question stringlengths 1 6.54k | choices listlengths 4 4 | answer stringclasses 4
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Medical treatment of ectopic pregnancy is : | [
"Methotrexate",
"Progesterone",
"Oestrogen",
"Adriamycin"
] | A | Methotrexate | train | med_mcqa | null |
A man aged 60 years presents with intermittent dysphagia & foul breath. He regurgitates food that is eaten few days ago: Likely diagnosis is: | [
"Zenker's diveiculum",
"Meckel's diveiculum",
"Scleroderma",
"Achalasia cardia"
] | A | Answer is A (Zenker's diveiculum) Essentials of Diagnosis : Zenker's Diveiculum (Current Otolaryngology) Dysphagia (Intermittent) Regurgitation of undigested food (with risk of aspiration) Gurgling sounds in neck Halitosis | train | med_mcqa | null |
Which of the following poison retards putrefaction: | [
"Organophosphorus",
"Carbolic acid",
"Oxalic acid",
"Hydrogen-chloride"
] | B | B i.e. Carbolic Acid | train | med_mcqa | null |
All of the following conditions are known to cause diabetes insipidus, except - | [
"Multiple sclerosis",
"Head injury",
"Histiocytosis",
"Viral encephalitis"
] | A | Diabetes insipidus (DI) is a condition characterized by large amounts of dilute urine and increased thirst.[The amount of urine produced can be nearly 20 liters per day.[Reduction of fluid has little effect on the concentration of the urine.Complications may include dehydration or seizures Nephrogenic diabetes insipidus is due to the inability of the kidney to respond normally to vasopressin. Dipsogenic Dipsogenic DI or primary polydipsia results from excessive intake of fluids as opposed to deficiency of arginine vasopressin. It may be due to a defect or damage to the thirst mechanism, located in the hypothalamus, or due to mental illness. Treatment with desmopressin may lead to water intoxication. Gestational Gestational DI occurs only during pregnancy and the postpaum period. During pregnancy, women produce vasopressinase in the placenta, which breaks down antidiuretic hormone (ADH). Gestational DI is thought to occur with excessive production and/or impaired clearance of vasopressinase. Most cases of gestational DI can be treated with desmopressin (DDAVP), but not vasopressin. In rare cases, however, an abnormality in the thirst mechanism causes gestational DI, and desmopressin should not be used. Diabetes insipidus is also associated with some serious diseases of pregnancy, including pre-eclampsia, HELLP syndrome and acute fatty liver of pregnancy. These cause DI by impairing hepatic clearance of circulating vasopressinase. It is impoant to consider these diseases if a woman presents with diabetes insipidus in pregnancy, because their treatments require delivery of the baby before the disease will improve. Failure to treat these diseases promptly can lead to maternal or perinatal moality. Ref Davidson edition23rd pg 887 | train | med_mcqa | null |
Goodpasture syndrome has antibodies against - | [
"Collagen 1",
"G-y or x-y of Collagen",
"Collagen 4",
"Collagen 2"
] | C | . Collagen 4 | train | med_mcqa | null |
Components of Innate immunity that are active against viral cells includes - | [
"NK cells",
"Cytotoxic cells",
"B-cell",
"Memory B cell"
] | A | A class of lymphocytes called natural killer cells or NK cells are impoant in nonspecific defense against viral infections and tumors. They selectively kill virus-infected cells and tumors cells. - they are activated by interferons. Reference : Anathanarayan & paniker's 9th edition, pg no:81 <\p> | train | med_mcqa | null |
Heat stiffening in muscles occurs above temperature (degC) | [
"30",
"40",
"50",
"60"
] | D | D i.e. 60degC Heat stiffening or heat coagulation is found in bodies exposed to heat ie temperatures above 65degC (Reddy) / 70degC (Parikh) as is seen in death due to burning, high voltage electrocution (electric shock), or falling into hot liquid. | train | med_mcqa | null |
Primary auditory coex in human beings is located in: | [
"Postcentral gyrus",
"Posterior pa of parietal lobe",
"Limbic system",
"Superior pa of temporal lobe"
] | D | The auditory coex (areas 41 & 42) is located in the superior temporal gyrus in temporal lobe Postcentral gyrus: In the parietal lobe there is somatosensory coex (S I) - areas 3, 1, and 2 Posterior parietal coex (PPC): Posterior to the S I, this area harbors S II (areas 5 & 7). It receives inputs from S I, and visual & auditory coices. The area is concerned with visuo-spatial orientation and performance of a planned movement. | train | med_mcqa | null |
Somatosensory cortex lesion will affect | [
"Pain",
"Temperature",
"Localization",
"Vibration"
] | C | Somatosensory cortex lesion- proprioception and tactile sensations are lost while pain and temperature sensations are preserved. | train | med_mcqa | null |
Treatment of cataract in infant is | [
"Lensectomy",
"ECCE",
"Phacoemulsification",
"All of the above"
] | D | ICCE is contraindicated in children, because there is a strong adhesion between the posterior capsule of the lens and vitreous called hyaloidocapsular ligament Dissicision is an obsolute procedure Refer: Khurana 6th edition page number 201 | train | med_mcqa | null |
A patient with GUN SHOT injury to anterior abdomen presents . On evaluation he is hemodynamically unstable and shows signs of peritonitis. Initial management of patient should involve: | [
"FAST",
"Exploratory laparotomy",
"Local wound exploration and suturing",
"CECT abdomen"
] | B | PENETRATING ABDOMINAL INJURIES: | train | med_mcqa | null |
Marker for acute viral hepatitis caused by HBV: | [
"IgM anti-HBc Ag",
"IgG anti-HBc Ag",
"IgM anti-HBs Ag",
"IgG anti-HBs Ag"
] | A | Ans. a. IgM anti-HBcAg | train | med_mcqa | null |
Alkalinization of urine is done in | [
"Aspirin",
"Atropine",
"Amphetamine",
"Morphine"
] | A | Alkalinization of urine is done to treat acidic drug poisoning
Ex:- Aspirin, Barbiturates, Methotrexate, Penicillin.
Acidification of urine is done to treat basic drug poisoning
Ex: - Amphetamine, Morphine, Atropine, Quinine. | train | med_mcqa | null |
Necrotizing granulomatous inguinal lymphadenopathy is caused by -a) Syphilisb) Granuloma inguinalec) Sarcoidosisd) Tuberculosis | [
"ad",
"c",
"ac",
"ab"
] | A | null | train | med_mcqa | null |
Longest acting beta adrenergic blocker? | [
"Atenolol",
"Sotalol",
"Nadolol",
"Esmolol"
] | C | (Ref: Katzung Pharma, 14th ed. pg. 162-166)The b antagonists are rapidly distributed and have large volumes of distribution.Most b antagonists have half-lives in the range of 3-10 hours. A major exception is esmolol, which is rapidly hydrolyzed and has a half-life of approximately 10 minutes. Therefore, esmolol is the shortest acting b blocker.Nadolol is excreted unchanged in the urine and has the longest half-life of any available b antagonist (up to 24 hours).The half-life of nadolol is prolonged in renal failure. Therefore, it is contraindicated in renal failure.b blockers which are contraindicated in renal failure are: ' (remember as ANS)# Atenolol# Nadolol# Sotalol"ALSO KNOW" ABOUT b BLOCKERS:b1 receptors are present mainly on heart. Therefore selective b1 BLOCKERS are for cardiac condition mainly.b2 receptors are present mainly on respiratory pathway and some on liver, uterus, bladder etc. therefore b2 stimulators are used in conditions like asthma, preterm labor, urinary incontinence etc.Most cardioselective b blocker- NEBIVOLOLLongest acting- NADOLOLShortest acting- ESMOLOLb blockers which is DOC in open angle glaucoma in India-TIMOLOL | train | med_mcqa | null |
Opsoclonus-Myoclonus is a phenomenon seen in | [
"Wilm's tumor",
"Meningioma",
"Neuroblastoma",
"Coical tuberculoma"
] | B | Opsoclonus-myoclonus syndrome(OMS) is a rare disorder that affects the nervous system. Symptoms include rapid, multi-directional eye movements (opsoclonus), quick, involuntary muscle jerks (myoclonus), uncoordinated movement ( ataxia ), irritability, and sleep disturbance. Ref ganong's review of medical physiology 25e p978 | train | med_mcqa | null |
Preload leads to | [
"Isovolumetric relaxation",
"Isovolumetric contraction",
"Peripheral resistance",
"Parasympathetic nervous system activation"
] | B | The force of contraction of cardiac muscle depends on its preloading and its after loading. The initial phase of contraction is isometric; the elastic component in series with the contractile element is stretched and the tension increases until it is sufficient to lift the load. The tension at which load is lifted is the afterload. The muscle then contracts isotonically. In vivo preload is the degree to which myocardium is stretched before it contracts.Ref: Ganong&;s Review of medical physiology, 24th edition.Pg no. 547 | train | med_mcqa | null |
Management of steroid resistant asthma is done by: March 2005 | [
"Oral steroids",
"Long acting Beta-2 agonist",
"Leucotrine antagonist",
"Theophylline"
] | A | Ans. A: Oral steroids It is defined as failure to respond to a high dose of oral prednisolone (40 mg once daily over 2 weeks) More common is reduced responsiveness to coicosteroids where control of asthma requires oral coicosteroids (coicosteroid dependent asthma) Most of these patients requires a maintenance therapy with oral coicosteroids. Low dose of theophylline may be helpful in some patients. Few patients may benefit from infusion of beta-2 agonists. | train | med_mcqa | null |
Which of the tumours are unique to pregnancy | [
"Luteoma",
"Serous cystadenoma",
"Mucinous cystadenoma",
"Teratoma"
] | A | *Physiological proliferation of luteal cells in response to gonadotrophins in pregnancy - Theca lutein hyperplasia of pregnancy*Pathological proliferation of luteal cells in response to gonadotrophins in pregnancy- Luteoma . Luteoma is a type of sex cord stromal tumours( Ref: Robbins 8/e p1051) | train | med_mcqa | null |
Regarding bacterial vaginosis, all are true except: | [
"Homogeneous vaginal discharge with pH 5.0 to 6.0",
"Positive KOH - With fishy odour",
"Positive WBCs in 50% of cases",
"It is due to gardenella vaginalis"
] | C | - The main organism in bacteria vaginosis is gardenella vaginalis which replaces the lactobacillus in vagina A fishy vaginal odor, which is paicularly noticeable following coitus Vaginal secretions are gray and thinly coat the vaginal walls. The pH of these secretions is higher than 4.5 (usually 4.7 to 5.7). Microscopy of the vaginal secretions reveals an increased number of clue cells. Leukocytes are conspicuously absent. In advanced cases of BV, more than 20% of the epithelial cells are clue cells. The addition of KOH to the vaginal secretions (the "whiff" test) releases a fishy, amine like odour. There is no associated inflammation or edema and that's why it is called vaginosis in place of vaginitis | train | med_mcqa | null |
Purkinje cells from the cerebellum end in: | [
"Extrapyramidal system",
"Cranial Nerve Nuclei",
"Cerebellar Nuclei",
"Cerebral Cortex"
] | C | Ans. C. Cerebellar NucleiCerebellar cortex consists of the following three distinct layers:a. Outer molecular layer.b. Intermediate Purkinje cell layer.c. Inner granular layer.Purkinje cells are large flask shaped cells. The outgoing Purkinje axons constitute the sole output from the cerebellar cortex and exert an inhibitory influence on the intracerebellar nuclei. | train | med_mcqa | null |
Stress-induced ulcers are most commonly found in the | [
"Fundus of stomach",
"Antrum of stomach",
"Pyloric channel",
"First pa of duodenum"
] | A | 95% of benign gastric ulcer occurs towards lesser curve. A benign gastric ulcer is more common in lesser curvature, as it takes more burden of a passage of food and so more of wear and tear. A benign gastric ulcer is rare in greater curvature, fundus and cardia. Ref: SRB&;s manual of surgery,3 rd ed, pg no 754 | train | med_mcqa | null |
What dose of radiation therapy is recommended for pain relief in bone metastases – | [
"8 Gy in one fraction",
"20 Gy in 5 fractions",
"30 Gy in 10 fractions",
"Above 70 Gy"
] | A | Radiation therapy is used for painful bone metastasis.
The radiation can be given as:-
Single fraction:- 8 Gy in one fraction.
Multifraction regimen:- 20 Gy in 5 fractions or 30 Gy in 6 fractions.
"The greater convenience and lower cost make 8 Gy single fraction the treatment of choice for the majority of patients". _ Bone metastasis: experimental & therapeutic | train | med_mcqa | null |
Kartagener's syndrome is characterized by all EXCEPT | [
"Dextrocardia",
"Bronchiectasis",
"Bronchitis",
"Sinusitis"
] | C | (Bronchitis) (11, 18-LT) (409-Maqbool 1lth)Kartagener's syndrome (immobile cilia). These patients have a constantly runny nose, secretory otitis media, chronic sinusitis, bronchiectasis and often sinus inversus (Dextrocardia) Cystic fibrosis of pancreas. | train | med_mcqa | null |
Healing of of bone is affected by: | [
"Micromovement",
"Muscle interposition",
"Hypoxia",
"All"
] | D | A i.e. Micromovement; B i.e. Muscle interposition; C i.e. Hypoxia | train | med_mcqa | null |
Tetanus is caused by | [
"Clostridium perfringens",
"Clostridium tetani",
"Staphylococcus aureus",
"Bacillus cereus"
] | B | Tetanus is caused by Clostridium tetani. It produces two toxins: tetanolysin and tetanospasmin. Tetanospasmin is responsible for tetanus. Tetanus is characterized by tonic muscular spasms usually commencing at the site of infection later become generalized, involving the whole of the somatic muscular system. Reference: Textbook of Microbiology; Anathanarayan and paniker's; 10th edition; Page no: 265 | train | med_mcqa | null |
Ulnar collateral nerve is | [
"Branch of ulnar nerve",
"Branch of radial nerve supplying medial head of triceps",
"Branch of radial nerve supplying long head of biceps",
"Branch of radial nerve supplying lateral head of triceps"
] | B | In the arm, the radial nerve is posterior to the brachial aery. Here it gives muscular branches to long and medial heads of triceps brachii. The branch for medial head lies very close to the ulnar nerve and hence is called the ulnar collateral nerve. ReferenceClinicall Anatomy for students, a problem-solving approach, Neeta v Kulkarni, 2nd edition, page no.179 | train | med_mcqa | null |
Mild mental retardation is defined when IQ is- | [
"50-70",
"35-49",
"20-34",
"<20"
] | A | Ans. is 'a' i.e., 50-70 CategoryIQMild50-70Moderate35-49Severe20-34Profound<20 | train | med_mcqa | null |
The main components of the respiratory control pattern generator is responsible for automatic respiration. Pacemaker of respiration is: | [
"J-center",
"DRG",
"Pneumotaxic centre",
"Pre-BOTC"
] | D | Rhythmic respiration is initiated by a small group of synaptically coupled pacemaker cells in the pre-Botzinger complex (pre-BOTC) on either side of the medulla between the nucleus ambiguus and the lateral reticular nucleus. These neurons discharge rhythmically, and they produce rhythmic discharges in phrenic motor neurons that are abolished by sections between the pre-Botzinger complex and these motor neurons. Ref: Barrett K.E., Barman S.M., Boitano S., Brooks H.L. (2012). Chapter 36. Regulation of Respiration. In K.E. Barrett, S.M. Barman, S. Boitano, H.L. Brooks (Eds), Ganong's Review of Medical Physiology, 24e. | train | med_mcqa | null |
The optic nerve terminates in the | [
"Thalamus",
"Pituitary gland",
"Medulla Oblongata",
"Lateral Geniculate Body"
] | D | null | train | med_mcqa | null |
Buerger's disease affects all except:- | [
"Lymphatics",
"Small vessels",
"Nerves",
"Veins"
] | A | BUERGER'S DISEASE (THOROMBOANGITIS OBLITERANS) Segmental inflammatory disease, affecting small and medium sized aeries in upper and lower extremities . Inflammatory process involves neighboring veins and nerves (not lymphatics ) | train | med_mcqa | null |
Horse shoe kidney lies below the level of: | [
"Coeliac trunk",
"Superior mesenteric aery",
"Inferior mesenteric aery",
"Median sacral aery"
] | C | Inferior mesenteric aery | train | med_mcqa | null |
Disputed maternity can be solved by using the following tests except - | [
"Blood grouping",
"HLA typing",
"Precipitin test",
"DNA fingerprinting"
] | C | Precipitin test is used to determine the species of the stain of blood under examination i.e. whether it belongs to human or either animal.
For setting disputed maternity/paternity, tests used are:-
Blood grouping - ABO, MN, RH system
HLA - Typing
DNA - Fingerprinting | train | med_mcqa | null |
Investigation of Choice for Vesico-Vaginal Fistula is: | [
"IVP",
"Cystoscopy",
"3 Swab Test",
"X ray"
] | C | Ans. (c) 3 Swab TestRef: Shaws Textbook of Gynecology 16th Ed; Page No-222Vesicovaginal Fistula (VVF)* Most common cause of bladder fistulae (80-90%) in India:Obstetrical problem.# Prolonged labour-- operative--vaginal caesarean section.* Sometime gynaecological cause:# Hysterectomy# Sling operations for stress incontinence* Clinical features: Continuous dribbling of urine--no micturition (true incontinence).* Investigation: Methylene swab test.# The vaginal cavity is packed with three sterile swabs; 50-100mL of dilute methylene blue dye is injected into the bladder through the catheter.# If there is a VVF present, the methylene blue dye stains the uppermost swab.* IVP: Normal in Vesicovaginal Fistula (VVF), but Hydronephrosis on the affected side seen in Ureteric Fistula. | train | med_mcqa | null |
An epidemiological hypothesis should specify the following except ? | [
"Population",
"Time response relationship",
"Geographical trends",
"Expected outcome"
] | C | Ans. is `c' i.e., Geographical trends An epidemiological hypothesis should specify : - The population The expected outcome The time response relationship The specific cause The dose response relationship | train | med_mcqa | null |
Perinatal moality denominator include:- | [
"1000 live bihs",
"1000 Still bihs",
"1000 Live bihs+ still bihs",
"1000 Still bihs + early neonatal deaths"
] | A | Perinatal moality rate includes both late fetal deaths and early neonatal deaths PNMR = late fetal death and early neonatal deaths weighing over 1000 gms at bih /Total live bihs weighing over 1000 gm at bih x 1000 Perinatal period is from 28 weeks period of gestation to 7th completed days of life. The WHO's definition, more appropriate in nations with well established vital records of stillbihs is as follows : PMR = Late foetal deaths (28 weeks gestation and more)+ early neonatal deaths (first week) in one year - - ----- --- ----- x 1000 Live bihs + late foetal deaths(28 weeks gestation and more)The WHO's definition, more appropriate in nations with less well established vital records, is : Perinatal moality rate- Late foetal deaths + postnatal deaths/Live bihs in a year X 1000There is a difference in denominator of the perinatal moality rate defined by the WHO and industrially developednations. | train | med_mcqa | null |
People are arranged alphabetically by their names and then every 3rd person is chosen for study. The type of sampling is ? | [
"Stratified random",
"Systematic random",
"Simple random",
"None of the above"
] | B | Ans. is 'b' i.e., Systematic random Simple random sampling Simple random sampling, also, known as 'unrestricted random sampling'; is applicable for small, homogenous, readily available population and is used in clinical trials. In simple random sampling each individual is chosen randomly and entirely by chance. So, each individual has the same probability of being chosen at any stage during the sampling process. For example Let us assume you had a school with 1000 students, divided equally into boys and girls, and you wanted to select 100 of them for fuher study. You might put all their names in a bucket and then pull 100 names out. Not only does each person have an equal chance of being selected, we can also easily calculate the probaility of | train | med_mcqa | null |
A patient of left hemiplegia with previous history of right deep vein thrombosis. Cause hemoptysis in this patient is? | [
"Pulmonary thromboembolism",
"Disseminated intravascular coagulation",
"Fat Embolism",
"Superior Vena Cava Syndrome"
] | A | ANSWER: (A) Pulmonary thromboembolismREF: Harrisons Internal Medicine 17th edition Chapter 256. Deep Venous Thrombosis andPulmonary ThromboembolismPULMONARY THROMBOEMBOLISM:PathophysiologyWhen venous thrombi dislodge from their site of formation, they embolize to the pulmonary arterial circulation or, paradoxically, to the arterial circulation through a patent foramen ovale or atrial septal defect. About half of patients with pelvic vein thrombosis or proximal leg DVT develop PE, which is usually asymptomatic.With increased use of chronic indwelling central venous catheters for hyperalimentation and chemotherapy, as well as more frequent insertion of permanent pacemakers and internal cardiac defibrillators, upper extremity venous thrombosis is becoming a more common problem. These thrombi rarely embolize and cause PE.Pathophysiological abnormalities include:The most common gas exchange abnormalities are hypoxemia (decreased arterial P02) and an increased alveolar-arterial 02 tension gradient, which represents the inefficiency of 02 transfer across the lungsIncreased pulmonary vascular resistance due to vascular obstruction or platelet secretion of vasoconstricting neurohumoral agents such as serotonin.Impaired gas exchange due to increased alveolar dead space from vascular obstruction, hypoxemia from alveolar hypoventilation relative to perfusion in the nonobstructed lung, right-to-left shunting, and impaired carbon monoxide transfer due to loss of gas exchange surface.Alveolar hyperventilation due to reflex stimulation of irritant receptorsIncreased airway resistance due to constriction of airways distal to the bronchiDecreased pulmonary compliance due to lung edema, lung hemorrhage, or loss of surfactantSigns & SymptomsSudden-onset dyspnea (shortness of breath)Tachypnea (rapid breathing)Chest pain of a "pleuritic" nature (worsened by breathing)Cough and hemoptysis (coughing up blood).More severe cases can include signs such as cyanosis (blue discoloration, usually of the lips and fingers), collapse, and circulatory instability due to decreased blood flow through the lungs and into the left side of the heart.Occasionally, a pleural friction rub may be audible over the affected area of the lung (mostly in PE with infarct)A pleural effusion is sometimes present that is transudativeA low-grade fever may be present, particularly if there is associated pulmonary hemorrhage or infarctionAbout 15% of all cases of sudden death are attributable to PERisk factorsThe most common sources of embolism are proximal leg deep venous thrombosis (DVTs) or pelvic vein thromboses.The development of thrombosis is classically due to a group of causes named Virchows triad (alterations in blood flow, factors in the vessel wall and factors affecting the properties of the blood). Often, more than one risk factor is present.Alterations in blood flow: immobilization (after surgery, injury or long-distance air travel),pregnancy (also procoagulant), obesity (also procoagulant), cancer (also procoagulant)Factors in the vessel wall: of limited direct relevance in VTEFactors affecting the properties of the blood (procoagulant state)Estrogen-containing hormonal contraceptionGenetic thrombophilia (factor V Leiden, prothrombin mutation G20210A, protein C deficiency, protein S deficiency, antithrombin deficiency, hyperhomocysteinemia and plasminogen/fibrinolysis disorders)Acquired thrombophilia (antiphospholipid syndrome, nephrotic syndrome, paroxysmal nocturnal hemoglobinuria)Cancer (due to secretion of pro-coagulants)DiagnosisD-dimer is highly sensitive but not very specific (specificity around 50%), In other words, a positive D-dimer is not synonymous with PE, but a negative D-dimer is, with a good degree of certainty, an indication of absence of a PEThe gold standard for diagnosing pulmonary embolism (PE) is pulmonary angiographyCT pulmonary angiography (CTPA) is a pulmonary angiogram obtained using computed tomography (CT) with radiocontrast rather than right heart catheterization. Its advantages are clinical equivalence, its non-invasive nature, its greater availability to patientsVentilation/perfusion scan (or V/Q scan or lung scintigraphy), which shows that some areas of the lung are being ventilated but not perfused with blood (due to obstruction by a clot). This type of examination is used less often because of the more widespread availability of CT technology, however, it may be useful in patients who have an allergy to iodinated contrast or in pregnancy due to lower radiation exposure than CT | train | med_mcqa | null |
Identity '1' in the illustration depicting compliance of lungs: | [
"Inspiration",
"Expiration",
"Inspiration Air filled",
"Expiration air filled"
] | A | Ans. A. InspirationThe illustration shows a Pressure-volume curve of the lung during inspiration and expiration. | train | med_mcqa | null |
Which of the following statements on lymphoma is not True - | [
"A single classification system for Hodgkin's disease (HD) is almost universally accepted",
"HD more often tends to remain localized to a single group of lymph nodes and spreads by contiguity",
"Several types of non Hodgkin's lymphoma (NHL) may have a leukemic phase",
"In general follicular (nodular)NHL has w... | D | One of the confusing aspects of the lymphoid neoplasm’s concern the use of descriptive terms "Lymphocytic leukaemia" and "Lymphoma"
Leukemia is used for lymphoid neoplasms presenting with widespread involvement of the bone marrow usually accompanied by the presence of a large number of tumor cells in the peripheral blood.
Lymphoma, on the other hand, is used to describe proliferations arising as discrete tissue masses.
Traditionally these terms were attached to what were felt to be distinct entities.
However, the line between lymphocytic leukaemia’s and the lymphomas often blurs.
Many types of "lymphoma" occasionally present with a leukemic peripheral blood picture accompanied by extensive marrow involvement and evolution to "leukemia" is not unusual during progression of incurable "lymphoma". Conversely, tumors identical to leukaemia’s sometimes arise as soft tissue masses without evidence of bone marrow disease.
Hence when applied to particular neoplasms, the terms "leukaemia" and "lymphoma" merely describe the usual tissue distribution of the disease at the time of clinical presentation.
Historically few areas of pathology have evoked as much controversy and confusion as the classification of NHL and related lymphoid neoplasms. In some older classification schemes, more than two dozen types of B-cell lymphomas were listed - a nomenclature system that was mind-numbing challenge for students and pathologists. This chaotic situation has improved greatly during the last decade.
In 1994, a group of hematopathologists, oncologists and molecular biologists came together to create the revised European-American classification of lymphoid neoplasm’s. (REAL)
This classification incorporated objective criteria such as immunophenotype, and genetic aberrations together with morphologic and clinical features to define distinct clinicopathologic entities.
Experience shows that most entities in the REAL classification can be diagnosed reproducibly by experienced pathologists and stratify patients into good and bad prognostic group.
More recently an international group of hematopathologist and oncologists convened by the World Health Organization (WHO) reviewed and updated the REAL classification, resulting in the inclusion of a number of additional rare entities
Presented here is the WHO classification, which sorts the lymphoid neoplasm into five broad categories based on their cell of origin :
Precursor B-cell neoplasm (neoplasm of immature B cells)
Peripheral B-cell neoplasm (neoplasm of mature B cells)
Precursor T cell neoplasm (neoplasm of immature T cells)
Peripheral T cell and Nk cell neoplasms (neoplasm of mature T cells and natural killer cells)
Hodgkin’s lymphoma (neoplasm of Reed-Sternberg cell and variant)
Within the broad group of lymphomas, Hodgkin lymphoma is segregated from all other forms, which constitute the Non Hodgkin lymphomas (NHL.)
Hodgkin lymphoma is clinically and histological distinct from the Non Hodgkin’s lymphoma, while Non Hodgkin lymphomas frequently occur at extranodal sites and spread in an unpredictable fashion„ Hodgkin’s lymphoma arises in a single node or chain of nodes and spreads first to anatomically contiguous nodes.
Clinical difference between Hodgkin’s and Non Hodgkin’s lymphoma :
Hodgkin’s lymphoma
More often localized to a single axial group of (cervical, mediastinal, paraaortic) nodes
Orderly spread by contiguity
Mesenteric nodes and waldeyer ring rarely involved.
Extranodal involvement uncommon
Non Hodgkin’s lymphoma
More frequent involvement of multiple peripheral nodes
Non contiguous spread
Waldeyer ring and mesenteric nodes commonly involved.
Extranodal involvement common
The prognosis of Non-Hodgkin’s lymphoma varies markedly with various histological types of Non Hodgkin's lymphoma, "In general lymphomas with a follicular histological pattern are of lower grade (longer survival than those of diffuse pattern)" | train | med_mcqa | null |
Which of the following carpal bone fracture causes median nerve involvement? | [
"Scaphoid",
"Lunate",
"Trapezium",
"Trapezoid"
] | B | Perilunate dislocation Among all of the lunate dislocation, perilunate dislocation is most common. The most common type of perilunate instability is transscaphoid perilunate fracture dislocation. Median nerve is most commonly involved nerve. The most commonly used method of closed reduction is tavernier's maneuver. Ref: Rockwood & Green's fracture in Adults 6/e, Page 864-82. | train | med_mcqa | null |
Intra op radiation is given to - | [
"Pancreas",
"Breast",
"Cervix",
"Thyroid"
] | A | null | train | med_mcqa | null |
40 years old man has glare in both eyes. Examination revealed whorl like opacities of corneal epithelium. He gives history of long term treatment with amiodarone. What is the MOST likely diagnosis? | [
"Band shaped keratopathy",
"Cornea veicillata",
"Climatic droplet keratopathy",
"Fuchs endothelial dystrophy"
] | B | Cornea veicillata is a whorl - like opacity in corneal epithelium seen in patients on long term treatment with amiodarone, chloroquine, phenothiazine, indomethacin and patients with Fabry disease. It is usually asymptomatic, glare and discomfo may occur. It is reversible on stopping the drug. Ref: Parsons' 21st / pg 214. | train | med_mcqa | null |
A person is brought to you with suspicion of driving under the influence of alcohol. Assuming that all the facilities are available for alcohol level estimation, which of the following is the MOST desirable test for alcohol estimation? | [
"Breath analysis",
"Kozela Hinc method",
"Gas chromatography",
"Cavett test"
] | C | Though all of the above are methods of estimation of alcohol levels, gas chromatography is the most specific. Breath analysis is the method commonly used by highway police. Cavett test involves distillation of the alcohol which is oxidised to acetic acid. It is also used for estimation of blood alcohol levels. Ref: Textbook of Forensic Medicine and Toxicology by Narayan Reddy, Edition 23, Page - 484, 485. | train | med_mcqa | null |
Shotgun does not contain - | [
"Barrel",
"Choke bore",
"Bullets",
"Muzzle"
] | C | The synopsis of forensic medicine & toxicology ; Dr k.s narayan reddy ; 28th edition ; pg.no. 122 A shot gun have a muzzle ,barrels,choke bore but not a bullet . | train | med_mcqa | null |
Which of the following is an extrinsic membrane of the larynx? | [
"Quadrangular membrane",
"Thyrohyoid membrane",
"Cricothyroid membrane",
"Conus elasticus"
] | B | "Thyrohyoid membrane is an extrinsic membrane of the larynx" Ligaments and membranes of the larynx can be divided into: Extrinsic Intrinsic Ligaments and membranes of larynx Extrinsic Intrinsic Membras - Thyrohyoid membranes - Quadrangular membrane - Cricothyroid membrane - Conus elasticus Ligamens - Median thyrohyoid ligament - Lateral thyrohyoid ligament - Hyoepiglottic ligament - Cricotracheal ligament - Anterior (median) cricothyroid ligament - Thyroepiglottic ligament | train | med_mcqa | null |
The best investigation to detect renal stone is- | [
"X- ray",
"CT",
"MRI",
"US"
] | B | Ans. is 'b' i.e., CT * Non - contrast spiral CT has now become the investigation of choice to diagnose renal and ureteric stones.Urinary stones radiography1) Plane abdominal X-ray ("KUB" or kidney - ureter - Bladder X-ray): - The first radiological test that is performed is the plain abdominal X-ray. Because majority of stones (90%) are radiopaque, these can be easily identified on X-ray :-a) Radiolucent stones Uric acid stone, Orotic acid stones, Xanthine, Triamterens, Dihydroxyadenine.b) Radiopaque stonesCystine, Struvite, calcium oxolate, calcium phosphate.2) Intravenous pyelogram (IVP):- IVP can demonstrate urinary obstruction from renal stone and can demonstrate the position of non - opaque (radiolucent) stones.3) CT scan:- Non - contrast helical CT is 95 to 100% sensitive and specific for detection of renal calculi and, therefore, is the imagining modality of choice for urinary stones.4) USG:- USG provide excellent assessments of kidney and bladder but inferior to IVP and CT scan in evaluation of the ureters. | train | med_mcqa | null |
Anorectal ring is formed by the following muscles except: | [
"Puborectalis",
"Superficial part of external sphincter",
"Deep part of external sphincter",
"Internal sphincter"
] | B | Ans. B. Superficial part of external sphincter. (Ref BDC 4th/Vol2Jpg. 383; Bailey and Love 25th/pg. 1241).Bailey and Love 25th/pg. 1241........."Anorectal ring marks the junction between the rectum and the anal canal. It is formed by the joining of the puborectalis muscle, the deep external sphincter, conjoined longitudinal muscle and the highest part of the internal sphincter. The anorectal ring can be clearly felt digitally, especially on its posterior and lateral aspects. Division of the anorectal ring results in permanent incontinence of faeces. The position and length of the anal canal, as well as the angle of the anorectal junction, depend mainly on the integrity and strength of the puborectalis muscle sling".Anal canal musculature# The internal sphincter is a thickened continuation of the circular muscle coat of the rectum. This involuntary muscle commences where the rectum passes through the pelvic diaphragm and ends at the anal orifice, where its lower border can be felt. The internal anal sphincter is 2.5 cm long and 2-5 mm thick. Spasm and contracture of this muscle play a major part in fissure and other anal affections.# The longitudinal muscle is a continuation of the longitudinal muscle coat of the rectum intermingled with fibres from the puborectalis. The longitudinal muscle fibres that are attached to the epithelium provide pathways for the spread of perianal infections, and mark out tight compartments that are responsible for the intense pressure and pain that accompany many localised perianal lesions.# Beneath the anal skin lie the scanty fibres of the corrugator cutis ani muscle.# The external sphincter, formerly subdivided into a deep, superficial and subcutaneous portion is now considered to be one muscle. Some of its fibres are attached posteriorly to the coccyx, while anteriorly they are inserted into the midperineal point in the male, whereas in the female they fuse with the sphincter vaginae. In life the external sphincter is pink in colour and homogeneous. Unlike the pale internal sphincter muscle, which is involuntary, the red external sphincter is composed of voluntary (somatic) muscle.# The puborectalis plays a key role in maintaining the angle between the anal canal and rectum and, hence, is essential for the preservation of continence. There is a close association between the puborectalis portion of the levator ani and the external sphincter muscle.# The mucous membrane. The pinkcolumnar epithelium lining the rectum extends through the anorectal ring into the surgical anal canal. Passing downwards where it clothes the series of eight to 12 longitudinal folds known as the columns of Morgagni, the mucous membrane becomes cubical.# Just below the level of the anal valves there is an abrupt, albeit wavy, transition to squamous epithelium, which is parchment colour. This junction constitutes the dentate line. The squamous epithelium lining the lower anal canal is thin and shiny, and is known as the anoderm. At the dentate line the anoderm is attached very firmly to deeper structures. This line is a most vital landmark both morphologically and surgically. It represents the site of fbsion of the proctodaeum and post-allantoic gut, and the position of the anal membrane, remnants of which are frequently seen as anal papillae at the free margin of the anal valves.# The dentate line separates:abovebelow# cubical epithelium;# autonomic nerves (insensitive);# portal venous system;# from squamous epithelium;# from spinal nerves (very sensitive);# from systemic venous system.# Anal valves of Ball are a series of transversely placed semilunar folds linking the columns of Morgagni. They lie along and actually constitute the waviness of the dentate line. They are functionless remnants of the fusion of the post- allantoic gut with the proctodaeum.# Crypts of Morgagni (anal crypts) are small pockets between inferior extremities of the columns of Morgagni.# Anorectal ring marks the junction between the rectum and the anal canal. It is formed by the joining of the puborectalis muscle, the deep external sphincter, conjoined longitudinal muscle and the highest part of the internal sphincter. The position and length of the anal canal, as well as the angle of the anorectal junction, depend to a major extent on the integrity and strength of the puborectalis sling.Educational points:Anal canal anatomy# The internal sphincter is composed of circular, non-striated involuntary muscle supplied by autonomic nerves# The external sphincter is composed of striated voluntary muscle supplied by the pudendal nerve# Extensions from the longitudinal muscle layer support the sphincter complex# The space between sphincters is known as the intersphincteric plane# The superior part of the external sphincter fuses with the puborectalis muscle, which is essential for maintaining the anorectal angle, necessary for continence# The lower part of the anal canal is lined by sensitive squamous epithelium# Blood supply to the anal canal is via superior, middle and inferior rectal vessels# Lymphatic drainage of the lower half of the ana! canal goes to inguinal lymph nodes# Blood supply o f anal canal:Superior, middle and inferior haemorrhoidal arteries. The most important is the superior haemorrhoidal. The superior and middle haemorrhoidal veins drain via the inferior mesenteric vein into the portal system, having become the superior rectal vein en route. The superior haemorrhoidal vein drains the upper half of the anal canal. The inferior haemorrhoidal veins drain the lower half of the anal canal and the subcutaneous perianal plexus of veins: they eventually join the external iliac vein on each side.# Lxmphatic drainage o f anal canal:Upper half of the anal canal drain upwards into the post-rectal lymph nodes and from there drains to the para-aortic nodes via the inferior mesenteric chain. Lymph from the lower half of the anal canal drains on each side first into the superficial and then into the deep inguinal group of lymph glands. However, if the normal flow is blocked, e.g. by tumour, the lymph can be diverted into the alternative route. | train | med_mcqa | null |
Bile acids are reabsorbed from ? | [
"Duodenum",
"Proximal jejunum",
"Distal jejunum",
"Ileum"
] | D | Ans. is 'd' i.e., Ileum | train | med_mcqa | null |
Transovarian transmission is seen in- | [
"Rickettesial disease",
"Malaria",
"Filaria",
"None"
] | A | When the infectious agent is transmitted veically from infected female to her progeny in the vector is known as transovarial transmission. Transmission of the disease agent from one stage of the life cycle to another as for example nymph to adult is known as transstadial transmission(refer pgno:98 park 23rd edition) | train | med_mcqa | null |
Following can cause endometrial cancer : | [
"Metropathia hemorrhagica",
"Gynandroblastoma",
"Dysgerminoma",
"Teratoma"
] | A | Metropathia haemorrhagica Characterised by periods of amenorrhoea followed by prolonged and heavy bleeding May be associated cystic glandular hyperplasia of endometrium and risk of future endometrial cancer Granulosa cell tumors secrete estrogen which produces endometrial hyperplasia and may predispose to endometrial cancer Germ cell tumors are not associated with endometrial cancer Reference: Textbook of Gynaecology; Sheila balakrishnan; 2nd edition; Pg no:50 | train | med_mcqa | null |
A child under 7 years of age is incapable of committing an offence comes under | [
"Sec 82 IPC",
"Sec 83 IPC",
"Sec 84 IPC",
"Sec 89 IPC"
] | A | An act which is done by a child under 7 years of age is not an offence S.82, I.P.C. A child between 7 and 12 years is presumed to be capable of committing an offence if he attained sufficient maturity of understanding to judge the nature and consequences of his conduct on that occasion.S.83.I.P.C. The Synopsis of Forensic Medicine and Toxicology by Dr. k.S. Narayan Reddy 29th edition page no: 49. | train | med_mcqa | null |
A 78 year old male is admitted with chest pain. His ECG shows widespread ST depression in all leads except aVR which shows ST elevation. Whilst in ER, he passes melaena and on fuher questioning, gave history of altered bowel habit, weight loss and dark stools for 2-3 months. O/E he is pale, pulse rate is 115 bpm and BP is 80/50 mmHg. Blood tests demonstrate a hemoglobin of 3.6g/l and a high-sensitivity troponin of 140ng/l. What is the best initial management? | [
"Aggressive treatment with dual antiplatelets",
"Packed RBC transfusion",
"Nitrates to relieve ischemia",
"Beta blocker to slow hea rate and reduce ischaemia"
] | B | Dx is NSTEMI : Type 2 MI (due to Anemia) Option A : No, as he is already having GI bleeding, so antiplatelet therapy is not given. Option B : Yes, packed RBC transfusion is useful for anemia component to | oxyhemoglobin. Option C : Nitrates are C/I if Systolic B.P <80 mm Hg Option D : He's already having hypotension & b blockers are C/I in hypotension | train | med_mcqa | null |
Atlanto axial joint is which type of a joint? | [
"Pivot",
"Condylar",
"hinge",
"biaxial"
] | A | Ans. is 'a' i.e., Pivot Classification of JointsA. Fibrous joints* Lack intervening cartilage and hence have restricted mobility.1. Gomphosis2. Syndesmosis::Dento-alveolar pegInferior tibiofibular jointPosterior part of sacroiliac jointInterosseous membrane of forearm3. Schindylesis4. Sutures of the skull:Vomer - sphenoidal rostrum junctionB. Cartilagenous joints* These are of 2 types depending on intervening cartilage.I. Primary cartilaginous joints (Synchondrosis/Hyaline cartilage joints)1. Spheno-occipital joint2. Growth plate3. Costochondral joint4. 1st chondrosternal jointII. Secondary cartilaginous joints (Symphyses / fibrocartilagenous joints)Fibrocartilage is interposed between bone ends covered with articular hyaline cartilage.All of them occur in midline.1. Symphysis menti2. Pubic symphysis3. Sacrococcygeal joint4. Intervertebral joint5. Manubriosternal joint6. Xiphisternal jointC. Synovial joints I. Uniaxial 1. Plane/Flat joint-Acromioclavicular jointIntermetatarsal joints2. Hinge joints-Elbow joint3. Pivot joint-Atlantoaxial jointSuperior radioulnar jointII. Biaxial 1. Bicondylar (condyloid joint)-Knee jointTemporomandibular jointAtlanto occipital joint2. Ellipsoid joint-Wrist jointMetacarpophalangeal joint3. Saddle joint-1st carpo-metacarpal jointSternoclavicular jointCalcaneocuboid jointAnkle jointIncudomalleolar jointIII. Multiaxial Ball and socket joint-ShoulderHipIncudostapedial jointTalo-calcaneo-navicular joint | train | med_mcqa | null |
True statement about Vi polysaccharide vaccine is? | [
"Has many serious systemic adverse reactions",
"Has many serious local side effects",
"Has many contraindications",
"Can be administered with yell ow fever and hepatitis A vaccine"
] | D | Ans. is 'd' i.e., Can be administered with yellow fever and hepatitis A vaccine The Vi polysaccharide vaccine can be co-administered with other vaccines relevant for international travelers such as yellow fever and hepatitis A and with vaccines of the routine childhood immunization programs- Park o Vi polysaccharide has no serious systemic adverse effects and a minimum of local side effects are associated with it. o There is no contraindication for Vipolysaccharide vaccine except for severe hypersensitivity reaction in previous vaccine infection. | train | med_mcqa | null |
The following statements are true about DPT vaccine except - | [
"Aluminium salt has an adjuvant effect",
"Whole cell killed bacteria of Bordetella peusis has an adjuvant effect",
"Presence of acellular peusis component",
"Presence of H.Influenza B component increase its immunolgenecity"
] | D | H.influenza B is not a component of DPT vaccine. Acellular peussis component is present. Peussis component in DPT vaacine enhances the potency of the diphtheria toxoid. Adsorption on a mineral carrier like aluminium phosphate or hydroxide increases the immunological effectiveness of the vaccine. Ref:PARK&;S TEXTBOOK OF PREVENTIVE AND SOCIAL MEDICINE 23rd edition , Page :162 | train | med_mcqa | null |
What is the mechanism of action of glucagon? | [
"Inositol Pathway",
"Arachidonic Acid Pathway",
"c-GMP Pathway",
"c-AMP Pathway"
] | D | ANSWER: (D) c AMP pathwayREF: Guyton 12th ed pg 948Glucagon causes glycogenolysis in the liver and this in turn increases the blood glucose levels by the following mechanismGlucagon activates adenylyl cyclase in the hepatic cell membraneThis causes formation of cAMPActivation of protein kinase regulator proteinActivation of protein kinaseActivation of phosphorylase b kinaseConversion of phosphorylase b to phosphorylase aDegradation of glycogen to glucose 1 phosphateDephosporylation and release of glucose | train | med_mcqa | null |
In Abetaltipoproteinemia result in absence of: | [
"Chylomicron",
"LDL",
"VLDL",
"All"
] | D | A i.e. Chylomicron, B i.e. LDL, C i.e. VLDLAbetalipoproteinemia: is a rare autosomal recessive disease due to defective synthesis or secretion of apo BQ & leads to absent or low level of chylomicrons, VLDL and LDLQ. [Apo protein B is major component of chylomicron (B-48), VLDL & LDL (B- 100)1 | train | med_mcqa | null |
A 31-year-old male patient complains of fatigue, yeast infection in his mouth, and enlarged lymph nodes under his arms. He said that he was involved in "high-risk" behavior 6 years ago while on a trip to eastern and southern Africa. He also indicated that his "HIV test" was negative. Which one of the following options would be most appropriate? | [
"Initiate treatment for HIV disease",
"Order a test for human T cell leukemia virus (HTLV)",
"Repeat the test for HIV-1",
"Order an HIV test which would include antibodies to HIV-1 and HIV-2"
] | D | HIV-2 is present in Africa, the Far East, and some pas of the Caribbean area. Many of the screening tests for HIV-1 will not detect antibodies to HIV-2. Either a separate HIV-2 antibody test or a combination HIV-1/2 is necessary. While HTLV disease is also seen in the same geographic areas, the symptoms are more akin to HIV disease. While an HIV-1 RNA PCR is a useful test for monitoring the results of HIV therapy, it is not approved for diagnosis nor will it detect HIV-2 nucleic acid. Reference: Ananthanarayan and Paniker&;s Textbook of Microbiology Tenth edition | train | med_mcqa | null |
Reverse splitting of 2nd hea sound heard in - | [
"RBBB",
"LBBB",
"Tricuspid stenosis",
"AR"
] | B | In LBBB, Left ventricular depolarisation is late than RV depolarisation, so A2 appeares late than P2. Causes of Reverse splitting : RV pacemaker WPW syndrome Eisen menkers syndrome AS LVF LBBB Ref : Harrison's 20th edition pg 1448 | train | med_mcqa | null |
Which of the following inhibits peripheral conversion of Thyroxin to Triiodothyronine? | [
"Lugol's Iodine",
"Carbimazole",
"Radioactive iodine",
"Propylthiouracil"
] | D | Ans. d (Propylthiouracil) (Ref. KDT, Pharmacology, 6th ed.,250)Propylthiouracil also inhibits peripheral conversion of T4 to T3 by D1 type of 5'D1, but not by D2 type. This may partly contribute to its effects. Methimazole and carbimazole do not have this action and may even antagonize that of propylthiouracil.Differences between propylthiouracil and carbimazole PropylthiouracilCarbimazole1.Dose to dose less potentAbout 5 x more potent2.Highly plasma protein boundLess bound3.Less transferred across placenta and in milkLarger amounts cross to foetus and in milk4.Plasma tl/2=l-2 hours6--10 hours5.Single dose acts for 4-8 hours12-24 hours6.No active metaboliteProduces active metabolite-methimazole7.Multiple (2-3) daily doses neededMostly single daily dose8.Inhibits peripheral conversion of T, to T3Does not inhibit T, to T3 conversion Antithyroid DrugsFeatures1. Carbimazole, methimazole, prophlthiouracilThyroid peroxidase inhibitors2. ProphythiouracilDrug of choice in pregnancy3. Thyroid constipating AgentLugol's Iodine, Potassium iodide4. Faster acting antithyroid drugLugol's Iodine, Potassium iodide5. Drug causing destruction of thyroid gland131I6. Drug inhibiting peripheral conversion of T4 and T3Propranolol, Prophylthiouracil, Lithium, Amiodoraone | train | med_mcqa | null |
Which of the following is explicit memory | [
"Procedural",
"Nondeclarative",
"Sementic",
"Working"
] | C | Declarative memory provides for the rapid learning of facts (semantic memory) and events (episodic memory). Ex. Facts, events. Non declarative memory includes skills & habits, priming, simple classical conditioning, non associative learning. Reference: Kaplan & Sadock's synopsis of psychiatry, 11th edition, page 117. | train | med_mcqa | null |
All are true about prognosis of cholangiocarcinoma except | [
"Scirrhous type has better prognosis than papillary",
"Major prognostic factors are margin status and tumor stage",
"Bile duct resection alone is associated with high chances of recurrence",
"Curative resection includes hepatic resection+bile duct resection + lymphadenectomy"
] | A | Prognosis of cholangiocarcinoma Predictors of improved survival are : well-differentiated tumors, negative - resection margin and the performance of a concomitant hepatic resection. Pattern of failure after curative resection includes peritoneal spread, hepatic metastasis, local extrahepatic recurrence and distant metastasis (most commonly lung) Surgery is generally not indicated for recurrent cholangiocarcinoma Sclerosing or scirrhous type is most difficult to treat Ref: Sabiston 20th edition Pgno :1514-1518 | train | med_mcqa | null |
All are true about Entamoeba Histolytica except - | [
"Cyst are 8 nucleated",
"Cyst are 4 nucleated",
"Trophozoites colonise in the colon",
"The chromatid bodies are stained by Iodides"
] | A | Life cycle of E. histolytica. (1) Trophozoite in gut lumen, (2) Precystic form, (3) Uninucleate cyst, (4) Binucleate cyst, (5) Quadrinucleate cyst, passed in faeces, (6) Mature cyst--infective when ingested, (7) Excystation in small intestine, (8) Metacystic form, (9) Eight daughter amoebulae, (10) Trophozoite shed in faeces--cannot encyst, (11) Tissue form of trophozoite in colonic ulcer--shows ingested erythrocytes TEXTBOOK OF MEDICAL PARASITOLOGY,CKJ PANIKER,6TH EDITION,PAGE NO 17 | train | med_mcqa | null |
MC cause of anovulation is- | [
"PCOS",
"Hyperprolactinemia",
"Premature ovarian failure",
"Low ovarian reserves"
] | A | Ans. is 'a' i.e., PCOS * Anovulation and ovulatory dysfunction can be caused by a number of factors. The most common cause of ovulatory dysfunction is polycystic ovarian syndrome, or PCOS. Other potential causes of irregular or absent ovulation:# Obesity# Underweight# Extreme exercise# Hyperprolactinemia# Premature ovarian failure# Perimenopause, or low ovarian reserves# Thyroid dysfunction# Extremely high levels of stress | train | med_mcqa | null |
An hour sweat rate should be MCARDLE's maximum allowable sweat rate – | [
"3.5 litres",
"21 litres",
"2.5 litres",
"4.5 litres"
] | D | null | train | med_mcqa | null |
Phase 1 biotransformation includes - | [
"Reduction",
"Acetylation",
"Sufate conjugation",
"Methylation"
] | A | Ans. is 'a' i.e.. Reduction Types of biotransformation reactionso Biotransformation reactions (metabolism) of drugs can be classified :A. Non-synthetic (phase I) reactionso Metabolism brings about a change in the drug molecule bv :1. Oxidation3. Hydrolysis5. Decyclization2. Reduction4. Cyclization o The new metabolite may retain biological activity or it may be an inactive metabolite.o Oxidation is the most important metabolizing reaction,o The most important enzyme for oxidation reaction is cytochrome P450.B. Synthetic (phase II or conjugation) reactiono Metabolism involves union of the drug with one of several polar (water-soluble ) endogenous molecules that are products of intermediary metabolism, to form a water-soluble conjugate which is readily eliminated by kidney or, if the molecular weight exceeds 300, in the bile,o Phase II metabolism almost invariably terminates biological activity, i.e. metabolites are usually inactive.o Reactions are1. Acetylation2. Glucuronide conjugation3. Glycine conjugation4. Glutathione conjugation5. Sulfate conjugation6. Methylation7. Neucleotide synthesis | train | med_mcqa | null |
Recurrent corneal erosion seen in | [
"Corneal dystrophy",
"Keratoglobus",
"Keratoconus",
"Peutz-anomalies"
] | A | Ans. is 'a' i.e Corneal dystrophy "Corneal dystrophies are a group of progressive usually b/l and mostly genetically determined corneal opacifying disorder which develops in the absence of inflammation."Age of presentation is 1st or 2nd decadeMC type of all corneal dystrophies - Cogan's microcytic dystrophyCornea guttata is seen in endothelial layer *Treatment of corneal dystrophy is by keratoplasty* | train | med_mcqa | null |
Evidence of decreased risk of Cardiovascular disease is associated with all of the following except: | [
"Vitamin E supplementation",
"Low to moderate daily alcohol consumption",
"Regular physical activity",
"Potassium"
] | A | Factors decreasing risk of cardiovascular diseases: Regular physical activity Dietary goals like decreased salt, cholesterol intake Low to moderate daily alcohol consumption Potassium *Vitamin E supplementation are not associated with a proven benefit of decreased cardiovascular risk. Although some aicles do cite a protective role of Vitamin E because of it's antioxidant action, there is no strong evidence to our Vitamin E supplementation. | train | med_mcqa | null |
Langerhans cells in skin are : | [
"Antigen presenting cells",
"Pigment producing cells",
"Keratin synthesisng cells",
"Sensory neurons"
] | A | A i.e Antigen presenting cells | train | med_mcqa | null |
Percentage of cystic glandular hyperplasia turning to malignancy | [
"0.10%",
"2%",
"1%",
"10%"
] | C | WHO classification and Progression to Carcinoma
Percentage of cystic glandular hyperplasia turning to malignancy is 1% | train | med_mcqa | null |
Behaviour therapy to change maladaptive behaviour using the response as reinforcer uses the principles of- | [
"Classical conditioning",
"Modeling",
"Social learing",
"Operant conditioning"
] | D | Reinforcement is used in operant conditioning. | train | med_mcqa | null |
Which of the following statements about Delphi Method is TRUE? | [
"Method involves formation of a team to undeake and monitor a Delphi on a given subject",
"Selection of one or more panels to paicipate in the exercise. Customarily, the panelists are expes in the area to be investigated",
"The first round in the Delphi method involves development of a questionnaire",
"All th... | D | The Delphi method is an organized method for collecting and organizing data. The team monitors a Delphi on a given subject. Knowledgeable and expeise people are selected to be in the panel to conduct the exercise. The first round in the Delphi exercise is development of a questionnaire. Ref: Research in Health Care By Julius Sim, Chris Wright, 2000, Page 80; Research Methods in Physical Activity By Thomas, Nelson, 2005, Pages 280-81 | train | med_mcqa | null |
Bleomycin toxicity primarily involves - | [
"Liver",
"Bone marrow",
"Skin",
"Lungs"
] | D | Ans. is 'd' i.e., Lungs | train | med_mcqa | null |
The following is the least likely manifestation of acute Budd-Chiari syndrome: | [
"Enlarged tender liver",
"Ascites",
"Jaundice",
"Venous collaterals"
] | D | Venous collaterals are formed in poal hypeension and require time to be formed and hence are unlikely to be seen in acute Budd Chiari syndrome C/F of B.C.S-1. Triad - RUQ pain, Ascites (poal HTN), Hepatomegaly2. Jaundice d/t necrosis in central pa of liver d/t backward pressure.3. Hepatorenal Syndrome4. IVC blocked - decreased blood to right hea - Obstructive shock5. Pedal edema6. Collaterals seen in chronic BCS 7. Most common cause of hepatic vein obstruction causing budd chiari syndrome is thrombosis of hepatic vein 8.Obstruction of two or more major hepatic vein produce budd chiari syndrome 9.Obstruction of a single main hepatic vein by thrombosis is clinicaly silent. | train | med_mcqa | null |
Which among the following is the best inotrope drug for use in right hea failure? | [
"Dobutamine",
"Digoxin",
"Dopamine",
"Milrinone"
] | D | Drugs with beta-adrenergic and dopaminergic D1 agonist have a positive inotropic effect. Milrinone is a phosphodiesterase 3 inhibitor that works to increase the hea's contractility and decrease pulmonary vascular resistance. (REF. Essentials of medical pharmacology KD TRIPATHI 8th Edition) | train | med_mcqa | null |
At 42 weeks gestation, a long, thin neonate is born. He is apneic, pale with HR 94 bpm and covered with "pea soup" amniotic fluid. Which of the following is the first step in the resuscitation at delivery? | [
"Aificial ventilation with bag and mask",
"Administration of 100% oxygen by mask",
"Chest compressions",
"Intubation and suction of the trachea; provision of oxygen"
] | A | Case of post-term neonate showing signs of chronic placental insufficiency (LBW for gest. age and wasted appearance). Higher risk of asphyxia and meconium aspiration. As per the latest guidelines on resuscitation of a neonate born through Meconium stained liquor, routine endotracheal intubation and tracheal suction of all neonates born through MSL is no longer recommended.. instead, the resuscitation should proceed as per the NRP, just ensuring that at least one person skilled in Endotracheal intubation should be available at the time of resuscitation.. | train | med_mcqa | null |
Fluctuating refractive errors with cataract are seen in - | [
"Morgagnian cataract",
"Diabetic cataract",
"Intumescent cataract",
"Traumatic cataract"
] | B | In diabetic cataract a large number of fluid vacuoles appear under the anterior and posterior pas of the capsule, initially manifesting as myopia and then producing a diffuse opacity. | train | med_mcqa | null |
The feature of petit mal epilepsy in EEG is ? | [
"Spike and dome",
"Continuous stunted spikes",
"Waves at the rate of 10/sec.",
"Continuous tall spikes"
] | A | Ans. is 'a' i.e., Spike and dome o The EEG hallmark of typical absence seizure is a generalized symmetric 3 Hz spike and slow wave discharge. | train | med_mcqa | null |
All of the following are true regarding Hyper IgE syndrome, except: | [
"Autosomal dominant",
"Kyphoscoliosis",
"Recurrent cutaneous abscesses",
"Low serum IgG, IgA and IgM levels"
] | D | Hyper IgE syndrome / Job's syndrome Autosomal dominant inhibitory mutations in signal transducer and activator of transcription 3 (STAT3) lead to inhibition of normal STAT signaling Patients have characteristic facies:- Broad nose Kyphoscoliosis Osteoporosis Eczema Abnormal chemotaxis is a variable feature Recurrent sinopulmonary and cutaneous infections ("cold abscesses") Serum IgE level is significantly elevated whereas IgM, IgG and IgA level are normal In vivo assessment of inflammation is possible with a Rebuck skin window test or an in vivo skin blister assay, which measures the ability of leukocytes and inflammatory mediators to accumulate locally in the skin. In vitro tests of phagocyte aggregation, adherence, chemotaxis, phagocytosis, degranulation, and microbicidal activity (for S. aureus) are used for laboratory diagnosis | train | med_mcqa | null |
In patient with listeria meningitis who is allergic to penicillin the treatment of choice is - | [
"Vancomycin",
"Gentamycin",
"Trimethoprim-sulphamethoxazole",
"Ceftriaxone"
] | C | null | train | med_mcqa | null |
Granisetron, has antiemetic properties because of: | [
"Dopaminergic receptor — blocking actions",
"Gabamimetic actions",
"Gaba-inhibitory actions",
"Serotonin receptor-blocking action"
] | D | Granisetron is 5-HT3 antagonist and is 10 times more potent than ondansetron, and probably more effective during the repeat cycle of chemotherapy. The weak 5-HT4 blockade seen with ondansetron has not been detected in granisetron. lts plasma t½ is longer (8-12 hrs) and it needs to be given only twice on the day of chemotherapy. | train | med_mcqa | null |
According to WHO classification of ovarian tumours, Brenner tumor of ovary belongs to: | [
"Epithelial tumours",
"Sex cord stromal tumours",
"Germ cell tumours",
"Metastatic tumours"
] | A | Cancer or Ovary | train | med_mcqa | null |
Antibody that is strongly associated with polymyositis? | [
"Anti-jol",
"Anti-ku",
"Anti-Scl-70",
"Anti-sm"
] | A | A. i.e. Anti Jol Myositis specific auto antibodies include the antisynthetases 2. Whereas, PM/Scl, Ro/SSA (Ro 52, Ro 60), and U1- RNP represent major myositis associated autoantibodies. | train | med_mcqa | null |
After giving a nerve block what is the sequence of Recovery of sensation in nerve. | [
"Pain> Temperature> Touch > Proprioception>skeletal muscle tone(SMT)",
"SMT>proprioception>touch>temperature>pain",
"SMT>proprioception>temperature>touch>pain",
"It is random"
] | B | null | train | med_mcqa | null |
IQ of 15 is which grade of mental retardation ? | [
"Mild",
"Moderate",
"Borderline",
"Profound"
] | D | Ans. is.'d' i.e., Profound Category IQ Normal intelligence > 90 Borderline intelligence 70 - 89 Mental retardation Mild MR Moderate MR Severe MR Profound MR 50 - 69 35 - 49 20-34 0-19 | train | med_mcqa | null |
"Nerve terminals release chemicals"-discovered by | [
"Dale",
"Withering",
"Domagk",
"Langley"
] | A | It was discovered in 1914 by Henry Hallet Dale. Acetylcholine was confirmed as a neurotransmitter by Otto Loewi. Ref : guyton and hall textbook of medical physiology 12 edition page number:675,676,677 | train | med_mcqa | null |
Normal PQ interval is - | [
"0.12 sec.",
"0.2 sec.",
"0.16 sec.",
"0.016 sec."
] | C | null | train | med_mcqa | null |
Chronic, sterile inflammation of meibomian gland is seen in: September 2010 | [
"External hordeolum",
"Internal hordeolum",
"Chalazion",
"Stye"
] | C | Ans. C : Chalazion A hordeolum, or stye, is an acute, localized, pyogenic (usually staphylococcal) infection or abscess of the eyelid that may be external or internal. Most hordeola are external and result from obstruction and infection of an eyelash follicle and adjacent glands of Zeis or Moll's glands. Follicle obstruction may be associated with blepharitis. An internal hordeolum, which is very rare, results from suppurative inflammation of a meibomian gland. Sometimes cellulitis accompanies hordeola Chalazion/Meibomian or Tarsal cyst is chronic, sterile and lipogranulomatous inflammation of meibomian gland. | train | med_mcqa | null |
In acute intersitial nephritis, proteins associated - | [
"Amyloid",
"Fibrinogen",
"Vitamin D binding protein",
"Albumin"
] | A | Acute interstitial nephritis Acute interstitial nephritis (AIN) is an immune-mediated disorder, characterised by acute inflammation affecting the tubulo- interstitium of the kidney. It is commonly drug-induced, with proton pump inhibitors (PPIs) fast becoming the most common cause, but can be caused by other toxins, and can complicate a variety of systemic diseases and infections . Causes Clinical features The clinical presentation is typically with renal impairment but, in some patients with drug-induced AIN, there may be signs of a generalised drug hypersensitivity reaction with fever, rash and eosinophilia. Proteinuria is generally modest (PCR < 100 mg/mmol) and tubular in type . The urine may contain white blood cells and white cell casts but is sterile on culture. Eosinophils are present in up to 70% of patients but this is a non-specific finding. AIN should always be considered in patients with non-oliguric AKI. There may be a rapid deterioration of renal function in some cases of drug-induced AIN, causing the condition to be mistaken for RPGN. Investigations Renal biopsy is usually required to confirm the diagnosis . This typically shows evidence of intense inflammation, with infiltration of the tubules and interstitium by polymorphonuclear leucocytes and lymphocytes. Eosinophils may also be observed, especially in drug-induced AIN. Often granulomas may be evident, especially in drug-induced AIN or sarcoidosis . The degree of chronic inflammation in a biopsy is a useful predictor of long-term renal function. Eosinophiluria may be present but is not a good discriminator for AIN. Management Some patients with drug-induced AIN recover following withdrawal of the drug alone, but high-dose glucocoicoids (prednisolone1 mg/kg/day) may accelerate recovery and prevent long-term scarring. Other specific causes should be treated, if possible. Ref Harrison20th edition pg 278 | train | med_mcqa | null |
Hemolytic Uremic Syndrome is characterizeda) Microangiopathic haemolytic anaemiab) ↓ed LDHc) Thrombocytopaeniad) Renal failuree) Positive Coomb's test | [
"abc",
"ad",
"bc",
"acd"
] | D | null | train | med_mcqa | null |
Break point chlorination means: | [
"Start of chlorination process",
"End of chlorination process",
"When free residual chlorine starts appearing",
"After partial saturation of water with chlorine"
] | C | The addition of chlorine to water to a point at which free residual chlorine begins to appear is called breakpoint chlorination.
The "chlorine demand" of the water should be estimated. The chlorine demand of the water is the difference between the amount of chlorine added to the water and the amount of residual chlorine remaining at the end of a specific period of contact at a given temperature and pH of the water.
The point at which the chlorine demand of the water is met is called the "breakpoint". If further chlorine is added beyond the breakpoint, free chlorine begins to appear in the water.
Essentials of preventive and community dentistry
Soben Peter
5th edition
Page number 466 | train | med_mcqa | null |
Scope of family planning services include all of the following except - | [
"Screening for cervical cancer",
"Providing services for unmarried mothers",
"Screening for HIV infection",
"Providing adoption services"
] | C | FAMILY PLANNING
Family planning refers to practices that help individuals or couples to attain certain objectives :-
To avoid unwanted births
To bring about wanted births
To regulate the intervals between pregnancies
To control the time at which birth occur in relation to the ages of the parent
To determine the number of children in the family
Scope of family planning services
Proper spacing & limitation of births
Advice on sterility
Education for parenthood
Sex education
Screening for pathological conditions related to reproductive system eg. cervical cancer
Genetic counseling
Premarital consultation & examination
Pregnancy test
Marriage counseling
Preparation of couples for arrival of their Is' child
Providing services for unmarried mother
Teaching home economics & nutrition
Providing adoption services | train | med_mcqa | null |
All are true about minimal change G.N. except ? | [
"Selective proteinuria",
"IgG deposition in mesangium",
"Common in age group 2-9 years",
"Responds to steroid's"
] | B | Ans. is 'b' i.e., IgG deposition in mesangium There is no depositon of immune reactants. | train | med_mcqa | null |
Chediak-Higashi syndrome, true is? | [
"Defect in phagocytosis",
"Neutropenia",
"Agammaglobulinemia",
"IgA deficiency"
] | A | Ans. is 'a' i.e., Defect in phagocytosis | train | med_mcqa | null |
Visceral leishmaniasis is caused by - | [
"L-braziliensis",
"L. tropica",
"L. donovani",
"L-orientalis"
] | C | Ans. is 'c' i.e., L. donovani * Visceral leishmaniasis (Kala azar)* Cutaneous Leishmaniasis- L. donovania) Oriental soreb) Mucocutaneous leishmaniasis (Espundia)- L. tropica- L. brasiliensis | train | med_mcqa | null |
Protrusion of tongue is brought out by: | [
"Genioglossus",
"Intrinsic muscles of tongue",
"Styloglossus",
"Palatoglossus"
] | A | Genioglossus Muscle:
It is a fan-shaped extrinsic muscle of tongue and along with its counterpart of the opposite side forms the most of the bulk of the tongue
Origin:
From superior genial tubercle of the mandible.
Insertion:
The fibres radiate backwards fan-wise into the substance of the corresponding half of the tongue alongside the median septum, from the tip to the base, for insertion.
Lower fibres are inserted into the body of the hyoid and form the root of the tongue.
Intermediate fibres pass beneath the anterior border of the hyoglossus and extend backwards up to stylohyoid ligament and middle constrictor of the pharynx.
Upper fibres turn upwards and forwards to extend up to the tip of the tongue.
Nerve supply
It is supplied by hypoglossal nerve.
Actions
The muscles of both sides together protrude the tongue and make an elongated gutter on the dorsal surface of the tongue for the passage of food.
Key Concept:
Genioglossus protrude the tongue and make an elongated gutter on the dorsal surface of the tongue for the passage of food. | train | med_mcqa | null |
Assessment of malnutrition is done by:- | [
"Mid-arm circumference (MAC)",
"Body mass index",
"Weight for age",
"All of the above"
] | D | Assessment of: Nutritional status in children: weight for age (growth cha) > MAC Nutritional status in adults : body mass index Best indicator for growth & development in children - weight for age. | train | med_mcqa | null |
Which of the following is a new drug recently approved for treatment of neovascular age related macular degeneration? | [
"Brolucizumab",
"Istradefylline",
"Lefamulin",
"Upadacitinib"
] | A | *Brolucizumab is a monoclonal antibody against VEGF. *It is recently approved for wet (neovascular) age related macular degeneration.* Istradefylline is adenosine A2 receptor antagonist. It is approved for off episodes in Parkinsonism* Lefamulin is a new antimicrobial that acts by inhibiting protein synthesis. It is approved for community acquired bacterial pneumonia. | train | med_mcqa | null |
"Flash back phenomenon" is seen in | [
"Hysteria",
"Organic illness",
"Acute stress reaction",
"Post-traumatic stress disorder"
] | D | (D) Post-traumatic stress disorder # PTSD is a reaction to being exposed to an event which is outside the range of normal human experience. It is a normal human emotional reaction to an abnormal situation. It is a psychological phenomenon. It is an emotional condition, from which it is possible to make a full and complete recovery.> Symptoms may come on soon after the trauma or fifty years later. That is what is meant by the post in PTSD. It is normal too for symptoms to come up again when faced by further trauma and in very stressful times. It is normal to be affected by trauma.> Intense fear, helplessness, or horror. Repeated and distressing recollections of the event, including images, thoughts, or perceptions. Unable to distinguish between past events and reality. Such incidents are often called "flashbacks" Distressing and or frightening dreams about the event. Associating various words, happenings, or "triggers" to the actual event wnich then causes a "flashback". Avoidance of anything that may "trigger" a flashback including not talking about the attack itself. Pretending it never happened, and an inability to recall anything about the attack, "denial". A feeling of numbness, detachment or "unrealness" about everything. A lack of emotion or inability to feel love or care about anything. | train | med_mcqa | null |
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