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In which of the following form of leprosy, lepromin test is highly positive in | [
"Borderline type",
"Typical tuberculoid",
"Lepromatous",
"Intermediate"
] | B | Lepromin test has 2 reactions. at 2 days early reaction of Fernandez due to the late hypersensitivity reaction.Staing 7-10 days peaking at 21 is the late reaction of Mitsuda. It is a cell-mediated immunity. It is more positive in typical tuberculoid type. Gets weaker as it passes through the spectrum to lepromatous type. Thus typical lepromatous type with failed cell-mediated immunity are at risk of developing progressive multibacillary leprosy.Hence Lepromin test has prognostic significance.Park 23rd edition Pg: 321 | train | med_mcqa | null |
Efficacy of Moist Heat Sterilization is tested by using the Spores of | [
"Bacillus stearothermophilus",
"Clostridium tetani",
"Bacillus subtilis",
"Clostridium botulinum"
] | A | (A) Bacillus stearothermophilus > For determining the efficacy of moist heat sterilization, (e.g. autoclaving), spores of Bacillus stearothermophilus are used as the test organism. This a thermophilic organism with an optimum growth temp. 55-60degC. Its spores are killed at 121 degC after 12 min exposure. | train | med_mcqa | null |
Drug of choice in interstial lung disease is - | [
"Antibiotics",
"Steroid",
"Bronchodilators",
"Anaesthetic"
] | B | null | train | med_mcqa | null |
Longest antero posterior diameter of the inlet is seen in pelvis : | [
"Anthropoid",
"Platypelloid",
"Android",
"Gynaecoid"
] | A | Anthropoid | train | med_mcqa | null |
The chemotactic factor is: | [
"C2a",
"C3b",
"C4a",
"C5a"
] | D | 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 particles and ingests them.
C5a not only has a chemotactic effect on neutrophils, but also activates these cells causing their reversible aggregation and release of stored enzymes, including proteases.
C5a also enhances the adhesiveness of neutrophils to the endothelium.
Parija SC. Textbook of Microbiology & Immunology. Elsevier Health Sciences; 2014. Page:120 | train | med_mcqa | null |
Gas commonly used in laparoscopy is : | [
"Air",
"Pure 02",
"N20",
"CO2"
] | D | CO2 | train | med_mcqa | null |
The valuable test for evaluating caries activity in very
young children is | [
"Lactobacillus colony count test",
"Swab test",
"Alban test",
"Calorimetric snyder test"
] | B | null | train | med_mcqa | null |
Gestation sac is picked up by USG earliest at | [
"5 - 6 weeks of gestation",
"6 - 8 weeks of gestation",
"8 - 10 weeks of gestation",
"12 weeks of gestation"
] | A | Earliest by 4 1/2 weeks of gestation. | train | med_mcqa | null |
A 26 years old female suffers from PPH on her second postnatal day. Her APTT is prolonged while bleeding time and prothrombin time and platelet count are normal. Likely diagnosis is: | [
"Acquired haemophilia A",
"Lupus anticoagulant",
"DIC",
"Inherited congenital hemophilia"
] | A | This is a case of acquired hemophilia A. Approximately 50 percent of acquired hemophilia A patients have an underlying condition, such as an autoimmune disorder (e.g., rheumatoid ahritis or systemic lupus erythematosus), malignancy, pregnancy, or a history consistent with a drug reaction. Patients with acquired hemophilia A have a prolonged aPTT caused by decreased or absent factor VIII activity in the intrinsic pathway of blood coagulation. The diagnosis of acquired hemophilia A is made by the demonstration of a solitary prolonged activated paial thromboplastin time (aPTT) that fails to correct on mixing with equal volumes of normal plasma (50:50 mix). The prothrombin time (PT), thrombin time (TT), and fibrinogen activity are all normal. Specific factor assays then are performed to determine whether a specific coagulation factor inhibitor or a lupus anticoagulant is present. Ref: Lollar P. (2010). Chapter 128. Antibody-Mediated Coagulation Factor Deficiencies. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e. | train | med_mcqa | null |
Blood loss in class III hemorrhagic shock - | [
"<750 ml",
"750-1500 ml",
"1500-2000 ml",
">2000 ml"
] | C | Ans. is 'c' i.e., 1500-2000 ml IndicatorClass IClass IIClass IIIClass IVBlood loss (% of blood volume)Less than 15%15-30%30-40%Greater than 40%Blood-loss (mL)Less than 750 ml750-1500 mL1500-2000 mLGreater than 2000 mLHeart rate/minLess than 100Greater than 100Greater than 120140 or greaterBlood pressureNormalNormalDecreasedDecreasedPulse pressureWidened or normalNarrowedNarrowedNarrowedCapillary retillNormalDelayedDelayedDelayed or absentVentilatory rate/min14-2020-3030-40reater than 35Urine output (mL/hr)30 or greater20-30Less than 20NegligibleSkin appearanceCool, pinkCool, paleCold moist, paleCold clammy, cyanoticNeurologic statusSlightly anxiousMildly anxiousAnxious, confusedConfused lethargy | train | med_mcqa | null |
A patient complains of frequent dislocation of the temporomandibular joint and frequent bleeding from gums, on examination, it was noticed that gingival tissue is very fragile, what should be the diagnosis: | [
"Lichen planus.",
"Pemphigus.",
"SLE",
"Ehlers-Danlos syndrome."
] | D | The oral mucosa was of normal color but was excessively fragile and bruised easily. Although the mucosa did not hold sutures satisfactorily, healing was only slightly retarded and there was no defective scar formation. No remarkable hyperextensibility of mucous membrane could be demonstrated, and the patients had no difficulty in wearing dentures. The gingival tissues appeared fragile and bled after tooth brushing, gingival hyperplasia and fibrous nodules were also noted. Tooth mobility was not increased. Hypermobility of the temporomandibular joint, resulting in repeated dislocations of the jaw, has been reported. | train | med_mcqa | null |
All are synonymous to radial styloid fracture except | [
"Chauffer's fracture",
"Hutchinson fracture",
"Backfire fracture",
"March fracture"
] | D | null | train | med_mcqa | null |
What is epoophoron? | [
"Urogenital sinus",
"Remnants of the wollfian duct",
"Unfused poion of wollfian duct",
"Vestigeal structure of urogenital sinus"
] | B | Epoophoron also known as organ of rossenmullar is a vestigal remanat of the cranial end of the mesonephros or the wollfian body. It is situated above the ovary. Caudal end of the wollfian body gives rise to paraoophoron situated between the uterus and ovary. It can form paraovarian cyst. Ref: Testbook of gynaecology By Dutta, 5th Edition, Page 35. | train | med_mcqa | null |
Which of the following antibiotic acts by inhibiting cell wall synthesis | [
"Cefepime",
"Aminoglycoside",
"Erythromycin",
"Doxycycline"
] | A | Ref KDT 6/e p669 Cefepime is a beta lactam antibiotic. It acts by inhibiting cell wall synthesis | train | med_mcqa | null |
Staging of ovarian tumor involving bladder | [
"Stage IIB",
"Stage IIIA",
"Stage IIIB",
"Stage IVA"
] | A | -Stage II ovarian cancer: tumor involves one or both ovaries or fallopian tubes with pelvic extension or primary peritoneal cancer. IIA: ovarian tumor involving uterus or fallopian tubes IIB: ovarian tumor involving pelvic intraperitoneal organs ( bladder, rectum or pelvic side walls) Reference : textbook of gynaecology Sheila balakrishnan, 2nd edition, pg no:277 <\p> | train | med_mcqa | null |
A preterm neonate has come to pediatric OPD for follow up. On examination, the child has a systolic murmur with tachypnea and hepatomegaly. On fuher history taking, it appeared that the mother had an episode of fever with rash in antenatal period. If CECT was done, it would reveal following finding: Which of the following marked area is probable pathologic in the given neonate? | [
"1",
"2",
"3",
"4"
] | C | Ductus venosus Ductus aeriosus Interventricular septum Descending aoa CECT Chest and its 3-D reconstruction: shows abnormal communication of pulmonary aery with aoa i.e PDA. A preterm neonate having a systolic murmur with tachypnea and hepatomegaly is likely to have patent ductus aeriosus (PDA) and 2 corresponds to ductus aeriosus. The mother having rash and fever may be suggestive of rubella infection in the antenatal period. There , the child has o be evaluated for SNHL Cataract. | train | med_mcqa | null |
A 60 year old woman presents with generalized edema, Skin Ulceration and hypeension. Urine examination shows subnephrotic proteinuria (<2gm) and microscopic haematuria. serum complement levels are decreased and she is positive for anti-hepatitis c antibodies. The likely diagnosis is - | [
"PSGN",
"Essential mixed cryoglobulinemia",
"Membrano proliferative glomerulonephritis",
"Focal segmental glomerulosclerosis"
] | B | Acute post streptococcal glomerulonephritis is an immunologic response of the kidney to infection, characterized by the sudden appearance of edema, hematuria, proteinuria and hypeension . It is essentially a disease of childhood that accounts for approximately 90% of renal disorders in children. Ref Harrison20th edition pg 278 | train | med_mcqa | null |
Which is not seen in fracture maxilla: | [
"CSF rhinorrhea",
"Malocclusion",
"Anesthesia upper lip",
"Surgical emphysema"
] | D | Clinical Features of Maxilla--Common to All Types Malocclusion of teeth Elongation of mid face Undue mobility of maxilla Specific Clinical Features CSF rhinorrhea is seen in Le Fo II and Le Fo III fracture as cribriform plate is injured. Injury to infraorbital nerve is seen in Le Fo II fracture. So anesthesia will be seen in area of supply of infraorbital nerve injury viz. cheek and upper lip (area of supply of infraorbital nerve). | train | med_mcqa | null |
Not true about somnambulism among the following is? | [
"Sleepwalking.",
"Patient consciousness is preserved.",
"Disorder of sleep arousal.",
"Low-level motor skill/function is present"
] | D | Ans: D- Low-level motor skill/function is present.Sleepwalking (somnambulism): The patients may carry out a range of activities for which he doesn't have any memory later on.It may include leaving the bed and walking around and also activities like dressing, moving around, or even driving.It occurs during the slow-wave sleep stage, in a state of low consciousness, with the performance of activities that are usually performed during a state of full consciousness | train | med_mcqa | null |
All of the following are causes of pansystolic murmur, EXCEPT : | [
"VSD",
"TR",
"MR",
"ASD"
] | D | Conditions associated with pansystolic murmur are VSD, TR and MR. On auscultation of patients with ASD: S1 is normal or split with accentuation of the tricuspid valve closure sound. Increased flow across the pulmonary valve result in mid systolic pulmonary outflow murmur. S2 is widely split. Amid diastolic rumbling murmur is heard in the tricuspid valve due to increased flow across the tricuspid valve. Ref: Child J.S., Aboulhosn J. (2012). Chapter 236. Congenital Hea Disease in the Adult. In D.L. Longo, A.S. Fauci, D.L. Kasper, S.L. Hauser, J.L. Jameson, J. Loscalzo (Eds), Harrison's Principles of Internal Medicine, 18e. | train | med_mcqa | null |
Retinitis pigmentosa is a feature of all except | [
"Refsum's disease",
"Hallervorden-Spatz disease",
"NARP",
"Abetalipoproteinemia"
] | B | Ans is 'b' i.e. Hallervorden-Spatz disease Retinitis pigmentosa is associated with many systemic conditions. These are important as they may be recognized first by an ophthalmologist.Systemic conditions associated with retinitis pigmentosa (RP)-Bardet-Biedl syndrome: It is characterized principally by retinitis pigmentosa, obesity, polydactyly, mental retardation, hypogonadism, and renal dysfunction.Laurence-Moon-Biedl syndrome: similar to Bardet-Biedl syndrome. In addition to Bardet Biedl syndrome has paraplegia.Usher's syndrome: RP & labyrinthine deafnessBassen-Kornzweig disease (Abetalipoproteinemia) : RP, fat malabsorption, spinocerebellar degeneration, and acanthocytosisKearns-Sayer syndrome: Mitochondrial myopathy characterized by external ophthalmoplegia, lid ptosis, cardiac conduction block & mild RP.Cockayne's syndrome: RP, progressive infantile deafness, dwarfism, mental retardation, nystagmus & ataxia.Refsum's syndrome: RP, peripheral neuropathy, cerebellar ataxia. (This is an autosomal recessive hypertrophic neuropathy caused by defective oxidation of phytanic acid, a branched-chain fatty acid found in dairy products, beef, lamb, and fish. The onset is in late childhood or adolescence, with a slowly progressive course of a sensorimotor demyelinating neuropathy with sensorineural deafness, cerebellar ataxia, and anosmia. Retinitis pigmentosa presenting as night blindness often precedes the onset of neuropathy)Hallgren fs syndrome: RP, vestibulo-cerebellar ataxia, congenital deafness & mental deficiencyNeuronal Ceroid Lipofuscinosis: is a devastating condition that involves progressive neurological failure, mental deterioration, seizures, and retinitis pigmentosa. It results from excessive accumulation of lip pigments (lipofuscin) in the body's tissues.Olivopontocerebellar degenerationNARP: Neuropathy, ataxia, retinitis pigmentosa, developmental delay, mental retardation, lactic academia (Ref: Harrison chapter e39)This list has been compiled from the above mention books. Hallervorden-Spatz finds no mention in these books. However on the below mentioned web-addresses, associations have been described with RP.(http://www.ncbi.nlm.nih.gov/pubmed/!734303; http://www.ncbi.nlm.nih.gov/pubmed/7898702) | train | med_mcqa | null |
. Risk factor for Ca Cervix:a) HPVb) Smokingc) Late Menarched) Nulliparitye) Early sexual intercourse | [
"abe",
"bcd",
"cde",
"acd"
] | A | null | train | med_mcqa | null |
Which of the following receptor gene has the ability to control TSH secretion? | [
"TR alpha 1",
"TR alpha 2",
"TR beta 1",
"TR beta2"
] | D | The THRB gene has two promoters that lead to the production of TR beta 1 and TR bete 2. TR beta 1 is ubiquitous, whereas TR beta 2 has a highly restricted pattern of expression. Mutations in THRB cause the syndrome of resistance to thyroid hormone. TR beta 1 has a specific role in liver metabolism (including the hypocholesterolemic effect of T3). Role of TR beta 2 is in the negative feedback by T3 on hypothalamic TRH and pituitary TSH. TR beta 2 also is impoant in the development of cones in the retina and in inner ear development. Ref: Brent G.A., Koenig R.J. (2011). Chapter 39. Thyroid and Anti-Thyroid Drugs. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds), Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. | train | med_mcqa | null |
Which nerve lesion could produce the condition where stimulation of right cornea results in the blinking of the left eye but not the right eye? | [
"Left trigeminal",
"Left facial",
"Right trigeminal",
"Right facial"
] | D | Summary of blink reflex:Ipsilateral blinkContralateral blinkNormalPresentPresentFacial nerve lesionAbsentPresentTrigeminal nerve lesionAbsentAbsent | train | med_mcqa | null |
A patient is brought to the casualty in the state of altered sensorium. He was on lithium treatment for effective fits. On examination, he has tremors, increased TR's and incontinence of urine. He has also undergone an episode of severe gastroenteritis 2 days ago. The serum lithium was found to be 1.95 meq/Lit. The probable cause for his present state is : | [
"Lithium toxicity",
"Dehydration",
"Manic episode",
"Depressive stupor"
] | A | Toxic symptoms of lithium toxicity are frequent at serum level of lithium exceeds 1.5 meq/L and regularly seen at plasma concentration above 2 meq/L.
The most common symptoms of acute lithium intoxication are neurological, i.e., tremor (being the most common), increased tendon reflexes, seizures, drowsiness, delirium, muscle twitching/weakness and coma. Gastrointestinal toxicity may also occur, e.g. Nausea, vomiting, diarrhea, abdominal pain, and metallic taste.
Chronic intoxication can cause hypothyroidism and nephrotoxicity (diabetes insipidus, polyuria, polydipsia, nephrotic syndrome). | train | med_mcqa | null |
Angiography is the investigation of choice in: | [
"Posterior vitreous detachment",
"Rhegmatogenous retinal detachment",
"Retinoschisis",
"Central serous retinopathy"
] | D | Ans. Central serous retinopathy | train | med_mcqa | null |
A chronic alcoholic develops palpitations suddenly after alcohol binge. Which of the following arrythmia is most commonly associated with alcohol binge in the alcoholics? | [
"Ventricular fibrillations",
"Veicular premature contractions",
"Atrial flutter",
"Atrial fibrillation"
] | D | Answer is D (Atrial fibrillation) Atrial fibrillation is the most common arrhythmia appearing after a drinking binge. Fibrillation is followed by atrial flutter and ventricular premature depolarization in frequency. | train | med_mcqa | null |
A 55-year-old woman presents to the clinic for evaluation of several weeks of fever, abdominal pain, weight loss, and lack of energy. Three days prior to the assessment, she developed a left foot drop. Her blood pressure is 160/90 mm Hg, pulse 80/min, and the physical examination confirms left peroneal nerve damage and a bilateral sensory neuropathy in both legs. There are no skin rashes. Laboratory evaluation reveals an ESR of 105 mm/h, WBC of 14,000/mL, and negative serologic tests for antineutrophil cytoplasmic antibody (ANCA) and ANA. The eosinophil count is normal, and urinalysis is negative for casts, protein, and red cells. A clinical diagnosis of polyarteritis nodosa is made. Which of the following is the most likely mechanism for renal injury in this condition? | [
"nephrotic syndrome",
"diffuse glomerulonephritis",
"granuloma formation",
"necrotizing vasculitis of vessels"
] | D | This patient has polyarteritis nodosa (PAN) and in classic PAN, unlike microscopic polyangiitis, both small and medium vessels are involved. The renal lesions are ischemic secondary to fibrinoid necrosis of the vessels. In microscopic polyangiitis, a diffuse glomerulonephritis is frequently present. The most common organ systems involved are the kidneys, musculoskeletal system, and peripheral nervous system. | train | med_mcqa | null |
All of the following are features of Goodpasture syndrome, except: | [
"Antibody to alpha-3 chain of type IV collagen (COL4A3)",
"Glomerular basement membrane is involved",
"Pulmonary haemorrhage",
"Subendothelial IgG deposits in renal biopsy"
] | D | Goodpasture syndrome Uncommon autoimmune disease in which kidney and lung injury are caused by circulating autoantibodies. Most common in 2nd & 3rd decades of life. Anti-GBM antibody-mediated disease Goodpasture syndrome applies to the 40% to 60% of patients with these autoantibodies who develop pulmonary hemorrhage in addition to renal disease. Characterized by linear deposits of IgG and, in many cases, C3 in the GBM. The antigen common to the alveoli and GBM is a peptide within the noncollagenous poion of the a3 chain of collagen type IV (COL4A3). | train | med_mcqa | null |
Which of the statements are True/False regarding dengue fever? a) All four distinct dengue viruses have Aedes aegypti as their principal vector. b) A. aegypti usually inhabits dwellings and bites during the day. c) Severe myalgia that gave rise to the colloquial designation "break-bone fever". d) A macular rash on the first day as well as adenopathy, palatal vesicles, and scleral injection. e) Epistaxis and scattered petechiae are features of complicated dengue. | [
"a,b,c,d,e-True & None-False",
"a,b,c-True & d,e-False",
"a,b,c,d-True & e-False",
"a,b,e-True & c,d,-False"
] | C | Epistaxis and scattered petechiae are often noted in uncomplicated dengue. Ref: Harrisons Principles of Internal Medicine, 18th Edition, Page 1621 | train | med_mcqa | null |
A 7-year-old boy is brought by parents with abdominal pain, joint aches, and a rash on his legs and feet. He does not have a history of frequent nosebleeds, easy bruising, or other episodes of abnormal bleeding. What is the most likely diagnosis? | [
"Acute urticaria",
"DIC",
"Erythema nodosum",
"Henoch-Schonlein purpura"
] | D | Ans. D. Henoch- Schonlein purpura* Henoch- Schonlein purpura (HSP) is a subtype of acute LCV that is seen more commonly in children and adolescents following an upper respiratory infection.* The majority of lesions are found on the lower extremities and buttocks.* Systemic manifestations include fever, arthralgias (primarily of the knees and ankles), abdominal pain, gastrointestinal bleeding, and nephritis.* Direct immunofluorescence examination shows deposits of IgA within dermal blood vessel walls. Renal disease is of particular concern in adults with HSP. | train | med_mcqa | null |
Large doses of pyridoxine are of value in some cases of- | [
"Phenylketonuria",
"Homocystinuria",
"Nonketotic hyperglycemia",
"Ketotic hyperglycemia"
] | B | Ans. is `b' i.e., HomocystinuriaInborn error of Metabolism and treatmentAlkaptonuria- Vitamin C, NitisinoneHomocystinuria- Pyridoxine + Folic acidCystinuria- Alkalization of urine + d-Penicillamine, captopril,Hanup disease- NicotinamideMultiple carboxylase deficiency- BiotinMethyl malonic acidemia- Vit B12Hyperoxaluria- PyridoxineTyrosinemia- NTBC, Liver transplantation | train | med_mcqa | null |
Which of the following is measured by the device, Bellow's spirometer? | [
"TLC",
"RV",
"Closing volume",
"ERV"
] | D | The spirometer is a simple device for measuring gas volumes. The frequently used water spirometer, rolling seal spirometer and bellows spirometer. The last two are not water-filled and are more poable. The VT, IRV, ERV, IC, and VC can all be measured with a spirometer (as can the forced expiratory volume in 1 second , forced vital capacity , and forced expiratory flow ). The RV, the FRC, and the TLC, however, cannot be determined with a spirometer because the subject cannot exhale all the gas in the lungs. The lung volumes not measurable with spirometry can be determined by the nitrogen-washout technique, by the helium-dilution technique, and by body plethysmography. The FRC is usually determined, and RV (which is equal to FRC minus ERV) and the TLC (which is equal to VC plus RV) are then calculated from volumes obtained by spirometry. Ref: Levitzky M.G. (2007). Chapter 3. Alveolar Ventilation. In M.G. Levitzky (Ed), Pulmonary Physiology, 7e. | train | med_mcqa | null |
Which is ss-RNA un-envloped virus - | [
"HBV",
"HEV",
"HCV",
"None"
] | B | null | train | med_mcqa | null |
Which of the following is FALSE regarding Neurofibromatosis inheritance: | [
"Von Recklinghausen's Disease is due to defect in chromosome 17",
"Autosomal dominant type of inheritance",
"NF-2 - Musculoskeletal deformities is characterstic",
"NF-1 - Most common single gene disorder affecting human nervous system."
] | C | NEUROFIBROMATOSIS (NF) NF - 1/Von Recklinghausen's Disease NF-2/Bilateral acoustic neurofibromatosis Most common single gene disorder affecting human nervous system. Peripheral neurofibromatosis, is due to defect in chromosome 17. AD inheritance 100% penetrance Due to defect in long arm of chromosome 22. AD inheritance Musculoskeletal deformities absent 8th nerve vestibular schwannomas Meningioma occur in 50% cases. Note: Usually Skeletal disorders are Autosomal Dominant and Inborn errors of metabolism are autosomal recessive | train | med_mcqa | null |
True about epidural anaesthesia in pregnancy – a) Given through subarachnoid spaceb) Increases cardiac outputc) Decreases venous returnd) Venous poolinge) Decreased placental circulation | [
"ab",
"bc",
"cd",
"ac"
] | C | In epidural anesthesia, local anesthetic is injected into epidural (extradural) space (not in subarachnoid space).
Epidural anesthesia causes venodilatation with venous pooling of blood that results in decreased venous return → decreased cardiac output and hypotension.
Hypotension from regional anesthesia can decrease uterine blood flow, However in the absence of hypotension neither epidural nor spinal anesthesia have any effect on the uterine blood flow and placental circulation. | train | med_mcqa | null |
Best prognostic type of Hodgkin's lymphoma is - | [
"Lymphocytic predominant",
"Lymphocytic depletion",
"Mixed cellularity",
"Nodular sclerosis"
] | A | Hodgkin's lymphoma (HL) is a type of lymphoma, which is generally believed to result from white blood cells of the lymphocyte kind. Symptoms may include fever, night sweats, and weight loss. Often there will be non-painful enlarged lymph nodes in the neck, under the arm, or in the groin. Those affected may feel tired or be itchy. About half of cases of Hodgkin's lymphoma are due to Epstein-Barr virus (EBV). Other risk factors include a family history of the condition and having HIV/AIDS. There are two major types of Hodgkin lymphoma: classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Diagnosis is by finding Hodgkin's cells such as multinucleated Reed-Sternberg cells (RS cells) in lymph nodes. Hodgkin lymphoma may be treated with chemotherapy, radiation therapy, and stem cell transplant. The choice of treatment often depends on how advanced the cancer is and whether or not it has orable features. In early disease a cure is often possible. The percentage of people who survive five years in the United States is 86%. For those under the age of 20 rates of survival are 97%. Radiation and some chemotherapy drugs, however, increase the risk of other cancers, hea disease, or lung disease over the subsequent decades. | train | med_mcqa | null |
Etanercept used in rheumatoid arthritis act by - | [
"TNF alpha",
"TFG beta",
"IL-2",
"IL-6"
] | A | null | train | med_mcqa | null |
A 2 years old male is brought to the hospital there is a compressible swelling at the root of nose, likely diagnosis is | [
"Meningoencephalocele",
"Lacrimal sac cyst",
"Ethmoid sinus cyst",
"Orbital extension arterial malformation"
] | A | Ans. is 'a' i.e.meningoencephalocele It is herniation of the brain along with meninges through a congenital bony defectSwelling shows cough impulse*.It may be reducible. | train | med_mcqa | null |
The inclination of teeth towards Frankfort horizontal plane in Simon's classification is | [
"Attraction",
"Protraction",
"Retraction",
"Distraction"
] | A | null | train | med_mcqa | null |
The depicted instrument is used in which procedure? | [
"Punch Biopsy",
"Tubectomy (Female Sterlisation)",
"Bone marrow biopsy set",
"Trocar and cannula for laparoscopy"
] | B | Above given image is of Fallopian ring applicator used forLaproscopic sterilization. | train | med_mcqa | null |
All are manifestations of SLE except | [
"Lesions resemblig Chr. DLE",
"Butterfly rash",
"Photosensitivity",
"Sex ratio is nearly equal"
] | D | D i.e. Sex ratio is nearly equal - Most authors agree that females outnumber malesQ by a ratio of --8:1 and 90% of SLE patients at diagnosis are women of child bearing age (-38 years). The condition is universal; people of all genders, ages and ethnic groups are susceptible; but SLE is 3 times more common in black people than in white. So highest prevalence is in black women and lowest in white men. - According to American rheumatism association diagnostic criteria of SLE, it may present with photosensitive, butterfly (malar) rash or discoid rash (resembling chronic DLE) Q and non erosive ahritis, oral/nasopharyngeal ulcerations, serositis, renal/neurological/hematological/ immunological disorder and ANA. - Systemic constitutional symptoms like fatigue, malaise, fever, anorexia and weight lossQ are present in 95% of patients (although these are not included in diagnostic criteria). ANA are positive in > 98% of patients so repeated negative tests suggests that the diagnosis is not SLE, unless other antibodies are present. High titer Ig antibodies to Sm antigen & ds DNA are both specific for SLE and, therefore our the diagnosis in presence of compatible clinical symptoms . Presence of multiple autoantibodies without clinical symptoms should not be considered diagnostic for SLE, although such persons are at increased risk. Nephritis is usually the most serious manifestation of SLE, since nephritis & infections are the leading causes of moality in 1st decade of disease. Since nephritis is mostly asymptomatic, urinalysis should be done in suspected cases. Renal biopsy to classify nephritis (minimal mesangial, proliferative mesangial, focal, diffuse glomerulonephritis, membranous and advanced sclerotic) is useful in planning current and near future therapies. | train | med_mcqa | null |
Compensating mechanisms involved at high altitude is | [
"Hyperventilation",
"Hypoventilation",
"Respiratory depression",
"Respiratory acidosis"
] | A | The most important compensatory mechanism that occurs at high altitude is hyperventilation. This may lead to respiratory alkalosis which is not a compensatory effect but may cause an opposing effect at the respiratory centre, to hypoxic stimulation. | train | med_mcqa | null |
Rooting reflex is also known as: | [
"Error reflex.",
"Hide reflex.",
"Search reflex.",
"None."
] | C | null | train | med_mcqa | null |
Counter coup injury seen in when ? | [
"Moving head is suddenly decelerated",
"Stationery head is suddenly accelerated",
"Fall of heavy object on head",
"None of the above"
] | A | Ans. is 'a' i.e., Moving head is suddenly decelerated Countrecoup injury is caused when moving head is suddenly decelerated by hitting a firm surface. It can either be a subdural or subarachnoid hemorrhage. Brain injuries Coup injury is defined as the injury of skull and/or brain at the site of impact, e.g. a blow on forehead, resulting in fracture of frontal bone and injury or haemorrhage in frontal lobe. Contre coup injury is defined as an injury to the skull or brain, on opposite (contralateral) side of the area of impact. Cerebral concussion (stunning) occurs due to head trauma and is characterized by gross physiological disturbance of brain without any anatomical damage. There is sudden loss of consciousness with a tendency to spontaneous recovery. The condition is more severe when damage is caused to the moving head (decceleration injury) than when it results from blows to skull. Recovery from concussion is often followed by retrograde amnesia. | train | med_mcqa | null |
True about esmolol is: a) It is a cardioselective β–blocker b) It increases airway resistance c) It causes tachycardia d) Its t 1/2 is 4 hrs e) It has negative inotropic activity | [
"de",
"cd",
"ae",
"bc"
] | C | Esmolol is an ultrashort acting β-blocker (t1/2 < 10 min.)
It is inactivated by esterases in blood.
β-blocker decreases heart rate and force of contraction (negative inotropic action).
Beta blockers can precipitate or aggravate CHF.
Selective beta 1 blocker and are less likely to cause bronchoconstriction, thus do not increase airway resistance. | train | med_mcqa | null |
Depression is not a side effect of | [
"Propanolol",
"Oral contraceptives",
"Reserpine",
"Flupenthixol"
] | D | Answer is option4, flupenthisol. The antidepressive and anxiolytic efficacy of flupenthixol has been investigated in numerous controlled and open trials involving patients with endogenous, reactive as well as senile depressions. When administered at a mean daily single or multiple dose of 1-2 mg, flupenthixol proved to be a very effective and well-tolerated antidepressant. As opposed to some of the currently available antidepressants, flupenthixol has a rapid onset of action which is often displayed within the first 2-3 days following its application. Ref: | train | med_mcqa | null |
The following structure is involved in Dupuytren's contracture - | [
"Thickening of the palmar fascia",
"Thickening of the dorsal fascia",
"Contracture of the flexor tendons",
"Post burns contracture"
] | A | Dupuytren&;s contracture is characterised by a flexion deformity of one or more fingers due to thickening and shoening of palmar aponeurosis.Normally palmar aponeurosis is thin but tough membrane lying Immediately beneath the skin of the palm. Proximally it is in continuation with palmaris longus tendon. Distally it divides into slips one for each finger. The slip bends with the fibrous flexor sheaths covering the flexor tendon of the finger , and extends upto the middle phalanx. In Dupuytren&;s contracture aponeurosis or a pa of it becomes thickened and slowly contracts, drawing the fingers into flexion at the metacarpo-phalangeal and proximal interphalangeal joints. Reference- Essential ohopaedics- Maheshwari- 5th edn- pg no 302 | train | med_mcqa | null |
Wood&;s lamp is made up of - | [
"9% nickel oxide with 6% BuSO4",
"9% nickel oxide with 9% BuSO4",
"% nickel oxide with 6% BuSO4",
"9% nickel oxide with barium silicate"
] | D | WOOD'S LAMP Hand held device used to diagnose various dermatological conditions. It is a mercury vapour long wave,ultraviolet lamp with an inbuilt wood's filter made of barium silicate with 9% nickel oxide. Opaque to all wavelengths except those between 320 nm and 400 nm with a peak at 365 nm.Flourescence occurs when wood's light is absorbed and radiation of longer wavelengths is emitted.Examination done in dark room. Tinea capitis-greenish fluorescence extent of pigmentation. Epidermal/dermal bacterial infection- pseudomonas infection yellowish-greeen fluorescence diagnosis of prophyria- reddish fluorescence in urine iadvl textbook of dermatology page 109 | train | med_mcqa | null |
Meningomyelocele patient after being operated developed hydrocephalus due to: | [
"Arnold Chiari malformation",
"Injury to absorptive surface",
"Central canal injury",
"Arachnoidal block"
] | A | Type II Chiari malformation is characterized by progressive hydrocephalus with a myelomeningocele. | train | med_mcqa | null |
Defibrillation with what energy level is appropriate for ventricular fibrillations: | [
"120J",
"250J",
"300J",
"400J"
] | B | The management of ventricular fibrillation and pulseless ventricular tachycardia is the same. Immediate chest compression is to be staed. It is ofutmost necessity to defibrillate at the earliestbecause of the chances of survival decreases by 7-10% every minute without defibrillation. Cardiac arrest - 200 J AC shock only given in ventricular fib & pulseless VT Defibrillation involves delivering an electrical current between two pads placed on the chest so to interrupt disorganized cardiac activity and restore an organized cardiac rhythm or asystole for at least 5 seconds. The energy that must be applied is Monophasic defibrillator- 360 J Biphasic defibrillator- 120 J | train | med_mcqa | null |
In normal kidneys, which of the following is true of the osmolarity of renal tubular fluid that flows through the early distal tubule in the region of the macula densa?(2018) | [
"Usually isotonic compared with plasma",
"Usually hypeonic compared with plasma",
"hypeonic compared with plasma in antidiuresis",
"Usually hypotonic compared with plasma"
] | D | distal tubule, paicularly its first pa, is in an extension of the thick segment of the ascending limb. It is relatively impermeable to water, and continued removal of the solute in excess of solvent fuher dilutes the tubular fluid(hypotonic fluid). Ref:- Ganong, pg num:-684 | train | med_mcqa | null |
Most common organisim causing T. capitis is | [
"Trichophyton tonsurans",
"Microsporum",
"Epidermophyton",
"Candida albicans"
] | B | B i.e. Microsporum | train | med_mcqa | null |
True about branchial cysta) Seen deep to lower 1/3 of sternocleidomastoidb) Wall consists of lymphoid tissuec) Filled with straw coloured fluid with cholesterol crystalsd) Presents at birth | [
"a",
"c",
"bc",
"ad"
] | C | A branchial cyst probably develops from the vestigial remnants of the second branchial cleft, is usually lined by squamous epithelium and contains thick, turbid fluid, full of cholesterol crystals... Microscopic examination of these cysts commonly shows a layer of lymphoid tissue and the modern theory is that these cysts may arise as a result of branchial epithelium entrapped within a lymph node." - Bailey | train | med_mcqa | null |
Most common epithelial tumor of lacrimal gland:- | [
"Adenoid cystic carcinoma",
"Pleomorphic adenoma",
"Squamous cell carcinoma",
"Non hodgkins lymphoma"
] | B | Pleomorphic adenoma are most common epithelial tumors of lacrimal gland Lacrimal tumors High Yield Facts Pleomorphic adenoma are most common epithelial tumors of lacrimal gland Adenoid cystic adenocarcinoma are most common malignant tumors of lacrimal gland. They are usually painful Present with superotemporal mass and inferonasal dystopia Inflammatory lesion and lymphomas are most common tumors of lacrimal gland | train | med_mcqa | null |
Patient is presenting with deformity of the finger as shown The PIP is involved but DIP is spared | [
"osteoahritis",
"Rheumatoid ahritis",
"Psoriatic ahritis",
"Ankylosing spondylitis"
] | B | Rheumatoid ahritis (RA) is a chronic, systemic autoimmune disease that involves inflammation in the membrane lining of the joints and often affects internal organs. Most patients exhibit a chronic fluctuating course of disease that can result in progressive joint destruction, deformity, and disability. RA affects between 1 and 2 million Americans. It occurs three times more often in women, and peaks at age 35 to 50 years. Signs & Symptoms of RA Fatigue. Stiffness, especially in early morning and after sitting a long period of time. Not relieved by pain Low Grade Fever, Weakness. Muscle pain and pain with prolonged sitting. Symmetrical, affects joints on both sides of the body. Rheumatoid nodules. Deformity of your joints over time. Raynauds phenomenon. Pain Treatment objectives The goals in the management of RA are: 1. To prevent or control joint damage 2. To prevent loss of function 3. To decrease pain 4. To maintain the patient&;s quality of life 5. To avoid or minimize adverse effects of treatment. 6. Preservation of muscle and joint function. 7. Return to a desirable and productive life. ref : maheswari 7th ed | train | med_mcqa | null |
Which of the following is given as live oral vaccine | [
"B.C.G",
"Measles",
"Typhoid",
"Rabies"
] | C | . Ghai essential of pediatrics, eighth edition, p.no:189 Typhoid vaccine(s.typhi Ty21a) is given as live oral vaccine | train | med_mcqa | null |
Sulfasalazine is used in - | [
"Ulcerative colitis",
"Osteoarthritis",
"Gouty arthritis",
"Irritable bowel syndrome"
] | A | Ans. is 'a' i.e., Ulcerative colitis Inflammatory bowel disease (crohn's disease & ulcerative colitis)o 5-aminosalicylic acid (5-ASA) is the main anti-inflammatory compound that acts locally in colon. It is the first line of treatment in mild to moderate UC and CD. When given alone 5-ASA is absorbed > 80% in proximal intestine and very little reaches upto colon. To decrease the absorption it may be associated with some innert compound.o Sulfasalazine (5-AS A + sulfapyridine), olsalazine (ASA+ASA) and balsalazide (5-AS A + aminobenzoylalanine) are effective in ulcerative colitis.o Different formulations of 5-ASA have been developed to deliver it to colon, called mesalamine.o Other drugs used in IBD are :-1. Glucocorticoids - They are used only for remission of U.C. and have no role in maintenance therapy.2. Purine analogues (Azathioprine, 6-MP) - Can be used for the induction and maintenance of remission of U.C. and C.D.3. Methotrexate - Can be used in CD, but has no use in U.C.4. Anti TNF-a (Infliximab, adalimumab, certolizumab, etanercept) - Can be used in CD.5. Cyclosporine - Used in severe U.C., which is refractory to glucocorticoids.6. Anti-Integrin therapy (Natalizumab) is recently approved for moderate to severe Crohn's disease not responding to other therapies. It is targeted against a4 subunit of integrins. The patient on natalizumab therapy should not be given other immunosuppressants due to risk of progressive multifocal leukoencephalopathy. | train | med_mcqa | null |
Which of the following changes is commonly seen in cancers? | [
"Hypomethylation of oncogenes",
"Methylation of Tumor suppressor genes",
"Loss of heterozygosity",
"Mutation of introns"
] | B | . Methylation of Tumor suppressor genes | train | med_mcqa | null |
A 64-year-old male noticed the development over the past 3 months of thickened, darkly pigmented skin in axillae and flexural areas of the neck and groin. These areas are neither painful nor pruritic. A punch biopsy of axillary skin reveals undulating epidermal acanthosis with hyperkeratosis and' basal layer hyper pigmentation. Which of the following underlying diseases is he most likely to have? | [
"Mastocytosis",
"AIDS",
"Acanthosis nigricans",
"Langerhans cell histiocytosis"
] | C | He has findings typical of acanthosis nigricans, a cutaneous marker for benign and malignant neoplasms. The skin lesions often precede signs and symptoms of associated cancers. They are believed to arise from the action of epidermal growth-promoting factors made by. neoplasms. The rashes that develop with SLE are the result of antigenantibody complex deposition and often exhibit photosensitivity. 'Skin lesions of mastocytosis in adults often exhibit uicaria. There are a variety of skin lesions with AIDS, including disseminated infections and a variety of papulosquamous dermatoses, although not pigmented lesions. "Involvement of the skin with Langerhans cell histiocytoses typically occurs in children and produces reddish papules or nodules or erythematous scaling plaques because of the histiocytic infiltrates in the dermis. | train | med_mcqa | null |
Patient presents with fasting sugar as 167mg/dl, skin pigmentation and hypogonadism. His liver enzymes showed SGOT as 678 and SGPT as 692. Most probable diagnosis is? | [
"Alpha 1 antitrypsin deficiency",
"Wilson's disease",
"Hemochromatosis",
"Glycogen storage disease"
] | C | Hemochromstosis clinical features Initial symptoms are often nonspecific and include lethargy, ahralgia, skin pigmentation, loss of libido, and features of diabetes mellitus. Hepatomegaly, increased pigmentation, spider angiomas, splenomegaly, ahropathy, ascites, cardiac arrhythmias, congestive hea failure, Excessive skin pigmentation is present in patients with advanced disease. The characteristic metallic or slate-gray hue is sometimes referred to as bronzing and results from increased melanin and iron in the dermis. Pigmentation usually is diffuse and generalized . Diabetes mellitus occurs in ~65% of patients with advanced disease and is more likely to develop in those with a family history of diabetes, suggesting that direct damage to the pancreatic islets by iron deposition occurs in combination with other risk factors . The liver is usually the first organ to be affected, and hepatomegaly is present in >95% of symptomatic patients. Ref - harrisons 20e p2980 | train | med_mcqa | null |
Inferior pancreaticoduodenal aery is a branch of which of the following aery? | [
"Splenic aery",
"Left gastric aery",
"Gastroduodenal aery",
"Superior mesenteric aery"
] | D | Inferior pancreaticoduodenal aery is a branch of superior mesenteric aery. It supplies the pancreas and adjoining pa of the duodenum. Its anterior and posterior branches anastomose with the branches of superior pancreaticoduodenal aery. This anastomosis is the only communication between the aeries of foregut and midgut. Branches of superior mesenteric aery are: Inferior pancreaticoduodenal aery Jejunal and ileal branches Ileocolic aery Right colic aery Middle colic aery Ref: Gray&;s anatomy text book of anatomy BD chaurasia 21st Ed. | train | med_mcqa | null |
Granulosa cell tumour secretes: | [
"Progesterone",
"Oestrogen",
"hCG",
"Calcitonin"
] | B | (Oestrogens): Ref: 362-S (339-40-S14th)GRANULOSA CELL TUMOURS* Common in women over 40 years in 80%* The main clinical features depends upon the oestrogenic activity of the tumour and only the larger ones causes pain and abdominal swelling, Feminizing tumours secrete oestrogens* Call - Exner bodies (arrangement of the cells into "rosettes ")* Most granulosa cell tumours are encapsulated and appear to be clinically benign* Strong evidence that association of carcinoma of the endometrium with granulosa cell tumours. Theca cell tumours more commonly involved* Androgens are elevated in Arrhenoblastoma* HCG elevated in Theca lutein cyst, Malignant teratoma | train | med_mcqa | null |
Injection of hypertonic saline in which region of hypothalamus produces intense thirst | [
"Posterior region",
"Paraventricular",
"Preoptic",
"Supraoptic"
] | C | The thirst centre is in lateral hypothalamus. Median preoptic nucleus acts as an osmoreceptor. | train | med_mcqa | null |
Virus responsible for non immune hydrops foetalis is? | [
"Cytomegalovirus",
"Herpes simplex virus",
"Hepatitis B virus",
"Parvovirus"
] | D | Parvovirus is the commonest infectious etiology for hydrops foetalis. The other viruses implicated include Cytomegalovirus, Hepatitis B virus, Herpes simplex virus, Rubella virus and Adenovirus. Ref : Dutta book of obstetrics 8th Ed | train | med_mcqa | null |
Blood supply during exercise is increased in: | [
"Cutaneous circulation",
"Hepato-splanchnic circulation",
"Renal circulation",
"Coronary circulation"
] | D | D i.e Coronary circulationDuring exercise blood is shunted from regions that do not require immediate suppo to areas with increased demands. (e.g. skeletal muscles, hea.) Quiet standingExerciseEffectCardiac output ml/min590024,000/IVBlood flow to:Active skeletal muscle65020,850'11'Hea2501000DIeBrain750750UnchangedSkin500500UnchangedInactive skeletal muscle650300.1,Kidney, Liver, GIT ect.3100600.1.tQ | train | med_mcqa | null |
A 15-year-old female presented to the emergency depament with history of recurrent epistaxis, hematuria and hematochezia. There was a history of profuse bleeding from the umbilical stump at bih. Previous investigations revealed normal prothrombin time, activated paial thromboplastin time, thrombin time and fibrinogen levels. Her platelet counts as well as platelet function tests were normal but urea clot lysis test was positive. Which one of the following clotting factor is most likely to be deficient? | [
"Factor X",
"Factor XI",
"Factor XI1",
"Factor Xlll"
] | D | Factor XIII deficiency causes formation of blood clots that are unstable and susceptible to fibrinolytic degradation by plasmin. As a result, affected individuals have an increased tendency to bleed. Bleeding from the umbilical stump during the first few days of life is common, and intracranial hemorrhage is observed more frequently than in other inherited bleeding disorders. Ecchymoses, muscle hematomas, prolonged bleeding following trauma and hemahroses also are characteristic. PT and aPTT are normal in factor XIII deficiency. Diagnosis of factor XIII deficiency is established by demonstrating increased clot solubility in 5 M urea, dilute monochloroacetic acid, or acetic acid. Factor XIII activity also can be determined quantitatively by a chromogenic assay or by an incorporation assay. Ref: Seligsohn U., Zivelin A., Salomon O. (2010). Chapter 125. Inherited Deficiencies of Coagulation Factors II, V, VII, X, XI, and XIII and Combined Deficiencies of Factors V and VIII and of the Vitamin K-Dependent Factors. In J.T. Prchal, K. Kaushansky, M.A. Lichtman, T.J. Kipps, U. Seligsohn (Eds), Williams Hematology, 8e. | train | med_mcqa | null |
Stroke prevention | [
"Streptokinase",
"Streptase",
"Warfarin",
"Tissue plasminogen activator"
] | C | (C) Warfarin# MEDICATIONS for TIA/STROKE PREVENTION> Anti-platelet medications:> Anti-platelet medications used to prevent and reduce the risk of stroke include: Aspirin; Aspirin/extended-release dipyridamole; Clopidogrel; Ticlopidine> Aspirin is the most commonly used preventive therapy for patients at risk for stroke. However, at least 10 percent of patients are unable to take aspirin long-term, usually due to stomach problems.> Anticoagulant medication: that is usually prescribed to reduce the risk of stroke is warfarin. Warfarin usually is prescribed in patients with atrial fibrillation and other cardiovascular disorders to reduce the risk of stroke. If you are in the hospital, heparin is an anticoagulant that may be given intravenously. Anticoagulants can also be injected into the skin to prevent clots in the legs. Such clots can form when patients are on bed rest.> Anticoagulants decrease the blood's ability to clot and prevent the formation of additional clots. If you are prescribed an anticoagulant, your follow-up will include frequent blood tests so your response to the medication can be monitored.> Treatment for acute (sudden onset) stroke is the administration of a thrombolytic agent, or "clot buster," including streptokinase or streptase and tissue plasminogen activator (TPA).> These medications can dissolve the blockage within the artery to restore blood flow to the brain. They must be given within the first three hours of the onset of stroke symptoms and are usually given in a hospital where the patient can be closely monitored. The risk, however, is bleeding into the brain, which can worsen the disability. Patients need to be carefully screened and evaluated before and after thrombolytic treatment. | train | med_mcqa | null |
All of the following are characteristic features of treatment of iron deficiency anemia with oral iron supplements, except: | [
"If 200-300 mg elemental iron is consumed, about 50 mg is absorbed",
"The propoion of iron absorbed reduces as hemoglobin improves",
"The reticulocyte count should begin to increase in two weeks and peak in 4 weeks --this suggests good response to treatment",
"The treatment should be discontinued immediately ... | D | A total of200mg given daily in three divided doses produces the maximal haemopoietic response. Iron therapy should be continued for 3-6 months after the correction of deficiency in order to replenish the iron stores. From medical pharmacology padmaja 4th edition page 328 and essential of medical pharmacology K D Tripati 7th edition page no 603 | train | med_mcqa | null |
Posterior staphyloma is associated with? | [
"Pathological myopia",
"Uveoscleritis",
"Pseudocornea",
"Angle closure glaucoma"
] | A | ANSWER: (A) Pathological myopiaREF: Khurana 4th ed p. 132Staphyloma refers to localised bulging of weak and thin outer tunic of eyeball (cornea and sclera) lined by uveal tissue which shines through the thinned outer fibrous coatTYPES OF STAPHYLOMA:AnteriorEctasia of pseudocornea ( due to organisation of exudates and fibrous tissue covered by epithelium)Intercalary - It is the name given to the localised bulge in limbal area, lined by the root of the irisIt results due to ectasia of tveak scar tissue formed at the limbus, following healing of a perforating injury or a peripheral corneal ulcer. There may be associated secondary angle closure glaucomaCiliary - bulge of weak sclera lined by ciliary body which occurs about 2-3 mm away from the limbus.Its common causes are thinning of sclera following perforating injury, sderitis & absolute glaucoma.Equatorial -On the equator of the eye (region circumferencing the largest diameter orthogonal to the visual axis).Its causes are sderitis & degeneration of sclera in pathological myopia. It occurs more commonly in the regions of sclera which are perforated by vortex veins.Posterior - In the posterior segment of the eye, typically diagnosed at the region of the macula, deforming the eye in a way that the eye-length is extendedPathological myopia , perforating injuries , posterior sderitis | train | med_mcqa | null |
Function of superior oblique muscle is: | [
"Intorsion, adduction and depression",
"Intorsion, abduction and elevation",
"Intorsion, abduction and depression",
"Extorsion, abduction and depression"
] | C | The primary action of the superior oblique muscle is intorsion (internal rotation), the secondary action is depression (primarily in the adducted position) and the teiary action is abduction. | train | med_mcqa | null |
Under eradication of congenital rubella syndrome progarmme the first priority group for rubella vaccination is- | [
"All non pregnant women of age 15-34",
"All adolescent non pregnant girls 15 to 24 years of age",
"All female children at one year",
"All non pregnant women"
] | A | The priorities being first to protect women of child-bearing age (15-34 yrs of age) Then to interrupt transmission of rubella by vaccinating all children currently aged 1-14 yrs And subsequently all children at one year of age. Ref:PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition , Page:151 | train | med_mcqa | null |
On which of the following tRNA acts specifically? | [
"ATP",
"Golgi body",
"Specific amino acid",
"Ribosome"
] | C | Ans. C. Specific amino acid(Ref: Harper 31/e page 346)At least one species of transfer RNA (tRNA) exists for each of the 20 amino acidstRNA molecules have extra ordinarily similar functions and three-dimensional structures. The adapter function of the tRNA molecules requires the charging of each specific tRNA with its specific amino acid. | train | med_mcqa | null |
This serum immunoglobulin constitutes 80% of immunoglobulins in our body is | [
"IgM",
"IgA",
"IgG",
"IgD"
] | C | 80% of immunoglobulins in our body is IgG -major ig Half-life is 23 days Transpoed through placenta Ref: Text book of Microbiology Baveja 5th ed Pg 99 | train | med_mcqa | null |
All of the following are characteristic feature of obstructive pulmonary disease, except: | [
"Normal Residual Volume",
"Decreased FEV1",
"Normal Vital Capacity",
"Decreased FCV1/FVC"
] | A | Answer is A (Residual volume Normal): Lung disease is typically associated with an Increased Residual volume Taken from Harrison 17th/1588 The hallmark of obstructive Lung Disease is decreased expiratory flow rate such the FEF25_75 is reduced and FEVI is typically reduced out of propoion to the Forced Vital Capacity ('FEV1/FVC). The Residual volume is typically increased. The vital capacity (FVC) may be normal or decreased while Total Lung capacity may be normal or increased. The hallmark of Restrictive Lung Disease is a decrease in lung volume typically TLC and vital capacity. Flow rates are preserved and hence FEF25_75 is generally normal. Also, when FEV1 is considered as a percentage of FVC, (FEV1/ FVC), the flow rates are often supranormal i.e. disporopoionately high relative to the size of lungs. Residual volume is also generally decreased. | train | med_mcqa | null |
A 45-yrs-old man presents with progressive cervical lymph nodes enlargement, since 3 months; the most diagnostic investigation is | [
"Xray soft tissue",
"Lymph node biopsy",
"FNAC",
"None of the above"
] | B | in cases of lymphadenopathy, if the patient's history and physical findings are suggestive of malignancy, then a prompt lymph node biopsy (excisional biopsy) should be done. FNAC is not of much use, as it does not provide enough tissue to reach a diagnosis. ("FNAC should be reserved for thyroid nodules and for confirmation of relapse in patients whose primary diagnosis is known") | train | med_mcqa | null |
Therapeutic level of lithium is: | [
"5-Jan",
"10-May",
"15-Oct",
"15-20"
] | C | Ans: c (10/15 ) Ref:Katzung, 10th ed, p. 455Surprised!!!? There is common consenses that option c was definitely 10/15andnot 10-15.Even though there is a chance that it was a typing error, going by basic mathematics the option (c) 10/15 = 0.666.This definitely falls between the range 0.6-1.25 which is considered as the effective and safe concentration of lithium. The next best option might be a) 1 -5 mEq/L.LITHIUMLithium carbonate is often referred to as an "antimaniac" drug and is considered as a "mood-stabilizing" agent because of its primary action of preventing mood swings in patients with bipolar affective (manic- depressive) disorder.Concentrations considered to be effective and acceptably safe are between 0.6 and 1.25 mEq/L.The range of 0.9-1.1 mEq/L is favoured for treatment of acutelymanic or hypo manic patients.Somewhat lower values (0.6-0.75 mEq/L) are considered adequate and are safer for long-term use for prevention of recurrent manic-depressive illness.Adverse Effects & Complications of Lithium.1) Neurological and psychiatric manifestationsTremor is one of the most common adverse effects of lithium treatment.Treatment - propranolol.Appearance of any new neurologic or psychiatric symptoms or signs is a clear indication for temporarily stopping treatment with lithium and close monitoring of serum levels.2) Decreased thyroid functions - reversibleThyroid function test (TFT) should be done before starting the drug.3) Nephrogenic diabetes insipidus and other renal adverse effectsDue to loss of responsiveness to ant diuretic hormone (nephrogenic diabetes insipidus). Lithium-induced diabetes insipidus is resistant to vasopressin but responds to amiloride.4) OedemaOedema is a common adverse effect of lithium treatment and may be related to some effect of lithium on sodium retention.5) Cardiac adverse effectsThe bradycardia-tachycardia ("sick sinus") syndrome is a definite contraindication to the use of lithium because the ion further depresses the sinus node.6) Use m pregnancyLithium is contraindicated during pregnancy. It causes fetal goiter,Ebteins anomaly etc. More recent data suggest that lithium carries a relatively low risk of teratogenic effects.7. Miscellaneous adverse effectsTransient acneiform eruptionsFolliculitisBRIDGE Leukocytosis is always present during lithium treatment (direct effect on leucopoiesis) - used therapeutically in patients with low leukocyte counts. | train | med_mcqa | null |
Cyclosporine acts by inhibiting the proliferation of | [
"ILl",
"IL2",
"IL6",
"Macrophages"
] | B | Ans. is 'b' i.e., IL2 Cyclosporine enters target cells and bind to cyclophilin (an immunophilin). This cyclosporine-cyclophilin complex inactivates calcineurin IL-2 trascripitan and proliferation of T cells. | train | med_mcqa | null |
Rapid, diffuse, excessive hair loss after 3 months of pregnancy is due to? | [
"Androgenic alopecia",
"Telogen effluvium",
"Anagen effluvium",
"Alopecia areata"
] | B | ANSWER: (B) Telogen effluviumREF: Harrison's 17th edition table 54.5Telogen effluviumDiffuse shedding of normal hairs following either major stress (high fever, severe infection) or change in hormones (post-partum)Stress causes the normally asynchronous growth cycles of individual hairs to become synchronous; therefore, large numbers of growing (anagen) hairs simultaneously enter the dying (telogen) phase Observation; discontinue any drugs that have alopecia as a side effect; must exclude underlying metabolic causes, e.g., hypothyroidism, hyperthyroidismEtiologyFever of any cause, prolonged , high , recurrentChild birthAbortion and cessation of OCPOperations and blood lossPsychiatric disturbance or acute mental illnessCrash dieting or nutritional def.Hypothyroidism , hyperthyroidismTreatmentAnticoagulants, antihypertensive, lithium or oral retinoid.Reversible without treatment | train | med_mcqa | null |
A person's X-ray chest showing homogenous opacity on right side writh shifting of mediastinum on opposite side. Most probable diagnosis is/are: | [
"Collapse",
"Pleural effusion",
"Pneumothorax",
"Consolidation"
] | B | Ans: B (Pleural effusion) Pleural effusion: X-ray chest pjm20th/139 Homogenous opacityShift of mediastinum to the opposite sideConcave upper border(Ellis's curve)Pneumonectomy chest(Earlv sign: within 24 hr): Partial filling of thorn, ipsilaterai mediastinal shift & diaphragmatic eievation"- Dahnert Radiology 5th/513Table: PjM 20th/139PathologyMediastinumChest wall processConsolidationCentralNormalTotal collapseSame sideRetractionPleural effusionOpposite sideNormalPneumothoraxOpposite sideNormalFibrosisRetractionSame side | train | med_mcqa | null |
Which of the following component of the eye has highest refractive index? | [
"Anterior surface of the lens",
"Posterior surface of the lens",
"Centre of the lens",
"Cornea"
] | C | The refractive index of the lens coex is 1.386 while that of the lens core is 1.406. Refractive index of each component of the eye as an optical system Refracting medium Refractive index Air 1.000 Cornea 1.373 Aqueous humour 1.336 Lens(coex-core) 1.386 - 1.406 Vitreous humour 1.336 Ref: Parsons' Diseases of the Eye By Ramanjit Sihota & Radhika Tandon page 52. Theory And Practice Of Optics And Refraction By Khurana page 32. | train | med_mcqa | null |
A patient presented in emergency with tachycardia, hyperthermia, bronchial dilatation and constipation. The person is likely to be suffering from overdose of: | [
"Atropine",
"Organophosphorus compound",
"Mushroom",
"Paracetamol"
] | A | Ans. (A) Atropine(Ref: Modi's Medical jurisprudence and Toxicology. 23rd, 2005/92, 403, 429-430, Goodman and Gilman 12/e p234-235)These are the characteristic features of anti-cholinergic overdose. | train | med_mcqa | null |
A 72-year-old woman with mild hea failure is treated overzealously with a thiazide diuretic. A few days later, the woman complains of muscle weakness, and laboratory tests demonstrate hypokalemia. Which of the following is most likely increased in this woman? | [
"Aerial H+ concentration",
"Plasma aldosterone",
"Plasma sodium",
"Potassium retention"
] | B | Diuretics lead to aldosterone excess and hypokalemia by a variety of mechanisms. Diuretic induced volume depletion stimulates the formation of angiotensin II, which, in turn, causes a secondary increase in plasma aldosterone concentration. This increase in plasma aldosterone stimulates potassium excretion, contributing to the hypokalemia. The saline diuresis increased sodium delivery to the collecting tubule. The increased availability of sodium along with the elevated plasma aldosterone augments sodium reabsorption iin the collecting tubule, thereby raising luminal negativity. This high luminal negativity in the collecting tubule promotes secretion of cations, especially hydrogen ions, which raises bicarbonate reabsorption. The saline diuresis causes rapid fluid flow in the distal tubule, which, in turn, keeps luminal potassium concentration low by carrying it away and thus preventing the accumulation of any potassium that enters the lumen. This low luminal concentration of potassium creates a steep concentration gradient for additional potassium losses in the urine. The treatment of edema with thiazide or loop diuretics is the most common cause of metabolic alkalosis. Aerial pH is increased and aerial H+ concentration is decreased with metabolic alkalosis. Sodium depletion tends to decrease plasma sodium levels, although the effect is usually small. Overuse of the thiazide diuretic has caused depletion of sodium and potassium by the kidneys, not retention of sodium and potassium. | train | med_mcqa | null |
In ETC, Oxidative phosphylaion (ATP formation) is regulated by: | [
"NADH Co-Q reductase",
"Cytochrome C oxidase",
"Co-Q-Cytochrome C reductasev",
"All of the abobe"
] | D | A, B, C i.e. (NADH Co-Q reductase, Cytochrome C oxidase, Co-Q-Cytochrome C reductase) Mitchell's chemiosmotic hypothesis links the respiratory (i.e. electron transpo) chain to ATP production (i.e. oxidative phosphorylation)Q. It explains how the free energy generated by the transpo of electrons from NADH to molecular oxygen (in respiratory chain) is used to produce ATP from ADP + Fi (from proton pumps). For each NADH oxidized (pair of electron), complex I (NADH -Q- oxido reductase) and complex III (ubiquinone /Qcytochrome C- oxidoreductase) pump (translocate) 4 protons (H+) each, whereas complex IV (Cytochrome C- oxidase) translocates only 2 protons (H+). In ETC. oxidative phosphorylation (ATP formation) occurs at these sites (ie complex I, III & IV) | train | med_mcqa | null |
True regarding child labor act- | [
"True regarding child labor act-",
"does not include children in wool cleaning",
"Does not include children in cashew descalding and processing",
"Excludes school based activities"
] | D | Ans. is 'd' i.e., Excludes school based activities Child labour act (1986) o Except in the process of family-based work or recognized school-based activities, children are not permitted to work in occupations concerned with :- Li Passenger, goods mail transpo by railways q Carpet weaving Cinder picking, cleaning of ash-pits Cement manufacturing Building construction operations Cloth printing a Dyeing, weaving Manufacturing of matches, explosives, fire-works Beedi making Mica cutting, splitting Abattoirs Wool cleaning Printing Cashew descalding and processing Soldering process in electronic industries o This act includes children less than 15 years of age | train | med_mcqa | null |
5 year old child with posterior fossa mass. Biopsy from the mass shows the following rosettes. | [
"Homer Wright rosette",
"Perivascular pseudorosette",
"Flexner Wintersteiner rosette",
"None"
] | A | Ans. (a) Homer Wright rosettes*Type of pseudo rosette in which differentiated tumor cells surround the neuropil seen in neuroblastoma, medulloblastoma, pinealoblastoma | train | med_mcqa | null |
Which of the following is a primary fructose transporter? | [
"GLUT-1",
"GLUT-3",
"GLUT-5",
"GLUT-4"
] | C | GLUT-5 is primarily Fructose transporter. It is located on small intestine, Testis, Sperm. | train | med_mcqa | null |
Not as used as induction agent among the following is - | [
"Midazolam",
"Etomidate",
"Ketamine",
"Propofol"
] | A | Ans. is 'a' i.e., Midazolam Anaesthetics| |InhalationIntravenous||||GasLiquidsInducing agentsSlower actingN2Oo Ethero Halothaneo Isofluraneo Enfluraneo Sevofluraneo Desfluraneo Thiopentoneo Methohexitoneo Propofolo Etomidateo Ketamineo Benzodiazepineso Opioidso Dissociative anaesthesia# Ketamine | train | med_mcqa | null |
Epiphyseal enlargement is seen in: | [
"Rickets",
"Ankylosing spondylitis",
"Spondo-epiphyseal dysplasia",
"Juvenile rheumatoid ahritis"
] | D | Ans. Juvenile rheumatoid ahritis | train | med_mcqa | null |
On per vaginal examination, anterior fontanelle and supraobital ridge is felt in the second stage of labour. The presentation is: | [
"Brow presentation",
"Deflexed head",
"Flexed head",
"Face presentation"
] | A | null | train | med_mcqa | null |
Dietl crisis is seen in: | [
"Intermittent hydronephrosis",
"Unilateral hydronephrosis",
"Bilateral hydronephrosis",
"Refractory hydronephrosis"
] | A | Ans: a (Intermittent hydronephrosis) Ref: Bailey & Love, 24th ed,Died crisis is seen in intermittent hydronephrosis.Dietel crisisAfter an attack of a/c renal pain a swelling in loin is found. Pain is relieved and swelling disappears following the passage of a large volume of urine some hours later.Note:Unilateral hydronephrosis is most commonly caused by idiopathic pelviureteric junction obstruction or calculus. Right side is more commonly involved. | train | med_mcqa | null |
Amyloidosis is associated with all of the following except: March 2012 | [
"Multiple myeloma",
"Renal failure",
"Alzheimer's disease",
"Acute inflammatory conditions"
] | D | Ans: D i.e. Acute inflammatory conditions Amyloidosis In many cases of primary amyloidosis, the patients have some form of plasma cell dyscrasia. Best defined is the occurrence of systemic amyloidosis in 5% to 15% of individuals with multiple myeloma, a plasma cell tumour characterized by multiple osteolytic lesions throughout the skeletal system Patients on long term hemodialysis for renal failure develop amyloidosis as a result of deposition of beta-2 microglobulin. Alzheimer's disease may cause systemic senile amyloidosis/localized amyloidosis At one time, TB, Bronchiectasis and chronic osteomyelitis were the most impoant underlying conditions for reactive systemic amyloidosis. More commonly now, reactive systemic amyloidosis complicates rheumatoid ahritis, other connective tissue disorders such as ankylosing spondylitis, and inflammatory bowel disease (Crohn disease and Ulcerative colitis). | train | med_mcqa | null |
Sputum can be disinfected by all except | [
"Autoclaving",
"Chlorhexidine",
"Boiling",
"Cresol"
] | B | Autoclaving is the safest and most effective method for sputum disinfection Incineration is an effective alternative. Boiling used after an initial disinfection by 5% phenol (carbolic acid) or its derivatives like Lysol and Cresol. | train | med_mcqa | null |
For a weight of 98 kgs and height of 175 cms, BMI is: | [
"28",
"32",
"36",
"46"
] | B | 32 | train | med_mcqa | null |
Specific sign of kwashiorkor is: September 2007 | [
"Pitting edema",
"Weight loss",
"Flag sign",
"Muscle wasting"
] | A | Ans. A: Pitting Edema Early signs of kwashiorkor present as general symptoms of malnutrition and include fatigue, irritability and lethargy. As protein deprivation continues the following abnormalities become apparent. Failure to thrive (failure to put on height and weight) Loss of muscle mass Pitting oedema- This is the main sign Large protuberant belly (pot belly) Fatty liver Failing immune system so prone to infections and increased severity of normally mild infections Skin and hair changes Characteristic skin and hair changes occur in kwashiorkor and develop over a few days. Skin lesions are at first erythematous before turning purple and reddish-brown in colour with marked exfoliation (skin peeling and sloughing) Where the skin becomes dark and dry, it splits open when stretched to reveal pale areas between the cracks ("lacquered flaky paint", "crazy pavement dermatosis") Irregular or patchy discolouration of the skin caused by pigmentary changes Hair becomes dry and lustreless and may turn reddish yellow to white in colour. It becomes sparse and brittle and can be pulled out easily. A 'flag sign is alternate bands of hypopigmented and normally pigmented hair pattern and is seen when growth of child occurs in spus. Nail plates are thin and soft and may be fissured or ridged. | train | med_mcqa | null |
Glucose-6 Phosphatase deficiency is seen in | [
"Von Gierke disease",
"Tay sach disease",
"Pompe disease",
"Anderson disease"
] | A | NameEnzyme DeficiencyClinical FeaturesVon Gierke diseaseGlucose-6-phosphataseGlycogen accumulation in liver and renal tubule cells;hypoglycemia; lactic acidemia; ketosis; hyperlipemiaRef: Harper&;s Biochemistry; 30th edition; Chapter 18 Metabolism of Glycogen; Page no: 179 | train | med_mcqa | null |
Intraepidermal intercellular IgG deposition is seen in – | [
"Pemphigus",
"Bullous pemphigoid",
"Herpes genitalis",
"Not recalled"
] | A | null | train | med_mcqa | null |
The ideal dimension for the luting agent space is | [
"0-20 microns",
"20-40 microns",
"40-80 microns",
"80-120 microns"
] | B | null | train | med_mcqa | null |
An alcoholic presented with ascites, bloody tap and elevated alfa fetoprotien. The diagnosis is | [
"Choriocarcinoma",
"Hepatocellular Carcinoma",
"Acute haemorrhagic pancreatitis",
"Pancreatic carcinoma"
] | B | (B) Hepatocellular Carcinoma # Hepatocellular carcinoma (HCC) is a primary malignancy of the hepatocyte, generally leading to death within 6-20 months. HCC frequently arises in the setting of cirrhosis, appearing 20-30 years following the initial insult to the liver.> 25% of patients have no history or risk factors for the development of cirrhosis.> Extent of hepatic dysfunction limits treatment options, and as many patients die of liver failure as from tumor progression.# Causes:> Cirrhosis: In general, cirrhosis of any etiology is the major risk factor for HCC.> Major causes of cirrhosis are attributed to alcohol, hepatitis C infection, and hepatitis B infection.# Alcohol> The risk of HCC is greater once the patient stops drinking alcohol, because heavy drinkers do not survive long enough to develop cancer.# Hepatitis B virus> Global incidence of chronic HBV infection is estimated to be 350 million persons; chronic HBV infection is the most common cause of HCC worldwide. In the United States, about 20% of HCC cases are thought to be related to chronic hepatitis B infection.> Chronic infection in the setting of cirrhosis increases the risk of HCC 1000-fold.> The mechanism by which the hepatitis B virus causes HCC is thought to be from a combination of chronic inflammation and integration of the viral genome into the host DNA.# Hepatitis C virus> HCV is a global pandemic affecting 170 million persons. HCV infection results in a higher rate of chronic infection compared to HBV infection (approximately 80% of infected subjects).> Co-infection with HBV further increases the risk; many patients are co-infected with both viruses. Alcohol use in the setting of chronic HCV doubles the risk of HCC compared with HCV infection alone.> Recent studies suggest that antiviral treatment of chronic HCV infections may reduce the risk of HCC significantly.# Hemochromatosis:> Patients with hemochromatosis, especially in the presence of cirrhosis, are at an increased risk of developing HCC. HCC accounts for about 30% of all iron-related deaths in hemochromatosis.# Aflatoxin:> This hepatic carcinogen is a by-product of fungal contamination of foodstuffs in sub-Saharan Africa and East and Southeast Asia. It causes DNA damage and mutations of the p53 gene. Humans are exposed to aflatoxin through the ingestion of moldy foods found in susceptible grains.# Lab Studies:> Expect total bilirubin, aspartate aminotransferase (AST), alkaline phosphatase, albumin, and prothrombin time to show results consistent with cirrhosis.# Alpha-fetoprotein (AFP) is elevated in 75% of cases.> The level of elevation correlates inversely with prognosis> An elevation of greater than 400 ng/mL predicts for HCC with specificity greater than 95%. In the setting of a growing mass, cirrhosis, and the absence of acute hepatitis, many centers use a level greater than 1000 ng/mL as presumptive evidence of HCC (without biopsy). | train | med_mcqa | null |
Reverse cold chain is used for | [
"Carrying stool samples of polio patients from a PHC to the lab",
"Transpoing outdated vaccines from PHC to district hospital",
"Transpoing vaccine to lab, to check its potency",
"Transpoing vaccine from camps to sub - centre"
] | A | The cold chain is a system of storage and transpo of vaccines at low temperatures from the manufacturer to the actual vaccination site. The cold chain system is necessary because vaccine failure may occur due to failure to store and transpo under strict temperature control (refer pgno:109 park 23 rd edition) | train | med_mcqa | null |
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