receptors (such as epidermal growth factor) Helps in entry of fragment A. Toxin Production is dependent on: Phage coded: DT is coded by b corynophage carrying tox gene. Iron concentration: Toxin production depends on optimum iron concentration (0.1 mg/liter). DT repressor gene (DtxR) is an iron dependent negative regulator of DT production and iron uptake in C.diphtheriae. | train | med_mcqa | null |
A young, tall, thin, male with archnodactyly has ectopia lentis in both eyes. The most likely diagnosis is | [
"Marfan's syndrome",
"Marchesani's syndrome",
"Homocystinuria",
"Ehler's danlos syndrome"
] | A | Answer is A (Marfan's syndrome): Arachnodactyly and ectopia lends (dislocation of lens) in tall thin male suggests a charachteristic diagnosis of Marfan's syndrome. Marfan Syndrome : Review Marfan's syndrome is a genetic disorder of the connective tissue of the body manifested principally by changes in the skeleton, eye and cardiovascular system. | train | med_mcqa | null |
Infective dose of salmonella typhi - | [
"10 bacilli",
"1000 bacilli",
"103 - 106 bacilli",
"1010 - 1012 bacilli"
] | C | Ans. is 'c' i.e., 103-106 bacilli [Ref: Ananthanarayan 9th/ep. 295 & 8th/e p. 293)o In human volunteer experiments, the infective dose was found to be I0M06 bacilli.Organism Infective doseo ETEC-106-1010oEIEC-108-1010o EHEC-10-100 (< 103)o Shigella-10-100o Campylobactor jejuni-104o Yersinia enterocolitica-1010-109o Vibrio-1010 (if source of infection is water) -10*-104 (if source of infection is food) | train | med_mcqa | null |
For which malignancy, intensity Modulated Radiotherapy is the most suitable | [
"Lung",
"Prostate",
"Leukemias",
"Stomach"
] | B | The prostate is a walnut-sized gland located between the bladder and the penis. The prostate is just in front of the rectum.
The urethra runs through the center of the prostate, from the bladder to the penis, letting urine flow out of the body.
The prostate secretes a fluid that nourishes and protects sperm.
During ejaculation, the prostate squeezes this fluid into the urethra, and it’s expelled with sperm as semen. | train | med_mcqa | null |
HIV virus primarily effets: | [
"CD4 + T cells",
"CD 8 cells",
"Lymphocytes",
"Plasma cells"
] | A | CD4 + T cells | train | med_mcqa | null |
To minimize the effects of diffusion hypoxia during N2O-O2 analgesia, the patient should be oxygenated for | [
"30 seconds to 1 minutes",
"3 to 5 minutes",
"10 to 30 minutes",
"30 to 45 minutes"
] | B | null | train | med_mcqa | null |
A 3 month old, asymptomatic infant with, H/o TB exposure, has taken 3 months of chemoprophylaxis( isoniazid ), what is to be done next? | [
"Test sputum and then decide",
"Continue for 3 more months",
"Tuberculin test then decide",
"Immunise with BCG & stop prophylaxis"
] | B | A child born to mother who was diagnosed to have TB in pregnancy should receive prophylaxis for 6 months, provided congenital TB has been ruled out | train | med_mcqa | null |
All lesions are seen in leprosy except | [
"Erythematous Macule",
"Hypo pigmented patch",
"Vesicles",
"Flat & raised patches"
] | C | C i.e. Vesicles | train | med_mcqa | null |
A 22 year old man had a Beef sandwich and Potato salad. He Vomited 2 hours after the meal. What is the probable diagnosis | [
"S. aureus poisoning",
"Bacillus cereus poisoning",
"Clostridial poisonong",
"Helicobacter pylori poisoning"
] | A | Preformed toxin of S. aureus causes nausea within 1-6 hours of ingestion.
Common food associated are: Poultry, potato and egg salad. | train | med_mcqa | null |
A newborn child shows subconjunctival hemorrhages. What is the next line of management? | [
"No treatment",
"Antibiotic eye drops",
"Aspitation",
"Antibiotic and steroid drops"
] | A | Ans. is 'a' i.e., No treatment o Repeat from previous sessions | train | med_mcqa | null |
Mesophilic organism grows at | [
"- 20 to 7degC",
"10 to 20degC",
"25 to 40degC",
"55 to 80degC"
] | C | Ref: Ananthnarayan, 9th ed. ch-1Organisms on the basis of their growth at different temperature:* Psychrophilic: (below 20degC)* Psychrotrophs: (important cause of food spoilage)* Mesophilic: (25-40degC)* Thermophilic: (55-80degC) | train | med_mcqa | null |
In osteogenic sarcoma predominant histological finding is ? | [
"Giant cells",
"Osteoid forming tumor cells",
"Fibroblastic proliferation",
"Chondroblasts"
] | B | Ans. is 'b' i.e., Osteoid forming tumor cells Histologic appearance of osteosarcoma It appears pale and extending through the coex on gross cut section examination. On histological sections it consists of malignant stromal tissue showing osteoid formation. Osteoid bone formation by tumor cells is diagnostic of OGS. | train | med_mcqa | null |
Specific immunological unresponsiveness is called tolerance. Which one of the following statements best describes immunological tolerance- | [
"Immunologic maturity of the host does not play a major role",
"It occurs only with polysaccharide antigens",
"It is related to the concentration of antibody",
"It is prolonged by administration of immuno-suppressive drugs"
] | D | null | train | med_mcqa | null |
False statement about Racecadotril is | [
"It is a peripheral acting enkephalinase inhibitor",
"It is a drug used in constipation",
"It is metabolized by liver",
"It has antisecretory action on GIT"
] | B | Racecadotril is used in cases of diarrhoea, which acts by inhibiting breakdown of endogenous opioids by enkephalinase enzyme. | train | med_mcqa | null |
A daily water supply considered adequate to meet the need for all urban domestic purposes is | [
"10 litres per capita",
"20 litres per capita",
"40-60 litres per capita",
"150-200 litres per capita"
] | D | null | train | med_mcqa | null |
A patient presented with some unknown fungal infection. Microscopic examination revealed brown coloured spherical fungi with septate hyphae. Possible condition: | [
"Histolasmosis",
"Chromblastomycosis",
"Coccidioidomycosis",
"Candida albicans"
] | B | Dermatiaceous Fungus Involves skin & sub cutaneous tissues Sclerotic bodies seen in tissue biopsy Brown colored lobose bodies Aka medlar bodies Show copper penny appearance Examples - 1) Philophora 2) Cladosporium | train | med_mcqa | null |
"Cystercosis" is caused by : | [
"Taenia solium",
"Taenia saginata",
"Echinococcus",
"None"
] | A | Taenia solium | train | med_mcqa | null |
The amount of blood lossduring each menstrual period is about : | [
"10 cc",
"35 cc",
"50 cc",
"100 cc"
] | B | 35 cc | train | med_mcqa | null |
Which one of the following is not a premalignant condition for colon cancer? | [
"Familial adenomatous polyposis coli",
"Villous adenoma",
"Ulcerative colitis",
"Hamaomatous polyps"
] | D | .Hamaomatous polyps are seen in * Peutz-Jegher's syndrome. * Juvenile polyp. * Cronkhite - Canada syndrome. Juvenile Polyps * Commonest polyp of colorectum in infants and children. * Can cause intussusception, prolapse through rectum, bleeding. Cronkite - Canada Syndrome * Polyps in stomach, duodenum and colorectum. No polyps in oesophagus * Intractable diarrhoea, pigmentation, cachexia, alopecia, onychodystrophy * In females * 15% will have malignancy * Colonoscopic polypectomy is done. * Not a pre-malignant condition. ref:SRB&;s manual of surgery,ed 3,pg no 834 | train | med_mcqa | null |
Intramuscular injection of atropine causes initial bradicardia. The reason for this effective being seen is | [
"Stimulation of medullary vagal centre",
"Stimulation of vagal ganglia",
"Blockade of ME receptor and SA nodal cells",
"Blockade of muscarinic auto receptor on vagal nerve ending"
] | D | Ref-KDT 6/e p107 Atropine is a non-selective antagonist of M1, M2, and M3 muscarinic receptors. M2, cholinergic receptors are responsible for bradycardia and blockade of these receptors can result in tachycardia. Atropine initially acts on presynaptic M1, receptors (normally decrease the release of ACh) and result in greater release of ACh which is responsible for bradycardia. Later on, blockade of M2 receptors will lead to tachycardia. | train | med_mcqa | null |
A 33 year old male who was travelling by a flight staed fighting with one of the air hostesses. The man alleged that the airhostess is actually his 'wife' and she has changed her face, so that she cant be identified. This history is consistent with- | [
"Capgras syndrome",
"Fregoli syndrome",
"Othello synderome",
"de Clerembault syndrome"
] | B | Delusions of misidentification Fregoli syndrome: Delusion of familiar person imposing as a stranger and can take multiple different appearances. Capgras syndrome: Belief that a familiar person is replaced by a stranger or a stranger is imposing as a familiar person. | train | med_mcqa | null |
Which of the following is the neuromuscular blocking agent with the shortest onset of action ? | [
"Mivacurium",
"Vecuronium",
"Rapacuronium",
"Succinylcholine"
] | D | Fastest acting (shortest onset of action) muscle relaxant → Succinylcholine
Fastest acting non-depolarizing muscle relaxant → Rocuronium. | train | med_mcqa | null |
Most common site of lymphangioima is- | [
"kidney",
"head and Neck",
"Groin",
"Hea"
] | B | Lymphangiomas are the benign lymphatic counterpa of hemangiomas. Simple (capillary) lymphangiomas are slightly elevated or sometimes pedunculated lesions up to 1 to 2 cm in diameter that occur predominantly in the head, neck, and axillary subcutaneous tissues. Cavernous lymphangiomas (cystic hygromas) typically are found in the neck or axilla of children, and more rarely in the retroperitoneum. (Robbins basic pathology,9th edition,pg no.359) | train | med_mcqa | null |
All the following are characteristic feature of Cluster headache except: | [
"Periodic pain",
"Conjunctival injection",
"Bilateral photophobia",
"No response to oral sumatriptan"
] | C | Ans: C (Bilateral photophobia) Ref: Hcirrisotis principles of Internal Medicine. 18th edition. 2012. Chapter 14. Pg.112Explanation:CLUSTER HEADACHEThe pain is deep, usually retroorbital, excruciating in intensity, nonfluctuating, and explosive in quality.A core feature of cluster headache is Periodicity. At least one of the daily attacks of pain recurs at about the same hour each day for the duration of a cluster bout.The typical cluster headache patient has daily- bouts of one to two attacks of relatively short- duration unilateral pain for 8 to 10 weeks a year; this is usually followed by a pain-free interval that averages a little less than 1 year.Patients are generally perfectly well between episodes.Onset is nocturnal in about 50% of patients, and men are affected three times more often than women.Patients with cluster headache tend to move about during attacks, pacing, rocking, or rubbing their head for relief. This is in sharp contrast to patients with migraine, who prefer to remain motionless during attacks.Cluster headache is associated with ipsilateral symptoms of cranial parasympathetic autonomic activation: conjunctival injection or lacrimation, rhinorrhea or nasal congestion, or cranial sympathetic dysfunction such as ptosis.The sympathetic deficit is peripheral and likely to be due to parasympathetic activation with injury to ascending sympathetic fibers surrounding a dilated carotid artery as it passes into the cranial cavity.When present, photophobia and phonophobia are far more likely to he unilateral and on the same side of the pain, rather than bilateral, as is seen in migraine.Cluster headache is likely to be a disorder involving central pacemaker neurons in the region of the posterior hypothalamusTreatment:Acute Attack TreatmentOxygen inhalation.Sumatriptan 6 mg SC is rapid in onset and will usually shorten an attack to 10-15 minSumatriptan (20 mg) and zolmitriptan (5 mg) nasal spraysOral sumatriptan is not effective for prevention or for acute treatment of cluster headache.Preventive Treatments (See the following table)Neurostimulation TherapyIndicated when medical therapies failDeep-brain stimulation of the region of the posterior hypothalamic gray matter has proven successful in a substantial proportion of patients. | train | med_mcqa | null |
Treatment of choice for CSOM with veigo and facial nerve palsy is: | [
"Antibiotics and labyrinthine sedative",
"Myringoplasty",
"Immediate mastoid exploration",
"Labyrinthectomy"
] | C | Ans. C Immediate mastoid explorationFacial Palsy and CSOMIn CSOM, facial palsy may be due to erosion of fallopian canal by cholesteatoma (which erodes fallopian canal) osteitis, or demin!eralization. The treatment should be urgent mastoid exploration, with decompression of the facial nerve in the fallopain canal.However, the scenario is not the same in ASOM. An acute inflammatory process cannot effectively erode the bony falopian canal within the sho period of time. Hence, the only possibility in a patient with ASOM to develop facial palsy is the presence of a congenitally dehiscent fallopian canal (facial nerve without a bony canal), which is the commonest congenital maliformation of temporal bone .Thus in this case the treatment is myringotomy to relieve pressure on the exposed nerve or sometimes cotical mastoidectomy. | train | med_mcqa | null |
Rapid high-frequency fluttering of anterior mitral valve leaflets during systole on 2D ECHO is characteristically seen with | [
"Mitral regurgitation",
"Tricuspid regurgitation",
"Pulmonary regurgitation",
"Aoic regurgitation"
] | D | Echocardiogram in aoic regurgitation:In chronic aoic regurgitation (AR), the LV size is increased and systolic function is normal or even supernormal until myocardial contractility declines.A rapid, high-frequency diastolic fluttering of the anterior mitral leaflet produced by the impact of the regurgitant jet is a characteristic finding.The echocardiogram is also useful in determining the cause of AR, by detecting dilation of the aoic annulus and root, aoic dissection or primary leaflet pathology. With severe AR, the central jet width assessed by color flow Doppler imaging exceeds 65% of the left ventricular outflow tract, the regurgitant volume is >=60 mL/beat, the regurgitant fraction is >=50%, and there is diastolic flow reversal in the proximal descending thoracic aoa. Surveillance transthoracic echocardiography forms the cornerstone of follow-up and allows for the early detection of changes in LV size and/or function. On auscultation, in patients with severe AR, a low-pitched, rumbling mid-to-late diastolic murmur is heard at the apex. This is called the Austin Flint murmur. It is probably produced by the diastolic displacement of the anterior leaflet of the mitral valve by the AR stream.It may be mistaken for MS but can be differentiated from MS murmur because the Austin Flint murmur is not intensified in presystole and becomes softer with the administration of amyl nitrite.Ref: Harrison's 18/e p1944, 1931 | train | med_mcqa | null |
Chance of subsequent baby having NTD when first baby was born with NTD - | [
"2%",
"4%",
"10%",
"20%"
] | B | Ans. is 'b' i.e., 4%The recurrence risk of neural tube defect is :3 - 5 % if a couple has previously had a child with either anencephaly or spina bifida.5% if either parent was born with a NTD.10% if a couple has two affected children | train | med_mcqa | null |
A post-mortem clot is most likely to: | [
"Grossly display features of recanalization",
"Grossly have lines of Zahn",
"Grossly have the appearance of “chicken fat” overlying “currant jelly”",
"Microscopically appear attached to the wall of the blood vessel"
] | C | The postmortem clot is usually rubbery, gelatinous, and lacks fibrin strands and attachments to the vessel wall. Large postmortem clots may have a “chicken fat” appearance overlying a dark “currant jelly” base. | train | med_mcqa | null |
Clubbing is not seen in | [
"Bronchiectasis",
"Hydropneumothorax",
"ILD",
"COPD"
] | D | Clubbing not seen in COPD. | train | med_mcqa | null |
Which tooth is first to erupt in lower jaw is? | [
"Central incisor",
"Lateral incisor",
"Canine",
"Molar"
] | A | Ans. is 'a' i.e., Central incisor First temporary tooth to appear (in primary dentition) is lower central incisors and last temporary tooth to erupt is 2nd molar.The sequence of eruption is lower central incisor > upper central incisor > upper lateral incisor > lower lateral incisor > 1st molar > Canine > 2nd molar.Therefore eurption of temporary teeth is completed by eruption of 2nd molar at 25 months (2 years). | train | med_mcqa | null |
Streak ovaries are seen in: CMC (Vellore) 09 | [
"Klinefelter syndrome",
"Turner syndrome",
"Down syndrome",
"Kallamann syndrome"
] | B | Ans. Turner syndrome | train | med_mcqa | null |
Percentage of Halothane metabolized - | [
"50%",
"5%",
"2.50%",
"25%"
] | D | The extent and location of inhaled anesthetic metabolism depends on multiple chemical factors. Inhaled anesthetics undergo varying degrees of biotransformation in various tissues. Methoxyflurane undergoes by far the greatest metabolism, estimated at 70%, and experiments indicate that only a small fraction of drug taken up into body tissues is exhaled. Given the remarkable lipophilicity of methoxyflurane, respiratory clearance of this drug from muscle and fat extends over a period of days. Halothane is the next most lipophilic drug and ranks second in metabolic clearance. Thus, prolonged residence in body tissues is an impoant factor in the biotransformation of inhaled anesthetics. Chemical stability is another impoant factor. Of the major organs involved in anesthetic biotransformation, the liver and kidneys are exposed to the highest metabolite concentrations and thus are most susceptible to damage from toxic metabolites. Clinically significant hepatotoxicity is primarily associated with exposure to halothane, and nephrotoxicity is associated with methoxyflurane. Ref: Miller's anesthesia 8th edition | train | med_mcqa | null |
True about body fluid osmolarity- | [
"Major contributor is proteins",
"Major contributor is Na+",
"ECF osmolarity is 250 mOsm/L",
"Measured by dilution method"
] | B | Ans. B. Major contributor is Na+OSMOLAL CONCENTRATION OF PLASMA: TONICITY: -a. The freezing point of normal human plasma averages -0.54degC, which corresponds to an osmolal concentration in plasma of 290 mOsm/L. This is equivalent to an osmotic pressure against pure water of 7.3 atmospheres (atm). The osmolality might be expected to be higher than this, because the sum of all the cation and anion equivalents in plasma is over 300 mOsm/L.b. It is not this high because plasma is not an ideal solution and ionic interactions reduce the number of particles free to exert an osmotic effect. Except when there has been insufficient time after a sudden change in composition for equilibrium to occur, all fluid compartments of the body are in (or nearly in) osmotic equilibrium.c. The term tonicity is used to describe the osmolality of a solution relative to plasma. Solutions that have the same osmolality as plasma are said to be isotonic; those with greater osmolality are hypertonic; and those with lesser osmolality are hypotonic. All solutions that are initially isosmotic with plasma (ie, that have the same actual osmotic pressure or freezing-point depression as plasma) would remain isotonic if it were not for the fact that some solutes diffuse into cells and others are metabolized. Thus, a 0.9% saline solution remains isotonic because there is no net movement of the osmotically active particles in the solution into cells and the particles are not metabolized. On the other hand, a 5% glucose solution is isotonic when initially infused intravenously, but glucose is metabolized, so the net effect is that of infusing a hypotonic solution.d. It is important to note the relative contributions of the various plasma components to the total osmolal concentration of plasma.e. All but about 20 of the 290 mOsm in each liter of normal plasma are contributed by Na+ and its accompanying anions, principally Cl- and HCO3 -. Other cations and anions make a relatively small contribution. Although the concentration of the plasma proteins is large when expressed in grams per liter, they normally contribute less than 2 mOsm/L because of their very high molecular weights.f. The major nonelectrolytes of plasma are glucose and urea, which in the steady state are in equilibrium with cells. Their contributions to osmolality are normally about 5 mOsm/L each but can become quite large in hyperglycemia or uremia. The total plasma osmolality is important in assessing dehydration, overhydration, and other fluid and electrolyte abnormalities | train | med_mcqa | null |
Maximum risk of invasive breast carcinoma is seen with? | [
"Complex Fibroadenoma",
"Sclerosing Adenosis",
"Intraductal papilloma",
"Atypical ductal hyperplasia"
] | D | ANSWER: (D) Atypical ductal hyperplasiaREF: Sabiston Textbook of Surgery, 18th ed Table 34-3, Schwart'z 8til edition Table 17-4"Annual risk for development of breast cancer in a woman with lobular carcinoma insitu (LCIS) is slightly less than 1% per year, and with either atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH) it is between 0.5% and 1% per year" (NOTE: Annual risk and relative risk provided in the chart are different)Cancer Risk Associated with Benign Breast Disorders and In Situ Carcinoma of the BreastNonproliferative lesions of the breastNo increased riskSclerosing adenosisNo increased riskIntraductal papillomaNo increased riskFlorid hyperplasia1.5 to 2-foldAtypical lobular hyperplasia4-foldAtypical ductal hyperplasia4-foldDuctal involvement by cells of atypical ductal hyperplasia7-foldLobular carcinoma in situ10-foldDuctal carcinoma in situ10-fold | train | med_mcqa | null |
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