question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4
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Foetal hea sound can be seen by transvaginal doppler from : | [
"5th week",
"10th week",
"8th week",
"None of the above"
] | A | 5th week | train | med_mcqa | null |
Bipolar staining is seen in- | [
"Bacillus anthracis",
"Yersinia pestis",
"Proteus vulgaris",
"Klebsiella pneumonia"
] | B | Organisms with bipolar staining: Staining at poles better In between poorly stained (like safety pin appearance) Seen in: Yersinia pestis Klebsiella granulomatis Burkholderia mallei Burkhoolderia pseudomallei Vibrio parahaemolyticus Haemophilus ducreyi Yersinia pestis: Gram-negative oval coccobacilli with rounded ends surrounded by capsule. Wayson stain /Giemsa: Demonstrates bipolar appearance (safety pin appearance) with both ends densely stained and a clear central area of the bacteria. Option 1 - Gram staining of Bacillus anthracis: Gram positive chain of bacilli arranged in bamboo stick appearance. Option 3, 4 - Proteus vulgaris or mirabilis - GNB (gram negative bacteria) - Klebsiella pneumonia - Capsulated GNB | train | med_mcqa | null |
"Multibacillary" is a spectrum of disease, seen in- | [
"Leprosy",
"TB",
"Tetanus",
"Trachoma"
] | A | Ans. is 'a' i.e., Leprosy | train | med_mcqa | null |
Which of the following can be given orally aEUR' | [
"Cytosine ara",
"Actinomycin D",
"Doxorubicin",
"Mesna"
] | D | Mesna MESNA is given alongwith alkylating agents to prevent nephrotoxicity due to cyclophosphanzide. Cyclophosphamide and Ifosfamide are alkylating agents that release a nephrotoxic and urotoxic metabolite -> Acrolein. Acrolein causes severe hemorrhagic cystitis. MESNA is administered to prevent hemorrhagic cystitis. MESNA conjugates with Acrolein and forms a nontoxic compound. It can be administered intravenously or orally. Mesnex injection is given as intravenous bolus injection in a dosage equal to 20% of the ifosfamide dosage at the time of ifosfamide administration whereas Mesnex tablets are given orally in a dose equal to 40% of the Ifosfamide dose 2 and 6 hours after each dose of Ifosfamide. The total daily dose of mesna is 100% of the ifosfamide dose. Cytarabine Cytarabine (Ara C) is degraded by the enzyme cytidine deaminase. Cytidine deaminase is present in high concentrations in g.i. tract therefore only about 20% of the drug reaches the circulation after oral Ara-C administration. Thus the drug must be given intravenously. Dactinomycin or Actinomycin D It is administered by intravenous route. Doxorubicin It is administered intravenously and are cleared by complex pattern of hepatic metabolism and biliary excretion. | train | med_mcqa | null |
Crude bih rate is a simplest measure of feility because it includes | [
"Total population",
"Mid year population",
"Live bihs only",
"Pre term bihs"
] | B | Crude bih rate : Number of live bihs in a year per 1000 mid-year population CBR is simplest indicator of feility : Total mid-year population is not exposed to Child bearing thus it doesnot give true idea of feility Ref: Park 25th edition Pgno : 539 | train | med_mcqa | null |
While investigating an epidemic, search for more cases is continued till what period ? | [
"Twice the incubation period of the disease since occurrence of the last case",
"Thrice the incubation period of the disease since occurrence of the case",
"The longest incubation period for the disease",
"Incubation period for the disease plus two standard deviations"
] | A | null | train | med_mcqa | null |
Cryptococcal meningitis is common in: | [
"Renal transplant recipient",
"A gamma globulinemia",
"Neutropenia",
"IgA deficiency"
] | A | Ans. is 'a' i.e., Renal transplant recipientPredisposing factors of cryptococcal meningitis are AIDS, hematologic malignancies, transplant recipients and patients on immunosuppressive or steroid therapy. | train | med_mcqa | null |
Opsonization takes place through- | [
"C3a",
"C3b",
"C5a",
"C5b"
] | B | 1. All the three complement activation pathways(classical , alternate , lectin) lead to activation of C3, resulting in the production of C3b. Hence, C3b is considered as the central molecule in the activation of the complement cascade. 2. The C3b has two impoant functions to perform First, it combines with other components of the complement system to produce C5 convease, the enzyme that leads to the production of membrane attack complex(MAC) Second, it opsonizes bacteria due to the presence of receptors for C3b on the surface of the phagocytes. Biological Effects of Complement C5a: C5a is a chemotactic molecule specifically recognized by polymorphonuclear leukocytes or phagocytic cells. This substance causes leukocytes to migrate to a tissue in which an antigen-antibody reaction is taking place. At that site, a phagocytic cell recognizes opsonized paicles and ingests them. | train | med_mcqa | null |
Most common site for carcinoma cervix is : | [
"Endocervix",
"Ectocervix",
"Near the internal os",
"Vault"
] | B | Ectocervix | train | med_mcqa | null |
Not a radiosensitizing drug ? | [
"5-Fu",
"BUDR",
"Cyclophosphamide",
"Hydroxyrea"
] | C | Ans. is'c'i.e., Cyclophosphamide lRef. Cancer nursing: Principles & practice p. 256Clsplatin and 5-FU - Most common radiosensitive drugs. | train | med_mcqa | null |
Which of the following is true about a child with severe acute malnutrition? | [
"His height for age should be < -3 z score",
"His weight for age should be < -3 z score",
"His weight for height should be < -3 z score",
"His mid arm circumference should be < 13.5 cm"
] | C | Diagnostic criteria for severe acute malnutrition in children between 6 months to 5 year age include: 1. Weight/height or Weight/length < -3 Z score, using the WHO Growth Standards 2. Presence of bipedal edema of nutritional origin 3. Mid- upper arm circumference (MUAC) < 115 mm Criteria for discharge of a child with severe acute malnutrition from hospital include: Child should have lost edema & staed gaining weight All infections & micro nutrient deficiencies should have been taken care of Child's appetite should have improved & he should be accepting well orally Mother should be confident of taking care of child at home | train | med_mcqa | null |
Which one of the following is the most common problem associated with the use of condom: | [
"Increased monilial infection of vagina",
"Premature ejaculation",
"Contact dermatitis",
"Retention of urine"
] | C | Directions for use of condom
The condom should be put on by unrolling it over the erect penis after pulling back the foreskin, before there is any contact between the male and female organs. An airfree space should be left by squeezing the tip and holding it up, till it is unrolled fully for better collection of semen.
It should be used only once.
It should not be inflated for testing.
Vaseline oils, skin lotions, cold creams, should not be used as they increase the chance of rupture. If lubrication is needed, glycerine, K-Y jelly or spermicidal jelly can be used.
Soon after discharge, the male should withdraw the penis holding the condom firmly against his body
To increase the effectiveness, a dose of spermicidal jelly or foam tablet may be used at the same time. In case of breakage, slippage, or defective use, women should report or use emergency contraceptive within 72 hours and a spermicidal agent should be quicldy inserted into the vagina.
Advantages of condom
Condoms gives very good protection against STDs. These includes syphilis gonorrhea, trichomoniasis, moniliasis, nongonococcal urethritis, and infection with Chlamydia and Herpes virus.
They are the only contraceptives to protect against HIV and against sexually transmitted hepatitis B Virus.
Condoms reduce the chances of developing cervical dysplasia and cancer cervix (by preventing HPV infection)
Disadvantages
It can lead to contact dermatitis in female partners.
Failure rate 12% | train | med_mcqa | null |
Name the technique which usually involves teaching the patient how to induce a state of deep muscle relaxation and describing imaginary scenes relevant to his fear: | [
"Desensitization",
"Contingency management",
"Hypnosis",
"None"
] | A | Desensitization: The technique usually involves teaching the patient how to induce a state of deep muscle relaxation and describing imaginary scenes relevant to his fear.
Indications of desensitization are:
Child's initial visit.
At subsequent appointments when introducing dental procedures which are new to the patient.
When treating referral patients. | train | med_mcqa | null |
A 19 year old male came for routine physical examination prior to playing for a college basketball team. He takes no medications and has no allergies. In his family history his father & his uncle died at the age of around 40 with sudden cardiac death. However, his mother is healthy. O/E- his height is 195 cm, weight is 92 kg. He has pectus excavatum and arachnodactyly. A high-arched palate is present. He wears glasses for severe myopia and has had ectopia lentis on the right. A diastolic murmur is heard in the left third intercostal space. What will you advise him? | [
"He is not safe for fuher competitive basketball or other strenuous physical activities.",
"He is safe to resume physical activity without fuher evaluation.",
"He may continue to practice with the team while fuher evaluation with an echocardiogram, slit lamp examination, and genetic testing is performed.",
"H... | A | Given clinical presentation is suggestive of Marfan syndrome. Features of Marfan syndrome. Skeletal Cardiovascular Others Long limbs and tall stature Upper segment: lower segment <2 SD Arachnodactyly- long, slender fingers and hands Pectus excavatum/pectus carinatum Scoliosis MVP Dilatation of aoic root Aoic regurgitation Aoic aneurysm Ectopia lentis Spontaneous pneumothorax Inguinal hernia Diagnosis is based on the revised Ghent criteria- major and minor criteria. 4 major criteria Ectopia lentis Dilatation of ascending aoa with/without dissection A blood relative who meets the same criteria With/without DNA diagnosis Fuher workup with echocardiogram and slit-lamp examination will be required in this patient. Sudden death of the patient's father is likely to represent an aoic aneurysm rupture. Because this patient has several clinical features and a murmur concerning for Aoic regurgitation, an echocardiogram would not be required before removing him from fuher strenuous physical activity. | train | med_mcqa | null |
All of the following statements about nateglinide are true except ? | [
"Decreases postprandial hyperglycemia",
"Hypoglycemia is less common than with sulfonylureas",
"It decreases insulin resistance",
"It acts by releasing insulin"
] | C | Sulfonylureas, nateglinide and repaglinide act by inhibiting ATP sensitive K channels and thus resulting in the release of insulin.
Like insulin, all of these drugs can cause hypoglycemia. However, nateglinide therapy produces fewer episodes of hypoglycemia as compared to other oral insulin secretagogue.
Nateglinide and repaglinide are short-acting and thus can reduce post-prandial hyperglycemia. | train | med_mcqa | null |
Gancyclovir is used intravitreallyfor treatment of? | [
"Influenza",
"Rhinovirus",
"HZV",
"CMV retinitis"
] | D | Ans. is 'd' i.e., CMV retinitis Some drugs which are used intravitreally are :? 1) Bevacizumab : inhibits VEGF action; used in metastatic colorectal cancer; off label use as intravitreous injection to slow progression of neovascular macular degeneration. 2) Foscarnet : CMV retinitis. 3) Gancyclovir : CMV retinitis. 4) Ranibizumab : slow macular degeneration. 5) Pegaptanib : neovascular age related macular degeneration. | train | med_mcqa | null |
Not true regarding Argyll robeson pupil | [
"Accomodation reflex present",
"Pupillary reflex present",
"Pupillary reflex absent",
"Seen in Tabes dorsalis"
] | B | Pupillary reflex is absent in Argyll robeson pupil Argyll Robeson pupil Accomodation Reflex present Pupillary Reflex absent Seen in Tabes dorsalis, DM | train | med_mcqa | null |
In a 60-year-old female with polydipsia, water deprivation test was performed and the values obtained are as following -Baseline: Na - 139 mEq, K-3.6mEq. Osm.plasma-274 mosm/l, Osm. urine-150 after vasopressin: Na-142mEq, K-3.9mEq, Plasma osm-271 mosm/ l,Urine osm - 489 mosm/l. These findings suggest a diagnosis of - | [
"Cranial diabetes insipidus",
"Psychogenic polydypsia",
"Nephrogenic diabetes insipidus",
"SAIDH"
] | A | null | train | med_mcqa | null |
Advantage of epidural anaesthesia includes all except: | [
"Adequate analgesia",
"Reduced blood loss",
"Reduced stress response of surgery",
"Slow onset"
] | D | • Advantages of epidural anaesthesia
Profound analgesia
Profound muscle relaxation
No need for intubation
Reduction of surgical haemorrhage
Excellent post operative analgesia
Reduced stress and respons | train | med_mcqa | null |
The pathognomonic feature of rheumatic hea disease is | [
"Aschoff nodule",
"Caterpillar cell",
"McCallum plaques",
"Fibrinous pericarditis"
] | B | During acute RF, distinctive lesions occur in the hea, called Aschoff bodies, consisting of foci of T lymphocytes, occasional plasma cells, and plump activated macrophages called Anitschkow cells (pathognomonic for RF). These macrophages have abundant cytoplasm and central round-to-ovoid nuclei (occasionally binucleate) in which the chromatin condenses into a central, slender, wavy ribbon (hence the designation "caterpillar cells"). | train | med_mcqa | null |
Normal curve | [
"Distribution of data is symmetrical",
"Mean > Mode",
"Mode > Mean",
"Median > Mean"
] | A | Ref:Parks 23rd edition pg 849 Stadardised normal curve : Smooth, bell-shaped, perfectly symmetrical curve based on an infinitely large number of observations . Total area of the curve= 1 Mean= 0 Standard detion = 1 Mean, median and mode all coincide. | train | med_mcqa | null |
Gemcitabine is used mainly in which cancer ? | [
"Colorectal",
"Breast",
"Pancreatic",
"Cranipharyngioma"
] | C | Ans. is 'c' i.e., Pancreatic | train | med_mcqa | null |
Which of these is present midway between the anterior superior iliac spine and the pubic symphysis? | [
"Deep inguinal ring",
"Superficial ring",
"Femoral aery",
"Intra epigastric aery"
] | C | Midway between the anterior superior iliac spine and the pubic symphysis in midinguinal pointIt&;s landmark for femoral aery | train | med_mcqa | null |
Which of the following technique is used to treat fibrous ankylosis: | [
"Condylectomy.",
"Gap arthroplasty.",
"Interpositional gap arthroplasty.",
"Any of the above."
] | A | null | train | med_mcqa | null |
Which one of the following acts as second messenger? | [
"Mg++",
"Cl-",
"Ca++",
"P04+3"
] | C | Ans. is 'c' i.e. Ca++ Second messengers are molecules that relay signals received at receptors on the cell surface (such as the arrival of protein hormones, growth factors, etc.) to target molecules in the cytosol and/or nucleus.Not only they relay the signals, they greatly amplify the strength of the signal.There are three major classes of second messengers.cyclic nucleotides (e.g. cAMP & cGMP)products of membrane phospholipid breakdown-inositol triphosphate (1P3) and diacyl glycerol (DAG)calcium ionsCalcium ions are probably the most widely used second messengers. | train | med_mcqa | null |
Resting muscle length means? | [
"Length of actin and myosin before contraction",
"The length of the muscle fiber at the onset of contraction which is required to attain maximum active tension",
"It is about 4 micrometers",
"Length at which muscle has minimal tension"
] | B | Resting length: The length of the muscle fiber at the onset of contraction which is required to attain maximum active tension It is about 2 micrometers. Also known as optimum length. At this state, the ends of actin filaments extending from 2 successive Z disks barely overlap one another. | train | med_mcqa | null |
A 49-year-old woman has had a severe headache for 2 days. On physical examination, she is afebrile and normotensive. Funduscopic examination shows papilledema on the right. One day later, she has the right pupillary dilation and impaired ocular movement. She then becomes obtunded. Which of the following lesions best explains these findings? | [
"Chronic subdural hematoma",
"Frontal lobe abscess",
"Glioblastoma with edema",
"Hydrocephalus ex vacuo"
] | C | The papilledema and the herniation are a consequence of brain swelling, typically the vasogenic form of edema from blood-brain barrier disruption adjacent to the neoplasm. A large aggressive neoplasm, such as glioblastoma, may produce a mass effect via enlargement from rapid growth, hemorrhage, and surrounding edema. The mass effect with herniation of the medial temporal lobe results in a third cranial nerve palsy as the nerve is compressed. A chronic subdural hemorrhage accumulates slowly enough that herniation may not occur. An abscess may cause a mass effect with some associated brain swelling, but this patient is afebrile. There is no pressure effect with hydrocephalus ex vacuo, which is a consequence of cerebral atrophy. An infarct is not likely to produce pronounced associated brain swelling, and a mass effect in the occipital lobe is unlikely to affect the third nerve. Rupture of a berry aneurysm produces subarachnoid hemorrhage at the base of the brain, which is less likely to cause a mass effect. | train | med_mcqa | null |
According to F.D.I formula, the tooth that is denoted by the number 34 is | [
"Upper right temporary first molar",
"Lower right permanent first molar",
"Upper left first premolar",
"Lower left first premolar"
] | D | Each tooth is numbered by the quadrant (1 to 4) and by the tooth within the quadrant (1 to 8) 1 Maxillary right 2 Maxillary left 3 Mandibular left 4 Mandibular right Tooth Numbers Within Each Quadrant: Sta with number 1 at the midline (central incisor) to number 8, third molar so 34 is left lower, 4th tooth (first premolar) Ref - https://en.m.wikipedia.org/wiki/FDI_World_Dental_Federation_notation | train | med_mcqa | null |
All of the following are features of juvenile Myoclonic epilepsy, EXCEPT | [
"Myoclonus on awakening",
"Generalized tonic-clonic seizures",
"Automatism",
"Absence seizures"
] | C | Answer is C (Automatism): 169. Automatism is not seen in Juvenile myoclonic epilepsy Juvenile myoclonic epilepsy is an epilepsy syndrome.' Epilepsy syndromes are disorders in which epilepsy is a predominant feature and there is sufficient evidence to suggest a common underlying mechanism. | train | med_mcqa | null |
Effects mediated by H1 histamine receptor include : | [
"Inhibition of gastric acid secretion",
"Induction of hepatic cytochrome P450 enzymes",
"Maintenance of a wakeful state",
"Vasoconstriction of arterioles"
] | C | null | train | med_mcqa | null |
The reticular formation is a diffuse collection of | [
"Only motor neurons",
"Only sensory neurons",
"Only autonomic centres",
"All of the above"
] | D | (D) All of the above # Reticular formation, the phylogenetically old reticular core of the brain, occupies the midventral portion of the medulla and midbrain.> It is primarily an anatomic area made up of various neural clusters and fibers with discrete functions.> It contains the cell bodies and fibers of many of the serotonergic, noradrenergic, and adrenergic systems.> It also contains many of the areas concerned with regulation of heart rate, blood pressure and respiration> The RAS is a complex polysynaptic pathway. | train | med_mcqa | null |
A 56 year old women presents with post-menopausal bleeding. Her Transvaginal scan shows endometrial thickness of 8mm. Endometrial biopsy shows moderately differentiated adenocarcinoma cells. Which of the following is most appropriate staging investigation | [
"CT - Scan of Pelvis",
"Chest X-ray",
"MRI scan of Pelvis",
"Hysterosalpingography"
] | C | MRI scan is used to determine extent of tumor for staging, so as to plan surgery | train | med_mcqa | null |
Phrynoderma is due to ...deficiency- | [
"Vitamin D",
"Niacin",
"Vitamin A",
"Essential fatty acid"
] | D | Ans. is 'd' i.e., Essential fatty acid In vitamin 'A' deficiency there is toad like skin also known as phrynoderma. o But this is due to associated deficiency of essential fatty acids. | train | med_mcqa | null |
Which of the following enzymes require NAD as cofactor? | [
"Citrate Synthase",
"Isocitrate Dehydrogenase",
"a-Ketoglutarate dehydrogenase",
"Succinate Thiokinase"
] | C | a-Ketoglutarate dehydrogenase REF: Harper 27th ed p. 496 NAD is cofactor in: Lactate dehydrogenase Pyruvate dehydrogenase Alpha ketoglutrate dehydrogenase | train | med_mcqa | null |
Most common cause of non-gonococcal urethritis - | [
"Mycoplasma hominis",
"Mycoplasma genitalium",
"Ureoplasma urealyticum",
"Chlamydia trachomatis"
] | D | Ans. is 'd' i.e., Chlamydia trachomatis urethritisGonococcal Nongonococcal Neisseria gonorrhea Chlamydia Trachomatis (most common) Ureoplasmaurealyticum Mycoplasmagenitalium Bacterioides Haemophilus species Candida albicans T.vaginalis | train | med_mcqa | null |
True about miliary tuberculosis | [
"Occurs following primary reactivation",
"Occurs following secondary reactivation",
"Both primary and secondary reactivation",
"All"
] | D | Military TB is due to hematogenous spread of tubercle bacilli.Although in children,it is often the consequence of primary infection,in adults,it may be due to either recent infection or reactivation of old disseminated foci.The lesions are usually yellowish granulomas 1--2 mm in diameter that resemble millet seeds Reference: Davidson edition23rd pg 589 | train | med_mcqa | null |
Chronic dystentery, abdominal pain, and rectal prolapse in children is caused by - | [
"Enterobius vermicularis",
"Ascariasis",
"Trichuris trichura",
"Trichinella spiralis"
] | C | Infection with T.trichiura (trichuriasis. whipworm infection or trichocephaliasis) is asymptomatic except when the worm load is heavy. Disease may result either due to mechanical effects or allergic reaction. The worms lie threaded into the caecal mucosa and even though it is not a blood feeder, oozing of blood may occur at the sites of attachment. The blood loss is about 0.005 ml per worm per day. Over a period of time this may lead to anaemia and malnutrition. It has been suggested that mechanical blockage of the appendiceal lumen by masses of whipworms may cause acute appendicitis. In heavy infection, the worm may be abundant on the colonic mucosa, even upto the rectum. Mucus diarrhoea, chronic dysentery and abdominal pain are frequently seen in such cases. Some patients, paicularly young children may develop rectal prolapse. REF:TEXTBOOK OF MEDICAL PARASITOLOGY;CKJ PANIKER;6TH EDITION;PAGE NO165 | train | med_mcqa | null |
Carbon monoxide poisoning causes:JIPMER 11; AIIMS 14 | [
"Anemic hypoxia",
"Histotoxic hypoxia",
"Anoxic hypoxia",
"Stagnant hypoxia"
] | A | Ans. Anemic hypoxia | train | med_mcqa | null |
Pituitary secretes all hormones except ? | [
"GH",
"Prolactin",
"Oxytocin",
"Thyroxine"
] | D | Ans. is 'd' i.e., Thyroxine | train | med_mcqa | null |
A 50-year-old man came to the ophthalmologist with the complaint of inability to read newspaper. His vision problem is likely due to inadequate contraction of which of the following structures? | [
"Ciliary body",
"Dilator pupillae",
"Extraocular muscles",
"Suspensory ligaments of lens"
] | A | The process by which the curvature of the lens is increased is called accommodation.If the gaze is directed at a near object, the ciliary muscle contracts. This decreases the distance between the edges of the ciliary body and relaxes the lens ligaments so that the lens springs into a more convex shape. By the time a healthy individual reaches age 40-45 years, the loss of accommodation is usually sufficient to make reading and close work difficult. This condition, which is known as presbyopia, can be corrected by wearing glasses with convex lenses. | train | med_mcqa | null |
Hypeension with hyperkalemia is seen in - | [
"Conns syndrome",
"Gordon's syndrome",
"Addisons disease",
"Renal failure"
] | B | GORDON&;S syndrome with identified mutations of WNK1 and WNK4 (members of a family of serine-threonine kinases) have been shown to cause the rare familial autosomal dominant disease, Gordon&;s syndrome (also known as pseudohypoaldosteronism type II). Wild-type WNK1 and WNK4 inhibit the thiazide-sensitive Na-Cl co-transpoer in the distal tubule. Mutations of these proteins are associated with gain of function and increased co-transpoer activity, excessive chloride and sodium reabsorption, and volume expansion. This syndrome is characterized by sho stature, intellectual impairment, dental abnormalities, muscle weakness, SEVERE HYPEENSION by the third decade of life, low fractional excretion of sodium, normal renal function, hyperchloremic metabolic acidosis, and low renin and aldosterone levels. Hyperkalemia, another hallmark of this syndrome, might be a function of diminished sodium delivery to the coical collecting tubule | train | med_mcqa | null |
Not a pa of informed consent is: | [
"All information should be given about treatment options",
"Concealed information",
"Any treatment option better than the treatment being provided should be told",
"All disclosure should be done in a language that the patient can understand"
] | B | B i.e. Concealed information | train | med_mcqa | null |
Rubella vaccine is given in which age - | [
"1-14 yrs",
"< 5 yrs",
"> 50 yrs",
"None"
] | A | The first priority is to protect women of child bearing age (15 - 34 or 39) years of age
Immunization strategy to prevent congenital Rubella infection
First priority is to protect women of child bearing age (15 - 34 or 39 years)
Next priority is to vaccinate all children currently 1 - 14 years of age (to intercept transmission)
Next priority is to vaccinate all children at one year of age (To intercept transmission)
The programme would then revert to one of routine universal immunization of all children at age one, preferably using combined Measles - Rubella or MMR vaccines | train | med_mcqa | null |
All are true about Ove diabetes complicating pregnancy except | [
"Brain enlargement as a pa of macrosomia",
"Hyperglycemia in infant",
"First trimester aboion",
"Unexplained fetal death"
] | A | Complications MATERNAL FETAL NEONATAL Preeclampsia Polyhydramnios Infections Operative delivery Genital trauma Puerperal sepsis Wound infection Ketoacidosis Early miscarriages Congenital malformations Unexplained fetal demise Prematurity Macrosomia IUGR Respiratory distress syndrome Hypoglycemia Polycythemia Hyperbilirubinemia Hyperviscosity Cardiomyopathy Bih trauma Reference: Textbook of Obstetrics; Sheila Balakrishnan; 2nd edition; Page no: 241 | train | med_mcqa | null |
Prostaglandin E2 analogs can be used for all of the following conditions EXCEPT: | [
"Treatment of patent ductus aeriosus",
"Treatment of bronchial asthma",
"Cervical priming",
"Treatment of NSAID induced peptic ulcer"
] | A | PGE2 analogues are used to maintain the patency of ductus aeriosus whereas aspirin or indomethacin are used for the treatment of PDA. PGE2 is a bronchodilator and can be used to treat bronchial asthma inhalational route. Cervical priming and NSAID induced PUD are other indications of this agent. | train | med_mcqa | null |
SLE is which type of hypersensitivity reaction: March 2005 | [
"Type I hypersensitivity",
"Type II hypersensitivity",
"Type III hypersensitivity",
"Type IV hypersensitivity"
] | C | Ans. C: Type III hypersensitivity Type III hypersensitivity response (Immune-complex mediated response) Examples are: Some form of glomerulonephritis Serum sickness Ahus reaction SLE Antinuclear antibody (ANA) testing and anti-extractable nuclear antigen (anti-EN A) form the mainstay of serologic testing for SLE. Several techniques are used to detect ANAs. Clinically the most widely used method is indirect immunofluorescence. The pattern of fluorescence suggests the type of antibody present in the patient's serum. ANA screening yields positive results in many connective tissue disorders and other autoimmune diseases, and may occur in normal individuals. Subtypes of antinuclear antibodies include anti-Smith and anti-double stranded DNA (dsDNA) antibodies (which are linked to SLE) and anti-histone antibodies (which are linked to drug-induced lupus). Anti-dsDNA antibodies are highly specific for SLE; they are present in 70% of cases, whereas they appear in only 0.5% of people without SLE. The anti-dsDNA antibody titers also tend to reflect disease activity, although not in all cases. | train | med_mcqa | null |
Action of alpha 2 and b1 receptors on adenyl cyclase | [
"Stimulate; Stimulate",
"Stimulate; Inhibit",
"Inhibit; Inhibit",
"Inhibit; Stimulate"
] | D | Beta receptors are GsPCR -so increase adenyl cyclase activity.alpha 1 -g1 pcr,alpha 2 GiPCR-decrease adenyl cyclase activity Ref: KD Tripathi 8th ed. | train | med_mcqa | null |
The number of pairs of flagella in the below organism is | [
"1",
"2",
"3",
"4"
] | D | Trophozoite of Giardia lamblia:*Shape: viewed flat-tennis or badminton racket; viewed side- pear shaped*Dorsal surface: convex*Ventral surface: concave with sucking disc*Anterior end: broad and rounded*Posterior end: tapers to a sharp point*Bilaterally symmetrical and there are 2 axostyles, 2 nuclei and 4 pairs of flagellaRef: K.D Chatterjee 13th edition, p47-48 | train | med_mcqa | null |
. A neonate is seen crying with eyes closed and moving all his limbs. What is the Neonatal Behavioral response scale - | [
"Scale 1",
"Scale 3",
"Scale 5",
"Scale 6"
] | D | Scale 6 Neonatal behavior assessment scale It is a scale developed by T. Berry Brazelton for evaluating the neurological conditions and behavior of newborn by assessing his or her aleness, motor maturity, irritability and interaction with people. Scores SLEEP STATE I)Deep sleep: - Sleep with regular breathing, eyes closed, no spontaneous activity except stales or jerky movements at quite regular intervals. 2)Light sleep: - Sleep with eyes closed: rapid eye movements can often be observed under closed lids; low activity level with random movements and stales. AWAKE STATE 3)Drowsy: - Drowsy or semidozing; eyes may be open but dull and heavylidded, or closed, eyelids fluttering; activity level minimal, Movements are usually smooth, although there may be stales. "Some infants may also show fuss/ cry vocalizations in this state"Q. What distinguishes state 3 from state 5 when both are accompanied by fuss/ cry vocalizations is the minimal movement in state 3 and considerable movement in state 5 4)Quiescent ale: - Ale, eyes open with bright look. Motor activity is minimal there can be a glazed look that is easily changed into a brighter look with appropriate stimulation. 5)Active ale : - Eyes likely to be open; considerable motor activity, with thrusting movements of the extremities, and even a few spontaneous stales reactive to external stimulation with increase in stales or motor activity. 6)Crying:- Crying characterized by intense, loud, rhythmic, and sustained cry vocalizations that are difficult to break through with stimulation; motor activity is hige. Eyes may be tightly closed. | train | med_mcqa | null |
All of the following are neural tube defects except: | [
"Myelomeningocele",
"Anencephaly",
"Encephalocele",
"Holoprosencephaly"
] | D | Ans. D. HoloprosencephalyNeural tube defects (NTDs) are a group of birth defects in which an opening in the spinal cord or brain remains from early in human development. In the 3rd week of pregnancy called gastrulation, specialized cells on the dorsal side of the embryo begin to change shape and form the neural tube. When the neural tube does not close completely, an NTD develops. There are 2 types of NTD: open and closed. Open NTDs occur when the brain and/or spinal cord are exposed at birth through a defect in the skull or vertebrae (back bones).Examples of open NTDs are anencephaly, encephaloceles, hydranencephaly, iniencephaly, schizencephaly, and spina bifida. Rarer types of NTDs are called closed NTDs. Closed NTDs occur when the spinal defect is covered by skin. Common examples of closed NTDs are lipomyelomeningocele, lipomeningocele, and tethered cord. | train | med_mcqa | null |
A 2-year-old child presented with the following abnormality. There is a history of similar illness in his father. What might be the underlying condition responsible? | [
"Retinitis pigmentosa",
"Acute Leukemia",
"Retinoblastoma",
"Coloboma"
] | C | c. RetinoblastomaLeucocoria or white eye reflex is present in left eye; Presence of leukocoria in a young child with a positive family history suggests a diagnosis of Retinoblastoma | train | med_mcqa | null |
In case of pelvic fracture with urethral injury, the most impoant first step in management is? | [
"Repair in injured urethra",
"Fixation of pelvic fracture",
"Treatment of shock and haemorrhage",
"Splinting urethra with catheters"
] | C | Ans. is 'c' i.e., Treatment of shock and haemorrhage | train | med_mcqa | null |
According to Sigmund Freud, primary process thinking is - | [
"Illogical & Bizarre",
"Rational",
"Absent during sleep",
"Logical & unconscious"
] | A | Primary process (related to Id):- Unorganized & non-logical thinking.
Secondary process (related to Ego):- Reality oriented, goal-directed, logical, rational, concrete and/or abstract conceptual thinking. | train | med_mcqa | null |
Which of the following is a differentiating feature of anopheles from aedes mosquito ? | [
"Pupa has broad siphon",
"Eggs are oval shaped",
"Wings unspotted",
"Popi are sho"
] | A | Ans. is 'a' i.e., Pupa has broad siphon | train | med_mcqa | null |
Which cervical veebra that does not have a body or spinous process? | [
"C1",
"C2",
"C3",
"C4"
] | A | First cervical veebra is ring-shaped. It has neither a body nor a spine.Features of typical cervical, thoracic and lumbar veebra are given belowFeaturesCervical veebraThoracic veebraLumbar veebraBodySmall and broad from side to sideMedium size and hea-shapedLarge and kidney-shapedVeebral foramenLarge than the body and triangularSmall and circularTriangularSpinous processSmall and bifidLong and directed downwardsSho, flat and projected backwardInferior aicular facetDirected forward and downwardsDirected forwards, slightly downwards and mediallyDirected laterallyTransverse processHave foramen transversariumHas costal facets Long and slender | train | med_mcqa | null |
In case of acute severe colitis on day 3 of hospital , the best predictor of colectomy is: | [
"CRP > 45 mg/L and 3-8 stool frequency",
"ESR > 60 mm Hg and abdominal pain",
"Bleeding PR and abdominal distention",
"Tachycardia and fever"
] | A | C-reactive protein is a less good marker for assessing disease activity in UC than Crohn's disease. In acute severe colitis a raised CRP > 45 mg/L on day 3 following hospital admission together with 3-8 stools a day is highly predictive for colectomy. Ref: Journal of Crohn's and Colitis (2012) 6, 965-990. | train | med_mcqa | null |
The amino acids producing ammonia in kidney is | [
"Methionine",
"Glycine",
"Glutamine",
"Alanine"
] | C | Transpoation of Ammonia : Inside the cells of almost all tissues , tge transamination of aminoacids produce glutamic acid . However, glutamate dehydrogenase is available is available only in liver . In kidney the ammonia is formed to Glutamine by the enzyme Glutamine synthetase. Ref : DM.VASUDEVAN.TEXTBOOK SEVENTH EDITION ; PAGE NO : 203 | train | med_mcqa | null |
Following are the clinical features of Leber optic neuropathy except - | [
"Seen in the 2nd or 3rd decade of life",
"It is a example of gradual painless visual loss",
"Males can transmit the disease",
"No leak of dye is observed in fluorescein angiography"
] | C | It is a type of hereditary optic neuritis which primarily affects males around the age of 20 years. It is transmitted by the female carriers. The condition is characterised by progressive visual failure. The fundus is initially normal or in the acute stage disc may be mildly hyperaemic with telangiectatic microangiopathy. Eventually bilateral primary optic atrophy ensues. Ref: AK Khurana 4thE pg 296 | train | med_mcqa | null |
Citelli's angle is - | [
"Solid angle",
"CP angle",
"Sinodural angle",
"Part of Mac Evans triangle"
] | C | null | train | med_mcqa | null |
Epithelial lining of glottis/ true vocal cords:March 2013 (c) | [
"Stratified squamous non-keratinized",
"Stratified squamous keratinized",
"Ciliated columnar",
"Non-ciliated columnar"
] | A | Ans. A i.e. Stratified squamous non-keratinized | train | med_mcqa | null |
Following virus is of poxvirus - | [
"Variola",
"Coxsackie",
"ECHO",
"HSV"
] | A | null | train | med_mcqa | null |
A 4-year-old child presented with fatigue, malaise, fever, sore throat, headache, nausea, abdominal pain and myalgia. On examination generalized lymphadenopathy and hepatosplenomegaly was noted. There was marked tonsillar enlargement along with palatal petechiae, rashes and edema of the eyelids. Peripheral smear is given below.Paul Bunnel test was performed and was positive. All of the following except one can be caused by the above organism? | [
"Nasopharyngeal carcinoma",
"Non Hodgkins Lymphoma",
"Diffuse gastric carcinoma",
"Primary effusion lymphoma."
] | D | 1st image shows tonsillitis with membrane formation in infectious mononucleosis. Peripheral blood film shows atypical lymphocytes or Downey cells are lymphocytes that become large as a result of antigen stimulation. | train | med_mcqa | null |
Following are the modifiable risk factors of atherosclerosis except ? | [
"Physical inactivity",
"Obesity",
"Diabetes",
"Hypeension"
] | B | Ans. is 'b' i.e., Obesity | train | med_mcqa | null |
The most common complication of mumps is: | [
"Myocarditis",
"Orchitis",
"Uveitis",
"Conjunctivitis"
] | B | null | train | med_mcqa | null |
Treatment of choice in desmoid tumours is ? | [
"Irradiation",
"Wide excision",
"Local excision",
"Local excision following radiation"
] | B | Ans. is 'b' i.e., Wide excision | train | med_mcqa | null |
All of the following are microsomal enzyme inhibitors except | [
"Glucocoicoids",
"Cimetidine",
"Ciprofloxacin",
"INH"
] | A | Other inhibitors- Ketoconazole, Metronidazole, Allopurinol, Erythromycin, OCPs, Omeprazole | train | med_mcqa | null |
Platelets can be stored at - | [
"20-24deg C for 5 days",
"20-24deg C for 8 days",
"4-8deg C for 5 days",
"4-8deg C for 8 days"
] | A | Ans. is 'a' i.e., 20-24degC for 5 days Summary of Available ]Blood ComponentsComponentCompositionShelf LifeWhole bloodRBCs; nonfunctional WBCs and platelets; plasma (450 ml total volume contains 200 ml of RBCs)CPDA-1: 35 days (1deg to6degC)Packed RBCsRBCs; some plasma; nonfunctional WBCs and platelets (250 to 350 ml total volume contains 200 ml of RBCs)AS-1: 42 daysLeukocyte-reducedRBCsRBCs; minimum plasma and nonfunctional WBCs and platelets (200 ml total volume contains 170 to 190 ml of RBCs)24 hr (1deg to 6degC)Platelets (single unit from whole blood donation)Platelets; some nonfunctional WBCs; few RBCs; plasma (50 to 70 ml total volume contains 5.5 (1010 platelets); levels of labile clotting factors depend on storage time5 days (20deg to 24degC)Platelets (apheresis from random donor)As above; usually contains as many platelets as 6 to 10 single units (>30 (1010)Usually 24hr; up to 5 days (20deg to 24degC)Leukocyte concentrate.|WBCs; may contain large numbers of platelets, some RBCs (600 ml total volume contains 5 to 30 (109 granulocytes)24 hr (20deg to 24degC)Fresh frozen plasma|Plasma, all coagulation factors (180 to 250ml contains 0.7 to 1 unit/ml of prothrombin; factors V, VII, VIII, IX, XII, and XIII; and 500 mg of fibrinogen)Frozen: 1 yr (<- 30degC) Thawed: 24 hr (1deg to 6degC)Cryoprecipitate|Fibrinogen, factors VIII, VIIIR, XIII, fibronectin (10 to 20 ml contains 80 units/ml factor VIII, 200 mg fibrinogen)Frozen: 1 yr (<-30degC) Thawed: 4hr if pooled (20deg to 24degC)AlbuminAlbumin (12.5 g albumin in 50 or 250 ml)3yr (room temperature) | train | med_mcqa | null |
Labyrinthine artery is a branch of artery: | [
"Anterior inferior cerebellar",
"Posterior cerebellar artery",
"Vertebral artery",
"Internal carotid artery"
] | A | Five branches of basilar artery
1. Pontine artery
2. Labyrinthine artery
3. Anterior inferior cerebellar artery
4. Superior cerebellar artery
5. Posterior cerebral artery
“The membranous part is supplied by the labrynthine artery1,3 which either arises from Anterior inferior cerebellar (85-100% times)2 or is the direct branch of the basilar artery (<5% times)2”
Ref:
1. Gray's Basic Anatomy by Richard Drake, A. Wayne Vogl, Adam W. Pg 493
2. Learning Human Anatomy: Laboratory Text and Workbook by Julia Guy.
3. Clinical Anatomy for Students: Problem Solving Approach by Neeta V. Kulkarn, Pg 387 | train | med_mcqa | null |
Appreciation of shape and size of an object placed in the hand is lost in the lesion of | [
"Tractus gracilis",
"Tractus cuneatus",
"Lateral spinathalamic tract",
"Spino - reticular tract"
] | B | Ans. (b) Tractus cuneatus(Ref: Ganong, 25th ed/p.168)Appreciation of shape and size of an object placed in the hand is a function of Tractus cuneatus | train | med_mcqa | null |
Osteoclastoma arises from which pa of bone? | [
"Epiphysis",
"Metaphysis",
"Diaphysis",
"All the above"
] | A | OSTEOCLASTOMA (GIANT CELL TUMOUR) Giant cell tumour (GCT) is a common bone tumour with variable growth potential. Though generally classified as benign*, it tends to recur after local removal. The tumour is seen commonly in the age group of 20-40 years i.e., after epiphyseal fusion. The bones affected commonly are those around the knee i.e., lower-end of the femur and upper-end of the tibia. Lower-end of the radius is another common site. The tumour is located at the epiphysis**. It often reaches almost up to the joint surface. Common presenting complaints are swelling and vague pain Reference: Maheshwari; Essential Ohopaedics; Page no: 237 | train | med_mcqa | null |
Doctors role in noting dying declaration is to ? | [
"Asceain compos mentis",
"Call the magistrate",
"Elicit information by leading questions",
"Ask the investiating medial officer to be there"
] | A | Ans. is 'a' i.e., Asceain compos mentis Dying declaration It is the written or verbal statement made by a person likely to die because of some unnatural act done on his body, narating the circumstances or the conditions responsible for his present state of health or the cause and manner of likely unnatural death. Ideally dying declaration should be recorded by executive or honorary magistrate, but can also be recorded by doctor, village head man, police or any other person, if there is no time to call a magistrate. Doctor has to ceify the patient to be compos mentis (sound mind). It is recorded in presence of two disinterested witnesses. Relatives and police officers are not allowed to be present. No oath is administered. It carries less weight than dying deposition as no cross-examination is possible. If the patient does not die after the recording of declaration, the dying declaration loses its impoance sice now he can be called to the cou and his evidence can be recorded after cross-examination. | train | med_mcqa | null |
Macrophages in nervous system is known as: | [
"Schwann cells",
"Oligodendrocytes",
"Astrocytes",
"Microglia"
] | D | Microglia are scavenger cells that resemble tissue macrophages and remove debris resulting from injury, infection, and disease (eg, multiple sclerosis, AIDS-related dementia, Parkinson disease, and Alzheimer disease). Microglia arise from macrophages outside of the nervous system and are physiologically and embryologically unrelated to other neural cell types. Ref: Ganong's Review of Medical Physiology 23rd edition, Chapter 4. | train | med_mcqa | null |
A patient had injury with development of diy lacerated wound 10 hours back. There is history of booster dose of TT 7 years back. The patient requires? | [
"Not treatment",
"Only I dose of Tetanus immunoglobulin",
"Only 1 dose of TT",
"Complete course ofTT and Tetanus immunoglobulin"
] | C | Ans. is 'c' i.e., Only I dose of TT | train | med_mcqa | null |
Charcot arthropathy most commonly seen in: | [
"DM",
"Syringomyelia",
"Leprosy",
"Rheumatoid arthritis"
] | A | Ans. a. DMCharcot arthropathy is the destruction of bone and soft tissues at weight bearing joints.Diabetes is the most common etiology of Charcot arthropathy.It occurs most commonly in the lower extremity, at the foot and ankleIts most severe form can disruption of the bony architecture. | train | med_mcqa | null |
Which of the following structures seen in the cavernous sinus? | [
"Maxillary division of V nerve",
"Mandibular division of V nerve",
"Internal carotid aery",
"Trochlear nerve"
] | C | Ans. c. Internal carotid aery | train | med_mcqa | null |
Clinical audit means ? | [
"Measuring hospital records",
"Measuring current patients care against explicit criteria",
"Measuring input-output analysis",
"Measuring shoest time needed to complete task"
] | B | Ans. is 'b' i.e., Measuring current patients care against explicit criteria Clinical audit is a quality improving process, in which patients care is improved. In this, current patients outcome and outcomes are measured against explicit audit criteria (against reference standards). | train | med_mcqa | null |
All of the following are adverse effects of Digoxin except | [
"Hyperkalemia",
"Yellow vision",
"Atrial Flutter",
"Gynaecomastia"
] | C | Digoxin can cause all type of arryhthmias except Atrial Flutter. Infact Digoxin is used to treat Atrial Flutter. | train | med_mcqa | null |
Which of the following malformation in a newborn is specific for maternal insulin dependent diabetes mellitus ? | [
"Transposition of great arteries",
"Caudal regression",
"Holoprosencephaly",
"Meningmyelocele"
] | B | The fetal malformations seen in Caudal regression syndrome are the most typical seen in cases of maternal diabetes'.- Early detection of caudal regression syndrome, D. Subtil et al.
Caudal regression :
Caudal regression syndrome (CRS) is a rare malfonnative syndrome seen mainly in cases of maternal diabetes with poor metabolic control.
This syndrome associates vertebral agenesis of variable level with genito-urinary and digestive malformations. These abnormalities are related to the impaired development of the mid-posterior axis mesoderm | train | med_mcqa | null |
All of the following are true about inverted papilloma except- | [
"Most common in females",
"Arises from lateral wall of nose",
"Can causes epistaxis",
"Recurrent in nature even after removal"
] | A | null | train | med_mcqa | null |
The type of cartilage shown in the colour plate: | [
"Hyaline cartilage",
"Elastic cartilage",
"Fibrocartilage",
"Mixed cartilage"
] | A | There are three types of cartilage:
Hyaline—most common; matrix contains a moderate amount of collagen fibers (e.g., articular surfaces of bones)
Elastic—matrix contains collagen fibers along with a large number of elastic fibers (e.g., external ear)
Fibrocartilage—matrix contains a limited number of cells and ground substance amidst a substantial amount of collagen fibers (e.g., intervertebral discs). | train | med_mcqa | null |
An organism grown on agar shows green coloured colonies; likely organism is: | [
"Staphylococcus",
"E.Coli",
"Pseudomonas",
"Peptostreptococcus"
] | C | The above pigments account for the greenish colonies seen with psuedomonas. Ref: Text Book of Microbilogy By Ananthanarayan, 6th Edition, Page 294 ; Harrison's Principles of Internal Medicine, 14th Edition, Page 944 | train | med_mcqa | null |
The presence of pulp stones on the radiograph of a tooth
indicates the presence of | [
"Acute pulpitis",
"Acute pulpalgia",
"Chronic periodontitis",
"None of the above"
] | D | null | train | med_mcqa | null |
Taste loss due to radiation therapy is recovered in: | [
"2 weeks",
"60 - 120 weeks",
"60-120 days",
"Not reversible"
] | C | Salivary Gland
60 mGy Xerostomia develops
Taste Loss – Reversible – recovery 60 to 120 days | train | med_mcqa | null |
Which of the following anticancer drugs are competitive inhibitors of tyrosine kinase? | [
"Imatinib and Sunitnib",
"Letrozole",
"Bicalutamide",
"Fulvestrant"
] | A | null | train | med_mcqa | null |
Erythema multiforme is most commonly caused by? | [
"Herpes simplex",
"Idiopathic",
"TB",
"Drugs"
] | B | Ans. is 'b' i.e., Idiopathic Idiopathic erythema multiforme is the most common cause of EM. Herpes simplex is the most impoant infectious cause of EM. Causes of Erythema multiforme Idiopathic --) Most common cause Viral --> HSV (most impoant) HBV, Mumps, Adenovirus Bacteria - Streptococci, tuberculosis Fungal --> Coccidioidomycosis, Histoplasmosis. Drugs ---> Antibiotics (Sulphonamide), Phenytoin, NSAIDS. Autoimmune disease --> SLE, thyroiditis, RA Others --> Sarcoidosis, Pregnancy, Malignancy. | train | med_mcqa | null |
The most potent topical coicosteroids is - | [
"Hydrocoisone butyrate cream 0.1%",
"Betamethasone valerate cream 0.1%",
"Clobetasol propionate cream 0.5%",
"Clobetasone butyrate cream 0.5%"
] | C | Super potent topical coicosteroids Clobetasol propionate 0.05% halobetasolpropionate 0.05% betametnasone dipropionate 0.05% Fitzpatricks textbook of dermatology, principles of topical therapy page 3363 | train | med_mcqa | null |
Interpeduncular fossa contains all except - | [
"Mamillary bodies",
"Posterior perforated substance",
"Occulomotor nerve",
"Ophthalmic nerve"
] | D | null | train | med_mcqa | null |
In a patient with NIDDM which of the following condition is seen : | [
"Ketosis commonly occurs on stopping treatment",
"Hyperiglyceridmia never occurs",
"Pancreatic beta cells stop producing insulin",
"Increased levels of insulin in blood, may be seen"
] | D | Answer is D (Increased levels of insulin in blood may be seen): The prominent mechanism involved in pathogenesis of NIDDM is 'insulin resistance' i.e. the decreased ability of insulin to act effectively on peripheral tissues. This insulin resistance is relative and supra normal levels of insulin are still capable of normalizing blood glucose. In NIDDM (type II DM) insulin secretion initially increases in response to insulin resistance to maintain normal glucose levels in blood. Thus increased levels of insulin in blood may be seen in patients with NIDDM or type II DM. Pancreatic 1 cells respond by an initial increase in insulin secretion. They are however unable to maintain there hyperinsulinemia for long and gradually as the disease progresses insulin levels decline. Secretion of insulin from )6' cells may thus decrease but it never stops completely. Ketosis or diabetic Ketoacidosis is an acute metabolic complication of diabetes mellitus. It is typically seen in patients of type I D.M or IDDM who either are untreated, inadequately treated or have stopped treatment-API 7th/1113 Individuals with DM may have several forms of dyslipidemia Dplipidentias are more frequent in type II DM or NIDDM The most common patterns of dyslipidemia is hyperiglyceredemia & reduced HDL cholestrol | train | med_mcqa | null |
All open into hiatus semilunaris except | [
"Posterior ethmoid sinus",
"Anterior ethmoid sinus",
"Frontal sinus",
"Maxillary sinus"
] | A | Hiatus semilunaris. The hiatus semilunaris is a semicircular shaped openinglocated on the lateral wall of the nasal cavity. It is a component of the ostiomeatal complex and serves as the opening for the frontal and maxillary sinuses and the anterior ethmoid air cells. | train | med_mcqa | null |
Anterior pituitary gland secretes all of the following EXCEPT | [
"GH",
"TSH",
"FSH",
"GnRH"
] | D | (D) GnRH # Gonadotropin-releasing hormone (GnRH), also known as Follicle-Stimulating Hormone-Releasing Hormone (FSH-RH), Luteinizing Hormone-Releasing Hormone (LHRH), gonadoliberin, & by various other names in its endogenous form and as gonadoralin (INN) in its pharmaceutical form, is a releasing hormone responsible for the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary.> GnRH is a tropic peptide hormone synthesized and released from GnRH neurons within the hypothalamus.> The peptide belongs to gonadotropin-releasing hormone family. It constitutes the initial step in the hypothalamic-pituitary-gonadal axis.> The anterior pituitary secretes seven hormones: adrenocorticotropic hormone (corticotropin, ACTH), thyroid-stimulating hormone (thyrotropin, TSH), growth hormone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), Melanocyte stimulating hormone(MSH) and prolactin (PRL).> An additional polypeptide, b-lipotropin b-LPH), is secreted with ACTH, but its physiologic role is unknown. The actions of the anterior pituitary hormones are summarized in.> The hormones are discussed in detail in the chapters on the endocrine system. The hypothalamus plays an important stimulatory role in regulating the secretion of ACTH, b-LPH, TSH, growth hormone, FSH, and LH.> It also regulates prolactin secretion, but its effect is predominantly inhibitory rather than stimulatory. | train | med_mcqa | null |
7. Which of the following is not a feature of Le Fort II fracture: | [
"Enophthalmos",
"Malocclusion",
"Paraesthesia",
"CSF rhinorrhea"
] | A | null | train | med_mcqa | null |
"MONICA Project" is associated with: | [
"Risk factor intervention trials for CVD",
"Oslow diet/smoking intervention study",
"Monitoring of trends and determinants in cardiovascular disease",
"Lipid research clinics study"
] | C | To look out for the reasons behind the changing trends of Cardiovascular disease worldwide , WHO staed project named MONICA ( Monitoring of trends and determinants in Cardiovasculardisease). Population centres need to be large and numerous; to reliably establish 10-year trends in event rates. Foy-one MONICA Collaborating Centres, using a standardized protocol, are studying 118 Repoing Units (subpopulations) with a total population aged 25-64 (both sexes) of about 15 million. | train | med_mcqa | null |
Thyrotoxicosis patients with least radio iodide uptake seen in: | [
"Toxic adenoma",
"Grave's disease",
"MNG",
"Sub - acute thyroiditis"
] | D | Sub-acute thyroiditis or de Quervain thyroiditis is an uncommon condition, yet is considered the most common cause of painful thyroiditis. Disease is thought to have a viral origin, Has the least radioactive iodine uptake. RAIU in other diseases: | train | med_mcqa | null |
Gaucher's disease is due to deficiency of enzyme : | [
"Sphingomyelinase",
"13-Clucosidase",
"Hexosaminidase-A",
"P-Galactosidase"
] | B | B i.e. 13-glucosidase | train | med_mcqa | null |
A patient has a right homonymous hemianopia with saccadic pursuit movements and defective optokinetic nystagmus. The lesion is most likely to be in the | [
"Frontal lobe",
"Occipital lobe",
"Parietal lobe",
"Temporal lobe"
] | C | Right nomonymous hemianopia with saccadic pursuit movements and detective optokinetic nystagmus confirms the diagnosis of perietal lobe lesion.
Optokinetic Nystagmus: - It can be elicited in all normal individuals.
Defect in optokinetic nystagmus and lesions of brain associated with it.
In a case of hemianopia due to lesions of the parietal lobe optokinetic nystagmus is absent.
Other lesions where optokinetic Nystagmus is defective:-
Frontal lobe lesions - it inhibits this response only temporarily.
Brainstem lesions - it results in asymmetry of this response in vertical plane. | train | med_mcqa | null |
Electrophoresis done under pH gradient is | [
"Isoosmotic",
"Isoelectric",
"Ion exchange",
"None"
] | B | Ionic buffers called ampholytes and an applied electric field is used to generate a pH gradient within a polyacrylamide matrix. Applied proteins migrate until they reach the region of the matrix where the pH matches their isoelectric point (pI), the pH at which a peptide&;s net charge is zero. IEF is used in conjunction with SDS- PAGE for two-dimensional electrophoresis, which separates polypeptides based on pI in one dimension and based on Mr in the second (Figure 45). Two-dimensional electrophoresis is paicularly well suited for separating the components of complex mixtures of proteins.Ref: Harper&;s Illustrated Biochemistry a LANGE medical book twenty-sixth edition Page no: 24 | train | med_mcqa | null |
The sensitivity of mammography is low in young females because : | [
"Less glandular tissue and more fat",
"Young females are less cooperative",
"Young breast have dense tissue",
"Because of less fat content"
] | C | The mammographic appearance of breast depends on the relative amount of fat and glandular tissue which are present. Young woman's breast contains a large proportion of glandular tissue which appears as a soft tissue density and lowers the sensitivity of mammogram.
Mammographic appearance of breast (Based on the relative amount of fat and glandular tissue) :
Glandular breast : (Dense breast) In young woman, where breast contain large amount of glandular tissue.
Adipose breast : (Fatty breast) In older women, where most of the glandular tissue has involuted.
Involuting breast : When mixture of soft tissue and fat density present. | train | med_mcqa | null |
Malnourished children are at risk for complications of measles, leading to greater morbidity and mortality. Which of the following should be given to children to reduce these risks? | [
"Vitamin A",
"Vitamin B",
"Vitamin C",
"Vitamin D"
] | A | High-dose vitamin A (a) given to malnourished children and anyone with vitamin A deficiency reduces the risk of mortality. The World Health Organization recommends that all children with measles receive vitamin A supplementation (not necessarily high-dose). The remaining vitamins listed do not have any effects on the outcome of measles. | train | med_mcqa | null |
First heart sound is soft in all, except | [
"Short PR interval",
"Ventricular septal defect",
"Mitral regurgitation",
"Calcified valve"
] | A | S1 is loud in short PR interval
"S1 is heard due to closure of AV valves"
THE INTENSITY OF S1 DEPENDS UPON -
1) Position of mitral leaflets at the onset of ventricular systole
Mitral leaflets at greater distance than normal - S1 loud (short PR intervar)
Mitral leaflets at a lesser distance than normal - S1 soft (long P-R intervals)
2) The rate of rise of left ventricular pressure
Low rate of rise of pressure
S1 soft (VSD and MR)Q
High rate of rise ofpressure
S1 loud (ASQ)
3) Presence or absence of structural disease of mitral valve
Calcification of mitral leafierQ → Soft S1
Defective closure in MRQ → Soft S1
4) Amount of tissue, air or fluid between heart and stethoscope
Pericardial effusionQ → Soft S1
ObesityQ → Soft S1
EmphyseinaeQ → Soft S1
Explanation of the loud S1 in short PR interval
PR interval denotes the time interval between atrial and ventricular contraction.
PR interval occurs due to delay at the A.V. node. This delay allows maximal time for atrial contraction and protects the ventricle from fast stimulation. What would be the implication of early ventricular contraction on first heart sound ??
It has been already discussed that first heart sound occurs due to closure of the mitral valve at the start of ventricular systole or contraction.
At this time increased intraventricular pressure exceeds the atrial pressure and the A.V. valves close, producing first heart sound.
Keep in mind one important fact that just before the start of the ventricular systole, the atrial contraction stops. (The atrial contraction occurs during late diastole, just before the start of ventricular systole).
With reduced PR interval the ventricle starts contracting, while the atria is still in a state of contraction.
Thus at the start of a ventricular contraction, the mitral valve leaflets are maximally separated because the atria is still contracting.
That means that ventricular systole will now push the mitral leaflet from a greater distance than usual.
This results in loud S (imagine the sound produced when a door is closed form a short distance or from a widely opened position. When the door is forced to shut from a large distance, obviously more sound will be produced).
The reverse happens in longer PR intervals -
Larger PR interval means there is more time lag between atrial and ventricular contraction.
Thus when ventricular systole begins the mitral leaflets have already begun to close due to atrial relaxation.
Thus less force is applied to the mitral valve and its closing velocity is decreased resulting in soft S1 | train | med_mcqa | null |
A child presents with brown colored urine and oliguria for last 3 days. He has mild facial and pedal edema. His blood pressure is 126/90. He has +3 proteinuria with 100 red cell and a few granular casts. His creatinine is 0.9, urea is 56. What is his diagnosis? | [
"PSGN",
"Nephrolithiasis",
"FSGN",
"Infection associated glomerulonephritis"
] | A | Ans. (a) PSGNRef: Nelson Text book of Pediatrics 20th Ed; Page No-2498 & Ghats Essential Pediatrics 9th Ed; Page No-469* Most common cause of glomerulonephritis is immune mediated injury caused by Immune complexes and glomerular antigen mediated damage. It is characterized by the triad of hematuria, azotemia and hypertension.* The most common cause of acute glomerulonephritis is that following streptococcal infection (PSGN-Post streptococcal Glomerulonephritis).Post streptococcal Glomerulonephritis (PSGN)* Acute post streptococcal Glomerulonephritis is caused by autoimmune injury only due to selective nephritogenic strains of streptococcus.* The patient develops glomerulonephritis with streptococcal pharyngitis usually in winter after 1-2 weeks of infection and with streptococcal pyoderma in summer after 3-6 weeks of infection.* Nephritogenic strains include types 4 and 12 (pharyngitis) and type 49 (pyoderma).Clinical Features:* The most common age o presentation is 5-12 years (school- age children) and is rarely seen before 3 years of age.* The onset is rapid, with puffiness around the eyes and pedal edema.* The patient presents with gross hematuria with smoky, cola or tea colour urine and hypertension.* Peripheral edema typically results from salt and water retention.* Complications that can be seen are hypertensive encephalopathy, pulmonary haemorrhage, cerebral vasculitis, hyperkalemia, hypophosphatemia and acidosis.Diagnosis* Light microscopy: Proliferation of endothelial & mesangial cells* Fluorescence: Ig G, Ig M, and C3 deposits in mesangium.* RBCs casts on urine analysis is a characteristic feature* Urine shows 1-2+ proteinuria* Elation ASO titer (In skin infection ASO titre remains normal-here elevated anti-DNAse B titers help in diagnosis).Management* The treatment is usually suppurative most of the cases resolves spontaneously and rarely my progress to renal failure.* Close monitoring of blood pressure and diet (should be low in sodium and potassium).* Fluid restriction.* Diuretics (e.g. frusemide) for edema.* Penicillin is usually given for infection however it does not alter the course of glomerulonephritis.* Antihypertensive drugs (Amlodipine, nifedipine or diuretics); hypertensive emergencies need treatment with IV nitroprusside or labetalol. | train | med_mcqa | null |
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