question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4
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Findings of trigeminal nerve injury include - | [
"Pupillary dilation",
"Loss of blinking reflex of eye",
"Normal jaw reflex",
"Ptosis"
] | B | Shining a bright light into one eye causes reflex closure of both eyes the blink reflex ophthalmic division of trigeminal nerve. Pupillary dilation and ptosis is seen in 3rd nerve injury In trigeminal nerve injury their is loss of jaw reflex which is mediated by mandibular nerve | train | med_mcqa | null |
Repair of cleft palate should be undeaken at: | [
"4 months",
"6 months",
"8 months",
"12 months"
] | D | Most plastic surgeons believe that the ideal patient age for undergoing cleft palate repair surgery is between 6 to 18 months of age (though the ored age for cleft lip repair is generally much earlier, at about 10 to 12 weeks old). This age appears to be advantageous paially because healing times are fast, the patient's memory of the recovery process is sho, and the area around the cleft hasn't had much of a chance to develop surrounding tissues in an abnormal manner. | train | med_mcqa | null |
Percentage of COHb that usually causes death: NEET 13 | [
"> 50%",
"> 60%",
"> 70%",
"> 80%"
] | C | Ans. > 70% | train | med_mcqa | null |
Most common cervical carcinoma: March 2007 | [
"Adenocarcinoma",
"Sarcoma",
"Squamous cell carcinoma",
"Small cell carcinoma"
] | C | Ans. C: Squamous Cell Carcinoma Cervical cancer is typically composed of squamous cells. The most impoant risk factor in the development of cervical cancer is infection with a high-risk strain of Human papilloma virus. Women who have many sexual paners (or who have sex with men or women who had many paners) have a greater risk Risk factors for cervical cancer: HPV infection (16,18,31,33), HIV infection Smoking Chlamydia infection, Multiple pregnancies Exposure to the hormonal drug (DES) and a Family history of cervical cancer. Biopsy Procedures While the pap smear is an effective screening test, confirmation of the diagnosis of cervical cancer or pre-cancer requires a biopsy of the cervix. This is often done through colposcopy. Fuher diagnostic procedures are loop electrical excision procedure (LEEP) and conization. These are carried out if the biopsy confirms severe cervical intraepithelial neoplasia. Pathologic Types Cervical intraepithelial neoplasia, the precursor to cervical cancer, is often diagnosed on examiniation of cervical biopsies. Histologic subtypes of invasive cervical carcinoma include the following: Squamous cell carcinoma (about 80-85%) Adenocarcinoma (nearly 5%) Adenosquamous carcinoma Small cell carcinoma Neuroendocrine carcinoma Staging Cervical cancer is staged by the FIGO staging system Stage 0 - full-thickness involvement of the epithelium without invasion into the stroma (carcinoma in situ) Stage I - limited to the cervix - IA - diagnosed only by microscopy; no visible lesions IA1 - stromal invasion less than 3 mm in depth and 7 mm or less in horizontal spread IA2 stromal invasion between 3 and 5 mm with horizontal spread of 7 mm or less - IB - visible lesion or a microscopic lesion with more than 5 mm of depth or horizontal spread of more than 7 mm IB1 - visible lesion 4 cm or less in greatest dimension IB2 - visible lesion more than 4 cm Stage II - invades beyond cervix - IIA - without parametrial invasion, but involve upper 2/3 of vagina - IIB - with parametrial invasion Stage III - extends to pelvic wall or lower third of the vagina - IIIA - involves lower third of vagina - IIIB - extends to pelvic wall and/or causes hydronephrosis or non-functioning kidney IVA - invades mucosa of bladder or rectum and/or extends beyond true pelvis IVB - distant metastasis Treatment Microinvasive cancer (stage IA) is usually treated by hysterectomy (removal of the whole uterus including pa of the vagina). For stage IA2, the lymph nodes are removed as well. Early stages (IB1 and IIA less than 4 cm) can be treated with radical hysterectomy with removal of the lymph nodes or radiation therapy. Larger early stage tumors (IB2 and IIA more than 4 cm) may be treated with radiation therapy and cisplatin/ Paclitaxel+Ifosamide+Mesna based chemotherapy, hysterectomy (which then usually requires adjuvant radiation therapy), or cisplatin/ Paclitaxel+Ifosamide+Mesna chemotherapy followed by hysterectomy. Advanced stage tumors (IIB-IVA) are treated with radiation therapy and cisplatin-based chemotherapy. The use of a combination of two chemotherapy drugs, hycamtin and cisplatin for women with late-stage (IVB) cervical cancer treatment is recommended. Combination treatment has significant risk of neutropenia, anemia, and thrombocytopenia side effects. | train | med_mcqa | null |
Intraoperative Radiotherapy for treating pancreatic carcinoma mainly uses | [
"Alpha Rays",
"Gamma Rays",
"Electron Beam",
"Proton beam"
] | C | Electron Beam is preferred for intraoperative Radiotherapy. The Intraoperative radiotherapy (IO) appears to be an ideal therapeutic strategy for pancreatic cancer, Having the advantage of enabling the delivery of high doses of radiation to areas that are at risk for microscopic disease, saving critical organs and reducing the possibility of inducing radiotoxicity. | train | med_mcqa | null |
Which antineoplastic agent is an antifolate drug ? | [
"Methotrexate",
"Adriamycin",
"Vincristine",
"Cyclophosphamide"
] | A | Ans. is 'a' i.e., Methotrexate | train | med_mcqa | null |
Majority of lung cysts occur in | [
"Mediastinum",
"Near carina",
"Base of the lung",
"Peribronchial tissue"
] | A | The bronchogenic cyst is a congenital lung lesion which arises from the anomalous development of foregut or tracheobronchial tree. Characteristics of Bronchogenic Cysts - Most of the Bronchogenic cysts arise in the mediastinum but ~15% occur in pulmonary parenchyma. In the mediastinum, they are usually located just posterior to the carnia or main stem bronchi. Mediastinal bronchogenic cysts do not communicate with the bronchi but those situated within the lung may communicate with the airways and consequently are prone to abscess formation. When located in the lung, they are more common in right lung and lower lobes These are lined by cuboidal or ciliated columnar epithelium and are usually filled with mucoid material. Complication: - Infection of the cyst leads to abscess Compression can produce either hyper infection of the lung or atelectasis due to obstruction Tension pneumothorax - d/t Rupture of the cyst that communicates with bronchus. | train | med_mcqa | null |
Internal oblique, external oblique and transverses is retracted laterally in: | [
"Classic renal approach",
"Laparoscopic approach",
"Spigelian hernia",
"None"
] | D | Ans is none | train | med_mcqa | null |
The term given to the phenomenon of moisture absorption by an alginate impression is | [
"Imbibition",
"Syneresis",
"Hysteresis",
"Gelation"
] | A | null | train | med_mcqa | null |
Delusions of control, persecution and self reference are seen in | [
"Paranoia",
"Paranoid schizophrenia",
"Mania",
"OCD"
] | B | null | train | med_mcqa | null |
Which of the following is true about Odontogenic keratocyst? | [
"Most common in females",
"Not pre malignant",
"Seen in posterior mandible",
"Treatment is observation"
] | C | Odontogenic keratocyst has risk for SCC transformation. Treatment is removal. | train | med_mcqa | null |
Treatment of seasonal affective disorder | [
"SSRIs",
"ECT",
"Bright light therapy",
"Sensate focus"
] | C | Seasonal affective disorder is mood disorder with seasonal pattern treated with Bright light therapy. | train | med_mcqa | null |
Common bule duct injuries are most commonly seen in | [
"Radical gastrectomy",
"Penetrating injuries of abdomen",
"ERCP & sphincterotomy",
"Laparoscopic cholecystectomy operation"
] | D | Bile duct injuries are most common in laparoscopic cholecystectomy(0.8 %),i.e.,around 3 times more than that of an open cholecystectomy.BDI can lead to bile leak,fistula formation,biliary strictures and lately biliary cirrhosis and poal hypeension. Reference:SRB's manual of surgery,5th edition,page no:666 | train | med_mcqa | null |
Not included in the definition of substance abuse syndrome: | [
"Withdrawal symptoms and tolerance to drugs",
"Use despite knowing that it can cause physical/mental harm",
"Use despite substance related legal problems",
"recurrent substance abuse"
] | A | The DSM-IV, diagnosis of substance abuse includes the following four criterion (1) recurrent use resulting in failure to fulfill major obligations at work, school or home. (2) Recurrent use in situations in which it is physically hazardous (such as while driving) (3) substance use causing legal problems and (4) substance use causing social or interpersonal problems (e.g. fights with spouse). Withdrawal and tolerance are a criterion for "substance dependence" but not substance abuse" Please remember in DSM-5, both these diagnosis of "substance dependence" and "substance abuse" have been removed and replaced by "substance use disorders". | train | med_mcqa | null |
Which of the following produces bile stained eggs ? | [
"Ankylostoma duodenale",
"Taenia solium",
"Enterobius vermicularis",
"Necator americanus"
] | B | null | train | med_mcqa | null |
A 22-year-old man with AIDS complains of persistent cough, night sweats, low-grade fever and general malaise. A chest X-ray reveals an area of consolidation in the periphery of the left upper lobe, as well as hilar lymphadenopathy. Sputum cultures show acid-fast bacilli. Which of the following is the most likely diagnosis? | [
"Bronchopneumonia",
"Pulmonary abscess",
"Sarcoidosis",
"Tuberculosis"
] | D | Tuberculosis represents infection with Mycobacterium tuberculosis, although atypical mycobacterial infections may mimic it. The Ghon complex includes parenchymal consolidation and enlargement of ipsilateral hilar lymph nodes and is often accompanied by a pleural effusion None of the other choices feature acid-fast organisms | train | med_mcqa | null |
Perception of objects without external stimulus is called: | [
"Hallucination",
"Illusion",
"Delusion",
"Euthymia"
] | A | Ans) a (Hallucination) Ref Ahuja 6/E page 59Perception of objects without stimulus is hallucination.Delusion-Are false unshakable beliefs which are not in keeping with the patients sociocultural and educational background and not amenable to reasoningIt is a disorder of thoughtTypes of delusions in the following conditionDepression - nihilistic delusionDelirium - transient delusionSchizophrenia - delusion of persecution/ reference/control/infidelityMania - delusion of grandeurNote:delusions are not seen in compulsive disorder, anxiety and dementiaHallucinationsFalse perception experienced without external stimulus to the sense organsAuditory hallucinations are the commonest in non organic psychiatric disordersVisual hallucinations are commonest in organic psychiatric disordersHallucinations is involuntary, does not depend on will of observerIt occurs in inner subjective spaceIt is vivid sensory perceptionIllusionsIllusions are misconceptions of external stimuli | train | med_mcqa | null |
Shoe leather survey was carried out by | [
"McKay",
"Eager",
"Trendley Dean",
"Brown"
] | C | null | train | med_mcqa | null |
Acinic cell carcinoma of the salivary gland arise most often in the | [
"Parotid salivary gland",
"Submandibular salivary glands",
"Minor salivry glands",
"Sublinguial salivary glands"
] | A | ACINIC CELL CARCINOMA It is a low-grade tumour which appears similar to a benign mixed tumour. It presents as a small, firm, movable and encapsulated tumour, sometimes bilateral. Metastases are rare. A conservative approach of superficial or total parotidectomy is adopted. Ref:- Dhingra; pg num:-235 | train | med_mcqa | null |
8 year old child having unilateral condylar fracture with chronic pain and normal occlusion; what will be the treatment modality? | [
"IMF for 2 weeks",
"IMF for 4 weeks",
"Active jaw movements",
"Open reduction"
] | C | null | train | med_mcqa | null |
The stimulus, which provokes pain easily? | [
"Analgesia",
"Allodynia",
"Dysasthesia",
"Hyperpathia"
] | D | null | train | med_mcqa | null |
Psammoma bodies features are all except: | [
"Seen in meningioma",
"Concentric whorled appearance",
"Seen in papillary thyroid carcinoma",
"Seen in teratoma"
] | D | Ans. (d) Seen in teratoma(Ref: R 9th/pg 65; 8th/pg 38)Psammoma bodies (PBs) are concentric lamellated calcified structures, observed most commonly in papillary thyroid carcinoma (PTC), meningioma, and papillary serous cystadenocarcinoma of ovaryThey represent a process of dystrophic calcification | train | med_mcqa | null |
The substance which accumulates in Tay Sach's disease is? | [
"Cerebroside",
"Ganglioside",
"Sphingosine",
"Sphingomyelin"
] | B | Tay sach's disease is caused due to deficiency of the enzyme hexosaminidase A. During this disease there is an accumulation of gangliosides and the symptoms include mental retardation, blindness and muscular weakness. Also Know: In Tay sach's disease gangliosides are found in highest concentration in cells of the nervous system and are normally broken down inside lysosomes by orderly removal of the sugar residues, paly by the action of the enzyme -N-acetylhexosaminidase. When this enzyme is missing or deficient, ganglioside GM2 cannot be broken down and Tay-Sachs disease results. Symptoms of weakness and delayed development of muscle skills are usually evident before the age of 1 year with subsequent blindness and death, usually by the age of 3 years. Neurons of affected patients are literally swollen with lysosomes filled with GM2. Ref: Hopkin R., Grabowski G.A. (2012). Chapter 361. Lysosomal Storage Diseases. 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 |
Endolymphatic decompression is done in - | [
"Tinnitus",
"Acoustic neuroma",
"Meniere's disease",
"Endolymphatic fistula"
] | C | Decompression of endolymphatic sac is done in Meniere’s disease | train | med_mcqa | null |
Adductor tubercle gives attachment to? | [
"Adductor magnus",
"Adductor brevis",
"Adductor longus",
"Vastus intermedius"
] | A | ANSWER: (A) Adductor magnusREF: Keith L. Moore 4th ed p. 540Repeat (**)The medial lip of the linea aspera ends below at the summit of the medial condyle, in a small tubercle, the adductor tubercle, which affords insertion to the tendon of the vertical fibers of Adductor magnus. | train | med_mcqa | null |
Relatively higher dose of theophylline is required to attain therapeutic plasma concentration in | [
"Smokers",
"Congestive hea failure patients",
"Those receiving erythromycin",
"Those receiving cimetidine"
] | A | Drug interactions:- 1) Agents which enhance theophylline metabo lism primarily by inducing CYP1A2 lower its plasma level so, dose has to be increased in case of Smoking, phenytoin, rifampicin, phenobarbitone, Charcoal broiled meat meal. 2 ) Drugs which inhibit theophylline metabolism and increase its plasma level are--erythromycin, ciprofloxacin, cimetidine, oral contraceptives, allopurinol; dose should be reduced. 3. Theophylline enhances the effects of--furosemide, sympathomimetics, digitalis, oral anticoagulants, hypoglycaemics. 4. Theophylline decreases the effects of--phenytoin, lithium. Ref:- kd tripathi; pg num :-226,227 | train | med_mcqa | null |
All are modifiable risk factors except | [
"Weight",
"Cigarette smoking",
"Personality",
"Diabetes"
] | C | null | train | med_mcqa | null |
Lamellar bodies in amniotic fluid, used to assess fetal lung maturity are derived from | [
"Syncytiotrophoblast",
"Pulmonary vascular endothelium",
"Type II pneumocytes",
"Chorionic epithelium"
] | C | Lamellar body count is rapid, simple and accurate method to assess fetal lung maturity that is comparable to L/S ratio. | train | med_mcqa | null |
Ophthalmoplegic migraine means | [
"When headache is followed by complete paralysis of the IlIrd and VIth nerve on the same side as the hemicrania",
"When the headache is followed by paial paralysis of the IIIrd nerve on the same side as the hemicrania without any scotoma",
"Headache is associated with IIIrd, IVth and VIth nerve paralysis",
"H... | B | B i.e. When the headache is followed by paial paralysis of 3rd nerve without any scotoma Ophthalmoplegic migrane is characterized by recurrent episodes of migraine like headache accompanied mostly by recurrent, ipsilateral and transient paresis of 3rd (most common), 6th (rare) and/ or 4th (rarest) cranial nervesQ. It is more common in childhood & typically stas before the age of 10 years. | train | med_mcqa | null |
Midyear population calculated on? | [
"1st june",
"30th june",
"1st july",
"31st june"
] | C | ANSWER: (C) 1st JulyREF: Park 18th ed p.639Mid year population is estimated population on 1st of julyCensus estimation is done at end of first quarter in the first year after a decade (end of march) | train | med_mcqa | null |
Ocular symptom of Von Recklinghausen disease is | [
"Deformed anterior chamber with reduced angle of AC",
"Glaucoma",
"Choroidal hemangioma",
"Subretinal neovascularization"
] | B | • NF-1 is the most common phakomatosis, affecting 1:4000 individuals, and presents in childhood.
• The gene locus is on 17q11. | train | med_mcqa | null |
All of the following statements about angiotensin II are TRUE, EXCEPT: | [
"Autoregulation of GFR",
"Release aldosrerone",
"Secreted from endothelium",
"Constriction of afferent aeriole"
] | C | Angiotensinogen is the circulating protein substrate from which renin cleaves angiotensin I. It is synthesized in the liver within a few seconds to minutes after formation of angiotensin I, two additional amino acid are split from the angiotensin I to from the 8-amino acid peptide angiotensin II. This conversation occurs almost entirely in the lungs while the blood flows through the small vessels of lungs, catalyzed by an enzyme called angiotensin conveing enzyme (ACE) that is present in the endothelium of the lungs vessels. FUNCTION: Angiotensin II is an extremely powerful vasoconstrictor. Vasoconstrictor occurs intensely in the aerioles and much less so in the veins. It decrease excretion of both slowly salt and water by the kidneys. This slowly increases the extracellular fluid volume, which then increase the aerial pressure during subsequent hours and days. It exes impoant actions at vascular smooth muscle, adrenal coex, kidney, hea and brain. Act directly on the zona glomerulosa of the adrenal coex to stimulate aldosterone biosynthesis. At higher concentrations, angiotensin II also stimulates glucocoicoid biosynthesis. Angiotensin II act on the kidney to cause renal vasoconstriction, contraction of mesangial cells with a resultant decrease in GFR increase proximal tubular sodium reabsorption, and inhibit the secretion of renin. In addition to its central effects on blood pressure, angiotensin II acts on the central nervous system to stimulate drinking (dipsogenic effect ) and increase the secretion of vasopressin and adrenocoicotropic hormone (ACTH). Ref: Ganong 23/e, page 670 ; Guyton 11/e, page 201-02,223-24,907 | train | med_mcqa | null |
Which is not a poxvirus- | [
"Vaccinia virus",
"Molluscum contagiosum",
"Tanapox virus",
"Coxsackie virus"
] | D | Ans. is 'd' i.e., Coxsackie virus o Poxviruses are the largest viruses with largest genome. o Poxviridae has been classified into two subfamilies -i) Chordopoxvirinae: Poxviruses of vertebrates.ii) Entomopoxvirinae: Poxviruses of insects which do not infect vertebrates, o Chordopoxvirinae are classified into six genera or subgroups -i) Orthopoxvirus: These are mammalian poxviruses that tend to cause generalized infection with rash. Exmples are variola (smallpox virus), vaccinia, cowpox, monnkeypox, rabbitpox, buffalopox, camelpox, mousepox.ii) Parapoxvirus: Viruses of ungulates that may occasionally infact human, eg. Orf (contagious pustular dermatitis) and paravaccinia (milker's node, bovine pupular stomatitis).iii) Copripoxvirus: Viruses of goat and sheeps, eg. sheep-pox, goatpox, lumpy skin disease.iv) Leporipox virus: Viruses of of leporids (rabbits, hares, squirrels), e.g. myxoma and fibromas.v) Avipoxvirus: Virus of birds, eg. fowlpox, turkeypox, pigeonpox, canarypox.vi) Suipoxvirus: Virus of swine, eg. swinepox. | train | med_mcqa | null |
Sunflower cataract is associated with: September 2011 | [
"Chalcosis",
"Juvenile diabetes mellitus",
"Down syndrome",
"Trauma"
] | A | Ans. A: Chalcosis Sunflower cataract is associated with deposition of copper Chalcosis lentis/ Copper cataract/ Sunflower cataract A cataract caused by excessive intraocular copper. May be due to intraocular, copper containing foreign bodies Copper deposits in Descemet membrane, vitreous, internal limiting membrane of the retina, and fibrous capsule around the foreign bodies could be demonstrated by rhodanine, rubeanic acid, and alizarin blue stains Eyes with foreign bodies containing more than 85% copper tended to show more disseminated copper deposits. Eyes with alloy containing less than 85% copper showed more localized deposits of copper. | train | med_mcqa | null |
The intricately and prodigiously looped system of veins and aeries that lie on the surface of the epididymis is known as: | [
"Choroid plexus",
"Tuberal plexus",
"Pampiniform plexus",
"Pterygoid plexus"
] | C | The pampiniform plexus of veins refers to the plexus of veins emerging from the testis, it drains the venous blood from the testis. This plexus ascends up and at the superficial inguinal ring condenses to form four veins, and pass through the inguinal canal within the spermatic cord. At the level of deep inguinal ring, they join to form a single testicular vein which accompanies the testicular aery. The right testicular vein drains into the inferior venacava. Left testicular vein drains into the left renal vein. Ref: Cancer and Sexual Health By John P. Mulhall, Page 10 | train | med_mcqa | null |
A female patient after injury comes to casualty. Her ABG shows low pH, pCO2 high, bicarbonate normal. The diagnosis is: | [
"Respiratory alkalosis",
"Respiratory acidosis",
"Metabolic acidosis",
"Metabolic alkalosis"
] | B | Answer is B (Respiratory acidosis) The acid base disorder is respiratory acidosis. There is acidosis (pH : low) Raised pCO2 (acidosis) indicates that the change in CO2 is therefore primary Normal bicarbonate indicates that there is no alteration in the metabolic component The acid base disorder therefore is Respiratory acidosis. | train | med_mcqa | null |
Normal endothelial cell count in Corneal endothelium is | [
"500-1000 cells / sq.mm",
"1500-2000 cells / sq.mm",
"2000-2500 cells / sq.mm",
"2500-3000 cells / sq.mm"
] | D | Normal endothelial cell count in Corneal endothelium is 2500-3000 cells / sq.mm | train | med_mcqa | null |
Fine needle aspiration cytology is not enough to diagnose which of the following? | [
"Papillary cancer",
"Follicular cancer",
"Medullary cancer",
"Anaplastic cancer"
] | B | - There is no reliable cytologic difference b/w follicular adenomas & minimally invasive follicular carcinomas. - Hence, FNAC is not enough to diagnose follicular cancer of thyroid. - To differentiate b/w these two, extensive histologic sampling of tumor-capsule-thyroid interface to see capsular and/or vascular invasion is needed. - Vascular & capsular invasion is seen in follicular carcinoma which is absent in adenoma - Criterion for vascular invasion is applicable only to capsular vessels & vascular spaces beyond capsule. | train | med_mcqa | null |
Which of the following cements is most kind to pulp? | [
"Glass ionomer",
"Polycarboxylate",
"Silicate",
"Resin cement"
] | B | Polycarboxylate cements produce minimal irritation to the pulp. The larger size of the polyacrylic acid molecules compared with those of phosphoric acid limits acid penetration into the dentinal tubules, contributing to the excellent bio-compatibility and lack of postoperative sensitivity of polycarboxylate cement.
Ref: Manappalil P: 96 | train | med_mcqa | null |
Pyruvate formation is associated with aminoacid | [
"Alanine, glycine, histidine, proline",
"Alanine, glycine, methionine, cystidine",
"Phenylalanine, methionine, threonine, proline",
"Alanine, valine, isoleucine, leucine"
] | D | null | train | med_mcqa | null |
Which of the following is not a feature of constitutional growth delay? | [
"Normal height velocity",
"Normal bone age",
"Delayed Pubey",
"Final height normal"
] | B | Distinction between constitutional delay in growth and familial sho stature Feature Constitutional growth delay Familial sho stature Height Sho Sho Height velocity Normal Normal Family history Delayed pubey Sho stature Bone age Less than chronological age Equal to the chronological age Pubey Delayed Normal Final height Normal Low but normal for target height | train | med_mcqa | null |
Which of the following metabolic pathway in carbohydrate metabolism is required for synthesis of nucleic acids - | [
"Gluconeogenesis",
"Glycolysis",
"HMP shunt",
"Glycogenesis"
] | C | Ans. is 'c' i.e., HMP shunt o HMP is an alternative route for the oxidation of glucose (beside glycolysis). It is also called as **pentose phosphate pathway ", "Dickens - Horecker pathway", "Shunt pathway" or "phosphogluconate oxidative pathway"o HMP shunt is required for provision of reduced NADPH and fiver-carbon sugars e.g. ribose (Pentose phosphates) for nucleic acid synthesis.o Normally, 90% of glucose is oxidized by glycolysis and 10% is oxidized by HMP shunt. However, in liver and RBCs HMP shunt accounts for oxidation of 30% glucose,o HMP shunt occurs in the cytosol. It is highly active in liver, adipose tissue, adrenal cortex, lens, cornea, lactating (but not the noniactating) mammary gland, Gonads (testis, ovary) and erythrocytes. Activity of this pathway is minimal in muscle and brain, where almost all of the glucose is degraded by glycolysis. | train | med_mcqa | null |
Metabolic complication of cirrhosis are all except | [
"Hypokalemia",
"Hyponatremia",
"Hypoglycemia",
"Hypoammonemia"
] | D | Electrolyte Abnormalities in Cirrhosis Hyponatremia Hypokalaemia Metabolic acidosis( decreased PNH) Ref: Sabiston 20th edition Pgno : 565 | train | med_mcqa | null |
A 33 year old man presents to AIIMS ophthalmology OPD with pain and watering of eyes. On examination there was a 3X2 mm greyish white corneal ulcer with indistinct elevated margins. The lesion is surrounded by feathery finger like infiltration into the adjacent corneal stroma. Minimal hypopyon is also observed. Based on the information provided the microbiological investigation should be directed against | [
"Aspergillus spp.",
"Pseudomonas spp.",
"Herpes simpex virus",
"Acanthamoeba spp"
] | A | Ans. (a) Aspergillus spp.Ref: Kanski 7/e, p. 180 - 181Feathery margins with hypopyon is indicative of a fungal ulcer and the most common cause for it is Aspergillus. | train | med_mcqa | null |
A patient with acute psychosis, who is on haloperidol 20mg/day for last 2 days, has an episode characterized by tongue protrusion, oculogyric crisis, stiffness and abnormal posture of limbs and trunk without loss of consciousness for last 20 minutes before presenting to casualty. This improved within a few minutes after administration of diphenhydramine HCI. The most likely diagnosis is | [
"Acute dystonia",
"Akathisia",
"Tardive dyskinesia",
"Neuroleptic malignant syndrome"
] | A | * <48 hours of staing antipsychotics * M.C in======Younger black males * If a patient develops dystonia he is more prone for eps Patient considers this as an Allergic reaction , thereby may stop drugs Layryngeal dystonia is a Psychiatric emergency, should be treated with IV lorazepam TREATMENT * Diphenhydramine * Benztropine mesylate * Prophylactic anticholinergics helps Ref.Kaplon and sadock, synopsis of psychiatry, 11 th edition, pg no. 923 | train | med_mcqa | null |
Which of the following bacteria grows better in alkaline pH? | [
"Vibrio cholerae",
"Pseudomonas",
"Shigella",
"Salmonella"
] | A | Ans. a (Vibrio cholerae). (Textbook of Microbiology by Anantanarayan, 6th/281)VIBRIO CHOLERAE# Gram-negative, strongly aerobic, Pleomorphic bacteria.# Vibrio lyse when injected intraperitoneally into specifically immunized guinea pigs (Pfieffer's phenomenon).# 'Fish in stream' appearance.# Darting motility (swam of gnats).# Grow better in alkaline medium.# NaCl required for optimal growth.# Bile salt agar# TCBS agar selective media(AIIMS Nov 2007)# Alkaline peptone water--enrichment media# "Cholera red" reaction -Indole is formed & nitrates are reduced to nitrites.# Vibrio cholerae toxin permanently activates Gs, causing rice-water diarrhea. ADP ribosylation of G protein stimulates adenylyl cyclase; -pumping of Cl into gut and -Na+ absorption. H2O moves into gut lumen; causes voluminous rice-water diarrhea. | train | med_mcqa | null |
Which of the foliowingmay present with isolated prolongation of prothrombin time (PI> | [
"Factor VIiI deficiency",
"FActor VII deficiency",
"Factor XII deficiency",
"Factor IX deficiency"
] | B | Ans. is 'b' i.e., Factor VII deficiency o Factor VII deficiency may present with isolated prolongation of prothrombin time.Cause of Isolated prolongation of PT (CMDT)# Vitamin K deficiency# Warfarin therapy# Liver disease# Factor VII deficiency | train | med_mcqa | null |
A patient comes to the clinic requesting a tuberculin skin test as a pa of his preemployment check up. All of the following are methods of tuberculin testing except | [
"Tine test",
"Heaf test",
"Pirquet test",
"Quantiferon gold"
] | D | Quantiferon gold is not a type of tuberculin skin test. It is a type of interferon-gamma release assays (IGRAs), a whole-blood tests that can aid in diagnosing Mycobacterium tuberculosis infection. Two IGRAs that have been approved by the US (FDA) are QuantiFERON-TB Gold In-Tube test (QFT-GIT); T-SPOT.TB test (T-Spot) There are 3 described methods for tuberculin skin testing (TST): Mantoux test, also known as the Pirquet test (preferred method) Heaf test Tine test Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | train | med_mcqa | null |
The syndrome of inappropriate ADH secretion is characterized by the following: | [
"Hyponatremia and urine sodium excretion > 20 mEq/L",
"Hypernatremia and urine sodium excretion > 20 mEq/L",
"Hyponatremia and hyperkalemia",
"Hypernatremia and hyperkalemia"
] | A | In SIADH, the excessive retention of water expands extracellular and intracellular volume. This explains Dilutional Hyponatremia. Since the urine is concentrated hence urine sodium mEq/unit of time can be explained. Another plausible explanation is that expanded volume leads to release of ANF and resultant natriuresis explains the urine sodium> 20mEq/L. Hyponatremia sub-classified according to volume status Clinical example Sodium levels TBW Hypovolemic Hyponatremia Diarrhea Cerebral salt wasting Low Low Euvolemic Hyponatremia SIADH Normal Increased Hypervolemic Hyponatremia CHF Cirrhosis Nephrotic Increase Increased | train | med_mcqa | null |
The fusion of a myeloma cell with an antigen sensitized B cell lymphocyte is termed as? | [
"Dendritic cell",
"Opsonization",
"Natural killer cell",
"Hybridoma"
] | D | The usefulness of hybridomas arises from their ability to produce abundant monoclonal antibody to specific antigens. Natural killer and null cells are types of lymphoid cells. Dendritic cells may possess weak phagocytic activity and may be helpful in antigen presentation. Opsonization is the coating of antigens, usually bacterial, with complement fragments to enhance phagocytosis. Ref: A Textbook of Immunology By J.K. Sinha & S. Bhattacharya, Page 462 | train | med_mcqa | null |
70 year old man with Ca.prostate with osteoblastic secondaries in pelvis and lumbar vertebra showed well differentiated Adeno Carcinoma prostate on needle biopsy. He is idealy treated by - | [
"Radical prostectomy",
"TURP",
"Radiation",
"Hormonal manipulation"
] | D | null | train | med_mcqa | null |
The criteria for 'at risk' infant include the following except - | [
"Aificial feeding",
"Grade II malnutrition",
"Working mother",
"Bih order 4 and more"
] | D | Criteria for identification of at risk infants. 1.bih.wt. Less than 2.5 kg 2.twins 3.bih order 5 or more 4.weight below 70 % of expected - II and III degres of malnutrition 5.aificial feeding 6. Failaure to gain wt during 3 succesive months 7.children with PEM and diarrhoea 8.working mother/one parent Parks textbook of preventive and social medicine.K Park. Edition 23.Pg no: 535 | train | med_mcqa | null |
Ghrelin is a hormone produced by the enteroendocrine cells of the stomach. It is responsible for: | [
"Stimulation of appetite",
"Suppression of appetite",
"Stimulation of sleep",
"Suppression of sleep"
] | A | Ghrelin is a hormone produced by the enteroendocrine cells of the stomach, and to lesser extent by the placenta, pituitary, and hypothalamus. In humans, ghrelin has been shown to be a potent growth hormone secretagogue and appetite stimulant. Good to know: Increased ghrelin levels seen in, Fasting Individuals consuming low calorie diets Chronic strenuous exercise Cancer anorexia Anorexia nervosa Prader-Willi syndrome Decreased ghrelin levels seen in, During meals Obesity Ghrelin levels are decreased in obese individuals. Ref: Molina P.E. (2010). Chapter 10. Endocrine Integration of Energy & Electrolyte Balance. In P.E. Molina (Ed), Endocrine Physiology, 3e. | train | med_mcqa | null |
Most common site for the osteoporotic veebral Fracture is : | [
"Dorsolumbar spine",
"Cervical spine",
"Lumbosacral spine",
"Dorsal spine"
] | A | *Most common symptom of osteoporosis is back pain secondary to veebral compression fracture. *Dorso - lumbar spine is the most frequent site. <img alt="" src=" /> * Other common sites of fracture are lower end radius and fracture neck femur. *Osteoporotic fracture are : (1)Fracture veebrae (2)Colle's Fracture (3) Fracture neck (4) femur Ref: Maheshwari 6th/e p.308 | train | med_mcqa | null |
Epidemiological studies of H. pylori are done by using | [
"Urea-breath test",
"Serological markers",
"Culture",
"Gastric-biopsy urease test"
] | B | Answer is B (Serological markers) An enzyme linked immuno-sorhant assay (ELISA) is the most commonly used serological method. `Compared with endoscopic detection of H.Pyloric infection, ELISA has proved to be sensitive and specific and is paicularly suited for Epidemiological studies'. Diagnostic Tests for Helicobacter pylori Test Sensitivity Comments Serology 95 Does not differentiate between active and remote infection; epidemi()Imjc too i ; titer decreases slowly after eradication Urease assay Breath Biopsy 90-95 90-98 Simple ; may be used to monitor therapy Requires endoscopy Histology Requires endoscopy; may be essential if antibiotic resistance emerges Culture 70-95 Requires endoscopy; may be essential if antibiotic resistance emerges | train | med_mcqa | null |
Anaesthetic circuit that prevents rebreathing of CO2 – | [
"Magil's circuit",
"Mapleson D circuit",
"Ayre's piece",
"Circle system"
] | D | You all know, amongst the given options only circle system is rebreathing system. It is quite obvious, CO2 must be eliminated from the exhaled air before rebreathing to prevent hypercapnia. Therefore, rebreathing system has a CO2 absorbent that absorbs CO2 and prevents CO2 rebreathing. Don’t get confuse by name (rebreathing system), there is rebreathing of exhaled gases after absorption of CO2. | train | med_mcqa | null |
Not easily culturable but well ble and used in epidemiology are: | [
"Stapp",
"Mycobacterium TB",
"E. coli",
"Salmonella"
] | B | Ans. (b) Mycobacterium TB S. aureus: grow rapidly on ordinary media within a temperature range of 10-42degC. E. coli: good growth occurs on ordinary media. Salmonella: grow readily on simple media over range pH 6-8 and temperature 15-41degC. M.TB: grow slowly, colonies appear in 2-8 weeks. Culture remain ble at room temperature for 6-8 months and may be stored up to 2 year at -20degC. | train | med_mcqa | null |
In a patient of cholangitis, surgical intervention was performed. In post-operative period, on 10th day this investigation was performed. What is the name of this investigation? | [
"ERCP",
"MRCP",
"T-tube cholangiogram",
"PTC"
] | C | The investigation is T-tube cholangiogram. | train | med_mcqa | null |
The primary function of Toll-like Receptors is? | [
"Activation of Immune System",
"Vasodilation",
"Regulation of Calcium channel",
"Second Messenger"
] | A | In the late 1990s and early 2000s, researchers identified mammalian analogs of the Drosophila Toll receptor, cloned the mammalian Toll-like receptor 4 (TLR4), identified TLR4 as the receptor for lipopolysaccharide (LPS) and the membrane transducer for LPS signaling in mononuclear phagocytes and other cells, and identified other TLRs as receptors for other microbial components.
CD 14 binds bacterial LPS (endotoxin) and, as a component of a multimolecular complex, plays an important role in LPS-induced activation, inflammatory response, and innate immunity. LPS is captured by a serum LPS-binding protein and is transported to CD14, which binds the complex. CD14, however, cannot trigger activation because it lacks an intracellular region. This function is mediated by one of a group of molecules known as Toll-like receptors (TLR), as they are structurally homologous to the Toll receptors of the fruit fly Drosophila melanogaster. | train | med_mcqa | null |
Bassini's repair for hernia is done for | [
"Inguinal hernia",
"Femoral hernia",
"Spigelion hernia",
"Epigostric hernia"
] | A | null | train | med_mcqa | null |
All true about accidental intraerial injection of thiopentone except- | [
"Immediate intense vasoconstriction and excruciating pain",
"Cause is precipitation of thiopental crystalls in the aerial vessels",
"To relieve pain we have to immediately remove the misplaced aerial cannula",
"Stellate ganglion block is one of the treatment modality"
] | C | The accidental intraerial injection of drug by wrongly placed cannula M/N- 1 Leave the cannula 2 Intraerial injection of heparin 3 Lidocaine, papaverine, phenoxybenzamine injected 4 Stellate ganglion block | train | med_mcqa | null |
Mental health programme was staed in? | [
"1982",
"1987",
"1990",
"1995"
] | A | Ans. is 'a' i.e., 1982 The Government of India has launched the National Mental Health Programme (NMHP) in 1982. Also know Mental health act was staed in 1987. | train | med_mcqa | null |
. Tretinoin is useful in the treatment of - | [
"M2",
"M3",
"M5",
"M7"
] | B | Tretinoin is a cancer medication used to treat acute promyelocytic leukemia Acute Promyelocytic Leukemia For use in patients with APL classification M3, which is characterized by the presence of t(15;17) translocation and/or the presence of the PML/RAR-alpha gene, who are refractory to, or have relapsed from, anthracycline chemotherapy, as well as for use in patients for whom anthracycline-based chemotherapy is contraindicated Ref Davidson 23rd edition pg 1313 | train | med_mcqa | null |
All are contraindications of diaphragm except: | [
"Multiple sex paners",
"Recurrent UTI",
"Uterine prolapse",
"Herpes vaginalis"
] | A | Having multiple sex paners is not a contraindication for the use of diaphragm. Contraindications to use of diaphragm: Proplapse, cystocele, rectocele because accurate fitting is not possible. Recurrent urinary tract infection Allergy to rubber or spermicidal agent. Toxic shock syndrome (TSS) may occur if the diaphragm is left in the vagina for a long period. TSS is caused by Streptococcus pyogenes or Staphylococcus aureus infection Ref: Shaw&;s textbook of Gynaecology 17th edition pgno: 255 | train | med_mcqa | null |
A nursing mother presented with fever and breast tenderness after two weeks postpaum. Which oral antibiotics is ideal for her condition? | [
"Ampicillin",
"Dicloxacillin",
"Ceftazidime",
"Ciprofloxacin"
] | B | Dicloxacillin:- Anti - staphylococcal penicillin :- B lactamase resistant penicillin. Their use is restricted to the treatment of infection cause by penicillinase producing staphylococci including MSSA. Other drug of this class:- Methicillin Oxacillin Methicillin because of its toxicity (interstitial Nephritis), Methicillin is not used. Ampicillin/Amoxicillin:-Extended- Spectrum penicillin. More effective against gram -ve bacilli. Ampicillin is a drug of choice for gram positive bacilli : listeria monocytogenes Ceftazidime:-3rd gen cephalosporin, has activity against P. aeruginosa Ciprofloxacin: of the fluoroquinolone it has best activity against P. Aeruginosa and is commonly used in cystic fibrosis patient. | train | med_mcqa | null |
Best for treatment of multi-focal atrial tachycardia is? | [
"DC shock",
"Amiodarone",
"Verapamil",
"Beta blocker"
] | C | Multifocal atrial tachycardia is encountered in patient of COPD. > 3 different morphologies of P wave. b Blocker c/I in MAT DC shock is ineffective Rx MAT= Verapamil Therapy for MAT is directed at treating the underlying disease and correcting any metabolic abnormalities. Electrical cardioversion is ineffective. The calcium channel blockers verapamil or diltiazem may slow the atrial and ventricular rate. Patients with severe pulmonary disease often do not tolerate beta blocker therapy. MAT may respond to amiodarone, but long-term therapy with this agent is usually avoided due to its toxicities, paicularly pulmonary fibrosis. | train | med_mcqa | null |
Contraindication of laparoscopic cholecystectomy is: | [
"Coagulopathy",
"Obstructive pulmonary disease",
"End stage liver disease",
"All of the above"
] | D | Contraindications to Laparoscopic Cholecystectomy Absolute Relative Unable to tolerate general anesthesia Refractory coagulopathy Suspicion of carcinoma Previous upper abdominal surgery Diffuse peritonitis Cirrhosis or poal hypeension Chronic obstructive pulmonary disease Cholecystenteric fistula Morbid obesity Pregnancy | train | med_mcqa | null |
The safe limit of Fluorine in drinking water is ? | [
"0.2-0.5 mg/L",
"0.5-0.8 mg/L",
"0.8-1.2 mg/L",
"1.2-2.0 mg/L"
] | B | Ans. is 'b' i.e., 0.5 - 0.8 mg/L o The recommended level of fluoride in drinking water in the country is accepted as 0.5 to 0.8 mg/ Liter, -Park o Maximum permissible limit is 1.5 mg/Lit. | train | med_mcqa | null |
The half-life of oxytocin is | [
"2-3 min",
"3-5 min",
"5-6 min",
"7-8 min"
] | B | OxytocinIn general, oxytocin should be discontinued if the number of contractions persists with a frequency of more than five in a 10-minute period or more than seven in a 15-minute period or with a persistent nonreassuring fetal hea rate pattern.When oxytocin is stopped, its concentration in plasma rapidly falls because of the half-life is approximately 3 to 5 minutes.Ref: William&;s Obstetrics; 25th edition | train | med_mcqa | null |
Which of the following is not an ototoxic drug ? | [
"Neosporin",
"Penicillin G",
"Kanamycin",
"Cisplatin"
] | B | Ans. is 'b' i.e., Penicillin G Impoant ototoxic drugs o Aminoglycosides o Cisplatin o Furosemide o Deferoxamine o Quinine o Chloroquine o Interferons o Erythromycin o Bleomycin o Aspirin | train | med_mcqa | null |
Which of the following is a criteria for clinical Stage II of AIDS in children? | [
"Lymphadenopathy",
"Oral candidiasis",
"Hepatosplenomegaly",
"Oesophageal candidiasis"
] | C | Ans. is 'c' i.e., Hepatosplenomegaly Revised WHO clinical staging of HIV/AIDS for infants and childrenClinical Stage 1* Asymptomatic* Persistent generalized LymphadenopathyClinical Stage 2* Hepatosplenomegaly* Papular pruritic eruptions* Seborrhoeic dermatitis* Extensive human papilloma virus infection* Extensive molluscum contagiosum* Fungal nail infections* Recurrent oral ulcerations* Lineal gingival erythema (LGE)* Angular cheilitis* Parotid enlargement* Herpes zoster* Recurrent or chronic RTIs (otitis media, otorrhoea, sinusitis)Clinical Stage 3* Moderate unexplained malnutrition not adequately responding to standard therapy* Unexplained persistent diarrhoea (14 days or more)* Unexplained persistent fever (intermittent or constant, for longer than one month)* Oral candidiasis (outside neonatal period)* Oral hairy leukoplakia* Acute necrotizing ulcerative gingivitis/periodontitis* Pulmonary TB* Severe recurrent presumed bacterial pneumonia Conditions where con?rmatory diagnostic testing is necessary* Chronic HIV-associated lung disease including brochiectasis* Lymphoid interstitial pneumonitis (LIP)* Unexplained anaemia (<8g/dl), and or neutropenia (< 1000/mm3) and or thrombocytopenia (<50 000/ mm3) for more than one monthClinical Stage 4* Unexplained severe wasting or severe malnutrition not adequately responding to standard therapy* Pneumocystis pneumonia* Recurrent severe presumed bacterial infections (e.g. empyema, pyomyositis, bone or joint infection, meningitis, but excluding pneumonia).* Chronic herpes simplex infection; (orolabial or cutaneous of more than one month's duration)* Extrapulmonary TB* Kaposi's sarcoma* Oesophageal candidiasis* CNS toxoplasmosis (outside the neonatal period)* HIV encephalopathy* Conditions where confirmatory diagnostic testing is necessary* CMV infection (CMV retinitis or infection of organs other than liver, spleen or lymph nodes; onset at age one month or more)* Extrapulmonary cryptococcosis including meningitis* Any disseminated endemic mycosis (e.g. extrapulmonary histoplasmosis, coccidiomycosis, penicilliosis)* Cryptosporidiosis* Isosporiasis* Disseminated non-tuberculous mycobacteria infection* Candida of trachea, bronchi or lungs* Visceral herpes simplex infection* Acquired HIV associated rectal fistula* Cerebral or B cell non-Hodgkin lymphoma* Progressive multifocal leukoencephalopathy (PML)* HIV-associated cardiomyopathy or HIV-associated nephropathy | train | med_mcqa | null |
Anaemia, punctate basophilia, constipation blue line and abdominal colic are characreristic of | [
"Opium addiction",
"Arsenic poisoning",
"Mercuric poisoning",
"Lead poisoning"
] | D | D i.e. Lead poisoning | train | med_mcqa | null |
Earliest sign of deep vein thrombosis is | [
"Calf tenderness",
"Rise in temperature",
"Swelling of calf muscle",
"Homan's sign"
] | A | null | train | med_mcqa | null |
Lymphohistiocytic variant of Reed Sternberg cells are typically seen in which of the following variants of Hodgkin&;s Lymphoma: | [
"Nodular Sclerosis",
"Lymphocyte Rich",
"Lymphocyte Predominant",
"Lymphocyte Depleted"
] | D | Lymphocytic and histiocytic (L and H) variant of Hodgkin&;s Lymphoma is typical of Lymphocytic Predominant Hodgkin&;s Lymphoma. (True diagnostic Reed-Sternberg cells are not seen). The neoplastic cells resemble &;popcorn&; by viue of their folded or lobated nuclear nuclear membranes (nuclei resemble an exploded kernel of corn). Note that cells resembling the Lymphohistiocytic or popcorn cell variants of Lymphocyte Predominant (Non-classical) Hodgkin&;s Lymphoma may also be seen in Lymphocyte Rich Variant of Classical Hodgkin&;s Lymphoma. These if present can be differentiated by Immunophenotyping: Lymphocytic and Histiocytic (L & H) or &;popcorn&; cells are typical of Lymphocytic Predominant Non-Classical Hodgkin&;s Lymphoma. These cells are negative for CD15 and CD30 and positive for CD45. Cells resembling Lymphocytic and Histiocytic (L & H) or &;popcorn&; may be seen in Lymphocyte Rich form of classical Hodgkin&;s Lymphoma. These cells are positive for CD15 and CD30 and Negative for CD45. Ref: Bailey and Love 27th edition | train | med_mcqa | null |
Gs alpha mutation is associated with all Except | [
"Mc-cune Albright syndrome",
"Pitutary adenomas",
"Pseudohypoparathyroidism",
"Papillary carcinoma thyroid"
] | D | In Papillary carcinoma there are mutations in RET , BRAF, NTRK1 genes but not in Gs alpha. Ref: Robbins and cotrans 9e Pg 1095 | train | med_mcqa | null |
All are true about uteroplacental circulation except - | [
"Blood in the intervillous space is completely replaced 3-4 times per minute",
"The villi depend on the maternal blood for their nutrition",
"A mature placenta has 150 ml of blood in the villi system and 350 ml of blood in the intervillous space",
"Intervillous blood flow at term is 500 - 600 ml per minute"
] | C | Ans. is 'c' i.e., A mature placenta has 150 ml of blood in the villi system and 350 ml of blood in the intervillous space Uteroplacental Circulationo A mature placenta has a volume of about 500 ml of blood; 350 ml being occupied in the villi system and 150 ml lying in the intervillous space.o Intervillous blood flow at term is around 500 - 600 ml per minuteo The blood in the intervilllous space is completely replaced about 3-4 times per minute.o The villi depend on maternal circulation for nutrition, thus it is possible for the chorionic villi to survive for a varying period even after the fetus is dead. | train | med_mcqa | null |
Blanket consent is consent taken- | [
"When the patient comes to doctor for treatment",
"Oral consent",
"Written consent",
"Taken at the time of admission to do any surgery"
] | D | Ans. is 'd' i.e., Taken at the time of admission to do any surgery Blanket consent : It refers to consent which is taken usually on a printed form, at the time of admission of the patient, authorizing the doctor to do any surgery under any anesthesia. Legally, it is no consent, i.e. it is of no value in cou. To be legally valid consent is to be obtained for each specific procedure and operation. Implied consent : In this, consent presumed to be there. The very fact that the patient has come to the doctor for treatment, it is persumed that his consent is there for routine physical examination. e.g. inspection, palpation, auscultation and percussion. Implied consent is non-written but legally effective form of consent, which is not expressly asseed. Expressed consent : It is stated (oral or written) in clear and explicit language. Oral consent, given in presence of two or more witnesses is as valid as written consent, but there is no record. Written consent is better as there is record of consent available, in cases of dispute. Written informed consent : It is a type of expressed consent in written form which is given by the patient after being informed of nature of illness or nature of procedure or operation to be done, its alternatives, its consequences and complications. | train | med_mcqa | null |
An 70 yrs. aged patient with epistaxis , patient is hypertensive with B.P = 200/110 mm Hg. On examination no active bleeding noted, next step of management is: | [
"Observation with hypertension control",
"Internal maxillary artery ligation",
"Anterior and posterior nasal pack",
"Anterior nasal pack"
] | A | Ans. is 'a' i.e Observation with hypertension control MC cause of epistaxis in elderly is hypertension *.In cases of active bleeding it is controlled by anterior or posterior nasal packingArtery ligation is helpful only if bleeding cannot be controlled by conservative measures.Since in this patient there is no active bleeding and further the cause is hypertension the management is observation & antihypertensives.Remember:MC cause of epistaxis in children & adults - finger nail trauma *.MC site of epistaxis is- little's area *MC cause of epistaxis in a 15 yr old female- Hematopoietic disorder *. | train | med_mcqa | null |
All of the following statements regarding Dracunculiasis are true except - | [
"India has eradicated this disease",
"Niridazole prevents transmission of the disease",
"The disease is limited to tropical and subtropical regions",
"No animal reservoir has been proved"
] | B | null | train | med_mcqa | null |
25 years old laborer 3 yrs back presented with penile ulcer which was not treated. Later he presented with neurological symptoms for which he got treated. Test to monitor response to treatment is NOT RELATED-DERMATOLOGY | [
"VDRL",
"FTA ABS",
"TPI",
"RPR"
] | A | The above said laborer is suffering from neuro syphilis. The best test to monitor response to treatment is VDRL which is a Cardiolipin (Nontreponemal)TestsVenereal Diseases Research Laboratory (VDRL)is the best test for monitoring therapy inINDIA. A titer of > 1:8 is positive and A titre <1:8 is a False Positive VDRL. | train | med_mcqa | null |
Hypothetical situation is - | [
"Police inquest",
"Magistrate inquest",
"Dying declaration",
"Dying deposition"
] | D | Dying deposition is a statement of a person on oath, recorded by the Magistrate, in the presence of the accused or his lawyer, who is allowed to cross examine the witness.Not in India. Ref:synopsis of forensic medicine (Dr.K.S.Narayan Reddy) PG NO:7 28th edition | train | med_mcqa | null |
RCH-I1 major strategies are all except ? | [
"Essential obstetric care",
"Emergency obstetric care",
"Family planning",
"Strengthening referral system"
] | C | Ans. is 'c' i.e., Family planning o Major strategies under RCH-11 are :? 1. Essential obstetric care a) Institutional delivery b) Skilled attendance at delivery 2. Emergency obstetric care a) Operationalising first Referral units. b) Operationalising PHCs and CHCs for round the clock delivery services. 3. Strengthening the referral sestem | train | med_mcqa | null |
All of the following genetic mutations are associated with an increased risk of deep venous thrombosis, EXCEPT: | [
"Factor V Leiden mutation",
"Glycoprotein 1b platelet receptor",
"Heterozygous protein C deficiency",
"Prothrombin 20210G"
] | B | Affecting procoagulant or fibrinolytic pathways: The most common inherited risk factors for venous thrombosis are the factor V Leiden mutation and prothrombin 20210 mutation. Other mutations predisposing an individual to venous thrombosis include inherited deficiency of protein C or S and mutations of fibrinogen, tissue plasminogen activator, thrombomodulin, or plasminogen activator inhibitor. In contrast, aerial thrombosis occurs in the setting a platelet activation, and the genetic predisposition for aerial thrombosis includes mutations that affect platelet receptors or redox enzymes. The glycoprotein 1b platelet receptor mutation would increase the risk of aerial thrombosis. Ref: Goldhaber S.Z. (2012). Chapter 262. Deep Venous Thrombosis and Pulmonary Thromboembolism. 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 |
In a social group a social act which is considered natural and right is referred to as - | [
"Taboo",
"Ritual",
"Custom",
"Tradition"
] | C | Ans. is 'c' i.e., Custom Terms custom and tradition are used interchangeably. But there is a difference (though minute) between these two : - Customs It the established patterns of behaviour that can be objectively verified within a paicular society. 3 In simple words, it is the act (social act) which is commonplace considered to he normal for that society. It should be keep in mind that custom of one society may be strange or abnormal to other society. Traditions o Traditions are a daily pa of our lives which is herited by other persons. o That is Tradition is a custom that is handed down. That means : ? o Custom is usual behaviour (social act). o When custom is handed to other persons of society, the same act (custom) becomes tradition. About other options. Taboo --> A tabbo is a social prohibition (ban) relating to any area of human activity (custom). Breaking of taboo is usually considered objectionable by society. o Ritual --> It is a prescribed order of cremony. | train | med_mcqa | null |
A term neonate, with a bih weight of 2700 g, who is otherwise well, and is exclusively breastfed, presents for routine evaluation. His total serum bilirubin is found to be 14mg/dl on day 5. What is the management? | [
"Phototherapy",
"Exchange transfusion",
"Stop breastfeeding for 2 days",
"No active treatment required"
] | D | Management of above case is by giving Routine baby care to baby, no active treatment is required. Breastfeeding need not to be stopped unless Contra-indicated AAP provides two age-specific nomograms for neonates >=35 weeks gestation- one each for phototherapy and exchange transfusion. The nomograms have lines for three different risk categories of neonates- lower risk babies (38 wk or more and no risk factors), medium risk babies (38 wk or more with risk factors, or 35 wk to 37 wk without any risk factors) and higher risk (35 wk to 37 wk and with risk factors) As a rough guide, phototherapy is initiated if TSB vales are >10 mg/dl at 24 hours >=13 mg/dL at 48 hours >=15 mg/dL at 72 hours >= 18 mg/dL at 96 hours and beyond in babies at medium risk. The babies at lower and higher risk have their cut-offs at approximately 2 mg/dL higher or 2 mg/dL lower than that for medium risk babies, respectively. Risk factors include: Presence of isoimmune hemolytic anemia G6PD deficiency Asphyxia Temperature instability Hypothermia Sepsis Significant lethargy Acidosis Hypoalbuminemia | train | med_mcqa | null |
The following are features of primary hyperaldosteronism except - | [
"Polyuria",
"Hypeension",
"Hypokalemia",
"Hyperkalemia"
] | D | hyper secretion of aldosterone increase the renal distal tubular exchange of intratubar sodium for secreted potassium and hydrogen ion with depletion of body potassium causing hypokalemia( Harrison 17 pg 2260) | train | med_mcqa | null |
The following clinical presentation qualify for the term "Severe Falciparum Malaria" EXCEPT | [
"Severe anemia",
"Acidosis",
"Pulmonary oedema",
"High grade fever with rigors"
] | D | null | train | med_mcqa | null |
At which of the following levels the predominant regulation of gene expression of both prokaryotes and eukaryotes take place? | [
"DNA replication",
"Transcription",
"Translation",
"Post-translational"
] | B | Expression of a functional gene product from genes is the gene expression. The functional product is not always proteins. Non-protein coding genes are also expressed as functional RNAs (tRNA, snRNA, miRNA etc.) Regulation of gene expression occurs at transcriptional level in both prokaryotes and eukaryotes. | train | med_mcqa | null |
All are true regarding Toxoplasmosis, except- | [
"Subclinical in most cases among adults",
"Intracerebral calcification in children",
"IgM antibody in new born suggests congenital infection",
"NOT infective in 3rd trimester in pregnancy"
] | D | Congenital infection during the first trimester of pregnancy may cause aboion or still bih.Second and third trimester infections induce less severe neurological damage. Cerebral calcification +convulsions +retinochoroiditis (refer pgno:67 baveja 3 rd edition) | train | med_mcqa | null |
Rate limiting step in cholesterol synthesis is inhibited by | [
"Probucal",
"Statins",
"Cholistyramine",
"Gemfibrozil"
] | B | Refer kDT 6/e p 614 About 80% of total daily cholesterol production occurs in the liver and the intestines; other sites of higher synthesis rates include adrenal glands, and reproductive organs. Synthesiswithin the body stas with the mevalonate pathway where two molecules of acetyl CoA condense to form acetoacetyl-CoA. Statins inhibit HMG-CoA reductase and decrease cellular cholesterol synthesis. ... The over-expression of the LDL-receptor in the liver increases the clearance of circulatingLDL, decreasing the LDL-cholesterol plasma levels. | train | med_mcqa | null |
Dietary changes advocated by WHO for prevention of hea diseases include all of the following except? | [
"A decrease in complex carbohydrate consumption",
"Reduction in fat intake to 20-30 percent of caloric intake",
"Consumption of saturated fats be limited to less than 10% of total energy intake",
"Reduction of cholesterol to below 100 mg per kcal per day"
] | A | A decrease in complex carbohydrate consumption | train | med_mcqa | null |
All of the following are side effects of Dantrolene therapy except- | [
"Muscle weakness",
"Phlebitis",
"Respiratory insufficiency",
"Renal dysfunction"
] | D | Common side effects of Dantroleum Intravenous include: muscle weakness, drowsiness, dizziness, low energy, tired feeling, injection site reactions (pain, redness, or swelling), diarrhea, constipation | train | med_mcqa | null |
Which among the following is a cardioprotective fatty acid? | [
"Palmitic acid",
"Stearic acid",
"Oleic acid",
"Omega-3 fatty acid"
] | D | Ans. D. Omega-3 fatty acid(Ref: Harper 31/e page 199)Significance of o3 Fatty AcidDecrease the risk of cardiovascular disease.Appear to replace arachidonic acid in platelet membranesLower the production of thromboxane and tendency of the platelet aggregation.Decrease serum triglyceridesImportant for infant developmentLower the risk of various mental illness Lower the risk of chronic degenerative diseases, such as cancer, rheumatoid arthritis, and Alzheimer's disease. | train | med_mcqa | null |
Bone resorption markers are: | [
"Serum propeptide of type I procollagen",
"Osteocalcin",
"Urine total free deoxypyridinoline",
"Free glutamic acid cross linkage."
] | C | C. i.e. Urine total free deoxypyridindine | train | med_mcqa | null |
Samogyi effect is - | [
"Morning hyperglycemia due to insulin resistance",
"Morning hyperglycemia due to large dose of exogenous insulin",
"Morning hypoglycemia due to large dose of exogenous insulin",
"Evening hypoglycemia due to insulin resistance"
] | B | Answer- B. Morning hyperglycemia due to large dose of exogenous insulinRebound hyperglycemia, results from excess xogenous insulin, which causes hypoglycemia overnight and stimulates the release to counter regulatory hormones that in turn increase blood glucose levels. | train | med_mcqa | null |
What is the the most probable diagnosis of a child who presents with white umbilicated lesions on face? | [
"Molluscumcontagiosum",
"Herpes simplex infection",
"Erythema toxicumneonatorum",
"Human pappiloma virus infection"
] | A | Ans. is 'a' i.e., Molluscumcontagiosum Pearly white umblicated papule on face in children is most commonly seen in Molluscumcontagiosum. Molluscum contagiosum It is a common viral infection in children. It is caused by pox virus, i.e., Molluscum contagiosum virus. It is characterized by multiple pearly white, dome-shaped papules which are umbilicated centrally. On using a hand lens, many of the papules has a mosaic appearance. Epidermal cells contain eosinophilic intracytoplasmic inclusion bodies (Molluscum or Henderso-Paterson bodies). Autoinoculation can give rise to lesions arranged linearly along line of trauma ----> pseudoismorphic (pseudokoebner's) phenomenon. M.C. may involve any pa of the body In children face is involved most commonly. Anogenital molluscum contagiosum is a STD. Treatement Curretage, electrocautery, cryotherapy are simple and effective methods. Imiquimed, a recently introduced immunostimulant, is helpful in patients with multiple lesions and in small children. | train | med_mcqa | null |
Primary biliary cirrhosis is most commonly associated with______ | [
"Systemic sclerosis",
"Sjogren syndrome",
"Ulcerative colitis",
"Pancreatitis"
] | B | Primary Biliary Cirrhosis Autoimmune disorder Clinical manifestation - obstructive jaundice F > M Antibody seen in antimitochondrial ab which is formed against E2 subunit of PDH enzyme. Interlobular bile ducts are actively destroyed by lymphoplasmacytic inflammation with or without granulomas. | train | med_mcqa | null |
Pitting nail dystrophy seen in – a) Dermatophytic infectionb) Psoriasisc) Lichen planusd) Seborrheic dermatitis | [
"a",
"c",
"ac",
"bc"
] | D | Skin disorders causing nail pitting → Psoriasis, Alopecia areata, Reiter's syndrome, Lichen planus,Eczema, Incontinetia pigmenti | train | med_mcqa | null |
A 6-week-old boy ,is seen by his physician in Hyderabad. His parents repo that he has not had significant use of his right arm since bih. Bih history is significant for a prolonged labor with difficult breech delivery. On physical examination, his arm hangs at his side and is in a medially rotated position with the forearm in pronation. He will actively use his left arm, but does not move his affected right arm or hand. Injury to which of the following cervical nerve roots account for this patient's posture? | [
"C4 and C5",
"C5 and C6",
"C6 and C7",
"C7 and C8"
] | B | This patient has an Erb-Duchenne palsy, which is the result of an injury to the superior trunks of the C5 and C6 nerve roots. The C8 and T1 nerve roots are injured in a Klumpke's paralysis. The other combinations all may be injured as a result of bih palsy, but do not have distinct syndromes associated with them. | train | med_mcqa | null |
Karyotyping is useful in diagnosis of- | [
"Autosomal recessive disorders",
"X-linked recessive disorders",
"Chromosomal abnormalities",
"Biochemical abnormalities"
] | C | A karyotype is a photographic representation of a stained metaphase spread in which the chromosomes are arranged in order of decreasing length.A variety of techniques for staining chromosomes have been developed. With the widely used Giemsa stain (G banding) technique, each chromosome set can be seen to possess a distinctive pattern of alternating light and dark bands of variable widths . The use of banding techniques allows identification of each chromosome, and can detect and localize structural abnormalities. Karyotype analy- sis of chromosomes by G banding remains the classic approach for identifying changes at the chromosomal level; however, as might be expected, the resolution with this technique is fairly low. In order to identify subchromo- somal alterations, both focused analysis of chromosomal regions by FISH and global genomic approaches such as comparative genomic hybridization (CGH) have become popular. Fluorescence in Situ Hybridization (FISH) FISH utilizes DNA probes that recognize sequences spe- cific to chromosomal regions of greater than 100 kilobases in size, which defines the limit of resolution with this tech- nique for identifying chromosomal changes. Such probes are labeled with fluorescent dyes and applied to metaphase spreads or interphase nuclei. The probe hybridizes to its complementary sequence on the chromosome and thus labels the specific chromosomal region that can then be visualized under a fluorescence microscope. The ability of FISH to circumvent the need for dividing cells is invaluable when a rapid diagnosis is warranted (e.g., in a critically ill infant suspected of having an underlying genetic disorder). Such analysis can be performed on prenatal samples (e.g., cells obtained by amniocentesis, chorionic villus biopsy, or umbilical cord blood), peripheral blood lymphocytes, and even archival tissue sections. FISH has been used for detection of numeric abnormalities of chromosomes (aneuploidy) (Fig. 6-37, A); for the demonstration of subtle microdeletions (Fig. 6-37, B) or complex transloca- tions not detectable by routine karyotyping; for analysis of gene amplification (e.g., NMYC amplification in neuroblastomas); and for mapping newly isolated genes of interest to their chromosomal loci. Array-Based Genomic Hybridization It is obvious from the preceding discussion that FISH requires previous knowledge of the one or few specific chromosomal regions suspected of being altered in the test sample. However, chromosomal abnormalities may also be detected without previous knowledge of what these aber- rations may be, using a global strategy known as array- based CGH. Here the test DNA and a reference (normal) DNA are labeled with two different fluorescent dyes (most commonly, Cy5 and Cy3, which fluoresce red and green, respectively). The differentially labeled samples are then hybridized to an array of segments of genomic DNA "spotted" on a solid matrix, usually a glass slide (Fig. 6-38, A). These segments of DNA are representations of the human genome at regularly spaced intervals, and cover all 22 autosomes and the sex chromosome (Fig. 6-38, A). Amplifications and deletions in the test sample produce an increase or decrease in signal relative to the normal DNA that can be detected down to a 10-kilobase (kb) resolution (Fig. 6-38, B). Newer generations of microarrays using single-nucleotide polymorphisms (SNPs) (see fuher on) provide even higher resolution (with more than 1 million SNPs from the human genome on a single microarray!) and are currently being used to uncover copy number abnor- malities in a variety of diseases, from cancer to autism. (Robbins Basic Pathology, 9 th edition. page : 263) | train | med_mcqa | null |
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