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Rosiglitazone mechanism of action is - | [
"Acts as PPAR gamma agonist",
"Inhibitor of alpha glucosidase",
"Acts as amyl in analogue",
"Acts as dipeptidy! peptidase inhibitor"
] | A | Ans. is "a' i.e., Acts as PPAR gamma agonist [Ref KDT 7*/ep. 276\Rosiglitazoneo It is oral antidiabetic drugo They are selective agonists for nuclear peroxisome proliferator activator receptor gamma (PPAR gamma) expressed in the fat and muscle cells.o It enhances transcription of several insulin responsive genes,o Reverse insulin resistance by enhancing GLUT 4 expression and translocation. | train | med_mcqa | null |
In angle-closure glaucoma, treatment given to the fellow eye is: | [
"Pilocarpine eyedrops",
"Atropine",
"Laser iridectomy",
"Trabeculoplasty"
] | C | C i.e. Laser iridectomy | train | med_mcqa | null |
All are antioxidants except | [
"Vit A",
"Vit C",
"Vit D",
"Vit E"
] | C | Antioxidant Vitamin Vitamin E Vitamin C Beta Carotene (Vit A) selenium ref Satyanarayana 4th ed page 661 | train | med_mcqa | null |
Diphtheria toxin resembles toxin of? | [
"Birds",
"Spider",
"Snake",
"Scorpion"
] | C | ANSWER: (C) SnakeREF: Jawetz Microbiology 24th Ed Ch. 13Diphtheria toxin is absorbed into the mucous membranes and causes destruction of epithelium and a superficial inflammatory response. The necrotic epithelium becomes embedded in exuding fibrin and red and white cells, so that a grayish "pseudomembrane" is formed--commonly over the tonsils, pharynx, or larynx. Any attempt to remove the pseudomembrane exposes and tears the capillaries and thus results in bleeding. The regional lymph nodes in the neck enlarge, and there may be marked edema of the entire neck. The diphtheria bacilli within the membrane continue to produce toxin actively. This is absorbed and results in distant toxic damage, particularly parenchymatous degeneration, fatty infiltration, and necrosis in heart muscle, liver, kidneys, and adrenals, sometimes accompanied by gross hemorrhage. The toxin also produces nerve damage, resulting often in paralysis of the soft palate, eye muscles, or extremities. The nerve damage resembles to actions of neurotoxic snakes (Cobra). | train | med_mcqa | null |
Constipation is caused by all of the following drugs EXCEPT : | [
"Neostigmine",
"Atropine",
"Morphine",
"Fentanyl"
] | A | Neostigmine is an inhibitor of acetylcholinesterase and thus acts like a cholinergic drug. Therefore, it can produce diarrhea (not constipation).
Atropine is an anticholinergic drug, thus can cause constipation.
Morphine and fentanyl are opioids. These can also result in constipation. | train | med_mcqa | null |
All of the following are examples of tumor markers, except- | [
"Alpha-HCG (a-HCG)",
"Alpha-Feto protein",
"Thyroglobulin",
"b2-microglobulin"
] | A | Ans. is 'a' i.e., Alpha-HCG (a-HCG) Human chorionic gonadotropin (HCG) o HCG is a placental hormone. It is synthesized by the syncytiotrophoblasitc cells of the placental villi It is a glycoprotein It is a dimer and has two dissimilar subunits a Subunits b Subunits o But only the b subunit of HCG is typically measured as a tumour marker because of specificity of the b subunit o The b subunit of HCG has unique sequences that are not shared with other human glycoprotein hormones. It is detected by radioimmunoassay using antibodies to the b chain. o a HCG is not used as tumour marker because a unit of the FSH, LH and TSH are identical So there can be cross reactivity between a subunits of these hormone. o That is why in case of testicular tumours the patients also undergo simultaneous assay of LH to be ceain that the marker detected is PI HCG. | train | med_mcqa | null |
ln response to an increase in GFR, the proximal tubule and the loop of Henle demonstrate an increase in the rate of Na+ reabsorption. This phenomenon is called ? | [
"Autoregulation",
"Glomerulotubular balance",
"Mineralocorticoid escape",
"Saturation of tubular transport"
] | B | *Autoregulation refers to the relative constancy of renal blood flow and GFR despite changes in arterial blood pressure.
*Mineralocorticoid escape refers to the fact that the salt-retaining action of mineralocorticoids does not persist but is overpowered by factors that promote renal Na+ excretion.
*Saturation of transport occurs when the maximal rate of tubular transport is reached. Tubuloglomerular feedback results in afferent arteriolar constriction when fluid delivery to the macula densa is increased; it contributes to renal autoregulation..
Glomerulo-tubular balance:
More the filtered load, more the reabsorbed load (load-dependent reabsorption).
What is reabsorbed is a constant percentage and not a constant amount. This helps in preserving the solute.
Possible mechanism for glomerulo-tubular balance:
As more fluid comes out of the glomerulus (due to increase in GFR), the protein concentration and therefore the oncotic pressure in the plasma increases. When the plasma comes to the peritubular capillaries, there is an increased oncotic pressure; this results in pulling the excess water in the tubular lumen into the capillaries. Along with the flow of water, sodium is also reabsorbed (this is known as bulk flow or solvent drag). | train | med_mcqa | null |
Mamillary body receive afferent fibers | [
"Corpus callosum",
"Thalamus",
"Pituitary gland",
"Fornix"
] | D | Mammillary body receive afferent fibers Fornix C - shaped bundle of nerve fibers which acts as major output tract of hippocampus They are association fibers(connects one brain center to another) It is pa of limbic system (Papez circuit) Papez circuit - for memory consolidation, emotions & behavior | train | med_mcqa | null |
Biopsy from a testicular mass following orchidectomy showed sheets of uniform cells containing abunndant clear cytoplasm with prominent nucleus. Which of the following is the histopathological diagnosis? | [
"Embryonal Carcinoma",
"Lymphoma",
"Seminoma",
"Teratoma"
] | C | null | train | med_mcqa | null |
Duret hemorrhage seen in - | [
"Brain",
"Kidney",
"Heart",
"Lung"
] | A | Ans. is 'a' i.e., Brain o Duret - Bernard hemorrhage can be seen with severe compression of the midbrain and other brainstem areas during transtentorial herniation. | train | med_mcqa | null |
A young boy presented with a lesion over his right buttock which had peripheral scaling and central clearing with scarring. The investigation of choice would be: | [
"Tzank smear",
"KOH preparation",
"Biopsy",
"Sabourad's agar"
] | C | C i.e. Biopsy | train | med_mcqa | null |
Which is not involved in Ankylosing spondylitis - | [
"Knee & Ankle",
"Sacroilac Jt.",
"Wrist & elbow",
"Spine"
] | C | Joints involvement in AS
Sacroiliac > spine & costovertebral > Hip > shoulder > knee > ankle | train | med_mcqa | null |
Rhinosporidium seeberi belongs to: | [
"Fungus",
"Bacteria",
"Aquatic protistan protozoa",
"Virus"
] | A | Ans. (a) Fungus Ref Ananthanaravan' 7/e; p 603 Rhinosporiduim seeberi Lower aquatic fungi forming spores Natural habitat is reservoir water and perhaps soil contaminated with that water. Once infected organism produce a polypoidal mass lesion in the affected area, commonest site being nose, nasopharynx, tonsil, eye. Diagnosis: Can not be cultivated in aificial media. Histologically the lesion is composed of large number of fungal spores embeded in stroma of connective tissue and capillaries. Treatment: Excison of the polyp is the treatment of choice. | train | med_mcqa | null |
Beta blockers are contraindicated in: | [
"Decompensated CHF",
"Asthma",
"Variant angina",
"All of the above"
] | D | null | train | med_mcqa | null |
Huhle cells are seen in: | [
"Granulomatous thyroid disease",
"Hashimoto's thyroiditis",
"Papillary carcinoma of thyroid",
"Thyroglossal cyst"
] | B | Huhle cells (Oncocytes) are epithelial cells with abundant eosinophilic, granular cytoplasm. They are seen in the following conditions: Hashimoto's thyroiditis Follicular adenoma of thyroid Follicular carcinoma of thyroid | train | med_mcqa | null |
According to frankel behavioral rating scale, a negative child is the one | [
"Who shows reluctance to accept treatment with some evidence of negative attitude",
"Who accepts treatment but at times cautiously",
"Cries forcefully but accepts treatment",
"Who refuses treatment and cries forcefully"
] | A | null | train | med_mcqa | null |
Auxotonic contraction of a muscle is: | [
"Same as isotonic contraction for different lengths of fibres",
"Based on the principle of \"recruitment of motor units\"",
"Combination of isometric + isotonic contractions",
"Dynamic followed by adynamic contraction"
] | B | Auxotonic contraction: is the one in which the strength of contraction goes increasing, as the contraction proceeds. This phenomenon is about a single contraction. As the contraction proceeds, more and more motor units may be recruited in the contraction, thus increasing the strength of contraction.This is in skeletal muscle. Staircase phenomenon: is phenomenon for multiple contractions;in which the strength of contraction goes increasing in successive contractions. | train | med_mcqa | null |
Limpet-like cone-shaped lesions in psoriasis refers to: | [
"Rupioid psoriasis",
"Elephantine psoriasis",
"Ostraceous psoriasis",
"Inverse psoriasis"
] | A | Rupioid psoriasis refers to limpet-like cone-shaped lesions. The term elephantine psoriasis is used to describe persistent, thickly scaling, large plaques. Ostraceous psoriasis refers to a ring-like hyperkeratotic lesion with a concave surface, resembling an oyster shell. Ref: Rook's textbook of dermatology, 8th edition, Pg 20.12 | train | med_mcqa | null |
Substance that is used for vertebroplasty is: | [
"Polymethyl methacrylate",
"Polyethyl methacrylate",
"Polymethyl ethacrylate",
"Polyethyl ethacrylate"
] | A | (a) Polymethyl methacrylate- Vertebroplasty and kyphoplasty are interventional radiologic procedures for the treatment of the intense pain refractory to medical management or bracing caused by vertebral compression fracture associated with osteoporosis, tumors, and trauma.- Vertebroplasty and kyphoplasty involve intraosseous injection of acrylic cement- polymethyl methacrylate under local anesthesia and fluoroscopic guidance. | train | med_mcqa | null |
All of the following are causes of Urothelial Carcinomas Except - | [
"Smoking",
"Industrial solvents",
"Exposure to thorotrast",
"Alcohol consumption"
] | D | Ans. is 'd' i.e., Alcohol consumption Etiology of transitional cell Cao Smokingo Industrial dyes or solventso Excessive analgesic intakeo Balkan nephropathy, ando Those exposed to Thorotrast, (a contrast agent previously used for retrograde pyelography) | train | med_mcqa | null |
The national health policy is based on - | [
"Comprehensive health care",
"Subsidized health care",
"Socialized medicine",
"Equitable distribution of health resources"
] | A | Ans. is 'a' i.e., Comprehensive health care National health policy points to : o Need of establi sh ing comprehensive primary health care. ervices to reach the population in the remotest areas of the country. o The need to view health and human developed as a vital component of overall integrated socioeconomic development. o Decentralized system of health care delivery with maximum community and individual self reliance and paicipation. | train | med_mcqa | null |
Papillomavirus has been found in all of the following lesions except _____. | [
"Oral papillomas",
"Verruca vulgaris of the oral mucosa",
"Condyloma acuminatum",
"Condyloma latum"
] | D | Condyloma latum is one of the lesions that may be seen in secondary syphilis, which is caused by Treponema pallidum. All the other lesions listed may be associated with human papillomavirus. | train | med_mcqa | null |
Select the diuretic that is most effective in acute congestive glaucoma | [
"Furosemide",
"Amiloride",
"Indapamide",
"Mannitol"
] | D | Angle closure (narrow angle, acute congestive) glaucoma It occurs in individuals with a narrow iridocorneal angle and shallow anterior chamber. The i.o.t.remains normal until an attack is precipitated, usually by mydriasis. The i.o.t. rises rapidly to very high values (40-60 mmHg). It is an emergent condition with marked congestion of eyes and severe headache. Treatment:- 1. Hypeonic mannitol (20%) 1.5-2 g/kg or glycerol (10%): infused i.v. decongest the eye by osmotic action. 2. Acetazolamide:- 0.5 g i.v. followed by oral twice daily is staed concurrently. 3. Miotic:- Once the i.o.t. stas falling due to the above i.v. therapy, pilocarpine 1-4% is instilled every 10 min initially and then at longer intervals. Contraction of sphincter pupillae changes the direction of forces in the iris tolessen its contact with the lens and spreads the iris mass centrally - pupillary block is removed and iridocorneal angle is freed. 4. Topical b blocker:- Timolol 0.5% is instilled 12 hourly in addition. 5. Apraclonidine (1%)/latanoprost 0.005% instillation may be added. Drugs are used only to terminate the attack of angle closure glaucoma. Definitive treatment is surgical or laser iridotomy. Ref:- kd tripathi; pg num:-155,156,157 | train | med_mcqa | null |
A body is brought to you for autopsy. On examination of the stomach, smell of bitter almonds is present. The lividity on the body is brick red in colour. Which of the following poison could have been responsible for the individual's death? | [
"Phosphorous",
"HCN",
"CO",
"H2S"
] | B | Phosphorous cause dark brown lividity and is similar to garlic in odour. CO poisoning causes bright red lividity with no peculiar smell. H2S poisoning causes blue green lividity and smells like rotten egg. HCN smells like bitter almonds and causes brick red lividity. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 24, page - 126 | train | med_mcqa | null |
Most common agent causing tuberculosis in AIDS patient in tropical countries is - | [
"Mycobacterium tuberculosis",
"Mycobacterium intracellulare",
"Mycobacterium parvum",
"Mycobacterium atypical"
] | A | null | train | med_mcqa | null |
Interstitial nephritis is seen with all except Beta lactam inhibitors | [
"INH",
"Diuretics",
"Allopurinol",
"RIFAMPCIN"
] | B | [Ref. Harrison 20th Ed. DRUGS CAUSING INTERSTITIAL NEPHRITIS Antibiotics Diuretics Anticonvulsants Miscellaneous . filactams * Thiazide * Phenytoin . Captopril . Sulfonamides * Furosemide * Phenobarbitone * H2 receptor blockerse * Quinolones . Triamterene * Carbamazepine . Omeprazole . Vancomycin . NSAIDSdeg * Valproic acid . Mesalazine * Erythromycin . Indinavir . Minocycline . Allopurinol . Rifampicin * Ethambutol . Acyclovir | train | med_mcqa | null |
Rarest variety of pemphigus among the following is | [
"P. vulgaris",
"P. foliaceus",
"P. vegetans",
"P. erythematosis"
] | C | "Pemphigus vulgaris is most common among all pemphigus patients followed by pemphigus foliaceus, pemphigus erythrematosis and then pemphigus vegetans"(Ref: IADVL textbook volume 1 pg 937) | train | med_mcqa | null |
Which of the follow ingstatement about atheroscelerosis is true? | [
"Intake of polyunsaturated fatty acid is associated with decreased risk",
"Thoracic aorta involvement is more severe than abdominal aorta involvement",
"Extent of lesion in veins is same as that in arteries",
"Hypercholesterolemia does not always increase the risk of atherosclerosis perse"
] | A | Ans. a. Intake of polyunsaturated fatty acid is associated with decreased risk 'Med Essentials '{Kaplan Publishing} 2007/249; "Pan Vascular Medicine ' by Topal (2002//90)Intake of unsaturated fatty acids (PUFA > SI UFA) is associated with decreased risk of atherosclerosis."Intake of unsaturated fatty acids (PUFA > MU FA)i is associated with decreased risk of atherosclerosis. The maximal benefit is observed with omega-3 polyunsaturated Fatty Acids, howe\-er monounsaturated fatty acids also have consistent anti-atherosclerotic benefits and both polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA) are considered cardioprotective fatty acids. "''Hyperlipidemia and more specifically hypercholesterolemia is a major risk factor for atherosclerosis. Even in the absence of other factors, hypercholesterolemia is sufficient to stimulate lesion developmentRobbins 8* p497".Atherosclerosis is always severe in areas where pressure and velocity are high (as in arteries) in contrast to areas where pressure and velocity are low (as in veins). Overall atherosclerosis is more severe in high-pressure arteries than in pulmonary arteries with lower blood pressure. It is least severe in veins where pressure and velocity are lowest. 'Pan - Vascular Medicine' by Topol (2002J/90"Abdominal aorta is more commonly involved than thoracic aorta in atherosclerosis. Within the abdominal aorta lesions tend to be more prominent around the ostia. - 'Med Essentials' (Kaplan Publishing) 2007/249"In the systemic circulation severity is accentuated in the abdominal aorta and large arteries of the lower limb where pulse wave reflection and summation effect elevate the pulse and systolic pressures. The disease is more severe in large rather than small vessels indicating the importance of mural tension and Reynolds number both of which are proportional to radius increasing the likelihood and severity of effects of blood flow disturbance at arterial forks, junctions and curvatures''- 'Pan Vascular Medicine' by Topal (2002)/90"Atherosclerosis: Most heavily vessels involved are abdominal aorta > Thoracic aorta > Coronary? arteries > Popliteal arteries > Internal carotid arteries > Vessels of circle of Wiilis.Risk factors for AtherosclerosisFirmly establishedRelative* Hypercholesterolemia* Cigarette smoking* Hypertension* Diabetes mellitus* Advanced age* Male gender* Hypertriglyceridemia* Hyperhomocystenemia* Sedentary lifestyle* Family history | train | med_mcqa | null |
The position of the hip in a patient with posterior dislocation of the hip is | [
"Extension, abduction, internal rotation",
"Flexion, adduction, internal rotation",
"Flexion, abduction, internal rotation",
"Flexion, abduction, external rotation"
] | B | Position and attitude of hip pathology Flexion, Abduction, External rotationFlexion, Adduction, Internal rotationu1st stage of TB hip uAnterior dislocation of hip uFracture shaft of femur uPolio hipuHip joint effusion u2nd and 3rd stage of TB hip uPosterior dislocation of the hip uTraumatic hip dislocation (Refer: Watson Jones Textbook of Ohopedics & Trauma, 6thedition,pg no: 901-935) | train | med_mcqa | null |
First priority in management of burn injury is | [
"Exposure",
"Fluid resuscitation",
"Circulation",
"Airway control"
] | D | null | train | med_mcqa | null |
NRR is defined as: | [
"Total number of children in a family",
"Number of daughters a newborn girl will bear during her lifetime",
"Total number of members in family",
"Total number of female children in a family"
] | B | Ans: b (Number of daughters a newborn girl....) Ref: Park, 19th ed, p.Net Reproduction rate (NRR) is defined as number of daughters a newborn girl will bear in her life time assuming fixed age specific fertility and mortality rates. NRR is a demographic indicator. The present level of NRR is 1.5 in India (1990). NRR of 1 is equivalent to attaining 2 child norm. NRR=1 can be achieved only if at least 60% of eligible couples are effectively practicing family planning. Fertility related statisticsQuestions were asked from this topic. Just go through the following important fertility rates.General fertility rate- is the number of live births per 1000 women in the reproductive age group (15-44 or 49 years) in a given year.GFR is a better measure of fertility than crude birth rate.General Marital fertility rate- is the number of live births per 1000 married women in the reproductive age group (15-44 or 49 years) in a given year.Age-specific Fertility rate (ASFR)- is defined as the number of live births per 1000 women in any specified age group in a given year.ASFR shows the fertility pattern. They are also sensitive indicator of family planning achievement.ASFR =Number of live births in a particular age groupMid year female population of same age groupx 1000Total fertility rate (TFR)- represents the average number of children a woman would have if she were to pass through her reproductive years bearing children at the same rate as the woman now in each age group. It is obtained by summing the age specific fertility rates for all ages. This measure gives the approximate magnitude of "completed family size."TFR= 5x OASFR | train | med_mcqa | null |
The mesial surface of the crown is almost parallel to long axis and the root of a: | [
"Maxillary 1st premolar",
"Mandibular 2nd Premolar",
"Maxillary canine",
"Mandibular canine"
] | D | null | train | med_mcqa | null |
Toxin responsible for epidemic dropsy is: September 2005 | [
"BOAA",
"Sanguinarine",
"Pyrrolizidine",
"Ergots"
] | B | Ans. B: Sanguinarine Epidemic dropsy is a form of edema of extremities due to intoxication with Argemone mexicana (Mexican prickly poppy). In India, epidemic dropsy occurs as a food adulterant disease where use of mustard oil as cooking medium is common. When mustard oil is adulterated deliberately (as in most cases) or accidental contamination with argemone oil, proteinuria (specifically loss of albumin) occurs, with a resultant edema as would occur in nephrotic syndrome. Other symptoms are bilaterall pitting edema of extremities headache, nausea, loose bowels, erythema and breathlessness. In severe cases fatalities are repoed due to congestive hea failure. The toxic effects of argemone oil have been attributed to the presence of benzophenanthridine alkaloids, sanguinarine and dihydrosanguinarine. it has been repoed that the sanguinarine alkaloid content in argemone oil varies from 0.44% to 0.50%. Sanguinarine and Dihydrosanguinarine alkaloids, present in argemone oil are the responsible etiological agents of Epidemic dropsy. Though, epidemic dropsy is known in the country for the past hundred years still there are no established effective lines of treatment. | train | med_mcqa | null |
25 year old labourer 3 yrs back presented with penile ulcer not treated. Later he presented with neurological symptoms for which he got treated. Test to monitor response to treatment is | [
"VDRL",
"FTA ABS",
"TPI",
"RPR"
] | A | VDRL The history of the patient suggests neurosyphilis. Diagnosis of Neurosyphilis No definitive tool /test exists to establish the diagnosis of neurosyphilis with 100% accuracy. Most of the serological tests used in the diagnosis of syphilis cannot accurately diagnosis neurosyphilis. Hence, the diagnosis of neurosyphilis usually depends on combination of clinical features plus C.S.F. finding and serological tests. C.S.F. findings in syphilis:? - Lymphocytic pleocytosis - Protein is moderately elevated - Glucose is usually normal Among the serological tests - "The VDRL C.S.F. test is the standard serological test for and is considered diagnostic of neurosyphilis". - Since invasion of C.S.F. by syphilis stimulates production of antilipoidal antibodies in C.S.F., VDRL test can be performed on C.S.F. to diagnose neurosyphilis. - The VDRL test is highly specific albeit insensitive for the diagnosis of neurosyphilis. - The sensitivity of VDRL for neurosyphilis is 30% and specificity is 90%. Specific treponemol tests have proved to be quite inaccurate in the diagnosis of neurosyphilis Why ??? - The antibodies against the specific treponemal antigen have the tendency to cross C.S.F., so enough antibodies may be present in the C.S.F. even before neurosyphilis develops. - Therefore specific treponemal tests have no specificity for neurosyphilis. The C.S.F. becomes positive for these tests even when neurosyphilis is not present. Moreover, Specific treponemal tests cannot be used to monitor treatment because? - These tests become positive soon after infection and typically remain positive .for life despite adequate treatment. An impoant point - Like VDRL test RPR test can also be used to monitor the treatment in syphilis but it is not suitable for testing C.S.F., so it cannot be used in neurosyphilis. (Anantnarayan 8"/e p.375) | train | med_mcqa | null |
IV rule for burns- | [
"% body surface area X weight in pounds X 4 = Volume in ml",
"% body surface area X weight in Kgs X 4 = Volume in Lts",
"% body surface area X weight in Kgs X 5 = Volume in ml",
"% body surface area X weight in Kgs X 4 = Volume in ml"
] | D | Ans. is 'd' i.e., % body surface area x weight in Kgs x 4= Volume in ml This is the Parkland formula which is the simplest and most widely used formula. This calculates the fluid to be replaced in the first 24 hours. Half this calculated volume is given the first 8 hours, and the second half in the next 16 hours. | train | med_mcqa | null |
Low bih - weight babies are at a higher risk of dying in the first week because - | [
"Congenital anomaly, bih injury and infections",
"Bih injury, convulsions and asphyxia",
"Convulsions, congenital anomaly and hypothermia",
"Hypothermia, asphyxia and infections"
] | A | The foetal causes of low bih weights are foetal abnormalities,intauterine infections,bih injury etc.REF.PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE.Editon-21.Page no.-494 | train | med_mcqa | null |
Most common viral disease affecting parotid glands- | [
"Mumps",
"Measles",
"Rubella",
"Varicella"
] | A | null | train | med_mcqa | null |
AFP is raised in all except: | [
"Polycystic kidney",
"Trisomy",
"IUD",
"Oesophageal atresia"
] | B | As we have discussed earlier – AFP levels are raised in :
Under estimated gestational age
Decreased liqour
Decreased birth weight of infant and decreased maternal weight
IUD
Multifetal pregnancy (The amount of AFP entering the maternal circulation is proportional to the number of fetuses).
Defects which permit more release of AFP into maternal serum
– Neural tube defects
– Abdominal wall defects :
omphalocele
gastroschisis
– Pilonidal cysts
– Congenital skin defects
Maternal causes:
– Preeclampsia
– Maternal hepatoma, teratoma, endodermal sinus tumor
Shaw 14/e, p 380
Placental causes:
– Chorioangioma of placenta
– Placenta accreta
– Abruptio placentae | train | med_mcqa | null |
A 6 year old child has an accident and had elbow, after 4 years presented with tingling and numbness in the ulnar side of finger, fracture is | [
"supra condylar humerus",
"lateral condylar humerus",
"olecranon",
"dislocation of elbow"
] | B | B i.e. Lateral condyle | train | med_mcqa | null |
Larval form in stool is found in ? | [
"Strongyloides",
"Ancylostoma duodenale",
"Necator americanus",
"All"
] | D | Ans. is 'a' i.e., Strongyloides; 'b' i.e., Ancylostoma duodenale; c i.e., Necator americanas | train | med_mcqa | null |
19.The current treatment of choice for a large antrochonal polyp in a 10 year old: | [
"Intranasal polypectomy",
"Caldwell luc operation",
"Fess",
"Laterl rhinotomy and excision"
] | C | Treatment of choice for antrochoanal polyp in a child is functional endoscopic sinus surgery (FESS) or intra-nasal polypectomy. Caldwell-Luc operation is avoided. Ref.Dhingra 6/e p 175,7e pg 510 | train | med_mcqa | null |
Which of the following bullets leaves a visible mark in path so that a person can see it - | [
"Tandem bullet",
"Tracer bullet",
"Dum Dum Bullet",
"Incendiary Bullet"
] | B | The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ;28th edition ; pg.no. 126 Tracer bullet leaves a mark or trace while in fight due to which the gunner can observe the strike of shot . | train | med_mcqa | null |
Fatal dose of arsenic in adults: | [
"20-30 mg",
"50-60 mg",
"60 to 80 mg",
"100 to 200 mg"
] | D | Ans. d. 100 to 200 mg (Ref: Parikh 6/e p9.9; Reddy 33/e p535)Fatal dose of arsenic in adults is 100 to 200 mg.Arsenic PoisoningArsenious oxide (Sankhya or somaikhar) also known as arsenic trioxide (AS2O3) is MC form of arsenic usedQ.Other Arsenic Salts* Copper arsenite (Scheele's green)* Arsenic trisulphide (yellow orpiment or hartal)* Copper acetoarseniteQ (Paris green or emerald green)* Arsenic trichloride (butter of arsenic)* Arsenic disulphide (red realgar or manseel)Fatal dose:100-200 mgQ is fatal doseArsenophagist: Take arsenic regularly as aphrodisiac or tonic can tolerate up to 300 mg dose.Fatal period:Fatal period is 2-3 hours in narcotic form and 12 hours-2 days in gastrointestinal formQ.Patient may die from subacute poisoning in 7-10 days due to heart failure or from chronic poisoning in weeks due to liver or kidney damageQ.Clinical Features:Acute poisoning:Usually manifest within 15-30 minutes after the dose, but may be delayed if arsenic is taken with food; Nausea, burning pain in the esophagus, stomach and epigastrium, severe, persistent vomitingQ.Stools are tinged with blood, watery like the rice water stools of cholera, and contain shreds of mucus membrane and fragments of the poison in three or four hoursQ.Intense thirst is a constant featureQ.Skin eruptions may appear in late stages.Collapse sets in, with cold clammy skin, pale anxious face, sunken eyes, dilated pupils, rapid feeble pulse, and sighing respirations.Convulsions or coma may precede death.Subacute poisoning:In some cases where the patient survives the initial acute attack, the poisoning becomes subacute, the symptoms persisting in lesser degree for some time.The patient becomes progressively weak and may die of heart failure and weakness in 7-10 days.When a large dose of arsenic is taken:Poison is quickly absorbed, the symptoms of gastroenteritis may be absentSymptoms of narcotic poisoning, such as vertigo, headache, spasms, followed by stupor and vascular collapse may be present.Death occurs in 2-3 hours.Tests:Excretion of >100 mg in 24 hours urineQAtomic absorption spectroscopy detectionMarsh's and Reinschs testQ are obsoleteDisadvantages:Delays putrefactionQ and can be found in bones, hair and nails for several yearsQCan be detected in completely decomposed bodies, charred bones or ashesQ. | train | med_mcqa | null |
Which of the following is most acceptable theory explaining development of endometriosis | [
"Coelomic metaplasia",
"Retrograde menstruation",
"Lymphatic spread",
"Mullerian remnants outside uterus"
] | B | Sampson's Theory of Retrograde menstruation is the most favoured theory explaining endometriosis. | train | med_mcqa | null |
NO is synthesized by | [
"Uracil",
"Aspaate",
"Guanosine",
"Arginine"
] | D | Nitric oxide is formed from Arginine by the enzyme Nitric oxide synthase.The enzyme utilizes NADPH and molecular oxygen. Citrulline is also formed.Ref: DM Vasudevan - Textbook of Biochemistry, 7th edition, page no: 227 | train | med_mcqa | null |
CNS involvement in DLBCL is not seen with which of the following organ involvement: | [
"Ovary",
"Testis",
"Kidney",
"Adrenal"
] | A | Ans: (a) OvaryWHO, CNS 2017, Page 272CNS Diffuse Large B Cell Lymphoma (DLBCL)Primary CNS lymphomas (PCNSLs) account for 2.4-3% of all brain tumours and 4-6% of all extranodal lymphomas.Most common location - Supratentorial region.PCNSL can affect patients of any age, with a peak incidence during the fifth to seventh decade of life.CNS lymphoma are at increase risk when DLBCL involves kidney and adrenals, and testicular DLBCL is closely linked with CNS DLBCL.MRI is the most sensitive technique to detect PCNSL, which is hypointense on T1-weighted images, isointense to hyperintense on T2-weighted images.Stereotactic biopsy* is the gold standard for establishing the diagnosis and classification of CNS lymphoma.PCNSLs are highly cellular, diffusely growing, patternless tumours. Centrally, large areas of geographical necrosis are common, and may harbour viable perivascular lymphoma islands.IHC - The tumour cells are mature B cells with a PAX5-positive, CD19-positive, CD20- positive, CD22- positive, CD79a-positive phenotype. | train | med_mcqa | null |
T. trichuria maintains its position in the intestinal tract by | [
"Penetration into tissues",
"Anchorage with its anterior poion",
"Retention in the folds of the mucosa",
"Attachment with its cutting plate"
] | B | Trichuris trichiura also called whip tapeworm lie embedded in the cecal wall, with the thread-like anterior poion piercing the mucosa and the thick posterior end projecting out.The infection is diagnosed by demonstrating the adult worm or the egg in the stool. Freshly passed eggs are bile stained, barrel-shaped and unembryonated.Panicker 7e pg: 172 | train | med_mcqa | null |
Most ideal site for sterilisation by tubectomy is: | [
"Ampulla",
"Isthumus",
"Fimbriated extremity",
"Interstitial portion"
] | B | Ans: B (Isthumus) Ref: Dutta Textbook of Gynecology 7th ed pg 554Explanation:Most ideal site for tubectomy consists mainly of isthumus and ampullary part of tube .METHODS OF STERILISATIONPomeroy Tubal Ligation -- In this method of tubal ligation, a loop of tube is "strangled" with a suture. Usually, the loop is cut and the ends cauterized or "burned".Uchida technique--Proximal end of resected tube is buried into the serous coat along the antimesentric border.Irving procedure--The proximal ends of the tube are buried into the posterior surface of uterus.Madlener technique--Loop of the tube is crushed with artery forceps and tied with black silk.Kroener method of fimbriectomy.laparoscopic method using rings, clips and electrocoagulation. | train | med_mcqa | null |
Which of the following is associated with atherosclerosis ? | [
"Chlamydia trachomatis",
"Chlamydia pneumonae",
"Chlamydia psittaci",
"Chlamydia gingivalis"
] | B | Ans. is 'b' i.e., Chlamydia pneumonae o Epidemiologic studies have demonstrated an association between serologic evidence of C. pneumoniae infection and atherosclerotic disease of the coronary and other arteries. | train | med_mcqa | null |
Baby is bed-dry at age of: March 2013 (g) | [
"3 years",
"4 years",
"5 years",
"6 years"
] | C | Ans. C i.e. 5 years More than 85% children will have complete diurnal and nocturnal control by 5 years of age | train | med_mcqa | null |
Acute osteomyelitis commonly affects - | [
"Epiphysis",
"Epiphyseal plate",
"Metaphysis",
"Shaft"
] | C | Ans. is 'c' i.e., Metaphysis Pathophysiology of acute osteomyelitis* Organism reach the bone through blood stream from a septic focus elsewhere in the body.* Metaphysis of long bone is the earliest and most common site involved because: -i) Metaphysis is highly vascularii) Commonest site is metaphysis. This is because of the peculiar arrangement of the blood vessels in that area, which leads to relative vascular stasis, favouring bacterial colonization -iii) Metaphysis has relatively few phagocytic cells than physis or diaphysis.iv) Metaphysis has thin cortex.* Acute osteomyelitis may result from hematogenous spread of the infecting organism, or may be infected secondarily from the spread of a contiguous area of infection, or direct inoculation of bacteria in the bone (open fractures, nail punctures of the foot). In adults, hematogenous infection is more common in the vertebrae than in the long bones. | train | med_mcqa | null |
Muscles involved in quiet expiation: | [
"Diaphragm",
"Intercostal muscles",
"Both of the above",
"None of the above"
] | D | Apa from the diaphragm and the intercostals, other less impoant muscles also contract on inspiration and assist in elevating the ribs, namely, the levatores costarum muscles and the serratus posterior superior muscles. Quiet expiration occurs passively by the elastic recoil of the pulmonary alveoli and thoracic wall.In deep forced inspiration, a maximum increase in the capacity of the thoracic cavity occurs. Every muscle that can raise the ribs is brought into action, including the scalenus anterior and medius and the sternocleidomastoid.In respiratory distress the action of all the muscles already engaged becomes more violent, and the scapulae are fixed by the trapezius, levator scapulae, and rhomboid muscles, enabling the serratus anterior and pectoralis minor to pull up the ribs. Forced expiraion is brought about by the muscles of the abdominal wall and the latissimus dorsi | train | med_mcqa | null |
Dicrotic notch corresponds to? | [
"Closure of AV valves",
"Closure of Aortic and pulmonic valves",
"Opening of AV valves",
"Opening of Aortic and pulmonic valves"
] | B | Ans. (b) Closure of aortic and pulmonic valvesRef.: Ganottg 25th ed. 1540The Dicrotic notch is small oscillations on the falling phase of the pulse wave caused by vibrations set up when the aortic valve snaps shut. | train | med_mcqa | null |
A 55 year old male presented with painless terminal hematuria. Cystoscopic examination revealed a solitary papillary tumor, histopathological of completely resected tumor is suggestive of grade III transitional cell carcinoma with no muscle invasion. Which of the following is the next best step in management? | [
"Follow up",
"Cystectomy",
"Intravesical BCG",
"Intravesical chemotherapy"
] | C | Patient in the question stem is suffering from T1 grade III transitional cell carcinoma with no muscle invasion. He has undergone resection of the tumor, so the next best step in the management is intravesical instillation of BCG. Treatment of high grade non muscle invasive bladder cancer (Ta,T1,carcinoma in situ) is transurethral resection followed by intravesical immunotherapy with BCG. When compared to intravesical chemotherapy, BCG was found to prevent tumor recurrence in 43%cases, and was also found to decrease the risk of tumor progression. Ref: Bladder Tumors: Molecular Aspects and Clinical Management By Vinata B. Lokeshwar, Page 304; Carcinoma of The Bladder By David MacVicar, Page 42 3. Radiology Illustrated: Uroradiology By Seung Hyup Kim, 2nd Edition, Page 256. | train | med_mcqa | null |
Keratic precipitates are on which layer of cornea - | [
"Epithelium",
"Endothelium",
"Stroma",
"Bowman's membrane"
] | B | KPs are proteinaceous cellular deposits occuring at the back of cornea (corneal endothelial deposits). | train | med_mcqa | null |
Salivary peroxidise system is known to be effective against | [
"Actinomyces viscosus",
"Lactobacillus acidophilus",
"Streptococcus mutans",
"Veilonella parvula"
] | B | null | train | med_mcqa | null |
All of the following intercellular communications occur extracellular chemical messengers except | [
"Paracrine",
"Gap junctions",
"Neurohormones",
"Autocrine"
] | B | Gap junctions form direct intercellular communications and donot require extracellular chemical messengers as seen in indirect communication. Gap junctions are made of connexons. Each connexon is made up of six proteins subunits called connexins. Mutation in the gene coding for connexon causes Clouston syndrome Erythrokeratodermia variable Inherited deafness X-linked Charcot Marie Tooth Disease Predisposition to atherosclerosis , myoclonic epilepsy, cataract Ref: Harper's Illustrated Biochemistry 30th edition Pgno: 494 | train | med_mcqa | null |
Sunflower cataract is seen in ? | [
"Wilson's disease",
"Congenital rubella",
"Blunt trauma to eye",
"Myotonicdystrophica"
] | A | Ans. is 'a' i.e., Wilson's disease | train | med_mcqa | null |
Depolarization of cochlea due to: | [
"Potassium influx",
"Potassium efflux",
"Sodium influx",
"Sodium efflux"
] | A | Ans: A (Potassium influx) Ref: Diseases of the Ear Nose and Throat by PE Dhingra 5th edn. 2010. Page 13 and 19Explanation:There exists a potential difference approx (125mv) between the K+ rich endolymph (+80mv) and the inner hair cells (-45mv).When the ion channels of the hair cells open, K+ is driven into the hair cells because of this potential difference and causes depolarization.This mechanism helps covert the mechanical energy of sound into electrical impulses.This gradient and energy for transduction is provided by the Na+/K+ ATPase pump in the stria vascularis. | train | med_mcqa | null |
Epiplocele is also called: | [
"Omentocele.",
"Omphalocele.",
"Enterocele.",
"Gastrocele."
] | A | Ans: a (Omentocele) Ref: S. Das, p. 442Epiplocele is also called omentocele. Herniation of omentum is called omentocele.Clinical featuresFeels doughy and granular. It is dull on percussion and reduces without gurgle.Enterocele - Herniation of intestine (enteron)Cystocele - herniation of urinary bladder.OmphaloceleHerniation of abdominal content into the umbilical cord. (May be small with small amount of intestine or large and may contain even liver)There may be rupture of the umbilical cord and herniation of contents to amniotic cavity.In 2/3rd cases, associated anomalies are present.GastroschisisRepresent the rupture of umbilical cord at the site of resorption of right umbilical vein.Intestinal atresia is the only associated anomaly. | train | med_mcqa | null |
Which of the following are non-spore forming anaerobic bacteria that assume major significance in disease processes - | [
"Bacteroides fragilis",
"Fusobacterium nucleatum",
"Peptostreptococcus anaerobius",
"All"
] | D | Ans. is 'd' i.e., All | train | med_mcqa | null |
All are the following are features sideroblastic except- | [
"Microcytosis with hypochromia",
"Increased iron stores in bone marrow",
"Responds to pyridoxine therapy",
"Responds to folic acid therapy"
] | D | null | train | med_mcqa | null |
Which of the following statements about Tigecycline is false: | [
"Binds to 50S subunit and inhibits protein synthesis",
"Bacteriostatic Glycylcycline",
"Dose titration is not required in Renal impairment",
"Used for the management of MRSA"
] | A | Tigecycline inhibit bacterial protein synthesis by binding to the 30S bacterial ribosome. Tigecycline is a broad-spectrum Glycylcycline antimicrobial (a novel drug of the tetracycline family), with potent activity against MRSA, MRSE and Enterococci including VRE (Vancomycin resistant Enterococci). Tigecycline is a bacteriostatic inhibitor of protein synthesis. It inhibits bacterial protein synthesis by binding to the 30S bacterial ribosome and preventing access of aminoacylt-RNA to the acceptor (A) site on the mRNA-ribosome complex. Tigecycline is available only for paterenteral administratio. It is eliminated mainly in the bile so dose adjustment is needed in hepatic disease not in renal insufficiency. The majority of antibiotics that block bacterial protein synthesis interfere with the processes at the 30S subunit or 50S subunit of the 70S bacterial ribosome. Antibiotics that inhibit Protein synthesis at the 30S ribosome subunit: Tetracycline Tigecycline (Glycylcycline) Aminoglycosides Antibiotics that inhibit protein synthesis at the 50S ribosome subunit: Macrolides- Erythromycin Lincosamide-Clindamycin Streptogramins (Quinupristin/dalfopristin) Oxazoladinone-Linezolid Chloramphenicol Ref: Goodman of Gilman 13th edition PGno: 1049 | train | med_mcqa | null |
All the following factors predispose to Aoic dissection , except | [
"Systemic hypeension",
"Takayasu's aeritis",
"1 at trimester of pregnancy",
"Marfan's syndrome"
] | C | Ref Harrison 19 th ed pg 1541 Aoic dissection is the major cause of morbidity and moality in patients with Marfan's syndrome or Loeys- Dietz syndrome, and similarly may affect patients with Ehlers-Danlos syndrome. The incidence also is increased in patients with inflamma- tory aoitis (i.e., Takayasu's aeritis, giant cell aeritis), congenital aoic valve anomalies (e.g., bicuspid valve), coarctation of the aoa, and a history of aoic trauma. In addition, the risk of dissection is increased in otherwise normal women during the third trimester of pregnancy. Aoic dissection also may occur as a consequence of weight lifting, cocaine use, or deceleration injury. | train | med_mcqa | null |
True of the following: | [
"Calcium reabsorbed in DCT",
"90% calcium excreted by glomerulus",
"Parathormone (PTH) promotes absorption of Ca++ from intestine",
"PTH promote action of calcitonin"
] | C | Ans. (c) Parathormone (PTH) promotes absorption of Ca++ from intestine(Ref: Ganong, 25th ed/p.379)Parathormone (PTH) promotes absorption of Ca++ from intestineThis is an indirect action of PTH by increasing vitamin D levels | train | med_mcqa | null |
Most virulent dengue fever strain is ? | [
"1",
"2",
"3",
"4"
] | B | Ans. is 'b' i.e., 2 "Dengue type-2 strain is being considered to be more virulent strain". | train | med_mcqa | null |
All of the following are true regarding sodium cromoglycate except: March 2010 | [
"Given in acute bronchial asthma",
"Inhibits degranulation of mast cells",
"It is not a bronchodilator",
"it is not absorbed orally"
] | A | Ans. A: Given in acute bronchial asthma Cromolyn sodium/sodium cromoglycate prevents the release of mediators that would attract inflammatory cells and it stabilizes the inflammatory cells. Sodium cromoglycate stabilizes mast cells. It is not a bronchodilator. Sodium cromoglycate is not absorbed orally Forms available are: As a nasal spray to treat allergic rhinitis. In a nebulizer solution for aerosol administration to treat asthma. As an inhaler for preventive management of asthma. As eye drops for allergic conjunctivitis In an oral form to treat mastocytosis, dermatographic uicaria and ulcerative colitis. | train | med_mcqa | null |
Virus mediated transfer of host DNA from one cell to another is known as - | [
"Transformation",
"Conjugation",
"Transduction",
"None"
] | C | TRANSDUCTION: the trannsfer of a poion of the DNA from one bacterium to another by a abactriophage is known as transduction . Bacteriophages are viruses that parasitise the bacteria and consist of a nucleic acid core and a protein coat. A phage paicle may have its core beside its own nucleic acid a segment of host DNA . When this paicle infects another bacterium DNA transfer is effected and the recepient cells acquire new characteristic coded by the donor DNA REF:Ananthanarayan and Panicker's Textbook ofMicrobiology 8thEdition pg no:63 | train | med_mcqa | null |
Lateral boundry of ischiorectal fossa is formed by | [
"Gluteus maximus",
"Levator ani",
"Gluteus minimus",
"Obturator internus"
] | D | Boudaries of ischiorectal fossa
Anterior - Perineal membrane
Posterior - Gluteus maximus
Lateral - Obturator internus
Medial - External anal sphincter and levator ani | train | med_mcqa | null |
True about Flail chest | [
"of two or more ribs",
"Paradoxical respiration on the side of flail",
"Intubation is contraindicated",
"No treatment needed"
] | B | A flail chest results from blunt trauma associated with multiple rib fractures, i.e. three or more ribs fractured in two or more places. The diagnosis is made clinically,not by radiography.On inspiration the loose segment of the chest wall is displaced inwards and on expiration,it is displaced outwards-paradoxical respiration. Voluntary splinting as a result of pain, mechanically impaired chest wall movement and the associated lung contusion are all causes of the hypoxia. The patient is also at high risk of developing a pneumothorax or haemothorax. Traditionally, treatment consisted of mechanical ventilation to 'internally splint' the chest until fibrous union of the broken ribs occurred. The price for this was considerable in terms of intensive care unit resources and ventilation dependent morbidity. Currently, treatment consists of oxygen administration, adequate analgesia (including opiates) and physiotherapy. If a chest tube is in situ, intrapleural local analgesia can be used as well. Ventilation is reserved for cases developing respiratory failure despite adequate analgesia and oxygen. Surgery to stabilise the flail chest is currently in use again. Reference:Bailey & Love's sho practise of surgery,25th edition,page no:343. | train | med_mcqa | null |
Which of the following is a dimorphic | [
"Rhizopus",
"Sporothrix schenckii",
"Tinea versicolor",
"Microsporum"
] | B | Ans. is 'b' i.e., Sporothrix schenckii | train | med_mcqa | null |
Poor prognostic factors in a child with kwashiorkar include all of the following- | [
"Hypothermia",
"Hepatomegaly",
"Purpura",
"Dermatosis"
] | B | Ans. is 'b' i.e., Hepatomegaly o Hepatomegaly is one of the essential diagnostic feature of kwashiorkor, it does not indicate poor prognosis. o Poor prognostic factors in PEM, which can lead to early death ? Hypothermia 4. Diarrhea 7. Cardiac failure Hypoglycemia 5. Severe anemia 8. Dehydration or overhydration Systemic infections 6. Liver failure 9. Fluid & electrolyte imbalance | train | med_mcqa | null |
Hairy cell leukemia is | [
"B cell tumor",
"T cell tumor",
"NK cell tumor",
"All of above"
] | A | Ans. (a) B cell tumorRef: Harrison 19th ed. / 706* Hairy cell leukemia is a B cell tumor disease that presents in older males.* Usual presentation involves pancytopenia with splenomegaly.* The malignant cells appear to have "hairy'projections on light and electron microscopy and show a characteristic staining pattern with tartrate-resistant acid phosphatase.* Bone marrow is typically not able to be aspirated, and biopsy shows a pattern of fibrosis.* Patients with this disorder are prone to unusual infections, including infection by Mycobacterium avium intracellulare, and to vasculitic syndromes.* Hairy cell leukemia is responsive to chemotherapy with interferon , pentostatin, or cladribine, with the latter being the usually preferred treatment. | train | med_mcqa | null |
Lung carcinomas most frequently metastasize to - | [
"Brain",
"Liver",
"Adrenal",
"Bone"
] | A | Ref:Textbook of pathology (Harsh mohan) 6th edition,page no.502 Bronchogenic carcinoma can invade the adjoining structures directly, or may spread by lymphatic and haematogenous routes: 1. Direct spread. The tumour extends directly by invading through the wall of the bronchus and destroys and replaces the peribronchial lung tissue. As it grows fuher, it spreads to the opposite bronchus and lung, into the pleural cavity, the pericardium and the myocardium and along the great vessels of the hea causing their constriction. Extension of the cancer located at the apex of the lung into the thoracic cage may involve brachial plexus and the sympathetic chain causing pain and sensory disturbances, so called Pancoast's syndrome. 2. Lymphatic spread. Initially, hilar lymph nodes are affected. Later, lymphatic metastases occur to the other groups leading to spread to mediastinal, cervical, supraclavicular and para-aoic lymph nodes. Invasion of the thoracic duct may produce chylous ascites. 3. Haematogenous spread. Distant metastases blood stream are widespread and early. The sites affected, in descending order of involvement, are: the liver, adrenals, bones, pancreas, brain, opposite lung, kidneys and thyroid | train | med_mcqa | null |
Confirmatory investigation in retinitis pigmentosa is- | [
"Optical coherence tomography",
"Pachymetry",
"Visual Acuity testing",
"Electroretinogram"
] | D | Ans. is 'd' i.e., Electroretinogram Diagnosis of retinitis pigmentosao An accurate diagnosis of retinitis pigmentosa relies on the documentation of the progressive loss photoreceptor cell function, confirmed by a combination of visual field and visual acuity tests, fundus and optical coherence imagery, and electroretinographv (ERG),o Visual field and acuity tests measure and compare the size of the patient's field of vision and the clarity of their visual perception with the standard visual measurements associated with healthy 20/20 vision. Clinical diagnostic features indicative of Retinitis Pigmentosa include a substantially small and progressively decreasing visual area in the visual field test, and compromised levels of clarity measured during the visual acuity testo Additionally, optical tomography such as fundus and retinal (optical coherence) imagery provide further diagnostic tools when determining an RP diagnosis. Photographing the back of the dilated eye allows the confirmation of bone spicule accumulation in the fundus, which presents during the later stages of RP retinal degenerationo While visual field and acuity test results combined with retinal imagery support the diagnosis of Retinitis Pigmentosa, additional testing is necessary to confirm other pathological features of this disease. Electroretinographv (ERG) confirms the RP diagnosis by evaluating functional aspects associated with photoreceptor degeneration, and can detect physiological abnormalities before the initial manifestation of symptoms. | train | med_mcqa | null |
Centrilobular zonal necrosis in liver is seen with which of the following drug? | [
"Carbon tetrachloride",
"Rifampicin",
"INH",
"Yellow phosphorus poisoning"
] | A | Carbon tetrachloride characteristically produce a centrilobular zonal necrosis, whereas yellow phosphorus poisoning typically results in peripoal injury. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 2558. | train | med_mcqa | null |
A middle aged man presents with paraesthesia of hands and feet. Examination reveals presence of 'Mees' lines in the nails and rain drop pigmentation in the hands. The most likely causative toxin for the above mentioned symptoms is: | [
"Lead",
"Arsenic",
"Thallium",
"Mercury"
] | B | B i.e. Arsenic | train | med_mcqa | null |
Trimetazidine acts by | [
"Inhibiting Rhokinase",
"Inhibits Molecular light chain kinase (MLCK) and increase cGMP",
"Inhibits pFox enzyme and inhibits β - oxidation of Fatty acids",
"Inhibits sodium channels and decreases funny current"
] | C | It inhibits pFox enzyme and inhibits β - oxidation of fatty acids and increases glucose oxidation. Thus reduces the oxygen consumption & demand in an ischaemic cell. | train | med_mcqa | null |
All of the following are seen in a patient who has the habit of smoking EXCEPT | [
"Increased pocket depth",
"Attachment loss",
"Increased gingival bleeding on probing",
"All of the above"
] | C | null | train | med_mcqa | null |
The portal vein is related to all, except - | [
"Pancreas",
"Gall bladder",
"Inferior vena cava",
"CBD"
] | B | Important relations about portal vein
Infraduodenal part
i) Anterior:- Neck of the pancreas
ii)Posterior:- IVC
Retroduodenal part
i) Anterior:- 1st part of the duodenum, bile duct, gastroduodenal artery
ii)Posterior:- IVC
Supraduodenal part
i) Anterior:- Hepatic artery, bile duct
ii)Posterior:- IVC, separated by epiploic formal | train | med_mcqa | null |
A flat discoloration on the skin about 1 cm is called | [
"Papule",
"Macule",
"Plaque",
"Boil"
] | B | null | train | med_mcqa | null |
Most common tumor of urinary bladder is ? | [
"Sq. cell carcinoma",
"Adeno carcinoma",
"Transitional carcinoma",
"Str. squamous carcinoma"
] | C | Answer is 'c' i.e. Transitional cell carcinoma There are 3 common histological types of bladder cancer a) Transitional (urothelial) cell ca -- 90% b) Squamous cell ca -- 5-10% c) Adenocarcinoma -- 2% | train | med_mcqa | null |
In UNICEF's GOBI campaign, 'O' stands for: | [
"Oral contraceptives",
"Oral rehydration therapy",
"Obesity",
"Occupational hazards"
] | B | UNICEF - United Nations International Children Emergency Fund] UNICEF is promoting GOBI campaign to encourage 4 strategies for a child health revolution: G: growth chas (to better monitor child development) O: oral rehydration (to treat mild and moderate dehydration) B: breast feeding I: immunization (against TB, polio, diphtheria, Peussis, tetanus and measles) GOBI campaign is now GOBI-FFF: Family Planning Female education Food supplementation | train | med_mcqa | null |
which of the following antidepressent causes paraesthesis due to pyridoxine deficiency | [
"tranylcypromine",
"amitriptilline",
"duloxetine",
"milnacipran"
] | A | MAOI * IMPOANCE First class of antidepressant drugs that were introduced * MECHANISM There are three monoamines namely dopamine, adrenaline and serotonin. These mon amines are degraded by monoamine oxidase. MAOI inhibit this enzyme and acts increasing monoamines * DRUGS Phenelezine Tranylcipromine * USE ATYPICAL DEPRESSION, depression with reverse vegetative symptoms * SIDE EFFECTS Hypeensive crisis Cheese reaction When a patient on MAOI takes tyramine rich food like tyramine there will be increased release of monoamines. These excess monoamines cannot be degraded by MAO as it is blocked by MAOI. Thus, this may result in hypeensive crisis. Paresthesia's due to pyridoxine deficiency LIKE IPRONIAZID WEIGHT gain SEXUAL dysfunction Ref. kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 955 | train | med_mcqa | null |
In Meckel's diverticulum, ectopic gastric tissue is diagnosed by: | [
"Radionucleotide scan",
"Endoscopy",
"Ultrasound",
"RBC tagged scanning"
] | A | Ans: a | train | med_mcqa | null |
Carcinoma cervix is more common in:a) HIV Patientb) Multiparityc) Smokingd) Nulliparitye) Family history | [
"ab",
"abc",
"acd",
"bcd"
] | B | Factors Predisposing to CIN/Ca cervix:
Human Papilloma virus infection
Sexually transmitted infections:
Coitus before 18 years of age
Multiple sex partners
Multiparity
Poor personal hygiene
Poor socioeconomic status
Smoking
Immunosuppressed individuals
Women on OCP, Progesterone therapy for long time are predisposed to adenocarcinoma of endocervix.
In utero exposure to DES
"HPV is central to the development of cervical neoplasia. HPV - DNA is found in 95% of all squamous cell carcinoma & 90% of all adenocarcinomas." | train | med_mcqa | null |
Taste buds are absent in | [
"Fungiform papillae",
"Circumvallate papillae",
"Filiform papillae",
"Foliate papillae"
] | C | null | train | med_mcqa | null |
A woman had a chest X ray without realizing that she is pregnant. The x ray was done after 7 weeks of her last menstrual period. She is now worried about the adverse effects of the X rays on fetal development. What is the time when organogenesis is completed? | [
"4 weeks",
"10 weeks",
"18 weeks",
"26 weeks"
] | B | 10 weeks after the last menstrual period is generally accepted the embryonic period. Prior to this time teratogens can cause severe defects, with paial to complete absence of organ structures, depending upon the stage of development when the teratogen was present. The case here is of X rays exposure and its accepted that 5-10 rads will have no significant deleterious effect on the fetus sincethe threshold for gross fetal malformations is more likely to be 0.2 Gy (20 rad). | train | med_mcqa | null |
Multiple Cutaneous Sebaceous adenomas are seen in | [
"Grdner's syndrome",
"Turcot's syndrome",
"Muir Torre syndrome",
"Cowden syndrome"
] | C | .* Multiple sebaceous adenomas with visceral malignancy are called as Torre-Muir syndrome. * Secondaries in skin can occur like sister -Joseph nodules around the umbilicus. ref:SRB&;S manual of surgery,ed 3,pg no 244 | train | med_mcqa | null |
A 5 yr old boy presented with leukocoria in right eyeball diagnosed to be retinoblastoma involving full eyeball, while other eye had 2-3 small lesions in the periphery. What will be the ideal management for this patient? | [
"Enucleation of both eyes",
"Enucleation of right eye & conservative management of the other eye",
"Enucleation of right eye and focal therapy of the other eye",
"6 cycles of chemotherapy"
] | C | Enucleation is treatment of choice for group E tumors .involves more than half of retina , optic nerve and AC involved, glucoma present. Ref: ak khurana 6th edition | train | med_mcqa | null |
All are true about arsenic poisoning EXCEPT: | [
"Aldrich mees line on nails",
"Mimics tetanus",
"Rain drop pigmentation on body",
"Hyperkeratosis of palms and soles"
] | B | Ans. (b) Mimics tetanusRef: The Essentials ofFSM by K.S. Narayan Reddy 31st ed. / 501-502Arsenic Poisoning Features* It is the most commonly used homicidal poison.* Presents with Haemorrhagic gastroenteritis and necrosis of intestinal mucosa.* It mimics Cholera NOT tetanus (Strychinine mimics tetanus).* Diarrhea accompanied by tenesumus and anal irritation.* Arsenic poisoning is also characterized by 3 Rs# Red velvety mucosa upon PM# Rain drop pigmentation on body# Reinsch test or maRsh test- used to test the arsenic* They deposited on skin, hair and nail because they contain keratin, hence it is preserved.* Hyperkeratosis on palms and soles.* Fatal dose: 0.1-0.2 gm.* On nails specific lines seen known as: Aldrich Mees Line* Upon chronic poisoning# Sensory motor polyneuropathy causing tingling, numbness 8c paresis# Encephalopathy* Antidote: Hydrated Ferric oxide. | train | med_mcqa | null |
Regional specification of stomach is by gene: | [
"SOX2",
"CDXC",
"CDXA",
"CDXA"
] | A | Regional specification of the gut tube into different components occurs during the time that the lateral body folds are bringing the two sides of the tube together. Specification is initiated by transcription factors expressed in the different regions of the gut tube. Thus, SOX2 "specifies" the esophagus and stomach; PDX1, the duodenum; CDXC, the small intestine; and CDXA, the large intestine and rectumRef: LANGMAN'S EMBRYOLOGY 11TH ED Chapter 14. | train | med_mcqa | null |
Commonest site of peptic ulcer is : | [
"1st pa of Duodenum",
"IInd pa of duodenum",
"Distal 1/3 of stomach",
"Pylorus of the stomach"
] | A | Answer is A (1st pa of Duodenum) First pa of duodenum is the most common site for peptic ulceration. Sites in order of decreasing frequency : Duodenum, 1st poionQ Stomach, usually antrum Q At the gastro-esophageal junction, in the setting of gastroesophageal reflux Q Within the margins of a gastrojejunostomy Q In the duodenum, stomoch or jejunum of patients with Zollinger- Ellison Syndrome Q Within or adjacent to a Meckels diveiculum that contains ectopic gastric mucosa Q Peptic ulcers are usually solitary lesions less than 4 cm in diameter | train | med_mcqa | null |
The intracranial tumor most likely to be encountered in a middle-aged man with the acquired immunodeficiency syndrome (AIDS) is: | [
"Glioblastoma multiforme",
"Ependymoma",
"Meningioma",
"Lymphoma"
] | D | DISCUSSION: Primary intracranial lymphomas occur with increased frequency in patients who are immunocompromised, such as recipients of organ transplants and patients with AIDS. | train | med_mcqa | null |
Multiple fractures are seen in: | [
"Rickets",
"Osteogenesis imperfecta",
"Osteomyelitis",
"Osteoma"
] | B | null | train | med_mcqa | null |
Cholestasis may lead to the following complications except - | [
"Intrauterine fetal death",
"Meconium stained liquor",
"Preterm labour",
"Neonatal jaundice"
] | D | Ans-D | train | med_mcqa | null |
1 month old baby brought by the mother complaining of a mass on back associated with wetness and inability of both legs to move ever since birth. Possible diagnosis? | [
"Pilonidal cyst",
"Spina bifida",
"Meningomyelocele",
"Sacrococcygeal teratoma"
] | C | Ans. (c) Meningomyelocele style="font-size: 1.04761904761905em; color: rgba(0, 0, 0, 1); font-family: Times New Roman, Times, serif; margin: 0 0 8pt"> | train | med_mcqa | null |
Wilm's tumor is associated with all of the following except | [
"Hemihyperophy",
"Aniridia",
"Hypeension",
"Bilateral polycystic kidney"
] | D | Wilms Tumor Children aged 2-5 years Abdominal mass(cross the midline) , Hematuria , Fever =Associated with: WAGR syndrome: Wilms tumor Aniridia Genitourinary anomalies Mental Retardation Denys-Drash syndrome: Wilms tumor Gonadal dysgenesis (male pseudo-hermaphroditism) Beckwith-Wiedemann syndrome: Wilms Tumor Hemihyperophy Hypeension seems to be the result of increased Renin production secondary to renal ischemia produced by the mechanical effects of thetumor. | train | med_mcqa | null |
Renal stone which is formed due to proteus infection is? | [
"Calcium oxalate",
"Uric acid",
"Cystine",
"Struvite"
] | D | Ans. (d) StruviteRef::Robbiris 8thed Table 20-12, Sabiston Textbook of Surgery, 18thed chapter 77, | train | med_mcqa | null |
Bilateral inferior lens subluxation is seen in- | [
"Marfan syndrome",
"Homocysteinuria",
"Ocular trauma",
"None of the above"
] | B | Ans. is 'b' i.e., HomocysteinuriaDiseaseTypical lens dislocationo Marfan syndromeSuperotemporalo HomocystinuriaInferonasalo Weil-Marchesani syndromeForward | train | med_mcqa | null |
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