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Impetigo contagiosa is caused by - | [
"Group A beta hemolytic streptococci",
"Staphylococcus",
"H.influenzae",
"Pseudomonas"
] | A | Ans. is 'a' i.e., Group A beta hemolytic streptococci | train | med_mcqa | null |
The permanent anterior tooth, which is most commonly atypical, is: | [
"Maxillary central incisor",
"Maxillary lateral incisor",
"Mandibular central incisor",
"Mandibular 1st premolar"
] | B | null | train | med_mcqa | null |
The substance that is present in both serum and plasma is: | [
"Fibrinogen",
"Factor VII",
"Factor V",
"Factor II"
] | B | Factor VII or stable factor - Is present in plasma and is also stable in serum ("Noble factor"). It is essential for generation of Tissue Thromboplastin. Its congenital deficiency rarely gives rise to coagulation defects. | train | med_mcqa | null |
A full course of immunization against Tetanus with 3 doses of Tetanus toxoid, confers immunity for how many years: | [
"5",
"10",
"15",
"20"
] | B | 10 | train | med_mcqa | null |
True about gap junctions are all, except ? | [
"Transmit electric signals",
"Allow ions to pass",
"Intercellular space 1000 nm",
"Seen in cardiac muscle"
] | C | Ans. is 'c' i.e., Intercellular space 1000 nm Gap junctions are intercellular connections consist of a pair of hemichannels (connexons) inseed into the membrane of adjacent cells. Each connexone is made of six identical protein subunits called connexins which enclose a central channel. When the corresponding connexons of adjacent cell link up end-to-end, they form a continuous channel that permits substances to pass through from cell to cell. At gap junctions, the intercellular space narrows down to 3nm, thereby helping in binding the cells together. o However, their real physiological significance lies in allowing ions to flow through them, i.e. they conduct ionic current. This enables electrical excitation to spread from cell to cell, as in smooth and cardiac muscles. The pore size of gap junctions decreases when intracellular Ca' is high or pH is low, both of which are commonly associated with cell damage. Closure of gap junctions in response to these stimuli isolates damaged cells so that the Ca+2 and 1-1+ do not spread from the damaged to normal cells. | train | med_mcqa | null |
Characteristic of subdural hematoma is – | [
"Convex hyperdensity",
"Concavo convex hyperdense",
"Biconvex hyperdense",
"Concavo convex hypodense"
] | B | null | train | med_mcqa | null |
SA node is the pacemaker, under normal conditions, due to which of the following:- | [
"Slow depolarization, slow repolarization",
"Rapid depolarization, rapid repolarization",
"Slow depolarization, early repolarization",
"Rapid depolarization, delayed repolarization"
] | C | SA node acts as pacemaker because of slow & spontaneous depolarization (due to slow influx of Na (If) causing || in prepotential). Repolarisation is rapid - due to RAPID EFFLUX OF K+ Automaticity is also provided by AV node but recovery after every impulse is fastest in SA node. Every pa of the hea has its own rhythmicity, but they follows the rhythm of SA-node because it has fastest rate and the main reason is Overdrive suppression . | train | med_mcqa | null |
A patient who has undergone partial gastrectomy presents with neurological symptoms. Most probable diagnosis: | [
"Folic acid deficiency",
"Thiamine deficiency",
"Vitamin B12 deficiency",
"Iron deficiency"
] | C | Ans. (c) Vitamin B12 deficiencyRef: Sabsiton 20th Edition, Page 1212* Following partial gastrectomy there is decreased production of Intrinsic factor which leads to vitamin B12 deficiency. | train | med_mcqa | null |
The antibiotic that inhibits protein synthesis by premature termination and which structurally resembles amino acyl t–RNA is : | [
"Tetracycline",
"Chloramphenicol",
"Puromycin",
"Erythromycin"
] | C | null | train | med_mcqa | null |
Glucocoicoids causes all, except : | [
"Muscle wasting",
"Osteoporosis",
"Diabetes mellitus",
"Reduced appetite"
] | D | Glucocoicoid excess leads to bone dissolution by decreasing bone formation and increasing bone resorption. This leads to osteoporosis, a loss of bone mass that leads eventually to collapse of veebral bodies and other fractures.Glucocoicoids in excess accelerate the basic electroencephalographic rhythms and produce mental aberrations ranging from increased appetite, insomnia, and euphoria to frank toxic psychoses. Many of the amino acids liberated from catabolized proteins are conveed into glucose in the liver and the resultant hyperglycemia and decreased peripheral utilization of glucose may be sufficient to precipitate insulin-resistant diabetes mellitus, especially in patients genetically predisposed to diabetes. Patients with excess Glucocoicoids are protein-depleted as a result of excess protein catabolism. The skin and subcutaneous tissues are therefore thin and the muscles are poorly developed. Ref :Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 20. The Adrenal Medulla & Adrenal Coex. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | train | med_mcqa | null |
Normal values of Schirmer-I test are: | [
"5 mm",
"10 mm",
"15 mm",
"15 mm or above"
] | D | Ans. 15 mm or above | train | med_mcqa | null |
Toxic substance commonly used by washermen to put marks on clothes: Delhi 06 | [
"Calotropis procera",
"Plumbago rosea",
"Semecarpus anacardium",
"Croton tiglium"
] | C | Ans. Semecarpus anacardium | train | med_mcqa | null |
The electrogenic Na/K ATPase plays a critical role in cellular physiology by? | [
"Using energy in ATP to extrude 3 Na+ out of cells in exchange for taking two K4 into the cell",
"Using energy in ATP to extrude 3K+ out of cells in exchange for taking Na+ into the cell",
"Using the energy in moving Na+ into the cell or K+ outside the cell to make ATP",
"Using energy in moving Na+ outside of... | A | Ans A Using energy in ATP to extrude 3Na+ out of the cells in exchange to taking two K+ into the cells* Na+K+ ATPase catalyse the hydrolysis of ATP to adenosine diphosphate and uses energy to extrude three Na+ from the cell and take two K+ into the cell for each molecule of ATP hydrolysed.* It is therefore said to have a coupling ratio of 3:2* Its activity is inhibited by Ouabain and related digitalis V glycosides which are used for CHF.* Active transport of sodium and potassium is a major energy consuming process in the body. In body it accounts for 24% of energy utilized by cells and 70% of energy utilized by neurons.Hormones increasing Na-K ATPase activity are* Thyroid hormones* Aldosterone* Insulin | train | med_mcqa | null |
In children, Superior quadrantanopia is due to | [
"Pituitary lesion",
"Temporal lobe lesion",
"Optic neuritis",
"Migraine"
] | B | (Refer: AH Khurana, Comprehensive Textbook of Ophthalmology,5thedition,pg no: 310-311) | train | med_mcqa | null |
Call exner bodies are seen in: | [
"Granulosa cell tumor",
"Yolk sac",
"Dysgerminoma",
"Embryonal carcinoma"
] | A | Ans: (a) Granulosa cell tumorBerek and Novak's Gynecology, 14th editionWHO classification of ovarian tumoursCommon epithelial tumorsSex cord (gonadal stroma) tumorsGerm cell tumors*. Serous tumors*. Mucinous tumors*. Endometrioid tumors*. Clear cell (mesonephroid tumors)*. Brenner tumors (Transitional cell tumor)*. Mixed epithelial tumors*. Undifferentiated carcinoma*. Unclassified epithelial tumors*. Granulose-stromal cell tumors, theca cell tumors*. Androblastomas: Sertoli-Leydig cell tumors*. Gynandroblastomas*. UnclassifiedGonadoblastoma*. Pure*. Mixed with dysgerminoma or other germ cell tumors.*. Dysgerminoma*. Endodermal sinus tumors (yolk sac tumour)*. Embryonal carcinoma*. Polyembryoma*. Choriocarcinoma*. Teratoma*. Mixed formsLipid (lipoid) cell tumorsSoft tissue tumors not specific to ovaryUnclassified tumorsFamilial ovarian cancers: HNPCC (LYNCH-2), BRCA1 and BRCA2NOTE:Ovarian cancers are the most common cause of death among all gynecological malignancies.Ovarian cyst adeno carcinoma is most common malignant tumor of ovary (33-50% of epithelial cancers)Most common benign tumour of ovary: Dermoid cystMost common benign epithelial tumor: Serous cystadenomaLargest benign ovarian tumor: Mucinous cyst adenomaMost common ovarian tumour in <20 years of age group - germ cell tumourMost common germ cell tumour (GCT): Mature teratomaMost common malignant germ cell tumour (GCT): DysgerminomaOvarian tumor whose incidence is increased during pregnancy: Dermoid cystMost common ovarian tumor to undergo torsion in pregnancy: Dermoid cystMost common ovarian tumour to involve opposite side: Granulosa cell tumourSerous cyst adenoma is overall most common tumour of ovary.Of all the malignant tumors, 90% are epithelial in orgin, 80% are in primary in the ovary and 20% secondary from breasts, gastrointestinal tract and colon.Mucinous cyst becomes malignant in 5% but papillary cystadenoma becomes malignant in 50% if left untreated.Most common ovarian tumor associated with pseudomyxoma peritoni: Mucinous cystadeno Ca.Most common ovarian tumor associated with hyperthyroidism: Germ cell tumour with struma ovarii (struma ovarii is a teratoma with thyroid tissue).Ovarian tumors with calcification:Cystic teratoma / dermoid cyst (bone + teeth)GonadoblastomaFibromaTorsion of ovarian cyst in the most common complication and seen in teratoma/dermoid cyst most commonly.Tumors with lymphocytic infiltration: DysgerminomaOvarian serous tumors, both low- and high-grade, have a propensity to spread to the peritoneal surfaces and omentum and are commonly associated with the presence of ascites.Meig s syndrome: Combination of ovarian Fibroma + Ascites + right sided hemothoraxPseudo Meig's syndrome: Brenner's tumor, Granulosa Cell tumor, ThecomaRisk factorsProtective factors*. Repeated ovulation*. Old age*. Nullipara*. Early menarche, late menopause*. White race*. Late marriage, infertility*. Perineal exposure to talc*. OC pills*. Pregnancy*. Breastfeeding*. Chronic anovulation*. Bilateral salpingo oophorectomy*. Tubal sterilization*. HysterectomyAge Group:Malignant epithelial tumors40-60 yearsBenign cystic teratoma10-20 yearsDysgerminoma<20 yearsEndodermal sinus tumour15-20 yearsGranulose cell tumourPost-menopausalSertoli leydig cell20-30 yearsThecomaPost-menopausalGERM CELL TUMOURSAccount for 15-20% of all ovarian tumors.95% are benign cystic teratoma, also called as dermoids.Below the age of 20 years, 60% of the tumors are of germ cell origin.<10 years: 85% belong to this group and are malignant.Tumour markers of ovarian cancer:CA-125:>35U/ml indicates malignant and residual ovarian tumour. It is also raised in abdominal tuberculosis and endometriosis.CEA: >5 mg/dl seen in Mucinous ovarian tumour.Endodermal sinus tumors produce AFP.a fetoprotein and alpha-1-antitrypsin: Endodermal sinus tumorAFP and HCG: Embryonal carcinomaHCG: ChoriocarcinomaDysgerminomas and other germinomas: No markers, but secrete LDH Krukenberg's TumourPrimary site: Stomach (70%), large intestine (15%) and breast (6%), spread by retrograde lymphatics.Characteristic features: Signet ring cellsInvolvement of ovary by: Retrograde lymphatics.Always bilateral with smooth surface, slightly bossy and freely mobile over the pelvis.Maintains the shape of ovary and has a peculiar solid waxy consistency.No tendency of adhesion and no infiltration of nearby tissues.Ovarian Tumours and Their Specific FeaturesSchiller Duval bodies - Endodermal sinus tumourSignet ring cells - Krukenberg's tumourCoffee bean cells/Call Exner bodies - Granulosa cell tumourSertoli and Leydig cells - ArrhenoblastomaPsammoma bodies - Papillary Serous CystadenomaRokitansky's protuberance - Dermoid cyst (Mature teratoma)Hobnail cells - Clear cell Ca (mesonephroid Ca)Reinke's crystal - Hilus cell tumourWalthard cell nest - Brenner tumour | train | med_mcqa | null |
A patient Manoj with severe pain thought to be of gastrointestinal origin received 60 mg of meperidine subsequent to which he developed reaction characterized by tachycardia, hypertension, hyperpyrexia, and seizures. He gave the history that he is also taking some medicine for his psychiatric condition. Which of the following drug can be held responsible for this sort of reaction? | [
"Alprazolam",
"Imipramine",
"Lithium",
"Phenelzine"
] | D | null | train | med_mcqa | null |
The hea assumes its normal four chambered shape by the end of:- | [
"4 weeks",
"6 weeks",
"8 weeks",
"12 weeks"
] | B | - The hea assumes its normal four chambered shape by the end of 6 weeks of intrauterine life. - From then, only minor changes occur & consist mainly on growth of the hea as a whole with increasing age of fetus. | train | med_mcqa | null |
Safe injection practices can prevent: | [
"Hepatitis B",
"Hepatitis A",
"Typhoid",
"Hepatitis E"
] | A | Ans: a (Hepatitis B)Ref: Park, 20th ed. Pg. 188Again a repeat question from 2008 Kerala, regarded as a zero value question and will gain significance when you make it wrong. | train | med_mcqa | null |
Exercise is also prescribed as an adjuvant treatment of depression. Most probably it acts by: | [
"Increasing pulse pressure",
"Improving hemodynamics",
"Raising endorphin levels",
"Inducing good sleep"
] | C | Ans. (c) Raising endorphin levels(Ref: Guyton, 13th ed/p.1086)Exercise can help relieve symptoms of depression by raising endorphin levels | train | med_mcqa | null |
A patient with carcinoma has a tumour of 2.5 cm located close to and involving the lower alveolus. A single mobile homolateral node measuring 6 cm is palpable.
Based on these clinical findings TNM stage of the tumour is: | [
"T2 N2 Mo.",
"T2N2Mo.",
"T1N2Mo",
"T2N1Mo."
] | A | null | train | med_mcqa | null |
In case of brain injury, laceration occurs, which is most severe on the side opposite to that of the injury, this type of injury is known as: | [
"Laceration.",
"Contrecoup injury.",
"Contusion.",
"Concussion."
] | B | null | train | med_mcqa | null |
Lactose fermentation is seen in - | [
"Blood agar",
"Chocolate agar",
"MacConkey agar",
"LJ medium"
] | C | Ans. is 'c' i.e., MacConkey agar o Culture on differential media that contain special dyes and carbohydrates distinguishes lactose-fermenting (colored) from non-lactose-fermenting (non-pigmented) colonies and may allow rapid presumptive identification of enteric bacteria.o Such media, used to see lactose fermentation, are :-Eosine-methylene blue (EMB)MacConkey's agarDeoxycholate agar | train | med_mcqa | null |
All are causes of eosinophilia except: | [
"Allergic Rhinitis",
"Trichinosis",
"Corticosteroid therapy",
"Rhematoid arthritis"
] | C | Ans: C (Corticosteroid therapy) Ref: Nelson Textbook of Pediatrics, 19th edition. Pg 740.Explanation:Corticosteroid therapy causes eosinopenia.Causes of EosinophiliaAllergic DisordersAllergic rhinitisAsthmaAcute and chronic urticariaHypersensitivity drug reactionsInfectious DiseasesTissue-Invasive Helminth Infections TrichinosisToxocariasisStrongyloidosisAscariasisFiiariasisPneumocystis cariniiToxoplasmosisAmebiasisMalariaBronchopulmonary aspergillosisScabiesMalignant DisordersBrain tumorsHodgkin disease and T-cell lymphomaMyeloproliferative disordersGastrointestinal DisordersInflammatory bowel diseaseEosinophilic gastroenteritisChronic active hepatitisRheumatologic DiseaseRheumatoid arthritisEosinophilic fascitisImmunodeficiency DiseaseHyper-IgE syndromeWiskott-Aldrich syndromeLoftier syndromeEosinophilic leukemiaHypersensitivity pneumoniaMiscellaneousThrombocytopenia with absent radiiVasculitisHistiocytosis with cutaneous involvement | train | med_mcqa | null |
Alcohol abuse is associated with an increased risk of all the following types of cancer EXCEPT: | [
"Breast",
"Esophageal",
". Liver",
"Cervical"
] | D | Alcohol abuse increases the risk of esophageal and laryngeal cancer, as well as liver cancer. A modest increase in the risk of breast cancer has been demonstrated in woman who drink more than 2 drinks per day. Cancer of the cervix has not been associated with alcohol use. | train | med_mcqa | null |
Following can cause rib notching except: | [
"Blalock Taussig shunt",
"Waterston Cooley's shunt",
"Pulmonary atresia with large VSD",
"All"
] | B | B i.e. Waterston Cooley's shunt | train | med_mcqa | null |
Glomerular filtration rate (GFR) is favoured (directly proportional) by: | [
"Intracapillary glomerular pressure",
"Oncotic pressure",
"Bowman's capsular hydrostatic pressure",
"All of the above"
] | A | Ans. a (Intracapillary glomerular pressure ). (Ref. Guyton 11th /320; 322; Table 26-4; Ganong 22nd /707)GLOMERULAR FILTRATION RATE (GFR)# Inulin is freely filtered and is neither reabsorbed nor secreted.GFR = UV/PWhere, U--concentration in urineV--volume of urine passed/minuteP--concentration in plasma.# Clinically, creatinine clearance is good measure of GFR.FACTORS THAT CAN DECREASE THE GLOMERULAR FILTRATION RATE (GFR) include:Physical DeterminantsPhysiologic/Pathophysiologic Causes| Kf (glomerular filtration coefficient) -|GFRRenal disease, DM, Hypertension| PB (Bowman's capsule hydrostatic pressure) -| GFRUrinary tract obstruction (e.g., kidney stones)| paiG (glomerular capillary colloid osmotic pressure) -| GFR | Renal blood flow, | plasma proteins|PG (glomerular capillary hydrostatic pressure) -|GFR|AP -|PG|Arterial pressure (has only small effect due to autoregulation)| RE -| PG| Angiotensin II (drugs that block angiotensin II formation)| RA-|PGT Sympathetic activity, vasoconstrictor hormones (e.g., norepinephrine, endothelin)FACTORS THAT AFFECT GFR fGFR: Kf x (Pgc - Pco - Pt)l1. Intracapillary glomerular pressure (Pgc):It is determined by the systemic arterial pressure and the tone of the pre- glomerular and post-glomerular arterioles. It is the most important GFR modulator.2. Intracapillary oncotic pressure (Pco):It is low in malnutrition and following plasma volume expansion with Ringer's solutions. It is high in dehydrated states and primary hyperproteinemia.3. Intra-capsular glomerular pressure (Pt):It is normally close to zero, however, it increases in urinary obstruction i.e tubular protein casts, urinary stones, tumors, prostatic hypertrophy, congenital abnormalities of the lower urinary tract, etc.4. Filtration coefficient (Kf):It is a function of the total number and the size of "pores" in the glomerular sieve. It is lowered by vasoactive substances that cause the glomerular filtration area to decrease. Angiotensin II, for example induce contraction of mesangial cells causing decreased glomerular capillary area. The Kf of superficial glomeruli is higher than that of deep glomeruli.Hormones and Autacoids That Influence Glomerular Filtration Rate (GFR):Hormone or AutacoidEffect on GFRNorepinephrine|Epinephrine|Endothelin4Angiotensin II(prevents |)Endothelial-derived nitric oxide|Prostaglandins|Also remember:Glomerular filtration rate GFR = Uinulin XV----P inulln= CinulinGlomerular filtration rate GFR = Kf Effective renal plasma flow ERPF= UPAH XV---PPAH= CPAHRenal blood flow RBF=RPF----1-Hct Filtration fraction FF =GFR----RPF Free water clearance CH2O=V-Cosm. | train | med_mcqa | null |
which of the following is true regarding nuclear bag fibres of motorunit ? | [
"responds to length only",
"responds to both length and velocity changes",
"responds to contraction of muscle fibres",
"responds to reflex relaxation"
] | B | Two types of intrafusal fibres -- nuclear bag fibre * primary (la) afferent -- supplies annulospiral ending in the centre -- provide information on muscle length and velocity (phasic response) fast stretch reflex -- nuclear chain fibre * primary (la) and secondary (II) afferent -- supplies flower spray ending -- monitor the length of the muscle (tonic response) --slow stretch reflex ref : guyton and hall | train | med_mcqa | null |
The inferior border of the rectus sheath posteriorly is called the? | [
"Falx inguinalis",
"Inguinal ligament",
"Internal inguinal ring",
"Arcuate line"
] | D | The rectus sheath is a tough, tendinous sheath over the rectus abdominis muscle. It covers the entire anterior surface of the rectus abdominis. However, on the posterior side of the muscle, the sheath is incomplete. It ends inferiorly at the arcuate line. Below the arcuate line, the rectus abdominis is covered by transversalis fascia, not the rectus sheath. The linea alba is also related to the rectus abdominis. It is a ligament that runs down the middle of the abdomen, bisecting the rectus abdominis. It is made by the intermingling of the aponeuroses of the external oblique, internal oblique, and transversus abdominis. All of the other answer choices are related to the inguinal canal. The falx inguinalis (sometimes called the inguinal falx or conjoint tendon), is the inferomedial attachment of transversus abdominis with some fibers of internal abdominal oblique. It contributes to the posterior wall of the inguinal canal. The inguinal ligament is the ligament that connects the anterior superior iliac spine with the pubic tubercle. It makes the floor of the inguinal canal. The internal (deep) inguinal ring is the entrance to the inguinal canal, where the transversalis fascia pouches out and creates an opening through which structures can leave the abdominal cavity. | train | med_mcqa | null |
Single most important prognostic indicator of colorectal carcinoma is - | [
"CEA titres",
"Degree of atypia",
"Size of tumor",
"Extent of tumour"
] | D | The single most important prognostic indicator of colorectal carcinoma is the extent of the tumor at the time of diagnosis, the so-called stage. | train | med_mcqa | null |
Which is the earliest histopathological change in myocardial infarction? | [
"Stretching and waviness of fibers",
"Neutrophilic infiltration",
"Coagulative necrosis",
"Fibrovascular response"
] | A | Time frameLight microscopy0-6 hoursNo change, stretching and waviness of fibres6-12 hoursCoagulative necrosis begins with neutrophilic infiltration48-72 hoursCoagulative necrosis is complete3rd-7th dayInitiation of resorption of necrosed fibres and fibrovascular response3rd weekNecrosed muscles removed and in growth of fibrocollagenous tissue. | train | med_mcqa | null |
Treatment of choice for adenomyosis is | [
"Estrogens only",
"OCP",
"Laser endoscopy",
"Hysterectomy"
] | D | Treatment of adenomyosis: Diagnostic hysteroscopy combined with curretage is the initial management Total hysterectomy is the treatment in elderly Ref: Shaw Gynecology 17 e pg 186. | train | med_mcqa | null |
As per immunisation schdule, Hepatitis A vaccine is recommended at? | [
"1 year",
"2 year",
"5 years",
"10 years"
] | B | 2 year REF: Nelson Textbook of Pediatrics 17th edition page 1178, WHO website: vaccines/en/hepatitisa.shtml Hepatitis A vaccines "Hepatitis A vaccine is recommended at 24 months of age in states and regions with an increased incidence of disease. A second dose is administered 6-12 months later to complete the series"' The vaccines are given parenterally, as a two-dose series, 6-18 months apa. Four vaccines are available commercially; three vaccines are manufactured from cell-cultureadapted HAV propagated in human fibroblasts (One vaccine is formulated without preservative; the other two are prepared with 2-phenoxyethanol as a preservative). The fouh vaccine is manufactured from HAV purified from infected human diploid cell cultures and inactivated with formalin. A combination vaccine containing inactivated hepatitis A and recombinant hepatitis B vaccines has been licensed since 1996 for use in children aged one year or older in several countries. The combination vaccine is given as a three-dose series, using a 0, 1, 6 month schedule. Hepatitis A vaccines are all highly immunogenic. Nearly 100% of adults will develop protective levels of antibody within one month after a single dose of vaccine. 99%-100% of vaccinated individuals had levels of antibody indicative of protection five to eight years after vaccination. Kinetic models of antibody decay indicate that the duration of protection is likely to be at least 20 years, and possibly lifelong. | train | med_mcqa | null |
Million-Nasse’s reaction is specific for the amino acid: | [
"Tryptophan",
"Tyrosine",
"Phenylalanine",
"Arginine"
] | B | Millon’s Test: The phenol group of phenylalanine and tyrosine containing proteins, when heated with mercuric sulfate in sulfuric acidand sodium nitrite (or, mercurous and mercuric nitrates in nitric acid) form red colored mercury phenolate.
Reference: Vasudevan 7th ed, pg 31 | train | med_mcqa | null |
Target lesions are observed in case of | [
"Erythema multiforme",
"Lichenplanus",
"Pemphigus vulgaris",
"Psoriasis"
] | A | "Target" or "Iris" or "Bull's eye" lesions on hands, wrists and ankles are characteristic of erythema multiformae. | train | med_mcqa | null |
Anakinra acts as- | [
"IL-1 agonist",
"IL-1 antagonist",
"IL-2 agonist",
"IL-2 antagonist"
] | B | Ans. is 'b' i.e., IL-1 antagonist BIOLOGIC RESPONSE MODIFIER (BRMs)* Several recombinant proteins/monoclonal antibodies that bind and inhibit cytokines, especially TNFa or IL-1 have been used succesfully in autoimmune diseases like RA, IBD, psoriosis or scleroderma.A. TNF-a inhibitorsa. Etanercept# It is a recombinant fusion protein of TNF - receptor and Fc portion of human IgG1'# It is administered by S.C. injection.b. Infliximab# It is a chimeral monoclonol antibody which binds and neutralizes TNF-a.# It is given by i.v. route.# It is indicated in RA, psoriotic arthritis, Crohn's disease, Wegener's granulomatosis and sarcoidosis.c. Adalimumab# This recombinant monoclonal anti-TNF antibody.# It is administered by S.C. route.B. IL-1 antagonistAnakinra# It is a recombinant human IL-1 receptor antagonist.# It is less effective than TNF inhibitors.# It is administered by S.C. route.C. T-cell costimulatory blockersAbatacept# It is a fusion protein that combines the extracellular domain of the molecule CTLA4 (CD 154) with the Fc portion of a human immunoglobulin.# It interfere with the interactions between antigen presenting cells and T lymphocytes. Therefore, it affects early stages in the pathogenic cascade of event in RA.D. B-cell depletersRituximab# B-cells are inflammatory cells with multiple functions in the immune response. The depletion of B cells has been shown to be effective in reducing signs and symptoms of RA and in slowing radiographic progression.# Rituximab is a chimeric monoclonal antibody that binds to the CD20 molecule on the B cell surface leading to the removal of B cells from the circulation. | train | med_mcqa | null |
Desmoid tumor, treatment is - | [
"Local excision",
"Wide excision",
"Wide excision with radiotherapy",
"Radiotherapy"
] | B | Ans. is 'b' i.e., Wide excision o Desmoid tumors, also known as "aggressive fibromatosis," are soft tissue lesions that behave similarly to other truncal soft tissue sarcomas but have unique characteristics. These tumors, like other soft tissue sarcomas, present as slow-growing, indolent masses (sometimes can be aggressive). Unlike typical sarcomas however, these tumors rarely metastasize.o Desmoids are diffusely infiltrative and tend to recur locally, even after complete resection.o Most desmoid tumors arise sporadically, but a small percentage (~5%) occurs in association with FAP syndromeo Desmoids are classified as either abdominal or extra-abdominal. Abdominal desmoids are categorized further as superficial or intra-abdominal tumors . The superficial disease, also known as Dupuytren's fibromatosis, is slow growing, is small in size, and rarely involves deeper structures.Most of the intra-abdominal lesions are seen in association with FAP. These lesions are associated with mutations in the APC gene that are found in patients who have FAP. These tumors usually are found in the mesentery, and their growth and compression of neighboring structures can lead to significant morbidity and sometimes even death in these patientso Sporadic abdominal wall desmoid tumors have been found to be associated with pregnancy. Oral contraceptive use has also been associated with the occurrence of these tumors. These associations, combined with the detection of estrogen receptors within the tumor, suggest a regulatory role for estrogen in this disease. Tissue injury, such as trauma and/or surgery, also has been implicated in tumor developmento The natural history of desmoid lesions is unpredictable. Although most are indolent and slow growing, some lesions are aggressive. There are some reports of spontaneous regression, but such occurrences are mainly in women and are associated with chemical or surgical menopause. Most lesions are indolent and have benign- appearing histology, but local growth and compression have caused significant morbidity. Involvement of abdominal vessels and organs often complicates management.o Patients with desmoid tumors present with a painless enlarging mass. Local symptoms may arise from compression of adjacent organs or neurovascular structureso MRI is done to define the extent of disease and its relationship with other structureso Incisional biopsy or a core needle biopsy is done to confirm the diagnosis.Management:# Surgery with wide negative margins is the best treatment. Unfortunately, even with complete resection, the local recurrence rate is as high as 40%. Surgery is also the tit of choice for recurrences.# For tumors where vital visceral organs and local infiltration often make achieving negative margins difficult, other therapeutic modalities have been suggested.o Antiproliferative agents and cytotoxic chemotherapy have been used to palliate these tumors with variable results. The two most widely used groups of noncytotoxic drugs are NSAIDs (such as sulindac and indomethacin) and antiestrogens (such as tamoxifen).o Chemotherapy has generally been reserved for unresectable, symptomatic, and clinically aggressive disease. Partial responses have been observed after treatment with doxorubicin, actinomycin C, dacarbazine, or carboplatin, although toxicity has been relatively high.o Radiotherapy-"The role of radiation therapy in the management of these tumors, either as an adjunct to surgery or as primary treatment, continues to be defined." - Sabiston | train | med_mcqa | null |
Fregoli's Syndrome is? | [
"Delusion of Doubles",
"Delusion of persecution",
"Delusion of twins",
"Delusion of parasites"
] | A | Ans. is'a'i.e., Delusion of Doubles[Ref.: Kaplan 6 Saddock IF/e Chap. I4The Fregoli delusion, or the delusion of doubles, is a rare disorder in which a person holds a delusional belief that different people are in fact a single person who changes appearance or is in disguise. | train | med_mcqa | null |
Prophylactic chemotherapy in hydatidiform mole should preferably be given: | [
"Prior to evacuation as a routine",
"Following evacuation as a routine",
"Selected cases following evacuation",
"As a routine 6 weeks postevacuation"
] | C | ptophylatic chemotherapy is not reconmended .Hence,it is advisable to follow uo the cases of molar pregnancy with serum beta hcg and institute chdmothetapy only in selected cases. Refer page no 171 of Text book of obstetrics,sheila balakrishnan,2 nd edition. | train | med_mcqa | null |
True regarding Mc Naughten rule is/are | [
"Concerned with brain dysfunction and criminal responsibility",
"Not accepted in India",
"A psychiatric not a legal concept",
"Judges delusions as real"
] | D | D i.e. Judges delusions as real | train | med_mcqa | null |
Which of the following is not true about bulimia nervosa - | [
"Invariable weight loss with endocrine disorders",
"Occurrence of both binge eating and inappropriate compensatory behavior at least twice weekly, on an average, for 3 months",
"Recurrent episodes of eating binges",
"Recurrent self - induced vomiting"
] | A | Ans. is 'a' i.e., Invariable weight loss with endocrine disorders o Bulimia nervosa is characterized by episodes of uncontrollable excessive eating (binges) followed by vigrous weight-reducing measures like self-induced vomiting, purgative abuse, diuretics, or abuse of emetics; and less commonly severe dieting and stemous exercise.o Episodes of binge eating occur relatively frequently (twice a week or more) for at least 3 months.o As in anorexia nervosa, there is extreme preoccupation with the shape and weight of the body. However, bulimia nervosa differs from anorexia nervosa:-i) Patients of bulimia are slightly older than those with anorexia i.e., Late adolescence.ii) Most of the patients with bulimia nervosa have a weight within their normal weight range.iii) Amenorrhea is usually not present and most are sexually active, compared with anorexia nervosa patients.iv) Peculiar behavior about the food of anorexia nervosa is absent.v) Depressive symptoms are more common - Post-binge anquish.vi) Patient with bulimia nervosa may have dental caries/tooth decay, Sore throat, Swollen salivary gland (parotitis), and internal bleeding due to vomiting. | train | med_mcqa | null |
The RBC morphology in a peripheral blood smear in thalassemia trait resembles that of - | [
"Vitamin B12 deficiency anemia",
"Folate deficiency anemia",
"Hereditary spherocytosis",
"Iron deficiency anemia"
] | D | Recognition of Beta thalasssemia trait is impoant for 2 reasons. 1. superficially resembles the hypochromic microcytic anemia of iron deficiency 2. It has implications for genetic counselling. Iron deficiency can be usually excluded through the measurement of serum iron,total iron binding capacity and serum ferritin. The blood picture in alpha thalassemia is also identical and resembles iron deficiency anaemia. Ref: Robbins and Cotran Pathologic basis of disease.South Asia Edition volume 1.edition 9/e page no. 420-421 | train | med_mcqa | null |
Mitral valve vegetations do not embolism usually to - | [
"Brain",
"Liver",
"Spleen",
"Lungs"
] | D | Emboli originating from the left side of the heart go to systemic circulation in the organ such as
Spleen
Kidney
Brain
Liver
Emboli originating from right side of the heart will enter pulmonary circulation and produce lung abscesses or pneumonia. | train | med_mcqa | null |
Weight of the liver is - | [
"1.5 kg",
"4 kg",
"0.5 kg",
"7 kg"
] | A | Ans. is 'a' i.e., 1.5 kg * The liver is a reddish-brown wedge-shaped organ with four lobes of unequal size and shape.* A human liver normally weighs 1.44-1.66 kg (3.2-3.7 lb).* It is both the heaviest internal organ and the largest gland in the human body. | train | med_mcqa | null |
What is true regarding sulfasalazine? | [
"Active moiety is 5 amino salicylic acid in ulcerative colitis",
"Inactive moiety is 5 amino salicylic acid in ulcerative colitis",
"Inactive moiety in rheumatoid ahritis is Sulfapyridine",
"It gets activated in the stomach"
] | A | Around 90% of a dose of sulfasalazine reaches the colon, where most of it is metabolized by bacteria into sulfapyridine and mesalazine (also known as 5-aminosalicylic acid or 5-ASA).5 ASA is the active moiety produced in the colon in U.Colitis.In rheumatoid ahritis the active moiety is sulphapyridine.Ref: Katzung 13th ed. Pg: 1072 | train | med_mcqa | null |
Gene for Rh antigen is located on chromosome: | [
"1",
"19",
"4",
"9"
] | A | null | train | med_mcqa | null |
Weight gain during pregnancy: March 2013 | [
"4-6 Kg",
"7-9 Kg",
"10-12 Kg",
"13-15 Kg"
] | C | Ans. C i.e. 10-12 Kg | train | med_mcqa | null |
Friedlander Pneumonia refers to Pneumonia caused by | [
"Klebsiella",
"Pneumococcus",
"H. Influenzae",
"Staphylococcus"
] | A | Ans. is 'a' i.e., Klebsiella Klebsiella Pneumonia is also known as "Friedlander Pneumonia". Klebsiella initially described in 1882 by Friedlander was also known as Friendlander's bacillus. Community acquired Pneumonia caused by Friendlander's bacillus (Klebsiella) was termed as Friedlander Pneumonia | train | med_mcqa | null |
Diseases transmitted by louse - | [
"Epidemic typhus",
"Scrub Typhus",
"Trench fever",
"Q fever"
] | A | 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. Mite Scabies, Scrub typhus, Rickettsialpox. Louse Epidemic typhus, Trench fever, Relapsing fever Park's Textbook of Preventive and Social Medicine, 25th edition, Page No. 840 | train | med_mcqa | null |
Least common complication of lead poisoning in adults - | [
"Abdominal colic",
"Peripheral neuropathy",
"Anemia",
"Encephalopathy"
] | B | Among the given options, peripheral neuropathy is least common, and occurs in less than 10% of cases. | train | med_mcqa | null |
Circumcorneal congestion is not seen in | [
"Acute bacterial conjuctivitis",
"Acute iritis",
"Acute glaucoma",
"Scleritis"
] | A | Acute bacterial conjunctivitis Conjunctival congestion, which is more marked in palpebral conjunctiva, fornices and peripheral pa of bulbar conjuctiva, giving the appearance of fiery red eye. The congetion is typically less marked in circumcorneal zone. Ref;A.K.Khurana; 6th edition; Page no:63 REF IMG | train | med_mcqa | null |
Which of the following is the last site of fat loss during starvation? | [
"Periorbital",
"Pericardial",
"Buttocks",
"Omental"
] | B | Ans. B .Pericardial (Ref. Apoorba Nandi FMT 349; OP Ghai Paediatrics 6th /p.104; Reddy FMT 24th / p 285) # The buccal pad of fat is preserved till the malnutrition becomes extreme. # Loss of subcutaneous, periorbital (sunken eyes), omental, and fat from other sites of body is the most conspicuous and constant feature on PM study of a death due to starvation. | train | med_mcqa | null |
MANTREL score is done for | [
"Acute appendicitis",
"Acute pancreatitis",
"Acute cholecystitis",
"Acute salpingitis"
] | A | Ans. (a) Acute appendicitisCharacteristicScoreM = Migration of pain to the RLQ1A = Anorexia1N = Nausea and vomiting1T = Tenderness in RLQ2R = Rebound pain1E = Elevated temperature1L = Leukocytosis2S = Shift of WBCs to the left1Total10RLQ = right lower quadrant; WBCs = white blood cells | train | med_mcqa | null |
Which among the following is not TRUE regarding kerosene aspiration? | [
"Stomach wash is unhelpful",
"X ray finding appear earlier than physical findings",
"Fever may occur",
"Steroids are the drug of choice"
] | D | Steroids, stomach wash and activated charcoal has no use in kerosene aspiration pneumonitis. The principal adverse effect arising from ingestion of kerosene is chemical pneumonitis secondary to aspiration of vomitus. Patient's temperature may be elevated due to the body's reaction to the foreign substance. Ingestion of kerosene or acute exposure to vapour may lead to general signs of intoxication such as mild CNS symptoms (dizziness, headache, nausea) and vomiting. Skin exposure to kerosene may result in dermatitis through the extraction of endogenous skin lipids. Initially, the chest radiographic results may be normal, but positive findings may develop over the first few hours after ingestion. Common findings include fine perihilar opacities, bibasilar infiltrates, and atelectasis. Because a major complication of hydrocarbon ingestion is aspiration, reserve the use of gastric decontamination for only cases of large intentional ingestions or those involving an increased risk of systemic toxicity. Activated charcoal has a limited role in the management of hydrocarbon ingestion. | train | med_mcqa | null |
An isograft indicates transfer of tissues between: | [
"Related donors",
"Monozygotic twins",
"Parts of same individual",
"Unrelated donors"
] | B | null | train | med_mcqa | null |
A middle-aged woman suffers from weakness of her ocular and facial muscles, which worsens with repeated use. She has antibodies to acetylcholine receptors in her serum. The likely diagnosis is: | [
"Lymphangioma",
"Parkinson's Disease",
"Osteoid Osteoma",
"Myasthenia gravis"
] | D | Myasthenia gravis is an autoimmune disease caused by the product of antibodies against acetylcholine receptors. The ocular and facial muscles are usually weakened. The weakness worsens with repeated contractions of the muscles. Treatment with anticholinesterase agents can improve the weakness and fatigability by increasing the quantity of acetylcholine available at the motor. Ref: Ropper A.H., Samuels M.A. (2009). Chapter 53. Myasthenia Gravis and Related Disorders of the Neuromuscular Junction. In A.H. Ropper, M.A. Samuels (Eds),Adams and Victor's Principles of Neurology, 9e. | train | med_mcqa | null |
Screening method of medullary carcinoma thyroid is: | [
"Serum calcitonin",
"Serum calcium",
"Serum alkaline phosphatase",
"Serum acid phosphatase"
] | A | Medullary Carcinoma Thyroid (MTC):
Neuroendocrine carcinoma arising from parafollicular ‘C’ cells of thyroid.
Parafollicular ‘C’ cells are derived from the ultimobranchial bodies and secrete calcitonin.
‘C’ Cells are concentrated superolaterally in thyroid lobes, from where MTC usually develops.
Most MTCs (75-80%) arise sporadically.
Spread is both lymphatic and hematogenous.
MC site of metastasis: Liver | train | med_mcqa | null |
Agglutination with 'O' antigen of S. typhi is inhibited by :- | [
"Vi Ag",
"Flageller",
"F antigen",
"All the above"
] | A | Agglutination with 'O' antigen of S. typhi is inhibited by Vi antigen. Vi antigen: Surface polysaccharide envelope or capsular antigen covering the O antigen. Prevents its agglutination with O antiserum. Phage typing of S. typhi can be done by using Vi specific bacteriophages. Used for vaccination. | train | med_mcqa | null |
The histology of Lobular carcinoma of breast reveals- | [
"Single file pattern",
"Pleomorphic cells in sheets",
"Clustersl/lslands of cells with mucous lakes",
"Solid syncytium like sheets"
] | A | Invasive lobular carcinoma consists of cells morphologically identical to the cells of LCIS. Two thirds of the cases are associated with adjacent LCIS. The cells invade individually into stroma and are often aligned in "single-file" strands or chains. This growth pattern correlates with the presence of mutations that abrogate the function of E-cadherin, a surface protein that contributes to the cohesion of normal breast epithelial cells. ref : Robbins Basic Pathology, 9E,page-711 REF of IMG : | train | med_mcqa | null |
A 25 year old female with 16 weeks of gestation presents with excess vomiting, apathy, ataxia, nystagmus and ophthalmoplegia. The diagnosis is | [
"Wernicke's encephalopathy",
"Hyperemesis gravidarum",
"Chorea gravidarum",
"Korsakoff's encephalopathy"
] | A | (A) Wernicke's encephalopathy# Features of WERNICKE'S DISEASE:> Wernicke's disease is a common and preventable disorder due to a deficiency of thiamine> Characteristic clinical Triad is that of Ophthalmoplegia, Ataxia, & Global confusion. Only 1/3rd of patients with acute Wernicke's disease present with the classic clinical triad.> Most patients are profoundly disoriented, indifferent, and inattentive, although rarely they have an agitated delirium related to ethanol withdrawal.> If the disease is not treated, stupor, coma, and death may ensue.> Ocular motor abnormalities include horizontal nystagmus on lateral gaze, lateral rectus palsy (usually bilateral), conjugate gaze palsies, and rarely ptosis.> Gait ataxia probably results from a combination of polyneuropathy, cerebellar involvement, and vestibular paresis.> Pupils are usually spared, but they may become miotic with advanced disease.> Tachycardia & postural hypotension may be related to impaired function of the autonomic nervous system or to the coexisterce of cardiovascular beriberi.> Most common cause of Wernike's disease is noise-induced hearing loss.> Other causes include: Neurological damage - Multiple sclerosis, Ear infections, Oxidative stress, Emotional stress. | train | med_mcqa | null |
Which cardiovascular change is physiological in last trimester of pregnancy? | [
"Mid-diastolic murmur",
"Occasional atrial fibrillation",
"Shift of apical impulse laterally and upwards in left 4th intercostal space",
"Cardiomegaly"
] | C | Ans. is c, i.e. Shift of apical impulse laterally and upwards in the left 4th intercostal spaceRef. Dutta Obs. 7/e, p 52; Williams Obs. 25/e, p 60-62, 119, 960Clinical findings related to cardiovascular changes occuring during pregnancy:Heart rate (resting) increases by about 10-15 bpm. QApex beat shifts to the 4th intercoastal space, 2.5 cm outside the mid clavicular line (as heart is pushed upwards, outward, with slight rotation to left). QSlightly enlarged cardiac silhouette. Q (marked enlarged cardiac silhouette is not normal in pregnancy)Exaggerated splitting of the first heart sound (both components loud). QSecond heart sound : Normal QThird heart sound : Loud and easily auscultated. QMurmurs: - Grade II systolic ejection murmur is audible in aortic or pulmonary area at about 10-12 weeks due to expanded intravenous volume. It diappears in the beginning of postpartum period.- Continuous hissing murmur Q audible over tricuspid area in left 2nd and 3rd intercoastal spaces known as Mammary murmur.ECHO - Shows increased left atrial and ventricular diameters. QECG - Shows left axis deviation QChest X-ray - Straightening of left heart border.Note: None of the arrhythmia are normal during pregnancy, rather their presence indicates heart disease during pregnancy. | train | med_mcqa | null |
The blood within the vessels does not clot normally because: | [
"Vitamin K antagonists are present in plasma",
"Thrombin has a positive feedback on plasminogen",
"Sodium citrate in plasma chelates calcium ions",
"Vascular endothelium is smooth and coated with glycocalyx"
] | D | D i.e. Vascular endothelium is smooth & coated with glycocalyxBlood clotting is prevented by endothelium d/t their smoothness and its glycocalyx- thrombomodulin layerQ. Thrombomodulin, a thrombin binding protein, is expressed by all endothelial cells except those in the cerebral microcirculationQ.Vascular endothelium is smooth and is coated with a layer of glycocalyx (mucopolysaccharide)Q which prevents activation of intrinsic system and repels clotting factor & platelets, thereby preventing clotting of blood with in vessels.Antithrombin (AT) III is the most impoant anticoagulant in blood which prevents clotting of blood in normal vascular systemQ. Heparin is powerful anticoagulant but its concentration in blood is low, so by itself it has little or no anticoagulant propey in normal vascular system. However, heparins binding with ATIII increases effectiveness of AT III upto 1000 times. Fibrin (not fibrinogen) also has antithrombin action during clot formation. | train | med_mcqa | null |
Accepting the null hypothesis when it is false: | [
"Type-I error",
"Type III error",
"Type II error",
"Type IV error"
] | C | null | train | med_mcqa | null |
Pulmonary embolism is best diagnosed by – | [
"USG",
"X-ray chest",
"Ventilation – Perfusion scan",
"CT scan"
] | D | No option is absolutely correct.
The pulmonary angiography has traditionally been considered as the gold standard test for pulmonary embolism. But, now a days CT contrast (MDCTA) is the investigation of choice.
Amongst the given options, lung V/Q scan is the best option as it is the 2nd choice of the investigation after MDCTA. | train | med_mcqa | null |
Which of the following studies is BEST in establishing causal association in aetiology of a disease? | [
"Case control study",
"Coho study",
"Randomized control trial",
"Ecological study"
] | C | Randomized control trials produce best evidence for evidence of causation. But in reality, experimental data may not be available in human beings. Coho studies also provide strong evidence for cause to effect relationship. Crossectional studies provide weaker evidence and ecological studies provide the least satisfactory evidence for cause effect relationship. Ref: Reference: Park 21st edition, page 85; Textbook of community medicine, Sunder Lal, 3rd edition, page 277. | train | med_mcqa | null |
Most common pattern of Joint involvement in psoriatic arthropathy | [
"Psoriatic spondylitis",
"Arthritis mutilans",
"Symmetrical polyarthritis",
"Asymmetrical inflammatory oligoarthritis"
] | D | Asymmetrical inflammatory Oligoarthritis - Most common pattern. | train | med_mcqa | null |
All are the disadvantages of cast restoration except: | [
"Not conservative",
"Less number of appointments",
"Relies on the bulk of tooth structure for resistance and retention form",
"Necessity for a cementing medium"
] | B | Disadvantages
In the restoration of a small carious lesion, an inlay is not very conservative.
Relay on the bulk of the buccal and lingual cusps for resistance and retention form (wedge the cusps).
Number of appointments are more.
Necessity for a cementing medium. | train | med_mcqa | null |
PCOD which of the following is seen:a) Hirsutismb) Secondary amenorrhoeac) Streak ovariesd) ↑ FSH / LHe) Oestrogen (E2) | [
"abc",
"bcd",
"abe",
"acd"
] | C | Friends, here I would like to point out that in option “e” it is mentioned oestrogen : which is correct in cases of PCOS but in brackets it is given E2, i.e. oestradiol which is not correct. | train | med_mcqa | null |
Nasopharyngeal carcinoma does not involve: | [
"Nasal cavity",
"Oropharynx",
"Pyriform fossa",
"Orbit"
] | C | Nasopharyngeal carcinoma does not involve the pyriform fossa. Inferiorly it may spread to the soft palate and oropharynx. Posteriorly it may spread to retropharyngeal space Laterally it may spread to the parapharyngeal space (post styloid compament). Tumors may directly invade the orbit leading to exophthalmos and blindness. Superiorly it extends intracranially by direct invasion through foramen lacerum and foramen ovale, sphenoid bone and sphenoid sinus causing multiple cranial nerve palsies. | train | med_mcqa | null |
Which of the following is the impoant reactive group of glutathione in its role as an antioxidant? | [
"Serine",
"Sulphydryl",
"Tyrosine",
"Acetyl-CoA"
] | B | Glutathione : lt is a tripeptide composed of 3 amino acids. Chemically, glutathione is y- glutamyl-cysteinyl-glycine. lt is widely distributed in nature and exists in reduced or oxidized states. 2G-SH =+G=S-S-G Reduced Oxidized Functions: In a steady state, the cells generally maintain a ratio of about 100/1 of CSH to G-S-S-C. The reversible oxidation- reduction of glutathione is impoant for many of its biological functions. Ref: Biochemistry by U. Satyanarayana 3rd edition Pgno : 65 | train | med_mcqa | null |
Melanized sclerotic cells / Medlar bodies (4-12 mm diameter) evident in this H & E stained cutaneous biopsy are of which disease? | [
"Rhinosporidiosis",
"Coccididomycosis",
"Chromoblastomycosis",
"Sporotrichosis"
] | C | The histological image above shows the fungus as spherical or irregular, dark brown, yeast like bodies with septae called sclerotic bodies/ copper penny bodies/muriform bodies/medlar bodies seen in Chromoblastomycosis. Chromoblastomycosis: Characterised by verrucous lesions and chronic localized infection of the skin and subcutaneous tissue. Seen commonly in wood workers. Caused by following dematiaceous fungi - Phialophora verrucosa Fonsecaea pedrosoi Cladophialophora carrionii Rhinocladiella aquaspersa | train | med_mcqa | null |
A child has a vocabulary of4-6 words however the main mode of communication and social interaction continues to be non-verbal what is the most likely developmental age of the child - | [
"12 months",
"15 months",
"18 months",
"24 months"
] | B | Ans. is 'b' i.e., 15 months o Vocabulary of 4-6 words in addition to jargon is achieved by 15 months of age. However | train | med_mcqa | null |
Which microorganism is responsible for classical presentation of hydrocephalus, chorioretinitis, intracerebral calcification ? | [
"Toxoplasmosis",
"Rubella",
"Measles",
"CMV"
] | A | Ref: Parija SC, Textbook of Medical Parasitology. 3rd Edition. London: John Wiley & Sons: 2004. Pg. 175 Explanation: Toxoplasma Gondii It is an obligate intracellular parasite, residing in reticulendothelial cells and nucleated cells of the host. Three major morphologic forms are present (All forms are infectious) Tachyzoites - Humans and cats Tissue cyst - Humans and cats Oocyst - Cats only Congenital toxoplasmosis It occurs when a non-immune pregnant woman becomes infected during pregnancy It is due to transplacental transmission of the tachyzoites If the infection occurs during first trimester, it can result in deg Abortion or Stillbirth (Most common) deg Congenital toxoplasmosis (17%) If infection occurs during last trimester, the symptoms are mild and the babies may be asymptomatic at birth. About 65% of the babies suffer from congenital toxoplasmosis due to infection during last trimester. The classical clinical triads of congenital toxoplasmosis are: deg Chorioretinitis deg Cerebral calcifications deg Convulsions. Microcephaly, hydrocephalus, organomegaly and mental retardation are the less frequent manifestations. | train | med_mcqa | null |
Medullary thyroid carcinoma is associated with? | [
"MEN I",
"MEN II",
"MEN III",
"MEN IV"
] | B | Ans. is 'b' i.e., MEN II About 70% of tumors arise sporadically. The remainder occurs in the rsetting of MEN syndrome 2A or 2B or as familial tumors without an associated MEN syndrome (familial medullary thyroid carcinoma, or FMTC. | train | med_mcqa | null |
Bronchial secretion secretes - | [
"IgA",
"IgE",
"IgM",
"IgG"
] | A | In its secretory form, IgA is the main immunoglobulin found in mucous secretions, including tears, saliva, sweat, colostrum, and secretions from the genitourinary tract, gastrointestinal tract, prostate, and respiratory epithelium. It is also found in small amounts in the blood Ref: Ananthanarayan & Parker's textbook of microbiology 9th edition pg:97 | train | med_mcqa | null |
All the following features are associated with Chancroid except- | [
"Painful ulcer",
"Painless lymphadenopathy",
"School of fish appearance on staining",
"Azithromycin is useful in treatment"
] | B | Ans is 'b' i.e. Painless lymphadenopathy* Chancroid is associated with painful suppurative inguinal lymphadenopathy.Chancroid (soft chancre/soft sore)* Chancroid is an STD caused by H.ducreyi, a gram negative cocobacilli. Incubation period of chancroid is 1-7 days. Clinically it is characterized by: -i) Multiple ulcersii) Non-indurated or soft indurationiii) Painful (Tender)iv) Bleed easilyv) Undermined, sloughed erythematous edgesvi) Painful suppurative inguinal lymphadenopathyDiagnosis & Treatment* Gram's staining of swab from the lesion may reveal a predominance of characteristic gramnegative coccobacilli, arranged in parallel chains giving a "School offish" or "rail road track" appearance. An accurate diagnosis relies on cultures of H.ducreyi from the lesion.* Azithromycin is the DOC for treatment. Ceftriaxoney Ciprofloxacin & erythromycin are alternatives. | train | med_mcqa | null |
Indication for surgical compartment release in compartment Syndrome in any compartment is absolute pressure greater than? | [
"15 mm Hg",
"20 mm Hg",
"30 mm Hg",
"Varies from compartment to compartment"
] | C | ANSWER: (C) 30 mm HgREF: With text"Setting the threshold for fasciotomy at a perfusion pressure of 30 mmHg can be considered safe, but still may lead to overtreatment if used routinely" REF: Evidence-based Orthopedics - Mohit Bhandari Page 634Different authors consider surgical intervention if: (REF: Tiwari A, Haq A I, Myint F, Hamilton G. Acute compartment syndromes. BrJSurg 2002; 89: 397-412.)Absolute ICP greater than 30 mmHgDifference between diastolic pressure and ICP greater than 30 mmHg3. Difference between mean arterial pressure and ICP greater than 40 mmHg"Intracompartmental pressure may be measured by the wick catheter in patients suspected to have compartment syndrome. By such method a pressure of 30 mm Hg or more sustained for 6-8 hours or more is a likely indication for decompressive fasciotomy" REF: Skeletal injury in the child by John Anthony Ogden Page 317IntracompartmentalpressureComments<15 mm HgNorma! compartment pressure of lower limbs>25 mm HgVenous drainage from dosed myofascial spaces is impaired.>30 mm HgComplete venous collapse>60 mm HgNeuromuscular ischemiaREF: Mastery of vascular and endovascular surgery - Gerald B. Zelenock, Thomas S. Huber, Louis M. Messina Page 507 | train | med_mcqa | null |
Lymphatics from the spongy urethra drain into the following lymph nodes? | [
"Superior inguinal nodes",
"Internal inguinal nodes",
"Deep inguinal nodes",
"Sacral nodes"
] | C | Lymphatics from the spongy urethra pass mostly to the deep inguinal lymph nodes. | train | med_mcqa | null |
Metabolically most active layer of cornea is: | [
"Endothelium",
"Stroma",
"Descemet's membrane",
"Epithelium"
] | D | Ans. Epithelium | train | med_mcqa | null |
Lens develops from: September 2012 | [
"Neural crest",
"Mesoderm",
"Neuroectoderm",
"Surface ectoderm"
] | D | Ans. D i.e. Surface ectoderm Embryology of eyeball Structures derived from mesoderm: Corneal stroma & endothelium, Only smooth muscles of iris, All muscles (EXCEPT iris muscle) Structures derived from surface ectoderm: Conjunctival epithelium, Lens Structures derived from neuroectoderm: Epithelium of iris & ciliary body, Muscles of iris (constrictor & dilator pupillae) | train | med_mcqa | null |
Hormonal stimulation of the formation of second messenger inositol 1, 4, 5-triphosphate (IP3) quickly leads to the release of which other intracellular messenger? | [
"Cyclic AMP",
"Prastaglandin",
"Calcium",
"Leukotriene"
] | C | Ans. is 'c' i.e., Calcium o 1P3 mobilizes Ca'from intracellular organelles and increases cytosolic Ca' and then Ca" acts as third messenger. | train | med_mcqa | null |
Which of the following is the most common pathogens responsible for nosocomial pneumonias in the ICU? | [
"Gram positive bacteria",
"Gram negative bacteria",
"Mycoplasma",
"Virus infections"
] | B | Most common organisms causing nosocomial pneumonia are gram negative bacteria in 50-70% cases, which reach the lower airways by aspiration of gastric contents or by microaspiration of upper airway secretions. Most common organism is pseudomonas aeruginosa followed by enterobacteriacea. Staphylococci aureus is second to gram negative bacteria and accounts for 15 -30%. Anaerobic bacteria is found in 10-30% cases. Ref: Infectious Diseases By Sherwood L. Gorbach, 3rd Edition, Page 477 | train | med_mcqa | null |
Lower dose of dopamine in cardiogenic shock will increase: | [
"Cardiac output",
"Urine output",
"Heart rate",
"Blood pressure"
] | B | null | train | med_mcqa | null |
Clinical features of H. influenzae is/are: | [
"Most frequently by biotype-I of type B strain",
"Occur in children (<2 years of age) due to absence of PRP antibodies",
"Most common complication of its meningitis – subdural effusion",
"All of the above"
] | D | null | train | med_mcqa | null |
Distressing Complication after modified radical mastectomy? | [
"Lymphedema",
"Axillary vein thrombosis",
"Seroma",
"Death"
] | A | Complications of Mastectomy
• Seroma
−− MC complication, beneath skin flaps and axilla, occurs in 30% cases
−− Catheter is retained until drainage is <30 ml/day
• Wound infection
−− Majority are due to skin flap necrosis
• Lymphedema
−− Occurs less frequently with the standard axillary dissections.
−− Extensive LN dissection, radiation therapy, presence of positive LNs, obesity are predisposing factors.
• Injury to Long Thoracic (Motor) Nerve
−− Seen in 10% of all cases.
−− Result in a palsy of the Serratus anterior muscle (classical winged scapula)
• Injury to Thoracodorsal Nerve:
−− Leads to palsy of the latissimus dorsi muscle.
• Redundant Axillary Fat Pad | train | med_mcqa | null |
Skeletal muscle use the | [
"GLUT-1 transpoer",
"GLUT-2 transpoer",
"GLUT-3 transpoer",
"GLUT-4 transpoer"
] | D | The entry of glucose into skeletal muscle is increased during exercise in the absence of insulin by causing an insulin-independent increase in the number of GLUT 4 transpoers in muscle cell membranes.(REF.GANONG'S REVIEW OF MEDICAL PHYSIOLOGY 23rd EDITION page no.331) | train | med_mcqa | null |
Initial investigation for obstructive jaundice is | [
"USG",
"CT scan",
"ERCP",
"MRI"
] | A | Obstructive jaundiceObstructive jaundice is a paicular type of jaundice and occurs when the essential flow of bile to the intestine is blocked and remains in the bloodstream.Causes of Obstructive jaundice Due to blocked bile ducts caused by gallstones, or tumors of the bile duct.Swelling of lymph glands, scar tissue (from previous infections or surgery), or a cyst, possibly of the pancreas.Clinical featuresDiagnosisTreatmentSymptoms of obstructive jaundice include yellowing of the skin and whites of the eyes; paler stools and darker urine; and intense itching. Other symptoms vary, depending on the underlying cause of the obstruction although you may also feel tired.Blood tests to examine the level of bilirubinUltrasound of the liver and bile ducts to find out the exact cause of the obstruction CT scans are also used to help examine what is causing the blockageSurgical resection ERCP or a procedure is known as Percutaneous Transhepatic Cholangiography (PTC) with percutaneous biliary drainage(Refer: Sabiston's Textbook of Surgery, 19th edition, pg no: 1535-1544) | train | med_mcqa | null |
Virulence of a biological agent is defind as - | [
"Ability of the agent to invade and multiply in host",
"Propoion of clinical cases resulting in severe clinical manifestation",
"Ability of the agent to induce a clinically apparent illness",
"Propoion of clinical cases in a virgin population"
] | B | For an infectious agent, infectivity refers to the propoion of exposed persons who become infected. Pathogenicity refers to the propoion of infected individuals who develop clinically apparent disease. Virulence refers to the propoion of clinically apparent cases that are severe or fatal. Ref: 25th edition, Park's Textbook of Preventive and Social Medicine, Page no. 43 | train | med_mcqa | null |
Which of the following is the most effective treatment modality for post-traumatic stress disorder | [
"Cognitive behavioural therapy",
"Hypnosis",
"Rational and emotive therapy",
"Eye movement desensitization and reprocessing"
] | A | The treatment for PTSD consists of the following measures: 1. Prevention: Anticipation of disasters in the high-risk areas, with the training of personnel in disaster management. 2. Disaster management: Here the speed of providing practical help is of paramount impoance. 3. Suppoive psychotherapy. 4. Cognitive behaviour therapy (CBT). 5. Drug treatment: Antidepressants and benzodiazepines (in low doses for sho periods) are useful in the treatment of anxiety and/or depression are impoant components of the clinical picture. Ref: A Sho Textbook of Psychiatry, Niraj Ahuja, 7th Edition, pg. no.112 | train | med_mcqa | null |
Organism implicated in Cellulitis following animal bites is | [
"Staph.aureus",
"Pseudomaonas",
"Pasteurella",
"Klebsiella"
] | C | Pasteurella multocidaDistinguishing Features: small gram-negative rods; facultative anaerobic rodsReservoir: mouths of many animals, especially cats and dogsTransmission: animal bites; paicularly from cat bitesPathogenesis: endotoxin, capsule; spreads rapidly within the skin, no exotoxins knownDisease: cellulitis with lymphadenitis (rapidly spreading wound infections, frequently polymicrobial infections)Diagnosis: rarely cultured because routine prophylaxis is commonTreatment: amoxicillin/clavulanate for cat bites; resistant to macrolidesPrevention: amoxicillin/clavulanate is standard prophylaxis and treatment for most bites (including human), along with a thorough cleaningOther organisms associated with animal bites:Eikenella corrodens: human bites or fist fight injuriesCapnocytophaga canimorsus: dog bite woundsBaonella henselae: Cats and dogs/ bites, scratches, fleasRef: Jawetz; 27th edition; Page no: 278 | train | med_mcqa | null |
The earliest evidence of Rickets is seen by: | [
"Radiological examination of growing end of bone",
"S. alkaline phosphatase level",
"S. calcium level",
"S. phosphorus level"
] | A | Ans. Radiological examination of growing end of bone | train | med_mcqa | null |
All of the following are signs of Cerebellal disease except | [
"Resting tremors",
"Past Pointing",
"Nystagmus",
"Ataxic gait"
] | A | . *When a person who have lost cerebellum performs a voluntary act the movements tend to oscillate,especially when they approach intended mark 1st over shooting the mark then vibrating back and foh before settling on the mark -intention or action tremors Ref Harrison20th edition pg 2567 | train | med_mcqa | null |
Passivating alloys are | [
"Cr, Al, Ti",
"Cr, Mo, Ti",
"Cr, Fe, Mo",
"Cr, Gold, Ti"
] | A | A thin surface oxide forms on chromium, which is a good example of a passivating metal. The most common example is stainless steel, which contains sufficient amounts of chromium added to iron and its alloys to passivate the alloy.
Titanium (Ti) also forms a passivating titanium oxide film, which is of interest, since both commercially pure Ti and alloys in which Ti is a major component are used for a variety of dental applications, such as cast restorations, orthodontic wires, endodontic instruments and implants.
Phillips 12th edition page 45 | train | med_mcqa | null |
Bulging fissures in lungs is seen in – | [
"Klebsiella pneumonia",
"Staph pneumonia",
"Pulmonary oedema",
"Pneumoconiosis"
] | A | The most important cause of bulging fissure is klebsiella pneumonia. Other causes are legionella pneumonia, streptococcal pneumonia, TB, Yersinia pestis, lung abscess, carcinoma bronchus | train | med_mcqa | null |
Which one of the following disorder is not x-linked recessive | [
"Fragile-x syndrome",
"Lesch-Nyhan syndrome",
"Hunter syndrome",
"Charcot marie tooth disease"
] | D | Charcot marie tooth disease : X-linked dominant | train | med_mcqa | null |
Which of the following is not a characteristic of Tumor Lysis syndrome | [
"Hyperkalemia",
"Hyperuricemia",
"Hyperphosphatemia",
"Hypercalcemia"
] | D | Hypocalcemia is a feature of Tumor Lysis Syndrome. | train | med_mcqa | null |
A 3-year-old child has eczematous dermatitis on extensor surfaces. His mother has a history of Bronchial asthma. Diagnosis should be – | [
"Atopic dermatitis",
"Contact dermatitis",
"Seborrhic dermatitis",
"Infantile eczematous dermatitis"
] | A | In this question:-
The child is 3 years old
History of Asthma in mother
Extensor involvement
First two points suggest the diagnosis of atopic dermatitis (childhood pattern).
About third point (extensor involvement) :-
"Though childhood atopic dermatitis mainly involves flexural parts, less commonly extensor surfaces may also be involved".
Further, you can easily rule out other three options:-
Contact dermatitis
The family history of asthma is not important.
No history of contact to an allergen.
Seborrheic dermatitis
Occurs in adults and less frequently in infants but not in children.
Infantile eczematous dermatitis
Occurs in Infant. | train | med_mcqa | null |
Insulin having longest duration of action is: | [
"Isophane insulin",
"Protainine zinc insulin",
"Insulin zinc suspension",
"Plain insulin"
] | B | null | train | med_mcqa | null |
Reduction of overbite can be accomplished most readily by which of the following tooth movements? | [
"Intruding maxillary incisors",
"Uprighting maxillary and mandibular incisors",
"Using a high-pull headgear to the maxillary molars",
"Using a lip bumper"
] | A | Intruding incisors would decrease overbite while uprighting teeth and using a high-pull headgear could make overbite correction more difficult. A lip bumper would likely have little effect on overbite. | train | med_mcqa | null |
A patient in shock diagnosed of having ectopic pregnancy in right fallopian tube. The cause of fetal death in ectopic pregnancy is postulated as: | [
"Vascular accident",
"Nutritional adequacy",
"Endocrine insufficiency",
"Immune response of mother"
] | A | Lack of a submucosal layer within the fallopian tube provides easy access for the feilized ovum to burrow through the epithelium and allow implantation within the muscular wall. As the rapidly proliferating trophoblasts erode the subjacent muscularis layer, maternal blood pours into the spaces within the trophoblastic or the adjacent tissue. The fallopian tube cannot sustain the growing pregnancy. This causes rupture and bleeding which expels the implantation out of the tubal end as tubal aboion. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 7. Ectopic Pregnancy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e. | train | med_mcqa | null |
Tober Ayer test is positive in: | [
"Lateral sinus thrombosis",
"Petrositis",
"Cerebral abscess",
"Subarachnoid hemorrhage"
] | A | The Tobey-Ayer test is used for lateral sinus thrombosis by monitoring cerebrospinal fluid pressure during a lumbar puncture. | train | med_mcqa | null |
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