question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4
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Population is 10,000. Of these 20% is having disease. The screening test has 95% sensitivity and 80% specificity. PPV is- | [
"54.3%`",
"98.50%",
"47.50%",
"20%"
] | A | Ref:Parks 23rd edition pg 139 Construct a 2x2 table using the above data. 1900 1600 100 6400 PPV = TP / (TP +FP) = 1900/ (1900+1600) =54.3 | train | med_mcqa | null |
In psoriatic ahritis, if the patient has liver fibrosis, ahropathy can NOT be treated with? | [
"Methotrexate",
"Anti-TNF-alpha agents",
"Steroids",
"Sulfasalazine"
] | A | Methotreaxte is absolutely contraindicated in liver fibrois. In case of treatment for long duration liver fibrosis should be assessed by liver biopsy. | train | med_mcqa | null |
Goitrous hypothyrodism commonly occurs in all of the following except - | [
"Hashimoto's thyroiditis",
"Dyshoromonognesis",
"Thyroprivic hypothyroidism",
"Iodine deficiency"
] | C | HYPOTHYROIDISM TYPES Ref image - semantischolar.org | train | med_mcqa | null |
Cervix develops from: | [
"Urogenital sinus",
"Mesonephric duct",
"Paramesonephric duct",
"Mesonephric tubules"
] | C | Mullerian ducts (or paramesonephric ducts)They are paired ducts of the embryo that run down the lateral sides of the urogenital ridge and terminate at the Mullerian eminence in the primitive urogenital sinus.In the female, they will develop to form the Fallopian tubes, uterus, cervix, and the upper two-thirds of thevagina; in the male, they are lost.These ducts are made of tissue of mesodermal origin. | train | med_mcqa | null |
Investigation of choice for Acute cholecystitis is: | [
"H.I.D.A Scan",
"USG",
"CT Scan",
"Biopsy"
] | B | IOC for Acute Cholecystitis: USG USG is the IOC for most GB pathologies Most Accurate Investigation for Acute Cholecystitis: H.I.D.A Scan (H.I.D.A is used for equivocal cases where USG is not conclusive ) IOC for Abdominal trauma :CECT | train | med_mcqa | null |
7th Pandemic of cholera was caused by - | [
"El Tor",
"0139 V. cholerae",
"Classical V. cholerae",
"V mimicus"
] | A | Ans. is `a' i.e., El Tor | train | med_mcqa | null |
What is the appropriate management of seizures complicating hypeension during pregnancy? | [
"MgSo4 as I.V or I.M as pritchards regime",
"Pethidine, promethazine, chlorpromazine.as 'Lytic cocktail'",
"Intravenous Hydrallazine",
"Lean's (Benzodiazepine) regime"
] | A | The appropriate management of seizures complicating hypeension during pregnancy(Eclampsia) is Pritchard regimen. Pritchard regimen I.M. & I.V. regime This is the most preferred and the 'method of choice' Loading dose-Sta with a loading dose of 14g in which 4g given as intravenous and 10g given as intramuscular Maintenance dose - Maintain 5 gm 4 hourly till 24 hours pass after delivery or 24 hours pass after the last convulsion Whichever is later. Meanwhile monitor the patient for the following prior to giving the next dose Respiratory rate: >14/min, Output >100ml in last 4 hours Knee jerks are present | train | med_mcqa | null |
Straite cortex is involved in which function? | [
"Vision",
"Auditory",
"Smell",
"Speech"
] | A | ANSWER: (A) VisionREF: Guyton 12th Ed. Pg 624PRIMARY VISUAL CORTEX is also called visual area I or striate cortex because of the highly striated appearance.The primary visual (VI) cortex is mostly located on the medial aspect of the occipital lobe, and is coextensive with the subcortical nerve fibre stria of Gennari in layer IV, hence its alternative name, the striate cortex.It occupies the upper and lower lips and depths of the posterior part of the calcarine sulcus and extends into the cuneus and lingual gyrus. Posteriorly it is limited by the lunate sulcus, and by polar sulci above and below this sulcus. It extends to the occipital pole.The primary visual cortex receives afferent fibres from the lateral geniculate nucleus via the optic radiation. The latter curves posteriorly and spreads through the white matter of the occipital lobe. Its fibres terminate in strict point-to-point fashion in the striate areaThe primary visual cortex is divided into six functionally distinct layers, labeled 1 through 6. Layer 4, which receives most visual input from the lateral geniculate nucleus (LGN), is further divided into 4 layers, labelled 4A, 4B, 4Ca, and 4Cb. Sublamina 4Ca receives most magnocellular input from the LGN; while layer 4Cb receives input from parvocellular pathways .The striate cortex is granular.Layer IV, bearing the stria of Gennari, is commonly divided into three sublayers. Passing from superficial to deep, these are IVA, 1VB (which contains the stria), and JVC. The densely cellular I VC is further subdivided into a superficial I VCa and a deep IVCb. Layer IVB contains only sparse, mainly non-pyramidal, neurones. The input to area 17 from the lateral geniculate nucleus terminates predominantly in layers IVA and IVC. | train | med_mcqa | null |
Acute pain in fibroid is due to all except. | [
"Torsion",
"Red degeneration",
"Hyaline degeneration",
"Sarcomatous change"
] | C | Ans. is c, i.e. Hyaline degenerationRef Shaw 16/ed, p397Pain in a fibroid can be due to Torsion/Haemorrhage & Red degeneration. Hyaline degeneration is a painless condition. | train | med_mcqa | null |
Jacobson's nerve is a branch of: | [
"Vagus nerve",
"Hypoglossal nerve",
"Glossopharyngeal nerve",
"Trigeminal nerve"
] | C | Ans. (c) Glossopharyngeal nerveRef: Dhingra's ENT 6th ed./4* Jacobsons nerve is a branch of glossopharyngeal nerve (CN- IX) in middle ear.* It supplies medial aspect of tympanic membrane. | train | med_mcqa | null |
Effective leprosy control programme may be indicated bn all of the following except ? | [
"Increasing number of children affected",
"Decreased grade 2 disability",
"Low MDR resistant, multibacillary cases",
"High new case detection rate"
] | A | Ans. is 'a' i.e. Increasing number of children affected' FNaluation of programme: here are two main types of indicators in leprosy control a) Operational indicators These are related to case-finding, treatment, relapses & disabilities for e.g. o Relapse rate - One of the best indicators of the efficacy of drug regimen o Case detection ratio - No. of cases registered / no. of cases estimated. o Propoion of children among newly detected cases. o Propoion of multibacillary cases on regular treatment during the year. o Propoion of female cases among newly detected cases. o Treatment completion/cure rate. o Propoion of new cases presenting with grade 2 disability/impairment at the time of diagnosis. o Propoion of treatment defaulters. o Propoion of patients who develop new/additional disability during MDT. b) Epidemiological indicators: To assess the impact of the actions taken with regard to the problem reduction. o Incidence rate - most sensitive index of transmission of disease. Only index for measuring the effectiveness of the measure taken i.e. reduction of transmission. o Prevalence - This provides a measure of case load & is useful in planning of the treatment services. High new case detection rate comes under operational indicators which shows that the Leprosy Control Programme is effective in detecting new cases from the already pool of leprosy cases. Thus these new cases could be treated to reduce fuher transmission of disease. | train | med_mcqa | null |
Which of the following characteristics are TRUE or FALSE about osteopetrosis in a child? 1. Growth retardation 2. Mental retardation 3. Multiple fracture 4. Cataract 5. Hepatosplenomegaly | [
"1,3, 5 True & 2,4 False",
"1,3,4, True & 2,5 False",
"1.3,4, True & 5,2 False",
"2,3 False & 1,4,5 True"
] | A | It is an autosomal recessive disorder in which paly calcified cailaginous intercellular ground substance is not regularly reabsorbed and replaced by regular osteoid tissue & bone. Clinical features are Multiple fractures, hepatosplenomegaly, growth retardation, blindness, dental problems, macrocephaly, deafness, etc. Ref: Ghai, 6th Edition, Page 600; Nelson, 18th Edition, Page 2882 | train | med_mcqa | null |
"Potter's syndrome" is associated with | [
"Renal anomalies",
"Severe oligohydramnio's",
"Flattened nose",
"All of the above"
] | D | JCDR - Potter's Syndrome, oligohydramnios, Potter's facies, pulmonary hypoplasia. Potter's Syndrome is a rare congenital disorder which is diagnosed at birth. It refers to a group of findings which are associated with the lack of amniotic fluid due to renal failure in an unborn infant. | train | med_mcqa | null |
Triple deformity of knee includes following except? | [
"Flexion of knee",
"External rotation of tibia",
"Posterior subluxation of tibia",
"Extension of knee"
] | D | Ans. is 'd' i.e., Extension of knee Triple deformity of knee refers to : - Flexion of knee External rotation of tibia Posterior subluxation of tibia Triple deformity is seen in RA, TB of knee and Polio. | train | med_mcqa | null |
Rabbies is identified by - | [
"Guarneri bodies",
"Negri bodies",
"Cowdry A bodies",
"Cowdry B bodies"
] | B | Diagnosis may be made postmoem by demonstration of Negri bodies in the brain but may be absent in about 20% of cases. REF:ANANTHANARAYAN AND PANIKER'S TEXTBOOK OF MICROBIOLOGY 9TH EDITION PAGE NO-533 | train | med_mcqa | null |
Shape of stab wound depends on: NEET 14 | [
"Edge of weapon",
"Shape of weapon",
"Width",
"All of the above"
] | A | Ans. Edge of weapon | train | med_mcqa | null |
When flashlight is moved from normal eye to abnormal eye the affected pupil dilates. What is the MOST likely diagnosis? | [
"Amaurotic pupil",
"Marcus gunn pupil",
"Hutchinson's pupil",
"Argyll Robeson pupil"
] | B | In patients with relative afferent pupillary defect in one eye the affected pupil dilates when flashlight is moved from normal eye to abnormal eye. This is called Marcus Gunn pupil and it is an indicator of optic nerve disease. Amaurotic pupil is a total afferent pupillary defect. A complete optic nerve or retinal lesion leading to total blindness on the affected side causes it. The eye has no perception of light. This pupil neither reacts to direct light stimulation, nor does it creates a consensual light reflex in the opposite eye. When light is shone on opposite eye there is a good light reflex in that eye and a good consensual light reflex in the affected eye. Ref: Textbook of Ophthalmology edited by Sunita Agarwal, page 303. | train | med_mcqa | null |
Dogs are responsible for transmission of all the following except - | [
"Hydatid disease",
"Toxoplasmosis",
"Kala-azar",
"Toxocara canis"
] | B | Definitive host- cat and other felinies Intermediate host- humans (refer pgno:64 baveja 3 rd edition) | train | med_mcqa | null |
Which of the following morphological changes in the lungs would be found in this patient of asthma | [
"Destruction and dilation of the bronchi and bronchioles",
"Free air in the interstitium",
"Viscid mucus plugs in the small airways",
"Peribronchiolar fibrosis"
] | C | In the given case of atopic asthma,airway wall may be thickened and edematous.Another common finding is occlusion of the airway lumen by a mucous plug.,which is comprised of mucous glycoproteins secreted from goblet cells and plasma proteins from leaky bronchial walls.There is also vasodilation and increased numbers of blood vessels (angiogenesis). Ref:Harrison's medicine-18th edition,page no:2104. | train | med_mcqa | null |
Which of the following is found in secondary granules of neutrophils? | [
"Catalase",
"Gangliosidase",
"Proteolytic enzyme",
"Lactoferrin"
] | D | Neutrophils have two main types of granules
The smaller specific (secondary) granules contain lysozyme, collagenase, gelatinase, lactoferrin, plasminogen activator, histaminase, and alkaline phosphatase.
The larger azurophil (primary) granules contain myeloperoxidase, bactericidal factors (such as defensins), acid hydrolases, and a variety of neutral proteases (elastase, cathepsin G, nonspecific collagenases, proteinase).
Reference-Robbins BASIC PATHOLOGY 10th edition pg-68 | train | med_mcqa | null |
Mastoid infection which erodes through the outer cortex of bone results in - | [
"Sub-periosteal abscess",
"Epidural abscess",
"Perichondritis",
"Lateral sinus thrombosis"
] | A | null | train | med_mcqa | null |
True about ITP is all except | [
"Splenectomy is Rx of choice in paediatric patients",
"Splenectomy is not done in all cases",
"Splenomegaly is not essential for diagnosis of ITP",
"IV gammaglobulins are not useful in adults"
] | C | Ans. c (Splenomegaly is not essential criteria for diagnosis of ITP). (Ref. Harrison 18th/Ch. 115.)IDIOPATHIC THROMBOCYTOPENIC PURPURA# The explosive onset of severe thrombocytopenia following recovery from a viral exanthema or upper respiratory illness {acute ITP) is common in children and accounts for 90% of the pediatric cases of immunologic thrombocytopenia.# Of these patients, 60% recover in 4 to 6 weeks and =90% recover within 3 to 6 months.# Transient immunologic thrombocytopenia also complicates some cases of- Infectious mononucleosis- Acute toxoplasmosis- Cytomegalovirus infection- Prodromal phase of viral hepatitis- Initial infection with HIV# Acute ITP is rare in adults and accounts for = 10% of post-pubertal patients with immune thrombocytopenia.# Most adults present with a more indolent form of thrombocytopenia that may persist for many years and is referred to as chronic ITP.# Women age 20 to 40 are afflicted most commonly and outnumber men by a ratio of 3:1.# These patients have an autoimmune disorder with antibodies directed against target antigens on the glycoprotein (Gp) IIb/IIIa or, less frequently, the Gp Ib/IX complex.# Treatment:- Specific therapy may not be necessary unless the platelet count is <20,000/mL or there is extensive bleeding.- Hemorrhage in patients with either acute or chronic ITP can usually be controlled with glucocorticoids but, in rare cases, may require temporary phagocytic blockade with intravenous immunoglobulin (IVIg) or anti-RhD (WinRho).- Emergency splenectomy is usually reserved for patients with acute or chronic ITP who are desperately ill and have not responded to any medical measures.- Glucocorticoid-responsive but glucocorticoid-dependent patients are very likely to respond to splenectomy, and 70% will have a normal platelet count within 1 week after surgery.- Persistent splenic tissue can be confirmed by a radionuclide scan.- Patients still thrombocytopenic after splenectomy or who relapse months to years after initial therapy have received a variety of immunosuppressive drugs including azathioprine, cyclophosphamide, vincristine, vinblastine, and cyclosporine.- Danazol has also been used with some success.- IVIg and anti-RhD are only transiently effective and expensive.- Rituximab, an anti-CD20 monoclonal antibody used to treat lymphoma, has also proven an effective approach to ITP and is probably preferable to long-term glucocorticoid therapy. Rituximab eliminates normal B cells, including those producing the anti-platelet antibody. This B cell depletion is transient (lasting 12 to 18 months, normally) and has surprisingly few S/E. | train | med_mcqa | null |
Right atrial distension leaading to increased heart rate occurs in | [
"Bezold Jarisch reflex",
"Bain bridge reflex",
"J reflex",
"None of the above"
] | A | null | train | med_mcqa | null |
The following is a B cell specific mitogen: | [
"Concanavalin A (conA)",
"Lipopolysaccharide (LPS)",
"Pokeweed mitogen (PWM)",
"Phytohaemagglutinin (PHA)"
] | B | Mitogens: Molecules that promote cellular mitosis in a non-specific way are known as mitogens. They activate lymphocytes but bypass antigen receptor specificity. Concanavalin A (conA), Phytohaemagglutinin (PHA) and wheat gram agglutinin (WGA) promote human T cell proliferation. Lipopolysaccharide (LPS) is specific for B cell, while Pokeweed mitogen (PWM) promotes both T cell and B cell. Ref: Analytical Techniques, edited by T.P. Mommsen, Peter W. Hochachka, Page 346, 347 ; The Immune Response: Basic and Clinical Principles, By Tak W. Mak, Mary E. Saunders, Page 387 | train | med_mcqa | null |
Myoglobin dissociation curve is: | [
"Almost linear",
"Parabola",
"Rectangular hyperbola",
"Sigmoid"
] | C | Myoglobin dissociation curve is: Rectangular hyperbola. P50for myoglobin (PO2at which 50% of myoglobin is saturated)- 5 mmHg. Myoglobin has high affinity for O2. | train | med_mcqa | null |
True about vertebral artery - | [
"A branch of thyrocervical trunk",
"Enters skull through foramen magnum",
"Unite to form posterior cerebral artery",
"A small artery"
] | B | Ans. is 'b' i.e., Enters skull through foramen magnum Vertebral arteryo It is the largest branch of subclavian artery.o Vertebra] artery traverses through vertebral triangle, foramina transversaria of upper six cervical vertebrae. suboccipital triangle, posterior atlanto-occipital membrane, vertebral canal, pierce duramater and arachnoid (Subarachnoid) and passes through foramen magnum to enter posterior cranial fossa. It gives following branches:-Cervical branches Spinal branches, muscular branches (to suboccipital muscle).Cranial branches Posterior inferior cerebellar artery, medullary artery, meningeal branches, anterior spinal artery, posterior spinal artery and both vertebral arteries unite to form basilar artery. | train | med_mcqa | null |
Mr. X complained of chills and fever following a louse bite. He had rashes all over the body and was delirious at the time of presentation to the hospital and subsequently went into the coma. A provisional diagnosis of vasculitis due to rickettsial infection was made. Which one of the following can be the causative agent? | [
"Rickettsia typhi",
"Rickettsia rickettsiae",
"Rickettsia prowazekii",
"Rickettsia akarai"
] | C | R. typhi- Endemic typhus- agent is rat flea R. rickettsial- Rocky mountain spotted fever- the agent is tick R. prowazekii- Epidemic typhus- the agent is louse R. akarai- Rickettsialpox- agent is mite Ref : Ananthanarayana textbook of Microbiology 9th edition Pgno : 405 | train | med_mcqa | null |
Fat-soluble vitamins, compared with their water soluble counterpas. generally have a greater potential toxicity for because they are | [
"Administeicd in larger doses",
"Avidly stored by the body",
"Capable ot dissolving membrane phospholinids",
"Involved in more essential metabolic pathways"
] | B | Fat soluble vitamins, especially A and D, can be stored in massive amounts and hence, have a potential for serious toxicities. Water soluble vitamins are easily excreted by the kidney and accumulation to toxic levels is much less common. Conversely, inadequate dietary intake will lead to manifestations of deficiency relatively faster. | train | med_mcqa | null |
Kehr's sign seen in splenic rupture is - | [
"Pain over left shoulder",
"Pain over right scapula",
"Periumbilical pain",
"Pain over renal angle"
] | A | null | train | med_mcqa | null |
All of the following drugs can worsen angina except: | [
"Dipyridamole",
"Oxyphedrine",
"Thyroxine",
"Sumatriptan"
] | B | Oxyphedrine is claimed to improve myocardial metabolism so that the hea can sustain hypoxia better. Dipyridamole can cause 'coronary seal' phenomenon - By dilating resistance vessels nonischemic zone as well, it dives the already reduced blood flow away from the ischaemic zone. Sumatriptan causes coronary vasoconstriction. Thyroxine increases sympathetic stimulation (REF. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D TRIPATHI-6th edition.Page No-535) | train | med_mcqa | null |
All of the following hea sounds occur sholy after S2 except | [
"Opening snap",
"Pericardial knock",
"Ejection click",
"Tumor plop"
] | C | An ejection sound is a high-pitched early systolic sound that corresponds in timing to the upstroke of the carotid pulse. The other three are heard during diastole. ref - harrson's internal medicine 20e pg1671-1673,1811,1815 | train | med_mcqa | null |
Cisapride differs from metoclopramide in which of the following aspect? | [
"It accelerates gastric emptying",
"It alters colonic motility",
"Its action is blocked by atropine",
"It decreases the bioavailability of digoxin"
] | B | Cisapride does not block the dopamine receptors, thus does not cause extrapyramidal symptoms or alter the prolactin levels.
Though its effects on the stomach and small bowel motility are similar to metoclopramide, the colonic motility is increased with cisapride (no effect with metoclopramide).
Like metoclopramide, its actions on the gut are blocked by atropine. | train | med_mcqa | null |
What percentatge of the healthcare waste generated is infectious? | [
"10% - 15%",
"50%",
"75%",
"100%"
] | A | - about 80% of health care wastes accounts for general health care wastes. - 1% accounts for sharps - 15% is pathological and infectious wastes. - 3% chemical and pharmacological wastes. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:790 <\p> | train | med_mcqa | null |
A 30 year old housewife repos with 6 months amenorrhoea. Her serum LH and FSH are high with low estradiol levels. What is the most likely cause of amenorrhoea : | [
"Pituitary tumour",
"Polycystic ovarian disease",
"Exercise induced",
"Premature menopause"
] | D | Premature menopause | train | med_mcqa | null |
Serial interval is: | [
"Gap between primary and secondary cases",
"Gap between maximum and minimum incubation period",
"Difference between sensitivity and specificity",
"Indicates secondary attack rate."
] | A | Ans. is 'a' i.e. Gap between primary & secondary cases | train | med_mcqa | null |
Duke's criteria is used for evaluation of? | [
"CHF",
"Severity of aoic stenosis",
"Chronic Stable Angina",
"Infective endocarditis"
] | D | Duke's criteria =Infective endocarditis Duke's score= severity of chronic stable angina Duke staging= Colorectal CA | train | med_mcqa | null |
Tidal volume in a normal man at rest is | [
"0.5 L",
"1L",
"1.5 L",
"2 L"
] | A | Normal tidal volume is 500 ml Ref: guyton and hall textbook of medical physiology 12 edition page number:324,325,326 | train | med_mcqa | null |
Maximal permissible hours of work per person per week (including the overtime) under the Factory Act 1976, should not exceed_______? | [
"42 hours",
"48 hours",
"56 hours",
"60 hours"
] | D | Ans. d (60 hrs ) (Ref. Park Textbook of PSM 22nd/pg. 759) Answer is d). because the question includes overtime, so 60 hours/week. If including overtime was not mentioned then it should be 48 hours/week. With 9 hours/day with rest for at least Vz hour after continuous 5 hours. "......But the option in exam was 60 yrs....... certainly a misprint....we consider option as 60 hrs....so ans. is d........" FACTORY ACT- 1948: # Applicable to whole India except Jammu & Kashmir. # Scope - establishment >10 workers where power is used and > 20 where power is not used. # Minimum 500 cu.ft of space for each worker. Factories before 1948 minimum 350 cu.ft. # Prohibit employment <14 years. 15 to 18 are called adolescents; they should be dully certified by certifying surgeon. They are allowed to work only between 6 am to 7 pm. # Hours of work - max 48 hours/week. Including overtime 60 hours/week. # Leave with wage - after 12 months of continuous service- adult 1 day for 20 days of work, children 1 day for 15 days. Maximum accumulated leave - adult 30 days. Children 40 days. # Notifiable diseases - byssinosis, asbestosis, occupational dermatitis, and noise-induced hearing loss. # Officers - safety officer- > 1000 workers, welfare officer- >500 workers, canteen > 250 workers # Creches - > 30 female workers. | train | med_mcqa | null |
Which of the following is NOT seen in Paroxysmal Nocturnal Hemoglobinuria - | [
"Hypocellular bone marrow",
"Hemosiderinuria",
"Increased LAP score",
"Pancytopenia"
] | C | null | train | med_mcqa | null |
Yellowing of the skin occurs in hypothyroidism because of: | [
"Increased bilirubin",
"Increased cholesterol",
"Increased carotene",
"Increased"
] | C | Answer is C (Increased Carotene): The yellow colour of skin in patients with hypothyroidism results from the accumulation of carotene (carotenoderma) in the top layer of the epidermis (Stratum Corneum). Increased levels of carotene are believed to result from impaired hepatic conversion of beta-carotene to Vitamin A. 7'4 is essential for conversion of carotene to vitamin A. In hypothyroidism, this reaction is very slow and carotene accumulation in the blood and tissue (carotenaemia) gives a yellow colour to the skin (carotenoderma). Carotenaemia can be clinically differentiated from jaundice by the fact that sclera of the eyeballs are not affected Carotenaemia | train | med_mcqa | null |
Content of citrate in ORS is...............millimoles ? | [
"20",
"25",
"30",
"None"
] | D | Ans. is 'None' o Correct answer is 10.m mol/litere or 30 meq/litre. | train | med_mcqa | null |
Enzymes not used in glycogen metabolism | [
"Glycogen phosphorylase B",
"Glycogen synthase I",
"Glycogen synthase C",
"Glycogen synthase D"
] | C | The liver phosphorylase-b is the inactive form. It becomes active on phosphorylation. The active form is phosphorylase-a.Glycogen synthase exists in two distinct forms that can be interconveed by the action of specific enzymes; active dephosphorylated glycogen synthase(glucose-6-p-independent) and less active, phosphorylated glycogen synthase D(glucose-6-p-dependent.Ref: DM Vasudevan, page no: 127 | train | med_mcqa | null |
All the following are criteria to say substance dependence except | [
"Tolerance",
"Withdrawal symptoms",
"Unable to quit the drug",
"Use of illegal substances"
] | D | Usage of illegal drugs doesn't come under substance dependence as per WHO definition. Remaining 3 options make up the definition Ref: Essentials of postgraduate psychiatry By JN Vyas 1st ed Pg 326 | train | med_mcqa | null |
Wernicke Korsakoff's syndrome is due to the deficiency of which of the following (Repeat): | [
"Pyridoxine",
"Thiamine",
"Vitamin B12",
"Riboflavin"
] | B | Ans: B (Thiamine) Ref: Synopsis of Psychiatry. Kaplan & Sadock, 10th editionExplanation:See 2010 Psychiatry question explanation. | train | med_mcqa | null |
,70yr old male with history of HTN and DM developed the following rhythm with Bp 90/ 40 mm Hg and feeble pulse what is the next step of management | [
"IV adenosine",
"IV Diltiazem",
"DC cardioversion",
"Ibuteilide"
] | C | ECG : SVT REF : HARISSONS 21ST ED | train | med_mcqa | null |
Which of the following diagnostic techniques is most specific for pulmonary embolism? | [
"Pulmonary angiography",
"Ventilation lung scanning",
"Perfusion lung scanning",
"Arterial blood gas analysis"
] | A | null | train | med_mcqa | null |
The investigation of choice in pancreatic trauma is? | [
"CECT",
"MRI",
"USG",
"Radionuclide scan"
] | A | Ans. A. CECT* CT is the simplest and least invasive diagnostic modality currently available for evaluating suspected pancreatic trauma and its complications, because of the subtlety of the US findings. However, this study is only rarely useful in acute penetrating injury.* Computed tomography is the radiographic examination of choice for hemodynamically stable patients with abdominal trauma as it provides the safest and most comprehensive means of diagnosis of traumatic pancreatic injury.* The pancreas may appear normal in 20%-40% of patients when CT is performed within 12 h after trauma because pancreatic injuries may produce little change in the density which may not be detectable on CT scan.* In addition, there may be minimal separation of lacerated pancreatic fragments. Currently, multidetector-row CT scanners are used for evaluation of abdominal trauma cases as they are faster to scan, which greatly reduces bowel artifacts and resolves many previous technical problems.* Lacerations tend to occur at the junction of the body and tail due to shearing injuries with compression against the spine | train | med_mcqa | null |
A 15 year old boy, in Mumbai is brought to the emergency depament with several stab wounds inflicted during an attack by members of a rival street gang. One lesion, between the 9th and 10th ribs along the left posterior axillary line, penetrated to a depth of about 5 cm. Which of the following organs would be the first one pierced by the sharp object that caused this injury? | [
"Ascending colon",
"Duodenum",
"Left kidney",
"Spleen"
] | D | The spleen follows the long axes of ribs 9 to 11 and lies mostly posterior to the stomach, above the colon, and paly anterior to the kidney. Therefore, it is the most likely organ of the group to be pierced by a sharp object penetrating just above rib 10 at the posterior axillary line. Note that the pleural cavity, and possibly the lower pa of the inferior lobe of the lung, would be pierced before the spleen.The ascending colon is on the wrong side (the right) to be penetrated by a sharp instrument piercing the left side. Most of the duodenum is positioned too far to the right to be affected by this injury. Even the third pa of the duodenum, which runs from right to left, would still be out of harm's way. In addition, the duodenum lies at about levels L1 to L3, placing it too low to be injured in this case. The superior pole of the left kidney is bordered by the lower pa of the spleen. However, it is crossed by rib 12 and usually does not extend above rib 11. It would probably be too low and medial to be injured in this case, since this penetration is at the posterior axillary line. | train | med_mcqa | null |
Antischkow cells are characteristic of the | [
"Acute rheumatic fever",
"Yellow fever",
"Malarial spleen",
"Itp"
] | A | Refer robbins 9/e p558 Anitschkow (or Anichkov) cells are often cells associated with rheumatic hea disease. Anitschkow cells are enlarged macrophages found within granulomas (called Aschoff bodies) associated with the disease. The cells are also called caterpillar cells, as they have an ovoid nucleus and chromatin that is condensed toward the center of the nucleus in a wavy rod-like pattern that to some resembles a caterpillar. Larger Anitschkow cells may coalesce to form multinucleated Aschoff giant cells.Anitschkow cells were named after the Russian pathologist Nikolay Anichkov. Squamous epithelial cells with nuclear changes resembling Anitschkow cells have also been observed in recurrent aphthous stomatitis, iron deficiency anemia, children receiving chemotherapy, as well as in healthy individuals | train | med_mcqa | null |
Which of the following type of cerebral palsy is common in low-birth weight infants | [
"Spastic quadriplegia",
"Spastic Diplegia",
"Choreoathetoid cerebral palsy",
"Hemiplegia"
] | B | Diplegia is common in pre term and low birth weight infants. | train | med_mcqa | null |
In epidural anaesthesia, local drug deposited in | [
"Intrathecal space",
"Extradural",
"Paraspinal",
"Intervertebral space"
] | B | (Extradural) (494- Lee's 13th) (361- KDT6th) (128-A. yadav. Anaesthesia 3rd)Epidural Anaesthesia - mainly used for controlling post operative pains** Main site of action is Anterior and posterior nerve root*** Drugs diffuses through dura and arachnoid and inhibits descending pathways in spinal cord* Epidural (extradural) anaesthesia* Spinal (Intradural) anaesthesia* Extradural - The extent to which drugs reach their site of action is termed bioavailability* Intradural - although the dura is a relatively rough, avascular fibrous membrane, the arachnoid with its tight overlapping cells represents 90% of resistance in drug permeability and keeps CSF confined to the subarachnoid space*** Epidural anaesthesia - LA injected in the this space acts primarily on nerve roots (in the epidural as well as subarachnoid spaces to which it diffuses) and small amount permeates through intervertebral foramena to produce multiple paravertebral blocks | train | med_mcqa | null |
Oliguric phase of ARF is characterized by A/E | [
"Chest pain",
"Acidosis",
"Hypeension",
"Hypokalemia"
] | D | Ans. is 'd' i.e., Hypokalemia | train | med_mcqa | null |
In the lungs bronchial aeries supply: | [
"Till teiary bronchi",
"Till segmental bronchi",
"Till respiratory bronchioles",
"Till alveolar sacs"
] | C | Bronchial aeries are branches of the descending thoracic aoa. They supply the bronchial wall as for as the respiratory bronchioles. | train | med_mcqa | null |
The doctor who did surgery' on the wrong side of the patient is punishable under section - | [
"S. 304A IPC",
"S.104 IPC",
"S.305A IPC",
"S.305 IPC"
] | A | Ans. is 'a' i.e., S. 304 A IPC Section 304 A IPCo Causing death by negligence: Whosoever causes the death of any person, by doing any rash or negligent act not amounting to culpable homicide shall be punished with imprisonment for a term which may extend to 2 years or with fine, or with both.o The doctor doing surgery on the wrong side of the patient is an example of gross inattention and recklessness shown by the doctor and is thus an example of criminal negligence.o Criminal negligence is punishable under S. 304 A IPC | train | med_mcqa | null |
Losartan is:(2001) | [
"ACE inhibitor",
"Angiotensin receptor blocker",
"Ca++ channel blocker",
"Ganglion blocker"
] | B | b | train | med_mcqa | null |
In Gonorrhea, the selective media is | [
"Thayer-Martin medium",
"Thioglycolate medium",
"Nutrient broth",
"Mackonkey's medium"
] | A | (A) Thayer-Martin medium # Gonococci are more difficult to grow than meningococci. They are aerobic but may grow anaerobically also. Growth occurs best at pH 7.2-7.6 and at a temperature of 35-36 degC. It is essential to provide 5-10% CO2. They grow well on chocolate agar and Mueller-Hinton agar. A popular selective medium is the Thayer-Martin medium (containing vancomycin, colistin and nystatin) which inhibits most contaminants including nonpathogenic neisseria. | train | med_mcqa | null |
Primary lesion in lichen planus is: | [
"Macule",
"Papule",
"Vesicle",
"Bulk"
] | B | null | train | med_mcqa | null |
Hypercalcemia is caused by? | [
"Adrenocoical insufficiency",
"Amyloidosis",
"Hypehyroidism",
"Vitamin C Intoxication"
] | C | Hypehyroidism can result in increased bone turnover though the mechanism is not elucidated. Causes of hypercalcemia associated with high bone turnover Hypehyroidism Vitamin A intoxication Thiazides Immobilization | train | med_mcqa | null |
Two year old has vocabulary of how many words ____________ | [
"20",
"50",
"100",
"200"
] | B | Developmental milestones:- GROSS MOTOR DEVELOPMENT: 2 months: Holds head in plane of rest of the body when held in ventral suspension. In prone position in bed, the chin lifts momentarily. 3 months:lift head above the plane of the body. Head control stas by 3 months and fully developed by 5 months. 4 months:Remain on forearm suppo if put in prone position, lifting the upper pa of the body off the bed. 5 months: Rolls over. 6 months:sit in tripod fashion. 8 months: sits without suppo., crawling 9 months: Takes a few steps with one hand held. Pulls to standing and cruises holding on to furniture by 10 months. 10 months: creeps 12 months:creeps well, walk but falls, stand without suppo. 15 months: walks well, walks backward/ sideways pulling a toy. May crawl upstairs. 18 months: Runs, walks upstair with one hand held. Explores drawers 2 years: walk up and downstairs, jumps. 3 years : rides tricycle, alternate feet going upstairs. 4 years: hops on one foot, alternate feet going downstairs. 5 years:skips FINE MOTOR DEVELOPMENT:- 2 months- eyes follow objects to 180 deg. 3 months-Grasp reflex disappears and hand is open most of the time. 4 months- Bidextrous approach( reaching out for objects with both hands). 6 months- Unidextrous approach( Reach for an object with one hand). 8 months- radial grasp sta to develop. Turns to sound above the level of ear. 9 months- immature pincer grasp, probes with forefinger. 12 months-Unassisted pincer grasp. Releases object on request.Uses objects predominantly for playing, not for mouthing. Holds block on each hand and bang them together. 15 months- imitate scribbling , tower of two blocks 18 months- scribbles, tower of 3 blocks.turn pages of a book, 2-3 at a time. 2 years- tower of 6 blocks, veical and circular stroke. 3 years-Tower of 9 blocks, dressing and undressing with some help, can do buttoning. 4 years- copies cross, bridge with blocks 5 years- copies triangle, gate with blocks. SOCIAL AND ADAPTIVE MILESTONES: 2 months: social smile(smile after being talked to).watches mother when spoken to and may smile. 3 months:Recognizes mother, anticipates feeds. 4 months: Holds rattle when placed in hand and regards it . Laughs aloud. Excited at the sight of food. 6 months:recognizes strangers, stranger anxiety . Enjoy watching own image in mirror, shows displeasure when toy pulled off. 9 months:waves bye bye 12 months:comes when called, plays simple ball game.kisses the parent on request. Makes postural adjustments for dressing. 15 months:jargon, stas imitating mother. 18 months: copies parents in tasking, dry by day, calls mother when he wants potty, points to three pas of body on request. 2 years: ask for food, drink, toilet, pulls people to show toys. 3 years:shares toys, know fullname and gender, dry by night. 4 years:Plays cooperatively in a group, goes to toilet alone, washes face, brushes teeth. Role play . 5 years:helps in household task , dresses and undresses. LANGUAGE MILESTONES: 1 month: Ales to sound. 2 month:respond to sound by stale or quitening to a smooth voice. 3 months: babbles when spoken to. Makes sounds (ahh,coos, ) laughs. 4 months: laughs aloud. 6 months: monosyllables 9 months: understands spoken words, bisyllables. 12 months: 1-2 words with meaning. 18 months: vocabulary of 10 words. Can name one pa of body. 2 years: 3 word simple sentences 3 years:asks questions, knows full name and gender. 4 years: says songs or poem, tells story, knows three colours. 5 years: ask meaning of words. Reference: GHAI Essential pediatrics, 8th edition | train | med_mcqa | null |
A 64-year-old woman presents to the emergency room with flank pain and fever. She noted dysuria for the past 3 days. Blood and urine cultures are obtained, and she is started on intravenous ciprofloxacin. Six hours after admission, she becomes tachycardic and her blood pressure drops. Her intravenous fluid is normal saline (NS) at 100 mL/h. Her current blood pressure is 79/43 mm Hg, heart rate is 128/min, respiratory rate is 26/min, and temperature is 39.2degC (102.5degF). She seems drowsy yet uncomfortable. Extremities are warm with trace edema. What is the best next course of action? | [
"Administer IV hydrocortisone at stress dose.",
"Begin norepinephrine infusion and titrate to mean arterial pressure greater than 65 mm Hg.",
"Add vancomycin to her antibiotic regimen for improved gram-positive coverage.",
"Administer a bolus of NS."
] | D | This patient is septic, and immediate therapy should be directed at correcting her hemodynamic instability. Patients with sepsis require aggressive fluid resuscitation to compensate for capillary extravasation. This patient's vital signs suggest decreased effective circulating volume. Normal saline at 100 cc/h is insufficient volume replacement. The patient should be given a saline bolus of 2 L over 20 minutes, and then her blood pressure and clinical status should be reassessed. The elevated respiratory rate could be evidence of pulmonary edema or respiratory compensation for acidosis from decreased tissue perfusion. Even if the patient has evidence of pulmonary edema, fluid resuscitation remains the first intervention for hypotension from sepsis. She is more likely to die from hemodynamic collapse than from oxygenation issues related to pulmonary edema.Stress doses of hydrocortisone and intravenous norepinephrine are both used in patients with shock refractory to volume resuscitation but should be reserved until after the saline bolus. Vancomycin is a reasonable choice to cover enterococci, which can cause UTI-associated sepsis, but again would not address the immediate hemodynamic problem. If the patient does not improve, a central line (to measure filling pressures and mixed venous oxygen saturation) would allow the "early goal-directed" sepsis protocol to be used. | train | med_mcqa | null |
Area of mitral orifice in adults is: | [
"6-8 cm2",
"5-2 cm2",
"4-6 cm2",
"1-4 cm2"
] | C | Answer is C (4-6 cm2): The normal area of mitral valve is 4-6 em2. Mitral Valve & pathology Area Normal Mitral Valve 4-6 cm2Q Mild Mitral Valve < 2 cm? Severe Mitral Stenosis < 1.3 cm2Q Critical Mitral Stenosis < 1 cm2 Q Aoic Valve & pathology Area Normal Aoic Valve 2.6 - 3.5 cm2Q Mild Aoic Stenosis 1.5 - 2 cm2 Moderate Aoic Stenosis 1 - 1.5 cm2 Severe Aoic Stenosis < 0.8cm2 | train | med_mcqa | null |
Dose of centchroman is ? | [
"30 mg",
"60 mg",
"120 mg",
"240 mg"
] | A | Ans. is 'a' i.e., 30 mg Cetchroman (Saheli) Ormeloxifene, research product of Central Drug Research Institute, Lucknow, India. It is a potent non - steroidal compound with potent anti - estrogenic and weak estrogenic propeies. It is taken orally (30 mg) twice a week for first three months then once a week. It works primarily by preventing implantation of feilized ovum. It does not inhibit ovulation. It is avoided in PCOD, with liver and kidney diseases and in tuberculosis. There may be a tendency of oligomenorrhoea. The failure rate is 1 - 4/100 woman years of use. Failure rate is less with increased doses. It is devoid of any significant adverse metabolic effect. This may also be used as a emergency contraceptive. | train | med_mcqa | null |
A 29-year-old woman comes to the physician for follow-up of a right breast lump. The patient first noticed the lump 4 months ago. It was aspirated at that time, and cytology was negative, but the cyst recurred about 1 month later. The cyst was re-aspirated 2 months ago and, again, the cytology was negative. The lump has recurred. Examination reveals a mass at 10 o'clock, approximately 4 cm from the areola. Ultrasound demonstrates a cystic lesion. Which of the following is the most appropriate next step in management? | [
"Mammography in 1 year",
"Ultrasound in 1 year",
"Tamoxifen therapy",
"Open biopsy"
] | D | Breast lumps are a common complaint in women. Many of these masses are benign processes. Benign conditions of the breast include fibrocystic disease, fibroadenomas, galactoceles, abscesses, and necrosis. It is appropriate to aspirate a palpable macrocyst in the breast; the fluid should be placed on a slide and sent for cytologic evaluation. If the cytology is negative, no fuher treatment is needed. However, when a lesion recurs twice, as has occurred in this patient, open biopsy is warranted. To wait to perform mammography in 1 year (choice A) or ultrasound in 1 year (choice B) would be incorrect management. First, if a malignancy is present, waiting another year will allow progression of the cancer. Second, the mammogram is not definitive. Imaging can contribute information to the workup of a breast mass, but the definitive diagnosis rests on histologic evaluation. Tamoxifen therapy (choice C) is used to both prevent and treat breast cancer. However, this patient does not yet have a diagnosis. She has a cystic mass that has been aspirated twice and has recurred twice. She therefore requires a biopsy to establish a diagnosis prior to the institution of any treatment. | train | med_mcqa | null |
RHD diagnostic criteria include | [
"Oral ulcer",
"Malar rash",
"Erythema marginatum",
"Nail telengectasia"
] | C | Erythema marginatum is a cutaneous finding associated with acute rheumatic fever. The lesions typically develop 7 days to months after the onset of the streptococcal pharyngitis or, rarely, streptococcal skin infections. Erythema marginatum occurs in about 10% cases of acute rheumatic fever. Jones criteria is used for diagnosis of rheumatic fever . Its shown in the following picture Ref Davidson edition23rd pg 532 | train | med_mcqa | null |
During embryonic development, prolapsed gut returns to the abdominal cavity by: | [
"12th week",
"15th week",
"18th week",
"20th week"
] | A | During the sixth week of fetal development, the midgut grows too rapidly to be accommodated in the abdominal cavity and therefore prolapses into the umbilical cord. Between the tenth and twelfth weeks, the midgut returns to the abdominal cavity, undergoing a 270-degree counterclockwise rotation around the superior mesenteric aery. Because the duodenum also rotates caudal to the aery, it acquires a C loop that traces this path. Ref: Schwaz's principle of surgery 9th edition, chapter 39. | train | med_mcqa | null |
Burkitt's lymphoma is associated with which of the following genetic abnormality- | [
"t(9:22)",
"del.5q",
"t(8:14)",
"t(17:15)"
] | C | Ans. is 'C' i.e., t(8:14) o t(8:14) is the most common translocation seen in association with Burkin's Lymphoma. # Demonstration ofvety high proliferative fraction and the presence of the t (8:14) or one of its variants t (2:8) or t(8:22) can be confirmatory of Burkiti s lymphoma/leukemia Translocation in Burkitt's Lymphoma Burkitt s lymphoma/leukemias are associated with reciprocal translocations involving the c-myc gene on chromosome 8 | | Most common translocation (70%cases) Less common translocations t (8 : 14): c- may gene on chromosome 8 and lgH heavy chain on chromosome 14 t (8 : 22) c- myc gene on chromosome 8 and l-light chain on chromossome 22 t (2 :8): c- mye gene on chromosome 8 and l-light chain on chromosome -2 | train | med_mcqa | null |
A 43-year-old window cleaner fell off a scaffold. He sustained an open wound on the right leg. Debridement was carried out in the emergency department, and the edges of the wound were left open.Which factor is least likely to inhibit wound contraction? | [
"Radiation",
"Cytolytic drug",
"Transformation growth factor b",
"Full-thickness skin graft"
] | D | Following the application of a full-thickness graft, contraction at the site of the recipient site is maximally inhibited by a full-thickness and to a lesser extent by the partial-thickness graft. | train | med_mcqa | null |
IMNCI differs from IMCI in all of the following, EXCEPT: | [
"Malaria and anemia are included",
"0-7 days neonates are included",
"Emphasis on management of sick neonates over sick older children",
"Treatment is aimed at more than one disease at a time"
] | D | Integrated management of childhood illnesses (IMCI) is a strategy developed by WHO and UNICEF to manage childhood illnesses in a integrated way. The diseases included are diarrhea, malaria, ARI, malnutrition and measles. IMCI was launched in four selected districts each in in Uttranchal, Madhya Pradesh, Orissa, Rajasthan, Maharashtra, Gujarat, Delhi, Haryana and Tamilnadu. The Indian version of IMCI has been named as Integrated Management of Neonatal and Childhood Illnesses (IMNCI). Strategies wise both interventions differ in their principles; but both focus on treating more than one disease at a time. Both of them follow a horizontal approach for management of diseases. Ref: Park's Textbook of Preventive and Social Medicine, 19th Edition, Pages 372, 461; The State of the World's Children: Child Survival By UNICEF, Page 35. | train | med_mcqa | null |
Reflux oesophagitis is common in which type of Hiatus Hernia | [
"Sliding type of Hiatus Hernia",
"Paraoesophageal type of Hiatus Hernia",
"Both",
"None"
] | A | HIATUS HERNIA It is displacement of stomach into the chest through oesophageal opening of the diaphragm. Most patients are elderly, past 40 years. This disorder is of two types: 1. Sliding:- Stomach is pushed into the thorax, in line with the oesophagus. Reflux oesophagitis is common and may give rise to ulceration and stenosis. Haematemesis may occur. It is caused by raised intra-abdominal pressure. 2. Paraoesophageal: A pa of the stomach along with its peritoneal covering passes up into the thorax by the side of oesophagus. The gastro-oesophageal junction still remains below the diaphragm and the angle between oesophagus and stomach is maintained. There is no reflux oesophagitis in this type of hernia. The main symptom is dyspnoea on exeion due to position of stomach in the thorax and sometimes bleeding. Ref:- Dhingra; pg num:-343 | train | med_mcqa | null |
X-ray finding of ostemyelitis within 8 day is: | [
"Cystic swelling",
"Soft tissue swelling",
"New bone formation",
"Seyuestrum formation"
] | B | B i.e. Soft tissue swelling Radiological features of Acute osteomyelitis: < 7 days Soft tissue swellingQ > 10 days Periosteal reactionQ After 2-6 weeks Lytic changesQ when 50-75% of bone density has been lost | train | med_mcqa | null |
All of the following are true about mitral valve prolapse, except | [
"Commonly associated with marfan's syndrome",
"Valve leaflets show myxomatous changes",
"Majority of cases present with mitral regurgitation",
"Also known as Barlow syndrome"
] | C | MItral valve prolapse is generally asymptomatic. | train | med_mcqa | null |
After an accident a male patient had come for his routine evaluation. His RBCs showed Cabot's ring. What is the likely condition responsible? | [
"Acquired hemolytic anemia",
"Hemochromatosis",
"Thalassemia",
"After splenectomy"
] | D | Cabot'srings are red cell inclusions consist of mitotic spindle remnants appearing as fine, threadlike filaments of bluish purple color in the shape of a single ring or a double ring (figure-eight shape). They stain red or reddish purple with Wright's stain and have no internal structure. These are arginine rich and acidophilic. Cabot's rings are present in anemia (severe, pernicious), lead poisoning, myelofibrosis, and myeloid metaplasia, but are typical of post splenectomy. Ref: Medical Laboratory Technology By Sood, 2005, Page 201 ; Wintrobe's Clinical Hematology, 11th Ed p. 22 Table 1.4 ; Laboratory Medicine Hematology 6th ed. CV Mosby Co., 1982, p. 488 | train | med_mcqa | null |
Frusemide acts on | [
"Ascending limb of LOH",
"PCT",
"DCT",
"Collecting duct"
] | A | Ans: a (Ascending limb of Ref: Katzung 11th edLoop diuretics selectively inhibit NaCl reabsorption in the Thick Ascending Limb.Frusemide is a loop diuretic. Because of the large NaCl absorptive capacity of this segment and the fact that the diuretic action of these drugs is not limited by development of acidosis, which is usually seen with the carbonic anhydrase inhibitors.Loop diuretics are the most efficacious diuretic agents currently availableSegmentFunctionsDiuretic with Major ActionGlomerulusFormation of glomerular filtrateNoneProximal convoluted tubule (PCT)Reabsorption of 65% of filtered Na+/ K+/ CA2+, and Mg2+; 85% of NaHC03 , and nearly 100% of glucose and amino acids. I sos mo tic reabsorption of water.Carbonic anhydrase inhibitorsProximal tubule, Straight segmentsSecretion and reabsorption of organic acids and bases, including uric acid and most di ureticsNoneThin descending limb of Henl e's loopPassive reabsorption of waterNoneThick ascending limb of Henle's loop (TAL)Active reabsorption of 15-25% of filtered Na7 K7 CP; secondaryreabsorption of Ca2+ and Mg2+Loop diureticsDistal convoluted tubule (DCT)Active reabsorption of 4-8% of filtered Na+ and Cl"; Ca2+ reabsorption under parathyroid hormone controlThiazidesCortical collecting tubule (CCT)Na+ reabsorption (2- 5%) coupled to K+ and H+ secretionK+-s paring diureticsMedullary collecting ductWater reabsorption under vasopressin controlVasopressin antagonist | train | med_mcqa | null |
The histology of pterygium includes - | [
"Elastotic degeneration",
"Epithelial inclusion bodies",
"Precancerous changes",
"d) Squamous metaplasia of the epithelium"
] | A | Pathologically pterygium is a degenerative and hyperplastic condition of conjunctiva. The subconjunctival tissue undergoes elastotic degeneration and proliferates as vascularised granulation tissue under the epithelium, which ultimately encroaches the cornea. The corneal epithelium, Bowman&;s layer and superficial stroma are destroyed. ref: A K KHURANA OPHTALMOLOGY,E4, Page-80 | train | med_mcqa | null |
Which of the following is NOT a cause of congenital hypercoagulability aEUR' | [
"Protein C deficiency",
"Protein S deficiency",
"Antiphospholipid antibody syndrome",
"MTHFR gene mutations"
] | C | Antiphospholipid antibody syndrome Congenital Factor V Leiden (5% of the population are heterozygous for FVL). Prothrombin mutation (G20210A, 5'UTR). High homocysteine levels due to MTHFR mutation Sickle-cell disease (only small risk) Antithrombin III deficiency. Protein C deficiency. Protein S deficiency. Plasminogen and fibrinolysis disorders (very rare) Acquired Antiphospholipid antibodies - Anti-cardiolipin antibodies and/or - Lupus anticoagulants Heparin-induced thrombocytopenia Paroxysmal nocturnal hemoglobinuria Nephrotic syndrome Hyperestrogenemia Estrogen-containing honnonal contraceptives Tobacco smoking Hyperhomocysteinemia due to vitamin B12 and folic acid deficiency | train | med_mcqa | null |
The differential diagnosis of lesion, histologically resembling giant cell tumour in the small bones of the hands or feet, includes all of the following except: | [
"Aneursymal bone cyst",
"Fibrosarcoma",
"Osteosarcoma",
"Hyperparathyroidism"
] | B | Ans. is 'b' i.e. Fibrosarcoma Histological differential diagnosis of Giant cell tumorGiant cell reparative granuloma (a benign reactive condition)Brown tumor of hyperparathyroidism Non-ossifying fibroma Benign fibrous histiocytoma Aneurysmal bone cyst Osteosarcoma with prominent giant cells.Metastatic ca with giant cells. | train | med_mcqa | null |
Dates are rich source of - | [
"Calcium",
"Iron",
"Vit C",
"Carotene"
] | A | In dates calcium present is 120mg,vitamin C is 3,carotene is 44mg per 100mg of datesREF. PARK'S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICAL 21ST EDITION. PAGE NO - 581 | train | med_mcqa | null |
Trial of labour is given in minimal contraction of : | [
"Brain",
"Midcavity",
"Inlet",
"Moderate contracted pelvis"
] | C | Inlet | train | med_mcqa | null |
All of the following are derived from the pharyngeal orches except : | [
"Tensor tympani",
"Palatine tonsils",
"Mylohyoid",
"Tensor veli palatine"
] | B | Platine tonsils from 2 endodermal pouch. | train | med_mcqa | null |
A 5-yr old boy presents with pubic hair development. He is tall and has increased pigmentation of his genitalia and phallic enlargement. Blood pressure is 130/90 mm Hg. Measurement of which of the following hormones would be most likely to be diagnostic? | [
"Increase 17b hydroxyl progesterone",
"Increase cortisol",
"Increase aldosterone",
"Increase 11 deoxycortisol"
] | D | Ans. is 'd' i.e., |11-Deoxycortisol Presence of Precocious puberty in a male child and hypertension (BP of 130/80 in a 5 year old child is considered hypertension) suggests a diagnosis of congenital adrenal hyperplasia due to 11-b Hydroxylase deficiency.11-b Hydroxylase deficiency.Deficiency of 11-b hydroxylase (CYP11B1) results in decreased conversion of 11-deoxycortisol and 11- deoxycorticosterone to cortisol and corticosterone, respectively.The decrease in cortisol production causes an increase in corticotropin (ACTH) secretion. The resulting adrenal stimulation leads to excessive production of 11-deoxycortisol, 11- deoxycorticosterone, and adrenal androgens.The clinical manifestations of the disorder result from excess adrenal androgens and the mineralocorticoid actions of 11-deoxycorticosterone;11-deoxycortisol has little biological activity.Clinical manifestationsNeonates Male - Ambiguous genitalia Female - Penile enlargementChildhood (sexual precocity)Both male and female child present with sexual precocity, early pubertyClinical features that would be present irrespective of age group and sexHypertensionHypokalemiaIncreased pigmentation increased ACTHHypertension and hypokalemia is seen in most of the patients due to increase in 11 deoxycorticosterone level.Hypertension and hypokalemia differentiates it from 17a hydroxylase deficiency.Lab diagnosis * Patients with CYP11B1 deficiency have a characteristic set of hormonal findings.High serum concentrations of 11-deoxycortisol, 11-deoxycorticosterone, and the androgens dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEA sulfate), androstenedione, and testosterone.Increased urinary excretion of the tetrahydro metabolites of 11-deoxycortisol and 11-deoxycorticosterone, which are normally present in trace quantities.Urinary 17-hydroxycorticosteroid excretion is high, because 11-deoxycortisol reacts in the assay for these steroids. Urinary excretion of 17-ketosteroids, most of which are androgen metabolites, is also increased.Congenital adrenal hyperplasiaCongenital adrenal hyperplasia is a group of autosomal recessive disorder characterized by deficiency of an enzyme involved in the synthesis of cortisol or aldosterone or both.Clinical manifestations * The clinical manifestations are related to the degree of cortisol deficiency and / or the degree of aldosterone deficiency. In some cases these reflect the accumulation of precursor hormones.Clinical presentation in Males21 hydroxylase deficiency (Testosterone production increased)Generally not identified in the neonatal period because the genitalia are normal Toddlers present with signs of puberty.These male neonates present at age 1-4 weeks with failure to thriveRecurrent vomitingShock17 hydroxylase deficiency, 3 b hydroxysteroid dehydrogenase deficiencyAmbiguous genitalia (because of inadequate testosterone production in first 3 months of life).Clinical presentation in Females21 hydroxylase, 11 b hydroxylase, 3 b hydroxysteroidThey have ambiguous genitalia at birth due to excess androgen production in utero.17 hydroxylase deficiencyFemales appear phenotypically female at birth but later on in life do not develop breast or menstruate absence of estrogen.Diagnosis of congenital adrenal hyperplasiaThe common feature of all the congenital adrenal hyperplasia is:- - Inadequate production of cortisol, aldosterone or both in the presence of accumulation of excess concentrations of precursor hormones.Cortisol and aldosterone deficiency is common to all congenital adrenal hyperplasia the distinguishing feature is the accumulation of excess concentration of precursor hormones.Elevated precursor in 21 hydroxylase deficiencyHigh serum concentration of 17 hydroxyprogesteroneIncreased concentration of urinary pregnanetriol (metabolite of 17 hydroxy progesterone's)Elevated precursor hormones in 11 b hydroxylase deficiencyExcess concentration of 11 deoxy cortisol and deoxy-corticosterone.Elevation in the ratio of 24 hour urinary tetra hydro-compound S to tetrahydro compound F.Both are accompanied by elevated levels of 24 hour urinary 17 ketosteroids, the urinary metabolites of adrenal androgens.Elevated precursor hormones in 3 b hydroxysteroid dehydro- genase deficiency * Abnormal ratio of -17 hydroxypregnenolone to 17 hydroxyprogesterone and- Dehydroepiandrostenedione to AndrostenedioneMore on congenital adrenal hyperplasia 21 a hydroxylase deficiencyTwo forms of this deficiency include -Salt wasting adrenogenital ismSimple Virilizing adrenogenital ismA) Salt wasting syndrome (complete lack)The salt wasting syndrome results from complete lack of 21 hydroxylase. There is no synthesis of mineralocorticoids and glucocorticoids in the adrenal cortex.Decreased mineralocorticoids causes marked sodium loss in the urine, resulting in hyponatremia, hyperkalemia, acidosis and hypotension.Because of the enzyme block, there is increased formation of 17 - hydroxyprogesterone, which is then shunted into the production of testosterone.This may cause "virilization" (pseudo-hermaphroditism) in female infants. That is (XX) Female with 21 hydroxylase deficiency develops ovaries, female ductal structures and external male genitalia.But in the male child the effect of increased testosterone will not be manifested at the time of birth. Toddlers will present with signs of puberty.The complete 21 hydroxylase deficiency or salt wasting syndrome usually comes to light only after the birth because in utero the electrolytes and fluids can be maintained by maternal kidneys.Males with this disorder comes to clinical attention 5 to 15 days later because of salt losing crisis while females comes to attention soon after the birth because of the virilization.B) Simple Virilizing adrenogenital syndrome (Partial deficiency)Occurs in individuals with partial deficiency of 21 hydroxylaseLess severe deficiency of mineralocorticoid, is sufficient for salt reabsorption, but the lowered glucocorticoid fails to cause feedback inhibition of ACTH secretion. Thus level of aldosterone is mildly reduced testosterone increased and ACTH elevated with resultant adrenal hyperplasia.11b hydroxylase deficiency -RareLeads to decreased cortisol and increased ACTH.This in turn leads to the accumulation of DOC (deoxycorticosterone) and 11 deoxy cortisol both of which are strong mineralocorticoids. This results in increased sodium retention by the kidneys and hypertension, hypokalemia.Patients also develop virilization due to androgen excess.17 a hydroxylase deficiency -Patients with deficiency of 17 hydroxylase also have impaired cortisol production, increased ACTH and secondary increased DOC.These patients, however, cannot synthesize normal amount of androgens and estrogens.This is because the gene that codes for 17 a hydroxylase is the same for the enzyme in the adrenal cortex and the gonads and the deficiency is same in both organs.Because of decreased sex hormones genotypic females develop primary amenorrhoea and fail to develop secondary sex characterize tics while genotypic males will present as pseudohermaphrodite. | train | med_mcqa | null |
Block veebrae are seen in | [
"Pagets disease",
"Leukemia",
"TB",
"Klippel-Feil syndrome"
] | D | A block veebra is a type of veebral anomaly where there is a failure of separation of two or more adjacent veebral boidesAssociationsThere is a frequent association with hemiveebrae/absent veebra above or below block level, posterior element fusionFusion of multiple cervical veebral bodies is also seen in Klipple-Feil syndrome and VACTREL anomaly(Refer: Mohindra's Fundamentals of Ohopedics, 2nd edition, pg no. 380 - 381) | train | med_mcqa | null |
Function of endonucleases: | [
"Cut DNA at specific DNA sequences",
"To point out the coding regions",
"Enhancers",
"To find out antibiotic resistance"
] | A | Ans. A. Cut DNA at specific DNA sequences(Ref: Harper 31/e page433)Restriction endonuclease cut DNA at specific palindromic sites.These enzymes are isolated from bacteria.They restrict the entry of phages into the bacteria. | train | med_mcqa | null |
Safest radiological investigation in pregnancy is- | [
"CT",
"MRI",
"X-ray",
"HRCT"
] | B | Ans is 'b' i.e. MRI * "The American college of radiology (ACR) advices that pregnant patients can undergo MRI without risks for the fetus" - MRI of fetal and maternal diseases in pregnancy; p 439Other advantaged and disadvantages of MRIAdvantagesDisadvantages* Static and cine or movie images* Multiple plane images* Good contrast* No known health hazard* No ionizing radiation* Excellent soft tissue differentiation* Good for soft tissue injuries of knee, ankle, shoulder* Better than CT in visualizing vascular structures* More expensive than CT* Long scan time may result in motion artifacts* Limited availability* Not good for calcified lesions and bone (CT is better) | train | med_mcqa | null |
Ewing's tumour arises from- | [
"Mesothelial cell",
"Endothelial cell",
"Squamous cell",
"None of the above"
] | D | Ans. is 'd' i.e., None of the above o Ewig's sarcoma arises from primitive neuroectoderm. | train | med_mcqa | null |
Successful fertilization is most likely to occur when the oocyte is in: | [
"The oviduct and has entered the second meiotic division",
"The uterus and has completed the first meiotic division",
"Metaphase of mitosis",
"The graafian follicle, which then enters the oviduct"
] | A | Ans. A. The oviduct and has entered the second meiotic divisionFertilization occurs in the oviduct. The oocyte must have entered a second meiotic division to reduce the chromosome number of the oocyte to a haploid state (n) so that it may fuse with the sperm (also haploid), producing a 2n zygote. Fertilization does not occur in the uterus, especially not after the first meiotic division when the chromosome number is 2n. In the adult ovary, oocytes do not undergo mitosis. Graafian follicles do not enter the oviduct and are not fertilized. Fertilization does not occur in the uterus, and the oocyte does not implant. The blastocyst will implant in the uterus. In addition, extrusion of the polar body is associated with fertilization, but this event occurs within the oviduct. | train | med_mcqa | null |
A 20-year-old female on OCPs resented with behaviour changes & abdominal pain most probable diagnosis is - | [
"SLE",
"Acute intermittent porphyria",
"Pancreatitis",
"Aortic aneurysm"
] | B | null | train | med_mcqa | null |
Mesothelioma is caused by - | [
"Asbestosis",
"Silicosis",
"Baggasosis",
"Anthracosis"
] | A | - asbestos enters the body by inhalation and fine dust may be deposited in the alveoli. - the dust deposited in the lungs causes pulmonary fibrosis leading to respiratory insufficiency and death. - also causes mesothelioma of the pleura or peritoneum. Reference: Park's textbook of preventive and social medicine, 23rd edition, pg no:807 <\p> | train | med_mcqa | null |
Urban malaria is spread by | [
"Anopheles stephensi",
"Anopheles culcifacies",
"Culex fatigans",
"Mansonides"
] | A | Anopheles.culicifacies is the main vector of rural and peri-urban areas Anopheles.stephensi is responsible for malaria in urban and industrial areas Ref: Park's textbook of preventive and social medicine; 23rd edition | train | med_mcqa | null |
Drug that is safe in G6PD deficiency: | [
"Primaquine",
"Acetanilide",
"Quinidine",
"Dapsone"
] | C | c. Quinidine(Ref: Nelson's 20/e p 2335, Ghai 8/e p 339)Quinidine does not carry risk of hemolysis in persons with G-6-PD deficiency. | train | med_mcqa | null |
False regarding lateral geniculate body | [
"Part of thalamus",
"M Cells are responsible for Depth",
"P Cells are responsible for movement",
"None of the above"
] | C | P cells are responsible fo color, texture, contrast. | train | med_mcqa | null |
Which of the following chromosomal abnormalities is most likely to cause mental retardation? | [
"Klinefelter's syndrome",
"Fusion of chromosomes 21 and 15",
"Turner's syndrome",
"Trisomy 21"
] | D | Ans. D. Trisomy 21An extra chromosome 21 is the most common genetic abnormality found in Down syndrome, and the abnormality most likely to cause mental retardation. Abnormalities in autosomal chromosomes are, in general, associated with mental retardation. The chromosomal aberration represented by 46 chromosomes with fusion of 15 and 21 produces a type of Down syndrome that, unlike trisomy 21, is usually inherited. Aberrations in sex chromosomes are not always associated with mental retardation, such as in XO (Turner's syndrome), XXY (Klinefelter's syndrome), and XXYY and XXXY (Klinefelter's syndrome variants) genotypes.Some children with Turner's syndrome have normal to superior intelligence.Girls with Turner's syndrome have gonadal agenesis and do not develop secondary sexual characteristics without medical intervention. Another hallmark feature is a webbed neck. In Klinefelter's syndrome and its variants, individuals have underdeveloped male genitalia and infertility and may develop gynecomastia beginning in adolescence. | train | med_mcqa | null |
Which of the following is Pan leukocyte marker | [
"CD19",
"CD3",
"CD45",
"CD45 RO"
] | C | CD 45 is Pan leukocyte marker.
CD 45 RO is marker for MEMORY cell. | train | med_mcqa | null |
Characteristics of normal distribution curve includes: | [
"Bell Shaped",
"Symmetrical",
"Mean=median=mode=0",
"All of the above"
] | D | Characteristics of normal distribution curve:
Bell Shaped
Symmetrical
Asymptotic – The two tails never touches the X-axis
Standard deviation = variance
Mean=median=mode=0 (Coincide) | train | med_mcqa | null |
Which of the following is true of chicken pox ? | [
"Virus not found in scab",
"Virus can be grown on the chick embryo",
"Caused by RNA virus",
"Does not cross the placental barrier"
] | A | Ans. is 'a' i.e., Virus not found in scab The fluid of vesicle of chickenpox contains virus during first 3 days of illness, but scab is noninfective. About other options Option b VZV does not grow in experimental animal or chick embryo. It can be grown in tissue culture cell lines ---> Human fibroblast, hela cells, vero cells. o Option c VZV is a DNA virus. o Option d VZV can cross placenta and infect the fetus. | train | med_mcqa | null |
Which of these types of asbestos is LEAST associated with mesothelioma -a) Chrysoliteb) Crocidolitec) Amosited) Tremolite | [
"a",
"bc",
"ac",
"b"
] | C | null | train | med_mcqa | null |
Addison's disease is characterized by following except- | [
"Hyperkalemia",
"Hypotension",
"Hyponatremia",
"Hvnncalcemia"
] | D | there is hyper pigmentation, asthenia, hypotension,hyperkalemia, hyponatremia Ref -( Harrison 17 pg 2263) | train | med_mcqa | null |
Anti tobacco day is: September 2009 | [
"1May",
"15-May",
"25-May",
"31-May"
] | D | Ans. D: 31st May World No Tobacco Day is observed around the world every year on May 31. It is meant to encourage a 24-hour period of abstinence from all forms of tobacco consumption across the globe. | train | med_mcqa | null |
Seventh, Ninth ant Tenth cranial nerves end in? | [
"Nucleus Tractus Solitarius",
"Nucleus Ambiguous",
"Nucleus Ambiguous",
"Nucleus Ambiguous"
] | A | A i.e. Nucleus tractus solitarius- Dorsal nucleus of vagus, Edinger westphal nucleus & salivatory (superior & inferior) nucleus lie in General visceral efferent columnAll the skeletal muscles (except for those derived from branchial arch) are supplied by nerves containing general somatic efferent nucleus. Branchial arch muscles are supplied by cranial nerves containing special viscera efferent nucleus. So 5th), 7, 9, 10, 11and 12 have special visceral component, where as cranial nerves responsible for eye and tongue movements i.e., 3rd, 4th, 6th and 12th (hypoglossal nucleus) have general somatic efferent component.In the same way peripheral nerves supplying skeletal muscles (eg musculocutaneous nerve supplying biceps brachi muscle) also possess GSE component.7th, 9th, 10th cranial nerves end in nucleus trachus solitaries | train | med_mcqa | null |
Which of the following aeries supply pectoralis major muscle?1. Pectoral branches of thoracoacromial aery2. Intercostal aery3. Lateral thoracic aery4. Subclan aery5. Internal mammary aery | [
"1, 2 & 3",
"2, 3 & 4",
"1, 2 & 5",
"1, 2, 4 & 5"
] | C | Blood supply of pectoralis major: Pectoralis major derives it blood supply mainly from pectoral branch of the thoracoacromial aery.Other aeries supplying the muscle are: First perforating branch of the internal thoracic aery (Internal mammary aery) and intercostal aery. | train | med_mcqa | null |
In humans, the end product of purine metabolism is uric acid. End product of purine metabolism in non-primate mammals is: | [
"Uric acid",
"Ammonia",
"Urea",
"Allantoin"
] | D | Humans conve adenosine and guanosine to uric acid. Adenosine is first conveed to inosine by adenosine deaminase. In mammals other than higher primates, uricase conves uric acid to the water-soluble product allantoin. However, since humans lack uricase, the end product of purine catabolism in humans is uric acid. Ref: Rodwell V.W. (2011). Chapter 33. Metabolism of Purine & Pyrimidine Nucleotides. In D.A. Bender, K.M. Botham, P.A. Weil, P.J. Kennelly, R.K. Murray, V.W. Rodwell (Eds), Harper's Illustrated Biochemistry, 29e. | train | med_mcqa | null |
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