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A two-month-old infant presents with irritability and lethargy. The parents state he was well until he rolled off the couch onto the floor on the previous day. On examination, he is inconsolable and afebrile. The fontanels are full and tense. He has a generalized tonic-clonic seizure in your office. The most impoant additional diagnostic study is: | [
"Serum calcium, phosphorus, and alkaline phosphatase levels",
"Viral cultures of nasopharyngeal swab",
"Retinoscopic Exam",
"Serum ammonia level"
] | C | Though infection must be considered as an etiology, acute trauma is more likely in this scenario. This case represents the classic picture of the shaken baby syndrome, which produces intracranial trauma without obvious external findings. This infant is critically ill and lacks preceding illness or constitutional symptoms. The tense fontanelle reflect increased intracranial pressure. A retinoscopic exam most often would reveal retinal hemorrhages that would confirm the diagnosis. A history of trauma, which does not correlate with the child's injury should ale health care providers to the possibility of child abuse. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 35. Craniocerebral Trauma. In A.H. Ropper, M.A. Samuels (Eds), Adams and Victor's Principles of Neurology, 9e. | train | med_mcqa | null |
Indication for liver transplantation in an infant is | [
"Alcohol cirrhosis",
"Biliary cirrhosis",
"Biliary atresia",
"Hematochromatosis"
] | C | Most common indication for liver transplantation in children - Biliary atresia in adults - Cirrhosis Ref : Bailey & Love 25/e p1426 | train | med_mcqa | null |
Which one of the following is not a feature of renal aery stenosis? | [
"Hypeension responds well to drugs",
"Kidneys may be asymmetrical",
"Atherosclerotic plaques are common",
"Serum creatinine may increase with ACE inhibitors"
] | A | In renal aery stenosis - Hypeension is difficult to control with drugs. Patients often respond to Revascularization procedures like percutaneous renala aery angioplasty . There may be decline in GFR during therapy with ACE -inhibitors or ARB'S. Renal aery stenosis can be unilateral or bilateral, so kidneys may be asymmetrical . Atherosclerosis is the common cause of renal aery stenosis in elderly. Ref:Harrison 20 th edition pg no 1906 | train | med_mcqa | null |
Palpable pupura is seen in all conditions except – | [
"Cryoglobulinuria",
"H.S. pupura",
"Gaint cell arteritis",
"Drug induced vasculitis"
] | C | Vasculitis of small vessels cause palpable purpura, whereas giant cell arteritis affects large vessels. | train | med_mcqa | null |
Child with frog like position and resistance to move the limbs - | [
"Scurvy",
"Rickets",
"Trauma",
"Congenital dislocations"
] | A | Congenital dislocations | train | med_mcqa | null |
A 40 years old female is came in the depament by describing "1 have worst headache of my life". The investigation of choice for this patient | [
"Four vessels carotid angiography",
"Computed tomography (CT)",
"MRI",
"No scan is required"
] | B | Answer- B. Computed tomography (CT)It is a case of "acute subarachnoid hemorrhage".The explosive onset of severe, excruciating headache is a common feature of subarachnoid haemonhage (SAH).Diagnosis of Subarachnoid hemorrhageThe hallmark of aneurysmal rupture is blood in the cerebrospinalfluid.More than 95% cases have enough blood to be visualized on a high quality non contract CT scan obtained within 72h.MRI can also be used to diagnose subarachnoid hemorrhage but CT is more sensitive than MRI for acute blood | train | med_mcqa | null |
Population covered by a community health centre- | [
"5000",
"30,000",
"1000",
"100,000"
] | D | As on 31 st march 2014 ,5,363 community health centers were established by upgrading the primary health centers,each community health center covering a population of 80,000 to 1.20 lakh(one in each community development block) with 30 beds and specialists in surgery,medicine,obstetrics and gynecology and paediatrics with x-ray and laboratory facilities (refer pgno:907 park 23 rd edition) | train | med_mcqa | null |
Treatment of acute cardiac tamponade is | [
"Emergency paracentesis",
"Emergency thoracotomy",
"Pericardiactomy",
"IV fluids"
] | A | Initial management in hospital is by pericardiocentesis. This involves the inseion of a needle through the skin and into the pericardium and aspirating fluid under ultrasound guidance preferably. This can be done laterally through the intercostal spaces, usually the fifth, or as a subxiphoid approach.A left parasternal approach begins 3 to 5 cm left of the sternum to avoid the left internal mammary aery, in the 5th intercostal space. Often, a cannula is left in place during resuscitation following initial drainage so that the procedure can be performed again if the need arises. If facilities are available, an emergency pericardial window may be performed instead] during which the pericardium is cut open to allow fluid to drain. Following stabilization of the person, surgery is provided to seal the source of the bleed and mend the pericardium. In people following hea surgery the nurses monitor the amount of chest tube drainage. If the drainage volume drops off, and the blood pressure goes down, this can suggest tamponade due to chest tube clogging. In that case, the person is taken back to the operating room for an emergency reoperation. If aggressive treatment is offered immediately and no complications arise (shock, AMI or arrhythmia, hea failure, aneurysm, carditis, embolism, or rupture), or they are dealt with quickly and fully contained, then adequate survival is still a distinct possibility. Ref Davidson 23rd edition pg 453 | train | med_mcqa | null |
All of the following abnormalities are predisposing causes for torsion of the testis except | [
"Inversion of testis",
"Low investment of tunica vaginalis",
"Between 10 to 25 years of age",
"Seperation of the epididymis"
] | B | Predisposing factors for torsion testis are: *Inversion of the testis. *High investment of the tunica vaginalis which acts like a mesentry through which testis rotates. Here testis hangs like a clapper in bell. *Presence of gap between the body of the testis and epididymis, as a result of which testis twists over epididymis. *Heavy straining often ppts torsion d/t vigorous contraction of the cremaster which is attached spirally. Reference : page 1082 SRB's manual of surgery 5th edition | train | med_mcqa | null |
Definitive managenment in primary angle closure glaucoma: March 2005 | [
"Trabeculectomy",
"Surgical iridectomy",
"Laser iridotomy",
"Pilocarpine"
] | C | Ans. C: Laser iridotomy Although intraocular pressure is only one of the major risk factors for glaucoma, lowering it various pharmaceuticals and/or surgical techniques is currently the mainstay of glaucoma treatment. A. Medications used for lowering intraocular tension: Prostaglandin analogs like latanoprost, bimatoprost and travoprost increase uveoscleral outflow of aqueous humor. Bimatoprost also increases trabecular outflow Topical beta-adrenergic receptor antagonists such as timolol, levobunolol, and betaxolol decrease aqueous humor production by the ciliary body. Alpha2-adrenergic agonists such as brimonidine work by a dual mechanism, decreasing aqueous production and increasing uveo-scleral outflow. Less-selective sympathomimetics like epinephrine and dipivefrin increase outflow of aqueous humor through trabecular meshwork and possibly through uveoscleral outflow pathway, probably by a beta2-agonist action. Miotic agents parasympathomimetics like pilocarpine work by contraction of the ciliary muscle, tightening the trabecular meshwork and allowing increased outflow of the aqueous humour. Carbonic anhydrase inhibitors like dorzolamide, brinzolamide, acetazolamide lower secretion of aqueous humor by inhibiting carbonic anhydrase in the ciliary body. B. Conventional surgery to treat glaucoma makes a new opening in the meshwork. This new opening helps fluid to leave the eye and lowers intraocular pressure. Canaloplasty is a nonpenetrating procedure utilizing microcatheter technology. By opening the canal, the pressure inside the eye may be relieved. Laser trabeculoplasty may be used to treat open angle glaucoma. It is a temporary solution, not a cure. Nd: YAG Laser peripheral iridotomy reduces the risk of developing an attack of acute angle closure. In most cases it also reduces the risk of developing chronic angle closure or of adhesions of the iris to the trabecular meshwork. It is mandatory after reducing the intraocular pressure in all eyes with any form of primary angle-closure glaucoma and also prophylactically in the unaffected eye. Diode laser cycloablation lowers IOP by reducing aqueous secretion by destroying secretory ciliary epithelium. Trabeculectomv allows fluid to flow out of the eye through this opening, resulting in lowered intraocular pressure. | train | med_mcqa | null |
A patient complaints of post coital bleed; no growth is seen, on per speculum examination; next step should be : | [
"Colposcopy biopsy",
"Conisation",
"Repeat pap smear",
"Culdoscopy"
] | A | Ans is a i.e. Colposcopy biopsy Patient is presenting with post coital bleeding, which is a specific symptom of Ca cervix; since there is no visible lesion - colposcopic biopsy is the next line of investigation as it is a diagnostic procedure. Pap smear is only a screening method. | train | med_mcqa | null |
H. Pylori is known to cause all of the following except- | [
"Gastric ulcer",
"Duodenal ulcer",
"Gastric lymphoma",
"Fundal gastritis"
] | D | null | train | med_mcqa | null |
Not a B cell marker | [
"CD19",
"CD20",
"CD34",
"CD10"
] | C | . | train | med_mcqa | null |
A 30 year old man came to the outpatient depament because he had suddenly developed double vision. On examination it was found that his right eye, when at rest, was turned medially. The most likely anatomical structures involved are: | [
"Medial rectus and superior division of oculomotor nerve",
"Inferior oblique and inferior division of oculomotor nerve",
"Lateral rectus and abducent nerve",
"Superior rectus and trochlear nerve"
] | C | C i.e. Lateral rectus & abducent nerve Abducent (6th) nerve supply lateral rectus muscle (LR6) Q. Palsy of lateral rectus presents with fully adducted eye (due to unopposed medial rectus), inability to abduct eye Q & diplopia in all gaze (maximum in ipsilateral outward gaze)Q except on looking to the side opposite to lesion (i.e. on normal side) | train | med_mcqa | null |
Tattooing around the entry wound is seen in - | [
"Close shot",
"Contact shot",
"Distant shot",
"All of the above"
] | A | Ans. is 'a' i.e., Close shot Contact shotClose shotDistant shoto The discharge from the muzzle consisting of the flame, powder metallic are blown the track taken by the bullet.o The discharge of muzzle is flame powder etc is within the fange of entrance woundo The discharge of muzzle isoutside the range of entrance woundo Consequently there may be no buring no soot, no tattooing around the entrance woundo Consequently wound is singed by flame, surrounded by soot (blackned) and shows tattoingo No burning, no tattooing, soot.o Skin surrounding the wound shows no -# No abraded collar# No grease collaro The skin surrounding the wound shows -* Abraded collar* Grease / dirt collaro The skin sorrounding the wound may be -* Abraded collar may be present* Dirt collar or grease collar presento Surrounding tissues may be cherry red incolour owing to presence offcarboxyhaemoglobino Carboxyhaemoglobin is present in the wound track in diminishing concentrations - Reddy (This explains cherry red colour of surrounding tissues)o Surrounding tissues may be cherry red due to present of carboxyhaemoglobino Wound may be -# Small and regular or# Larg and irregular (triangular, stellatecruciate)Q# Contact head wound result in undermined, ragged', stellate (star shaped), triradiate or cruciform wound with everted marginsQ from which lacerations (tears) over skin radiating outward from entrance hole because of expansion of gases between scalp and skullo The entrance wound is circular with inverted margins but the rebounding gases may level up or even evert the margino The wound is circular with inverted margins and may be of same size or even smaller than the bullet due to initial stretching of skin. | train | med_mcqa | null |
In volume cycled ventilation the inspiratory' flow rate is set at: | [
"140-160 L/min",
"110-130L/min",
"60-100 L/min",
"30-50L/mm"
] | C | In volume cycled ventilation the inspiratory flow rate is usually set at 60-100 U/min to allow greater expiration time for each breath. Use of high inspiratory flow rate can minimize end inspiratory lung volume and intrinsic PEEP, but it can cause higher peak airway pressures. Volume cycled assist control mode of ventilation is the most commonly used mode of ventilation. Volume targeted modes deliver a preset volume unless a specified circuit pressure limit is exceeded. Its major advantages are capacity to deliver unvarying tidal volumes, flexibility of flow and volume adjustments, and power to ventilate difficult patients. Disadvantages of this type of ventilation are: Unless the airway is well sealed volume cycled modes cannot ventilate effectively and consistently. After the flow rate and profile are set the inflation time of machine is set and remains unresponsive to patients native cycling rythm and flow demands. Ref: Respiratory Emergencies By Stephan Kamholtz, page 413. Critical Care Medicine: The Essentials By John J. Marini, page 134. | train | med_mcqa | null |
MTP is not done in: | [
"Case of rape",
"Baby with congenital disease",
"Mother at risk",
"Family is poor"
] | D | Family is poor | train | med_mcqa | null |
Features of allergic bronchopulmonary aspergillosis (ABPA) are all except | [
"Bronchial asthma",
"Central bronchiectasis",
"Peripheral eosinophilia",
"Raised IgA levels"
] | D | Ans. d (Raised IgA levels). (Ref. Harrison's 18th/Ch. 204)ABPA represents a hypersensitivity reaction to A. fumigatus; rare cases are due to other aspergilli and other fungi. ABPA occurs in ~1% of patients with asthma and in up to 15% of adults with cystic fibrosis. Episodes of bronchial obstruction with mucous plugs leading to coughing fits, "pneumonia," consolidation, and breathlessness are typical. Eosinophilia commonly develops before systemic glucocorticoids are given. The cardinal diagnostic tests include an elevated serum level of total IgE (usually >1000 IU/mL), a positive skin-prick test to A. fumigatus extract, or detection of Aspergillus- specific IgE and IgG (precipitating) antibodies. Central bronchiectasis is characteristic. Primary Rx is Itraconazole therapy.ABPAPrimary diagnostic criteria for Allergic bronchopulmonary aspergillosis (ABPA)Secondary diagnostic criteria (less common)1)Asthma (84-96%) (Episodes of bronchospasm)1)Aspergillus fumigatus mycelias in sputum2)Roentgenographic transient or fixed pulmonary infiltrates2)Expectoration of brown sputum plugs (54%)3)Test for Aspergillus fumigatus positive (skin)3)Arthus reaction to Aspergillus antigen.4)Eosinophilia (8-40%)4)Fungal ball with Air crescent or Monads' sign is characteristic of aspergilloma.5)Precipitating antibodies to Aspergillus fumigatus (70%) 6)IgE in serum elevated 7)Central (Proximal/perihilar) bronchiectasis (late manifestation that proves diagnosis) 8)Serum specific IgE and IgG A. fumigatus levels elevated. | train | med_mcqa | null |
10% Tumour is | [
"Pheochromocytoma",
"Papillary Thyroid Carcinoma",
"Follicular Thyroid Carcinoma",
"Brown’s Tumor"
] | A | Pheochromocytomas normally obey the “rule of 10”. Hence, they are also called the “10% tumor”. i.e. 10% of pheochromocytomas are:
Familial.
Malignant.
Bilateral.
Extra-adrenal.
Seen in children | train | med_mcqa | null |
Primary dentition is complete by: UPSC 08 | [
"1.5 years",
"2.5 years",
"3.5 years",
"4.5 years"
] | B | Ans. 2.5 years | train | med_mcqa | null |
structure holded by forceps is seen in ? | [
"Stomach",
"Appendix",
"Colon",
"Duodenum"
] | C | Appendix Epiploica are one of numerous pouches of the peritoneum filled with fat and attached to the colon. | train | med_mcqa | null |
Although more than 400 blood groups have been identified, the ABO blood group system remains the most important in clinical medicine because - | [
"It was the first blood group system to be discovered -",
"It has four different blood groups A,B, AB, O (H).",
"ABO(H) antigens are present in most body tissues and fluids",
"ABO(H) antibodies are invariably present in plasma when person's RBC lacks the corresponding antigen"
] | D | The basic difference between the ABO blood group system and other blood group systems (such as Rh, Kell, Duffy, MNSs blood groups), which makes the ABO group so important is that -
Preformed ABO antibodies (agglutinins) are present in person serum when his RBCs lack the corresponding antigen (ie. anti B antibody would be present in a person of type A and type O blood groups. These two blood groups do not have the 'B' antigen on the RBCs)
This is not the case with other blood groups. Preformed antibodies are not present. They are formed only after an exposure to the antigen, for example, an Rh-negative person do not have anti- Rh antibodies, these antibodies are formed only after an exposure to Rh-positive blood (by a blood transfusion, i.e. this makes the first blood transfusion safe even if mismatched)
These preformed antibodies, rapidly destroy the RBCs of any mismatched blood transfusion.
Read the following lines from the Journal of hematology-
"In clinical transfusion practice, the ABO blood groups are the most important and can never be ignored in red cell transfusion, because individuals who genetically lack any antigen, have antibodies against the red cell types that they have not inherited. These antibodies can destroy red cells rapidly in circulation". | train | med_mcqa | null |
Levosulpiride acts as an antagonist of which central dopamine receptor | [
"D1",
"D2",
"D3",
"D4"
] | B | D2 receptor antagonists being explored as prokinetic agents include levosulpiride, the levo-enantiomer of sulpiride Levosulpiride is claimed to have mood elevating propeies. Levosulpiride is used in the treatment of psychoses, paicularly negative symptoms of schizophrenia, anxiety disorders, dysthymia, veigo, dyspepsia, irritable bowel syndrome and premature ejaculation. Ref: G&G 12e pg:1506 | train | med_mcqa | null |
A 12-year-old boy with a femur fracture after a motor vehicle collision undergoes operative repair. After induction of anesthesia, he develops a fever of 40degC (104degF), shaking rigors, and blood-tinged urine. Which of the following is the best treatment option? | [
"Alkalinization of the urine, administration of mannitol, and continuation with the procedure",
"Administration of dantrolene sodium and continuation with the procedure",
"Administration of dantrolene sodium and termination of the procedure",
"Administration of intravenous steroids and an antihistamine agent ... | C | The patient is manifesting symptoms of malignant hypehermia (fevers, rigors, and myoglobinuria), which is treated by administration of dantrolene, immediate discontinuation of offending medication (which can include succinylcholine or halothanebased inhalational anesthetics), and suppoive cooling measures. While urine alkalinization, loop diuretics, and mannitol are appropriate treatment measures for rhabdomyolysis, the underlying problem in this patient is malignant hypehermia, which, because of its associated moality of 30% in severe cases, should be treated first and foremost. Malignant hypehermia is not a manifestation of anaphylactic shock, and therefore steroids and antihistamines have no role in its treatment. | train | med_mcqa | null |
In which of the following conditions Parakeratosis most frequently occurs – | [
"Actinic keratoses",
"Seborrheic keratoses",
"Molluscum contagiosum",
"Basal cell carcinoma"
] | A | Normally, nuclei disappear in stratum corneum. Retention of nuclei within the cells of stratum corneum is referred to as parakeratosis.
Parakeratosis is seen in -
Normally → Mucous membrane of mouth and vagina.
Disorders → Actinic keratosis, Psoriasis, Squamous cell carcinoma, Seborrheic dermatitis, Eczema. Don't get confused with option b; It is seborrheic keratosis, not seborrheic dermatitis. Seborrheic keratosis (also known as senile wart) is a noncancerous benign growth that originates in keratinocytes, seen in old people. | train | med_mcqa | null |
Most immunogenic Typhoid antigen | [
"O antigen",
"H antigen",
"Vi antigen",
"Somatic antigen"
] | B | null | train | med_mcqa | null |
A 50 year old lady with history of jaundice in the past has presented with right upper quadrant abdominal pain. Examination and investigations reveal chronic calculous cholecystitis. The liver functions tests are within normal limits and on ultrasound examination the common bile ducts is not dilated. Which of the following will be the procedure of choice in her- | [
"Laparoscopic cholecystectomy",
"Open choledocholithotomy with CBD exploration",
"ERCP ± cholecystectomy followed by laparoscopic cholecystectomy",
"Laparoscopic cholecystectomy followed by ERCP ± choledocholithotomy"
] | A | null | train | med_mcqa | null |
Nasopharyngeal carcinoma seen in which occupation? | [
"Asbestos industry",
"Cement industry",
"Wood workers",
"Chimney workers"
] | C | Ans. is 'c' i.e., Wood workersRef Dhingra 4h/e p. 235; Nasopharyngeal carcinoma By Andrew Van Hasselt,Alan G. Gibb 2d/e p. 4Wood dusts exposure is a risk factor of nasopharyngeal carcinoma andAdenocarcinoma of PNS.Formaldehyde exposure is a risk factor of Nasopharyngeal carcinoma. | train | med_mcqa | null |
A 45-year-old woman is being examined as a candidate for cosmetic breast surgery. The surgeon notes that both of her breasts sag considerably. Which structure has most likely become stretched to result in this condition? | [
"Scarpa's fascia",
"Pectoralis major muscle",
"Pectoralis minor muscle",
"Suspensory (Cooper's) ligaments"
] | D | The suspensory ligaments of the breast, also known as Cooper's ligaments, are fibrous bands that run from the dermis of the skin to the deep layer of superficial fascia and are primary supports for the breasts against gravity. Ptosis of the breast is usually due to the stretching of these ligaments and can be repaired with plastic surgery. Scarpa's fascia is the deep membranous layer of superficial fascia of the anterior abdominal wall. The pectoralis major and pectoralis minor are muscles that move the upper limb and lie deep to the breast but do not provide any direct support structure to the breast. The serratus anterior muscle is involved in the movements of the scapula. | train | med_mcqa | null |
All of the following are the Intranatal causes of Perinatal moality except:- | [
"Bih injuries",
"Bih asphyxia",
"Antepaum hemorrhage",
"Obstructed labor"
] | C | Causes of perinatal moality: Antenatal cause Intranatal cause Maternal disease -HTN,DM,TB,Anemia,Cardiovascular disease Bih injuries Pelvic disease Bih asphyxia Anatomical defects Prolonged effo time; obstructed labour Endocrine imbalance Other Obstetric complications Malnutrition Postnatal causes Toxemias Prematurity Antepaum hemorrhage Respiratory distress syndrome Congenital defects Respiratory and alimentary infections Advanced maternal age Congenital anomalies Blood incompatibilities | train | med_mcqa | null |
Vaccine strains changed every year is | [
"Measles",
"Rubella",
"BCG",
"Influenza"
] | D | Influenza virus shows changing antigenic characteristics due to antigenic shift and antigenic drift, hence new vaccines are constantly required. WHO makes recommendations every year as to what strains should be included in the vaccine. FLU VACCINES FOR 2020 Southern hemisphere H1N1 (Brisbane strain) (Influenza type A) H3N2 (South Australia) (Influenza type A) Influenza type B (Washington strain of Victoria lineage) Influenza type B (Phuket strain of Yamagata lineage) Nohern Hemisphere H1N1 (Brisbane strain) (Influenza type A) H3N2 (Kansas) (Influenza type A) Influenza type B (Colarado strain of Victoria lineage) Influenza type B (Phuket strain of Yamagata lineage) | train | med_mcqa | null |
True about pectoralis major muscle | [
"Abductor & Internal rotator of shoulder",
"Blood supply by perforating branch of internal thoracic aery",
"Blood supply by thoraco acromial aery",
"Nerve supply by intercostal aery"
] | C | PECTORALIS MAJOR:-Origin: Small clavicular head- medial half of anterior aspect of clavicle.Sternocostal head- lateral half of sternum upto 6th cailage., and medial pas of 2nd to 6th costal cailages.Inseion:-U shaped inseion into lateral lip of bicipital groove.Nerve supply:-Lateral pectoral( C5-C7)Medial pectoral (C6-C8, T1)Action:-Clavicular head- flexes arm Sternocostal head-adducts and medially rotates armOnly muscle of upper limb which is supplied by all 5 spinal segments that form brachial plexus.Blood supply:- pectoral branch of thoracoacromial aery{Reference: Vishram Singh, pg no.40} | train | med_mcqa | null |
Nitric oxide is used for treatment of pulmonary hypertension via which route - | [
"Inhalational",
"Intramuscular injection",
"Subcutaneous",
"Intravenous infusion"
] | A | Ans. is 'a' i.e., Inhalational Inhaled Nitric oxide* Inhaled nitric oxide gas is an important development in the management of pulmonary hypertension.* It is delivered directly to the pulmonary circulation.* Nitric oxide acts on the vascular smooth muscle. It produces relaxation by acting on smooth muscle guanylate cyclase to produce cGMP which acts on series of protein kinases and resuces intracellular calcium levels to produce muscle relaxation.* Nitric oxide in blood is rapidly bound and inactivated, thus inhaled nitric oxide has minimal effect on systemic circulation and functions as specific pulmonary vasodilator. | train | med_mcqa | null |
A 7 day old infant presented with lethargy, decreased feeding, emesis, poor weight gain,hypotonia, a high-pitched cry, seizures, and the characteristic maple syrup smell of the urine.The following features are due to defect in | [
"Oxidaton",
"Deamination",
"Carboxylation",
"Decarboxylation"
] | D | Maple syrup urine disease (MSUD)-1 is due to impaired Alpha-Ketoacid decarboxylase component of BCKAD (branched chain alpha keto acid dehydrogenase) complex,leading to defective decarboxylation reaction and the formation of branched-chain amino acids (leucine, isoleucine, and valine) and their toxic byproducts (keto-acids) in blood and urine. A peculiar odor (burnt sugar) is found in urine, sweat, and cerumen. Treatmet:Diet lacking in branched chain amino acids Reference: Harpers illustrated biochemistry 30th edition | train | med_mcqa | null |
First line of treatment in Ascitis is: | [
"Salt Restriction",
"Diuretics",
"Paracentesis",
"Shunt"
] | A | Answer is A (Salt Restriction) The.first line treatment of Ascitis is dietary salt restriction. Treatment of Ascitis: Oxford Textbook of Medicine : Recommendations Bed Rest is of Nile value Dietry sodium Restriction is the first line management Diuretic therapy is the mainstay of treatment ofAscitis (Spironolactone should be employed as the first line drug) Large volume paracentesis should initially be carried out on patients with moderate or marked ascitis Shunts (TIPS) may he used in cases of Refractory Ascitis in whom recurrent paracentesis is too frequent or poorly tolerated, or in those with a hepatic hydrothorux | train | med_mcqa | null |
All are true regarding SCID except: | [
"Due to deficiency of adenosine deaminase",
"Toxicity of leucocytes due to accumulation of cAMP",
"Both cellular and humoral immunity affected",
"Bone marrow transplantation is the treatment"
] | B | Ref: Nelson's Textbook of Pediatrics. /9th Edition, Page:Explanation:"Marked accumulations of adenosinef 22 - deoxyadenosine. and 22 -O-methyladenosine lead directly or indirectly to T-cell apoptosis, which causes the immunodeficiency " (Ref: Nelson) Severe combined ImmuntKief'iciency (SCID)Both cellular and humoral immunity affectedMC type is X-linked SCID (X-SCD) due to mutation in Common Cytokine Receptor g Chain (gC)Second most common form of SCID is absence of the enzyme adenosine deaminase (ADA)(15% patients)All patients with SCID have very small thymuses (<1 g)Thymus fail to descend from the neck, contain no thymocytes, and lack corticomeduliary distinction or Hassall corpuscles.The thymic epithelium appears histologically normal.Both the follicular and paracorticai areas of the spleen are depleted of lymphocytes.Lymph nodes, tonsils, adenoids, and Peyer patches are absent or extremely underdevelopedClinical ManifestationsAffected infants present within the 1st few months of life with Recu rrent or persistent diarrheaPneumoniaOtitis media SepsisCutaneous infectionsGrowth failurePersistent infections with opportunistic organisms including lead to deathCandida albicansPneumocystis jiroveciParainfluenza 3 virusAdenovirusRespiratory syncytial virusRotavirus vaccine virus Cytomegalovirus (CMV)Epstein-Barr virus (EBV)Varicella-zoster virusMeasles virusMMR-V vaccine virusBacillus Calmette-Guerin (BCG)Affected infants also lack the ability to reject foreign tissue and are therefore at risk for severe or fatal graft versus host disease (GVHD) from T lymphocytes in non irradiated blood products or in allogeneic stem cell transplants or less severe GVHD from maternal immunocompetent T cells that crossed the placenta while the infant was in utero.* These infants also have an absence of lymphocyte proliferative responses to mitogens, antigens, and allogeneic cells in vitro.Patients with adenosine deaminase (ADA) deficiency have the lowest absolute lymphocyte counts, usually <500/mm3.Serum immunoglobulin concentrations are low or absentNo antibodies are formed after immunizations.T cells are extremely low or absentTreatmentSCID is a true pediatric emergency.Unless immunologic reconstitution is achieved through stem cell transplantation, death usually occurs during the 1st yr of life and almost invariably before 2 yr of age. | train | med_mcqa | null |
Epiphysis involved in which bone tumor ? | [
"Osteosarcoma",
"Multiple myeloma",
"Giant cell tumor",
"Ewing's sarcoma"
] | C | Ans. is 'c' i.e., Giant cell tumor Epiphyseal tumors are : Chondroblastoma, Giant cell tumor (osteoclastoma), Clear cell chondrosaroma. | train | med_mcqa | null |
Which one of the following is NOT used in testing for adequate pasteurization of milk? | [
"Phosphatase test",
"Coliform count",
"Standard plate count",
"Methylene blue reduction test"
] | D | Tests used to detect adequate Pasteurization of Milk are(sufficiency of pasteurization): - Phosphatase Test: Widely used test - Standard Plate Count: Enforced limit is 30,000 bacterial count per ml of pasteurized milk. - Coliform Count: Standard is Coliform be absent in 1 ml of milk. Methylene Blue Reduction Test : - Is an indirect method for detection of microorganisms in milk . - Blue colour disappears from milk when held at a uniform temperature of 37degC. - Milk which remains blue the longest, is of the best quality. | train | med_mcqa | null |
Cri du chat syndrome involve: | [
"Chromosome 13",
"Chromosome 18",
"Chromosome 22",
"Chromosome 5"
] | D | Cri du chat (named after cry of infant like that of a cat) syndrome occurs due to deletion of short arm of chromosome 5.
Mohan H. Textbook of pathology. Jaypee Brothers Medical Publishers; 2015. Edition 7. Page 254 | train | med_mcqa | null |
All are true about Adult laryngeal papilloma except- | [
"M >F",
"Do not recur",
"Posterior half of vocal cord",
"Treatment is surgery"
] | C | null | train | med_mcqa | null |
Which of the following markers is specific for Gastro intestinal stromal tumors (GIST)? | [
"CD 117",
"CD 34",
"CD 23",
"S-100"
] | A | CD 117 is most specific marker for Gastrolintestinal stromal tumor, than CD 34. GIST has a universal expression of CD117. It can also be present in fibroblastic and endothelail tumors. Ref: M. Wasif Saif (2010), Chapter "Gastrointestinal Stromal Tumors", In the book, "Gastrointestinal Malignancies", Volume 1, Issue 1, USA, Page 152; Robbin's Basic Pathology, 7th Edition, Page 826; Oncology: An Evidence Based Approach, (2006), Pages 413-14; Sternberg's-Diagnostic Surgical Pathology, 4th Edition, Page 1590 | train | med_mcqa | null |
Blue hypostasis is seen poisionig due to : | [
"H2S",
"Phosphorus",
"CO",
"Organophosphorus compounds"
] | A | A i.e. H2S | train | med_mcqa | null |
Blood samples for glucose estimation are collected in fluoride bulbs/tubes as fluride prevents glycolysis byinhibition of | [
"Enolase",
"Aldolase",
"Glucokinase",
"Phosphofructokinase"
] | A | Ans. a (Enolase) (Ref. Harper's Illustrated 26th ed., 137; 27th/Ch. 18)ENOLASE# The step of glycolysis catalyzed by enolase involves dehydration, forming phosphoenolpyruvate.# Enolase is inhibited by fluoride.- To prevent glycolysis in the estimation of glucose, blood is collected in tubes containing fluoride.# The enzyme is also dependent on the presence of either Mg2+ or Mn2+.# The phosphate of phosphoenolpyruvate is transferred to ADP by pyruvate kinase to generate, at this stage, two molecules of ATP per molecule of glucose oxidized.# The product of the enzyme-catalyzed reaction, enolpyruvate, undergoes spontaneous (nonenzymic) isomerization to pyruvate and so is not available to undergo the reverse reaction.# The pyruvate kinase reaction is thus also irreversible under physiologic conditions. EnzymeInhibitorPathway1.AconitaseFluoroacetateKrebs cycle2.L-KG dehydrogenaseArseniteKrebs cycle3.EnolaseFluorideGlycolysis4.Succinate dehydrogenaseMalonate oxaloacetateKrebs cycle5.Glyceradehyde-3 phosphateLactoacetate dehydrogenaseGlycolysis6.MOAIproniazid 7.Pyruvate dehydrogenaseArsenite 8.Carbonic anhydraseSulfanilamide | train | med_mcqa | null |
Risk of the damage to the fetus by maternal rubella is maximum if the mother gets infected in - | [
"6-12 weeks of pregnancy",
"20-24 weeks of pregnancy",
"24-28 weeks of pregnancy",
"32-36 weeks of pregnancy"
] | A | Ans. is ‘a’ i.e., 6-12 weeks of pregnancy
Congenital rubella syndrome (CRS) refers to infants born with defects secondary to intrauterine infection or who
manifest symptoms or signs of intrauterine infection sometimes after birth.
Rubella infection inhibits cell division and this is probably the reason for congenital malformations and low birth
weight.
Always remember these important points about congenital rubella infection.
The fetus can be infected as well as affected in all stages of the pregnancy.
The rate of infection, as well as damage to the fetus, is highest during the first trimester.
• Both the risk of infection as well as the risk of damage to the fetus goes on decreasing as the pregnancy progresses, so the rate of infection and the risk of damage to the fetus is lowest in the 3rd trimester. | train | med_mcqa | null |
A body builder taking steroids and creatinine presented with hip pain and unable to squat. On MRI, femoral aicular surface is disrupted and there is cresent sign seen on radiograph. What is the diagnosis? | [
"AVN",
"Osteochondroma",
"TB hip",
"Fracture neck of femur"
] | A | History of intake of steroids usually results in avascular necrosis. The classic appearance of a thin subchondral fracture line known as "Crescent sign". It is seen on X -ray signifies Avascular necrosis. Most common location of AVN is Head of Femur which is called Chandelier's sign. | train | med_mcqa | null |
Least penetrating power - | [
"X-ray",
"Beta-rays",
"Alpha particle",
"y-rays"
] | C | Ans. is 'c' i.e., Alpha particle Penetration power : Gamma rays> X rays > Beta particle > Alpha particle (or helium ion)Ionizing & damaging power : is reserve Alpha particle (or helium ion) > Beta particle > X ray> Gamma rayImportant facts about ionizing radiationso Alpha particles (Helium nuclei) have highest ionizing power because they have a large charge, o Alpha particles have the highest damaging power as they are relatively slow and heavy,o Gamma rays have highest penetrating power because they are high energy photons.o X-rays have 2nd highest (slightly less than g-rays) penetrating power,o Gamma rays have minimum ionizing power,o Gamma rays have least damaging power.o Order of penetrating power - Gamma rays > X-rays > b-particles > a-particles.o Order of ionizing & damaging power - a-particles > b-particles > X-rays > Gamma rays. | train | med_mcqa | null |
Delayed pubey in female? | [
"No breast budding in 10 years",
"Menarche > 16 year",
"menarche > 1 year of brean budding",
"FSH <20 in 16 year"
] | B | Ans. is 'b' i.e., Menarche Delayed Pubey More common in boy than girl Most common cause in constitutional delay Girls-Delayed pubey is defined as Lack of secondary sexual character by age of 17 years Absence of menarche by age of 16 year 5 year after pubeal onset. Boys-Lack of pubeal changes by the age of 14 years. | train | med_mcqa | null |
Botulinum affects all of the following, EXCEPT: | [
"Neuromuscular junction",
"Preganglionic junction",
"Post ganglionic nerves",
"CNS"
] | D | Diplopia, dysphagia, dysahria, dry mouth, vomiting, thirst, constipation are the clinical features associated with botulinum toxin. Patients experience minimal or no CNS effects and usually there's no significant alteration in their mental status. Ingested, inhaled or formed botulinum toxin travels through the vascular system and affects neuromuscular junction, pre ganglionic junction and post ganglionic nerves. Ref: Textbook of Microbiology, Ananthanarayan and Paniker, 7th Edition, Chapter 28, Page 263 & 264 ; Harrisons Principles of Internal Medicine, 16th Edition, Page 843. | train | med_mcqa | null |
Which artery can be felt at anterior border of masseter against the mandible? | [
"Facial artery",
"Maxillary artery",
"Posterior auricular artery",
"Superficial temporal artery"
] | A | ANSWER: (A) Facial arteryREF: Anatomy at a glance by Omar Faiz, David Burns Moffat page 165 Surface anatomy of facial artery:"Facial artery can be felt on the mandible at the anterior border of the masseter" | train | med_mcqa | null |
An elderly female is diagnosed to have Ca cervix stage III B. What is the management of choice in this patient? | [
"Weheims hysterectomy",
"Shautas procedure",
"Chemotherapy",
"Intracavitary brachytherapy with external beam radiation"
] | D | In stage IIIB cervical carcinoma the cancer has extended beyond ther cervix to the pelvic wall with/ without causing hydronephrosis. Cervical carcinoma of stage IIB to IVA is considered to be advanced stage cervical cancer. Current evidence states that chemotherapy given along with radiation therapy significantly improves the outcome in such cases. Of the chemotherapeutic agents used, cisplatin is associated with better survival rates. | train | med_mcqa | null |
In NPCB, vision testing in school done by - | [
"Teachers",
"Ophthalmologist",
"NGO",
"Optometrist"
] | A | <p> NPCB:National programme for control of blindness Launched in the year 1976 as a 100% centrally sponsored programme and incorporate the earlier trachoma control programme staed in the year 1968. Objectives:- 1. Reduce the backlog of avoidable blindness through identification and treatment of curable blind at primary, secondary and teiary levels. 2. Develop and strengthen the strategy of NPCB for "Eye health for all" and prevention of visual impairment through provision of comprehensive universal eye care services. 3. Strengthen and upgrade the Regional institutes of ophthalmology to become centre of excellence in various sub specialities of ophthalmology. 4. Strengthening the existing infrastructural facilities and developing additional human resource for providing high quality comprehensive eye care in all districts of the country. 5. To enhance community awareness on eye care and lay stress on preventive measures. 6. Increase and expand research for prevention of blindness and visual impairment. 7. To secure paicipation of voluntary organisations or private practitioners in eye care delivery. School eye screening programme:- Children are first screened by trained teachers . Children suspected to have refractive error are seen by ophthalmic assistants and corrective spectacles are prescribed or given free for persons below povey line. {Reference-park&;s textbook of preventive and social medicine, 23rd edition, pg no.439}</p> | train | med_mcqa | null |
Which of the following is seen retinitis pigmentosa? | [
"Aeriolar attenuation",
"Neovascularization",
"Retinal aery thrombosis",
"Papilledema"
] | A | Retinitis pigmentosaApoptosis of rodsAR - most common RISK FACTOR- Consanguineous marriagesC/F- Nyctalopia- Ring scotoma +nt- Progress to tubular vision (constriction of visual fields) O/E- TRIAD- Pale waxy disc- Aeriolar attenuation- BONE SPICLUE PIGMENTATION (characteristic) - Gold standard for Dx - ERG- Measures the potential difference ofNeuro sensory layerNORMAL ERG- Negative 'a' -wave- Positive 'b' -wave- Small 'c' -wave (sometimes)- a-wave - measures the potential difference of photoreceptors- b-wave - measures the potential differenceOf Muller's cells (neuroglia) & bipolarCells (neuronal cells) In Retinitis Pigmentosa- ERG becomes FLAT | train | med_mcqa | null |
A 34 yr old woman comes to OPD complaining of abnormal uterine bleeding . Which of the following is the LEAST likely reason for abnormal bleeding in her age? | [
"Adenomyosis",
"Fibroids",
"Endometrial atrophy",
"Polyps"
] | C | INFANCY PREPUBEAL ADOLESCENT REPRODUCTIVE PERIMENOPAUSAL POSTMENOPAUSAL maternal estrogen withdrawl vulvovaginitis anovulation exogenous hormone anovulation atrophy foreign body exogenous hormone use pregnancy fibroids endometrial polyp precocius pubey pregnancy anovulation cervical and endometrial polyp gynaecological cancer tumour coagulopathy fibroids thyroid dysfunction H cervical and endometrial polyp thyroid dysfunction Atrophy is the usually a reason for AUB in Post Menopausal woman | train | med_mcqa | null |
Increased cardiac oxygen demand is caused by – | [
"Ketamine",
"Nitrous oxide",
"Thiopentone",
"Halothane"
] | A | null | train | med_mcqa | null |
Diuretic which can be given in mild to moderate hypeension is | [
"Loop diuretic",
"Thiazide",
"Osmotic diuretic",
"Potassium sparing diuretic"
] | B | Thiazides are safe, reduce clinical events. Provide additive blood pressure lowering effects wheb combined with beta blockers, Ace inhibitors or arb's. Potassium sparing diuretics are weak anti hypeensive agents Loop diuretics are reserved for hypeensive patients with reduced GFR or edema or Na retention. Ref:Harrison 20th edition pg no 1901 | train | med_mcqa | null |
When heparin is given in pregnancy, which of the following is to be added ? | [
"Iron folic acid",
"Copper",
"Calcium",
"Zinc"
] | C | side effects of heparin haemorrhage heparin induced thrombocytopenia osteoporosis fat necrosis and hematomas elevated transaminases to counteract osteoporosis calcium is added TEXTBOOK OF OBSTETRICS,SHEILA BALAKRISHNAN,PG NO:577,2ND EDITION | train | med_mcqa | null |
Following organelles are involved in the formation of Nglycosylated product: | [
"Golgi apparatus",
"Nucleolus",
"SER",
"All"
] | A | A i.e. Golgi apparatus | train | med_mcqa | null |
Which of the following shows Kevorkian sign? | [
"Retina",
"Sclera",
"Choroid",
"Vitreous"
] | A | Kevorkian sign is fragmentation of blood column in retinal vessels which occurs few minutes after death and lasts for an hour. It is visualised by ophthalmoscope. Ref: K.S.Narayan Reddy's Synopsis of Forensic Medicine and Toxicology, 29th edition, Chapter 7, page-83. | train | med_mcqa | null |
Charcot's joint includes all of the following Except: | [
"Syrimgomyelia",
"Leprosy",
"Diabetes",
"Ahrogryposis multiple congenital"
] | D | Answer is D (Ahrogryposis multiple congenita): Ahrogryposis multiplex congenital is not associated with charcot's joint. Charcot foot occurs in patients with peripheral neuropathy resulting from diverse conditions including diabetes mellitus, leprosy, syphilis, poliomyelitis, chronic alcoholism or syringomyelia. Repetitive microtrauma that exceeds the rate of healing may cause fractures and dislocations. Changes in circulation may cause resorption of bone, weakening the bone and increasing susceptibility to fracture and dislocation. | train | med_mcqa | null |
CD4 cells recognize the antigens in association with | [
"MHC I",
"MHC II",
"MHC III",
"B-cell receptor"
] | B | null | train | med_mcqa | null |
Jeep disease is also known as: March 2008 | [
"Anal incontinence",
"Hemorrhoids",
"Pilonidal sinus",
"Anal fissure"
] | C | Ans. C: Pilonidal sinus | train | med_mcqa | null |
Primary immune response is by which cell? | [
"B cell",
"T cell",
"B and T cell both",
"Complement mediated"
] | A | Ans. (a) B cellsRef: Robbin's pathology 9th ed. /187, 191PRIMARY IMMUNE RESPONSE* The first exposure to a foreign antigen, a lag phase occurs in which no antibody is produced, but activated B cells are differentiating into plasma cells. The lag phase can be as short as 2-3 days, but often is longer, sometimes as long as weeks or months.* The amount of antibody produced is usually relatively low.* Over time, antibody level declines to the point where it may be undetectable.* The first antibody produced is manily IgM (although small amounts of IgG are usually also produced). | train | med_mcqa | null |
Which of the following statement is true regarding pyogenic liver abscess: September 2009 | [
"Diagnosis can be confirmed by serological test",
"Radiographic features are diagnostic",
"Usually a large and single abscess is seen in cases of direct spread.",
"Systemic manifestations are uncommon"
] | C | Ans. C: Usually a large and single abscess is seen in cases of direct spread Pyogenic liver abscess: Usually seen in elderly patients Can be multiple or solitary (mostly) Arise as a result of biliary sepsis Moality is high as diagnosis is often delayed Commonest organisms involved - E. coli, Klebsiella, Proteus and Bacteroides species. Etiology: Poal pylophlebitis - appendicitis, diveiculitis or pelvic infections Biliary disease - cholecystitis, ascending cholangitis or pancreatitis Trauma - blunt or penetrating Direct extension - empyema of the gall bladder, subphrenic or perinephric abscess Septicaemia Infected liver cysts or tumours Clinical features: Patients are generally systemically unwell Severe abdominal pain usually localised to right hypochondrium Swinging pyrexia, rigors and weight loss 25% present with jaundice Examination shows an hypochondrial or epigastric mass 30% has a pleural effusion Investigation: Serology shows a raised WCC, increased ESR and deranged LFTs Chest X-ray often shows a raised right hemidiaphragm and pleural effusion Ultrasound will localised the abscess and will guide drainage CT useful if diagnosis in doubt or if there are multiple abscess Management: Patients should be staed on appropriate antibiotic Percutaneous drainage under ultrasound guidance is the initial treatment of choice If biliary obstruction is present, consider decompression Surgery may be required if - Failure of resolution with percutaneous drainage Intraperitoneal rupture Laparoscopic drainage may succeed after failure of percutaneous route | train | med_mcqa | null |
Worst prognosis in renal cell carcinoma is assocaited with - | [
"Haematuria",
"Size>5cm",
"Invasion of renal vein",
"Pulmonary secondaries"
] | D | null | train | med_mcqa | null |
After fracture of middle cranial foramen there is epiphora this is due to damage of: | [
"Ciliary ganglion",
"Greater palatine nerve",
"Infraorbital nerve",
"None of the above"
] | D | null | train | med_mcqa | null |
Centrilobular necrosis of liver may be seen with | [
"Phosphorus",
"Arsenic",
"ccI4",
"Ethanol"
] | C | CCl4 is hepatotoxic. Centrilobular necrosis seen in CVC liver. Causes: right sided hea failure. Mechanism: dilatation of central veins-Transmission of increased venous pressure to the sinusoids-dilatation of sinusoids-ischemic necrosis of hepatocytes in centrilobular region. Gross: congested centrilobular area appear dark red brown, peripoal region is better oxygenated hence appear pale Microscopy: centrilobular region: congestion, hemorrhage, thickening of Central veins and fibrosis, centrilobular hepatocyte necrosis. Peripoal region: fatty change in hepatocytes. GENERAL AND SYSTEMIC PATHOLOGY RAMDAS NAYAK PGNO.89 | train | med_mcqa | null |
Normally, the rate of the heart beat in a human is determined by: | [
"The bundle of His",
"All cardiac muscle",
"The sinoatrial node",
"The cervical ganglion"
] | C | null | train | med_mcqa | null |
A 60 year old male was diagnosed as carcinoma right lung. On CECT chest there was a tumor of 5 ✕ 5 cm in upper lobe and another 2 ✕ 2 cm size tumor nodule in middle lobe. The primary modality of treatment is - | [
"Radiotherapy",
"Chemotherapy",
"Surgery",
"Supportive treatment"
] | C | null | train | med_mcqa | null |
Direct globulin test is positive in? | [
"PNH",
"Sickle cell anemia",
"Thalassemia",
"Paroxysmal cold hemoglobinuria"
] | D | Ans. (d) Paroxysmal cold hemoglobinuria(Ref: Robbins 9th/pg 642; 8th/pg 654)Direct globulin test is positive in Paroxysmal cold hemoglobinuria, as anti P antibody is formed. | train | med_mcqa | null |
Lice are not the vectors of - | [
"Relapsing fever",
"Q fever",
"Trench fever",
"Epidemic typhus"
] | B | Vector Diseases transmitted Soft tick Relapsing fever, Q fever, KFD (outside India) Hard tick Tularemia, Babesiosis, KFD (India), Tick paralysis, Tick encephalitis, Indian tick typhus, Tick hemorrhagic fever, Rocky Mountain spotted fever. Lice Epidemic typhus Trench fever relapsing fever REF: PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE, 25TH EDITION, PG NO. 841 | train | med_mcqa | null |
Chyluria is due to- | [
"Carcinoma",
"Tuberculosis",
"Filaria",
"Malaria"
] | C | The most common presentations of the lymphatic filariases are asymptomatic (or subclinical) microfilaremia, hydrocele , acute adenolymphangitis (ADL), and chronic lymphatic disease. If there is obstruction of the retroperitoneal lymphatics, increased renal lymphatic pressure leads to rupture of the renal lymphatics and the development of chyluria, which is usually intermittent and most prominent in the morning. (Harrison's Principles of internal medicine, 20th edition, page 1747) | train | med_mcqa | null |
Flaky paint appearance of skin is seen in | [
"Dermatitis",
"Pellagra",
"Marasmus",
"Kwashiorkor"
] | D | There are skin lesions in kwashiorkor which consist of increased pigmentation, desquamation, and dyspigmentation. Pigmentation, when gets confluent, is known as flaky paint dermatitis. Ref: Page 100; Ghai Essential Pediatrics; 8th edition. | train | med_mcqa | null |
Which of the following bacterial disease is associated with the 3 "Rs" i.e., rats, ricefields, and rainfall? | [
"Plague",
"Melioidosis",
"Leptospirosis",
"Rodent-bite fever"
] | C | Leptospirosis is the bacterial disease that has been associated with the 3 "Rs" i.e., rats, ricefields, and rainfall. Leptospira infects various animals including rats and other rodents, domestic livestock, and household pets. Animals excrete leptospiras in urine, which contaminates water and soil. Swimming in contaminated water or consuming contaminated food or drink results in human infection. Leptospira are tightly coiled, thin, motile, flexible spirochetes with very fine spirals, one end is often bent forming a hook. Human infection usually results from the entry of organism through breaks in the skin and mucus membranes. Ref: Jawetz, Melnick and Adelberg's Medical Microbiology, 25th Edition, Chapter 24; Review of Medical Microbiology and Immunology By Warren Levinson, 11th Edition, Chapter 24 | train | med_mcqa | null |
The poly-acid modified composite are known as | [
"Compomers",
"Hybrid Ionomers",
"Poly Carboxylates",
"Poly acrylates"
] | A | null | train | med_mcqa | null |
Test of detecting damage to cochlea are all EXCEPT: | [
"Caloric test",
"Weber test",
"Rinnies test",
"ABC test"
] | A | Ans. a (Caloric test). (Ref. Diseases of ENT by PL Dhingra, / 3rd/pg.55)TESTS FOR ASSESSING VESTIBULAR FUNCTION# Caloric test: COWS (normally), cold opposite and warm same, i.e. cold water produces nystagmus to opposite and warm to same side.- Modified kobrak- Fitzgerald-Hallpike (bithermal caloric)- Cold air caloric test# Electronystagmography# Optokinetic test# Rotation test# Galvanic test# Posturography | train | med_mcqa | null |
. Hirschprung's disease is treated by | [
"Colostomy",
"Excision of aganglionic segment",
"Colectomy",
"Sodium chloride wash"
] | B | null | train | med_mcqa | null |
Snowman Shaped Heart is typically seen in - | [
"Tetralogy of fallot",
"Total Anomalous Pulmonary' Venous Connection",
"Transposition of Great Vessel",
"Coarctation of Aorta"
] | B | Ans. is 'b' i.e., Total Anomalous Pulmonary Venous Connection o Snowman Shaped Heart or figure of '8' Heart has typically been described in association with Total anomalous Primary Venous Connection (TAPVC).Also knowo Boot Shaped Heart-Tetralogy of Faloto Snowman Shaped Heart (Figure of 8 Heart)-Total Anomalous Pulmonary Venous Connection to the Innominate Veino Egg on Side Appearance-Complete Transposition of great arterieso Figure of '3 ' sign-Coarctation of Aorta | train | med_mcqa | null |
Area of brain involved in OCD: March 2004 | [
"Basal ganglia",
"Temporal lobe",
"Cerebellum",
"All of the above"
] | A | Ans. A i.e. Basal ganglia | train | med_mcqa | null |
All of the following are covalent modifications of enzyme regulation EXCEPT: | [
"Phosphorylation",
"ADP Ribosylation",
"Acetylation",
"Glycosylation"
] | D | Various ways of covalent modifications of enzymes are : Most common is Phosphorylation and Dephosphorylation ADP Ribosylation, Methylation, Acetylation | train | med_mcqa | null |
A person has different multiple personalities is suffering from - | [
"Mania",
"Personality disorder",
"Paranoid schizophrenia",
"Dissociative disorder"
] | D | More than one personality appears to possess the individuals, showing their characteristic behavior is seen in dissociative identity (multiple personality) disorder. | train | med_mcqa | null |
According to WHO, exclusive breast milk is given upto- | [
"6 months",
"4 months",
"8 months",
"10 months"
] | A | Ans. is 'a' i.e., 6 months Exclusive breast feeding : The baby should be given only breast milk and nothing else (not even water) for first 6 months of life. Weaning should be started by 6 months of age with semisolid food, in addition to continuing breast feeding.o The WHO recommends exclusive breast feeding for the first six months of life and then breast feeding up to two years or more. ______InternetComplementary feeding means giving the child other nutritious foods in addition to breast milk. Breast feeding is sufficient food for first 6 months. Thereafter, concentrated energy' dense complementary' foods are essential in order to maintain an adequate velocity of growth for the infant. | train | med_mcqa | null |
Ribonuclease-P is a ? | [
"Ligase",
"Ribonuclease",
"Ribozyme",
"Ribosome"
] | C | Ans. is 'c' i.e., Ribozyme There are five classes of ribozymes :Ribonuclease PHammerheadTetrahymena group I intron HDV ribozymeHairpin ribozyme | train | med_mcqa | null |
Diseases spread by the shown vector is all except | [
"Kala azar",
"Oriental sore",
"Chagas disease",
"Cutaneous leishmania"
] | C | The insect shown in the figure is sandfly. Sandflyis the vector forLeishmaniasis. Sandfly actsas avector for the following diseases: - Kala azar - Oriental sore - Sandfly fever - Oroya fever Reduviid Bug is transmitter of Chagas disease. | train | med_mcqa | null |
Orchidopexy for undescended testis is recommended at which age ? | [
"3 months",
"6 months",
"2 year",
"5 year"
] | C | Orchidopexy is usually performed after the age of 1 year to avoid the risks of operating on a tiny patient. Testes should be brought down into the scrotum before the boy stas school.Orchidopexy during the second year of life is currently recommended by paediatric surgeons. Orchidopexy before 2 years of age improves feility, may reduce the risk of malignancy and has psychological benefits Reference : page1378 and 77 Bailey and Love's sho practice of surgery 25th edition | train | med_mcqa | null |
in sodomy passive agent adult is named? | [
"catamite",
"paedophile",
"gerantophillia",
"peadestry"
] | C | SODOMY: Other names: 1. Greek love 2. Buggery 3. grantophilia -- when passive agent is adult 4. Paederasty -- when passive agent is child. Paedophil - Active agent - sexual activity with children below sexual age Catamite -- Passive agent -sexual activity with children below sexual age ref : narayanareddy | train | med_mcqa | null |
Train of four response is shown by all of the following neuromuscular blockers except:- | [
"Succinyl choline",
"Mivacurium",
"Vacuronium",
"Rocuronium"
] | A | Depolarizing neuromuscular blockers show no fade on Train of Four stimulus thus with succinylcholine there would be no train of four response. Non depolarizing neuromuscular blocker shows fade on train of four stimulus. | train | med_mcqa | null |
A newborn baby presented with profuse bleeding from umbilical stump after birth. Probable diagnosis is | [
"Factor XIII deficiency",
"VWF deficiency",
"Factor XII deficiency",
"Glanzmann thrombosthenia"
] | A | Ans. is 'a' i.e. Factor XIII deficiency Bleeding from umbilical stump suggests Factor XIII deficiency.Neonates with a positive bleeding history, particularly with features such as delayed bleeding, umbilical stump bleeding or miscarriages and in whom the initial panel of screening test is negative should be tested for factor XIII deficiency.The normal screening tests such as PT and PTT are normal in factor XIII deficiency because factor XIII is needed to stabilize the clot after a fibrin clot has formed, so tests used for evaluating the extrinsic or intrinsic pathways are not affected. (Note, that factor XIII is used, once the clot has formed.)Test used for evaluation of factor XIIITest used in qualitative evaluation of factor XIII is evaluation of clot stability in 5M urea.Clots formed from normal individuals remain stable in 5M urea, while clots from factor XIII deficient patient dissolve in urea.This assay detects only the most severely affected patients with 1% to 2% factor XIII deficiency or tests.A quantitative chromogenic assay has been developed but is not yet readily available.In addition to hemorrhages these patients may have poor wound healing a high incidence of infertility among males and abortion among affected females and a high incidence of intracerebral hemorrhage.About other options:Von Willebrand diseasePatients with Von-Willebrand disease rarely presents in the neonatal period because plasma concentration of Von Willebrand factor is high in neonatal period.Platelet function disordersGenetic disorders that result in deficient platelet function are rare causes of bleeding in infants.Most patients with these platelet disorders do not present in neonatal period but rather later in life. They are not recognized as a problem during the neonatal period.Glanzman's thromboastheniaThis is an extremely rare disorder of the blood in which the platelets lack the glycoprotein IIb/HIa.Hence platelet aggregation cannot occur and bleeding time is significantly prolonged and there is increased bleeding.Bernard Soulier syndromeIt is an autosomal recessive disorder characterized by thrombocytopenia and large platelets (giant platelets)There is absence of the platelet membrane GpIb/IX complex.Symptoms are consistent with low or dysfunctional platelets and include easy bruising, nosebleeds, mucosal bleeding, menorrhagia and occasionally G.I. bleedingFactor XII deficiency * It is not associated with clinical bleeding. | train | med_mcqa | null |
A 75years female patient with fracture neckof femur 1 month back,presents with 2 days history of altered sensorium & decreased urine output. Urea is 140 mg/dl, creatinine is 2 mg/dl, Ca is 15.5 mg/dl. All of will be useful in immediate treatment except - | [
"Give NS",
"Furosemide",
"Hemodialysis",
"Bisphosphonates"
] | B | Answer is option 4.. Bisphosphonates Bisphosphonates have a delayed onset of action beginning after days and are not recommended in patients with renal failure Furosemide saline and dialysis act immediately Ref Harrison 19/e p2481 | train | med_mcqa | null |
A person is not able to extend his metacarpophalangeal joint. This is due to injury to which nerve : | [
"Ulnar nerve",
"Radial nerve injury",
"Median nerve injury",
"Posterior Introsseus nerve injury"
] | D | In radial nerve head surgery, the most common nerve to get injured is posterior interosseous nerve. There is thumb and finger drop. Extension of wrist is spared. | train | med_mcqa | null |
Remnants of the Hertwig's root sheath are found in | [
"Gingiva",
"Alveolar bone",
"Periodontal ligament",
"Cementum"
] | C | null | train | med_mcqa | null |
One of the earliest features of Neonatal sepsis is: | [
"Alteration of established feeding behaviour",
"Shock",
"Bleeding",
"Sclerema"
] | A | Alteration of established feeding behaviour - is one of the earliest features of neonatal sepsis. | train | med_mcqa | null |
Linitis plastica is ? | [
"Disease resembling lichen planus",
"Benign lesion of the stomach",
"Diffuse gastric carcinoma",
"Inflammation of stomach resembling acute gastritis"
] | C | Linitis plastica is a diffuse type of gastric carcinoma which is characterised by thickening and rigidity of the stomach wall, giving leather bottle appearance. | train | med_mcqa | null |
The following structures are felt on per rectal examination except - | [
"Bulb of penis",
"Ureter",
"Anorectal ring",
"Urogenital diaphragm"
] | B | null | train | med_mcqa | null |
Visual cut off for referral to nearest PHC? | [
"<6/9 in either eye",
"<6/12 in either eye",
"<6/9 in both eye",
"none of the above"
] | A | Visual cut off for referral to nearest PHC: <6/9 in either eye. Screening is done by school teachers. Female teachers are preferred. Focus on middle school(5-8th) covering 10-14 years age. 1,50,000 children to be screened per block One trained teacher to handle 150 students 1- day training for the teacher at nearest PHC Teacher Kit: Vision screening cards, referral cards, tape/rope to measure 20 feet | train | med_mcqa | null |
Widening of the C loop in X-ray is diagnostic of: | [
"Chronic pancreatitis",
"Carcinoma head of pancreas",
"Periampullary carcinoma",
"Calculi in the ampulla junction"
] | B | Ans. Carcinoma head of pancreas | train | med_mcqa | null |
Which of the following is not a ototoxic drug - | [
"Paracetamol",
"Cisplatin",
"Quinine",
"Erythromycin"
] | A | Ans. is 'a' i.e., Paracetamol Important ototoxic drugso Aminoglycosideso Cisplatino Furosemideo Deferoxamineo Quinineo Chloroquineo Interferonso Eiythromycino Bleomycino Aspirin | train | med_mcqa | null |
The earliest sign of maceration is | [
"Coppery brown discoloration",
"Ransid smell",
"Hypermobility of joints",
"Skin slippage"
] | D | Degradation: Decomposition causes a loss of anatomic integrity of skin and other tissues such as localized peeling of skin ('skin slippage'), loosening of the skin of hands and feet ('degloving') and loosening of hair and nails. The earliest sign of maceration is skin slippage of the face, back or abdomen which may be seen in 12 h after death in utero. By 24 h, sin is brown or purplish in color. Ref - Krishan Vij textbook of forensic medicine and toxicology 5e pg : 148 | train | med_mcqa | null |
Which of the following drug is not used in the treatment of leprosy? | [
"Rifampicin",
"Dapsone",
"Kanamycin",
"Clofazimine"
] | C | Ans. is 'c' i.e., Kanamycin | train | med_mcqa | null |
Direct disease transmission (man to man) is NOT seen in | [
"Malaria",
"Influenza",
"Hepatitis",
"Impetigo"
] | A | (Malaria): (93- 237 - Park 22nd/ edition)Direct transmission* STD and AIDS, leprosy, leptospirosis, skin and eye infections* Droplet infection includes - many respiratory infections, eruptive fevers, many infections of the nervous system, common cold, diphtheria, whooping cough, tuberculosis, meningococcal meningitis* Contect with soil - hookworm lamae, tetanus, mycosis* Inoculation into skin or mucosa - Rabies virus by dog bite, hepatitis B virus through contaminated needles and syringes* Transplacental (or vertical) transmission - TORCH, varicella virus, syphilis, hepatitis -B Caxsackie B and AIDS, Thalidomide diethyl stilbestrolInfluenza is spread mainly from person to person by droplet infection or droplet nuclei created by sneezing coughing or talkingMalaria - Direct transmission may be induced accidentally by hypodermic intra muscular and intravenous infections of blood or plasma eg blood transfusion, malaria in drug addicts (237- Park 22nd /ed)* Malaria is most commonly transmitted through vector borne Indirect Transmission - by bite of certain species of infected, female | train | med_mcqa | null |
Seat belt injury results in: | [
"Injury involving mesentery",
"Splenic laceration",
"Liver laceration",
"Pancreatic laceration"
] | A | Ans: a (Injury involving mesentery) Ref: Bailey & Love, 24th ed, p. 1147* Sudden deceleration can result in a tom mesentery* If any bruising of abdominal wall or even marks of clothing is impressed into the skin, laparotomy may be indicated* Diagnostic peritoneal lavage may be helpful in this situation* Laceration of mesentery - TransverseHorizontala) Transverse tear often imperils the blood supply of a segment of intestine, making resection necessaryb) Longitudinal tear can be closed by sutureConditions producing mesentery injury* Traumatic tears* Torsion* Embolism/thrombosis* A/c non specific adenitis* Cysts* Neoplasms- benign & malignantAttachments of mesentery (Root of mesentery)15 cm long and is directed obliquely downwards and to the right.It extends from the duodenojejunal flexure on the left side of vertebra L2 to the upper part of right sacroiliac jointRoot of mesentery crosses the following structuresa) Third part of the duodenum where the superior mesenteric vessels enter into itb) The abdominal aortac) The inferior venacavad) The right uretere) The right psoas major | train | med_mcqa | null |
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